Choosing a home birth:
Home birth...I never really imagined myself having a home birth. With my older son, C, I had a good experience with a non-medicated hospital birth. There were a few details that I’d rather have gone a little differently, but over all it went wonderfully, the nurses were great, and I didn’t have any complaints. There were, however, some things that were a little less comfortable. The drive to the hospital was hard on me because my contractions hit quickly and strongly. Additionally, once we got to the maternity ward they kept asking for my social security number even though it was on the paper work that I brought with me and I couldn’t speak through the contractions. I also didn’t like recovering in the hospital, even though we were there less than 48 hours. The bed was uncomfortable, the air was too dry (it made me lose my voice), and it just wasn’t home. So, when I found out that I was pregnant again (when L was almost 14 months old), I started to consider how I wanted my second pregnancy and birth to go. There were a few things that made me consider a home birth:-I knew I wanted to go without an epidural: I didn’t have an epidural with C and I loved being able to get up and pee quickly after birth, plus the thought of a needle going into my back kind of creeps me out. -I was in labor with C for a whopping 4 hours. That’s insanely fast for any birth, especially a first pregnancy. This included about an hour from when my water broke at home to when contractions hit. The ride to the hospital was miserable (45 minutes) and my muscles were really tense from sitting for so long rather than being able to move. I think I would have been physically more comfortable had I not needed to be in the car with such strong contractions, but I also didn’t want to go to the hospital too early and potentially stall labor.-With a very active toddler, I was concerned with him visiting us in the hospital (he’s into everything and loves to move constantly). Plus with a history of fast labors, waiting on someone to come to our house or dropping him off at someone’s house would just add more time to a trip to the hospital.
I say all of this because my husband and I really weighed comfort and convenience heavily into our decision. I had read some blogs about home births in preparation for my older son’s birth, since I wanted (and had) an unmedicated birth. I also talked to a friend who had a home birth and then did some online research about local midwives. I found out that there was a midwife who lives in Bedford, IN (where we live) which was prefect!
Prenatal care:
Michelle, of Mother Nurtured Midwifery is a Certified Direct Entry Midwife (licensed midwife) and she works with a local OB/GYN doctor, Dr. Labban, to provide care. I first had a consultation appointment with her to discuss my current pregnancy, previous pregnancy, and ask questions about home birth and her practice. To be a candidate for a home birth, you must have a low-risk pregnancy. In Indiana, midwives can only attend births at home or in birth centers (not a hospital), so in the event of complications or other reason for a hospital transfer, an OBGYN doctor would take over care, and in order to be “legal” the midwife needs to work in col laboration with an OBGYN. I had monthly appointments with Michelle at her office through week 28, then every-other-week through week 36 and weekly after that. I also had one appointment with Dr. Labban, the physician who works with Michelle (and one of only a few in our area who work with home birth patients) in each trimester. Additionally, I had 2 ultrasounds with Dr. Labban (one at about 8 weeks to confirm how far along I was—yay irregular cycles—and an anatomy scan at 20 weeks) that were optional. I also had blood work and the glucose tolerance test done through Dr. Labban’s office. When I was about 7 months pregnant and at my third trimester appointment with Dr. Labban, my iron levels were found to be a bit low. Michelle was able to test my iron levels at her office in the following weeks. The prescription iron supplement that Dr. Labban wrote wasn’t causing much of an increase in my iron levels so Michelle gave me a different, more bio-available form of iron that my body responded to much better. With the second iron supplement, my iron levels were back in the normal range within 2 weeks. Each appointment with Michelle was an hour long (they didn’t always take that long, but she allowed that much time). At each one, I would have my urine tested using a test strip, she would take my vitals, and listen to baby’s heart rate with the fetal doppler. Aside from the finger prick for testing my iron, Michelle didn’t do any blood work. Any prenatal screenings would have been done through Dr. Labbban’s office, but I opted out of all of those. Aside from that, we would discuss any questions/concerns and also chat a little. She was able to spend a lot more time with me than a doctor at an OB/GYN office would be able to do. She also had a lending library of books and videos, which I took advantage of. At my appointments, she did not do pelvic exams or check for dilation or effacement as I got closer to my due date, though if I asked she probably would have.
At 37 weeks, Michelle came to our house for a home visit. We showed her where I planned to labor and give birth, and she made sure we had everything in the birth kit (she brought some items and we supplied the rest). Additionally, we went though my birth plan. I had selected which area hospital I would go to in the event that complications arose and I needed to transfer.
A third component of my prenatal care was with my chiropractor, Dr. Karen Drummond in Bloomington. I’ve received chiropractic care for over 10 years, so it was only natural to also see her specifically for pregnancy (with both of my pregnancies). I had monthly adjustments leading up to my due date, and then in the last couple months, every-other-week appointments. I feel like I was able to be more comfortable throughout pregnancy as a result, and possibly help me have a smoother labor.
