I Gave Birth at Home
One woman describes why she chose to give birth at home, and how she prepared for the event.
HERE in the United States one sometimes hears of a baby surprising his parents and being born, contrary to plan, somewhere other than in the hospital. But one seldom hears of parents planning it that way. We did, however. Why?
Although the question of finances entered into our decision, it was not a case of being so destitute that we couldn’t afford the services of a hospital. Nor was it a rash decision made in ignorance of the risks involved to mother and child, including possible complications at the time of birth.
Our decision, rather, was based on what to us was a balanced view of all the factors involved—first, the risks of childbirth, which we believe are not nearly so great as most people think, and, secondly, the value of hospital care, which we believe is also, in many instances, not nearly so great as most people think.
As a young girl I, like perhaps most people, believed a hospital to be a place in which the infirm are under careful, highly specialized surveillance. However, when I was nineteen I was employed as a nurse’s aide in a small community hospital in southern California.
True, modern hospitals have wonderful equipment available and skillful personnel ready to help patients in emergencies. But I was surprised to see how much of the care one receives and pays for is not of such a specialized nature. It seemed to me that many patients could have received similar care at home, with more love and for less money.
I remember the first day working in the hospital I was assigned to the labor and delivery rooms in obstetrics. I was taken to a woman in labor, and her progress was explained to me without so much as a “hello” to the patient. I remember thinking, ‘Here, at one of the most important occasions in her life, this woman has become a mere topic of disattached discussion.’ I introduced myself, and found her to be a very nice lady who, although in some physical discomfort, was very calm.
I asked her how many children she had. This was to be her seventh. She asked me the same. I told her that I was unmarried. She patted my hand and smiled as if to say, “Don’t worry; I’ll get you through this just fine.”
After a while she said that she was ready to deliver and asked me to call the nurse. I did so; but the nurse informed me that the doctor had checked her dilatation (the extent to which the mouth of the uterus was opened), and that it had not been sufficient for her to be delivering yet. So I, a teen-age virgin, hung up the phone and informed her that she was, indeed, not having her baby yet. However, baby number seven put forth his head a minute later. The doctor didn’t arrive until the birth was almost completed. And I must say that this also occurred in other cases I later witnessed.
I was often irritated by the rude arrogance of certain obstetricians whom I observed at close range in the delivery room. Lacking in human kindness and common courtesy they seldom spoke to mothers during delivery, and then only abruptly. “Scoot down.” “Put your legs up.” “Who’s the doctor here, me or you?” “Are you going to do as I say, or shall I leave?”
Of course, not all doctors are by nature so unfeeling and abrupt; many are compassionate. And I realize that some are overworked, and this is no doubt a contributing cause to their impatience. But, nevertheless, it hurt me to see their disregard of a patient’s wishes—like those of a woman who begged not to be given “gas,” pleading that in previous deliveries it had upset her stomach. Yet her wish was ignored without explanation or apology.
I was later shocked to read that a danger during delivery is that the mother, lying on her back in a stupor from the drugs, may suffocate in her own vomit and that the “gas” may contribute to this. Despite the fact that many medical authorities feel that excessive medication is hazardous, drugs are often routinely given to mothers to lessen their discomfort. I also read that these drugs cross the placenta and reach the baby, concentrating in the liver and the brain. One of every thirty-five American babies is significantly retarded, and I wonder how much of this harm is done by medical procedure in which unnecessary drugs and artificial practices, such as induced labor, are used.
I saw only one birth-related death in that hospital. It occurred due to an adverse reaction to the blood transfusion the mother had received. I noted that, in spite of the well-known risks involved in blood transfusions, many obstetricians prescribed them almost routinely after delivery. I cannot help wondering if that woman might not be alive today if she had been too poor to have her baby in the hospital.
I don’t doubt that some lives are saved in the maternity wards. But how many, really? And how does that number compare to the lives that are lost? In 1972, fifteen other countries in the world had lower infant mortality rates than the United States. In 1965 about 69 percent of the babies born in the Netherlands were born at home, yet the infant mortality rate was only 14.4 per 1,000 births. But, alas, in the U.S., where over 97 percent of the births took place in hospitals, the death rate was 24.7 per 1,000 births!
Skyrocketing Cost—A Consequence?
