My first experience with pregnancy and birth was not what I would consider ideal. Months of undiagnosed Hyperemesis Gravidium that ended in a typical hospital birth: IV pain meds, epidural, unproductive pushing stage ending in a vacuum delivery. Day 2 and jaundice set in and our son was taken to the nursery to be under UV lights most of the day. They brought him to me so that I could attempt to nurse him for half an hour every three hours. He was kept an extra two days and upon discharge we were set up with a portable light blanket at home. Same rules: pick him up to nurse or change him, otherwise he stays on the lights. When we finally saw our own family doctor at a week old he seemed baffled by the hospital staff’s concern over what he considered not terribly high numbers. He gave me a much needed hug and told me to send the lights back. “Stay in bed all week. Don’t put a shirt on and keep him in just a diaper. Open your windows and nurse nurse nurse. Can you do that?” Absolutely. I wanted nothing more!
This was one of the first times I had ever really truly realized that doctors are fallible. Of course I knew that intellectually but I had never ever considered questioning one. But what if I had? What if I had researched the risks associated with the anti nausea meds I had taken my entire pregnancy, to IV antibiotics and pain meds, epidurals, assisted deliveries, and separating mom and baby in the first week. Those initial “what ifs” led to others: what if we didn’t have to cut the cord right away? What if we didn’t need antibiotic eye ointment? What if we had the right to question recommended treatments when problems arose?
By the time I met Liz at a local homeschooling field trip a couple of years later I knew I would do things differently next time. When she mentioned she was a midwife I had a hard time not hounding her with questions right then and there; although I tried hard to restrain myself I had found out by the end of the outing that she was familiar with Hyperemesis Gravidium and could run IV fluids at home, that her standard of care included many if not all of the things I wanted for next time and that I loved being in her presence. She was knowledgeable and confident yet understanding and calming. We weren’t quite ready to try for number two and I hadn’t even officially interviewed her yet but my mind was made up: Liz would deliver our next baby.
So when the two little lines showed up on the pregnancy test she was one of the first to know. We initially discussed going to a local birthing center but after some persuading on my part my husband, Nathan, agreed to a home birth. I managed my HG with OTC meds for the most part; baby was always healthy and in a favorable position. Everything was totally routine in my pregnancy. To help us achieve our goals Nate and I participated in a Birth Boot Camp class. The experience definitely gave both of us more confidence in our decision. I was going to have my healing birth. There would be calm music and warm water and soft lighting. I would be surrounded by care providers I felt comfortable with and those that I loved and my sweet baby would make the transition from womb to world surrounded by joy and serenity.
But my sweet baby had other plans.
The day after my due date I found myself in our family doctor’s office with my four year old son who had a fever, body aches, and a sore throat, all of which he had so generously shared with me. That night contractions changed from the occasional Braxton Hicks discomfort to what I considered real contractions: painful, regular, with distinctive peeks and patterns. After they had been consistently 3-4 minutes apart for more than an hour we called my midwife. She came over with her assistant, Bailey, listened to baby through a few contractions, took my vitals, and watched and waited. After another hour or so I was physically exhausted. I had lost track of time, every muscle in my body hurt, and I felt like I couldn’t go on. Liz offered to check my cervix. I was reluctant at first simply because I was afraid of hearing that nothing was happening. But I decided if that was the case it meant I could crawl into bed and sleep so I agreed. I was at a 1 or 2; time to rest.
Over the next week I barely left the couch. My mom was off expecting to be helping with a newborn but instead spent the week nursing both my son and I back to health. As 41 weeks approached I was just hoping that labor would hold off until I was healthy – I knew I couldn’t possibly do this until my body had recovered. Thankfully I had done just that almost completely by the wee hours of February 15th, six days after my EDD.
The first truly painful contraction came around 3 am. They continued every five or ten minutes. I was not able to manage them well laying in bed and didnt want to wake Nathan just yet so I headed to the tub. Another hour of inconsistent yet painful contractions and I woke up my husband for support. He helped me time them on my pregnancy app and kept me hydrated, encouraged, and comfortable. As the contractions started to come farther and farther apart I decided to get out of the tub and do something to encourage them to keep coming. For the next three hours I walked, sat on a ball, stood with support from Nate, rocked my hips on hands and knees, attempted to lay down and watch TV – nothing was keeping them 3-4 minutes apart for longer than half an hour at a time. By 7 I was frustrated and asked Nate to call my midwife. She asked how far apart contractions had been and he told her: as close together as 3 minutes and as far apart as 9 for the last four hours. She had another appointment that morning but promised to swing by with an herbal supplement to maybe help get things going and to offer some support to help me deal with the contractions a little better as by this point I was having a harder time breathing through them and had moved on to the “I don’t want to do this” and occasionally “I can’t do this” stage. I was frustrated and discouraged. I felt like I was doing all this work for nothing.
