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Advice about Home Birth

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Homebirth for 2nd child - what to do with 1st?

Feb 2010

We are expecting our 2nd child in June and will be having a homebirth. Our first daughter will be 3 yrs old. We'd like for our daughter to be present/at home during the birth. I'm wondering if anyone out there has been in this situation, and can share their experiences. I'm worried about having someone present that she and I feel comfortable with so that she can choose to be with us or to play in another room. I know I will most likely need my husband by my side the whole time. Another option for us would be to have a doula with me so that my husband can come and go as needed. The problem is that I can't think of anyone else that I would feel very comfortable having around while I am in the throws of labor. I guess I'm just not sure how to handle it and would love to hear how others have made this work. Thanks! Mama


Having just had a wonderful home birth, I would urge you to find someone you feel comfortable with to care for your 3 year old. If you are like me, and like numerous other moms I know who had home births, you will want and need your husband by your side for the whole birth. It is also an experience that he will treasure and not want to miss. anon
Hi! Yes, i can tell you my experience, I've had a few:) First, we had a homebirth with both my second and third. My daughter was 3 for the first, and it was the single best experience of my life! (don't tell my husband!) We were lucky enough that her ''Aunt'' Jen was there, for two days! She is my wonderful friend, whom i felt was intuitive enough about my daughter, even though she had no kids of her own, or any birth experience. We arranged that she would make the call, if it got too much for my girl, Jen would take her to her own house. But, she was more than fine, and there for almost every second, though looking back, there were times she got bored, and they went on walks, etc.

We did the same for my third, though the middle one was only 18 months and couldn't handle it. We had another friend take her to her home, and Aunt Jen came again and took care of my oldest. This time she was almost 5, and was there every single second, soothing me, wiping my brown, catching the baby and cutting the cord! It was magical, and she is now blessed with a perception of childbirth most people never get. On the flip side, I'm a doula, and have done many homebirths, in that very situation. Especially people who are not from here, they don't have anyone close enough to help. So, my experience was, we meet asap, and I visit several times, simply to get to know the family, esp. the child. We go to parks, cafes, whatever the child is used to, so they get acquainted with me.

Then, when the time comes, I come at the same point any doula would, and when the midwife is called, that's when I take over for the child, because dad's getting busy, things are bustling, etc. That's how I've done it from both perspectives. I'm sure experiences vary greatly! Feel free to contact me directly if you want to hear any more stories! All in all, it'll be great! Congratulations!!! alison


Get somebody that your daughter already has a trusted relationship with to come take care of her in your home. or hire a doula to do this. They will provide as much info as she wants and can also play with her at home or take her out to the park if she needs a break. She'll be fine as long as somebody's job is to take care of her needs. Of your doula and your husband can take turns caring for your daughter... good luck
i had a homebirth 2 months ago. My second child. First is going to be 3 in March. I went into labour at night while he was sleeping so he woke up to a little sister so have no advice as to what to do with a first kid. I think that the first kid just finds their way. I'm not sure if this is your first homebirth but in my case my husband could have done all the work with the 1st kid. I didn't need him at all. Every experience is different but once i w as in labourland i didn't even know who was around me. Other than my midwife i don't think i needed anyone else! Perhaps between a couple of good kid movies and your husband you don't need anyone else. i didn't want anyone else around like people next door or brother in laws... judy
We just had our 2nd child at a birth center. Our first child is 4 years old. We told our daughter that the birth room was just for grownups until the baby is born, and of course the baby isn't a grownup, so she could come in when the baby was there. She played with her grandmas in the birth center playroom, until the baby was born - then she came in to the birth room and announced the sex of the baby (we all pretended we hadn't already looked!). She then went back to the playroom and told the grandmas about the baby. After the placenta was delivered and I was modestly in bed under the covers, the grandmas came in and our daughter showed them the baby. This arrangement worked out well for me, as I could labor without worrying about her worrying, and she felt she was being helpful, and the grandmas were clear that their role was to help the older grandchild. I hope your birth goes smoothly and that you find a way to arrange your support people that works for you. Good luck! -MIL doesn't need to see me naked!

Thinking about a homebirth for 3rd child

Jan 2009

I just found out I'm expecting a third child in 2009. I've always said ''that if I have a third, I would like to birth at home''.

My first 2 pregnancies is everyone's dream. No problems, except swollen feet for the first, and itchy skin for the second in last month of pregnancy. Both births were short and natural. Less than 3 hours for the first and less than an hour for the second.

As both births have been straight forward and simple, I was thinking of staying home might just be easier. I've never seen a real home birth or really know what goes on. I'm more concerned about what happens to the baby after labor, as I've gotten used to the hospital letting me hold my baby for a few minutes and then whisking of to check health, etc.. I'm aiming for a natural birth again. I have a gut feeling I should work with my midwife and just stay home instead of going to the hosptal, which seemed a waste of time and money last time. My HMO paid most of the cost of the 11k natural birth I had at Alta Bates, but I feel I will be just fine at home. I'm still young, not a high risk pregnancy, etc..I'm looking for advice on any of you who decided to stay home and how it worked out for you, and what the procedure was for baby and you? I look forward your advice! Don't hate me, made to have babies!! :) Anonymous


I've had two straightforward homebirths, so can't give you hospital vs. homebirth perspective, but here's my experience. Specifically to answer your question about what happened after I delivered:

I held baby about 10 minutes (in birthing tub / on bed) and the midwives checked baby briefly in my arms. My husband held baby while I delivered the placenta. Once I was settled in bed, baby had a full checkup while laying next to me. Weighed baby and then I had help nursing her while midwives/doula cleaned my kitchen, hauled away dirty laundry and made me something to eat. Family cuddled in bed and midwives left once we were settled and secure. I recall feeling relieved we didn't have to go anywhere. Pediatrician dropped by to check the baby a few hours after we called to let them know the baby was born. Midwife came back to check on me the next day, then several times over the next few weeks.

I was expecting (and got) a very fast labor for my second, so called my midwife as soon as I realized I was in labor. Worked out fine. Congratulations on your pregnancy! Heather


You should rent the movie ''The Business of Being Born'' It was a great movie and will most likely solidify your desire to have a home birth. I did not have one, but after I saw this movie I wish I had. It documents a few women (one being Ricki Lake) and their home birth experiences. Good Luck! Anon
We've had four homebirths, and I cannot imagine doing it any other way. The older siblings were always at present, and all the kids are extremely close; each other's best friends. We believe it's mostly because of the homebirths. Our #4 wasn't covered by insurance, but we decided that the new baby deserved an equally wonderful beginning as his siblings. We paid the midwife little by little after I had seen a doctor (a good friend of our midwife's) at a clinic for prenatal care (covered by insurance). After the birth, the midwife checks the baby, and you make an appointment with your pediatrician to take the baby in. Our youngest was a day or two old when we took him in for a check-up. never a hospital-patient mom (knock-on-wood)
If your last birth took only an hour, you might be having the next one at home regardless of whether you had planned to go to the hospital! I would recommend waiting to make a decision until later in your pregnancy when you and your doctor are sure that everything still looks good. Also, check how much your HMO will pay toward your home-birth expenses. Sometimes, HMOs function better in assembly-line fashion than in handling special needs. Practical
I know that you are going to get many supporters of home birth on this forum, but please reconsider the hospital. At Alta Bates you can get little to no intervention, but if you needed it, there are professionals there who can save the life of you and your baby. Berkeley Pediatrician
I had a home birth at age 41, and I am so deeply grateful for that experience. My sister-in-law is an obstetrical nurse and says that, knowing what she knows, she'd be crazy to give birth in a hospital. She's had all 3 of hers at home too! She is back in school now to become a certified nurse midwife because she is so uncomfortable with the aggressive hospital interventions she sees.

My midwife's name is Mason Cornelius, and you could probably find her contact info. online. In 2004, the cost was $4000 for very consistent, competent, and educational home visits throughout the pregnancy, and for the delivery. The cost is the only downside as far as I'm concerned.

My labor was not easy (3 days) and those midwives were pro's. My husband was in awe of them. Their depth of knowledge, creative problem-solving, and wisdom are just phenomenal. I have no question that if I had needed to go to the hospital, they would have erred on the conservative side and taken me right in.

I researched exhaustively before making my decision, and the upshot was that infant/mom risk is about the same with professional midwife homebirth as in a hospital. The causes differ, but the statistics don't much. In a homebirth, issues arise, not surprisingly, from a lack of medical technology in a crisis. At the hospital, the dangers are exposure to infection from being in a sickhouse, basically, and from interventions that are botched/unnecessary. If you have any questions, feel free to email. kailo


You might want to check out the film ''The Business of Being Born''. It's a wonderful documentary put on by Ricki Lake who explores having your baby at home. The USA has the 2nd highest infant mortality rate in the developed world for hospital births and an alarming maternal death rate related to medical interventions. Some of the most prominent medical doctors in the U.S., among them, Christiane Northrup and namely, Marsden Wagner, who served as the Director of Women's & Children's Health for the World Health Organization (WHO) for 15 years, agree (and Wagner is quoted as saying): ''If you want a safe, humanized birth, get the hell out of the hospital.'' I'm not trying to scare you into having your baby at home, but these are the real statistics on these issues. When I start to build my family in 2-3 years, if my baby is healthy and a homebirth is indicated, I will definitely be having my babies at home. Best of luck to you! I know whatever you decide to do will be a wonderful experience! Sarah
Hi! How wonderful, congratulations!!! I have three kids, too, and my last two were born at home. I will tell you, it was amazing. Neither would I call ''easy'', my third being extremely trying (3 days of labor, 10 pound baby, etc. ), but healthy and normal. Rather than tell you all the details here, i would really suggest you start contacting midwives in the area. They are happy to come to your house for an interview, you can ask them every ?? you can think of, and all of them understand there's a good chance you won't hire them (you can only choose one, and there are alot of them!). They'll leave you with pamphlets of info, and you can choose the one you connect with the most. Two that I will suggest is Ellen Levitt in Alameda, her website is wombservice.com , Also there's the well known Awakenings with Debrah Simone and her clan. Both are freaking great! Also, look up some birth videos on line, or Natural Resources in the city rents birth videos of homebirths. It really is a completely natural process, it sounds like you already have great faith in yourself and your body, and birth in general. I would just suggest you start doing some research. (BTW, the midwives come fully prepared to do all the newborn checks that are necessary.)And please feel free to contact me personally, it's good to be with people that can relate!! Best of luck to you in making the choice right for you and your family!! Alison
You might really enjoy watching ''The Business of Being Born,'' a movie about birth, including homebirth, that came out last year. My experience of homebirth was that I could hold my baby as long as I wanted. The midwife did the health checks when we were ready. In fact, my baby didn't even leave the house for two or three days after he was born. Jennifer N.
I had both of my babies at home and it was the best decision for me. I worked with a wonderful midwife, Amrit Khalsa, and was so well taken care of and supported and I cherish that. Each one of us needs to choose where we feel the most comfortable and for me it was definitely at home and not in the hospital. I was able to labor in familiar surroundings, have family close by (and a midwife who could manage when I needed to be surrounded or not surrounded) and not have to move during labor. After each baby was born I could relax and enjoy being cozy at home with a wonderful home cooked meal and feel all the amazing energy that comes with a birth emanating from our home. The midwives came by to visit regularly after the birth and checked in on us and helped in so many ways.

My son, who is a teenager, loves to drive by the house he was born in in San Francisco and just see where he was born. We live in the home my daughter was born in and she jokes that is why she loves to play in our bedroom. Have your baby at home! I can go on and on and I would be happy to talk more about it with you if you have any questions. regards, Nina


You should totally go for it! I had my first baby six months ago at home and it was so wonderful for many reasons. I can't compare with hospital birth, but being home was comfortable and relaxed. All the people who were with me were loving, trusted friends and family and skilled practicioners. If you want more information please feel free to email me. My midwife is Judy Luce. She lives in Berkeley and is amazing! She has a website you can look at. Have you seen the documentary, ''The business of being born''? You should see it! mycatflora
How exciting that you are expecting your 3rd baby. Congratulations! I just had my 3rd baby and had him at Alta Bates. Our first two were home births. My home births were beautiful (except for the pain, which is why I decided to have baby #3 in the hospital with an epidural.) With my first two births I decided to get a birthing tub, which was a wonderful experience. I labored with my first in the tub, but she was born outside of the water. Our 2nd child was born in the water, which is truly magical. Our midwife listened carefully to what we wanted and let me hold the baby for as long as I wished. Unfortunately, I was pretty much out of it from the extreme pain and my interest in the baby at that time was fairly low. The midwife caters to YOU.

The aftercare at home is 100% different from that in the hospital. In the hospital I was just pretty much dumped in a room and I was instantly a statistic. Our vitals were checked, but there was zero care given. At home you are in your own bed, the baby is with you and there is no interference whatsoever.

I was also much more relaxed because I was at home. I wasn't a patient. I was a mother giving birth. It wasn't invasive with monitors, etc. Just my husband and I sharing the moment of birth.

It sounds like you already made up your mind, so I'd say: GO FOR IT! Have a wonderful birth and enjoy your new baby when he/she arrives! joj


By all means, yes! Have your baby at home! I had three children, two of those babies were born in my bed at home. I cannot speak highly enough of the experience, the midwives and the after birth care. I loved not having to go anywhere for check-ups. I found the midwives to be experts at what they do, for example, they really know how to help you get your baby out. Some things that really surprised me about homebirth-

1. It's all you baby. Depending on how much you want the midwife to be involved, it's really you who are having to push that baby out. I spent most of my labor alone in my bedroom because that's how I felt most comfortable.