Labor and delivery:
So now onto the fun part—my birth experience. I woke up in the middle of the night, around 2 am, and just couldn’t get back to sleep. I felt a little more uncomfortable than I had been feeling, but I was almost 40 weeks pregnant. You’re just kind of uncomfortable all the time. So I got up to eat a snack and to try to figure out if I was going into labor. Some time passed and I started noticing contractions (granted, with both pregnancies I had fairly regular but minor contractions for a couple weeks leading up to “real” labor). So I went into the bedroom to give my husband a heads up. I told him I was going to shower, and to listen for me to call him if I thought it was real labor. While in the shower, I called out for him to bring me my phone. While still bearable, the contractions were getting stronger and more regular. I called Michelle, our midwife. She asked me a couple questions about when I started noticing contractions, how they felt etc. Then she asked if I wanted her to come at that point or just be on stand by. Just in the amount of time we were talking they got strong enough to catch my breath, so I told her to head on over. I then called my mom and mother-in-law so they could also make their way to our house. The plan was for them to be there to help watch our older son, C, and also be available to give a hand with food if anyone got hungry or relive hubby if he needed a break. Then, I asked my husband to get our birth kit ready and to turn on the crock pot for warm compresses while I relaxed in the warm shower. The crock pot wasn’t working, so he called his mom back so she could bring hers. When Michelle got to our house (about 30 min later), I was laboring in our kitchen with the lights turned off, alternating between leaning over the island with hubby rubbing my back/applying hip squeezes and sitting/rocking on an exercise ball. Shortly after, my MIL and mom both arrived. At that point, I was in a sports bra and maxi skirt so that I could be as comfortable and have as much range of motion as possible. Contractions quickly got stronger and closer together, so Michelle, hubby and I all moved into our spare bedroom (C was asleep in our room, where we originally planned for the birth to take place). Fortunately, all or our birth kit items were in a laundry basket, so my husband just moved that from our room into the spare bedroom. We turned on a small lam, which let the room be as dim as possible, and Michelle got her things set up and organized while I stood facing my husband. The most comfortable laboring position for me was to face him with my arms around his waist while he either squeezed my hips or rubbed my back, depending on what I needed. At one point he took a quick bathroom break and my mom filled in, but other than that he was by my side constantly. He was my rock during labor (as well as throughout pregnancy), anticipating my needs and providing the comfort and other assistance that I needed. The key to a successful unmediated birth, in my opinion, is a strong support person, both physically and emotionally, whether that person is your spouse, mother, friend, or doula—I’m my case it was my husband. There were times when he was literally holding all of my weight while I allowed my body to do its’ thing during a contraction. Occasionally, Michelle would check my vitals or see how much I was dialated, but she was very non-intrusive. After a while, I felt a major shift in the intensity of my contractions—they got very strong, almost non-stop and I felt nauseous and threw up a couple times. With that, I could tell that I was transitioning and that pushing would soon follow. At that point, standing was very uncomfortable so I took off my maxi skirt and moved to the birthing stool—A low seat in the shape of a crescent. It really allows for me to open my hips and allow my body to do most of the work, while resting a little in preparation for pushing. One big thing I learned with my labor with C was to trust my body—when I felt the urge to push, I knew it was time. My water finally broke and I felt the urge to push shortly after. Imagine how it feels when you have to poop really bad—multiply that by 10 and add a sweet little baby at the end, and that’s kind of what labor feels like. Anyway, I pushed for about 15 minutes and our youngest son “L” was born! We chose to delay cord clamping, so after we caught our breath a little, L and I moved to the bed to rest and so he could start nursing, with hubby by our side. Around that time, C woke up so my mom got him up, fed him breakfast and then he got to meet his baby brother. It was so comforting to have our whole little family under one roof.
Postpartum care:
The post partum care that I received from our midwife, Michelle, was so much more personal than my experience with ONGYN care. First off, she stayed for a while after birth, to make sure I was going to the bathroom, baby was nursing and that I felt good. Then we all moved into the living room, joined my both of our moms. Michelle took baby’s stats, took footprints for our baby book & birth certificate, and did the paperwork needed to file the birth certificate and for social security. Upon examining baby, she noticed that he had a tongue and lip tie. While she couldn’t officially diagnose it, she was able to let me know about it so we could bring it up to our pediatrician and discuss options for correcting it, since nursing and weight gain problems could arise because if the ties. She also gave us the name of a local dentist who does laser tie corrections (that’s another story though). The next day, she came back to check up on us and do the newborn screening. Our pediatrician administered the vitamin K shot: they wrote a prescription for the vitamin K, which I picked up from the pharmacy and took to the pediatrician during his appointment. We went to our local audiology clinic for the newborn hearing screening. Michelle stayed in easy communication with me via text, which was super helpful because I was experiencing pain nursing and baby was dropping more weight than he should due to the tongue tie. She was able to provide support outside of what an OBGYN’s office could provide, specifically with breastfeeding. She also came by the house at 1 and 2 weeks post partum to check up on us, and then I had appointments at her office at 4 and 6 weeks post partum. Much better than the typical “see you in 6 weeks” that you get from an OBGYN. While I had a pretty uneventful and easy healing process, the frequent check-ins were still much appreciated.
Reflections:
If I am pregnant again, I will go with a home birth with Michelle again. In summary, our home birth experience was relaxing and allowed me to feel in control while also focusing on laboring. I loved being able to move into our living room and rest on the couch and the recliner in the company of not only my husband and our new baby, but also our older son and both of our mothers. While a home birth may not be for everyone, I’m so glad we were able to welcome baby L from the comfort of our home.