Bellies to BirthCast

Bellies to BirthCast  |  Week of December 8 |  Episode 5  |  Subscribe

Choosing Homebirth After 35

Mikaela Seligman joins the Bellies to BirthCast to discuss her decision to have a homebirth with her first child at age 39.




A full transcript of the interview appears below:


CATHERINE:  First of all welcome Mikaela; it's a pleasure to have you with us today.


MIKAELA: Thank you so much Catherine, it's a pleasure to be here.


CATHERINE: Well, tell us a little about yourself, when did you first become interested in having a home birth?


MIKAELA: Sure. Well, we, my husband and I first became interested in having a home birth I would say really after seeing I think unlike many women these days, fortunately after seeing “The Business of Being Born”.  My husband is in public radio and they had actually done a show on it, and I was in the early stages of the pregnancy and quite sick.  I had that version that doesn't just last in the morning but goes the twenty-four hour cycle.  I remember lying on the sofa one night and having him bring home the DVD and say, “We just got this.  I think you'll be really interested in it.”  And we both really started the conversation at that point.  Natural childbirth was definitely on my radar and in fact, what I had planned to do and had for many years, planned to do and considered, knew lots of people who had natural childbirth but largely in hospitals, and the notion of home birth I think to me at that point was somewhat fringe.  I sort of thought well, how do you do that, you have the baby at home?  What about all those other things that you're in the hospital for?  All those other reasons people have to be in the hospital?  And after watching that, and doing some research, my husband are talking about it, we started to think what are those other reasons that people go to the hospital?  I'm not sick.  There's nothing wrong with me.  I'm in great health.  I'm in great shape.  He is a totally committed partner so the idea of us being able to do this together is a reality and it was at that point that we really started to consider it and to make it happen.


CATHERINE: Did being 39 affect your decision?


MIKAELA: It didn't for me.  I feel as I said I'm in very good shape, I take really good care of myself.  I certainly don't whatever it is, to feel what your age is.  When I think about that fact that I'm almost forty I go wow, but I don't feel like there's anything in my health that would make that in issue so it didn't for me.  But it was interesting because my mother was quite nervous at first.  And I do not come from a family that is concerned about alternative options in medicine.  My mom has been very supportive and is herself interested in lots of complimentary treatment and lots of other ways of looking at things so she wasn't particularly inclined to like hospitals anyway.  But she was concerned because I was 39.  She said, “Have you really looked into this?  I'm a little concerned.”  And I actually said to her, “Can you get this film?  I really think you'll have a different opinion if you get the film.”  And she got it and actually called me crying and just was delighted and said, “This was so not available to us when I was having a baby; and I think this is such an amazing choice you're making; and I support you whole-heartedly; and my Mom just really turned around.  I think there were other people who sort of didn't outright say, “No, we think you're crazy.”  But who kind of vaguely would say, “Oh.  What are the concerns?  Aren't you concerned about that?”   But my husband and I, we really weren't so it was really coming from other people more than anything.  Those close to us, I think really once they understood became supporters as well.


CATHERINE: Were there any desires you had that foremost you thought would not be available at the hospital?


