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Sosrodzice.pl: Childbirth at home is for many the ultimate irresponsibility. How do you think?
Hanna Krawsz: Precisely because of the responsibility that I take on myself: for the health of my child and myself, I decided to give birth at home, because the child's health, both physical and mental, is influenced by all the perinatal processes.
I do not want to give my childbirth and child into the hands of institutions, where it will depend on random people who are on duty. The body knows how to give birth. I accept responsibility for childbirth, aware that, contrary to popular belief, the hospital does not guarantee a successful ending of labor, it is similar at home.
The hospital also generates a lot of unnecessary, routine medical interventions that later affect the health of the child, as well as the mother. In addition, even in the best in the hospital often there are infections with dangerous bacteria and other undesirable changes that doctors do not mention, and the newborn is defenseless in all this. At home, the environment is safe, also known in the sense of a biosystem.
During pregnancy, full diagnostics are always carried out, in addition, tests are performed that are worth commissioning if you want to give birth safely at home, e.g. ultrasound to detect so-called umbilical cord conflict, position of the child in the last weeks of pregnancy, flows, etc.
The midwife may also order additional medical examinations or consultations if she is concerned about something. I "conduct" pregnancy with a doctor who is not an opponent of home births and prepares for them. This is a very good arrangement, because it saves the stress of explaining home delivery decisions to the doctor. In the last pregnancy I had so-called GBS positive for the presence of group B streptococcal bacteria, accredited by my magnificent doctor, in cooperation with my midwives conducted oral antibiotic treatment so that I could give birth safely at home. In hospital, this could not work, because for an intravenous antibiotic to work, it must be given a minimum of 4 hours before the baby is born - my delivery lasted less than 2 hours.
Such a solution, when midwives know and cooperate with the doctor "conducting" pregnancy, and in addition cooperate with the hospital is ideal, but unfortunately, apart from Warsaw and Wroclaw, still not very common in Poland, due to the reluctance of doctors, and this should be the standard. I am grateful to the hospital of Saint. Zofia in Warsaw, that she conducts a policy friendly towards domestic deliveries and does not cause problems in the event of transfer and necessity of hospitalization.
Where do comments come from that do not understand the idea of births at home: from stereotypes, prejudices, lack of knowledge?
H.K: A bit of everything. Doctors have a distorted picture of deliveries because they are from treating pathology, saving lives and watching births from this side, then they duplicate this opinion among their patients. However, there are doctors who are wonderful, enlightened who can go beyond a routine, anxious attitude, especially if they see that a woman has knowledge of the subject.
Among women who define themselves as strong opponents of home births, unfortunately I often encounter a lack of knowledge about the basic physiology of pregnancy and childbirth, the physiology of a newborn. These are the women who would best like someone to give birth to them. They are also women who got a very negative family message about childbirth and are simply afraid of it. Often they are not confident in themselves or their bodies, or do not trust their partner. They approach labor not as a birthing process, but rather as something that needs to be "survived".
Parents use arguments about a child saved from perinatal death at the last minute ... I do not deny these stories, but often when I ask about the details of delivery, it turns out that the delivery from the beginning was not very natural and certain routines, e.g. lying in the first and second stages delivery, instead of vertical position, or administration of oxytocin, caused later complications. Often transport to the hospital alone disturbs the delivery process, it is, after all, additional, unnecessary stress. I highly recommend watching the movie "Childbirth business", you can watch it in parts, e.g. on YouTube, the film fairly presents a closed circle: unnecessary intervention-complication-rescue intervention.
Still many people think that home delivery is illegal ...
H.K: I have often met, talking about my births, with the question "How is this, and what is legal?", So the association of childbirth = hospital is so rooted in Polish society. I am very surprised how little time it takes for it to persist, 60 years ago women gave birth at home, my father, his younger brother, was born at home ...
In communism in all the countries of the Eastern Bloc, they were ordered to give birth in a hospital, I think that since the dawn of the child's life, in this way he was forced into a paternalistic system, where nothing was to depend on the individual, where it was necessary to surrender to those who know better, what you need. " Children taken away from their mothers, crying alone ... This can be seen very clearly when you look at which countries are the most reluctant to give birth at home: these are all countries of the former Eastern Bloc. Midwives who receive home births still face oppression, e.g. in Hungary (Agnes Gereb case). On the so-called "West" home births are the norm, they are one of the options available to a woman, nothing strange, unusual or "irresponsible".
