Self-Test: Which birth location is right for you?

Not sure which birth location is right for you? Take this completely unscientific and grossly overgeneralized survey to see if your personality is best suited for a hospital, birth center, or home birth.  If you’re on the cusp, you could go either way, so be sure to read all the results.

1.       Your idea of a heavenly day is:

a.       Hiking in the mountains

b.      Getting pampered at a spa

c.       Dinner and a movie

2.       Your office is holding a potluck. You:

a.       Create the sign-up list, organize RSVPs, and cook two healthy homemade meals – just in case someone forgets their dish

b.      Whip up some of your famous gluten-free oatmeal cookies

c.       Pick up a store-bought lasagna

3.       You find a strange mole on your shoulder. You:

a.       Research skin conditions on the Internet, then apply a homemade salve

b.      Keep an eye on it, vowing to see your doctor if it gets worse

c.       Call your dermatologist – he’s on speed dial

4.       At the grocery store, you:

a.       Always buy organic fruits and grass-fed beef even if it costs more – you’ll just cut back in other areas

b.      Always buy organic fruits but sometimes buy conventional beef (let’s be honest, the grass-fed stuff can get expensive!)

c.       Buy mostly conventional products with a smattering of organic goods ever mindful of the cost

5.       Which television show best represents your personality?

a.       Little House on the Prairie

b.      Buffy the Vampire Slayer

c.       Sex and the City

6.       A friend makes a snide comment about your new haircut. You:

a.       Think: “Who cares? What does she know?”

b.      Wonder if maybe you went a little too dark but decide to stick with it

c.       Feel awful – next time you won’t let your stylist talk you into a new ‘do

7.       You hear a strange noise in the middle of the night. You:

a.       Ignore it and go back to sleep

b.      Think it’s probably nothing but get up to investigate

c.       Call the police

8.       You and your partner/husband get into a fender-bender on the way to the store. Your husband:

a.       Makes sure you’re okay, then gets out to survey the damage, exchange contact information with the other driver, and call your insurance company

b.      Calls a friend to take you to your doctor for a quick once-over

c.       Calls the paramedics – you can never be too sure

9.       When you had to do group projects in school, you were generally:

a.       The self-appointed leader

b.      One of the key team members doing much of the work

c.       A contributor, but you let others take the lead – they probably know more than you do anyway

10.   Which extreme sport would you be willing to do?

a.       Skydiving

b.      Bungee-jumping

c.       Uh, no thanks, I don’t do extreme sports.

Scoring

Give yourself 1 point for every “A” answer, 2 points for every “B” answer, and 3 points for every “C” answer.

Results

10-16 points:  Homebirthing Hero

You’ve got that do-it-yourself, self-confident spirit that’s just right for homebirth. You’re comfortable going against the grain – less than 1% of births take place at home, so you’d better get used to being an oddball - and you can handle a little criticism from friends without questioning your ideals. You favor a natural birth experience, and you’re suspicious of modern medicine’s approach to many ailments. You’re not easily alarmed by the unexpected. You're okay with "roughing it." You like to be in control, and you don’t mind putting in the research and legwork to ensure success. You also recognize that your ideal birth experience may cost more out-of-pocket than the other options, but you’re willing to sacrifice for it. Your husband/partner is calm and collected under pressure with a similar non-alarmist approach and an ability to focus on practical logistics, which is vital when birthing at home. You understand that homebirth involves some risks, but you believe the outcome is well worth it.

17-23:  Birth Center Bound

You want a natural unmedicalized birth experience with a strong support team, and you want the freedom to move around, to labor in the water, and to avoid unnecessary interventions. You’re open to new ideas but cautious, willing to take some risks, but nothing crazy. A hospital feels wrong but a homebirth is a little too kooky for your taste – maybe next time. A birth center provides a calm, nurturing environment for unmedicated birth without having to do all the prep work. It’s that happy space between homebirth and hospital, and since you need to drive there, it feels a little more normal than just plopping out a kid in your living room. You’re also cost-conscious, and there’s a far better chance of getting insurance reimbursement for an accredited birth center than a homebirth, which is nothing to sneeze at. Your partner has the same cautiously optimistic approach to birth – he’ll thrive in a birth center where he can support you emotionally without having to worry about logistics.

