The Path Toward the Rest of My Life: Birth Story of Identical Twin Boys

by Jess Helle-Morrissey, MA, MSW, LGSW, LCCE, CLEC

23 weeks pregnant with twins!

Nothing about my pregnancy went according to plan. After nearly 12 years of marriage and completion of my clinical social work graduate program, my husband Mitch and I decided it was finally time for us to start thinking about a family. Part of me always knew I’d have twins and so when I began dreaming of twins in the 5th week of my pregnancy, I had a feeling then that something magical was happening. And when I would talk to “baby” in my tummy, every cell in my body said, “That’s not right!” So I always talked to “babies” instead, just in case…

Each time we had a midwife appointment, Mitch would ask, “Can you tell if there are two in there?” (We have been together a long time – long enough for him to know that my intuition isn’t usually just a fluke.) My best friend was pregnant at the same time, due the same day, and I was consistently bigger than her, and MUCH sicker than her. I remember one day shopping for maternity clothes together – the two of us standing in front of the dressing room mirror and seeing how much bigger I was. I told her, “Look at my belly compared to yours. I think there are two babies in there.” She said, “Oh my god, can you imagine?!” In retrospect, I also started feeling movement around 12 weeks – like little ping pong balls bouncing around my belly – what my midwife referred to as an “early quickening”. So there were lots of signs backing up my intuition.

By the time our first ultrasound came around at 20 weeks, I told Mitch I was pretty sure they would find two babies. But I didn’t completely believe it yet – my heart knew it, but my head had not quite caught on. The ultrasound technician put the wand down on my belly and two perfect circles appeared on the screen. She immediately removed the wand, looked at us, and said, “Wait, is this your first ultrasound?” Thinking this was a standard question, I told her that it was. “Ahhhh, ok,” she said. She put the wand back down on my belly. “Because here’s a head, and here’s baby number two’s head.” Mitch immediately started laughing and I screamed and said, “I knew it!” The only place my intuition was off was that in my dreams, there was one boy and one girl. Instead, there were clearly two sweet identical little boys in there.

Our first glimpse of the babies! Two beautiful heads…

This was the first of many changes to how I imagined my birth would go. I’d been planning a home birth or a birth center birth and had been getting my care through a local birth center. My midwife told us they could not birth twins at the center due to their license. (No twins, no breech). She recommended an amazing OB in just over the border in Wisconsin. Kind of a drive, but totally worth it. Dr. H has the heart of a midwife, and I felt totally calmed to be working with him. He had a lot of experience with twins and was regarded as an expert on vaginal breech delivery – something that is fairly common with twins. “Breech is a perfectly valid way to come into the world,” he told me. I have never been afraid of unmedicated childbirth, but the idea of a hospital birth always scared me. Dr. H and this small community hospital were as close to a birth center as I would get this time around, and I knew it was the right place to get my care.

We certainly experienced some major “twinshock” – I spent the day after our ultrasound alternately laughing hysterically and crying hysterically. But once the news sunk in, we began to realize what an amazing miracle was taking place. Feeling the boys grow and move in my belly over the next few months was something I’ll never forget. As the months went by, I got bigger and bigger. I was measuring 40 weeks by 28 weeks pregnant, so… that was fun.

One of my final belly pictures, at 34 weeks…

Fast-forward to 34 weeks: I’d been feeling restless the past few days. I’d gotten up at 2 in the morning and taken a shower one night because I just had to. Mitch later told me that the late-night shower was when he started to think that the babies would be coming sooner than we thought – I’d never done anything like that. On a Thursday, I took a nap on the couch and woke up to a feeling that wasn’t quite right. Turns out I’d lost my mucus plug. I saw Dr. H the next day and he said not to worry – losing the mucus plug was a “nonspecific” sign. For the next few days, I started passing mucus regularly. Again, not necessarily anything to be concerned about. Still, we scheduled our second meeting with our doulas for that Monday just in case we were closer to the big show than we’d thought. Tuesday morning, I woke up with another feeling that a change had happened and found that I’d had some decent bloody show. We drove in to the L&D unit at our hospital and they put me on the fetal monitors, found that both babies looked good and saw that I was having some mild Braxton-Hicks contractions (which I’d been having since about 20 weeks). I was 80% effaced and 1-2 cm dilated, (within normal range for twins at my gestation) so they again weren’t worried. That was the first cervical check of my pregnancy.

That night, some friends came over for a visit. In retrospect, I was having a low “restless” backache, and some intermittent crampiness in my thighs, but I chalked it up to the fact that I’d been laying on that hospital bed all day. I was in denial that I would go anything less than 40 weeks, so why would I think that labor would begin any time soon?

1:45 am, Wednesday 1/12/11: I was asleep and heard/felt a slight “pop!” and felt what seemed like a tidal wave of amniotic fluid rush out. (Good thing we’d just put the waterproof mattress pad down). Our joke now is that Mitch and half our bedroom furniture went rushing down the hall on the gigantic wave of amniotic fluid. Mitch woke to me saying, “Oh shit oh shit oh shit oh shit.” There was no mistaking what had just happened and it was too early. Just as Mitch asked me what was wrong, he started getting drenched and realized what was going on. He tells me now that he’ll never forget the sound of my voice when I woke him up that night.

Because I was 34 weeks and 4 days, it meant we couldn’t have the delivery at our Wisconsin hospital that we’d wanted, but my wonderful OB could catch our babies at a local hospital in the Twin Cities (ha!) with a NICU attached. Already one of my biggest labor fears was being realized: I’d be delivering in the most medicalized possible environment. Quite the change from my initial dream of a water birth at home. But I knew it was best for my early boys.

We called one of our doulas, who told me to take a shower, have a little meal, and take some time to breathe and reflect on the fact that I would meet my babies soon. She told me, “Check in with your babies, and let them know that it’s okay that they decided to be born today.” Until the day I die, I will remember those as some of the most powerful words ever spoken to me.

