By Alyssa Johns
“The more I learn the more I really want to have my baby out of hospital, but I feel like it’s too late to switch.” I hear this sentiment quite frequently when I am teaching childbirth classes. These women have just learned about how well equipped their bodies are for birthing and they have gained confidence in the process of giving birth. I see many women begin to question whether or not they really want to give birth at a hospital and possibly have to defend their choices through labor when they could give birth outside the hospital where the type of birth they wish for is the norm. We watch videos of calm water births, peaceful home births, and families start to recognize that there is another safe option available.
I remember when I was pregnant with my son 8 years ago, I had planned for an unmedicated birth at the hospital until I became friends with a doula who was very involved with out of hospital birth. She showed me pictures of her home birth and I remember staring at them in awe. I literally had no idea birth could look like that. It was private, peaceful, cozy, and joyful. The complete lack of machines and tubes and wires was such a stark contrast to the hospital scenes with gowns and metal poles and beeping machinery. I clearly remember having the thought, “If birth can look like this, why would I want anything else?” The fact that it was my first baby didn’t deter me from choosing home. The more I researched the more I found evidence that home was a safe option for low risk women and that I would likely be able to avoid that downward spiral that happens when one intervention is given and a cascade of others often follow. I was around 28 weeks pregnant when I found my home birth midwife, changed directions, and I never looked back.
As a midwife now, I have the privilege to sit with women and hear their stories when they begin care. If they have had a previous hospital birth I always ask what made them choose out of hospital for this pregnancy. Their stories often have a common theme. Usually the story is that their first birth in the hospital did not go at all how they had hoped. They felt pressured to accept interventions, they felt disrespected, sometimes it was just as simple as they don't want to be in a hospital overnight being interrupted while they try to rest. Some tell horrific stories, some tell stories of more mild disappointments. Some speak of the fact that they just want to be somewhere that feels comfortable where they can let down their guard. The reasons are many, but the common thread is that they are seeking a chance for a better birth.
I hear women who are considering switching late in their pregnancy worry about the stress of finding a new provider and about possibly offending their doctor. The choice weighs heavily on them and they often set aside the idea of switching and stick to their current path. Let me give you two things to consider if you are thinking about switching to your out of hospital birth, but feel like it’s too late:
1) Do you trust your current provider?
Trust is hugely important in easing the labor process. We don't tend to labor well with our guard up or while we are having to defend our choices. Makes biological sense right? Stress hormones directly oppose labor hormones. That is a protective factor so our bodies won’t be as likely to go into labor during times of impending danger. Everyone needs a provider that understands and respects your wishes. If your birth plan is totally derailed because of special circumstances in your labor, you want to be able to just take a deep breath and trust that your provider is doing what’s needed in those moments.
2) What environment makes you feel safe?
We give birth more easily in a location where we feel safe. If we don’t feel safe, our bodies will begin to enter fight or flight mode which is not at all conducive to labor, in fact it can completely stall a labor. For some people, the hospital is the place that gives them a sense of safety. For some, the idea of birthing in the hospital creates anxiety and out of hospital sounds comfortable and safe. Know that your labor will be affected if you have a provider you don’t trust or a location that makes you feel anxious.
If you’re not currently in labor, it is not too late to make a change if you are unhappy with your current situation. I encourage you to be honest with yourself on those two questions and seek a change if needed. Set yourself up well for your current pregnancy and upcoming labor, don’t wait for the next one to trust your instincts.