Real-life dramas

By WENDY BLUMFIELD
Amy's story Amy and Boaz Shapira live in Rehovot. Amy, a former American, is herself a childbirth educator and physical therapist and already knew the system in Israel. For her third child, Naomi, she opted to give birth at Ilana Shemesh's home, a choice she made because "I make a lot of noise in labor and didn't want to disturb my children." At one point her plans were threatened because until the final three weeks of pregnancy, the baby was breech (head up), a contraindication for home birth. It was a hot August day. Her two older sons were on holiday, and Amy had got very tired finishing up her work and commitments. When she felt regular contractions, she and Boaz made their journey to Shemesh's home; but Amy felt uncomfortable being away from the home and children. Possibly because of this ambivalence, there were several false alarms. Eventually the couple returned home and asked Shemesh to attend the birth there when the time was appropriate. It was only a couple of days later that Boaz (who had worked in cow sheds in the past) proclaimed that he was sure today was the day. "The labor started so slowly, but it was in the early hours of the morning when the children were asleep that the contractions got stronger and more regular," says Amy. "Progress was still slow, and Ilana was considering transferring me to hospital, but I needed just another hour or two of using the bath and trying all the squatting positions." True to her prediction, Amy made so much noise as the baby was born that the neighbors called the police, suspecting domestic abuse. A policewoman knocked on the door just as Amy was resting with the baby at her breast, surprised and relieved when Amy smiled and reassured her: "It's all right. It was only me having a baby!" Roni's story Roni Shalev, 31, is the mother of two daughters and lives in Pardess Hanna. She has not had negative experiences of hospital birth because her first daughter was born with a private midwife at the Misgav Ladach women's hospital, which specialized in natural birth before closing in 2001. But this time she did not have the constant support of the father, and she preferred to birth at the home of friends, attended by them and an American-trained professional midwife. "I wanted familiar conditions, not interventions," says Roni. "I did not want this birth taken away from me." She gave birth in an inflatable pool in her friends' living room. As the baby was born, she helped the head crown. "But instinctively I knew when to ask the midwife to take over. This was the right environment for me. I felt safe," she says, asserting that this confidence can only come with having a qualified midwife and the appropriate equipment, "not because it is trendy or fashionable." Roni is a yoga instructor working with pregnant women, and she affirms that physical and emotional preparations are even more necessary for home birth. "You are taking much more responsibility," she says. Breastfeeding was spontaneous, and Roni was happy that no strangers handled the baby and there was no separation after the birth. "I felt so independent and active," she concludes. Nurit's story Nurit and Hanoch Klil Hahoresh, an Orthodox couple, were living in Hoshaya in the lower Galilee when they had their fifth baby at home. They had good experiences of hospital births, but this time Nurit wanted to birth at her own pace with the person of her choice. "I felt it would flow well at home," says Nurit. Initially Hanoch was concerned. A previous home birth had been planned but changed because of raised blood pressure. Eventually Hanoch had so much confidence in home birth and their midwife of choice, Mindy Levy, that even when Nurit's blood pressure started to rise, he encouraged her to try yoga, acupuncture and natural remedies to stabilize it so that she could give birth at home. "I suffer from hospital blood pressure," she says, describing how it varies according to who is checking and where she is. The day labor started was cleaning day. While Nurit got on with her chores, the other children helped to massage her. As labor progressed, the children stayed with friends. Only her 14-year-old daughter was rather tense and anxious. "We were very discreet about our home birth," says Nurit. "When we planned a previous home birth, we got a lot of pressure from family and friends, so this time we kept quiet. But I knew I could do it. I had experience of the cycle of interventions. A hospital takes the birth away from you. I am more mature now and had more confidence. Home birth is woman-centered." Hadas's story Hadas and Benzi Carmona were living in Tivon not far from Mindy Levy when they gave birth at home to their first baby six months ago. "When my sister gave birth at home three years ago, I could not fully understand why she did that," says Hadas. "But when I became pregnant and started to read about the process of birth, I understood how important the right environment is for releasing the birthing hormones." Hadas had no specific negative association with hospitals but began to feel that going into hospital for birth in itself causes stress, which can delay the stages of labor and cause more pain. "Benzi was all for birthing at home. He said our home was so ideal for this experience," she continues. Hadas's obstetrician was extremely unsupportive and warned her that her pelvis was small. The family had already accepted her sister's home birth, and Benzi's family supported their choice. "Of course, we had fears," says Hadas. The couple even participated in hospital tours in order to become familiar with the procedures should they change their mind or should it be necessary to transfer during the labor. "I had great confidence in my midwife," says Hadas. "I knew that she was very experienced, and I trusted her judgment. In our meetings, we understood her limitations and were happy with her criteria for transfer to hospital - she doesn't take chances." Since nature often helps women with a small pelvis, Hadas's baby weighed in at 2.750 kilograms (6.1 pounds). However, her labor was long and painful because the baby was in a posterior position (face forward); and in spite of using all the recommended positions, the baby did not turn. "I was exhausted and in pain, but I was not frightened," she says. "Yes, at one stage I would have welcomed an epidural, but the prospect of traveling to the hospital, being confined to bed with IV fluids before the epidural and the subsequent procedures was more frightening than the pain." Breastfeeding did not get off to a good start. The baby was sleepy after such a long entry into the world, and did not attach well. "I had to give a few supplementary bottles of formula, but I persevered and am still fully breastfeeding." The baby was examined at Nazareth Hospital. The staff were fully supportive of the home birth and released the baby immediately after making sure all was well and registering the baby. Shahar's story Shahar and Eran Gal live in Haifa. "When I got pregnant I was in denial, I was so afraid," says Shahar. "I felt such relief when we met Mindy and could talk about all my concerns." Shahar says that from then on they met with the midwife monthly, and this built their confidence. Her family lives abroad, but Eran's family was concerned about all the things that could go wrong. Eran himself was enthusiastic about home birth and saw how the prospect calmed his wife. "We didn't want negative vibes, so we only told friends who we knew would support us," says Shahar. Only one week before this interview, Shahar gave birth to a 4 kg (8.8 pound) baby boy with no interventions and no sutures. "The labor was quite long, but I did not feel the hours. There was such a calm atmosphere, and I was up on my feet most of the time." Breastfeeding started spontaneously and continues without any problems. "I asked a breastfeeding counselor to call and give me some guidance, but it is going really well," she says.