Seren’s Birth Story

Seren’s Perfect Home Birth

Born May 23, 2010 at 9:46 pm

7 lbs 10 oz, 13.5 inch head circumference , 20 inches long

I think I knew I was going to be going into labor on Saturday night (May 22).  I had just spent Friday and Saturday at the Colorado Midwives Association conference listening to the legendary Ina May Gaskin and when I got home I just felt like I needed to get the house ready.  I was sort of irritable, flying around putting laundry away, etc.  Kyle said, “Just do it tomorrow” but somehow I knew I should do it then.  I had some sporadic contractions all Saturday evening (about 5-10 minutes apart but nothing serious), then had a glass of wine and went to bed.

I continued to be woken by contractions all night long, some of them even working their way into my dreams!  I had a dream we got pulled over by two cop cars for making an illegal U-turn.  I was in the driver’s seat but somehow Kyle was driving.  They asked me to step out of the car and I proceeded to have a contraction (in the dream and in real life) and squatted next to the car.  The cops sort of backed away and said “Umm, never mind!”

I woke up around 7 am with contractions that were about 10 minutes apart and 1.5 minutes long.  They were stronger than they had been and just weren’t going away.  At that point I was thinking that I was maybe 75% sure I was going into labor.  I got up to eat breakfast around 9 and as soon as I was upright they got a lot closer together (3-5 minutes) but still very manageable.  I tried to eat some cereal but was kind of nauseous and gave up.

Laboring in the bathtubKyle took care of the girls while I spent some time in a lavender bath my friend Ashley had gotten me.  They would slow down to about 10 minutes apart when I was laying down so I knew it was still early.  I decided to take advantage of it and get some rest while I still could.  I got out of the tub and laid down for about an hour.  Haven came in to join me and we cuddled with her rubbing my back during my “belly squeezes.”  It helped so much to see her sweet little face looking at me during the contractions!  I just kept thinking that I was about to have a sweet little girl just like the one in front of me.

I got up around 1:30 pm and Heather (one of my best friends) came over to hang out with Haven while Lyric took a nap and Kyle and I walked around the park by our house.  It was a BEAUTIFUL day!  Blue skies, warm but not hot, light breeze, perfect.  We had a leisurely time walking around and swaying during contractions and talking.  We definitely got some looks from neighbors!  The only down side was that there was only one port-a-potty in the park and with Seren’s head so low I had to pee all the time.  Whenever my bladder was full I’d have lots of contractions (about 2 minutes apart) which made walking to the potty really hard!  Not to mention the ones I would have in the port-a-potty…

Haven and I nappingStacie (my midwife) and Miranda (my friend and doula sister) kept telling me that I didn’t have to keep walking if I didn’t feel up to it but it felt so good to be out in the sunshine.  I even got a little bit of a sunburn during my labor which I think is fabulous!  We walked around for about two and a half hours, just making loops and walking with one foot on the curb when I could.  Sometimes we’d sit for a bit in the shade and update our birth team.  Heather was the only one at our house yet so we were letting Stacie, Miranda, Jessica (our other midwife), Diane (one of my best friends), and Ashley (my friend and photographer) know where things were at.  The contractions were (on average) 3 minutes apart while we were walking and sometimes spaced out to 5 minutes apart when we were sitting down, so I knew we were down to business but things were still early.

Back from the park

Back from the park

At about 4:30 pm I started to feel like we should head back to the house.  We got home and ordered some sandwiches from Jimmy John’s (the peppers were great until they weren’t).  I could feel something switching over in my mind and body, and I felt like I wanted to start turning inward and go inside myself.  I sat on the couch, Lyric in my lap, and breathed through some strong contractions.

Stacie came at 5:30 pm and I could feel things starting to move into active labor as I was rocking on the birth ball.  The contractions were getting much more intense, much harder to relax into, and I started feeling sort of shaky.  Stacie wanted to check me just once to try and figure out when to call Jessica, our second midwife.  Seren’s head was so low in my pelvis it was hard for her to feel behind it and all the way around my cervix, but she told me that I was safely 5 cm, if not 6 or 7.  This made me so happy!  I was so worried I’d be 2 cm and be disappointed.  I told myself I’d be satisfied with 4 cm and happy with 5 cm so this was perfect!