Mitch printed out my birth plan, put my labor playlist on my iPod, and made me some oatmeal. I sat on the couch in the dark and cried some tears – both happy and scared, and listened to a favorite song from my labor playlist,Djorolen, by Bela Fleck and Oumou Sangare. I hummed quietly to my boys and connected with them, and let them know that yes, it was okay that they decided to come earthside today. I didn’t remember it at the time but the translation of the lyrics to this song are, “The worried songbird cries out in the forest. Her thoughts go far away. For those of us who have no parents, her thoughts go to them.” I don’t think I fully understood the profundity and the sanctity of that moment at the time. In that moment, I was that worried songbird whose thoughts were far away. I felt worried, lost, happy, excited, calm – all at the same time. But from that moment on, there was no fear. I knew somehow that it would all be okay, that I would push both these babies out of my vagina with little problem, that my body knew how to do what needed to be done that day. Despite the fact that they were coming early, I knew deep down that they had chosen their birth day. I had total faith in my body and my babies.

About two hours from when my water broke, we were on our way to the hospital. By the time I got there at 4 AM (on all fours in the backseat, which felt GREAT), I’d begun having some mild contractions – nothing worse than period cramps. Our doulas Sarah and Amber met us in our labor room and we met Lori, our nurse for the day. Much to my pleasant surprise, she was totally accommodating of my natural birth plan – not wanting pain meds, epidural, or continuous fetal monitoring, etc. It really was the luck of the draw because depending on the nurse, she could have required continuous fetal monitoring due to hospital twin policy. She checked me and I was dilated to 4 cm. I couldn’t believe it – I’d barely felt a thing at that point.

I spent the morning in the early labor phase doing lots of hip circles on the birth ball, doing squats and lunges, and yoga led by Sarah. This was where I was sooooo glad I’d gone to prenatal yoga classes during my pregnancy. I felt so strong and powerful. I was able to moan through contractions and recover my sense of humor and ability to converse in between. Both my doulas and Mitch had their hands on me almost all the time, which was exactly what I wanted – I felt so supported. I had my labor play list playing which was also tremendously comforting – it helped the small, sterile hospital space feel more like home.

Early labor contractions

Sometime around 10 or 11am, a distinct shift in my labor occurred. We’d been to a parent topic night at The Childbirth Collective called “The Natural Rhythm of Labor” where the presenter, an experienced doula, acted out the stages of labor in a very realistic manner. This proved to be one of the most helpful things throughout my labor because I sort of knew based on how I was acting where I was in the labor, and that how I was behaving was normal. I moaned, vocalized, and moved my body in a rhythm that came from deep within. Once I felt this shift, I knew we’d moved to the next level. I was beginning to feel tremendous downward pressure in my bottom and a need to bear down. The contractions were intense and I could no longer talk between them. I needed lots of help to not tense up with each contraction. Again, my doulas and Mitch were amazing in helping me to relax as best I could. Because of the urge to bear down, my favorite place for the rest of my labor was on the toilet in the dark bathroom. I spent some time in the tub, but it wasn’t very deep and didn’t provide the relief I’d hoped it would. While I was in the tub, our nurse checked me again and even though I was sure I was at about 28 centimeters dilated at that point, I was instead at 6.

We went back to the labor room and this was when I was beginning to tell my support team, “You guys, I don’t think I can do this anymore.” Again, I remembered from the Childbirth Collective class that this was a good sign because it meant I was getting closer to the end. “You ARE doing this!”, my support team reminded me. Eventually I began begging for an epidural – supposedly another sign that things were progressing. Sarah, Amber, and Mitch knew I didn’t want the epidural so they helped me through more contractions. All the while, I was saying I couldn’t do this anymore. I was so exhausted – I couldn’t understand why they wouldn’t just let me lay down in the bed! It was hard not to tense up so much, but Amber helped me do a low roar through my contractions. I also threw up several times at this point (sorry Amber!) – I again remembered from our Lamaze class that this was a “good sign”. Even deep in laborland, I was somehow able to remember that barfing was often an indicator of transition.

Amber and Mitch, helping me through a contraction…

The nurse checked me again because I was doing so much grunting in my contractions that she felt sure I was ready to push. She discovered that I was still at 6 cm, had a slight fever, and that my cervix was beginning to swell from all the downward pressure over the hours. Sarah and Amber had me switch my breathing technique so that I wouldn’t bear down so much, but it was nearly impossible not to. The nurse said, “Okay, I know you don’t want an epidural, but I think we need to do something to take the swelling out of your cervix.” There was part of me that wanted to look at my labor support team and say, “See!? I won! Epidural!” Even though I didn’t want it, the idea of relieving the intense pressure of the contractions had taken over. The anesthesiologist came in and as he was prepping me, he said, “I see you have some acne on your back. That can increase the potential for infection which can lead to paralysis and death.” I was like, “Yep, paralysis, death, got it. Sounds good. Let’s get that epidural now, please!”

After the epidural was placed, it took only about 10 minutes for a powerful realization to sink in: I was one of the small percentage of women the anesthesiologist mentioned during the informed consent for whom epidurals don’t work. The intensity of the contractions had only increased and I had full feeling and movement from the tips of my toes to the top of my head. I could have stood up and tap-danced, no problem. (If I knew how to tap-dance. Also, I did not feel like tap-dancing). Sarah and Amber sent Mitch to go get something to eat thinking that we’d have some time now that the epidural was in. Wrong – nurse checked me again since I was still vocalizing loudly, involuntarily bearing down, and clearly feeling the increasing intensity of each contraction. In retrospect, this was the final part of transition. The nurse informed me that I was at 10 centimeters – fully dilated and obviously pushing already.

Sarah called Mitch and told him to get back upstairs quickly. The nurse got scrubs for everyone (Twins automatically have to be delivered in the OR at most hospitals. Bummer.) And even though I was in a deep internal place, I knew we were at the end of my labor and the birth was near. I have never felt so fully in my body in my life – it was the most profound physical experience I think I’ll ever have. Sarah told me it would be okay if I started working with the pushes when my body felt like it. My OB was on his way from Wisconsin (at about 4pm – rush hour!) and I could tell the nurse was beginning to get a little nervous about who was going to catch these babies.  Luckily, we rolled past Dr. H as they were wheeling me to the OR. Seeing his smile and thumbs-up was very reassuring. “You’re amazing!”, he called to me. “I’ll meet you in there!”

