Talking Home Birth

Meet Kate, a Chicagoland mama who is preparing for her second home birth. Below she shares her experiences, suggestions and lessons learned from her first home birth.

What inspired you to have a home birth?

I think the first time I ever thought seriously about home birth was after seeing [Ricki Lake's documentary] The Business of Being Born. It tipped what I thought I knew about birth on its head and gave me a new perspective. Of course, this was a couple years before I was even thinking about having my own babies. When my husband and I got to that point, we were living in Sweden, which has the best maternity care and maternity outcomes in the world. I knew that the care I received there would most likely be superior to the expectations I had of US hospitals and maternity care, and yet it wasn't a risk I was willing to take. By this point I had read enough birth stories and observed that so often it was a traumatic first birth that inspired women to go on to have subsequent home births. I wanted to skip that middleman.

How did you handle objections from friends or family?

No one flat-out called me crazy to my face, which I appreciated. I certainly detected reservation and some fear from people that I talked with, but they were dealing with an educated person. My husband and I didn't make this decision blindly or lightly. Two resources that I told just about everyone about were The Business of Being Born documentary and Ina May Gaskin's book, Ina May's Guide to Childbirth. These are both tools that present birth options in a palatable, mainstream light, while at the same time are based on scientific data and contain loads of resources.

Did you use a doula and/or nurse midwife?

My home birth was attended by two midwives, the equivalent of which would be a Certified Nurse Midwife (CNM) here in the States (we were in Sweden, remember). They both worked in the hospital as midwives, and in Sweden they use a midwifery model of care instead of a medical, or obstetrical, model. This means that barring any complications or high risk factors all women are automatically attended by midwives for pre-natal care and delivery. Home birth is actually not a popular option in Sweden, and the rate of home birth there is about the same as it is in the US, <1%.

Ironically, even though I'm a doula myself, I did not use a doula for my birth. The reason for this was because my midwives were comfortable acting in this role for me, and our apartment was quite small (less than 400 square feet) so I was concerned that it would feel a bit cramped with another body thrown in the mix. It turned out to be the perfect mix of people, with each one taking a turn to support me in vital ways. I wouldn't change a thing.

How did you go about finding/ choosing a doula or/and midwife? What were your criteria?
Well, for us it was pretty easy. There was only one group of midwives I could find that offered home birth where we lived, so it was either them or a hospital birth. This doesn't mean we didn't make our decision carefully. Before our initial interview with our midwives we printed out a list of questions that was probably four pages long (you can literally Google “questions to ask your midwife” and get a million lists in return). In the end, our biggest concern was safety. What would they identify as an emergency? How would we transfer? How long would it take? Where would we go? What equipment would they have with them? The answers to these questions satisfied us, and so our final decision was clear.

What were your literal and emotional preparations for your home birth?

Having a relaxing and cozy environment was important to me so I put thought into how our space was decorated. Our son was due in December so we had Christmas lights up. We used a mix of low lighting and candles, and I had worked on a labor playlist that was on in the background. Practically speaking, I went to the hospital to pick up a box of supplies that my midwives would need. I laugh when I think about it because Swedish culture is so trusting, and in the box were vials of Pitocin (in case of hemorrhage) that I just carried home on the bus. I also had a birth ball, lots of towels and sheets, plenty of food and drinks. Emotionally, I spent a lot of time envisioning the birth and made a list of what I hoped for. I read a lot of positive birth stories, and my husband and I studied a book on the Bradley Method and focused on relaxation techniques. I talked with other home birthing mamas and by the time the birth came, I was so excited to 'do this’!

What were your preparations in case there was an emergency?

Besides picking up the birth box from the hospital (which also contained IV’s and other items for emergency), the biggest thing is having a plan in place. We knew that once my labor commenced, my midwives would call the hospital and let them know that a home birth was in progress. We lived within 15 minutes of two hospitals, either one of which would have been a great place to transfer to (what few people know is that even in the hospital it generally takes about 30 minutes to prep an operating room, gather the surgical team, prep the mama, etc... this is the “decision to incision” time). While home birth is not common in Sweden, we knew the culture was such that I would be treated with respect and great care if the need to transfer arose (unfortunately this is not always the case in the US, where some women and midwives are treated like out-laws when they transfer to a hospital, thus compromising the safety and well-being of mama and baby). As would have been the case in the hospital, my midwives knew what signs they to look for to indicate a potential issue.

Who was present at your home birth?
My two midwives (both named Johanna) and my husband were present for the birth. And, the group of university guys drinking up on the roof that cheered every time I had a contraction.

How was it? Highlights? Lowlights?

Oh, man. I still get all dreamy thinking back to this birth. I love that I never had to leave my apartment. I love that no strangers were coming in to poke and prod my baby or me. I love that my midwives never told me to do anything, but offered suggestions and allowed the decision to be mine. I love that there was no protocol or policies to either uphold or fight against. I love that my baby never left me, and that my midwives didn't even weigh him until the next day so that he didn't have to leave my arms in those crucial first hours. I love that I can say “I birthed my first-born in a 400 square foot student apartment in Sweden next to the freezer and then my husband emptied the birth pool into the court yard out the window.” What?! That's just crazy! I did not expect the pain to be so extreme. I did not expect to be so sore after the birth. I thought that pushing would feel good but it didn't (in hindsight I think I pushed before my body was truly ready).

You’re next baby is due in mid-February. How are you preparing for your next home birth?

Right now I'm in the gathering stage, getting all the items that are on my midwives' birth list. I'm planning where the tub will go, deciding if we should roll up the rug or not - simple things, really. My husband and I are going to take a refresher course on labor comfort measures (so labor will actually be comfortable this time), and I've assembled my birth team. Besides my two midwives, I'll have a doula, a buddy for my two-year-old, and hopefully, my friend to take pictures. Mentally I feel a bit more disconnected than I did last time, probably because instead of having endless amounts of time to daydream about birth I'm trying to keep my son from drawing on the walls and using me as a horsy. But, I'm getting there, squeezing in those happy birth thoughts when I can.

How did your personal birth experience help your work as a doula?
I think it's given me more compassion and more empathy. I truly believe in my soul that each woman I'm working with can achieve a birth in which she feels empowered and satisfied, and I also know how hard it can be to get there. I believe that our biggest successes are not achieved alone. I am eternally grateful to the women that supported me through my pregnancy and birth, and to know what that is worth to the women I'm working with is totally humbling and honoring. Some people believe in karma, I prefer to call it God's Economy; this idea that what we receive in times of need we will at some point have the opportunity to give back, in one form or another. My title may be 'doula', but I feel like I'm just involving myself in the thousands of ways that women offer and receive support from each other.

What is the best resource for someone wanting to have a home birth?

Talk to someone else that's had a home birth. You can read books, websites, papers, statistics, statements, and more, but talking to someone who has done it is the best starting point. You can't quantify personal experience, and that's what I believe birth is about. More and more research is showing that birth experience is hugely influential on both short- and long-term outcomes for mother and baby. So if home birth is appealing to you, don't hesitate to explore that as an option.

Kate Jaggard Tyo lives in Chicagoland and is a wife, mama, and doula, currently planning her second home birth for early next year. She blogs (though not so recently) at Kate is Fun and is a passionate lover of good food. That noise you heard? It was a foodgasm. Have questions for Kate? Email info@adelinesroom.com and we’ll put you in touch.