Home Birth FAQ

Mothers love to share birth experiences with each other. Actually, everyone loves to share birth experiences with mothers. I've heard birth stories from husbands and parents and siblings of mothers. As soon as I share that I've had two natural home births, people usually have one of two reactions: the minority are genuinely curious about how I liked it and how it worked. Sometimes they've even been looking into home birth themselves. The majority, though, look at me with horror, like I'm some kind of negligent hippie freak, and after a few condescending questions try to nervously redirect the conversation. Here are some of my most frequently asked questions about home birth:

Q: Home birth? Ugh, I could never do that. I wanted pain meds.
A: If you wanted them, then I'm glad you had them! I wish every woman's birth experience would go the way she wanted, if it was safe for the baby.

Q: Wow. I couldn't have done that. I wanted the option of professional medical care right away if my baby or I needed it. 
A: So did I. That's why I chose a midwife to attend my births who is a Licensed Direct-Entry Midwife (LDM) and a Certified Professional Midwife (CPM) who has attended over 1000 births and has only excellent recommendations from other mothers in the area. Oregon LDMs are trained in and authorized to use oxygen, IV therapy, anti-hemorrhagic medications, local anesthetics for suturing and vitamin K and ophthalmic antibiotics for newborns. Oregon LDMs can order lab work, obstetric ultrasound and newborn metabolic screening. And she has the experience to know when it's time to take a woman and her baby to the hospital, where she is a wonderful patient advocate for both mom and baby. If I hadn't wanted experienced professional medical care, I would have just had my babies at home with my husband. (That actually never would have worked. He was an EMT and had possibly a negative amount of interest in delivering babies himself.) Or I would have built a mud birthing hut in our back yard. (And, realistically, everything still would have been fine, though a lot less comfortable.)

Q: Home birth wasn't an option for me. I had medical problems/ My baby had medical problems/ I have a family history... it's a good thing I was in the hospital.
A: Then I am glad you were in the hospital too. I have known people with "family histories" who had successful home births, and I've known women who were otherwise healthy and wanted a home birth and ended up needing to go to the hospital. If you wanted or needed to be in a hospital, I'm glad you and your baby were there.

Q: ...It's a good thing we were in the hospital: the cord was wrapped around my baby's neck!
A: I know, right? Mine too. What with not having any room and moving all those little limbs out of a relatively tiny space, umbilical cords get tangled all up in babies' business all the time. Diana was born with the cord around her neck- Lisa just unwound it. She's seen babies born with the cord wrapped multiple times around necks, shoulders, etc. It just has to be untangled. It's usually not as big a deal as the movies would have you think it is.

Q: So what about all the required tests/examinations/vaccinations you/your baby gets at the hospital? Does your midwife perform those? 
A: Yes, she performs the newborn screening "heel prick test" that is required in Oregon to check newborns for a host of potentially worrisome conditions. She can do vitamin K injections and newborn eye drops. I think you have to take your baby to a pediatrician to do most of the other vaccinations a hospital would perform right after birth. She tells you about what vaccinations and procedures newborns would normally have performed on them in hospitals, and you can opt out of some of them, I just can't remember what they are right now.

As you can see, most of the questions I get aren't questions at all. In fact, mostly people get very defensive when they hear I've had home births. Look, babies are born every day naturally, by C-section, by VBAC, in hospitals, in taxis on the way to the hospital, breech, with epidurals, in a yurt, etc. I'm not trying to convert people to a home birth mentality. Sometimes when I'm in groups of other mothers, if someone shows an interest in home birth, the other mothers will actually rally to try to dissuade them from it, saying they can have natural-birth options in a hospital or birth center setting. Of course that's completely true, but honestly it feels like I am spreading a dangerous idea that other women need to be protected from. Seriously. The prevailing unspoken response I get from most people is that I am a selfish idiot having children via witch doctor in a mud hut. Are they worried I am trying to trump their birth experiences by saying I've gone all-natural and not even in a hospital?

