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Running head: HOME BIRTH 1
Home Birth: A Mother Shares Her Story
Susena Araisa
California State University, Stanislaus
HOME BIRTH 2
Home Birth: A Mother Shares Her Story
Nowadays having two or three kids is becoming the norm. Huge families are rare
because of the new roles women have taken in society. Women are becoming more independent
and starting a family early in life is not the priority. This is not the case for Maria Alcaunter.
Mrs. Alcaunter is known in the small community of Newman for her child bearing abilities (M.
Alcaunter, personal communication, June 5, 2015). Mrs. Alcaunter gave birth to 14 children.
Her story behind each birth was breath taking, so talking a bit more in depth about them was a
necessity. The interview took place in the small town of Newman, CA. From the beginning, it
was expected that the interview could not be one on one. Who would want to miss her story?
Every person in the house wanted to listen to how she delivered a newborn on her own. The
interview took place with an audience. This report compares and contrasts current practice with
a birth that took place in 1964 and one that took place in 1995 by the same mother. The areas
that will be addressed include: birth setting, pain management, parental involvement, role of the
nurse, use of technology, care routine, events surrounding childbirth, cultural belief practices,
and the personal meaning of the birth experience. Besides the interview the author’s clinical
experience will be included in some of the areas addressed.
Birth Setting
Rafael Alcaunter
In 1964, at the age of 15, Mrs. Alcaunter had her first child. The birth setting was her
home in the town of Reparto, Michoacan Mexico. To ensure privacy the bed was enclosed with
long curtains. The room did not have regular flooring, it was a dirt floor and the dust in the air
was inevitable. The lay midwife had someone rinse water all over the room to help calm down
the dust around the birthing mother. After being in labor for more than four hours the lay
HOME BIRTH 3
midwife was pushed to the side and substituted by Mrs. Alcaunter’s mother. Her mother
delivered her first newborn. With all the suffering involved she vividly remembers that birth. In
the room, only the husband and the person delivering the newborn were allowed. Having other
members of the family would be a disgrace to the laboring mother.
Laura Alcaunter
In 1995 she had her last newborn. This time she went to the hospital to deliver the
newborn. The hospital setting did not feel normal to her. This was her only newborn that would
be born at a hospital. The bed felt uncomfortable as it was small for her heavy set body and it
was too firm for her liking. The birth setting was clean and all the furniture and equipment was
nicely organized. Having a male doctor made her very self-conscious and anxious. At the time
of delivery, her husband, one nurse and the doctor where present. If she could go back in time,
she would had never gone to the hospital. The room felt cold and the bright lights over her head
made her more uneasy with the new environment. She also remembers a loud crying mother
next door which prevented her from resting after delivery.
Current Practice
Current practice birth setting in the United States are very different when compared to
third world countries, like in the case of Mrs. Alcaunter. In today’s society, the most common
birth setting is a hospital but other options include birth centers and home births (Lowdermilk,
Perry, Cashion, & Alden, 2016). It was observed by the student nurse that hospital birth settings
have rooms suitable for the pregnant mother. Rooms are bright and full with the latest modern
equipment. The colors on the walls are light to provide a more relaxed environment. Privacy is
enhanced by providing a curtain that covers most of the bed. This curtain is commonly used to
provide additional privacy when invasive procedures are being performed. The rooms are
HOME BIRTH 4
spacious to accommodate family members and a few chairs are provided especially for them.
The hospital environment is cold but sheets are always an option for the mother. The beds are
wide and firm and with the press of a button can be adjusted to a position suitable for the mother.
Pain Management
Rafael Alcaunter
Pain medication was very limited for Mrs. Alcaunter during her first pregnancy. Her
only two option were herbal teas or common Mexican analgesics such as Neo-melubrina.
Chamomile, common rue, and mint herbs where used during her labor. Some teas were used to
induce labor while other where used to help her relax after labor. She believes in these herbs
more than she believes in current medicine. These herbs provided comfort while pain was
reduced from a 10 to a five. Multiple tea options were available but her favorite was chamomile.
