When Kate Kellogg became pregnant with her third child, she decided to give birth on The Farm, a midwifery center in Summertown, Tennessee, run by world-renowned midwife Ina May Gaskin. Some might think this is a surprising decision, given that Kellogg, 33, is a doctor. But after watching the documentary Birth Story and learning that The Farm's 1,700 acres were just an hour from where they were living at the time, Kellogg and her husband became intrigued with the idea of giving birth there.
Kellogg had delivered her first two children (a now 5-year-old son and 3-year-old daughter) at a hospital, but didn't like that she had been pressured into getting several medical interventions that didn't seem to help.
"I'm a physician and a relatively risk-averse person in general, so initially the thought of a home birth was a bit unsettling," Kellogg admits. "Yet, after doing more research, the thought of having our birth with women trained by Ina May Gaskin, arguably the most famous midwife in the world, did seem pretty exciting."
During the past 40 years, more than 3,000 births (at about $4,500 each) have taken place at The Farm, which has 10 birth houses where women can stay if they're flying in from other countries or live too far away to drive (high-risk pregnancies are ineligible). Each of The Farm's seven midwives typically tend to about three births a month, so 20-some births may occur at the Farm in any given month.
Here Kellogg shares her experience.
How did you feel when you heard you'd been selected to give birth at The Farm?
I'm a very healthy, low risk patient so I was hopeful they would accept me, but I wasn't sure there would be space. When I heard they could take us, I was really excited. I was a little nervous to be taking this leap and going a non-traditional route, but once I'd decided to do this, I couldn't imagine it any other way.
What were your thoughts the first time you saw The Farm in person?
When you first drive through the gates, there's a little house that serves as the visitor center and museum. Then you drive down a road through a big field and then past some horses and solar panels. As you drive through the property it really feels like a rural neighborhood. There are roads off the main road with homes with play sets and gardens, plus there's a lot of open land and woods beyond the neighborhoods. There's not a lot of actual farming going on there these days, as far as I could tell. In the middle of the property, there's a store and a playground, which is a spot for a lot of gatherings. Just beyond that is the clinic where the midwives work, and the homes where patients can stay overnight. The house we stayed in was a 3-bedroom, 1.5-bath house. It was basic but it felt, really, like any other house rather than a cabin or a barn like I had initially pictured. We decided to make a vacation out of waiting for baby and really enjoy the whole experience. That way I wouldn't have to drive in labor, which is not comfortable, and I wouldn't have to worry about having the baby on the side of the road.
How often did you have appointments? How would they typically unfold?
Midwives see moms on a similar schedule to any other practice for prenatal visits. So I went once a month, then once every two weeks, then every week at the end. Deborah was my primary midwife. While at other clinics you might be in and out in 20 minutes, that was never the case at The Farm. Going to an appointment was like grabbing a coffee with a friend. We would sit on the cozy couches in the clinic room and chat about how I was feeling, my work, my kids, an interesting delivery she had had the night before, or a recent midwifery class they had run. At any point during the appointment Deborah could be found on the floor, showing me yoga moves for whatever was ailing my pregnant body that day. Instead of telling me I was crazy for training for a half marathon in pregnancy -- something I do routinely in a non-pregnant state -- we talked about what I was drinking and eating and how I was sleeping to keep up with everything baby needed.
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More often than not, my whole family would come for the appointment. My husband is a stay-at-home dad so we have the luxury of flexibility. We would bring the kids and they would play at the playground or read books while I had my visit with Deborah. The Farm is such a beautiful spot that we would take the opportunity to go for a hike or, more often, a swim at the swimming hole. My kids loved building sand castles on the shore of the swimming hole, deep in the woods. I would float in the middle of the pond, enjoying the weightlessness of my abnormally weighted body. Sometimes a resident of The Farm would come down on her golf cart for her afternoon laps and we would chat about the weather or the chilly temperature of the water. The folks on The Farm never seemed to mind if my 2-year-old had decided to ditch her swimsuit that day! So my appointments at The Farm were so much more than just checking on baby's heartbeat and growth, all of which we did as well. I loved that the midwives there really do balance quality medical care with quality care of the woman herself. The medical care I received was very much on par with what I have experienced in hospitals. But the care for me and my family as people was without comparison.
Given you're a physician, how did your coworkers react to your decision not to give birth in a hospital?
They were surprised at first. Most of them knew me pretty well by that point, though, and actually once they thought about it most of them realized it fit me! A lot of them chose not to ask too much or tell me their thoughts, which I think was often them being polite and not wanting to tell me they thought I was completely nuts. I told one or two people about it and suddenly the entire department knew, so clearly there was talk going on behind my back! That's to be expected, I guess. Some asked questions about safety practices and hospital transfers, some asked about the condition of the house we would deliver in, etc. Some people get so hung up on the idea of choosing a birth without an epidural in the first place that the fact that I was doing it on a farm seemed to be less of a part of the conversation! Family and friends needed some explanation. No one really tried to talk us out of it, though. By the time we told people about it, we had been there and done a lot of research so we were convinced it was the right thing and it didn't take much to convince everyone else. Or at least to make it clear this was what we were doing so we weren't really interested an argument.
Once your labor started, who delivered the baby? Who was in the room with you?