Personally, I think we're completely indoctrinated throughout our lives with the idea that women and babies need professional medical intervention during pregnancy and the birth process. There is an overall feeling of fear about the whole thing. (Not that it's completely unwarranted- the United States does, after all, even with it's advanced medical system, account for more than half of all first-day deaths of newborns in the industrialized world. That's about 11,300 babies. In addition, American mothers have the same maternal death rate as mothers in Iran, according to the most recent State of the World's Mothers Report.) New moms and dads are consumed with worry about birth, as if babies and women's bodies weren't made for it. When we interviewed the midwife who has delivered two of my babies, many of my nieces and nephews, and even some Joseph's siblings, she described herself as a lifeguard, which is exactly what she acted like during my births and was exactly what we wanted. I liked that every step of the way during pregnancy and labor, she only ever made me feel confident that if I kept myself healthy physically and mentally, I would have no problem having a baby.

Here are some questions nobody ever asks me:

Q: Why did you choose home birth?
A: I chose home birth because I believe women's bodies were designed to handle childbirth. I am a private person and I hate doctors, examinations, and hospitals, but of course none of that would have mattered if I had thought that a hospital birth would be best for my babies. I don't like the idea so prevalent in the American medical system that everything is a dire problem coupled with my experience that doctors never have a solution or really any idea what the problem is exactly. If I didn't have to be a part of that system, I wanted to try a peaceful experience with a few people I trusted because I feel that childbirth is an intensely personal event that I want to own, instead of being in the passenger's seat directed by doctors who are probably more comfortable with medical intervention.

Q: Did you enjoy the experience? Would you do it again?
A: I enjoyed it so much I did it twice and hope to do it a third! I don't have a hospital birth experience to compare it to, but I can say that it worked for me and it was exactly what I hoped for. Someone put on peaceful music, I never felt rushed, I received a few words of encouragement and some helpful suggestions, and I was left to do my own work. My EMT husband was impressed by my midwives' knowledge and medical expertise and my mother (who was amazingly skeptical of home birth during my first birth) was impressed by how beautiful and peaceful the whole process was. (She even told me she wondered why she hadn't done that with her kids!) And can I say again how much I loved my midwives? Lisa was amazingly supportive and knowledgeable. She checked my babies' heart rate throughout labor to make sure they were doing well. I never worried about my kids with her around. Her assistant, Rachel, (who is now a licensed midwife herself) was also sweet and supportive. I had various complications with healing and nursing in the early weeks of having newborns, and I called Lisa day and night to ask her questions or just talk.

Q: How did you evaluate the pros and cons? Weren't you concerned for your baby in case of an emergency?
A: Especially during my first pregnancy, we worried (like most new parents) that there would be some medical emergency and we would lose precious minutes needing to transport to a hospital to get more care than the midwives' could offer. However, when we evaluated the likelihood of a medical emergency, it seemed like we were taking a comparatively small risk having our baby at home. Once we saw how "normal" my births were, we became more confident that we had made the right decision. And in the intervening years we've had the opportunity to hear from friends and family members how Lisa reacted in the event of medical emergencies during birth and I'm pretty certain that we'd be in good hands.

Anyone have any questions? Did you get the birth experience you wanted? If you had a home birth, have you had the same experiences with other people and mothers? Am I really just a selfish hippie freak who consorts with witch doctors and preaches heretical ideas about birth at the risk of my children's health? Comment below!

Thank you for the eczema break!

It has been a dark few weeks with Diana's eczema, but in the spirit of not only posting doom and gloom, I want to thank everyone who's been praying for us. I think it's really helping. The past two days have been so much happier all around. I hope this means that God is drawing this latest eczema flare-up to a close.

