Tuesday, January 3, 2017

My Road to a Home Birth

Bethany with her midwives and baby Eli
by Bethany Hyder, guest blogger

I am a natural childbirth junkie. I LOVE it! I love to learn about it and hear other people’s experiences with it, and I’d REALLY love to educate others about it! I really wish all women could have such a gratifying birth experience. It makes me sad to hear the horror stories of some women’s births. It doesn’t have to be that way! So when I got pregnant at 16, I learned a lot about natural childbirth. My mom had all four of her kids naturally, so why shouldn’t I?!? I read a lot of books, and although I can’t remember all of them, I do remember reading The Bradley Method. I went on to have a (mostly) natural birth with an awesome OB/GYN – Dr. G, at a small hospital (Parkway Medical Center) in Decatur. Anna’s birth is another story though (which I’d love to share, too!).

Fast forward 10 years, and I was 26, married, and had OVER planned for this sweet baby I was pregnant with (seriously…over-planned). At 8 weeks gestation, Christian and I excitedly went to see Dr. G and had an ultrasound – perfect little baby cooking away! Expected due date of January 1st (but I already knew that, because I had over-planned)! We continued with regularly scheduled prenatal appointments, but I always had a nagging desire for a home birth. It was always just one of those “maybe one day” type things. I had met a mom of a girl in Anna’s girl scout troop that had numerous home births. I wanted to be her. Then my cousin had planned a home birth, and although she did deliver in the hospital, it helped to know more people that actually planned this sort of thing.

Curiosity got the better of me, and I started looking into midwives. In Alabama, it is completely legal to have a baby at home. However, it is ILLEGAL for a midwife to attend a home birth. The state only recognizes Certified Nurse Midwives (CNMs) and they are only authorized to work in hospitals, under an OB/GYN. So basically, you can have your baby at home, but not with anybody that’s trained or skilled in home deliveries! Surrounding states license Certified Professional Midwives (CPMs), but these women would face prosecution if they were caught assisting home births in Alabama. It’s sad, really. I found out that there are some midwives that work “under the radar” in AL and will come to your home for birth. This seemed a little dangerous to me given that 1) I don’t really want to get anybody arrested, and 2) if I did need to transfer to the hospital, the midwife would not be able to come. What if the midwife had important medical information that the doctor needed?

Through a random facebook post, a co-worker recommended his wife’s midwife – Karen Brock. I emailed Karen. I really just wanted to ask questions and figure out how it “worked.” Karen offered to meet with me. So, at about 24 weeks gestation, Christian, my mom, and I drove to Cullman on a Sunday afternoon to meet her. Karen is a CPM, licensed in Tennessee. She does prenatal appointments at her office in Cullman, and has a house just across the TN state line for births. I immediately trusted her. The conversation about birth that we had was SO reassuring. It was nice to talk to somebody that recognized birth as a normal, natural process and not a medical emergency. I was like a giddy school girl leaving her office. I had made up my mind, but I wasn’t too sure about Christian. When I initially told him that I wanted a home birth, before we met with Karen, he said, “Ok…will Dr. G be there too??” HA! No, honey, she won’t. I don’t know if he just trusted that I would make a good decision, or if he didn’t know to be worried, but he agreed to it!

My next appointment with Dr. G would have been my 28 week appointment, before which I was supposed to have the nasty glucose test completed. I never took that test. I faxed Dr. G’s office a medical records release form to have my information sent to Karen, not knowing the can of worms I was opening up. In my mind, I was going to keep going to Dr. G AND go to Karen, and then assuming everything kept going good, I’d just birth with Karen. Good idea, right? WRONG! Later that day, as I was walking out of work, my cell phone rang. It was Dr. G calling to inquire about sending my records to Karen. She was not happy to hear that I was planning a home birth. She made sure I knew that was illegal in AL, and I assured her that I would be birthing in TN. She gave me a few horror stories and tried her best to dissuade me. I was about to get in a van full of coworkers (we have a ride share program) so I told her I’d think about it and let her know. Her scare tactics worked…for a few minutes. I had done enough research and knew enough about childbirth and the midwifery model of care to know I was making the right choice. When I called back, I told her nurse to send the records to Karen. Dr. G had made it clear that she would not be able to continue to provide OB care during this pregnancy knowing that I was going to Karen. She stated that it was a conflict of interest. She would, however, continue to see me as a GYN patient in the future. When I went for my first prenatal with Karen, she told me that Dr. G had called her as well! She quizzed Karen about what she would do if I started to hemorrhage, etc. It turns out that every year when the midwifery bill is presented in Montgomery, Dr. G is one of the opponents there speaking against the bill. It sounded like Karen and Dr. G were going to meet to discuss how both parties could come together for the benefit of mothers and babies (i.e. the midwives and the medical community), but I never heard more about that happening.

