157 Home Birth and Hospital Birth, Risks vs Benefits

The VBAC Link - A podcast by Meagan Heaton

It’s an ongoing and classic debate-- home birth versus hospital birth. Trying to decide where to have your VBAC is one of the toughest decisions to make. There are LOTS of opinions out there to navigate. Julie and Meagan sit down with you today to share some pros and cons (and some myth busters!) of each based on their personal experiences as doulas, as well as the most current evidence-based research out there.    This discussion is only the beginning.    We include tons of resources with even more information about these topics to help you continue your research and get closer to making your informed decision. We hope this episode leaves you feeling empowered and more confident in your birth choices no matter where you end up birthing.   Additional links   How to VBAC: The Ultimate Preparation Course for Parents The VBAC Link Community   VBAC Link Blogs:  Writing a Home Birth Plan Natural Birth versus Epidural Home Birth After C-section (HBAC) Laboring at Home What to Write in a VBAC Birth Plan 13 Tips to Prepare for an Empowering Birth Evidence-Based Birth® article: What is Home Birth? The VBAC Link Shop   Episode sponsor   This episode is sponsored by our signature course, How to VBAC: The Ultimate Preparation Course for Parents. It is the most comprehensive VBAC preparation course in the world, perfectly packaged in an online, self-paced, video course. Together, Meagan and Julie have helped over 800 parents get the birth that they wanted, and we are ready to help you too. Head over to thevbaclink.com to find out more and sign up today.   Full transcript Note: All transcripts are edited to eliminate false starts and filler words.   Meagan: Hello, hello. It’s Meagan and Julie with The VBAC Link, and today, you just have us. Lucky you. We’re so excited to be with you today.    Julie: Woohoo!   Meagan: We’re going to actually be talking on a very, very sensitive topic in a lot of areas because this can be one of those lovely debates out there. We’re talking hospital birth versus home birth. Definitely, something that we know some people are passionate about on both sides. That is great, and we love that, but today we want to talk about all the evidence on both sides, the pros and the cons, and how to determine what’s best for you.   Julie: Absolutely. I’m excited. We actually have a blog about this, I think. I’m looking it up right now.   Meagan: We do. We do.    Julie: Home birth versus hospital? I know we have one on Natural Birth versus Epidural. We have Writing a Home Birth Plan; we have an HBAC one, Natural Birth versus Epidural. I don’t think we have a hospital versus home birth. We have Laboring at Home.   Meagan: We don’t?!   Julie: We need to write one.    Meagan: Oh, Laboring at Home. Yeah.    Julie: Yeah. So basically, during this episode, we’re going to talk about a lot of things that we cover in our blog, so go to our blog right now and search for “home birth.” It’s going to bring up results Laboring at Home, What to Write in a VBAC Birth Plan-- that’s for a hospital or home birth. We have-- let’s see.   Meagan: Home Birth After Cesarean. We’ve got lots of stories on the podcast.    Julie: Uh-huh. We’ve got Natural Birth versus Epidural, lots of podcast stories, How to Write a Home Birth Plan, all sorts of things. And then, we’re going to tell our content writer who tells us what to do about blogs that we need a home birth versus hospital birth blog.    Meagan: Yeah, we do. We totally do.    Review of the Week   Julie: We do. Maybe there will be one there by the time this episode airs. Alright, but should I read a review?   Meagan: You should read a review.    Julie: Alright. I’ve got one from Google. We haven’t read a Google review in a long time. So, if you didn’t know that, you can review us on Apple Podcasts, you can review us on Google by just searching for The VBAC Link, and you can review us on Facebook. We love reading and having reviews from all three of those platforms. It keeps us going when the times get tough.    This review from Google is from Anne McLaughlin. She says, “These ladies are an absolute joy to listen to on their podcast! I feel so fortunate to have found them on my journey to what will hopefully be a 2VBAC with twins! When I had my 1st VBAC, I felt educated, as I had read through books and websites. Now, I feel empowered! Thanks to Julie and Meagan, I feel more confident advocating for myself and asking the right questions. I recommend you to all of the mamas I come across in other VBAC groups and often refer to specific episodes I've listened to. Thank you for all that you do, you Women of Strength, you!”   