The Differences Between Home and Hospital Birth

birth, home birth, postpartum, babies, motherhood, hospital births

Before I start writing this story, I would like to say that I believe everyone is doing the best they can with the awareness and training they have. 

When I was pregnant with my son Jasper, I decided to have a home birth so I had no idea what a hospital birth was like until I helped my sister with the birth of my niece Liv. 

My home birth was the hardest thing I’ve ever done but it was also the most empowering and transcendental. Experiencing giving birth with a great team of professionals, at the comfort of my own home was special.

Having my cats around, my bed, my husband and privacy. Also my candlelights, mantras and my dear bathtub with loads of epsom salt made many challenging moments easier and bearable.

I’m at a hospital now, my sister just had her baby. I watched her push on and off for the past 4.5 hours. I’m still trembling as I write this blog. I loved being there for her but I’m disappointed with the hospital's birth protocols.

It seems as if hospitals view birth as nothing more than commercial transactions in which both the hospital and the pharmaceutical industry make tons of money. 

Between all meds and medical intervention, the bliss of the golden hour was not respected. The magic I and everyone experienced after my son’s birth wasn’t there.

Of course it was beautiful to see my sister holding her baby in her arms. We all felt relieved and emotional when my niece came out, but as far as magic is concerned, I didn’t feel it.

 My sister’s hospital birth took me back to the 2008 documentary The Business of Being Born. It powerfully captures what I’m stating — today births take place in a climate of fear, and of bureaucratic control that is really a reaction to that fear. 

A little more about the documentary:

In 2008, Barranca Productions released a documentary called The Business of Being Born, detailing the topic of childbirth. Ricki Lake and Abby Epstein produced and directed the documentary. The documentary explores pregnancy related healthcare in the US, including the history of midwives and obstetrics. The film also discusses potential consequences of medicalized childbirth common in the twenty-first century. The Business of Being Born provides viewers with information about home-births, midwives, and the positive and negative aspects of going to the hospital for childbirth. 
The documentary ripples with insight, with the wise words of midwives, doulas, obstetricians, and mothers who want to recapture the primal reality of the birth experience. And — no small issue — mothers who want to feel powerfully connected to their babies right after they’re born. In a hospital, the baby is taken away from you, which is one reason — not often talked about — that a lot of women have trouble breastfeeding, getting their babies to “latch on.” The organic process of feeding has been interrupted from the start.

There are so many nuances to a hospital birth that I only realized once I experienced it. The process of “latching on” is just one of them. I decided to write down the main differences between a home birth and a hospital birth from a practical point of view. All personal feelings aside. 

Medical Intervention

As my sister got admitted to the hospital, they started giving her pitocin to help speed up the contractions. Afterwards came the epidural to deal with the contractions. Since pitocin makes contractions stronger, it becomes more painful for the mother to handle them so the epidural becomes the natural course of action. 

Aside from pitocin and epidural, they gave her antibiotics, and pain medication. I understand medical intervention is needed when things are going wrong, but why so much intervention in a healthy mother and baby? Just to speed things up? Why get in the middle of the natural process of birth? Have we stopped trusting our bodies? Have we given our power away to the medical system?

As Baby Enters The World

The doctor grabbed my niece from her mama’s vagina with more force than necessary. She wasn’t gentle by any means. Though my niece is doing well, I remember when I was birthing my son at home, my midwife was there to give us safety. Instead of pulling him out, she allowed the baby to come out naturally. 

 Instant Removal Of The Vernix Caseosa 

When mama finally held her baby for the first time, they had no privacy. There was a nurse right in their faces wiping the vernix out of my niece's little body. She was wiping it so hard, I asked her to stop but she didn't hear me.

Unfortunately, I was late to the game. In order for them not to remove the vernix, I had to have asked for it in the birth plan. If you don't know what vernix is,the vernix caseosa is a protective layer on your baby’s skin. It appears as a white, cheese-like substance. It helps protect the baby in the womb, but its benefits also extend beyond the womb.

The benefits of the vernix caseosa aren’t limited to pregnancy: This coating also benefits your baby during and after the delivery. Regardless of how little or how much of the substance remains on your baby’s skin after birth, consider keeping the vernix caseosa on your newborn’s skin for as long as possible. This means delaying the first bath.

