Kerr: 'Homebirth in Hospital' can be a reality

<p>She had her own two babies the natural way back in the ’70s. In fact, Stacey Marie Kerr had one daughter at The Farm, the spiritual commune in Tennessee where the legendary Ina May Gaskin incubated the modern midwifery movement.</p><p>She even collected statistics for Gaskin’s groundbreaking book, “Spiritual Midwifery,” which remains the seminal work on home birth.</p><p>Thirty-five years and many home- and hospital-based deliveries later, the Santa Rosa family practice physician still believes hospitals are not the best place for healthy moms to have their babies. But Kerr is a realist. For a variety of medical, cultural and social reasons, most women wind up giving birth in hospitals. Very few hospitals have the separate birthing centers that she says she would like to see.</p><p>For those expectant moms who must or choose to have their babies in a hospital, but want to do it as naturally and with as little direct medical intervention as possible, Kerr advocates an integrated approach.</p><p>Her new book, “Homebirth in the Hospital” (Sentient Publications), shows how to make a hospital birth as much like a home birth as possible by empowering women to trust their own bodies to do the work, and by relying on medical technology only when necessary.</p><p>The book includes practical advice and a checklist for expectant parents to use when evaluating childbirth providers. But it’s primarily a storybook, showing how 15 real women managed to pull off a more satisfying and more natural childbirth in the hospital.</p><p>“Everything has shifted to the more fearful direction of childbirth,” lamented Kerr, who has delivered countless babies applying this approach. “It’s partially driven by the medical legal system, partially driven by the public’s expectations of perfection, which are unrealistic, and partly driven by economics. But we have this prenatal paradox now. We’re doing more and getting less for it. We’re spending more money, and we’re getting poorer outcomes.”</p><p>The title has raised the hackles, she said, of some anti-hospital zealots who find the whole notion impossible. But it received two thumbs up from TV personality Ricki Lake and Abby Epstein, co-creators of the film “The Business of Being Born,” who mentioned the book, noting that Kerr’s “wise embrace of nature and technology demonstrates that the best births have the right mix of midwifery and medicine.”</p><p>Kerr maintains that to achieve homebirth-like experience in a hospital means a “midwifery model of care ... which is hands off other than careful skilled observation.”</p><p>“And then if the situation warrants it,” she explains, “we step in with what we need to do.”</p><p>The standard hospital model of emergency care applied to childbirth, an otherwise natural process, leads to overreaction and overintervention, Kerr says, noting that the rate of Caesarean sections has soared to more than 30 percent, and epidurals (spinal anesthesia) have become standard in many women’s minds, even though it means being tied to a blood pressure monitor and IV. An expectant mom should seek out the C-section rates of her provider and hospital, although facilities, Kerr says, aren’t always forthcoming.</p><p>Contrary to popular practice, husbands don’t necessarily make the best birth coaches, Kerr says. She recommends expectant moms seek out doulas, professional birthing assistants who provide continuous physical, emotional and informational support before, during and after birth.</p><p>Kerr counsels that for those who choose it, there are real advantages to a natural childbirth experience with minimal medical management. Immediately after a vaginal birth, the level of the hormone oxytocin rises, she says, stimulating that critical bonding. And pushing out a baby is one of life’s peak experiences.</p><p>“If you could have a really good experience offered to you, why would you say no? If I won a cruise to the Caribbean, would I say no? That is why I want women who have to birth in the hospital,” she says, “to be able to have at least some if not all of the emotional, spiritual, empowering advantages of staying at home.”</p>