Our HBAC Story
Before our firstborn, more than 4 years ago, my HBAC story began. I read about a homebirth in a mainstream magazine; some celebrity had given birth at home and I felt it was staying true to one's body and mother nature to have a natural childbirth at home. Living in Maryland, I took some time finding a practice that included midwives; however, by the time we were pregnant in 2005, the midwives had left the practice due to increased medical insurance costs. I assumed this meant they were not practicing and that a homebirth was out of the question. The OBs in the practice were amicable and since I also assumed because I wanted my body to have a natural, vaginal birth, it would; I stayed with the practice without investigating other options. In hindsight, I wish I had done more investigating about the medical perspective of birth versus the natural perspective of birth.
My pregnancy progressed merrily along to 42 weeks, so of course the OB (male) spoke to us using all of the scare tactics and explained why he wanted to induce. I knew once we induced our chances of a vaginal birth were slim, so we tried numerous other things first. I cried the whole night before the induction. Because we didn't feel our doula remained calm with our OB's scare tactics, we ended up asking her not to attend our birth. Instead, my sister, mom, some great nurses and my husband were in the the labor room with me. Exhausted after 19 hours of labor and only progressing to 4 cm, I was hungry and tired and so, through no pressure from my OB (female), I made the choice to have a cesarean. The fact that I made the decision was helpful to my emotional recovery and thankfully, our baby boy was healthy and happy and I knew we were blessed for that.
Everyone's body and mental image reacts to a c-section differently. I knew I didn't enjoy the side-effects of the c/s: itching directly after coming off the epidural, nor the recovery of the c/s, not remembering anything about our baby from after the birth. What I did remember, I didn't like. I remembered: my anesthesiologist telling me I wasn't cold when I was shivering, but giving me warm towels anyway; feeling my stomach pulled, feeling our baby being pulled from me, my OB holding him up, but not being able to hold him, itching like crazy as I came off the drugs, and laying on a table in the recovery area, not seeing my husband or baby, and not feeling the desire to see our baby. These memories would come back to me in my second pregnancy quite vividly, especially in the middle of the night. In the midst of all, I also remember my nurse sharing a ray of hope with me "You can always vbac, I did." I was exhausted and had a long road to recovery ahead of me.
So, before getting pregnant a second time, I took the time to research options in our area and was stunned to find a practicing midwife just miles from our home. When I went to meet her she asked me if I had ever considered a homebirth. Whoop! Started thinking about HB again and I knew for this pregnancy, I would be more careful about the assumptions I made and do more reading to prepare myself for the process.
Unfortunately, before we became pregnant, we were transferred to Houston, Texas which is not a very friendly VBAC city. I quickly surmised if I wanted to do a vbac I would need to find a midwife willing to do a HBAC. It's a big place, so I interviewed quite a few. Each midwife had a quality that I liked and it was difficult to choose. In the end, while all of the midwives we interviewed exuded confidence, I felt some were too overbooked, some were too new, some were too far away, and some had too much of a medical background which I felt might adversely affect our birth. We chose Chris Duffy because of her belief in a woman's natural ability to birth and because of her references. (We did have the choice to use a midwife with a birth-center and a back-up OB, and did have the choice of a few OBs who would still perform vbacs in a hospital; I chose home for optimum amount of success. I was afraid if we went to a hospital, I would cave to their pressure).
We were already at least 3 months pregnant by the time we chose a midwife, but once we chose a midwife, my commitment to a HBAC began. I used all of the resources suggested to me from all of the midwives I had interviewed, websites, ICAN, other people who had done HBAC/HB. I read all of the books suggested for vbacs and natural birth, I followed the suggestions of Chris for vitamins, I exercised, visited the chiropractor, ate well, looked for positive stories, quotes and support and played with our little boy; and still I vacillated between confidence and worry. The one time I had to go to a mainstream OB for an ultrasound reminded me of how happy I was to have a midwife. I was able to spend quality time at our visits, didn't have to wait to be seen, didn't have to do unnecessary tests such as the glucose test. Our pregnancy just progressed. Naturally.
Because our midwife did not have a back-up OB; another worry for me that kept surfacing was being afraid that if I didn't progress, I would have to go to a hospital and have a c/s with a doctor I did not know. In our first birth, the nurses had made numerous comments that our female OB performed much better c/s than our male OB; I had a friend whose c/s left her skin scar slightly off kilter, and I was mostly afraid of being butchered or laughed at and being treated poorly if we had to go to the hospital. This worry was stronger than being worried about a rupture or anything happening to the baby...that was never a concern for me ironically. A doula we interviewed supplied us with good wisdom, "if you have to transfer and speak intelligently about the situation, they will treat you with respect."
Because I needed only positive chi and didn't want to have to soothe anyone else's fears except my own or defend our decision to anyone, the small circle of people we told our about homebirth included only one family member, 4 friends, 1 friend who had a HB and one of Chris' references who had just had a hbac. I used the last two immensely the last month of my pregnancy. I shot them quick questions on email and their responses were so helpful and supportive.
So most days, I visualized a homebirth in a positive way. I bought a picture frame to envision the photo that I would place in it; a photo of us holding our baby in our bed at our home. I printed off positive quotes, searched for HB stories, read, talked and tried to focus. I found the days when I did not exude confidence were the days when I was worn down, feeling allergies, or suffering from some pregnancy related discomfort.
Approaching our 40 week mark, my stomach felt like it would pop, my hemorrhoids were back, I was so anxious because we hadn't started labor yet and I started doubting. I think this was the most difficult time period for me. During my pregnancy, I had had some doubts off and on, sometimes related to statistics or just wondering if I would be able to do it, wondering if my husband really wanted to do this, wondering if something went wrong, if I would be able to reconcile with it. But from week 38 on, I shut down and turned within completely.
