Education in Schools is sincerely lacking on the subject of birth, it seems that one should be armed with a balanced education on both hospital and home births by the time one graduates high school. Women have to seek out this information themselves and unfortunately it is not a celebrated topic among women who aren’t yet mothers or looking to become mothers. Pregnancy is almost taboo among young women.
At 37 weeks my doctor became very controlling and told me "You know you will have to give birth on your back right. I have a bad back and can't reach down there." This after I was told my birth plan was fine by her staff months earlier. At this moment I realized she did not respect my choice and I could not feel confident that she would not push inducement or a c-section on me.
Instead of being yet another woman, like the many I consulted who were very unhappy with the way their first child was born, I found a midwife. I loved the experience of a home birth and would pay full price, $4,000, again. I think insurance companies would be well advised to cover homebirths and/or physicians who "back-up" midwives for healthy mothers as it would surely lower costs for them.
The $4,000 included prenatal care, education on childbirth and babies, and postpartum care for both my child and me. The postpartum care is very valuable as the midwife helps the father, mother and child adjust to their new life to each other by addressing most concerns (physical, psychological) at one meeting. My mother is a nurse and my father is a doctor so this was a controversial choice to make. My mother supported me with apprehension but is now sold on homebirths...though she still likes to point out that a hospital is the best place for medical emergencies. I agree but I do not think birth is an emergency.

I have two children, both of whom I birthed at home with midwives.

Having a close friend who is a family practice physician (and women's health advocate) support my early thoughts of having a homebirth (long before I was pregnant), and witnessing a birth in a hospital (again, long before I was pregnant, this is important) inspired me to do more research on homebirth. I learned of positive outcomes, AND just as important to me, positive _experiences_ for the families who birthed at home.

An obstacle I faced with my second birth is that my baby was in a so-called "frank" breech (buttocks first, not the usual head-first presentation) position for several weeks before--and during--the birth. I was fortunate to have a midwife willing to attend my homebirth because she had prior experience with vaginal breech birth (this is increasingly rare). However, our midwife agreed to continue with our planned homebirth only after I took full responsibility for whatever might happen during the birth. This means my husband and I authored and signed a statement saying that no matter what happened, including my or the baby's death, we, nor any of our family members, would sue her for any reason.

Since I had already given birth at home once before, and I had recently learned that even the National Institute of Health had once (in the 80's) convened a panel of experts that supported vaginal birth for frank breeches if the mother was attended by someone with experience, I chose one set of risks over another (major surgery) and am glad I did.

My breech daughter's birth was terrific. It cost $3700 total for all my prenatal care, the birth, and postpartum care through 6 weeks. My PPO paid for 80% of it, I believe. I am guessing that this is less money than would have changed hands had I gone the conventional-style route (and, most likely, because of the baby's breechness, had a C-section).

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I have had three midwife-assisted, unmedicated, vaginal deliveries (the first in a hospital, the second in a freestanding birth center and the third at home). My birth choices were influenced by a few factors: 1. I believe birth is a normal physiological act that WORKS. 2. I believe that in order for birth to work as it is supposed to, a woman needs the freedom to do whatever is necessary to give birth: walk around, take a shower, focus inward, receive loving support, listen to her body, etc. 3. I believe in EVIDENCE-BASED healthcare; studies have shown time and again that home birth is safe; "managed labor" hospital models carry a high risk for interventions, and consequently, surgical birth. 4. I believe in making informed choices; having a baby under the care of an OB/Gyn, in a hospital, with labor-enhancing drugs and pain medication IS NOT the only way to give birth.

When I was pregnant with my first child 11 years ago, my husband was a fourth-year OB/Gyn resident at a major teaching hospital in Pennsylvania. At the time, I chose to have my baby in a smaller, community hospital; our daughter was the first midwife-assisted birth at that hospital. Today, my husband is in private practice in South Florida, where, unfortunately, defensive medicine has left women with very limited choices when it comes to childbirth. The threat of lawsuits (some meritorious and many frivolous) has completely warped the way doctors approach childbirth. And women, too, are too blame, as many of them come to childbirth with excessive fear and do not take the time to educate/empower themselves.

All of my births were paid by our insurance at the time (it varied, but all were HMOs). The birth center and home births were about $3500 each. Interestingly enough, my husband is currently paid about $3000 per birth (this includes all prenatal care, delivery, and post-partum care), regardless of the type of delivery. There is a misconception that doctors are paid more for C-sections than vaginal births, but we have not found this to be true. HOSPITALS get paid more for C-sections, but not the attending physicians.

When I think about the state of birth in the US today, I am overcome with sadness. The medical community is focused on "managing" birth so that as many unfavorable outcomes as possible are avoided (meanwhile they are creating other, more dangerous, unfavorable outcomes in the process). Mothers are not being responsible with their choices (or, more accurately, by not MAKING choices). Both parties are hyperfocused on convenience and ease (scheduled births and pain medication). Nobody seems to be thinking of the sacred nature of birth, or honoring the baby's transition into the world by setting the stage for a peaceful, gentle birth.

Well, some people are thinking about it: the alternative birth community. But there are so few of us and it doesn't seems as though the mainstream culture will ever come around.

My story, that of an OB's wife choosing alternative births, is an unusual one, but one I hope exemplifies that both "sides" can co-exist. There IS a place for medical birth, as there are times when complications arise. But there is also a place--a much larger place than we are currently seeing--for normal birth. I would like to see the day when most women have their babies in a peaceful setting of their choosing, with the confidence that their bodies will work, and without the use of drugs or interventions. For those who need the assistance of a medical doctor, it is important that they receive the care they need also. That is the appropriate role of OBs--for complicated cases.

There is so much to say about this topic, but I will stop for now. I will end with this observation: Over the last 10 years, I can't tell you the times I have looked upon my childbirth experiences for strength and inspiration. At my most challenged moments, I have been able to reach inside myself and recall the euphoria I felt immediately after birth, the heightened state of awareness, the all-encompassing feeling of triumph and pride I felt after pushing through the pain and accomplishing my goal of delivering my babies the way nature intended. Many time, I have told myself "If you can got through unmedicated birth three times, you can definitely do XXX". That has been a surprising and long-lasting effect of active, empowered birth that I never knew would be so meaningful to me.

Folks, these are great stories.

It's interesting that everyone who's posted so far chose an alternative birth, while also having a personal relationship with a traditional medical practitioner (mother, father, friend, husband).

For women who don't have that, I'm guessing it can be a little daunting to decide between the alternative and traditional options. I wonder what might make that choice easier...? Maybe a doctor willing to take a back seat to the mid-wife, so that someone can have both?

I shared my story earlier, see the top. I would like to say that my father, a family practice doctor in a small town, was not supportive and during the two weeks that I was past due left me messages stating that I should be induced in a hospital because that is "what we do now at 41 weeks". Inducement most likely would have led to a c-section. I did not talk to him until after my daughter was born.

