I've been attending births for about 13 years now and over that time I've been to around 450 births. They've been all different kinds of births. I've seen homebirths, hospltal births, birth center births, births in a hospital in Jamaica that had little equipment or medications, births that were triumphant, and births that were traumatic. I've seen and experienced a lot!

I've been asked to share my experiences and knowledge by many people over the years. So what kind of information do I usually share with people who ask? It depends on who they are. I understand I can't sell homebirth to everyone and I don't try to. For those who choose to birth in the hospital, I encourage them to do the following things:

~Educate yourself: You wouldn't even walk out on a showroom floor at a car dealership without researching it first. Knowledge it power!
~Ask questions before each and every test or procedure is suggested. (BRAIN: Benefits?: What are they? Risks? What are they and how likely are they to happen? Alternatives? Is there anything we can try first? Instinct? What is my instinct telling me I should do? Nothing? What if we do nothing?)
~Hire a doula: A doula is like a guide in uncharted waters. No matter how many books you read or how many classes you take, you can still feel unprepared for labor. Your doula is like the cliffnotes version of your childbirth class right there in the labor room with you! She provides comfort and information to both of you and you should not birth without one! Why? You will be treated differently with a doula by your side. They know they can't just do whatever they want, you have a witness. 
~ Question whether your provider is the one for you: Don't just keep going back to someone you aren't 100% comfortable with. There are lots of options. Again, it's just like buying a car. You'll feel better about your choice if you researched your options and then made your choice.

For people who are interested in birth center or homebirth, I like to share the following things:
~ For most out-of-hospital births the same midwife who you saw for prenatals will be there at your birth. No strangers, no surprises.
~ Prenatals with an out-of-hospital midwife are more family-centered and encompass both your physical and emotional development throughout the pregnancy. Doctor or hospital-based midwife = 1 hour in waiting room, 7 minutes with your provider, MAX. Out-of-hospital midwife = 1 hour actual face-to-face time, MINIMUM, no waiting.
~ Birth feels different when you are in the comfort of your home, able to do whatever you want to do, eat whatever you want to eat, and are attended by people you know and trust. In this situation, it feels managable and you feel in control.
~ Birth is safe at home: My joke is that we don't just show up with a birth drum and a feather, though we bring those too! We bring equipment that any small hospital might have. We're also specially trained to be able to detect potential problems ahead of time and handle any emergency that arises. Emergencies rarely if ever happen without warning. Reputable studies show that homebirth is just as safe or safer as hospital birth and involve significantly less interventions.
~Your baby will be treated with respect and will not be taken from you...EVER!
~Postpartum visits take place in your home because...you just had a baby!

It all sounds incredibly reasonable to me! And let me tell you, this knowledge doesn't come from books. It comes from experience! I'm not a zealot. I don't have these ideas for no reason. They are based on my experiences and I tell you, if you had my experiences, you would feel the same way I do. I've often thought if people could see what I've seen, they would see the problem! So I thought I would write about some of the things I have seen. Each and every one of these things actually happened. Don't worry, I'm not telling horror stories! I'm also not being selective about my experiences to try to paint a certain picture. The specific situations I am discussing are the most typical births I have attended, not exceptions to the rule.

Some people ask me why I'm such a huge proponent of homebirth and I like to say, "Because I've seen birth in the hospital!" The response is the same for countless others that have been where I have.  I've seen birth after birth in the hospital where women are treated routinely. This is a once in a lifetime event in their life but to that nurse or that doctor, it's Tuesday, just one more day until my day off.

I've seen what happens when women don't question their doctor as to WHY they are being induced. When they ended up with a cesarean for "failure to progress" the nurse said it was because the mom's body "wasn't ready yet. Why did you come in for an induction anyway?"

 I've seen what happens when a couple gleefully tells me about how their doctor or hospital-based midwife is going to be on-call "just for us!" Uh...no, sadly they are not!

 I've seen what happens when a woman specifically asks for no male providers and is greeted upon admission with a male doctor as he proceeds to do a vaginal exam without permission, before he's introduced himself.
 
I've seen what happens when a couple decides it's not necessary to go to a childbirth class and then has no idea what the doctor is talking about. "What's a cervix?"

I've seen what happens when a woman feels like birthing at home is "wierd" and "people might think I'm wierd if I do it"...and then she doesn't feel comfortable at all in the hospital environment.

