This dad wouldn’t have done it any other way. Surprised? You won’t be after reading his reasons.
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My pregnant wife came home from a documentary film, glowing. “I know what I want now,” she said. “I’m going to give birth at The Farm.”
The documentary was Abby Epstein and Ricki Lake’s The Business of Being Born, with footage from the locally famous hippy commune some seventy miles from our home in Nashville. I had been made aware of the existence of The Farm because my wife had read everything about birth and was drawn to the softer approaches found in Ina May Gaskin’s Spiritual Midwifery.
This is a book many women have read. It has sold 500,000 copies. Ask around, you’ll see. Spiritual Midwifery is a cult classic among our women and a practical and personal path to empowerment.
This labor induction drug makes contractions more painful so that women who thought they didn’t want an epidural will suddenly opt for one.
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Steven Gaskin and a troupe of San Francisco hippies set out for Summertown, Tennessee in 1971. After living communally and free of neighboring institutions, the women were having children, and the women were attending each others’ births. Ina May Gaskin and The Farm midwives are credited with reinvigorating the midwifery movement in the U.S. in the 1970s and here they were in our backyard.
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I’m a feminist, and a liberal, but I’m also a man. I was open to the idea but was plagued by “what ifs.”
My wife had taken to watching the birthing reality shows that aired all morning on TLC. We’d get to know the couple, who would often express a desire to have a natural birth, but with the cameras rolling and the laboring mother at the mercy of her doctor, the hospital birth was almost always accelerated with pitocin, the beginning of a cycle that increased the chances of a c-section delivery.
Pitocin is a drug used to induce labor and it increases the intensity of labor contractions. If a birth professional in a modern setting feels the labor isn’t moving along quickly enough, pitocin is often administered, to the extent that it could be considered routine. This labor induction drug makes contractions more painful so that women who thought they didn’t want an epidural will suddenly opt for one.
By contrast, the epidural can slow labor, and on the birthing reality shows you will often hear a delivery nurse call out for “more pit,” and by this point the healthcare professionals have taken over.
Ironically, while birthing at a hospital would probably cost $25,000 more than a Farm birth, because our insurance would cover nearly everything at the hospital, it would actually cost us less.
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In the condensed half-hour narrative of a TLC birth, the couple will always be rewarded at the end with their baby. But first the baby is whisked away. A nurse will clean the baby, weigh the baby, apply an antibiotic ointment to its eyes, and within these first minutes of its life, the baby will also be given its first vaccine. After a brief reunion with the mother, the baby will be taken to the nursery, and regardless of the baby’s health, the nursery is where the baby will stay.
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Natural childbirth is not simply a birth without pain medication, but a wholly different perspective with respect to women and birth. Midwives don’t “deliver” a baby, but they “attend” a birth. In 2008 when our son was born, we probably could have only had him naturally outside of a hospital.
For a while we tried to compromise. There are a lot of birthing centers cropping up at hospitals, and there was one at a world-renowned university hospital in our town. It seemed we could have our midwife and be in a hospital too.
I have to admit I was relieved that this seemed like an option for us. We would have our safety net and my wife could have the birth she wanted.
Ironically, while birthing at a hospital would probably cost $25,000 more than a Farm birth, because our insurance would cover nearly everything at the hospital, it would actually cost us less. And while I wish it weren’t true, cost was a consideration.
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What hadn’t really occurred to us, at least not yet, was that the hospital’s nurse-midwives would have obstetricians as their superiors and that being in the hospital might actually complicate the birth, as opposed to making my wife and baby safer.
We had a nurse-midwife who was beholden to the institution and she wouldn’t take my wife’s side when my wife needed rest.
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This became clear to us over time. First, when my wife was informed that if she were having twins the doctor would take charge, because, after all, this was a teaching hospital and most obstetricians never have the opportunity to witness a natural twin birth. If we had had twins and my wife chose to birth naturally, the doctors and medical students would all be present for the sake of science.
Secondly, when my wife was experiencing added stress at work—much of it a direct result of taking the time for the maternity check-ups that were well within her rights—and she asked our nurse-midwife for a note, the midwife explained that even she couldn’t take time off because of stress during her own pregnancy.