There were about 15 people in the OR – a team of NICU nurses for each baby plus the NICU resuscitation team, and some nurses for me. Mitch was at one side, my nurse at the other, and Sarah was at my head. Amber was taking pictures and videotaping. Side note: I’m SO glad my delivery was videotaped. I tell everyone to video their birth if possible. It was very healing for me to be able to watch what I did during the birth of my sons. It was tremendously empowering to be able to see the whole experience from a different vantage point. In the time since the birth, I’ve watched the video countless times, and I will show it to anyone who will watch it so they know the amazing things I am capable of. UPS guy? Thanks for the package, want to watch when I pushed two babies through my vagina without the aid of any pain medication?

A doula’s support during pushing.

So anyway, pushing. I didn’t realize how much pushing a baby out feels like the exact same sensation as pooping. My pushing wasn’t super productive at first, but once Sarah started telling me to push into my bottom, it made all the difference. No wonder I’d wanted to sit on the toilet for the last several hours. At one point, I reached down and felt my little baby A’s head as I was pushing. That really helped me focus as well – there really and truly was a baby coming out of me! All this pushing wasn’t for nothing – I was moving that baby!

I was in such a deep internal place – a place I’ve never been before. Most everything just melted away and I had a singular focus that I wasn’t in control of. My body was doing the pushing and I was just along for the ride. My eyes were closed. I was aware of Sarah at my ear. I was aware of Dr. H’s kind and gentle encouragement. I was certainly aware of the intensity of the physical sensation. What I was most aware of, though, was my sweet Mitch at my left side. With each push I could hear his words of excitement, telling me I was amazing and telling me how each push got us a little closer to the end. I could hear the smile in his voice. I could tell he could see the progress I was making – our first baby’s head making more and more of an appearance with each push. I didn’t hear a trace of worry in his voice – only joy and amazement, and that more than anything else got me through.

After what felt like an eternity, but what was actually less than 40 minutes, Oskar Jeffrey was born at 5:09 pm, coming in at 4lb, 14oz and 18 inches long. O had a tough time at first – he was gray and floppy and did not cry for quite some time. They whisked him off to the NICU team as soon as Mitch cut the cord. Mitch went to Oskar, and Sarah told me to talk to him so he could hear my voice. He had to be intubated because he was having trouble breathing on his own. For whatever reason, I wasn’t able to do anything but watch – I could not find my voice in that moment. I’ll always be grateful to Sarah for being my voice when I could not speak, saying, “Oskar, honey! Hi, baby! You’re doing such a good job! We’re so glad you’re here!”

All of the sudden, I began to feel the urge to push again. I’d sort of forgotten that I had another baby in me. I heard Dr. H say, “There’s another bag of waters” and as he was saying that, my second bag of waters broke. When that happened, I heard him say, “And there’s a head!” Those were some of the sweetest words I’ve ever heard. My second little boy, who’d been breech the whole time in utero, had somehow managed to turn after his brother was born. I was honestly thinking, “I don’t know how I’m going to do this a second time.” But one contraction and about 3 pushes later, Henry Christopher entered the world head-first at 5:13pm, wriggling and crying. I barely felt him come out – all 5lb and 18 inches of him. They were able to put him on my chest for about 15 seconds and it was amazing – the biggest high of my life. I cried out, “Baby, baby, baby, baby, sweet baby! I’m your mom!” I felt an almost primal urge to lick him, and I wanted to kiss him nonstop. But he had to be intubated as well, so he was taken off pretty quickly also. “Just give a little push,” I heard Dr. H. say. And so I did, barely noticing I was delivering the enormous placenta that my boys had shared over the last eight months.

Moments after the boys were born. We did it.

Meanwhile they’d stabilized the boys and were able to bring them to me briefly before transporting them to the NICU. I couldn’t believe how much I loved them. I kept saying over and over, “Mommy loves you so much.” It was scary seeing them with their ventilators in, but I had the feeling that everything would be alright. I knew they were in good hands. The same deep part of me that had known that I had twins in my belly from practically the moment the fertilized egg split into two also knew that they would be okay.

I was on such a high after the delivery. They wheeled me back to my room and right away I asked for the room service menu. I ordered grilled cheese and chocolate pudding and cole slaw and V8 and nothing ever tasted so good. Mitch was shocked to hear me say, “You know, that wasn’t so bad. I’m really already starting to forget how much that hurt!” About an hour after that, I started to feel like I’d been put through the ringer, and was so ready to go see my boys. It was such a strange and empty feeling to have given birth so triumphantly but to be without my babies in my arms.

A few hours later, I was allowed to go to the NICU to see my boys. I could not hold them, but I held their hands and stroked their heads and marveled that they had come out of my amazing body. I sang to each of them – “Beautiful Boy,” by John Lennon. Before you go to sleep, say a little prayer, every day in every way, it’s getting better, better, better. Beautiful, beautiful, beautiful, beautiful boy. I’ll never forget Oskar’s little eyes popping open at the sound of my voice.

The first picture of the four of us, in the NICU at St. Paul Children’s Hospital.

When it was all said and done, even though almost nothing went according to plan, it worked out exactly like it was supposed to. I had what I can only describe as an amazing, magical labor and birth. Because of my experience, I also feel strongly that beautiful, sacred, soulful birth can happen anywhere: I have had two truly transcendent, at-one-with-the-universe, experiences in my life, and one of them occurred in a brightly lit, sterile OR, on my back, in stirrups, with a literal crowd of people looking on. I felt every second of each passing sensation and now I wouldn’t have wanted it any other way. I ended up getting my “unmedicated” childbirth after all, and I’m really glad now that the epidural didn’t work. In the difficult days after the birth when my boys spent a few weeks growing and getting stronger in the NICU, I thought over and over about how strong and amazing and powerful I was during their birth. If I could do that, then I am capable of anything.

In the time since my boys’ birth, I have become a doula and a childbirth educator. For me, one of the most powerful and important parts of being a birth worker stems from the phrase, “When a baby is born, so is a mother.” I love it so much because that phrase, maybe more than any other, defines who I am now.  I was re-born when my boys were born.  I’d spent most of my life feeling like I was not very strong, and I’d always been one to give up when something didn’t come easily to me. But our birth – my boys’ and mine – showed me a strength I could never have dreamed I had in me. The experience of giving birth changed me down to my core, and I am forever grateful to those two little souls who illuminated the path toward the rest of my life.

