Written by a physician, this book embraces the power and possibility of integrative childbirth, in which the compassionate tradition of midwives is combined with the technical expertise of western medicine.
Too often pregnant women feel they have to choose between the emotional support of a homebirth and the technical advantages offered by a hospital. Women may need a hospital birth because their insurance covers it, or because of family concerns, health problems, or previous experience with a difficult birth. Yet they still want the compassion and empowerment of a natural childbirth at home.
The book presents fifteen powerful testimonies of women who have had an integrative childbirth in a hospital setting, with commentary by the physician who enabled these emotionally satisfying births. These stories show that women can prepare for birth in ways that minimize fear and put technology where it belongs.
Dr. Kerr provides clear guidelines for planning an integrative birth, focusing on the “Five C’s”: Choice, Communication, Continuity, Confidence, and Control of Protocols. Prospective parents will learn what questions to ask when searching for a provider and how to make their hospital birth the personal and fulfilling experience they desire.
As a family physician, Dr. Kerr has been providing the “homebirth in the hospital” experience for women for over fifteen years.
What others have said about Homebirth in the Hospital:
If you’re pregnant or planning to be, read this book! Dr. Kerr’s wise embrace of nature and technology demonstrates that the best births have the right mix of midwifery and medicine.
—Ricki Lake and Abby Epstein, creators of the film The Business of Being Born
Dr. Stacey Kerr's wonderful book of birth stories shows how the midwifery model of care can be provided within a hospital setting. I hope that Homebirth in the Hospital reaches a wide audience of parents-to-be and physicians, as it's just what the midwife ordered! It should be required reading for all obstetric and family practice residents.
—Ina May Gaskin, author of Spiritual Midwifery
Homebirth in the Hospital is a wonderful breath of fresh air! Dr. Kerr’s balanced approach to childbirth is inspiring and very helpful. I highly recommend this book.
—Christiane Northrup, MD, author of Women’s Bodies, Women’s Wisdom
A much-needed book showing that women can have real choices in hospital childbirth, and that the key ingredient in their ability to give birth as they wish is the ideology, the wisdom, and the heart of the practitioner. In this case, that practitioner is Stacey Kerr MD, who, like the best of midwives, is there to guard, guide, and inspire the women she attends to help them achieve their desires. A must-read for any woman interested in giving birth normally in the hospital setting—usually very difficult to achieve, but entirely doable, as this book beautifully demonstrates, when the doctor is truly on and by your side.
—Robbie Davis-Floyd PhD, author, Birth as an American Rite of Passage
Homebirth in the Hospital is an outstanding book and a must read for all expectant parents as well as the providers who care for them. Dr. Kerr has truly integrated concerns for safety and the use of appropriate technology of the medical model with the skills and comprehensive wisdom of the midwifery model, thereby using medical interventions only when truly necessary. Dr. Kerr clearly illustrates with detailed examples how women and their clinicians can work through the challenges that are unique to each woman's individual birth. Caregivers and women will benefit by seeing how empowering and healthy normal and natural childbirth can be when using skillful hands-on maneuvers, instilling confidence and facilitating the woman's own ability to understand what her body can do, the choices she has, and the confidence to communicate her needs. This book is a significant contribution to modern and normal childbirth.
—Phyllis Klaus, MFT, LCSW co-author of The Doula Book
Women who want a natural childbirth often feel compelled to choose between a home birth and a hospital birth. They want the warmth and comfort of home, but they also desire the security of the medical support available in the hospital. Kerr, a family physician who provides family-centered childbirths, tells families how they can have the best of both worlds. She had two children, one in a birthing center and one at home, and trained with Ina May Gaskin at The Farm before going to medical school at the University of California, Davis. Her book offers clear guidelines for integrative childbirth, emphasizing the "Five C's": choice, communication, continuity, confidence, and control. Parents learn how to choose a health-care provider and hospital that will partner with them for a fulfilling birth experience. Physicians learn how to work with patients and their families to make sure this happens. The stories of 15 families who have had "homebirth in the hospital" illustrate that it does work. This is an excellent book for public, health sciences, and consumer health libraries.
