Rachel’s Birth Story

Today’s guest post is from Rachel at The Minimalist Mom. As you likely know from my past posts, Rachel has helped to inspire me to minimalize my possessions and life. Today I am happy to share her wonderful (and minimalist) home birth story.

Rachel and Henry

Rachel’s Birth Story: An Unlikely Home Birther

If you had asked friends of mine, or family, if they ever thought I would have a home birth, the resounding answer would have been no. Before getting pregnant I was a fairly mainstream follower of medicalized health care. I had been an athlete for many years and managed overuse injuries with a slew of medications and some half hearted physiotherapy. Once I retired from sport I had surgery on my elbow and gladly filled, and consumed, the Tyelenol 3 with Codeine pills prescribed for pain.

Before getting pregnant I watched the documentary The Business of Being Born. It was fascinating. And home birth looked quite interesting but I still didn’t think it was for me.

When I got pregnant I chose to visit a midwife, an option available to women in British Columbia, Canada under federally funded health care services. I chose to see midwives over an OBGYN simply because I heard the appointments were longer and more relaxed. Later I also learned that they did home visits for the first two weeks post-partum. Bonus!

I didn’t inititally intend to have a home birth. I did hire a Doula for labor assistance but I registered at a large hospital thinking that that was where my son would be born.

Like most women pregnant for the first time I read about pregnancy and labor voraciously. I read stories in books and online. I started to notice a common theme to the hospital stories, they were full of markers of dilation, shift changes for nurses and a lot of drugs. I knew I wanted to avoid getting an epidural because the thought of a needle going into my back made me nauseous.

I also read some painful descriptions of riding in a car while in labor. My husband and I lived in an urban centre at the time and we walked every where. Getting in a car while in labor sounded terrible. I started to read more home birth stories because most of the hospital stories were scaring me.

Another factor that began to deeply change my thoughts on laboring in a hospital was that we were already spending a lot of time in hospitals. Both of my in-laws had been very ill we had spent a lot of time driving to hospitals and visiting. The thought of going to a hospital to give birth started to seem very wrong. I associated hospitals with serious illness and cancer, not bringing new life into this world.

After a lot of soul searching I brought up having a home brith with my husband. His first reaction was, won’t it be loud and messy? I told him I didn’t think so. He also asked me why I wouldn’t want to be in a hospital setting seeing as I had never had a baby before and didn’t know how hard labor would be. As a former athlete I knew that I had good focus and pain management techniques. Also, my instincts were telling me I would be much more comfortable laboring at home.

After some discussions with my Doula and midwife we decided to plan for a home birth. With our healthcare system you can transfer to a hospital at any time so there are no financial repercussions (or pressures) if you end up having a hospital birth.

We told almost no one about our plan. My sister knew and I had told a few work colleagues. I knew most of my family would have negative opinions about my choice so I decided to keep it to myself.

At 38 weeks and 2 days my water broke. Unexpected for sure. I had been reminded time and time again that first baby’s come late. I was still working at the time and 48 hours before my water broke I had been in another country (Seattle – I am from Vancouver, Canada).

In typical low-key Westcoast fashion I went into work to finish a few things. My coworkers were slightly horrified that I had come in after my water had broken. But I wasn’t having any contractions and knew it might be a while. Also, I wanted to officially put my out-of-office reply on – no more work for me!

We did end up going to the hospital because I had tested positive for Strep B. I got a bag of antibiotics, a few more to take home so the midwives could come and adminster them later, and a small vial of a tincturn to help me go into labour.

On the way home we picked up our home birth kit, got labor snacks and had lunch at Whole Foods and I took my first labor cocktail (tincturn, castor oil, juice, peanut butter). I mixed the cocktail right in the Whole Foods cafe and downed it.

The home birth went off mostly without a hitch. My midwives visited me twice to administer IV antibiotics and see how I was progressing. I labored in the dark in my home doing a lot of swaying and listening to an awesome playlist of Ray La Montagne and the Weepies. My doula arrived and put me through a mini bootcamp of lunges with one leg on a stool. My husband rubbed my back and was generally amazing.

Because of my GBS+ diagnosis and ruptured membranes my care providers had wanted to avoid internal exams to reduce risk of infection. My midwives arrived at my home at 5am to adminster another does of antibiotics and they gave me my first internal exam. 10 cms. I literally pumped my fist in excitment. After my IV I went to labor on the toilet and started to have pushing contractions. My team got me up onto my bed and a few minutes later my son arrived.

It was amazing.

