The decision is yours and your husband's to make, after researching your options and praying for God's guidance. A doula can be helpful in each birthing location. As you research your options, ask your doula to help you gather information, so that you can make an informed decision.
Here is an excellent annotated bibliography of a variety of resources having to do with this issue. The selection here leans toward the pro-home birth position, but the resources themselves are not overly biased. And if you want an easy-to-assimilate article about this decision, you can read this one. And for an eloquent and convincing apologetic for homebirth, spend a few minutes with this essay.
Thank you so much to my dear friend Michal for writing out her experiences with both kinds of births.
MY HOME BIRTH
When I learned I was pregnant with my first son, I was in South Africa. My husband Ben and I were there working with orphans for five months on a short-term mission trip. I had previously had two miscarriages, so I waited nervously to see if I would carry our new baby past the first trimester. I considered going to a doctor while we were there, but knew that there was little a doctor can do to prevent miscarriage, so I decided to wait.
By the time we returned to the United States, I was four and a half months pregnant, and so happy to be home. I began looking around to find a health care provider. I didn’t limit my search to OB/GYNs. I am one of five siblings and my mother gave birth to three of us at home. I knew that she preferred a homebirth to a hospital birth, and I felt certain that I would, too. A home birth would provide more comfort and privacy, I knew. I could labor, deliver the baby, and recover in one place. There would be no strangers walking in and out of my room. I could sleep in my own bed and settle the new baby immediately in his. Despite popular belief, a home birth is very safe for low-risk pregnancies and deliveries. The rate of infection in the mother is lower than in a hospital. Medical intervention is less likely to be needed.
I knew that a midwife would be my best choice of birth attendant for a home birth. I learned that the state of Indiana recognizes only one of two types of legitimate midwife certifications. The “Certified Nurse Midwife (CNM)” can legally practice medicine and deliver babies in Indiana. However, the “Certified Midwife (CM)” can be prosecuted for “practicing medicine” by attending a birth in Indiana. There is a CNM in this area, unfortunately she will not attend home births. I had, in fact, been present at a friend’s birth attended by this CNM. As far as I could see, she worked the same way most OB/GYNs work. She walked into the hospital room at the last possible moment, just in time to catch the baby and leave again. I knew I wanted someone who would be there for more of the labor, who would take the time to get to know Ben and me during the pregnancy, and be more involved and attuned to our needs and preferences during both the pregnancy and the labor.
I found a CM named Mary Helen Ayres who serves the Bloomington area and set up a meeting. She met with Ben and me, and we immediately decided soon after that she would be the perfect fit. She was very professional, yet loving. She answered all our questions perfectly. If we needed transport to the hospital, she had a plan. She was very knowledgeable and experienced. She wasn’t dogmatic about natural birth or natural remedies. She had an OB/GYN that worked with her by seeing her clients twice during their pregnancy so that if anything went wrong, he would be familiar with their medical history and be ready at the hospital to take over. She was exactly what we were looking for.
Every remaining month of my pregnancy, Mary Helen came to my house for a pre-natal visit. She monitored my health carefully, and made sure everything was progressing well. She answered all my questions, and Ben’s questions too. She made sure to get to know my mother, who would also be attending the birth. She made sure I was comfortable with her assistant who would be there, as well. She treated my pregnancy as a blessing and not a condition.
The night I went into labor, I called my mom and Mary Helen to let them know. It was a Sunday evening, and I told them I would call them again when things were really progressing, because I didn't need them yet. Mary Helen was attending another birth of an Amish woman a couple hours away, but she thought she would be finished there soon. Ben and I went to bed and got some sleep. I woke after about four hours when the contractions became too intense for me to sleep through them. Then I read a book in the early morning, pausing as each contraction came and went. When things really started to pick up, I woke Ben up and asked him to get me something to eat. Then we called my mom and Mary Helen to ask them to come. My mom got there soon, but Mary Helen had to call her back-up midwife and send her in our direction because the Amish woman had not given birth yet. By the time I was told this, I was far along enough during labor that I couldn’t give it too much thought, and consequently, I didn’t have time or energy to be severely disappointed.
