Why We’ve Chosen a Birth Center

35 Weeks

With less than six weeks to wait until Alex’s due date, I’m beginning to anticipate the end of another (number 3) pregnancy journey. Not only do I continue to get comments like, “Any day now, ‘eh?” and “Someone’s about to pop!”, I am actually starting to FEEL the end nearing.

Alex feels strong and healthy! I’m not too uncomfortable, but I am having no problem recognizing the strain nearly 40 extra pounds causes my body. Overall, I feel GOOD. Pregnancy (and I suppose the first month postpartum) is the only time that being tired and a wee bit sore seems like no big deal.

Several of you have asked us recently for our reasons for making the choices we’ve made for this birth, specifically why we’ve chosen a birth center, so I’m going to take some time to answer.

I’m written before about how I feel about birth. I’ll admit I’m one of those who think it’s pretty awesome. You can read my “birth philosophy” series here:

Birth Philosophy Part 1: My beliefs about birth and our bodies.
Birth Philosophy Part 2: The implications of those beliefs.
Birth Philosophy Part 3: The application of those beliefs.

I also highly recommend reading “The Christian Woman’s Guide to Childbirth” and “Your Best Birth” for more.

Ok, so why a birth center birth?

Why not a homebirth? Or another hospital birth (I’ve had two without any augmentation or medication)?

Lessons from Aidan’s birth

Our first birth (Aidan) was set to be a birth center birth. We lived in a basement apartment (then moved to a studio apartment – smaller) in a state (MO) where homebirths were mostly illegal. I’d already done enough research to be a bit afraid of going to an OB if I didn’t need to, so we chose a birth center just over the state line (KS).

Unfortunately, that birth center had financial troubles and closed when I was just one week away from my due date! I found myself scrambling to choose another birth setting with the clock ticking. I spent a couple of days frantically consulting people online and over the phone. Thanks to Louise (who ended up being our doula with Cora), Dionna (of Code Name: Mama and TIME magazine fame), and Anita (A KS homebirth midwife), I was able to narrow down my options (which really weren’t many) and find an OB who would take me and hopefully be respectful of my birth plan.

It wasn’t ideal, but I was thankful that our new OB was so understandng and took me in on such short notice. Aidan’s labor and birth were uneventful – a little TOO much so, actually. I labored for 41 hours (steadily!) and by the end was so sleep deprived and exhausted that I had to lie on my back to push him out. The hospital staff never pushed me to get things moving and mostly left me alone.

At the hospital, a large part of me wanted to prove to them that “natural” birth is doable and good. I was hesitant to complain or make a scene about anything. I even agreed to being on the monitor 30min then off for 30. That was one of my biggest mistakes. It meant sitting for nearly half of my 16 hours there.

I was also completely unsure of what to really expect. There’s no way I could have known what each stage of labor feels like, despite my extensive reading. I wish I would have had someone (a midwife, a doula) there to encourage me along. I really think that I made labor longer than it needed to be by refusing to get too excited about it. I wanted to be stoic and “save my energy” till the end, but I know now that I could have used a bit more stimulation – especially considering the fact that my contractions were regular, labor never stalled, and I was in no serious pain (no back pain, etc).

In the end, Aidan was born with no problem – healthy as can be – and I *thought* I felt fine, just tired. When I still couldn’t stand without passing out after 24 hours, tired turned into something more serious. I opted for a blood transfusion after 3 days of not recovering on my own. It wasn’t the *amount* of blood that I lost, but my body’s inability to recover from the blood loss due to fatigue that did me in.

Cora’s birth

Not knowing if this would be a recurring problem, we decided to stick with the same OB the next time around. We switched to a different hospital that had more experience with women laboring without intervention because they had midwives on staff. We also hired a doula (Louise, that I mentioned above).

EVERYTHING was SO much better! I knew what to expect, I stayed active other than the nap I took (!!!), I delivered Cora upright (on my knees), and I felt SO good compared to the first time! We left at the 24 hour mark and other than some tenderness “down there” I didn’t feel like I’d had a baby!! Her labor was a total of 15 hours.

Still, there are a number of things that bothered me about our birth setting and how my labor was “handled”:

• Intake in the ER was very frantic. I was 7cm dilated and they acted like they’d never seen a laboring woman before!!
• They had a terrible time getting my IV (I opted for just a hep-lock, so no tubing) in – it took three (I think, I’m a little fuzzy on details) people trying. Keep in mind I’m nearing/in transition at this point, and they wanted me to sit STILL for the IV!
• They still wanted to get a 20-30 minute “baseline” of Cora’s heartrate using an external monitor even though I was practically ready to push!
• Then they wanted me to WAIT to push b/c my OB wasn’t there yet!!
• When he finally got there and gave me the ok to push, he wasn’t comfortable catching Cora in the position I’d chosen (upright on my knees). Thankfully he did it anyway.
• Because he wasn’t comfortable, he urged me to push her out quickly. I really wanted to wait and push with contractions. :(
• I hate feeling like I’m being watched by a hawk in the postpartum time. They check in so often it’s nerve-wracking!

To some of you, the things on this list might seem silly or negligible. I get that. But they are enough for me.

Why I prefer the midwifery model

Whether in the hospital or out, the midwifery model of care is my preference. Obviously if I used a midwife in a hospital I’d still have to deal with some, but not all, of the things I listed above. Here are my reasons for using a midwife OUT of the hospital setting:

• Shorter/no intake procedures.
• Individual care with the same professional throughout pregnancy.
• Longer prenatal appointments and continuous labor support (midwives generally have fewer clients at one time).
• Interventions kept to secondary/last resort.
• Possibility of having a water birth.
• No minimum required stay (in my case) as opposed to the hospital’s 24 (or more) hr rule.
• Fewer chances of acquiring antibiotic resistant infections and other icky-ness (technical terms!)
• Fewer people in and out of the room during/after labor (quiet and rest are so important for labor progressing and establish a good breastfeeding relationship).
• No pressure to have to go against the norm and be super-diligent about possible undesired interventions and treatments.
• Warmer, more comfortable environment.

Ok, so why not a homebirth???

I think homebirths are great. Healthy women with few risk factors should definitely consider homebirth as an option. And in fact, I see no difference in safety between homebirths and birth centers in most cases. I also believe that homebirths are often safer than hospital births.

So, I’m NOT going to a birth center to be “safer.” To be completely honest, we’ve chosen a birth center so that I don’t have to clean! :) Most homebirth midwives do a great job (from what I hear) at cleaning up after birth and helping you transition into life with your new little one, so it’s not really the afterwards mess that bothers me. It’s really that I don’t want to muster up the energy to get the house to a place where I feel good about birthing in it.

I also like the idea of being in my midwife’s domain – where she is most comfortable and has everything at her disposal. Really, our choice to use a birth center as opposed to birthing at home is completely a tiny matter of personal preference.

I think Rob still has a little mental block when he thinks about homebirth, but he logically understands there’s no big difference. Who knows, maybe baby #4? ;)

Pretty long winded for such a simple answer, ‘eh? Well, that’s me! :)

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