Birth is always a major event in life. As a society, we seem to know very little on the topic. Birth is a gaping hole in an important conversation which leaves many pregnant and birthing people feeling alone and scared. Revered Midwife, Ina May Gaskin says, “Whenever and however you give birth, your experience will impact your emotions, your mind, your body, and your spirit for the rest of your life.” Wouldn’t it be great if the impact was positive? Below are some options should you choose to give birth.
As a general rule, effectively all procedures regarding pregnancy, labor, and birth are elective. All procedures and interventions require informed consent by law. Informed consent is defined as, “permission granted in the knowledge of the possible consequences, typically that which is given by a patient to a doctor for treatment with full knowledge of the possible risks and benefits.” This rule applies to vaginal exams, amniocentesis, non-stress tests, inductions, and just about any other standard procedure.
One of the easiest and most cost-effective ways to prepare to make informed decisions is by creating a birth plan. There are free birth plan templates online. Birth plans make clear what procedures may require some more research or thought. Copies of the birth plan can be given to the hospital staff to ensure everyone understands the desires of the birthing person. Taking note of all possible procedures and interventions and making decisions by weighing the risks and benefits is the best way to ensure a positive birth experience and informed consent.
A doula can be especially helpful in the prenatal planning process when things need further explaining or defining. If hiring a doula is not in the birth budget, some cities have programs such as LA Doula Project which provide free birth or abortion support for those who desire it and are unable to afford it. Click here to read more about what a doula is.
While it is common for most births in the US to take place in a hospital, that is actually not the only possible location to give birth. Giving birth at home or at a Birth Center are also available options.
Many people see birth centers as a sort of happy medium between a home birth and a hospital birth. Birth centers tend to provide a home birth experience outside of the home. This is an attractive option for people who desire a home birth, but their home is not suitable for birthing for any number of reasons. Birth centers already have all of the midwifery equipment there, are required to be within a certain distance from a hospital in the rare instance a hospital transfer becomes necessary, and midwifery assistants clean up after the birth.
A home birth is attractive to those who wish to birth with the comforts of their own home and desire a natural birth with little to no intervention. In the instance of a home birth, the midwife will arrive with all of the equipment she would have at a birth center. This includes a very long list of items which can be found here. The home also must be within a certain distance of a hospital and midwifery assistants will also clean up after the birth here.
Model of Care
The model of care is probably the most important option to have because the model of care chosen dictates the type of experience throughout the entire pregnancy and birth. There are two main models of care in the US which are the Medical Model of Care and the Midwifery Model of Care.
A medical model takes place in a hospital and an obstetrician is typically the main care provider. Some hospitals also have midwives on staff. When participating in a medical model of care, a person can birth with or without interventions (drugs for induction and/ or pain management). Depending on the type of insurance, most of the cost of the birth may be covered with the exception of the deductible and possibly the exception of certain interventions or procedures such a cesarean section. Most of the time a hospital will recommend a person stay at the hospital for at least 24 hours postpartum (after the birth) to check on them and the baby.
A midwifery model can take place in a hospital, birth center, or home and a midwife is the main care provider. When participating in a midwifery model of care, a person usually desires a natural birth without any interventions for induction or pain. Depending on the type of insurance, birthing at home or at a birth center is typically not covered, or is minimally covered. There are ways around this, however, for many insurance types. After giving birth at a birth center, the parent is usually sent home within a few hours if there are no complications. After giving birth at home, the midwife usually leaves within 2-3 hours after the birth baring any complications. In both instances, the parent(s) will receive postpartum care instructions and the midwife usually follows up within 48 hours of the birth.
It is becoming more common, however, for pregnant people to try to combine these two models of care. Some choose to do this by opting for a natural hospital birth, sometimes with the hospital midwife as their caregiver. Some choose to do this by opting to birth at a Birth Center and use less synthetic interventions for induction and/ or pain management.
No matter what kind of birth experience somebody desires, there are numerous options to make that experience a positive one. It is possible to have a positive labor and birth experience and it starts with people knowing their options. The freedom to choose how to handle pregnancy and/or birth makes that impactful difference because if you don’t know your options, you don’t have any. Happy birthing!
1) Informed Consent by: ACOG (American College of Obstetrics and Gynocology) Committee of Ethics; https://www.acog.org/-/media/Committee-Opinions/Committee-on-Ethics/co439.pdf?dmc=1&ts=20151214T2054307809
2) Informed consent definition by: Google; https://www.google.com/#q=informed+consent+definition
3) 4 Reasons to Write a Birth Plan - Plan Your Best Birth Part 2 of 3 by: Adriel Booker; http://adrielbooker.com/4-reasons-to-write-a-birth-plan/
5) Free birth support by: LA Doula Project; http://www.ladoulaproject.org/
6) Doula definition by: DONA (Doulas Of North America); https://www.dona.org/what-is-a-doula/
7) Trends in Out of Hospital Births in the United States by: CDC (Center for Disease Control); https://www.cdc.gov/nchs/products/databriefs/db144.htm
8) Midwifery Kit by:Pregnancy, Birth, & Beyond; http://www.pregnancy.com.au/midwifery/midwifery-resources/setting-up-in-private-midwifery-practice/midwifery-kit.shtml
9) Models of Maternity Care by: Our Bodies Ourselves; http://www.ourbodiesourselves.org/health-info/models-of-maternity-care/
10) Mama Musings: How I Secured Health Insurance for Our Home Birth by: The Other Baby Book; https://theotherbabybook.wordpress.com/2013/04/04/mama-musings-how-i-secured-health-insurance-for-our-home-birth/