Tina McMahon was pregnant and about to tell a man she’d known for years, with whom she’d had two children, that their relationship was over.

Breaking up is hard to do, especially when it’s with your obstetrician. 

“It’s not you,” she laughs, “it’s me.”

When McMahon’s 6 ½-month old daughter, Amelia, was born, she was one of the almost 11,500 Ontario children a year birthed by a midwife (8 per cent of all births), and almost 2,000 born at home (1.3 per cent). The home birth was McMahon’s second. She recalls her first.  After having her first two children in a hospital, McMahon was ready for a change.”

It’s not that I wasn’t given good care,” says McMahon, “It’s just that I wanted a different philosophy of care.”

“I don’t believe birth is a medical event,” she continues. “I didn’t want to be distracted by any outside powers, medical authority and policies, that could come before my innate needs.”

She says that labour in the hospital was scary. “It was painful and there was no one around to really help me work with that, to normalize it.  They help you by offering you drugs,” she says.

For McMahon, home birth was a completely different experience, with her midwives supporting and encouraging her through the process of childbirth.

“I was incredibily empowered and felt really confident in my body,” says McMahon.  “I had an entirely new relationship with my body and strength.”

Amelia’s birth took place in McMahon’s Ottawa bedroom, with 14 people present, including her husband, two older daughters, close friends, two midwives and a student midwife.

The room was practically silent before the birth, but McMahon says the entire room lit up when Amelia was born.

”It was like a surprise party, when everyone pops up and yells ‘Surprise!’ “ she says. “It didn’t occur to me that there were 14 people there until that moment.”

After her first homebirth, McMahon says she went through a lot of self-healing.  At home with a medical disability, McMahon says the experience was so powerful, and the transition so huge, that it prompted her to enrol in Ryerson University’s Midwifery Education Program. As one of 116 students in the program, she will begin her clinical training in January. She says she’s found her space in life, where she can be strong and grow.

While earlier studies on home births suggested they were unsafe, these studies have been criticized for a lack of consistency in their methodology. Recent controlled trials, including those done by Patricia Janssen of the University of British Columbia, have shown the mortality rate for mothers who give birth at home, and their babies, is comparable to those who deliver in hospitals or birthing centres. Furthermore, these studies show that home births mean less medical intervention, less severe lacerations and higher Apgar scores (tests done on babies after childbirth to judge their health).

Despite this, the number of homebirths in North America remains low. In Canada, only one to five per cent of all births take place at home and even less occur in the United States. Compare that with the Netherlands, which has a home birth rate of 35 per cent.

“Why is no one talking about home births?” asks Saraswathi Vedam, a registered midwife and director of the midwifery program at the University of British Columbia.  She says that homebirths are cheap, safe and, in a world of over-crowded hospitals, provide space that is immediately available. She questions who decides where birth takes place, “Is it the woman?” she asks, “Probably not. It’s probably the provider.”

With no existing North American studies on home maternity care, Vedam set off to investigate the attitudes of U.S. Certified Nurse Midwives towards home births.

On Nov. 21, Vedam presenting the preliminary results of her study at Ryerson, analyzed with help from Kathrin Stoll, research manager at UBC. Among her preliminary findings:

• Most American midwives feel that home births are safe, require less interventions, facilitate cultural differences, and are empowering experiences that help mothers and babies bond, however
  
  
• More than 50 per cent were opposed to, or unsure about, practicing in homes themselves. 

For the second phase of her study, Vedam plans to consult maternity-care providers in Canada, including registered midwives, obstetricians and family physicians, asking them similar questions.

But while Vedam searches for answers to why providers resist home births, McMahon suggests why the general population may be hesitant.

“We’ve done giving birth in a medical sense for a long time,” she says. “It’s engrained.  That’s what giving birth is.”

She says that many of the women who chose home births have some experience with it, whether by witnessing a birth or crossing paths with a midwife.

This is partly why she wanted her two daughters, Emily, 13, and Hilary, 11, to be present during Amelia’s birth. Her 17-year old son, Alex, declined. 

“I was thrilled to give them that first-hand experience, hopefully of what else birth can be,” she says. “It was quite a special thing.”

McMahon’s husband, Nick Heisler, agrees.  A first-time parent, Heisler describes Amelia’s birth as an intimate and profound experience.  “What,” he asks, “is essentially more human than birth?"