Unassisted: Home Birth in Nebraska

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... Birth is big business to a healthcare industry ... Hospitals are reinventing themselves to create an atmosphere catering to a woman’s evolving needs. However, some Nebraska women want to take their business out of the hospital altogether, but find their choice may not be a legally viable option.

Methodist Women’s Hospital ... sits just off the interstate in Elkhorn. The modern, two-building facility is a “one-stop shop” for women’s health. Women-centered facilities are not a new concept in the health care industry, but resorting back to a more home-like and natural birth experience is ... the hospital’s new labor and delivery rooms ... are as “home-like” as they can get.

... a lot more women are asking for natural birth plans lately, meaning births with limited medical interferences such as epidurals, labor inducing medications, and cesarean sections. After our tour, I asked Korth about the most natural of birth plans: the home birth.

“We feel like we’ve done a very good job as getting as close to that as we possibly can,” she said ...

But, there are some Nebraska couples who feel a hospital will never replace the comfort of home ...

“I’m terrified of hospitals,” laughed Katie. And she knows hospitals, Katie works at one in Omaha and her husband, John, is a paramedic.

“It’s just an uncomfortable environment, I think,” she said. “From the bed you’re in, to the room that you’re in, to multiple people coming in and out, in and out, not necessarily telling you what they’re doing or what’s going on—they’re just doing it. It’s just so impersonal…I’m just afraid of that.”

The couple is not expecting just yet, but is looking at their options. They prefer an assisted home birth with a ... Midwife, but they will face some difficult choices in their planning. The birth experience they want is also an illegal one. Nebraska is one of two states where an assisted home birth attended by a ... Midwife is prohibited. Alabama is the second.

Katie fears the professional and personal implications of having a home birth.

“I would fear for my job if I had a home birth,” she said. “But it is scary, the thought of doing it, not just my job, but with my family and society and the view of what that means.”

John said he’s also unsure of the professional implications he could face. He hasn’t told any of his paramedic instructors about their plans, but only one co-worker because he said he trusts her.

... If Katie decides on a home birth, it would be difficult to find a ... Midwife willing to help. The penalties for an attending midwife can range from license revocation to jail time.

... Prentice is the owner of the WomanKind Midwifery, located in ... South Dakota ... She never delivers in Nebraska, but says Nebraska mothers from as far southeast as Lincoln drive hours, or days, to see her. She said these women are “desperate” to have a different type of natural birth.

Speaking from her office in Spearfish, Jeanne said, “They want a different experience, they don’t want to be induced, they don’t want an epidural, they don’t want to be flat on their back with a monitor. They want something different. They want that personal care. And they can’t get it in their home state.”

Prentice said the atmosphere that compels women to drive hundreds of miles can never be replicated in a hospital setting. Hospitals are meant to treat disease ... something she sternly added pregnancy is not. And as for the new home-like atmospheres, Prentice isn’t buying it. She feels hospitals are quick to perform interventions, sometimes unnecessarily, breaking the tranquility of an otherwise quiet room.

“You can put nice Pergo floor in and you can hide your equipment, but the minute things look a little or feel a little scary to you, you drag that stuff out,” ...

... Back in Elkhorn, Certified Nurse Midwife, Marilyn Lowe is one of four CNMs who make up Methodist’s new Midwifery Department. Lowe says a natural birth doesn’t have to take place outside of a hospital. After a full day of seeing patients, Lowe spoke with me after hours in her office.

“Birth is a philosophy,” Lowe said. “And it can be as natural in a hospital as it can be in a home. Our goal is to help that woman accomplish what she wants to accomplish.”

“We also have patients who want epidurals,” she said. “But if somebody wants a natural birth, that is our goal to help them accomplish that with as little intervention, but yet knowing if we need that intervention, it’s available.”

... But for Katie and John, not having the option of an attended home birth leaves them feeling unsafe and frustrated. Katie is perplexed at the notion that they can deliver themselves, but not with a trained professional.

“For me I want to have a home birth, but I don’t wanna just be by myself at home popping out a kid,” she said. “What if something goes wrong?”

“My biggest frustration is that I can have a home birth, me and my husband can have our kid at home, but we can’t have somebody who’s trained to be there with us.”

... Tony Fulton of Lincoln wants to repeal a single line in Nebraska’s medical laws: the one prohibiting ... Midwives from attending home births ...

Fulton was approached by Nebraska mothers asking for his help years ago ... “For them to be stigmatized as strange or awkward, it’s the ultimate of ironies because these are moms,” ... “And often times the stigmas are being foisted upon them by those who are not moms.”

Jessica Freeman is a mother of three and a board member of Nebraska Friends of Midwives. During her first pregnancy, she said like most newly expectant mothers, she had read many books on child birth. But when it came time to deliver, she said she experienced interventions by hospital staff she felt might not be safe.

Her doctor broke her water, and told her to push, an urge, Freeman said, she never had.

“I came out feeling… just not sure what I was doing,” Freeman said. ... And that translates into your mothering.”

That experience led Freeman to seek out a home birth for her next two children. Her first home birth was performed in New York, and despite the ban, her second was in Nebraska. For that birth, Freeman imported a midwife from New York*. (*Correction: the imported midwife was not from New York, but was imported from another state)

“We’re not looking for 50 percent of births to be in the home,” she said. “We’re just saying we want the ones who know about home birth, want to be able to have a safe home birth, we want to be able to have an attendant there, to make sure nothing goes terribly wrong, and to help us if something does go wrong.”

... Sarah Jacobitz-Kizzier is in her final year as a University of Nebraska Medical Center student. She’s planning to become a family physician. I asked her why she believes the medical community is resistant to allow home births. She said it’s a “fear of lawsuits, losing their own medical license ...

... in medical school, the practice of home birth is never brought up. And often, she said, the topic was “taboo” with fellow med students. She said she feels women should have as many options as they want. And she said there are widespread misconceptions about women who want home births.

“The one that is most polarizing and the most untrue, is ... that women who choose to do home births are labeled as having a stronger emphasis on the process of the birth rather than the outcome ...

... “Virtually every other state allows this except Nebraska,” he said. “Either Nebraska is going to be the safest place on the planet to have babies, or it’s going to stick out like a sore thumb.”

No matter how "home-like" the hospital delivery suite is, it will never be like home. There is something about being in your own private, comfortable and familiar space, using your own shower / kitchen / lounge room, eating off your own plates and being surrounded by what you know, that can never be replicated by a hospital. Of course, some women will be safer birthing in the hospital, but wherever possible, I believe women should be encouraged and supported to birth at home.

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