My mother was the first woman in all the generations of our family to give birth in a hospital. Now most persons seem to have forgotten that babies were ever born anywhere else. And as dependence upon hospitals has grown, so have the prices.
When I was born thirty-two years ago, my father paid $75 to the doctor and another $75 to the hospital for a ten-day stay for my mother and me in Los Angeles. Today in California a family may expect to pay from $620 to $1,500 or more for a normal pregnancy and birth!
Care of the Newborn
In the hospital where I worked the nursery was, for all practical purposes, under the charge of a nurse’s aide. Although she was an intelligent and kindly person, she had no more specialized training than many parents. The fact that she had several children of her own was considered to be her qualification for the job.
However, if that qualified her to take care of newborns, why doesn’t it qualify parents, grandparents, aunts and uncles to care for babies born into their own families? Who do you think will examine, kiss, hold, smell and look at your baby more—the delighted family, or a nurse’s aide who has many babies in her charge?
A case in point is the experience of a family in our hometown. The mother took her newborn home after the usual hospital stay. On the second day home the mother was worried. The child hadn’t had a bowel movement. She was taken to a doctor to be examined. He found that she had an abnormality. She couldn’t possibly have had a single bowel movement since birth, yet this had gone unnoticed during her four-day hospital stay. Don’t you think the mother would have noticed such a thing sooner if she had been caring for her newborn at home from the very start?
Also, many doctors admit that the hospital regimen is not conducive to successful breast-feeding. The breast needs the frequent stimulation of a sucking child to establish a good milk supply, yet in many hospitals the mother is discouraged from breast-feeding, sometimes not even being allowed to suckle her child for as long as the first eighteen hours after birth. Even after the hospital-born baby is finally brought to the mother, it is usually only briefly and at strictly kept intervals.
So there were a number of reasons why my husband and I decided that our third child should be born at home. We realize that others may have had different experiences, and so will not agree with our decision. Our purpose isn’t to recommend home birth for others, especially for women bearing their first child since this is generally a more difficult delivery. However, after careful consideration, we felt that, at least for us, the advantages of home birth outweighed the possible disadvantages. So we went ahead with preparations.
I fully appreciate the value of a mother’s receiving special care before the birth of her baby. Complications can occur—a woman may not have a large enough opening for a normal birth, or a breech birth may occur, in which the baby is not delivered in the usual head-first position, or a woman may have a multiple birth. In the past, such conditions or circumstances often resulted in deaths, but modern medical techniques now save many of these babies. So I checked with a doctor in advance, and found that all indications were that mine would be a normal birth.
I desired to have a professional midwife attend me. But in California professional midwifery is illegal; only a licensed physician may charge for his services. However, the authorities with whom I discussed the matter, including a person on the district attorney’s staff, said that a woman may have anyone aid her just as long as there is no fee involved. So I arranged for a friend to serve as “midwife.”
I must say, I’m often surprised at how little knowledge of the birth process many women have, including those who have given birth under heavy sedation. They ask, “Who made the baby breathe?” “Did you have to massage his heart?” “How did you know what to do?” “Weren’t you afraid of making some serious mistake?” “What is the umbilical cord connected to?” “How did you tie it and cut it?” “What equipment do you need to give birth at home?”
In these days when the attitude toward so many institutions long taken for granted is changing, perhaps it would be good for married women of child-bearing age to inform themselves on the subject of birth. They might do well to review in their minds what they would do if they should find themselves, either by choice or by inadvertent circumstances, giving birth outside a hospital.
What is needed to give birth at home? First, a clean place to squat, or lie down if preferred. It can be as simple as that. What special instructions are needed? Actually the great Giver of life has seen to all the important details, leaving only the very obvious to the mother’s instinct and intelligence. During labor and birth the mother does what the body compels her to do to bear her child, and that turns out to be the right thing.
To make matters more convenient and sanitary, I went about making certain simple preparations. We planned that I should give birth on my mother’s sewing table. So I purchased a couple of large plastic drop cloths at a paint store to protect it from moisture. I also washed some old sheets and towels. After they dried, I sealed them in a brown paper sack and I baked them for several hours in the oven at a low heat. The sheets were to squat upon, and the towels were to be used as needed. The terrible cases of maternal infections in the past were not generally contracted by mothers giving birth at home, but were due to medical personnel passing on these infections when they attended the mothers in hospitals.