MIKAELA: Yes, I think it's really; there are a couple of things.  I think at the core it's really philosophical on one level and not that I'm not at all doctrinaire and my husband and I both said and I also felt that if we needed go to a hospital, thank God it's there, right?  Thank God that the interventions and the treatments and all of the options are available. But that, for us and for me giving birth at home just felt like the right place and it felt like the right tone.  That it would be the two of us really guiding the process that the midwife, as midwives say, “They don't deliver the babies, they catch the babies.”  That this was really, for us it's really a start to what it was to be parents.  Now that I am a parent and all of seven weeks expertise and experience and that, I can see how often people get tripped up by what the experts are supposed to tell you.  Do you cry your child to sleep or not?  Do you do this?  Do you do that?  And I feel like for us, home birth was the start of saying this is our journey with our son and this is not anyone else's to sort of tell us how it should be or what to do, but to get their facilitation and their guidance along the way. That, to me, was very much what home birth was.  Our midwife, wonderful midwife out here in the Bay area, Maria Iorillo, really supported us through the birth; answered questions; did what we needed to do. But it wasn't her having the baby, it was me. That was one of the biggest reasons for us.  And we really also felt like it was a kind of environment, I just thought of being in a hospital; I actually toured one of the hospitals out here. It was at that point, this is early, early on when we talked to a hospital midwife as one of the options.  And I went and toured the building with her and I thought it's bright and sort of technical and felt sterile. Interestingly this midwife, who is a hospital midwife, had both of her children at home and she gave us Maria's name.  And she said, “I really encourage you to think about this.”  And so it was at that point that we really started interviewing lots of other people.  But it just made sense to me all along that this was the place, we could do it.  And we had a lot more, I want to say control but it's not so much control in the birth because I think that's a place about really losing control; but it was in the space of our home, I would have the freedom to do that.  No one would tell me I had to be in the bed at this time; or I had to have the monitor at this time; or I had to take this drug; or was offered this drug at this time.  And I also think that, I have to be honest that I think I thought I would be a lot more tempted that if I reached the point where I was in a great deal of pain and I called out and I wanted an epidural, it would be available and someone would probably give it to me.  And I knew that ultimately I didn't really want it, that that wasn't what I would want.  But it points, I know that most woman, that many, many women in the birth will look for something to help. I thought at home, we're in our own environment and that's not going to be what I'm looking for, so its really going to be our process.


CATHERINE: So would you say that it gave you more ownership over the birth rather than control?  


MIKAELA: Yes, that's a great way to say it.  It gave me more ownership.  It gave us more; yes, ownership, I think ownership is a good word.

 
CATHERINE: Now what role did your husband play in this decision?  You said that he's very supportive, but did he have any reservations or any questions he needed answered?  Did he do some active research on his own?


MIKAELA: Yes, my husband's just; I, of course adore him and chose him and love him, so I think he's a very interesting person but, I think kind of like we say our kids are cute, we know they are our own so we're somewhat biased.  But I would say my husband is very much I think an advocate for this in a way that even surprised me.  In fact one of the jokes early on, he said in one of our birth classes, we had to say something that we didn't expect.  We had to each share something that we didn't expect since the pregnancy.  And he said that I didn't expect that my wife would tell me to kind of tone it down at dinner parties about home birth.”  Because he became a very early and staunch advocate and we would go and we would be with other people who weren't necessarily to do home birth, and I'd be like honey they might do something else.  I don't want to over state the thing here. But, so he needed no persuasion and was really, really kind of got it, I think what it was for the woman, an so what it meant to me.  And always what it meant for his role. He was, we actually took two birth classes; one that was focused on a Mindfulness practice out here, that's really using meditation and Mindfulness practice.  And we practiced everyday together; we meditated every day together so there was very much a whole process of doing this together.  And then we took a second class that was particularly focused on home birth, and he was eager and enthusiastic about all of that. and we did some other courses as well.  So he really was a true, true partner I think at every step of the way.


CATHERINE: Wow, it really sounds like it.  It doesn't sound like the typical story you hear for most couples that birth in the hospital, it's more of a, the husband is for decoration than being a party advocate.


MIKAELA: Yes, yes, completely.


CATHERINE: Now it sounds like you did a lot of preparation, how were you able to find these different resources and classes in your area?  


