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I’m paralyzed by the thought of birthing in a hospital. But I’m also uncomfortable with a home birth. What should I do?

Excerpt from Asking for a Pregnant Friend: 101 Answers to Questions Women Are Too Embarrassed to Ask about Pregnancy, Childbirth, and Motherhood

I would like to say that the answer is as simple as choosing a birth center (and it might be!). But there’s probably more to this question because it’s really about fear, and choosing a birth center won’t dissolve the underlying fears you may have. So let’s start by exploring why some women are afraid of hospital births.

For many of us, the hospital is associated with injury and illness. It’s the place you go when something is wrong and you need to be poked and prodded. That’s enough to make anyone nervous. In addition, almost every depiction most people have seen of birth was from mainstream media: panicked women being rushed into a hospital, hooked up to machines and an IV, and then screaming at their partner (comedies), or almost dying (dramas). Those are the messages our minds have received about hospital birth. For some women, these images translate into, “I have to birth in a hospital because it’s the only safe place.” For others, they trigger the fight-flight-or-freeze response, making the hospital a suboptimal place for them to birth.

And now for the fear of home birth. Going back to the messages we’ve received from mainstream media, the rare home births shown in prominent shows or movies almost always end in an emergency transfer to a hospital, and the mother regretting her decision to try a home birth. In addition, many people have the misconception that a home birth is dangerous and irresponsible. But the reality is, if a certified midwife who has confirmed you’re a good candidate for a home birth is caring for you, this environment is almost always incredibly safe. An article published in Journal of Midwifery & Women’s Health reported that planned home births for low-risk women result in low rates of interventions, without an increase in adverse outcomes for mothers and babies. The key term in that finding is low risk — if you have special circumstances that could require medical care to keep you and baby safe, a hospital birth is likely the best choice. But if you and baby are all good, a home birth is a viable option.

Taking all this into consideration, it’s easy to see why many women have a tricky time deciding where to birth. However, there is a way through.

What to do

The following exercises and considerations can help you discover what you’re actually afraid of, process the resulting information in a way that helps you make a birthing-location decision you feel good about, and acquire tools to reinforce comfort in your decision:

Break down your fears. Figuring out the makeup of our fears often makes them more manageable.

  • To do this, write Hospital and Home Birth on the top of a page.

Then, under each, write everything about that birthing environment you’re afraid of. Get specific. For example, under Hospital you might write, “The IV. The sterile smell. Infection. A mean nurse. The impersonal energy. Pressure to have invasive interventions.” For Home Birth you might list, “Not being able to get quick care if surgery is needed. The midwife not knowing What to do in an emergency situation. Having to clean up the mess. The guilt if anything goes wrong.”

  • Next, talk to a doctor you trust about your list of fears about a hospital birth. Have them give you the skinny on the object of each of your fears. For example, you can ask what’s the likelihood that it will occur, and if there’s anything you can do to prevent it.
  • Then, talk to a home birth midwife about your list of home-birthing fears.
  • After you’ve had these discussions, sit with the information as you flow through the following suggestions.

Consider a birth center delivery. After you’ve explored your fears, visit a few birth centers. In each one, tune into how the environment and care providers make you feel. Does it seem like a happy medium? Does it make you lean toward a hospital or home birth? Or are fresh fears coming up?

If big doubts still come up, the base of your fears might be more about the process of birth than the environment where you’ll be birthing. In this case, review question 44, about the fear of death during childbirth. This question breaks down the deeper fears of childbirth and provides tools for working through them. After you’ve worked these tools, you’ll likely have more clarity about the birthing environment that’s right for you.

Interview OB-GYNs and midwives. A big factor in how comfortable women are in a birth environment is how safe they feel with their care provider. So I recommend meeting a handful of OBs and midwives (both birth center and home birth midwives) to see if you find some- one who makes you feel heard and protected. This relationship will likely inform where you want to give birth.

Listen to this meditation. The meditation recording at the following link helps you process the information you’ve gathered by walking you through visualizations of what it might be like to birth in each space: yourserenelife.wordpress.com/ideal-birth-space/.

Watch reassuring birth videos. If you Google the terms “HypnoBirthing home birth videos,” “positive home birth videos,” and “Hypno- Birthing hospital birth videos,” you’ll find numerous videos showing home birth and hospital birth in a gentle, positive light. It’s easy for me to tell you how safe birth can be in both settings, but actually seeing women soundly birthing in these environments can go a long way in convincing you.

In addition, look up the video Birth as We Know It — Educational Version on YouTube, as it also shows peaceful births. (Some of the births are a bit unorthodox, but many are really powerful — there’s even an orgasmic birth!)

Know that it’s okay if you’re not totally comfortable in your birthing environment of choice. Regardless of where you choose to give birth, there will likely still be some nervousness when you’re in that space, as it’s where you’ll be going through an intense life change. If you’ve gone through all the steps above and thoughtfully chosen the birth space that feels best, these nerves likely have more to do with what will happen in that environment than the environment itself.

Avoid letting your trepidation spin into intense anxiety by continuously reminding yourself that it’s okay to feel nervous — I can almost guarantee that every birthing woman who came before you felt the same way. And remember that nervousness can absolutely live in harmony with excitement and courage.

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