My mother, a nurse, was not happy with the notion of her first grandchild being born outside of her comfort zone, the hospital, but she supported me because I told her it was my choice and her opinion didn't really count. I don't think familiarity with the hospital system makes the choice easier; probably the opposite. Perhaps having a relative in the medical field and deciding to have your baby at home makes one more passionate on the subject as you have had to argue from both sides of the coin. Not just your own need for a truly empowering moment as a woman but also that it is as safe as hospital births.

In San Diego and I believe in California the insurance companies have forbade (maybe even made it illegal) for doctors to "back-up" midwives. If they do they could lose malpractice coverage which for any OB Gyn is unthinkable. Midwives must have their patients sign paperwork acknowledging their awareness that a midwife is supposed to be backed-up by law but that a doctor is not allowed to back them up.

I think in the end a woman has to take responsibility for her own health and this is the major difference between hospital and homebirth. A woman can walk into a hospital knowing nothing about childbirth and the staff will see to it that she has her baby. A woman chooses homebirth and thereby becomes responsible for her baby and herself. I think this is what scares people, both women and men. It is at one time more comforting to know that someone else is responsible and that the woman does not hold that power in our society. Generally people on the media and in grocery stores like to talk about taking drugs rather than self empowerment.

So getting your family to understand your decision was actually an uphill battle for you. I love how you describe the difference between the two styles of birthing as you see it: that you don't consider birth an emergency, and that choosing homebirth empowers a woman by making her responsible for her baby and herself.

Interesting point about insurance companies and back-up OB Gyns; not sure what the reality is, but that's something we could look into and clarify for the show.

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By the time I had my first child, my husband and I had been together for 11 years, and married for 6...he knew who he was with (someone who is not extreme, but definitely NOT mainstream either!) and he had witnessed the progression of my self-education about pregnancy, birth, and parenting choices. I count it a blessing to have been with this guy since we were both 17, as our relationship has been deepened by the fact that we've "grown up together"--he into manhood and his chosen profession and me into woman/motherhood and my chosen passions (one of which is now my profession, but that's another story...).

As I said in my original post, my first child was born in a hospital. It was a midwife-assisted birth, and I did not have any drugs at all (labor enhancing or for pain), or continuous monitoring or separation after the birth. At the time and in the place that I had this child (1997, Pittsburgh, PA), I did not feel comfortable with a birth center or home birth. By the time I was pregnant with my second child, I knew I did not want to deliver in a hospital.

I have to say that my husband was a bit concerned when I came to the decision that I wanted to leave the Ob-with-a-midwife-on-staff practice I was going to for prenatal care for a midwife-owned birth center birth, but he trusted me. He met with my midwife, asked all the questions he needed to ask, met with the back-up OB...became okay with the idea. That was the biggest leap; after that, the concept of a home birth (for baby #3) was a no-brainer.

I can't say if/how my decisions were influenced by my husband's profession. We influence each other in much of what we do, regardless of our professions, so it is hard to categorize. I know it would've been immensely difficult not to have a supportive partner for such a life-changing decision. I would like to think that I would've made the same birth choices if I were married to someone outside the medical profession, but who knows. In a way, his being as OB/Gyn helped my resolve to push away the messages that a medicalized, hospital birth is best. It was not in a combative way, but he and I both knew I had something to prove with my choices--to myself, him and "the world" (ha!). It worked.

Sorry so long-winded!

Sorry so long-winded!

Oh, don't be! It's fascinating to read about how you worked through your decision. I'm sure it will help others to read this.

I was planning a hospital birth at first, and then took a great independent (not hospital sponsored) birth class. Through that class, I decided that a wonderful program called Homestyle Midwifery would be the best for me. It was a HOMEBIRTH midwifery model of care (The midwife is with you for your whole labor, and you have had enough meetings with all of the midwives by the time of the birth that you know the midwife who delivers your baby.), but in a hospital.

This is what I felt most comfortable with, and could afford because my insurance covered it. I had a wonderful delivery, but it was not without it's difficulties due to th e hospital setting. Had I to do it over again, I would find the money to have a homebirth. The pressure from the hospital staff to induce (when all the testing was coming back with flying colors) and the uncontrolled anxiety of the attending OB did have some negative effects on things.

Through my birth education, my birth experience, being at my best friend's birth a month prior to my own, and with the encouragement of my birth doula, I decided to become a doula myself. Now I am doing postpartum doula work, because my baby's too young (11 months) for me to be away for the extended periods of time that would be required of a birth doula.

I believe that education is key. Birth is not an emergency! It is a natural process, and women are perfectly equipped to birth their babies the vast majority of the time. Yes, 'alternative' birthing options should be readily accessible to everyone.

I have three children. One was born in a hospital with an OB attending. The second and third were born at home with a midwife.

I gradually educated myself about birth when I was expecting my first child. I had pregnancy-induced hypertension, which was serious enough that it would have precluded a homebirth that first time, but I don't know that I was really ready to consider homebirth. It just seemed outside of my normal.

Then a met a woman who was planning a homebirth for her first birth. Through our friendship I began to be convinced that I could do this, too. Parenting my first child, especially breastfeeding, also convinced me that the biological systems are designed to work right, without intervention, in most circumstances. I became increasingly aware of the places where what the evidence shows (for example, that most women can birth without episiotomies) is ignored by a sizeable chunk of the medical profession.

The main obstacle I feared was my husband's reaction. As we interviewed midwives, however, he grew convinced that birthing at home would be at least as safe and certainly more gentle than our comparatively-good hospital birth.

I again developed PIH, but it remained low enough that my midwife felt comfortable proceeding with a homebirth. I had a super-fast birth and my son required a bit of oxygen at birth, but my midwife handled that confidently and we were always safe. When you say you are going or have homebirthed you inevitably hear everyone's horror story. Most people don't realized that midwives come prepared to deal with a wide range of complications. My third birth was similarly smooth.

All three of my births were "natural" (ie: no anesthesia), but the differences were huge. In the hospital we were left feeling like the baby belonged to the hospital staff, not us. At home the babies never left our arms unless it was okay with us. We felt more more connected and confident as a result. I strongly believe that the hormonal impact of normal, non-intervention-filled birth is huge in paving the way for an easier transition to parenthood.

We paid for our homebirths out-of-pocket, although I also did concurrent prental care with an OB that was covered by insurance. It is certainly a more cost-effective way to birth. I would love to see out-of-hospital births covered by insurance, but for me it would be worth every penny to homebirth again.