Hospitals, and health professionals, don’t always practice good health. We had a nurse-midwife who was beholden to the institution and she wouldn’t take my wife’s side when my wife needed rest. The woman who was supposed to help us gently bring our baby into the world didn’t really see her job beginning until my wife was in labor.
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So my wife contacted The Farm and we switched midwives. We were lucky, since The Farm midwives accept a limited number of women. They attend births for the Amish and for many of the low-income families in this rural community. In fact, when the midwives started practicing in Tennessee, they were given support and supplies from the state board of health.
In our short experience with this world-renowned hospital, it seemed that what they were best at was sending us bills.
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Our Farm midwife had been on the original caravan from San Francisco and had attended hundreds of births. She wrote my wife the note she had wanted, and she assured us my wife could take as much time off from work as she needed. My wife continued to work, feeling better because she had support, though her maternity visits took even longer, since now they included the drive out to The Farm.
We would continue to receive bills from the world-renowned university hospital long after our son was born, and we were charged, at phenomenal rates, for things that it took months to clear up with the insurance company. In our short experience with this world-renowned hospital, it seemed that what they were best at was sending us bills.
The nurse-midwife at the hospital had grown up on The Farm and our Farm midwife knew her, The Farm being a close-knit communal family. Many of the kids who grew up on The Farm would keep in touch and attend reunions, but they also tended to leave and go out into the world.
Without intending to, we had witnessed the generational tensions between those who set out young to change the world, and those who were born into this idealistic life and were at times more willing to compromise.
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The Farm had been through changes, transitioning from a communal economy to a private economy in the 1980s, and The Farm was also a learning institution, with midwives-in-training and doulas-in-training often present.
By contrast, my wife was always glad to meet the young women who trained at The Farm, and she allowed them to practice feeling around on her for the baby inside.
If the woman isn’t relaxed in her surroundings, the cervix won’t dilate and the pregnancy will be prolonged.
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My wife is a beautiful woman prone to anxiety. She’s a private person and she doesn’t always get along with other women. In a hospital situation she would have been exposed. There would have been strangers coming and going, and she would have been—thanks to the electronic monitoring central to modernized birth—literally chained to the bed.
Modern birth is steeped in anxiety: from the woman’s expectation that birth will be prolonged, complicated, and painful; to the doctor’s expectation of how long labor should last and that a C-section intervention is often the best scenario for both mother and child.
The Farm midwives believe in the wisdom of the body. If a baby is head up, there is faith the baby will turn itself around in time, and if the baby doesn’t turn they will employ ancient and noninvasive methods that also work. If the pregnancy is prolonged, not all bodies are the same, and the baby will come when ready.
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The alleviation of anxiety is central to the Farm midwives’ philosophy. In Ina May Gaskin’s Spiritual Midwifery it is explained that if the woman isn’t relaxed in her surroundings, the cervix won’t dilate and the pregnancy will be prolonged. And kissing, or even lovemaking, is encouraged with the mantra “what got the baby in can also get the baby out.”
There wasn’t any lovemaking with my wife at The Farm, but when she labored in bed, I was in bed with her. When she labored in a hot bath to help reduce labor pain, I was there applying pressure to her hip, to help relieve the pressure on her pelvis.
But the irony is that our infant mortality rates and the mortality rates of our post-partum mothers are appalling.
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I find it hard to imagine anyone, even when they are on drugs, relaxing in a hospital setting. Many birthing centers will do their best to make the birthing rooms look more like a home setting, and many are starting to introduce birthing tubs. But it all begs the question: if there is value in making the hospital more like the home, why are tens of thousands of dollars of resources being expended for every birth when the baby could have been born at home?
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There are two obvious answers. Despite the good intentions of doctors and healthcare professionals many hospitals are for-profit institutions and those that aren’t still have to worry about the bottom line. Hospital birth is big business.
The other issue is the very small percentage of cases where surgical intervention is necessary to save mother and child.
Safety is something of a misnomer. Yes, modern medicine has saved many birthing mothers and their children. But the irony is that our infant mortality rates and the mortality rates of our post-partum mothers are appalling. Hospitals introduce at least as many dangers as they prevent.
