Where to Have the Baby: Hospital, Home or Shopping Mall?

childbirthThere she lay … a stranded beetle tethered to the bed … a bleeping machine with wiggly lines on one side … another bleeping machine infusing some kind of ominous cocktail into her veins on the other side … and suddenly she sat bolt upright and cried, “I’m frightened!”

The midwife seized her by the shoulders and pushed her down flat.

“Now listen to me! Just lie still!”

“Deep breath, dear. Nearly there! We just have to give you a little pizzy,” came from the nether regions beneath the surgical drapes.

An aside to the student nurse: “Jab that into her thigh with the birth of the anterior shoulder. Don’t worry. She won’t feel it.”

Such was my lasting impression of birth during my rotation in an obstetric unit. That was enough to make any thinking woman run screaming down the road in the opposite direction. Recently, I’ve read in various women’s magazines that “parturiphobia”, the pathological fear of childbirth is on the rise, especially among educated, middle class women.

I vividly remember my midwife mother tut-tutting, “These modern career women! They’ve no instinct, you actually have to teach them how to breastfeed - and the fuss they make during the delivery!”

In due course, I myself became one of these modern career women and in the fullness of time, got pregnant. My mind still echoed with the gory stories Mum brought home from the delivery suite. I winced at the memory of myself as the student nurse poised with the needle aimed at the trembling thigh of the stranded beetle (I never did believe that ‘she didn’t feel a thing’). I knew one thing for sure …. Wild horses couldn’t drag me into a hospital to have my baby.

To be humiliated and stripped of my clothes and my choices… Left shell-shocked and outraged, struggling with ambivalent feelings towards the squalling infant in my arms… Swallowing rage at the loss of control and dignity, yet having to act grateful… All banged up and cut and stitched and patronized and having all different uniforms peering at my intimate bits …. Oh sure. Sign me up now.

There just had to be a better way.

So I did a bit of research. I found that the basis for the “smart women have no instinct” view dated back to the Victorian era when it was supposed that the intellectual exercising of a woman’s mind interfered with her biological mothering instincts. Which explains why not educating women was really an act of benevolence - to protect them from influences that would disrupt their ability to function in their natural role.

Oh, I see. So although knowledge and education combats the ignorance that perpetuates poverty, disease and social injustice, in the case of childbirth, it actually works to the detriment.

Surely, I thought, it’s fear that interferes with one’s ability to listen to one’s inner wisdom and instinct – not erudition!

A jaunt down the lane of obstetric history convinced me that we’re better off than any previous generation when it comes to choices in childbirth. Death was a real risk for our foremothers, as the pioneer graveyards testify. Modern medicine at least gave their daughters the assurance that actually dropping dead was unlikely. But the swing towards technological intervention left many feeling like butchered slabs of meat on the stainless steel delivery table.

While the greatly reduced maternal and infant mortality rates were something to applaud, it seemed that somewhere along the way, the baby of natural birth got chucked out with the bath water.

Is the dread of childbirth actually on the rise – or is it just that contemporary women are more assertive about saying so?

Fear of the unknown is surely a contributing factor. These days, it’s rare for a woman to have the opportunity to witness another woman give birth before she herself embarks on the adventure. I’d hate to try bungy jumping without watching someone else do a few times first. Most of the books in popular bookshops only contain the clinical facts – with maybe a token inclusion of women’s personal experience of birth in the margins. The media is not much help. How often do we see a labouring woman pacing up and down the hospital halls of “ER”, pausing to breath with intense concentration through a contraction? Boring. Nope – she’s shrouded in her hospital garb, semi-reclining cooperatively in her hospital bed as if labour precludes the ability to walk, and is soon shrieking, “I can’t do it!”

I thought talking to some birth veterans might be a good idea. I soon learned that even this approach required caution. One woman, upon eyeing my watermelon waistline, insisted that I accept every drug on offer. I weakly offered, “But I want the pain. I embrace the pain. I don’t want my natural hormones to be inhibited.” This was as a red rag to a bull. She practically forbade me to give birth without an epidural. “Why suffer if you don’t need to? Have everything!” She turned to my husband. “Make sure she has everything!”

Any thinking woman would be apprehensive.

