Choices in Childbirth, NY/CT Region By Joyce Havinga-Droop
It’s all about Birth choices
Did you know you can have a home birth in Larchmont? Did you know you can choose not to have your water bag broken in the hospital? Did you know you can ask to hold your baby, even if you’ve had a cesarean section? Did you know you can walk around and eat or drink while in labor?
As new parents to be there are many choices you need to think of, choosing a name for your baby is only one of them.
When I became pregnant with my youngest in Larchmont, I just was thankful to find a wonderful midwife in a practice of three competent midwifes working out of White Plains. I could not be more pleased with their collective care. Being pregnant at 35 years, they gave me excellent advice in the choices of prenatal tests. Did we really want to do an amniocentesis? What would we do with those results as the results would probably need us to make more choices? Our midwives and a genetic specialist explained those choices, but WE made them.
When I was eight months pregnant third time around, we visited the hospital where I would give birth. I had not contemplated about having a home birth as this was America, and not the Netherlands where homebirth is a common practice. After the visit of the maternity ward, I was convinced that the proximity of the operating room was too close for comfort, also a baby nursery being at the center of the maternity ward, did not appeal to me. But where do you go from here?
With the choice being a home birth, the midwife that saw me at my next prenatal visit gave me the advice I needed. She gave me the names of two “home birth” midwifes, who I set out to interview.
I ended up selecting Anne Margolis CNM, NP, MSN, RNC (www.myhomesweethomebirth.com). She works together with a doula and trained homebirth assistant, Nancy McDaid CD (DONA), CBE. Together, they brought the expertise and experience that allowed me to birth and welcome our baby in our own home. Anne and Nancy worked together as a team to comfort me and work through various positions during labor. When I was exhausted and dehydrated Anne hooked me up to an IV to give me the necessary fluids and rest to rebuild my strength. After that I was able to push that baby out.
Being at home, precious bonding time with our newborn was the big reward. She could just lie on my breast, be admired and respond to her new environment at her own pace. She did not have to be separated immediately to go to a warmer or to be weighed. Only after an hour or so, she was weighed and measured in our own bedroom. Later her sisters came in to meet their new sibling. I would not have wanted to miss these very intimate moments with my family.
Having great hospitals in Westchester that are well equipped and have well trained medical staff brings a great sense of security. However, birthing at home is still a perfectly safe choice to make. Actually, if you are having a home birth and need to go to a hospital for an emergency, the midwife can call ahead to the hospital. If you are already in a hospital and need special care, like a cesarean, it may take an equal amount of time for the hospital to act.
The statistics on home birth are making the point of the safety of home birth. For instance, Anne Margolis’s c-section rate is 4.9%, rate of episiotomy 1.1% as documented by her participation in the MANA statistics project. In contrast, the Westchester c-section rates are between 25 to 53%, compared to an average of 34% nationwide.
Canadian researchers Kenneth Johnson and Betty-Anne Daviss studied over 5,400 low-risk pregnant women planning to birth at home in the United States and Canada in 2000. The researchers analyzed outcomes and medical interventions for planned home births, including transports to hospital care, and compared these results to the outcomes of 3,360,868 low risk hospital births. According to the British Medical Journal press release, they found:
- Medical intervention rates of planned home births were dramatically lower than of planned hospital births, including: episiotomy rate of 2.1% (33.0% in hospital), cesarean section rate of 3.7% (19.0% in hospital), forceps rate of 1.0% (2.2% in hospital), induction rate of 9.6% (21% in hospital), and electronic fetal monitoring rate of 9.6% (84.3% in hospital).
- 97% of over 500 participants who were randomly contacted to validate birth outcomes reported that they were extremely or very satisfied with the care they received.
Some numbers for hospitals inWestchester County , 2007
Primary Cesarean Rate
Attended by Midwife %
Paid for by Medicaid %
Phelps Memorial Hospital Assn
Northern Westchester Hospital
White Plains Hospital Center
Sound Shore Medical Center of Westchester
Westchester Medical Center
Lawrence Hospital Center
Some numbers for hospitals in Connecticut, 2009:
# of C/S
SOURCE: Connecticut Department of Public Health, HISR Section, HCQSAR Unit, August 2009.
The hospitals in Westchester County showed an increase in its c-section rate by 46%, from 30% in 2000 to 43% in 2007. The highest rate of c-sections is at Lawrence Hospital, Bronxville (53%)
What ARE the choices you can make? And how do you make them?