Jess Helle-Morrissey is a doula, a Lamaze-Certified Childbirth Educator, a psychotherapist, a wife, and a mama. She teaches several childbirth education classes at Blooma, including one for families expecting twins, and lives in St. Paul, Minnesota with her three dudes: Mitch, Oskar, and Henry. 

Editor’s Note: A version of this story originally appeared on Birth Without Fear.

Cesarean Awareness: A Doula’s Humble Reflection

by Erin Stertz-Follett, CLD, LCCE, HBCE

 

My journey into birth began 10 years ago after the birth of my first nephew, Micah. I wouldn’t fully embrace birth as my calling until many years later, after the birth of my own two girls and the ‘birth’ of the passion inside me to bring services of meaning to pregnant women and their families.
I will never forget that moment. After an induction that lasted more than 24 hours, and “arrest of descent” of the baby during pushing, my sister was told that she would need a cesarean section. I watched as her face turned from determination, to disappointment, to resignation, and to sorrow. As my mom and I left the room while they began the surgical prep, I said to Mom, “That’s not what we wanted.” With tears trickling down her cheeks, she shook her head, “No.” The grief for what Sarah so badly wanted – a vaginal birth with minimal interventions – was palpable.

A few years later, as I was pregnant with my first child and wanting to learn as much as I could to avoid my own surgical birth, Sarah invited me to an ICAN (International Cesarean Awareness Network) meeting. At that time, the group was small and had just begun reforming here in the Twin Cities. I happened to attend on a night when a wise midwife named Gail Tully was on hand to provide information and practice in ‘optimal fetal positioning’ for birth. I didn’t know anything about birth halls or Rebozos, or the side-lying release. I just knew that it felt so good (and kind of funny!) as I was used as the ‘pregnant model’ for Rebozo belly sifting.

Two babies later, both of which included my sister’s attendance and support, I began the true path to birth work as a Lamaze Certified Childbirth Educator, doula, and HypnoBirthing Certified Educator. Again, my journey was largely inspired not only by Sarah’s first birth, but also by her successful HBAC (home birth after cesarean) her second time around.

To offer full disclosure, I dreaded as a doula the first time I would need to step into the surgical suite and witness a mama experience a cesarean birth. In some small way, I was traumatized by my sister’s experience. Now with several under my belt, I can say that my perspective has changed. Yes, it is still difficult. But, with my doula hat on, I enter the experience with an open heart and an open mind, with nothing but how I can best support that mama in that moment as my focus. It is at that time that we turn our trust over to the trained surgeon whose job now is to safely bring the baby forth from the mother’s womb. I offer a grounding hand on the forehead, an explanation of what to expect and what is happening, sounds and smells that calm the mother, words of reassurance to the partner, and pictures if mama desires.

I have seen mothers who view their surgical births in many different ways: From full-on acceptance (even requesting one at the end of a long, stalled labor); to complete devastation (offering my doula hands to wipe away tears); to somewhere in the middle (perhaps with resignation and a resolve to process the experience later).  I have seen cesareans that are completely medically necessary, and those that fall in a grey area.

Look, the cesarean rate in this country (32.8%) is too high. There’s no way around that. We can do better. For women, for babies, and for their families. It may feel daunting to tackle this subject on a grander scale and I know many of us birth workers often feel at a loss. But here is what we can do:

• Approach the subject with mamas (clients, patients, friends, family) with gentleness, understanding, an open heart; and, when needed, the statistics.
• Remember and value the fact that not all mamas view their cesarean as traumatic or unnecessary. Don’t assume that all mamas do and meet them where they are, especially as they plan a subsequent birth.
• Educate. Educate. Educate. Knowledge truly is power. Whether it is ways to more optimally position baby for birth, or methods for deep relaxation, or just knowing all options and all places of referral. Education is key. The ability to ask questions and have them honestly answered is tantamount.
• Refer to birth providers who offer options for mamas in pregnancy and labor; and who understand normal, physiologic birth… Those whose rates of cesarean birth are on the lower end (including out-of-hospital options if the mother desires).
• Refer mamas who have experienced cesarean birth, especially those that view their births as traumatic, to resources such as ICAN and Homebirth Cesarean groups.
• When a surgical birth becomes truly medically necessary either before the birth or during the laboring process, we can offer support and guidance for having a more family-centered experience.
• Put our time, our money, and our voices behind organizations that support mamas in having births with low interventions.

And finally, as doulas and as friends or family, we can hold hands. Wipe tears. Validate fears. Lift them up. Walk down to the lowest lows with them. Remind every mama how strong they are… that they brought their baby into the world; that they can do it again with love.

Erin Stertz-Follett owns Flutterby Birth Services, located in Burnsville, MN. In addition to doula services, she offers HypnoBirthing, Lamaze, and Breastfeeding classes as well as other workshops and events. She is the mother to two lovely and lively little girls.

Editor’s Note: This post first appeared on the Flutterby Birth blog. Photos credited to Stephanie Ryan Photography.  All birth stories used with the permission of the mothers. 

Eat, Pray, Doula: A Doula’s Journey in Bali

by Karen Bruce, AAHCC

I am writing from a hotel room in Ho Chi Minh City, Vietnam, awestruck by the experiences of the past 10 days, still overcome with emotion at the intense connections formed among a group of strangers in that time, and brimming with anticipation for my future birth work.  I just attended Eat Pray Doula 2014 in Ubud, Bali Indonesia with 27 of the most beautiful birth keepers you have ever met.

 

What better place to celebrate World Doula Week than in SouthEast Asia with such a diverse group of women?  We represented at least 11 countries and spoke numerous languages.  We included midwives and teachers, translators and nurses, small business owners, and, of course, doulas. Some brought their families on this adventure, some traveled alone.  All of us converged in this beautiful land they call the Island of the Gods for a DONA Birth Doula Workshop taught by Debra Pascali-Bonaro, chair of the International MotherBaby Childbirth Organization and creator and director of the film Orgasmic Birth, Ibu Robin Lim of Bumi Sehat International and CNN’s Hero of the Year 2011, and Katherine Bramhall, co-founder of Bumi Sehat and homebirth midwife.

