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The Essential Homebirth Guide

When it comes to books on birth, Seattle has a best-selling reputation to uphold.

After all, this is where renowned doula, childbirth educator and author Penny Simkin has penned several revered books on the topic, including Pregnancy, Childbirth, and the Newborn: The Complete Guide (now in its fourth edition) and The Birth Partner: A Complete Guide to Childbirth for Dads, Doulas, and All Other Labor Companions (now in its third edition).

This winter, the city became the birth place of one more essential tome –The Essential Homebirth Guide for Families Planning or Considering Birthing at Home, written by local certified professional midwives Jane E. Drichta and Jodilyn Owen.

Laid out in an easy to navigate system of overarching chapter topics, subtopics and question-and-answer sets, the guide covers everything you need to know – and ask – if you are considering or planning to deliver your baby at home.

It is important to note, however, that this book is not a traditional childbirth preparation book. There are no anatomical drawings of the uterus. While it does touch briefly on how to cope with labor discomfort – aptly located under the question, "I'm in labor and it hurts! What do I do?" – it does not go into great depth. For more on the anatomy and physiology of birth as well as pain-coping strategies for labor, Simkin's books and/or a childbirth education course are a good idea.

The Essential Homebirth Guide does, on the other hand, offer some great non-jargon answers to questions rarely found in other books, but often on the minds of pregnant women, from potential vitamin D deficiency, to the issue about cats, to hyperthyroidism.

Equally critical, it helps a woman determine whether or not home birth is for her. It offers solid advice on how to communicate the decision to birth at home to others, how to choose a provider, and what to expect in special circumstances like the discovery that your baby is breech. It simplifies common pregnancy-related issues and provides both hope and strategies for overcoming them.

Drichta and Owen write in a swift-moving and easy-to-understand voice that makes even the most complicated topic understandable. Throughout the book, they integrate vignettes and commentary from real home birthing women, giving the whole reading experience a more personal feel, a bit like sitting around a table with girlfriends.

For those who have chosen home birth, the guide offers ample information on what to expect during prenatal visits, what tests are common, how to prepare for a home birth, what you need on hand, when to call the doula or midwife, and what to do to keep labor moving smoothly forward. It also provides useful information on navigating the sometimes difficult postpartum period.

The Essential Homebirth Guide could not have been published at a better time. The number of women birthing in their homes has been going up across the nation over the past decade, just as the number of certified professional and licensed midwives (who deliver babies outside of hospitals either at home or in free-standing birth centers) has climbed. And the percentage of women birthing at home in Seattle/King County is particularly high, nearly 2 percent compared to .72 percent nationwide.

The authors are not shy about controversial topics, some of which have long divided the maternity care community. Should a mom attempt a homebirth after a cesarean? Is twin birth safe at home? How about breech? Is water birth safe?

"No doubt, everyone's comfort level is different and women (and their healthcare providers) process and understand risk in very individual ways," wrote Seattle doula and educator Sharon Muza in a review posted on the Lamaze International research blog scienceandsensibility.org. "These situations may not be for everyone, but the authors don't ignore that these birth situations are occurring at home all around the country. Information is power; mothers, when given accurate information in a respectful manner, will be able to determine what feels like the right decision for them."

An Interview with Jane E. Drichta and Jodilyn Owen

Why did you decide to write this book?

We decided to write this book after years of searching for one resource that provided meaningful information in the context of trust in mothers and babies. We were sending women to certain chapters of books, bits and pieces of movies, articles, handouts, and websites. This book provides one coherent place where families can access detailed information about their pregnancy, birth, and early mothering in an accessible format. It is designed to boost confidence and knowledge in the process, the journey, and a woman's day-to-day experience with pregnancy.

What does it offer families that others do not?

As part of our pre-writing research, we looked at just about every home birth book out there. Most were extremely outdated; the demographics of home birthers have changed radically since the late 1980s and early 1990s. We didn't find a lot of books written by midwives which detail the midwifery model of care and what that really means for mothers and families. Many books out there seemed so prescriptive – they were all about telling women what they needed to do to have a great birth. That's not really how we roll. We wanted to build up mothers' confidence in themselves, and help them uncover how they felt about home birthing, so they could make meaningful decisions around it. And we wanted to do it with a minimum of technical jargon.

Did you learn anything in the writing/researching of it?

We learned to follow our own inner-guidance systems about how we share information. The biggest pregnancy books out there are fear-based and full of sarcasm about what we believe to be a transformative and critical time for women in their lives. While that does seem to sell a lot of books, it does not reflect what we know about expecting families: that they are smart, capable, and searching for relevant information. Bringing that tone forward, and letting our sense of what we wanted to share guide us, was a wonderful growth experience.

Why is this book important?

There is no other book that covers pregnancy and birth in a nonjudgmental, nonprescriptive way. Although we wrote it for parents planning or considering a homebirth, experts like Dr. Christiane Northrup have hailed it as a necessary read for all pregnant mothers. This is a book mothers can read before bed and then fall asleep and have happy dreams about everything they are capable of.

If you had three pieces of wisdom to share from this book -- the three things you would want families to take away from it – what would they be?

Women are strong, capable, and fabulously designed for the work of pregnancy, birth, and early mothering. While every woman is amazing in all of her pregnant glory, we are all just links in the chain, connecting us to all women since the first woman birthed, and to women around the globe who are birthing today. This context helps normalize the experience of pregnancy and birth as healthy and meaningful and normal in a woman's life. (See chapter one: "The Story of Homebirth.")

Great things happen between midwives and the families they serve. The long appointments, focus on relationship and individualized care, and the esteem with which midwives hold mothers, all matter deeply. This care propels women forward into their mother-selves in a healthy, supported way. (See chapter three: "Prenatal Care with a Homebirth Midwife.")

A mother is the natural habitat for her new baby. Just like certain animals and plants have a symbiotic relationship with the rainforest, a newborn needs his mother, and a mother needs her newborn. In the profound act of holding a new baby, a mother is providing physical and emotional nourishment that helps the baby make sense of herself and her environment, regulates her heart beat and breathing, and keeps the baby at just the right temperature for comfort and health. (See chapter 11: "The Postpartum Period.")

Is homebirth for every woman?

Homebirth is not for every woman. Of course, some women risk out of homebirth for health-related reasons. We include a brief appendix for "High Risk Mamas with Homebirth Hearts," and hope that these women find loving providers and surround themselves with a great support team. There are other times that homebirth is not a good fit. A healthy, low-risk mother needs to feel safe where she is birthing. She needs her family to support and agree with her choices. We encourage women to sit quietly and envision their birth. Who is surrounding you? What does the environment look like? Sound like? Feel like? What kind of new mother do you want to be – in those first moments after birth – and who do you need around you to be that mother? Every woman's answers will be unique, but she can gather some information together and begin to make the choices that will help her reach her goal.

Who is a good candidate?

A good candidate for homebirth is a woman who is healthy, has no outstanding risk factors that need higher level care than homebirth midwives can provide, and who wants to fully engage in her care and birth. Homebirth is not the place where you hand over the decision making in your care. Midwives rely on shared decision making, providing education, resources, and support as parents make their way through their pregnancies and births. This process is not always easy, and we have several stories from mothers who share their experiences with this shift.

Jodilyn Owen is a Certified Professional Midwife and owner of the local community-oriented Essential Birth & Family Center in South Seattle, where she lives with her husband and children.

Jane Drichta is a Certified Professional Midwife and owner of Equinox Healing Arts in Ballard, where she lives with her husband and daughter. Learn more about Owen and Drichta at EssentialMidwifery.com.

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