That is why the idea of the project came about - the publication of a book with authentic accounts of home births. Someone asked me, "What is the next book about births?" Well, the book is to be free, I want to give the voice to women, they describe their home births, but also motivations, beliefs in this topic. I would like the book to reach women from all walks of life so that, having read these stories, they are aware that childbirth at home is one of the available choices.
I do not intend to convince anyone by force, but I would like it to become natural in society that a woman has a choice, how and where she wants to give birth. Some of the stories can be read now on the Rodzimywdomu.pl blog. They are beautiful, full of feminine strength and life. I want as many women as possible to know that this is the case. Any such tale is worth it to be read by other women and their often doubting women power. I also talk about my own.
I still collect birth reports and think that after the book is out, I will still want to collect and publish them on the blog. I also encourage financial support for the project, the book has a chance to appear only thanks to the good will of the donors.
You gave birth at home twice. Did you have any doubts?
H.K: My husband had doubts before the decision about the first home delivery, they were turned up by friends and colleagues terrifying visions of horror ... However, after meeting with our then midwife, the icon of Polish home obstetrics, dear, mgr. Irenka Chołuj, all our doubts have been dispelled.
Irena explained to us, among other things, the relationship between common perinatal complications and the use of some hospital routines. Before the second delivery, I got a book from my friend Irena's book, "Birth together and naturally," also in it issues are clearly and simply explained which raise doubts among parents, we also met our wonderful midwives; Edyta Dzierżak Postek and Maria Romanowska. In addition, in the current era of the Internet, there are fantastic forums and websites about home births, where you can learn a lot.
Were there any negative comments condemning your decision?
H.K: We release those negative thoughts, so I don't even remember the majority.
You gave birth to your first child in hospital. Moms who decide to have a second childbirth at home are probably easier ...
H.K: Certainly, we already know "what it is used for". Before the first delivery, there are still fears of the unknown, although now I have met many women who decide to go home with their first child. I think that the availability of knowledge about home delivery, e.g. on the Internet, has a big impact on this.
Eleven years ago, we didn't even have a computer with our first daughter, our awareness of home delivery was negligible. It wasn't until later that I heard from a friend that she gave birth at home, but it was too late to change her mind. In addition, our home conditions at that time - we lived in my parents' corner with my grandmother, did not support this decision.
Many women decide to give birth at home after having a negative experience at the hospital. I always emphasize that our first delivery, despite being in hospital, was still positive and natural, but we found that next time we would be able to give birth at home. We were lucky, but not everyone who gives birth in the hospital has it.
Is childbirth at home more expensive than at hospital?
H.K: Theoretically, the cost of a home delivery is much cheaper than a hospital delivery, however, for incomprehensible reasons, the National Health Fund has not fully carried out the processes that are needed to make such delivery so-called. refunded, i.e. that the costs of e.g. midwife will be reimbursed. In this way, unfortunately, we have to pay midwives out of our own pocket, despite the fact that we are theoretically insured in ZUS and childbirth should be free for us.
This is also incomprehensible because hospital delivery rooms are often overcrowded, doctors complain about excess work. If the public awareness of home births was widened, also in the medical community, it would be beneficial for everyone, because people who really need help would be hospitalized and doctors could provide them with decent conditions. That's what the hospital is for - for the sick in urgent cases. Childbirth is not an accident, it is a natural physiological process, one should only ensure, as in civilized countries, easy and quick access to the hospital in case of complications.
The cost of renting a midwife to give birth at home varies depending on the region of the country, traditionally, as with everything, it is the most expensive in the capital. I think that it is worth investing your money in a good home delivery. Most women today give birth 1-2 times in their lives, it is worth that these moments remain in our memory as beautiful, and the child was born in safe conditions. Start in life is very important, it is good when the child enters into life without perinatal trauma.
Is it difficult to find a midwife who will help you give birth at home? Does your pregnancy doctor have to give permission for giving birth at home so that it is possible?
H.K: As for midwives, there are regions where it is easy to find home delivery recipients, e.g. Warsaw, Wrocław, and there are areas where midwives need to be taken from afar. Fortunately, there are more and more midwives. It is best to look for information on forums or websites, or on social networks.
As for consent to home delivery, no one has to give such consent, there are people who decide to give birth without medical assistance, in Poland these are negligible cases abroad, especially in the USA, more and more popular, but I do not urge anyone to do it, because it is very big responsibility.