2. Even though you might be dialated to a ten and through transition, you don't HAVE to push the baby out. This happened to me, and I tryed to push the baby out for at least an hour to no effect. Because I was so tired, my midwife advised me to take a nap, I said,''can you do that?'' She said ''that babies gonna come out of you at some point.''

3. The after birth was wonderful! The midwives immediately placed the babies on me and didn't take it off until I was ready- or in the case of my last baby, after listening to him breath she felt it necessary to take him into a steamy bathroom to help him breath and clap a special cup several times firmly on his back. There was NO SUCTIONING! I thought this was necessary, but that is not always true. The nurses in the hospital did this to my first baby and I thought it was so disturbing to him.

4. With the help and constant supervision of your midwife you can shower after the birth- meanwhile, the other midwife will change your sheets and make everything perfect for you and your new baby to get cozy and rest. I was treated like a queen! Huge glass of fresh squeezed juice and whatever else I needed. I suggest reading lots of books. I read Misconceptions by Naomi Wolf, Baby Catcher by Peggy Vincent, I can't remember the other ones, but they were about homebirth as well. I think that this is the most peaceful wonderful way for a baby to enter this world! homebirth mama


I had a great homebirth in Albany - much more pleasant than going into Alta Bates. My daughter was born in our living room in front of a cozy fire. I took an herb bath afterwards. The midwives cooked my husband and I dinner and tucked us all in bed before they left. I think that was a little unusual, though! This was Madres widwifery in Berkeley with Lucero Dorado. Work with a midwife you trust and respect - it was a beautiful experience for us. Katia
What a wonderful question. My most heartfelt advice is to give yourself and your whole family the lovely gift of a homebirth. I work in a Bay Area hospital birthing center, so I am very familiar with hospital birth, and I gave birth to my own child at home. Many hospitals will ''allow'' you to labor as you wish, especially in the case of someone like you who has relatively easy labors and births. But what was so radically different at home was what happened AFTER the birth. There was no rushing, no whisking, no timetable, no obligatory hospital routines, no frequent interruptions. Just me, my partner, and our baby gazing at each other, snuggling in our own bed, eating our own food, using our own shower, being dressed or naked as we felt like it, resting when we needed to, and with the incredibly loving and constant attention of our midwife. It was truly magical. And, with two older siblings, I think that it can be an incredible way to include children in the birth (to the extent that they and you want them involved). There's really nothing like it. Of course, pregnancy can bring surprises, and the best laid intentions to birth at home don't always work out. Your baby could be breech, you could have a placenta previa, or any other number of factors could necesitate a hospital birth. During the birth itself, there are a number of situations that would require transport to the hospital, and then of course you would just go. No one is so committed to homebirth that they would jeopardize a mother or baby just to give birth at home. That said, most of the time pregnancy and birth proceed normally and can happen quite safely at home. I think the best approach is to set your intention to birth at home, work with a reputable midwife whom you trust, make your plans, and then be flexible and willing to let it go if need be.

Logistically, there are a few things that happen after the birth that you need to make arrangements for: 1) the newborn screening blood test (PKU, etc.) -- most midwives will do this for you, so that you don't have to take your newborn to an office or lab to get it done. It should be done sometime between 12 hours and 7 days of life. 2) a pediatric exam -- midwives will do the initial assessment of your baby, but you should probably have a pediatric exam within 24 hours or so after the birth. Your pediatrician may be willing to come to your home to do this, or you can pay any number of pediatricians in the area who will do this. Much nicer than having to go in to the office. You must make arrangements in advance for this. 3) the birth certificate -- your midwife will give you the necessary paperwork and information. Then, on your own sweet time, you need to make an appointment at the county records clerk office and go down in person to fill out and sign their paperwork. An easy visit, I think we did it when our son was about 6 weeks old. It was sort of fun to have him ''off the grid,'' so to speak, and not known to any bureaucracies for that small window of time.

I hope this answers some of your questions. As a medical professional who is involved with birth, and especially as a mother who gave birth at home, I truly do not see any downside to homebirth. And the upside (well, there are too many to mention) is a beautiful, transformational experience for the whole family. Best of luck to you!


I decided to have a home birth for my second child and it was great. That was eight weeks ago and I am so glad that I went that route. You are the perfect candidate: low-risk pregnancy with easy, fast births. The midwife will give you a list of supplies that you will need for her to use and to keep your house clean. My midwife's priority is to let the family bond with the new baby right after the birth (provided everything goes fine and mom or baby don't need extra care for complications). So, I actually pulled my baby out myself (about 1/2 to 2/3 of my baby was out). I scooped her up under the shoulders and pulled her onto my tummy. My baby stayed on my tummy/torso until the placenta was out, I believe. They wrapped her up at some point and I nursed her fairly soon after the birth. They don't weight the baby for an hour or two (or give the baby its vitamin K shot, etc.), and they didn't give me my three stitches that I needed for about three hours. My midwife really believes that if everyone is healthy, bonding takes priority and that these other things can wait. They clean up and make sure I get a shower before they leave, and also make sure that we are all OK and settled in. It is so nice after the birth to be home and not in the hospital in their uncomfortable beds with constant interruptions from nurses and other staff members, and no roommates! The atmosphere after the birth is calm and warm. I suggest that you seriously cosider this option. Andi
Congratulations on your pregnancy! It sounds like your first two births were ''easy'' and fast. I have had two homebirths and am planning our third. Here are some facts for you to consider: Midwives who attend homebirths are either CNMs (like the ones at your hospital) or LMs; both have had extensive training, just different routes. Both are certified by the State of California. Homebirth midwives are trained for emergencies and what to look out for and would never keep you at home if they sense something is not right. They carry oxygen, are neonatal resuscitation certified and almost always work in pairs (one midwife for the mother, one midwife for the baby). The cost of homebirth in the bay area is about $4000.00 and HMOs will NOT pay for this. PPOs would consider this as outside of their provider network and usually pay up to 70% of the cost after deductibles. Homebirths are wonderful and I believe you get more care and one on one time with the midwife than you would at the hospital. First of all, most midwives will do home visits with you and they will last up to an hour each time. They first come once a month or once every 3 weeks, and then every 2 weeks, and then every week. AFter the baby is born, they do a complete check of the baby and there are even some pediatricians in the area who have worked enough with the homebirth community here that they trust the midwives' judgement enough to not ''require'' the families to come for a 1 day or 3 day appt. with their baby. Some pediatricians will even do a home visit after the baby is born! One of my favorite things about the midwifery care is that the midwives will attend to you after the baby is born, 1 day, 3 days, 1 week, 2 weeks and and then 3 weeks later, checking both YOU and the baby. You do not get this from a hospital birth. Most doctors require that you come in only at 6 weeks to get a check and you need to take your baby to the pediatrician yourself. Also, midwives can do all lab tests or sign off of them if you need them during prenatal/postnatal visits. Midwives will do the Vitamin K shot and the eye antibiotics if you choose for your baby. Midwives can even perform IV lines for you during labor if you are GBS positive.

What they will not do is strap you to a continuous heart rate monitor throughout your pregnancy (they will check at appropriate times with their doppler) and they will not make you stay in bed. They will not deprive you of food or drink; in fact, they will encourage you to eat whatever you want and to hydrate yourself. They do not care how many people are in your home, if you don't want the cord to be cut right away, if you don't want the cord cut at all (called a lotus birth)!! All decisions are mutually agreed upon; they will advice you but you have the final say of anything (unless of course it's an emergency during pregnancy - say, preeclampsia - or during labor/birth). You will need to be aware that you are fully responsible for all decision making, more so than at a hospital. Midwives usually don't carry malpractice insurance because 1) it is cost prohibitive and 2) it may not be offered to them, so be aware of this. Also remember as I already said, midwives are trained to know what are unusual or abnormal pregnancy symptoms; they will only offer homebirths to low risk women. If symptoms arise that cause a woman to be high risk, they will refer you to your OB/GYN or hospital based midwife for a hospital birth. Lastly, you live in a great area where there are so many wonderful, experienced midwives available. Call SOON because most midiwves are booked 9 months in advance!!! My favorite is Cindy Haag, of the Homebirth Collective, www.bayareahomebirth.org. She has a fine balance of alternative and western medical knowledge and is respected by midwives, doctors and hospitals throughout the bay area, inc. SF. She is often booked though!! I can compare hospital and homebirth care because I have been a birth doula at hospitals and also a homebirth apprentice midwife, as well as having had concurrent care for my pregnancies. You can post a reply with your email address if you need more information or want to talk. 3rd timer homebirther


I realize that there can be many beautiful aspects to a homebirth and I see all the positive feedback regarding choosing that path, but here is my 2 cents...I had two midwife attended, intentional drug free hospital births. There were about a dozen times that I thought to myself during labor how glad I was to NOT be at home. They were...that birth is messy! How nice to not even think about that aspect and who was dealing with the mess, the endless hot water the hospital had for 6 hour showers, the birth/toilet seat, the comforting knowledge that IF something should go wrong, I was where I needed to be, the team behind the scenes making sure I and baby were fine, all the paperwork that was just handled, and the feeling that I was NOT at home...with the phone, doorbell and other daily interruptions that I would find to be intrusion. My second child did wind up getting stuck and it was an intense few moments, but the right Dr was called and there in a second. I was able to breathe through it and the midwife coached me, but the knowledge that SHOULD the baby or I need immediate intervention, we would have been okay was worth more that what I perceive to be the pluses of having a home birth. If we had crystal balls that would be a different story, but we don't and why risk it? I don't mean to be the lone fear monger here, but things can and do go wrong in childbirth and if you can still have a positive natural birth experience with support there in case of an unforeseen circumstance, why wouldn't you? Pro natural hospital birther

Bureaucratic paperwork for a Homebirth

May 2007

I'm planning a quite late switcheroo to a homebirth (32nd week) from Kaiser. I was hoping to get some advice about all the bureaucratic stuff that is typically done for a birth. I.e. the pregnancy disability paperwork, birth certificate, etc. I know at Kaiser, they usually help you with all this stuff. Is it more of a hassle when working with a midwife? Anyone with experience, I'd greatly appreciate your advice. Jina


Congratulations on your baby. We also switched to a homebirth from Kaiser, but ours was at 16 weeks. The midwife was wonderful, really helping us a great deal, and she handled all the paperwork for tests and screens she did through her. We took care of the birth tub ourselves (midwife had a list of renters), and ordering our birth kit, for which the midwife provided the info as well. There was a Labor and Delivery form Kaiser had for us, as they were our backup.

We did have to fill out a couple Government forms ourselves. To get pregnancy-related disability, I had to fill out a claim form for State Disability Insurance (SDI) benefits. I sent it in the day I stopped working. Here's a link to SDI phone numbers: http://www.edd.ca.gov/direp/diloc.htm#Phone

Then for paid family leave, California state's EDD automatically sent me the form ''Claim for Paid Family Leave (PFL) Benefits - New Mother, DE 2501FP'' when my SDI claim was ending. I sent the form back with the documentation it asked for. They phoned me to verify the info was correct and they phoned the midwife to verify the birth. PFL kicked in when the SDI ended. My partner was able to claim PFL as well.

For the birth certificate, our midwife gave us the number to call for birth certificates at the county health department. They set up an appointment for us to come in with the baby. At the appointment, the midwife met us there, so we could all sign the form and certificate at the same time, and it was all easy and friendly as they knew the midwife well. We were in and out in about 20 minutes--not a hassle for us. Much joy to you on your amazing journey. Homebirth Mom


Good for you for choosing a homebirth! You will be so thrilled. From my own experience, there is no hassle about any of the paperwork. I filed for my maternity leave/disability with no problem, and the birth certificate is something you and your midwife do at your convenience with the county. As I recall, we waited several weeks to file it. Good luck! Julia
we did just this! because of open enrollment timing, we switched insurance at 36 weeks (jan '05) from kaiser to a PPO. and the baby came so fast that she beat the midwife by half an hour (so she did not sign off on the birth cert).

the paperwork isn't that difficult.

SDI: midwife (hired when i was ~3mos along, and still with kaiser) filled out/signed the MD portion, i mailed it in. my PFL was automatically extended afterwards (ie forms sent to me by EDD when SDI was due to run out). when my husband applied for PFL, we didn't have the ''required'' paperwork for proof of birth yet (hospital D/C record, birth cert), so we sent in copies of the midwife's affadavit of pregnancy and the preliminary application for the birth certificate. no questions asked, checks started arriving.

birth cert: took midwife's affadavit of pregnancy, and the application forms she had given us to fill out, to alameda co. registrar (?1100 broadway). had to call for an appt, and there was supposed to be a lag time of several weeks, but when i explained we were going to need the birth cert in order to apply for PFL (which i later turned out not to actually need, but didn't know then), and were having $ difficulty waiting for PFL benefits, the registrar kindly fit us in that week. we had to take the baby to the appt (required, ?so people don't scam?), and since my huband and i (and our 3yo daughter) were the only witnesses to the birth, my husband signed as attendant/witness (where the midwife/OB would usually sign). the hardest part was getting out the door (with a 2 week old), and sitting in the registrar's office for an hour (with a restless/whining 3yo), while he filled out the computer fields. i can't recall his name, but he was very nice, and told us that he was born at home, too! he does all the birth/deaths in alameda co (mostly sent in by hospitals), except for some reason berkeley is separate.

have a great birth! signed :done it, it's not so bad.


a home birth is worth it! there may be a little more effort on your part, and your midwife will help steer you, but having your newborn, snuggling in your bed, having your family around and not having any unneccessary prodding or poking is way worth it! i've had a hospital birth and home birth, and although both experiences were great and fortunate, home is the way to go, no matter what the trade off. c

Worried about sister's home birth plan

Feb 2007

My sister is having her first baby. She announced to the rest of the family that she and her husband decided to have the baby at home. We are very concerned about it. She says that she has done a lot of ''research'' about it, which I think means that she's surfed the internet and found postings about how horrible hospitals are. She hasn't visited the hospital and is somewhat unwilling to hear other points of view. I did some basic internet searching and found that most of what is out there is very biased towards home births. Even statistics like ''40% of first time moms end up having to go to the hospital anyway because of slow progression'' are presented with a more positive slant. I have known lots of moms who have had successful home births for their second, third or fourth child. My main concern is that it is her first baby so no one knows how it will go. Another sister and I both have been able to have normal vaginal deliveries but we each had significant tearing and two of the four babies we have between us had some complications during delivery (umbilical cord around neck and one was a ''floppy baby'' and needed to be resuscitated).