I decided I really wanted to get in the birth tub and I wanted Jessica and Miranda to come.  I wanted to give Jessica a lot of time since she was driving up from Colorado Springs just for us!  I think everyone got here exactly when they were meant to, even Ashley who flew in from Oklahoma at 6 pm and still made the birth!

Haven laboring with meI got into the tub and have seriously never felt anything so wonderful!!  The warm water washed over me relaxing all the muscles that I could relax and I felt like I could sink into the contractions so much easier!  I labored in the tub while Jessica, Diane, and Miranda made their way here.  Heather, Diane, and the kids played together outside and it was fun to hear their voices in the backyard.  I think it was a good distraction for Haven and Lyric to have some friends to play with them.  They came up periodically.  Haven was particularly interested and wanted to hold me through some “belly squeezes.”  Lyric came up and saw me have a contraction on the toilet and looked a little concerned, but when she saw everyone’s smiling faces (including mine) she seemed reassured.

Birth teamI stayed in the tub most of the time, leaning on Kyle and moaning through contractions.  Miranda was rubbing my back, and Stacie and Jessica would wipe my forehead and hold my hand if I needed them to.  Everyone was perfectly in sync and were exactly what I needed!  If one of them had to leave the room for something it felt like there was a definite void.  The contractions were getting more intense and taking on a different quality.  The contraction itself felt mostly muscular, but during the peak they started to take on a skeletal quality as well.  I just felt like my whole pelvis felt sort of achy.  This was different than my births with Haven and Lyric.

Kyle and IIt turns out that this was because Seren was facing sunny side up.  For those of you who don’t know, most babies come out OA (occiput anterior, or facing mom’s back).  If a baby is OP (occiput posterior, or facing mom’s front) there is usually a greater surface area to the head and the back of the head pushes into mom’s sacrum causing what’s called “back labor.”  Because I was carrying Seren totally different than Haven and Lyric (Seren’s back was always on the right, the girls were always on the left) this was my number one fear!  I’ve been at births with women experiencing back labor that described it like an axe embedded in their back, even in between contractions. It can also cause a lot of false starts to labor, long labors, long pushing stages, etc.

I didn’t want this to happen to me!  The completely ironic thing was that I never had back labor.  Besides the sort of aching in my pelvis it was completely normal!  Not only that but it was by far my fastest birth!  Apparently I have one of those pelvises that can accommodate an OP baby.

Around 8 pm things started to get really intense.  The contractions were coming about every 3 minutes and it was getting more and more difficult to relax through them.  In between, however, I was really able to relax and be present and happy about my baby being born that day.  I asked to have some music played (Heart Sutra: Bliss and Serenity) and it just made me cry!  It was the music that was playing at our wedding and at Lyric’s birth, and it made me think of when my last sweet baby was born.

Getting more difficultI was starting to think that this intensity was going to last forever.  I had only been checked once (I had GBS, group B strep, in my urine and everyone agreed on keeping vaginal exams to a minimum) and I had no idea how close I was to giving birth.  I also had never lost any of my mucous plug or had any bloody show, the usual signs that you’re getting closer.  I was starting to think I couldn’t do it.  Jessica said, “Don’t worry, she’s just packing up her womb” which made me laugh.

And then everything happened at once, LITERALLY!  I felt a huge gush as my water broke like a torrent.  I immediately started projectile vomiting (on Kyle, sorry babe!), and as soon as that subsided I felt her stretching my perineum.  I shouted, “She’s coming NOW, go get Haven!” and that was all I could muster before my body took over and started to bear down.  It was the most amazing, crazy, beautiful, frightening thing I’ve ever felt!  Haven’s pushing and birth had been very coached (first baby, epidural) and even though I waited for a while with Lyric I never had that urge to push.  This was completely different.  My body took over and it was like I was hanging on by my fingernails!  Jessica told me later, “It’s like throwing up except it’s throwing down,” which is exactly how it felt!  I’d never realized how strong the fetal ejection reflex is.

She's born!Kyle jumped in the tub to catch Seren like we planned (in his clothes, there was no time to put on a swimsuit) and Haven did as well.  A few minutes later Seren’s head was born, it whipped around like a corkscrew, then shoulders, and then she was out.  I couldn’t believe how aware I was of every sensation.  I could feel every contour of her body as she came out and there was such a relief once she was out.  I had really wanted not to tear with this one like I did with the others and had told everyone prenatally that I wanted reminders to go slowly, stretch, breathe her out, etc.  Now everything was happening so fast that I felt like my my mind was telling my body “Slowly, breathe!” and my body was saying, “Nope, here we go, out she comes!”  Even so, Stacie told me later that my body eased her out beautifully, that it took breaks when it should have to let her rotate, that I stretched wonderfully, etc.  In fact I didn’t need stitches after all!  I only had a “skid mark” that would heal if I rested enough postpartum.

