# Birthing at home: Getting over the fear.

**URL:** <https://boards.straightdope.com/t/birthing-at-home-getting-over-the-fear/584990>\
**Category:** In My Humble Opinion\
**Created:** [June 10, 2011, 4:44pm UTC](https://boards.straightdope.com/t/birthing-at-home-getting-over-the-fear/584990 "2011-06-10T16:44:30Z")\
**Posts on this page:** 20\
**Page:** 3

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**Author:** ![Farmer\_Jane](https://avatars.discourse-cdn.com/v4/letter/f/bbe5ce/32.png) [@Farmer\_Jane](https://boards.straightdope.com/u/Farmer_Jane)\
**Post date:** [June 10, 2011, 6:14pm UTC](https://boards.straightdope.com/t/birthing-at-home-getting-over-the-fear/584990/41 "2011-06-10T18:14:38Z")

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> [@MsWhatsit](#):
>
> If you were knocked out with ether, as in the hypothetical situation that we are discussing in this thread.

Oh. It was my understanding (as a mom who devoured everything there was to read about pregnancy) that most C-sections have awake moms and that hospitals are moving away from knee-jerk reactions/c-sections.

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**Author:** ![Freudian\_Slit](https://avatars.discourse-cdn.com/v4/letter/f/5daacb/32.png) [@Freudian\_Slit](https://boards.straightdope.com/u/Freudian_Slit)\
**Post date:** [June 10, 2011, 6:16pm UTC](https://boards.straightdope.com/t/birthing-at-home-getting-over-the-fear/584990/42 "2011-06-10T18:16:17Z")

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> [@CitizenPained](#):
>
> Oh. It was my understanding (as a mom who devoured everything there was to read about pregnancy) that most C-sections have awake moms and that hospitals are moving away from knee-jerk reactions/c-sections.

Yeah, but someone else asked if we’d like to go back to the days of ether and stirrups and I said I wouldn’t mind–if the ether didn’t have horrible side effects. Waking up with an ether hangover wouldn’t be fun, for example. I really hate medical procedures, though…

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**Author:** ![MsWhatsit](https://avatars.discourse-cdn.com/v4/letter/m/eb8c5e/32.png) [@MsWhatsit](https://boards.straightdope.com/u/MsWhatsit)\
**Post date:** [June 10, 2011, 6:16pm UTC](https://boards.straightdope.com/t/birthing-at-home-getting-over-the-fear/584990/43 "2011-06-10T18:16:33Z")

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> [@CitizenPained](#):
>
> Oh. It was my understanding (as a mom who devoured everything there was to read about pregnancy) that most C-sections have awake moms and that hospitals are moving away from knee-jerk reactions/c-sections.

Yes. If you go back and read through the thread that we are currently participating in, you will find that a side discussion cropped up, in which one poster mentioned that we would not want to go back to the days of ether and stirrups, and another poster said that actually sounded pretty great because why wouldn’t you want to just fall asleep and wake up with a baby, and a couple other people mentioned why this would not be a desirable outcome for them.

This courtesy thread recap has been provided to you free of charge.

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**Author:** ![MandaJo](https://avatars.discourse-cdn.com/v4/letter/m/ac91a4/32.png) [@MandaJo](https://boards.straightdope.com/u/MandaJo)\
**Post date:** [June 10, 2011, 6:17pm UTC](https://boards.straightdope.com/t/birthing-at-home-getting-over-the-fear/584990/44 "2011-06-10T18:17:16Z")

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> [@CitizenPained](#):
>
> In Canada, health care is not an issue. In the U.S., I thought pregnant women were eligible for Medicaid? Most should be.
> 
> No one is going to refuse to treat you. And rarely will a low-income woman be forced to pay a 20k hospital bill if she can’t afford it.
> 
> :dubious:

There is a non-trivial number of households out there that have pretty decent income ($50Kish) but no insurance: basically, both halves of the couple are working low-level retail/food service management or for a telephone bank or something like that. Unless there is a special exemption for pregnant women, people in those situations do not qualify for medicare and they often cannot buy health insurance through work. They do make enough that they will certainly be hounded to pay their bills, and will end up with no credit for a decade if they do not.

