I am 38 weeks pregnant with my second child and I am planning on having a home birth. I have loved the idea of a home birth for many years before I was ever pregnant but it has been the most difficult decision of my pregnancy. It took a long time to arrive at this answer and I feel an urge to write down the thinking behind it because, if it goes well, I want to remember the courage it took before I knew it would, and if it doesn’t go to plan, I want to at least retain the seeds of the vision.

Here is something hard: ultimately, this decision falls on me. Of course, my husband Jeff and I share in the responsibility, but the burden is not shared equally. It is my body, my labor, it will be chiefly my triumph or my blame. While a home birth may be safer and healthier the majority of the time, there are risks associated with being farther from medical care in those rare extreme cases. If anything were to go wrong, it wouldn’t just be “society” that placed the blame on me, I would do the same. That’s why I have to dig and wait and listen so much to figure out where this desire comes from. That’s why I can’t hold it too closely, or make it out to be mine alone. 

When I was pregnant with our son Louis, I began with the default birth plan of going to the nearest hospital, Henry Ford. I liked the proximity, I knew people who had successfully delivered there, and I had little interest in visiting various providers, comparing their stats and amenities. A few months into the pregnancy, I confided to a friend about my secret wish to have a home birth, and she reminded me that we actually knew a home birth midwife through another friend. From the moment Jeff and I had our first conversation with Krissie, I had a feeling of “yes.” It was like my dream suddenly had a piece of reality to latch onto and a new plan was in play. I continued to see an OB at Henry Ford, though I was becoming less and less comfortable with their general mindset. They weren’t impressed that my family has an extremely strong history of giving birth multiple weeks past the due date and implied it is was not ok for me to go past the due date. They actually mentioned inducing early if the baby was small, which felt crazy to me. I often left my check-ups with a sensation that translated to: “get your hands off me.” 

Jeff and I took a 12 week class to learn as much as we could, and I continued to see both my OB and our home birth midwife. We seemed to have all the bases covered. Excited as I was for the home birth, I had plenty of concerns. I had never labored before, didn’t know what to expect. I didn’t know how I’d react to the pain. I wasn’t sure if I would know if something was wrong. Home, at the time, was not close to our hospital. And there were many people around me who felt strongly that it amounted to an unnecessary risk. It was hard to answer their concerns over and over. My gut-level confidence was hard to reconcile against the simple fact that I cannot see the future, do not know what will happen and certainly cannot compare two alternative hypothetical futures. I can’t tell the concerned faces “I promise nothing bad will happen.” Instead, I tried to explain myself and try to strike a balance of listening to my instinct while also considering other views. 

I waited eagerly each day of July for labor to start. I wasn’t upset when the due date came and went, but I was truly surprised, at 42 weeks, when it seemed my body was not close to labor, despite the fact that I’d tried every DIY induction method out there. Our baby was head-down but “sunny side up” and so he didn’t drop, didn’t put pressure on the cervix, didn’t try to leave the womb. The family history said this was normal, and both baby and I were doing fine, but our  midwife said she was past the point where she could do a home birth. So, we went to the hospital for a check up to see how I and the baby were doing and quickly became the scandal of the waiting room. They didn’t want to give me a check up, they didn’t want to do any tests, they wanted to induce no matter what. It was as though gestational age was the single relevant fact and no other factor could alter their certainty that induction was absolutely necessary. There was no need in their view to investigate the current welfare of the baby, to weigh the risk of induction, to consider my family history. It seemed like my desire to collect more data was a personal indulgence at the expense of my child’s very life. One study shows an increased rate of fetal mortality beyond 42 weeks and so it was an immutable fact that we must get the baby out immediately. “We can’t fix dead,” they said. Despite the pressure, it didn’t feel right. I walked out of the hospital that night, still pregnant.

Two days later I still had not gone into labor, and we returned to the hospital for an induction. Quickly, our willingness to cooperate took a sideways turn when we learned that the hospital’s induction plan was nothing we had prepared for, they wanted to use a drug called Cytotec. Our birth class teacher taught us the mnemonic device “t” is for “terrible” because Cytotec, while often used for induction, is actually not approved for that use. How was this somehow safer than continuing past the due date? How could we even compare the risks when there are no studies for this use? This didn’t feel like science, it felt like “this is how we do it.” Jeff and I didn’t understand why they were so certain when we were so not. But this time, we chose to stay.

