My wife and I knew long before her pee said pregnant that we were going to have a home birth. That is to say, we were planning on a home birth. We all know birth plan ? birth story. More on that below. We chose a home birth for many reasons. My wife is a free spirit, most comfortable barefoot, in love with the woods and old stone walls, still believes in faeries, makes her own tinctures, self-medicates with organic tea, uses tarot cards regularly, and is a legitimate descendent of a witch. Sounds like someone who might choose a home birth, right? I think she also knew deep down that if she delivered in a hospital, she would be more likely to succumb to the pain and request an epidural. And she didn’t want an epidural. She didn’t want intervention. She didn’t want hospital bed sheets, hospital walls, hospital air. She didn’t want to have to get in a car with a two-day-old baby and drive 30 minutes to bring him home. Before I get too deep, it’s important to state my belief that all birth – home, hospital, or otherwise – is magical and awesome. All you moms are heroes to me. This isn’t about birth plan superiority complex. It’s about respecting choice, and also about word choice. But mostly it’s instilling in all moms-to-be, no matter their birth plan, that they got this. When we started sharing our birth plan with friends and family, the responses were...mixed. I share the five below because I believe they were uttered with good intentions, but maybe not enough consideration. Here’s what we heard when we told people, “We’re having a home birth!”
1 | “You’re so brave.”
Let’s talk for a minute about pregnancy and birth in general. A lot can go wrong. Risk is inherent. There’s miscarriage, preterm birth, nuchal cord, and breach, just to name a few and get your heart rate going. “Pregnancy Complications” is the 6th leading cause of death for woman ages 20 through 34 in the United States. But we don’t tell pregnant women they’re brave just for carrying a child to term. Is home birth riskier? Yes. According to a 2015 study by the “New England Journal of Medicine”, “out-of-hospital births” were 2.4 times more likely to result in perinatal death than a planned hospital birth. That’s not insignificant. But if there’s one thing I learned throughout my wife’s nine months of pregnancy and 29 hours of labor it’s that a positive mindset and self-confidence in the female body to do what it is programmed to do are invaluable. I mean sacrosanct. You don’t mess with a pregnant woman’s belief in her ability to successfully bring new life into the world. “You’re so brave” sounds like a compliment, but it can also be interpreted as “home births are scary and dangerous, and I would never take such a risk.” A better response: “A home birth! Cool! I’m sure it’s going to be amazing.”
2 | “Do you have a back-up plan?”
Sounds like genuine concern, right? In our case, it was a close family member who dropped this knee-jerk response to hearing our birth plan for the first time. Don’t get me wrong. I’m all for Plan Bs and first aid kits, and my wife and I knew full well the importance of having a “back-up plan.” True story: My wife’s sister planned an out-of-hospital birth for her first child six months prior to our due date. When, after 20-some hours of labor her cervix started constricting, the midwife made the call to transport to the hospital, where my sister-in-law ended up getting a C-section, which was about as opposite her birth plan as you can get. My sister-in-law is not exactly an outlier. In a 2014 survey of 17,000 planned home births between 2002 and 2012, 11 percent resulted in the woman being transported to a hospital after beginning labor. So, yeah. We had a Plan B. “Do you have a back-up plan” infers worst-case scenario. Is that really what you want someone thinking about moments after they share their birth plan with you? What I wanted my family member to do was assume that, since my wife and I are grown adults capable of making intelligent decisions and calculating risks, that, yes, we and/or the professional midwife we had enlisted (see below), had accounted for the worst-case scenario. Variations: “How far away is the nearest hospital?” A better response: “A home birth! Cool! That’s so your style.”
3 | “Is your midwife qualified?”
Believe it or not, this was asked by the same family member, practically in the same breath, and was followed a day later by an email with a link to an article about certified professional midwives (CPMs) and certified nurse midwives (CNMs). It felt like a scare tactic, not a supportive gesture. Maybe it was the article title: “Why Is American Home Birth So Dangerous?” I don’t know. Our state is one of 28 that license or regulate CPMs, which our midwife happens to be. She has also attended the majority of home births in our state – far more than any other practicing CPM. We put our faith in her track record and in the laws of our state, which say she has the qualifications to do what she does. What we were asking for from that family member was faith in us to respect the laws of our state and do our homework before making one of the most important decisions in our unborn child’s life: who he would first lay eyes on when arriving in this world. A better response: “A home birth! Cool. Who’s your midwife?” And now you have permission to research said midwife, discover all her certifications, read testimonials, ask around, etc. But privately. On your own time.
4 | “I was going to have a home birth, but…”
Let me stop you right there, because I know where this is going. Whatever your reasons for not choosing a home birth, this is not the time to share it. Because we have chosen a home birth, and furthermore, we have not yet had it. So this is a delicate time for us. Even with all the conviction in the world supporting that decision, we are human, and as such, we are subject to doubt. Another true story: A close friend’s partner was expecting their first child about five months after ours was due. He knew all about our birth plan and our midwife. He was nothing but supportive. After we had our baby boy, he and his partner came over to meet him. It was only then that he told me they had considered having a home birth with the same midwife, but for a variety of reasons decided against it. “I didn’t want to tell you until after,” he said, “because I didn’t want to put any doubt in your head.” Now that’s a friend. A better response: “A home birth! Cool! I know a bunch of people who had home births, and they were amazing!”
5 | “I hope nothing goes wrong.”
If someone has shared with you their birth plan, there’s a good chance you mean something to them. You’re an important person in their life. Your words pack enormous power with them, for better or for worse. Given that power, wouldn’t you prefer to use it for better? There’s a great meme I’ve shared with my mother, the eternal worrier. It goes “Worrying is praying for what you don’t want.” Hoping nothing goes wrong feels like the same thing to me. Don’t hope for nothing to go wrong. Hope for it all to go right! But maybe don’t say, “I hope it all goes right.” That just sounds awkward. A better response: “A home birth! Cool! I hope it unfolds exactly how you’ve planned it.” Did you have a home birth? I’d love to hear some of the choice phrases you heard in the lead up to D-Day.