Diana's skin is just miraculously better. The angry redness that covered so much of her body has mostly gone away. Her many scratches have healed up. I gave her an antihistamine twice yesterday, but I haven't given her any today and she still seems just less itchy than before. It's such a blessing to see Diana not be uncomfortable in her own skin, but the part I enjoy maybe more than that is just being able to see and talk to my Diana again, instead of a frustrated toddler in distress. Diana is smart and perky and rascally and sweet. She has been smiling so much over the past two days, and telling me how much she loves me and how beautiful I am. She plays with me and her brother and has an altogether better attitude. Diana has a personality very much like her dad, where she likes to sometimes just sit quietly and think. For the last two days, I've been able to let her do that. She has been able to just stare off into space listening to music or sit in her room thinking or reading a book without being distracted by a scratching fit.

We haven't been doing anything remarkably different with her skin. Our routine is still the same, her skin is just better for some reason. This kind of happiness may just be a brief break in the clouds, but it's just what we needed to help both of our sanity. Thank you so much for praying for us!

The ins and outs of eczema

People who are concerned by Diana's eczema will occasionally ask me if we've figured out what causes it yet. Yes, we think we have. After many weeks of frustration, I sat down the other night to diagram what we knew about Diana's eczema. This is what I came up with:

No problem, right? 

• Topical Allergies: Her topical allergies include: cocoa butter, sunflower oil, coconut oil, anything with fragrance, animals (dogs, cats, horses, etc.), carpets and upholstery (possibly due to the soap/chemicals used on them?), and a host of other things we haven't identified yet, including some ingredients in different brands of "free and clear" laundry detergents. Basically, any time we leave the house or see friends and relatives, Diana needs a bath/shower/to be wiped down with a warm, wet washcloth that has been washed in Arm & Hammer free and clear detergent. 
• Dry Skin: The moisturizers we use to help her dry skin can't have anything in them that she might be allergic to. So far, that leaves Aveeno Eczema Therapy Cream (when her skin isn't too scratched up) and Vaseline.
• Yeast: Even if her skin is generally doing well, sometimes yeast may colonize her skin which makes her itchy. We need to give her bleach baths occasionally just to keep her skin clear. Unfortunately, chlorinated water dries out skin. 
• Sugar: One mini marshmallow or even one M&M doesn't seem to do much, but give her an entire cookie and Diana's hands instantly go to her face to scratch. Somehow she reacts to too much sugar. 

I forgot to add that it's important that her skin can breathe, so she has to wear all-cotton everything all the time. 

Also, we have no idea where her food allergies figure into making her itchy. When we tried an elimination diet, nothing seemed to really make her skin much better. We're pretty sure that the allergies that affect her skin are mostly topical, not food-related.

The factors that contribute to scratching are, if possible, even harder to address because some of them are just a consequence of being an almost-three-year-old. Skin irritation is probably the easiest thing to control. We have to make sure her clothing isn't at all scratchy or too tight (unfortunately, the tights we use to keep her from getting at her ankles and knees are tighter than nice, loose pants). But how do you keep a child from being bored?? I think it's healthy for kids to be bored sometimes. It allows them the freedom to develop some creativity and use their imagination. And while I take care of a house and, soon, two other kids, I can't be Diana's full-time entertainer. However, when she's bored, she'll often default to scratching, which makes her itchy. Another big factor is stress, which also seems impossible to control. The world is a new, uncertain place for toddlers, and when she's uncomfortable with a situation, Diana will often scratch. The world can also be a frustrating place when you figure out there are things you can't do. Trying to mold a smart, frustrated, itchy toddler into a good and happy person results in a lot of angst for both parties, and a Diana who is unhappy about being sent to her room or told she can't do something will invariably scratch. In fact, more commonly, I can't allow her to go to her room or out of my sight at all because she will pull her gloves or tights off and scratch at the slightest opportunity.

