A new CDC report looks at the trends of home birth from 1990-2009. While home birth was relatively stable from 1990-2004, after that there was a 29% rise in the number of home births, though still a very low number.  You’re more likely to have a home birth if:

• Non-hispanic white woman
• Over 35
• Married

Interestingly enough 33% are listed as being attended by “other.”  This is dad, mom, EMT, etc.  I wonder if this is in part by midwives not wanting to be listed on the birth certificates.

While many like to cite the rise in the home birth rate as being from Ricki Lake and Abby Epstein’s Business of Being Born, it wasn’t released until May 2008. (See trailer below.) So what’s your take? Why do you think the rates of home birth are increasing?

_{MacDorman MF, Mathews TJ, Declercq E. Home births in the United States, 1990– 2009. NCHS data brief, no 84. Hyattsville, MD: National Center for Health Statistics. 2012.}

Home Births and the Public Health Response:

Promoting Informed Choices and Healthy Outcomes

Presenters:

Eugene Declercq, PhD Assistant Dean, Doctoral Education Professor, Community Health Sciences Boston University School of Public Health

Mairi Breen Rothman, CNM, MSN Certified Nurse Midwife Metro Area Midwives & Allied Services

Wednesday, July 20, 2011 Noon – 1:30 p.m.

Live webcast on our website at www.jhsph.edu/maphtc

For more information, please contact the MidAtlantic Public Health Training Center at 443-287-7833 or maphtc@jhsph.edu

No registration is necessary!

Dr. Declercq can also be seen discussing birth data in the clip from Orgasmic Birth in this free video.

If the answer to any of these questions is yes, then please join us at the PushSummit, on August 6 in Cary, NC, to learn from veteran birth activists who’ve been there in the trenches and will share their insight, wisdom, experience, and not-so-dirty tricks! To register, click here: http://bit.ly/PushSummit2011 (Discounted student rates are available).

The Summit’s PushUniversity is a unique opportunity for people who want to become agents of change to learn from the birth community’s experts on everything from effective organizing tactics, to grassroots mobilization, to utilizing the media—as well as the many resources available via The Big Push for Midwives—to promote positive messages about midwifery and out-of-hospital birth and to build effective legislative campaigns that expand access to the full range of birth options for families nationwide.

Groups in every state that are working to improve birth can benefit from sending a representative to the Summit, not only to learn but to share. All of us have valuable information to share, and every time we leave our virtual worlds to spend face-time together, it makes our community stronger.

Hope to see you there, and please forward widely!

The Summit will take place alongside the MANA Region 3 conference, which has secured a special rate of $115 per room. Rooms can be booked at http://ncmidwife.org/MANARegion3Conf/?page_id=17

An MSNBC article describes this trend as a growing “natural birth subculture” led by white women. Just calling it a subculture lends a derogatory connotation, as if all home birthing families are… what? Hippies? Cultists? Anarchists? A “lunatic fringe”? Maybe some home birthers are any or all of the above, but many of them are no different from anyone else, except that they reject the hospital/medical model of childbirth.

The fact that white women have the highest rate of home births is a reflection of the way health care works in this country. With private insurance offering only spotty coverage for midwifery care and home birth, it is often affluent white women who can afford to seek midwife care outside the scope of their insurance. Minority women are unfortunately more likely to be under- or uninsured, or covered by Medicaid.  Their options for home birth are severely limited as a result, and they are often unable to afford to pay cash to a midwife for a home delivery.

Rather than scoff at home birth as some sort of fad among affluent white women, perhaps we should take the data provided by the research to make midwifery care available to women of all races and socioeconomic strata. I have heard it suggested many times that in the poorest regions of the country, midwives could make all the difference in terms of access to prenatal care, reducing preterm births, and improving maternal and infant mortality. Yet Big Obstetrics seems desperate to hold on to every single patient it can, even as OBs complain that they are overworked, underpaid, and burdened with high patient loads and mounds of insurance paperwork.

