Disclaimer: I have included a lot of very personal information that I would not probably share if you and I were talking face to face. I disclose so much because I hope that my experience with help other women during their pregnancies and labors. There is no Right Way to labor and labors differ so much from woman to woman. One of things I found especially helpful during my first pregnancy was reading lots of different birth stories. It gives you a better idea of the wide range of possibilities, labor “types,” coping mechanisms, and birth philosophies.
Let’s bring you up to speed . . . After having a cesarean section with my daughter in April 2004 via a low transverse incision, I knew I wanted a VBAC for my next child. It was only after a couple years of reading and researching did I start to consider, and ultimately decided, to plan a homebirth VBAC (HBAC.)
This pregnancy was so different than my daughter’s and I attribute that to several things. First, the superior prenatal care I received from my midwife, L. One of the major discomforts many women experience during pregnancy is constipation. I suffered my entire first pregnancy, but the solution is so simple: fish oil, flax seed oil, and a calcium/magnesium supplement daily. I was also aware of optimal fetal positioning this time around, which I knew nothing about with my first. I think my daughter was in a footling breech presentation because I was working from home three days a week with a computer on my lap, sitting in a recliner for 8-10 hours a day. I now know that this position contributes to a variety of abnormal presentations including breech. This pregnancy, being a full-time mom, I don’t spend much time on the sofa anymore and most of my time on my feet.
In addition to contributing to a vertex baby, being an SAHM affected me a couple of other ways. First, during my pregnancy with my daughter, I was very conflicted over whether to quit my job or not. That stress was not present this time. Second, I didn’t have the general stress associated with working full-time. Being a SAHM is stressful, but it’s a different kind of stress and, for me, it’s far less stressful than working full-time. So, my overall stress level was lower and I was more peaceful. Enrolling in a Hypnobabies home study course also contributed to my overall mentality of peace and confidence. I did not have problems sleeping because I fell asleep to the Hypnobabies scripts every night. This daily relaxation, and slow rewriting of those often incorrect deeply held beliefs about pregnancy and labor, put me in the perfect state of mind. I experienced fewer aches and pains and my body felt fantastic until about the last week of pregnancy. I attribute this to exercising 2-3 times per week and seeing an Osteopath (DO) who specializes in Osteopathic Manipulative Medicine or OMM. Not only did this eliminate back and hip pain, but she also ensured that my pelvis remained aligned providing the baby with the largest pelvic outlet, and hopefully shortening my labor. (Find a DO near you.)
I was so pleased that the baby was vertex, or head down, at every prenatal appointment. At 36 weeks, I started to get a little worried about the baby’s position, but L confirmed that baby was still vertex and at 38 weeks, the baby was engaged in my pelvis. I was thrilled!
In the wee hours of the morning on Friday, November 16, 2007, I woke up to a growling stomach. I laid in bed for about 15 minutes before decided to get something to eat. I had some cheese and then some yogurt and then got sucked into the latest ER. I look back now and wonder if my body was preparing itself to go into labor in just a few hours.
At 511am I woke up to a contraction, probably lasting about 30 seconds. I grabbed my iPod and started listening to my Hypnobabies scripts. After a couple more contractions, I sent a quick email to L and a friend letting them know that I thought labor was underway! My husband, T, started waking up. He had a meeting that afternoon to transfer his projects to coworkers since he planned to take two weeks off once the baby was born. I told him that he should go in now and move the meeting to the morning – labor had begun! He quickly got dressed, gave me several kisses, and ran out the door.
One of the Hypnobabies scripts has you envision your labor: when it will start, what the weather is like, who is there, where you are, every detail. One of the things I always envisioned was labor beginning after a good night’s rest! And despite my midnight snack and TV watching, I felt rested and very calm. I stayed in bed for about an hour, having another 4 contractions during that time, and then my daughter, K, woke up. Time to start the day! I told her how I was having “belly squeezes” and she knew that this meant that she had to be very quiet during belly squeezes. For the next 90 minutes, I ran around the house, trying to clean with contractions coming about every 3 – 5 minutes. That last week, I had been so tired that I had completely neglected the housekeeping and I wanted to at least pick up a bit.