 

Benefits of this natural protectant include the following:

  • It has antimicrobial properties. Lubrication through the birth canal. Helps regulate a baby’s body temperature.
  • Moisturizes your baby’s skin. Antioxidant properties. Wound healing properties.

A consensus statement based on the results of the study directed “removal of all vernix is not necessary for hygienic reasons” and “vernix may provide antibacterial promotion and wound healing”. Interestingly, the World Health Organization (WHO) also recommends leaving vernix intact on the skin surface after birth. 

Super Bright Lights

My niece was only on my sister’s chest for about one minute. Afterwards, she was taken to get checked where she was placed under a very strong white light. I stayed by her side covering her eyes with my hands to make sure she was a bit more comfortable. 

I kept on telling her, “baby girl everything is okay, aunty Ariel is here.” But she didn’t stop screaming. I asked the nurse, “why are these lights so bright? It’s right in my niece’s eyes!” 

The nurse didn’t answer and just kept on telling me Liv needed to be checked. After about 3 minutes I was like, “This is enough, please give her to my sister.” The nurse waited for a diaper to be delivered to her first. She seemed very concerned about Liv peeing on my sister. Can you believe her concern? OMG!

At that moment, my biggest concern was related to the fact that my sister wasn't holding her newborn daughter. We all know mother and baby’s skin contact right after birth is very important. Right? 

Delayed Cord Clamping

Although there are several studies that show the benefits of delaying cord clamping, doctors don’t really do it, unless you ask for it. My sister’s doctor “delayed” cord clamping for a full minute. When I asked why she didn’t wait until it stopped pulsating, she replied by saying that the recommendation is for her to wait one minute before cutting the umbilical cord. One minute is better than 15 seconds, but most midwives wait until the cord stops pulsating, which can take up to one hour.

What Is Delayed Cord Clamping?

Delayed cord clamping is the prolongation of the time between the delivery of a newborn and the clamping of the umbilical cord. Delayed umbilical cord clamping is usually performed 25 seconds to 5 minutes after giving birth. Delayed cord clamping allows more blood to transfer from the placenta to the baby, sometimes increasing the child’s blood volume by up to a third. The iron in the blood increases the newborn’s iron storage, which is vital for healthy brain development. 

What are the Benefits?

Some new studies have found that DCC can have a positive effect on both preterm and full-term babies. These benefits include an increase in placental transfusion, a 60% increase of RBCs and a 30% increase in neonatal blood volume.
Another advantage of DCC is the decreased risk of iron deficiency anemia. By performing DCC, an additional 40 to 50 mg/kg of iron transfers to the newborn, which reduces the risk of the baby suffering from the severe side effects associated with iron deficiency.
Common side effects of iron deficiency at birth include cognitive impairment and central nervous system problems.
Dr. Rabe believes there are other benefits: 
“The extra blood at birth helps the baby to cope better with the transition from life in the womb, where everything is provided for them by the placenta and the mother, to the outside world. Their lungs get more blood so that the exchange of oxygen into the blood can take place smoothly.” 
Some people go beyond and decide for lotus birth. A lotus birth, or umbilical nonseverance, is the practice of not cutting the umbilical cord after birth. The placenta then remains connected to the baby until it detaches naturally, usually up to 10 days after birth.
The placenta is often placed in a bag or wrapped in a piece of fabric and may be treated with lavender oil, salts, rosemary, or other herbs to decrease the odor. The idea began in 1974 in the United States and Australia as “a logical extension of natural childbirth, and invites us to reclaim the so-called third stage of birth, and to honor the placenta, our baby’s first source of nourishment.”

Erythromycin Eye Ointment

In hospital births, soon after the baby is born, nurses apply erythromycin eye ointment in order to prevent  ophthalmia neonatorum (ON), also known as neonatal conjunctivitis. An infection that causes inflammation of the conjunctiva during the first four weeks of life. 

It’s up to the parents to decide whether or not they want the eye ointment in their baby’s eyes. I don’t believe my sister has a birth plan so she just went with the hospital protocol. 

Below I added the risks associated to this ointment based on the same article. 

