Here’s part two (finally!) of why my husband and I have elected for me to birth our babies at home. If you’re new to this “series,” please catch up with part one of “Why I choose homebirth.” And as a refresher, please re-read the section in the middle about how I don’t care how you birth your baby. It’s really important.
I’m now at 39.3 weeks and still a-gestating. I’m at the point where my medium maternity shirts no longer fit, but there’s no way in God’s green earth I’m forking over another $12 to get a larger size. I’m also chubbing out. Big time. I call it getting “ripe.” I really want this sweet girl to show up before I tip two-hundie on the scale. I absolutely REFUSE to be the same weight as my husband, even if it’s only for a couple of days.
After quickly realizing how much money we would be spending on an out-of-pocket hospital birth with our first baby (we were making too much to be on Oregon Health Plan), I started researching homebirth and Portland-area midwives. I interviewed three midwifery practices — one licensed, direct-entry set of midwives, a pair of nurse-midwives who also attended homebirths and a naturopath.
After interviewing all three sets of practitioners, we settled on the pair of licensed, direct-entry midwives. I really felt comfortable with them (they were just a bit older than me), they displayed a great amount of confidence in their abilities as midwives and honestly, they were really normal, which is kind of a rare commodity in the Portland midwifery community (there I said it).
Here were (and still are) the main reasons we choose homebirth:
Cost: Yes, cost was major factor for us. If a hospital birth would have been cheaper out-of-pocket, we would have definitely elected to birth there, especially with our first baby. With subsequent babies though, I would have still chosen a homebirth even if a hospital birth would have been less with our health insurance. We went into homebirth for the cost, but really fell in love with the experience after that (if you can really “love” anything about birth).
Our first birth was $2000, which included all pre-natal appointments, our birthing class (taught by our midwives), the actual birth, and all post-natal and well-baby appointments for six weeks. We were also responsible for all lab work (probably $60 without insurance) and had to purchase the birthing kit (around $60).
Fast forward nine years and our midwife’s fee (same midwife) is now $3200 (discounted from $4000 for paying cash in full at the beginning — luckily we have an emergency fund that we used and have spent the last few months replenishing). I haven’t had any outside lab tests done with this birth and the birthing kit and related supplies was just under $100. We did pay $75 for a gender ultrasound at UltraSona Portland (a lovely place next to a fish market in SE Portland). My husband is still annoyed about this expense.
Since my health insurance deductible is $5000 (we have a lower-cost, high-deductible individual plan), homebirth is still the cheapest option for us. By far.
Expertise: From the beginning, I wanted a non-medicated birth. And if I was going to have a non-medicated birth, I wanted to select a location and a caregiver that lent itself the most to helping me achieve this. I knew that if I went to a hospital, it was very likely I would chose the drugs at some point. Seriously, who wouldn’t? I’m in incredible pain and someone’s offering me a needle to make it go away? Yeah, hook a sista up. So I figured it was best to remove that option altogether.
I also wanted a care provider that was an expert at normal, low-risk, non-medicated births. And midwives are just that — they are trained to help a woman deliver a baby without medical intervention. They are actually really, really good at it.
My first birth was a typical first birth in that it took a very long time. Like 40 hours long. And I had a difficult time pushing that little girl out. Not “scary” difficult, but just regular “this is my first time doing this and my mind and my body need to adjust” difficult. My midwives patiently and competently lead me through those four long hours of pushing.
Level of care: I didn’t realize this with my first baby, but midwifery and homebirths absolutely hit a home run when it comes to post-natal care. For six weeks (and longer if you need it), you have instant access to their services. I have post-natal appointments at one day, two days, one week, two weeks, four weeks and six weeks post-postpartum and the first four visits are at home, so no one needs to get in the car for almost a month.
In addition, a midwife also provides newborn care for the first six weeks (you can always elect to see a pediatrician or family doctor at any point) and provides all breastfeeding care. Having trouble making the nursing work? One phone call and my midwife would be at my house in a jiffy, day or night. And she won’t give up until the problem is solved. Because of this, almost every single homebirth mother is able to breastfeed for as long as she wishes.
PSA: We’re going to talk girl stuff, so fellas, you have been given fair warning.
With my first birth, my midwives and I decided together not to stitch a small stretching of my perineum (it wasn’t a “tear,” but what they call a rug burn, I think? Sounds grody to me). Well, I didn’t follow the instructions to “keep my legs together” well enough and ended up tearing two days after birth. Needless to say, the recovery was not pleasant.
Since repairing the tear with stitches would have required some “roughing up” of the wound (are you gagging yet?), I had to wait for my body to heal on its own. But you know what? My midwife was at my house day after day helping me fix the problem. Obviously, we both wished we would have just stitched the stupid thing in the first place, but she was with me the entire time.
Just for the record, me and my perineum are doing just fine now. Everything healed correctly within a few months.
Birthing Flexibility: I absolutely love that homebirth leaves most birth decisions up to the parents. Every single test available is optional. My midwife has a couple that she strongly suggests, but she doesn’t require them. I elect to do all the blood work, strep test thingy, and I am fine with Doppler monitoring during prenatal visits and labor, but we do not do the tests in the middle that indicate Down Syndrome and other things (I have absolutely no idea what the test is actually called). I also elect to skip the fasting gestational diabetes tests, as I have never had any symptoms of gestational diabetes.
I get to birth the way I want to as long as the baby and I are safe. I am not constrained by an IV hanging out of my arm or a fetal monitor strapped to my belly (my midwife regularly checks the baby’s heartbeat with a Doppler during labor and during every pushing contraction, which is really, really annoying). I can get in whatever position I want or that is suggested to me, though I usually don’t have many preferences during labor except to get this thing out of me. I have been able to birth all four of my babies in a birthing tub, which is really nice for pain control and post-birth clean-up.
I would love to answer some of you questions in the next post as well as fill in some of the interesting details of how homebirth actually works. So, let me have it! What have you always wanted to know about homebirth?
Yet another disclaimer: Please understand that the main reason I am posting all of this homebirth stuff is that I know some of you find it interesting. And I’m all about satisfying your curiosity. Also, I know there are some of you interested in having a homebirth yourself, but you don’t know anyone who has done it. I would love to be “that friend” who has gone before you, letting you in on the details, answering your questions and cheering you on with “You can really do this!”
Remember, no one has to defend their birthing choices in the comments. I think you are all totally rad :).
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