After 12 hours of labor, my son was almost here.
“I can do this!” I shouted. “You are doing it,” the nurses sang back. I reached down to feel his head and, with one final push, out he came into my arms and onto my bed. At home. On purpose.
“You hired two midwives, and they had you catch the baby yourself? You should get your money back,” one friend joked later.
But the truth is no amount of money could have bought what I received that day: an empowering birth that respected me and my baby.
Recent news coverage of Karen Carr, a Maryland midwife convicted of two felonies last month in a Virginia baby’s death, has reignited debate over birth options. It has also raised questions about midwifery and, unfortunately, led to misconceptions about home births.
But that was an unusual case involving a risky birth. For me — a healthy woman with few risk factors — delivering at home was a safe choice that offered better care. It was also more convenient, comfortable and cost-effective.
I knew exactly what I was missing.
Four years ago, my husband and I had our daughter at a local hospital. It was a frustrating experience filled with dismissive staff: A receptionist who sent me to the waiting room even though I was ready to push, nurses who said to “hold it in” as I waited an hour for a doctor, and a doctor who never even introduced himself.
This time around, I did more homework. I found out I was a good candidate for a home birth because my first pregnancy was uneventful and I was healthy. Early tests indicated another low-risk pregnancy.
We settled on Takoma Park-based M.A.M.A.S. midwives, whose care outshined the busy OB/GYN practice we used the first time despite hour-long waits for 10-minute appointments. Our midwives made house calls and spent an hour checking on me and the baby. They let my thrilled preschooler measure my belly. And they came armed with laptops and answered questions by e-mail. Talk about modern medicine.
We cared about safety, of course. When I went into labor, our midwives brought with them everything a birthing center would use. Both baby and I were constantly monitored — more so than in a hospital, considering we were never left alone, strapped to a machine. If there had been an emergency, we would have gone to the hospital just a mile away.
Not surprisingly, some doctors and other critics have said in recent weeks that home births are unsafe, even selfish. They argue that the only safe place to have any baby is at the hospital, with access to the latest technology. And earlier this year the American College of Obstetricians and Gynecologists said it does not support planned home births, even for low-risk women.
But where does all that technology get us? It hasn’t helped our babies. Nearly every developed country has a better infant survival rate than the United States, which ranks 43rd out of 196 countries, according to the United Nations.
To me, the hospital seemed riskier. I was pregnant, not sick.
I’d be exposed to the growing risk of hospital-acquired infections. And then there was the Pitocin-epidural-“emergency C-section” trap that can make it difficult to breastfeed, among other potential complications. Already about one-third of Washington-area births end in Caesarean surgery, a statistic echoed nationwide.
At home, I could walk and move freely to ease the pain. I could eat whatever and whenever I wanted to keep up my strength.
Oh, and did I mention it was cheaper?
My 2007 pregnancy cost several thousand dollars in prenatal visits, and the hospital charged nearly $4,000 for the birth — a rate so low only because I gave birth quickly and left a day early. It’s not unusual for hospital births to cost $10,000 or even twice that for C-sections. My midwives charged $3,800, including prenatal visits and five checkups afterward.
Of course, most insurers don’t cover planned home births. Just as some emerging studies show home health care for the elderly may save money with similar outcomes over assisted living facilities or nursing homes, maybe a closer look should be taken at home births, especially as health-care costs continue to soar.
I’m not saying every woman should stay put to give birth. And home is certainly no place for complicated cases. If my baby or my health ever seemed in jeopardy, I’d be the first one checking into the maternity ward. But when I caught my son that March evening at home, I knew it was the right place for us. As I introduced him to his big sister, there was no other place I wanted to be.
The writer is a Washington-based journalist.