By Nancy Johnson
previously published in Birth Issues Fall 2011
My parents are quietly conservative. My husband and I are reluctant radicals. Our daughters are savvy Internet-age researchers and cautious consumers. What do we have in common? We have all chosen to birth our babies at home. It has been a long road for each of us to find our way, but we have no regrets that we stuck to our decision to have homemade babies.
My parents started their birthing career the way most people did in the 1960s. Dad brought my labouring mother to the hospital, she was mysteriously whisked away by strangers, and he was banished to a lonely waiting room until another stranger came to inform him that he was now a father. For my mother, the story was even more dismal. After enduring the various indignities of the mandatory prep, her ordeal culminated in a battle between the nurses and the forces of nature, with the nurses screaming in fury at my mother to quit pushing because the doctor had not arrived yet. For the hostile half hour until he got there, they kept angrily shoving their hands up her to push my head back up the birth canal. With her second and third babies, my mother refused to come to the hospital until the last possible moment. It was only a marginal improvement. The nurses were still furious with her.
By the time they were expecting their fourth baby, my parents decided there must be a better way. It was now the 1970s, and it seemed only hippies had their babies at home barefoot on the commune. That was not my parents’ style. Midwifery was commonly believed to be illegal, and there was a huge stigma attached to home birth. However, my cautiously conservative parents studied all their options and decided that despite the various ramifications home birth would be their safest and most satisfying choice. Their quiet enquiries led them to a foreign-trained nurse-midwife in Montreal who was willing to deliver their baby at home in Ottawa. I remember it as a rather clandestine affair. We children came home one day to find two strangers in our parents’ bedroom. One was a lady we had never seen before and whose name we were not told, and the other was our brand-new baby sister. For my parents, it was a deeply satisfying birth experience, and in the following years my mother quietly helped many other women on their journey to a more empowered birth.
My sister’s birth was an epiphany for my 9-year-old self. By the time I was 11, I had secretly read all my mother’s pregnancy and birth books cover to cover. I also had a radar for conversations about pregnancy and birth experiences, and I would quietly tune in whenever I could. I learned a whole lot. I learned that the ladies that went for natural childbirth in the hospital had much happier stories than the ladies who went for the whole works. I discovered that most ladies didn’t know they had any choice in how they would give birth or who would attend them. I was intrigued that the ladies who seemed to have the happiest stories of all were the ones who delivered at home, expectedly or unexpectedly, and I decided very early on that when I grew up my own choice would be to birth my babies at home my own way.
Interestingly, none of my siblings chose home birth. My parents’ positive experience did not automatically create a new family tradition. We each independently weighed our various options and came to our own conclusions. I chose home birth and my three siblings planned hospital deliveries. Ironically, home birth chose one of my sisters when despite an elaborate hospital birth plan her first baby arrived precipitately in her bedroom one morning before the paramedics could arrive. She subsequently planned a midwife-attended home birth for her second baby, with no regrets.
Before we married, Bill and I had already agreed that if all was progressing normally we wanted our children to be born at home. When we found ourselves unexpectedly expecting, the first task on our to-do list was to find someone who would do a home birth for us. It took eight months before we had anyone who would commit to helping us out, and she lived 250 miles away from our small northern Ontario town. The year was 1984.
The only local doctor who was willing to help us at home was told by his superiors that he would lose his job if he did. There were no midwives in our area, so if we were really committed to a home birth, it began to look like our only choice would be to take on the responsibility of doing it ourselves. We read everything we could get our hands on. We studied the process and mechanics of birth, various childbirth methods, and we devoured midwifery handbooks. We studied the development of the fetus and newborn care. We pored over the variations of normal birth and birth emergencies, and we had a clear plan for every possible situation we could think of. We dutifully attended medical prenatal clinic visits and a prenatal class. And we kept asking everywhere we could think of for leads on a midwife somewhere within birthing distance of our home. It seemed to be a pretty hopeless dead end.