Thanks for this lively and important discussion.
I am a midwife practicing in San Francisco and the East Bay. What strikes me about the comments posted thus far is that they speak to the level of satisfaction that people experience with their care. Giving birth with a midwife is an experience that goes above and beyond what most people experience in even the best of hospital births. Childbirth is not just an everyday occurrence, it is a monumental life event. When people choose to have a home birth midwife care for them through pregnancy, they are choosing to have prenatal visits that last an hour or more, rather than the 5-10 minutes that are standard in an OB practice. They are choosing to actively participate in decision making during their care. They are choosing to have a meaningful relationship with the person who will assist them in bringing their baby into the world. A midwife provides support consistently throughout the birth process, acknowledging that the body knows how to give birth, just like it knows how to grow a baby inside. Most often all that is needed is support, nurturing, and physical comfort measures, and the body does what it knows how to do. The experience of giving birth at home often exceeds expectations, and those who make this choice commonly proclaim that they wouldn't do it any other way.

It is encouraging to see this topic covered. I had a hospital birth and was assisted by a midwife, doula, my husband and one of my best friends (the Birth SWOT team as my husband lovingly calls it). It was completely unmedicated. I decided to go this route after losing my dad in heart surgery four months earlier and losing my faith in the medical establishment. Also, my OB - who is fabulous - could not guarantee who would be at my birth and I did not care for some of the other doctors in her practice (especially the one that said "Of course, you will have an epidural!"). Another factor was that I did not want to be induced because it often leads to C-section surgery. I too feel birth is a natural process and wanted to be as present as possible during and after the birth.

There are 3 midwives who can practice at Alta Bates Hospital in the East Bay and I choose one of them to catch my baby. We developed a relationship over a couple of months during prenatal appointments where the midwife not only checked on the pregnancy's progress but also made a point of getting to know my husband and myself. This made an important difference during the birth. She understood the loss of my father, my fears, my expectations and supported me 100%. We talked about the possibility of a homebirth but I was not comfortable with those risks.

Insurance paid for all of the expenses - I have an HMO.

There are other choices that went along with feeling empowered to have natural childbirth and which our midwife supported and advocated. We decided to delay the vitamin K shot and the eye drops for at least 1 hour so that they would not be the first thing our son experienced. We insisted he be with us (really on me or my husband) as much as possible from the beginning and we continued to make choices that felt right for us, not what was standard hospital procedure.

I want to echo the woman ("anaestorino") who wrote how she looks to her childbirth experience for strength and inspiration. Having given birth to my baby naturally is my badge of honor. I think I am more proud of it then anything I have done in my life. It has also helped me heal from my father's passing. I wish all woman could have that experience and that their partners could be apart of it.

Ruthann, did you make your decision before you were pregnant or after? How long did it take you to find the right people for your team?

In response to Stacy's question, I made my decision during the 6th month of my pregnancy. There are 3 midwives who practice at Alta Bates Hospital in the East Bay and so I easily chose one of them. I chose my doula based on the recommendation of my midwife. - RA

I had my first baby at home in November of 2004. I made the switch from prenatal care and a planned birth at UCSF in my 32 week of pregnancy to a midwife assisted homebirth. Frankly, until late in my pregnancy homebirth had never crossed my mind. My 'epiphany' came suddenly and was influenced by several factors. An old friend from graduate school had recently given birth naturally and assisted by a midwife at Alta Bates after laboring mostly at home. She was the person that provided me the references on the safety and advantages to infant and mother of homebirth. I then found out that my Grandmother had birthed four of her six children safely at home with the support of local midwives. I also kept replaying the four previous hospital births I had attended for friends and family and knew that their experiences would have left me feeling deeply unsatisfied and fearful that decisions in the hospital would be made FOR me rather than WITH me. I observed first hand that interventions/technology (epidural, pitocin, episiotomy, baby monitor, IV, etc) were more likely to adversely affect the outcome of a birth than help it (the four births I had attended resulted in one natural birth, one emergency c-section, one vacuum extraction and one forecep extraction). These factors convinced me to find and interview local midwives and switch care and birthplan. With a healthy pregnancy and no signs of complications, I gave birth in the privacy of my own home with my husband and two attending midwives after a typical 16h labor. It was the toughest thing I have ever done and the greatest experience of my life (and my husbands). I experienced mostly nervous nods of support, or downright objection, from friends and family about our decision to homebirth.

My second child was born in August of 2007. I had planned a homebirth and received prenatal care by the same midwife that had helped me deliver my first baby, but by my 32 week a diagnosis of a complete placenta previa necessitated transfer to an OB and a scheduled c-section at 37 weeks. This was a relatively traumatic turn of events for me, having experienced the comfort and exhilleration of a homebirth. I did not have fear or concern about the surgery itself, but felt that we had to prepare as if going to court on a strategy to retain some control over what I and my baby experienced while in the hospital. Despite the care of a terrifically suportive OB, we were routinely pressured by other staff and pediatricians to succumb to their standard operating proceedures despite consistently advocating for minimal testing/intervention. in the end, I am still dealing with refuting charges made to my insurance company for services that we declined while in the hospital.

My homebirth was much less expensive than my hospital birth, but I was required by my insurance company to pay a greater % out of pocket for the homebirth. The quality and depth of care for myself and my newborn throughout the pregnancy, labor, and post-partum recovery was first rate. In fact, I can offer many examples of how my midwife-based care was superior to my OB/GYN practice care. I feel that women require and deserve early access to information on safety, advantages, and disadvantages of birthing options in order to make an informed decision that best fits their personality and mindset. Of course, many also need improved access to alternative options in their area. I also feel that insurance companies should pay equally regardless of a woman's decision to birth at a hospital, at a birth center, or at home with a professional midwife.

I did not have an alternative birth, however, I would prefer to with my next one.

I have one daughter who was birthed in a local community hospital almost 2.5 years ago. I used a Certified Nurse Midwife (CNM)/Nurse Practitioner (NP) who belonged to a OB/GYN practice. Unfortunately, when my daughter came 3 weeks early, my CNM/NP was on her honeymoon (we had joked about it, but never thought it would happen). I ended up having to use the MD's for my daughter's birth which ended up become a very complicated situation which I think could have been avoided if the doctors had listened to and respected me.

Every book you read, every class you attend, and during prenatal visits, the same mantra comes back: Every pregnanacy is different. I was so angry that the doctors did not listen to me, that they made me doubt my own body and instincts. The doctors did not bother to treat my situation as a unique one. I felt insulted by the whole experience and was angry that when I was finally believed that I was in labor, that the doctors then had to "react" to the situation (which I believe they created).

We are trying for another baby at the moment and I am considering alternative birthing options. What makes it difficut now is that I would be attempting a VBAC (Vaginal Birth After Cesasian). My husband is very concerned about what sort of health implications this means for me and a baby, and does not want a homebirth because of this. As I understand it, most hospitals in the Bay Area are not allowing VBAC's at their facilities because of liability issues. I have also heard that many doctors will not attend VBAC's for the same reason.

