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How I Got Pushed Into Homebirth

When a home pregnancy test revealed that I was pregnant with my first child, I called my OB and told her I was pregnant.

"You are having trouble getting a baby?" she asked. I was speaking very rudimentary Dutch.

"No, I am pregnant," I said.

"Oh, then you do not need a doctor," she said and hung up.

Confused, I made an appointment to see my general practitioner.

"I'm pregnant," I told him.

"Oh," he said, somewhat somberly. "And you… you are not happy about it?" He thought I wanted to terminate.

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Finally he explained: "What you need is a midwife, and, when the baby is ready, someone will come to your house."

And that's how I learned that homebirth is the default in the Netherlands. It is possible to choose hospital delivery (still assisted by a midwife), and you must go to the hospital if the midwife says so. (If you have gestational diabetes or high blood pressure, for example, you can't have your baby at home.) But homebirth is encouraged if the pregnancy is low-risk.

Homebirth also means natural labor, as midwives can't administer drugs. More than the location, the notion of a drug-free labor gave me pause. It was logical, to me, that it's better for the baby and the process. But the idea that I would do such a thing seemed absurd—I was terrified of labor and always assumed I'd want to avail myself of whatever drug I could get.

But I decided to look into it.

I bought a copy of "Birthing from Within," but couldn't get past the birth art or even, really, the title (where else would one birth from, I wondered?). I read another book that suggested I prepare for labor by stretching a blanket over my husband and slowly pulling it off him again, to illustrate the cervix and the baby—or something like that.

I read about meditations and breathing methods that can help in labor, and then I spoke with a doula who recommended against these things, because they are too easily forgotten in the throes of labor, leaving women without the trusty pain management system on which they'd planned to rely.

I read about TENS machines and sterile water injections as natural pain relievers during labor. I read about acupuncture and aromatherapy. None of these felt like me somehow, and I didn't trust myself to depend on something I only hoped would be helpful.

I moved on to more medical texts. Reading about how contractions worked to dilate the cervix helped me understand them not as something to fear but as a necessary means to an end. The pain was an indicator that your body was doing what it was supposed to do, and the stronger the pain the nearer you were to the end. It wasn't something to retreat from, but to work with and get through. Thinking that way made me feel a lot calmer about the whole thing.

I think the best thing any woman can do in labor is be as relaxed as possible. For some, that means drugs in a hospital environment. For others, it's water birth, or Cesarean by choice. Other women, like me, find they prefer to be like the cat who crawls into the closet by herself to deliver quietly and privately.

The more I read about and considered it, being in the hospital didn't seem necessary or appealing. For one, I'm a big baby around doctors, and I didn't trust myself to not just convert what I believe can be managed naturally into a medical situation, in which I was following instructions instead of listening to my own body.

As much as I would not recommend getting dressed and piling into your car at 10 centimeters, I believe I was better off being able to labor as long as I did at home.

I stopped reading books and began to think of labor as a joint effort of my baby and me. To visualize my baby moving from the uterus to the midwife's arms and to be able to sense what positions and motions would make the best use of gravity. I thought about the shape and workings of my own body to make this passage easier for him and for me.

I didn't think I could do that with an epidural in a hospital bed. I decided to opt for a homebirth.

I had no new-agey visions of burning incense, playing Lisa Gerrard records and ensconcing my husband and myself in beautiful love. If I had, they would have been quickly eradicated by the so-called kraampakket that your insurance company sends you, which includes all you need for home delivery: stuff like maxi pads the size of surfboards and an umbilical cord clip.

I wanted to be in my own bed, my own bathtub, to wander my own home as needed. I believed I would feel more in control there during labor and that it was important for me to feel that way.

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And it was practical: In Holland you are basically sent straight home after birth, if everything is okay. I figured why not just stay there.

I now have three children—only one of whom, the third, was actually delivered at home. With the other two, there were last-minute reasons we had to go to the hospital—with my son, there was meconium in the water, which means by law you have to go to the hospital. With my daughter, I was fully dilated, but she wasn't budging. In the end, both babies were born trouble-free in the hospital without any intervention, and then we were allowed go home.

As much as I would not recommend getting dressed and piling into your car at 10 centimeters, I believe I was better off being able to labor as long as I did at home. I never regretted my choice, which is why I opted for it again with my third baby.

But I do believe it's important to think about labor as something that you are going to do, rather than something that is going to happen to you.

When her labor began, I didn't wake my husband. I went downstairs. During each contraction, painful but effective, I paced around the dining room table, making myself stay in motion to help the process along. Between them, I stretched my back on my birthing ball and let myself rest. But I also talked to my baby and rubbed my belly to give her encouragement. If this was a method, I was making it up. But it felt right.

We—my daughter and I—did this on our own for five hours before I woke my husband and suggested he call the midwife, who arrived within 15 minutes, on her bike with a birthing stool in hand. About an hour later, I was alone in the bath while the midwife sat next door in the bedroom with my husband. She was listening to my breathing, but staying out of my space. At one point, she called me into the bedroom and said I could push when I wanted.

My daughter was born on my bed while my two other children slept across the hall.

It's not something I always imagined myself choosing, and it's not something I think is for everyone. Where and how a woman wants to give birth is a personal if not medical choice, and not something I'd ever want to try to influence. Of course, we don't all get what we want—labor is unpredictable.

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But I do believe it's important to think about labor as something that you are going to do, rather than something that is going to happen to you. Understand all of your options and really think about what makes you feel most comfortable, most calm. What you choose may surprise you.

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Photo by Calmtwood

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