#386 | Why Home Birth: A Father's Perspective on Choosing Birth Outside the System

I'm Cynthia Overgard, birth educator, advocate for informed consent, and postpartum support specialist. And I'm Trisha Ludwig, certified nurse midwife and international board certified lactation consultant. And this is the Down To Birth Show. Childbirth is something we're made to do. But how do we have our safest and most satisfying experience in today's medical culture? Let's dispel the myths and get down to birth.

My name is Jacob Dubois, and I am the author of the book Why Home Birth, and I am a dad of two boys, husband to my wife, Madison, and I would describe myself as the least likely person ever to write a book about birth for a bunch of reasons based on the things that I thought about birth before my wife presented this idea of out-of-hospital birth to me and what I learned through the process of supporting her in what she wanted to do and what she felt called to do. I was like, oh my gosh, I can't believe how much there is to unpack here with this conversation around birth. It was something that I didn't even realize how absent the conversation was in our culture about birth in general, and so I just felt that I needed to write this book.

Mainly, the way that I would describe the book is basically all of the things that would have convinced me to be fully on board and supportive of home birth for my wife, just condensed down. This is the thesis, I guess, of all the things that convinced me to be supportive and more understanding of home birth in something that you can read in under 90 minutes, and it's geared to both moms-to-be and dads-to-be. It's not really one way or the other. It's basically all the arguments on why I think home birth is awesome.

This is a much-needed book, especially for fathers. I mean, it's really needed for anybody considering home birth because it's sort of the starting place for many people considering home birth. They want to know, what are the risks? Why should I choose it? But it really becomes challenging when a mother really would like to give birth at home and believes through and through that that is the right place for her, and her partner or husband is not on board. That is so often the case. We talk to so many mothers who are in that situation.

So let's hear what you have to say. And thank you for writing this book, and I hope that every father reads it.

Yeah, Jacob, can we start by you telling us about that moment that Madison first presented it to you? Were you dating? Were you married and pregnant?

Yeah, I can. I can try to do a better job of painting the picture for you and for the audience. Anyone listening, I'm just a normal guy. Like I said, the least likely person to write a book on birth. I'm a Marine Corps officer right now, into things like firearms and jiu-jitsu and going to the gym, and birth had never even crossed my mind. It was never something that I had ever even thought of or cared to think about or cared to ask about until my wife got pregnant.

She came to me and she was like, "Hey, I do not want to go to a hospital for the birth of our child." This was as soon as we found out. She had done a little bit of research around birth, listening to some podcasts beforehand when we were trying and stuff, but mostly I would say she was just strongly guided by her intuition. She just knew it from the beginning. She viewed a hospital as a place that you go to if you're sick, injured, or have a disease, and she kind of knew it in her gut.

Simultaneously doing some reading and exploring, she came to me and said, "I don't want to go to the hospital," and I was like, "That sounds crazy. Why would you ever say anything like that? That's where births happen. That's what everybody does. That's just what we do."

She was like, "Hear me out. Can you at least look into it?" She didn't push it on me hard or anything. She kind of let me take it at my own pace as far as digesting this thing because, me just being me, I didn't want to blindly support her and just be like, "Go for it, honey, whatever you want." I also didn't want to... obviously I'm not going to put my foot down on something that I don't know anything about. There's clearly a reason she's bringing this to my attention.

So I started looking into it, and one of the first dominoes, which I kind of describe in the book a little bit, the first thing where I was like, "Oh wow, maybe there's something here..." I'm sure you could maybe guess it, but we sat down and watched The Business of Being Born. She kind of subtly stuck that in there. She was like, "Hey, can we watch a movie tonight?" I was like, "Sure."

Then we watched that, and I would say that was the first domino. Then I started needing to look for more because I was like, okay, I need to prove or disprove all the subtle things that are being implied in this documentary and just look more into it.

So over the course of the next 25 weeks or so of her pregnancy, I was doing some reading, listening to podcasts. Every time we got in the car together, we were listening to a podcast about birth. Dr. Stuart Fishbein and midwife Bliss Young were huge influences on my own learning journey.

Eventually I was like, okay, this is a no-brainer at this point. Let's go talk to some midwives.

