Monday, March 7, 2011

My Thoughts on Hospital Birth vs. Home Birth

On the heels of a 21 hour birth with a client, my longest yet (and also finally a birth that counts as my last birth for certification! yay!), I am going to share some thoughts.

Here are a few things about Hospitals Births that solidify my desire to have a Home Birth:

1. I HATE directed pushing. Hate it. You do not need to be told when and how long and how strong to push in order for your baby to come. You also do not need to "know" that you are 10 cm and then be "allowed" to push. You will know when it is time to push. You will feel the urge!

I think women push much more effectively when they follow their bodies. They breathe more than they do with directed pushing, which gets more oxygen to the baby and themselves. They do not push so hard that they are not letting their perineum tissue stretch, and so they tear less. They tend to push in more effective positions, especially if they are not in a hospital confined to the bed (which is more convenient for the doctor).

I told my client recently who was experiencing a nurse who was telling her not to push during a strong pushing contraction because she had to "give the baby a rest, she's having her head compressed a lot," that this was HER show. She needs to push and breathe when she feels it is right.

2. Monitors. Constantly attached and tethered, constantly beeping and squeezing, constantly readjusted. I think they are so freaking obnoxious. They also haven't been shown to identify and prevent what they are "supposed" to (see my post Where's the Evidence Based Medicine?) How can I labor effectively if I am so profoundly irritated?

I don't think the blood pressure cuff, thermometers, contraction monitors, heart rate monitors, etc etc really help my baby have a safer labor and delivery. I think they hinder that which creates a healthy birth, namely, a mother who is at peace and as comfortable as possible, a mother who can get up and more around and be in any position she likes, a mother who doesn't feel encumbered or worried.

3. Not being able to eat or drink whatever I want. Again, there is no evidence that eating and drinking during labor is bad, but its certainly true that not being able to eat or drink lowers your energy level and also makes your labor unpleasant. I'd much rather eat and drink what I want for energy than be attached to a painful IV.

I also think its ridiculous that we withhold such a thing from a laboring woman. Its like its some power trip to be able to control their eating (and their peeing, too, if mom has to have a urinary catheter).  All part of the Rite of Passage (see: Robbie Davis-Floyd).

4. People telling me where and how and in what position I can labor/birth. Uh uh, no. I am going to labor how I damn well please. I am not going to stay still in that bed just so YOU and the hospital record room can have a "nice strip on the monitor." I am not going to lay here and suffer pain that would be alleviated by moving or a hot shower just so you can fill in your charts with my blood pressure. That's bullshit.

I'm also going to push in whatever position feels the most comfortable for me. I don't care if its hard for you to catch the baby that way - I don't actually need you! I can catch my own baby! Or my husband can do it! One does not need a medical degree to catch a baby. That baby is coming whether we like it or not, and its coming in whatever position I choose at that moment.

5. The hospital atmosphere. Strange smells, weird sounds, the fact that hospitals are full of illnesses and germs, and being in someone else's territory. I've never liked the sterilization smells of doctors offices and hospitals. They just remind me of being sick and uncomfortable. I don't think I could fully relax in an atmosphere where people can come and go as they please, touch me and tell me what to do whenever they please, and me and my family have to "ask" to be able to do things or go places. I also don't want to feel embarrassed during my labor, and I don't want people there that I don't know. That atmosphere can stall a labor, and I've seen it happen.

I should emphasize, also, that all of these things also solidify my decision to have a home birth because I want a natural birth. If you want a natural birth, STAY OUT OF THE HOSPITAL.

What about you, what do you think? Other than the "safety" or "fear" aspect of the hospital vs. home birth debate, tell me what prompted you to make the decision you did!


  1. I chose the hospital because I did not feel ready for a home birth. I really want a home birth now, but for my first birth I needed that comfort of being in the hospital "just in case." I know that is an annoying reason, but that's the truth.

    I also chose to birth at a hospital one hour away from my home even though I have FOUR within ten minutes because there was a practice of midwives that supported my desire to have a natural birth. I had my dream birth, even though it was in a hospital. Once I was moved to the labor/delivery room I had no monitors, no lights, I labored in the tub in the dark like I wanted. No one touched me except my husband. I felt very at ease because I did not have to worry about the "just in case." My labor was 4.5 hours!

