But this was 1982; we lived in a more freewheeling San Francisco, and home births with midwives were not so rare. In fact, our son Dashiell had been born in the very same bedroom, in then funky Bernal Heights, ushered into the world by his mother and a full cast of attendants. Led by a very experienced (if unlicensed) midwife, the birth team included her assistant, her back-up doctor complete with a traveling medical kit and oxygen tank, and three other doctors, all women, who happened to be relatives or close friends. I even had a bit role as a labor coach. There was little need for this full entourage, but it was reassuring.
Dash was three weeks past his due date — these days two weeks is the usual maximum before labor is induced. But Pippa had been intent on a home delivery and at the last possible moment, after a spicy dinner and some strong tea, she went into labor. With the midwife’s expert help, all went well. In just under three hours, from start to finish, our son slid into the world in that small room full of people.
This time, however, the room was empty, except for Pippa, me and our rapidly approaching second child. My only reassuring thought was that I’d been through this before, and I hadn’t passed out.
Frankly, I would have opted for a hospital delivery, but I wasn’t the one having the baby.
Pippa had been born at home in Johannesburg, and in those days, especially for a privileged family, the doctor came to you. Even though Pippa was a social worker in a San Francisco medical clinic, she still preferred to avoid hospitals unless absolutely necessary. For a pregnant American, this attitude was considered rebellious, even ill-advised. And the U.S. medical establishment still discourages home birth.
But the British national health service now agrees with Pippa, declaring late last year that it’s safer in the UK for healthy women with uncomplicated pregnancies to give birth at home or in a birthing clinic than in a hospital. Naturally, “Call the Midwife” on KQED is one of Pippa’s favorite British import shows.
For this second pregnancy, Pippa had chosen a team of licensed midwives affiliated with a local San Francisco hospital.
When her first labor cramps woke her around midnight, she promptly called the midwife on duty. They timed the contractions over the phone. The midwife advised her to take a warm bath to slow down the labor and give her a call later.
Pippa drew the bath and I started vacuuming. It’s a habit I picked up from my mother. She vacuumed with great vigor before any major event at home. It’s the one household chore I’ve never minded. It's something about operating machinery and making myself useful. Very appealing.
But before I could finish the carpeting in our living room, Pippa emerged — starkers — from the bath, saying, “Bloody hell, this baby won’t wait.” Wrapping herself in a robe, grabbing the phone, she notified the midwife, “This is it, ready or not.”
I was not feeling quite so ready myself. The midwife was now on her way, but she lived in Marin County, north of the Golden Gate Bridge. She wouldn't be here anytime soon. I encouraged Pippa to relax. But as the contractions came stronger and faster, relaxation was not much of an option. With mounting anxiety, I called the nearest doctor I could think of, our friend Kathy, who lived in our neighborhood. She’s a gerontologist, but at that moment I was not particularly picky.
Pippa began pacing, insisting that our child’s arrival was imminent. I implored her to hold back. She informed me this was no longer possible. A brief “I Love Lucy” scene ensued in which I kept yelling, “Not yet!” and Pippa kept moaning, “Yes, now.” Then she pressed her hands against the wall and pushed and I saw the undeniable validity of her argument. Our child’s head was emerging.
In a flash, she was born. I had just enough sense to reach over and let her slide out into my hands. It was a basket catch, Willie Mays-style. She was slippery, and she was blue. Wrong color, I thought. I stuck my finger in her little mouth, she gagged, coughed, and instantly turned a proper pink. I was euphoric with relief.
The doorbell rang. I handed our gurgling baby to her joyous, exhausted mother, and raced downstairs to admit a breathless Kathy. Upstairs, she quickly ascertained that everyone was alive and breathing and apparently healthy. She started to ask how this happened, but I interrupted to ask, “Aren’t we supposed to cut the umbilical cord?”
Scissors were promptly sterilized in boiling water; the deed was done.
The next hour or so passed in a daze, but we were all smiling now, temporarily delirious, as this newborn child, Caitlin, began to nurse. By dawn the house was full of relatives and friends, including the midwife who, apologizing for her late arrival, made certain all was well. It had been chaotic, but successful. A delivery in less than an hour. Mother and daughter doing fine.
When he awoke, our son Dash walked out of his room, saw all the people, yawned, and wondered aloud, “What’s happening?”
“You have a baby sister,” I said, “born right here at home.” And he wandered into our bedroom to see for himself.
Caitlin was not the only baby born at home in San Francisco that year. But over time, Pippa and I noticed that home births were going out of fashion. Our own son and his wife chose to have their first baby last year in a hospital in Santa Monica, where they were very happy with the way things went. Deliveries at home or in birthing clinics aren’t for everyone.
But now, 30 years after the home birth of my daughter, and after much debate over the soaring frequency of hospital C-sections, I wonder if this new endorsement by British medical authorities of non-hospital births will lead to a resurgence in midwifery, even in the U.S.
My advice to prospective parents? Hospital or not, just in case, be prepared to handle that delivery yourselves.