Monday: why we chose to plan a home birth. Yesterday: the birth story.
Peanut was born in Haarlem, in the
Netherlands; Pumpkin in Chicago, in the United States. Both have dual
citizenship. He's kind of fair, like his father. She's kind of dark,
like her mother. We're all perfectly balanced out in a silly story
book kind of way. I love that our dual-nationality family has one
child born in each country. We didn't plan it that way, but it
happened and it's nifty.
It means that we did a pregnancy in the
Netherlands and one in the United States. Can two countries be much
farther apart? The US has a C-Section rate approaching 35%. In the
Netherlands, most women go to a midwife unless they have a high-risk
pregnancy. Perhaps most importantly, these countries see each other
as opposite ends of the spectrum. In the US, a number of natural
birth advocates were thrilled to hear I had given birth in the
Netherlands. This is in part due to the fact that people like Ina May
Gaskin often refer to the Netherlands as the golden land of natural
child birth. In the Netherlands, people assume that birth in the US
is all epidurals and scheduled C-sections. Neither is entirely true,
and neither is entirely wrong. But the differences are far more
nuanced
When I was pregnant with Peanut, I went
to the local midwives. They took good care of me. It was a practice
with six ladies and they were all nice to talk to. My visits were
brief – they checked my blood pressure, felt the baby, measured my
belly, listened for a heart tone, asked me how things were going, and
sent me on my way. I met all but one of the women in the practice.
They were patient with my questions and concerns concerning the
birth. It was nice.
We elected to have a midwife assisted
hospital birth (in the Netherlands, if you are low risk, you can
choose whether you want a home birth or a hospital birth) and it was
fine. We had a large, well furnished room to ourselves. Everything
was there for the baby and husband to stay in the room. The room has
double doors (a door, a hall, a second door) for privacy. The
lighting was adjustable from low to operating room bright. There was
even a refrigerator (for champagne, of course).
During the birth, we were assigned one
nurse. She was the only person aside from our midwife who came into
the room. When her shift ended, the next nurse took over. We ended up
seeing an OB/Gyn at the very end because Peanut ended up being a
vacuum-assisted birth, but they way they transformed the room was
amazing – apparatus and people rolled in, Peanut was born, and
everything went away – all within about half an hour. We ended up
staying for 24 hours as a result, but we could all stay and sleep in
the room together.
All of this sounds and was lovely, but
I'm one of those women who want a natural birth. I was in the
hospital, so when we needed the doctor, it was easy. But it's not all
beautiful bellies and happy mamas over here. For instance, about half
of all home births (for first time mothers) end up in the hospital.
That usually means a transport to the hospital in a later stage of
labor. If you haven't been in a Dutch house lately – the stairs are
often as steep as ladders. Sometimes people are lowered out of
windows because a stretcher can't go up and down the stairs. Imagine
that.
Up until about three years ago, pain
relief in the form of an epidural was not guaranteed. If a laboring
woman requested pain relief outside of office hours (Monday through
Friday, 9-5), it was at the anesthesiologist's discretion. Why
interrupt a family meal or a good night sleep because some woman
can't manage her birth pain? This has changed, thank goodness. But
back when Peanut was born, I knew one woman who went home to Germany
for her birth because she was afraid of not being able to get pain
relief. There is a lot of support here for breastfeeding moms, but
I've also heard women refer to the breastfeeding mafia – the
pressure to breastfeed, whether you want to or not. Most women start,
but not many keep it up.
There's also an ongoing debate between
midwives and gynecologists over who should be in charge. Midwives
aren't always eager to take their laboring mothers to the hospital
and I've heard such transfers referred to as regrettable as opposed
to necessary. I think it has to do with payments and power, but I'm
not sure about the details there.
On the other hand, in the United
States, pregnancy and birth are basically in the hands of doctors.
This thanks in part to the insurance companies for reasons maybe
someone can explain to me because it makes no sense. There's a clear
(statistical) tendency towards more intervention and more pain
treatment. Women are the objects of a birth, not necessarily the
actors. In other words, birth is seen as something that happens to
women, not something that women do. Instead of a process, it is an
inconvenience between the rose-colored pregnancy and baby shower
stage and the rose-colored new mother stage (neither of which are
rose-colored, but the cupcakes might be).
If you decide that
you do want a midwife or a birth center, the resources are out there.
It takes more work on the mother-to-be's part (and partner), but it
is possible. If you decide on a home birth, you may have your fair
share of “what on earth are you thinking” conversations, as well.
It's making a statement to choose for a home birth. The advantage
here is that midwives who choose to offer their services to support
home births (at least the ones I met) are very dedicated to their
work, in part because their work is part cause.
So there are some
of my thoughts. I'm curious to know about what birth is like in other
countries or cultures. And how closely my observations match the
experiences of other mamas. Do tell!
Thanks for your balance, I usually stay out of birth discussions as both sides can get so militant. My three experiences in Australia have been really positive and I guess pretty broad. With one epidural delivery, one breech c-section and one all a bit too natural and rapid with no time for anything but a shower.
ReplyDeleteIn Aust we have a good public (free system) that offer birth centers through to c- sections. We also have a user pay private health insurance where you end up paying half and the insurance (which you also pay for) covers the rest. When you go privately you choose your Dr and see the same Dr once a month and weekly in the last month. In that time you have the opportunity to build a relationship and have lots of discussion. I used private with my first which was a great birth experience for a first baby and my Dr was a great non interventionalist. My second baby I had really wanted a mid wife delivery but when it showed baby was a footling breech and I would need a c - section I changed to private so I could plan it well in advance with a Dr who had a great C - section record. Third baby I also went private as I wanted a V-back with a really experienced, confident Dr.
In my experience the private system worked nest for me. I felt that we had a Dr who owned me and took responsibility for getting us the best possible outcome. My half a pregnancy, reltionshipless experience in the public system, seeing a different person every time was disappointing and made me feel like a number.
Gosh can't believe I had a birth rant, hope I made sence. For me I feel it's about choice - I feel we were able to make informed choices that best suited our needs and had a great people around us to make our choices happen so we are happy with our outcomes and wouldn't change a thing. (I do acknowledge that we were in a finacial potion to have so much choice. It is sad for birthing mums if choice is only for those who can pay.)
Thanks for the bought provoking post x.