No, thank you, you Woman of Strength, you! Do you know what? I just saw in our Facebook community a twin birth posted.   Meagan: Oh, really? Really, that’s awesome.   Julie: I’m going to go stalk her and see if it was that same one. I’m actually in it right now.   Meagan: Yeah. That would be fun if it was. It would be super fun.   Julie: Anne McLaughlin.   Meagan: We’re stalking you, Anne.   Julie: Let’s see. Nope. She might not be in our community.   Meagan: Speaking of, if you didn’t know, we do have a community, and no, we don’t usually stalk you.   Julie: Only if you leave a review. Don’t put your real name on it.   Meagan: Only if you leave a review. So, it’s on Facebook, and if you search The VBAC Link Community, you will find us. Now, we do have questions that you have to answer, and we are kind of strict on it. So, you have to answer all three or—   Julie: Two. There are only two now.   Meagan: Oh yeah. There are two now. You have to answer both, or you don’t get added in. Sorry. We love you, but we really want to protect our group and keep everyone safe.   So, if you are not with us in that community, definitely check it out on Facebook, The VBAC Link Community. I promise you’re going to love it because these people in this group are just incredible. I am honestly learning from them. Do you find that, Julie? You see a post, and you’re like, “I actually didn’t know that was a thing,” and I go and research it.   Julie: Yes, or I make a statement and then somebody else says, “Actually, blah blah blah,” and I am like, “Do you know who I am? I own this community.” Then I go and research it, and I was like, “Oh crap. I was wrong.”   Meagan: Oh, that’s funny. That’s funny.   Julie: Okay, I found it. Anne McLaughlin in our Facebook group. I am looking at her story. Oh, shoot, wait. Let’s see—growth scans. Oh no, this is on October 26th. Dang, it. September no. Oh well. We will have to see. I’m going to be looking while we are talking, so if I interrupt the episode, you will know. Because she’s new, she should have been due-- or maybe she is still pregnant. I don’t know.   Episode sponsor   Julie: Do you want a VBAC but don’t know where to start? It’s easy to feel like we need to figure it all out on our own. That’s what we used to do, and it was the loneliest and most ineffective thing we have ever done. That’s why Meagan and I created our signature course, How to VBAC: The Ultimate Preparation Course for Parents, that you can find at thevbaclink.com. It is the most comprehensive VBAC preparation course in the world, perfectly packaged in an online, self-paced, video course.    Together, Meagan and I have helped over 800 parents get the birth that they wanted, and we are ready to help you too. Head on over to thevbaclink.com to find out more and sign up today. That’s thevbaclink.com. See you there.    Hospital birth versus home birth   Julie: Anyways, we’re going to be done talking about Ms. Anne right now, and we’re going to talk about hospital birth versus home birth.   Meagan: Let’s do it.   Meagan: This is something as individuals-- we’ve both had a hospital birth and, well, you had a home birth. I had a birth center, which is kind of like a home birth, right?   Julie: Yeah, pretty much.   Meagan: Yeah. I mean, out-of-hospital birth. So I definitely know the difference from my personal perspective on birth, but then I have also attended many births as a doula in hospital. In fact, I would say the majority of my clients deliver in hospital, which is something that a lot of people don’t realize. A lot of people think doulas are only supporters for natural, unmedicated birth, and I’m just going to myth bust that one right there.   Julie: Boom.   Meagan: It’s not. It’s not. And really, I would say, 85 to 90% of our clients are in hospitals. I definitely have seen a lot of hospital birth, and then I’ve definitely seen home birth. I’m excited to talk about the things that I’ve seen and the differences on both.   Julie: I’m excited, too. We both have, I think, things that rub us the wrong way that we see some providers do constantly. I want to preface this before we get into it, that these are just experiences that we’ve seen in the birth room, at-home birth, hospital birth, and birth center birth. It’s not to be replaced by advice from your provider. It doesn’t necessarily mean that your provider’s doing anything wrong if they do things that we see that we don’t necessarily like. Some of us like some things that the other one doesn’t like. It’s going to be a fun conversation.   