Emotional Eczema

While I was doing some recent research about eczema, I came across two interesting articles. The first was entitled "Psychosocial adjustment in preschool children with atopic eczema," written in 1993 by three researchers at the University of Machester and published in the Archives of Disease in Childhood. According to the abstract, "The psychiatric adjustment and mother-child attachment in 30 preschool children with severe atopic eczema was compared with 20 matched controls. Patients with eczema had a significant increase in behavior symptoms, with significant excess of dependency/clinginess, fearfulness, and sleep difficulty, but there was no difference in the security of attachments." (I don't know if Diana is overly clingy or fearful, but sleep is definitely an issue. She wakes up usually between 3-8 times each night, and I don't know how much of it is because she's uncomfortable and itchy, but it definitely messes with her sleep cycle at a time when she needs to be getting lots of sleep.) " In relation to the mothers of the children with eczema, the abstract stated, "Significantly fewer... felt supported socially." That's been one of the biggest emotional challenges for me: I feel so very lost and alone. I know I have Joseph to talk to, but Diana's eczema is like no one else's eczema. Sometimes I just wish I could talk to another mother who understood the physical and emotional challenges and the confusion and the frustration and the hope and the anguish. Talking to other people sometimes helps put struggles in perspective, and I don't know of any other moms who are dealing with anything remotely like this. Diana sticks her hands down her pants to scratch or sometimes even removes her clothes and people laugh and tell me my daughter is walking around half naked, but they never seem to notice that I am never laughing too. The consequences of Diana scratching can be setting her skin back for days, and it results in enough unhappiness for everyone in our family that it's really no laughing matter. One night, we didn't use athletic tape to hold Diana's PJs together because she had a cold and we didn't want to restrict her breathing at all. I found her in the morning with her pajamas removed and also all the skin from the backs of her hands. Regardless of how comical people find the situation, I will never laugh when Diana scratches, since this is the result:

The abstract continues, "Significantly more [mothers] felt particularly stressed in relation to their parenting and less efficient in their disciplining of the affected child. Child behavior problems and maternal distress were significantly more common in the more severely affected children." Yes! There's no way to know how much of your child's bad attitude is just being a toddler and how much is actual excusable distress due to their discomfort. I know during allergy season I'm a bear because I can't think or focus on anything else when all the soft tissues in my head are itchy. If life was like that for me every day, I'd be grumpy all the time too! Lately, every day for Diana has been a bad day, and almost every minute of those days is filled with unhappiness. I don't want Diana to be faced with sadness and frustration all the time.

The second article was "Stress in mothers of young children with eczema," published in the Archives of Disease in Childhood in 2007 and written by three authors with The Children's Hospital at Westmead in Sydney, Australia. They evaluated the parental stress levels of mothers of children younger than 6 years old (the average age was 2.8 years) who were receiving care at the hospital for management of eczema. If you have the stomach for scientific papers at all, I'd suggest you read it, because almost everything that they found seems true for me. "Mothers of children aged 5 years or less with eczema exhibited significantly higher total stress scores as compared to mothers of normal children and children with other chronic disorders such as insulin-dependent diabetes and profound deafness. Stress scores in the parental domain did not differ significantly from the scores of parents of children with severe disabilities such as those requiring home enteral feeding and those with Rett syndrome." That seems like a pretty profound result. I don't want to use this to enable my own pity party, but taking care of a child with eczema is incredibly stressful. Just maintaining her skin quality is hard. It seems like everywhere, everyone, and everything negatively affects Diana's skin and we're only safe when we're at home. When we take steps to fix her skin or try new coping methods, it's way more stressful. I know I've said it before, but there's nothing as hard as seeing your child in complete misery just ruining themselves physically. Diana is both the victim of eczema and her own worst enemy. I wish there was some way for me to describe the sadness, the pity, the frustration, the confusion, the hopelessness, the guilt and the alone-ness that has driven me to tears on a daily basis for the last few weeks! Stress in mothers of young children with eczema? Yeah, it's bad. I guess I'm happy that anyone cares enough to write a paper about it at all. 

/Venting

Here's what I know: Diana's eczema is essentially dry, sensitive skin that is affected by a host of things, some of which we don't understand and some of which are mental or developmental or closely related to her personality. There is no one cure for her eczema. We cannot fix Diana's eczema.