At 8am, I called my midwife and, as luck would have it, she was with another client in labor! After a couple minutes of chatting, she said, “Oh, we are pushing here!” and we agreed to chat later in the day.
I hopped in the shower and then starting actually tracking contractions at 817am. For the next two hours, K and I labored. It felt best to lean over the countertop in the kitchen, push/lean against the wall standing, or fall to my hands and knees. I was quietly using my Hypnobabies cue, “Peace” over and over again and K, right next to me, would be copying my position and saying, “Peace.” She would also rub my legs, which I gently told her to stop – I don’t like being touched during a contraction. She was really great during that time and contractions where coming about every 4-5 minutes lasting about a minute.
I called T at 9am and pleaded that he hurry up! He had coworkers around his desk and they were having the meeting as we spoke. Yeah! I settled into the guest room where we had the tub set up and started playing my Hypnobabies scripts through my iPod speaker. T got home at 10am and started tracking the contractions and filling the birth tub. At 11am, I got in the tub for the first time. It felt great until I had a contraction. My contractions were going down my thighs, almost like a leg cramp, so lying down was horribly painful. I needed to have that counter-pressure created my standing on my legs. That felt more comfortable. In addition, my contractions slowed down to 6-7 minutes apart and even two that were 12 minutes apart. Despite this, I stayed in the tub for about an hour because it did feel so good between contractions.
Around this time, we called a friend and asked if she could pick up K and take her to another friend’s house who was going to watch her for the day. K, trying to be so sweet and supportive, wanted to get into the birth tub with me but that would certainly disrupt my concentration. It was time for her to go. At 1150pm, we noticed some bloody show in the tub. Yeah! Progress! As T installed K’s car seat into our friend’s car at noon, I started to vocalize and moan. Labor was intensifying. Once T came back, I got out of the tub and tried a few contractions on the birth ball which were ok, but standing still felt the best to me, so that is that I continued to do. At 1240pm, my contractions started double-peaking. I had more bloody mucous at 1250am and I started to have hot and cold flashes.
I had tried a few times earlier in the day to labor in bed, and it just was to painful, but I decided I needed to refocus and try my Hypnobabies again by lying down in a fully supported position so I could completely relax. I became very sensitive to sound. Hearing the crunch of the plastic sheeting as T walked down the hall was excruciating to me. Within minutes, my water broke and I immediately thought, “Ok, things are going to intensify even more now.” It was shortly after 1pm.
I got up and quickly walked down the hall to the shower feeling something bulging between my legs. Reaching down, I felt an almost C-shaped balloon. I wondered if it was the cord but it wasn’t pulsing and as soon as I got into the shower, it broke – it was the rest of the amniotic sac. Being in the shower felt good for a microsecond and then the shower massage setting started to bother me and I didn’t have the mental clarity to fuss with it or tell T. I walked from the shower back to the birth tub and decided to give this another try. While this was going on, T called L to fill her in. She was finishing up the other birth at the birth center and was on her way. At 130pm, I told T to stop using the kitchen timer, which we were using to time contractions, because the beep was driving me crazy. I was laboring in the tub on my hands and knees and I lost any sense of time. I turned to T at one point and said, “I can’t do this.” I started to get scared and really felt like it wasn’t ever going to end. T was so incredible. He told me, “This is all going according to the book. It’s all normal. You are doing great.” We had this conversation at least a couple times. It was the most vulnerable moment of my life and he helped me cope. He was so calm, collected, and confident. What a moment to share. No else there. Just the two of us, laboring, coping, supporting – it was tremendously intimate and private. Just like I wanted.
Around 230pm, L and her apprentice C arrived. I was so relieved because I was starting to feel the urge to push and it seemed to me that L walked in, put on a glove, and then was supporting my perineum as I pushed on my hands and knees in the tub. There was no need to check my dilation since L could easily see a purple line leading up to my sacrococcygeal joint -the presence of this line meant I was fully dilated. Labor was so intense at this point that I started to yell at the beginning of each contraction which was excruciatingly painful. I also was using the F word a lot and was very relieved that K wasn’t there. If I had been able to be more serene and calm, like I envisioned, it would have been wonderful to have K there, but I was far from serene. And I really resisted starting to yell, but it did feel so good to just channel that energy out of my body. I felt like there was this power going through me and I had to expel it and yelling helped me do that.