I actually found Anne‘s post. She had her babies. They were a TOLAC turned elective Cesarean. So she had a repeat Cesarean after an induced TOLAC. It looks like she chose a Cesarean. She hasn’t written up their birth stories yet, but they look beautiful and well and nice, chunky 8 pounds, 7 ounces and 7 pounds, 7 ounces twins.   Meagan: Wow, twins. Those are nice sized babies for twins.   Julie: I know, right? Nice chunky little boys.   Meagan: That’s cool. That’s awesome.   Julie: Well, now, you know.   Meagan: Congrats, Anne. Yes.   Julie: Alright. I don’t know how to get started.   Meagan: Well, first of all, I want to talk about home birth in general.   Julie: Do it.   Meagan: A lot of people are very, very scared of home birth, right? Because of that fear that is placed upon us. I say the word “uterine rupture”-- two words. Uterine rupture. That is a very scary thing to think of. Doing it at home, and the thought of not being right next to an OR can be scary and intimidating. Really, really hard to comprehend. Is it safe? Is home birth safe after all? There is something on our blog, so I’m jumping into home births first versus hospital. I don’t necessarily suggest one or the other, generally. This is very much a personal decision, but I just want to share this.   It says, “Homebirth in general, and especially home birth after Cesarean, also known as HBAC, is growing in popularity. In 2013, 1.4% of U.S. births took place outside of a hospital. Laboring at home is common, but many women also decide to stay home for the birth itself. Surprisingly, 64.4% of these occurred at home.”   64.4. That’s a pretty high number. That is really high. I mean, that was in 2013, so that was years ago. But still, it’s actually more common than you may think, and it’s more safe than you think.   So, okay. I’m going to go backwards. I want to talk about-- how do you know? How do you know what to do or where to go? How to decide? How do you know what to decide to do?   One, I think it’s really important to write a pros and cons list for yourself because everyone is different. Everyone is going to see different pros and different cons. Some peoples’ pros are going to be those other peoples’ cons. So write a pros and cons list.    Be honest with that pros and cons list. If money is a factor, write it down. Money. Insurance will cover it, right? If fear is a factor or a con, then write it down. Fear. Then, let’s break those down. Okay. What is the fear surrounding? What brings this fear? Then, let’s educate on those topics and see if that fear still stays. If that fear still stays and you were like, “Nope. I still feel very comfortable at the hospital,” stay at the hospital. If you’re like, “Oh, well actually, I didn’t know that it was not like that,” then that may change your mind for a home birth.   This is something that I’ve stuck with for so long. Honestly, ever since Blyss Young with-- I don’t know if you guys know Dr. Stu’s Podcast, but Blyss Young-- she said this, and I just can’t even let go of it. I can’t because it’s too good.    It’s the analogy of like, okay. For our weddings, we pick out the flowers. We pick out the venue. We go to places. We get comfortable. We pick out the colors. We are picking out the destination, and everything included, right? And then, for some reason, when it comes to birth, which is another very big day of our lives, we let our insurance companies tell us exactly what we’re going to do. I loved that when she said it, I was like, “Whoa. I never even thought of it like that.”   So, yes. Money can be a factor, but don’t let someone tell you who you can deliver with, where you can deliver, and how you can deliver if that’s not something you’re comfortable with. You may be like, “I don’t care really where I go; I just want to have a baby.” And that’s okay, too. But just keep that in mind.   So, writing a pros and cons list, really understanding the facts, and then following your intuition. I know Julie, and I talk about it all the time but follow your intuition. It’s huge. If your intuition says, “I shouldn’t be there,” then don’t go there, wherever “there” is. Right? And it’s hard to differentiate fear versus intuition. But usually, if you are feeling scared, that’s not your intuition. Right, Julie? It’s fear creeping in. So, talk about that.   Julie: Yeah. I want to touch on that. I feel like sometimes we don’t explain enough about what intuition is. I actually made a post yesterday because I wrote about a blog about how to have an empowering birth experience.   