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<div class="post-metadata">

**Author:** ![Farmer\_Jane](https://avatars.discourse-cdn.com/v4/letter/f/bbe5ce/32.png) [@Farmer\_Jane](https://boards.straightdope.com/u/Farmer_Jane)\
**Post date:** [June 10, 2011, 6:18pm UTC](https://boards.straightdope.com/t/birthing-at-home-getting-over-the-fear/584990/45 "2011-06-10T18:18:13Z")

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> [@Phlosphr](#):
>
> One thing would be that you miss the birth.
> 
> We live in the Mountains near Boulder, this is a very friendly midwife town. The town stats [no cite] are ridiculously high for healthy home births. Luckily the birthing center we are attached to with our insurance is very, very good, possibly best in Colorado. Many women have midwives, and the center is located in the hospital’s parking lot.
> 
> I’m not too worried. I am looking forward to walking with my wife during labor, looking at the mountains, playing a little Ben Folds, and other music, getting in the tub, and just being in a climate and location that is very familiar. The reduction of stress is incredibly helpful during birth and our midwife is all about the low stress!

Wait - you’ll be transferred to a birthing center if an emergency arises or you are giving birth at a birthing center? Because that birthing center is pretty much part of the hospital campus!

And I’m sorry, but the Boulder thing make me think, “Oh yeah. That explains it!”

😃

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<div class="post-metadata">

**Author:** ![MandaJo](https://avatars.discourse-cdn.com/v4/letter/m/ac91a4/32.png) [@MandaJo](https://boards.straightdope.com/u/MandaJo)\
**Post date:** [June 10, 2011, 6:18pm UTC](https://boards.straightdope.com/t/birthing-at-home-getting-over-the-fear/584990/46 "2011-06-10T18:18:54Z")

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> [@CitizenPained](#):
>
> Really? I live in a state that is not rabidly liberal, and we have things called hospitals that coordinate with low-income health programs.
> 
> Hmm…where else could I get medical care for pregnancy? California, Vermont, Mass., Iowa…all states have some kind of program.
> 
> Now that I think about it, home birth is probably _more_ expensive.

As I said, low-income are probably covered. It’s people with decent but not great incomes and no access to insurance that are screwed.

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<div class="post-metadata">

**Author:** ![Farmer\_Jane](https://avatars.discourse-cdn.com/v4/letter/f/bbe5ce/32.png) [@Farmer\_Jane](https://boards.straightdope.com/u/Farmer_Jane)\
**Post date:** [June 10, 2011, 6:20pm UTC](https://boards.straightdope.com/t/birthing-at-home-getting-over-the-fear/584990/47 "2011-06-10T18:20:32Z")

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> [@MsWhatsit](#):
>
> Yes. If you go back and read through the thread that we are currently participating in, you will find that a side discussion cropped up, in which one poster mentioned that we would not want to go back to the days of ether and stirrups, and another poster said that actually sounded pretty great because why wouldn’t you want to just fall asleep and wake up with a baby, and a couple other people mentioned why this would not be a desirable outcome for them.
> 
> This courtesy thread recap has been provided to you free of charge.

I’m going to assume your snark has been provided free of charge due to discomfort of one disagreeing with you and uncertainty in your positions.

Psychological analysis: 5 cents.

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**Author:** ![Rand\_Rover](https://avatars.discourse-cdn.com/v4/letter/r/db5fbb/32.png) [@Rand\_Rover](https://boards.straightdope.com/u/Rand_Rover)\
**Post date:** [June 10, 2011, 6:23pm UTC](https://boards.straightdope.com/t/birthing-at-home-getting-over-the-fear/584990/48 "2011-06-10T18:23:03Z")

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> [@Phlosphr](#):
>
> Both our midwife and the back-up [they are both present] are Certified Nurse Midwives] which means they have the medical background. That was important in our decision. They have emergency medical equipment right with them, including pictocin (sp?) if needed. Our particular midwife had to have a certification to carry it, otherwise it was illegal.
> 
> Also, she has never used it. Case in point, one of her last births, [last week] the baby’s heart beat [tones] went waaay down, far enough where a doc would have called for a c-section. Our Midwife, alerted the father and mother they may have to transport, but before we do, she asked the woman to stop squatting and move into the tub, 30 seconds later, dad was holding the mother, moms back was relieved of all tension and her legs spread in the tub - floating - the baby’s heart tones immediately went back to normal.
> 
> Very true, but back then we were still considering the birthing center. After meeting with the midwife several times, we opted for the home birth.
> 
> One thing I must mention, something I put a lot of stock in: is that the chemicals that are floating your the mothers brain at the time of birth are very important to bonding - not that bonding does not happen during a c-section or with an epidural - but one of the main reasons for natural birth is to experience it…some people say it is a spiritual experience: I’ll say for me and my wife, it is a rite of passage that we want to be fully present for.