I've seen what happens when a dad thinks he can definitely handle doing all of the labor support for his wife without a doula...and 42 hours later is he exhausted and regretful.

I've seen what happens when a woman doesn't really like her doctor but she's afraid his feelings will be hurt if she changes providers. Guess what? He's 100x as bad in labor as he is in the office. 

I've seen couples be terrified into doing something they know in their heart they don't want to do because someone finds it necessary to "pull the dead baby card" as I call it. You should never have to threaten a patient into doing what you want them to do by telling them their baby could die if they don't.

I've seen women have 20 or more vaginal exams during the course of her labor, by many different people. Her vagina is supposed to be a sacred place at any other time of her life but this is BIRTH! Put your feet up in the stirups and let everyone in the hospital in there!

I've seen women be forced to lie down when it is excruciating for them to do so for.no.reason. I've seen those same women finally submit to an epidural because they can't take it any more.

I've seen nurses act more like drug pushers than nurses. "Are you sure you don't want an epidural now? How about now? Come on, everyone's doing it."

I've seen endless parades of staff coming through a room to examine the woman with the wierd whatever. Yes it's a teaching hospital but this woman is trying to give birth!

I've seen women yelled at and told they don't know what they are doing. "You'll never figure out how to push if you don't listen to us!"

Nearly every birth I've seen at the hospital ended with the entire room yelling "Push!!! 1,2,3,4,5,6,7,8,9,10 Now PUSH AGAIN!!!" Next time you're doing something difficult, see if that helps.

I've seen a doctor say if he doesn't cut her, her baby will never come out and will die in the birth canal. The baby was born 1 minute later without assistance.

I've seen a doctor who refused to deliver a woman unless she was on the bed. Thankfully the father caught the baby before he hit the floor as she was walking to the bed with her baby crowning.

I've heard the cries of a woman begging to be given her baby and then heard the nurse say "It'll be just a few minutes. I have to weigh him, give him his shot, give him his eye ointment, diaper him, and swaddle him. THEN you can have him." She just birthed a baby after losing her first one and you are going to deny her the first 30 minutes of that baby's life for WHAT?
 
I've seen babies go to the Neonatal Intensive Care Unit (NICU) for silly hospital policies such as: The baby is under 5lb, albeit 1 oz under, and the parents are VERY short, small people. The baby is under 37 weeks, albeit 36 weeks and 6 days...The baby's temperature is .1 degrees too cold, we have to take her to NICU. Believe me, if you are a baby, you want to do everything you can to avoid NICU!

I've seen NICU staff tell parents that they can only hold their fullterm newborns 1 out of every 3 hours, not because it is for their baby's health but because it's NICU policy. I've come to understand that NICU's "Hands On" policy actually means hands OFF.

I've seen moms forcibly stretched by doctors doing "perineal massage" (not the real perineal massage, this is no massage!) who then tell the woman that pain she's feeling is from the baby's head. 

I've seen women talked into scheduled cesareans rather than being given the support they need.

I've seen women be talked into repeat cesareans because of the risk of uterine rupture. That same doctor then induces a mom with a previous cesarean, upping the chances of rupture from .5% to 3%. I guess the doctor doesn't care about that .5% as much as she emphatically stated.

I've seen a woman at 10cm be forced to under-go a repeat cesarean because she didn't follow hospital protocol in coming to the hospital at the first sign of labor.

I've seen the nurse turn on pitocin when a woman was 9cm, calm, and relaxed. As the nurse said, "She's not hurting enough to be 9cm."

I've seen an entire staff of a hospital not provide any assistance when the mom threw up on herself after they forced her to chug 2 liters of water. Not a towel, not a mop, not a napkin.

I've seen a couple be pressured into amniotomy at 5 cm (manual rupture of the baby's protective amniotic sac) to screw an internal monitor into their baby's scalp because the baby forcibly kicked the belts of the external monitor every time they put them on. Smart baby I say!

I've seen a woman be given an epidural when she was 10cm and pushing just because the anesthesiologist hadn't been able to get to her until then. She then spent 2 1/2 hours trying to push her baby out who was in distress and needed to be born. She had absolutely no feeling except that helpless feeling of knowing her baby is in trouble and she couldn't help him.