I next purchased at a drugstore a rubber-tipped ear syringe for clearing mucus from the baby’s nose, if needed. I boiled it in water along with a pair of scissors for cutting the umbilical cord. Then I dropped each into a plastic “baggie” and sealed it up. In addition, I baked in the oven a package of white hem-binding tape, purchased at a sewing supply center. This was for tying the cord. Also, I bought a good supply of large sanitary napkins and, of course, packed some clothes for the baby.
Realizing that it is good to be aware of potential complications, we reviewed what we would do in an emergency. If labor didn’t progress normally, we would go to the hospital. It isn’t far from my parents’ house, which is why we chose to have the birth there. Also, I would go to the hospital if, after giving birth, the uterus should fail to firm up; it should draw into a hard knot after delivery to stop the bleeding.
If the baby should seem to have an obstruction in his throat at birth, we would clear it out with a finger. This isn’t so difficult; parents must sometimes do this with older children when they get something lodged in their throat. If the baby should be slow to breathe, we’d hold him upside down, or give him mouth-to-mouth resuscitation. This is something all parents should be prepared to do, for even toddlers are in danger of choking, or drowning or being electrocuted, which are all situations that could require artificial resuscitation.
My labor began on a Monday evening. It was helpful to me to have learned beforehand basically what is happening during its various stages. The explanation most helpful to me described the uterus, or womb, as a rubber bottle with the mouth, or opening, that is held tightly closed by a set of muscles that work something like drawstrings. Early in labor the woman feels intermittent contractions, or squeezings, of the uterus, at intervals of about twenty or thirty minutes. They last about forty seconds. If she puts her hand on her abdomen, she feels a hard mass rise and then become soft again as the contraction subsides. This mass is her uterus, a huge muscle, which holds her baby.
As labor progresses, the contractions become more frequent and more intense. The uterus squeezes until the pressure forces open the ‘drawstring’ muscles that have held it closed during the pregnancy. This gradual opening of the cervix, which can be compared to the mouth of the bottle, is known as “dilatation.” This constitutes the first stage of labor. It all takes place involuntarily, without any help or attention from the mother.
Finally, toward the end of the first stage of labor when dilatation is complete, the contractions become so hard and frequent that a woman finds it difficult to think about anything else. I measure the progress of labor, not by the increasing frequency of the contractions, but by my own ability to concentrate. When I can no longer concentrate on any other matter, then I know that it is time to turn my attention to having the baby. This begins the second stage of labor.
It was early Tuesday morning that I realized that the time to give birth had drawn close. So, leaving our children with their aunt, my husband and I drove to my parents’ apartment.
As my parents and husband sat around in housecoats and slippers, I paced the floor. To me pacing is the most natural behavior during labor. It seems to aid the body in its downward pushing efforts. Also, it serves as a distraction from the discomfort. Singing aloud, too, helped distract me from the discomfort, and I also found it helped me to keep my breathing from becoming tense.
During the second stage of labor, the uterus, which now has its mouth wide open, begins to act as a mighty piston. It pushes the baby’s head against the narrow, bony passage of the pelvis. Yes, labor is well named. No matter what the “mean-wellers” try to tell expectant mothers, it is very unpleasant.
The contractions are ruthless in their efforts to push the baby into and through the birth canal. The sensation of the head lodging ever deeper into the pelvis is very disconcerting. Yet nothing is gained by trying to resist the force. In the hospital I occasionally saw women stiffen their bodies and try to stop the force of the contractions. They were soon hysterical from the frustration.
As the head lodges in the pelvis, the woman feels the urge to “bear down” or “push.” She should go along with this urge, though at the time of delivery it is wise to let up on the pushing, since too explosive a delivery can result in vaginal tears. My instinct was to lock my breath for a moment at the peak of the contractions and push, as one does when pushing a heavy object, such as a car. This aids the uterus in its efforts, and makes the force of the contractions much easier to bear.
It seemed natural to me during these hard contractions to stop my pacing, spread my feet in a wide stance, drop into a sort of squat, and then, excuse the expression, to grunt. This might seem a little crude to a prissy person, but this is a good time to forget the childish ideas as to what constitutes feminine behavior. After all, what’s more distinctively feminine than giving birth?
