1) You’d like an episiotomy, even though that is no longer the standard of care, but the home midwife doesn’t carry Supercut Episiotomy Scissors, 23 cm, in her bag.
2) You don’t care that you will be attended by hospital staff who consistently refuse to wash their hands. (Hospital health workers wash their hands as little as 30 percent of the time.)
3) You have too many dust bunnies under the bed.
4) The research shows home birth with a qualified birth attendant is as safe or safer than hospital birth and the most scientific birth is the least technological but you pay more attention to television shows and birth haters than you do to research.
5) You’d rather be rushed through 15-minute appointments with an obstetrician who can’t remember your name and really wants to get on to the next client than spend an hour or an hour and a half talking about diet, exercise, stress, and having any questions or concerns you have addressed with a midwife in the comfort of your own home or in her plant and light-filled office.
6) Anne of Green Gables had all seven of her children at home, and she’s a fictional character so home birth couldn’t possibly be for you. Plus her first baby died a few hours after birth (of a congenital heart condition that was incompatible with life), so home birth must be bad.
7) Meryl Strep had a home birth and she danced like a crazy lady in Mama Mia, you don’t want to be like her.
8) Emmy Award-winning TV host Ricki Lake had a home birth. You always thought she was too out there.
9) Actress Pamela Anderson gave birth to both her sons at home and she’s been a lifelong animal rights activist so she must be wacko. She, and all these other home-birthing celebs, are nutsola granola.
10) You’ve watched The Business of Being Born and realize that medical doctors are ignorant and even fearful of natural childbirth. Since you’ve never had a baby you’re fearful too. So you’ve decided to birth with the docs.
11) Your obstetrician had a home birth but you’d rather do as she says not as she does.
12) You don’t want to eat or drink during labor, even if your body tells you to. Luckily most American hospitals will allow laboring women nothing but ice chips.
13) You won’t mind having complete strangers repeatedly barge into the room where you are giving birth, take no notice of you, say nothing to you, but instead stand in front of the computer print-out from the electronic fetal monitoring with concerned looks on their faces.
14) You also won’t mind having a nurse you’ve never seen before barge into the room where you are giving birth and roughly stick her fingers up your yaya, pull off the glove in disgust, declare, “Nothing, not even a dimple!” about your cervical dilation, and rush out again. That won’t be in the least bit discouraging or have any effect on your cervix’s ability to dilate.
15) You also won’t mind having a group of young residents, mostly men, stand around the bed where you are lying and each take a turn measuring your cervical dilation with their fingers, which they do so roughly and awkwardly that it causes your cervix to swell. Someone’s got to teach ’em, why not you?
16) You don’t want a birth attendant you know and trust to be there with you, thank you very much. You’re happy to have an obstetrician or a family practitioner who doesn’t show up until you are ready to push.
17) You don’t mind being strapped down to the bed. Because you’re not really strapped down. You’re just not allowed to move because movement makes the fetal and uterine monitors malfunction.
18) You don’t mind that when the uterine monitor does malfunction—because the hospital equipment is broken—you are told a catheter must be inserted into your vagina “to measure the strength of your uterine contractions.” You ask if this runs the risk of infection. Your nurse says, “Yes, of course, any foreign object inserted into the vagina runs the risk of causing an infection.” You say you don’t want the catheter. The nurse and doctor bully you into accepting it anyway.
19) You’d rather throw up in front of labor and delivery nurses who will shake their heads in revulsion and who won’t remind you that throwing up is a good thing because your body’s hormones are kicking in and you are making room for the baby to come out, than throw up in front of your kind and loving support team in the privacy and comfort of your own home.
20) You could always go to the hospital if things get rough at home, but you’d rather just start off there instead.
21) You aren’t worried about the fact that you might get a virulent antibiotic-resistant infection in the hospital. After all, you have dust bunnies (see #3) at home.
22) You don’t feel comfortable in your own home.
23) You don’t want your birth to be natural.
24) You’re happy to have the hospital nurses and doctors tell you to “be quiet” or “stop making noise” so you don’t scare the birthing women in adjacent rooms.
25) You haven’t read the science so you don’t know that continuous electronic fetal monitoring leads to unnecessary C-sections but does not improve fetal outcomes. Your hospital insists on it, for LIABILITY reasons, and that’s reason enough for you.
26) You want your baby to be ahead of the pack so you have no problem having your labor artificially induced so the baby can come early.
28) You find hospital birth professionals wearing blue pajamas to be more reassuring than experienced home birth midwives wearing their regular clothes.
29) You don’t actually want to feel anything and, like Jessica Gottlieb, you plan to get “my epidural” as soon as they’ll give it to you.
30) You have no idea what you’re doing. So you figure it’s best to do whatever the doctor tells you. Only the doctor won’t actually be there (see #16.)
31) You were afraid to take aspirin during your pregnancy but look forward to the drugs and anesthesia that will be foisted on you during hospital labor. Bring on the Demerol. You aren’t worried about the myriad negative side effects of epidurals or opiates. The doctor says they’re safe.
32) You want your labor to be on a time line. You’re as impatient as the obstetrician, though for different reasons.
33) You understand that if your labor takes longer than is convenient for the doctors—and for the hospital’s insurance reimbursement plan—it will be aggressively managed with synthetic hormones to speed things along. Not for the good of your body or your baby. But for the doctor’s convenience.
34) You understand that if your long labor does not respond quickly enough to Pitocin (see #33), you are likely to have a C-section.
35) What’s wrong with a C-section anyway? And who cares that some hospitals have over 50 percent C-section rates?
36) You like the idea of scheduling your baby’s birthday. 11/11/11 was a popular C-section day.
38) You want the medical personnel to scream at you to “PUSH! PUSH! PUSH!” while they watch your contractions on a computer screen.
39) You think it’s best for a baby to be born into bright lights and a cold, sterile room.
40) You want the cord to be cut immediately, which is what will most likely happen in the hospital, depriving the baby of up to 40 percent of its blood volume.
41) Immediate cord clamping causes anemia. You’re grateful to be in the hospital where they have technology to help your baby overcome the anemia the hospital’s policies caused.
42) You think your baby should be vaccinated at birth against a sexually transmitted disease (hepatitis B) for which you and your partner have both tested negative and that is most common in prostitutes and IV drug users. You know that’s good thinking and good science but home birth midwives don’t administer the hepatitis B vaccine.
43) You don’t mind that the hospital personnel may take your baby away from you right after birth, scrub your baby with antibiotic soap (see #21), and separate you from your baby for long periods of time, whether it’s necessary or not.
44) You don’t want to breastfeed and are glad to know that the hospital does product placement and covert advertising for the formula companies and will be loading you up with “free” formula and coupons.
45) Your baby’s birthday is your birthing day too. Your world changes forever when you become a mother. Your friend who had a home birth tells you it was the most empowering and validating experience of her life. For you it was a day of humiliation, bullying, emotional, and physical abuse. Being treated so badly validates all your childhood feelings of self-doubt and self-hate. It must be your body—not the system—that is broken. So next time you’ll have a hospital birth as well.
Jennifer Margulis, Ph.D., is an award-winning journalist and the author/editor of six non-fiction books. Her oldest daughter was born at Crawford Long Hospital in Atlanta, Georgia. Read more about birth in her most recent book: Your Baby, Your Way: Taking Charge of Your Pregnancy, Childbirth, and Parenting Decisions for a Happier, Healthier Family (Scribner 2015).