Please be kind in your responses. I'm just looking to hear experiences, positive and negative and maybe some suggestions on where to find information that presents both options(hospital and home) in a non-biased way. anon


I think you'll be hard pressed to find non-biased information for both sides in the same publication. We all suffer from confirmation bias - ignoring data that doesn't support our pre-conceived notions and overvaluing data that confirms what we already believe. As a woman who had her first baby at home and is planning the second in a couple months, I'm biased toward home birth.

My pregnancy and birth progressed differently than my sister's; each woman and each birth is different. I got flack from my family for choosing home birth. I wish they had been supportive. I had a short birth with a healthy alert baby. Her cord was around her neck, but it was not an emergency that TV shows portray. Midwives have the training and equipment for handling minor complications. Those requiring additional care are transferred to a hospital, and how wonderful it is to have that resource when needed. Transfer to a hospital is rarely an emergency; usually evidence of midwives being cautious.

Each woman has to make her own decision. I think each of us will birth best wherever we feel safest. I can tell you love your sister and are worried about her, but challenging her first major parenting decision is not helpful in the long run. If she appears headstrong about it, I'd bet she's just bracing herself for the reaction she anticipates from family, not that she is uneducated. Buy her a copy of "Ina May's Guide to Childbirth" and tell her how excited you are for her. Heather


Hi Sister of First time Mom, I had a wonderful home birth for my first son and didn't tear at all because I labored in a tub and birthed him in a tub (not allowed in hospitals). it was a wonderful joyous experience with almost no pain (fear but not pain) and without drugs. I've never met anyone who felt bad about their homebirth but many many moms who do about their hospital births. The research i've read, and i've read a lot, is very clear-- healthy moms are better off at home. As someone who's family didn't origianlly support my home birth but are now very happy I chose it, I hope you can slow down and recognize that this is your sister's birth to plan. She will feel more loved by you if you respect her choice then if you challenge it. BTW, my midwives let me have the 45 minutes it took for me to birth the placenta (my baby wasn't latched on correctly so I didn't have enough nip stim) but in a hospital they would have separated me from my son and given me a dnc-- and that's really painful without anastegia but with anastegia I'd be giving it to my newborn in milk. I am so glad for the loving home birth I got to have. Thanks for listening Julia
I am the mother of one child and I had an absolutely beautiful home birth. There are a lot of books that have been written that include real research based on birth experiences in other countries (see ''Gentle Birth Choices'' by Barbara Harper as an excellent example) that show that home birth can be a safe and positive alternative for those who choose it. I don't think home birth is for everyone, but for me it was an important choice. I knew that I would feel most comfortable if I had control over my environment. I took a birthing class specifically designed for people who intended to birth at home. I hired a team of highly experienced Certified Nurse Midwives who came to my home to guide me through my birthing experience and who I trusted implicitly. I knew that if I or the baby faced any serious danger they would not hesitate to transfer me to the hospital (Alta Bates was about a 10-minute drive from my house), but I also knew that as long as everyone was healthy and looking good I would be able to stay at home. In the end I needed an episiotomy, which I didn't mind having at all in part because I knew that my midwife would not have suggested it if she didn't think it was important to do. If I had been in the hospital I might have second-guessed whether it was really necessary, which might have made me feel bad after the birth about having an unnecessary intervention (something I very much wanted to avoid). Even with the minor procedure, I healed up in no time. My baby had the gentle entrance into the world that I wanted for him and I have a very postive memory of an empowering, beautiful, even fun (at times) labor and birth.

I have a graduate degree and I know how to do research, and I also know how to follow my gut. Home birth was absolutely the right choice for me. I would do it again in a heartbeat. If it's right for your sister, please find a way to be open to her perspective if you can. If you do some reading about the statistics of home birth in other developed countries you might be surprised to see how safe it is (particularly if an experienced midwife attends the birth). Good luck to you and to her. Happy to have had #1 at home


I'm not trying to be unkind, but this is not your birth. You've made your decisions and now your sister is making hers. If you've told her your point of view and she has not been receptive, you should drop it. Ask yourself if there is any statistic or fact she could have given you to make you change your mind and have a homebirth for yourself. If the answer is no, then why do you think you can convince her against something she feels is right for her? Anon
I've had both a hospital birth and a home birth. My homebirth midwife spent several hours with me talking about risks, and I really liked the way she summed it up: some risks are greater in a homebirth, some risks are greater in a hospital birth: what set of risks are you most comfortable with? All sorts of educated, rational, reasonable, informed, and cautious people prefer the set of risks in a homebirth.

I asked my midwife LOTS of questions about what would happen if something went wrong, including worst-case scenarios i.e. what could happen that would cause the baby or me to die before we could get to the hospital? With that information, I felt that I could make a responsible and considered decision. I had a high degree of confidence in my midwife's expertise, including medical expertise (she had been a labor and delivery nurse, and a neo-natal ICU nurse)-- certainly, a highly-competent midwife is essential.

I guess it's hard to describe why giving birth at home is so important to some of us. My hospital birth experience wasn't horrible: unmedicated, no interventions, and of course the indescribable joy of a healthy baby. But, giving birth at home was...a truly spiritual experience, like a veil opened up in our house, an incredibly deep peace, even in the midst of strong labor.

Perhaps you could embark on your research project with a truly open-mind, with the intent of educating yourself instead of convincing your sister-in-law. Then, you might be able to share in the joy of her pregnancy, and truly support her. Happy and healthy at home


I had a homebirth with my first child, and the research does support the idea that, for a normal pregnancy, homebirth has equally good outcomes for the babies, and better outcomes for the moms. I also had an excellent midwife, which is important. You might want to watch the excellent PBS video ''Born in the USA''. I showed it to my mom and to anybody else who had misconceptions about homebirth, and it seemed to work really well. In fact, my mom ended up realizing that she would have been a perfect candidate for a homebirth, and would have had a much better experience. Here is a link to a page about the video--I think you can order it there, also. http://www.itvs.org/bornintheusa/index.html I hope you end up being able to support your sister in her choice. Hope This Helps
Hi, I just had to write to your post, and I'll try to be gentle. I had VERY strong opinions towards having a home birth though my family was very worried about it. I had a wonderful experience as a first time mother. My midwives were amazing, and I am totally sure that I would have had a c-section if I were in the hospital because my labor was very long. My midwives not only skillfully unwrapped the umbilical cord from around my baby's neck without my even being aware of it, but also helped my baby who wasn't breathing in a way they felt comfortable with. Midwives, especially around here, are very careful when it comes to the health of their clients, and will recommend a transfer to a hospital if they have concerns. If I were you, I would celebrate my sister's choice to have her baby in a way that feels the best to her. She most likeley will give birth in a natural and loving enironment, and best of all after the baby is born, she will be able to curl into bed with her new little one, in the peace of their own home. happy homebirther
I know someone who had a home birth (first child) in a rural area and the baby died of complications that could have been handled at a hospital. Another mom with a first birth had to call 911 to have the baby resuscitated; the umbilical cord was wrapped around the baby's neck. My first birth had complications and only quick action by a team of specialists prevented my son from having possible brain damage. For a home birth it is good to have a well thought out emergency plan. anon
Did you know that women in many European countries always have their births at home? That is the norm. They are moved to the hospital when there are complications. The reason for this is that women generally feel much more relaxed in their home environment which often results in a more relaxed birthing experience and less complications.
Hi, I'm sorry that you're so fearful about home birth for your sister. Here's my bias up front: I had a first-baby home birth in Berkeley in 2004 and could not have been happier. Prenatal visits were one hour, in my home. I was required to do a lot of homework with my husband regarding our hopes and expectations; also about complications and their outcomes. My midwife provided educational books and videos and wanted us to visit the hospital and take a childbirth course. In other words, she strongly encouraged us to learn about the reality of birth in general and home birth in particular. All standard medical tests were available and discussed extensively. She and her team came to my home five hours before my delivery (when I called) and stayed for six hours after, then visited my family many times in the days and weeks following the birth. She did an excellent job with the 13 stitches I needed (with local painkiller) and had oxygen on hand. My son was born totally healthy and we were all unexpectedly happy not to be stuck in the hospital AFTER delivery.

It turned out that 3 of 12 women in my Mom's group had successful home births.

It's true that no one knows what will happen with a first -or second, third or fourth birth. But home birth midwives are obligated to turn down women who have medical reasons not to give birth at home. That's why their morbidity and mortality statistics are better than doctors and midwives in hospitals. A 40% hospital transfer rate for first time births is much higher any I've seen, though it is true that some women go to the hospital. Remember that few of these women transfer because of medical emergencies and very few of these transfers result in poor outcomes for mother or baby.

Are there risks in home birth? Yes. There are also real risks in hospital births, resulting from the hospital setting. I wouldn't recommend home birth for anyone who has not chosen to learn about birth and pain management - you really need to train for it. It sounds as though you AND your sister could both learn more about the realities of home and hospital births. Maybe buy her the book ''Birthing from Within'', which has accurate information about preparing for hospital and home birth and is ''alternative-y'' enough that you may be able to slip it past your sister's defensiveness. For you I'd recommend reading Ina May Gaskin's most recent book about home birth - the back of the book has outcome statistics about thousands of home births.

You'll probably get a lot of responses to this question and I'm looking forward to reading all of them. Good luck, Would Do it Again Tomorrow


-- I had both our children at home. There are two midwives present during the birth and they are highly trained and will also know when to make the decision to move the mother to the hospital if that is necessary. Both my births were wonderful. No complications and I received wonderful after care at home. I realize that it seems controversial to have your child at home, but it is a very normal, beautiful experience. Good for you for trying to get more information about this, though. JOJ
I understand and appreciate your concern for your sister. I had a homebirth three years ago and was so happy we were fortunate to birth in our own bedroom and spend the night in our own bed with our new baby. Ultimately, this is your sister's journey and her experience, while possibly similar to yours, will be her own. In our situation, I found that those who were supportive, even if they wouldn't choose it for themselves, were the most helpful to me during my own decision- making process and the birth itself. I know that a few of my sisters and my parents never really got on board with the idea (and definitely none of my in-laws did), but they were respectful and caring throughout the process. That meant the world to me. You might be able to find comfort in the research that indicates that homebirths are as safe or safer than hospital births for a non-high-risk pregnancy, but even if you can't come to a place of total confidence for yourself, you can provide loving support and back-up to your sister during this important time. happy homebirth momma
I have three friends who had successful home births for their first pregnancies. This is actually quite common and most births turn out fine. If your sister has a competent midwife, she will be fine, even if she ends up with complications. Anon
Have you read the study ''Outcomes of planned home births with Certified Professional Midwives: Large Prospective Study in North America'' from the British Medical Journal? http://www.bmj.com/cgi/content/full/330/7505/1416

It will help you to be informed. I had a homebirth with my first and it was the best thing I've ever done. I hope you can come to support your sister and her decision--it is a great one for her and her baby, a safe choice (far safer than hospital births according to studies that have convinced European nations to advise homebirth for low-risk pregnancies to increase the safety of birth there...a little research will point you there (most of this is on my computer in .pdf form and you didn't leave your email address)).

If your sister is in the Bay Area, point her to the Bay Area Homebirth Collective for support. http://bayareahomebirth.org

I could go on and on about the upside of homebirth, but I will let others sing that song. Suffice it to say, the interventions regularly used in hospitals (induction, etc) inevitably lead to even more intervention (epidural, episiotomy, etc) and doctors will tell you this (if you have x, you are more likely to have y as well). As a doula, I have seen this up close.

Your belittling of your sisters research seems to indicate that you generally don't trust her; that seems like a bigger issue to me than her choice of venue for her birth and one better resolved directly rather than indirectly through dissuading her from a safe choice around her labor and delivery. Best wishes to your sister and her husband! proud and informed homebirther


I was a two-time homebirth mother and know many others. In fact, I would suggest that you go to one of the Bay Area Homebirth Collectives potlucks. They are very informative and new parents will talk about their experiences, whether they had a homebirth or a hospital birth. And you would get to talk to many homebirth midwives. The potlucks aren't just for expecting parents: http: www.bayareahomebirth.org

You may also want to read this very recent study, published in the British Medical Journal regarding homebirths in North America. Most if not all of the homebirth midwives in our area were part of this study: http://www.bmj.com/cgi/content/full/330/7505/1416?ehom_

Lastly, no one knows whether a first time or a second time or a fourth time labor and birth will be ''normal''. But, licensed midwives, like certified nurse midwives (who mostly work in hospitals) are trained to screen out mothers who may have a high-risk pregnancy, so chances for a normal birth at home are optimal. And licensed midwives are trained in neonatal resuscitation, carry oxygen and other such medical devices. They also know how to suture most tears if that happens. Umbilical cord around the neck is actually not so rare and often OBs and midwives just take the cord off when the baby's head comes out - true umbilical cord wrapping that creates a serious problem is not as common. And yes, you're right - many first time mothers end up transporting to a hospital - but for NON- EMERGENCY reasons, the main one being for ''lack of progress'', meaning that labor may have stalled and the mother is exhausted. There are definitely times when a hospital birth is necessary or advised, and homebirth midwives know when this is so - they are not going to keep you at home just for the sake of a homebirth.

