“Our goal is not to have every mother birth at home—our goal is to encourage parents to gather quality information, to gain exposure to a philosophy that screams trust in mothers and trust in babies, and to provide parents who do plan a homebirth to be well equipped with an understanding of how to thrive in that decision.” – Jane E. Drichta, CPM and Jodilyn Owen, CPM, authors of The Essential Homebirth Guide: For Families Planning or Considering Birthing at Home.
The Essential Homebirth Guide: For Families Planning or Considering Birthing at Home by midwives Jane E. Drichta, CPM and Jodilyn Owen, CPM is a new book on the birth scene, being released today both in print and as an e-book. I had an opportunity to read an advanced copy and and will share my thoughts with Science & Sensibility readers in this review.
The Essential Homebirth Guide is a book that is long overdue and will be welcomed by consumers and healthcare providers alike. With the recent National Birth Center Study II released last month, many women and their families may now be considering an out of hospital (OOH) birth. Some areas of the US offer the opportunity to birth in a birth center, while other parts of the country have no birth centers available at all and homebirth is the only OOH option. Even where birth centers are available, women in greater numbers are now considering birthing in their own homes, with midwives, for many reasons, including comfort, cost and choosing a location where they feel they have the best chance to achieve a low intervention birth.
Sitting down to read Drichta and Owen’s guide is like spending a long weekend with your very best friend. A best friend who just happens to be a midwife. Whether you are just starting to explore the idea of a homebirth or have already decided that homebirth is for you, you will find that all your questions get answered in an easy to understand, factual way, with all the details and inside information that only your best friend can provide. Drichta and Owen even provide answers to the questions you hadn’t thought of yet, but would want to know if you choose to homebirth, such as the section on communicating your homebirth choices with friends and family.
The book is arranged into chapters, and then subtopics. Each subtopic has a nice Q&A format, with all the major questions covered in easy to understand language. Peppered amongst the topics are real life stories and musing submitted by homebirthing women and their families, as well as special “The Midwife Says:” sections that provide additional information. The personal stories offer a peek into the thoughts and experiences of homebirthing women, and readers will feel comforted by their stories. References are included for each chapter, and there are several hearty appendices at the back for more information. Lovely black and white pictures are scattered throughout.
One of the things that I loved best in The Essential Homebirth Guide is how the authors use every opportunity to speak to the mother, helping to develop her self-determination. Throughout the book, they reinforce that every mother knows both her body and her baby best. Women who read this book will feel confident that they are (or should be) equal partners in their care with their healthcare provider and are capable of asking questions, gathering information and making decisions that feel right to them.
“…A lot happens between the time of conception and diapers, and it all matters. It will affect you. It will change you. It will propel you into motherhood in a profound way and can leave you with feelings of power, health, and peace, or it may leave you with feelings of anxiety, fear, and even trauma. What kind of emotional context do you want as you become a new mother? What kind of new mother do you aim to be? Think about these questions first, and then start building your prenatal care to lead yourself down the road that ends with you – the kind of new mother you intend to become in the kind of health you strive to have…” The Essential Homebirth Guide
Chapters on interviewing and choosing a midwife, what to expect during your prenatal care, prenatal testing options, information on the top ten pregnancy issues, preparing to birth at home, and what to expect after the birth all provide details on what normally occurs and include topics that can be discussed with your midwife along with things you can do to keep yourself healthy and low risk. In fact, this book is useful for any pregnant woman, as it will help facilitate conversations with hospital based healthcare providers, to help the woman who has chosen to birth in the hospital avoid unnecessary interventions.
Drichta and Owen tackle some controversial subjects such as homebirth after a cesarean, home breech birth and homebirth of twins. No doubt, everyone’s comfort level is different and women (and their healthcare providers) process and understand risk in very individual ways. 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.
I would have appreciated more information in the book on how low income families and women of color might find their way to homebirth in today’s maternity care climate, as the increase in homebirths has not been observed amongst those populations. Where I live, in the state of Washington, almost half of our births are paid for by the state, and we are fortunate that homebirth is an option for those families receiving state aid. That is not the case for most of the rest of the country.
I had the opportunity to ask Jane Drichta and Jodilyn Owen some questions about their book, and wanted to share my interview with Science & Sensibility readers.
SM: Why did you want to write this book, and why now?
JO: This book has been running around in circles inside of our heads for years. We make it a habit to check in with each other after most births, and so there are at least a decade of late night conversations here. As we talked, we realized that we were running into the same problem; there was not one definitive source of information for homebirthing families. We had websites and articles and handouts, but not one place where we could send parents for unbiased, evidence based information, served up with sides of common sense and love. Homebirth is becoming more and more popular, and the time just seemed to be right.
SM: What was the most challenging topic for you to cover in the book? How did you handle it?
JD: The chapter on The Big Ten, which details ten common complications in pregnancy, was difficult to write. We are used to speaking around these topics in very technical terms, and it was difficult to distill the information down to what mothers needed to know. We were more interested in providing a model for how we approach these issues that any woman can adapt to her situation than being prescriptive about what one must absolutely do in a given situation. When we started that chapter, it sounded like we were writing a term paper. We completely lost the friendly, accessible tone that we were going for. So that was a challenge.
SM: What is the main piece of information that you hope that women will know/take away after finishing your book?
JD: That they can do this. That birthing at home is a viable option in 21st century America. That the desire to do this doesn’t mean you are crazy or hate the patriarchy, or that any of the other homebirthing stereotypes apply. Women can birth at home more safely than ever before, and it is a real alternative for most women.
SM: What challenges do you see facing the potential growth of homebirths in the US?
JO: The integration of homebirth midwives into our current health care system. The politics around midwifery and its place in the system are myriad, and not something that we wanted to get into in the book. However, we do support the right of women to birth in the place of their choice, with the provider of their choice, and that is sometimes difficult and can be limiting.
SM: If midwives and doctors read this book, what do you hope they take away from it?
JO: We hope they take away a few key points: That mothers and partners should be held responsible to seek information and share decision making in their care, that a pregnant and birthing woman is in partnership with her baby and this dyad perspective should be promoted at all times with the language and behavior providers use, and that a woman is never just her numbers—she is a whole human being with a context worthy of their curiosity and respect.
SM: How can childbirth educators use this book with their students?
JD: Simply presenting this paradigm of woman-centered, individualized, continuous care is a great way to open the door for discussions about creating intention for pregnancy and birth. What is it that parents really mean to establish for themselves when it comes to their care and birth? Understanding risk, breaking apart decision-making models, and tuning in to their inner-wisdom are just some of the great tools that educators can work through.
I wanted to see what the authors had to say about childbirth classes for women considering homebirth and was delighted to find that they encourage all women to take classes and hold Lamaze International and our Healthy Birth Practices in high esteem. “We can’t find anything not to love here” is found in the childbirth class section under the Lamaze heading..
Overall, I really enjoyed reading this book and found it to be an easy read and full of information that I would find useful if I was still deciding where to birth or had already made up my mind to birth at home. I could also see myself referring back to this as my birth got closer. This book acknowledges that I am the best person to make this very personal decision about where to birth my baby. I think that healthcare providers who offer OOH birth services might want a few copies on their bookshelves to lend to potential and current clients, and childbirth educators might very well recommend this resource to parents in their classes who want to know more about what a home birth might be like.
Please consider coming back to the blog and sharing your thoughts after reading the book. I would love to know what you think and if you would recommend this to clients and students. If you would like to contact the authors, they can be reached through their website Essential Midwifery.
Disclosure: The authors of this book and I are all members of the professional birth community in Seattle, WA. I have known them on a professional and personal level long before this book was even conceived.