Birthing at Home
Author’s note: When I wrote this article pre-pandemic, homebirthing was often the subject of contentious debate. If there were to be a silver lining to the coronavirus pandemic (and that’s a big IF), perhaps the rise of homebirthing could be added to the list. With hospitals facing shortages of staff, PPE, beds, as well as new (and arguably harmful) policies regarding birthing in a hospital, many families across our nation have begun to opt for homebirth. It is with great pleasure that I present this interview with Burlington-based homebirth midwife team Full Spectrum Midwifery and two Vermont families who chose a homebirth. May this article serve the growing need for more information on the safety, efficacy, and culture of homebirth in Vermont and beyond.
Giving birth in the comfort and privacy of one’s own home is a longstanding tradition in the Green Mountain state. But it’s not all hippies and counterculture. As Vermont-based homebirth midwife Peggy Cohen points out, there are legitimate health concerns for opting to birth in one’s own home that make it a desirable choice for many expecting parents.
Upon first meeting, Peggy is charismatic yet practical. She approaches the topic of midwifery from an evidence-based perspective. Her Burlington-based clinic, Full Spectrum Midwifery, is simple and comforting, I felt warm and at ease after a visit with Peggy to talk about the home-birthing movement in Vermont. Her practice is one of only a handful in the state that qualify to bill health insurance, and her ability to do so is a more recent development in Vermont’s legislative history. In her 25 years serving the Vermont community, Peggy has worked tirelessly for mothers and families and has pushed homebirth-friendly legislation through the Vermont statehouse.
Meet Jennifer Bishop, Kali Brgant and Matt Niklaus, Full Spectrum Midwifery clients, based in Jeffersonville, who chose to have homebirths. Jennifer, owner of The Farm Store, moved to Vermont over 18 years ago out of necessity: she wanted to birth her child at home. She and her husband had been residing in New Hampshire where homebirthing was becoming obsolete. More recently, Kali and Matt, owner of Bootlegger Bikes, chose to birth at home over health concerns with hospital environments.
I spoke with Peggy, Jennifer, Kali, and Matt about Vermont’s homebirth history and present day culture.
Q+A
How has Vermont’s homebirth culture progressed over time?
P.C.: When I started practicing in Vermont in 1995, midwifery was not illegal and it was not legal. There were about 15 midwives practicing at the time. It was an active homebirth culture. We would get together for meetings and there was a little bit of collaboration between midwives. As the years progressed New York State legalized midwifery but, at the 11th hour of their legislation going through, they put in place a law that required a certain educational path which differed from the experience/apprenticeship route of midwives. The apprenticeship model was no longer suitable to become a homebirth midwife in New York. It was controversial like hell.
In response, in 2001, Vermont midwives decided to be proactive and write up a proposal to legalize the apprenticeship model. The legislation reviewed different educational routes for becoming a licensed midwife in Vermont. All stakeholders in terms of childbirth in Vermont disputed in the statehouse whether or not homebirth midwifery should become licensable. We had a great representation of homebirth families show up and the statehouse representatives’ hearts were warmed; all of these babies, moms, papas, kids on their parents’ shoulders, shared their stories. Meanwhile the medical society disputed that babies should only be born in hospitals. Anyhow, it was legalized.
What was the birth culture in Vermont like 18 years ago when you had your first child?
J.B.: When I initially was pregnant with Ayla we were still living in New Hampshire, but were planning to move here. We had friends here that had homebirths. In New Hampshire, the nurse midwives could only practice in their doctors office at a hospital. They were sending us to Maine for a legal homebirth. It felt like this really weird, underground conversation. I kept saying to my husband, “I can’t believe that you wouldn’t be able to choose where you were going to have a baby, and that somebody that’s not a female would tell you that where you birth your child would be illegal.” We just decided we needed to hurry up and get the heck out of there. The conversations made me feel like we were doing something totally wrong, totally illegal, and didn’t have a clue in the world what was best for our family.
My husband’s father is a retired OB/GYN from New Hampshire. As soon as he found out that we were doing homebirth he thought that we had completely lost our minds. I didn’t really have anything to base it on except that I had friends that had done homebirth in Vermont and I didn’t see what the problem was. It just seemed really natural, and why would I go to the hospital for a procedure that isn’t an emergency situation? Birth doesn’t seem like an emergency situation.
As a father, what inspired you to choose homebirthing?
M.N.: I don’t like the traditional medical system and specifically hospitals. Being in the comfort of our own home is really how we see bringing a child into this world. I don’t know a ton of people that have had homebirths. I’ve been talking to people since we decided to do it, and it sounds like there’s a fair number of people who have done it, and a lot of support around it. Just like anything with Vermont, we tend to be pretty progressive and that feels good.
Do you trust your homebirth midwife?
K.B.: I do. I feel like in a hospital setting interventions are more widely available and part of the protocol. I think that disrupts the natural flow of the birthing process. Once you interrupt that process, there’s more of a likelihood for it to be continued to be interrupted. I’d like to minimize that because I trust in the natural process of birthing. We’ve been doing it forever!
You were born and raised in Vermont. Did you get to experience homebirth culture as you were growing up?
K.B.: No. I was born in a hospital via c-section, and so was my brother. All of my family members - everyone was born in a hospital. I hadn’t really thought about it until I started to think about conceiving, but without question both my partner and I wanted a homebirth. Being in a hospital setting is not appealing.
Vermont has one of the largest populations of homebirthing in the country, right?
P.C.: Yes, Minnesota is number 1 in terms of homebirths per capita, and Vermont number 2.
What are the cultural influences encouraging mothers toward homebirthing in places like Vermont and Minnesota that may not be found in cities like Chicago or New York?
P.C.: My sense of it is that Vermonters like to be independent and take care of themselves and their neighbors. They like to live close to the land and provide for themselves. Even the “flatlanders”, the newer Vermonters, are drawn to this area because of the culture of growing our own food, living more alternative and less mainstream. We’re not doing the cookie cutter lifestyle just because that’s the way life’s supposed to be lived. We’re making decisions for ourselves: decisions about our healthcare, decisions about the foods we eat, decisions about how we have our babies. Also, at the end of life, Vermont is one of the few states with laws in place that are humane. Homebirth is a part of that kind of mindset.
What’s a typical day in the life of a midwife?
P.C.: It is different all of the time! I carry my pager and phone nearby in case anybody needs to reach me and people often do reach out. Just prior to our meeting a client called with some postpartum needs, and this afternoon I could be called by a client who might wonder if her membranes have ruptured. Being a homebirth midwife is running a business and caring for clients - it’s a fun mix. I’m always restocking our inventory and preparing for clients upcoming births by bringing a birth tub to a home, or dropping off herbs to someone…it’s pretty dynamic. Some deliveries are simple and straight-forward and may take me out of my routine of office visits for six hours, or it might take me out of that routine for 36 hours. It’s helpful to have supportive family and friends because sometimes I have to reschedule. It’s not the lifestyle for everybody but I love it. I enjoy supporting the natural process and trying to avoid interventions. I feel like I’m good at that and families appreciate that.