When my mom arrived, labor was growing very intense and I remember hearing her call the mid-wife to tell her I was in transition. I thought, “Thank God!” I vomited on our couch and was very upset with myself, and soon afterward I moved into my bedroom. When the midwife arrived, she got everything ready then checked me. She said I was 9cm dilated and almost ready to push. I started to push soon afterward. Then someone asked if I needed to use the toilet. I made my way to the bathroom and continued to push on the toilet for a couple minutes. Ben was behind me, supporting my weight, and I actually gave birth on our bathroom floor. Oops.
Someone asked me if I could get back to the bed, and I thought, No, I can’t, but I stood up to go anyway. I passed out immediately, but my dear sister-in-law who had come too caught me. I woke up on the floor of my bedroom. The mid-wife stitched me up since I had torn. I was very nauseous and lightheaded, and the mid-wife asked if I would like to have an IV. I said no, because I thought I would feel better pretty quickly. Looking back, I wish I had taken the IV. I ended up being in bed for the next four hours. I couldn’t move without feeling sick, and every time I tried to drink anything, I was afraid I would vomit again. My mom had to keep coaxing me to sip juice, and I was exhausted. I think if I had just taken the IV, I would have felt better much sooner.
My family all came to see the new baby that afternoon. Daniel was surrounded by his grandparents, aunts and uncles, and I was able to sleep in my own bed, eat my own food, and enjoy uninterrupted sleep and privacy.
MY HOSPITAL BIRTH
When I became pregnant with my second son, Ben and I were getting ready to buy our first house. We would move in the beginning of August and I was due at the end of September. We knew that buying the home and moving would take most of our time and energy that summer, and we opted for a hospital birth for several reasons. We didn’t know what condition our home would be in by the end of September, but we had lots of “projects”. I didn’t want to give birth in a house that didn’t feel like a home, especially if we weren’t completely unpacked and if I didn’t know where everything was. Money also played into the decision. I knew that if I gave birth at the hospital, it would be all-expenses-paid because I was eligible for Medicaid. I was pretty laid-back about the decision to give birth in the hospital. I felt more comfortable and confident this time around, knowing what to expect. Ben was much more nervous about switching venues. Now that we had done a home birth, and that was what he was familiar with, he wasn’t sure he wanted to switch things up. Once we made up our minds, I actually did grow quite nervous about having a hospital birth. Hospitals, doctors, and nurses make me nervous in general, and I was afraid that would have a negative affect on my ability to focus and labor. I was also nervous that I might be made to do things I didn’t want to do, like stay in bed during contractions or that the nurses would interfere. But we stuck with our decision.
It was easy to choose my OB/GYN. I chose the same doctor who had been my “back-up” during Daniel’s birth—John Labban. He is very accepting of home birth and I knew he wouldn’t have a “raised eyebrows” attitude towards me for my first birth. I also knew he would be very favorable of doing everything the natural way, as far as that was possible. He also came very highly recommended from other mothers I knew—Anne Wegener, Barbara Lehr, Kyla Curell, and my own sister-in-law Heidi Bayly, among others. He also is pro-life and seems to understand the sanctity of human life better than other doctors in town. He apparently could tell that I was nervous about having a hospital birth, because he did everything he could to make me comfortable with the idea. After a few pre-natal visits, he said I seemed much more relaxed about him and the process.
My second pregnancy was very uneventful. During the second trimester, I was looking at houses, houses, and more houses. During the third trimester, we were mostly focused on moving and making some improvements and repairs to our new home. I worked so hard during that third trimester, packing, sanding floors on my hands and knees, washing down walls, unpacking, chasing Daniel, painting, unpacking some more… When I went into labor, I was eating dinner at my sister’s house. I told her that I was having contractions that seemed to be at regular intervals, so she started watching the clock for me. When I determined that I really was in labor, we made a plan for the evening. Our church had an ice cream social planned and Ben and I usually taught a class that night for elementary-age boys. Ben went ahead to church, I went home and got everything I needed, and we all met back up at church. Labor was not intense yet, so we waited until events at church were over to go to the hospital.
We probably checked into the hospital around 11 pm, and I met my attending nurse, Cynthia Ray. She was young and laid-back, and extremely accommodating. I took a liking to her immediately. She didn’t boss me around, and she took everything I said and did in stride. The first nurse had been taken aback by the fact that I didn’t want to change into a hospital gown. Cynthia thought it was just fine that I didn’t want to stay hooked up to the monitor. She was a complete answer to prayer.
