A hospital birth doesn’t make my pregnancy an illness

On Monday, a good friend of mine posted a story on Facebook called “It’s time to stop treating pregnancy like a disease,” written by Globe and Mail health columnist André Picard. At first glance, I thought the story was going to be a push toward medication-free childbirth, which, as a parenting editor, I’ve read before, and I’m neither here nor there on the matter. To each their own. Que sera sera. Whatever floats your delivery boat.

But as I read further, I realized Picard was touting the necessity of non-hospital births in this country, adamantly insisting that hospital births under the care of physicians are unnecessary in most pregnancies—that such care and delivery practices are costly and a waste of obstetrical education and skill. According to Picard, doctors should be reserved for complicated pregnancies only, leaving the majority of births in Canada to midwives at home or in birthing centres. Moving toward this model of prenatal care will apparently mean fewer needless interventions, not to mention savings on the healthcare bottom line.

All right, Mr. Picard, I see your point. But I don’t think it can be so black and white. Aside from the system cost debate, of the availability of services in some areas, of the differences in care, the line you wrote—“Where and how you give birth matters”—is absolutely true, but not in the societal and political sense of the word. It matters to each mother, to her comfort level, to her desired experience. Decreeing that hospital births should be outlawed for typical pregnancies takes the choice away from a mother. It removes her needs and flatly ignores any reason she might have for opting for a hospital room rather than her bed at home or a suite in a birthing centre. I’m a prime example: I was highly anxious through my first pregnancy (and I know, from writing about my experience and hearing from other women, that I’m not the only one). I wanted an obstetrician and a labour and delivery ward, knowing that if something went wrong—because things do go wrong from time to time—I was in a place equipped to deal with an emergency within minutes; surgeons and specialists only a page away. I know that labouring mothers are usually only an ambulance ride from a hospital (though not always) when they deliver elsewhere, but I wanted to be 30 seconds away from an operating room. That should be my right. If these assurances are going to keep me calm and focused, why should I have to give that up? Another woman may have different issues than mine. Maybe hospitals freak her out. Maybe she wants to be in the comfort of her own home, where she can move about freely or labour in a birthing tub in her living room. I don’t judge that woman for her choices and I would never expect that woman to conform to mine.

I understand that interventions are higher in hospitals, and I agree that this is far from ideal. But in that case, I challenge women to learn about the potential interventions ahead of time and be your own best advocate. I know there is a fair amount of fear involved in making these decisions, but know what questions to ask. During the birth of my daughter, one of the nurses kept saying, “I think she could use some Pitocin to hurry things along.” After she mentioned it for the third time, I turned to her and said, “Why? Is the baby in danger?” She had to say no, that it would just speed things up. My doctor arrived then, and she gave the answer for me: “No, we’re close here. Let’s just let her do her thing.” By asking the question, rather than just agreeing, it allowed us to have the dialogue. I think this part of the process is important regardless of where you are or if your caregiver is a doctor or a midwife—your birth team needs to communicate with you and explain the reasons for suggested procedures, rather than making you afraid to disagree.

There are many ways to give birth, and none of them are wrong. But I don’t think it comes down to hospitals versus homes or birthing centres, or physicians versus midwives. We are lucky to have both alternatives in Canada. I worry that limiting those options, and insisting that each birth experience be the same regardless of an individual woman and her specific needs, is unnecessary. “Where and how you give birth matters”: You bet it does, but I don’t see why it should matter to anyone else but me.