second baby but ultimately decided against it. While I don’t consider myself particularly squeamish, I just couldn’t imagine how we’d avoid making a mess all over the bedroom carpet. What really clinched it for us, though, was that our first child had been an emergency Cesarean section. Fearing that we might run into problems again, we opted to be near the doctors.
If you’re thinking about a home birth, be prepared. Having a baby at home is quite a bit different from the way it’s made out to be in those old westerns. You’ll need to assume much more responsibility for the whole process than if you were using a hospital. It takes a lot of research and preparation. At the very least, you’re going to need a lot more than clean towels and boiling water.
Making the decision to give birth at home does not mean that your partner can skip getting prenatal care or that the two of you should plan on delivering your baby alone. You’ll still need to be in close contact with a medical professional to ensure that the pregnancy is progressing normally, and you should make sure to have someone present at the birth who has plenty of experience with childbirth (no, not your sister or your mother-in-law, unless they happen to be qualified). So if you’re planning on going this route, start working on selecting a midwife right now.
Statistically, it’s pretty unlikely that you’ll go this route. But in case you’re considering it, I want to take you through some of the reasons people commonly give for wanting to have their baby at home, and some situations that would make a home birth unnecessarily risky.
Natural vs. Medicated Birth
In recent years giving birth “naturally”—without drugs, pain medication, or any medical intervention—has become all the rage. But just because it’s popular doesn’t mean it’s for everybody. Labor and delivery are going to be a painful experience—for both of you, although in different ways—and many couples elect to take advantage of the advances medical science has made in relieving the pain and discomfort of childbirth. Whichever way you go, make sure the decision is your partner’s. Proponents of some childbirth methods (see pages 159–63) are almost religiously committed to the idea of a drug-free delivery, to the extent that they often make women who opt for any pain medication feel as though they’re failures. Besides making a lot of new parents feel bad about themselves when they should be celebrating the birth of their baby, that militant attitude is simply out of touch with reality. Nationwide, about half of women give birth using an epidural (which is the most common method of pain relief), and in some big-city hospitals that rate is north of 85 percent.
There are advantages and disadvantages to both medicated and unmedicated births, and we’ll talk about them when we get closer to your baby’s due date. But for now, the most important thing is to be flexible and not let your friends, relatives, or anyone else pressure you into doing something you don’t want to do.
You and your partner may be planning a natural childbirth, but conditions could develop that necessitate intervention or the use of medication (see pages 60–62). On the other hand, you may be planning a medicated delivery but could find yourself snowed in someplace far from your hospital and any pain medication, or the anesthesiologist may be at an emergency on the other side of town.
WHO’S GOING TO HELP?
At first glance, it may seem that your partner should be picking a medical practitioner alone—after all, she’s the one who’s going to be poked and prodded as the pregnancy develops. But considering that more than 90 percent of today’s expectant fathers are present during the delivery of their children, and that the vast majority of them have been involved in some significant way during the rest of the pregnancy, you’re probably going to be spending a lot of time with the practitioner as well. So if at all possible, you should feel comfortable with the final choice, too. Here are the main players.
Private Obstetrician
If your partner is over twenty, she’s probably been seeing a gynecologist for a few years. And since many gynecologists also do obstetrics, it should come as no surprise that most couples elect to have the woman’s regular obstetrician/gynecologist (OB/GYN) deliver the baby.
Private OB/GYNs are generally the most expensive way to go, but your insurance company will probably pick up a good part of the bill. Most private OBs, however, aren’t strictly private; they usually have a number of partners, which means that the doctor you see for your prenatal appointments might not be the one in attendance at the birth. So make sure that you’re aware of and comfortable with the backup arrangements—just in case your baby decides to show up on a day when your regular doctor isn’t on call. Labor and delivery are going to be stressful enough without having to deal with a doctor you’ve never met before.
Researcher Sandra Howell-White found that women who view childbirth as risky, or who want to have a say in managing their pain or the length of their labor, tend to opt for obstetricians.
WHY TO HAVE THE BABY AT HOME
• The surroundings are more familiar, comfortable, and private.
• You don’t like—or are afraid of—hospitals and doctors. Or you had a negative experience with a previous birth.
• You’ve already had one or more uncomplicated hospital births.
• You can surround yourselves with anyone you pick.
• The birth is more likely to go exactly as you want than it might anywhere else. And your partner will be treated less like a patient than she would be in a hospital.
• You can pay attention to the spiritual aspects of the delivery, an intimate matter that you might be discouraged from, or feel embarrassed about, in the hospital.
• Hospitals are full of sick people and it’s best to stay far away from them.
• It’s cheaper.
WHY NOT TO HAVE THE BABY AT HOME
• Your partner is over 35 or has been told by her doctor that she’s “high risk.”
• She’s carrying twins (or more) or you find out that the baby is breech (feet down instead of head down).
• She goes into labor prematurely.
• She developed preeclampsia, a condition that affects about 10 percent of pregnant women and that can have very serious complications if it’s not detected and treated early (see pages 61–62 for more on this).
• She has diabetes or a heart or kidney condition, has had hemorrhaging in a previous labor, has had a previous Cesarean section, or smokes cigarettes.
• No insurance coverage.
Family Physician (FP)
Although many FPs provide obstetrical care, not all do, so check with yours to see whether he or she does. If not, he or she will refer your partner to someone else for the pregnancy and birth. One of the big advantages of going with your family doctor is that after the birth, he or she often can see your partner and baby on the same visit. The time saved running around from doctor to doctor will be welcome.
Like