The tide is just beginning to turn. Home birth advocates recognize that home birth isn’t for everyone, but what we do realize is that midwife care has the potential to change the lives and the outcomes for women and babies across the country and around the globe. That’s not a trend, that’s common sense and compassion.

Is home birth becoming more main stream? Is Pampers trying to reach out to moms who might otherwise be more likely to cloth diaper? What’s up with this? Share your thoughts in the comments.

Yesterday my midwife must have seen into my soul and understood what my mind and body were going through. She offered to stir things up a bit to my relief. I took two homeopathic remedies rotationally (Caulophyllum and Cimicfuga) every hour since our noon visit until 10 at night and she stretched my cervix a bit and performed what is called a “membrane sweep”.http://www.birthingnaturally.net/birthplan/intervention/induction/membranes.html

After this meeting, I experienced some spotting for the rest of the day and some light cramping. I continued to take the homeopathic remedies throughout the day into the evening. At about 6:30 pm, I experienced some pretty strong contractions. These came sporadically at about every hour and a half to every 10-15 minutes apart. At about 8 we put my daughter to bed (she’s 14 months). Strangely enough, when we thought she was fast asleep at about 9:00 she woke up and started crying for her momma. When I went upstairs to cuddle her, she seemed to be aware of what was going on. She usually curls up next to me but that night, she laid her head on my belly and fell asleep cooing “mama”, like she knew it would be our last bedtime together before her sister arrived. It brought me to tears. I think that even though she is so young she had some sort of sixth sense about it all.

After my daughter was securely in bed, my husband and I sat down to watch a movie and I chose to sit on the exercise ball to manage the contractions. My intention was to keep going what had started so I moved around quite frequently throughout the movie. At about 10:30 we went up to bed to try to get some rest and to my dismay, my contractions had quieted down to about 45 minute intervals.

I was in and out of bed, anxious and still experiencing contractions when they grew more intense and started lasting over a minute in which I had to hold my breath through the waves. They were now about ten minutes apart and somehow I knew that I should wake my husband up to start the labor preparations such as blowing up the tub and getting the bed labor-proofed.

I followed him downstairs and while he was blowing up the tub, and getting the bed ready I first attended to him by giving him vitamins and making him tea (he was feeling ill that day and he NEVER gets sick). When my contractions got stronger I was walking around and counting the minutes on the clock. They were still 10 minutes apart but very strong (I was instructed to call the midwife at 5 minutes apart).

During this time, I spent a lot of time in the bathroom, because the toilet with the hole for a seat was the most comfortable since it didn’t put any pressure “down there”. I started bleeding and to me it looked like a great amount. My contractions got to 5 minutes apart and I calmly called my midwife. She said that I seemed so calm on the phone that she’d make herself some tea to wake up and then head over there. I also texted my friend who had agreed to come get my daughter and told her about what was going on.

In a span of about 10 minutes, I yelled at my husband to hurry up and start filling the tub, and to call my midwife back and tell her to come NOW because 1) I was bleeding A LOT and 2) My contractions suddenly were on top of one another with about a half a minute break. He also called my friend and told her to come NOW. I think I said “Call Suzanne, get Ellen OUT of the house! (Because I was screaming at this point through every contraction they were so intense).

Instinctually I thought to myself “I have to get up now and move to the tub because if I don’t I’ll be stuck on this toilet” and I was right. Somehow I managed to lift myself out of the bathroom and into the tub, which was set up in the dining room, which was only a quarter of the way full. Doing awesome tub management, my husband was concerned about the temperature and kept checking it but I really didn’t care if it was too hot, it felt better than being dry and dealing with those waves.

As soon as I got in, I started moaning loudly with the contractions. They were still right on top of one another. After about only 5 minutes I felt something “pop” which was my bag of waters breaking. Right after the pop, I yelled to my husband that she was going to come NOW and that I “don’t want to push”. I was scared. We were alone. What if the baby came out not breathing or what if I was bleeding too much like I thought?