I loved so many things about seeing a midwife. Number one was probably the “hands-off” approach. There were no “routine” pelvic exams. Even when I was in labor, she didn’t need to “check my cervix” or see how far along I was. She certainly would, if I wanted her to, but it was not mandatory. Listening to the body is so much more indicative of where you are in labor. Second, the personal relationship we had. Every prenatal appointment was at least an hour long – no rush. Every decision made was ours (mine and Christian’s) to make. We researched, asked questions, and made decisions about how this birth would go and what kinds of things would happen immediately after. We made a transfer plan in case of emergency, and thankfully didn’t have to use it. I felt in control at every point of the pregnancy and birth, and trusted my midwives 100%. I am SO happy I left Dr.G and went to Karen. Best.Decision.Ever!
The Birth Tub felt amazing to Bethany!

Eli’s Birth
Saturday, Dec. 29th
That morning, I woke up and headed straight to the bathroom to pee. I noticed a little bit of blood when wiping. I got excited because SOMETHING was happening! I went on about my day, but made everybody aware that things were slowly getting started, hopefully. Christian went to work, and my sister

Julie, Anna, and I went to walmart to get various things. We drove out to where I work because I had left some information I would need while out on maternity leave. Later in the day, I took a little nap on the couch. All throughout the day, I was aware of very light contractions - nothing worth paying much attention to. Julie made homemade chicken noodle soup (I requested that for while I was in labor), and that evening we went to the mall to “walk the baby out” / get contractions going stronger. That night, I called my midwife, Karen, to let her know that early labor had begun. There was actually a birth going on at that time at the house in Elkton, but she told me to check back in to give her an update before going to bed. Contractions remained fairly mild, so I tried to sleep, knowing my sleeping days were soon to be over!

Sunday, Dec. 30th
Stronger contractions woke me up around 3am, and I lay in bed and timed them with my phone (yes, there’s an app for that). They were around 6 minutes apart. At 4am, I woke Christian up and thought it was time to head to Tennessee. I wanted to go up there with plenty of time to labor in the tub and relax. I called Karen, and she told me to get up and get moving to see if the contractions were going to stall out. Once Christian, Anna, Julie, and my mom had been alerted and the car packed up, I decided it wasn’t time! Contractions had waned again, so Karen suggested trying to get some rest.

Around noon, Karen and Wetawnya (assisting midwife) were ready to leave the house in Elkton after ANOTHER birth (they had 3 that night before me!), so they stopped by my house to check on me. I decided I wanted to know how far along I was, and it turned out to only be about 2cm! Again, rest was prescribed. I took a nap for about an hour before contractions woke me up. I spent the next couple of hours or so walking around, swaying, and finally rocking in the rocker in the nursery while looking out the window. Christian and Anna were so quick to get anything I needed, and they both helped time my contractions. Anna got bored and decided to go to her grandparents’ house, but she wasn’t there long.

Around 4pm we checked in with my mom, and she suggested that we head on to TN so that I could get in the Jacuzzi tub to labor. Christian packed up the car (again) and we headed out. Julie and Nana went to pick up Anna. We called Karen on our way to let her know we were headed there and to see what we needed to know about the tub. She said that she and Wetawnya would head that way too. The drive was about 40 minutes, and contractions were steady at around 4 minutes apart. I wasn’t all that uncomfortable during the drive. I thought it would be hard to sit still for that long, but I made it fine and kept concentrating on the task at hand. We got to the house a little before 6pm, and my mom, Julie, and Anna arrived shortly after.