Nature is kind and my contractions spaced out quite a bit giving me a nice break between pushing. I remember being in the tub, on my hands and knees, with my eyes closed, slowly waging my head back and forth. This was very soothing to me.
It amazed me how much power was flowing through me. It’s quite humbling to see your body work so hard. It knows exactly what it’s doing – you are simply along for the ride following your instinct on positions and pushing. It seemed that my contractions peaked very quickly and then I had about 75% of the pain which felt manageable. What was very difficult was to try to recover from that peak of pain, take a breath, and then push before the contraction ended. After about 20-30 minutes of pushing on my hands and knees, L suggested getting out of the tub and pushing in a squat. I was willing to try anything at that point, but since my contractions were going down my legs, I couldn’t support myself in a squat position, so I got on the birthing stool which I loved. Things seemed to progress very quickly at this point and I got to experience the legendary ring of fire.
It seemed to me that he was born within one of my super-long contractions. At one point, I reached down and felt the head just as it started to emerge and that was the most wild feeling. Soon, I heard L say, “I see lots of hair!” and then “I see ears!” Once I felt the ring of fire, I knew I wanted this over fast. Plus, the notion of his head half-way out for any longer than necessary was unbearable. As soon as the head was born, relief swept over my body. The next push, the body was born. Within 30 minutes of moving to the birth stool, at 328pm, M was born.
It quickly became obvious why things were so painful – M was a big baby at 9 lbs, 10 oz, and 21 inches… but it was the fact that his head was 14 inches in circumference, not including the nuchal hand – his hand was up by the side of his head. Yet, I, a VBAC mom with an “unproven pelvis,” was able to birth this baby, whose weight placed him in the 95th percentile, resulting in just a couple labial tears requiring 4 stitches, and an intact perineum. I felt victorious.
As soon as he was born, L put him right in my arms. I was in complete shock that I did it. I could not believe that I finally gave birth! Immediately L noticed that I was bleeding to much. She told me she was going to give me a shot of Pitocin in my leg. Within a minute or so, she gave me another shot in my other leg. I moved from off the birth stool into bed and while I started to nurse the baby, they gave me a couple doses of Placenta Out. I wasn’t feeling any urge to push, but L was concerned about my continued bleeding, so I tried to push the placenta out as I laid in bed. My legs were so tired, and I was so tired, and after pushing on the birth stool, pushing on my back in bed felt impossible. I remember wondering how anyone could push a baby out lying down. So, I scooted to the edge of the bed where I pushed more and the placenta was finally born. Turns out it had partially separated so all the blood that would usually go into the placenta was just flowing out of my body.
While this was all going on, I thought of a birth story I had read in Midwifery Today where a midwife experienced a post-partum hemorrhage. She described how she felt so warm and comfortable – how she just wanted to close her eyes and go to sleep. I never felt that way, so I wasn’t scared plus I had complete confidence in L. We were talking the whole time and I felt alert, strong… not scared. L attributed how well I handled the hemorrhage to the “green” supplements (alfalfa, spirulina, or chlorophyll) she recommends during the third trimester. This builds up the vitamin K in the mom’s body so her blood clots better and aids in her body’s ability to cope with, and recover from, hemorrhage. She also gave me a pill of Methergine which caused some rather intense uterine contractions, but helped further reduce the bleeding. The entire time, I was able to hold and nurse M.
L and C stayed at the house for several hours cleaning up, inspecting the placenta, making placenta prints, conducting the newborn exam, suturing me up, and observing me and M.
My mom asked me the next day, “Are you glad you had a homebirth?” and the answer is “Yes!” for so many reasons. Now that I’ve had a homebirth, I simply could not imagine birthing in a hospital. It was so incredible to just have people I know and trust at the labor. No random nurses. No shift changes. It was incredibly intimate to share the bulk of my labor with just my husband. I loved being in my own home, using my own bathroom and when I wanted to take my clothes off and just be naked, I could do so without worrying about whether I had a private room or not, and who would be walking in. I also doubt I would have been able to labor and deliver in so many different positions. I’m certain my local hospital does not have a birthing stool. A doula friend of mine talked about how she attended a hospital labor where despite the fact that there was a poster on the wall showing various labor and delivery positions, the nurses insisted the mom labor in bed and deliver in bed, on her back. The difference between marketing and reality are gigantic.