I yelled for him to find the bulb syringe because I knew that if she wasn’t breathing, we might have to suck water/ mucous out of her mouth to help her. He got on that task right away and before he was done washing the syringe, I felt a huge urge to push, screamed that I didn’t want to push but my body had other intentions.

She was out in two pushes, back to back with no break in between. I felt for her head in the water and cupped it while her body slid out. I took her out of the water immediately and onto my chest. I looked at her face and my husband emerged from the bathroom with the clean bulb syringe. We waited for her to cry and she let out a wet little peep. One tiny cry. She opened her eyes and looked around. I held her close to me in the warm tub and instructed my husband to get a towel. I couldn’t really move because she was attached and I didn’t know how long the cord was so I just held her there, close to the water with a towel that got soaked. After a few minutes I said, “I think with this wet towel, she may get cold”. We need to try to get the placenta out and get her detached and warm.” So I carefully stood up onto my knees in the tub and handed her to my husband while I pushed the placenta out. He handed her back to me and got a bowl to put it in so it wouldn’t just be floating around in the tub.

I then asked him to get some scissors to cut the cord since the placenta was out and it had been about 5 minutes. He found some kitchen scissors and again, cleaned them off the best we could in limited time and then he cut her cord.

This is the time my midwife and my friend arrived. I was sitting in the tub; holding her, cord freshly cut. We explained what had just happened and that we had just cut the cord. “Did you clamp it?” she said. “No I didn’t even think about that, I just thought we needed to get her warm and in a dry clean towel.

So my midwife, a bit stunned that this had all just happened in the 15 minutes she was in route, quickly dug into her bag, found a clamp, put it on, and then cut the cord to a proper length (we were smart for cutting it long).

I told my friend thank you for coming but our daughter had slept through the whole thing.

My midwife then took on the grandmotherly role helping us manage self- care, and we passed the baby to daddy so that I could get out of the tub and we could get her bundled.

I arose from the tub dazed. Did that all just really happen? Did I deliver my own baby?

I was not bleeding profusely as I had believed, I have two TINY hairline tears that stitches would cause more damage to then good, so it’s not needed, and the baby latched on right away and is rosy cheeked and healthy as an ox.

Certainly if I was not planning to give birth at home, she would have been born in the car on the way to the birth center or the hospital.

Thank god for my husband, my birthing tub, my daughter for sleeping through the whole thing, and my baby for entering this world so swiftly.

It was a crazy ride and I’m so glad that I was on it.

Oh AND while I’m blogging away because I’m still high on love hormones, can’t sleep, and want to record this to the best of my memory, my husband made me breakfast in bed (banana pancakes, and bacon), is cleaning up all of the mess, and taking care of our older daughter. Life is good.

When I had my first baby in a hospital, I was told no photography during the birth, including video.  I didn’t really question this, though I was disappointed. I was told that the reason was the photographer might get in the doctor’s way.  My mother came to the birth and was videotaping, she just never turned it off, so we have a video of the whole thing, unintentionally.  Ouch.  After watching the video, I knew why they didn’t allow it. When I tried to talk to the doctor who had done my birth (someone I had not met until that evening) I offered to sit with her and watch the video after she refuted my claims.  She refused to watch the video, but sent a letter of half-hearted apology for my complaints, dismissing her unprofessional behavior to the fact that she was tired.

So this bears asking – why is it okay for doctors to video tape and photograph labor, birth, c-sections and hospital procedures and surgery (Yes, it’s in the consent forms!), but you can’t do the same for your own body?  There was a case several years ago where the doctor was performing a scheduled hysterectomy and videotaped it, sending the woman home with the video.  She decided to watch it and was horrified when he etched the name of his alma mater into her uterus. The case wound up being dismissed because he explained that was how he was taught to orient himself during surgery.  After hearing his explanation, it actually made more sense to me and apparently to those dealing with the complaint.  In this case the video exonerated him. So if you have someone telling you no birth photos in case of liability, then ask them why they film so many other procedures.  Work your way up to the administration if need be to get your birth videos.