Warm chamomile was very soothing and decreased the pain from contractions significantly.
Pain options were never discussed prior to labor. The day she felt contractions her husband ran
to go find the lay midwife and soon after labor started. Back in the days, according to Mrs.
Alcaunter, pain was not as big of a deal as it is nowadays. Women believed that enduring pain
was part of being a good mother and a way to repay sins. Pain management was frowned upon
and herbal teas were the only options for these women.
Laura Alcaunter
Having her last pregnancy at a hospital gave Mrs. Alcaunter more options as far as pain
management. She had the option of getting an epidural, getting a caesarian section to avoid pain,
or getting opioid analgesics. The epidural was not an option she was willing to consider so she
decided to get a short acting opioid analgesic. She does not have a recollection of the name of
the medication. Mrs. Alcaunter received the medication intravenously which made her feel
HOME BIRTH 5
better for a short amount of time. She also remembers getting normal saline to help with
dehydration. The pain medications received were not as effective as the teas that she was used to
taking at home. The effects lasted very little and she was afraid of asking for more medicine
because of potential harm to the fetus. Pain management was never discussed prior to giving
birth. She never went to prenatal consultations. Prenatal consultation was not a common
practice in her home town. At the time of her last pregnancy, pain management was still
frowned upon so getting an epidural was not an option for her. She admits guilt after getting the
pain management medications at the hospital. If she had to do it again, herbal teas would be the
only pain management she would consider.
Current Practice
Pain management in current practice ranges from nonpharmacologic techniques such as
breathing exercises to pharmacologic options such as general anesthesia. Nowadays women
have a wide variety of choices when it comes to pain management. Pain management options
are discussed during prenatal care or sometimes the day of delivery. Some of the most common
nonpharmacologic techniques used are: relaxations exercises, effleurage, counterpressure,
application of heat and cold, acupuncture, water therapy, music, and biofeedback (Lowdermilk,
et al., 2016). Some of the pharmacologic options for pain management includes: systemic
analgesics, nerve block analgesia and anesthesia, general anesthesia, local anesthetic injection,
pudendal block, tranquilizers, narcotics, and nitrous oxide for analgesia (Lowdermilk et al.,
2016). It was evidenced by the student nurse that some of the most common narcotics used at
the hospital where: Demerol, Stadol, Nubain, fentanyl, and morphine.
Paternal Involvement
Rafael Alcaunter
HOME BIRTH 6
At the time of her first delivery only the father and the lay midwife where allowed in the
room. Having other people, such as siblings, would be a disgrace to the birthing mother. Her
mother, the lay midwife, cut the umbilical cord because the father was afraid to do it. The father
did not help during post-partum. His job was to be the bread winner and no help of any sort was
offered to the mother. The mother was the only caregiver and there was no way around this as it
was part of their culture. During the times of her first pregnancy no parental classes were
offered.
Laura Alcaunter
During her last birth the father was also present. Even though the father refused to cut
the umbilical cord he was more involved with this birth. This time around, the father assisted in
carrying the newborn to give Mrs. Alcaunter a break. He also assisted in taking care of the older
children. At the time of the last birth, no prenatal classes were available. They come from a
very small town in Mexico and that was never an option. The biggest contribution the father did
was paying for all medical expenses. In Mrs. Alcaunter’s culture parental involvement is not
expected. If the father was too involved the women would be accused of being lazy and the
father would be seen as a wimp.
Current Practice
It was observed by the student nurse that parental involvement is different for each child.
In one situation the father was camera ready and eager to meet his newborn. Pictures were taken
of each movement the newborn was making after birth. He was constantly asking about the
mother’s status and stayed by her side the whole time. In a different situation the father of the
newborn was not as involved, despite the fact that his newborn was in the intermediate care
nursery. He came to visit his son for about 10 minutes but seemed distant during the interaction.
