By Bekah Ferguson
I never would have dreamed of having a homebirth until two things happened to set things a-percolating.
First, I ran into an old friend I hadn't seen in years and she told me she'd delivered both of her sons at home in the bathtub. Then, later, when I was 3 months pregnant with my third child, I watched the Ricki Lake documentary, The Business of Being Born and my perception of modern childbirth was gloriously changed. (I highly recommend this film, by the way! View trailer here .)
For the first little while, though I was greatly intrigued by homebirth, I didn't think I could work up the nerve to actually do it, even though I was convinced that it was safer than hospital birth for a low-risk pregnancy. So, I decided on a compromise: I'd have a midwife this time instead of an obstetrician! Well, I called them up and one of the first things they told me is that they ask their clients to agree to no epidural; reason being because it's the O.B.'s domain and they'd have to transfer care during delivery, which would defeat the purpose of having a midwife in the first place. So, I agreed apprehensively. See, my first two babies were born in hospital with an epidural and I remembered how painful the contractions were before the drugs kicked in . . .
Without getting side-tracked by too many details, here's my backstory:
With my daughter, I agreed to an epidural simply because of the fear of the unknown (I'd never given birth before); but with my middle son, I was bound and determined to give birth naturally, without drugs. Unfortunately, he ended up being 9 days overdue and my O.B. recommended induction. Everything I'd read about induction, particularly birth stories, described how much more intense the artificial contractions are to natural ones; and so sure enough, when things got really heated, I caved to the epidural. It didn't help that the nurse kept warning me, "There's only 2 hours left that you can have an epidural or it'll be too late" . . . "There's only 1 hour left before it's too late," and so on. The clock was ticking loudly and there were no midwives there to encourage me. When I finally caved, I was hugely disappointed, but being essentially strapped to the bed by cables, the fetal monitor, I.V. and the like, I just couldn't cope with the contractions. When it was all said and done, I was convinced that if only I'd had the freedom to walk around, change positions, try hands and knees, rocking, anything, I just possibly could have done it without drugs.
So, back to baby #3. After disconnecting from my phone conversation with the local midwives, the first thing I thought was: Okay, if I'm not going to be having an epidural anyway, why should I give birth in the hospital? Why not give birth at home? All the research I'd done thus far had shown without a doubt that homebirth in Canada is safer than a hospital birth for a low-risk pregnancy. Also, our midwives are licensed and attend university for 4 years before gaining their degree, and their services are paid for by the government. So, nerves aside, I went to my first appointment and let them know that I was considering a homebirth. Then, when I was 7 months along, my husband and I attended a homebirth information night at the midwife center and our decision was confirmed: we were going to go for it.
My first appointment with the midwives was a pleasant surprise. Unlike my previous pregnancies with an O.B., the whole environment was comfortable and homey, rather than formal and clinic-like. One example: instead of vinyl gurnies with crinkly paper, there were fabric-covered chaise lounges in each office. The best part of all was that I didn't feel like a faceless number. The midwives were engaging and warm; and everything is informed consent with them, which means they were all about educating. Everything was described to me; which was a stark contrast to my previous experiences with O.B.s who barely utter a word at each visit. There wasn't that aura of mystery that I felt at the obstetrical offices. I finally felt involved in my own pregnancy! The midwives are also detailed oriented. So, instead of merely stating, "The baby is head down," they took the time to figure out his exact position. i.e. what side of the ponch he was lying on, the position/direction of his back, his hands and feet. They also let my 3-year-old son hold the doppler to hear the baby's heart beat at every visit, which he enjoyed doing. So, all in all, a very family friendly environment.
Okay, back to my homebirth story.