Was it the triple dose of Cytotec that caused Louis’ heart rate to plummet? Was it his advanced gestational age? Or was it an inevitability no alternate decision could have averted? Either way, it happened, and we ended up conceding to an emergency C-section just moments before I was going to begin pushing. From one intervention to another, and then one I truly had not anticipated- they took our newborn baby to the NICU for reasons I still fail to understand.

Sometimes in the early morning hours, I have a sort of waking dream where I am back on the operating table, still in the midst of a “cut-him-outta-me.” I have heard my baby’s cry but I can’t see him and no one is talking to me, no one is bringing him to me, we are completely separate. The moment that he leaves my physical body, we are supposed to still be together. Connected by a cord, connected by touch, connected by smell and sight. But I can’t even see him, let alone hold him. When this happened in real life, I wanted patiently, I looked at Jeff and asked what was going on, I stayed calm. My body was paralyzed and wide open with a gaping wound and I behaved like a good patient. But in my daydream, I am not polite. I am rude and brave and I shout “Give me my baby!” And they do. And I get to hold him and be with him the way he needs me to be and the way I deserve. This dream fills me with sadness and regret, I can feel the words sitting there in my throat. I will be ready if this happens again, but the day dream isn’t about shouting this time, it’s about not needing to. 

Women are often told that our dreams are foolish. We are encouraged to be practical, and to settle. Sometimes our dreams are difficult to relay because they are abstract and immeasurable, they are based on an experience, a knowing, a feeling. Sometimes we ourselves doubt our dreams, have we been sold a line? It’s hard to make solid decisions on the seemingly weak foundation of an intuition. Many women dream of a birth in which their body- the same body that has built an entire human step-by-step without any instruction- is also able to birth that baby in the way it knows how. When so many of us fall short of that ambition, our sadness, or trauma, over having been robbed of that essential experience is dismissed. We are told “your baby is healthy, that’s all that matters.” Of course, of course, that is what matters the most. But it’s not true to say that’s all that matters. The birth process isn’t merely a means to the end, where any route will do. No one would think to say to the dying “you’re going to die anyway, that’s all that matters.” We know it matters how. But somehow this logic, applied to the other end of life, seems like an open-and-shut case, and we are left to question that voice that wants to shout to say “I want another way.”

I am not anti-medicine. There are many wonderful doctors and nurses at my hospital whom I appreciate deeply for the care they’ve given me and the work they did to bring my sweet boy into the world. I will gladly accept it again if need be, and I will place that assistance at a higher value than the “birth experience” I would like. I will seek medical care if I need help, but I will not preemptively seek it because I might need it. I trust the good people at the hospital to fix what is broken, but I don’t trust them to support what is not. I sense the itchy hands of the surgeons and the aching pockets of the financiers and the anxious minds of the in-house counsel. I could go back there, a bit braver this time. I could ask all the questions and be rude when I have to be, scream if need be. I could anticipate more contingencies and watch youtube videos about “informed consent” and hire the baddest doula in Detroit. But I don’t want to be a good warrior, I don’t want to go to battle, I want to focus on the job I have to do. I want to be present enough to understand what my body knows and is trying to tell me. I want to greet my child the moment he or she emerges into the world. I want to recover my physical wounds without any emotional ones. Having a healthy, peaceful, non-hostile birth experience is not some trivial ambition I pursue at the expense of the welfare of my child. It is a vital part of life. And I know this to be true because otherwise it wouldn’t hurt so badly to go without it.

My baby is in an “optimal” position, head down and sideways. There are a pair of feet using my ribs as a footrest. He or she has dropped low in my pelvis and I am now walking with a waddle. I’m not scared for these signs that labor is approaching, I am excited by them. It is encouraging to think that my baby and I are working together to do the job that is before us. I trust us so much more than I trust anyone else, and I look forward to learning what unspoken knowledge we both possess. I’m still open to the possibility that we may have to end up back in the hospital- I’ll willingly take that step if need be- but I have no doubt that to attempt a home birth is the right decision. We are lucky if we get to die at home, we are lucky if we get to be born at home, surrounded by the ones who love us most. It’s not always possible, but it is absolutely worth aiming for, and I am filled with hope that my wish will come true this time.