Unlike hospital births, homebirth midwives visit their mothers and babies the day after birth, three days after birth, 6 days after birth, 10 days after birth, 3 weeks after birth, and then 6 weeks after birth - and are on call 24 hours a day. They check on the mother AND the baby AT HOME. Care with a homebirth midwife is like being pampered, and rightly so as a new mother!

Like you would interview for an OB - which is HIGHLY RECOMMENDED - you should interview for a midwife. I hope your sister has done this. I think you would benefit from going to one of the BAHC potlucks.

Good luck and please keep an open mind and most importantly, support your sister in whatever decision she makes - she is already stressed about all of the decisions she has to make as a new mother. homebirth mama


i can understand your concerns around a first-time mom having a home birth, but speaking as a first-time mom who wanted an unmedicated birth, i wish i had given birth at home instead of the hospital.

i labored at home with the support of my husband and doula. i actually handled labor so well (walking the entire time, which probably progressed labor faster, and just riding each wave as it came) that i was ready to push when i was still in our bathroom. i was waiting for this horrible pain and experience to consume me. i figured it must be horrible if most people in our culture talk about labor so negatively and use drugs with little hesitation. but it wasn't that way at all. to my surprise, i was ready to push after only 4 1/2 hours of labor.

although i was ready to push, i felt going to the hospital was the ''responsible'' thing to do, so i held my daughter in for an hour until the nurses let me push at the hospital. HELLO!!! i held her in for an hour! we'll never know what caused what, but our daughter was EXTREMELY colicky and suffered from reflux for months. colic is still one of those baby mysteries (which some attribute to digestive issues), but in our experience it wasn't that cut and dry. we tried every remedy, between alternative medicine and conventional medicine, and nothing worked. to this day, we can't help but think the trauma of holding her inside of me for so long contributed, if not, caused our daughter's colic and reflux issues.

so all of that was a long way of saying that no one can predict (whether first-time or not) what will happen in labor. it's most important that the mother and partner choose a provider they're absolutely comfortable with and trust completely. complications usually present themselves with warning signs, so there's time to get to a hospital, if the provider knows what to look for.

to address a couple of other points you mentioned... tearing is less likely if the mother is unmedicated and pushes when she feels she's ready (not when she's ''coached'' to do so).

resources on this matter are never unbiased, especially if you ask my husband, who has come a long way in his views on childbirth. during pregnancy, i enjoyed reading _birthing from within_ by pam england and rob horowitz and especially _ina may's guide to childbirth_ by ina may gaskin. ina may's book is rich in information and is supplemented with inspiring stories about women who birthed in a home-like setting. lydia


I want to be clear that I am not being judgemental. This is a very personal decision. But, let me not mince with words, my son would be DEAD, not sick, not ill, dead, if we had chosen a home birth. He was our first. I had no complications during my pregnancy, was extremely healthy and carried to term. We had no inkling, I repeat, no idea, that the baby was sick until the moment he was born, with acute pnemonia and unable to breathe on his own. There wasn't even time for the doctor to call for a crash cart, he simply took the baby off of my chest and literally ran him to the intensive care unit. During his stay in intensive care, there was at least one more baby born with identical circumstances. I feel for you as you worry over her decision, especially in light of your own family experiences. Just the chance that this could happen to anyone else, and that they could be far from help, makes me cringe. The possibility that my baby would not be alive today because of a decision I made is not something I could live with, maybe your sister-in-law is a stronger person that I am. Grateful to be a Mom to a Healthy Baby
We recently had our beautiful baby girl at home. It was a peaceful, quiet, joyful first birth. There two websites I would recommend for information on home births and why they are safer than hospital births (for 'normal' pregnancies). www.mothering.com www.midwiferytoday.com Ina May's Guide to Childbirth book may help you understand more about home births and the birthing process. In addition, there was a midwife on KPFA's Your Own Health and Fitness this week (2/27/07) The show was called Cesarean Epidemic. Here is the link: http://yourownhealthandfitness.org/radioshow.php After our homebirth experience, I couldn't possibly imagine having a birth anywhere else, especially in a hospital. And as a doula who has assisted in numerous hospital births I can attest from personal experience that a hospital is the least conducive place to give birth. I wish your sister all the best in her home birth and that you will be able to support her decision. Kim
I may not be the person you are looking for to answer this question, since my homebirth was with my second child. But I did have one hospital birth and one homebirth. I was initially very skeptical about a home birth and very worried that a complication would force me to go to the hospital anyway, or that there would be a medical emergency. I had a very stress- free experience with my homebirth. My hospital birth with my first son was in general fine, but I did have significant tearing and there was some stress around getting him out because of a dropping heartrate. For several reasons, I have come to the conclusion that my stressful experience at the hospital was actually CAUSED by things that the attendants at the hospital did and didn't do, and if I had been at home, that birth would have gone completely differently.

While I was laboring at the hospital, the nurse on duty made me stay on my back with the monitor on for several hours because the baby's heartrate was dipping. I had a very strong urge to get onto my hands and knees, but they wouldn't let me. My labor slowed down. Once the shift changed, the new nurse put in an internal monitor which allowed me to change to hands and knees. As soon as I made that change, his heartrate was absolutely fine and my labor sped up again. When it was time for me to push - inexplicably - they made me go back to being on my back. As soon as they did that, his heartrate started dipping. They didn't let me change position - instead, they decided to use suction. He came out, and because of the suction, I tore considerably. Right after that, the doctor said that she regretted they'd used suction, because he came out pretty easily, he would have come out in time anyway, and the suction really made me tear. I had a very long recovery period (it was 3 months before I was walking right again) and some depression issues that I am fairly certain were related to that.

4 years later - my homebirth was entirely on my hands and knees, and that position worked so well for me that between when my contractions started to get strong and when he came out was about 20 minutes tops. Yeah, some of that had to do with the fact that it was a subsequent birth, but I really think that the atmosphere at home and the fact that I was really self- directed in my laboring made a huge difference in my experience.

Another thing that I want to say... midwives KNOW when there is a chance someone will have to be transported to the hospital. They are not waiting and hoping situations will improve - they transport right away if they think there is a need. They are also fully trained in resuscitation, handling hemorrhages, etc - all the common complications that can arise. The midwives I worked with had plenty of first-time parents as clients. When I asked them about transporting to the hospital, they said that they would not hesitate to do it at all, and that in 10 years of practice they had not had a single medical emergency at a home. So if your worry is that she will have a medical emergency and she or the baby will be harmed - look at the statistics about how often that happens at a homebirth vs. a hospital and I think that will ease your mind.

I also want to say that the quality of care given by midwives is really unbeatable. For this last pregnancy, I changed to a homebirth very late in the game (36 weeks) so I experienced Kaiser care vs. midwife care. I can't tell you how different it was. At Kaiser I didn't see the same person twice for my appointments, which were all of 5 minutes each, and no one paid any attention to my state of mind (which I was worried about because of previous PPD), my other child, my knowledge of caring for a newborn - they were only interested in the baby. After one or two weekly hour-long meetings with the midwives, I felt very different, and much better, about my pregnancy. I didn't realize before that how much the tone of the care you receive really influences how you think about yourself, your body, your baby.

Anyway - please don't take this as propaganda or dismiss this as biased. Actually, I AM biased but it is thoroughly based on my experience. I hope you can let her make her decision and stand behind her. experienced (again)


-- Like you, I support homebirths but am a bit more nervous for first-timers. At any rate, midwives do carry resuscitation equipment. They also sew tears and have the same medicines to stop hemorrhage that the hospital uses. I don't think it's really your business to pass info along to her. This is her body, her birth, she knows what she wants to do and she doesn't need your approval. Though, showing disapproval will add to her stress. So, do everybody a favor and be nice about it. maybe homebirthing next time
I'm sure you'll get plenty of responses, so I'll try to make mine short. I think most people consider home birth because (ironically) they are scared of the birth process (aren't we all?)/and or hospitals/doctors, and are trying to exert any kind of control they can on an unknown situation. If I were you I would try to get your sister to open up about her specific fears or concerns. Most of them can be addressed with a good birth plan/doula/midwife in a hospital setting.

In my own birth experience, after a completely healthy, uneventful pregnancy and labor, my daughter got stuck in the last phases of pushing, and her heart rate was dropping with each contraction. It turns out her cord was also around the neck (very common). My ob suggested using forceps to get her out (and then gave me and my husband time alone to discuss it, btw) and if she hadn't, I don't know what would have happened.

To be more on the direct side, you could always use this approach: ''If your baby stopped breathing when it was one day old, would you insist (s)he be treated at home, or would you take them to a hospital?'' and then assuming she says she would go to the hospital, ''So what difference does that one day make?'' Sure, a lot of babies are born at home and MOST of them do okay, but do you want your baby (or yourself) to suffer what could be irreparable damage if something should go wrong?

And lastly, in the words of a (young) pediatrician I know.... ''My grandmother gave birth to all 10 of her children at home, and 8 of them lived'' If your sister does decide on home birth, I wish her all the luck in the world, she'll need it.

Expect the best, but prepare for the worst... Believe in the Boy Scout Motto


when i was pregnant with my first, i wanted completely natural childbirth. i was going to, however, have a tub birth with a midwife in a birth center with docs on site. much to my shock (having an unbelievably great pregnancy) i ended up with a cesarian. it turns out my uterus was abnormal (bicorunate) and i couldn't give birth naturally. we didn't find out until they noticed my baby was breech - which they didn't find out about until they went to check something else on ultrasound.

the reason for my story? i thought everything was going to be perfect with my birth. but the truth is, birth isn't perfect. if i hadn't gone in to the hospital, either i or the baby could have died. now, tons of women have successful home births, but i don't know if i would risk finding out that i am the one who will have a problem. that is why we wanted natural birth in the hospital in the first place. anon


Hi! I have had TWO successful homebirths! My first child was born after 17 hours of grueling back labor at home. She was positioned funny as well (hence the back labor), but heart tones were always great and she was born completely pink. I stalled for several hours at about 7 centimeters and we did begin talking about transfering to the hospital because I was so exhausted. But, I really wanted this baby at home, so we prayed hard, worked together, and had a baby!! It was amazing! I tore very badly (I think the worst my midwife had seen) and needed lots of stitches which my midwife did. I attribute the tearing to the transverse position of the baby. I did take months to heal. But, this could have just as easily occured in the hospital.

I was one of 3 women in my childbirth preparation class who had successful homebirths, all of us first-timers. I did lots of research as well (including a research paper on homebirth vs. hospital birth in nursing school) and it all points to the fact that in the presence of a qualified practitioner, homebirth is as safe as hospital birth. I think she should go for it! As long as she is close to a hospital and has a good midwife, she will most likely be fine. She will most likely also have a much much more positive experience as well. Take care, an RN who chooses homebirth


sorry if this is ''biased,'' but really, 99% of pregnancy/birth info in the US is biased towards the ''necessity'' of hospitals and interventions that disturb the automatic unconscious efficiency of birth. i am a PT, i work in a hospital, and was pretty mainstream UNTIL i gave birth in a hospital. mine would be considered a ''natural birth'' (no drugs, 7 hrs labor, 2 hrs at alta bates), but i felt bossed around and ''processed'' by the system. they even gave me pitocin WITHOUT TELLING ME (found out later when i got my records) to speed delivery of the placenta, which left me with terrible afterpains. i felt so strongly about my needs/feelings being ignored the first time, that i started researching. when i read about ''undisturbed'' birth (=unassisted childbirth) it sounded like heaven!

i chose a homebirth for my next birth. i now know many women who've had first babies at home. it was like night and day how great the care of my midwives was. they came to my house, spent 1 to 1 1/2 hours with me each visit, gave me tons of info, and really dealt with finding out what i needed. i'm sure i would have had a great first labor with midwifery care. in fact, my 2nd labor was so easy (and quick, ~4hrs) that i had the baby shortly before the midwives got there, no active pushing, just the strength of the contractions doing their job. i felt so empowered by this experience because I myself delivered my baby. women's power is co-opted by the medical industry that distrusts our bodies, and thus we have insane C/S rates.

so if you distrust the internet, read some books, anything by: sheila kitzinger: http://www.sheilakitzinger.com/BooksUSA.htm ina mae gaskin: http://www.salon.com/people/bc/1999/06/01/gaskin/ Michel Odent: http://www.michelodent.com/section.php?section=odent or contact the Bay Area Homebirth Collective for more resources.

please educate yourself to allay some of your fears, and allow your sister to make her choice without trying to scare her. as you read, ask yourself if some of the problems you and your other sister had were CAUSED by the hospital model. were you given freedom of choice in positioning? or did you deliver in stirrups for the convenience of the doctor, like i did, which is much more likely to cause tearing than any other position, such standing, all fours, sidelying (where i wanted to be), or squatting. were you monitored, and thus expected to stay still for the convenience of monitoring, then saw your labor slow? there's a lot to learn about birth, and most of what conventional OB's and ''birth classes'' teach is geared towards teaching women to be expectant and accepting of medical intervention. i hope you can learn to trust your sister's decision. biased: wish i'd homebirthed the first time


I hear that you feel concerned for your sister out of fear for her and her baby's well-being. It's truly a big unknown. Personally, I had a planned homebirth for my first baby that turned out fine, and we'd do it again. When DH and I were trying to make our own decision, it was by talking to a friend who was a homebirth mom, then reading ''Having a Baby, Naturally'' by Peggy O'Mara & ''A Thinking Woman's Guide to a Better Birth'' by Henci Goer (I recommend the above Henci Goer book as it wasn't biased against hospital birth), touring the L&D ward at a hospital, talking to three hospital doulas, then extensively interviewing three homebirth midwives. After that we made our decision, by which time I was 18 weeks along. When I told my OB, she said, ''How exciting that must be for you.'' I still kept going to the OB for tests and cursory exams.

