Emma Downs
The Journal Gazette
Kat Hickey was nine months pregnant – although anyone who has gone through a pregnancy knows that nine months feels a lot like 19 somehow – and ready … really ready … to deliver.
Sitting in a bathtub inside her Fort Wayne home, Hickey diligently breathed through a series of contractions and waited patiently for her certified nurse midwife to arrive.
OK. Maybe not that patiently.
“My husband asked me if I could hang on just a little longer,” Hickey says. “The midwife was just 10 minutes away.”
And then Hickey felt the crown of her soon-to-be-born daughter’s head touching her hand. So that answered that question.
Ummm … no. Huh-uh. There would be no hanging on for a little longer.
“Knowing it would just take one good push and I would have her in my arms,” Hickey says. “That was the motivation.”
So she pushed. And, with the help of her husband, a few minutes later a beautiful, healthy baby girl was staring at them with that “Whoa. What just happened?” newborn expression.
“It was beautiful. We had the baby the same way we made it,” Hickey says. “Just two idiots, in our own house.”
And as dramatic as this story sounds, this is exactly what Hickey and her husband had planned from the beginning: a home birth involving the whole family.
As with many women who choose to deliver at home, Hickey wanted to avoid what she considered to be the unnecessary medical interventions she’d encountered while delivering her first child at a hospital. For her, this had included Pitocin to speed up or regulate labor, an epidural and narcotics, an IV, a catheter, a constant fetal monitor and, eventually, forceps used to extract the baby from the birth canal.
“When it came to pushing, I could’ve been blowing my nose for all I knew,” she says. “It was a bazaar situation. It seemed like the baby had been ejected from my body. And that left me thinking, ‘Did I do that? Or did they?’ I knew that couldn’t be the best way to do it.”
Growing demand
The process of delivering at home – even in the bathtub – was transformative, Hickey says. And it convinced her to become a doula, a trained labor coach. She began assisting with home births in 2000, shortly after her daughter was born.
“One of the biggest misconceptions is that giving birth at home is not an informed choice,” Hickey says. “A lot of people who do research on birth and the risks of giving birth come to the conclusion that the risks of the medical interventions are higher than the risks of delivering naturally at home.
“And the number of women who encounter an unexpected complication – when no problems existed prenatally – is incredibly small. My husband, for instance, was mostly just worried about our carpet. I knew we could work around that.”
Hickey frequently assists in births with Laura Gilbert, a certified nurse midwife with Homebirth & Women’s Health in Goshen. Gilbert, who assists with births in Fort Wayne, has recently started to turn clients away. The demand for home births is growing for a number of reasons, she says.
“There really is a desire to avoid unnecessary medical interventions,” Gilbert says. “But there is also a drive to have the birth be a family-centered event instead of a medical-centered event.”
Gilbert performs about six deliveries a month and insists that all of her clients be single, low-risk pregnancies. Although the majority of her clients are Old Order Amish, the next largest group are conservative Christians looking to save money, she says.
“The cost is probably less than half of a natural birth in the hospital,” Gilbert says. “But despite the cost, I always tell people who are thinking about home birth to have the baby in the place where they feel most comfortable.
“For me and my clients, that’s at home. For some people, that’s the hospital. There is no right or wrong.”
‘Informed choice’
For local mom Kristin Rahn, the most comfortable place to have her most recent child was standing up next to the living room couch. Gravity, it turns out, helps more than you’d think.
“That’s the big advantage to having a baby at home,” Rahn says. “You’re on your own turf, so your fight-or-flight instinct is less likely to kick in and inhibit your labor.
“And you’re more comfortable listening to your own body. You decide whether to eat or drink, whether to stand up, squat, take a bath, take a shower. You’re not flat on your back, hooked up to an IV and a catheter.”
Rahn and her husband have four children; two born in the hospital, two born at home. And when the couple first made the decision to deliver at home, they didn’t tell all of their relatives.
The midwifery model of care treats birth as a normal occurrence, relying on the idea that biologically a woman is designed to give birth. It was easy for Rahn to trust that her body and the process of giving birth naturally would work.
But not everyone felt the same. Some people she encountered felt a home birth was innately risky, she says.
“There were people who were worried,” she says. “People who frowned and said, ‘We’ll be praying for you.’ And people who thought my decision was based on bravado and not research. And that is a misconception.
“It’s totally evidence based. It’s definitely an informed choice, not second-rate or a last choice. It’s always something consciously chosen.”
Gilbert combats the misconception that home birth is dangerous with a rundown of what’s inside the travel bag she carries with her to every home birth – a dopler to check the fetal heartbeat, injectable Pitocin, oxygen and an IV for any needed antibiotics.
Fewer than 10 percent of Gilbert’s patients end up in the hospital – most of them due to long drawn-out labors when pain relief is needed.
“It’s important for the mother and baby to be low risk,” Gilbert says. “Prenatally, we check for anything out of the norm. And thank goodness hospitals are there. It’s the best of both worlds, really. You can have a home birth, but the hospital is nearby, too.
“If you were living 600 years ago, you wouldn’t have had that choice.”
For Hickey, the birth of her daughter – at home, in the bathtub – is a story worth retelling. Every year on her birthday, Hickey and her husband tell their daughter about the day she was born.
“My husband has this visceral memory of seeing our daughter’s little face, fitting perfectly in the palm of his hand,” she says. “And it’s that – those memories. That’s the beautiful thing about home birth.”