Your intuition doesn’t have to be a warm and fuzzy, feel-like-you-get-wrapped-in-a-big-hug, and be 100% confident in your decision. Intuition can look a lot of ways. The decisions that you make because of your intuition or the things that your intuition is telling you can cause a fear in you. In that case, that would be an indication that you need to do some processing and make sure that you enter into whatever decision you made with confidence as much as you can.   But sometimes, depending on yourself, acting on your intuition can look like asking questions when something doesn’t feel right to you. It can look like taking a look at the big picture rather than what’s happening at this exact moment. Or checking in with what you’re saying to yourself.   Your self-talk, sometimes self-talk, we confuse with intuition. Let’s check-in. Do you say things to yourself like, “Oh my gosh, I’m going to have such a hard time finding a provider.” Well, how can we turn that into a more productive statement? Like, “Alright. I know that I can find the right provider for my birth. I know that I can do the work necessary.” Things like that. Asking for reassurance from others sometimes.   I know for me-- oh my gosh, Meagan can attest to this, but I need reassurance big time. If I am making decisions, and I’m trusting my gut, and I’m taking a leap; I need people to tell me that it’s the right choice. Even if they think that I am completely off my rocker, right?   Meagan: Yeah, no. Totally, yeah.   Julie: I need it. Words of affirmation is my love language. Reassurance is a big thing. Reassurance that I’m trusting myself and that I’m making the right decision based on the things that I know and feel. Not second-guessing yourself. If it was the right decision when you made it, can I keep trusting that that’s the right decision? Also, trust that if changes need to be made, then you will know when and if they do need to be made.   Forgiving yourself can be part of trusting your intuition because sometimes we have to forgive ourselves for not knowing what we didn’t know or making decisions that we didn’t know we could’ve made differently when they happened.    And allowing yourself to feel negative emotions. Oh my gosh, please, please, please, can we say that again? Allowing yourself to feel negative emotion. Sometimes people think, “Oh, only positive vibes. Good vibes only when I’m preparing for my birth.” But if you do not allow yourself to feel and process those emotions and then send them off to their own little wherever-negative-emotions-go land, then you’re going to be doing yourself a great disservice because they can come up and appear while you’re in labor and birth. It can negatively impact the physiologic process of your birth.    Then, just being kind and loving to yourself. Sometimes that is simply what your intuition needs you to do. Just stop and slow down. Take a break and be kind to yourself.   But, yeah. I like that. I think that it’s important to clarify that intuition doesn’t just look like a still voice while you’re in a quiet and dark room.   Meagan: Right, right. And not allowing all of the outside static to impact it. Because I feel like it kind of just jumbles around, and you’re like, “Wait, what? Now, what am I feeling? Is that intuition? Is that opinion? Is that fair? I don’t know? Oh, what is it?” Do you know what I mean? There is so much. So, yeah. I love that. Perfect.   Let’s talk about hospital birth. What are the pros of hospital birth? Let’s talk about them. Pros and cons.   Julie: Well, I think the biggest pro of hospital birth is probably the biggest pro of home birth too, is making sure that it’s a space you’re comfortable in. Because some people just don’t feel comfortable, and they never will feel comfortable giving birth at home, right? If you’re not comfortable, then what happens? Everything locks up, and your physiologic process is destroyed. The obvious pros of hospital birth really are if you have an emergency that needs immediate attention, then your baby can be out of your body in 1-2 minutes with a crash Cesarean. I think that immediate access to emergency resources and care is probably the biggest pro about hospital birth.   