There was never any doubt that should my wife’s birth become dangerous, our midwife would understand the situation, and we would be transferred to the hospital closest to The Farm. For this reason it was recommended to us to meet with an obstetrician at this hospital, because we would want a doctor who already knew us and who would willingly accept my wife as a patient.
Many obstetricians are not amenable to nonhospital births and they may resent “cleaning up the mess” of a young idealistic couple who thought they might have their baby out in the woods. In some states it is illegal to give birth outside of the hospital (for example, in Indiana, midwifery only became legal in 2013). So that there are conservative states taking Obama’s health care bill to court over the mandatory health insurance clause, meanwhile some of these same states have outlawed natural birth.
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The birthing mother is encouraged to do what would make her self-conscious in a hospital setting.
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We were happy to meet an obstetrician who was aware of and open to the work that was being done on The Farm, and who didn’t see The Farm midwives as a threat to her profession or a danger to the couples who chose to birth there.
Nearly all of our anxieties were quelled before our birth. We were told, only half-jokingly, that if my wife wanted to give birth naked out in the rain that the midwife would support her decision.
At The Farm we stayed in a birthing cabin, a small two-story rustic home with two beds, a bathroom, a kitchen, and a dining area. There was air-conditioning and a space heater, both of which we used, depending on my wife’s shifting whims. And there was also a birthing pool available should we choose to use it (the pool had been set up and was slowly filling with water, but we abandoned this option when it became clear my wife’s labor was proceeding rapidly).
At The Farm my wife was encouraged to walk around to alleviate her labor pains, to take a hot bath or shower, to sit on a large “birthing” ball, or to find a position in the bed other than on her back—whatever might make her, if even for a moment, feel more comfortable. After being confined to the passenger seat as she labored on the drive down to The Farm, my wife did walk around, and she moved from bed to bath to bed.
At The Farm my wife was encouraged to vocalize her discomfort with primal guttural outbursts. This is also an important part of the midwifery philosophy. The birthing mother is encouraged to do what would make her self-conscious in a hospital setting.
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As men, we have a duty to protect our women when they are most vulnerable.
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For centuries midwives have accommodated birthing mothers while many of the commonalities of a hospital birth are for the convenience of the obstetrician. Can you imagine, for example, a doctor on his hands and knees, with the mother also on her hands and knees, as they birth on the floor? Can you see a doctor wading in the birthing pool with the mother?
The elevation of the bed, the woman on her back, the stirrups, the monitoring devices—these are all for the sake of the doctor and not necessarily in service of the best birth.
The midwife is mostly responsible to mother and child, while the obstetrician has many competing loyalties: the intrusion of work schedules, multiple births to attend, fear of lawsuit.
Some states and hospitals have published their c-section rates, with 50% or higher no longer uncommon. Some women elect for abdominal surgery over vaginal birth, but once a woman is in a doctor’s care, the choice is no longer hers alone, and an experienced healthcare professional can be quite persuasive.
It is well known that c-section rates tend to spike around 5:00 PM. But babies have no reason to respect such arbitrary time commitments and the only way to speed things up in the anxiety-laden atmospheres of hospitals is through chemical or surgical intervention, with the former often leading to the latter.
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As men, we have a duty to protect our women when they are most vulnerable. And despite the birthing mother’s best intentions, her ability to stick up for herself may be waylaid while she is in labor.
In the same way we can laugh at the sexism of a show like Mad Men, we no longer have the option to extricate ourselves from birth.
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As men, no matter how our women birth, it is our responsibility to understand, as best we can, what a woman will go through, and to help her through the experience. I would recommend to any future-father with a partner about to give birth in a hospital setting to find out as much as they can, and to be willing to stand up to healthcare professionals who may have competing interests once labor has begun.
In the same way our women are culturally conditioned to think of birth as painful, men are conditioned to think of birth as a woman’s realm, to be avoided like Barbie dolls and pink princesses. We were split apart during sex ed. as little girls were told about their bodies and little boys were kept in the dark about quite a lot.