While I was not the most likely person to choose home birth I am now a big proponent of it for women that want the option and are good candidates. It can be safe and it can be a very healthy experience for mother and child.

In the last two years I’ve made some remarkable changes to my lifestyle, reducing possessions and debt and gaining more time and space in my life. It’s been wonderful. When I think about what gave me the confidence to make these changes I think about making that decision to have a home birth. It wasn’t easy to do something I knew family and friends wouldn’t agree with. It wasn’t easy but it was so empowering. Making such a big decision, and having it be successful, has given me more confidence in my body and my instincts.

I know home birth isn’t for every woman not only because medical complications but because many women will feel more comfortable in a hospital than their home. But I wish the option, the choice, was there for every woman.

Rachel Jonat writes about living a rich life with less stuff at The Minimalist Mom.

Twig’s Birth Story

The night before I had been wondering if my amniotic fluid was leaking very slightly. My underwear was slightly damp and I was fairly sure it wasn’t urine or cervical fluid. When we got home from watching a basketball game at my in-laws’ around 11:30pm, I decided to just change my underwear and go to sleep. I woke around 3am to pee and didn’t have anything gush out when I stood up, though my underwear was damp again. I figured it wasn’t amniotic fluid and went back to sleep. I had a midwife appointment the next day, so I’d ask about it then.

We woke at around 8:30am and I got up to pee. I was still sitting on the toilet taking care of other business after I peed when I felt a small gush. It was obvious it wasn’t pee by both the amount and the sensation. I called my husband in and told him of my suspicions and he brought me a cloth pad. I decided I’d just tell the midwife about it at our appointment in a couple hours.

I got up and went into Peanut’s room to help her take her diaper off. When I went to put the diaper in the pail, I felt another gush and ran to the bathroom to stand in the shower. I called in my husband and told him that for sure my water had broken and he took my went clothes to the hamper and brought me new ones. We called the midwife at 8:48 and she said that contractions would probably start within a couple of hours, if they didn’t, we could come to our appointment. If they did, she could have her assistant stop by to check on us on her way into the office.

While we were debating if my husband should go to work, contractions started. They were around 5-6 minutes apart and pretty strong from the get go. We figured I still had a while and they were just strong because of the lack of fluid cushioning the baby against my cervix. We decided he should go in to make sure things were in order for his paternity leave and then come right home. We called the midwife at 9:21am and told her contractions had started. She asked us to time them and said she’d see if her assistant was still in the area. She said she’d call us back when she knew.

While he was gone, Peanut and I ate cereal and a blueberry muffin. It was painful to sit through the contractions so I started walking in the kitchen. They were getting pretty intense and I was wishing I could get in the birth pool, but realized it wouldn’t be wise to even fill it, let alone get into it, this early in labor. I decided it was smart to take a shower and get clean for the last time in a while anyway, so I got in.

Peanut was dilly-dallying downstairs so I called her up. She tried to tell me something, but I was too distracted. She climbed in and I started cleaning myself. A few minutes later, my husband came in and told me the midwife’s assistant was here and Peanut was supposed to have told me when she came up. I finished getting clean as quickly as possible and headed downstairs to meet her.

She checked my blood pressure and the baby’s heartbeat. I told my husband to call my mother so she could come watch Peanut because I needed him. While he was in the other room on the phone, I stood through some contractions leaning over and the assistant pressed firmly with her hands flat on my back, which felt great. At this point I started vocalizing through contractions.

She asked to check my cervix and I agreed, hoping it would tell us this wasn’t just the beginning because the pain was getting so intense. She said I was at about 7cm and I felt immediate relief. She also said I had a bit of an anterior lip, which is a thickening of the cervix. She said, if I could tolerate it, I could lay there during a contraction and she could try pushing it out of the way. Not only could I tolerate it, but it made the contraction less intense. She said that meant that standing would probably bring the baby faster and that leaning forward like I was earlier was good for the lip. The assistant called the midwife to let her know the progress and I heard her say my contractions were about 3 minutes apart.

My husband came back and I said I wanted the birth pool. He and the assistant started filling it up and I walked the hall between contractions, calling my husband to come help when a contraction started. He pressed on my back and it helped, but the contractions were still very intense. Peanut almost melted down at one point when she wanted to push on my back with daddy, but he quickly gave her the job of pushing on my leg and she was happy to help.

After some amount of contractions, standing was hurting too much. I decided to lay on my side on the bed since the pool still wasn’t full. I started what I can only describe as howling through contractions and my husband did counter pressure on my knees and lower back. I started feeling like I could maybe push, but I thought it couldn’t be that time yet.