FamilyFrom my water breaking to Seren coming out was just 6 MINUTES!  At this point Lyric was upstairs as well.  We had tried to get her up here for the birth but everything happened so fast there just wasn’t a good opportunity.  She jumped in the tub with us and started blowing bubbles in the birth water (oh well)!  The girls took turns smooching Seren’s head and Lyric kept pointing to her saying “Baby, nursing!” though quizzically looking at my empty belly.

Beautiful girlWe all looked our new baby over.  No one could get over the fact that she was such a pretty baby!  So perfect and chubby with a button nose and sweet little rosebud lips and a little round head.  She reminded me a lot of Haven, especially the nose.

Since she came out so fast Seren was a little stunned.  Her APGARs were 8-8 (off for color and tone) but her respirations and heart rate were as perfect as it had been during labor.  A little postural drainage from Jessica helped her get some of the gunk out and then she pinked up quite nicely (no bulb syringes at this birth thank you very much!).  Kyle felt that the cord was still pulsing so we knew that she was still getting lots of oxygen from the placenta.  About 25 minutes later Seren latched on (and I got a dose of Angelica herb), and I felt cramping and pressure, as well as a little separation gush of blood.  Then I pushed out the placenta.  All in all I only lost 250 cc’s of blood, which is really great!

In bedWe decided to go and get cozy on the bed as a new family.  Seren kept nursing like a champ.  After a long while of that I got up to try and pee and Kyle took Seren for a while.  He was such a sweet daddy, smooching and loving on her.  He had waited for a long time to hold an itty bitty baby.

Haven cutting Seren's cord

Haven cutting Seren's cord

I came back and we did the newborn exam and of course she was perfect, term, and healthy!  Stacie helped Haven to cut the cord like she had been telling her preschool teachers for months.  Then Haven got to hold her (Kyle had to put Lyric to bed, she was so tired) and Miranda made placenta prints which turned out beautiful.  I was feeling great and Seren was nursing and pink and beautiful when everyone went home.  In fact, Seren nursed until 2:30 am when I finally cut her off and gave her my pinkie finger so I could get some sleep.  She’s still a champion nurser.

It was by far the most perfect, lovely, empowering, beautiful birth I could have ever hoped for!  I absolutely loved giving birth in my own home because I could settle into my space and my body and it made everything really peaceful and manageable.  I wouldn’t do it any other way!

Daddy smooches

Our midwife Stacie Meredith

Our midwife Stacie Meredith

Haven holding her sister

Haven holding her sister

Seren's first morning

Seren's first morning

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The Safety of Home Birth – New Study of 530,000 Women

A recent study in the Netherlands, a country known for it’s fantastic maternal and infant outcomes, has proven that home birth is safe.  It is the largest study of it’s kind and found that low-risk women planning to give birth at home had as good outcomes as low-risk women birthing in the hospital.

Check it out!

Home births ‘as safe as hospital’

Newborn baby

There have been few comprehensive studies into home births

The largest study of its kind has found that for low-risk women, giving birth at home is as safe as doing so in hospital with a midwife.

Research from the Netherlands – which has a high rate of home births – found no difference in death rates of either mothers or babies in 530,000 births.

Home births have long been debated amid concerns about their safety.

UK obstetricians welcomed the study – published in the journal BJOG – but said it may not apply universally.

The number of mothers giving birth at home in the UK has been rising since it dipped to a low in 1988. Of all births in England and Wales in 2006, 2.7% took place at home, the most recent figures from the Office for National Statistics showed.

The research was carried out in the Netherlands after figures showed the country had one of the highest rates in Europe of babies dying during or just after birth.

FROM THE TODAY PROGRAMME

It was suggested that home births could be a factor, as Dutch women are able and encouraged to choose this option. One third do so.

But a comparison of “low-risk” women who planned to give birth at home with those who planned to give birth in hospital with a midwife found no difference in death or serious illness among either baby or mother.

“We found that for low-risk mothers at the start of their labour it is just as safe to deliver at home with a midwife as it is in hospital with a midwife,” said Professor Simone Buitendijk of the TNO Institute for Applied Scientific Research.

