Homebirth. Scared?

Recently Farfallina at a Roam to Rome and Cherrye at My Bella Vita had the same question for me. Wasn't I scared to have a homebirth? This is a great question and I have given it much thought. So here is my short answer. (Yes, I am laughing at myself). I think it is natural to have some level of fear when thinking about giving birth. First of all it is something that hasn't happened yet, and so there is the fear of the unknown. Even if you have given birth before you are aware that each birth is different. Things can go wrong. Education is a great antidote to fear. Also there is a natural tendency to fear pain. This is where pain management techniques come in handy, such as self hypnosis or relaxation techniques. Unless you are lucky enough to be assured of having an epidural to manage your pain (something that here I was told I could only have if there were an anaesthesiologist available) in the hospital at the time I was in labor. This seemed an iffy prospect at best to me, and so I discarded it as a pain management technique. How disappointing if all my hopes were pinned on an epidural and in the moment of need it was unavailable. Shudder. No, I had to learn to manage the pain on my own. So, about my homebirth? It was everything I could have asked for. In fact it was much better than I was able to imagine it might be. How can I show you, using only words, how contented I feel about the birthing of my third son? I truly didn't know a birth could be such a celebration. My first two were also natural childbirths, and each was born in a hospital in the USA. I had very good births, if a bit long on the contractions part... but everything went smoothly and there were no unexpected interventions or emergencies. However, my choice of positions was very limited as each time I was hooked up to a fetal monitor, in effect on my back and bound to the bed. I later learned that this position for childbirth doesn't allow the pelvis to open as much as it can in other positions. No wonder with my first son I felt strong back labor and then after the birth was told I had a cracked tailbone that would take at least six months to heal. I gave birth to my second son in the same position, (no alternatives were available with the fetal monitoring) in a hospital in another state. I suppose that if I were to criticize anything about these births it would be to say I regret not having options of birthing in another position. But really, how can I criticize when each birth was without unexpected problems, and each baby was completely healthy. I was also able to give birth and stay with the baby in the same room; not being rushed off to the delivery room as I had imagined.
I am sure I made the right choice to have my first son in a hospital. I didn't know what to expect, and was afraid, and really needed the assurance of health care professionals and the availability of hi tech machines.
With my second son, I knew what to expect but didn't think of home birth, nor would it have been available to me in the small community I lived in.
Flash forward ten years and I am living in another country and became pregnant. I learned many things about birth in an Italian hospital that made me dread giving birth in one. Women, after births are not given a private room, unless you pay privately of course, and (this is another subject but my husband feels strongly that he pays high enough taxes here that he is entitled to the healthcare provided by the Italian healthcare system and we should not have to pay privately unless strictly necessary). I learned that if I were to give birth here in an Italian hospital, it is most likely that I would be in the same room as 4 or 5 other women and their babies, and their visitors, and have I mentioned that I have never once seen a privacy curtain in a hospital room here? I think the noise level alone would make it impossible to sleep in such surroundings. I also read that we must provide our own amenities, such as toilet paper, oh, and there are not bathrooms in the rooms, but you must go down the hall. Can you sense my unease? I must mention here that after the birth of my second son, the hospital in the U.S. served me a champagne breakfast the next morning before I went home. They brought me a tray of unbelievably good food (for hospital food), a long stemmed rose, and a small bottle of champagne. I had my own private room, with its own bathroom. Let me tell you, after giving birth that is a good thing. I guess you could say I became spoiled. I couldn't happily imagine myself in a hospital here in Italy. But the very worst thing of all? I would have to give birth attended by strangers. I would of course have prenatal care, but for the actual birth I would check in to the hospital, and have to try to trust myself to people who didn't know me, or my history, or even possible birth preferences. Ugh!
Then something wonderful happened! Our general practitioner referred me to le ostetriche (midwives) at Sant'Anna here in Torino. There while waiting in the hall, I saw a sign on the door to the office next to the one I was waiting for that advertised midwife services for home births. While at my first prenatal appointment I asked about that, just to become informed. I learned that the same team that provides prenatal care would also (at least one of them) be there for the birth! Continuity of care! I was very interested.
I read a lot then about home births, and then about their philosophies in particular.
First to be eligible for a home birth attended by them the pregnancy had to advance with no physiological problems. After talking things over with M,  I decided to sign up for prenatal care and hopefully a homebirth with them. We learned that in the event of needing to go to the hospital one of the midwives would still attend me there. But in the case of a true emergency, we live only a five minute walk away from the hospital that M was born in, and so I felt completely at ease that the baby and I would receive hi tech assistance if it truly became necessary.
In the days before my littlest one was born, the midwives told me to call them about 2 hours before I thought I would give birth. They knew I would know when because I had given birth before and knew to listen to my body. They would need at least an hour to gather their things and get to our house. Then they wanted a little time to ready their equipment and attend my needs before the actual birth.