When the birth pool was full enough, I got in. It was freezing to me though, so they started boiling water on the stove. I was on all fours with my legs spread open in the pool and my husband got in to push on my back more. Peanut stood on the outside watching and trying to help. She was very good at listening and was happy  when we gave her the job of bringing mama water between contractions.

I started feeling like I needed to push, but it hurt when I did it. I almost stopped pushing because of the pain, but the midwife (who had just gotten there) and the assistant were cheering me on so I continued. It also provided some sort of relief to push, though it was still incredibly painful.

The contractions became more and more painful as I continued to push through them and I could tell they we’re further apart now. It was also quite painful between contractions, especially on my tailbone. They told me that it would feel better once the baby got past my tailbone, so I kept telling myself that to get myself to push harder.

The assistant was supporting my perineum on both top and bottom. She explained to me later that she supported both because it was shaped like a volcano, though I’m not sure what she meant. At one point I heard her ask my husband if he wanted to feel the baby and he did. This made me wonder how close the baby really was so I felt too and it was just inches from crowning, if that. My mom showed up around this time and started taking pictures. I started feeling the baby after contractions to know where it was until I started to be able to feel the baby crowning without the need to feel with my hand.

By this point the tailbone pain was gone, but the stretching pain replaced it. I was screaming as low as I could as I pushed and the midwives kept telling me I was doing great. It hurt so bad that I just wanted the baby out. Apparently I was screaming that I wanted it out. I pushed harder and more frequently trying to get the baby out until finally its head emerged, which relieved some of the intensity.

What happened next felt to me like the midwives were pulling the baby out of me and it was painful, though not as bad as the head coming out. It turned out that the baby had shoulder dysocia, which means its shoulder was stuck behind my pubic bone. They told my husband later that if we weren’t in the water, they would have let me push more before assisting, but in the water they needed to get the baby out before it got panicked and inhaled water.

The baby came out at 11:12am and I flipped over to hold it. My immediate feeling was relief that the pain is gone, but it was quickly followed my the intense joy over the fact I was holding my baby. It was still absolutely covered in vernix, which the midwife said that, along with looking at some other stuff (possibly something with its ears?), made the baby seem more like an early baby than a late baby. I don’t know how that would work out considering how positive we are on my date of ovulation.

They put a blanket over the baby when they placed it on me, so we didn’t look at the sex. After a couple of minutes my mother started to ask and I was amazed I was level-headed enough to say I wanted Peanut to check. I moved the blanket and Peanut told us the baby was a girl! She was ecstatic that the baby was here and she was a big sister now. And how much little sister looks like big sister!

We stayed in the pool while I started to nurse and pushed out the placenta, which we put in the container and allowed to float next to us in the water. My husband was behind me supporting me as I nursed and he cut the cord once the placenta was out, which the midwives said meant the cord was done pulsing.

The pool was getting cold, so we got out and went to the bed, where we nursed more. She nursed pretty much constantly for the next couple of hours actually. When she was unlatched at one point within those hours, we decided to take her measurements. She wasn’t very happy about it.

She weighed 9 lbs 8 oz, which I immediately tried to justify with all the nursing, but the midwife said she had also pooped while we were in the pool (something I didn’t notice), so it kind of evened out. She was 20.25 inches long and her head was 14 inches around. Certainly a big baby!

The midwives checked me out and I hadn’t torn. They weren’t concerned by my amount of bleeding until I tried to get up to shower and almost passed out. They told me my options were pitocin, an herb called shepard’s purse, or just wait it out. I decided to wait it out, but when I got up to pee I passed some large clots and lots of blood, so we decided to try the herb. It tasted disgusting, but quickly got my bleeding under control. The midwife went back to her office for her appointments, but the assistant stayed for a while to make sure things were okay.

Peanut immediately wanted to hold her new little sister, but was happy enough to play games with my mother as we got settled before taking a family of four nap. She is already absolutely in love with Meredith Renee. We all are.

Are Hospitals Really Safer?

The great majority of births are in hospitals. In 2007 in the United States, only .62% of all births were at home. While trends show an increase in both homebirths and birth center births, they are still remarkably low.

I get it. As is obvious by the fact that I had an accidental home birth, I wasn’t planning on a home birth when I was pregnant with Peanut. No matter how naturally minded I got and how good a home birth sounded, it was terrifying to me. I whole-heartedly supported the idea of women giving birth at home, but I decided it just wasn’t for me. I needed the hospital to feel safe and, as the numbers above suggest, so do a great majority of moms-to-be.

