Photo by Coco Hunt. All rights reserved. Use with permission only.
Since the onset of my pregnancy, I have been very open with readers. (See here and here and here and here and here and here.) Now, nearing the end and preparing to give birth, I want to fill you in on my quandary. I can’t decide whether to prepare for a home birth or to plan on giving birth at the North Hawaii Community Hospital Full Birthing Unit (FBU) in Waimea.
The Hilo Medical Center is out. In the months preceding this pregnancy and right after I first found out I was pregnant, I was hopeful about leading a movement to convince the powers that be to allow midwives to attend births there. But, as you read, I reached a road block and I’ve been unsuccessful in changing anyone’s mind in time to have a midwife-attended birth at the Hilo hospital. I had a midwife-attended birth in Waimea for my first child, and I just can’t imagine having it any other way. I’ve also toured the Hilo Medical Center’s neonatal unit and, not trying to be insulting, the Waimea hospital is far superior. Hilo is what it is, a hospital. Waimea is more like a room at a bed and breakfast, with the amenities of a hospital.
So, it’s either Waimea or home. I had given myself yesterday to decide. But yesterday has turned to today, and I really haven’t been able to make up my mind! I figured, it might be helpful to write out my thoughts, to help me decide what I’m going to do and to further shed light on the politics of birth here. So, please excuse the stream of consciousness writing, but it’s necessary at this point.
After having a natural child birth for my first child, there is a part of me that feels like I could give birth anywhere. Throughout this pregnancy, I have fantasized about having this baby without having to leave Puna, without having to leave my home. I think back to being in labor with baby no. 1 and I believe that my labor would not have stopped and started as many times as it did if I wouldn’t have had to make that commute to Waimea. So, at the same time that I have been faithfully going to Waimea for my prenatal appointments, I have sought out a midwife that I have a rapport with and find trustworthy. Her name is Nina Millar,and I didn’t find her in Puna. She is based in North Hawaii. Whenever I have had a prenatal appointment in Waimea, I have also met with her.
I’ve had a very open relationship with Nina and with the Waimea Women’s Center, where I’ve been meeting with the hospital-based midwives each month and now every two weeks. Everybody knows about each other and that I’m trying to decide between a home birth and a birth at the FBU. That’s the beauty of Waimea, the midwives there are supportive of home births. They aren’t practicing defense medicine, making you feel like you are going to be harming yourself or your baby by choosing the home-birth option.
Typically, I carpool up to Waimea with my friend who is planning a vaginal birth after cesarean (VBAC). We plan our prenatal appointments for the same day, and she joins me for my appointment with Nina afterward. No offense to the Waimea hospital midwives, but my friend and I have found our visits with Nina to be far more enriching. She spends an hour with us, and there is a personability that comes along with our visit that cannot be replicated in a hospital setting. Nina is a registered nurse who graduated from the Midwifery Program at the Maternity Center in Texas in 1983. You can tell that she has attended hundreds of births, she is quite knowledgeable about female anatomy and the process of birth. Involved with the Midwives Alliance of Hawaii, Nina advocates for a standard of practice for midwives. She is solid and grounded, what I believe to be the ideal person to attend a birth. And she isn’t swayed by the fact that we live about two hours from each other.
Nina has attended births in Puna, and doesn’t think the rural setting should be of too much concern, particularly since I didn’t have any complications with my first child. Her confidence has really helped me wrap my brain around the idea of giving birth in an area that is by no means a hop, skip and a jump away from a hospital. As you know, should there be any complications with the home birth, the nearest hospital is in Hilo. And I already told you I don’t want to give birth at the Hilo Medical Center. Actually, I have to fight my mind not to reel the nightmare scenario of me being transported to Hilo in an emergency and then staring in the face of the obstetrician I had such a problem with at the onset of my pregnancy! I tell myself, Don’t even think like that. The birth is going to go just fine. It will. I read “Ina May’s Guide To Childbirth” and remind myself my body and my baby know what to do. I just need to figure out where the birth will be.
So, home births do cost money, and unfortunately there isn’t a midwife on this island who accepts insurance. There is a certified nurse midwife on Kauai named Claudia Brown who I understand accepts insurance for home births, but she is apparently an exception to the norm in the state. Hopefully, there will be someone like Brown on the Big Island sooner than later, because that is definitely a need. But if I choose the home birth route, I’ll be paying between $1,500 and $2,500 for Nina and her accompanying apprentice who acts as a doula. I had all but convinced my husband to go along with a home birth, until I told him the cost, which isn’t covered by insurance. Mr. Practicality that he is, my husband is saying, as nice it would be not to leave our home to have a baby, we cannot afford the expense. I’m more quixotic. I feel like, in the bigger scheme of things, $1,500 to $2,500 is not a lot of money, and there is always the option of a payment plan! But Mr. Practicality has suggested, at that rate, why not just go stay at a hotel in North Hawaii and have the baby at Waimea’s FBU.
