In the last few weeks, I have fielded quite a few questions from a specific “type” of mama–one that has had at least one previous hospital birth and is now starting to investigate homebirth. Within this breed of mama, there are still some differences. I’d say that some are sold on homebirth because of their hospital experiences, and some are not sold (yet?) but merely curious. There was something, something about the hospital experience that left them questioning, or yearning, or who knows what…but it is usually something that brings a woman with a previous hospital birth to start seeing what homebirth is all about.

So, I thought I would do a little question-and-answer for all of you other mamas out there who wonder what some of the differences are. I thank the women I have run into in the last few weeks for bringing these specific questions to my attention. To me, the differences are so numerous that it gets overwhelming and it is nice to have a focus. The women I meet that do question their experience, whether or not they actually leave the hospital scene for home, are the smartest kind, in my estimation. It takes a lot of guts to ask questions and maybe hear that what you were told wasn’t quite the truth, or to come to terms that you (we, really!) have fears that may be keeping you from the natural birth at home that you desire.

My water broke last time before labor started. So, my doctor needed to induce me. What do we do if my water breaks again this time and I am not in labor? What will you do?

I can’t orchestrate your birth experience for you…so it could happen again where your water breaks either prematurely or before you notice contractions. I’d say that the prevention happens months before that, though. Membranes rupturing (the technical term) before labor doesn’t happen very often–and it happens even less in nourished, well-fed women. For a woman with a history of this, we would focus intently on nutrition in the prenatal period as well as be diligent in ruling out any kind of infection which could have contributed to the early water’s breaking last time. There is so much we can do preventively to arrive at labor and birth, full-term, with a healthy mama and baby. But, if this did happen again and you were full-term, we would monitor you for infection and simply wait for labor to start. Besides that, I always encourage women with past birth experiences to work on releasing them (the negative, disturbing or not ideal experiences) before embarking on the next labor and birth. I can assist you in visualizing and preparing yourself for a different experience. Each baby, each labor and birth is unique and there is comfort in that.

My doctor always induces me early because he says my baby will be too big. I’m afraid of not being induced and having a baby I can’t birth!

Wow, induction again. First of all, induction as a matter of course is pretty disturbing to me. I’ve been induced myself (first birth), and I have been present at hospital births. And I can assure you that no birth I have ever been at where Pitocin (the induction drug) has been used has the mom been informed as to the risks. The “benefits”, yes. But I have never heard it mentioned that when the uterus is forced to contract, the baby is at risk for fetal distress and the mom is at risk for uterine rupture–EVEN if she has never had a cesarean. OK, I digress……
I believe that babies fit through the body of a mama that made her, or him. I just do. For women that have always been induced with what turned out to be a 6 pound baby, the thought of having an 8 lb baby is rather scary. But, you will make a baby you can get out! And a full-term, full birth weight baby navigates the birth canal easier and is probably better suited to labor itself, as well as nursing afterwords. This is a hard one, because I feel like there is nothing I can really say except there needs to be some trust. You have to believe that your baby will come when it is ready, and when it is ready, the baby will have the easiest time being born. Imagine getting kicked out of the womb, literally, before you were ready! I really urge women like this to be patient and kind with their bodies. It has to start with the message, “I trust you. I know you can do this, because you conceived and grew this baby perfectly. I won’t rush you or doubt you. I trust you, too, baby. That you are conscious and able to be born when it is time”.

I was induced at the hospital and it was really scary because I hemorrhaged afterwards. My husband is really scared to have a homebirth now and I don’t know what to tell him.”

Again, I cannot orchestrate a birth or be sure that we will not encounter an issue that needs to be solved. I do not pretend that birth at home is perfect, only that with preventative care, healthy moms, and good care during labor and birth, we do set ourselves up for better outcomes than when there is a lot of intervention. Anyway, I digress again!
Hemorrhage (bleeding excessively) after birth is scary. Especially for a husband watching! Like the first question, I would focus on great prenatal nutrition and this can be a great preventative. If we build up your blood volume enough, you will have more blood to spare than a woman who has not had good nutrition. Secondly, this may seem very skeptical, but this actually goes for any woman that has had a previous birth–home or hospital. Request your records. Sometimes our memory in birth is shabby, and sometimes we do not even know why certain procedures, etc. are done to us. In other words, I would want to see the notes and read what happened. Was their a placental issue? How much blood was lost? Was their a tear? There is always more info to be gleaned when we start to take responsibility for our own healthcare.
Last but not least, midwives are prepared to handle some bleeding at home. If that does not work, there is always the possibility of transport. You also will not be left after birth until you and baby are 100% stable.

I could probably go on for a while, but those have been the most recent homebirth questions I have fielded. No one has all the answers, but I am confident that most midwives can walk with women on what will likely be an amazing and empowering experience for them—one that the hospital rarely provides.