Oh, we’re sharing anecdotes now as if they mean something? OK. When my wife gave birth (in a hospital, duh), the baby’s heart rate went down. My wife then did absolutely noithing–no hot-tub or change of postion or anything–and the baby’s heart rate returned to normal (whereupon the doctor dismissed the 5 extra people he called in). So, perhaps the hot tub in your anecdote was completely superfluous.

Also, I would imagine that the “spiritual experience” you discuss is simply a product of being in extreme pain for a long period of time. Native Americans used to hang themselves by hooks through their skin to achieve the same effect.

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<div class="post-metadata">

**Author:** ![Farmer\_Jane](https://avatars.discourse-cdn.com/v4/letter/f/bbe5ce/32.png) [@Farmer\_Jane](https://boards.straightdope.com/u/Farmer_Jane)\
**Post date:** [June 10, 2011, 6:24pm UTC](https://boards.straightdope.com/t/birthing-at-home-getting-over-the-fear/584990/49 "2011-06-10T18:24:38Z")

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> [@MandaJo](#):
>
> As I said, low-income are probably covered. It’s people with decent but not great incomes and no access to insurance that are screwed.

Cite?

Pregnancy is a special category on most Medicaid rolls.

Seriously - paying 3-5k for a midwife is probably than what MOST women pay OUT OF POCKET re: uninsured pregnant women.

Dare I suggest that uninsured, low-income pregnant women are less likely to hop on the home birth trend?

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<div class="post-metadata">

**Author:** ![Heart\_of\_Dorkness](https://avatars.discourse-cdn.com/v4/letter/h/4bbf92/32.png) [@Heart\_of\_Dorkness](https://boards.straightdope.com/u/Heart_of_Dorkness)\
**Post date:** [June 10, 2011, 6:26pm UTC](https://boards.straightdope.com/t/birthing-at-home-getting-over-the-fear/584990/50 "2011-06-10T18:26:34Z")

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> [@WhyNot](#):
>
> I would totally welcome home dentistry, if a dentist wanted to lug all her equipment to my home. Why not? 😉

This actually brings up a great point. I didn’t, and wouldn’t, have a home birth, but that’s already been well-covered. That aside, though, another huge benefit of going to the hospital was that they had everything we needed right there, including a bunch of things we never would have guessed we needed until we had them. So if you’re going to do this at home, make sure you or the midwife have the following on hand:

- an assload of chux pads (or two assloads of towels)
- another assload of towels, for regular towel purposes
- plenty (not a full assload needed) of sheets, blankets, and pillows
- lots of ice, and water
- heat packs
- cold packs (you want the long skinny ones that will fit in your wife’s underwear like a maxipad)
- maxipads - the most ginormous size you can get
- a few pairs of ginormous underwear that will accommodate a cold pack and maxipad.
- ibuprofen\* (generally safe even while breastfeeding)
- a squirt bottle (_not_ a spray bottle with a trigger, but the sports-bottle kind; your wife will find it very useful for gently cleaning her undercarriage in the shower)
- a sitz bath (see above)
- a literal assload of newborn diapers
- swaddling blankets
- a huge cup, preferably with a lid and straw, so your wife can carry it around with her and drink plenty of water, especially if she’s breastfeeding
- plenty (a couple of weeks worth) of frozen or fresh meals and snacks (preferably things you can eat with one hand, so your wife can eat while breastfeeding) so that you don’t have to spend time shopping/cooking when you could be hanging out with the baby.

I hope it goes well, and wish all of you the best.

\*After you give birth, your uterus contracts to its normal size very rapidly. Breastfeeding also speeds this process. Apparently, for some women, this is not that bad. To me, this felt like the worst menstrual cramps I’ve ever had - and I’ve had bad ones. I felt it from my waist all the way down to my toes. It was agony. It didn’t hurt quite as much as labor, but I was in tears every time I nursed for the first couple of days - and he nursed about every half hour, around the clock. Ibuprofen did not really help. They had stronger stuff on hand at the hospital that was still relatively safe while breastfeeding. Particularly if your wife has had painful cramps in the past, you may want to ask the midwife if she can give you something stronger to have on hand.

