Home Birth? What!?

I got an email from my good friend Sarah, with questions about our home birth decision and details on how it was going to work. By the time I finished replying to her, the entire thing was typed out, so here is the 'copy and paste' version of how we got to where we are so far....

"I originally stumbled on the idea while researching ways to make my hospital experience less hospital-y. Alex’s delivery ended fine—healthy baby and mommy, but the getting there part was less than desirable. I hated how out of control I felt and how dependent I was on everyone else. I think that made me feel weaker and by not being able to make more of my own decisions about moving and eating and resting, I believe that it prolonged the process that ended with the eventual use of forceps. I’m not a total “I-am-woman-hear-me-roar” type person, but the more I thought about how Alex was literally pulled from my body with me having so little to do with anything by the end, the more I realized that I just couldn’t let that happen again. (This is all based on the presumption that this baby will be born with no complications—if there is any doubt as to her health and well-being, by all means, pull, push, cut—whatever it takes to get her out safely.)

So as I was poking around the internet, I kept coming across home birth sites. My first thought was “Ha—don’t think so.” But the more I read, the more I liked. I did some research on statistics and such and was surprised to find that for a non-complicated birth, it is actually safer (or as safe, depending on the study) to deliver at home than at a hospital. The rate of episiotomies, c-sections, and every other intervention is drastically reduced while the overall feeling of satisfaction and maternal control is increased. I approached Kevin and his first reaction was “Yeah right.” (And that’s a direct quote). But I made him do some research of his own (you know those academic types, haha) and we watched the “Business of Being Born” documentary together for a little bit of extra propaganda for my case. He also spoke with his aunt who is a nurse midwife and though she wouldn’t give a “yahoo, go for it” type of answer—she assured him that people really do deliver at home safely and like it too. By the end of all of that, he was pretty much in agreement with what I needed and wanted. Not exactly a flag-waving advocate, but okay with the idea. :) He will still tell you that if it was “up to him”, I’d be delivering in a hospital, but as it gets closer I think he’s getting kind of excited (in a terrified kind of way) too.

Now, a few things HAD to fall into place to make this happen: 1) Insurance, 2) Doctor support, 3) Finding a midwife. If any of those had fallen through, we wouldn’t even have the option. We have UnitedHealthCare insurance (the HRA version) that will cover a midwife-attended home birth as an ‘out of network’ thing—meaning they will pay 60% instead of 100%. Because we have an HRA (the health reimbursement account), even out-of-network stuff is covered 100% as long as I’ve satisfied my deductible for the year. And after being sick a couple of times and all of my other OB-GYN appts, I only have a little left of my deductible to pay. So basically (and I confirmed this with like 7 calls to our insurance company), it will cost us the exact same amount whether we deliver in a hospital or at home, or in an ambulance (please, no) in between. If you have insurance that would cover a midwife 100%, you’d be set—the thing is that most home birth midwives do not work in a doctor’s office, so they will be ‘out of network’. The midwives who do work in a doctor’s office and will attend your hospital birth will be covered because they fall under your doctor’s network coverage. So anyway, hurdle number 1 was cleared.

And for 2 & 3, it was surprisingly easy. I chose my current OB-GYN from a lot of recommendations from friends. Coincidentally, he is one of the few in the area (perhaps state) that will support a home birth decision. We went in for a regular visit with him, told the nurse we saw that we wanted to pursue a home birth and without batting an eye, she said, “Oh, you need Debbie then. Here’s her number.” Very cool. A lot (LOT) of doctors are too burdened by policy and insurance nightmares to even support home birth patients. (By support I mean that he is “on call” when I am delivering and will take over if we need to transfer to the hospital. Most home birth midwives do not have hospital privileges so they need a doctor on the ‘inside’ so to speak to be able to hand their patients over to). I’ve seen him a few times and just went last week for my last check up with him. The rest of my visits have been with Debbie, our midwife (we initially spent about 2 hours meeting and talking with her after she was recommended to us and really liked her), and if all goes well, I won’t need to see the doctor again until I need my next GYN check up. So, with 1, 2 & 3 all taken care of, we’re pretty much set on “go”.

I will see Debbie weekly now until the day arrives and the visits with her are SO different from a doctor’s visit. I am there at least an hour with her and she keeps a careful record of my entire being—how I’m feeling, what I’m eating, whether I’m exercising, everything. She does all the same tests that I would do at a doctor’s visit. The only thing I didn’t have to do was the glucose test b/c she doesn’t worry about that unless I’m showing symptoms of a problem. I feel very “taken care of” by her and though I don’t discount the bonus of having a doctor’s support, I feel like she is going to know me better and be a better support than any doctor or doctor’s office nurse or midwife could by the time I deliver.

When I feel like I am in labor, we will call her and she will come to our house with an assistant. Because we are doing a water birth, sometime in the next week or two, we will go ahead and get the pool from her (she has a few) and have it set up and ready to fill. I also had to order a birth kit from a company online (she gave me all the info and it is pre-packaged) that includes everything from clamps to gloves and have that ready. There are also a few other ‘good to haves’ that she gave us a list of that I will be gathering and having on hand in the next couple of weeks. She and her assistant (and Kevin’s aunt if she can make it) will be with us for the birth and will stay around for a few hours afterwards to make sure all is good. Then she’ll come back the next day to check us out again. We will take the baby to a pediatrician around day 3 or so, just like you would with any hospital-delivered baby. Debbie comes with the ability to do stitches, an IV, and rescue oxygen—just in case any of that is needed. She has a very low rate of having to transfer to a hospital, but says she will not “mess around” if she feels like the situation could take a bad turn. Because we are only about 20 minutes from a hospital, we could transfer easily or have an ambulance at our house in minutes. If for some reason my blood pressure decides to go crazy before then, if the baby decides to go breech or has signs of distress, or if the baby is more than 2 weeks early (or more than 2 weeks late), we will proceed with a hospital delivery. We are crossing our fingers, of course, that none of that will happen.

My parents are on call to come and get Alex—he’s a little young to participate. And everyone else will be notified when things are rolling, but no one will be at the house except for me and Kevin and the midwives. I want a calm and quiet atmosphere with no distractions. We’ll let the family and friends come when it’s all over and we’ve had a little time to rest and recuperate.

SO—that is all the info in a (very large) nutshell. I don’t think I could have done this with Alex, simply because I had so much fear and uncertainty about the whole labor and delivery process. But this time I feel a lot more confident about the situation and I think that by being more “in charge”, I’ll really be able to handle myself and the situation so much better. I’m not doing it to be a hero or for any fame and glory, just mainly for myself. It’s one time in life where I can get away with being truly selfish and can truly claim that it’s pretty much all about me—and the baby, of course. :)

I will definitely update everyone on how it went—the good, bad, and ugly too. I hope that it’s going to be the experience that I’m looking for—but if not, I can at least say we tried. The main goal is a healthy and complication-free delivery, and as long as that happens, I suppose it doesn’t really matter where it happens."

That should pretty much cover it! But feel free to ask anything else. This is kind of an exciting thing for us and kind of fun to talk about. :)