I've seen a woman arrive at the hospital at 10cm with the baby's butt crowning, then rushed back for an "emergency" cesarean where the baby had to be pushed back up to be delivered. All of this despite her protests "I don't want a cesarean! If the baby is coming, can't I just push and give birth vaginally? Please let me birth my baby! I don't want a cesarean!"

To be honest, this list is but the tip of the iceberg of the things I have seen in my 13 years as a doula and midwife.   

I've seen some nice births in the hospital too but those only happened when people did those things I mentioned before. They educated themselves, hired a doula, chose the best provider for them, and asked questions before deciding on any test or procedure.

In those situations, I've seen a woman say things like "Oh you need to assess my baby? Well you can do that while I am holding her, thank you!"  

I've seen a woman who slapped the midwive's hands away when she went to do a vaginal exam without permission and declared "Don't touch me! I'll let you know when and if it's ok."
 
I've seen a dad get angry at the nurse for forcing his wife to lie down, despite the midwife's written orders that she could be off the monitors. He yanked the belts off of her and threw them at the nurse when he (yes the nurse on L&D was a man) refused to take them off. (I always tell parents that you catch more bees with honey but in this situation, it was very effective!)

I've seen a dad who openly questioned the lab results of his newborn girl who was in the NICU and then told the doctor that if she tried to lie to him again, he was moving his daughter to a different NICU.

I've seen a mom refuse to go home when she was discharged and her baby wasn't. She spent the next 7 days and nights in NICU with her baby, happily and cheerfully going against the policies that would prevent her from holding or breastfeeding her baby on-demand, the policies that had NOTHING to do with her baby's health.

I've seen parents who asked questions every step of the way on their birth journey and made every decision that led up to their cesarean. They never felt out of control or forced to do anything because they had educated themselves and made decisions based on the information and their own instincts. They never questioned the outcome, ever.

I've seen women birth their own babies, even in the hospital.

I've seen a dad crawl right into bed with the mom and tell the nurse (jokingly but also serious) "I guess I'm your patient too. If she wants to be cuddled, I'm going to do that for her no matter what anyone else says."

I've seen a couple patiently wait 48 hours after her water broke at home and then announce to the doctor that yes, it had been 48 hours but they had been monitoring for infection and were not going to come in for an automatic induction. She birthed 3 hours later.
 
I've seen a woman who had to be induced at 37 weeks be offered a cesarean because an induction would be likely that fail and would probably take at least 3 days. With the power of her mind, she willed herself into labor and gave birth painlessly 5 hours later, much to the shock of the doctors!

The commonality with all of these births is that the couple knew what they wanted and they were insistant that they were going to get that. They expected and demanded integrity of the staff. Most of them were extremely nice about it but left absolutely no question as to their own intentions. I like to remind people that these people work for YOU, not the other way around!

Homebirths are a stark contrast. Rather than good birth outcomes being few and far between, they are the norm. The majority of births at home are quick, involve very little if any pain, and result in a securely attached mom, dad, and baby. The difficult ones are the ones that are few and far between. When a woman births at home, she is in her own space and she feels she can do whatever she needs to do, without having to ask permission.

At home I've seen a woman smiling, joking, and happy at 10cm. As in, you could barely tell she was in labor.

I've seen a woman silently breathe her baby out and then announce to everyone, "The baby's out now."

I've seen a young dad bond instantly to his baby as he helped bring her into this world.

I've seen a mom say after every surge "That one felt sooooo good."

I've seen a mom bring her baby to the surface of the water and say "Hi Baby! I love you so much that I'll never let anyone take you away from me! EVER!"

I've seen babies who never cry the whole 4 or 5 hours I am there after the birth. Why cry? They have everything they need!

I've seen babies make their journey completely on their own to the breast and latch on, without assistance from mom.

I've seen a baby completely birth himself, without mom's assistance. As mom said "He's coming! But I'm not pushing, HE is!" Babies are smart and they are strong!

Every time I am at a homebirth, I think to myself that this is how birth is supposed to be! Women birthing without fear, surrounded by loving support. Babies coming into their parents arms, feeling love and peace as their first emotions, instead of fear and pain. Families supported in their home environment and encouraged to make their own decisions, rather than listening to the decisions of their provider. Families supported through their transition, creating strong, emotionally stable, loving bonds. This is how birth is supposed to be! I'm not biased, I'm RIGHT!!!