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<div class="post-metadata">

**Author:** ![kayaker](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kayaker/32/441_2.png) [@kayaker](https://boards.straightdope.com/u/kayaker)\
**Post date:** [June 10, 2011, 6:27pm UTC](https://boards.straightdope.com/t/birthing-at-home-getting-over-the-fear/584990/51 "2011-06-10T18:27:13Z")

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Having been present for my daughter’s and son’s hospital births, all I can say is consider investing in some tarps. The whole process is messy!

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<div class="post-metadata">

**Author:** ![Farmer\_Jane](https://avatars.discourse-cdn.com/v4/letter/f/bbe5ce/32.png) [@Farmer\_Jane](https://boards.straightdope.com/u/Farmer_Jane)\
**Post date:** [June 10, 2011, 6:30pm UTC](https://boards.straightdope.com/t/birthing-at-home-getting-over-the-fear/584990/52 "2011-06-10T18:30:04Z")

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btw, I don’t think that home births or midwives should be outlawed. I was explaining my line of thinking. I have friends who only eat organic food and breastfeed and restrict tv and I have friends who want their children to be tekkies but recycle religiously. My son’s bff’s family leases on a kosher chicken farm (as they can’t have urban chickens) and restrict sugar but they also watch movies that we don’t. I think parents have the right to make most of their child’s decisions without interference. I had people who tried to make me feel guilty about circumcising my son, but those were also the home birth types. 😉

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**Author:** ![MandaJo](https://avatars.discourse-cdn.com/v4/letter/m/ac91a4/32.png) [@MandaJo](https://boards.straightdope.com/u/MandaJo)\
**Post date:** [June 10, 2011, 6:37pm UTC](https://boards.straightdope.com/t/birthing-at-home-getting-over-the-fear/584990/53 "2011-06-10T18:37:16Z")

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> [@CitizenPained](#):
>
> Cite?
> 
> Pregnancy is a special category on most Medicaid rolls.
> 
> Seriously - paying 3-5k for a midwife is probably than what MOST women pay OUT OF POCKET re: uninsured pregnant women.
> 
> Dare I suggest that uninsured, low-income pregnant women are less likely to hop on the home birth trend?

According to the [American Pregnancy Association](http://www.americanpregnancy.org/planningandpreparing/affordablehealthcare.html), 14% of women who become pregnant are uninsured. The site goes on to say that IF you are eligible for medicare, they will cover pregnancy, but it sure doesn’t assume that all uninsured women will be eligible for medicare.

I agree that this isn’t a factor for most births, but there is a non-trivial number of women out there who pay for births out of pocket, and those women likely include the relative costs in making the decision for home or hospital births. I don’t even see how that’s a controversial statement.

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<div class="post-metadata">

**Author:** ![Vihaga](https://avatars.discourse-cdn.com/v4/letter/v/b4bc9f/32.png) [@Vihaga](https://boards.straightdope.com/u/Vihaga)\
**Post date:** [June 10, 2011, 6:37pm UTC](https://boards.straightdope.com/t/birthing-at-home-getting-over-the-fear/584990/54 "2011-06-10T18:37:46Z")

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It does look like planned home births are relatively safe for low-risk mothers. I’m not buying it for the babies, however. There was an interesting comment [column in Lancet](http://proxy.library.upenn.edu:2070/pubmed/20674705) pointing out some issues with the Dutch study. In addition, a [more recent](http://www.ajog.org/article/S0002-9378(10)00671-X/abstract) study in the American Journal of Obs. and Gyn. seems to indicate that there is, in fact, more risk to the infant when birth occurs at home. Everybody’s got an agenda, so it’s surprisingly difficult to find an unbiased study in a field that seems to be rife with sampling and attribution errors. [This study](http://www.ncbi.nlm.nih.gov/pubmed?term=Infant%20outcomes%20of%20certified%20nurse%20midwife%20attended%20home%20births%3A%20United%20States%202000%20to%202004.)seems to show higher infant mortality rates in home births, but wasn’t as carefully controlled, thought they did use a large population. It’s bottom line looks like even at-home births with cerfified midwives are a bit more risky, but, for the love of crap, don’t use an uncertified one.  
The thing that concerns me is that there’s a lot of cherry-picking going on on the home birth side, here. One study (in Midwifery Today) states that

> [@](#):
>
> “Currently available published research suggests planning a hospital birth is not safer than planning an attended homebirth for women with one head-down fetus, between 37-42 weeks, no high blood pressure, no previous cesareans and no serious medical conditions that affect pregnancy outcome.”

