Making informed choices As a family choosing a homebirth and midwifery care, you will need to make a number of choices and decisions during your pregnancy, labor and birth, as well as for your baby. As your midwife, I want to equip you with the information you need to make informed choices. Making informed choices involves weighing the benefits and risks of any decision or course of action while taking into account your intuition, personal experience, individual circumstances, advice and opinions of trusted sources and evidence-based practice.
The value of a risk-based approach Statistics and research are one tool in the decision-making process. When considering statistics, it is important to remember that they reflect a population-based risk assessment. They consider what occurs across a given population. In many ways, in the reality of an individual's life or one's family, it does not matter if the odds are very great that nothing bad will happen if you are the one in some great number that statistic applies to, as well as vice-versa.
The value of evidence-based research I also want to emphasize that, while research is important, the vast majority of the research around issues and practice pertaining to childbirth to date is designed, implemented and reported through the lens of the medical model of care, and thus reflects the assumptions, biases and limitations of that model. Often, the studies from which we currently have to choose in making evidence-based decisions as midwives, parents, and consumers are from their inception asking the wrong questions and grounded in a different paradigm and belief system than that of families and providers choosing homebirth. Therefore, while they can and should be considered in decision-making, the weight you give them should be taken in that context and be balanced by the other influences and factors named above.
Making your own choices Some decisions are cut and dry; others choices involve navigating through much more of a gray area. I ask that in reading through any informed choice document, including those from our practice, you remind yourself why you are choosing a homebirth and why you are following this path and journey for your pregnancy. I also encourage this same approach when you are reading an article on a specific topic, or engaging in a discussion about decisions for you, your baby and family.
I don't believe there are right or wrong answers to any given question that applies to everyone. I support you in making informed choices. This is a cornerstone of my practice philosophy, as is the very real belief that you know what is best for you and your baby and family, and that you are responsible for those decisions. No matter what you choose, as your midwife, I can make no guarantees as to the outcome, but rather continue to offer my deep trust in you as the birthing woman and my belief in the beautifully designed process of birth.