Now that I clarified that on to the update:
Yesterday Brian and I had our first consultation with a midwife about birthing at home. I have always been intrigued by home births but I thought, 'Oh I could never do that!'. Well after having my 3rd baby and realizing how big of a failure hospital births can be I knew that I would not birth in a hospital unless it was medically crucial to do so. Home birth was my first thought. I have had non medicated births. I have listened to my body and trusted it. I was the one who told the nurses that it was time to push with each baby. I lead my own births completely. I love the idea of birthing at home for many, many reasons. Brian wasn't sold on that idea though. He thought that we are too far from a hospital. We are a good 20 minutes from one but it's honestly not one that I'd prefer to birth at. The nearest good hospital is an hour away. I did share his concern with that but I also have had smooth natural births so it was not a big issue for me. His other issue was midwife qualifications and education. After our consultation he was officially on board with me. Ultimately though we have came to a decision about where we plan to birth and it's not what I expected.
Here is the reasoning for what we've decided:
Home birth can be a wonderful experience and very beneficial to both mother and baby because it decreases the risks of medical interventions that in return can lead to complications such a c section, dropped fetal heart rate from certain medications, a stalled labor due to epidurals, prolonged/stalled labor from induction, stress to the baby from being induced before your body or baby is ready, ect. The statistically proven list goes on and on. Labor without medical intervention is often the smoothest labor possible and home birthing greatly reduces the risk of any these interventions. Home birth is also a form of birthing that is lead by the mother. It's based around her doing what she wants to stay comfortable and trusting her body. Some women labor better on a birthing ball. Some find great relief in laboring in the water. Some like to eat while they labor. Some like to walk. Some like to sleep without being hooked up to IVs and monitors. Some want to be distracted by a house full of guests and their other children if they have any. Some want to turn off all of the lights and burn candles for a peaceful environment. Some want to blare music and dance their babies out. Everyone is different and the hospital completely restricts you of doing what feels the best to you.
Now that we've discussed why someone would choose home birth let's move on to midwife qualifications and education!
Education involved: In order to become a labor and delivery nurse, you must graduate from an accredited registered nursing program, which may be two or four years long. Passing a state exam is the next part of the process to become licensed as a nurse. After becoming licensed, nurses may apply for work in the labor and delivery department. Some hospitals may require nurses have a few years of general nursing experience before working in L&D. But other facilities will train new grads.
It takes longer to become a midwife. Midwives also have to become registered nurses. They can also choose a two or four-year program and must become licensed. But after becoming licensed, there is additional training. Midwifery programs have different admission requirements. For example, some require nurses have a BSN degree while others may not. In general, midwifery programs take about two additional years to complete.
Level of responsibility: The level of responsibility for L&D nurses and midwives are different. Nurses in labor and delivery work under the direction of a doctor. They have an important role, but they are not alone. For example, an L&D nurse is not the person who makes the decision to use forceps or perform a C-section.
Midwives are usually used in place of a doctor during labor, which means they have the same responsibility as an obstetrician. Similar to a doctor, a midwife is the person who is responsible for making critical decisions, such as if emergency interventions are needed during delivery. They transfer you to a hospital should anything raise a red flag.
Some have the conception that you irresponsibly trust your baby and you own life with someone who isn't very qualified. That is far from the truth. Midwives are just as qualified as any labor and delivery nurse or OB. They just don't use the same medical methods in their practices unless they have to. In that case they transfer you to the hospital and treat you there. Typically they have rights at neighboring facilities to continue to take care of you or they partner with the on staff OBs so that they can assist your birth regardless of what happens once you arrive at the medical center.
Midwives are, unquestionably, equipped to handle emergencies for both mother and baby. They are certified in NRP which is the standard of training for healthcare professionals who care for newborns at the time of delivery - it is taught at local hospitals to their L&D staff, and also AHA BLS for Medical Professionals - also taught at local hospitals. They have extensive training (generally from the same books as hospital providers) on how to resolve all childbirth emergencies, as this is basically the most important job we hope we never have, and are constantly updating our skill set with the latest techniques via continuing education. They have all of the resuscitation equipment proven to be beneficial at OOH births (they do not administer drugs during resuscitation, but frankly, many of the reasons you might need to administer drugs are direct results from other thing they don't do, like administer narcotics to the mother). They call the ambulance in case of an emergency where they would need to continue to provide care in-route, but most emergencies are handled completely in-house with no transport needed. Midwives ARE really awesome at promoting bonding and breastfeeding (uninterrupted skin to skin, physiological attachment, compassionate breastfeeding support, etc.) They can get erythromycin ointment, vitamin K injection, and hep B vaccine (or not). They also do the standard metabolic screening and file for birth certificates and social security cards. They refer out for hearing screenings, and those are often done in hospitals, audiologists offices, or the health dept.
All of this information is why I personally felt comfortable pursuing a home birth. I felt like it was perfect for us and our situation.
However, after further research there was one thing that kept coming up in studies that ultimately made our choice for us.
There is a undeniable increase in infant death risks after a home birth vs a hospital/birth center birth. With home birth a baby is 3-4 times more likely to pass away 0-4 weeks post partum. This is because there isn't the typical monitoring of the baby after birth. Of course they do a general exam to check all of the basics but there are many undetectable issues that can be there and be overlooked. I can not ignore these facts. I tried to discredit them but they are everywhere. Multiple credible studies have proven this to be true.
I'm not going to lie letting go of this dream when I had finally got my husband on board was a let down for me but I have never questioned my choice. I can not take that risk because I want a certain type of birth even if I truly believe it's best for the baby and I in a situation where we are both perfectly healthy.
That being said we have decided to stick with our original plan. We will be birthing at a birth center in Rogers, AR under the care of a midwife who is partnered with a wonderful hospital like a block away from the birthing center. She was rights to treat her patients at the hospital but also works with the OB staff there if a c section was needed. We will get that over all feel and lowered risk of intervention that a home birth has but with the perks of having a medical facility next door should an emergency arise. We will also be able to transfer to the hospital after our natural water birth at the birth center to have 24-48 hour monitoring of the baby and I just to be safe. It's truly the best of both worlds. The drive won't be as convenient but it'll be worth it. If home births has the option of hospital transfer for monitoring we would most definitely be birthing at home. I've yet to find a midwife who offers that though.
I want to add that I am not bashing ANY type of birth. I am not bashing anyone's choice in how they want to have their babies or how the did have their babies. We all do what we think is best for us personally. I think that induction and other interventions are greatly abused and come at an increased risk of complications that can lead to fetal distress and cesarean section. That is medically and statistically proven to be true. However, women do it every day and it all works out wonderfully.
Hopefully this post educated someone who was curious about different birthing options. My advice if you want to know more about birthing outside of a hospital or even birthing non medicated inside of one is to research, research, research. Go into it knowing your rights and knowing the facts. Call around and demand hospital policies on things like having to have an IV or being able to bring a birthing ball. Ask for the policies on any restrictions that you are given during labor. Often we just do what they tell us to do not knowing that we can refuse to do those things.
More reasons why I personally want to avoid a hospital birth:
I was pressured so much into things during my hospital births. From scare tactics on how my baby could die if I didn't supplement when she was only 2 hours old to not being able to stand up during labor to relieve back pain. The nurses would double check my cervix every single time. Like literally 2 different nurses would check me back to back each time. A nurse told me to not worry about my blood pressure because it wasn't high. It was 168/108 and I was in preterm labor due to preeclampsia. The list could go on and on.
All of that to say, know your rights as the mom and the patient. Do not let anyone scare you or boss you around! Your body, your birth.
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