“These results should strengthen policies that encourage low-risk women at the onset of labour to choose their own place of birth.”

Hospital transfer

Low-risk women in the study were those who had no known complications – such as a baby in breech or one with a congenital abnormality, or a previous caesarean section.

Nearly a third of women who planned and started their labours at home ended up being transferred as complications arose – including for instance an abnormal fetal heart rate, or if the mother required more effective pain relief in the form of an epidural.

The NHS is simply not set up to meet the potential demand for home births
Louise Silverton
Royal College of Midwives

But even when she needed to be transferred to the care of a doctor in a hospital, the risk to her or her baby was no higher than if she had started out her labour under the care of a midwife in hospital.

The researchers noted the importance of both highly-trained midwives who knew when to refer a home birth to hospital as well as rapid transportation.

While stressing the study was the most comprehensive yet into the safety of home births, they also acknowledged some caveats.

The group who chose to give birth in hospital rather than at home were more likely to be first-time mothers or of an ethnic minority background – the risk of complications is higher in both these groups.

The study did not compare the relative safety of home births against low-risk women who opted for doctor rather than midwife-led care. This is to be the subject of a future investigation.

Home option

But Professor Buitendijk said the study did have relevance for other countries like the UK with a highly developed health infrastructure and well-trained midwives.

Women need to be counselled on the unexpected emergencies which can arise during labour and can only be managed in a maternity hospital
RCOG

In the UK, the government has pledged to give all women the option of a home birth by the end of this year. At present just 2.7% of births in England and Wales take place at home, but there are considerable regional variations.

Louise Silverton, deputy general secretary of the Royal College of Midwives, said, the study was “a major step forward in showing that home is as safe as hospital, for low risk women giving birth when support services are in place.

“However, to begin providing more home births there has to be a seismic shift in the way maternity services are organised. The NHS is simply not set up to meet the potential demand for home births, because we are still in a culture where the vast majority of births are in hospital.

“There also has to be a major increase in the number of midwives because they are the people who will be in the homes delivering the babies.”

Mary Newburn, of the National Childbirth Trust, said: “This makes a significant contribution to the growing body of reassuring evidence that suggests offering women a choice of place of birth is entirely appropriate.”

The Royal College of Obstetricians and Gynaecologists (RCOG) said it supported home births “in cases of low-risk pregnancies provided the appropriate infrastructures and resources are present to support such a system.

But it added: “Women need to be counselled on the unexpected emergencies – such as cord prolapse, fetal heart rate abnormalities, undiagnosed breech, prolonged labour and postpartum haemorrhage – which can arise during labour and can only be managed in a maternity hospital.

“Such emergencies would always require the transfer of women by ambulance to the hospital as extra medical support is only present in hospital settings and would not be available to them when they deliver at home.”

The Department of Health said that giving more mothers-to-be the opportunity to choose to give birth at home was one of its priority targets for 2009/10.

A spokesman said: “All Strategic Health Authorities (SHAs) have set out plans for implementing Maternity Matters to provide high-quality, safe maternity care for women and their babies.”

Great Midwifery Article in the LA Times

Here’s a wonderful pro-midwifery article in the LA Times!

I also have the text here:

Midwives deliver

America needs better birth care, and midwives can deliver it.

By Jennifer Block
December 24, 2008
» Discuss Article (23 Comments)

Some healthcare trivia: In the United States, what is the No. 1 reason people are admitted to the hospital? Not diabetes, not heart attack, not stroke. The answer is something that isn’t even a disease: childbirth.

Not only is childbirth the most common reason for a hospital stay — more than 4 million American women give birth each year — it costs the country far more than any other health condition. Six of the 15 most frequent hospital procedures billed to private insurers and Medicaid are maternity-related. The nation’s maternity bill totaled $86 billion in 2006, nearly half of which was picked up by taxpayers.

But cost hasn’t translated into quality. We spend more than double per capita on childbirth than other industrialized countries, yet our rates of pre-term birth, newborn death and maternal death rank us dismally in comparison. Last month, the March of Dimes gave the country a “D” on its prematurity report card; California got a “C,” but 18 other states and the District of Columbia, where 15.9% of babies are born too early, failed entirely.

The U.S. ranks 41st among industrialized nations in maternal mortality. And there are unconscionable racial disparities: African American mothers are three times more likely to die in childbirth than white mothers.