MIKAELA: I feel like so much of it, and I think maybe this is partially my personality as well; that I'm very much an extrovert so I tend to learn from other people.  And as I started getting into this, I talked to one person who would refer me to someone else etc. etc. etc. so that was really how it started to happen.  Now I feel like I'm literally steeped in this whole birth culture here, which is very, very rich.  I'm feeling very fortunate to be in the Bay area these days; it's very, very rich here.  And that said, I think there's probably a whole lot in very many people's areas that people aren't aware of.  So we kind of started playing that networking game.  I also found some parent listservs really helpful.  There are a couple out here that are very active so I really encourage people to check out listservs like that because it's other parents talking about it.  In fact, that was what I did because I remember the, I'm just remembering this now, it sort of becomes like tacit at some point but early on I was really unsure about what class to take.  There were so many classes offered.  There were ones that seemed more about that kind of medical piece; you just know how the baby is born and how it works and all of that.  There were some more geared to people in the hospital of course.  There were different ones.  And we learned about the Mindfulness class in particular and started doing some research online and just found all these reviews from parents saying or from perspective parents, saying this really changed the experience for us.  And then what was funny was as we took the class, we then started realizing people we knew had already taken it, and we're like “Oh, you were in that class.”  So I definitely found the word of mouth thing is probably the biggest resource. But I also found just looking online, checking it out, to be really helpful as well.


CATHERINE: Now what type of challenges did you face as you started to prepare for your home birth?  You're lucky to be in a much more urban area where there are a lot of options.


MIKAELA: Right, right.  I don't know that I would say that I faced any external challenges.  I think there are all those that we all feel, the fear of heading into birth, whether it's a home birth or otherwise.  I think just for me on a more internal level, it was really just finding room to sort of slow down and I think to be really in touch with myself; which I think is critical to birth.  Its what women do, but I think it happens sort of naturally anyway. But I think with the home birth in particular there is sort of a, again it was a sense of walking into something where no one else was going to tell me what to do.  And so I had to really get in touch with that place within myself.  But I wouldn't say that, again we had a backup doctor who was quite willing to play that role.  She'd worked with our midwife a lot.  She's been a real advocate herself for home birth so I knew that if the home birth thing didn't work out for whatever reason we wouldn't walk in the hospital and be turned away or treated badly or anything like that.  So I think other than just kind of perceptions and other people which, again, were few and far between really, I don't think we faced too many challenges externally.


CATHERINE: That's excellent to hear.  That certainly isn't always the case.  


MIKAELA: Yes, the one thing, it just occurred to me, the one thing was insurance.  That was the one thing was the insurance company was sort of unwilling to say how much they would cover. At this point we're actually still not sure.  The first round they've had with my midwife they've said they won't pay for any of it, which contradicts California State's law from what I understand.  So we're going back around with them and I just have the feeling it will involve some phone calls and some notification of what the laws are, or how this is suppose to work or something, I'm not sure exactly. Hopefully that will work out.  But that was really the only big thing.  And I just find that incredibly ironic that home birth cost, what a typical birth is like 40 thousand dollars in the hospital and a typical home birth is 4000, and they won't support it. But that's another whole phone call I suppose, or another conversation for us.  So that was I think the only thing early on.


CATHERINE: Right, and that is a definite system wide issue that you're talking about that right now in hospital staffers are rewarded for the more that they do, the more intervention.  But when everything goes right, and nothing is needed it doesn't support low intervention birth.


MIKAELA: Right, it doesn't make sense.


CATHERINE: No, it doesn't which is probably why it happened.  Tell me a little bit about your care.  I know that you had chosen Maria as your midwife.  What did your typical prenatal care look like?  Your appointments, the types of tests and care and things that are involved in midwifery care.