Liz came just before 9:00 that morning. After checking our vitals and looking over my contraction tracker she asked if I’d like her to check my cervix. Once again a big part of me just didn’t want to know but I agreed. I was crossing my fingers and daring to hope for a 3, maybe even a 4, anything to show that at least a little progress had been made. I almost wept with joy when she told me I was at a 6 or 7; it took a few minutes to sink in. It was baby time!
My mom was already wrapping things up at work and headed our way to relieve Nathan who had been my sole support for 5 hours now. Nathan called my sister and his mom and let them know it was time to make their way to our house. Liz asked if we were okay while she ran to the office just down the road to grab a liner for the pool. I had been on my knees draped over the ball for quite some time now and was ready to get back into the water. The water was my focus at this point. Just a few more contractions and I could get into the water. Just a few more.
Nine minutes after Liz left I felt the urge to push. My sweet husband remained calm, no stress in his voice as he called the midwife to update her. I continued pushing, rupturing the bag of waters as he was on the phone. I have since learned he was “calm on the outside but freaking out on the inside.” Liz had called Bailey and her back up midwife, Julia, at this point. When Liz arrived with Julia’s assistant, Crystal, I was still pushing on hands and knees. Julia, Bailey, and my mom arrived shortly after.
Things moved quickly now. Liz noted the spontaneous rupture of the membranes and that there was meconium not in the water but on the towel beneath me – something I had noticed as well but hadn’t quite connected yet. Liz felt for baby’s position and confirmed that he was breech. I knew at this point that something was off but not exactly what and there wasn’t much I could do about it anyway as I continued to focus on pushing. My birth team was great about keeping me focused and calm without overloading me with information. I felt the pressure build, the burning as he “crowned” and then the immediate release of pressure as his “head” was born. In my mind I felt relief. I was done, just a few easy pushes to guide baby out and he or she would be here. But instead of relief I felt a surge of more pressure. I was told to keep pushing, to push harder, that the head was stuck and we needed to get it out. Liz instructed Crystal to call 911. By this point I had been pushing for 20 minutes on my hands and knees – my least favorite of the positions we had practiced in our Birth Boot Camp classes. I was tired. Pushing was not effective. I remembered this EXACT feeling with the birth of my first: exhaustion, frustration, and an ever growing sense of urgency, fear, and panic because what I was doing just was not working. The “I can do this” warrior started to cower and fear for the “what if I can’t” scenarios.
I could tell my midwives felt the same; there was more urgency in their voices as they told me to push. “Baby is trying to breathe.” “Baby needs to come out now.” They had me move to the bed, flat on my back, the exact place I didn’t want to be. Julia told Liz she had his chin tucked. Liz had an airway open so that baby could breathe if he or she tried. But that dang head still wouldn’t budge. At this point Liz told Julia to cut an episiotomy and baby was out a minute later at 9:51 am.
I don’t remember anyone telling me he was a boy, to be honest; they’d all known for almost half an hour at this point since he decided to present his rear end and family jewels to the world first. He didn’t cry right away and needed help to get breathing, which Liz performed at the foot of my bed. While logically I knew he was okay, that the cord and placenta were still attached, providing everything he needed, it was still a complete feeling of panic. Finally he cried. He started breathing on his own, and Julia handed him to me so that we could do skin to skin. He was cold and limp, I remember I didn’t feel much relief when she handed him to me. I kept asking over and over if he was okay, if he would be okay. I was always reassured he was perfect but it wouldn’t feel that way until much later.
The paramedics arrived at 9:55. Liz instructed Crystal to keep all but one or two out of the bedroom when they showed up. Apparently it was quite a few trucks – enough to give my neighbor and friend a near heart attack (sorry, Shanna!) They were very respectful and kind. Liz informed them that she called them as a precaution but that baby and mama were doing well. They wrote down Liz’s stats on baby, requested to check her electronic BP’s reading with their manual cuff on me, and that was that. She told them they were welcome to hang out in the living room for a little while to check up again before leaving if they felt the need. They didn’t. They had my husband sign the decline to transport, congratulated us, and were on their way. I need to bake them cookies or something.