She was about 30 weeks, and we were living in California at the time, so we made an appointment at the Monterey Birth and Wellness Center. Luckily they had room, and we were able to sit down with them. That was equally as impactful, if not more impactful, than all of the "learning," quote unquote, that I did by myself because they were just very comforting and encouraging. By "they," I mean the midwives. They're CPMs, and they were just very comforting, like, "Wow, it's really awesome that you're even asking these questions."

We went in, and I sat down and I was like, "What about this? What about this? What about this?" They were like, "Most people don't ask these questions." It was like an hour-and-a-half appointment.

This is the first piece of advice that we give to couples who are not on the same page about home birth: just simply go meet the midwife. Take him, let him ask his questions, get a feel for how they handle things, and he will leave there feeling completely different about home birth than when he went in. He will at least have an open mind, but that is the first and most important step. You can study all...

...the data...

...follow all the Instagram pages, listen to all the podcasts, but until you go and sit in front of a midwife who does this day in and day out, it's really hard to actually get a sense of feeling like, oh, this is actually something I can wrap my mind around doing.

Even if he still isn't supportive of a home birth, though, my advice is always to put a little heavier weight on where the woman says she's going to feel safest. Even if he doesn't change his perspective, he's done his part. It's reasonable to go have the conversation.

I was a little intrigued, Jacob, when you just said that they said, "We haven't heard these questions before," because when I first brought my mother to meet my midwife, I did that for her. My husband was on board, but I brought my mom to an appointment, and I remember my mother said, "Now, what if something comes up and Cynthia needs medical intervention or something like that?"

I thought, oh my gosh, they must get this question from literally every person, as if they haven't thought about it. So I figured she would say to you, "Oh, well, we get these questions all the time."

Do you remember any questions you asked where she said, "I've never been asked this before?"

No, maybe it wasn't just the questions themselves, but the extent of them because that first appointment was really long. It kind of continued throughout the entire relationship we had with those midwives. I got to the point where I honestly just started getting really intrigued by birth because, from the cultural perspective, I was just like, we're doing this so backwards.

These midwives clearly have so much knowledge, and picking a random number, like 95% of people probably don't even know what a midwife is. I didn't know what a midwife was until my wife got pregnant. Never mind the fact that there are different types of midwives and each state is a little bit different and all these nuanced things.

I fully thought before sitting down with those midwives that midwives were kind of hippies and they rolled out of a VW bus to support birth with good vibes.

That's what I thought when I was first pregnant, but I thought only hippies had home births.

Well, guess what? I am one, and I had the same thoughts. This is very common. I did not know that there was such a thing as a nurse-midwife until I took a class in women's health and was introduced to the idea. So you're absolutely right. Most people don't even know that this is an option, especially the nurse-midwife route.

Otherwise, most people think that the only people having home births are those who are living off the land and living in a VW bus, as you said.

But outside of the most common fear that everybody has around home birth—what if something really urgent or emergent happens? What happens?—what were your other major concerns or fears around home birth?

At a certain point, it wasn't questions that I was asking out of fear. It was really interest and asking them about their experiences.

But the two biggest concerns that I had as a husband and dad-to-be were the safety aspect and the financial aspect because, like most people paying for a CPM for an out-of-hospital birth at a birth center or home birth, it was totally out of pocket. That was tough at first when I was like, oh wow, that's pretty expensive, and if we went to the hospital, it would basically be free. Tricare, with military insurance, is really good, and the bill would have been basically nothing.

So that was definitely the second thing that I was like, wow, that's a big obstacle to kind of overcome.

It absolutely is a very important part of the conversation. Most people are thinking about the safety, as you said—risks to the mother, risks to the baby—but choosing to pay or invest heavily in your birth is something that people really struggle to do when they have a free option and think, well, how could it be that bad? Why do I need to invest in this birth?

Then once you start to understand what happens in a home birth versus a hospital birth, and the risks of a hospital birth, that's the thing that people miss all the time. We're always just talking about the risk of home birth, and we're never talking about the risk of hospital birth. Once you start comparing those risks side by side, investing in something that starts to feel more safe becomes much more worthwhile.

Yeah, not only worthwhile, but I would say life-changing. So life-changing that there's no dollar value that could truly describe what it's actually worth.

This is how I personally got over that hump of, okay, this is worth $7,000 or $8,000. I personally believe, and it's because of this belief that we will always figure out a way to pay for midwife care, that a birth is not just about the day that you get to meet your baby. It's going to shape how the woman experiences and lives the rest of her life.