MIKAELA: Sure, and one other thing I had to say about that because we did choose Maria and we interviewed a number of people.  And that's one thing that I really recommend because I think it's sort of like Goldilocks.  You just have this feeling, you meet with all these people and then you're like oh this one is just right.  And all of them that we met with were great midwives; had tremendous experience and I think we would have felt comfortable with largely.  But it just felt right and I think that's a good way to go.  So the visits, I mean that was one of the things again that I think is so different about this whole other infrastructure of care is the visit on average lasted an hour.  On most occasions my husband went with me.  Actually my parents were in town at one point so they came as well and Maria asked my Mom about her birth stories and we talked about how my birth might go related to hers.  It was just very warm and familiar in that way.  And then on the regular visits there would be combinations of just conversations.  So we'd sit in her, she has actually an office, so we'd sit in the front and we'd talk through any issues that I brought up and questions that I brought in.  From anything from diet; to a pain I was having; to wondering about how this was going to work when she showed up the day of the birth or whatever; all the things that are going on in my head, in my heart, we would just talk through those.  And then we'd do an exam and each time we'd hear the baby's heart beat and I would get weighed.  It was a combination, but I would say the bulk of the time was not the physical exam.  The bulk of the time was really the conversation and the sharing of fears and ideas and information, that sort of thing.


CATHERINE: Now did you encounter any specific obligations or procedures due to your age?  Was that at all a concern for you and your midwife throughout your care?


MIKAELA: We were, and I would say that part, and I think I felt much more comfortable ultimately choosing home birth and just even choosing all of it after I did get some tests.  So because of my age, we did go through a number of the early tests.  We got the CVS early on.  So this was actually before I even, I guess it was, I think I started with Maria at about right after that in fact, at three or four months.  So we do a number of the early, the blood screenings and the CVS I guess was the most invasive.  And it was very, it was a choice for us because we went back and forth about it and we also knew that there was some risk of miscarriage from it and that it was the most invasive, because of course they take a piece of the placenta.  But the more we learned about these ratios in urban areas and in hospitals like the ones here we felt pretty comfortable about it.  So as much as we largely didn't choose a kind of hospital based birth or system, I felt like there was a way in which in this day and age we have the opportunities to choose those.  To choose the parts of that that makes sense for us, and for us that really did make sense.  So we did several ultrasounds early on and then we did the CVS.  We did not do the amino or any other, we didn't do any really, tests after I guess it was like twelve or fifteen weeks.


CATHERINE: So no ultrasound, nothing of that nature?


MIKAELA: We did one ultrasound.  I'm trying to remember; when I went to see the backup doctor.  I think it was at twenty weeks we did one ultrasound then, we did the last ultrasound we did.  But we did do two early on in the first visits when they are first just checking, and then one when they do the CVS and then one when they did the twenty week visit with the doctor.  And then after that no, I believe we didn't do any after that point.


CATHERINE: You talked about a very valid point there, that because technology is available doesn't mean that it is always necessary, but it doesn't mean that it's not.  So I guess the point is to choose judicially.  What really makes sense in your situation, which can be different for everyone?


MIKAELA: Right, because I do know a number of women my age and I think that also I talked to a number of friends, and I know women who went both ways in that choice.  Some just felt like whatever the story is, this is my baby.  And others of us felt like I kind of want to know.  And part of the reason we selected the CVS is because one of the early tests I got back just had a really low, sorry, I mean it actually placed us pretty high for the possibility of Downs and the possibility of, I forget the, Trisomy.


CATHERINE: Trisomy 18.


MIKAELA: Yes, which of course is fatal I believe and we just thought; we want to know.  We want to know that nothing that this is not really, that this child has a good chance and so we did the other test as well.


CATHERINE: It sounded like you were able to have a pretty supportive environment; your parents were pretty on board.  But if you did encounter nay sayers, how did you respond?