I am in the process of trying to find a new OB/GYN practice that will support my decisions. I am also planning to use a doula for my next pregnancy because I think having an birthing advocate would have helped my situation the first time around by keeping things in perspective and to support me to listen to my body. I am prepared to pay more for an alternative birthing option, I can afford to do so this time around. I am also more determined with the next pregnancy to be more assertive because it is my body. Pregnancy should not be treated as a disease or illness, but rather as a part of a natural process.

Wow Kim, you seem very disappointed in the traditional experience you had. You also raise an interesting point:

I am prepared to pay more for an alternative birthing option, I can afford to do so this time around... 

Many of the posts here mention wanting to have more control during the actual birthing situation, and at least a few folks seem willing to pay for that. But that might not be an option for everyone. I'm curious about those who might be considering an alternative birth but who don't have the economic resources to supplement insurance coverage (those who have insurance, that is). If this describes you, how are you planning to cover the costs?

In response to Stacy's question regarding cost of home-births... My daughter was born at home with a mid-wife, a very positive experience and one I strongly recommend for others given many of the reasons people have so eloquently stated. If we have another child, I would also choose a homebirth... however... we are one of those family's with a very limited income and our HMO does NOT pay for homebirth. Even though it will cost them close to $15,000 for a no-intervention hospital birth. It is ludicrous. So, money is a huge factor for us and I imagine many families, in having the option to even have a homebirth. If insurance companies could be educated and understand the health benefits and cost benefits to them in terms of the cost of a home birth vs. a hospital birth, would they change their policies to support home birth? I'd be interested to hear others thoughts on how to go about educating insurance companies as well as better understanding the "business side" of how the hospitals, insurance and docs all make money with hospital births vs. a homebirth.

Surprisingly, my completely natural second birth at Stanford Hospital in May 2007 was only $4400 (with the OB this time, the first birth was with the midwife at the same hospital - too bad they don't offer this service anymore).

I have had two homebirths in 3 years and we live in El Cerrito, CA. In fact, because of my first homebirth and the amazing support I received from my midwives, I decided to become a midwife myself and am currently in an apprenticeship. The main reasons I decided against a hospital birth are that birth should be treated as a normal event, not as a sickness or illness; I wanted few interventions and only ones that were necessary; and I wanted to birth my babies in any position I felt comfortable - something which the hospital staff told me may not be possible. I could not see being stuck in one room for my entire labor and having to probably lie on my back for the births. At home, I had the entire house and my neighborhood to walk around in; I had a birth tub for labor and in case I wanted to birth in it; I had as many people as I wanted to support me. For my first birth, I was in my own bed squatting. For my second birth, I was in the living room, in the hands and knees position to give birth. At my second baby's birth, he was born as the sun was rising, with my then 2 1/2 year old son and my parents as witnesses; and within hours of the birth, we had family visit while the four of us snuggled in our own bed, ate our own food and got to know each other uninterrupted. My midwives cared for me and my baby in my own home for the next 6 weeks. The entire birth, including prenatal and postpartum visits at home, cost $4000.00. If I were to have given birth in hospital, it would be at least 3 times that amount and I wouldn't have had any at-home postpartum visits! My insurance company paid 70% of it although the second time around, it took about a year of calls and letters before I was reimbursed. As a homebirth parent and as an apprentice midwife, I think that hospitals and doctors should be more open to the choices that some of us make and help these families be comfortable in a hospital setting should they end up in hospital for one reason or another. Midwives should catch babies and doctors should take care of high risk pregnancies, as is the case in many many other nations, developed and otherwise. Morever, homebirth families should be able to see an OB or practitioner at a doctor's setting in conjunction with their homebirth midwifery care, should the need arise. Instead, once our primary care provider/OB found out we chose to have a homebirth with concurrent care from them, they dropped us immediately as patients due to malpractice insurance reasons.

Minutes after my second child was born in our living room, with my then 2-1/2 year old son present at the birth.

I have had two children delivered vaginally without medication at Mills-Peninsula hospital. Before having my children I would NOT have thought of this as an “alternative” birthing method, but after going through the hospital experience and talking to my many mommy friends it feels like my un-medicated method was not typical.

For my first pregnancy in 2004 my ob/gyn practice had midwives and MD’s. For “normal” pregnancies the mid wives took care of most of the visits and deliveries. The midwives were very supportive of my birth plan; the primary goal of which was to labor at home as long as possible and avoid medical intervention. When I arrived at Peninsula hospital in the middle of a Sunday afternoon the nurses were FANTASTIC and very supportive of an un-medicated delivery. They helped me stay on my feet and off my back and I had a beautiful baby girl within 1.5 hours of arriving at the hospital (I labored for over 24 hours at home). I had such a great experience I announced moments after pushing out my daughter, “Let’s do that again!” I was able to labor in a way that made me most comfortable and I was not tethered to medical equipment or an IV.

When I was ready to have my second child in 2007 the midwives had been eliminated from the OB’s practice. Apparently their insurance costs were too high with midwives on staff. Wow, what a different experience having to meet with a medical doctor every month and then weekly. When I expressed my desire to not have an IV during delivery he scoffed and related a story of how he had a birth that went wrong and they needed to administer general anesthesia immediately through the IV. He thought it was an “unnecessary risk.” When I was one week late my doc started to push for an induced labor. When I got to the hospital to have the baby and told the doc on call and delivery nurse that I was going to go without medication they were shocked. The nurse asked me multiple times if I wanted pain meds. She offered no advice on good laboring positions. She commented that I should just have the epidural. The doc wouldn’t let me take the fetal monitors off so I had to labor within 4 ft of the bed. The nurse acted inconvenienced when I wanted to get out of the bed to labor. It made the experience stressful.

I was able to deliver that day without pain meds and the nurse and doctor were surprised. “We just don’t see that very often these days,” they said.

I desired a medication free birth because I believe that medical intervention is a slippery slope. I know many people who started with an induced labor, or got to the hospital early in the labor process, received medication and ended up with a c-section. I put a lot of time into labor preparation to try to avoid coming to these scenarios. I understand that medical intervention is sometimes necessary and saves lives, but I also believe it can be avoided in many cases.

My experience has been that when you live in the general vicinity of Berkeley, having your babies in the hospital is considered the alternative approach. It seems that almost everyone I know has chosen to give birth at home attended by a midwife. When people learned that I was planning to have my children in the hospital attended by a doctor, their reaction was often one of shock and bewilderment. ("WHY in the world would you want to do THAT"?)

One reason that women cite for choosing a home birth is fear of having unnecessary interventions pushed upon them and not having control of the birthing environment. As someone who has has given birth to three wonderful kids in the hospital (indicentally without an epidural or an episiotomy or any other medical interventions) I can say that it is possible to have a natural and postive birth experience in the hospital setting, if that's what you choose.

