I’m not a pregnant woman or even near that stage in my life, but the conversation I had with our guest this episode was truly one of the most intriguing. We were talking about home birth. If you’re like most people, you have some thoughts, emotions or questions around this practice. But you don’t truly understand what makes a home birth a legal and safe option for women today.
Our next guest, Monika Stone, is a certified professional midwife, licensed midwife and pediatric nurse who has taken care of hundreds of women during pregnancy, delivered their babies safely at home and cared for them and their newborns post-partum. She’s the author of Why Choose Home Birthand we talked about the updated picture of what home birth looks like today.
Monika Stone: As a home birth midwife, I feel like very few people understand what I do, right? I go to a dinner party and I always dread this question, “What do you do for a living?” And it’s like, “I’m a home birth midwife,” you know? I felt very strongly that it was time to educate people and help them understand what home birth today looks like.
That was why I wrote the book. I wanted people to understand what the modern home birth looks like. Everybody has feelings and emotions, thoughts around it. I get all sorts of reactions, and people just don’t truly understand that this is an option for women—how to have their babies. That’s why I had to write this book.
People always associate birth with hospital, and I’m not anti-hospital but I wanted women to know that they can choose out of hospital birth safely, if they desire to do so.
Differences in Models of Care
Rae Williams: What is that fundamental difference between a home birth and a hospital birth?
Monika Stone: The fundamental difference between a home birth and the hospital birth is that you are not a patient, that you are a client and that you form a team together with your midwife to journey through pregnancy, birth, and post-partum. The fundamental difference is that one of the most important parts is that you build a relationship with your midwife or your midwife team.
That you know who takes care of your pre-med, that you know who is taking care of you during the birth, and who takes care of you postpartum, and that you are a member of the team. I as the midwife, I am not the boss, I’m not the captain, I’m not in charge. I’m a member of the team, and we make decisions together.
You can bring your desires for your birthing, your desires for testing and treatment; you can bring all that to your provide, to me as your midwife. Then we talk about it and we make choices together. What is the best way for you to move forward?
When it comes to birthing, you are able to eat your own food, you’re at home in your own environment, you wear your own clothes, or you take off your clothes.
You sleep in your own bed, you have a sense of freedom and determination, self-determination but you are not giving up safety. As the midwife, I come to you and I monitor you and your baby. And amazing post-partum care, I would say, because it’s the same person, the same people who took care of you prenatally and in birth come back and continue to take care of you, and you know each other.
I would say those are the big things.
Understanding Home Birth
Rae Williams: There are a lot of questions about what actually happens in the hospital and why some of that stuff is dangerous. Would you be able to speak a little bit on some of those things and how we can avoid them with home birth?
Monika Stone: Yeah, I understand. You walk the same journey that any of my clients walk. Very few people come in and I just say, “Oh I’m just going to do a home birth.” There’s a lot of research that goes into it. Very few clientele come in and say, “My mother has done a home birth so I know all about it. I may have even been present.”
Many people start like you are. They start with researching hospital environment birth and then they realize, this isn’t quite how they want to birth the baby.
I want to be very clear that hospital birth has its place, just like I’m trying to help understand that home birth has its place. I would say, hospital birth, I wouldn’t consider it as a dangerous place to have your baby, just like I don’t consider home birth as a dangerous place.
It is a different model which utilizes different philosophies, right? Hospital births, which is called the medical model of care, they’re always looking for the next worst thing to happen and how can we fix that. They’re always on the lookout for something to go wrong and how can we fix that, right?
In home birth, we look at it a little bit differently in that we believe that we have built a relationship, that we know this woman, that she has eaten well, so she’s grown a healthy baby.
We have monitored her very carefully and determined that she’s very low risk and that she can move forward with this home birth. We’ve been with her for eight months, seven months and then we move forward with the home birth. Then, we just believe that her body is able to give birth, just like her body knew how to grow the baby, her body will know how to give birth. As a midwife, I just hold that space for her to do so.
I believe, if you choose that you’re at home at your safe zone, then this is a great place for you to birth. I facilitate and keep a check on you, I check on baby, I check on progress, I do all those things.
I’ve seen in many times, that women are perfectly able to give birth at home. They don’t need medication, I’m not waiting for something to go wrong.
I believe that birth works, and those are the difference between the two models, okay?
Hospital birth, there is this fear and this anxiety around what can go wrong, let’s jump, let’s be ready. That has its place. I utilize that when I need it, and in home birth, in the midwifery model of care, we do believe in the power of the woman’s body to birth her baby and we watch carefully. If it doesn’t work, we move to the hospital and we ask them for help.
But, over 90% of the times in my personal statistics, it just works.
Thoughts on C-Sections
Rae Williams: There’s a trend of women actually choosing to do a C-section instead of a natural birth and not because they have any complications ahead of time but because they choose that. Is that something that you recommend, or speak against, and if someone did choose to do that but they still want a level of that post-partum care and that dedicated team, is that something that a midwife would be able to still help with?