First you need to educate yourself. There are some really great Childbirth Education Classes to attend to get to know all the pro’s and con’s of birthing in our area. After or even before that, you can educate yourself more by reading. Two of my favorites are: “The Thinking Women’s Guide to a Better Birth” by Henci Goer or “Ina May’s guide to childbirth” by Ina May. Now remember there is a whole world out there to explore and educate yourself. Suggestions Anne Margolis makes are: Ina May’s new book “Birth Matters”, and “Pushed” by Jennifer Block, Peggy Vincent’s “Baby Catcher” and “Your Best Birth” by Ricki Lake and Abby Epstein, who also produced the DVD “Business of Being Born”. I also loved “Orgasmic Birth” a DVD and book by Debra Pascali-Bonaro and Elizabeth Davis, a DVD suggested by my midwife, Anne Margolis, when I was pregnant,
Write down what your choices, in first instance, are for the birth you want (birth preferences/ plan) and discuss them with your caretaker. Check your caretakers’ cesarean rates and the hospitals’ cesarean rates etc. Make your preferences flexible though as some things tend to change during birth, as always when there are more people involved. Your birth does not just involve you, your partner and caregiver, there is also a baby involved and he/she might have his/her own plans for this birth.
Some great websites: www.hudsonvalleybirthnetwork.com, www.childbirthconnection.org, www.birthingnaturally.net, www.childbirthconnection.org/pdf.asp?PDFDownload=cesareanbooklet, www.childbirthconnection.org/pdf.asp?PDFDownload=rights_childbearing_women, www.motherlovedoulas.com, www.organicbirthmovie.com.
Another smart choice? Choose a Doula
Another smart choice is to hire a Doula (pronounced DOO-lah). A Doula is someone who provides non-medical support to women and their families during labor and childbirth, and also the postpartum period. Doula comes from Ancient Greek meaning “woman who serves”. This type of labor support companion has the strongest impact on your health and safety during
labor and birth. Compared with women who have no support in labor, women who do have support from a companion who is neither a member of the hospital staff nor a friend or family member are:
• 28% less likely to have a cesarean section
• 31% less likely to use synthetic oxytocin (pitocin) to speed labor
• 9% less likely to use any pain medication
• 34% less likely to rate their childbirth experience negatively.
I had a postpartum doula for two weeks. Yes, I was lucky my insurance paid for it, as many of them do now. Some insurances even pay for a labor doula, just ask. My Doula was Margaret Yawman, CD (DONA), a wonderful, warm mother of four. She mothered me while I was getting precious time to recover from pregnancy and childbirth. She cared not only for me but also for my other two children and kept everything in my household going, so I could stay in bed, feed my baby, heal and get my strength back. She listened to my stories about the birth and the (nightly) feeding schedule of my new born and gave me advice when asked.. She looked up information to keep me well nourished while breastfeeding. She even took a detour during a snow storm one day to pass by Full Circle Family Care (www.fullcirclefamilycare.com) to get me a nipple shield and drove me and the baby to the pediatrician’s office of Dr. Alain A. Le Gouillou, MD, PLLC (www.alainleguillou.com) for our first checkup.
My choice now is to be a Birth Doula. I quit my job to follow my passion after working as an executive secretary for over 13 years in the diplomatic world. My passion is to guide and assist pregnant women in giving them the birth they want and delivering them the empowerment it provides. Building up this sense of confidence and self esteem in making the choices around the birth that serve them well is rewarding. It allows them to look back and be proud of the choices they made for their families.
I have lived in Larchmont for almost 10 years with a wonderful supporting husband and have three lovely daughters (of 12, 9 and 2 years old). After giving birth at home in the US to our youngest, many reactions about my homebirth expressed a lot of unawareness like “I didn’t know it was legal”, “Is it safe to give birth at home?”, “I didn’t know you could do that in the US!”. All clear indications that choices about birth are not well known.
I was trained in New York by Debra Pascali-Bonaro LCCE, BDT/PDT (DONA), co-author of “Orgasmic Birth”. Debra was very inspiring and taught me so much during the training, which made writing this article for the Loop so much easier. I wish for all the pregnant women in Westchester and beyond to get the birth that will empower them and give them huge satisfaction and spirituality during their birth experience.
By Joyce Havinga-Droop , DONA International Trained Birth Doula
16 January 2012, Larchmont