I also couldn’t imagine laboring with a heplock or IV in my arm. Some friends of mine made a “birthing bracelet” where they each contributed beads representing them and their families for me to wear during labor. I wore it till 10am and then took it off because I couldn’t stand having something around my wrist. Now imagine a heplock, complete with medical tape securing its position. That would have driven me nuts. Since lying in bed was excruciating, I would have been miserable in the hospital since my OB required 20 minutes of external fetal monitoring every hour for VBAC moms. (This is actually a very liberal requirement since most OBs require continuous fetal monitoring the entire labor limiting your movement.) That alone would have had me begging for my epidural. A friend birthed her son with a nuchal hand and once her OB saw that hand, he gave her a nice big episiotomy. I wonder if the same would have happened to me if I was in the hospital especially if the OB suspected a “big baby.” I also would not have been able to labor in the tub, if there was even a tub available to me, after my water broke. I would not have felt comfortable yelling, and ultimately screaming the last 10 minutes, if I felt that random medical professionals and fellow patients could hear me. I wonder how the stress of transporting to the hospital, checking in, and “getting settled” would have affected my labor. Would being in an unknown environment cause labor to slow down or stall? Would it have lengthened my labor since stress hormones inhibit progress? I suspect that if I was in the hospital and hemorrhaged, there would have been loads of drama and I wouldn’t have been permitted to hold my baby while they got the bleeding under control. Whereas, L handled things beautifully, calmly, and in complete control.
I’m so glad I didn’t have any vaginal exams checking dilation during those last few weeks of pregnancy. Women, especially second time moms, can walk around 2-5 cm dilated for weeks. It really means nothing in terms of predicting when labor will start. Your cervix can also be high and closed and you can go into labor that night. You can decline vaginal exams during pregnancy and labor. I’ve read to many stories of women working so hard during labor only to find out they are 3 cm – this does not keep you in the best mental state during labor. I spent my labor coping contraction by contraction trying not to think “How much longer is this going to last?!”
I’m also glad I had no idea how big he was. With all the worries about “big babies,” loads of women are coerced into believing elective cesarean deliveries are safer even though ACOG’s Practice Bulletin No. 22 does not recommend inductions or cesareans for suspected big babies less than 11 lbs. Or they are simply terrified of childbirth and it’s just an excuse. This is so sad that women in our society are so scared of a normal event. That said, I know if I knew how big he was, that would have affected my mindset during labor, especially during pushing. I probably would not have been able to fully relax and I might have torn my perineum. If I had an OB, I wonder if s/he would have suspected “big baby” and ordered an ultrasound resulting in a weight estimate and then a discussion about “what do to” especially since I’m a VBAC mom and some OBs have extra fear when a VBACing mom has a suspected big baby.
It was great knowing that L, C and I were all on the same page. I didn’t have to decline or request a thing. They already knew what I wanted and didn’t want so there was so need for unnecessary discussion in the heat of labor. I simply could not imagine having to debate an unwanted intervention in the mist of that pain.
And speaking of pain, I am no hero. My heroes are the women who birth in hospitals and manage to do it without pain medications. If I was in the hospital with drugs immediately available, I don’t know if I would have been able to decline drugs. I suspect that I would have ultimately received some type of drug. I knew that my best chance of having a successful vaginal birth was if labor progressed naturally, without outside interferences such as pain meds or drugs like Pitocin to hasten labor. And I knew home would be the only place I could guarantee that happening.
Recovery has been so incredibly different. Within an hour of giving birth, I was able to get out of bed, walk to the bathroom and urinate. No catheter. No “recovery room.” No waiting to eat or drink. No waiting for the spinal to wear off. No uncontrollable itching (a side effect of my spinal), requiring IV administration of Benadryl and morphine causing me to pass out in the mist of a huge visit of friends and family. No itchy IV and associated tubes. The ability to immediately hold and nurse my baby.