Katherine Bramhall, Karen Bruce, Debra Pascali-Bonaro, Ibu Robin Lim

I traveled with my partner from Minneapolis along with two fellow Childbirth Collective members, Angie Posine and Angie Sonrode and their families.  We all knew this was something special and were eager to share and learn with so many experienced doulas and world-famous birth gurus. Our Twin Cities contingent had much to offer by way of practical suggestions for natural pain relief, position changes, communication with families and staff, etc.  I am proud to say that the Childbirth Collective was a shining example to our peers of how birth keepers can work together to support one another and provide best practices with an evidence-based model of doula care.  We loved sharing how Minnesota is at the leading edge of a revolution in well-supported birth thanks to the many legislative efforts of Susan Lane and the Minnesota Better Birth Coalition.  Our community enjoys many options in childbirth that are sadly not widely available.

 

But Eat Pray Doula challenged me in many ways to move beyond the comfort zone I have created in my doula work – I know very well the culture of birth in the Twin Cities and my place in it, and my toolbox is filled with ideas to support the physical and emotional needs of the birthing families I serve.  However, I may not have been fully prepared for the deeply spiritual transformation I experienced at this workshop.  Our facilitators were skilled at creating the conditions that allow true connection with other people, and they lit a spark within me that has inspired me to create sacred space in birth, to preserve and protect the spiritual as well as the physical and emotional.

My first DONA Birth Doula Workshop with Gail Tully in 2006 prepared me in very practical ways to be a birth doula, and she certainly speaks to the spiritual, but I may not have been ready to hear it.  The 8 years of experience at over 200 births in between have prepared me to receive this new perspective in order to develop that part of my practice which is so critical to the mystery of life and love on this planet.

 

Not to be confused with religious expression, the spiritual aspects of creating life in our womb and birthing our babies into this world are simply related to the human spirit or soul.  Simply by choosing my words or silence more carefully, by being fully open to the MotherBaby mystery as it unfolds, and, when I have my activist hat on, by educating and encouraging gentle birth practices by other doulas and care providers – I know I am making a difference.  I remind myself that it is not necessary to understand this mystery in order to honor it and create space for its expression during this profound transition from pregnant to parent, from MotherBaby to mother and child.

 

Eat Pray Doula workshops are appropriate for new/aspiring birth doulas, but even the most experienced will learn many new ideas to breath new life into their important work.  I would especially encourage nurses, midwives, and obstetricians to consider registering for a future workshop as a gift to yourself and all birthing families you will hold sacred in the future!

Karen Bruce is a certified Bradley Method(r) Instructor and Birth and Postpartum Doula in the Twin Cities.  She serves as the Vice President of the board of the Childbirth Collective. Her website is karenbrucedoula.com.

Celebrate and Share World Doula Week 2014!

March 22-28 is World Doula Week! Did you know that just recently, ACOG and SMFM (American Congress of Obstetricians and Gynecologists & the Society for Maternal Fetal Medicine) named doula support as one of the most important and most underutilized tools in preventing cesareans in first-time mothers? This is just one of the amazing, research-based benefits of doula support.

So if you are a doula, used and loved a doula, or just want to shout the doula love from the rooftops, feel free to comment here and share these graphics on social media! We here at The Childbirth Collective are so proud to do what we do. Happy World Doula Week!

Driving Home From a Birth: A Tale of Triumph, Whimsy, and the St. Paul Police

by Mary Norby, CD(DONA)

As a birth doula, the drive home from a birth is meditative: replaying the birth, most often reliving the joy, sometimes a bit of regret. Driving home from Lori and Paul’s birth was pure joy—distracted joy.

Lori had, in her words, rocked her VBAC. It doesn’t get better than that for a doula. It is so rewarding when a birthing mom understands what a birthing rock star she was, how powerful she is, how forever awesome she will be.

Lori got it. She rocked her VBAC.

I was giddy as I drove home from St. John’s Hospital at 4:30 in the morning. Part of me realized that my euphoria was clouding my driving ability.
For those of us who have seen Bridesmaids, you may recall Annie driving home from Lillian’s shower, bemoaning the loss of her best friend to Helen: Annie’s car swerves all over the road as she chants, “Hi, I’m Helen. I’m Lillie’s new best friend, even though I’ve known her for 10 seconds.”

I believe my car was swerving, not because I’d lost a best friend, but because I just saw a woman do an amazing thing—and she gets it! She knows how amazing she is!

Wouldn’t it be funny if I got pulled over?

Whoa! Those are bright lights in my review mirror. Are those red and blue lights too?

I’m getting pulled over.
I actually smiled–did I have a story for the St. Paul Police.
The lights were so bright I covered my face. Would the officer think I was trying to hide my identity? A doula in the witness protection program, perhaps?

As I readied for the “Good morning, ma’am, a little distracted this morning?” I said a prayer, “Please God, please give me a female officer. Oh, while you’re at it, make her in her “childbearing years.”

Bingo.
“Good morning. A little distracted this morning?”
“Yes, officer. I’m a birth doula, and I’ve been up all night at a birth.”
“Is that why you ran that stop sign back there?”
I did?
“I did? Oh, I’m sorry.”
“License and registration, please.”
This is where I used some Doula Magic. Reaching into my bag, I made sure to send some lavender scent Officer Childbearing’s way. Calming to birthing moms. Calming to ticketing police officers.

She returned to my car a few minutes later, saying, “OK. Drive home safely, and get some sleep.”

“Thank you officer. Don’t you want to know how the birth was?”
A voice was saying, “Quit while you’re ahead.” But really, I was on a roll. “Yes. Is everybody OK?”
“Everybody is awesome! A beautiful baby girl.”
“Great, have a nice night.”
“Thank you, officer.”

Childbirth Collective named “Best Prenatal Resource” by Minnesota Monthly Magazine!

We at the Childbirth Collective are THRILLED to have been named “Best Prenatal Resource” in the Twin Cities by Minnesota Monthly Magazine. What an honor, especially in an area so rich with amazing prenatal resources!  