However, factors influencing one's decision to plan a homebirth differ for each individual. For example, does your sister have diabetes or high blood pressure? If there are things in her medical history that would make her pregnancy high risk, then a midwife could not work with her in a homebirth setting. Has she interviewed many midwives? To ease your mind, you could ask her to find out the midwife's history re: number of births attended, number of transfers to the hospital, how deliveries with high risks, wrapped cord, neonatal resuscitation and other complications are handled. My midwife had been trained to deal with those kinds of eventualities. I found her through the California Association of Midwives. http://californiamidwives.org/

One thing I tell people is that even if I had ended up being transfered to the hospital, the prenatal and postpartum care I received from my midwife was much more comprehensive than what I would have gotten from my OB. We formed a close relationship with her and her apprentice and backup midwife. Each prenatal visit was an hour or longer to include the exam, educational information, and question-and-answer sessions; she was on call 24 hours for me from the moment we hired her. I was able to call her anytime with questions, and when I suddenly started feeling an intense back pain at week 26, she even came over at 4am with her fetal heart monitor. The care during labor and postpartum was also of the highest quality, exceeding our expectations.

That's just my experience. Best of luck to you, and hope that eases your mind. Homebirth Mom


Is it your *younger* sister who's considering a homebirth? I'm a big sister myself, and there's something familiarly condescending about your attitude -- no offense intended, and your heart is in the right place, but it's so hard for us big sisters to stop trying to take care of the little ones, even long after they've grown up and no longer wish to be taken care of!

I know you're worried about her, especially as it's her first birth. But whether it's a first or a fourth birth, no one knows how it will go -- birth is always unpredictable. But reputable studies (not just Internet opinion) have shown that for uncomplicated births, homebirth is as safe (or safer) as hospital birth. So despite your sister's lack of experience, homebirths aren't any less safe for a first birth.

Unless she's planning an unattended homebirth, she'll have trained medical professionals monitoring her throughout her pregnancy, as well as at her side when she delivers -- if needed, they can deal with cords wrapped around necks, resuscitate the infant, stitch up tears, etc. And unless she lives way out in the middle of the woods, it's just a short journey to the hospital should anything more serious go wrong. (The Bay Area joke is that if a C-section is needed at a homebirth, it's ''decision to incision'' in 30 minutes, same as in the hospital.)

My family has a tradition of homebirth (one cousin had babies #1-3 at home, another cousin had #2 at home, and another cousin is planning #1 at home) and although the extended family was worried at first, now everyone thinks it's the way to go. I gave birth to my son in the hospital, barely -- I labored at home right through transition, then went to Alta Bates as I was pushing -- and I wish I had planned for a homebirth all along. It would have been much easier and more pleasant.

You asked for recommendations -- you might read ''Born in the USA: How a Broken Maternity System Must Be Fixed to Put Women and Children First'' (UC Press, 2006) or ''The Thinking Woman's Guide to a Better Birth'' for two scientific, evidence-based examinations of the issue. Nicole R.


Check out The Thinking Woman's Guide to a Better Birth by Henci Goer. While certainly biased toward natural birth (which it sounds like your sister is anyway), it gives a very informative view of hospital procedures, expectations, risks, etc., and it helps prepare you for how to advocate for a natural birth in a hospital setting. While it may not sway your sister away from home birth, it does provide a very realistic view of what hospitals will want to do and what it will mean. (I wavered about birthing at home myself, decided on the hospital, and hated the whole experience, wishing instead that I had stayed home.) I can say that we pulled out this book many times in the course of our 26 hour labor and it helped us get as close as we could to the birth we wanted to have. I will read it again when it is time for #2. Best of luck. wish I had birthed at home
Hi, I had a home birth for my first child and do not regret it. I did have complications with my delivery. I don't know of any specific impartial resources, however, mothering magazine covers alot of issues around both home and hospital birth. I know that they support home birth ,but also feel that they mostly support every woman being educated and comfortable with her birth decisions. I personally could not have imagined going to the hospital. I think it is important to respect the wishes of your sister. I suggest that you ask to meet with the midwife and share your fears and ask her how she deals with complications. I think, that as a first time mom, i didn't know what questions to ask my midwife before the birth which resulted in a less than ideal birth. As an experienced birther you could help your sister ask questions. I suggest that the midwife is very familiar with your sisters home before the birth, asks specific questions about how your sister sees her birth, talks about how present she will be durring the birth and for how long she will stay after the birth. We do not live in a rural area and a hospital is never too far away. I think that every mother knows that to give birth is to be on the brink of life and death. Choosing the right midwife is very important, as well as ensuring that your sister is in good health and recieves a lot of support from her family I have seen both home birth and hospital birth and a home birth can be an amazing experience, if everyone is prepared. P.S. most births are without complication, If at you look at statistics from holland and other european countries many people choose homebirth and the rates of complications are much lower. hard happy home birth
One of the biggest dangers in birth is mom's anxiety. If she will feel most comfortable at home then that's where she should be. Birth can be overwhelming, but having a calm familiar atmosphere can help a lot. When women are in labor, it tends to slow down if we are not where we can relax or at least feel safe. I think this is a major reason for the lack of progress many have in hospitals (that and some overly optimistic stats on how fast labor should progress).

I think there are many problems which are caused directly or contributed to by hospitals which are then ''solved'' by them. For example, according to medical journal articles I've read, almost all severe tears (3rd and 4th degree) are associated with episiotomies. this may or may not jive with your personal experience, it certainly does with mine (no episiotomy, very small tear (one stitch).

Also consider that hospitals and much more germ-ridden than homes so not really the best place for a newborn in general. Of course hospitals are great places to be in case of an emergency but if a woman is healthy and has had an uncomplicated pregnancy there's no reason why she shouldn't be able to have it at home if she wants. My advise, support her in her wishes and have a wonderful, if different, birth experience. mom and nurse


with all due respect, you should really consider leaving your sister and her husband be on this matter. unsolicited input creates wedges between people. think about it this way--how would you have felt as a first-time mom if someone tried to pressure you into giving birth at home when you were committed to a hospital birth? another point--those two will be parents soon enough and will be making all sorts of decisions about their child. why undermine their confidence in deciding what is best for their baby/family? even though you think your sister's choice is risky, it's her life and i'll bet she will appreciate your support and respect a lot more than your well-intentioned effort to change her birth plans. --your sis is a grown up now
Please do not assume that your sister's only research has been internet surfing on the evils of hospitals. There is significant and mounting evidence that homebirth is not only as safe or safer than hospital birth for low-risk pregnancies, but that women who choose homebirth have a much higher rate of satisfaction with their birth experience, which in turn eases mother-infant bonding and the transition into motherhood. I assume your sister and her husband have hired a midwife - if not, then you might have reason to be concerned. However, under the guidance of a midwife, your sister has a very good chance of "knowing how it will go" - the 10-15 minutes a nurse practitioner or OB/GYN would spend at prenatal visits with your sister is nothing compared to the hour+ most homebirth midwifes will spend at every appointment - for my homebirth (which I decided on in my 5th month of pregnancy), that totaled more than 20 hours spent with my midwife BEFORE the birth, going over all the mechanics, emotions, and expectations of birth. In the five months prior, pretty much all I had learned from my Kaiser practitioners was that the fetus growing inside me had a heartbeat. Also, a qualified homebirth midwife is amply prepared to deal with any of the complications you mentioned, as well as many others. My own baby was "floppy," and my midwife, Judy Luce, handled it beautifully, having oxygen at the ready, but also encouraging my son to take his first breath naturally by massaging his chest. A homebirth midwife will also be experienced in sewing up any tears, although it is possible that in an unmedicated birth with skilled and patient coaching, your sister's tearing will be minimal. As for doing research on your own, I highly recommend Ina May Gaskin's ''Guide to Childbirth.'' If your sister is open to the idea, you might ask to accompany her to one of her prenatal visits with her midwife.

Instead of grilling your sister, you can ask your questions of the "neutral" midwife, and if you can enter that meeting with an open mind, you should find all the answers you need. And then, the very best thing you can do is stand behind your sister's decision, and support her to her face, and to your family. She will have many people questioning her decision - she deserves to have the support of those closest to her. Homebirth Was One of the Best Decisions I Ever Made


Home birth and medical insurance

October 2005

I have a question about home birth and medical insurance. I met someone (with Aetna insurance, not a UC employee) who had had a home birth and said that her insurance covered it; she said they paid the midwife bills and didn't ask any questions about the fact that there were no hospital bills. Has anyone tried this? Do you think it would work better with a PPO? It seems to me getting the birth paid for would cover the excess cost of paying for the PPO for that year. I have looked at the archives on home birth, but if anyone can give me a name to get in touch with to ask this question that would be great. thanks for the help, Erika


We did get about 70% of our expenses covered with PPO Blue Shield. I would be very surprised if any HMO plan accepted homebirth. There are specific codes to put in not only for the services, but for the licensed practitioner, and direct-entry midwives don't have those numbers, unless they are CNM's. Anyhow, if you have a PPO, that's great. It is outrageous to me that homebirth is not covered, when in fact it is sooooo much cheaper than the hospital route for the insurance companies. Good luck with your home birth plans!!!!!!!!! allison
It might be worth checking if your friend's birth was before Aetna banned any coverage for homebirth. Most PPO's *do* reimburse for homebirths but Aetna is the exception. I don't think HMO's cover homebirth. I had a homebirth 2 years ago, using Beah Haber and had Blue Shield PPO. I called them ahead of time and they said that they cover homebirths with a CNM and gave me the ''allowed amounts'' for the birth itself and for the prenatal visits (you get the best deal if you bill these as separate items). The allowed amounts were so low that when I did the calculations it seemed that I would only be refunded about $1000 of my midwife's total fee of $4000. But, when we actually submitted the bill to them after the birth we got a check for over $3000! Beah had broken down the bill into 13 or so prenatal visits at $125 each, 2 postnatal home visits at $125 each and lumped the remainder under the birth itself. Blue Shield paid for 100% of the prenatal vists, none of the post- partum visits (I think because they were listed as home visits) and some of the birth. I am now pregnant again and have Aetna insurance. I called them and they very rudely told me that homebirths are NOT covered. I asked whether I could get my prenatal vists paid for and they said only if the bill comes from an OB's office.

We will go ahead and submit the bill anyway and see what happens. I will be very interested to hear if anyone has had any luck getting any money out of Aetna for a homebirth in recent months. Elizabeth


I had a home birth with a midwife years ago and our insurance paid for all prenatal care, and at that time we paid out of pocket for the home birth. Being very familiar with a local labor and delivery unit, I knew it was worth paying for the home birth, and we didn't have a lot of money, either. It was worth every penny. Grateful we had the courage
Unless things have changed recently, the law in California is that if your insurance allows you to use providers other than theirs (i.e. you use a PPO rather than an HMO), then they *must* pay the bills of an LM or CNM. The catch is that, as with any other out-of-plan provider, they can reduce the bill to what they consider to be a ''customary'' amount before they give you your percentage.

With a hospital birth you have two bills, the doctor's bill and the hospital bill. This adds up to much more than a home birth, but in the latter case the insurance company sees only the midwifes bill which is typically much higher than what a doctor charges (forget that the prenatal visits are in your home, much longer, more comprehensive, that the midwife will be there for a much greater amount of time at your birth and then do home postpartum visits).

One midwife I spoke to said she had a client who was a lawyer and challenged the ''customary'' amount that his bill had been reduced to by surveying all the home birth midwives and showing that they all charged much more. He lost. Most midwives use a billing agency that knows how to work the codes and most folks on a PPO plan get a half to three quarters of their money back.

To the person using Aetna, they are not above the law. Many of the folks you speak to at insurance companies don't know that homebirths are indeed covered. Call again and instead of using the word ''homebirth'', talk about a bill from a Licences Midwife. Checked It Out


Creating a homebirth-like setting in a hospital

Feb. 2005

Hi, I am new mom to be (currently 5 months into healthy pregnancy). I have a good OB, but I am feeling concerned about the prospect of giving birth in a hospital, where the tendency is to medicalize the process, and where I may or may not be attended by my OB, if he is not on call at that time. So: I am looking for a way to have a hospital birth (probably at Alta Bates, but I'm open to other facilities nearby) that as closely as possible replicates the benefits of homebirths (e.g. known/trusted attendant, minimal interventions, birth positions according to how I feel, birth as natural process, etc.) Any advice or recommendations are much appreciated, particularly for how to create that kind of atmosphere in a hospital setting, plus any recommendations about OB's or midwives that are committed to being the one who delivers their patients. Thanks! Erica New Mom to Be


I just had a great homebirth with my 3rd. I had a medicalized hospital birth with a midwife with my first (epidural and 10 med students watching the birth!), and a somewhat medicalized birth with my second (induction for low amniotic fluid, but they started the pitocin and since they thought it would take a while they didn't check in with us for 2 hours, so my midwife was with me only for the last hour of labor, lights were low, no complications, only my husband, my midwife and my mom were there) but that practice (at Stanford) closed. What you are asking for is very difficult to achieve, but here are some things you can do.

