My Dilemma

My daughter turned two just before Christmas, and I can just feel it. Everyone is waiting for another big announcement.

It's true that my husband and I are starting to think about number two. But ideally, before I get pregnant again, I'd like to know where and with whom I plan to give birth.

With my first pregnancy, it was a given. We chose OB's for our prenatal care and gave birth in a hospital--any other type of birth was just not on the radar. I used the nine months of my pregnancy to get informed about birth, and decided I wanted a natural birth for a slew of reasons... but I really didn't know a lot! I had no idea that the c-section rate for our country (and my chosen hospital) was over 30%. I didn't know what pitocin was. And I thought doulas were for women who weren't confident in their husbands ability to support them in labor.

Against all odds, I was blessed with an amazing birth experience in the hospital, in spite of its routine procedures and distractions. My labor started spontaneously at 38 weeks on the nose, and I was able to stay at home until I was 7cm dilated, enabling me to have a truly intervention-free birth!

Since becomming a doula, though, I have realized many sad realities of the way birth is treated in our country--both through reading books and from firsthand experience as a doula. So despite my great experience in the hospital the first time around, I am plagued with the knowledge of what could happen should things not go as smoothly for me as they did the first time.

I've thought and thought about my options (and regretted the lack thereof), and I just cannot decide. Some days (usually after attending a hospital birth) I think, "No way. I am not doing that again." Other days, I feel like homebirth is just not worth the hassle.

So I thought it'd be helpful to write out a list of pros and cons. Here they are:

Hospital Birth.

Pros:

  • I've done it once and had a great experience. I could probably do it again.
  • I really do like my OB's, in spite of the way they sometimes practice.
  • The hospital is equipped with a level 2 nursery should my baby need immediate medical attention.
  • Both my doctor's office and the hospital are a mere 3-minute drive from my front door.
  • Insurance would undoubtedly cover our expenses.
  • Maid service.
  • Room service.

Cons:

  • One in three pregnant women who walks into our hospital walks out with a scar on her stomach. C-sections have many risks, the greatest of which is maternal death (which is why our nation's maternal mortality rate is shockingly high).
  • Pitocin (which is not even approved by the FDA for non-medical induction NOR have any studies been published on its long-term affects on mom or baby) is given without a second thought to a large majority of laboring women.
  • Because I will probably be diagnosed with gestational diabetes again, the doctors will threaten induction at 38 or 39 weeks. Now I know that I can refuse to be induced, (and I believe that in most cases induction is more risky than waiting for labor to begin on its own). But I've seen how much stress is caused by women butting heads with their doctors at the end of pregnancy. It can be so so stressful and terribly unhealthy.
  • If my water breaks before labor begins, I will be on the clock. (They say a woman has 24 hours to deliver after her water has broken because of "risk of infection.") What she usually doesn't know is that if she is at home, and there are no doctors sticking their fingers up her vagina, the risk of infection is next to nothing. AND labor almost always starts up naturally within 48 hours.
  • I will be cared for under the medical model of care as opposed to the midwifery model of care.

Homebirth.

Pros:

  • My primary caregiver will be a midwife. This in itself is a very enticing factor.
  • I will be cared for under the midwifery model of care as opposed to the medical model of care
  • Statistically, planned homebirths are just as safe for babies, and are actually safer for moms.
  • Countries where homebirth is normal and common have WAY better outcomes than we do in the United States.
  • I will be able to spend my entire labor in the comfort of my home.
  • Family members (my mom & my sister) will be able to be a huge support and help to me during my labor.
  • I could labor and/or give birth in a tub.
  • I will be in my own clothes.
  • I will be able to eat and drink freely.
  • My daughter could be involved with the birth, depending on the time of day.

Cons:

  • Having to deal with the hassle of well-meaning albeit ill-informed friends and family members.
  • If my baby needs intense and immediate medical care, I won't be at a hospital. (Although midwives are equipped to deal with most medical emergencies and our hospital is a mere three minutes away).
  • The closest legal midwife is about an hour away. That means driving an hour for each prenatal visit, and risking that she may not make it in time if I have a quick labor (which I likely will).
  • The closest "underground" midwife (that I know of) is about 30 minutes away. If I choose her, our chances of insurance covering the birth are slim to none. Plus my husband is uneasy about hiring an underground midwife (despite the fact that these midwives are legal in over half of the 50 states).

So there you have it. Honestly, I'm not 100% comfortable with either option, and ideally would choose a birth center for our next birth if it were an option. (The closest one is in Oak Park--an hour away, depending on traffic). There, I would be cared for by midwives in a home-like setting, in a facility that would be able to handle any unforseen medical emergencies. Another option would be seeing an OB in Sandwich (30 minutes away) who is not quite as intervention-happy as the OB's here in DeKalb, and would truly support me in my desires for a natural birth. (The C-section rate at his hospital is 24%). I could also see midwives who practice at a hospital in Aurora.

Aargh. I hate having to make this decision. I guess I'll do a little more reading and interview a few more midwives and that OB from Sandwich, and trust that my path will be made clear. There's really no rush to make a decision... at least not for now :)