No hospital food. I had fresh made-to-order scrambled eggs and lemonade. No hospital bed. Just our comfy guest bed with our own sheets. No machines beeping recording my vitals. No nurses waking me in the middle of the night to get my vitals. No baby in the bassinet across the room from me, which, since walking was so painful, might as well have been across the hospital. M was snuggled up right next to me. No need to take major painkillers. While my enormous hemorrhoids and four stitches were relatively painful, I didn’t even take an Aleve until the second night of M’s life and I’ve only taken 5 Aleve this first week. Compare that with taking Vicodin 24/7 the first two weeks of K’s life and that still not eliminating the pain. It’s been 8 days since M was born, and while I am tired, I feel like me. I didn’t feel like myself for months after K was born. My body is not healing from major surgery. My nether-regions are healing nicely and I’m able to walk and sit without any discomfort. 8 days post-partum with K, I was still in considerable pain especially when trying to maneuver in bed. It was also amazing to be mentally clear at delivery – I had narcotics pumping through my system when K was born, so the intensity of the moment was dulled and that makes me so sad.
There is one other huge difference. This time, I actually gave birth and felt a tremendous sense of accomplishment. I was so devastated that I had to have a cesarean with my daughter. I was so looking forward to labor and giving birth and when that was taken from me. . . I was devastated. There are women who have had cesareans and feel like it was a birth – I’m just not one of them. K was surgically extracted from my body… which is very different than being born. And I felt like there was this huge thing that I hadn’t experienced which contributed to what made me a woman and a mom.
M’s experience was also very different than K’s. The first people to touch her where a bunch of random, anonymous people we didn’t know and wouldn’t recognize on the street because they were in full surgical garb. L guided M out of my body and then handed him immediately to me. K had a long tube stuck down her nose a couple times to get fluid out even though she had good muscle tone, was pink, was a term birth, and was crying, and thus clearly breathing on her own. M had no suctioning of any kind as it wasn’t necessary and nothing is done “routinely” at a homebirth.
There were no nurses asking to take M for “routine” procedures. K was rubbed vigorously and “cleaned.” M was held lovingly by me . He smelled so wonderful as is. No bath. No wiping off the vernix. This is absorbed into their skin. There is no need to “clean” the baby other than wiping away blood. “Early bathing of the baby removes vernix, which contains antimicrobial proteins that are active against group B. streptococcus and E. coli. Delaying the bath and keeping the newborn together with his or her mother until breastfeeding is established may prevent some cases of devastating infections caused by these bacteria.” (Akinbi, 2004)
We delayed clamping the cord until it stopped pulsing – something that was in my birth plan for K’s birth, but didn’t happen. I suspect because it was routine to immediately clamp and cut the cord. M got the benefit of all the blood from the placenta, whereas K did not.
M got all the benefit of the good bacteria present in our home: “Term infants born at home and breastfed exclusively had the highest numbers of bifidobacteria [good bacteria] and the lowest numbers of C. difficile and E. coli [pathogenic/ bad bacteria] compared with any other group of infants.” (Penders, 2006) Whereas K was exposed to all the bad bacteria present in hospitals: “Each day of hospitalization after birth was associated with a 13% increase in the rate of colonization with C. difficile.” (Penders, 2006)
All of these interventions can collectively interfere with breastfeeding. “Vigorous suctioning can create oral aversion as the baby protects himself by keeping his mouth shut (Kroeger & Smith, 2004). Overstimulating the baby with multiple assessment examinations, suctioning, weighing and measuring, heel sticks for glucose checks, eye treatment, and injections can cause the baby to “shut down.” The result is a sleepy baby that is difficult, if not impossible, to nurse. Routinely separating babies from their mothers for evaluation and bathing during the minutes and hours after birth disrupts the baby’s ability to find the breast and self-attach (Righard & Alade, 1990). Bathing possibly removes the smell of the amniotic fluid, a guide to finding the nipple. These birthing practices—induction, epidurals, instrument delivery, routine newborn care, and separation of the mother and her baby—create many of the problems we see in the early hours and days of breastfeeding.” (Lothian, 2005)
While I had considerable problems nursing K – undoubtedly from my inverted nipples, the suctioning she endured, the surgery and resulting drugs pumping through both of our systems, being separated from me immediately after birth and for that first hour – I had no problems nursing M. He was placed skin-to-skin on my chest and latched on.