Finally, by some miracle, we got hold of a Manitoba midwife’s phone number and made the call. I loved her instantly. She was calm, thoughtful, intelligent, open – everything I had hoped for. I told her where we lived and when I was due and asked if she would be willing to come. Her gentle answer was that 300 miles was pretty far away and she had small children in school. I thought she was giving a kindly but categorical no. I later found out that her gentle resistance was part of her screening process to see how committed we were. But I was only 19, not yet very assertive, and I mistook her answer for an out-and-out no. I was devastated. But she did give us the name of a midwife in Thunder Bay, Ontario.
Bill and I borrowed a car and drove 250 miles to Thunder Bay to meet the midwife there. By now, the big day was only about a month away. We were confident we could tackle the birth on our own, but we still would prefer to have a midwife with us. This midwife was young, energetic, enthusiastic – and leaving in two days to go practice midwifery in India. So she bundled us off down the highway a few more miles to the home of yet another midwife. It turned out this midwife was available and willing to take a bush plane to be with us for the birth of our first baby. She missed the birth by 15 minutes. My mom and Bill did the honors, and baby Anastasia arrived without a hitch. At home, my way.
Thirteen months later, our second daughter was on her way, and we discovered our midwife had changed some of her philosophies of care in ways that were not comfortable to us. In desperation, we contacted the Manitoba midwife again. This time we understood each other better, and she agreed to help us with our home birth. Our prenatal visits with her were awesome, intimate, soul-stirring celebrations of the beauty, sacredness, and normalness of birth. This midwife was a perfect fit for our family in every way. She and her nursing toddler took a bush plane in a blizzard to be with us for Hayley’s birth. Bill caught our baby, but we enjoyed the luxury of having a wonderful, competent, compassionate midwife as part of our birth team, guiding us gently through the rhythms and challenges of labour and birth.
In 1987 when our third daughter was ready to join us, this same midwife was ready to hop on a bush plane for us again, but our baby chose a Sunday to arrive—the only day of the week there was no air service to our town. The midwife offered to drive the 300 miles despite a snowstorm, but we all recognized that she would not make this birth on time. There was now a local doctor willing to do home births, so our choices were to call the doctor to come to our home, go to the hospital, call the paramedics, or carry on with another unassisted home birth. We chose to carry on, and the midwife braved the blizzard, hopped in her car, and headed our way. Bethany was already 2 hours old when we introduced her to the midwife. This woman’s passion and commitment to supporting birthing families has been our gold standard ever since. This was during a time when it was illegal for midwives to charge for their services, so a midwife’s work was truly an unpaid labour of love.
Fast forward about 20 years. We now live in Alberta, and our daughters are having children of their own. They live in the age of instant access to information and misinformation, hospital birth is as popular as ever, midwifery has undergone radical changes, and home birth is still widely misperceived as unsafe, too weird, and even illegal. We held our breath to see which way our daughters’ own birth philosophies would swing. Our hearts hoped they and our sons-in-law would be open to the advantages of home birth and midwifery care, but at the same time we respected their right to make their own choices, just as we had demanded that right for ourselves.
When our eldest daughter sought midwifery care for her first baby, our hearts sang with gratitude. Midwifery was now a registered and legal profession. She found a team of Edmonton midwives that she was comfortable with. This was in 2005 before Alberta had started funding midwifery services, and the out-of-pocket fee for a home birth was rather prohibitive for a young couple just starting out. However, their commitment to a midwife-attended home birth was strong, and they willingly made the sacrifices to meet their monthly midwife payments. It turns out our daughter had a breathtakingly precipitate delivery, and she and her husband had an unintentionally unassisted home birth. It seems to run in the family. We arrived before the midwives did and had the privilege of helping her deliver the placenta. It was a remarkable start to our career as grandparents of home-born babies. For our daughter, it was a very expensive do-it-yourself birth.
For her second baby, she wanted to try a water birth. We had a lot of reservations about her actually delivering our grandchild into the water. However, we recalled our own baby research days, opened our minds, and quickly came to understand and respect her choice. When the time came, we were ready, excited, and privileged to support her at her home water birth.