After my first birth I have a strict “my body my photos” rule.  This has led to a series of photos that I don’t bring out often but secretly make me happy to have.  There are photos of two ear surgeries, my husband’s appendix, my removed fallopian tube… You get the idea.

So why not give women the smiling photos of themselves giving birth?  In my subsequent births, I’ve always tried to capture the special moments of birth, greeting my new baby for the first time.  There was one of my baby’s that I never would have realized that only my husband and I caught her, hands together.  Our midwife hadn’t interfered and I hadn’t recalled putting my hands down to lift my baby out – only the photo told me that and makes me beam even today almost ten years later.  There is the photo of all of our hands holding the new baby, a series of them in fact, and what isn’t obvious to anyone but use, is that while there are always only four sets of hands in the photos (mine, baby’s, my husband’s and one of our children’s) is that the children’s hands are always from a different child!  So cool, sharing those first touches all around.

After all of my birth photos, my absolute favorite is the one of my husband’s face grinning from ear to ear as he caught or last baby, born in the water – it happened suddenly and he didn’t have a chance to even think about it.  I wasn’t even supposed to be in the bath tub, it just happened and only about 90 seconds before the birth.  Our midwife made it to the bathroom in time for him to make his first solo catch…

I would have never seen it if it hadn’t have been for the photos.

_{Photo © Grapevine Photography}

“You call her [the midwife] right now.  I’ve done a lot of crazy [insert expletive] in my life but I am NOT delivering a baby.”

Guest Post by Alyssa Chirco

This was my husband’s response when I realized that the irregular contractions that I had been experiencing all day were getting stronger and coming routinely every four minutes.  He had agreed to the home birth of our second child, but he was adamant that he would not be the one doing any sort of catching or delivering.  It was obvious that the whole thing still sort of freaked him out.

What is it about husbands and home birth?  Most of the women I know have had to either talk their husbands into home birth, or have compromised their own desires and been talked out of home birth by their skeptical partners.  Why are men so afraid of home birth?  And how do we convince them that, for many families, it can be a safe and viable alternative to birth in a hospital?

My own husband’s journey began with my first pregnancy, when I was planning a hospital birth with an obstetrician, but was also intending to have an unmedicated birth.  I hired a doula, and signed us up for Bradley childbirth education classes.  Most of the information in the classes was not new to me, as my sisters had been born at home and I had already read a lot, but the classes were incredibly eye-opening for my husband.  He learned about how birth really works, and realized why so many hospital policies and procedures are often unnecessary and even detrimental to the birth process.

My first birth experience was not ideal, but as a young, first-time mom giving birth in a hospital, I fared pretty well.  I refused an IV, was allowed to walk and use the shower, and received electronic fetal monitoring only twice during the few hours I labored at the hospital.  Thanks to my doula, I was never offered an epidural, and didn’t have any episiotomy.  And because my entire labor lasted less than eight hours, the obstetrician only made in time to catch a healthy baby girl.

This easy delivery (and lack of hospital interventions) made it a lot easier when it came time to casually mention to my husband that I wanted to have baby #2 at home.  As supportive as he was of my desire for natural childbirth, and as much as he understood the difficulties that come with trying to have a natural birth in a hospital, he wasn’t really comfortable with the idea of having a baby at home.  But I was able to point out to him that the doctors and the nurses at the hospital never really did anything at my first birth.  I never utilized any of the interventions that you need to be in the hospital to get; my body did it all on its own.

My husband agreed to a home birth the second time around because had witnessed a safe, natural birth first-hand and because, ultimately, he trusted that I had done my research and knew what was best for our baby (and, yes, I consider myself extraordinarily lucky that he has this much faith in me).  He also felt more comfortable after meeting with our midwife and hearing first-hand about her experience and how she handles emergency situations.  And when I finally got my hands in a copy of The Business of Being Born and he was able to see the safe and peaceful home births of so many babies for himself, he was more fully convinced that we were doing the right thing.