My due date was November 22nd, 2010, but it came and went without a peep. I worried that he would be way overdue like his brother and I'd end up having to be induced. All our plans for a natural birth at home would be out the window in that case. I needn't have worried, however. Thursday, November 25th, I woke up at 1:50 a.m. in the middle of a contraction. I timed them for an hour before waking hubby. They were 3 minutes a part and about 40 seconds long. This was the real deal! I woke hubby up then and he got the coffee brewing. I paced the living room and timed contractions for another hour. They had slowed down to 5-10 minute apart and I paged one of my midwives (I had three) to see whether they wanted to come over or not. She called back a few minutes later. All three were attending another homebirth just then. So, they sent over a midwife whom I hadn't met, just to check on my status. It was about 4 a.m. when she arrived and I was 2 cm dilated. Babe was still posterior though (and had been for most of the third trimester), so she suggested some positions to try to get him to turn, as well as a hot/cold bath which I will describe shortly. The contractions had slowed way down to 20 minutes apart by this time and were very mild. The midwife suggested I try to get a couple of hours sleep before things picked up. She left then and I went back to bed for a couple hours, dozing in between contractions (too excited to actually sleep!), while hubby stayed up chugging coffee and getting things ready. By 7 a.m. the contractions were back to 5 minutes apart and were stronger now; strong enough that I could no longer even doze. Lying on my side wasn't comfortable.
Hubby got the kids up, dressed, fed, overnight bags packed, and drove them to their aunt and uncle's house. He was back within 45 minutes and brought me some egg sandwiches from Tim Horton's. After breakfast, hubby poured me a warm bath, which I had to go in on hands and knees with an ice cold wash cloth on my back. The hopes was that the baby would turn his face away from the cold and toward the warmth of the water. I got out once my knees were too sore from the tub. So far as I could tell, he hadn't turned. i.e. I couldn't feel his back in front.
The rest of the morning went by in a flash, it seemed, because I have little memory of the time between breakfast and lunch. At some point during that time my primary midwife called to check up on me. They had finished the birth they were attending and planned to catch a couple hours sleep before I would need them. So, I sat on the couch for a couple hours watching daytime cable (i.e. boring) and the contractions continued to be 5 minutes apart on the dot. Outside was overcast with the sun occasionally breaking through. Come 1 p.m. I could no longer sit through contractions as I had been. I now had to stand up and breathe through them, as they were getting much stronger in sensation. I went upstairs and fussed around the bedroom for a few minutes, making sure everything was ready. Hubby had Christmas music playing softly on the stereo for me.
At 2 p.m. I called my primary midwife to let her know the contractions were getting stronger and harder to breathe through. She decided it was time to head over and arrived a half hour later, with my two other midwives arriving shortly afterwards. They checked my status first and found I was already 8 cms dilated! I'd never made it that far without drugs with my first two babies, yet the contractions were still completely bearable for me. (Having the freedom to move around instead being on your back or side, makes all the difference in the world.) Babe was still posterior, as I suspected, but I hadn't yet felt any of the dreaded back pain I've heard so much about. Next, the midwives hooked me up to an I.V. right there in my living room for a 15 minute dose of antibiotics, and then they unhooked it and put it away. This was completely unlike my hospital births in which I had to wear the I.V. for the entire labor, dragging the pole with me to the washroom and being completely bogged down by it. They also checked the baby's heartbeat approximately every 20 minutes with a doppler, giving me complete freedom to labor in any position that was comfortable. Again, in stark contrast to being strapped to a fetal monitor in the hospital for the entire labor while confined to the bed. By this point (I believe it was around 4 pm) I was having to grunt through contractions on my hands and knees as sitting, standing and lying down were much too uncomfortable; plus, we were hoping being on my hands and knees would encourage the baby to turn.
The living room was no longer a comforting place for me to be. I went upstairs to the bedroom and dimmed the lights way down and went on the bed on my hands and knees, listening to Christmas music during contractions, which were still 5 minutes apart but lasting up to a full minute.
This is when the back labor started.
I could no longer stay on the bed and got down on the floor at the foot of the bed, my knees on the floor, and my head resting on the mattress. I could no longer breathe through contractions and began moaning through them (impossible not to). The midwives bustled about getting all their equipment laid out, hubby running up and down the stairs doing this and that to help out. I then had to be checked again which required getting on my back and that was absolute agony and it took everything in me to stay put instead of getting back down on the floor. I was 9 cm, with waters bulging, and a slight cervical lip in the way. I was yelling through contractions at this point, having to put my face in a pillow to muffle the screams. I lost all track of time by this point but I did notice that the sun had set and it was completely dark out now. I no longer even noticed the Christmas music in the background. Hubby kept putting a cold compress on my lower back to help with the back pain but it made no difference and I ended up pushing it off everytime he tried. I manage to explain that it wasn't helping, in between yelling through contractions. There was no going back now, but I was glad that the epidural wasn't an option. I would have caved for sure and been disappointed all over again. So, I kept at it, trying not to think of the next contraction until it came. I tried to rest between contractions but they seemed only 30 seconds apart by now. The midwives had offered to break my water and at first I didn't want to but I was getting exhausted fast and I didn't know how much longer I could take it, so I agreed to have them kick-start things.