Even though I felt a lot more than just “pressure” during my labor, I am very glad I did the Hypnobabies home study. First, it helped me learn how to relax. When I was pregnant with K, we did Bradley and they said to relax for 15 minutes a day. It might sound weird, but I didn’t know how to relax other than watching TV or reading a book… and taking a bath every night seemed like a big waste of water. Hypnobabies helped me learn how to relax my body from head to toe and this relaxation helped me sleep better. This ability to relax, and concentrating on not tensing my face and hands, was helpful in early labor. There were also times when I started to get nervous about VBAC. The fear of wondering if I was crazy to homebirth. The fear of me being that statistic. Hypnobabies has a great VBAC CD set that helped put my mind at ease. And during labor, the thought of uterine rupture only crossed my mind once in early labor.
There were several tools I found very helpful that I learned from Hypnobabies. I loved the “peace” cue and used that a lot in early labor. Just quietly saying it almost like meditation. Even more, I loved the phrases, “your cervix is like melting butter” and “your cervix is so soft and stretchy,” and saying “open, open, open” while visualizing my cervix opening. I did this a lot. It’s hard for your body to tense when your cervix is melting like butter. I was also very aware of keeping my body as relaxed as possible during contractions and was able to do this for the bulk of my labor. It was only until the last 90 minutes when it was impossible to remain still and peaceful.
During pushing, I had the “Second Stage” script playing and at one point it says, “Anesthesia is flowing in front of your baby’s head.” At that moment, I was in a tremendous amount of pain and was not feeling any anesthesia, so hearing that really bothered me and I yelled, “It’s so fucking not!!”
Eight days later, we are adjusting. Breastfeeding has been established. K, at 3 years, 7 months old, is my big nursling now and I’m so glad that she has continued nursing. Adjusting to M has been hard for her. She is affectionate towards him, but has had lots of crying over random things and sometimes over nothing at all. Nursing has been a way for us to reconnect and have some special time after having so much of my time focused on M. I have explained to her how it was because M was born that I have milk – I’m hoping that this will ease this transition for her. Additionally, having an older nursling is invaluable when managing initial engorgement. M does have a touch of jaundice, but is doing great.
We are cloth diapering using the same wonderful diapers I used for K – Motherease Sandy’s, OneSize, and FuzziBunz – all of which I purchased used off of eBay making cloth diapering even more cost efficient. (Believe it or not, I spend more time telling people how easy it is to cloth diaper, than actually washing the diapers. It is a piece of cake and no midnight runs to the store because you are out of diapers! Plus, no poop “blow outs” or “up the back” poops – the only time this has happened to me is when K was wearing disposables. Cloth diapers are more fitted and thus you don’t have this kind of leaks!)
I owe so much to the wonderful women of the ICAN YahooGroup. In a world where people really believe that VBAC is risky and cesarean birth is safe, it is refreshing to be in a community of women all seeking VBAC. The information available to anyone who joins this group is absolutely invaluable if you plan on having a successful VBAC. There is so much research published continuously on VBAC, repeat cesareans, and birth in general, that it’s virtually impossible for anyone to stay on top of it. With so many (mostly) women coming together, sharing information from a multitude of resources – it is a must for any woman seeking a normal vaginal birth, not just VBAC. And while we are on the topic of supporting normal vaginal birth, why not join ICAN and help them further their mission of preventing unnecessary cesareans, supporting women who seek VBAC, and also providing post-cesarean support as well as post-VBAC joy? I became a Childbearing Member about a year ago which is a small way to support their mission. This is an organization that works so hard to advocate for a woman’s right to seek normal birth and not be bullied into surgery which is what happens every day around our country especially in more rural areas where the only hospital in town has “banned” VBAC.
Thank you to my incredible husband who trusted in my research and supported me every step of the way. After M’s birth, T told me that unless I was dying, he wasn’t going to let me transfer to the hospital because he knew how much it meant to me to birth our child. I never once asked to go to the hospital, but in that moment, where I felt like I truly could not do it, I thought of what it would be like to endure these contractions sitting in a car… that was out of the question!
It has been such an honor to be able to have this experience. I am humbled by birth. 11/25/07
12/30/07- I finally figured out how to have comments on pages, so please comment below. Previously submitted comments on my birth story can be read here.