As a patient and the daughter of a patient, I was amazed by how precise surgery had become and how fast healing could be. I was struck, too, by how kind many of the nurses were; how smart and involved some of the doctors we met were. But I was also startled by the profound discomfort I always felt in hospitals. Physicians at times were brusque and even hostile to us (or was I imagining it?). The lighting was harsh, the food terrible, the rooms loud. Weren’t people trying to heal? That didn’t matter. What mattered was the whole busy apparatus of care—the beeping monitors and the hourly check-ins and the forced wakings, the elaborate (and frequently futile) interventions painstakingly performed on the terminally ill. In the hospital, I always felt like Alice at the Mad Hatter’s tea party: I had woken up in a world that seemed utterly logical to its inhabitants, but quite mad to me.
– Meghan O’Rourke, The Atlantic magazine (emphasis added).
The things modern medicine can do when you’re sick are stunning. I am weak with gratitude to the surgeon who skillfully removed my appendix before it burst; for the antibiotic that saved my husband’s life when his foot became dangerously infected; for the medical professionals who took tender care of my son when he broke bones. Hospitals are marvels of health care delivery.
But a hospital is not necessarily the best place to have a baby.
I work with women who desire natural birth – that is, birth without interventions that interfere with the body’s innate process. Yet most of them do not question giving birth in hospital.
We should question it. I don’t mean chuck medicine altogether, but rather soften its influence by placing birth away from “the whole busy apparatus of care” and into the settings where the focus is not on the “inhabitants” – hospital employees and the tech they wield – but on the family: in independent birth centers and at home.
It’s time to think differently about birth. It may help if we notice that, instead of being like a chronic illness cured by medicine, birth is actually more like a wedding: an intimate and celebratory once-in-a-life time moment of social and spiritual significance for the whole family.
Here are some parallels to consider.
a rite of passage
Though our current moment interprets birth as a medical event, it has historically been understood to be a rite of passage: a time out of ordinary life in which initiates physically and symbolically shed the old life and enter a new one. The rite introduces initiates to guides and orients them to their new life.
Out of hospital, birth has retained this context and power. In hospital, however, birth is stripped of most of its significance and instructional value. The mother’s intuitive and community guidance is replaced by the clinical assessments of strangers.
An officiant to guide the couple through the rite of passage
In birth, the officiant is the birth attendant. In the US, obstetricians, who are surgical specialists, attend 92% of births; midwives, the experts in physiologic birth, attend the rest.
That’s like bishops officiating 92% of weddings, instead of the parish priest.
A marrying couple doesn’t simply take whomever they get. They choose carefully based on the officiant’s experience and on how well their philosophy and practice style align with the couple’s. They notice how they feel with the officiant. They respect the officiant’s expertise, but they also continue to trust themselves and their own judgment.
Choose your birth attendant similarly.
A special location
Again, the couple doesn’t just take the location nearest to where they live, or the place where their friends have married/birthed, let alone the place their parents/insurance will pay fully for. They choose the space carefully based on how it suits their unique needs and how they feel in it.
Some people choose to get married at home because it’s where they feel best. Similarly, home birth may be the right birthing location for the healthy moms and babies who choose it. It is important to know that although home birth is still rare in the U.S., it is not rare in the countries of the developed world which have better maternal/fetal outcomes. Out-of-hospital birth attendants also manage to keep Cesarians to about 5%, compared to a rate of 33% for hospital births.
Expect to pay to get what you want
Parents traditionally pitch in generously for a wedding, but if there isn’t agreement between parents and the couple, the couple usually finds a way to make up the difference.
It’s time we started to become willing to pay for birth, too – for the experience, not just the layette. Find out what your insurer pays for out-of-hospital birth. You may find they cover birth center birth and home birth, at least partially. Out-of-hospital fees are also much less than hospital fees. (According to “Evidence-Based Maternity Care,” in 2003 a birth center birth averaged $1,624, and an uncomplicated vaginal hospital birth averaged $6,239.) You may find that hospital birth, even with insurance coverage, costs more than a birth center or home birth you pay for entirely out of pocket.
By voting with your wallet, you are influencing trends in maternity care much more than with a birth plan. Think of it as paving the way for your siblings as well as investing in memories you will treasure for a lifetime.
Plan a special time for after
A honeymoon is a special time of adjustment and celebration set aside for just the couple after the wedding. It is time we started to plan “babymoons,” too – 28 days (and more) for everyone to adjust to their new life.
In traditional societies, the women of a new mother’s village stepped in to do her work so that the she could rest with her baby for four-to-six weeks. That is no longer traditional in modern society, but we can resurrect the practice. (I show you how in my “Beyond the Registry” course. The next one starts in February).
By reframing childbirth as more like a wedding than an illness, birth is restored to wholeness and its natural context within the family. Parents and child are restored to their place at the center of the event, and risk management and medicine in their place: still present, but on the sidelines.
If you like this way of thinking about birth and postpartum, please join me and a small-group of like-minded parents for my winter HypnoBirthing + Beyond the Registry series: eight 2 1/2 hour classes on Saturday mornings, Jan. 5 – Feb. 23, 2019, expertly designed to help you have the birth and early motherhood experience that you’re dreaming of. Enroll on the webpage or email me for more information @ email@example.com.