This required going on my back again which was excruciating. Once my water was broken, things intensified even more and I felt like I was on the verge of panicking. I didn't give into it though, as I knew I had no choice. Panicking would be disastrous. I reminded myself that losing control is usually a sign that it's almost over. The baby would soon be here! I tried the birthing stool then but sitting was out of the question. The baby was descending now and the pressure was unbelievable, I felt like I was going to literally split in half. I put my arms around hubby's neck because no other position was working, and I stood for the next dozen contractions, pulling down on hubby's shoulders and screaming into his shirt so hard I don't know how he kept his balance. I wasn't allowed to push yet because the cervical lip was still in the way but they checked again and I was finally 10 cm and ready to go.
Pushing made an enormous difference in pain management. I couldn't believe the difference it made. I felt like my eyes were bulging out of my head with every push and my screams were now guttural and totally involuntary. It was impossible to push without screaming, but it wasn't from pain this time, it was from the intensity of the muscular strain. Anytime I paused to take a breath of air, the pain of the contractions came back and I would immediately start pushing again to stop the pain. Pushing took more physical strength than I even knew I had, but it was phenomenal; like a natural painkiller. I never got to experience that with an epidural. Even though I still felt like I was splitting in half and was screaming like a banshee, I was utterly fascinated by the process. Here I was having my third baby and was experiencing for the first time what childbirth really felt like.
By this time, it seemed there was only 5 seconds between contractions, if even that. I'd been pushing in a standing position, arms around hubby's neck, but now they moved me to the bed in a reclined position on my side/back. Baby was crowning (it was a burning sensation, a "ring of fire") and I reached down and felt the top of his head. Unfortunately, the scar tissue from my previous episiotomies were preventing his coming out no matter how hard I pushed (one of the downsides of episiotomies - once you have one you're pretty much doomed to having one for every subsequent birth). I was getting desperate by now as my strength was beginning to fail me; I was growing too weak to keep up with the pushing. I'd run out of steam. So, I gave them the go-ahead on a tiny episiotomy. He came right out after that, though they had to push on the ponch to get his shoulders through. I was no longer splitting in half. What a relief. It was 7:25 p.m. - nearly 18 hours of labor all in all.
Babe was placed in my arms, his warm, soft skin on my chest, and hubby cut the cord. We put a tuque on his head and receiving blanket over him and I nursed him right away without a hitch (babe was an old pro within seconds of birth); while my primary midwife delivered the placenta, which was out within 10 minutes. They then stitched me up (using a local anesthetic) while I continued to nurse and cuddle my newborn baby.
And now came the best part of having a homebirth of all: the comfort and privacy of home. Hubby held the baby against his bare chest for some bonding time while I had a shower in my own shower and the midwives packed up all their things and tidied everything up and put fresh sheets on the bed. Hubby ordered a pizza to feed everyone and then two of the midwives left to attend yet another birth. The third midwife stayed for another hour to take the baby's measurements, weight and so on and so forth. He was 10 lbs on the dot. She left and hubby and I were all alone together with our newborn son. (Another positive contrast to the hospital in which hubby had to leave me by myself each night between 11 p.m. and 7 o'clock in the morning, which caused me a lot of separation anxiety.) The peace and quiet of our own bedroom was heavenly. No beeping noises, no talking, no chorus of crying babies from multiple women sharing a room separated only by curtains. It was wonderful.
The midwives came back the very next day to check on us, then day 3, day 5, then day 10. After that, I finished my post-partum check-ups at the midwife office until 6 weeks, at which time I switched back to my family doctor.
So, while the pain was more intense than I'd anticipated, the pay-off was more than worth it. I suspect an anterior birth would be less painful, as it was the back pain I found hardest to cope with. But over-all, it was an extremely positive experience and I would recommend homebirth with qualified midwives to anyone with a low-risk pregnancy. :)