MIKAELA: I think it's a great question.  I think it sort of depends on why they were nay sayers.  I think there are those among people who often just don't know.  So when you say home birth, again still because I believe it was at the turn of the century I think it was 98% of women and now it's like 2% or something ridiculous.  So at one point it was what a lot of people did. I think for a lot of people it's like now we have hospitals, why would you do that?  Why wouldn't you take advantage?  And so I think I approached it from that place which was “Here's why this makes sense to us.  Or even asking them some questions about, or if they were other people that were pregnant, which I tended not to get much nay saying although occasionally from people who were also pregnant. Because I think that everyone knows what kind of choices you go through to do it.  But it was less nay saying from people who were other pregnant momma's to be.  I think I just got more the like wow, you're really courageous; or wow, I can't believe you're doing that, which is not nay saying, but in a way it's sort of a way to say I couldn't do that and I'm not sure I would.  And I think at that point I'd say, it would be to sort of talk about what the differences were, that there is available research to suggest that there's not higher risk, that in fact there's a much lower risk of things like a C-Section or other kinds of interventions.  So it was sort of to meet people where they were, which I often found was a place, and I don't mean this in any disparaging way, but a place of ignorance, just of not knowing.  And I can't tell you how many times I recommended “The Business of Being Born” because I feel like I've said that to many, many women at this point that I feel like this film itself is something every woman should see, not just even pregnant women. Because I think it's about – in very many ways, its about women and medicine in this country and birth, and how birth has been medicalized and why.  And so I often would recommend some other, - whether it was that film or some other resource.


CATHERINE: That's a good starting place.


MIKAELA: Yes, so people would understand.


CATHERINE: This film is even more than just about birth it's about choice and understanding that you do have choices.


MIKAELA: Exactly.


CATHERINE: I think a lot of women don't realize.  Just hospital births is what you do and they, like you said, they don't know if it's something they would do, but it's not even something they considered.


MIKAELA: Exactly, and that's exactly it Katherine.  I think I feel like as long as you're making the ultimate choice with that understanding, that you've seen what the range of options looks like, then I think often for many women whether it's because of your parents or it's just because of what we've known, or feels like it makes sense, or feels available, we limit those options.  And I think that's what I really wanted to do was to say, “Hey, there are these other things available”.  And I'd say honestly other than that we didn't get a whole lot of people that were really like, wow, that's crazy or suggesting that's dangerous exactly.  I think there were ways in which, in veiled ways, a few people perhaps, that would have been their concern.  But again I think it was to sort of say, wow, I respect what you would have done or what you did, or what you're talking about.  But this is why this choice makes sense for many women and why it makes sense for me.  


CATHERINE: You talked a little bit about your emergency plan; you had some concurrent care with a backup physician.  Now can you tell us a little bit more of what the steps were that you had taken to prepare in the event that an emergency did arise?


MIKAELA:  Sure. As we said we had a backup doctor, Dr. Norrell. I met with her twice.  I met with her as I said about mid, about twenty weeks and then I met with her a second time, I'm not recalling exactly when it was.  But I just wanted to be sure that she was in touch too with where we were. She met my husband; and we talked to her about the other women and the other doctors in the practice, because the likelihood it would be, - it's a hospital practice, which was actually one of the other reasons we didn't want a hospital birth is very often you chose X doctor or midwife and you get Y doctor or midwife because that's the person on call or who's available, and we wanted someone we had a relationship with.  So Dr. Norrell, we talked to her about the other people that would be on, possibly, and knowing how that would work if we showed up at the hospital.  It was something that our midwife went through some steps with us, to talk about.  I actually, it was something, this kind of came through another friend who had a home birth and ultimately they had to, she had to go to the hospital after the baby was born for something, and her only recommendation was make sure you have the car seat in. Which was also recommended by the midwife, but that was something we got together before, just in case we either had to go to the hospital to deliver or we had to go to the hospital for some other reason that we had the car seat all ready.  And again, we are very fortunate; the hospital is about ten minutes away with traffic; so I think we knew that we would know in a consultation with our midwife if there was need for it, we would hop in the car and we'd deal with it then.  But we knew that on the other end we had a hospital that we could show up for, that would take us and that would serve us well.


CATHERINE: That's excellent.  Unfortunately, that's something that a lot of women don't have the option of that in areas that are more rural. There are physicians that are supportive.


