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Apartment Birthing

This was originally posted on Jun 6, 2010 on the blog I destroyed.  This is the article I was talking about yesterday.

I still don’t feel like it is “home,” but my family has survived the move and is settled into our new apartment.  Over the last week I have been reflecting on the lack of privacy afforded by apartment buildings and the necessity of apartment dwellings in urban areas.  Which made me wonder, are apartment dwellers less likely to give birth at home?

As I type this it is late, and I am only up because the young men who moved-in upstairs seem to be having a housewarming party.  So I am not going to take the time to find out if there is any research on this.  Instead, I’m going to consider all the factors that go into the decision to give birth at home.

You see, as a house-owning natural and home birth advocate my argument for birthing at home revolved around the ability of the mother to relax in her own environment; the privacy of her own home; the control she had and how all that works to create a better birth experience with at least as good of outcomes as the hospital.  But this week my eyes have been opened to a few holes in that argument.

My apartment may be my home, but my ability to relax in my own environment depends on what is happening in the homes above and around me.  Could I feel comfortably relaxed laboring at home tonight?  I doubt it.

My apartment is private to an extent – I can close the doors and shades to prevent people seeing in.  But I can tell what is happening upstairs right now, which leads me to believe if I were to use my birthing voice my neighbors would hear me.

And so, although I could control who was in the room with me and to some extent what they did, I could not control who would be home and be aware (or hear) what was happening.

Now, the catch to this is that I do not gain a relaxing environment, privacy or control by moving my labor to a hospital.  Far from it, I lose parts of each of those. But what I might gain is anonymity. The nurses won’t care and I will never see the people in the next room again – so there are no long-term consequences if I am loud or  walk out of the room naked.  I can only imagine the months of discomfort that would result from wandering out to my “private deck” naked during labor – I have to see my neighbors every day.

So if I were to become pregnant today, what would I chose?  A birth center may be a good option – except there is not one here.  While I dislike the idea of birthing in a hospital, I just might decide it is a better, more relaxing option for me than trying to not disturb the neighbors here.

While I accept there are many reasons birth should be a normal part of everyday life, I can also accept that many women live in a world where it is not.  Recognizing the challenges women face as they make decisions about where and how to birth can only make me a stronger advocate for the women I serve.

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Jennifer Vanderlaan CNM MPH is the author of the BirthingNaturally.net website. She has been working with expectant families since 2000, training doulas, childbirth educators, and midwives. She has worked with midwives in Central America and Sub-Saharan Africa. Her interest in public health grew in 2010, and she is now a PhD student learning to become a producer of knowledge.

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