  1. Adverse effects can include chemical pink eye, or eye irritation. A study in Kenya found that 13% of infants who received erythromycin developed pink eye with no evidence of infection (culture-negative) (Isenberg et al. 1995). If chemical pink eye is mistaken for bacterial pink eye, it could lead to treatment with more antibiotics while waiting for culture (test) results.
  2. Blurred vision could potentially interfere with bonding by disrupting early eye gazing between the newborn and parents (Personal correspondence, Brazelton Institute, 2017; Bruschweiler-Stern, 2009). Although bonding is difficult to study, it’s been shown that from birth, newborns can tell between direct and indirect eye contact, and that newborns prefer when they can mutually gaze with their parent (Farroni et al. 2002).
  3. Erythromycin is not 100% effective at preventing gonorrheal ON – it had a 20% failure rate in the past and might be less effective now due to growing resistance (Lund et al. 1987).
  4. Erythromycin may not be effective at preventing chlamydial ON or ON from other non-gonorrheal bacteria (CPS, 2015).  

Vitamin K

I remember my midwife asking me if I wanted to give Jasper a vitamin K shot. I asked her if I needed to give him the shot and she told me there’s a 99% chance he would be okay. I took my chances.

I’m not a doctor and I hope you don’t take my experience as medical advice. Instead, I’m just inviting you to ask questions and do your own research in order to make sure you are making the right decision for your family.

Here is a wonderful article with more information about vitamin K shot, Safe Alternatives to the Vitamin K Shot.


Hepatitis B Vaccine 

When I had my son, I asked myself, “If I don’t have hepatitis B, which is a sexually transmitted disease, why would I worry about my son having hepatitis B anytime in the near future?”

If you feel like I felt when I was offered to vaccinate my son, check out Kelly Brogan MD article, Hepatitis B Vaccine – Is It Safe for Your Newborn?

Plan B

Within 4 hours of my sister being 10cm dilated and pushing, the doctor considered plan b (c- section), even though everything was okay with mama and baby. As soon as she said this, I looked at her with an ugly face and she ended up waiting. 

The Golden Hour

I didn’t see any respect for the golden hour, which is the first hour after birth when a mother has uninterrupted skin-to-skin contact with her newborn. There were nurses coming and going. Some of them were having side conversations about unimportant things that didn’t matter. 

I remember having the most magical golden hour. Time stopped. The pain went away, magic was in the air and everyone was there watching the miracle of life happening right before their eyes. If you’d like to learn more about the golden hour, I have attached this article all about it, The ‘Golden Hour’ After Birth: You Should Protect It At All Costs.

Hospital Food

The menu options weren’t necessarily made for recovering postpartum mothers. Imagine going through endless hours of labor and delivery. Soon after the golden hour, you are going to be hungry. The best thing you can do is bring a homemade meal full of good fats and protein. Something that can be warmed and easily digestible. After having her daughter, my sister was hungry, so we looked at the menu and didn’t find anything nutritionally good for her to eat.  

Conclusion 

My biggest issue with the hospital birth is regarding the lack of sensibility with this special moment. It also bothers me that they follow protocols that are old and outdated -- even in a good hospital located in a first world country. It’s like they've built a birth system a long time ago and there’s no desire to keep on implementing better ideas as we learn more about health and wellness.

Do they really need to use those big bright lights? Can the doctor be more gentle when handling mama and baby? Can nurses respect the golden hour or learn more about important topics such as the benefits of the vernix caseosa? 

It’s a hospital for God’s sake, change the menu! 

I am a believer that the way a baby first experiences this world can make a lifetime of differences. Some may argue that the details I mentioned aren’t that important and the baby won’t remember any of this. 

It's not true. On a cellular level, we remember everything, even what happens to us while we are in our mama’s belly. 

P.S. On a wonderful note, my niece Liv is healthy, beautiful, and she was born on the same day as Bob Marley. I call her Liv Marley. 

I hope this information helps you to make the best decisions for you and for your family. 

I have attached some important readings for you below:

 

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Edited by: Lily Zara

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Comments

alice studart

♥️👏🏽 what a beautiful thing to read

Kamila

Ariel what an article! Thank you! My sister will be going through a home birth at the end of March and I am so excited to be part of it with her she has asked me to be there. Reading this is SO informational for myself and certifying that she has made a good decision !!
Thank you for sharing your experience!

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