That said, it is wise, if not imperitive, to hire a doula and be prepared to advocate for yourself if you're concerned about having to fight off over-zealous or insensitive medical personnel. One other important factor is to be sure that you and your doctor or midwife share the same philosophy when it comes to childbirth. My doctor, for example, is no more likely to recommend an intervention than a midwife, but is qualified to perform an emergency C-section if necessary. Personally, I liked having all options available to me with one practitioner.

Thanks for adding this perspective, Anon -- it's helpful to hear about the positive traditional experiences as well.

I had two home births. With my first pregnancy, I started with standard OB care, and also attended a Bradley Birth Class (natural childbirth) with my partner. The Bradley class led me to question my OB on her percentage of natural childbirths. She was somewhat disparaging about the Bradley method, and noted that first-time mothers invariably choose interventions and that natural childbirth is rare. This discussion led me to research alternatives, such as midwifery care. I discussed changing care models with my partner, despite my fears that he would be hesitant to switch, as he comes from a medical background, but to my surprise and delight, he was willing to make the change. I think I was around 25 weeks pregnant at this point. I am SO thankful that we went with midwifery care! Both of my babies were beautiful births, the first one involving 49 hours of labor, which very likely in a hospital setting would have led to interventions (hospitals typically don't like such long labors, despite them being "normal" in the homebirth community). The 2nd birth was only 3.5 hours long, and in a birth tub. It was so calming to be home at such a vulnerable time, and so empowering to know that I, like millions of women throughout time, was able to birth at home without the aid of hospital interventions! Like someone else said, birthing my babies at home, knowing that I had the power to do this with no medication, no intervention, just my body doing what it was supposed to do, was the most amazing thing I've ever done. (Incidentally, of the 6 couples who attended the Bradley class, we were the only homebirthers, and one other couple had natural childbirth at a birth center - the other 4 couples ended up with hospital C-Sections!)

Not so surprisingly, many of my coworkers thought I was completely wacky to choose such a "dangerous" birth method. (I am in a pretty conservative field as a CPA.) Some even begged me to rethink my choice. I just tried to point them to do the research on the safety of homebirths with midwife care. Our families supported our decision, despite some unspoken hesitance. I even learned that my mother would have chosen homebirth had my father allowed it.

The cost was significantly higher out-of-pocket than what insurance would have paid for hosiptal birth ($4000 per birth, not covered by our HMO), but VERY worth it. I wish we had a society that honored birth as a natural process, like in the Netherlands, where it is normal to birth at home, and OBs are called in only in more serious birth situations. Not surprisingly, their C-Section rate is much lower than ours, at < 10% (compared to our 30%). And of course, they don't have to pay $4000 per birth at home. It is so unfortunate that insurance typically won't pay for all (or often for any!) of the costs of homebirths. This of course negates many people choosing homebirth. We also need to educate people as to the choices available to them. Hospital birth is not the only option.

Thanks for covering such an important topic. I look forward to listening. My first child was born by "emergency" c-section 15 minutes after arriving at the hospital. The "emergency" was that I arrived fully dialated and ready to push a frank-breech baby. The hospital has a policy against vaginal breech births and, I found out later, none of the doctors have any experience with breech births.

Despite reading books, taking classes and choosing the "best" ranked hospital and doctor in my area, I found the overall experience frustrating and disapointing. I justified it all with the knowledge that both my baby and I were healthy and had access to the best care possible.

During my second pregnancy, the fear of a repeat C-section lead me to search for alternatives. Several of my friends had given birth at home or in birthing centers. I wanted a VBAC and was hopeful for a water birth. I found two amazing midwives who accepted me as a VBAC since my c-section was not due to any medical condition.

After 12 hours my second child was born at home (in the water) and is also wonderful and healthy. My midwives had to intervene a bit to keep things moving along. Because of my previous surgery, my body was not cooperating. They helped me in ways that I know would not have happened in the hospital. I am confident that I would have undergone a second c-section if I tried to birth at the hospital.

Because I was a VBAC and was having some heart palpatations, we continued to see our OB until the baby was born (I saw a cardiologist prior to the midwives agreeing to be at our birth). Our insurance paid for all the doctor visits and we paid out-of -pocket for the midwives ($3500 for all prenatal, a nutrition consult, classes, birth and after-care).

The drastic difference between the OB vists and the midwife visits were amazing. I could keep going, but will sumarize with this- There is no doubt that we made the correct choice birthing at home. Overall I found that my midwives were perceptive, educated, patient and comforting. They did not rely on techhnology providing them with all the answers. The doctors relied so heavily on technology that they did not listen to me or try to understand what was really going on. They made several "mistakes" during both of my pregnancies.

I believe that the model of childbirth in the US is an excellent example of what is wrong with the healthcare system. We have some of the highest rates in the world for infant mortality, maternal mortality and medical intervention. We have the highest C-section rate. We have one of the lowest rates for home-births and midwife attended births. It makes no sense.

My daughter was born in Nov. '04 and 6 weeks early. I wanted to try a homebirth, however, my husband was too fearful and wanted the 'bells, whistles and the machine that goes ping!' available. So we compromised and planned to have a 'natural' birth at a local community hospital with midwives (who had Ob backups).

Year prior I attended a good friend's homebirth and was amazed and empowered to see my friend birth this way. I was so impressed with the care and support she, her partner, her toddler son and the child to be received by their midwives. I wanted the same for me. I also did a fair amount of reading and research and determined that the more medical interventions one employs, the greater the risk for complications and/or c-section.

Well, as mentioned above, my daughter came early. I was told I would have to work w/ the Obs alone and not the midwives and it was a holiday weekend so my Ob wasn't on call. As I was getting ready to head to the hospital, the umbilical cord started coming out (prolapsed cord) and we knew we had to call 911 and get medical attention fast. I can say I'm very impressed with San Jose Fire and Santa Clara Valley Med Ctr as they were very professional and fast. I ended up having a c-section under general anesthesia. In this situation you want all the 'bells and whisltes' available. We were very lucky to have as they put it a 'viable live infant girl'.

I'm currently pregnant and am trying to have a VBAC. My Ob has informed me that she no longer does them. I'm running into many roadblocks with Obs unable to perform VBACs. What I have come to learn is that it comes down to time & $. Many hospitals are requiring 1 or 2 Obs and 1 or 2 anesthesiologists to be present the entire time the birthing VBAC mom is on the floor. Interestingly, the potential complications of a VBAC have not increased in the last 20 years. So it is confusing as to why the culture seems so against it. It is extremely frustrating to me not to have a choice. I think because c-sections are so prevalent, people forget that it is major surgery. It is risky and takes a long time to recover and heal. People seem to view it as not a big deal...like scheduling a haircut.