Meagan: Yeah, just having access to that care. Comfortability. Also, I don’t know. I think in some ways there is a pro of having more-- now this could be the pro and a con in both ways, but more resources. Does that make sense? So, say you’re going. You’re 9 centimeters, and there is this lip or whatever. There are other things you can do at home, but sometimes a drop of Pitocin really does help. Or, say you are pushing for hours and hours, and you have a provider that is right there that can help assist with vacuum or forceps. Does that make sense? So, those are little pros that we wouldn’t really think that they are pros because they are not something we want to think of a pro, but it’s there. If we are home and we’ve been pushing for a long time, we have to get in the car and transfer. Or get in an ambulance and transfer. Sorry, I’m getting deep into the not super--   Julie: I know. I feel like we’re kind of all over the place. I don’t know; I just think that with home birth and hospital birth, a pro to one person could be a con to another person.   Meagan: Exactly. That’s what I’m saying. It’s so hard.   Julie: I think you hit it right exactly on the head when you said, “You’ve got to make your own pro and con list.” I’ve been looking-- if you can hear my mouse clicks in the background-- I’ve been looking for the home birth studies that have been recent. The Canadian home birth study. It’s really interesting.    I’m going to go and talk about a couple of different resources about home birth, actually. Evidence-Based Birth® wrote an article about home birth safety. Here we go. Sorry. I’m just clicking back and forth really fast. So, here’s the thing. The Evidence Based® article was written in 2012. There have been studies that have come out in 2015 and 2017 that haven’t been updated in the study yet. But she has a couple of good references and information in here that I think is important to talk about, just about home birth generally, because she sums it up in a way that would take me 30 minutes to say because you know how long-winded I am.   Now, I want to say before I go into it that ACOG does not recommend home birth for a VBAC. With that being said, me and Meagan have both had out-of-hospital births with VBAC. The reason ACOG doesn’t recommend it is because there’s not enough data on the safety of home birth for women with a prior Cesarean. There’s just no evidence to prove whether it’s safe or not, and so ACOG considers it an absolute contraindication, just having a VBAC.    However, all these studies support that if a woman is low-risk, she could be a good candidate for a home birth. Being a low-risk includes that you are pregnant with a single baby, and you’ve made an informed choice to birth at home, baby is head-down at term-- although, I would kind of disagree with that one. Breech home birth can be done safely with a provider that is trained and experienced in breech birth. And if you have a back-up plan in place. That’s actually one of the things.    At birth, as long as the baby isn’t born before the 37-week mark, the mom has no serious medical conditions like heart disease, kidney disease, blood clotting disorders, type 1 diabetes, gestational diabetes managed with insulin, preeclampsia or excessive bleeding, no placenta previa obviously, and as long as parent goes into spontaneous labor-- although I think that’s also a gray area because there are certain things you can do to nudge and encourage labor to begin that aren’t medical things.   What I think the biggest thing is, is that people think that having a home birth midwife, which-- we don’t advocate for unassisted home birth, especially for VBAC. We think it’s important for everybody to have a provider that they can trust, and that is an expert in their type of birth. However, we realize that in some areas of the country and even the world, that’s not an option for you. I’m just going to leave that right there. We can go back to referencing your intuition and the pros and cons list for that.    Homebirth midwives are actually highly educated people that have gone through extensive trainings and attended hundreds of births. I know I am a midwife student right now. I am a student midwife and-- oh my gosh, the number of requirements, courses, educational pieces and information you have to learn, and hands-on experience you have to have. You have to have a mentor that will guide you, help teach you, and educate you. It is an exhaustive process to become a practicing midwife.    Midwives have lots of supplies on hand and bring lots of things to home birth. I’m just going to go over the list because sometimes people don’t think about these things. They have a handheld Doppler to monitor the baby, sterile instruments for cutting the cord, vitamin K and eye ointment for the baby, suction devices like the squeegee-little-bulb-thing to remove mucus from the infant’s nose or mouth. Oxygen tanks too-- they are required by law to have two oxygen tanks with them and adult and infant resuscitation equipment. They are required to be trained in neonatal resuscitation and CPR. There are so many things in the birth kit.    