24-30:  Happy in the Hospital

When it comes to your birth, you’re not taking any chances. So many things could go wrong, and you don’t want to lose any precious seconds on a transfer from home or birth center to the emergency room. You’ve read tons of pregnancy books and can rattle off dozens of potentially harrowing birth calamities – shoulder dystocia, failure to progress, postpartum hemorrhage, cord prolapse….why take the chance?  You may or may not want a natural birth but you think you can achieve your ideal experience in the hospital where at least you’ll have all the latest high-tech gadgets within grabbing distance if things don’t go as planned. You have a lot of faith in the medical establishment, and you’re not apt to question authority. You might be really, really nervous about the pain of childbirth and not sure you can handle it. During labor you want to be able to sleep, chat with friends, post Facebook updates, and not stress. You care about delivering a healthy baby, that's it. The birth experience is secondary.

Why not have an epidural?



Epidural - yikes!


What I love about my friends is that they're not crunchy granola types who easily embrace things like "perineal massage" or "eating your placenta" or "natural birth." Which means I get a lot of practice justifying my own perspectives on epidurals, hospital births, and cesarean sections while trying not to come across like a condescending know-it-all. And the truth is, sometimes I totally lose the argument.

Take for instance a recent exchange with a good friend who had a c-section with her first birth and made it clear that under no circumstances would she ever attempt a drug-free labor. Her point: If labor is painful (yes) and there are strategies available to eliminate the pain (yes) and those strategies are not excessively harmful to mother or baby (yes), why on earth wouldn't I take advantage of it?

In other words, why not have an epidural?

Natural birthers cringe at such a proposition, but it's a legitimate question. These days, we just don't tolerate discomfort anymore.  When I have a headache, I take Excedrin. If my muscles are sore, I pop Advil. I wouldn't dream of having a cavity filled without novocaine. Modern medicine has given us women amazing ways to reduce pain, and we've readily taken advantage of them. Why suffer? (Unfortunately, this same logic doesn't apply to high heels - why do I still wear them? Why?!)

My instinctual response was to tell my friend that epidurals have awful side effects - that's why you shouldn't have one. But the reality is, if you look at the medical literature, epidurals aren't that bad. There's a chance you'll get a monster headache from leaking spinal fluid, but that only occurs in about 1% of women. There's a very good chance the epidural will slow your labor, especially the pushing stage - lots of studies showing this trend (read here and here) - and that a prolonged labor could lead to other interventions, like vacuum extraction, Pitocin, and forceps, which can result in poor outcomes.  But a major review of medical literature in 2011 found no difference in overall c-section rates or baby's health with or without epidural. It may cause some problems, but overall, you won't be unduly harmed. So if it makes you feel better, why not go for it?

(On a side note, I find it funny that women who won’t eat brie cheese, ingest a sip of wine, or take Advil during pregnancy are often the first ones to have analgesics shoved into their spinal column as soon as the first contraction hits.)

I couldn’t win the argument with my friend, because in the end, my reasons for going natural didn’t have anything to do with side effects, statistics, or medical studies.

We women who choose natural birth do so because we have infinite faith in our bodies to birth. Because we recognize that it’s about more than us.  Because we want to give our babies the best start in life, and we don’t need a long list of scientifically verified side effects to know that sticking a catheter in your spine absent medical necessity is probably not the best start. 

Yes, I take pain killers when I have a headache. But when it comes to birth, I’m willing to tough it out and have trust that my body and baby are working in awesome harmony. I may have to sacrifice a little bit of personal comfort to get that benefit, but that’s okay. Isn't that what motherhood is all about?

Great home birth - now what?

You've had your beautiful home birth, your midwife has wished you well and taken off, and now you're left alone. How should you spend the next few hours?

 

1.  Eat.

Especially if you've had a long labor (and even if you haven't), eat something. You'll be shocked by how hungry you are.  That's why they call it labor!  Have your partner, doula, or any random companion fix you something healthy and nutritious with lots of protein because if you've lost blood, you'll need to replenish your iron stores.

 

2.  Rest.

Don't rush to get up.  Your body has been through a lot, and if you get up too fast, you’ll feel woozy and could pass out.  Just take it easy, let your body adjust.

 

3.  Sleep.

Your newborn likely will take a nice long slumber after birth - take advantage of this rare stretch and catch some z's yourself.  You'll be excited and hopped up on the miracle of home birth, probably wanting to post a zillion Facebook status updates and get some pictures on the family blog, but all of that can wait. You won't have another shot at hours of uninterrupted sleep for a few weeks so enjoy.