----------------------------------------------
The Birth:

On the day of the birth, in the morning I announced to the family that this was going to be the day, and that I was feeling some real contractions. M excitedly called the midwives, just to advise them. They came to our house right away anyway, just to see how things were progressing. After a nice chat, they left. I spent most of the day walking, talking with my boys and mom, and using a stability ball in stretches to relieve back pressure. In the afternoon when my contractions slowed down, I went to take a bath. I needed the alone time to re-focus. While in the bath tub, the contractions strengthened and became more close together. I asked my mom and M to begin to add the water to the birth pool, that we had set up in the kitchen. After it was ready I jumped in the hot water. Such bliss! I had read that the extra deep water would support my weight in a variety of positions so that I wouldn't use extra energy trying to hold difficult positions. It was true, I felt supported and buoyant and able to move to a variety of positions to labor in. My mom had made a chicken soup for dinner and I had a few bites to sustain me. There came a point that I didn't want to talk with my family any more, in fact once the boys were discussing something (too loudly in my opinion at the time) and I told them to shut up! That is when they realized I was really in labor. I guess before then I had looked too comfortable! Between contractions I closed my eyes and just enjoyed the time that wasn't such an effort. During contractions I had to focus on my body, on the work it was doing, and of course remind myself to relax. At one point M needed a break from the waiting, and went out to walk the dog. While he was gone I felt a "pop" and I think my bag of waters broke, although since I was in water, it wasn't apparent. After he came back I asked him to call the midwives. They arrived about an hour later. One was a student, one was part of my team and another that worked in the birthing ward at the hospital was there as support for my midwife. That one suggested I get out of the pool to walk around and get the contractions really going. At this point my contractions were averaging about 3 maybe 4 minutes apart, and I told my midwife I was sure I couldn't get out. She decided to examine me and seemed satisfied, and told me to do whatever I wanted. A couple times they monitored the baby's heart rate, and once my blood pressure. All was well. About 30 minutes later at the end of a contraction I felt a slight urge to push. I was surprised, I hadn't realized I was so close to that stage yet. I opened my eyes and told my midwife and she said "As you want. Do as you feel." So with the next contraction I pushed, but not voluntarily, there was no way I could have not pushed. The other midwife heard me growl, and came in the room saying "Mamma mia, already?!" Then I had a very long pause between contractions. I suppose it was my body's way of slowly stretching and preparing. The baby's head was beginning to show. With the next push he was born, completely! He came out so fast, like a champagne cork. The midwife lifted him from the water face down and I couldn't help myself, I scooped him from her arms and held him to my chest. I held him face down so any fluids could naturally drain from his nose and mouth. In the moment I embraced him he let out the sweetest sound I have ever heard. Someone draped him in towels we had warming in the oven. My boys and my mom came near to admire him and we all decided we should look to see what variety of baby it was. Yes, a boy! The moment he was born I was ecstatic! After a few minutes I felt like I could leave the pool, and so they helped me out and to a little cot bed we had prepared in the living room. We did the breast crawl, and after about 35 minutes he latched on and started feeding. Meanwhile they took some of his blood from the cord for tests. Then it was M's turn to cut the cord. While they weighed the baby and dressed him, I went into the bathroom, sat on the bidet and lost the placenta. Then they suggested I shower. Luxury! They helped me to dress, and I came back into the living room. I held my little one and we all toasted with moscato and ate salatini and pandoro! We celebrated until 2 in the morning when the midwives finally left. They came back the next morning, and each day for three days, then every other day for a while. The midwives of Sant' Anna are simply the best! I wish every woman could give birth like I did. I don't mean specifically homebirth. I mean I wish they could feel as supported by their caregivers, and could trust themselves and be trusted by others to make the crucial decisions for their health and their baby's. I think being trusted by your caregivers, and trusting them in return builds an atmosphere where there is little room for doubt, worry or fear. I wish all women regardless of where they birth could experience that. I think it is important for women to have as little fear as possible during labor, because the fear increases pain, which causes tension which causes more pain and fear. Moms need to be supported. If mom feels safe and wants to birth at home, she should be able to do so. If she feels safe in and wants to birth in a hospital she should be able to do so. If she chooses caesarean she should do so. I don't believe there is *one* right way to give birth. It depends upon the mother's needs, and those needs are important and should be validated. Anyway, that's my two cents!
So to sum up the birth I can say I was never afraid! It was so simple, not easy, but simple. Yes there was some pain, but it was completely manageable. I never shed a tear until he was born, and then it was from happiness. I felt supported by my family and by health care providers who knew I needed their quiet attentiveness. No one told me to push or not to push. They let me lead. Luca came into this world surrounded by family and health care providers who didn't whisk him away from his mamma, didn't poke or prod him, or make him cry or cut his cord too quickly depriving him of the usual 30% of blood babies lose when the cord is cut before it stops pulsating. No one syphoned out his nose. Instead the fluids drained out on their own, and the baby was in skin to skin contact with his mamma for at least the first 45 minutes of his life. It was a gentle birth, and a very happy one!