The Fight for Normal Birth Wages On (Part 2)

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I am an enthusiastic supporter of homebirth and natural (unmedicated) childbirth. However, I don’t consider myself a militant for the cause and I think the advocates chanting the “Trust Birth” mantra are crossing the line into nuttiness and possibly leading women astray. Yes, I listen to my body and trust it to “tell” me what it needs and what’s best for my health, but as a Christian I must trust God as all-sufficient (2 Corinthians 12:9). Vaginal childbirth is a God-given process, and a rite of passage for women into motherhood, but the experience is not meant to be worshipped or sought after. A woman does not need to push a baby out through her vagina with all her senses intact to be a whole woman and mother, or to fully bond with her baby. The “Trust Birth” faction are effectively spitting in the faces of women who have had to adopt to have a child to call their own. Adoptive parents are every bit parents of their children in the same sense as those who welcome a child into their family by birth. They bond with their children very strongly, and the fact that they didn’t come out of the mother’s body is merely a technicality. You might say they gave birth “in spirit” though another woman gave birth physically. I acknowledge that women have been traumatized by their birth experiences and the bonding process may have been interfered with early on, but these women are still responsible to pick up the mantle and be the mothers of their babies, doing whatever it takes to heal themselves so they can fully assume their role.

So, why do I believe in natural childbirth at home? Because I trust God to bring me and my baby safely through (Isaiah 66:9). After all He’s the one who made us (Isaiah 44:24). However, I acknowledge that we are mortal beings subject to complications, some which could lead to death, and I believe God gave mankind the knowledge and wisdom to study the human body and to treat the body when things go wrong. I don’t believe women were meant to give birth unattended. Midwives have traditionally tended women in childbirth from the dawn of history and were the norm even in Western industrialized society through the first half of this century. They still attend most births in most industrialized nations, though not in the United States. However, at this time I don’t intend to go into depth on the midwife vs. OB debate or the state of medical care in the U.S. - entire blogs can be and have been developed about these topics individually.

I believe the best scenario for medical care is for women who become pregnant to first consult with a midwife. If the woman has any conditions that require physician oversight, she can be referred to an OB who can manage her care and deliver the baby in a hospital. OB’s would willingly collaborate with and take referrals from midwives. Healthy women with normal pregnancies would have the option of delivering at home or in a birthing center that could be either freestanding or in a hospital. All birthing centers and L&D departments would have birthing pools available for any women who want it. A woman laboring at home who needs to transfer to the hospital could do so with no flack. Women who choose to be in a facility would not receive IV’s or continuous EFM as a routine. They would be allowed to move around and eat and drink if they wish. Pitocin and epidurals would not be assumed because labor would not be seen as a medical disorder to be micromanaged, but something to be allowed to progress at it’s own pace as long as mom and baby are doing fine. CNMs (Certified Nurse Midwives) would be allowed to attend homebirths as well as facility births because they would not be required by law to be under the direct supervision of physicians - they would be partnering and collaborating for the best maternity care model. I really want to see CNMs fully come into their own as maternity care providers, because of their level of education and experience compared to direct entry (non-nurse) midwives.

Just for the record, here are my birth experiences: My first pregnancy I received care from nurse midwives at a hospital-based birth center and attended Bradley Method classes. I liked the idea of a homebirth but was not fully comfortable with the idea of laboring and delivering at home with our situation at the time (we had 3 teenagers in the house, 2 stepkids and 1 foster kid) nor was there a legal direct entry midwife available at the time. I developed mild preeclampsia around week 35 and was induced at week 37, delivering vaginally after 2 days of cytotec to ripen my cervix and a day of pitocin. I used NO PAIN MEDS and the midwives cared for me the whole time. A year later I got pregnant again and miscarried naturally at 12wks. Three months after the m/c I got pregnant again with my son. This time I found a homebirth midwife who was a CNM. I delivered at home, laboring in a birthing pool, but getting out to push, with my husband catching. I had a problem with the placenta coming out and required the midwife’s assistance. I would have been in real danger of hemorrhaging to death if not for her (she had to manually extract the placenta). Except for a shot in the thigh of pitocin afterward I had no other drugs. Fourth pregnancy occurred when my son was only 5 mo and I was suffering from postpartum depression. I wanted a homebirth again but the midwife was no longer practicing. A new midwife to replace her would not be available until the month I was due. I was actually considering waiting it out for her or going unassisted, but I needed to be treated for the depression so I went to see the CNMs at the birth center and got put on medication (I was 14 weeks by this time, so it was considered safe). I got an ultrasound at 20 weeks and found out I was having twin girls!!! Not only that, but my blood pressure skyrocketed and I needed to be put on medication for that too. After much thought and prayer I decided homebirth was just not a good idea this time around. I also developed gestational diabetes and was put on modified bed rest to prevent premature labor because I was already 3+ cm dilated @31wks. I was encouraged to see the OB’s at the practice because an OB would have to attend the birth in the OR. My water broke at 38w2d at 11pm on a Fri nite. At 3am when I got to the hospital I had no appreciable contractions though I was 6cm. Baby A’s head was down but slightly tilted so there wasn’t enough pressure to stimulate contractions. At 8:30am the pitocin was started. I sat on a birthing ball for a while and mostly in a rocking chair through the day, until my labor really picked up at 5pm. I was 7-8cm at 6:00, my hubby was told to change into scrubs and the doctor was called. At 6:15 I had just an anterior lip, at 6:30 I was wheeled into the OR having the biggest, most intense contraction I’ve EVER had, EVER. At 6:35 my first twin dd was born after 2 pushes. The second twin turned breech while an u/s was being done, for a second I was afraid I was going to have an emergency c/s, but the doctor reached in and grasped a foot, asked for a needle to pierce the membrane (so the water wouldn’t just gush and cause the cord to prolapse), and my second twin dd was delivered footling breech at 6:46pm. I was back in my room nursing my twins at 7pm. Again, I had NO PAIN MEDS. I’ve had very different experiences every time, but I believe I received the care that was appropriate to each situation.

Now that I’ve laid my position and background out, in Part 3 I’ll actually get around to addressing the ACOG and AABC statements.

birth, birth center, certified nurse midwife, certified professional midwife, childbirth, CNM, CPM, direct entry midwife, home birth, homebirth, midwife, midwifery, midwives, nurse midwife, pregnancy, twins

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