That’s a lot of ifs, which the obstetric group doesn’t always exclude. **Whynot** ’s first cite was a very nicely controlled study, but the Dutch study had problems, and the third cite didn’t actually have its own controls. I’m glad I’m not involved in studying this, because it’s a mess. Even a preliminary literature search is a nightmare of conflicting methodologies and agendas.

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<div class="post-metadata">

**Author:** ![Rand\_Rover](https://avatars.discourse-cdn.com/v4/letter/r/db5fbb/32.png) [@Rand\_Rover](https://boards.straightdope.com/u/Rand_Rover)\
**Post date:** [June 10, 2011, 6:51pm UTC](https://boards.straightdope.com/t/birthing-at-home-getting-over-the-fear/584990/55 "2011-06-10T18:51:55Z")

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Yep, the baby is my concern as well. Since the OP seems to like anecdotes, here’s another one: a hippy-dippy friend of mine gave birth at home, laboring for 20 hours. The baby died (SIDS) a few days later.

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**Author:** ![Yllaria](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/yllaria/32/3452_2.png) [@Yllaria](https://boards.straightdope.com/u/Yllaria)\
**Post date:** [June 10, 2011, 7:00pm UTC](https://boards.straightdope.com/t/birthing-at-home-getting-over-the-fear/584990/56 "2011-06-10T19:00:36Z")

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> [@MLS](#):
>
> . . Last I heard, one had the right to refuse anything although it might mean signing an “against medical advice” form. . .

Somehow I don’t think the middle of labor is the best time to be arguing with the doctor and demanding forms. At, for instance, episiotomy time, I was strapped down and not forming complete sentences. The time for dickering and deciding is before labor starts.

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<div class="post-metadata">

**Author:** ![Heart\_of\_Dorkness](https://avatars.discourse-cdn.com/v4/letter/h/4bbf92/32.png) [@Heart\_of\_Dorkness](https://boards.straightdope.com/u/Heart_of_Dorkness)\
**Post date:** [June 10, 2011, 7:08pm UTC](https://boards.straightdope.com/t/birthing-at-home-getting-over-the-fear/584990/57 "2011-06-10T19:08:58Z")

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> [@Phlosphr](#):
>
> One thing I must mention, something I put a lot of stock in: is that the chemicals that are floating your the mothers brain at the time of birth are very important to bonding - not that bonding does not happen during a c-section or with an epidural - but one of the main reasons for natural birth is to experience it…some people say it is a spiritual experience: I’ll say for me and my wife, it is a rite of passage that we want to be fully present for.

I just wanted to respond to this specifically: I, too, wanted to be fully present for my son’s birth (I even had them set up a mirror so I could see everything happening). And I was - _because_ I had an epidural. It’s not an opiate or anything that affects your mental state; it just blocks the nerve responses so you don’t feel pain from your waist down (or any other sensation - that was kind of annoying). Instead of feeling exhausted and trying to focus on anything other than the pain, I was rested (woke up from a two-hour nap ready to push), calm, happy, and able to focus on the delivery. Which was awesome.

I’m not trying to convince you to do things any particular way. I just wanted to put out a little PSA for anyone reading who might shy away from an epidural because they don’t want to be “drugged up” - it’s not like that at all.

Well, I also want to reiterate, as I said in another thread of yours: it’s great to have a plan for how you want things to go, but please, do not feel like a failure, and do not let your wife feel like a failure, if things do not go as planned. If you have to have an emergency c-section, or some other intervention you hoped not to have, do _not_ let yourselves feel disappointed, or feel like you were robbed of your birth experience. If you have a healthy mom and baby to show for it at the end, that really is all that matters. Really.

