Some families opting for home births

  • A string of baby feet imprints hangs in Midwife and Nurse Practioner Sarah Bay’s office in Peterborough. Bay has delivered more than 150 babies at home since she started the practice in 2011.  Courtesy photo—

  • Midwife Sarah Bay performs a routine checkup on Autumn Cranfield, of Antrim, while her big sister Kennedy watches over a day after she was born.  Photo by Miranda Dunlap​—

  • Midwife Sarah Bay holds newborn Autumn Cranfield, of Antrim, a day after she was born in October 2016.  Photo by Miranda Dunlap​—

  • Midwife Sarah Bay performs a routine checkup on Autumn Cranfield, of Antrim, while her big sister Kennedy watches over a day after she was born.  Photo by Miranda Dunlap​—

Monadnock Ledger-Transcript
Friday, August 11, 2017 10:10AM

When Kimberly Jarest got pregnant with her first she was excited about the prospect of becoming a mom, she had always wanted kids, but the thought of giving birth was scary.

She said she’s always disliked hospitals too, a thought that compounded the fear.

“Hospitals always have made me more nervous than I feel like I should be,” Jarest said. “I hate even going to the hospital, I get sweaty hands and feel so nervous.”

Then she had a thought.

“I feel like there are options for a ton of other things in our life, so with birth, I thought, ‘there has to be more,’” Jarest said.

She typed “midwife” into a Google search and found one in the Monadnock area. Jarest started doing more research, scanning online articles and reading books and became more convinced with everything she found that she would give birth in the comfort of her own home.

“I fell in love with the idea,” she said.

After she made the decision, Jarest said the hardest part was convincing her family and friends that it was the best option. She was also afraid of the pain without the option of an epidural. And when the time came it was painful, but the fact that she was at home and that made all the difference.

“I was so comfortable at home,” Jarest said of giving birth at home. “It was like being sick, I had my pillow and my sheets and it made me feel better. I didn’t have to wear some other person’s clothes, there were no bright lights, and there weren’t a million people in my face. I was at home and things are better at home.”

Jarest is part of a relatively small but growing number of women who give birth at home. Between 1989 and 2012 the rate of certified nurse-midwife attended births in the U.S. doubled from 3.3 percent of all births to 7.9 percent, according to a study published in PubMed.

A committee opinion published by the American College of Obstetricians and Gynecologists in April said about 35,000, or about 9 percent, of births occur in homes every year in the U.S.

The same document says hospitals and accredited centers remain the safest settings for birth. It says while planned home birth is associated with fewer maternal interventions than in the hospital, there is also more than a twofold increase risk of perinatal death (1 or 2 for every 1,000), and a threefold risk of neonatal seizures or neurological dysfunction (0.4 to 0.6 in 1,000).

It says that if a woman chooses to give birth at home several factors should be considered to reduce perinatal mortality rates including having a certified nurse-midwife and access to timely transport to nearby hospitals.

The option of having a child at home is only available to healthy mothers who are full term with a baby who is head bound.

Sarah Bay, who is a certified nurse and midwife, said she started her own practice in the Monadnock region in 2011. Bay, who caught Jarest’s two kids, said she delivers about three to six babies every month. She said she has caught more than 150 babies since she began the practice. Bay recognized the milestone during an annual barbecue last Sunday.

Bay said she was a delivery nurse for six years at five different health facilities before she struck out on her own and became a midwife.

“What I was seeing at the hospital was similar to a conveyor belt, families weren’t necessarily being listened to or respected as individuals,” Bay said. “...I felt like so many people were being misunderstood.”

She said the main difference between her practice and more common births at hospitals is the intimacy aspect.

At a hospital, Bay said time slots for prenatal appointments can be restrictive, and there can be a one-size-fits-all approach to nutrition and exercise. Bay she’s able to work with mothers to customize care, make it more personal, and adjust it to their individual lifestyle.

When it’s time for a mother to give birth at a hospital, Bay said nurses come-and-go, following their lunch break and shift patterns. In general, she said, there’s less continuity. In contrast, Bay said she is the only person who delivers babies in her practice, meaning she sticks with a mother from their first appointment until they give birth, and beyond.

“It’s really special every time,” Bay said about delivering babies at home. “We get to know each other in a different way, you’re sharing one of the most intimate experiences in people’s lives. And you’re doing it in their homes.”

In Bay’s Peterborough-based office she has a string of footprints of babies she has delivered hanging on her wall. She said when she sees the kids she delivered growing up and running around that’s special, too.

“It feels like you have little heart strings running around all around the country side,” Bay said.

Bay said she doesn’t have anything against hospital births and is grateful the option exists, she just wants expecting mothers to know there are other alternatives out there.

The Monadnock Community Hospital said 344 babies were born at the unit last year.

In a press release to the Ledger-Transcript, the hospital said it believes where a woman gives birth is a personal choice.

“We strive to give women and families the birth experience they desire by offering an array of different options such as unmedicated birth, hydrotherapy, nitrous oxide, IV pain medication, and/or epidural anesthesia,” the release reads.

It says the hospital offers one-on-one nursing care in labor and delivery and employs skilled nurses and physicians that can intervene in emergency situations for both mother and newborn.

Jarest said when she got pregnant with her second, she knew she would give birth at home again. This time it was easier to convince her family and friends about the decision.

For her second, she opted for a water birth. Jarest said the decision helped with the pain.

“It was so relaxing, it just felt perfect,” she said.