Here in my parents’ front room I paced, squatted, and grunted. The familiar faces and their voices and smiles were comforting to me. This seemed a good, natural atmosphere in which to receive a new family member.
When the bag of waters broke (the sack containing the amniotic fluid), I knew from previous experience that the baby was only a few grunts away. I covered my feet with clean knee socks, and my husband helped me up onto the sewing table. The table was spread with clean sheets.
I’d decided to squat on the table rather than on the floor, so as to be easily observed and aided. It seems instinctive to seek aid and comfort during this experience, but there was really no point during the birth at which I couldn’t have cared for matters successfully without help.
During the delivery of my first two children I paced as long as the doctor allowed, and then reluctantly lay down on the delivery table just before the actual birth. I was glad that this time I would give birth in the position comfortable to me instead of the position convenient to a doctor. As it turned out I delivered in a half-standing and half-squatting position. I believe that a deeper squat would have been even more accommodating to the birth if I’d had something on which to support myself in such a position. I remembered that the Hebrew women assisted by midwives were supported on some kind of birth stool, and I can really see the advantage of such a support.—Ex. 1:16-19.
The woman friend who had agreed to serve as midwife had not yet arrived. So my mother and father stood behind me, one on each side of the table, and held out their hands across the table to receive their third grandchild—a boy. He began crying before his body was completely born. It was 4:15 a.m. as I peeked over my shoulder to see my new baby, Paul.
The umbilical cord connected to little Paul’s belly was still attached at the other end to the placenta, which was still inside me. The placenta is that marvelous organ by means of which the unborn baby breathes, gives off wastes and is able to perform other functions necessary to life. For several minutes the cord was black and full of blood. But, as my mother continued to hold Paul beneath my body, the blood drained into its rightful little owner. The cord then collapsed into a white piece of lifeless skin. It now, obviously, was time to cut it.
By this time the originally intended midwife had arrived, and she tied the cord in two places a few inches from Paul’s body, and then cut between the two ties. There appeared to be no danger of bleeding with or without the ties. In a few days the remains of the cord dried up and fell off.
Soon Daddy and Granddad were giving Paul his first bath in the kitchen, cleaning him with olive oil. He soon smelled like an Italian delicatessen. We had borrowed a pair of baby scales for the occasion. A baby can certainly survive without being weighed at birth, but it makes registration a little simpler, since many states wish to record the birth weight. By now the entire family was in the kitchen inspecting Paul, and so I found myself standing alone in the sewing room awaiting the final stage of labor.
After about fifteen minutes I expelled the placenta, the final stage of giving birth. We examined it to see if it appeared to be smooth, showing no signs of damage. A piece of placenta left in the uterus can later cause hemorrhaging. We disposed of it in a plastic sack that was put into the trash can.
I now felt, for the first time since the onset of hard labor, like lying down. My friend, who was knowledgeable about such matters, examined me for vaginal tearing. I had planned to go to the hospital outpatient treatment center for stitches if any had been necessary. My mother and friend helped me to change into a clean gown and outfitted me with sanitary napkins. I then stepped off the sewing table and walked to my parents’ bedroom, where a warm bed awaited me.
Paul, who was now dressed and blanketed, was brought in and put to my breast. We were amused by his eagerness and obvious enjoyment of his first meal outside the womb. His presence was comforting to me, as was the knowledge that his sucking action was causing the uterus to contract, thereby closing off severed vessels to protect me from excessive bleeding. Also, it interested me to read New York obstetrician Irwin Chabon’s recent comments in Today’s Health: “The uterus of the woman who nurses her baby returns to its pre-pregnant size, whereas the uterus of the woman who does not nurse always remains somewhat larger than it was before she became pregnant.”
Soon Paul was asleep, and we all found ourselves sitting around the table eating breakfast and musing over the events of the morning. We all felt a little closer, and we gave thanks to Jehovah God for the safe arrival of our new member of the family.
In conclusion, I would like to emphasize that I do not necessarily recommend that every mother give birth at home, especially women who are having their first child. Also, I want to stress the value of examination of pregnant women by trained medical personnel wherever this is possible. This is because such persons are often able to diagnose possible complications that may be encountered at the time of birth. Yet, at the same time, I personally believe that if a woman is properly informed and aided by a trained person, she can enjoy giving birth at home, even as I did.—Contributed.