MIKAELA: And I just want to share one story.  It's a friend of mine who is the exact same age as me and she actually had several miscarriages as well. She ended up getting pregnant, she's three weeks, her baby was born three weeks before ours and she's in a pretty rural part of California. She thought this was not a possibility.  And after we started talking about it, she was seeing a doctor, and in fact she got lots of scare tactics from the doctor who, when she left the doctors practice she called her and she said I think this is unsafe and you're making a bad decision.  And she ultimately followed through; she had a beautiful home birth.  But she had to really work it.  She did find a doctor who said to her I will not call it a backup he said kind of for insurance reasons.  And it was interesting that it was a man.  The doctors she was seeing before that were women and they were totally unsupportive of it.  And she found this guy who said I will do it, but I don't know exactly how they work that, she knew again that if she showed up at the hospital that they would work with her and she did see him once.  But that's just to say that I think for women in those situations as well, that it probably just requires some more work.  But I bet there are people that would support it if you look hard.

CATHERINE: Where there's a will, there's a way.


MIKAELA: Yes, yes.  But that is also to say again, I certainly can't, I'm in a very fortunate position to be here and those options available.


CATHERINE: And also in California you're lucky, it's a little bit unusual in most of the rest of the nation, but many of your hospitals do have midwifes on staff.


MIKAELA: Yes, yes.  It's much more common.  In the one birth class we had, there was one other couple doing home birth.  But out of that group I'd say 75% of the group had midwives, but they were just hospital-based midwives.


CATHERINE: Right, and that's pretty atypical of the rest of the nation especially in the less urban areas, that's just not an option.  Now tell us a little bit about your birth.  We've been waiting all this time.


MIKAELA: Well, it was a long one.  We went to dinner; my parents came in about two weeks before and we were ultimately, Asher, our son, was born just a day before his due date.  So we were having dinner with them and I just had this feeling that night.  I said to my husband Dan, something feels different, I feel crampy but it's different than those other feelings.  Because I think there's a feeling of many of us like, will we know?  Will we know when this is happening? And we went home that night and the contractions started about two hours later and that was a Saturday night, and just to give you a sense of it, Asher was born on Monday afternoon.  So I laboured through Saturday night and then Sunday the contractions were about ten minutes apart, twelve minutes apart and then they'd go a little longer, a little shorter.  And basically we called the midwife at that point of course and she said, “Well, I'll come when they're four minutes apart, on for an hour; when they're on a regular rhythm and they're much closer.”  And so we moved it along and it was basically my husband and I the whole first night and the day, they lessened significantly but I still was having contractions at least every half hour or so.  And we went through Sunday and I started to kind of despair on Sunday night a little bit because I thought why aren't these, - this is the point when it's suppose to, why aren't they moving along more quickly?  Why am I not having contractions at closer intervals at this point?  I understand this is pretty typical, and sort of this nocturnal way that birth occurs. But as literally night fell, that night, on Sunday night, they just kicked in again.  And the same thing, they hit at one point like four or five minutes, but then they'd get, they'd go to longer intervals again.  So I think I had sort of the next moment of what is happening here?  Why is this not moving more quickly?  Sunday night, and mostly I had no idea what time it was and I actually felt relieved.  We made an attempt not to have clocks around; and I think I went into a very different experience of time; which is sort of lacking the same constructs that time normally has.  I didn't even know what it was or how long time had passed.  But I happen to walk in the kitchen at some point, and saw the clock say four-thirty in the morning. I thought oh my God, it's going to be another day, and I'm still not having this baby.  But this was really, kind of a water shed moment in the whole thing when, I think I realized at some point that, because I kept wanting the midwife to come, and kept feeling like the midwife should come. I started to realize that we're still having the baby whether the midwife comes or not, I had my husband supporting me, it's my work, and our work to do.  So we did call her just to say what can we do? At that point I was concerned. She basically said, “Mikaela needs to sleep”.  I wasn't sleeping, I was just trying to go through the contractions, and mostly just resting a little bit, but not sleeping.  And she told my husband to get me a glass of wine, and get me to bed.  So I did sleep for a couple of hours, and that just helped enormously. Because by the time the morning came and I had gotten about three hours of sleep, I think I just felt renewed both physically some and psychologically.  I really felt at that point that okay, I can do this and the contractions started coming more quickly. By about ten that morning she came over, and she jokes that mine is one of the most mellow births she's ever seen.  She actually didn't believe that I was as far along as I was.  I practiced meditation for quite a while, and I don't know if it was because I was a much more quiet sort of, I went to a very inside place. She basically said to me we need to, - it wasn't sort of like, - it felt a little bit like don't be so mindful but it was sort of like we move this.  She said you're going to have this baby by tonight but we need to move that baby's head down.  At that point I was about five centimetres along.  And so all day on Monday we marched around the apartment and squatted and really tried to push the baby's head down. Asher was born at 4:38 that afternoon.  And then we got to the last stage, and I was pushing. He had meconium in the water, so she knew that that might be a concern and this is where I think, more than any time, I just, I felt the difference with not being in a hospital, where we know someone else where that happened, and they whisked them into some Peds unit, and it was a huge deal.  And Maria just basically looked at us and said, “So there's some meconium in the water.  I'm just going to move you out.”  We were going to have the baby in the water.  And she said, “I'm going to move you out of the water.”  And we had a bed kind of set up right next to it, and so the last couple of pushes we did on the bed.  But I never knew, she said, “I'm just going to suction him out as soon as he comes out, so you'll see me doing that.”  She sort of explained it but it didn't concern me.  I thought that everything was just fine and we were just going to have the baby.  So that's what we did, and he came out; and the pushing was about less than half an hour by the time we got to that stage, which was a great relief. He born that evening.