The only thing we can do is try to maintain the best skin quality we know how. Occasionally we have to adapt our coping methods to new information, incorporating new suggestions from her doctor, and the fact that her eczema changes as she gets older. It's widely acknowledged that sometimes eczema flares up for seemingly no reason, and I think we're in the midst of a crisis like that now. We're slowly figuring out ways to bring it under control and see our happy, carefree Diana more often. But ultimately, we're anticipating years of almost-constant care for a child with special skin needs. I think a lot of my stress has been fighting the idea that this is the way life has to be for Diana. I'm just starting to accept that the constant itching/scratching battle and all the care that goes into maintaining her skin might be her status quo for years to come. I don't like the idea.

I also know that God is in control. God cares for me and our family and our little girl. If we keep turning this horrible experience over to God in prayer, good things will come out of it. If we keep asking for wisdom, it will keep coming. It's difficult for me to remember those facts when a trial isn't one shocking event, but instead a wearying lifestyle. I think God knows that too, though, and he has shown me that's he's with Diana and me even in the tiring and miserable journey through her eczema. 

The Heart of the Eczema

The title of this post is misleading, because eczema has no heart. If it had an embodied form, it would be a soulless monster, preying on anyone, including the young and the helpless.

The past week has been filled with moments that just make me want to curl up on my bed and cry. Today especially was incredibly discouraging. There are few things more emotionally stressful and draining as a parent than seeing your child suffering, and there has been a lot of physical discomfort for Diana this week. I hate hearing her scream during the rare bath/shower times, or when I'm putting on a moisturizer that I know is good for her. I hate hearing her cry and beg me to stop because it hurts.

The Plan

We've declared war on her eczema again. It seemed to get worse in the past month, so Joseph and I did some brainstorming and came up with some plans. Everyone's skin in the house got drier once the temperature dropped and the heater started coming on, so we've been putting on the kids' humidifier every night. Also, we theorized that 60% of Diana's skin problems have to do with the fact that she scratches, leaving lots of scabs that are dry and itchy or open wounds that are always in danger of becoming infected. So we committed to stopping the damage done by scratching with fingernails by covering her hands EVERY time we see her scratch. We've got a couple pairs of lightweight cotton gloves from The Allergy Shop in Australia that we use, or if we're in a pinch, we just pop socks over her hands. Joseph sewed one pair of gloves onto an old pajama shirt Diana had so that we can use it when she sleeps without her pulling the gloves off. We put that on under some of her footie pajamas (because even with gloves on, she'll still peel off pants and diaper and scratch if she has the opportunity) and then put a band of athletic tape around her chest so that she can't retract her arms from her sleeves (something she perfected about a year ago) and scratch inside her PJs at night. Additionally, at our doctor's suggestion, we've been giving her 1/2 tsp Children's Liquid Zyrtec every morning and at night as needed to try to make her less itchy.

The Results

It was a bit of a rough transition to wearing the gloves during sleeping times, but now Diana asks for her "glove shirt" and is comfortable with putting her fingers in the fingers of the gloves herself. That seems to make it easier for her because she knows she mostly still has the use of all her fingers and isn't too limited in what she can do at night. It was (and is) much more frustrating for Diana to get used to being forbidden to scratch during the day. I hate to keep her from doing that, but she does so much damage to her skin and usually leaves herself bleeding. We stress that she can scratch with her gloves on all she wants or she can rub the itchy spot with her gloves off. Usually we have to revert to putting the gloves on. Understandably, it's frustrating for Diana, especially as she healed up and the scabs became dry and itchy. Her frustration has manifested in a lot of un-Diana-like behavior: blatantly tormenting her brother, not listening to mommy, being surly and whiny at every opportunity, and saying things like "I don't like you, mommy," "You're a naughty mommy," and "Go away, mommy, I don't want you here." I know that she doesn't mean it when she says that, but it's still a little disheartening. I've tried redirecting her to say things like "I'm frustrated/mad at you," because that seems more accurate, though I'm still not sure I like that.

Happily, though, as she was thwarted from scratching, her skin did heal up! Kids heal so quickly (when they let the healing happen), and soon her skin was free from scabs and scratches. I could use our Aveeno Eczema Therapy Cream on her without the alcohol hurting her skin! She began to willingly take baths and showers and just sit and enjoy them because the water didn't hurt her skin! Hallelujah! If you'd ever had the misfortune to be around our house at bath time, you'd know this was a huge improvement. Soon all that was left was, essentially, the heart of her eczema: dry skin with raised, irritated red patches.

