Risked Out

A few months ago I posted the home birth story of my friend, R. She is now weeks away from the birth of her third child and was planning a home birth. The birth kit had been ordered; arrangements were being made. But in the background, other things were happening.

Before R got pregnant, she had been diagnosed with an infection of some kind, which meant her platelets were low and she developed thrombocytopenia. Despite this, her doctor gave her the all-clear to become pregnant. This bleeding disorder means that if R had problems during labor, she could essentially bleed out. She has tried everything, to little avail. She finally emailed me and said her midwife, who sounds very caring and supportive, has officially risked her out of a home birth.

I told her I thought it was the best decision, under the circumstances, to have a hospital birth. In her situation, it was best to know ahead of time and not be faced with it for the first time while in labor. Her care so far, from her description, under both her OB and her midwife, has sounded thorough and excellent (contrary to the belief that midwives can't provide more than adequate care during pregnancy). Her midwife has agreed to also act as her doula and accompany her to the hospital.

While it's a tremendously emotional, difficult decision to make, I think R and her midwife were very wise to do so. I remember being faced with similar decisions in my last two pregnancies: attempt a VBAC or go with a repeat c-section? Proceed with the hopes for a vaginal birth even though the baby had turned and my blood pressure was up? It's a gamble we often have to take, and it does hurt when things are obviously not going to work out as planned.

I told R I wanted to highlight her situation on my blog if only to say, "Home birth mothers are not reckless; they do care about their babies!" Of course, we know that. But many people - including doctors - seem to think that people who desire home birth have an agenda; that they place the actual experience of giving birth over the importance of having a healthy baby. I think R, and many home birthing mothers, agree that you can achieve both. R has dealt with medical issues during her entire pregnancy, and none of what she decided to do was taken lightly. I get so irritated with people who have a certain stereotype of mothers who home birth - and chances are they, and the doctors who hold similar ideas, have never even attended a home birth to even know remotely what they're talking about.

Home birth has recently been a hot topic of debate in the media in the last few months, whether it's the snide, sneering comments about Gisele Bundchen's home waterbirth or the somewhat patronizing headline, "Should American women learn to give birth at home? " (When you click on the link, the headline is different on the page, almost like someone went back and changed it.) Learn? It almost sounds like society is asking itself, "Should we allow women in our culture to behave so stupidly?" not realizing that their own perceptions about care for the average, normal pregnancy and birth are defined by many outdated practices and ideas, shaping their thinking and creating a false idea that everything is inherently right, good and necessary because it comes from a doctor or hospital's standpoint.

What doctors, hospitals, the media and other critics of home birth fail to look at almost every time is why women are choosing to have one. Many like to just scratch the surface with things like unnecessary cesareans, Pitocin inductions and the basic idea that pregnant women are often treated like they're terminally ill instead of just having a baby. Many critics treat home birth and natural birth advocates as if they all disagree with interventions of any kind, when in fact, that's not true. (I haven't met anyone, ever, like this yet.) The idea of a pregnant woman being treated like a medical experiment or as if they are completely incapable of making decisions for themselves - and their unborn children - is nothing new and probably spans more than an entire century.

Therefore, when we understand that the roots of our maternity care system come from this standard of care, we will understand why many women choose home birth. We will understand why things like birth trauma matter, and why some women are even forced into a corner in order to avoid more trauma, which can lead them to make dangerous decisions in childbirth. Instead of demonizing them, however, we need to understand why they felt compelled to make the decision they did - and that sometimes, even though it's perceived as reckless, selfish or stupid it can still work out.