Childbirth: Home v. Hospital

   ’ , I was led to
believe throughout the prenatal period
that my O.B. and the hospital staff would
be supportive of a natural birth. When it
came time to actually labor and deliver,
the idea they seemed to have of “supporting”
a natural birth was not to physically
force you to have (most) interventions. (I
say “most” because the use of the vacuum
extractor WAS physically forced on
me.) There was no alternative offered to
any of the interventions, no actual “support”.
The two options for dealing with
the pain and difficulty of labor seemed to
be 1) drugs, or 2) nothing whatsoever. I
think it’s dishonest to allow a woman to
think you’re going to support her in natural
birth, when the entire system is set
up against it.
I was sent to the hospital by my OB
after about 24 hours of unproductive
labor, so they could start me on pitocin, an artificial version
of the hormone that gets labor going and keeps it
moving along. I had indicated that I didn’t want pitocin,
and had researched ways of getting labor moving, but
none of these measures were encouraged. Because of the
pitocin, continuous fetal monitoring was required. After
several hours strapped down to the bed with the fetal
monitor on one side and the IV on the other, I finally gave
in and started Nubain (a narcotic). The nurse came in to
turn up the pitocin periodically, despite my protests. After
several more hours, when I was fully dilated but had
stopped feeling contractions for some reason, I was told I
had to push. The baby was still very high up, and it was
really too early to push. He went into fetal distress and
was then pulled out by vacuum extractor without any
explanation or giving me even 10 seconds to get mentally
prepared for the insertion of the vacuum extractor. (Traumatic
birth has been compared to rape, incidentally, and I
suffered flashbacks and nightmares about the birth for
weeks.) I later read in a medical journal
that having the mother push when the
baby is up too high can cause fetal distress.
So basically, my OB actually created
a medical emergency. The term for this
type of situation is “iatrogenic”, meaning
that the physician’s actions actually do
more harm than doing nothing at all
would have done.
In the whole “emergency vacuum
extraction” fiasco, part of my vaginal
wall was caught in the thing, causing
damage that took many months to heal. This caused much
stress in our marriage, as we were not sure we would ever
be able to have another child. When I went back to see my
OB at about eight months postpartum to make sure everything
had healed right, she said it looked fine and told me
to use KY Jelly. I only found out after requesting (and
paying for) the birth record from the hospital that my
vaginal wall had been caught in the vacuum extractor.
Another example of dishonesty. I also believe that I was
given a “honeymoon stitch”, because things felt tighter
down there than before.
In contrast, my homebirth was a different experience
entirely. I realize that some of this is due to the fact that
this was my second baby, but not all of it. I am convinced
that if I had had my first child in the care of the homebirth
midwives, everything would have turned out completely
different than in the hospital. In my homebirth, I was able
to move around freely throughout the house. I was able to
work with my body, getting into different positions
depending on what felt better. We had planned to use a
birthing tub, but couldn’t get it filled up in time. If I had
had the baby at the hospital, they would not have allowed
me to push the baby out in the birthing tub because of my
weight. I am heavy but not morbidly obese or anything.
My homebirth midwives never did a single cervical
check. I didn’t want them, and they don’t do them unless
requested by the mother. Cervical checks don’t really give
much useful information, and can lead to the mother
being told to push when it’s not really time yet. They can
also be disheartening for the mother in a labor that is not
following the classic “one centimeter per hour” pattern.
The homebirth midwives used a Doppler periodically
to monitor the baby’s heartrate. This allowed us to have
that information without interfering with my labor, as the
continuous fetal monitoring had at the hospital.
When the baby was born, he was handed to me immediately,
and the cord was let be until it finished pulsating
(giving the baby that valuable, oxygenated blood). I was
allowed to sit and hold him while waiting for the placenta
to come out. There was no rush. (At the hospital birth, the
cord had been cut immediately and the placenta was
pulled out by the OB right away.) The midwives had
pitocin on hand, in case it became necessary to encourage
the placenta to come out that way.
While I experienced more pain at the time of the actual
birth with the homebirth (because of not having any shots
in my bottom, as had been done in the hospital), the
recovery time was not comparable at all. I
didn’t have any stitches, despite a 2nd
degree tear, and experienced no discomfort.
My bottom actually feels BETTER
now than it did before the delivery.
I had never felt the urge to push with my
first child because he was up too high. In
contrast, my second child was able to
move down on his own and put pressure
on my perineum, making me push without
even realizing it. I felt like I was on a
runaway train. My body was just doing it
on its own. The mind-body connection was allowed to
happen. Very, very different from the over-medicalized
first birth.
Here are the interventions I had during my first birth and
the consequences they can have (off the top of my head):
• IV with fluids: Can cause labor to slow because the
mother’s hormone levels drop. Can also cause swelling in
the birth canal, making it harder for the baby to work its
way out. Can cause baby to be overhydrated at birth, making
for a larger weight loss in the early days before nursing
is well-established, which can cause unnecessary concern
on the part of parents or doctors.
• Pitocin: Can cause overzealous contractions, which
are harder on the mother and can cause fetal distress.
• Nubain: Makes the mother loopy and makes for a
sleepy baby, who can have a harder time getting started
nursing.
• Episiotomy: They are done to avoid tearing or to get
the baby out faster, but many tears end up being WORSE
because of the episiotomy. They cut through muscle,
which takes longer to heal.
• Vacuum extractor delivery: Can be a wonderful tool
if used sparingly, but damage can be done to the mother. I
think it is also painful to the baby’s head.
There were no interventions like these in the homebirth.
I had good perineal support and only had a 2nd
degree tear, despite the baby being born very, very quickly,
not allowing things to stretch.