    Now there was a nurse who was trying to direct me during pushing, but when she realized I wasn't listening to her, she stopped trying to count for me. I think I was one of those rare women who did not feel the urge to push at all. I never had that "rest and be thankful" part either. My birth was very no-nonsense and simple.

    My husband does not feel comfortable with the home birth idea, even though I really want one now. We're still working on that! All I can say is I refuse to give birth in any other hospital other than the one I already went to. I know that my hospital experience is probably rare, so I am thankful that there is a place like that in my area.

    Congrats on your last birth for certification, btw!

  2. I chose a home birth because I've never felt very comfortable in hospitals (although now being a doula, I'm becoming much more comfortable there!!) Personally, I just want to labour in my own room and my own tub. I want things to be quiet and I want to control the temperature. I want to be able to moan and grunt really loudly without feeling inhibited. And I definitely wanted to avoid interventions, which was much easier to do (I couldn't ask for the epidural, because there wasn't one!!) I had a beautiful home birth, and I would do the same again. However, I do understand when women want to have a hospital birth, especially when they feel nervous/scared. If being at the hospital will lessen their anxiety, then that will go a long way in helping their birth be a positive experience

  3. Amen, Antrho Doula!

    I would argue, like Michel Odent (or at least I think it was Odent), that women should have their first birth at home. After they realize the power that they possess in the birth process, they can go to the hospital for their subsequent births. After that first, empowering birth experience, no hospital will tell them how to labor and birth their babies because they already will know that they can.

    Plus, at home you can eat- and I love to eat =)

  4. I don't think that you need to stay out of the hospital to have a natural birth. I had two natural births at two different hospitals and they were both wonderful experiences. With my first it was 12 hours of labor and 2 hours of pushing. Some of the pushing was done upright, but I was so tired after no sleep that I ended up in the bed. With my second it was a very short labor and I gave birth with the use of a birth stool that my doula brought along. I had a wonderful midwife who let me do everything and anything that I wanted and a wonderful nurse who crawled around me on the floor to get a short check on the baby's heart half way through labor while I was on the birth ball. I did not once touch the bed with this birth after the initial monitoring. I pushed when I felt the urge and my cervix was only checked once when I got to the hospital. I did not have a home birth either time because my husband was not comfortable with the idea and I do not regret for one moment the decision to birth the way I did because I would not have had the wonderful midwives that I had attend each of my births.
    That being said, there are hospitals that I would not step foot in, even if I were really sick. Having a natural hospital birth requires a lot of research and preparation. The most important thing is to have a truly supportive care provider.

  5. I absolutely LOVE hearing about these positive hospital birth experiences! Thank you for sharing! It gives me hope for the move for women-centered and positive, healthy birth experiences is working and making a positive difference in people's lives.

    I agree, if a woman feels that being in a hospital will lessen their anxiety, then that is definitely where they should be. I am all about making it each individual woman's ideal birth experience. Their birth is THEIRS, not mine. I am simply reflecting on why I think I would not want to be in a hospital!

    I definitely think that a good natural birth experience (like those described here in the comments) in a hospital is rare.
    As Alexa wrote, you definitely have to do your research and get lucky to have a hospital in your area that will allow you to labor like you're at home!

  6. I ended up in a c-section with my first because of many of the reasons you stated above and because they induced me at 38.5 weeks due to "big baby." He was 8lbs 9oz and 21.5".

    Anyway, as my husband and I come towards our time to TTC #2, we are opting for a nurse midwife that delivers at a baby-friendly hospital, has birthing tubs and has a high VBAC rate.

    Because I don't know for sure if my c-section was completely unnecessary, and will never know because it happened how it did, I feel more comfortable in a hospital setting this time around. If we go for #3 in the future and this next birth is a glorious VBAC, then I'll consider a birthing center or home birth.

  7. Directed pushing is the thing that drives me craziest. We will do so well with movement and managing active labor and then as soon as she starts needing to push, the doctor gets her flat on her back and once even told me "It's impossible to have a baby without directed pushing," the whole time my client is begging to be allowed to breathe and grunt. (And I whispered to her to do whatever the heck she wanted.) It makes me absolutely furious.


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