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**Author:** ![Hello\_Again](https://avatars.discourse-cdn.com/v4/letter/h/85e7bf/32.png) [@Hello\_Again](https://boards.straightdope.com/u/Hello_Again)\
**Post date:** [June 10, 2011, 7:17pm UTC](https://boards.straightdope.com/t/birthing-at-home-getting-over-the-fear/584990/58 "2011-06-10T19:17:40Z")

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> [@Heart\_of\_Dorkness](#):
>
> I just wanted to respond to this specifically: I, too, wanted to be fully present for my son’s birth (I even had them set up a mirror so I could see everything happening). And I was - _because_ I had an epidural. It’s not an opiate or anything that affects your mental state; it just blocks the nerve responses so you don’t feel pain from your waist down (or any other sensation - that was kind of annoying). Instead of feeling exhausted and trying to focus on anything other than the pain, I was rested (woke up from a two-hour nap ready to push), calm, happy, and able to focus on the delivery. Which was awesome.
> 
> I’m not trying to convince you to do things any particular way. I just wanted to put out a little PSA for anyone reading who might shy away from an epidural because they don’t want to be “drugged up” - it’s not like that at all.

This is exactly what my friend told me. She had back labor that was excrutiating and she couldn’t even stand, much less walk or take a shower\*. She had a hard time deciding to get the epidural, but once she did, she thought “what the fuck was I thinking not wanting an epidural??” and took a nice nap.

\*As backdrop, this friend is almost immune to normal forms of pain. Among her other feats, she spent the whole day hiking on an ACL that was ripped in two. Her knee was the size of a cantaloupe. She said it didn’t hurt.

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<div class="post-metadata">

**Author:** ![Farmer\_Jane](https://avatars.discourse-cdn.com/v4/letter/f/bbe5ce/32.png) [@Farmer\_Jane](https://boards.straightdope.com/u/Farmer_Jane)\
**Post date:** [June 10, 2011, 7:25pm UTC](https://boards.straightdope.com/t/birthing-at-home-getting-over-the-fear/584990/59 "2011-06-10T19:25:11Z")

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> [@MandaJo](#):
>
> According to the [American Pregnancy Association](http://www.americanpregnancy.org/planningandpreparing/affordablehealthcare.html), 14% of women who become pregnant are uninsured. The site goes on to say that IF you are eligible for medicare, they will cover pregnancy, but it sure doesn’t assume that all uninsured women will be eligible for medicare.
> 
> I agree that this isn’t a factor for most births, but there is a non-trivial number of women out there who pay for births out of pocket, and those women likely include the relative costs in making the decision for home or hospital births. I don’t even see how that’s a controversial statement.

Of the 14 per cent, it’s reasonable to assume, given that most states put women in a special status category, they will be covered by Medicaid or a state program.

If not, they can work out a program with a hospital where much of the bill is taken off.

I know of NO STATE where women will go into any more debt with a regular at home hospital visit than with a midwife.

It’s not logical. So show me the evidence…and I’ll consider your point.

Again, at-home births are trends of the middle and upper class.

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<div class="post-metadata">

**Author:** ![MandaJo](https://avatars.discourse-cdn.com/v4/letter/m/ac91a4/32.png) [@MandaJo](https://boards.straightdope.com/u/MandaJo)\
**Post date:** [June 10, 2011, 7:40pm UTC](https://boards.straightdope.com/t/birthing-at-home-getting-over-the-fear/584990/60 "2011-06-10T19:40:02Z")

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> [@CitizenPained](#):
>
> Of the 14 per cent, it’s reasonable to assume, given that most states put women in a special status category, they will be covered by Medicaid or a state program.
> 
> If not, they can work out a program with a hospital where much of the bill is taken off.
> 
> I know of NO STATE where women will go into any more debt with a regular at home hospital visit than with a midwife.
> 
> It’s not logical. So show me the evidence…and I’ll consider your point.
> 
> Again, at-home births are trends of the middle and upper class.

I gave you a cite that a significant number of pregnant women are uninsured. On that very site, it recommends that pregnant women look into birthing centers as a cheaper alternative. You are the one making the claim that **virtually all** of those 14% will find coverage or not be billed by the hospital–you prove it.

And I am speaking of the uninsured middle class. The piano teacher married to the McDonald’s shift manager, the data-entry clerk married to the hair-dresser, the receptionist married to the plumber’s helper. People who make pretty solid wages as a household but have no access to group coverage and do not make enough to pay for private coverage.

I am not saying and have never said that cost was a major factor in most home births. All I’ve said–and continue to say–is that for some couples it might well be the responsible choice, given no increase in risk.

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