Big brother arrived shortly with papa and helped daddy cut the cord. Family had begun showing up by this time so daddy brought his new son out to meet them while Liz and Julia handled the repairs and Crystal and Bailey cleaned up. This point in the process is clearer to me. I chatted with my sister and my mom who were by my side the whole time. I asked my childless sister if I had just scarred her for life and she assured me I hadn’t. I apologized to Liz and Julia for being a big baby about the repair and they reassured me I wasn’t (still think they were just being nice.) I laughed with my mom about the fact that she and my sister had barely made it in time – that I didn’t even clearly remember either of them showing up after spending so much energy prepping them to help me cope with labor. I do remember my mom telling me she was here while I was pushing on hands and knees and my sister crawling over my head to take one of my legs from my mom who had been holding both once I was moved to the bed. Did I mention she was supposed to witness my home birth to assuage her fears of having her own babies some day? Sorry, Terra!
Baby was weighed and poked and measured: 7 lbs 6 oz, 21″ long. Everyone left and Nathan and I decided on the name Judah Sherman and this big event that was nine months in the making was over.
I had a hard time processing his birth over the next few days. I had to grieve the loss of what I had wanted before I could really process the wonder of what actually happened. All the elements of my first experience with birth that I had wanted to avoid: the fear, the interventions we had no time to discuss or consent to, the loss of control, the feeling of helplessness. Judah wasn’t put on my chest right away, his daddy didn’t get to announce that he was a boy with great fanfare, his first breaths and experiences weren’t serene and full of comfort. There were even strangers parading in, just like at the hospital. If I’m being honest, his birth was traumatic for both of us in a lot of ways. And trauma takes time to heal. I still feel a tinge of jealousy when I see pictures of beautiful water births. There are no pictures of Judah’s first moments, only memories, and not ones I care to revisit over and over.
Another step in the process was the guilt. I had done exactly zero research on breech vaginal delivery. Why should I have? I didn’t have a breech baby! Reading the risks associated with breech birth after the fact in the swarm of post partum hormones was not my brightest idea and I wept more than once with the overwhelming fear, guilt, but relief in the fact that the scariest of the scary hadn’t happened to us. To be honest, had we known he was breech, we would have likely had a planned section. Liz doesn’t perform breech births at home and my insurance doesn’t cover them anyway. The closest hospital that would have let me attempt a vaginal delivery is over an hour away. My realistic options would have been at home unassisted or in the operating room. In the end, having two well trained professionals assisting with a vaginal delivery was best case scenario for both of us so this guilt passed quickly. You can’t possibly prepare for every scenario in labor and delivery. I can’t beat myself up for something out of my control.
I get asked quite often if I regret choosing a homebirth. While I was confident that my birth team did everything they could have possibly done for both of us I did think, briefly, that maybe I had made a mistake in not planning a hospital birth with an OB. But after playing out the alternative scenarios in my mind I am convinced that things would have been much MUCH scarier had we been planning a typical hospital birth.
Baby’s position would have been checked at the latest Friday afternoon by an obstetrician. Liz came to my house Saturday night for my last prenatal and he was head down. I went into labor early Monday morning so unless my obstetrician had Sunday office hours they would have also missed the last minute flip to breech presentation.
I was also not entirely convinced I was in labor. When Liz came to check on me I wasn’t even sure I wanted her to check my cervix. I was shocked when she told me I was at seven. I would not have been headed to the hospital at this point. No way. I wouldn’t have known it was go time until I was on my hands and knees pushing out my bag of waters at which point Nate would of had to either deliver him alone or call 911. The likelihood of an EMT knowing the proper procedures to deal with head entrapment in a breech birth is pretty much nil. They would have been completely unhelpful in the best case scenario and could have done very serious damage in the worst had they intervened without knowing what they were doing. The nearest hospital is at least 7 minutes away, even by ambulance and there are no doctors trained in breech birth there. BEST case scenario they would have gotten me to an operating room in time, knocked me out, shoved him back up into my uterus and delivered him via section. And if we were lucky the placenta would not have detached, he wouldn’t be overly stressed or in shock, he wouldn’t suffer any brain damage, he’d be alive and okay. Maybe. That’s terrifying to me. When I realized how scary things COULD HAVE been I was sobbing with relief that Nathan and I had made the choice to go with Liz and her team. Judah could very well owe them his life and I certainly owe them many thanks that my overall birth plan, healthy mom healthy baby was met. It may not have been exactly the story I wanted to tell but it’s ours, and I’m okay with that.