CATHERINE: During that birth, since it didn't go as quickly or follow that pattern that you had expected, did you at any point question your decision to have a home birth?


MIKAELA: Not once.  It's funny, I definitely, I think I questioned at points just my own capacity.  At points I was like, “Oh my God, I can't do this anymore” like “I'm tired”.  But it was never like; I kept thinking what would be different if I was in the hospital?  I am still having the baby and I honestly just kept thinking and if I were in a hospital, I wouldn't be able to move around like this; I wouldn't have, my husband and I wouldn't be, I wouldn't be able to get in and out of the tub; it just felt like there was nothing about the moments that I had of concern or just fear that would be any different in a hospital setting, and in fact I felt like being in the setting that we had was really intimate and beautiful.  We had candles everywhere.  We had very low light all the time whether it was morning or night.  It was very peaceful.  We were playing all sorts of music from at one point, this very relaxing music and then when it got to the point where we needed to speed it up we were dancing to Tony Bennett.  It was really our birth experience and my birth experience, rather than something I felt like was imposed by someone.   And so I think I just never felt this, that at any point that would have made more sense to be in a hospital to me.


CATHERINE: Now looking back over the whole experience, pregnancy, what were the foremost benefits of birthing at home?


MIKAELA: I really think it's some of what I just touched on, that I feel like the ownership; as you used the word earlier, which I really like; that we had of the process.  And as I said, everything from music, to environment, to lighting, I believe in hospitals you can't even have fire right, so you can't put candles, which seems minor on one level. On another, we could create the space in which this baby was going to come.  And the space that made sense to us and for me in having the baby. That included even, my Mom was here sort of in the kitchen for bits of it and had brought all this food.  And then during the birth, particularly in the later stages, was there, was part of this.  And it just felt really like there was a kind of intimacy to it.  And a kind of connection especially for me and my husband that - I don't know because I haven't had a baby in the hospital, so I think that's really possible there too so I don't want to in any way suggest that it's not; but I know for me, and for us, it just felt like that was a big part of it was the intimacy.  And I also, the more I do talk to other women and friends or just people I meet about birth, I'm struck by how often what they call the cascade of interventions get set into motion.  And I knew that birthing at home and then my experience with birthing at home; there was nowhere for that to start.  I wasn't going to be encouraged to get any drugs, so they weren't going to lead to any other drugs and change my experience.  So I felt like that was a very powerful place to stand as a woman.  This is my birth, and I can do this.  And I really feel like that's one of the biggest things about home birth is, it's really this statement about the power and the inner strength of women, and that we've done this for centuries, and that we can do it.  The final thing I'd say is I feel like my connection with my son, while again I know that no matter where he was born that would be true, I felt like having my husband, I mean, my husband caught the baby and put him on my chest, and he nursed right away as they suggest, kids will kind of, babies find their way.  We were laying there on this daybed in what is now his room, having him; and so every time we're in his room, that's the place where he was born and there's something very special and connected about that experience.  It felt like it really connected me to him; it connected both of us, my husband and I to each other and to him, and it just felt like that kind of experience was really much more possible in our home.


