Valley Interview : Couple Finds Birth at Home Empowering, Safe and Comfortable

Joanne and Bruce Shannahoff didn’t bring their 9-day-old daughter home from the hospital.

That’s because the baby, Sophie Marie Shannahoff, was born in the bedroom of the family’s Northridge home.

The home birth was the result of nearly nine months of preparation by the couple, who decided against repeating the experience they had during the hospital birth of their first child, Molly. She was delivered by Cesarean section while Joanne was under anesthesia.

It is estimated that about 5% of births statewide are at home, a practice hampered by both legal and medical constraints.

California insurance companies have stopped providing coverage to nurse-midwives for home births. And most physicians frown on the practice. The former president of the American College of Obstetricians and Gynecologists, Dr. Keith Russell, once described home births as child abuse.

The Shannahoffs’ case was complicated, from the traditional medical point of view, by the fact that Joanne’s first baby was born by Cesarean section. Generally, physicians do not recommend a vaginal delivery following C-sections.

That did not deter Joanne Shannahoff--a former graphic arts designer for the city’s Redevelopment Agency--who found a midwife with 20 years experience willing to direct the birth. Bruce, a chiropractor, assisted, along with a birthing instructor who served as the team’s labor coach.

A physician agreed to be on call should there be an emergency, but she was not needed. Mother and baby are healthy.

Question: Why did you decide to have a baby at home?

Answer: (Joanne) You can have a baby at a hospital; you can have a baby at an alternative birth center, or you can have a baby at home. My hospital experience was not one that I wanted to repeat.

But it was more than that. I felt that home birth was safer for the baby and the mother, more comfortable, and it was in keeping with how I felt about birth in general, that it is not a medical problem.

I thought my chances of having a vaginal birth after Cesarean were greater with a midwife, and their type of care, I felt, would be more personalized.

I think it is the greatest thing in the world. I’m very proud and very happy. Our child is calm. She didn’t have to move from a hospital to a home.

There is so much that I’ve gained. Not just the birth, but as a human being. It’s given me greater confidence in myself.

(Bruce) A home birth is something that takes planning and preparation. It is not something you do because you don’t want to drive over to the hospital. It has to be a thoughtful process.

Why at home? It seems that when you go into a hospital to have a baby, a countdown time starts. And if you don’t have a baby on their schedule, they are going to start to insist that it is time to cut it out. It is unfair to the woman because it puts her under a tremendous amount of pressure--the kind of emotional pressure that can prevent her from progressing as she should.

So the relaxed atmosphere at home, combined with the caring and the knowledge of a midwife, allows the woman the time and space to complete the natural process.

If we were going to have another child, I couldn’t imagine not doing it this way. I think if other people were open to it, and experienced it, they would feel exactly the same way.

Home birth is about empowering women. The hospital experience and the traditional medical experience, where you have six routine ultrasounds and an amniocentesis and fetal monitoring and drugs that are all basically telling the woman that she isn’t just capable of having a baby.

Joanne, I see her as having taken back her power and her womanhood, and it’s beautiful.

The baby was born in the room we sleep in, the place where the baby was conceived. A home birth steals back birthing from being a medical procedure to being a family event again. It is a bonding experience for the whole family. It allows the family to experience the joy of it, the wonder of it. Birth should be a family event as opposed to some kind of medical problem.

Q: What didn’t you like about the hospital birth?

A: (Joanne) What I didn’t like most of all was that you are not in charge. It is very important that I be in control. The people who take care of you, you need to trust them to make certain calls, but it shouldn’t be up to them what happens; it’s a woman’s choice.

I don’t like fetal monitors. They use a fetal monitor for everything, to tell you how the birth is going, and not looking at the person.

I didn’t like the food.

Q: Preparation?

A: (Joanne) The schedule is the same as seeing a doctor. You go once a month and then you go every two weeks, then you go every week. However the time I spent with a midwife was a lot greater. I probably saw more of my midwife for the first session than I saw a doctor throughout the entire pregnancy. She spends 45 minutes to an hour. You for your nutrition, your emotional well-being, your physical well-being, your spiritual well-being, everything there is.

I did a lot of reading about home birth.

Q: The birth ?

A: (Joanne) It was wonderful. I think we paid closer attention to my body and what was going on with the baby and in preparing me for the birth. I took a lot of different herbs and vitamins to prepare my cervix, to soften my cervix. I exercised. I took yoga, had chiropractic adjustments on a regular basis, had acupuncture.

So my body did what it was supposed to do very quickly. My water broke in a restaurant at 7 at night. I started labor within 20 minutes, and the baby was born just a little more than four hours later.

When my doctor suggested that I walk during labor in the last birth, I walked, but I did not walk during contractions. It didn’t do anything for expediting the birth. I must have walked for two hours, but my cervix would not dilate. My midwife told me to walk through the contractions. So this time, I walked around the block and went from three centimeters and dilated to eight. So by the time I got back I was ready to have the child.

I had a completely unmedicated birth. I haven’t even taken a Tylenol. My head was clear through the whole thing. The last time, I was out for the birth.

Q: How do you go about getting resources and help?

A: (Joanne) A great organization for me was I CAN, International Cesarean Awareness Network, based in Los Angeles. They help women be aware of Cesarean births and to help them make them own choice.

There are two different kinds of midwives. One is called direct-entry. One is nurse-midwives, who are RNs. They are easy to find, they advertise in the phone book and various papers. It is harder to find a direct entry.

Q: Why is having a vaginal delivery after a Cesarean considered dangerous?

A: (Joanne) You have a scar on the uterus after a C-section, and a lot of medical doctors say not to have a vaginal birth after that because the scar might rupture. But the actual risk for that rupture for a woman who is birthing a second time is lower than a woman who has the same kind of problem the first time she gives birth. Again, it is something you can transport for. And even if it does, chances are it will be only a part rupture, and that can be taken care of afterward.

Q: Were you nervous about it?

A: (Joanne) During the pregnancy, yes, of course. I found it was very important to talk about it, make sure I had a good backup and trusted my midwife to make the right decision if I needed to be transported. We discussed this at length.

But by the time the baby came, I was ready. I didn’t have that fear.

(Bruce) I don’t think the experience was unique. I think there are more people who are opening to the idea of doing it. And in fact, when we have all these concerns about health care costs and the complications of medical care, perhaps if more births started as home births, where people are fully prepared and ready to transport in case of an emergency, then would probably find more successful births in general and fewer Cesarean births overall and probably less expense.