My favorite new words: INTEGRATIVE CHILDBIRTH  

“Have you never heard anyone speak positively about labor and birth before?”  When I read this question in Ina May Gaskin’s Guide to Childbirth (Invitation, xiii, Bantam, 2003) my heart skipped a beat… “well, uh…no, not really…not ever!!”  All I’ve ever heard are the horror stories – rushing to the hospital, excruciating pain, c-sections, forceps, vacuums, four days of labor (sorry, mom…).  It all made the prospect of childbearing seem like a scene from Frankenstein rather than the most natural and wonderful thing that women do.

Since the hospital model of giving birth loomed like a shadow in my imagination, I was avid about having a homebirth.  I wanted my birthing experience free of needles, knives and chemicals, and everything to do with the peace and quiet of the mountains where I live.  My husband and I did a great deal of research on homebirth, we sought out and interviewed midwives in our area, we talked about the possibility of ‘un-assisted’ homebirth.  Our desires were for privacy and simplicity, and our constant prayer was that we might achieve a safe and healthy delivery without the presence of doctors and machines.  We were very disappointed to learn that our insurance would not cover a homebirth attended by a midwife, and paying out of pocket (although hiring a midwife would have amounted to $4,000 – $6,000 versus $25,000 + for a hospital birth!) was simply out of our reach.

A friend of mine recommended the co-op of Certified Nurse Practitioners at Boulder Nurse Midwives (www.boulderbirth.com) – a thirty minute drive from our home.  Greg and I had a tour, met with a midwife who answered our questions, and decided that the Nurse Midwives were a good ‘compromise’ between the options of homebirth and hospital birth.  Boulder Nurse Midwives is located right across the street from a hospital, and though the labor and delivery will happen in a hospital setting, it is attended by a midwife only, unless intervention is required.

A hospital birth was a compromise, but I felt like I had given up my freedom, my right to become a mother the way nature intended.  In the end, and at every step along the way, the priority was delivering a healthy child in the safest environment.  I did everything I could to prepare for a hospital birth with no intervention – herbs such as cohosh (labor tinctures should be used with caution!); homeopathics such as sepia for emotional stability, pulsatilla for optimal birth positioning and caulophyllum for regular contractions; and pre-natal yogas.  Imagine how surprised we were when the labor stalled and we opted for induction, and when little Jimmy turned ‘sunny side up’ at the last minute and we used an epidural to help me relax through the contractions, allowing Jimmy finally to turn down and slide out quite easily.

A homebirth would have been a completely different experience, and perhaps we would have rushed to the hospital anyway.  I know many women who chose a hospital birth for their first child and homebirths for their second and third.  Labor and delivery is the strongest karmic force I have ever experienced, and I am convinced that everything happens for a reason.  I am also convinced that choice is the most important factor in the whole process – from pre-natal care, through labor, delivery and post-partum.  A little research into local resources, talking to other parents in your area, reading the right books (see recommended readings below) and keeping an open mind are essential for the best possible birth experience.

Of all the books I read, I wish I had a copy of Homebirth in the Hospital  by Dr. Stacey Kerr before going into labor.  The biggest mistake I made was thinking about birth as home vs. hospital.  In my mind there was a strict either/or boundary about birthing possibilities, even though we had the luxury of working with a midwife in a hospital.  It turns out that Boulder Nurse Midwives is very much working within an integrative vision of childbirth.  The model of midwifery sees labor and delivery as a natural event, while the model of hospital birth sees pregnancy as a medical condition.  What about integrative childbirth?  Integrative childbirth is the term coined by Dr. Stacey Kerr to describe the potential to have a natural childbirth with the option of medical intervention.  Medical intervention is not a failure of the individual, and the experience of labor and delivery is unique and sacred to each woman.

My birth experience turned out quite unlike I had envisioned, and for a while afterword I felt like a failure.  I wasn’t strong enough, I didn’t have the endurance, yadda, yadda, yadda.  In the end, however, the most important thing is getting home safely with a healthy child.  I think this is what any expectant parent desires most of all.

For expectant parents of every philosophical and economic persuasion, my most ardent advice is to explore your choices and to keep an open mind.  Some families do not have any options other than a conventional modern hospital, while elsewhere midwives and birthing centers are common.  The practice of midwifery is still illegal in 23 states including Hawaii and the District of Columbia[1], and in many hospitals the mother has no power to determine her level of care.  It may be, however, that a birthing center exists in the next largest town in your state, or you may plan to commute to Ina May’s Farm from several states away (as some women have done)!  Here are my favorite books to help you prepare your mind, body and soul for the experience of your lifetime:

Everything by Ina May Gaskin, the Mother of Midwifery.  Especially Spiritual Midwifery (1977) and her Guide to Childbirth (2003)

Homebirth in the Hospital (Sentient Publications, 2009) by Dr. Stacey Kerr, and I also recommend her website www.homebirthinthehospital.com

Susan Weed’s Wise Woman Herbal for the Childbearing Year (Ash Tree Publishing, 1986) and the very complimentary Wise Woman Herbal (1989) for a poetic take on different modes of healing.

I was very attached to Active Birth by Janet Balaskas (Harvard Common Press, 1992) for the detailed explanation of the stages of labor and applications relevant in the home birth or the hospital.  She also includes a section on pre-natal yoga and discusses common labor drugs and their effects on mom and baby.