by Julie Tilsner
I have to admit that by my eighth month of pregnancy, I couldn't tell what I dreaded more – remaining hugely pregnant until my due date in mid-July or launching early into labor – an un-medicated, all natural home birth – an experience that I'd signed eagerly up for just eight months before. Every night as I hauled myself out of bed nine or ten times to pee I would feel strange little contractions; little jabs of pain down low, as if my body were trying to remind me as gently as it could about what labor and childbirth really felt like. "Dear God," I'd whimper. "What was I thinking?"
Three and a half years ago, I had my daughter Anna in the hospital. But because I'm such a wimp about needles (I panic at blood tests), I forwent all pain medication until, I told them, "The pain is worse than that big scary epidural needle." Needless to say by the time I asked about the morphine drip, it was practically time to push. So I had a natural childbirth despite myself.
So it was this extreme aversion to medical procedures in mind that I went looking into a birthing center option when I learned I was pregnant with my second child. Strangely enough, however, there are no longer any birthing centers in San Francisco or Berkeley. So I went directly to the home birth alternative. Through referrals I found a midwife I loved on the first meeting: Jen Bauman, who came along with her effervescent apprentice, Rebecca Smith. Jen was my age (35), and exuded both a love for midwifery and a quiet confidence that assured me she could handle the job.
Over the course of my pregnancy, Jen and Rebecca came to my apartment more than 11 times for my pre-natal exams. We'd drink tea on the floor of my small student family apartment while they took my blood pressure, and checked my weight. They asked me what I was eating and how many glasses of water I drank each day. They gave me information on herbal alternatives to prenatal vitamins, such as nettle infusion and raspberry leaf tea. They wanted to know what my fears were, what my hopes were, how my daughter and husband were faring. Finally, we'd repair to the bedroom, where they measured my growing belly with squeals of delight, and listened for the fetal heartbeat with an old-fashioned, low-tech listening device. By the time my son was born months later, I could call both women good friends.
The contrast with my pre-natal appointments with my health care provider were glaring. It took weeks to sort through the complicated process for getting my initial blood work done, and yet each of my six meetings with a nurse practitioner lasted all of five minutes. I was a faceless number. But my midwives advised me to keep these appointments so that they'd have my details should some complication arise during the birth that necessitated my being "transported" to the hospital.
I wanted a home birth not only because I hate shots. I really do believe that pregnancy and birth are natural states for a woman, and that if there are no medical complications, then there's no reason to treat it as a condition to be "cured." This is the norm in many Western European countries (In Holland, I understand, you need a good medical reason to have your baby in the hospital, otherwise, it's home births for everyone!). I also felt that since I'd already experienced a natural childbirth, I was prepared for the pain of labor and was up to handling it at home.
Women who choose home birth are a self-selected lot, with a whole host of alternative views ranging from the merely "alternative" to the downright nutty. I fall firmly onto the more mainstream side of this group (which may still seem pretty far out to some folks). For example, I see nothing wrong with getting an ultrasound, which some home-birthers are firmly against. I will vaccinate. I will circumcise. I will use disposable diapers, and I won't nurse for more than a year. While I might plant my placenta under a new fig tree, cooking it up in a pie is definitely not something on my to-do list of life. Fortunately, Jen, my midwife, could be as crunchy – or not -- as I needed her to be. "How you decide to parent your child is your job," she told me. "My job is to keep you healthy during your pregnancy and help you deliver a healthy baby."
My water broke at 3 a.m. on July 12. I sat straight up in bed, no mean feat for a hugely pregnant woman, and braced for action.
My husband slept soundly beside me.
"Huh? Snoring? Sorry." He rolled over.
"Luke, my water just broke!"
They should record that statement on clock radios. I've never seen a man go from deep sleep to full coffee mode so fast. We put on our bathrobes and turned on the light. Luke checked Anna, who was blissfully oblivious to any of this.
No contractions yet, but I paged Jen anyway, to let her know today was the day. By coincidence, we'd had a pre-natal exam scheduled for this morning. "We’ll be there this morning," she told me. "But call me if you see any meconium or if your contractions start to get bad."
We had spent a lot of time discussing my labor fears. Yes, it's true I'd already done this once, but that only meant I was very clear about how much pain was involved. And the closer B-day came, the more I worried about whether my decision to do it at home was the prudent choice. What if something went wrong? What if the pain was worse? But there was no turning back now. I bounced on my big blue yoga ball and turned inward. I felt a little afraid. I felt very open. I was going to meet my son today. And it was going to hurt. A lot.
By the time my midwives came for our scheduled appointment at 9 a.m., the contractions, which I wasn't bothering to time, were getting tighter, although they weren't what I'd call painful. Jen and Rebecca seemed confident that I was progressing well, and that we still had plenty of time. They went off to their next appointment and told me they'd be back after lunch. In the meantime, Luke dropped Anna off at her pre-school.
There was a lot of discussion about whether we'd have Anna in the room watching the birth. It seems a lot of home-birthers wanted to include their older children in the birth, but Luke and I didn't feel this way. Our daughter is very sensitive (the first time she saw kids hitting a piñata at a birthday party, she burst into tears and tried to rescue it.). I honestly don't think a 3 and a half-year-old can understand that mommy's howls of pain are actually a good thing. And we didn't think our particular 3 and a half-year old would get much out of the experience besides a bad fright. The timing in this case, then, couldn't have been better.