So if my wife wants to have a midwife, a doula, or a DJ in the corner—which I wouldn't recommend—but whatever she wanted to support her birth, whoever she wanted on her birth team to help her feel safe and have privacy and whatever she thought needed to happen in order to make that birth the way she wanted it to be, it's worth every penny because it's not something she's just going to forget a couple days later.

She's going to be playing that track about that day back in her head for years to come, decades to come, every single birthday of that child. It's going to be something that lives with her.

Who am I, as her husband, to say no to any of those things? It's just fertile ground for resentment later on.

I don't think I've ever heard a man understand it so well, honestly. Usually they only think of it as the day, and I love that you just articulated all of that.

Even the fact that you added, "I don't want her to resent it later," I think is so valuable because I have conversations like this with women a lot in my work, and I don't think most men can understand how much time a postpartum mother has to sit around and think about her life, think about her marriage, whether she's happy, what she's angry about. She's got a lot of time to sit and have those thoughts. She's up 23 hours a day.

And I know how common divorce is in midlife, particularly with women filing divorce against men. I can't believe how common it is for women to go back 20 years and start griping about when they had babies together. It's truly an investment in your lives and your lifelong happiness as a couple to start caring immensely about her perspective with her birth.

It's not just going to affect her. It's going to affect your relationship together and your family, and it's going to have an impact on, honestly, generations to come.

This kind of goes also into the cultural thing as well, where if we look at the current generation of birthing women, because we broke birth—and you can kind of argue on when that happened, when things started going wrong in allopathic medicine and when there were serious issues with hospital interventions and OBs—you can argue about when exactly that started, but for sure, all of the women who are giving birth today, their mothers and their grandmothers are still impacted by the negative things in the allopathic birth system.

That's what I mean by cultural conversation. The conversations you're having around the dinner table and the way that the media portrays it and all this stuff, the conversation around birth doesn't match the gravity of the situation. So that's what I mean. In order to be one of the 1% of people that is like, everybody's doing this whole hospital thing and I'm going to take a right when everybody's taking a left, it really is a way to chip away at some of that generational damage that has occurred over the past couple hundred years.

We really have to see birth as a rite of passage, not just an experience. The experience of it is very minimal compared to what the transformation is in the process of birth for a woman. It sounds very cliche, the old saying, "When a baby is born, a mother is born." You hear that thrown around. Most people don't think about the meaning of it that deeply.

It's not just that she's becoming a mother. It is that her birth experience influences her rite of passage into motherhood, how she experiences motherhood the rest of her life. It starts right there. How she experiences her birth influences the rest of her life. It influences how she sees herself as a mother. It influences how she breastfeeds. It influences how she parents. It influences how she relates as a wife.

It influences that child growing up and knowing his or her birth story. My mother told us our birth stories every Mother's Day, so as early as I can remember, she had us sitting around her and she would tell us our birth stories, and it just integrates into a part of you.

In the case of my birth, I knew, very sadly, my mother didn't get to lay eyes on me until I had a white dress on and a pink bow in my hair. I had a lot of hair at birth, and she didn't meet me till I had on a dress and a bow.

I grew up just unconsciously thinking, oh wow, that exciting moment when Mom got to meet me. Oh, and by the way, they almost wheeled me into the wrong room. She was so eager to meet me. She went into the hallway, and the nurse came down the hallway, and she said, "Is this my baby? This is the most beautiful baby I've ever seen. Is this my baby?"

And the nurse said, "Oh no, it's not. This baby belongs to a woman named Rachel in room four."

And my mother said, "Oh, I'm Rachel. They moved my room."

So it was like this exciting story to me as a child, like, wow, she knew I was hers. She felt it, but the nurse almost delivered me to another room. I grew up and got to look at it from such different perspectives, and it's so sad.

But imagine a child hearing a positive birth story like, "Oh, you just came out of my body and I held you to me." It's so different.

Yeah, and I think that is the importance of these conversations and trying to change the narrative a little bit, and at least, if anything, as a culture, let's just talk a little bit more about birth because it's like the availability heuristic, where you kind of form an opinion about something based off of the imagery that comes to mind first.