In short, we are overspending and under-serving women and families. If the United States is serious about health reform, we need to begin, well, at the beginning.

The problem is not access to care; it is the care itself. As a new joint report by the Milbank Memorial Fund, the Reforming States Group and Childbirth Connection makes clear, American maternity wards are not following evidence-based best practices. They are inducing and speeding up far too many labors and reaching too quickly for the scalpel: Nearly one-third of births are now by caesarean section, more than twice what the World Health Organization has documented is a safe rate. In fact, the report found that the most common billable maternity procedures — continuous electronic fetal monitoring, for instance — have no clear benefit when used routinely.

The most cost-effective, health-promoting maternity care for normal, healthy women is midwife led and out of hospital. Hospitals charge from $7,000 to $16,000, depending on the type and complexity of the birth. The average birth-center fee is only $1,600 because high-tech medical intervention is rarely applied and stays are shorter. This model of care is not just cheaper; decades of medical research show that it’s better. Mother and baby are more likely to have a normal, vaginal birth; less likely to experience trauma, such as a bad vaginal tear or a surgical delivery; and more likely to breast feed. In other words, less is actually more.

The Obama administration could save the country billions by overhauling the American way of birth.

Consider Washington, where a state review of licensed midwives (just 100 in practice) found that they saved the state an estimated $2.7 million over two years. One reason for the savings is that midwives prevent costly caesarean surgeries: 11.9% of midwifery patients in Wash- ington ended up with C-sections, compared with 24% of low-risk women in traditional obstetric care.

Currently, just 1% of women nationwide get midwife-led care outside a hospital setting. Imagine the savings if that number jumped to 10% or even 30%. Imagine if hospitals started promoting best practices: giving women one-on-one, continuous support, promoting movement and water immersion for pain relief, and reducing the use of labor stimulants and labor induction. The C-section rate would plummet, as would related infections, hemorrhages, neonatal intensive care admissions and deaths. And the country could save some serious cash. The joint Milbank report conservatively estimates savings of $2.5 billion a year if the caesarean rate were brought down to 15%.

To be frank, the U.S. maternity care system needs to be turned upside down. Midwives should be caring for the majority of pregnant women, and physicians should continue to handle high-risk cases, complications and emergencies. This is the division of labor, so to speak, that you find in the countries that spend less but get more.

In those countries, a persistent public health concern is a midwife shortage. In the U.S., we don’t have similar regard for midwives or their model of care. Hospitals frequently shut down nurse-midwifery practices because they don’t bring in enough revenue. And although certified nurse midwives are eligible providers under federal Medicaid law and mandated for reimbursement, certified professional midwives — who are trained in out-of-hospital birth care — are not. In several state legislatures, they are fighting simply to be licensed, legal healthcare providers. (Californians are lucky — certified professional midwives are licensed, and Medi-Cal covers out-of-hospital birth.)

Barack Obama could be, among so many other firsts, the first birth-friendly president. How about a Midwife Corps to recruit and train the thousands of new midwives we’ll need? How about federal funding to create hundreds of new birth centers? How about an ad campaign to educate women about optimal birth?

America needs better birth care, and midwives can deliver it.

Jennifer Block is the author of “Pushed: The Painful Truth About Childbirth and Modern Maternity Care.”

Fabulous Sibling Prep Book!

I just got the best sibling prep book for any sibling and/or parent who is interested in attending a birth.  My Brother Jimi Jazz follows the story of Trinity as she prepares for the birth of her new baby brother.   It’s frank and honest, but still very beautiful.  It has the laboring mom in all these great, active positions like hands and knees and squatting.  It talks about making birth noises, the crowning, umbilical cord, how the placenta looks like a tree, everything!  The book has great illustrations that are both realistic and beautiful.  I think this book is essential to anyone planing to have a child attend a birth!  Of course, it is a part of my lending library.  You can view the author/illustrator/mama/doula’s website here.  You can purchase it from Attachments Catalog and it’s a little cheaper.  She also has a new book on breastfeeding that I’m interested in buying.

New book/dvd in my library!

I’m so excited, I just ordered a new book/dvd set entitled “I Watched My Brother Being Born.” I think it’ll be great to add to my list of kids books and a resource for my Sibling Doula niche.

Here is a synopsis for the book:

This book by mother and daughter team Anne and Katarina makes a great compliment to the DVD by the same title. Katarina and her five year old brother Magnus watch their baby brother being born and tell about it in this charming and fact-filled book. The book takes on the voice of Katarina but also has an introduction for parents.