 

Here’s what they had to say about us: 

BEST PRENATAL RESOURCE

The Childbirth Collective

The non-profit group of midwives, doulas, bodyworkers, and other birth professionals known as the Childbirth Collective is one of the best birthing resources in the Twin Cities. Their free, incredibly informative Parent Topic Nights—which help addled parents-to-be navigate the heretofore uncharted health-care and emotional waters of the childbirth year—separate information from rumor and dispel many pregnancy myths. The collective’s website hosts a wealth of information, including recommended books and DVDs, a comparison of local hospital birthing programs, and profiles of its members. Bonus: the husbands we know enjoyed the classes as much as the expectant mothers. • childbirthcollective.org

3rd Time’s a Charm: The HBAC Waterbirth of Bryce

by Robyn Hustrulid

Before starting this birth story, I feel the need to mention my 1^st and 2^nd births.  They are the beginning of my journey and very much effected how I gave birth to my 3^rd child.  My first came a couple weeks early with my water breaking in the middle of the night.  I went to the hospital before contractions started and after walking around a bit, they started me on Pitocin.  It took the whole day for contractions to get strong, and after 2 hours of strong contractions, an epidural and a cervical check resulting in little progress, the OB recommended a cesarean.  Besides asking if we could wait, I didn’t know enough to fight this recommendation, so my first baby came to me via an unplanned, and what I have come to realize, an unnecessary cesarean.  The reasoning was “failure to progress,” or maybe we could call it “failure to wait.”

 

The cesarean wasn’t easy for me to accept.  I was happy I had a healthy baby, but not happy with how things went.  Breastfeeding started off rocky and recovering from major abdominal surgery was not what I had planned for.  I knew I wanted something different for my second birth.  I started asking about VBACs (Vaginal Birth After Cesarean) at my 6-week postpartum visit.  And then two and a half years later when I got pregnant, I read more books, watched the essential movies, attended some parent topic nights, became a regular at Blooma, switched to a midwife, and hired a doula.  I felt prepared and knew that I could accomplish a safe and rewarding VBAC.  My labor started at 41 weeks, again with my water breaking in the middle of the night.  I stayed home and waited for contractions to get intense, and then went to the hospital.  There were a few hiccups of back labor, stalled progress and an epidural, but eventually I welcomed my 2^nd baby into the world via a VBAC!

After that experience, I fell in love with the role of the doula, because I knew my first birth would have been different if a doula had been with me.  I decided becoming a doula was the right path for me and dove in headfirst.  After 2.5 years of witnessing strong mamas welcome their babies into the world, I decided it was time for me to do it again.  But again, from all that I had learned and witnessed, I knew this time would be different.  I decided to have a homebirth.  I hired 2 midwives and 2 doulas.  I focused on eating healthy, working out and doing yoga.  I also went to the chiropractor regularly to make sure my pelvis was balanced and my body was in alignment.  After hearing amazing reviews, I decided to give Hypnobabies a try as well.  I was very committed to doing all of the homework and listening to the tracks daily.  I was a believer but wasn’t sure if it would work for me until my birthing time came.

On Mother’s Day 2013, my guess date, I decided I wanted to have a low-key day and spend some time with my own mom.  I took a nap and listened to the “Come Out Baby” track from Hypnobabies.  Then I went for a walk in the afternoon with my mom and a movie after.  I had been having Braxton hicks daily for weeks, but started to notice some waves (Hypnobabies term) coming more regularly during the movie.  Later I realized this was my early birthing time, but during I dismissed them because they didn’t seem to be getting stronger.  These waves continued on through the night as I ate dinner with my kids, did the dishes (while listening to Birthing Day Affirmations) and then put the kids to bed.  I went to bed thinking nothing was happening, but decided to listen to my “Deepening” track.  I wasn’t able to fall asleep because the waves were getting a bit stronger.  Around 11:30, I felt some fluid leak a couple times and thought I was peeing, so I decided I should go to the bathroom.  When I stood up, I felt a gush between my legs and knew exactly what was happening.  I sat on the toilet and felt a bit stunned, excited, anxious, and in disbelief.  I called to my husband that “my water broke.”  It took him a bit to wake up, but then he got up, and we started getting things together.

I made my phone calls; told my mom to come over to sleep, and I let the midwives and doulas know that it was happening, but I didn’t need them yet.  I could feel the waves but they weren’t very strong, so we decided to get everything ready and then go back to bed.  David set up the birth tub and got me some water.  I got the camera, some snacks, the Hypnobabies scripts and my iPod out.  My mom got to our house around 12:30.  I told her “this one is sure different.”  I had a few waves in the kitchen and leaned over the counter while breathing through them.  They still felt somewhat mild to me or just like pressure.  I was sure there was a lot of time left.

 

Around 1am, after we felt like things were gathered and set up, I asked David to do the rebozo for a bit.  I was feeling some of the waves in my back so we wanted to encourage baby to get in a good position.  After a couple waves, I got up and sat on the ball and David turned on the “Fear Clearing” track.  The waves started to get a little more intense, so I decided to call my midwife around 1:30am.  She asked how close they were, and we had no idea.  So she asked that we time a few and call her back.  After timing them and seeing that they were 3 minutes apart, I realized that things were moving faster than I thought, but I still felt like it was early in my birthing time.  My midwife decided they should come, so I also called my doulas to come.  My midwife also suggested we do an initial fill of the birth tub, because it would probably take a couple, and we would need time for the water heater to heat more water.

With every wave, I was leaking a lot of fluid, so I decided to get in the shower.  I let the hot water run on my breasts in between the waves and drew peace signs and hearts on the steamed up shower door.  During the waves, I leaned over and let the hot water run on my back.  My mom got me my water bottle, and I put it in the shower with me.  I could hear some of the Hypnobabies in the background, and I was saying, “Open, Open, Open.”  After the waves I would burp, and I smiled as I remembered my midwife telling me that was a sign of active labor.  I loved the shower and the routine/rhythm I had created.  But sadly, because we were also filling the tub, the hot water ran out.  I got out and sat on the toilet around 2:25am. My mom started to boil some water just in case.  I didn’t realize it at the time, but my mom and David started to get a little anxious for the midwives to get there.  My mom asked David if he could deliver the baby if need be.  He just grinned and put his hands out like he was catching a baby.

One of my doulas arrived around 2:30.  She took note that waves were about 2 minutes apart, and I was listening to Birthing Affirmations.  I remember using my peace cue during waves, and feeling like it was really helping.  My doula said relax, and I could feel my shoulders melt and my body soften.  Around 2:45 one of my midwives arrived, so my mom was able to relax.  My doula suggested I eat something, so David went and got me some yogurt and an Emergen-C drink.  The midwife in training arrived shortly after, and then my other doula.  One of my doulas came and put her hands on my shoulders and forehead and told me to relax.