Because there are so many terrible birth experiences, and people describe it as, "Oh, you just go to the hospital, get hit by a truck, and then you walk away with your baby," or it's all these complications and extreme interventions described, or all the Hollywood scenes depicting it as this horrible experience. Those are the things that get implanted into people's minds subconsciously, to where you mention home birth and they're like, "Oh my gosh," just because of Hollywood and kind of the cultural narrative. Then they just associate, this is clearly dangerous because birth is really, really dangerous.

So I try to not be awkward about it, but just talk about birth a little bit more in order to help change that narrative.

That kind of goes back to the book too, where I wrote the book really because more women deserve to have an incredible, empowering birth story. I just think it doesn't only affect them. It impacts their family and society at large.

Unfortunately, we've done a really good job of normalizing traumatic birth in our society and culture, to the point where women will describe their hospital birth as, "It was pretty good," or "not that bad," and maybe subconsciously thinking that it was probably not what it's supposed to be, but they will think, well, nothing went terribly wrong, so it must have been fine. I don't know if that makes sense, but—

Yes, that does make sense. And the other thing that women experience often in hospital birth is the belief that the hospital saved their life, or they saved their baby from something that, thank God, they were in the hospital for, because otherwise they would have had something really horrible happen to themselves or their baby, when in fact the incident that they experienced was a result of the type of care or the intervention that they were receiving.

Now, that is not the case in every single scenario. Hospitals do save lives. They save babies. They save women. But they create a lot of unnecessary problems that women then have to justify or be told and believe that they were saved from, and then they have to live with that story for the rest of their life, believing that thank God they were in the hospital.

In many cases, deep down—and this is why they have trauma—deep down, something in them says, but what if that wasn't necessary? What if I didn't need that? What if that's not real? What if they really didn't save me? That's that deep pain that women sit with, and we process birth stories with women all the time, trying to come around to the real truth of it. But it's just something that we have accepted as a society.

I wanted to comment on that exact point because Jacob earlier said this, "cultural conversation," and what Trisha just said about accepting something as a society. How many of us, even who care about this and are close to this, even consider the absolutely bonkers fact that every time, for the past 30 years minimum, you put politicians together, especially on a debate stage, they're asked about so-called—it's a bit euphemistic—women's reproductive rights.

They're talking about abortion, abortion, abortion, abortion, abortion, and that's it. Full stop. They don't say we have the highest maternal mortality in the entire industrialized world. A couple of African nations are safer. Moscow is safer than New York City. This is insane, and birth affects literally every single family. Literally.

And even for those, of course the vast majority, who come out of their births and everyone's alive and well, a third of women are saying they're traumatized. This is a massive issue affecting marriages, affecting divorce rates, affecting how women are experiencing their lives, affecting how many babies live and die, how many women live and die, how many men go home with a baby without their wife.

And yet they've distracted us all because the decision is always in the Supreme Court's hands anyway, and states anyway. No president comes in and makes a change there anyway. They have us all distracted away from what we can change. We can improve birth, and we should improve birth, and we should be looking at those metrics, and we should get society to care about not only women's odds of surviving and their baby surviving, but coming out of it non-traumatized. But they're flashing lights over here, distracting us over something we actually can't influence.

Absolutely. Yeah.

And they're continuing to lead us to believe that birth was once terribly dangerous, mothers and babies were dying right and left historically in birth, and yes, there were things way long ago that made birth less safe, mostly infection—

Right?

Exactly. It was mostly related to infection. That has nothing to do with birth. But we've just continued to be fed the story that we have made birth so much safer by bringing it into the hospital, by having a 30 to 50 to 60% cesarean rate. Look at all these mothers and babies we've saved by doing this, when in fact we have actually just degraded a woman's experience, the most important experience in her whole life. The thing that makes her the most woman of all is becoming a mother, birth, pregnancy, taking care of her baby, nurturing her baby. And we just degrade it.

Jacob, what would you say is the reason you wrote your book, and what will people primarily be reading about when they read your book?

The reason I wrote the book was because of all the things we kind of touched on a little bit, where it's like there's very clearly a huge cultural paradox around birth in our country, where 99% of people are going towards—98.6 or something—but 99% of people are going to the hospital, and 1% of people are having out-of-hospital births, birth center or home birth.

