Pigs are flying and this snow storm made it as far south as Hell.

I am planning a hospital birth.

We came to a real and final decision after considerable discussion and disappointment this past Sunday. It wasn't easy for either off us... but the bottom line is that though a homebirth would be a possibility in our much loved new home, it wouldn't be the best choice for us.

It makes me so sad just writing those words.

How could we pass on it if it were a possibility? Well, we went through this same dilemma when Georgia was born. Though it was a different wonderful woman offering us the possibility, the dilemma was the same. When we became a homebirthin' family way back when Normy was born, we defined a set of criteria that we felt comfortable with when it came to planning our residential birth. I'm going to share it with you. But, I want to make it clear that this is OUR criteria and no one else's. You may have a different checklist that is important to you, and that doesn't make either your nor my choice "right" or "safe". There is ALWAYS risk associated with birth. There is no doctor, midwife, or hospital that can guarantee a perfect outcome. Therefore, it is up to every parent to take responsibility for which set of risks they are willing to accept. And it is every individual's job choose where and with whom they are going to feel most comfortable in birth.

OK, so for us to feel good about a homebirth:

1) Live within 30 miles of a hospital

2) Hire a midwife who lives within 100 miles of us.

3) Midwife must be credentialed. CPM or CNM... I love them both. Though they may represent very different paths to midwifery the destination is the same. Or at lease in the same neighborhood. ;-)

4) Midwife must suture, bring something like lidocaine for said stitches, bring pitocin for hemorrhage, ambu bag, and oxygen. And of course either a doppler or fetoscope.

It isn't a huge list. We just can't seem to make all the stars align just right for us here. And since moving to Nebraska we've gone round and round about weather we would be willing to fudge one little item on our list to make it work. And again we've decided that, no, we can't.

Plus, and here's the rub: even if we did decide to move ahead with a homebirth, we'd have to be so secretive about it. That sits very poorly with Smoochy and I who pride our selves so much on living in the light, so to speak. Homebirth per se IS NOT ILLEGAL IN NEBRASKA... but it lives in a sort of gray undefined territory. And any midwife who is willing to serve this community deserves complete solace and protection. It's not like we can't keep a secret, we just want to be able to talk openly about our baby's birth.

So, why aren't we going to Kansas again? Well, a couple of reasons. The big reason is that I do not want to do anything that may cause Smoochy to missing this birth. The birth of a child is one of life's most incredible and sacred moments... if you miss it, there's nothing you can do to get it back. It's over. And, we already learned that lesson the hard way once. Plus, the thought of up-rooting an almost four year-old, a two year-old, and our dog for two or more weeks and squeezing us all into my in-laws' life sounds like more of a challenge than I want to tackle at 40+ weeks pregnant.

Recently, I had the ultimate privilege of serving as my friend's doula at the birth of her twins. It was an amazing birth, and it went a long way relieving my general fear of a hospital birth. Her hospital room was quiet, dimly lit, and filled with respectful care providers who put her birth before hospital policies. Really, except for the shift change, her hospital birth was very very similar to my birth center birth.

The local teaching hospital, UNMC, has a CNM practice that is highly respected in our natural birth community. At my first prenatal the midwife said to me: I expect you to eat and drink in labor and to push in any position you choose. She told me a midwife can meet you in triage and streamline that process; use a doppler for the entire labor; and has no problem with clients going 100% IV free. All that sounded very very good. At a later visit with a different midwife, we were talking about GBS and my desire to avoid antibiotics. (I was GBS positive at the time of Georgia's birth and she and I developed a nasty case of thrush as a result of the IV antibiotics I received during her labor.) Anyway, the midwife went over the risk of foregoing the antibiotics, then told me "If you decide you don't want to receive the antibiotics, I suggest you simply don't get tested for GBS. That way no one gets nervous when you ask for an early discharge." I was pleasantly shocked.

The biggest down side to the hospital birth, besides leaving the comfort and safety of my own home and traveling to a disease infested hospital to birth my child is the fact that I will be at the mercy of whose on call. There are six midwives that work at UNMC, and there is no choosing when it comes time for the show. But, really that is no different than at the birth center. True, there were only two (both wonderful) midwives at the birth center where Georgia was born, but because I went to Kansas so rarely for prenatals, I only met with each of them twice. It probably won't be any different at the hospital. I'll get to meet with each midwife a few times. Weather they are all wonderful is as of yet to be determined!

I am not all sad about the hospital birth. A part of me can't help be interested in experiencing the great American cliche of rushing to the hospital with excitement in the middle of the night to have a baby. I'll have had a home birth, a birth center birth, and a hospital birth... three different birth stories for three different children. (They'll have each been born in different states as well!) And I am not scared of things going out of my control. I am going to go in there and have that baby in the exacts same way I would on my living room floor. Though they do have wonderful tubs and no restriction agains waterbirth... so maybe it won't be just like on my living room floor. In any event, It's not like Smoochy will take any crap from the hospital folks. I have a true lion of a husband who will protect my birth space. I pity the nurse who crosses him. ;-) But, the purpose of hiring health care providers we trust, is that hopefully there won't be any need for him to show his teeth. Right?

I've been marinating on a way to conclude this for the better part of an hour, but really that's just about it. We are going to the hospital... institutionalized medicine... here we come!

15 weeks today