WHAT? You're Not Going to the Hospital?

In an earlier post, I promised to tell you about our choice of an out-of-hospital birthing location. This was not a decision we came to quickly, and therefore the story outlining how we arrived at this decision is quite long. Enjoy!

During the process of trying to become pregnant, Dameone and I did a lot of reading and even watched a few documentaries on childbirth; totally wishful researching on our part. Even though month after month we continued to be disappointed by negative pregnancy test results, we also continued to torture ourselves by endlessly researching pregnancy and childbirth. Eventually, we found ourselves holding on to a positive pregnancy test along with some pretty firm ideas about how we wanted to bring our baby into the world.

There was one piece of media in particular that played a pivotal role in the direction we took for our prenatal care and choice of birthing place; the film The Business of Being Born by producers Abby Epstein and Ricki Lake. We watched this film rather early on in our attempts to become pregnant, and the information that was presented remained in the forefront of our minds each and every time we thought "Is this month the month?". The Business of Being Born provided us with a host of information that was previously unknown to us, and it sparked both of us to delve deeper into the topics presented.

Fast forward many months to November 2010 , and me holding a pregnancy test out to Dameone asking "Do you see one line or two?" Not immediately comprehending what he was saying to me, he replied "There's two lines babe.", and casually handed the test back to me. After all, we only decided I should take the test in the first place because I had come down with what I thought was a cold and wanted to rule out pregnancy before I started shoving cold medicine down my throat. Never in a million years did either one of us expect the results we received that day.


Feeling the need for someone in the medical community to confirm the at-home results, I started calling the list of obstetricians on my health insurance's list of approved providers. Doctor after doctor had either closed their practice, moved their office too far away, or was too busy to fit me in for an appointment. After calling no less than 20 obstetricians, I was finally able to get an appointment at a very large practice in Chandler, clear on the other side of the valley. We didn't care though; we were so excited that we would've driven to Tucson if that's where we could find the only appointment.


The day of our very first prenatal visit (12/01/2010, 5wk2d) was the same day that my morning sickness kicked in, which took a lot of the joy out of the experience for me. I gave my obligatory urine sample and, according to the doctor, it took all of 10-seconds to turn the pregnancy test "very positive". She had one of her assistants ask me about my health history, but one question in particular was the bright red flag that told us to run away as fast as we could and never come back. The assistant had the nerve to ask me, in front of Dameone, "Is your husband the father of this baby?" What kind of question is THAT?! And more importantly, what does it matter who the father is? When she initially asked the question, we just looked at each other and giggled like a couple of high-schoolers at the ridiculousness of the question. It wasn't until later that evening when the buzz of the day wore off that we realized just how offended we were.


Part of our wishful research in the early months of trying included learning about the very few out-of-hospital birthing centers in the Valley. An out-of-hospital birthing center is a place where babies are born, free from the environment of a hospital and with the guidance of a midwife, instead of an obstetrician (who, by the way, is a trained surgeon). Birth centers do not have operating rooms, and for this reason, do not have access to any pharmaceutical pain relieving and labor augmenting measures. Instead, things like deep soaking tubs, multi-head showers, walking, rocking, and a plethora of massage techniques are used in place of these unpredictable pharmaceuticals. In the event of a genuine obstetric emergency, all birthing centers, as well as the midwives who practice in them, have a relationship with the nearest hospital to provide backup, life-saving care.


Now, I know what many of you may be thinking..."Emergencies happen all the time during birth in the hospital...what makes you think those same things won't happen to you in the birthing center?" Well, first of all, a midwife's definition of a "genuine obstetric emergency" is vastly different from that of an obstetrician's. I'm not saying that one definition is more accurate than the other, just that we happen find a midwife's model of care (and therefore her overall system of beliefs) to be more in line with our personal goals, beliefs, and experiences. The facts show that, regardless of which "side" we're on, the routine use of obstetric intervention leads to further intervention, which is just something that this family is not interested in. What we are interested in is:

• for my body and this baby to be trusted enough to communicate with each other, the way bodies and babies have been for many millenia, to know just when the time is right to begin labor spontaneously instead of being held to a specific calendar date with the threat of medical induction hanging over our heads if I can't manage to conform;

• the ability for labor to run its course according to what my body needs on that day without any time limit, pressure to "perform", or being managed artificially with pharmaceuticals;

• for my own instincts to be trusted to sense when I'm hungry and thirsty and to be able to satisfy those basic needs with actual food and beverage, not IV fluids for hydration and completely prohibited from ingesting any food (i.e. the body's fuel) in the extremely unlikely event that general anesthesia would be needed for an immediate cesarean section;

• to have the freedom of movement that will allow me to work with my body to birth this baby, whether that be in a bed, in the bathtub, or standing up, not to be "tied down" ONLY to a bed by cords and monitors, told how to labor, and that I will "need" to get on my back to push since "that is how the doctor will want it";

• for my own instincts to be trusted enough to know when, how long, and how hard to push when the urge becomes overwhelming;

• for my perineum to be given ample opportunity to accept the prolactin that my body will produce that enables that tissue to stretch to the lengths necessary for birth without being threatened with "tearing" or an episiotomy;

• to give my baby the chance to get all of the blood that belongs to her in the umbilical cord and placenta by delaying the surgical separation of baby and placenta until after both have emerged from my body in their own time, instead of being forced to cut the umbilical cord immediately upon birth (which results in all of that additional blood volume to be discarded as medical waste along with the placenta);

• but most importantly, to allow this baby the labor that she needs, not a labor that is managed into convenience for anyone else.

Sure, there is a chance that we would be able to have all of these things in a hospital setting, but I can tell you right now that not a single one of these points are part of mainstream thinking in the Phoenix hospital circuit. Sure, there are obstetricians who not only believe in but also support the uninterrupted, natural birth process. Too bad the obstetrician is only a small part of the team of individuals that participate in a hospital birth. If all of the labor and delivery nurses that are on shift that day don't share in these beliefs, the chances for conflict or compromise to prevent conflict are great. Since neither conflict nor compromise to prevent conflict is something we should have to deal with during the birth of our child, we choose to have birth attendants who share our goals and will lead us down the path to achieving them. In our case, that would be a midwife at an out-of-hospital birth center called Blossom Birth and Wellness Center.

Throughout our journey we have come to respect the natural process of birth and admire those who seek to protect it while simultaneously respecting the science and technology of obstetrics that has saved the lives of countless women and children. What we simply can not respect or admire is the long-time misuse of this science and technology which has ultimately ripped birth from the home and shoved it into the hospital. We honestly can't blame (oh how I hate that word) the system as it is today. Today's obstetricians have inherited a mindset that started off nearly 100 years ago as politically charged and has been cultivated by mainstream media ever since.


We honestly do not pass judgement on the families who utilize this broken system; we were both born into it ourselves. We are all brought up to believe that doctors (just like policemen and firemen) are here to protect us; that we needn't question their authority; that they will give us all of the information we need to make the best possible decision for ourselves. The unfortunate reality is that medicine in the United States has become a retail establishment, where the pressure to turn a profit far outweighs the moral obligation to help people get well. The field of obstetrics is no exception. We feel fortunate that we live in a state where midwifery is legal (can you believe that its actually illegal anywhere??) and that our health insurance is willing to offset a small portion of the nominal fees our midwife charges for her services.




For information on birth centers near you, visit the American Association of Birth Centers.

To find a midwife in your area, visit the American College of Nurse-Midwives.