1. Get a doula. She can be with you at home---where you want to stay as long as possible---and go with you to the hospital. She can be your advocate for your desires.

2. Resist the medicalization. If you get an epidural, then they have to monitor you and your baby and your dreams of an unmedicalized birth are over. If you are exhausted that may not be so bad! But you will then have a necessarily medicalized birth.

3. Your doula has to be really upfront about what you want. For instance, I asked both of my midwives (in the office at appointments) to delay cord cutting for a few minutes and both times that clamp was on the cord before you could say umbilical. If you want or don't want something, like cord cutting or an episiotomy, you have to remind them just before the birth, because most often they don't remember and don't ask. They just do what they are used to doing.

4. The hardest thing about the hospital is that there are no distractions. The only reason you are there is to have a baby. When things get long or slow down for a bit, everyone wants to keep that freight train rolling. At home you can just relax and put on a movie if your contractions space out. At the hospital they are hovering and always wanting things to speed up. So, stay at home until you can't smile between the contractions. At that point things are really happening. You'll hate the drive, but your birth will be better. Oh, and don't take your labor seriously too early. Use distraction and putter about for as long as possible. First labors can be long and if you start doing breathing and deep relaxation from the getgo you can get bored and exhausted and be so discouraged if you arrive at the hospital and find you are 3cm or less. A doula can really help you to m! anage your labor well. Congratulations and good luck! susan


I sought a midwife because I really wanted to know the person who would deliver my baby. I have an HMO and it was pretty easy to change to a dr group that had midwives. I ended up with a midwife who assured me that she delivered 98% of her babies. I told her my delivery date and she said she was sure she'd be around. I liked her during my prenatal care. We talked a lot about my birth and what I wanted and she was supportive. I wanted the least medicalized, most natural birth possible. I had a doula -- something I highly recommend. I took natural childbirth classes and hypnobirthing -- also highly recommended. At my last prenatal apt (10 days before my due date) my midwife told me she was going out of town for 10 days, but was sure I wo! uldn't have my baby early. I was devastated. If I went into labor before she came back, I would be delivered by ''whoever'' is on call at Summit. She was sure I'd be late. I wasn't. My baby was 7 days early and ended up being delivered by c-section. I was devestated and felt abandoned. In the end, however, he was perfectly healthy and in many ways it was a great experience.

My advice -- get a doula! They are not as expensive as you think. There are many who do sliding-scale or even free births, especially those who are just starting out. Mine was just starting but she was wonderful. I labored at home for 15 hours before going to the hospital -- I felt like between what I knew and her help I KNEW I had done everything possible at home to stall the interventions and control the process. I wouldn't have felt this confidence had it not been for the doula and my preparation.

When I got to the hospital it was pretty medicalized. I had pretty much every intervention that I'd feared. But it was ok! I was in so much pain that it a great relief. It was good to have this acceptance rather than dispise the medical establishment that I'd rallied so much anger towards. And I was able to have low lights, my music, my family, and all the comforts that I wanted in my little room. I felt like my knowledge allowed me to understand everything they wanted to do. I was also tremendously grateful to my doula who helped me understand everything and who in the end agreed that the c-section was necessary and that it wasn't just the industry wanting to cut me up and make more money. I felt in control of the whole birth and by the end, I felt like a lot of my fear and anger at the hospitalization/medicalization of birth had disipated. I really learned that the pr! ocess of birth (and now motherhood) is so much about letting GO. And I coudl do that because of the knowledge I had. If I hadn't had the knowledge and preparation then I could have felt like it was forced as opposed to me letting go. So you can prepare a lot. You can get a midwife, which USUALLY ensures a much higher possibility that the woman who has seen you and known you for all those months will deliver the baby. There are some great midwives out there. Lindy Johnson has a great reputation, as well as Sho Li (that's not how you spell her name, that's phonetic.) They are recommended in the archives here. I would definitely try for a midwife If I have another baby -- I really didn't like the on-call OB who I had to deal with at Summit.

Most Bay Area hospitals are so open to letting you deliver any way you want -- in the dark on your hands and knees with your whole family in the room. Stay at home and labor as long as possible -- and be prepared for that. Labor was 1000 times harder than I expected! But take classes, take prenatal yoga (check out Cynthea Denise at Piedmont!) get a doula, learn relaxation techniques, and you'll be ok. The later you go to the hospital the better. Good luck! It's a wonderful, liberating journey you've embarked on..birth is only the beginning. happy new mama too


I, too, wanted a home-birth setting, but being my first delivery, I wanted the comfort of being in the hospital to ease my fears. I started with an OB, and was so disappointed with the lack of compassion, time and insight provided. In my seventh month of pregnancy, I found a wonderful midwife, Lindy Johnson. Lindy delivers only at Alta Bates, and has a midwife's approach of putting the mother first (rather than other appointments, medication, etc.). Because she delivers at Alta Bates, she knows all the staff, procedures, etc. Although I was induced (at 15 days post due-date), Lindy was flexible about the frequency of use of the fetal monitor - I could walk around, take a shower, squat on the floor in between being checked.&nbs! p; If I had had an OB, I think I would have been much more restricted. I absolutely loved my birth experience and look forward to having Lindy deliver our second baby someday. anonymous
I too tried to do everything I could to have a more natural birth setting in a hospital. I had a doula, knew I didn't want any sort of pain medication or intervention, and had prepared ags of stuff I wanted to bring to the hospital. I just assumed I would have an easy, and late, delivery. Instead, I had an emergency induction a few weeks prior to my due date. I left the house a mess, and could barely get in touch with my husband to tell him to meet me at the hospital, let alone remind him to bring all my birthing aids. I was still able to give birth without pain medication, but I had every other intervention known (breaking my water, IV, internal fetal monitor, etc.). The moral is, you can prepare all you want, but you can't control your baby's entrance! The one recommendation I have if you don't want pain medication is to get a doula. I had a great doula (Judy Ballinger - 510-536- 1543) - I left all the thinking up to her, and I focused on laboring. happy momma
I delivered at Alta Bates twice with completely natural births (no drugs, no enema, no episotomy, no epidural, etc.). The first time I was told I had the option of taking drugs but actually recommended not to do so because I was very dilated. The second time the process took longer and I spent the night in the hospital (I was asked to check in as soon as contractions started, given the rapid birht of the first baby), a! nd felt that my choices where always respected, although not always with a full heart. My advice is to have a clear birth plan, give copies to your OB, but most importantly, give copies to the nurses and to the Physician assisting you (which may not be your OB if he/she practices solo and is not on duty -which happened to me both times). Also, I was told by the nurses themselves that different nurses have different approaches, and that if one nurse does not fit your style, you are completely welcomed to go to the head nurse and request another nurse. You are allowed to bring your CD player and music to the room, and any other tools that help you relax. Also, they do have some bouncing balls and other things that may help you during labor. Oh! When you check in, ask for a room with a bath, some only have showers and a bath can be very relaxing (a hot shower is not bad, if there is nothing better) and not all rooms ! have baths. Good luck, ''Home-birth'' style mom @ AB
You don't mention why you aren't having an actual homebirth but you sound like a good candidate to me. As far as Alta Bates goes- its more up to your doctor than the hospital itself. If you feel unsure about your OB, I would check out DRs Arnesty and Deandrea. They are both women who work together and are commited to providing as low intervention a birth as safety allows. You could also see if Midwife Lindy Johnson is available (although she usually books up pretty far in advance and I'm not as fond of the two other midwives that she works with.) Now that Summit is merged with Alta Bates I'm assuming that the Summit Midwives are there too. Can anyone recommend one of them? sb
Birthing in a hospital does not have to be as ''medicalized'' as you may think. I too wanted what you want, and have had two very satisfying births in a hospital. First, read as much as you can about all that can happen in a birth. Then, I recommend having a birth plan. In it, say what you want in an ideal situation, and then what you want in case of unplanned events. Talk about your birth plan with your Ob, and ask that he share any details that are particularly important to you with his group. Bring the birth plan to the hospital and give it to the check-in nurse when you arrive. They do read them. As an example, I did not want drugs and asked in my birth plan that they not be offered. I also suspected that I would ask for them, so told the staff what to do when I did (check my cerix, wait through three contractions, see how I feel). I also recommend having someone knowledgable that you trust as an advocate, and for the first birth this should be so! meone in addition to your birth partner/husband, who may be too close emotionally to feel comfortable advising you. I had a doula, and she was a great support in helping me and my husband make decisions when things came up that we had not planned for. For my second birth it was just me and my husband. This time he knew more and was great in speaking for us. Birthing can be intimidating because there is so much at stake and you know so little compared to the doctors/nurses. Hence, read read read. The bottom line is that the hospital cannot make you do anything you do not want, and most are open to birth balls, tubs, doulas, etc. Good luck. jessica
I too had concerns about giving birth in the hospital, and had really wanted a homebirth, but it was just too expensive. I gave birth at Alta Bates last summer and was so pleased with my experience! I was actually really glad I was in the hospital.My suggestions for making it amore comfortable experience are to take the tour early and maybe go back a couple of times. I ended up up having to do a lot of Non-stress tests and going to triage a bunch, so Iwas really familar with thspace and friendly with the nurses and security guards, somethin that I think really helped me ( & my husband) feel comfortable at the hospital. good luck! happy at the hospital
I gave birth at Alta Bates in 2003, drug-free and with minimum intervention, and the best advice I can give you is to learn everything you can about the birth process, the hospital's practices, and your options at each step of the way. That knowledge will give you the confidence to advocate for what you want. The nurses espec! ially are pretty flexible and respectful of your desires, but you have to make them clear. I think too few people are willing to challenge the medical staff, especially during labor, when your mind is busy elsewhere. I imagine that's why a doula can be valuable, although I didn't have one. Good luck! It can be done. anon
Have you looked at the Birth Home in Pleasanton? I know it seems far away but I live in Berkeley and had my son (1st child) there last spring and I highly recommend it. We wanted a homebirth-like setting with all the benefits that you mentioned. I labored in the birth tub with music playing and candles lit, I had a midwife, nurse, doula, and my husband and the two friends I had brought all to myself. The atmosphere was so relaxing and intimate. The staff were wonderful in not only caring for me but caring for a! nd involving my husband as well. The only drawback was the distance. It usually took us 45 minutes to get there, although the night I was in labor we made it in 30. I figured, though, that I had never heard of anyone giving birth (at least for a first child) in less than an hour start to finish, and the time it took us to get there was totally worth it for the experience of avoiding the typical hospital birth. I'd be happy to talk to you more about my experience there if you're interested. Kim
Having experienced Alta Bates, one good thing about Alta Bates is that, giving where it's located, they've seen everything in terms of what people want in giving birth. They should be pretty open to whatever your wishes are. My sense was their goal was to have a ''natural'' process, but also that delivering a healthy baby was the priority. Make a birthing plan that details what you're expectations are, but also remember the birthing plan is really just a ''wish list'' as things often happen as they happen. Take a tour of the facility where you plan to deliver. Ask questions about what you can do/bring to make it more ''home'' like.

When it's time to deliver, go to the hospital as late as you safely can. The earlier you go, the more likely there will be an intervention.

Get a doula or someone who has gone through the experience to support you through the delivery. While the hospital staff is there for you, their interests and motivations are not necessarily aligned with yours. Having a doula or someone there giving you support and looking out for your interests is great since you'll be focused on delivering a baby. And for postions, you do what you want. The postion that felt comfortable was squating on the bed using the ''lean'' bar. I wanted to stand up on the bed between contractions, the nurse kind of freaked out a bit over that, but ended up saying ''okay, whatever''.


I gave birth at Alta Bates with a midwife. I was also concerned about the hospital setting, and my husband prepared a large suitcase full of goodies intended to make me feel 'at home' in the hospital (a portable CD player and some music, favorite stuffed animals, favorite pillow, small lights to make the room dim, a birthing ball, some favorite snacks... I don't remember everything anymore, but it was a lot of stuff). Well, you know what? We never even opened that suitcase. I got to the hospital in late labor and by the time I got there, I could care less where I was: I just wanted to get the baby out! So here's what I think: the most important thing, if you want to try for a natural birth experience, is to have the right attendant. As I said above, I went with a midwife (Nancy Barnett-Moore, who was great). When I first arrived at the hospital (a few minutes before the midwife), the nurses immediately got ready to do all the usual 'medical' things, like setting me up with an IV. But as soon as the midwife walked in, they stopped and switched modes, and let me do it 'naturally'. So make sure your Ob is with you and really believes in natural childbirth (and that anyone else in the practice does too). If not, find someone who does. I think it's also really important to feel very comfortable with, and have full trust in your Ob or midwife, and to have one or two other support people to help encourage you through the rough parts. And finally, stay home as long as possible, where you would hopefully truly feel 'at home'. All that said, it may make you feel better and calmer if you do pack a big suitcase full of goodies, as we did... If you are really committed to natural childbirth, two great books that may help you get ready and that discuss many of these issues are 'Birthing from Within' and 'Ina May's Guide to Childbirth'. Good luck! I hope it all goes well for you. did it naturally in a hospital
(1) Hire a doula to attend you while you labor, and (2) labor at home as long as you possibly can, before heading for the hospital. If you have a normal, uncomplicated birth, you won't actually spend very much time at the hospital, so you needn't worry too much about trying to modify the atmosphere there! As a general rule, midwives almost always attend the births of ''their'' patients, and most family practitioners do also. OBs are more likely to work in groups where whoever is 'on call' at the time will the the one at your birth. But of course, individuals vary. This is a question you simply need to ask any doctor or midwife you are considering. anon

Supporting out-of-state sister's homebirth

March 2004

My sister has decided to have a home birth which I fully support. She moved last year to New York though, and has no close friends or family who can be there during it. I am looking for advice from moms who have had home births about some things I could mail to her that would really show her how much I love and support her even though I can't be there. I guess I want to try to give her things that will make the whole process easier. Any suggestions?