HOME BIRTH 7
Unfortunately, in this case the pregnancy was not planned and it was evident with the lack of
bonding from both the mother and the father towards the newborn. Other factors that could
affect parental involvement are age of father, relationship with mother, social support, culture,
socioeconomic conditions, health of father, and personal aspirations (Lowdermilk et al., 2016).
Role of the Nurse
Rafael Alcaunter
No nurse was present during the first delivery. Mrs. Alcaunter had her mother as the lay
midwife deliver the newborn. A lay midwife is someone with no formal education who does
similar things as a midwife (Lowdermilk et al., 2016). The lay midwife was not wearing scrubs.
She did not wear gloves before, during, or after the delivery. The house did not have flooring so
the midwife recommended watering down the dust. To sanitize her hands, the lay midwife
washed her hands with hot water and alcohol. The expectations were met by the lay midwife
because there were no complications during labor. The role of the lay midwife before labor is to
come every four months to visit Mrs. Alcaunter to massage her abdomen and reposition the
newborn. The first bath, which is given eight days after delivery, was given by the lay midwife.
Some common herbal plants were used during this initial bath. Additionally, the lay midwife
provided some basic teachings for her. She mentioned no having sex for 40 days, taking one
shower every eight days, and absolute bed rest for 40 days. No family members where involved
during the teaching.
Laura Alcaunter
The nurse during her last pregnancy had similar job duties when compared to nurses in
current practice. The nurse during her delivery was in charge of cleaning, weighting, dressing
up, and showering the newborn. The nurse was very friendly and attentive to her needs. She
HOME BIRTH 8
looked clean and her long dress attire made her look professional. The care provided was
different when compared to her first birth. However, even after all of her expectations were met,
Mrs. Alcaunter would have rather given birth at home. The environment was very different and
that made her anxiety level rise. She was discharged the same day that she delivered. In this last
pregnancy the nurse did provide more teaching. Some of the teaching included the importance
of resting when the newborn is sleeping, immunizations, hygiene, breastfeeding, and postpartum
depression. The father was encouraged to be part of the teaching and the nurse even mentioned a
few ways he could help the mother at home.
Current Practice
The nurse’s role has evolved into becoming one of the most important roles during a
patient’s hospital stay, especially during pregnancy. The student nurse observed that nurses are
highly knowledgeable and they are held accountable for most of the mother and newborn’s care.
Some of the nurse’s role include: monitoring vital signs, doing head to toe assessment, creating
nursing diagnosis and interventions specific to each patient, evaluating lab values, passing
medications, assessing for overall newborn developmental status, offering perinatal services,
client referral, teaching, and most importantly giving recommendations of treatment to
physicians.
Use of Technology
Rafael Alcaunter
Mrs. Alcaunter is from a small town with a population of no more than 200 people. In
the early 1960’s technology was very limited. If a person owned a television or a radio they
were probably middle class families. As far as medical equipment and technology, there was
none. In her home town, not even a stethoscope was available. Every assessment performed
HOME BIRTH 9
was done by palpation with ungloved hands. For them to travel to the nearby city was a long
walk and no cars were able to be driven through the rough roads. Horses, donkeys, and mules
where the mode of transportation. During her delivery, there was a bucket of water, towels, a
rope to hold her legs, and a lay midwife. There was no such thing as technology.
Laura Alcaunter
The hospital where she delivered her last newborn was in a nearby city. Technology was
at its rise and she was able to benefit from it. During her stay, the nurse was assessing the
newborn with a fetal monitor. There was no such thing as an autonomic blood pressure so it was
done manually. Ultrasound machines were also available but were not used during her stay. She
was given IV but it was just a direct drip with no machinery involved. She also had a television
in her room and a telephone to receive and place phone calls.
Current Practice
The use of technology has revolutionized the health care system. It was observed by the
student nurse that multiple forms of technology are used before, during, and after pregnancy.