He still didn’t want to be the one who had to deliver the baby though, and he still had his doubts.  He worried that it would be messy, he worried that something would go wrong, and he worried about what the neighbors would think . . .

My second birth experience was far better than my first.  I labored at home.  I was allowed to eat and drink.  I didn’t have to fight to avoid interventions because my midwife didn’t believe in them in the first place.  When my son’s head emerged but his body didn’t follow, my midwife knew exactly what to do, and within a few minutes she had dislodged what she termed “sticky shoulders” and he slid easily into the world.  From my perspective, it was a great birth.

Overall, my husband found the home birth experience to be a positive one as well.  He particularly enjoyed the fact that he got to sleep in his own bed and not on a hospital couch.  But I also learned afterward that, at one point, he had been afraid that my son and I were going die right there in our bathtub (which was never even close to happening).  If we have another baby, I know that he will support my desire for another home birth.  But I also know that, on some level, he would still feel more comfortable if I chose to go back to the hospital.

As birth activists, it can be hard to see women who have given up on their hopes for a home birth because they can’t convince their husbands.  It’s easy to judge men who are hesitant about home birth, and criticize them for being unsupportive.  But, in fact, I think we are the ones who need to be more supportive and understanding.  Most men aren’t being trying to be difficult, or actively deny their wives and babies a safe and positive birth experience.

They just don’t know any better because no one has told them any better.

We talk a lot about how women in our culture know so little about birth and are rarely exposed to it before they have a baby themselves.  If American women know so little, doesn’t it stand to reason that American men know even less?

The notion of medical superiority is deeply rooted in American culture.  We tend to believe that doctors, hospitals, and procedures can make everything better, and this thinking is applied to birth as well.  Most Americans assume that interventions always help the birth process, and aren’t familiar with the idea that interventions can actually be harmful.  In many cases, pregnant women don’t even know that they have options and choices when it comes to birth.

Women come to home birth in a variety of ways – disappointment with a prior birth experience, reading books, participating in online forms, talking with other women at mom’s groups or playgroups, just to name a few.  But husbands don’t often share these experiences.  Men don’t have to heal from cesarean scars.  Men rarely participate in chat groups or attend support groups about pregnancy and birth.  Men don’t share intimate details of their birth stories with other women, and don’t hear about the experiences of others.

Instead, men mostly hear the messages from the mainstream media that home birth is dangerous.  Chances are they have never met or even heard of anyone who has had one.  So when husbands hear their wives start to mention the idea of having a baby at home, it’s no wonder that they’re skeptical.  Given what they know, concern and opposition actually seem like perfectly logical responses.

I don’t believe that husbands oppose home birth because they want to be difficult.  In most cases, it’s because they love their wives and they’re unborn children.  It’s because they have only been exposed to the mainstream media message that home birth is dangerous and hospital birth is always a safer alternative.  It’s because they haven’t read the studies and met the women and heard the empowering stories of birth at home.

As birth activists and home birth advocates, we need to change this.

My question to you is how.

If you had a home birth, did you have to convince your husband?  If so, how did you do it?  Or, did you want a home birth but agree to give birth in a hospital or birth center because you couldn’t convince your husband/partner?  How do we help men to be more comfortable with the idea of home birth?

Alyssa Chirco is a stay-at-home mom and freelance writer who lives in St. Louis, Missouri with her husband and two children.  She is active in both birth and breastfeeding education and advocacy, and combines her love of writing with her love of everything parenting-related in her blog St. Louis Smart Mama (www.stlouissmartmama.blogspot.com).

I suppose every woman has a few affirmations that speak to her more than the others.  For me, the crux of the collection was this:

I am prepared to calmly meet whatever turn my birthing may take.

I didn’t have a lot of expectations for my birth.  I wasn’t expecting it to be short or easy.  I kept an open mind about Mongan’s claim about birth not needing to be painful, and knew that I would deal with the birth beautifully whether it was painful or not.  But I really, really, really wanted my homebirth.  I was terrified of needing a hospital transfer.  I was terrified of needing a C-section.  I was terrified of letting go of my dream.