 

4.  Don't be afraid to call the midwife.

If you think something's wrong (for example, you start bleeding heavily) or you just don't feel right, call your midwife right away.  She may be able to assess your situation over the phone, or she'll take another trip out to see you.  Either way, she'll want to know if something isn't right.  And if things take a major turn for the worse, dial 9-1-1.

 

5.  Bask.

Congratulate yourself on a job well done. Feel proud of your accomplishment.  You're in the 1% of women who birth at home, and you've given your baby the best start in life you possibly could.

Things they didn't tell me about home birth

If you read the usual blogs, articles, and Facebook lovefests about home birth, you'll start to believe that birthing your baby at home is about the easiest thing you'll ever do. In fact, if you're like me, you'll actually start to look forward to the experience because everyone makes it seem so incredibly awesome.  Even up until the moment I went into labor, I thought my home birth would be kind of like a day at Burke Williams - you know, a mildly uncomfortable deep-tissue massage followed by lots of relaxing teas, cleansing breaths, and Zen-like escape.

Let me dispel you of that notion right now.

Home birth is a great alternative to a hospital birth for low-risk women, and if I had to do it all over again, I'd do another home birth, no question about it. But it ain't no day at the spa.

Here are some things the books don't tell you about natural birth and home birth and that many mamas conveniently omit from their awe-inspiring birth stories.

1.  "Early labor" still sucks.

My HypnoBirthing instructor made it sound like early labor (up until around 5 cm) was just a walk in the park. Oh, just keep yourself distracted when your contractions first start, she said - take a walk, run some errands, watch a movie, catch up with old friends, ha, ha, ha... maybe I have a lower pain tolerance than other women, but for me, “early labor” was still pretty rough. When your previously compact cervix is cranking wide open, it’s kind of tough to fold laundry or take a stroll around the mall. Use the skills you learned in natural childbirth class to get through it.  

  

2. You might have diarrhea.

Seriously. I could not stop shitting. Of the 27 hours I was in labor, I probably spent 20 of them on the toilet as my bowels released every shred of anything I'd ever eaten in the previous 30 years. When the midwife arrived for my first pelvic exam, I emerged from the fetid bathroom and the first thing I said to her - even before “hello, it's good to see you” - was “I have diarrhea.” Diarrhea is extremely common in labor so be prepared. And you might want to give your significant other a heads up while you’re at it.

3. You might bleed a lot.

I’m not talking about a hemorrhage, just a slow and steady drip throughout the labor, like the worst period you’ve ever had. Stock up on maxi pads and congratulations if you’re one of the lucky ones, like me, who had fluids coming out of both ends throughout your labor.

4. You more than likely won't go into labor at 9 a.m. and have everything wrapped up by lunch.

I prayed that my labor would begin at a reasonable morning hour after a good night’s rest and finish in a matter of hours. So naturally, my labor started at 8 p.m. and stretched into the next night. Labors tend to be very inconvenient, and they don’t always obey normal business hours. Think of it as your baby’s way of preparing you for motherhood.

5. You could find all of your comfort aids useless.

I had everything ready to go – the birth ball, aromatherapy oils, a playlist of relaxing music, massage tools. In the end, all I wanted to do was lay in bed on my back without anyone touching me or talking to me. The only thing that really helped was soaking in the tub. Everything else was a waste of money. No big deal, you just need to be flexible and realize that in the end, the best comfort aid is your breath and support team.

6. You'll realize your HypnoBirthing/Bradley Method/Lamaze instructor lied to you.

No, that can't be right, I remember thinking when the contractions first hit.  That felt like pain. But my HypnoBirthing teacher said I'd just feel some pressure, maybe some "sensations." Could she have been…gulp…wrong?  Okay mamas - let’s be honest about labor. Sure, there are some freakishly superhuman moms who manage to get through it pain-free (I’m suspicious of those women) but most of us won’t. Childbirth is not pleasant, and it hurts. There, I’ve said it. So don’t think there’s something wrong with you because you’re feeling pain. We’ve all been there. We got through it, and so can you. Labor pains aren’t going to kill you, and they’re not going to last forever. After a few months, you won’t even remember it.