How I embarked on this journey: The long version

(The short version is here.)

My birth -- June 19something (Yeah right. Like I'd tell you the actual year :) When I asked my mom about my birth when I was growing up, she described it like this: She went into labor early in the morning, precisely two weeks after my due date. She labored by herself for a few hours and then woke up my dad to go to the hospital. She did not receive an epidural or other pain medication. I was born about twelve hours later, weighing in at 9 lbs 6 oz.

What I wrote above is pretty much how she said it. No long drawn-out horror stories of the aaaaaaaaaaaaaaaaaaaaagony of waiting two looooooooooooooooooooong weeks to go into labor, or of laboring without an epidural for the better part of a day, or of delivering a nine and a half pound baby.

So I grew up thinking that delivering 9+ pound babies two weeks late with no epidural was just "normal."

Littles' birth -- June 2007

Throughout my pregnancy with Littles, I saw an OB and planned to deliver out of a hospital, with minimal interventions, including no pain medication.

Again, I believed that delivering babies two weeks late was "normal," and so I was not at all surprised when I went overdue. As week 40 turned into week 41 and started approaching week 42, everyone seemed to assume that I must be miserable and just done being pregnant. I really wasn't. I was eager to meet Littles, but I also loved being pregnant.

Finally, my OB said that she needed to be out by 42 weeks. I went in to the hospital on Sunday night to get Cervidil, and then started Pitocin on Monday morning. Littles was born that night, weighing in at 9 lbs 7 oz. Aside from the Cervidil, Pitocin, and antibiotics due to being GBS positive, I had no other medications.

I wouldn't say it was an easy birth. Mostly, it was just long. I was so tired by the end that I was falling asleep between contractions. But it was an absolutely amazing experience and I loved it. The next day, my nurse asked me if I'd do it without pain medications again, and I didn't even hesitate with my reply: "Absolutely."

I consider Littles' birth to be a very positive hospital birth experience. I'm not at all anti-hospital. I've learned over the years that having an experience like that, or like my mom's, may not be as automatic as it really should be, when you're birthing in a hospital -- but that doesn't mean it's impossible.

Noob's birth -- January 2010

We moved out of state when Littles was about a year old, so delivering future babies with my same OB was not an option. In a way, I was relieved, because although I had had a really positive experience, there were also some things I wanted to change, and our move gave me the opportunity to do that.

In particular, I felt that most midwifes would be more in line with my views on birth than most OBs. I considered out-of-hospital birth early in my pregnancy, but my husband wasn't comfortable with it. Instead, I found two midwives who delivered out of a hospital considered to be one of the most natural-birth friendly ones in my area.

I loved my midwives, but as the birth approached, I found myself turning back to the idea of out-of-hospital birth. My hospital was great, but it's still a hospital, and there were some things I really wanted that simply didn't work well with birthing in a hospital, such as allowing Littles (then age 2) to be an integral part of the birth.

I finally decided that my husband and I needed to meet with a homebirth midwife, "C." We did that just before New Years. I was 35 weeks pregnant. I fully expected my husband to walk away from that meeting saying, "I'm sorry, I'm still not comfortable with this idea." And then, I was fine sticking with our original plan of the hospital-based midwives.

To my complete and utter surprise, C was able to address most of his concerns. We decided to make the switch. Noob was born almost exactly four weeks later, two days before his due date, at home, weighing in at 8 lbs 11 oz. His birth was quick, easy, comfortable, peaceful. Incredible.

Hospital vs. home
When I switched to homebirth, obviously I knew that it would be very different from hospital birth. Still, I was surprised by some of the more subtle differences that came out, even in just the four weeks that I was under C's care. I quickly learned that homebirth is not just like hospital birth except you stay at home at the end. It is a completely different approach to pregnancy, birth, and the immediate postpartum period.

Take Group B Strep (GBS), for example. GBS is a bacteria that colonizes the vaginal tract in approximately 25% of women at any given point in time. It's harmless to the woman, but if she gives birth while colonized by GBS, her baby is at a higher risk of becoming infected with GBS. GBS infection in a newborn can be very serious, even fatal.

When I was pregnant with Littles, my OB followed standard American protocol for minimizing the risk of GBS-infected newborns: I was tested for GBS at 36 weeks. When I tested positive, I received IV antibiotics during labor, cutting Littles' risk of GBS infection. Of course, antibiotics carry risks as well, such as possible allergic reactions and an increased risk of acquiring other bacterial infections (since antibiotics kill off not only "bad" bacteria like GBS but also the "good" bacteria that naturally keep "bad" bacteria at bay).

With Noob, I switched away from my hospital-based midwives right at 36 weeks, but it appeared that they follow the same protocol: Test at 36 weeks, IV antibiotics during labor for women who test positive.

My homebirth midwife takes a different approach. She is not licensed to give IV antibiotics to GBS+ moms during labor. Some might point to that as an example of how homebirth is less safe than hospital birth... but that's not the full story.

Rather than simply treating GBS colonization when it's detected, my midwife tries to prevent it in the first place. She recommends taking probiotics and certain vitamins that have an antibacterial effect, starting a few weeks before the test. (With Noob, I was lucky that my doula had proactively passed along a similar GBS-fighting regimen to me when I was still under the care of the hospital-based midwives. So I had been following it even prior to my switch to homebirth.)

I ended up testing negative. So the lack of IV antibiotics was a non-issue, and I didn't have to worry about any negative side-effects of the antibiotics, either.

The difference between preventing and treating GBS is not something that I can quickly explain to the average person who looks at me in horror saying, "Giving birth at home? Are you insane? That's so unsafe!" But they're the kinds of things I want to document in this blog.