Some of the technology observed in the labor and delivery rooms included: a television, a
telephone, smart phones, an automatic blood pressure machine, pulse oximeter device, a digital
thermometer, an otoscope, glucose analyzer, external fetal monitoring, electronic health care
record defibrillator, electrocardiograph, infant incubator, and warming unit for the infant. Other
devices include ultranonography, fetoscope, doppler ultrasound stethoscope, electrical
breasfeeding pump, bilirubinometer, medication scanning system, magnetic resonance imaging,
ventilator, and weighing scale (Lowdermilk et al., 2016).
Care Routine
Rafael Alcaunter
HOME BIRTH 10
In Mrs. Alcaunter home town there were no such things as prenatal visits. Instead they
had the lay midwife do routine checks during the whole pregnancy. The lay midwife would
come and visit her every four months to give her a massage and reposition the newborn. If the
newborn was in a transverse position prior to delivery, the lay midwife would massage the
abdomen until the newborn was head down. During labor the lay midwife was the only other
women there. During postpartum the lay midwife gave Mrs. Alcaunter a bath and then follow up
with her every eight days. Mrs. Alcaunter was only allowed to take a bath once every eight days.
She was not allowed to leave her house for 40 days following delivery. At home, the husband
would assist her if needed but the whole town would come together and provide the meals of the
day. Every day for the next 40 days a town citizen would come and drop off food for the day.
Bathing privileges were granted but she had to be well covered from head to toe. In her culture,
it was believed that lactation will stop if the mother was exposed to cold weather.
Laura Alcaunter
Twenty years later the care routine for Mrs. Alcaunter changed in a negative way. No
longer did people come to feed her like in her first pregnancy. She was to take care of herself at
home without the assistance of a lay midwife before and after pregnancy. There were no follow
up appointments or prenatal visits to the healthcare provider. The whole 40 day rest period came
down to 15 days. The biggest help she received during the care routine was by her oldest
daughters. This was a big change for Mrs. Alcaunter. She was discharged from the hospital the
same day so the care routine was very brief. After she was discharged she went home rested for
a 15 day rest period and then she went back to work.
Current Practice
HOME BIRTH 11
The current care routine for pregnant women starts since the day she is thinking about
becoming a mother. Once she is pregnant there is prenatal care, labor and delivery care,
postpartum care, and newborn care. During the prenatal care the patient visits her regular doctor
and the healthy development of the fetus is monitored. As evidenced by the student nurse,
during labor and delivery the nurse becomes the eyes and ears of the patient. The nurse’s goal is
to provide optimum care and a care plan specific to each birthing mother. The nurse assesses,
provides a nursing diagnose, plans outcomes and interventions, implements interventions, and
evaluates the patient. During the postpartum stage a lot of teaching is involved. The postpartum
teaching depends on the type of delivery that took place and if there were any complications
(Lowedermilk, et al., 2016). After the postpartum stage the nurse will encourage a follow up
appointment that ranges from two to six weeks depending on whether it was a cesarean section
or a vaginal delivery.
Events Surrounding Birth
Rafael Alcaunter
Physically abusing women was a common practice in Mrs. Alcaunter’s home town.
Besides the events occurring in her hometown, Mrs. Alcaunter knew nothing about the outside
world. In the early 1960’s her family did not own a television or a radio to watch or listen to the
news. She lived in a small town in Mexico and driving to the city was not common. The only
means of transportation was by horse, donkey, or mule. In the town there was a small store that
sold all the groceries necessary for survival. During this time she does remember her mother
constantly getting sick. This event was significant because her mother was the main support she
had during her pregnancy. Mrs. Alcaunter never attended school so reading magazines or the
newspaper was not possible.
HOME BIRTH 12
Laura Alcaunter
With the arrival of the last newborn there was some historical changes taking place. For
one, men physically abusing women was not as common as it used to be. The authorities started
taking charge and these actions became a crime. Many men stopped this violent act but others
still continued and never faced the consequences. Hospitals and the city life became part of Mrs.
Alcaunter’s life. With the development of dirt roads, going to the city was much easier. The
primary way of transportation became cars and buses. During this last pregnancy her husband
was becoming very distant from the family. Shortly after the birth of her last child, he left. Mrs.