In my head, I knew some women cooked babies longer, but why wasn't my body doing this? Would it really know how to do it? Why didn't I start labor last time? Maybe I really couldn't do it. Searching for solace, comfort and reassurance, I visited ICAN's website a great deal, through mothering.com I spoke with a student midwife and some doulas for suggestions and moral support. I emailed and called the two friends who had a HB and HBAC; I focused on talking only to the few people knew our plans and would be able to offer positive support. I think this was critical to maintaining my hbac plan.
I was SO disappointed when we had not started labor at 40 wks and cried at our weekly visit. I went home and had my first ice cream sundae of my pregnancy, before dinner, because that I could at least control. Before our visit, I had told my husband I wasn't going to wait past 41 weeks; of course after our visit, I felt recharged and capable. So I set a new timeline - at 42 weeks, I would hit the stop button.
There were a few pieces of wisdom which had helped me through the pregnancy; one from a book "Birth is the safest part of life," an interview from a dad's website on his perspective on homebirth, and the last, at the end, from a friend, "You can push the stop button anytime you want." Eventually, I had to come to terms with the fact that it was me who was going to push this baby out; no one else. And while they would all be there to support me, they couldn't do it for me. The only disappointing outcome would be if I didn't try my best...other than that, I was doing everything in my power to have the birth I wanted.
Then suddenly, Sunday night, I started contracting every 10 minutes at night. Holy cow! Knowing rest was imperative, I did my best to sleep through some of them and take naps during the day. My hemorrhoids were back, I was contracting every 10 minutes all night long and I was miserable. So I switched to worrying about how was I going to handle real labor? Finally, on Wednesday, after going to the library, the grocery, and the market, I had a good cry and felt sorry for myself that I would have to go through another night of contractions. My stomach was contracting irregularly all day and I was anxious about going to sleep that night because of the contractions.
By Wednesday night, around 6 pm, I had to ask my husband to have our friends come pick up our little guy; his energy was too much and I was losing my patience. I still didn't think I was in real labor, but I needed him out of there. My husband started timing and by 7 pm, he called to tell Chris we had 12 in an hour, by 8 pm when our midwife arrived, they were regular and close together. I remember feeling so relieved when she said, "I need to call my apprentices so they don't miss this birth."
The best part of Chris arriving was that she was able to put pressure on my lower back right above my sacrum where the baby's head was descending. My husband had been pushing on my iliac bones and while it offered relief, it was nothing compared to the relief I received my a small amount of pressure in the correct spot. At that point, I felt I could do it; if I could alleviate the pain of back labor that I experienced the first time, I was okay.
With her recommendation, we swayed; it felt good to hold on to my husband's neck while Chris put pressure on my back. We tried lunges, but my left leg and buttocks was cramping terribly. And eventually we moved to the pool; sheer relief! So we stayed there until we had to get out and then I got back in when I could.
Once in the pool, things all sort of mesh together in my mind. It was sort of like being in a dreamlike sleep state, but still able to feel things. I do know the contractions were still not a walk in the park. It felt good in between contractions for someone to gently draw their fingers across my shoulders and back; that relaxed me more than someone telling me to relax. The hot water felt good, the pressure on my back felt good. The contractions, not so much. I remember being checked twice and feeling ecstatic that I was 6 or 7 cm dilated; Chris showed me where I was on a palette. I had started labor on my own AND progressed past 4 cm. It really was happening.
I had a bit of a lip, but Chris seemed to work with that; and we tried various positions in the water to help open even further. I think she told me I was 9 cm with a lip. The moment of joy at reaching 9 cm was not overshadowed by the lip. And regardless, suddenly, my body starting pushing on its own. The sensation for me was a little like having to vomit; where you have no control of the sensation, it's just a reflex of what your body needs to do.
At that point, I think I was a little wary of the actual delivery, of the ring of fire. I also think the pushing took a little longer than expected (later we learned the baby's hand was right by the face). But there reached a point where it was either deliver or keep pushing; what helped me the most was that people kept telling me how to push with very specific words: push down through your bottom, pull your legs up towards you. And through all of this, my husband was in the water with me. Exhausted but never faltering; such a relief not to be doing this alone. I never really experienced the ring of fire, I think the cramping in my leg and rear overshadowed that perhaps.
They kept telling and asking me, one more big push and she'll be out, can you do one more this round? I tried to keep bearing down on the pressure just a little after a push so her head wouldn't go back in. Chris kept asking if I wanted to feel her head, it felt like swollen velvet. And then I felt the baby coming through the birth canal; to me, just like what you see when you watch an animal giving birth ~ wiggly, squirmy, slippery, slimy. So incredible...the head, then the rest, just squiggling right out. But the absolute best was helping to catch the baby (while I was pushing, Chris had asked if I wanted to touch her head which I did, three times), and immediately placing baby on my chest. After not holding my firstborn, this was such a gift to my spirit. Right on my chest, right from my womb. Quiet as could be. Just lying there, waiting for life to begin. Chris checked and showed us, we had a baby girl. Looking up at both of us. Wrapped in our arms, in our tub, in our kitchen, in our house.
We stayed in the pool for a little bit with towels around the baby to keep her warm. What I remember from this time is holding her on my chest, in my arms, right away. Not having to move from where we were. Looking down at her head, wondering if she would choose to feed right away. Little fingers, little head, little arms. Getting to stay right where I was, in the warm water, with my husband's arms around both of us, her face looking up at us...knowing we did it.
We stayed in the water for a little bit and she got to stay with us, no one took her away. The three of us in the water, just being.