“My goal with this book is to teach our children that giving birth is a natural, safe and fulfilling process. Unless the birthing mother has an illness that needs special medical attention, it need not be treated like a disease. By including our children at birth they can see that it is a normal and healthy physical event…”

Illustrative photos from Anne’s third childs actual birth at home in a birthing tub make this book a rare find.

Here is a synopsis for the dvd:

I’m really excited about this great DVD that shows home water birth with children present. This is a great tool you can use to get your child(ren) ready to experience the birth of a sibling. This 21 minute movie is about two siblings ages five and seven who are present for their brother’s home water birth. Partially told in the voice of seven year old Katarina, this is an excellent resource for expectant parents and birth professionals who are wanting to prepare children for the arrival of a new baby. A paperback book version seen above is also available which is a great accompaniment to watching the video. 21 minutes long.

Choosing a Birth Attendant

Most people see pregnancy as a time to prepare for the baby.  I see early pregnancy as a time to figure out what you want before you even go to your first appointment.  A lot of women don’t even think about the actual birth until a few months or weeks before the baby is born!  It can be difficult to make a change that late in the game.  You should choose the provider who has the same philosophy as you instead of hoping to change them by the end of the pregnancy.

Tips for choosing a birth attendant

  • Think about your core birthing philosophy.  Do you feel that birth is a natural physiological process?  If so, a midwife is your best bet.  Do you have physical issues that dictate that there could be a potential problem?  Do you see birth as dangerous with lots of opportunities for things to go wrong?  Then an OB might be your preferred provider.
  • Visit The Birth Survey, a consumer reporting site dedicated to birth.  Go to rate your OB, midwife, and place of birth.  As of now the site is just up and running and they should have formulated the results by Fall of 08
  • Get recomendations from people who share your birthing point of view, visit online forums (like mothering.com) and ask questions.
  • Interview your potential care provider.  Remember, they are working for you, not the other way around.  Related posts:  Interviewing your OB, Interviewing your Midwife, and Interviewing your Place of Birth
  • Create a birth plan well before your second or third trimester.  Going to your provider interview with a birth plan or at least an idea of what you want can help you ask the right questions.  Just make sure to not be negative or badger the doctor!
  • How much one-on-one, hands-on support do you want during pregnancy? Midwives generally treat the whole woman:  mentally, physically, socially, psychologically, spiritually.  Prenatal appointments generally last about an hour and they are usually there for the majority of labor and birth.  OBs on the other hand are primarily surgical specialists who have a prenatal appointment time of about five minutes and generally just come in at the end to catch the baby.
  • How much involvement do you want in your pregnancy and birth? Many times in midwifery practices the mom gets to do her own urine dip and weigh herself at her appointments.  The midwife tries to explain things to her and tries to get her to interact during her visits.  An OB visit is more in-and-out with the nurses doing everything behind the scenes.
  • Where do you want to give birth? Some women just go to an OB because they think they’re supposed to and then realize late in pregnancy that they want a home birth!  Where you give birth automatically dictates who will be there.  For example in Colorado at this time, OBs work in the hospital, only Certified Nurse Midwives (CNM) can work at a birth center, and Certified Professional Midwives (CPM) and CNMs can do home births.  Most CNMs (90-95%) work with doctors in the hospital.
  • Do you want to have a waterbirth? Some hospitals allow it, some do not.  If you have to give birth in a hospital and want to fight a policy that does not allow waterbirth, having a provider who supports it can go a long way.  Yes, it is possible to change hospital policy!  In Gentle Birth Choices Barbara Harper talks about how to do this.
  • Choose someone you’re comfortable with. If you’re not comfortable with your provider there is no way you can let your body open up and relax enough to have a baby.
  • If a provider or place (like home or birthing center) is out of your insurance network, talk to your insurance provider.  Also, often times a home birth or birthing center is cheaper even though you have to pay in full.  For example, in Colorado a typical, no-intervention birth in a hospital usually costs around $12,000-13,000.  In an insurance plan where you pay 10% of hospital and doctor’s costs you’re looking at a few thousand dollars.  A home birth or birth center birth usually costs around that if you’re paying in full.
  • Do you feel more comfortable with a male or female doctor?  Remember that just because a doctor is female doesn’t mean she believes in the same birthing philosophy as you do.