Sitting there in front of Dr. Basin Mitchell, I wonder whether I should laugh or cry. My newly assigned OBGYN made one joke after the other, I guess in an attempt to lighten up the atmosphere in her gray, sterile office. As I put my legs in the cold stirrups for my first prenatal examination, a subtle, yet distinct odor of disinfectants lingering in the air interrupt my thought process. When she was done and my mind was back to my normal self, I remembered to ask her about the hospital’s flexibility during childbirth. “Every woman more or less ends up on their backs and begs for one or more among the abundance of different kinds of anesthesia anyway,” she replied.

Hand in hand, my husband Josh and I walked out of the hospital building on California Street in the Richmond District, excited about the little life we had created, but at the same time frightened by our “comedian” doctor and the rigid medical system we just had become part of. As a first-time mom I didn’t know what to expect, but a gut feeling told me that this was not what I wanted.
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In the weeks following the visit, I thought a lot about the phrases “doctors deliver babies” and “midwives catch them,” or even better “midwives guide the mother or father to catch their own baby.” What consequences would these different expressions practiced mean to us? What would be our role and how would that affect the way our baby entered the world?

Indulged in literature about childbirth in my quest to find options, halfway through I became frightened that I would loose control and spiritual strength if I put my body and baby in the hands of doctors who seemed to look at childbirth as a problem that needs to be solved (with drugs and other tools to numb and hurry the process). I wanted and needed to be fully conscious for this extraordinary event that was about to happen. After extensive research and dialogues with my encouraging husband, I decided that I was going to give birth on my own terms, at my own pace and space. We were going to have a home birth.
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A 2005 report published in the British Medical Journal, titled “Outcomes of planned home births with certified professional midwives: large prospective study in North America,” concluded that planned home births for low risk women in countries where midwifery is part of the healthcare system, are associated with similar safety to low risk hospital birth. The study also found that the rates for medical interventions for planned homebirths were lower than for low risk hospital births. (See side bar for comparable numbers) The term low risk is applied to women who are healthy and carry a single baby.

Despite fearful comments from some of my own family members and the general distrust of natural birth from society, I dealt with it and entered the ninth month prepared both mentally and physically for a home birth. After my decision I called different midwives, and after my second interview I knew I had hit home. Circle of Life was our choice. The three midwives in the group all had an impressive history within midwifery, and the wise and spiritual ambiance in the little purple house in Fairfax, Marin, made each prenatal visit pure bliss.

In order to be admitted into Marin General in case of a necessary transfer during birth, I had to go to their clinic for checkups. The pace was fast and it felt very impersonal. Although I had requested to see nurse-midwives to make sure a doctor wouldn’t “deliver me” in case of an emergency, they were so over-worked and exhausted that they seemed to lack any passion about the process of pregnancy and birth, that seeing them didn’t make me feel much different from my first appointment.

Our insurance covered fifty percent of the billings for our midwives, but in order to cover the rest we had to go into debt. But according to the report in the British Medical Journal, it’s actually less expensive to have a homebirth as oppose to a vaginal delivery, without interventions, in a hospital. Birth is such a profitable business for hospitals that insurance companies will not grant a pregnant woman new coverage if she didn’t have it before she got pregnant.
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A sharp sensation grabbing hold of my lower back and belly woke me up around 5 am on Monday morning of April 3rd, 2005. Light contractions had come and gone throughout the last month so I wasn’t sure what to expect, but when the second one grasped me without much of a break in between, I got a clue. I walked into the bathroom, and for the first, and so far the last time in my adult life, I put a watch around my wrist and started to count the intervals of the contractions.

I wanted to let Josh sleep a little longer, so I went back to bed, closely observing my clock and trying to breath through the now consistent waves of contractions that bobbed within my body. I closed my eyes and tried to remember Susan Bradford’s voice, “Trust your body, women have given births for millions of years; you know how to do it.” “Surrender” became my mantra.
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Every Thursday night in February and March, Josh and I, and six other couples, sat in a half moon circle learning and practicing different pain coping techniques such as relaxed breathing and visualizations and movements that Susan Bradford, a doula and our holistic childbirth educator, was teaching us. Bradford shed light on different birth options and weighed the pros and cons for each one. She didn’t try to underpin the fact that cesarean sections are sometimes necessary and save lives, and that epidurals, which is one of the most common anesthesia during birth, can be a great relief when the process has been long and the woman is exhausted. But she encouraged us to go natural as long as possible because both the woman and the baby need to be fully conscious and able to physically respond to the different levels of labor in order to get the ultimate birth experience.