Anna watched me quietly as she ate her Cheerios that morning, while my midwives took my temperature and checked my blood pressure. She might have sensed something was going on. I told her that her little brother would probably be here when she got back. She had no comment. I kissed her goodbye and Luke took her to pre-school. I was hugely relieved.
I briefly wondered if everything in my birth kit was assembled and ready. For home births, you order a birth kit that has everything from highly absorbent "chuks" for the birth to homeopathic remedies that will help you heal afterwards. I had my space heater. I had my 10 to 20 receiving blankets. I had the shower curtain cover for my mattress. Whoops. I realized I hadn't gotten my two sets of sheets ready. Oh well, they'd just have to find them themselves.
Luke returned and my labor progressed steadily. Things got ugly just before noon. The controlled breathing gave way to long, low moans, as each contraction got more intense. I took up residence at my bedside, rocking back and forth on my yoga ball and laying my head alternatively on Luke and a pillow. I tried to keep my mind empty.
I soon lost track of time altogether, although I vaguely remember the midwives' call. They could hear me groaning in the background and told Luke they thought the baby would be here in two hours. They'd be right over, they said.
Their timing was perfect. I was transitioning just as they arrived, and the pain was fantastic. It was a lot like surfing a wave of pain – the contraction would swell; gain power, crest, and then ebb. I'd moan, yell, or howl my way through each one, concentrating on my voice in front of me, and in between the waves I would float in nothingness. By the last handful of contractions, my moans had degenerated into odd "Wa-wa-wa-wa-wa!" sounds from deep in my throat, trying to counteract the pain wracking my body.
I couldn't have done it without Luke, who held onto me and let me make animal sounds into his shoulder and draw blood from his arms. Every now and then he'd whisper an encouraging phrase, like "You're almost there," and "It's almost over." When my wails reached a panic high-pitch, he'd wail an octave lower, holding my eyes with his and bring me back down. Rebecca would comment later that the two of us were like one laboring unit.
Doctors would say that my final opening contraction was very good. Very effective: which is to say, monstrously painful. I cursed and screamed and pounded on Luke as Rebecca, pushed on the exact spot on my lower back where the pain was most intense. The pressure built up hideously until an explosion of amniotic fluid spilled out of me and soaked my robe, my yoga ball, and my rug.
"Push! I gotta push!" I howled, throwing off the robe and bouncing hysterically on my ball.
"If it's time to push," said Jen calmly, "then I suggest you get off the ball."
The three of them hoisted me onto the bed, where I was free to assume whatever position I needed for maximum pushing leverage.
In the hospital with Anna, they'd screamed, "Push! Push! Push!" at me and given me 30 seconds to catch my breath before starting again. It was a horrible and exhausting two hours. Midwives do it differently. It was like we were on the baby's time and no one else's.
I bore down with each contraction. Nobody screamed anything. Nobody worried about how long the baby was in the birth canal. Nobody worried that he wouldn't fit. When the head began to crown, there was no panic to get him out. Instead, Jen and Rebecca let the head push against me, stretching out what needed to be stretched out, all the while massaging me with olive oil and their fingers. The "ring of fire" women talk about lasted what seemed like a long time, but in retrospect this was good, and prevented me from tearing at all. Jen asked me if I wanted to reach down and feel my baby's head, which I did, tentatively at first, then with more genuine curiosity after feeling a hard, warm orb with hair. A few more pushes and Rebecca held up a hand mirror so I could see this orb. Jackson's head! That encouraged me to push all the harder the next contraction. Pain be damned! Suddenly, his head was out!
"Julie," said Jen, "I need you to get on your hands and knees."
I didn't know this at the time, but Jack's arm was up by his neck, blocking the exit for his shoulders. Jen knew that it would be easier for her to slip that arm out and deliver the rest of the baby in the more open hands and knees position. Luke helped me flip over, and in a matter of seconds, our son slid out into the waiting hands of our midwives.
Jackson David was born at 3:30 p.m. in the afternoon. He emerged pink and lusty, waving his arms and crying at the insult of birth. "Hey, I liked it in there, lady," he seemed to be saying. "And who the heck are all these people smiling at me?" Luke was crying. I was dazed, but accepted him onto my chest, still pink and covered with gunk, and still attached to his umbilical cord. The midwives popped a warm cap on his head and put a receiving blanket over him. The room was already very warm so the space heater was never needed. Amazingly, the placenta slid out within five minutes. The midwives put it in the biggest bowl we owned, our plastic salad bowl, and set it next to me while I gapped at Jackson, crying on my chest. Jen and Rebecca slipped out of the room a few moments later to let us have a few moments alone with our son.
My mom showed up half an hour later and started organizing the washing of the sheets, the cooking of the soup. My midwives put fresh sheets on my bed and set about examining the baby and me. Rebecca came in and fed me soup. At some point they took Jackson and let me sleep for an hour, alone in my own bedroom, on my own bed, covered in a clean quilt. The shades were drawn, but I could still hear the wind chime dancing somewhere on a neighbor's patio.
There is a seamlessness to home birth. You're going about your business at home, then suddenly you’re in labor, and then you have a baby. This morning we woke up as a family of three. Tonight we went to sleep as a foursome.
Julie Tilsner is a mom of two and can't keep her apartment clean for love or money (or so she says…). Her insightful, humorous and helpful books include the following and can be purchased through these links: 29 And Counting: A Chick's Guide to Turning 30, Planet Parenthood, and Attack of the Toddlers.
Copyright © Julie Tilsner. Permission to republish granted to Pregnancy.org, LLC.