So, in light of his suggestion, I’ve been shopping around for a place to stay in North Hawaii should I decide to give birth at the FBU. I have discovered Waiaka Homestead, which is rumored to cater to laboring moms,and my friend and I will be touring the grounds this week. I’ve also been in dialogue with staff at the Hapuna Beach Prince Hotel, and they are happy to accommodate women such as myself who need a place to wait for/wait through labor.
Actually, for my first child, I had every intention of waiting out my labor at Hapuna Beach Prince Hotel. What happened is that I started having contractions, so we made our way from Puna and checked into our hotel room. My labor seemed to be progressing so, rather than stay the night at the hotel, my husband and I went to check in to the FBU. But after being in the hospital a short time my labor stopped. And it didn’t start up again the next morning. I checked out of the hospital and we met up with my sister and her boyfriend at Hapuna. I spent the day swimming and walking up and down Hapuna beach. I got a massage at the Hapuna spa and, walking back to the room in my hotel robe, contractions kicked in big-time. I sat on the hotel room lanai as my husband counted the intervals between contractions and reported his findings to FBU. He rushed me to the hospital, I checked in, and my contractions stopped again. We stayed another night at the hospital and nothing happened. The next morning, I opted for Cervidil. Twenty-four hours and doses of Pitocin and Stadol later, my daughter was born.
It would be so ideal to have a natural child birth without any intervention at all for this second baby. I feel like that is most likely to happen with a home birth. But I also feel like now that I know what to be expect, I can be really clear with the midwives at Waimea’s FBU.
The FBU is very comfortable, with hard wood floors and warm colors; you feel like you are in a hotel or a B & B rather than a hospital. Each room leads out to a courtyard where laboring women can walk around. At the end of the hallway, there is a room with a jacuzzi tub for laboring women. Laboring women are required to leave the tub when birth is imminent. A water birth is not permitted at FBU. Because the FBU jacuzzi tub is shared by all the women on the unit, it is possible that the tub wouldn’t be open while I was in labor.
Each room does have its own bathroom equipped with a shower, so I would be getting relief with water somehow. Water for me proved to be one of the key remedies during the labor of my first child. At home, I would not only have my own shower, but I would also have a tub set up for me alone to use throughout labor and potentially for a water birth.
The walls of FBU are thin, so it is possible to hear the laboring woman next door That is something I do not like about being in the hospital. For my first child, I was actually terrified to hear the woman laboring in the room next to me. I was in the initial stage of my labor, and she was quite obviously further along. I remember crying in fear of what was to come, and listening to my iPod to try and not hear her moans and wails. In jest but to remind each other of our intense experience together, my husband and I have referred to FBU as the “hall of horror.”
With a home birth, I wouldn’t be subjected to the sounds of anyone else’s labor but my own.
Also, I would have the full and undivided attention of the midwife and the doula. They wouldn’t need to leave the room to attend to another laboring woman. I wouldn’t have different shifts of nurses attending to me. It would be my midwife, my doula, and my husband in my own home without any interference or interruptions. It really does sound ideal.
January 18th, 2011 at 7:42 am
aloha Tiffany! Great account of your journey to birth! I am assuming you are going ahead with Waimea??
In any case, I look so forward to talking with you today. I have decided to return to Hawaii and have had many wonderful doors open since I landed. I am SO HAPPY to be back!! Right now I am staying at Midwife Pat’s house in Waimea!! I move into my new place in Ookala at the end of Jan. and I will be coming to Kurtistown next week where my sister-in-law lives so maybe we can visit then. I am on call for a birth due on the 25th, but available for your due date if you and Pierre
))))) would like.
Oh boy, oh joy!!! Love, Mary
January 18th, 2011 at 5:33 pm
Don’t forget your photographic royalties, Coco!
Good Luck Tiffany, you’re more brave than I! So what’s his name?
January 18th, 2011 at 10:35 pm
oh I absolutely loved FBU. I had my last child there and Patricia Hopkins was my midwife. She was so comforting actually all the women there (7 of em) Was just wonderful company. I was the only one in labor actually I was the only one there. They were all awesome. To top it off ht food was absolutely wonderful! Best wishes to you!