I am still researching alternative providers, so it will be interesting to see how this story unfolds. Homebirth is not an option for my husband. He was so tramatized by our previous birth that there is part of him that wants me in the hospital now....'just to be safe'.

I cannot comment on costs from my experience. However, my girlfried who had both of her children at home was able to negotiate with her insurance company to pay for the midwifery care. She presented it as saving them a ton of money. This was in the mid-late 1990s and in Colorado.

There are many doctors who will provide a more gentle birth experience that will be closer to what you want. Ronnie Falcao, midwife, has a list of resources on her website.
http://fal...s.html#OBs
I 'think' Dr. Kendrick might be able to do a VBAC.
http://www.../obgyn.htm
Good Luck

I have two wonderful, healthy children - the first was born via c-section at UCSF in 2001. The second was born 18 months later at home in Oakland.
I remain convinced that my c-section was not medically necessary. It was certainly avoidable. My baby was presenting posterior, but this was not diagnosed until I had been in the hospital for nearly 18 hours (and I had been in labor at home almost 24 hours prior to that). I never dilated past 4 cm. I believe this is likely due to the fact that I was, in my ignorance of the posterior position of the baby, doing all the wrong things. For example, I should have been spending time on my hands and knees encouraging her to turn. Instead, I spent hours on a birth ball, bouncing her head into my cervix in all the wrong ways. After 36 hours of unproductive back labor, we decided to try some interventions, and made our way through the menu of pitocin and pain medications up to, and including an epidural. Nothing led to further dilation. After 46 hours in labor, the doctor recommended a c-section, saying there was nothing further they could do and the baby needed to come out. I was exhausted, so I said yes. Looking back on it, though, there really was no medical urgency. My daughter had 2 9's on her Apgars, so she didn't seem to be in any danger. I think I had just been in their room for long enough! I wish I had had the perspective to say, no, let's turn up the epidural so I can sleep, and try again in a few hours.
I did a ton of research on the risk of VBAC and homebirth when considering my options for the second birth. After all, I didn't want to run unnecessary risks of leaving my child mother-less. I was unable to find any conclusive studies that would indicate that the risk of placental abruption would be higher if I attempted a VBAC. And it's clear from the studies that homebirth and hospital birth have about the same level of risk (although for different reasons). Anyway, I think it's naive to consider either one free of risk.
But I will say unequivocally that I received much more comprehensive (not to mention tender-loving) care from my mid-wives than I ever received in a physician's office, where the staff was professional, and kind, but always rather distant. The birth was AMAZING. POWERFUL. PRIMAL. EXHILARATING. Like a locomotive running out through the middle of my thighs, yes (my son was 10 lbs 4 oz!), but my support team and I navigated the pain through breathing, water submersion, and love. The labor was about 10 hours long and my baby was born in water, then placed on my chest for the first few breaths. I reached up between the legs to find out what kind of baby it was, and realized we had a son. Oh my god, I'll never forget that moment. So beautiful.

I have had two births in 2005 and 2007, both at home with a licensed midwife. I started prenatal care with an OB/GYN during my first pregnancy and at the same time began educating myself about pregnancy and birth. The OB encouraged me to have a multitude of prenatal tests and screenings despite being very healthy. I felt I was treated as a statistic – a 35-yr-old primipara (first-time mom) and not as a healthy individual. The more I learned from my own independent research, the more confidence I had to say no to the screenings and tests. It wasn’t even close to the birth and I was increasingly uncomfortable with the care I was getting. My neighbor had birthed her baby at home so I knew birthing at home was a possibility. When my partner and I began to look for other options we decided home birth with a licensed midwife was the right birthing option for us. We began care with a midwife at 20 weeks and birthed that baby and our second baby at home. We continue to feel that birthing at home was the right option and a wonderful experience. It was not just the birth, but the lengthy prenatal and post-partum visits that made us feel we were getting a quality service. These are actual conversations – almost verbatim that I think illustrate the difference in quality of care between a 10-minute visit with an OB and the 45-60+ minute visit with the midwife.

Me in my second trimester to my OB: I am having very bad pain in my lower back.
OB: Yeah, that’s a really common symptom (moves on to the next question).

When I switched to seeing a midwife…
Me in my second trimester to my midwife: I am having very bad pain in my lower back.
Midwife: There are some stretches you could do that might help (she shows me some stretches). Also, you should try using a heating pad and rubbing some arnica ointment on it. It may relieve some of the pressure to sit on a pilates ball some of the time since sitting can aggravate it. If none of these remedies helps I can recommend a massage therapist, chiropractor and acupuncturist, etc. who may be able to help.

When choosing a midwife over an OB for our birth we considered the following: Midwives are trained in normal, low-risk birth. That’s all they do, so they are good at it. They are not trained in surgery or other medical interventions. OBs are and they are good at what they do too. If I developed any medical conditions during my pregnancy or birth that my midwives could not manage, I would gladly go to the hospital and have my care provided by an expert in high-risk pregnancy or birth complications. This is exactly what happened with my first birth. I transferred to the hospital after the home birth for post-partum bleeding that could not be managed at home by my midwives. The professionals that they are, they recognized that the situation was outside the scope of their practice and got me to the hospital quickly.

Like some of the previous posters I too have a personal relationship with an MD. My father is a pediatrician and having attended many a high-risk birth he was a bit nervous about the whole thing. He would say things like “You should have your friend the respiratory therapist come to the birth too.” I responded with education “Dad, licensed midwives in California carry oxygen to the birth and are fully trained in helping newborn babies breathe. They can handle it.” Ultimately he and everyone else who may have raised an eyebrow knew I put a lot of research into my decision and supported me.

My home birth cost $4000 (the going rate in the SF bay area) and about 30% was reimbursed by insurance. I got a low reimbursement rate because I was using non-network providers (although there are no network providers offering home birth services). Alternative birthing options should be available to all low-risk women. There is no difference in outcomes for hospital vs. midwife-attended home births. This 2005 British Medical Journal research study is evidence of that. http://www...type=HWCIT Hospitals are great places for sick people and people with medical conditions. I don’t consider low-risk pregnancy and normal childbirth illnesses or medical events. Getting low-risk births out of hospitals seems like it would be a huge cost-savings to insurance companies. I hope that since there is empirical evidence that home births are safe insurance companies will fully cover patients using this option.

I lived in the Mountain View area for 6 years and worked as a producer for KPIX but have since relocated to Knoxville, TN. When deciding on care for my first pregnancy in 2003, I considered using midwives at both Stanford and El Camino hospitals. During my pregnancy, the hospital cut the funding for the Stanford midwives so that they would only be able to deliver babies M-F, 9-5. As babies usually arrive at the most inconvenient time, I did not want to depend on the attending on call (at stranger) to deliver my child. I had heard great things about the El Camino midwives, but I was already seeing Dr. Richard Lee, a family practitioner and certified OB-GYN, at the Stanford Family Medical Practice. As we talked more, I realized he had all the training and knowledge the medical profession offers with the sensibilities of a midwife (the desire to let nature take its course whenever possible). As he was nearby to my home and had privileges delivering at Stanford, I felt this was the best of all worlds.