My midwife tried to hear the baby with a fetoscope but wasn’t able to get a good angle while I was on the toilet.  My other midwife arrived and also tried to listen to baby while I was on the toilet, but it wasn’t working, so they asked me to stand up.  I stood up and leaned over my sink.  My doula did some double hip squeezes and massaged my back, which felt wonderful.  My midwife was still unable to find the baby with the fetoscope, so she asked if I wanted to get in the bed or use the Doppler.  I couldn’t imagine lying down, so I said Doppler.  She found my baby’s heartbeat, and it was perfect.  I remember hearing on the Hypnobabies track, “say your baby’s name.”  And I said, “I don’t know your name.”

 

At 3:24 I asked if I could get in the tub.  It wasn’t ready yet, so one of my doulas went downstairs and helped my mom bring the boiling water up to fill the tub.  David and my other doula were checking to see if the water was warm enough to start filling it with the hose.  Around 3:30, I started to feel like I needed to poop; my doula mind knew what that meant, but I wasn’t ready to admit it out loud yet.  As the pressure built, I asked again if I could get in the tub, but it still wasn’t ready.  One of my doulas suggested I sit on the toilet while I waited.  When my first wave came while on the toilet, I felt my whole body start to push and I couldn’t resist it.  I had about two waves like that, and heard my midwife say, “she is going to have that baby on the toilet.”  I said, “I NEED to get in the tub.”

Around 3:40 I got in the tub, and my mom was still dumping hot water in it.  When the first wave started to build, I got into a froggy squat position.  It felt like the rise of a roller coaster, excitement, nervous, anxious and joy in the anticipation.  I knew once I got to the top there wasn’t anything I could do.  This baby was coming down, and I was just along for the ride.  I felt my whole body start to involuntarily push.  It was such an unusual feeling, and I knew I had no control and needed to surrender.  The “Pushing” track was on, and I remember sending peace down and out in front of my baby’s head.  After the wave, I leaned over the side of the tub, rested my head on the edge and asked for cold washcloths.  David held one on my forehead and someone put one on my neck.  While pushing I could feel the baby’s head moving down and then rocking back up in between waves.  My midwives told me I could reach down and feel the head during the next wave, and it was then that I finally believed I would meet my baby soon.

Just before 4am, one of my doulas asked if I was ready for the kids to come in.  I said I didn’t know and asked if they thought the kids could handle it.  Everyone said yes, so I said ok.  My mom woke up Kyle and Jolie and they came around the corner sleepy eyed and smiling.  They got pillows and blankets and lied in the hallway.  They would sit up and watch as they heard me making grunting and pushing sounds.  Kyle asked my mom, “What’s all the drama?”  Apparently I was making more noise than the women in the movies I had showed them.  In between waves, I asked Kyle if he was ok and he said yes and didn’t look the slightest bit scared.

My midwife suggested I tilt my pelvis during the next wave so the baby could get past my pubic bone.  What a difference that made, I could feel the baby move down even further and stay down.  During the next wave I sat back and thought in my head I’m going to keep pushing even if I feel burning.  I reached down to feel the head coming out, and then the wave stopped.  I asked, “is this ok,” even though I knew it was.  My midwife assured me it was just fine and the baby’s color looked great.  During the next wave, I could feel the shoulder come out and then the rest of the body slide out.  I brought my baby up on my chest and felt the most incredible rush of emotions.  “Oh my God, oh my God, oh my God, this was awesome!  Everybody should do it!”  And then I heard my son say, “it’s a boy!”  My sweet little man, Bryce David Hustrulid, came into this world in such a beautiful way at 4:04am and changed our lives forever!

Bryce David Hustrulid born May 13, 2013 at 4:04am

8lbs 14oz, 21 inches

Birth Story: Emaline’s Home Water Birth under a Blue Moon

by Kerri Rivers

Editor’s Note: All photos in this birth story are from Megan Crown Photography. 

Kerri getting support from her partner and doula. (and doggie)

Our second pregnancy was accidental. Jason and I had been indecisive for several years about whether and when to have a second child. But we were thrilled when we saw the positive pregnancy test. We knew right away that we wanted to have this baby at home. The hospital birth of our son five years earlier was a lovely and natural water birth but we couldn’t help but feel that it had been unnecessary for us to be in the hospital. So we made calls to several home birth midwives. Our first interview was with Emme Corbeil of Trillium Midwifery and we felt an immediate connection with her. We didn’t end up interviewing anyone else.

Homebirth mama Kerri gets a hip-squeeze from her doula while her partner and son look on.

Our prenatal care was amazing. Our appointments were at Emme’s home and each one lasted an hour, giving us time to talk and get to know Emme and the midwife apprentices. We brought Eliot to each appointment and he loved being a part of the process (and playing with Emme’s great toys). Having our appointments at Emme’s home, always with a warm cup of tea, where there was intimacy and comfort,  was a blessing and wonderful preparation for birth. As I approached 40 weeks, I felt completely at peace and ready to meet the sweet baby in my belly.

Happy Birth Day, baby Emaline!

My water broke on Monday night a little after midnight. It was 2 days before my due date. I hadn’t yet gone to bed, but after a quick talk with Emme, I laid down to try to get some sleep. Jason stayed up and filled the birth tub. I had intermittent contractions throughout the night and didn’t sleep well, mostly due to anticipation. Neither of us got much sleep. The next morning I got up early and went for a long walk with a friend, hoping that it would get things moving along, but there was no change. Emme and Julie, a midwife apprentice, came over around 10am to check on me and the baby. Everything was great. Emme commented that her head was so low that she couldn’t really feel it. We agreed to touch base later in the day. Emme called while we were eating lunch just a few minutes later and told us that she couldn’t shake the feeling that maybe the baby was breech. She asked if we would be willing to go for a positional ultrasound and we agreed. I promised myself I wasn’t going to worry about the possibilities, but  it was difficult to keep my mind off the idea of not being able to have a home birth. The ultrasound took less than three minutes and the ultrasound technician was able to confirm immediately that the baby was head down. We were incredibly relieved.