Monika Stone: Yeah, this is a great question. I really think that every woman has the right to choose her own birth experience that she desires. Very early on, as we grow up, we grow up with an understanding of where babies are born, and we pick up a sense of either fear or a sense of trust.
Going back to what I said earlier, women who come in with mothers who have had them at home. I love them. They’re going to be just great home birthers because they grew up with the understanding that birth is normal, this is part of my experience as a woman, and they move on and they have a great home birth.
I will never ever judge anybody for the choices they make, for the choices they desire, because I’m not in this woman’s body and there’s a lot of fear around birth. Mothers tell their daughters how they were born, and it was scary and daughters pick up on that and so on.
Some women, they feel strongly to choose that elective C-section, and that is their choice and that is their line. As far as post-partum care goes, they have a vast choice, they have lots of choices who can help them postpartum and midwives tend to not care for them postpartum.
But for instance, I’ve come across situations where we started out in prenatal care, we went through the whole pregnancy, and then toward the end, there is a reason to do a scheduled C-section and then I give the couple a choice. Do you want me to continue care, do you want me to go with you to this C-section, do you want me to continue care with you, or do you want to just go of me at the stage? And they’re often overwhelmingly kind.
They say “No, let’s continue this walk, we have this relationship.” Then my role changes and I’ll become a Doula who helps them through birth. Because birth is birth and what women need is love and support. That’s what matters at the end of the day. Love and support.
Preparing for Birth
Rae Williams: What are some of the things that women can do to start preparing for that?
Monika Stone: Everybody’s always like “Oh, the mess, let’s go to a birth center, let’s go to a hospital. The mess. The mess.” Let me get you all a news flash. It’s not messy, okay? That’s one thing. It’s not messy.
There’s preparation for the actual birth and that is order of kit that has disposable materials, you get information, how to prepare your house, how to prepare your bedroom, it’s very simple, just like you would prepare to go to a hospital, you just prepare for home birth, right?
Not difficult, we say it’s not rocket science, and so there’s that physical kind of preparing, that’s very simple, and then there’s the emotional preparing.
Emotionally preparing for birth is very important. So childbirth classes, if it’s your first baby, if you’ve had a few babies, then we just tap into where you’re at. What do you think you need for this birth?
As a midwife, I do a lot of conversations where I meet people where they are, “What happened in your last birth, what do you want this birth to look like? What happened last time that bothered you and that you want to see differently, what is your dream?”
And so there’s those things that emotionally we prepare for.
Physically, it’s ongoing, women need to stay active, to eat healthy, that’s a big part of the preparation for home birth. If you grow a strong, healthy baby, then you have a baby that can handle labor in birth and then we’re good to go for the home birth. Those are physically, mentally, actual preparation.
We always utilize water, I give out birth pools, and that is also so, so, so foreign to so many people. That is one of the questions I get at the cocktail party, “Do you people really use kiddie pools to have babies in?” And yes, I spent many years delivering babies in kiddie pools and that was perfectly fine, but I do carry birth pools. There is actually such a thing, they are designed to keep the water warm and they hold the water in.
They are strong and sturdy, and that is part of your preparation. I drop the pool, you prepare to set it up, things like that—but it is all very simple. Nothing gets soiled at the end of the day. There is nothing hard about preparing for a birth.
Using Water in Birth
Rae Williams: What is the difference in having that birthing pool and having the presence of the water there as opposed to another type of home birth?
Monika Stone: I love that you asked that question because people are sometimes very confused about water birth and home birth. You know what? They are one and the same, all right? So basically, you choose to have your baby at home. You have access to a birth pool, you have access to labor in the water.
You have access to give birth in the water, but you do not have to. You can forgo the pool. You can have the pool and never use it.
So this is very confusing somehow, and my favorite part about the pool is really the fact that women can labor in the pool, and that is what helps them greatly to get through the last bit of contraction until the baby is born.
Let’s talk about the pain. Yes it is painful, but using the water, we call it hydrotherapy. I love that word because that is exactly what it is, utilizing the water helps women greatly to cope with the labor and birth.
It is the heat and it is the buoyancy in the water. So labor gets more intense and the contractions are very close, they’re strong, and then moms get into that pool and you can always hear that, “Whoa.” It helps them get finished. Get through the remainder of the contractions. Some women end up staying in the pool just to give birth, and a lot of them get out once they start pushing.
That’s the beauty about home birth. You just birth your baby wherever you want to birth your baby.
I am just following you. If you want to be on the bed, birth on the bed. If you want to birth in the water, you birth in the water. If you get out of the birth pool and you push out the baby next to the birth pool, then you do that. I am mobile, I follow you and I keep listening to your baby and I keep checking. I don’t care where you’re at.