Although full funding would not come into effect until 2009, by 2007 there were rumors that funding for midwifery care was in the works, so we were thrilled about that, but we were a little worried about what impact the proposed changes and the steps leading up to them would have on the traditional standard of midwifery care. One of the first disappointments was that her original midwife team would no longer attend home births. If our daughter was willing to commute for group prenatal care and travel to a rural hospital to deliver in a birthing room they would take her on a
s a client. Given her previous precipitate home delivery and current threatened preterm labour, plus the fact that her Edmonton home was 50 km away from the hospital, our daughter felt it was not a realistic option for her.
She began searching again for a midwife with a birth philosophy compatible with her own, and she soon found a wonderful midwife that she really connected with. Unfortunately, due to regulatory red tape, this midwife was obligated to work with a second midwife whose philosophies were not quite in synch and were much more interventional and less respectful of the birthing family’s right to participate in care decisions. The bureaucratic efforts to make midwifery care financially accessible ironically also took away some of our daughter’s power of choice as to who would attend her during the intimacy of birth. Although our second grandson’s water birth was in itself a beautiful experience, the behind-the-scenes tension marred the atmosphere somewhat, and some of the skirmishing spilled over and affected the standard of care that our daughter received. Fortunately, our daughter’s midwife of choice provided virtually all of her prenatal and postnatal care, so we are still grateful that the current midwifery system has served her reasonably well.
When our second daughter and son-in-law recently announced that their first baby was on its way, we were thrilled to learn that they too planned a home water birth. But we weren’t prepared for how rocky their road would be to finding a midwife who would, or could, attend them. There are now more midwives than ever in Edmonton, so we were boggled by the paradox that it is so difficult to plan a midwife-attended home birth.
With funding, empirically trained lay midwives have been forced to disappear from the landscape, while foreign-trained midwives are not guaranteed provincial registration. Home birth is more financially accessible, but women’s choices within funded midwifery services are more limited. Our hospitals no longer allow water births, so women wanting that option are forced to deliver at home. Home birth after a cesarean remains a tenuous option, but professionally attended twin, breech, and postdates deliveries are absolutely denied to women wanting to give birth at home. Under the current quota system imposed on midwives, when the midwives’ allotments are full, women wanting a home birth have two heart-searching choices: give it up or do it yourself.
Our daughter contacted every midwifery practice in Edmonton when she was only four weeks pregnant, stating she was firmly committed to birthing at home. She either got no reply, was told they were not taking bookings that far ahead, or was told that they were already completely booked. Within a month, our daughter re-contacted all the no-replies and the clinics that had said to try later. They were now all fully booked, not one opening amongst them, with no hope in sight due to the strict quotas imposed on them.
Our daughter was devastated, panicky, and worried sick about being forced to give birth in a hospital against her will. It was an unfortunate blot on the first several months of her pregnancy. However, she and her husband persevered, and finally their repeated enquiries were rewarded with an appointment to meet with a team of midwives. Fortunately for them, they stumbled into an excellent match and received beautiful care. In March 2011, with a superb team of midwives present, our second daughter gave birth at home to her first child, our little earlybird granddaughter.
Our youngest daughter is likewise passionately committed to passing on the legacy of home birth. Will she have more choice about her caregivers and her birth experience, or will legislation continue to define what constitutes the ideal birth?
Bill and I have been privileged to participate in the birth of each one of our little homegrown grandbabies. We treasure the memories of our own home birth adventures. We are grateful to my parents for quietly blazing their own childbirth trail. And we salute the generations of midwives who courageously and passionately honor the choices of their birthing families. Our hope is that midwifery and home birth will continue to flourish and that our family’s journey will encourage other families not to give up too quickly on the choices they cherish.
Nancy Johnson is a home-based wife, mom, grandmother, medical transcriptionist, and prenatal educator. When she is not busy as doula to her daughters, her family often finds her in a tangle of yarn or a heap of quilt scraps. Her secret dream is to be a midwife’s apprentice.