I was in a dilemma. I considered the work women have done over the last century to win more control and self-determination over many aspects of our lives. Should I have to renounce all that on walking in the door of the maternity hospital? Was it even reasonable of me to expect that I could stay in control over such a deeply personal aspect of my life without compromising the safety of my baby? My search for answers took me beyond the mainstream of modern obstetrical practice. I read everything I could find on natural childbirth, active birth and homebirth. I trawled web-sites, read birth stories addictively and watched every birth video I could get my hands on.

Eventually my baby was born at home after 24 hours of gradual labour. Now if you put a gun to my head and forced me to run for an hour, dang, I’d do it. I’d feel like I was dying, but I’d do it. My first labour was like that. I spent most of it in a warm birth pool. I was free to move around, and assume any position that felt right. Although it wasn’t a complete walk in the park (more like a forced run in the park), neither was it The Most Excruciating Pain I’ve Ever Endured or The Hardest Thing I’ve Ever Done – as the Prophetesses of Doom had advised me to be prepared for. And, amazingly, thanks to the unflagging support of my birth team (husband, midwife and doula), I stayed calm and coped well. No yelling and screaming, not even any swearing (unusual for a drama queen like me) – in fact, everyone was nodding off between contractions. My daughter was born into a room warmed by an open fire as the Irish spring rain pattered a lullaby on the roof.

Two years later, I thought a leisurely stroll around the shopping mall with friends would be better than mooching around at home in early labour. Things accelerated quickly and my second daughter ended up being born in the baby-care room just off the Food Court. She catapulted out like a salmon in a waterfall. A midwife who ‘just happened’ to be lunching at the next table helped catch the baby wearing a pair of food service gloves from the delicatessen. At the other table was a local reporter. The next day it was plastered all over the front page of the local rag. I’d been reading about using prayer or affirmations to reduce tension and promote relaxation in birth. All I can say is – it worked for me!

The third time round, we chose to go to New Zealand for the birth. We appreciated the woman-friendly services of the country where I grew up and trained as an R.N. Whether choosing to birth at home or in the hospital or a combination of both, women are attended by two government-funded midwives, with seamless hospital back up if necessary. We nearly experienced what it would be like to transport from home to hospital in mid-labour when light meconium was noticed. However, the foetal heart stayed strong, and I succeeded in getting into efficient labour by walking around outside for a couple of hours and skulling quantities of Raspberry Leaf Tea. Our third daughter was safely born with a perfect Apgar score.

Having three babies in five years has been hard work and very tiring at times – but I can honestly say that giving birth was an exhilarating adventure. Confessions of a Complete Wuss: I hate pain and I’m no Iron Woman. Homebirth was the right choice for me because I knew that with my ex-nurse aversion to the hospital system, it wouldn’t be the safe, empowering environment I needed. I didn’t think I’d have enough confidence to convince them to let me plod at my own pace without “helping” me with a rupture of membranes or a shot of syntocinin. I needed the hands-off approach of a midwife willing to watch, wait and allow me to do what she knew I could do.

Obviously, home birth isn’t for everyone. But I fervently hope that in the near future, government-funded home birth will be an option for healthy, ‘low risk’ Aussie women, as per the successful New Zealand model. Regardless of where women choose to have their babies, privacy, dignity, safety, loving support, and full say in all decisions are every woman’s birthright.

Like most things in life, there are still inherent risks in having a baby. Childbirth will always be hard work for most women, painful for many, and medical assistance may be necessary for some. But we are stronger than we know, and wiser than we think. I found that by doing my own research and asserting my own informed choices, I could reclaim responsibility, and therefore control of my childbearing experience.

Recommended reading:

Gentle Birth, Gentle Mothering – The wisdom and science of gentle choices in pregnancy, birth and parenting by Dr. Sarah J. Buckley, One Moon Press 2005

The Thinking Woman’s Guide to a Better Birth by Henci Goer

Birthing From Within by Pam England & Rob Horowitz, Partera Press 1998

Ina May’s Guide to Childbirth by Ina May Gaskin, Random House 2003

New Active Birth – A Concise Guide to Natural Childbirth by Janet Balaskas

Mothering the Mother – How a Doula Can Help You Have a Shorter, Easier and Healthier Birth by Klaus, Klaus & Kennell, Perseus Books 1993

A Labour of Love – An Australian Guide to Natural Childbirth by Gabrielle Targett, Fremantle Arts Centre Press, 2006

Recommended Websites:

Pregnancy, Birth and Beyond

Dr. Sarah J. Buckley, M.D.

Belly Belly

A Labour of Love

Joyous Birth