Midwives can do interventions at birth, as well. The interventions they can do is obviously monitor baby with her Doppler, monitor a woman’s progress of labor, perform cervical exams, provide physical and emotional support during labor-- although we absolutely recommend having a doula with you because the midwife can’t do both jobs at once-- being a midwife and a doula. They can perform all the newborn exams required by the state that your OB/GYNs and nurses do in the hospital. They can suture any tears after birth; they can recognize complications and transfer a patient to the hospital if they need to. Most of the time, complications are recognized earlier than they would be in a hospital just because you have a midwife there with you 100% of the time, and they can transfer you before the situation becomes emergent. They can also administer oxygen and emergency medications. Some certified midwives can carry Pitocin, Methergine, and other things like that to help in case of an emergency or hemorrhage.   Meagan: They have a lot of holistic things too.   Julie: Yes. Yeah, a lot of herbal things.   Meagan: They have a lot of herbal and holistic things that can help you avoid having those medications--   Julie: --that decrease your chances for having those things. Yep. They can also start IVs and administer IV fluids. Like I said, it depends if you are a Certified Midwife, or a Direct-Entry Midwife, or what your accreditation is. Each state varies by law on whether or not midwives can carry certain medications. But I think another reason people are kind of hesitant about home birth is not wanting to clean up the mess. That’s what my husband said.   Meagan: Yes, it’s dirty. Yes. Dirty. yes, yes, yes.   Julie: But midwives do such a really good job cleaning up the mess. In fact, my house was cleaner after my midwives left than before I went into labor on my three home births. Isn’t that funny? I’m like, “You guys should come back.”   Meagan: I believe it, though. I know that team. I know that team. They clean very well. Yeah.   Julie: “Are you going to clean at my newborn exam? The two-day postpartum visit?” Yeah. They do all the newborn checks and screenings things as if you were at a hospital. So those are some common myths about home birth.   Meagan: Yeah. Definitely myths there for sure. I love that you were talking about-- these midwives are not just some random people off of the street. They are trained. They’re qualified. And, I also want to encourage, when you are interviewing these midwives, ask them their credentials. Ask them their experience.   Julie: And their training.   Meagan: And other training. That’s going to help you. Also, I would say one of the pros of home birth versus hospital is the type of care. Now, I don’t want to say that hospital staff gives less care, or poor care, or anything like that. It’s not what I’m saying. It’s the quality of time that is put into the care. It’s not because these providers in the hospital don’t want to. It’s because they can’t. They can’t. It’s very rare, and there are people out there, but it’s very rare for a provider to be able to sit down and spend one hour with you, and answer your questions, talk about your pregnancy, talk about how you’re doing, talk about your plans and where you’re at in this journey. It’s just unlikely for them to be able to do that.    So, that is something that is huge, that was huge for me and my decision to deliver out of the hospital. Because I loved that I could go in and ask my doctor a couple of questions in my prenatal, it felt good to have a list, take it in, ask questions, and then leave and come up with more questions. But I can’t tell you how many times it was like, “Oh, well, this doctor is downstairs at birth, so you’ll have to keep your questions until next time.” Or, I’d ask a question, and he’d look at me like, “What?”   Julie: Yeah, or they’re like, “Well, the doctor is just five minutes away, so we can call him in whenever you’re ready, or you have a question.” And then they’re like, “Well, let me go check with what your doctor has to say about that,” and it’s just harder.   Meagan: Or like, you call him. You call into the office, “Hey, I have this question.” And like you said, “Oh, let me get a hold of your doctor.” And then the nurse calls you back, not your provider. But guess what? I had a question. I sent my midwife a text message. She texted me right back. She called me. “Let’s talk about this. Hey, okay. This is what I want you to do.”    Every single time I would go into a visit, she would sit down, and we would just kickback. It was like two friends at a coffee shop; only we didn’t have a table and coffee. Do you know what I mean? It was just natural.    