Birth Through Many Lenses

This week, Stacey Kerr, MD, shares her personal perspective on how seeing birth through multiple lenses — from the most natural form to the least — inspired her book, “Homebirth in the Hospital.” It all began with the birth of her daughter, leading her carefully and beautifully to the birth of her granddaughter.

Cara (my daughter) was sobbing into the phone while I stood helplessly in my kitchen, looking at the plane ticket to Hawaii that wouldn’t be good for another three days. “You’re supposed to be HERE!” she wailed. To both of our surprise, her first-born was coming two weeks early. We had both planned that I would be with her, but in that critical moment there was the wide Pacific Ocean between the two of us. After a flurry of considerations — evaluating my urge to pay anything to get a flight from California to Maui that very day — I realized that I could help her best by staying at home to coach her over the phone. Me being stuck on a flight while she gave birth was not going to do either of us any good.

So, that is what we did.

I coached her to stay home as long as possible, and when I heard in her voice that she was ready, I encouraged her to go on to the hospital. As a family physician, I have coached enough women over the phone to know when it’s time to accept assistance, so I had no doubts about my timing. Had I been there, we might’ve stayed home and had a successful home birth — but in my absence, she and Jason wanted the security of the hospital — off they went.

They arrived twenty minutes before Mia Kamalei was born. This was enough time for the nurses to put in an (unnecessary) IV, but not enough time for them to further interfere with an otherwise perfect physiologic birth. Her birth was so quick, even her obstetrician missed it. Cara and Mia were both doing wonderfully, and I arrived two days later to help with the challenges first-time parents face. Perfect!

My passion for birth began in 1973 when I delivered my first-born at a birthing center, deep in the woods of Missouri. I absolutely love the process of giving birth. I loved the feeling of having to give up control to my old friend, Mother Nature, and allowing that force to flow through my body. It was doing its best to make the magic of a newborn baby come into the world. In most other parts of my life, I was used to taking control, but birth was bigger than me. Birth was about feeling God within me, and getting out of Her way. It was the ultimate high.

After my own birth, I spent more than 10 years on a farm in Tennessee — helping deliver babies at home with midwives was exactly where I wanted to be. As I watched the midwives manage home births with skill and spirituality, I realized I wanted to help women give birth, too. So, I became a physician and started delivering babies in hospitals.

I gained skill and knowledge as I learned to handle emergencies, and also how to use all of the available technology in the hospital. I have helped hundreds of women deliver their babies, but very quickly after I started, I knew I was missing something — something essential. I was losing my ability to see birthing as a normal event. Practicing medicine in a hospital was overpowering my faith in Mother Nature. So, I turned to midwives for help.

For several weeks, I attended home births with midwives, once again as an assistant. Occasionally, my skills as a physician were needed, but for the most part, I simply observed and allowed myself to remember that birth is normal — that it does not happen according to protocols or schedules. When protected from fear and intervention, the majority of births occur without mishap. My job at these births was to stay out of Mother Nature’s way until it was clear that my assistance was needed.

The key was to know when I was actually needed. I could not allow fear to guide me, but neither could I be foolishly naïve to the consequences of missing a sign of distress. It was a balance I had to find — a beautiful balance that proves to provide the best outcomes.

Years later, I look around and see that almost all doctors who deliver babies actually know very little about physiologic childbirth. (Physiologic childbirth is the same as natural childbirth, but it’s more understandable to those who speak doc-talk.) Physicians are taught to manage childbirth as a high-risk medical emergency, with their whole career on the line if anything goes wrong.

Obstetricians are surgeons; they train for years to perform life-saving surgical procedures and learn to view the world through that operating room lens. They want good outcomes, and know they can take control of a dangerous situation and safely deliver babies through timely surgical interventions when necessary. But how often is it really necessary?

Family physicians who practice obstetrics are also taught to use technology and protocols, rarely getting an opportunity to observe non-intervened births. Certainly neither specialty’s training exposes doctors to physiologic births enough for them to trust the process. And once a provider’s insecurities are in control, the birth is forever changed.

Women give birth as they make love — in many wonderful and unique variations. Some are slow to get there — some are quick. What if we treated sex the way we treat birth? “If you don’t have an orgasm within the prescribed amount of time, we have to intervene and make it happen.” Whew! No thanks!

This journey I had been on — seeing birth through multiple lenses, from many different perspectives, in the most natural form and also the least — inspired my book, “Homebirth in the Hospital.” The births I attended, which are the stories I share, do have interventions; few are completely hands-off natural. But none were managed by fear or hospital protocols, and none took away the mother’s power against her will. Birth can be beautiful, satisfying and empowering no matter where it occurs, as long as the laboring mother, her child, and the normal process of childbirth are respected.

At the end of the journey I’ve shared here, and only the beginning of what’s to come, my wants have seemed to change very little.

I want fear out of birthing rooms.

I want physicians to trust women’s bodies, and to know that birth can happen safely without unnecessary interventions.

I want women to trust their bodies. And when they are vulnerable, as many are when pregnant and in labor, I want them to be able to trust providers to know when help is needed.

I want training physicians to learn from midwives. I want them to be exposed to so many normal births that they know what it looks like and feels like, so they allow variations in birthing styles without expecting all of us to birth the same way.

What do you want? (Please leave your comments below!)

Stacey Marie Kerr, MD, the author of “Homebirth in the Hospital,” is a family physician who has provided family-centered childbirth experiences for her patients for more than 15 years. Knowing these babies since they were just a heartbeat inside their mother has been the greatest joy of her professional life. Dr. Kerr graduated with an MD from the University of California Davis Medical School. She writes about current issues in medical practice, and has been published extensively in many medical journals. She believes that every birth can be a positive and empowering experience, no matter where it occurs or what Mother Nature does to surprise us. For more, please visit her Web site.

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