Nevertheless, I hired Sandy Caldwell as my doula to help me through most of the labor. As it turned out, my birth was extremely fast for a first timer. Sandy helped me through the bulk of my labor (2 1/2 hours) by recommending various positions and locations--the shower being my favorite. The medical staff seemed a bit bothered by our desire to labor alone but complied. My request for no epidural was met with a smirk and a shrug as if to say (yeah, I'll be back!).

The next time I saw anyone from the hospital, my baby was crowning. They all flurried around, wondering how I had slipped through the cracks because no one was monitoring me. In truth, Sandy was keeping a close eye on my progress the whole time and knew when to let me labor alone and when to push the red button. It was so fast that Dr. Lee did not make it and my baby was still delivered by the attending on call (yes, a stranger). But I couldn't have been happier with my experience.

I have since had another child at the Lisa Ross Birth & Women's Center in Knoxville, TN. They are a group of midwives who have offered an alternative to hospital births for 17 years. They work with an OB for any cases that may be more high risk and have privileges for delivering at a hospital less than 10 minutes away. That was a huge draw for me. The second birth was 3 1/2 hours, with only 25 minutes at the center. The experience was much calmer and peaceful than my first and I have nothing but positive things to say about them.

As for cost, my first birth cost me only $10 with excellent insurance coverage. We can't buy that level of coverage anymore. We were responsible for 20% of the bill wherever we went for the second birth. I did not choose the birth center for costs, but it was the cheapest option. I paid a little over $1000. A hospital birth could have been $2000 - $5000 (assuming nothing went wrong). I will say that if the birth center were not contracted with my insurance company, I would probably consider another option. I can't see paying for insurance and then not using it.

All that said, there are times an OB is needed. Sadly, tomorrow I am scheduled to have a D&C, a procedure that midwives are not able to do. I'm not looking forward to having this done by yet another stranger, but so is life.

Have you or someone you know had an experience with alternative birthing?

I birthed 3 of my children at home and 1 in the hospital between 1975-79. One child, a son, was stillborn at 4 months gestation at home. I have also worked at about 175 births since then.

What factors led you away from a conventional-style birth?

At the time, I lived in a spiritual community that originally existed on the East Coast and in N. CA; we firmly believed birth was a natural, human thing to do and our faith in God and ourselves guided us at the time; and we taught ourselves to be birth attendants for one another.

What obstacles, if any, did you face?

Perhaps concerns by some of our parents (who may have also been concerned that we were part of the spiritual community as well).

If we did interface with the medical community, we received mostly negative (but sometimes positive feedback). For instance, with the birth of my first daughter I needed stitches, the doctor who I encountered was so angry with me for birthing at home that he could not stop yelling at me as he stitched me up. This was in Harrisburg, PA.

What about cost factors? Should alternative birthing options be readily accessible to everyone? If so, who pays?

In my case, we took a vow of poverty as part of our community experience. When I needed medical care it was state paid care.

In my more current experience as a doula and as a co-founder of a developing birth center (Sanctuary for Birth and Wellness) in the Bay Area, I strongly feel women and their families should have the option to midwifery and doula care before, during and after birth at birth centers, home and hospitals.

In my observation, while there are some bright spots across the US, midwives, especially those who work in out of hospital locations or do not have certified nurse midwife licenses, are not integrated into the health care system. I could go on a long rant about the politics and finances of birth - it is very frustrating to watch because while ACOG and doctor associations, insurance companies, and others keep barriers up to midwives being integrated into our health care system, birthing mothers and their families have fewer choices. It is important to note that in other parts of the developed world where midwives are the primary contact for HEALTHY women, while doctors care for those who are NOT HEALTHY, or have high risk conditions that require specialized care, the outcomes for mothers and babies are better than those born in the US. In addition, where midwives ARE integrated into the health care system, such as at Kaiser or for those on Medical, the numbers of interventions (costs) are lower. Kaiser has the lowest rate of cesarean births in the area for instance, and because of their cost-savings business model, it saves them money.

And finally, if you are a midwife, doula or a traditional medical practitioner, what have your experiences been in the field? What can be done to make your role easier?

I have worked as a doula since 2002 and have worked at home and hospital locations. My experiences at home births have been primarily positive. I attribute that to the parents, babies, and midwife (Ronnie Falcao) I have worked with and how we all worked as a team. My experiences within hospitals and I've worked at all of them on the Peninsula and some in the South Bay, East Bay and SF, have varied greatly. I've been at hospital births where the nurses, doctor and other technicians, parents, babies and I all work like a well-oiled team, and those where nurses, especially, have been lukewarm to my presence and contributions. My focus remains on helping the parents have the kind of births they are hoping for and I do not take the nurses' discomfort personally. In fact, as a doula, I do my best to create a team environment any way. Also, while part of my role is to be an advocate for the parents, I keep my role as a birth activist for another time. In other words, the parents' and babies' birth experiences are what I am committed to. This transformational experience for each of them creates a life-long memory and sets in motion how they relate to themselves and others for a life time. I do whatever I can to ensure their memories will be ones in which they feel cared for, nurtured, powerful, coping and that they are part of the decision process if difficult choices need to be made.

Since that time I've attended about 150 births in addition to my early experience as a home birth attendant in our community. During my doula training I became depressed as I realized that most of my work would be in a hospital setting. Since I had experienced home birth personally and in working with others, I had to reconcile my feelings. At one point, early in my career, I had symptoms of PTSD (which were treated) after a birth in which the attendants (residents and attending doctor) ignored the pleas of the birthing mother (a teen mom) to stop an examination (she was having an un-medicated birth). Technically, their continued actions are considered an assault. Later, the mother asked me why they did not listen to her. She wondered if it was because of her age, race or that she was on Medical. I could not give her an answer only affirmed that how she was treated was not right and that she did a wonderful job birthing her child despite the treatment she received.

As I see it, as doulas become more part of the birth experience, doctors and nurses, for the most part, seem to be more accepting of the role. Nurses today have a tough situation (IMHO). I assume they became nurses to 'help people.' Today, in addition to checking vital signs of mother and baby and administering IVs and drugs and so on, they are documenting everything that goes on with the birth. Fortunately they have computers to do this on but I wonder if they really thought this is what they would be doing when they were student nurses. I've encountered some brilliant nurses who can do all that AND have a wonderful way of interacting with families that supports and encourages them. These nurses become beloved by the families.