—Library Journal
A must read for the expectant parents who want a natural birth but also want to have the security of a safe and happy delivery. Dr. Kerr is an impassioned advocate of patient empowerment in the birthing process. She has always practiced what she so eloquently believes. Congratulations to Dr. Kerr for writing this very timely and much needed book on natural childbirth in a hospital setting.
—Bob G. Field, M.D., former Director of High Risk Obstetrics, Sutter Medical Center, Santa Rosa, CA
The pregnant woman must trust her provider with her life, and with the life of her baby. You must have confidence that your provider will follow through on the agreements made during prenatal care. You should expect full communication, to be told the truth, and not to have to defend your preferences while you are in labor.
Similarly, you need to be honest and communicative with your provider throughout your pregnancy. You need to know you can voice your concerns and be heard. During the birth, with all the added stressors of nervous family members, the busy hospital staff, and the realities of labor, this trust will be the cornerstone of an integrative childbirth. Trust is built over time and will happen naturally if you have honest and open communication with your provider.
You will have made agreements about care with your provider before you go into labor. Ideally, procedures initiated during labor should be discussed and agreed upon at the time, though in the case of a sudden emergency, you must rely on your physician to act quickly and without negotiation.
Whenever I think of the trust issue, I remember a particular birth early in my career. Riki and Christine lived in the mountains and drove for more than two hours to come in for their prenatal appointments. They felt the effort was worth it because they wanted to be able to birth their baby with minimal intervention and in the hospital where they felt safe and where their insurance would cover the costs.
They were a fiercely independent couple; Christine stayed in shape throughout her pregnancy by hiking the mountains they called home. When her due date was near, they came down to stay in a hotel near the hospital to await labor. They spent her early labor in the hotel and came in to the hospital when she was almost six centimeters dilated. All went well until the second stage, when Chris started pushing. In spite of a powerful effort, this baby was not coming out. Two hours passed, then three. There was plenty of room in Christine’s pelvis. We did everything we could think of, short of medical intervention: changed pushing positions, made sure the people in attendance were not getting in the way, and kept Chris hydrated. She and Riki refused anything else, and because Chris and the baby were both doing well, I allowed her to continue pushing.
Four hours passed, then five, then six. The room was feeling stale. The nurses had changed shifts, and the new energy did nothing to help Chris bring that baby further down the birth canal. Still, she and Riki refused intervention. More hours passed. The baby was doing fine, but Chris was exhausted. The nurses were starting to question my tactics. Finally I had to explain that whether she wanted it or not, Chris was going to need help getting her baby out. Even with my minimalist style of labor management, I knew that Mother Nature needed help with this one.
I suggested starting some Pitocin to stimulate the uterus and produce stronger contractions. Chris was so tired she would have done anything I said, but Riki was protecting her by questioning my suggestions. After all, Chris had said very clearly, “Don’t let them give me any medicine if I can do it naturally!” As the doctor responsible for a safe birth, I saw Pitocin as a small intervention compared to the C-section most of my colleagues would have performed several hours ago. But Riki saw it as questionable.
I explained the risks of continuing along the path we were on: more pushing, more disappointing fatigue, and possibly a C-section if the baby started showing signs of distress. Riki was obviously confused and torn about what to do. Finally, I stood up tall and looked this six-foot, four-inch man in the eyes and asked him point blank, “Are you going to trust me to do what it takes to give you a healthy baby?” He searched my eyes for deception, blinked, and said, “Of course I will. Go ahead and do what it is you do best.” I started a Pitocin IV drip and thirty minutes later Jacob was born—healthy and lusty—and handed to a very tired Christine. For nine months I had been building this relationship bit by bit. In the end, they had no regrets and neither did I.
