When I tell people that I had a homebirth I usually get a very positive response. Usually, people say something like….”That is great. You are amazing" or "I could never do that.”
I really didn’t do anything amazing. Women’s bodies are designed to give birth and the vast majority of the time, it all happens perfectly.
Before I was pregnant, my sister had told me about a midwife that attended homebirths in the area. I wasn’t really interested. With my previous birth (at Northside Hospital in Atlanta) I had planned to have a birth without medications. However, after hearing from nearly everyone that the pain would be unbearable and exhausting, I had considered that I may not follow my birth plan. My active labor lasted 3 hours and I pushed for 2 contractions – there was no time for pain medication and it never even crossed my mind. The hospital didn’t even have time to offer anything.
Now, that I was pregnant again, I was confidant I could handle labor on my own. I wanted to find an OB that would not intervene unless medically necessary– instead just let me have the baby. I started calling around with a few questions – What is your C-Section rate? How often do you do an episiotomy? Do you require an IV? I thought these questions would give me an idea of the OB’s philosophy and willingness to work with “opinionated” mothers. None of the OBs would even answer my questions. Each suggested I make an appointment. This irritated me. I felt like… already, they were uninterested in treating me with respect and care. I asked around if anyone knew an OB that was supportive of natural childbirth – none.
I did get the name Ranata Hillman from a lactation consultant on the coast. I searched online and found her website. After a long phone conversation, I was considering the idea of homebirth.
I started searching online and reading books. I watched the movie “The Business of Being Born.” I learned a few facts that helped me make my decision. America is not good at delivering babies – we rank 45th in Infant Mortality Rate (not quite as safe as Cuba) according to the CIA World Factbook. Also, It is generally accepted knowledge that 12% C-Section rate is ideal, any more than that, and the risk to mother and baby actually increases instead of decreases. In many hospitals, the C-section rate is 35% to 40%. As I said, none of the OBs I called would tell me their C-section rate, neither would the hospital.
Giving birth at home is nice because you do not have to travel to the hospital while you are in labor and then recover in a hospital room. However, being “at home” is not the primary factor, in my opinion. More important is the professionalism and quality of care. I belived that the quality of care was inferior at the hospital. I believe that the ideal situation is to receive the same fantastic care I received that is supportive of the natural process of childbirth in a comfortable setting that can also provide the medical facilities & equipment that are sometimes needed. We simply don’t have that option. So, Renata Hillman at my house was the healthiest, safest option I had available for me and my baby.
During my labor, Caprie’s head was not positioned ideally for labor. This is called “Deep Transverse Arrest” or “Occiput Transverse.” Obviously, I am not trained in childbirth, but I did some research online. From what I understand, she engaged in the right position, but did not make the needed turn. The reason this happens is unknown – possibly the shape of my pelvis. If I had been in a hospital with this situation, I would have VERY likely not have been able to deliver vaginally. At 6am, when I was fully dilated, I would have been told to start pushing – most likely for counts of 10, while laying in bed, with my knees being held up. I probably would have pushed for hours before being told, “The baby is stuck” or “The baby won’t fit.” That type of pushing could have been painful and exhausting and stressful for the baby. The OB may have tried to turn her with forceps, but few doctors attempt this. Most likely, she would have been born via C-section. Re-positioning me on my hands and knees, in order to get the baby to turn is simply unheard of in the medical world. My birth and recovery would have been totally different in the hospital.
C-sections seem so common place, you may think – “no big deal” but it is a huge deal. It is one of the few invasive surgeries that is still performed. With a C-section, the risk to the mother and baby increase dramatically. If you want to learn more about these risks, I recommend the book, “Pushed” by Jennifer Block.
I feel so fortunate that I had a skilled midwife that had the knowledge to bring Caprie safely into this world.
Tuesday, July 14, 2009
Friday, July 3, 2009
Caprie's Homebirth
Caprie was born at home on June 13, 2009 at 9:02am. She weighed 9lb 1oz and was 21” long.
Following is a detailed story of her birth. If you are interested in the natural course of childbirth, this is just one example.