The day of baby's arrival I had intermittent contractions all the way until I put the kids to bed that night. I tried to lie down but a switch flipped pretty much immediately after the kids were in bed. I really think my body was waiting for them to be settled and not to need me anymore before labor started full on. The minute Deborah came in the door and saw me she said, "I'll call everyone." She called Carol, another of The Farm Midwives, and Sarah, her apprentice, both of whom would be there to help with the birth. They were all so great at being there and being ready for anything, but fading into the background and letting labor unfold. For so long this is how birth happened, in a candlelit room with a group of women sitting and waiting, saying encouraging words when needed and staying quiet when the laboring woman needs to focus.
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The contractions were hard and fast and there were moments where I wasn't sure I could get through them. Deborah and my husband were both there to encourage me. In between I felt great and kept pacing as they filled the tub. As things were getting tough, I got into the tub. It felt great and relaxing, for a few minutes anyhow. I hadn't planned to deliver in the tub, but after I had been in there just a few minutes it was clear that would be what happened. I simply couldn't make it out! I was able to deliver my daughter myself straight into my arms, and her entry into the world was as peaceful as I think it could have been. It was amazing. Deborah and Carol were right there to help and once the placenta stopped pulsating they were able to take her for just a minute to check her from head to toe. I was able to get a quick shower and get into bed with her. I was eating leftovers in bed and nursing my beautiful girl before I knew it! They checked in on us and then had the whole house cleaned before they headed home in the wee hours of the morning. All told, my labor started and stopped over about 24 hours. I'd say I was truly in labor for maybe 8 hours. I ate and drank whatever I wanted, although that wasn't much once things got going. I had some juice and tea. I had some cornbread and soup early on. Deborah and I had talked about good foods to have on hand for labor but in the end I didn't want much.
At hospitals, babies go through a series of things after birth -- the Apgar score, vitamin K shot, being weighed, etc. What happens to a baby after it is born at The Farm?
It's up to mom and dad. They can do everything or nothing. We didn't cut the cord until it stopped pulsating, which took a while. Then they weighed my girl after we had had lots of time to snuggle and nurse. I felt like things moved more slowly and more on our schedule than in the hospital where it felt like everyone was going through the motions to get baby off mom, cleaned and weighed. They also did the hyperoxia test and the next day did our newborn screening blood draw. I chose to do the vitamin K shot, although I know other Farm moms do the oral vitamin K drops or nothing at all. The midwives talk to moms about all of that and let them choose. Personally, I felt most comfortable giving her the shot and knowing she would be covered. So we pretty much did everything that would have been done at the hospital, just not as rushed as it feels there.
How did you feel emotionally after giving birth on The Farm?
Amazing! The next morning I woke up to a beautiful sunrise. I was so glad that this was the first place my baby would ever know, this place of quiet and clean air and beautiful fall colors. Shortly after that, my older two stumbled in to meet their sister. Both slept through the entire birth! They were delighted to find a baby in the morning. It was so great to be at The Farm with no one coming in to check vital signs every hour or noise from the hallway waking up the baby or other such hospital nonsense. We got to relax together and get to know one another. Deborah came back to check on us that morning and make sure all was well. I was happy to sit on the back porch with baby girl when she was just a few hours old and pop her into the sling for a stroll through the woods to the playground on her second day of life.
So that's it -- the adventure that ended in the addition of another beautiful person to our family. Everything went exactly as I hoped it would. I couldn't have asked for a better experience for all of us. I'm so glad we were brave enough to consider The Farm in the face of a culture of fear surrounding birth in this country. I was glad to bring our baby girl home, but sad to leave a beautiful place to which I feel such a strong connection now.
What were the major differences between giving birth at The Farm and at the hospital?
One, I felt that every decision about the pregnancy/birth was one we made together. The midwives never dictated to me how to do anything. They had opinions and thoughts and interesting articles, but nothing was a mandate. Two, I can't describe the huge difference in comfort between giving birth in a home and in a hospital. It wasn't even my home, although I had been there a few days by the time I gave birth, but I was just so much more comfortable there than I ever was in the hospital. My midwives were always accessible during my early labor, and then when I was in hard labor they were there the entire time but faded to the background when I didn't need them. It was the perfect balance. I was able to shower and sleep in a real bed without anyone waking us up every hour, eat my own food, and have my kids wake up in their beds and walk across the hall to meet their sister. The whole thing was actually relaxing. I never felt that way in the hospital. In the hospital I felt a basal level of anxiety about everything that was happening, could happen, and what "should" be happening that wasn't. That was totally absent on The Farm. Last but not least, I guess it goes along with my first point but the care at The Farm was so centered on the woman. They trust a mom to know herself, her body, and her baby. I feel like that is lacking in so many hospital experiences. Both of my births -- at the hospital and The Farm -- taught me about the power of my own body and about how little intervention this process really needs.
What would you tell women who are considering The Farm, home birth, or a birth with midwives?
Do it! I wish I'd had a home birth earlier, although I certainly could appreciate it more given my previous experiences. I am biased, of course, but I think The Farm is incredible and historic and if given the chance I'd give birth there again in a heartbeat. Every birth is it's own story but I loved ours being connected in some way to so many other birth stories. Trust your body and yourself. Be educated, be safe, and be realistic, but you don't have to believe everything you hear about birth in the mainstream media. For most women, pregnancy and birth is not an illness to be managed. As a pregnant woman, you are so strong and powerful. Birth is not something that needs to be feared, but rather is an experience to embrace and enjoy. Find the practitioner and the birth location that will help you live that.
Did you use a midwife for your birth, or would you?
Image via Kate Kellogg