When my mom got there, I started to cry because I felt like I was nowhere close to having the baby, and I was worn out already. I really felt like I had several more hours of labor left (this was actually most likely transition, but I did not recognize it bc my contractions were not THAT intense yet). She helped me get undressed and into the tub. I tried several different positions until finally settling into a squatting type position. Karen and Wetawnya arrived and I was vaguely aware of them setting up the bedroom. I was very much “within” myself. They periodically checked the baby’s heart rate and encouraged me to eat and drink something. I did not want to eat, but did have a little bit of gatorade to drink, although I really didn’t want to be bothered with that either. Christian sat/squatted (I’m not sure?) next to the tub and kept up with my contractions. I would announce when one started and when it ended, as best I could.

Newborn Eli on Mama's chest
I announced that I felt the need to push, and Julie later told me that Wetawnya had left to get some food, and Karen was eating some of the chicken noodle soup we had brought (remember my request?) so she called Wetawnya to come back! I guess everybody thought we were in for a few more hours of labor. I thought I only wanted to labor in the tub, and would get out of the water when it was time to push, but decided in the moment that I wasn’t going anywhere! We discussed whether or not my water had broken, because I wasn’t sure....but shortly after that it did. I heard/felt something like a rubber band popping, and could somewhat feel the warm liquid, even though I was in a tub full of warm liquid! The contractions quickly became much more intense. My hips and thighs started to ache, and I could feel the baby descending. For the most part, I kept my eyes closed and head down. My mom said that she thought I was going to dunk my head in the water a few times! The urge to push was so pronounced, and it felt so good to do so! I thought I was being quite loud with the guttural/moaning sounds I was making, but I’m told I was actually very quiet.

Crowning took me by surprise...I THOUGHT I had a natural birth with Anna, but apparently I missed a LOT at the end when she was crowning due to the pudendal block I received so that I would be able to stop pushing while Dr. G did some deep suctioning to remove meconium before she inhaled it. The pressure was insane, and I wanted that head OUT! It’s hard to describe, but I started to shift my weight from one foot to the other, while squatting, almost like I was trying to crawl away and “deposit” the baby! At one point, one of my midwives (I can’t even remember which one) got eye level with me and reminded me to breathe and focus. I put my hands between my legs and felt his sweet, soft head FULL of hair. I pushed with all my might to get his head out, and once it was, I SMILED. What a relief! I kept my hand on his head while I waited for the next contraction. I asked Karen how long I had to wait because it seemed like it was taking FOREVER! When his body slid out, I pulled him up to my chest and sat on the seat in the tub. He gurgled and cried, and was just absolutely perfect.

It was ONLY 7:08 pm...just ONE HOUR since we had gotten to the house! I was amazed. I felt like it had been longer, but time seemed to stop once things got more intense in the tub. I really believe that the water worked its magic to help me relax and everything jumped into gear. I wish I had gotten in that water sooner!

It was a bit cold in the water, so after a little bit of time had passed, Karen cut the cord and handed Eli to Christian. They had towels fresh out of the dryer to keep him warm while I delivered the placenta and got out of the tub. I sat on the bed and was able to nurse Eli while we all enjoyed him. He pooped on me while he nursed! Black, tarry meconium all over my tummy!  After we had a while with Eli, Karen and Wetawnya did all the baby checks right next to me on the bed while I ate some chicken noodle soup. He weighed in at 7lbs 9oz. Christian put his diaper on him and got him dressed, and I got in the shower to clean up. Anna, Julie, and my mom got to hold him a little bit too. Karen and Wetawnya left the house, and we were right behind them. We were back at home by 11pm.

I had a 2nd degree tear, and I KNEW I had pushed too hard to get his head out. It took me by such surprise - I was not prepared for the burning and stretching, so I pushed as hard as I could to get it over with! Bad idea...but I chose not to get stitches after discussing it with Karen. I healed just fine :)

Big sister Anna was very emotional, too!
Shortly after the birth, I looked at my sister and said, “THAT HURT”...ha! I told her I’d absolutely do it again, but I would need some time to forget first ;)

Anna has always been very sensitive to my emotions, so when I cried when we first got to the house, she got upset/nervous. Julie took her to the living room to find something on TV, but when I started pushing they came back to the bedroom. I’m sure Anna was nervous, not knowing what to expect, even though I had showed her videos of natural births. She cried and cried once Eli was born. It wasn’t a sad cry, more of a pent-up emotional release. She didn’t want to hold him until he had clothes on since he had pooped on me! Now, Anna says she is going to adopt…no childbirth for her! HA! I sure hope I didn’t scar her for life ;)

1 comment: