As a midwife, I see compelling reasons of why many couples choose a birth option that is outside of the hospital.
1. The Woman Has More Control in Her Birth
First of all, the mother is choosing to take more of the responsibility in her birth. She is making a conscious choice that she must educate herself so that she will be ready. And, she expects her voice to be heard.
The mother is the “direct care provider for her unborn child” according to Midwives Alliance of North America (MANA). So many women want that opportunity to give birth unmedicated. Each woman believes that she is giving the best options possible to her unborn child by having her labor untampered with. There is no need to convince her caregivers. They understand her choice and they applaud this decision.
2. The Woman is Cared for by Midwives
Secondly, the woman will be cared for (most often) by other women as midwives and assistants. These midwives will do her prenatal care, be there for her labor and baby’s delivery and give support through the postpartum period of six weeks. Mutual trust comes from these monthly, then weekly visits. She is surrounded by caregivers she knows and who have experienced what it is like to give birth. Great strength comes in women helping women.
There are three paradigms that identify today’s health care:
- Technocratic Model- belief that the body is a machine, disease comes from without, standardized care is best because it minimizes risk of the unexpected and that the practitioner knows best. It is based on control.
- Humanistic model: modifies the above model by making it more humane. It allows a bit more time for care, emphasizing bedside manner and concern for the patient’s needs and feelings. It is based on kindness and good intentions.
- Holistic model: defines the patient as a client and decision maker in the health care experience. She has authority on her own health status, responsibility for educating herself on her options and for carrying out daily self-care, with her health a manifestation of emotional, psychological, and physical factors. Is based on education and empowerment (Davis, 2012).
Midwifery care is the holistic model of care.
When labor begins, these same women are the caregivers. The woman and her husband are the principle decision makers having been fully informed of the pros and cons of different options they may have.
She retains the status she has in the home of being the queen. Now that she is in labor, she is still the queen whether she chooses to stay at home for her birth, or go to a birth center. In the ‘out-of-hospital’ setting, it is all about her, her needs and desires. Everything is done with her wishes in mind. As she cares for her unborn child, the midwives care for her.
3. Natural Birth Unfolds Empowerment
Thirdly, the birth tends to be much calmer. There is very little intervening with Mother Nature. Midwives model of care is that of expectant watchful care. The midwife allows the mother to labor as she chooses whether it is walking, rocking, soaking, or eating.
The mother has no IV unless she exhibits a need for one. Her baby’s heart tones are checked routinely, not constantly. The couple are given privacy or given extra support in the way of emotional reinforcement, coaching, massaging, etc. This is all about them and their baby. This is their time to be the center of the universe.
Without extra interventions, the body is able to manage the contractions in the time and strength that is best for the mother and baby. The body knows much more than we give it credit for. With all parties working with nature, the miraculous process of a baby born is generally a quiet experience even though the mother is working so hard to bring this about. She gives out energy equal to a marathon and yet, pushes this energy downward and out.
What about complications? They happen. Midwives are well equipped to deal with many complications. The ones that need extra attention that a hospital can provide are given their due respect. Midwives are able to communicate to the couple when it would be advised to transfer to the hospital to finish what they began. We live in a wonderful day and age when all of the best research and tools are available to families.
As Elizabeth Davis has said, “When women are in charge of their environment, when they have the privacy to labor undisturbed, when they feel completely at ease and supported, outcomes are always superior.
“Research now shows that inherent in the physiology of birth, the mother has the ability to know what is best for herself and her baby. We must never forget the opinion of the mother of how best to further her labor. Put simply, miracles happen in childbirth. The midwife must keep her senses alert but stand back, let birth happen, and gratefully bear witness.
“Midwives have an urgent obligation to educate the public and to stand firm in their support of holistic care. Why? Because whenever a woman reclaims her right to birth exactly as she desires, she opens the door to fulfilling her motherhood with strength and inner certainty.” Elizabeth Davis CPM, Renowned Midwife
Women are finding that when they choose to take more responsibility in their birth, get their knowledge base up to speed, and when they choose the Holistic model of care, the end result is empowerment. Her family is ever blessed for her heightened ability to conquer challenges. Out-of-hospital birthing is a very good wave of the future!
Davis, E. (2012). Heart & Hands: A Midwife’s Guide to Pregnancy and Birth. NY: Ten Speed Press.