Weddings can be Pricey but Birth Options are Priceless

Fourteen years ago in San Antonio, my husband and I quietly eloped. I never fantasized about a regal wedding. I was raised by a beautiful mother who had a lot of trouble with men. Her tumultuous dating life yielded abundant proposals. Sometimes there were weddings. Sometimes there were divorces. C-H-A-O-S...that's how we spelled love in our home. For the majority of the time while I was growing up my mother was single and it was just the two of us. We scraped by. There was no possibility that she would be able to contribute financially to the weddings of her daughters.

For my older half-sister, who married her high school sweetheart in a modest ceremony a few weeks before I was born, it was a point of bitter disappointment which caused her to be proactive about her own daughter's wedding. She began setting money aside as soon as she brought her baby girl home from the hospital. The funds she accumulated over 24 years paid for a magnificent ceremony and reception for my niece, a graduate student pursuing her MS in environmental biology. She looked the perfect picture of a princess that day, set among cascading tropical flowers, ice sculptures, and clouds of living butterflies released in unison from tiny butterfly-sized boxes by the guests. 

As for me, I wasn't disappointed in my lack of a dream wedding. I didn't want spectators or an extravagant ceremony. Coming from a home where romantic relationships seemed to have a lot of jagged edges, a showy, expensive party seemed...well, overly optimistic. I've seen people spend more than $30,000 on weddings to celebrate marriages that lasted less than 3 years. I don't get it. My husband and I went the penny-pincher's route with a no nonsense Justice of the Peace and solitary witness, and we postponed the honeymoon we couldn't afford too (which, come to think of it, we still haven't gotten around to.)

On the other hand, when we got pregnant, our extended family thought we were crazy for "throwing money away." We could have taken advantage of our full coverage military insurance and had our first child delivered at a military hospital at no cost to us. But I was determined that our child's birth not take place amidst beeping machines and the sterility and bustling efficiency of a conveyor-belt style delivery room. Thanks, Uncle Sam, but no thanks. We were broke at the time, so we scraped, borrowed, and bartered in order to pay out of pocket for a midwife to attend the home birth I wanted. No one else in my family had given birth at home, so the decision alarmed and baffled the relatives.

There are so many reasons that it never interested me to give birth in a hospital, including the desire to have a more intimate, motherbaby centered process rather than the hospital-centric, protocol driven, standardized treatment typical of conventional obstetric care. But the primary reason was not so much about what I DID want as what I DID NOT want. I did not want my baby taken from me at any point after the birth. I wanted to be in control of what was done to my baby at all times--did not want her poked or prodded by hurried hands-- and I was not willing to make concessions about this. There would be no nurses whisking her away to a nursery down the hall or telling me how or when to feed her or "accidentally" giving her a bottle of formula. We would be breastfeeding on cue, co-sleeping, and gently parenting this child and that was that.

People occasionally ask me if my husband was always on board with home birth, and particularly with unassisted birth since that's how our second and third children were born. No, he wasn't. The first time around, he was like the reluctant groom, acquiescing to the bride's dreams of the perfect wedding day. Our first home birth did not go as planned, as I've already blogged about here. It took the healing birth of our second daughter to help him see some of the method to my madness. Our third daughter's glorious water birth put him solidly in alignment with my birth philosophies but by then we were done having babies. If you ask him now, my husband will agree that the money we've spent on midwifery care, even when we've paid for the services of midwives who we ultimately chose not to have at the births, was not wasted. I'm thankful to have a partner who backed me up even before he was convinced that I was right.

What I value most in terms of prenatal care is support, information, and options. I believe that women are uniquely intuitive during pregnancy and birth. I've found through experience that it is much easier to follow one's intuition when there are a full array of options open to you. For how can a woman respond appropriately to her intuition if her options are limited or there are catastrophic financial or social costs attached to any of the appropriate courses of action? I believe every woman deserves to give birth on her own terms and to be in a position to trust and honor her instincts and not be second-guessed by the people around her. I believe that society needs to trust women to make the best choices for themselves and their babies. There are no better advocates for the health and safety of babies than mothers.

ACOG disagrees. Their latest fear-mongering statement on home birth includes the blatant attempt to shame women for viewing birth as anything other than a medical event: "Choosing to deliver a baby at home... is to place the process of giving birth over the goal of having a healthy baby.” Normal pregnancy and birth are not medical events. There is nothing inherently dangerous about the natural biological function of birthing a baby. It is, however, a profoundly spiritual rite of passage, as weighty in emotional significance as any other time that we pledge to love and bind ourselves to another human being for the rest of our lives. I don't expect ACOG to grasp that aspect of birth. But they should be able to acknowledge the growing body of research that tells us that the qualitative aspect of birth choices has life-long health consequences.

Desire for a certain kind of birth experience should never be dismissed as reckless romanticism and whimsy. Primal Health Research, which compiles the data from various scientific disciplines, has proven that experiences during the primal period (conception through the first year of life) have profound implications on health and well-being into adulthood. Whether or not a child is born at home or in the hospital matters because skin-to-skin contact matters. Mother/infant eye contact and scent recognition matter. The breast crawl matters. Gentle handling of the infant matters. The emotions of the birthing woman matter. All of these things influence the baby's imprinting and shape further experiences and overall health throughout life.

The average cost of a wedding is now slightly more than $27,000 (not taking into account any elective surgical expenses if the bride-to-be follows the latest "bridalplasty" trend). The average cost of a midwife attended home birth is about a tenth of that. Does it seem odd to anyone else that there are cultural traditions in place which compel us to spend extravagantly on the weddings of our daughters, if we can, but no traditions ensuring that the momentous occasions of our grandchildren's births are not dictated by money, or the lack thereof? I know people have different priorities but I just don't get it. The Feminist Breeder's blog post entitled "Blue Cross Blue Shield Doesn't Want Me To Homebirth" is a prime example of what I do not want my daughters to have to deal with when they're pregnant. 

I don't want insurance companies determining what options my daughters have access to as they traverse the transformational journey of motherhood. I have no hope that The Big Push to License Midwives, if it is successful, will improve access to homebirth. Listen to midwives about their experiences with licensure and you find sentiments like this: "My license has done nothing in preventing discrimination by insurance companies, medicaid programs (women who need midwives most) access to laboratories and supportive physician assistance. My license has tied my hands to procedures I do not like to perform and causes interference. It forces me to manage birth instead of supporting women who birth."  

I plan to contribute to my daughter's weddings if and when they decide to marry, but I feel much more passionately about doing whatever I can to help them have the births of their dreams. I welcome discussion about ways we can work together to ensure birth freedoms for future generations of mothers.