I had a wonderful home birth in August -- if your sister likes water, you might offer to contribute to a birthing tub rental (here, it costs something like $300 for a three-week rental). I did end up laboring in it, which was lovely, but best of all was floating in it for the three weeks before my little one arrived. (When I knew I was in labor, we drained the tub and filled it with fresh hot water.) I spent many, many hours in that tub -- it was the only place I was comfortable during the last month. Something else I loved: my midwife made something she calls ''Padsicles'' - which were sanitary napkins with an herbal tea poured on them, and then frozen for use in the days after the baby arrives. Oh my, I was very sorry when I used up the last of those! (e-mail me if you'd like the herbs used.) And lots of receiving blankets are needed -- atleast six or so. You could make them quite easily from flannel or other soft and warm fabric (just need to be a big square of material, say 42'' x 42'' or so). Best wishes to your sister! Alysson
I have a lot of family and friends far from me. My friends and family provided beads and a ''wish'' for the baby and family. Each bead was lovingly strung on a necklace which I wore from the day I received it (shortly after my shower) until partway through my labor (when I could only hold it b/c it bugged my neck). This necklace was very important during my natural labor and delivery as I was able to concentrate on the wishes, etc that everyone had made for us, all the love surrounding us.... I will cherish that necklace forever......

It is a common practice at a ''blessing way'' for each person to string their bead and state their wish, however, my friends and family being mostly far away, sent the beads with the wishes written down. I still have the wishes so I can never forget AND, a beader-friend put the necklace together very nicely and she added many beads to make it absolutely BEAUTIFUL! It meant the world to me, really, and still does.......

Also, I sent candles with little heart candle holders. I asked each person with one of these candles to light it when they heard we were laboring and to let it burn until it went out. There was a lot of love and light around us. We felt it and had a wonderful (albeit 50 hours of labor!) birthing experience! LogicalMama


As a homebirth mom myself, I can say that the best thing you can give your sister is unconditional verbal support. Educate yourself about the facts, and make sure she knows (and the rest of your family knows) how much you support her decision. While homebirth in low risk women is just as safe as hospital birth, the larger community is not aware of this, and often demonizes women who decide to birth at home and the midwives who help them. Other than that, I don't think there is any special thing you can send her to make the process ''easier.'' Birth is hard no matter what, and in a lot of ways, it may in fact be easier at home because of the comfort level, the intimacy, the full support of a birth team that loves you (rather than cynical or drug-pushing or overworked hospital staff). While you're in the process of educating yourself about homebirth, you can help your sister (and homebirthers in general) by communicating your support to the wider community, engaging in conversations and debunking myths. If your sister knew that you were doing that, I think she would feel like you really backed her (more than any material gift). anon
Hi there- your feelings on supporting your sis are so important! I would suggest that you possibly offer to help her find or pay for a doula who could be there to support her during her homebirth. While the midwife would be there for a longer period than any doctor in a hospital birth, she still has specific duties that she has to perform at certain times and cannot ''mother'' the mother the whole entire time. I think getting your sis a doula would be a wonderful gift. maybe you could hold a long distance shower with people here who could all chip in for the cost... Good luck- if you need more info, let me know. Shaana
Despite the fact that outcomes are better for the mom and the same for the baby for a homebirth (with a midwife) than they are in the hospital, people still freak out if you tell them you are having one. So good for you for supporting her--I'm sure she is running into people who are less supportive. So my suggestion for you is to ask your sister if she has the excellent video documentary ''Born in the USA'', and if she doesn't, send it to her. It follows 3 births: one in a hospital with an OB/GYN, one in a birth center with a Certified Nurse Midwife, and one homebirth with a midwife. I found it very useful to have to show people why I wanted to have a homebirth. It's not heavy-handed or anything--the OB/GYN seems like a nice person and she's very well-meaning--but even my mom understood after watching it. I would loan you my copy, but I can't find it. I bet if you post here, someone will have one. Happy with my Homebirth
How wonderful that you want to support your sister! After my homebirths, what I needed more than anything was help, not stuff, so while you can't mail her any of the following, hopefully some of these ideas will be useful.

Arrange for a postpartum doula. These wonderful women can do it all---dishes, laundry, meal prep, baby cuddling, and most importantly, they offer understanding of the physical and emotional rollercoaster that your sister might be on after the birth of her little one. Having a doula come once or twice a week can also help your sister catch up on her sleep, which she will likely need. Your sister's midwife certainly knows many to recommend.

Ready-to-go meals. While you're not there to cook for her, you can talk to her midwife and find out if there's a casserole circle you could tap into for your sister, so folks bring a wholesome prepared meal every other day or so. I bet she could hook you up. There are often services that provide food especially for postpartum women, keeping in mind their special nutritional needs. The midwife could also tell you about any of these in your sister's area.

Diaper service. If your sister's planning to use cloth diapers and hasn't set one up for herself, this is a thoughtful gift.

Grocery delivery. Is there any in your sister's area? Your sister's partner or doula could give you an idea of what they need and you could set it up.

An available ear. For me it was helpful just to have someone listen when I needed to gush, cry, complain, etc etc. Your sister is lucky indeed to already have a sister who wants to support her. She'd surely appreciate hearing that you're open to hear whatever she needs to share with you

Those are just a few thoughts. I'm sure you'll get many terrific suggestions. Congratulations on your impending aunt-hood! Best, dleto


If she doesn't have a doula for the birth and postpartum, get on the internet, help her find one, and share the cost or make it a gift. My doula absolutely saved me during unforseen complications. The support is priceless. In my case my doula didn't participate that much in the weeks after the birth, but a doula who does help around the house in the weeks afterwards would be fabulous. It's the next best thing to being there - providing someone who will be. Grateful for the Help

Homebirth - any regrets?

September 2003

Hi everyone, I'm interested in possibly pursuing a homebirth for my next pregnancy. I have heard and read about so many people raving about their own homebirths, and have never heard of anyone having a homebirth and then opting for the hospital for the next one (except for medical necessity). But there have got to be some people out there who didn't enjoy the homebirth experience and wouldn't do it that way again. Am I right? I'd like to know if these moms exist and I'd like to hear why they now believe that homebirth isn't right for them. Thanks so much. Homebirth Hopeful


I gave birth at home five weeks ago, and don't have any regrets, (it was, in fact, empowering and peaceful as hoped) but I thought I'd share with you my awareness sometime into the pushing phase of labor that it would be really horrible to have to go to the hospital at that point. I definitely had a moment of panic about feeling like there was no way out: the pushing seemed impossible (OK, so he turned out to be an eleven pound baby, and my first was a five-and-half pound baby...), moving to the other side of the room let alone into a car and across town seemed impossible. Of course, it wasn't impossible and my supremely caring and extremely competent midwife (Amrit Khalsa!) knew that this baby was coming out and that the birth was going just fine (even if I didn't quite believe her...). So for a few days post-partum, I was rolling over in my mind how wonderful it is that births usually go normally and naturally given the right support and environment, and also very aware that if you started labor at home and had to transfer to the hospital for some reason it could be a really big deal (and likely a bigger deal the farther on you are in your labor). Best wishes for a healthy baby, and a healthy birth -- whereever you decide to do it. Feel free to write if you'd like to hear more about homebirth, or about Amrit's midwifery skills. Alysson
I afraid I can't give you exactly what you asked for: an instance of someone regretting homebirth. I'm writing anyway to say that, for me, the circumstance that I thought would occasion regrets, a complication (specifically, hemorrhages after two of the births), did not. The emergencies were very capably handled, and I remained grateful and happy that I had been able to give birth at home. There are, of course, downsides to homebirth. For me, they were the expense, and the recurring need to defend my decision to people who simply hadn't informed themselves on the issue. Anon
I have an online friend who fits this description. If you send me your email address I will try and get you in touch with her. She had an extremely difficult first labor at home with a not-so-helpful midwife. Her younger two children were born in a hospital and I know she had an epidural the second time around (not sure about #3, may have come too fast). I'm not sure how much of her decision to go to the hospital had to do with choice of midwife though, you may need to ask her about it. Sophie

Want homebirth but hospital birth is cheaper

September 2003

We are planning our second child and considering birth options and I am confronting a dilemma. My husband and I have agreed that we would like to have a homebirth, but we are also really broke and the cost of doing it at home rather than taking the insured-hospital option makes a meaningful difference to us. I am looking for advice to help me weigh the costs and benefits of choosing a homebirth or a hospital birth.

Here are several factors entering into my decision:
(1) the labor with my first child was relatively short and uncomplicated; since second children are routinely born in half the time, my next labor is likely to be about four hours. Is it really worth several thousand dollars to have those hours at home vs. the hospital? Or should I be looking at this dilemma over a longer span -- i.e. comparing prenatal care styles.
(2) my husband and I are both strong-willed people and I feel confident that we can stand up for our interests in the hospital environment.
(3) The homebirth option is attractive because you don't have to stay in the hospital, but considering that we have a two year old, might not a night at the hospital actually give me an opportunity to have one-on-one time with the new baby?
(4) The cost of using a doula and midwife at the hospital would be almost as much as a homebirth, so if I took the hospital route it might make sense to go cheap and use an OB and no doula.

I guess the question that is nagging me is, why spend so much money and make such a big fuss when the next baby is likely to be born quickly. Maybe it would be better to go the cheapest route and use the ''saved'' money to hire someone to clean the house during the first couple months. Or maybe having a home birth will be special wonderful and invaluable? Help! I can't make up my mind.
wannabe homebirther


You mentioned a bunch of factors entering into your decision, but you didn't mention whether you have insurance. If you have a PPO, California Law (unless it's changed recently!) says that you can use a Midwife for homebirth (CNM, CPM or LM - but I'm pretty sure not lay midwives) and your insurance will pay for it - some, most or all of it, depending on your insurance. A homebirth in the bay area costs somewhere in the $3000.00 and $3600.00 range. And, you'd be in the comforts of your home, with your family. Your midwife would visit you at home for your prenatal AND postnatal appointments.!

On the other hand, it may be nice for you to stay overnight at hospital; if you were to use Alta Bates, bear in mind that you will have to pay out of pocket (somewhere less than $300.00) for a private room. If you don't choose a private room, you may have to put up with a noisy neighbor.

You mentioned that the costs of a doula and midwife in hospital would cost as much as a homebirth. I don't know about this, as it may depend on your insurance. I thought that if you went the hospital route, it wouldn't matter cost-wise whether you used a CNM or an OB. The Doula may be extra, as not all hospitals provide doulas. It doesn't sound like you're particular on which OB or CNM would help you deliver, but just remember that at hospital, there is no real guarantee that the one you want will be the one assisting you on that day.

Also, bear in mind that just because you had a quick and easy labor/delivery the first time, it doesn't really guarantee an as quick and easy or easier labor/delivery the second time around. So, where would you rather be - in hospital or at home, if your labor were long? (Most complications, other than long labor which isn't really a complication, can be diagnosed prior to labor. So if you had true complications, your midwife would send you to hospital anyway).

You sound like you are just thinking out loud for now and not really hedging one way or the other. Good luck with whichever decision you choose. doing it at home


Lots of good questions. I had my baby at home and am very happy that I did. I am committed to homebirth for many reasons, but particularly I liked not having the hospital routines interfere in any way with my time with the baby once he was born. If you are a good advocate for yourself, or if you have great support from others who can advocate for you, you can usually labor how you want to in a hospital. But once the baby is born, it is VERY difficult to bend the rules so that the baby isn't bathed right away (i.e. within that first hour or so) or taken to a warmer (even if it's in your room) to be examined, etc. So, that was very important to me to be able to linger and take my time and nurse him and be with him exactly as I wanted to be.

On the other hand, the cost of a homebirth can definitely be prohibitive. Some thoughts: you could get your prenatal care through your insurance (visits, all the tests, etc.) and maybe work out a deal with a homebirth midwife to lower her fee? Or, perhaps have your baby in the hospital but choose a nurse- midwife to be your provider. Or, have you checked out The Birth Home in Pleasanton? You can give birth in a home-like environment, attended by nurse midwives, and many insurance plans will cover it.

I have been to many beautiful births that took place in the hospital. If you choose a hospital, I think the most important things are to: a) have a health care provider who will respect your wishes for the birth, b) request a labor and delivery nurse who is comfortable with your birth choices, and c) have a great support system to be there with you.