Leopi Nicola, licensed and certified midwife and painter, who was the primary midwife at our birth, agrees with Bradford and says that an epidural relaxes the tone in women’s bodies and makes it more difficult for the baby to do the turns it has to do in order to position themselves to come out. An epidural also numbs the woman’s sensation, making it much harder to push, which can make the woman more physically passive during birth when mobility is needed to help progress labor. Synthetic pitocin, which is widely used as a means to start the birth process, is often given together with an epidural because the contractions are so unnaturally painful. All these different factors, just to mention a few, play an important role in the increasing rates of emergency cesareans and of other kinds of interventions. Cesarean sections, or c-section, are the most common surgery in the United States. Approximately one out of three births end up in cesareans in this country.
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I woke up hearing giggles. My husband, Leopi and Joan, the secondary midwife at our birth who had just arrived, were entertained by watching my head fall toward the water in the birthing tub, when a new contraction got me up on my knees again. Because I hadn’t interrupted the natural birth process with pitocin or drugs normally used durind birth, my own body was producing the natural anesthesia called endorphins—and I was high.

It had been about 40 hours since I first started counting the lengths of my contractions. Leopi came to our house a few hours after we’d called her in the morning; she didn’t rush because she could tell from the way I described my contractions that time was not yet ripe. Meanwhile, Josh and I went for the slowest walk in my life. I stopped every few minutes to breath through a contraction and felt as if I were going to have the baby right there on the street. When she finally arrived she examined me and said that I was only one centimeter dilated and that I could be days away from having a baby. She encouraged me to get some rest, which proved to be impossible except for the minute or two in between the contractions at the end of the night.

My power naps must have helped because once I was up that Tuesday morning there was no stopping me. I tried to be as active as I could in the hopes of naturally be able to speed up the process. None of our efforts had helped. I hadn’t dilated more than three centimeters, when she came back around 3 pm. I was disappointed, but tried to keep my spirits up. Many hours later, when I still wasn’t progressing much, I started to feel uneasy. Leopi, who strongly believes in the force of the unconscious, asked if I had any fears that stopped me from letting go. I didn’t have to think long. The nurse-midwives at the clinic had told me that I would have a difficult birth because I had scar tissue on my cervix, and now when there was no end in sight I started to doubt myself. Ultimately, I was scared to end up in the hospital, having a c-section. She countered my fears with love and trust, and told me that she could break the water bag so that the labor would speed up, but if it didn’t and I got too exhausted, the last resort would be to go to the hospital. I couldn’t imagine it getting any more intense, so I said yes.

I laid down on our bed and as she was about to check me, another contraction came upon me. It was unbearable to lie on my back; my whole being screamed that I had to get up. Leopi waited patiently, but in hospitals around the U.S. doctors are not always as understanding. Women have been encouraged, and in the past also forced, to lie on their backs throughout the labor. IV fluids (because women often aren’t allowed to drink in case of an emergency c-section), epidural or spinal analgesia, electronic fetal monitoring, and other interventional procedures conveniently disable women from being physically active during birth, making it easier for the doctors to do what they have to do.
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My water broke soon after she had broken the membrane, and I transitioned. Josh remembers it well, “You walked into the bathroom, faced a few contractions by yourself, and when you came out you had a different look on your face. You had become a birth warrior.”

It felt as if the primal animal within me had woken up when what I had feared the most was revealed. Instead of trying to control my breathing, I dove into the waves of the intenseness that overtook my body every few minutes. I had entered a different state of being—I wasn’t in my mind any more. I was fully present and I let my body do what it instinctively knew how to do. I finally dared to surrender.

My hands in tight grips around Josh’s slippery thighs, I arched like a cat animal and moaned along to the African drums playing in the background. It was 11 pm and my body was finally ready and my baby was on its way out through the birth canal. When I started to feel the urge to push I was excited. Finally, I could help my hard working baby with all my force. I pushed and pushed, stopped and panted for a short while so that I wouldn’t tear too much, but my baby wanted out and I couldn’t wait to introduce it to the world. After 19 minutes of pushing, Stella Hanoi slipped out into the water. Leopi gently pushed her behind my legs so that Josh could bring her up to me.

We stayed in the tub for a while and couldn’t take our eyes off our daughter. For two weeks following the birth we kept to our bed. Friends and family came over with meals, and Leopi came over twice to see how we were doing. Even though we eventually had to get out of bed, we never stopped being in awe.
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Although the American Public Health Association has adopted policies promoting or acknowledging home births, the American College of Obstetricians and Gynecologists continues to oppose it.

If you are interested in finding a midwife or for more information about home births go to www.mothering.com or www.birthworks.org or www.midwiferytoday.com or www.mana.org.