The last month of pregnancy was increasingly uncomfortable, but healthy. I had pre-labor contractions throughout each day. They increased in correlation with my activity level. My blood pressure was not high. I continued to take walks on a regular basis (until about 37 weeks). My previous labor with Luci, 5 years earlier was fast. My priority with this childbirth, was to recognize labor early so that my midwife, Renata, would arrive at our house before I started pushing.
Saturday, June 6th was a pretty busy day. We went to my grandmother’s 80th birthday party and a birthday party at the splash pad (for Luci’s friend, Stewart). It was very hot and I was exhausted by the end of the day. In the evening, I laid down early to get some rest. I was having contractions consistently 5 minutes apart, but there was no pain. However, I did feel “different” somehow. I called Renata. She and her apprentice, Stacey, arrived in about an hour. I was still having contractions. At that point, I was pretty sure it was a false alarm, since the contractions had not intensified. Renata did an exam and let me know that I was 2cm and the baby was in +1 station. The baby had probably moved lower in my pelvis that day, resulting in my feeling “different.” She recommended I try to go to sleep. She advised, if I go to sleep, it is probably not the big night. She stayed on the couch several hours, then went home. I fell asleep.
My last week of pregnancy was pretty miserable. The baby was low in my pelvis. I felt constant pressure on my front pubic bone area. The only relief was in the water. I spent several days in the water (at
Thursday, June 11th – I noticed small bits of my mucus plug each time I went to the bathroom. I was so excited. I was sure this was a sign and the baby would be in my arms soon. I tried not to think about it. Luci and I went to the movies and saw “UP.” That night, I had consistent contractions for over an hour. After some debate, I called Renata. Again, she arrived in about an hour. Again, I was pretty sure this was not it because nothing changed during the time it took her to arrive. Renata checked me and I was 3cm. She spent the night, just in case things started moving. Everyone feel asleep and nothing happened.
Friday, I was feeling discouraged and decided to put “going into labor” out of my mind. Luci spent some time with family (Aunt Patty, Uncle Warren and Shannon), I took a long nap and straightened up around the house. Graham and I watched a funny movie, “Ghost Town.” Each time I laughed, I felt uncomfortable pressure in my pelvis. I went to bed and fell asleep right away. I woke up at 12:30 with some lower back pain. I told Graham, “If this keeps up, then this is it….but I am not going to count on it.” I drifted in and out of sleep for a while. By 1am, we were timing contractions and I wanted Graham to press on my back during each contraction. When I called Renata and my sister, Vanessa, at 2am, I was sure we would have a baby by morning (Contractions were 7 minutes apart at 2am). Interestingly, Vanessa woke up just moments before I called and went to find her phone she had left in the other room.
From 2a to 6a, I had contractions that I could not talk through. Between contractions, Graham, Vanessa and I laughed and enjoyed each other’s company. Graham and Vanessa took turns pressing on my lower back during the contractions. I was in a variety of positions, but most of the time, I was sitting on the birth ball and leaning over onto a pile of pillows on my bed during contractions. Vanessa was making sure I had a few bites to eat and plenty of water. (Note: At no point did I even look at the clock, I had no idea what time it was, the times below are from the video Vanessa took periodically thought the morning).
Around 3:30, Renata and Stacey arrived. Renata checked my cervix. I was 80% effaced and 4 cm dilated. Because I had primarily been sitting up to that point, Renata recommended I stand, to get more pressure from the baby’s head onto my cervix. Contractions were now 4 minutes apart.
At 5am, I said, “It seems like things are not progressing.” I was tired of standing, so I moved to the birth stool. It felt good to sit on the birth stool – you can’t help but relax your pelvic floor when sitting on it. It is like a toilet seat, open at the front and very close to the ground. I was still asking for pressure on my back during contractions, but it wasn’t helping as much as it had earlier. The contractions were increasing in intensity.
Around 6am, things got much `more serious. I no longer wanted to talk between contractions. My concentration turned inward and I blocked out everything around me. The pressure in my lower back was very intense. I was feeling really tired and wanted to lay down for just a few minutes. I remember feeling like I needed a break. It seemed to have gone on for so long and I was sleepy. My legs were trembling and I was sweating.