I am prepared to calmly meet whatever turn my birthing may take.

I just  couldn’t hear it enough.

But a few weeks before my birth, I came across a very unusual birth story.  It goes as follows.

Sivan was pregnant with her fourth child and preparing for a homebirth.  She was diagnosed with gestational diabetes in the middle of her pregnancy, but she did not let that worry her.  Her 39-week ultrasound estimated the baby’s size at an impressive 4.4 kg (9.7 lbs).  This did not bother her either; she knew how notorious ultrasounds are for being inaccurate.

But her midwife was concerned.  She took a good look at all the factors involved, and told her that with all the data she had, she did not feel safe accepting this birth at home, and with great sympathy told her that in her professional opinion, a C-section would be the safest course for this particular baby.

Sivan was shocked.  She trusted her midwife and knew that she would never recommend a planned C-section without a really good reason, but she couldn’t grasp the idea that her midwife would tell her such a thing.  What about the inaccuracy of ultrasounds?  What about the inaccuracy of the glucose tolerance test?  What about the idea that women’s bodies have been doing this for millenia and know how to birth big babies too?

Eventually she began to accept that her midwife was not just being over-cautious.  In the case of gestational diabetes, it is the shoulders of the baby that put on a lot of weight, and the risk of true shoulder dystocia in this case was too high to ignore.  She did not want to put her baby at risk.

But a C-section?  After all her hopes for a perfect homebirth?

Sivan described going to the beach and watching the waves and wanting to just give birth there, alone, trusting her body to do what it knew how to do, proving to everyone how wrong they were.  She cried for the loss of her dream birth, feeling helpless, hopeless and disempowered.

As she sat there, she got a call from her midwife.  “Just wanted to check in on you.  I know you will be okay.  You’re not the type of person who gets stuck in the past, I got that feeling from you long ago.  Just remember one thing: at the surgery, despite all the disappointment, you are still going to meet your baby.  Remember?  It’s a celebration!  Go in celebration!”

From that moment, something changed.

Sivan went home and informed the hospital that she would not be coming that day, but on Sunday.  And that her surgery would not be on Sunday, but on Tuesday.  Why?  Because that’s what she wanted.  She was taking this birth into her hands.  Who said a C-section couldn’t be an active birth?!

She and her husband arrived at the hospital like a pair of celebrities arriving for their premiere, all dressed up and full of joy.  They asked every staff member for his or her name and chatted with them.  Sivan insisted on sitting, not lying down, on the bed as she was wheeled into the OR.  As the surgeon prepared for the incision, she asked him to tell her exactly what he was doing.  She described the moments of joy as her son was born, and when he was brought to her from across the curtain and put next to her cheek; how she wriggled her arm out of the restraint and stroked him.  Her husband waited with the baby carrier, took the baby and never left his side as the operation was completed.  Sivan insisted on giving the surgeon a hug before she was wheeled to recovery.  Determined to recover and see her baby, as soon as she felt some sensation in her legs she tried to move them, and she expressed some colostrum to prepare her breasts for nursing.  She refused morphium for the pain and had them give her Ibuprofin instead.  The staff was in shock at her quick recovery and determination to function.  When her beautiful, 9.8-pound boy was finally brought to her, she didn’t wait even one minute before attaching him to her breast.  “Don’t you want to wait until we reach the ward?”  The orderly asked in amazement.  No.  Not a chance.

She turned one of the worst nightmares of any homebirther into a positive, happy experience.  A celebration.  After all, a birth is a birth.

I am prepared to calmly meet whatever turn my birthing may take.

After I read that story, something changed in me as well.  I realized that the lack of control I had over my birth did not mean I was helpless.  There is always a choice, and the choice is in your response to the situation you are in.  You can choose to see a C-section as a failure, a nightmare.  Or you can choose to see it as a birth; not what you wanted, not ideal, but a birth nonetheless.

Suddenly, I was able to let go.

And my birth was amazing.