It's a huge mismatch in perceptions where, if you look at two similar cohorts of women, there are equal or better outcomes in the home birth environment. It's like this crazy idea. If you talk to the average person and say home birth is actually safer than hospital birth, they would think you're crazy, and they would think you're lying to them, and it's very not the case whatsoever.

Obviously, there are some groups of women who should go to a hospital, but for the majority of women, home birth is safer in terms of just looking at the biology of what birth is. That was a really big unlock for me, just looking at, okay, what is this thing that we are calling birth? What is the thing that we're scared of?

It being a function of the limbic system, the same part of the brain that governs digestion and breathing, and on the other side of it, you have the neocortex and the analytical part of our brain. The things that combat the limbic system from doing what it needs to do are high engagement with the neocortex. Things like leaving your house and getting stuck in traffic and checking in at the front desk of a hospital and strangers asking you questions when you're half naked. Those are all things that are hugely disruptive.

Quoting Michel Odent, those things make birth more dangerous. You're making birth more dangerous by engaging the neocortex in that way and going to the hospital. So based off of what birth is from a biological perspective, home birth is significantly safer. Once I realized that, I was like, wow, this is crazy. Once you get home-birth-pilled, you can't really go back.

The reason I wrote the book is because nobody was talking about it who was of my demographic, in terms of just being a dad sharing his experience. I was like, okay, I need to write this book that will talk about all the things we're talking about. Basic stuff. I share a little bit of our personal experience, but talking about risk, looking at different types of risk, looking at what are midwives, looking at the cascade of interventions, and basically the summarization of all the things that convinced me about my beliefs around home birth in order to support my wife.

That's the other thing. You don't want to support your wife and be terribly scared and not really supportive. You want to go into it confidently supportive and be like, this is going to be awesome, you got this.

The book, I think, is a good starting point for maybe skeptical dads. But like you said, talking to midwives, that's one of the most important things. There are corners of the internet that are the birth corners of the internet. I'm sure on all of your feeds and my feeds, there's a lot of birth content, but the average dad isn't thinking about this at all. The last time I was really thinking about birth as much as I am right now in this conversation is the last podcast that I did.

I'm a regular guy. I go to work. I work a nine-to-five. It's not in the birth space. I wanted to be able to put something together that a dad could read in under 90 minutes and be like, okay, this makes a lot of sense, this home birth thing.

I would say the average dad and husband who's really trying to support and provide for his family, this isn't something that comes naturally or easily to try to understand and think about. If you're working 90 hours a week and you're doing the best you can to do all the other things that are the responsibility of somebody who's a husband and father, it can definitely feel overwhelming to be like, okay, now I need to go become a doula, you're telling me, and read this book and do this home birth research.

It doesn't help in the movies. Childbirth classes are just the goofiest, most embarrassing scenes in any movie. It's so hard to watch, even in a really funny movie like Baby Mama or something. I'm just like, oh God, they're giving this impression that they're these weirdos teaching these classes, not intelligent people who are speaking to other intelligent people who are making really important decisions. I don't think that helps.

And the other thing, and I think this is why I was so impressed with the first thing you said, it was funny even, like, if she wants a DJ in the corner, put a DJ in. What does she want? What does she want? What does she want? What does she want?

Because I speak to my clients about this, and when I speak to them for the first time, and if their husbands aren't present, I can almost say this with total confidence and expect them to nod and get emotional and agree completely if I say, "You and your husband are going to get really close in this experience and have a really exciting experience together in learning about this, but probably, if he's like most men, he is probably thinking, please, dear God, healthy baby, healthy mom, healthy baby, healthy mom, healthy baby, healthy mom. I will ask for nothing more in life. Please just give me a healthy baby and healthy mother at the end of this birth."

And for the women, that's merely the first thing she wants, and she wants so much more. And if you ask her what she wants, she almost can't help but to begin with what she doesn't want. "I don't want to be bullied. I don't want to feel scared. I don't want to be abused in any way. I don't want to come out of this traumatized."

She almost can't even get to that next step of, now, what do you want? "I want a beautiful, intimate, fulfilling, satisfying experience." That is such a leap.

But when a man does come into this process with her, usually he sees it very quickly, like, oh my gosh, she is about to embark on the most significant combined physiologic, mental, emotional, and physical experience of her life. It takes only a moment before, again, they stop thinking about work and their duties and their responsibilities to their wives and families and homes, and they see it.