January 19th, 2011 at 9:26 am
Tiffany, ask yourself this. Can you live with the guilt if you experience fetal distress and can’t get to the hospital in time for a C section to prevent harm to the baby? Yes, it can happen after a normal lst delivery.
January 19th, 2011 at 10:56 am
Six children born in Hawaii
Three by midwifes one not so good the others excellent to the max.
Kona Hospital almost lost mt wife by their arrogance.
Hilo Hospital the first birth hit use with a big bill
Second birth was a lot better , but nothing compares to Waimea with midwife its like a trip to heaven of births. My wife is small with narrow hips so there has been a lot of drama in the past. The drive is long so we stayed in hotel when things got close. My best to the little surfer dude and his folks. Aloha
January 20th, 2011 at 8:48 pm
Although home birth was an option using a midwife, I opted for a delivery with the midwife in a hospital. When my baby was born with breathing problems, and there was the appropriate equipment there for a healthy outcome, I was very very glad that I’d chosen a medical setting. Ditto for when the doctor needed to be called in to tend to me afterward, he’d not have been able to get to my house nearly as quickly (and that result could have been bad). Yes, even a MOM can have problems during/after the birth, even with a fully qualified midwife. My advice – go where there is full medical equipment if needed.
Good luck and congrats!
January 21st, 2011 at 9:04 am
The insurance-money game persuades us with fears, which knocks them out of a good decision process in my opinion. I recommend you go with your gut intuition which seems to be with a midwife, at the very least. My 1980 delivery was with a hypnotist (as well as a midwife) in the University hospital that utilized interns. I heard plenty of screams around me with a 12-hour labor, but the hypnosis empowered and relaxed me. Turned out there was reason to be in a medical facility for minor complications, which can happen to anyone. Hence, I suggest you go for the pampering hotel or homestead while realizing you can’t control everything … just be sure Plan B is understood amongst your supporters!
January 22nd, 2011 at 11:28 pm
Hi Tiffany!
Hospitals can provide much needed measures that cannot be provided at home. When there are problems, hospitals can make the difference between life and death and physical/mental/emotional problems resulting from a complicated birth.
Hospitals can also make mistakes and poor decisions, resulting in problems with mom or baby that would not have happened at a home birth.
My grand daughter,Ara, should not be alive. Hospital procedures saved her from being born many weeks before term, and saved her from dying after her birth. Hospital “we know more than you, mom” attitudes, mistakes, and procedures also nearly killed her when she was in ICU after her birth. (My daughter told them they failed to follow protocol and remove a line that had been cut accidentally. They blew her off as a first-time mother. 24 hours later, instead of 5 minutes later, they changed the line. Which resulted in her getting an infection — which my daughter told them she now had, she could tell by the way Ara was acting — again they blew her off. The next day, the nurses had to resuscitate her. THEN they decided she had an infection!)
If my daughter hadn’t taken things into her own hands when she repeatedly lost almost all of her amniotic fluid during her second and third trimester, Ara probably wouldn’t be here, either. Hospital procedures helped her keep the baby, but if my daughter hadn’t done a couple of things on her own — which the medical personnel did not even know or think to tell her to do — the hospital procedures most likely would not have been enough to save Ara while in the womb.
Bottom line is, there are pros and cons to both. No matter where you are, TRUST YOUR GUT FEELING!
My first two babies were born in a hospital. The second birth resulted in my baby being rammed against my pelvis for so long that she didn’t open her eyes for 3 days, and she could not hold her head up, it would fall from side to side. Maybe that would have happened at home, too, and maybe not.
My last two babies were born at home. I had complications with the first one born at home. I kept spotting through the pregnancy, once a month, each month the gush of blood was heavier. This was back in the late 70′s, when home birth was VERY disapproved of. I got prenatal care with my family doctor, who said he didn’t think I should deliver at home, but also was frank enough with me to say that he didn’t think I would have problems if I did deliver at home.
When I delivered, the placenta came first — BEFORE the baby, along with a gush of blood. Peter was born blue — but the midwives got him breathing right away, and he was fine.
With my last baby, I was working around home, even sewing on my sewing machine, up until 1 1/2 hours before her delivery.
Both home deliveries were SO comfortable. I could do whatever I wanted, I could go wherever I wanted. I could sit and lie wherever I felt like, wherever I was comfortable, on my own comfortable, familiar furniture.
Given the choice, if I had more children, I would ALWAYS deliver at home, with a midwife(s) in attendance — I wouldn’t waiver a minute on the decision — unless I knew I had a risky delivery ahead of me. Home is just so comfortable, hands down there’s nothing better.
Good luck! Enjoy the experience, either way!
February 22nd, 2011 at 10:48 am
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