The stereotype of the expectant father pacing in the waiting room and passing out cigars, or even down the street drunk in a bar, while his wife and the doctor engage in the dirty feminine work of birth is long gone. In the same way we can laugh at the sexism of a show like Mad Men, we no longer have the option to extricate ourselves from birth.
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Personally, I believe that the only way for men to truly be involved in birth is for our women to give birth naturally. But I also believe the decision of how to give birth is one a woman should make for herself and one we should all respect, in much the same way I wish people would have respected our decision to birth at The Farm.
We were seen as eccentric for making the choice to give birth as women had for millennia. People thought of us as naïve, as children. Or as the states that have outlawed nonhospital births, some even saw us as unnecessarily endangering our baby—though we could say the same for those who choose to give birth in the hospital, and the statistics would back us up.
In 1934 when my father was born, my Italian immigrant grandmother gave birth to him at home, as she had his six other siblings and would again. There was a hospital within walking distance but it never occurred to her to go there.
I was born in 1968 at this same hospital. When I explained to my mother what my wife and I intended to do she hadn’t heard of “natural birth.” I asked if she’d been given pain medication when I was born and she said, “If they had it, they didn’t offer it to me.”
The way women give birth in this country has been completely transformed in a very short time.
The problem, as I see it, is that there is too much momentum behind modern healthcare and not enough of a critical perspective with respect to birth. Most couples don’t even recognize that there is a choice. They hand themselves over to the institution because that it is how it is done.
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The fact that natural childbirth is empowering for women is undeniable. That fact that doctors are empowered beyond what is reasonable is also undeniable.
If the only people we hear about having home births are celebrities, then it may send the message that it is an exclusive experience beyond the means of most couples.
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We live in an age where we have the benefit of easy access to knowledge on the Internet, and many will use that knowledge to assist or even challenge their doctors. Doctors often don’t appreciate being questioned and they may be dismissive of the reality that many of today’s patients are more enlightened.
Yet, many young women, and even more young men, haven’t really fully investigated the truth about hospital births. Partly, this is because we favor clinical results when it comes to healthcare research, and clinical results prefer a clinical setting. But the knowledge is out there and the success of Spiritual Midwifery is testament to a growing swell of counter-knowledge with respect to birth.
Our women are college educated. Our women work. Men today are increasingly accepting of feminist perspectives whether they realize it or not.
But not all women are feminists and not all feminists are feminists in the same way.
My own ideas about birth were changed by intelligent and courageous women who chose pain over painkillers, who understood the wisdom of breastfeeding and knew to have faith in themselves and the abilities of their own bodies. But even with access to the same knowledge, not everyone would come to the same conclusions.
Celebrity home births are starting to bring attention to midwifery in the same way the previous generation of celebrities popularized elective c-sections. If the only people we hear about having home births are celebrities, then it may send the message that it is an exclusive experience beyond the means of most couples.
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Our Farm birth was a humble and humbling experience. If more couples elected to birth with midwives, insurance companies would likely recognize that for the vast majority of births, nonhospital births are safer, with a fraction of the costs and resources.
After our son was born, the midwives gave us breakfast in bed while the newborn suckled. Then the sheets were changed and we slept, all of us together in the bed.
The midwife stopped by occasionally to check on us, but we were left alone.
The next morning as I was hanging up our laundry a family of deer walked past me to forage in the wild grass. There was a mother and baby deer with a few more adult deer. They had seen people here and hadn’t known a reason to be afraid. I acknowledged them and they acknowledged me. And before they wandered off, we brought our son outside to have a look.
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Photo: Getty Images
What a nice article. I gave birth twice with no drugs, my choice. First one was hard as our son had the cord around his neck and couldn’t proceed but fortunately some turns and gymnastics on my part and problem was solved. I hope more men see this experience as something sacred. When it was over my husband complained he was tired and was going home to go to bed. His whining totally ruined the experience. So bless your heart for truly being there and EXPERIENCING it fully.
Thank you John.
A great article. It’s good to see men writing about the birth experience. Being present at a birth, any birth, human or animal, is an emotional experience that imprints you forever. The cycle of life is beautiful and we men rob ourselves by ascribing coitus as the be all and end all when birth is also part of the sex act and the most meaningful.