CATHERINE: What was your husband's reaction after the birth?  Is he even more passionate now than he was before?


MIKAELA: Yes, absolutely.  Getting the word actually, the word that my son needs to eat; so speaking of which, so let me answer that question.  So yes, absolutely I think he's even more, I think both of us are just, we walked away from it going, wow; we really want other people to have this experience and have this opportunity.


CATHERINE: Now if you were to have another child, would you make different decisions the next time?


MIKAELA: No, I think if I were to have another child I'd just be like wow, I've done a lot of the work to learn about what's available here and would be able to make those choices.  I guess you never know, because were I to have another child and there'll be all sort of different conditions. I think each time, I'd probably, - I'm not going to assume I'd make any of the same or different choices, but I definitely think that I come to it with great advantage of having had this experience, and having done the research that we did.  


CATHERINE: I think that's a very important point.  You have to look at the individual circumstances of every situation. Even if you had a past home birth there might be circumstances in the next pregnancy that  you say “in our situation a hospital birth makes the most sense,” so it's definitely not home birth at all cost, but weighing the risks and benefits in each situation.


MIKAELA: Yes. It was one of the things we were really, we talked about with every midwife we interviewed. We felt very strongly that we wanted a midwife who would say part of my job is to know when you need to go to the hospital.  This is not about any statement of home birth.  This is about what makes sense for this baby being born.  And if at any point it's clear that it's not possible in our home, then let's go to the hospital.  We have no problem with that if that's what's necessary.  It was not our starting point but it was a possibility and an option for us.


CATHERINE: What is the one piece of take away advice you'd like to share with other women who may be considering home birth with their first baby at an advanced maternal age, or over the age of 35?


MIKAELA: I would just say to check it out.  I think it was one of the things that my midwife said to me at some point when I said to her what people said, and she laughed.  And she said your vitals are like those of a 32 year old woman, and there's really no reason we'd be more concerned about you than someone who has for example, just made poor health decisions or is unhealthy or unwell, and/or anyone that is well and is your age.  There's not a problem because of your age per say.  So I think it's just not to be deterred in any way by the age as an issue, because in it of itself I don't think that it is.  And I just think that, it's funny with one of the other things my midwife said to me when we kind of had the, I was going to say the debrief, but when we were just talking about birth after, she said I'm trying to come up with the word.  And she said that I think it was that your birth was very mature.  It was sort of like, she said often I see women where they're almost working through a lot of issues through the birth; and she said I felt like that wasn't true for you.  There were a lot of things you had kind of worked out as so you came to this in a place of maturity.  And I think that's probably true for a lot of women of my age is it was a real, - if you're 39 and having a baby or over the age of 35, it was really something you chose and waited a long time in life to do for whatever reason.  And so I think that it's like home birth for us almost, I don't know if it makes more sense but it's certainly an option, and something that kind of offers a place where, again you've made that one choice in a very discerning way.  It offers you a place the birth choice in a discerning way as well.


CATHERINE: Well, thank you so much, Mikaela, for being with us today and for sharing your story.


MIKAELA: You're welcome.  It was really a pleasure.  Thank you so much Catherine.

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Page Last Modified by Catherine Beier, MS, CBE