I’ve been thinking about the recent publicity regarding the rise in homebirth rates. You’ll hear Jane and I repeating our mantra in our sleep, “relationship, relationship, relationship…it’s all about the relationship mothers have with their provider.” Can the provider be trusted to provide continuity of care and individualized attention? Can the provider be trusted to guard the space and values of each family they work with? Can the provider do their work without needing the spotlight, a.k.a. can they in fact “catch” and not “deliver” ? Can they do it all while preserving the relationship most fundamental to humanity? Can they offer support, resources, and guidance without actually providing precise google-map type directions for how things will be, how long it will take to get there, and what roads parents will or will not take? A midwife is constantly thinking “re-routing!” as she adjusts her services to meet the needs and wishes of her clients. My grandfather used to point out (via drawings on napkins in restaurants) that the fastest way between two points is a straight line, but it’s not necessarily the right path to take.
Ok. Spoiler Alert: I whole heartedly believe that the safest place for a woman to birth is where she feels safest. Home. Birth Center. Hospital. Riding a float in the Macy’s Day Parade. What I’m about to say really isn’t about that, it’s about what I’ve seen and what I believe about why women are choosing homebirth.
The word “quintessential” is a pretty common adjective. It’s used to demonstrate the most likely or perfect example of something. I was staring at the ceiling today, trying to take a wee break from studying (and by wee break, I mean a small interlude, not a bathroom run). I was missing my friends and the strangers in Vanuatu who would never have let me sit at that table alone while staring at the ceiling. I miss the togetherness of that culture. Which got me thinking about how we create close relationships.
I started to reflect on the births I have attended here in the greater Seattle area (because of course when I wonder about anything I have to wonder first if birth affects that thing and how exactly it accomplishes it). The hundreds of them. I see little flashes. Early on, those first births as a hired and paid doula, where I was supposed to be smart about this stuff and know just what to do. Running out to the waiting room to call a more experienced doula for ideas. Learning to let the text book information sink to the back of my head and actually respond to the mother. The way a woman’s face changed as she was pushing, and how time stood still and all I could see was the force of birthing. More flashes of firsts: The first time a nurse gave me (me!) the code to the nutrition room (oohlala) so I could retrieve some ice water (the sacred nectar of hospital birth). The first time someone’s water broke on me (followed by two more times that same week). The first time a mother I was working with went to the OR. The first time I smelled thick meconium mixed with that metallic odor of too much blood which portends a massive hemorrhage which was also the first time I saw a mother and a baby in steep decline in the same moment. The first time someone told me that they had attended a birth that seemed a lot like rape (I was notably judgmental about this statement and couldn’t believe that this woman was sooooo dramatic). The first time I attended a birth that felt like watching someone be raped (after I finished throwing up I called the other doula to apologize and she lovingly let me vent).
The first time I went to a homebirth. The first hospital birth after a run of eight homebirths. The sheer terror I felt at the silence of that birth, at the language at that birth, so markedly different than the midwives I had just been over-exposed to. Of the total lack of raw power and connection between the mother and baby during that labor. The weird, unrelated chatting. The way the staff spoke with the mother as if she was totally inept about absolutely everything. The way they forced the baby to nurse without actually noticing what state of being the baby was in. Don’t mind me, brand new person who never felt, heard, or saw anything in this world before, while I overstimulate you with all this rubbing, thumping, sucking, talking, and stuffing of your mother’s breast into your mouth while pressing on your head with a force most adults would not appreciate….
It’s clear they are doing their j-o-b’s as they were instructed to, but there was no consideration for the variables of humanity of the mother or the baby. What about just watching as the mother explores her newborn in her own time, in her own way? What about allowing them to teach each other about the comfort, security, and nourishment that mom has to offer and those incredible newborn gazes which suck us in and make us fall in love if the baby is in the right state and the experience is organic?
I have been to some stunningly beautiful hospital births. But here’s the truth: It’s not the same. Even drug free and naked and vociferous, it is not the same. And the reason why, I realized, as I stared up at that ceiling in anygivenseattlecoffeeshop, is the quintessential togetherness that pregnancy and birth so dramatically and eloquently demonstrate when left to their own devices. Midwives know there is a mother and a baby. We actually call them motherbaby. They are a dyad. Inextricable from one another. The baby needs the mother for food and oxygen supply and comfort and love. The mother needs the baby to help her come into her mother-self. To see the power in her body and potential of life and the bulkiness of what it means to really really love. To lose sight of the small stuff; the control, the management, the ability to shave her legs all by herself.
The language of a hospital birth separates mother from baby. Blames the condition of the mother in any given moment on the baby. Questions the mother’s ability to continue to provide nourishment and oxygen for her baby on this single day when she has been doing it to perfection for the previous 260-280 days of her life (unmonitored, without permission, without apology, without doubt). The baby is seen as an imminent threat, the mother as an unfit and incapable hostess. The examples are too numerous to cite, just ask a doula for one or two and she’ll go pale and give you ten or twenty.
Motherbaby: Quintessential Togetherness. Bound by blood and water, time and love. She brings him life and security, he brings her motherhood—that gracious, spacious, place beyond measure where women are bolted to the basic cellular formula for the entire universe. We don’t do it alone, we don’t do it separate from our babies in even one single way. We do it together in concert with them in every single way.
I am a midwife now who sometimes attends births as a doula. It’s a lot easier as a midwife. The technical responsibilities are greater. But I never have to listen to a provider try to crack apart a mother’s relationship with her baby. I don’t have to think about what to say to try to help that mother find healing and strength and connectedness. Everything I do is about promoting that relationship and sense of what is right for the two of them, at the same time, together. Everything I do is about letting the mother’s sense of self and baby dictate what comes next. My terms are not that she will follow my protocols or accept my rules. My terms are that she seeks to understand what she does not, that she asks all of the questions that cross her mind, that she speaks her heart and shares her thoughts, hopes, fears, and desires. My terms are that the two of them work through birthing together using all of the resources they want to. Did you know that a mother and newborn know each other by smell within hours of life? They can pick each other out of a lineup with just their noses. That is so incredibly intimate. Who would ever mess with a system that provides for that level of connection?
It’s no wonder there’s been a 30% increase in homebirths of late… faced with the opportunity to spend the prenatal clinic hours with a provider who wants to promote and support that togetherness, faced with the opportunity to stay as together as they’ve been for the entire pregnancy during birthing, faced with the options that matter so deeply. The decision isn’t the quick or the easy one, but it is clear why, for so many women, it is the right one.