I love the idea of paying a housekeeper with the saved money. A great idea. Also, as far as needing a night away from your toddler, I've worked with women who have felt both ways: some wanted to get home from the hospital asap in order to be with their whole family; others relished the relative peace and quiet and time alone with the newborn. I think that's really a personal choice.

Good luck with your decision! Emily


I had a great experience both times doing a natural, unmedicated birth in a hospital with only a doula to support the OB/mid-wife (I got whoever was on call). My first birth was 8 hrs. and second 6 hrs. I liked having a natural birth but in the comfort of the hospital in case something went wrong, which happened with my first child. We had a stuck shoulder with my first where the baby's air supply was cut off from her shoulder pushing against the cord. Within seconds, the UCSF neo-natal team was in my room. Oxygen mask and all. I highly recommend our doula, Ellen Klima, who offers reasonable rates and is also the Bradley Birth Instructor in Oakland. You can get her number through the Bradley web site. anon
It seems as if you have really thought this through and have a picture of how you want your birth to be. I'm wondering if you've checked out any of the midwives that do hospital births. We went with that option for both of our children and our insurance paid for both. You could do that and then hire a doula to get the kind of midwife support you would have received if you had chosen a homebirth. Unfortunately, many of the hospital midwives are not with you the whole time like homebirth midwives are. On the other hand, you would save quite a bit of money to do other things. Also, you will most likely have a very successful birth with a healthy baby but if there is a problem, if you are at the hospital then you will have emergent care. Good luck deciding. I'm sure your next birthing experience will be an amazing miracle regardless of where it takes place. anon
I had my second child in the hospital and looking back I think it was nice to have 2-day break from being at home and worrying about my then 14-month old. Yes it will give you precious one-on- one time with your child and will give you a break from life. I felt like I was in a hotel!!! no kidding. They took care of me, of my daughter, no meal to cook or plan, no bath to take, no noises. It was great. I also made the decision after talking to my friend who is a emergency pediatrician. And you're probably right about saving the money and spend it on a housecleaner instead, or meal delivery, or home massages. m
My two cents (after just having had my second child in the hospital (very very quickly)) : I agree that it would be a waste of money to pay thousands of dollars for a very quick homebirth. These days you are given a good deal of freedom at the hospital to ''customize'' your birth. Plus, you can leave as soon as it is over (or stay if you like). I like your idea of using the saved money to hire someone to clean the house for the next year! mom, again
I paid $2,000 to have a homebirth and ended up in Kaiser for 5 days with a c-section. With my second I went to Hsieu-Li (pronounced Sho-Lee) Chen at Summit. She is a nurse-midwife who has had a lot of happy clients. Ironically, I could have had a homebirth with my second child who came fast and furious, but I was happy with Hseiu-Li and the nurses at Summit (insurance covered everything). I delivered at 11 a.m. and left at 6 p.m. the same day. I knew I would be happier in my own bed with my own food (I had a voracious appetite after birth). I did like that the option was there for me to stay if I needed it. Hospitals don't let you sleep any more than your toddler so don't count on more sleep. If you don't have the money for a midwife there really are plenty of good hospital options. Know that if you want to stay you can and if you don't want to you can leave. I played it by ear. mary
Hi there We are facing your exact dilemma. Here's what we decided: I switched medical group to Hill's physicians, because they authorize abd cover prenatal care, delivery at a hospital and postpartum care by a midwife (unlike Alta bates medical group, for example). The bad news are that you are not at home but at a hospital (Alta bates, in our case) and you have to be checked by monitor every hour for 15 min. The good news are that if all goes well you don't need to wear a hospital gown, you don't need IV, you can eat and drink, and a Dr is not in the room, only the midwife. She has to be from a specific list of midwives, but if you find there someone you have a click with, then it certainly seems like the best option. Ah, and you can go home in 6 hours, not 24, if you want to. Good luck! I.
I am in a similar situation as well (but not yet pregnant as far as I know-- hoping to be very soon). Two things struck me about your message:

1) There are no guarantees as to how long your labor will be. You say 4 hours, but I am betting it won't be that at all. Yes, you're right, statistically speaking your second labor will be easier and faster than your first, but I know several moms where that hasn't been true at all. I wouldn't even be considering labor length as a factor in deciding to have a homebirth.

2) You say insurance won't cover any portion of a homebirth. Now this I know nothing about, but I am seriously hoping that it's not true. When I spoke with someone at Blue Shield recently she told me that my medical group has to approve it first and then I have to use a midwife who's part of that medical group. Now because I'm not pregnant yet, I didn't continue with the research. It could be that the medical group won't approve it at all. I just have no idea. But the conversation with the BS rep gave me hope that a homebirth is possible for me...I could just be naive.

I am really looking forward to the responses you'll get. I would have been posting this exact same thing in a few months myself (fingers crossed!).

I personally hope you end up with a wonderful homebirth experience. Good luck to you! anon


Why not use a midwife in a hospital? Seems like that might be the best compromise for you. I found with my second birth (with midwife Tsui-Li Hseng-sp? with East Bay Perinatal Practice, birth at Summit Hospital) that once the baby was born we were pretty much left to our own devices--it seemed that since it was our second child the hospital staff trusted us to know how to care for the baby, who nursed and slept with me just as he would have at home. Insurance paid for pretty much everything, certainly the same as they would for an OB. Good luck! Lisa
Hi- I wanted to say something about your indecision whether or not to have a home birth. Homebirth is exactly that: in your home- and you have control completely over what you want to do in labor w/out worrying about when you need to go to the hospital. If you have a midwife who is willing to do a homebirth, she should be very knowlegeable about things to look for in emergency situations and also about normal things. My first son was born in a hospital and although I had a great experience, I have vowed that my second will be born at home. I want my son to be able to participate int he birth of his siblings, watching or not and also to feel like I have control over my situation and what I want during labor. Here is a good site that might help you.

http://www.gentlebirth.org/ronnie/homesafe.html

Good luck- and if you are interested in having a birth doula, please check out my site and email or call if you have any questions. I am a fairly new doula, so I don't charge quite as much as others, but I am eager for the experience and would love to help you! Thanks! Shaana Keller


The main benefit I see in a homebirth is preventing unnecessary interventions that may lead to greater physical and emotional risk for baby and me, but know firsthand how expensive it is compared to an insurance co-pay. I can recommend some books that discuss the pros of homebirth: Birthing From Within, Ina Mae?s Guide to Childbirth, Immaculate Deception II. Either way, you may be able to find a doula-in-training who will attend your birth for free, in exchange for writing up feedback that she needs to become DONA certified. There are free ?doula nights? at the Nurture Center in Lafayette (www.nurturecenter.com) and Birthways in Oakland (www.birthways.org) where you might meet, or find the names of, doulas. Heather
I had a wonderful experience at the Pleasanton Birth Home. It's in between a home birth and a hospital in that it is in a craftsman home and not a hospital setting, but is a couple of miles from the hospital. A nurse, midwife apprentice, doula--as well as the midwife or doctor on call- attend you, and there's lots of flexibility about how you give birth. I had a short labor as well, about 5 hours of active labor. The policy at the birth home is that you stay 6 hours after delivery, or until morning if you give birth at night. Many insurances pay at least part of the service as an out-of-network cost. If you call them, they can tell you what the cost would be based on your insurance. Email me if you want to discuss further. Rachel
I've had 3 homebirths and 1 hospital birth. I'd never go back to the hospital and once we had our first homebirth my husband decided he'd never want me to go back.

I believe it doesn't really matter how well you think you can advocate for yourself in the hospital; you shouldn't have to and it takes a LOT away from laboring and birthing.

We're on foodstamps and found midwives to work with us. It is more than a financial issue to us - it is a safety issue (safer at home) and respect issue (OBs and nurses as a whole simply do not respect parents who make their own decisions and do their own research). Kathy


A few thoughts...I would check with your insurance regarding their coverage. My recollection is that hospital bills are based on procedures done, supplies used, and the ''24 hour clock'' ie, who is admitted at 11:00 pm. Also, I'd look into any ''early discharge'' programs that your hospital has. Way back when I worked in L&D, we had a program for discharge 6 hours after delivery. In other words, you aren't required to spend the night. One-on-one time with your newborn can be accomplished many ways (your toddler sleeps through most nights, right?!). Another option might be a birthing center: a nice intermediate. Personally, I had my babes at home, and it was exactly what I wanted. I think it's really important that you pay to labor and deliver where you feel the safest, wherever that may be. And lastly, wherever you deliver, your toddler will need his/her own support person, whose only purpose is to meet your toddlers needs and is not invested in coaching you or being present at the birth. Lori
I had my first child at Summit, and my second at home. I had planned to have the first at home, but he showed up early. I had short, uncomplicated labors with both kids. I felt guilty spending the money on my homebirth for #2, but now, 15 months later, I'm very glad I did. Having my first child at home with us was important, and he played with friends while his brother was born upstairs. It was a very low-key, pleasant day. However, I think with the right OB your hospital experience can be almost as good as a homebirth, from the point of view of limited interventions and plenty of bonding with baby. I found a great OB when I had my first child (he just happened to be the doctor on call) and wished that he did home births when I had my second child. You do need to be prepared to stand up for yourself with the hospital staff (we did not want our baby taken to the nursery and separated from us for any reason) and we left the hospital as soon as possible because it was not a pleasant environment to hang out in. Blah, blah, blah...this could go on and on. Mail me if you want more details, and good luck! Patty
You might try going to the Birth Home in Pleasanton as an alternative. Many insurance companies will cover the charges but it is more of a home like experience than a hospital. You can check out their website at www.birthhome.com. If my father- in law wasn't the doctor there that's where I'd be in a second! Good luck. Juliette
I gave birth twice at home and had some of the same concerns that you have. My case is unusual in that my first labor was five hours and my second was twenty-four. I did feel a bit let down the first time because it all happened so quickly and I had paid so much. But that feeling didn't last. Within months I began to appreciate the beauty of the birth as I had wanted it. Clearly my decision to give birth at home a second time proves the lasting value to me of that first, short delivery at home. I was delighted with my prenatal care both times, and consider the counseling I received absolutely beneficial. The second labor was very long, and I got more than my money's worth from my midwives. I was nearly transported to the hospital but managed to give birth at the last minute. Homebirth requires the parents to assume more responsibility for the safety of the mother and baby. The pain after the birth was much worse the second time, which is typical, so I was grateful for a lot of support from friends and family for bringing food and watching my first child.

I would be happy to talk with you in person about my homebirth experiences. Sienna


I find it makes me at first sad, and then rather angry, to see so many hospital births where there is a need to 'have an advocate for you in labor' or to 'avoid unwanted intervention'. It is incredible to me that the hospitals should make mothers feel like this!

Home birth is wonderful, for positive reasons, as well as avoiding intervention. I do think it's important to become very informed about the birth process, so that you really know what is happening (as much as is possible for an experience that is way out there away from ordinary life!) - and to supplement your intuition (which is your strongest ally) with other women's experiences and tales, and also with knowledge, for the birth partner too, of what are real signs of problems, and what is just(!) the normal fear and extreme experience of 'transition', for instance. It is wonderful especially after the birth to be at home, in your known environment, and to relax and sleep in safety with the new baby.

The birth process seems to have a mind of its own, and is very sensitive to surroundings, environment and people present. It can be that entering a hospital slows contractions - many mothers say this. At home, a good midwife, reassuring and helping, is a treasure.

My ideal birth, should there be a next time (I have five children) would be with a water pool at home, with a trusted midwife, and music, and some gas-and-air(nitrous oxide) on hand, if I chose to use it for transition. And a good hospital within quick and easy reach in case of unforeseen difficulty. And someone in another room to look after my toddler. The most helpful thing to do in labor is to keep upright - letting the body find the positions it wants to for labor, and eventual delivery, is far easier at home. Maybe I just feel inhibited being watched, but it does feel like such a private thing to give birth! Somehow it can be quite sexual at times, and it's good to be at home for those moments. There's a lot about birth that isn't found in the mainstream books! Good luck with your choices. Janice


Affordable Homebirth

May 2003

I have read ALL of the recommendations for midwives on the P- Net site. I'd like to know if folks know of any homebirth midwives who do [or would possibly] charge less than $2500 for a student family having a second child. My last homebirth, in another state ofcourse, cost $1200 for EXCELLENT service over 9mths++. While I realize that EVERYTHING is more expensive in the Bay Area, I couldn't believe that the going rate for a homebirth here [according to one midwife I contacted from the P- Net recs] is $3500- on the low end! talk about a middle-class luxury. ANY LEADS will be a God-send. sincerely, natural-ly broke


Consider reposting your message, but including contact information for yourself. My homebirth midwife cut me a deal, but I'm not sure she'd appreciate my telling the world, including her more prosperous clients, about it.

Even so, I'm not sure you'll get a much better price than you've been quoted. I believe we paid over $2000 for the birth, but some of the discount was an allowance for a reduction in the number of prenatal care visits (because I had gotten some of my prenatal care elsewhere). If you truly cannot afford $2,500, then you are certainly eligible for MediCal. Not all midwives take it, but some do. Some who say they don't can be prevailed upon to change their minds if you discreetly offer to (illegally!) top up MediCal's shockingly low reimbursement rates with cash. Unlike much private insurance, MediCal does pay for homebirths.

You may also be able to negotiate a discount for payment in cash.

We have spent a shocking amount of money on homebirths, and it was the one expenditure that was worth every cent and more. Homebirth midwives work hard for what they earn. Consider whatever extra you pay a contribution to keeping *real* reproductive choice alive. Love my midwives dearly


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