Petaluma Health Center nurse explores home birth in new film

Color correction and sound mixing are not on the normal to-do lists of medical professionals, but in the past two years, Jessicca Moore, a family nurse practitioner at the Petaluma Health Center, has expanded her skill set.

After giving birth at home twice, surrounded by family, friends and the smell of banana bread baking in the kitchen, Moore was inspired to make a documentary film called “Why Not Home?” to tell people about her experience.

“I was post-partum delusional,” she said. “It was that feeling that I had just created a person and pushed them out of my body - if I could do that, I could do anything.”

With the encouragement of a friend who makes commercial films, Moore harnessed energy that, she said, birth at its best provides for women. She set out to make a 28-minute documentary about medical professionals who choose to have their babies at home instead of in the hospital.

Now, two years later, the film has grown to 80 minutes and is about much more than the reasons some people choose home birth.

“Having access to these choices is important,” Moore said, “but it’s bigger than that. It’s about raising questions about the quality of maternal care that’s available.”

Moore, who moved to Petaluma in 2005, is from Waynesville, Mo., a small town in the Ozarks. She said she didn’t grow up with the idea that birth was a wonderful experience. Her mother had two children, both through cesarean section, and she didn’t expect her own birthing experience to be particularly amazing: “I was fully prepared for it to be painful.”

In fact, Moore said, it was an intense experience, but intense in the “most beautiful way.”

Moore attended many hospital births through her medical training at UCLA and her work at the Health Center. She witnessed how a hospital-based midwife practice worked in Los Angeles and saw the importance of a birthing environment with familiar people and minimal interruption and distraction.

Because her own pregnancies were low-risk and a similar hospital midwifery practice did not exist in Sonoma County, Moore decided that, for her, the best chance of having a successful birth was to do it at home.

Even after the successful home birth of her son, however, she thought the ease and overall positive experience might have been a “fluke.” But after the birth of her daughter, she realized there was something different about having a child in the comfort of home.

Moore said she was left wondering why no one had told her how amazing birth could be. She said many of her friends and colleagues who worked at clinics and hospitals were also having home births, but it was not widely discussed.

“Even here in the medical community, there is concern if it’s safe,” she said. “But there are some stories I want to tell, things about this that people don’t know they should know.”

Moore explained that western medical training does not include births outside of the hospital. In fact, she said, midwives historically have been seen as untrained or dirty, despite the fact that before the 1900s, most women gave birth at home under the care of a midwife.

By the early 20th century, more women were giving birth in hospitals, perhaps to accommodate the desire for physicians to be involved in maternal care, Moore explained. Most of these physicians were men who didn’t have firsthand experience of birth or working with a midwife. At the time, because of the lack of knowledge of germ theory and other reasons, the outcomes were worse in the hospital than at home, she said. And even now, Moore acknowledged, there are reasons why most U.S. births occur in hospitals.

For example, home birth is not usually covered by insurance, she said, and while the cost of home birth is actually cheaper than hospital birth, the perception is that it’s more expensive because hospital costs are absorbed into the larger medical insurance-based system. And because less than 1 percent of births in the United States are at home, there is no standard data collection on those births and the results on safety outcomes are conflicting, she added. But statistics like the Centers for Disease Control’s cesarean section rate for the United States, which hovers around 30 percent, might encourage women to find out about their options, Moore said. (The World Health Organization considers the ideal rate for C-sections to be 10 percent to 15 percent.)

“We are not going to suddenly change the system,” Moore said. “We just want more collaboration (between midwives and hospitals) and an improvement of maternal care.”

In fact, “Why Not Home?” is not overly critical of the current system or its practitioners. Moore herself is one of these care providers, as are many of the film’s subjects. Through personal and emotional footage of live births, interviews with mothers, doctors and leaders in the field of maternal health like Eugene Declercq of Boston University’s School of Public Health and Saraswathi Vedam of the University of British Columbia, Moore demonstrates why it is important that even in a hospital setting, health care providers bring a sensibility that “birth is normal” to their practice.

“It is not my job to tell people what to do,” she said. “They should do their own research, but they need providers to support them.”

A marked difference between “Why Not Home?” and other films about home birth is that the women telling their stories in the film are not “on the fringe,” Moore said. “They are medical professionals and mainstream folks.”

She said her goal is to break down the stereotypes about home birth and minimize people’s judgments. She hopes the film will reach a broad audience, including expectant parents and medical and midwifery students. And while she’s entered it into some high-profile film festivals, her primary aim is for it to be seen in grass-roots screenings across the country.

So far, the film and the subject matter have attracted a strong community of supporters, Moore said. Her direct collaborators, including associate producers Erin Wrightsman and Kelly Collins Geiser and her editor, Victoria Toth, have synthesized their skills to move both the project and a related Kickstarter fundraising campaign forward.

Moore said she hopes the film’s unique perspective will lay the groundwork for western health care providers and midwives to collaborate to “make the experience and safety of birth better in the home and hospital.”

To learn more about “Why Not Home?,” go to whynothome.com.

Freelance journalist Ariana Reguzzoni worked on “Why Not Home” as a researcher and camera person.