We overcame the problem of scratched and bleeding skin and now we're left with just the eczema, which is no less confusing. Her dry skin is irritated by something, and we somehow need to combat both the dryness and irritation. We tried an exclusion diet with no noticeable results. We noticed that whenever she has sugar (including white flour), her face flushes red and she immediately begins scratching, so we tried removing sugar as well and haven't noticed any changes in her skin quality or itchiness levels yet, but that can supposedly take up to two weeks to get out of her system. To allow natural oils to accumulate on her skin, we cut out showers and baths and only did wipe-downs on her hands and face with a warm wet rag at the end of the day. Unfortunately, we encounter a lot  of irritants in the course of a day even just seeing friends, relatives and animals, so I'm not sure this did a lot of good either. Additionally, the dog has been in the house more often since the nighttime temperatures dropped to freezing and we also got a new couch, which may be covered in cleaners that irritate her skin. There are no limits to the amount of things that could be irritating Diana's sensitive skin!

And the new plan

A sweet, sweet friend saw some of my posts about Diana's skin and brought over some Arbonne Baby Care products for us to try. I was so touched by how thoughtful she was! Diana's eczema problems are like no one else's that I know, so it feels like a very lonely, frustrating battle sometimes, but it is encouraging to know that people notice and care, including you, lone reader. It makes me nervous to try new products sometimes, but I've never heard of Arbonne products and haven't tried them, so we're giving them a shot. 

Diana's unhappy skin after unsupervised scratching.

Diana's itchiness and attitude problems reached new lows today. Every minute or so she'd scratch uncontrollably, I'd pop the gloves on, she'd throw a fit, eventually calm down and I'd take them off, then she'd go right back to scratching. The cycle went on all day, with frustration misdirected at me and Liam. And do you know that it's actually impossible to reason with a toddler, or explain that their own scratching hurts their skin? At naptime, I checked on her every couple of minutes for almost an hour, taping gloves back on and putting clothes back on when she'd pulled them off. At last, it seemed like she was just falling asleep and it was quiet in the kids' room for about an hour. However, when I finally went in, I found her completely naked and scratching herself with no gloves. She set her skin back so far with this one incident. So we figured this was a good place to reevaluate and start a New New Plan. 

In the New New Plan, the dog lives outside exclusively. Diana's gloves will stay on all day except during meal times. We're going to shower every night, even if we don't use soap all the time. We will be using Arbonne Baby Care Hair and Body Wash occasionally in the showers and moisturizing with Arbonne Baby Care Body Oil and sealing in the moisture with our tried-and-true Vaseline. When her skin is a little less scratched up, we may try the Arbonne Baby Care Body Lotion as well. She still gets Zyrtec in the morning and at night as necessary, we're still keeping sugar as low as possible and substituting whole grains whenever possible. Humidifier and glove-shirt go on every time she sleeps. 

After the day's scratching, tonight's shower was, predictably, horrifying. It was also a huge emotional challenge as a mom to slather Diana with the body oil while she curled into a fetal position on her side and begged me not to put it on because it hurt her. HOWEVER, I did notice that as soon as the oil and Vaseline were on, Diana's scratching stopped. Under normal circumstances, Diana's hands will scratch away at her hot spots, even with gloves on, especially when she's distressed. (This is another complicating factor, because if she's ever startled/ uncomfortable/ tired/ hurt/ frustrated/ nervous/ etc. she will immediately start scratching herself even absent of other skin irritations.) Instead, her hands just stopped and she chatted with me. After getting her dressed, I asked her suspiciously if she was itchy and she said no, so we skipped the Zyrtec tonight. I'm curious to see what her reaction is to the new products after a few days of use. Her skin did feel extra soft after putting on the oil, and hopefully the moisture gives her some relief.