Labor was normal. I napped for a little while, watched part of a movie, snacked, spent a bit of time in the whirlpool bathtub, and then got down to business. Dr. Labban arrived and delivered Zion in the early morning. Dr. Labban was exactly what I had hoped for, too. He was calm and laid-back, even scolding the nurses for turning bright lights on that were “unnecessary” and for getting in Ben’s way.
Everything went more smoothly this time around. I didn’t vomit, I didn’t pass out, and I didn’t stay nauseous and dizzy after the delivery. I tore again, but my recovery was not nearly as difficult.
Comparing my first birth at home with my second birth at the hospital, I can say that there are aspects that I liked about each one. Whether you give birth at home or in the hospital there are some things that you cannot plan or anticipate. Both an OB/GYN and a mid-wife can be busy attending another birth when the time comes for your delivery. One of the main reasons Ben and I had chosen to go with a homebirth and a mid-wife was so that Daniel’s birth would be attended by someone we knew well, and who knew us well, and who would be there to reassure us for more than just the delivery, but would be present for the labor as well. It didn’t work out this way, but there is nothing we or our midwife could have done to prevent that.
Here’s what I liked about having a homebirth. There really is something beautiful about giving birth at home, surrounded by familiar people (family, that is!) and familiar things, attended by someone who is trained to welcome new life and spends her days dealing in health and not sickness. I liked not having perfect strangers walking in and out of the room, checking computers and seeing my in my most vulnerable and humiliating moments (though the midwife ended up being a perfect stranger, anyway). Ben liked being able to take a very active role in the delivery. I liked being able to sleep in my own bed, and not having to transport to the hospital during labor or back home a day later. I liked eating my own food that I had prepared and frozen several weeks in advance. I liked that I had all comfort measures that I knew I would want on hand, and access to my own refrigerator and freezer. I loved the fact that my mid-wife came to me in my own house, both before and after the birth. I didn’t have to leave the house for Daniel’s first check-up, or for my post-partum examination. That was wonderful.
Here’s what I didn’t like: the mid-wife and my mother did most of the clean-up and laundry for me right after the delivery, but there was still some clean-up that needed to be done later, and I didn’t wait as long as I should have to do it. I wish that after I refused the IV initially, I had continued to have as easy access to it so I could change my mind and have it immediately. The midwife had gone home and had said she would come right back and give it to me if I changed my mind, but I didn’t have the presence of mind to ask that she be called back.
Here’s what I liked about the hospital birth. I had access to highly-trained medical professionals and medical equipment, just in case. I had no clean-up whatsoever. I was pleasantly surprised by the accommodation of both my doctor and nurse, but this is no guarantee in a hospital. Many people have very different experiences, and much of it depends on what doctor or nurse happens to be on shift. I had a bigger, nicer bath tub!
Here’s what I didn’t like: doctors and nurses that I didn’t know came in all day and night to check me, check the baby, check everything! It was annoying, and I missed the privacy of my own home. The hospital food is terrible, and the food I brought in a lunch box I couldn’t keep refrigerated and still have access to it. The bed was not very comfortable. I had to be transferred from a pre-delivery room to a post-delivery room, which again, was just a minor annoyance. I opted for early release from the hospital, but it still took the hospital staff HOURS to okay me to leave, even a day and a half after I delivered and I had warned them I wanted to leave early. Then, I had to wait and wait and wait for someone to bring me a wheelchair so I could leave the building. I literally was not allowed to leave without being wheeled out in a wheelchair, and it took forever! By the time this fiasco of leaving was over, I had definitely shed tears. I just wanted to go home and they wouldn’t let me. Then, I had to bring Zion back to his pediatrician’s office first thing the next morning for his first check-up, and to get blood samples. That was hard. I loved that my mid-wife did all this for us in our own home after Daniel’s birth.
These are just some of the pros and cons that I experienced in contrasting a home birth and a hospital birth in Bloomington, Indiana. I know that these would vary from person to person. Hardcore pain medications was not something I really cared to get for either of those deliveries (though I haven’t ruled it out for future deliveries), but obviously that’s something you only have access to in the hospital. For any birth where there is any indication that there could be complications, the hospital is the only place to go. It’s not worth gambling the life of your little one for a “natural experience.” But this is a summary of my experience, and I hope it will help any of you trying to consider both options.