You've got to have moments where you think, how do women do this? You realize we are on this earth together, and we have radically different life experiences, and postpartum as well.

Yeah, one of the things you mentioned in there was when you ask that question, she starts listing the things that she doesn't want, like she doesn't want to get bullied, and that itself is a good representation of, what are we doing here, guys? As a culture, how is it that we have normalized a system where it's totally normal and encouraged to be like, okay, we have to have the birth plan and we need a doula to advocate for us and write down all the things we want?

How is it normal that we've normalized it to the point where we are equipping our doula for warfare in order to enter hospital doors? Clearly something's off if we're starting this whole thing from a place of, okay, we need to play defense, and we need a game plan. That itself is an indicator. Maybe we should look at a different option.

That's true. We presume we must go in with a defensive plan. It's presumed.

You're arming yourself with your tools. Your doula is your tool. Your birth plan is your tool, or your weapon against the system to fight against the system. That is because we have put birth, which is a normal, natural physiologic experience, like many other experiences that our bodies just do and go through normally and naturally, in the category of medicine. We have put it under the control of doctors.

When you break a leg, when you need brain surgery, you have a problem and you need a doctor to fix it. We've put birth under that same roof, and it does not belong there. That is why you have to go in armed up to fight the system, because you become low and they become high, and they know all the answers, and you are just supposed to sort of listen and follow along. It doesn't work.

Jacob, you said at the start of this conversation that you would invest any amount of money in the birth experience because it is that important to you, to your wife, to your family, to your life. Tell us how you see that play out. How does that show up? Why is it so important?

Well, hopefully none of my future midwives hear that and then upcharge me or something.

They might.

They might be like, "We heard you on the podcast."

They're officially capped. If they hear this, repeat customer, you pay the same price.

Yeah, but I would say that being an active participant in the birth of my boys has been probably one of the coolest things I've ever done. Just being able to look back and look myself in the mirror and know that this is what Madison, my wife, wanted, and she was spot on with her intuition.

That doesn't mean that the births were easy by any means. I think sometimes people can hear those of us talking about home birth and just assume, "Oh, must be nice." The births weren't easy. But she knew what was best for those boys.

Being able to walk by her side through both of their pregnancies and be with her in that moment and catch both of my boys as they entered this world, it gives me goosebumps just thinking about it.

It's really hard to describe the spiritual element to that moment when you're not in a sterile environment, when you're in a home or even a birth center, where it's just this blanket of peace of a new mother holding her new baby and me just being right by her side, knowing this is how God designed it. This is how it's supposed to be.

It's very empowering in terms of that setting the foundation for how we parent, how she mothers, in terms of the outsourcing component, where she feels empowered. She made a decision to birth our children this way despite all these outside forces and influences saying no, for the wrong reasons, "You're not supposed to do this. You're the weird one."

That puts her in a position to feel more confident and strong as a mother, to where, when one of our boys is doing something, she doesn't feel like she needs to go outsource to the expert in order to get an opinion that is probably coming from the same broken allopathic system that has broken hospital birth.

My wife's an amazing mother. She's very strong, and she makes a lot of the decisions where some people would be like, "Maybe we need to go take them to the expert for this thing." She's like, "I got this." It's not neglectful because it always comes out like she's right.

It just puts her in a position of confidence in the way that she mothers. How can you put a price tag on that?

You can't, because she has not been undermined in the most important transformation in her life. She trusts herself. She trusts herself because she listened to herself and she followed through, and you supported her. That builds confidence every single day in your decision-making as a parent and as a mother.

Birth practices today, and the way society treats, manages, views, supports, and lacks support for birth, undermine women's confidence all the time.

And that's the fundamental reason why I felt like I had to write this book, because more mothers deserve that feeling.

Thank you for joining us at the Down To Birth Show. You can reach us @downtobirthshow on Instagram or email us at Contact@DownToBirthShow.com. All of Cynthia’s classes and Trisha’s breastfeeding services are offered live online, serving women and couples everywhere. Please remember this information is made available to you for educational and informational purposes only. It is in no way a substitute for medical advice. For our full disclaimer visit downtobirthshow.com/disclaimer. Thanks for tuning in, and as always, hear everyone and listen to yourself.