“Doing My Research”
It seems a popular notion that once you have read enough material from any source to make up your mind about a topic, you can declare, “I have done my research,” and rest assured that your opinion is at least as valid as anyone else’s. I felt I had “done my research” regarding the safety of nonhospital birth when I opted to give birth to my second daughter in a warm bathtub at a freestanding birth center, attended by two licensed midwives and two student midwives. It was an extraordinary experience that was captured, with my approval, by the Discovery Health channel for international broadcast. I wanted to be on the show to help demonstrate that natural birth with midwives was a lovely experience to aspire to, in hopes that other women would dare to believe that they too could have a wonderful birth experience. My motives, both in choosing the birth center and in agreeing to the filming, were largely the same: I wanted an amazing experience, and I wanted to share it with the world. I wanted to avoid medical intervention and achieve something that many women seemed to think was outrageously difficult. I knew my baby would be fine, never doubted for a moment she would be, and she was. This was my experience, and I wanted to help others have the same sort of marvelous and enviable start to their parenting journey.
Fast-forward almost a decade, and I’m sitting in a university library. I have decided that it is high time that I did the legwork and read for myself the scientific literature regarding the safety of giving birth in a nonhospital setting. After years of assuring others of what “the studies show,” I wanted to do more than rely on others’ interpretations. I knew I wasn’t the first (or the most qualified) person to ever undertake this, but I could represent your average midwife who always took other people’s word that the safety of what I was doing was backed by evidence. I had to admit that regardless of how many books, blogs, websites, and Wikipedia articles I had previously read, I had never actually “done my research.”
I began in familiar territory, the website of the Midwives Alliance of North America (MANA.org). On this site there is a button titled “Research,” and it leads to an extensive collection of the studies that MANA has determined builds the case that nonhospital birth with a midwife is safe. MANA has categorized the research into sections A-F, Section A containing the “best available studies on planned home birth and maternal fetal outcomes.” Section B contains “studies exhibiting problems with the design, analysis or reporting” and so on, with the evidence becoming weaker as the letters progress. I opened up Section A and noted that it was divided into five tiers and included a total of 24 studies. Perfect! MANA had provided me with the 24 best studies to prove the safety of home birth. I spent the next several hours using my university library (and helpful librarians) to track down every one of these 24 studies and print them out, filling a large 3-ring binder with my efforts.
Shades of guilt danced in the back of my head: shouldn’t I have done this years ago? Perhaps before I decided to actually give birth to my own child in a bathtub in a residential neighborhood in Miami? Possibly during my years as a student of midwifery? Maybe before I had assured scores of women that “research showed” giving birth at my birth center was as safe as any hospital? I cleared my head to focus on the task at hand. The research was all here in front of me now. I sat down with my giant binder of studies, a cup of coffee, and a handful of pens and highlighters. I had a long day ahead of me. I began at the beginning of MANA’s list.