Renata suggested I walk between contractions. At 6:40, I walked into the living room. I remember standing there and suddenly wondering, “Why hasn’t my water broke? The sun is coming up, Luci is watching cartoons and nothing is happening!” This was the only time I was aware of the time, simply because the sun had come up. I was feeling impatient and in pain. I started to cry. Renata comforted me, she said it was ok to cry and that I was doing good.
At the time, I did not recognize the change that took place. Now, it seems obvious. The trembling, sweating, crying, and inability to find a good position were all signs of complete dilation and transition.
Around 7:10a, it seemed to everyone that I would start pushing soon, but I did not feel any urge to push. I noticed that they had laid out pads under me and started putting warm cloths on my perineum. Also, I heard Renata ask someone to turn the A/C off. I was sweating profusely and thought she must be crazy, but I didn’t have the ability to verbalize this to her. All of my efforts were focused inward.
At this time, I was sitting on the birthstool – then switched to my knees, then back to the stool, then standing. I could not find a position that would allow the baby to come down and trigger my desire to push. Each contraction was very painful and I was moaning loudly through each. I tried to think of the baby moving down and my cervix opening – also, I thought of my other muscles relaxing. I had a tendency for my thighs and shoulders to get tense, but I worked to relax.
At 8:15, Renata suggested I lay down in bed for a minute and relax. I was happy to lay down and rest my body. I vomited.
At 8:20, Renata checked my cervix and “read” the babies suture lines (to determine which way the baby was facing based on her head) and suggested that I get on my hands and knees with my chest on the bed and my behind in the air. Although I am sure she explained to me what was happening, it took all of my concentration just to change positions, so I didn’t even consider why I was changing positions. Stacey got beside me and “rubbed” my belly during a contraction. I felt the baby come out of my pelvis a bit. After the next contraction, my water broke. Renata told me to stand up quickly and not lean over again. I thought, “How absurd that she suggest I do something quickly.” I felt like the entire world was in slow motion.
By 8:45, I was squatted on my knees with my body draped over Graham’s legs on the edge of the bed. I knew something had changed dramatically. I could feel an intense amount of pain and my moaning and had changed to a deeper more intense sound. I pushed once and it hurt my back. I suddenly, felt panicky. I don’t know how to describe it, except to say I wanted to crawl out of my skin. Like, if I crawled forward, I could get away. Renata was sitting on the floor behind me keeping warm cloths and oil on my perineum. Stacey was beside me telling me that it was almost over and giving words of encouragement. They told me it was almost over.
I didn’t feel my body pushing on it's own as other women have described. Nor did it feel like I couldn’t stop the pushing. It was a decision to push. It just felt “right” to push. I would describe it like when you need to have a bowel movement. You know when you need to go. You can ignore it, or head to the bathroom. I just knew it was time for her to come out. The first push did not seem very effective, more of a “test” push.
At 8:57, I pushed for a second time and I felt the baby crown. I remember feeling the stinging and wanting to stop pushing, so I did. I pushed again and her head was out. I expected to be done at that point. With Luci, I was pushing to the counting of the L&D nurses and I pushed her head and body at once. Left to my own instincts, I pushed more slowly. With several small pushes over a couple minutes, I pushed out each shoulder then her body. She was born at 9:02am.
I don’t remember hearing that first cry. My memories of the first couple of hours are a blur. Renata and Stacey helped me flip over to sit on the floor while passing the baby to me between my legs. I tried to lift her to nurse, but her umbilical cord was very short (12 inches total), so I had to bend down a little to get her to my breast. She wanted to nurse immediately and her mouth kept moving.
The baby was draped in towels to keep her warm. She looked perfect to me. I don’t remember much vernix or blood, but according to pictures, there was a little.
Her umbilical cord stopped pulsing pretty quickly and the cord was cut by Graham. This allowed me to hold her more comfortably. I continued to feel mild contractions and within minutes, the placenta was out. From there, I am not sure what happened. At some point I got in bed and also took a very soothing herbal bath with Caprie.
Renata and Stacey stayed for about 4 or 5 hours. They took care of Caprie and I, checked are vitals, cleaned up, and explained what to expect in the next 24 hours. When they left, we fell asleep.
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