Alcaunter was left behind with 14 kids to raise and no family support. At this point she decided
to go back to work and with the help of her oldest children she was able to be a successful single
mother.
Cultural Beliefs and Practices
Rafael Alcaunter
Getting pregnant at the age of 14 was not uncommon in Mrs. Alcaunter’s culture. The
role of the women was to clean, have children, and respect their husband. If a woman was
unable to bear children it was frowned upon and seen as a punishment from God. People in her
home town would see these women as sinners and more than likely they will end up being single.
Breastfeeding was very common during her first pregnancy. Food was very scarce and
sometimes breastfeeding was the only way to feed the child. Formula was not available and
cow’s milk was the second option besides breastfeeding. If the women was unable to lactate,
there were other women in town with infants that would offer to breastfeed each other’s
newborn. Getting the epidural during her first born was not an option. Vaginal delivery was the
only option and experiencing the pain was part of being a mother. As part of her culture, Mrs.
HOME BIRTH 13
Alcaunter also believed in the bad eye or the evil’s eye. What this meant was that if another
person looked at your newborn with a malicious glare the baby will be cursed. If the baby ended
up being cursed, he will have bad luck for the rest of his life.
Laura Alcaunter
Live and learn is a common saying that Mrs. Alcaunter kept on repeating. She lived to
learn that being home for 40 days after delivery would not impact her health the way she
thought. For her last pregnancy she only took care of herself for 15 days and she felt perfectly
fine. She also lived to learn that enduring pain during labor and not seeking pain medications
was not a sin. On her last child she did get some pain medication and there was guilt felt. If
given the option she would rather have herbal teas since they work better on her. Some of her
cultural beliefs did remain the same. For example, she still believes in the bad eye and in the
importance of breastfeeding for the newborns health.
Current Practice
Back in the 1960’s having children at the age of 15 was a common practice. If a women
was not married with children at the age of 20 it was seen as abnormal and a sign that the woman
will end up single. Nowadays, teenage pregnancy is still seen but to a less degree. It was
evidenced by the student nurse that young moms are still occupying hospital beds but society’s
response is different. At the age of 15, society expects girls to be in school not pregnant. The
role of the women has evolved in various ways. For example, no longer are women seen as the
only ones responsible for raising children. In today’s society, the responsibilities are being
shared between both parents as more women are entering the work force. With women
becoming more independent, the age for having kids has increased and motherhood is getting
prolonged.
HOME BIRTH 14
Personal Meaning of Birth
Rafael Alcaunter and Laura Alcaunter
Giving birth at the age of 15 was a great experience that she remembers like if it
happened yesterday. Mrs. Alcaunter claims that she was at her optimum age for childbearing.
She did not feel getting pregnant at the age of 14 was too young at that time but looking back she
would not want her daughters to have kids that young. Her personal meaning of birth had
changed by the time she gave birth to Laura Alcaunter, the last child. No longer did she feel the
fear of the unknown like at the beginning. One thing did remain the same, that is, the feeling of
excitement with the arrival of the new member. Giving birth is one the most important women
obligations and God will decide who he wants to give that blessing to. Mrs. Alcaunter claims
that every child is a blessing from God. In her case she was blessed 14 different times.
Various differences were noted between Mrs. Alacunter’s first and last birth. The setting
went from her home to a hospital. The pain management went from having plain tea to pills for
pain relief. The paternal involvement improved as the years progressed and the use of
technology revolutionized from having no television to having fetal monitoring. Many things
changed; however, one thing did remain constant that is the joy she felt with the arrival of each
of her children. Current practice shows a more technology driven society but the idea behind
pregnancy is similar regardless of the culture of the individual. Having a baby changes people
regardless of the amount of technology or the type of care received during pregnancy.
Ultimately the goal of the mother is to have a perfect Gerber baby.
HOME BIRTH 15
Reference
Lowdermilk, D. L., Perry, S. E., Cashion, K., & Alden, K. R. (2016). Maternity and women’s
health care (11th ed.). St. Louis, MO: Elsevier Mosby.