Image courtsey of http://www.nytimes.com/

I started off my maternity care with my regular OBGYN. During my third trimester, I moved to the team of midwives in the office because I thought they would be better support for my natural birth. I told myself that it wasn’t that I was afraid of a homebirth, but that it wasn’t financially possible or that it wasn’t really our home. Truth be told, I think I was afraid. I liked the idea of a homebirth, but I was afraid to bring in another aspect of the unknown when the whole thing was already such new territory. Then, of course, Peanut came at home.

 

It was hard. It was scary. It was exactly what I want for this birth.

In my lab safety class, we’ve gone over a concept called risk perception. Risk perception is how you view a risk yourself. It’s entirely subjective and changes drastically depending on the person, current events, society you live in, et cetera. My original risk perception was that homebirth was less safe. We are taught that hospitals are wonderful places that save lives. We are taught that homebirth is an a crude thing that women used to do on farms and would often die shortly afterwards. There’s a commercial I often hear on the radio for a local hospital. It talks about how birth happens so frequently that it could be considered unimportant, but at their hospital they treat it like the miracle it is. Most babies are fine when they come into this world, but some aren’t so don’t you want the best care immediately available for your baby? Well, according to them, their hospital has the best of both worlds.

Part of risk perception isn’t only what you experience, such as in my case, but also what you know. Educating yourself means you can make educated decisions, which is the most important thing you can do for your family. The more you know, the better decision you can make. So I seek, as I always do on this blog, to educate. I will present information and hope that it helps you in your decision making process, no matter the outcome.

Here is our question: Are hospitals really the best for your birth?

First off, let’s examine birth in the United States. We rank 42nd worldwide in neonatal mortality rate and worst in maternal mortality rate for industrialized nations (for a full comparison and rebuts to arguments against these numbers, watch this video). It is clear that there is something wrong with our maternity system. These numbers, not so surprisingly, correspond greatly with the increase in cesarean births that our country has experienced over the last decade. The cesarean section is a wonderful, life-saving surgery. The only problem is that it is used too often (a whopping 1 in 3 births in our country and rising). There is no reason our c-section rate should be this high and it is costing thousands of lives every year. Yes, costing lives. While c-sections are in some situations the best thing you can do to save either mom or baby’s life, they open a whole new area of complications. A cesarean section is major surgery and as any surgery does, comes with risks. Infection, injury to other organs, medication reactions, and even an increased risk of the placenta fusing with scar tissues in future pregnancies (which at very least means a hysterectomy if not death and increases in risk with every c-section) just to name a few.

So what does this have to do with homebirth? Giving birth at home means drastically decreased interventions. While that study is quite old, I’m certain that it still holds true for a comparison of home to hospital birth. If anything, with our changes to the maternity system in our country over the last couple of decades, I’d say that a more current comparison would fair even worse for the hospital. Interventions, even ones considered so common such as the epidural and pitocin, start the slippery slope towards a c-section, not to mention open a whole new range of possible complications.

But what about comparing death rates in the hospital and at home? A 2009 Canadian study did just that. They found that homebirth had comparable, if not better, outcomes than hospital births. Part of this was obviously perinatal (directly surrounding the time of birth, depending on the definition it can mean anywhere from 20-28 weeks gestation until 1-4 weeks postpartum) death rate. Homebirths were .35 (per 1000), hospital with a midwife was .57, and hospital with a doctor was .64. These are very small numbers, but there is still a significant difference between them. This study didn’t include women who were induced in the hospital, which is the traditional beginning of the slippery slope mentioned above.

There’s also the increased risk of infection presented in a hospital. No, hospitals are not sanitary. Hospitals are places where sick people go and germs spread. Hospitals contain high amounts of antibiotic resistant bacteria that can kill. Newborns have incredibly weak immune systems. Team this with the lack of support for breastfeeding in the hospital (and therefore less immunities for your little one) and you’re bound to get at least something minor, if not something more serious.

Now you take this information and do with it what you wish. I realize that even if I gave you a study that said that you were 10x more likely to die in a hospital birth, that you still may choose the hospital. Even with the knowledge of the slippery slope, many women will continue to choose an epidural because our society’s insistence that birth is pain that is worse than anything you can imagine and no one can or should have to endure it. These are ideas that are ingrained into our heads from a very early age and you can not change things overnight.

The difference now is that you know. You are given the knowledge that some of your preconceived notions about hospital births may not be what they seem. You can take this new knowledge and expand on it how you wish. You can do your own research and make an educated decision on what is best for you and your baby.