That’s a pro that I could say. You can’t just text your doctor. You can’t just call your doctor, and rarely if you call your doctor, you get your doctor. So that was a really big pro for me is that established, individualized care. And then, guess what? I knew exactly who was going to help me get this baby here the day that I went into labor. One of the cons in the hospital is, you just don’t know these days. Usually, providers work in a group of 5+, right? You just get who you get. You may love them, and you may not have a great relationship, or you may have never met them. For me, and especially for VBAC, I feel it is so powerful to have had that relationship with the provider the entire time.   Julie: I think with that relationship too is, you learn to have trust in your provider more, and your provider learns to have trust in you more.   Meagan: Totally.   Julie: They know your specific needs more.   Meagan: Yes.   Julie: We need to wrap it up, but I feel like this episode might be more like clearing up myths about home birth rather than the pros and cons of hospital birth.   Meagan: Yeah, maybe. Yeah.   Julie: This is the thing about hospital birth. I want to just say; we are both 100% for you choosing your birth location with confidence and a provider that you are comfortable with. At hospital birth, you are just going to have to keep your eye out for more interventions being offered to you and know what those interventions are and when or when they may or may not be necessary. That’s really, really important.    But then again, there are some homebirth midwives that are really heavy on the interventions, like with herbs and oils, and things like that. I would ask, no matter where you are, what interventions are standard when they would decide something as an emergency, and for home birth, what their transfer plan looks like, what their transfer rate is.    With that being said, a high transfer rate doesn’t necessarily mean that a midwife isn’t a good midwife; it means that they are confident in their abilities with what they can and cannot handle. They are, I would say, overly cautious and would rather transfer before things become an emergency and be in the midst of an emergency, have to transfer, and possibly endanger the health and life of mom or baby. So, yeah. Pros and cons.   Meagan: Definitely. Yeah. I would say, maybe pros and cons. That’s what this episode is more pros and cons, and just the differences.   Julie: I’ve seen really, really awesome hospital births and hospital birth providers, and I’ve seen providers with their fingers in moms’ vaginas for two hours while they push. All I want to do is scream, “Get your hands out of the mom’s vagina!” They’re like, “Oh yeah, that’s a great push. That’s another great push. That’s another great push.” And I’m like, “Oh my gosh, if they’re great pushes, then why are we still just keeping our hands in vaginas?”   Meagan: And what are we doing to the pelvic floors?   Julie: Yes. What are we doing to the pelvic floor? Then there’s other times when having some fingers in to see how and where mom is pushing can be beneficial. But homebirth midwives can do that too.   Meagan: I think it’s more guidance. Because I’ve seen it at home birth, too, I think it’s more guidance for the parent, right? So like, “Hey, do you feel this right here? “I want you to focus all your individual strength right here. And then they’re out.   Julie: Yeah. Yeah. But you don’t have to keep them in for two hours. That kills me. It kills me every time. I think I’ve got to do some processing for that.   Alright. Well, we encourage you to look at the pros and cons of both hospital birth and home birth. You can find them on our blog like we mentioned at the beginning of this episode. Also, we go way in-depth about hospital birth, home birth, and other birthing locations and providers in our prep course for parents, which you can find at thevbaclink.com/shop. So, go ahead. We highly encourage you to take our course. It’s going to make you feel more empowered and more confident in your birth choices, no matter where you end up birthing.   Closing   Would you like to be a guest on the podcast? Head over to thevbaclink.com/share and submit your story. For all things VBAC, including online and in-person VBAC classes, The VBAC Link blog, and Julie and Meagan’s bios, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.   Support this podcast at — https://redcircle.com/the-vbac-link/donations Advertising Inquiries: https://redcircle.com/brands