How to Choose Birth Support
Rae Williams: What are the qualities that we should look for in a doula or midwife?
Monika Stone: This is also common misunderstanding, so doulas help women with the discomforts of labor and to help them through labor and help them with comfort measures. Midwives are the providers for mom and baby, and midwives are providing all of the prenatal care, all of the birth care, and all of the post-partum care, so their role is very different.
I love doulas. Please invite doulas to your home birth, birth centers, hospital births, they are wonderful.
The quality you want to look for in a midwife is, I would say the number one quality is honesty, then I would also say look at her personality and look at her track record. So find out how she works as well. My book has 10 questions to ask a midwife, and I feel like they are very encompassing, but here’s what happens when you look for a midwife.
You start on the internet, you see what website speaks to you, and then you choose three midwives and you meet them. I always tell people in my own interviews, in consultations, I say choose from the heart. If you feel like I am the right choice for you, or you want to invite me to your birth then let’s do it but if you meet someone else and she feels right to you then choose her. I really think that’s the number one thing, because you are going to spend a whole year.
This is someone you want to be with for one whole year, but not just only go by that, right? By that emotion, by that instant connection. Don’t only go just by that.
Ask her tough questions. Ask her, what is your track record? How much do you transfer? What are your outcomes? What care do you provide? These are very important questions to ask and you will see the way, how she answers if this feels right to you that she is a good provider.
A Beautiful Birth Story
Rae Williams: If you could just give us a story of one of your home births, I know in your book you do have some stories from your clients, but what is one of your favorite stories of a home birth?
Monika Stone: Oh gosh, one of my favorite ones. There is so, so many. I do think one that is in the book and comes to mind is definitely a mom who was able to have her baby at home after her first baby was a planned home birth, and because she wasn’t moving forward and the baby wasn’t coming, she had to go to the hospital. I wasn’t her midwife for that. But she had a C-section because the baby was just not positioned, and that is what makes home birth safe because we utilize the medical model of care for them.
Then she was like, “Okay for my second baby, I want to have a birth center birth,” and she had a successful birth center birth, what would be called a vaginal birth after a caesarian. For her third baby, she was planning this home birth and I was her midwife. First time for me, for us to be together, because she had moved around a bit.
I loved her birth so much because there were so many things done to her in the past and she had gone on this long journey.
And this time around, the labor was uneventful. She was in the water like she wanted to. She decorated the tub for a month on end and she got to be in the water and her husband was there and she got to be where she wanted to be and her baby was in this great position and there were no hiccups and nothing needed to be done to her.
The labor was just unfolding and her baby was just coming, and her baby came so much faster than she ever thought, and it was just this beautiful birth.
I knew her history and I knew how much she wanted this home birth, what was so amazing about this birth was that two hours later, she said, “Let’s take a picture. I want everybody in the picture.” We were all crawling towards her in the bed to crowd up around her, and she’s like, “What are you all doing in my bed? I am going to stand up.”
She jumped up and she stood there with her baby in her arms, and she had just given birth two hours prior.
We took this picture, and to me, this is why I do what I do. I was able to hold the space for her to have this baby at home, because if she would have remained with the medical model of care, she would have had repeat C-section after repeat C-section, and for this third baby, two hours after birth she would have been in a recovery room. She would have had for the third time in four years abdominal surgery and lots of monitors.
She would have recovered from that just fine and she would have been just fine. This is what women do all the time. But the fact that I was able to hold the space that she was able to avoid that, because that wasn’t her choice. She wanted to have a baby at home. She wanted to avoid repeated surgeries. The fact that I was able to hold the space so she could do so safely that made that birth so special. That made it so special.
Connect with Monika Stone
Rae Williams: If you had to give a challenge to people who are listening or people who read your book, what would that challenge be?
Monika Stone: Well I would say the challenge is read the book. Get the book and read the book, but also keep your mind, keep your heart open for the midwives for the home birth community.
Just acknowledge us and do not dismiss us. That is my challenge to you. I respect your choices as a woman, I respect how you chose to give birth, but I challenge you to learn about home birth, to read real studies, not sensationalism. To meet a home birth midwife.
That is my challenge to you before you judge. Because if you have not met women who have done home birth, if you have not met women who have dedicated their lives like me, to be home birth midwives, please do not judge me, because you don’t know me and you don’t know about my work.
Rae Williams: All right, awesome. So how can people contact you if they want to get more information but more importantly, if they want you to assist them in their home birth?
Monika Stone: They can contact me easily. They can find my website, which is very simple. It’s monikastonemidwife.com and you can find my email, you can book online for consultations and you can also find me on social media, on Facebook same thing, “Monika Stone Midwife.” You can also find me on Instagram. I am busy delivering babies, I am not busy with social media. But yes, you can find me. I am out there.