When we were talking about birth last week, Anjali pointed out that information on home birth just wasn’t readily available eight to ten years ago, the way it is now. She’s right, absolutely—and that got me thinking about what led me toward home birth in the first place.
I think it was a combination of circumstances and personality.
I’m a research-happy kind of person. Before making decisions, I have a pathological need to read up on all possible choices first, and talk at length (mostly to my long-suffering husband) about what I’ve learned, and then decide which of my options I think is best. I’m a little nutty that way.
I started out reading books like A Good Birth, A Safe Birth (no longer in print). But I was also just out of college when Abigail was born. My degree had required classes in advanced statistics and research methods and experimental design—so fun! and I’m not even joking!—and I still had access to medical journals through the university’s library system. And I think I mentioned, I love me some research.
I probably didn’t need to look that hard to find information on best practices in maternity care, and certainly no one needs to do that anymore. But once I knew what to ask about, it wasn’t difficult to find out which practitioners and which birth locations followed evidence-based best practices, and also which were able to accommodate the practices that were most important to me.
If I were researching today, I might start with some of these sources:
– Marsden Wagner’s book, Born in the U.S.A.
– Adrienne Lieberman’s Easing Labor Pain, an overview of all sorts of pain management options.
– Sheila Kitzinger’s Complete Book of Pregnancy and Childbirth, for information on healthy pregnancy and childbirth in any setting.
If I wanted to learn more about out-of-hospital birth choices, I might read these:
– Citizens for Midwifery’s resources page. There are links to news, studies, opinion, and explanation.
– Ina May Gaskin’s Spiritual Midwifery, a classic collection of home birth stories.
– Ina May’s Guide to Childbirth, which is all about natural childbirth.
– Mothering Magazine, in print or online, which regularly includes out-of-hospital birth stories and articles on natural childbirth.
If I wanted to know more about the midwifery model of care (as opposed to the medical model of care), I would look into these:
– North American Registry of Midwives. NARM licenses Certified Professional Midwives. CPMs are direct-entry midwives (midwives who are not also nurses).
– In the U.S., the American College of Nurse-Midwives. CNMs are first trained as nurses, and then receive additional training as midwives. They might attend births in hospitals, freestanding birth centers, or homes.
– Midwives Alliance of North America. MANA is an advocacy organization for all types of midwives.
– Citizens for Midwifery is a consumer group that advocates for midwifery and midwives in the U.S.
– The Big Push for Midwives campaigns for the regulation and licensure of Certified Professional Midwives in all 50 U.S. states.
– Heart and Hands: a midwife’s guide to pregnancy & birth, an accessible midwifery textbook that you can probably find at your library.
I would also interview the health care providers I was considering hiring. (I did this when I was pregnant with Abigail. Midwives expected it, and scheduled in-person consultations. Doctors and hospitals, I mostly interviewed over the phone, and sometimes I spoke to an office’s “medical assistant” rather than to the obstetrician.)
I had a long list of questions—among other things, I wanted to know how often they dealt with various complications, how regularly they performed various interventions, and, for out-of-hospital practitioners, how often they transferred care and under what circumstances. Their answers, as well as how comfortable they were being questioned, gave me enough specific information to choose the best health care provider for me. Presumably another woman, interviewing the same practitioners, could come to another conclusion based on what was important to her. And that, I think, is as it should be.
I know that not all options are available to every woman. In the real world, we’re constrained by money (which locations and health care providers will your health care plan pay for, if you have one? can you afford to pay out of pocket for other options?), by location and transportation (can you get to the birth location of your choice? can a health care provider get to you?), and by state and local politics (are midwives legal in your area? if so, are there any? and if they practice out-of-hospital, do they have good working relationships with local obstetricians, allowing for supportive transfer to a hospital in case of complication?). But for women who do have options, I hope resources like these are helpful.
What have I missed? What resources helped you decide where and how to give birth? Are there books and websites available now that you wish you’d had access to years ago?
For more about birth and midwives, check out the birth resources page.