What would make my role as a doula and co-founder of a birth center easier, would be for the US health care system to integrate midwifery care (and doula care) as part of the overall health care approach for women and families. Midwives are trained in 'normal' birth and wellness for women (and sometimes for the rest of the family, too). OBs are trained in surgery and specialize in the challenges of things that fall outside the scope of midwifery. If doctors and midwives worked as a team, it would be great for birthing families and for doulas.

Today, how things go really depends on the specific doctor the family is working with. We have our beloved and respected doctors (who get constant referrals from us) who respect the birth process, women and ONLY step if truly needed during a birth. So today, the outcomes are often based on the individual beliefs of the doctor; of his or her approach to birth. Wouldn't it be great if in addition to the individual doctor's approach to birth, the health care system set it up so that midwives and doulas were part of the fabric of care?

Shorter-term, if doctors, nurses, midwives, and doulas (and other practitioners as well) would begin getting to know one another, conversing with one another and bridging and connecting it would dispel stereotypes all the way around. This would benefit birthing parents and their children immensely. We have an organization, Bay Area Birth Information, that is comprised mainly of professionals, doctors, midwives, doulas, acupuncturists, chiropractors, massage therapists, etc. who interact with each other via email lists and in person. It is helping us all to provide better care for famiilies.

Thank you for focusing on childbirth choices for birthing women and families. We have a saying 'Peace on earth begins at birth.' Anything we can do to move to more humane treatment of mothers and babies (and fathers and other partners) will have a long-lasting ripple impact on our families, communities and society as a whole.

To Cald1905 and everyone else posting, thanks for these wonderfully detailed responses. It's great to see how passionate people are about their experiences.

My first son was born at home, in the loving presence of my family and my midwives. It was my mom's wisdom and encouragement for a natural home birth that led me to that threshold in my life. It was one of the most glorious and cherished moments in my life. I wish that every woman could have the opportunity to give birth in the comfort of their home, with the guidance of midwives, and disover her own innate courage. The only obstacle I encountered with home birthing was the cost. It saddens me that midwifery care and home birthing is not endorsed by our health care system and for most people, involves paying out-of-pocket. I had to borrow money from my parents in order to have a homebirth. I have since not been able to choose home birth as an option because of the cost involved. My second son's birth was scheduled for the hospital, but I stayed at home as long as possible, and thankfully it went so smooth and fast that we barely made it in time. This allowed me to avoid all the hospital interventions. We are now expecting our third child and again, I am going to have a hospital birth, for financial reasons. I think homebirth should be available to all women, regardless, and paid for by our government. It has been shown throughout history to be the safest, most supportive way for women to give birth.

I realized I neglected something important in my prior comments. With regard to midwives who practice in hospital locations, in addition to the Kaiser midwives in Redwood City, who are great (and the nurses are as well), Lin Lee and Olga Libova, at El Camino Hospital, are amazing to work with. One time one of the families with whom I worked transferred from home to hospital. Mom was very tired after a very long labor. Although the parents were very concerned about how the hospital (and the midwives) might react to the transfer (because they needed to keep their homebirth plans to themselves), Lin never batted an eyelash and greeted them with open arms. Then, after an epidural was administered the mother rested. Later, Lin and the mother (and baby) worked together in, what I felt was an amazing way. Lin literally instilled the mother with confidence and 'talked' the baby out. I am quite certain that almost any other practitioner (perhaps midwife and moreso, doctor) would have suggested a cesarean birth for this mother. Instead, once rested, this mother birthed her child vaginally. I'll never forget this experience and the skill of all involved.

Have you or someone you know had an experience with alternative birthing?
-I gave birth at home to my first daughter 2 month ago. I had a homebirth midwife and a doula. It was a wonderful beautiful experience! I cannot wait to have another baby at home.

What factors led you away from a conventional-style birth?
Birth is a normal, non-medical event. Hospital is for sick people. Giving birth in a hospital is appropriate if there are some health complications. Otherwise, if everything is normal, there is no reason whatsoever to go to a hospital.
In addition, I wanted to give birth with a midwife and not with an OB. Midwives are trained and experienced in healthy deliveries, while OBs have less experience in those, and more knowledge on diseases, complications and medical interventions.

What obstacles, if any, did you face?
I didn't face any obstacles. Discouraging comments from other people didn't bother me at all once I educated myself on safety of homebirth comparing to a hospital birth.

What about cost factors? Should alternative birthing options be readily accessible to everyone? If so, who pays?
My insurance - United Healthcare covered parts of the cost.

My first child was delivered by C Section 32 years ago, my choice after hearing the doctor say that she was in the breech position, head back and could sustain spinal damage if delivered vaginally. Whether the odds were great or not, my child's safety was paramount. I decided to home birth my next two children in Homer, Alaska. One was born in 1980, the other in 1982, both safely and healthily. In those pre-internet days, I gathered support from local midwives, from books written by and letter responses from women such as Janine Parvati Baker, Ina May Gaskin and Nancy Wainer Cohen and by using the Bradley Method of slow breathing during labor. Those women encouraged me to trust myself as a woman, to trust the natural process of birth, to trust my intuition, to trust my body, to gather support. Given the climate of fear about vaginal births after cesarean (VBAC), about giving birth at home, simply about the birth process itself, I quietly went about my business, taking care of both the physical, emotional and spiritual aspects of providing a nourishing, safe birth. I asked myself the hard question: could I live with the outcome of anything happening to my baby should anything be other than a straight forward birth? After months of digging into that question during both pregnancies, it was clear to me that I WAS being responsible, that I could trust myself as a birthing mother and to trust the midwives to not only be present during the birth but to also advocate if medical intervention was necessary. While I did not become an evangelical for home births nor for VBACs, supporting instead a woman's right to choose her birth situation, her right to educate and trust herself, I did go on to emotionally support other mothers who also wished to have VBACs. Some chose to have their VBACs in hospitals; one had her VBAC at home. I also supported women who'd not had C sections but chose to give birth at home. And I supported women who were giving birth, two of whom were my daughters. My eldest daughter had her child at home while my second daughter had both her children in hospital birthing centers. Both have told me that they learned from me that labor is natural, a part of life, intense but not something to be feared.

I am a midwife practicing in the Bay Area. I have worked internationally as well, and find it interesting whenever I return to the US that midwifery care is considered "alternative". In most European countries, midwifery is the standard of care for pregnant women; whether it be in the home, a birth center or hospital. Obstetricians are seen as specialists in the complications of pregnancy and birth; midwives are seen as experts in normal pregnancy, birth and postpartum. Midwives refer women in high-risk pregnancies, or with complications, to obstetricians, and obstetricians refer women with low-risk pregnancies to midwives. The model is very cooperative, and in the best interest of the pregnant woman. The Dutch model of maternity care is a good one to research for the purposes of your show. New Zealand also has a very mother-friendly approach to maternity care, with autonomy of choice of care.