After dinner that evening, Jason, Eliot and I took another walk. My contractions were becoming more regular and I was pretty tired. We talked with Emme and let her know that it was still stop and go. After making sure that our house was tidied up and everything was ready for the birth, we went to bed around 10pm. Around midnight, I felt like I couldn’t lay in bed anymore and I got up. I knew at that point that my labor had started in earnest. My contractions were still between 6-10 minutes apart but they were definitely getting stronger. I took a long shower and mentally prepared myself for whatever was to come. It was a Blue Moon that night and I spent a few minutes outside taking in the full beauty of the moon under which my daughter would be born (and getting a huge mosquito bite on my belly in the process).

A new family of four

After checking out the moon, I decided to sit on a birthing ball to see if it could help me get into a rhythm. I started my birth playlist and relaxed, while Jason and I chatted and kept track of my contractions. It felt so calm and peaceful and the birthing ball was definitely working its magic. Around 2:30am, we called our team and asked them to come over: Emme, Julie, Rebecca the second midwife, Margaret our doula, my friend Kristen who would be there for Eliot, and our birth photographer, Megan. Everyone showed up over the next forty minutes or so and we all got cozy in the living room. I was able to talk between my contractions and I continued to labor on the ball. I remember feeling incredibly comfortable, safe and surrounded in love at this point. We woke Eliot up around 4am to make sure he would have enough time to fully wake up before the baby arrived. It was important for him to see his sister’s birth. As my contractions started to intensify, Margaret suggested I try laying down in bed to rest for a couple of minutes. I agreed and we moved to the bedroom. The first contraction I had in bed felt so much more intense than all the others and I knew that I was ready to get into the tub. By this time, I was in a labor fog and had lost all sense of time. I got into the tub and remember that the water felt so warm and took the edge off the contractions, which were very intense at this point. I know that I labored in the tub for about an hour before I felt the need to start pushing, but at the time, it felt like only minutes to me. It is so incredible what birth hormones can do! I remember Margaret helping me through contractions and Jason and Eliot encouraging me. When I started pushing, I came out of the fog a bit and realized that Margaret was reading out loud a set of birth affirmations that I had written several days prior. I focused my mind on them as I allowed my body to open for my baby. After 4 or 5 good pushes, Emaline Ophelia was born at 5:55am. I distinctly remember hearing the song, The World Exploded Into Love All Around Me, playing from my birth playlist as she came into the world. Jason caught her while Eliot stood right next to him. The moment felt absolutely perfect to me, filled with so much love.

Happy big brother!

After the birth, Jason, Eliot, Emaline and I moved to our bed where we stayed while both Emaline and I were checked. She weighed 8 lbs and was 22 inches long. Emme guessed the weight exactly! By the time everyone left our home several hours later, everything was cleaned up, I had eaten, there were cold compresses in the freezer and perineal rinse in the fridge, and we were all tucked cozy into bed and ready to sleep.

Blue Moon Baby

Our home birth was everything we had hoped for and more. We were able to bring our daughter into the world in the most peaceful and loving way. Eliot was able to watch his sister’s birth. Jason was able to deliver his daughter. I was able to labor in my own home, surrounded by my family and a care team that honored and respected the normal and amazing process of birth. We feel so incredibly blessed, both to have had the birth we did and because of the precious life that joined our family that morning.

Kerri Rivers is a mama to Eliot (5) and Emaline (3 weeks) and wife to Jason. She is a Regulatory Compliance Specialist at Boston Scientific who likes to be crafty in her free time and is super passionate about natural birth.

Sweet Moments in OOH Birth: A Doula’s Perspective

by Anne Ferguson, CD(DONA), HCHI

A homebirth mama is comforted by her partner and her doula as her midwives look on.

Amazing, beautiful and empowering birth can happen anywhere, that’s for sure.  But there are some special things I’ve witnessed as a doula in out-of-hospital birth that you really don’t see in a hospital setting.  Here are just a few of the amazing things I’ve had the honor to be a part of in some of the birth center and home births I’ve attended as a birth doula.

 

• The doula waking the older children in the middle of the night just moments before their Mom pushed their new sibling out in the world so they could witness the birth, and the children announcing the sex of their new baby sibling.

 

•  The entire birth team and family enjoying chocolate cake and pink champagne at 6 am after a beautiful home birth.

 

• A strong Mom pushing her baby out into the world just as she envisioned, in the birth tub in her backyard as the sun rose on a beautiful summer morning.

 

• Enjoying Pizza Luce for lunch while sitting around the dining room table in a comfortable and cozy birth center with a Mom in early labor, waiting for her body to move into the next phase, without any expectations around timing or a need to rush the process along.

 

• A beautiful, quick birth during a power outage, because it turns out you don’t really need power to have a baby!

 

In general out of hospital birth offers the following perks:

 

• Taking a bath or shower in your own bathroom and then climbing into your own warm, comfortable bed not long after giving birth.

 

• A homemade meal made just for you, right in your own kitchen or in the birth center kitchen, made just to your needs and tastes. 

 

• Midwives who you know and trust because you’ve been meeting with the same people for months, and you know who is going to be there when the times comes for your baby to be born.  (This happens sometimes in hospital birth with small groups of care providers.)

 

• Moms being able to trust their bodies completely, knowing when it’s time to push their babies out without any cervical checks. 

 

• Control over who comes in to your postpartum space, instead of the constant flow of traffic that usually happens in the hospital setting.

 

Out of hospital birth is a safe and wonderful option for low risk mothers wanting a low-intervention birth.  In the Twin Cities we are incredibly lucky to have three free-standing birth centers and many, many wonderful, skilled home birth midwives.  If you are planning to have a low-intervention birth, it is well worth your while to consider your out-of-hospital options!

Anne Ferguson, CD(DONA), HCHI is a birth doula, Hypnobabies instructor and placenta encapsulator who has two sons, one born in the hospital and one in the comfort and safety of her own bedroom.  You can find her at www.bywaterbirth.com.

 

 

 

 

The Lowdown on Out-of-Hospital (OOH) Birth

by Kate Saumweber Hogan, CPM, LM

A homebirth mama gets support from her midwife.

What is OOH Birth?

Out-of-hospital (OOH) birth refers to births occurring outside of a hospital, such as at a home or a free-standing birth center that is not connected to a hospital.

Planned OOH births can be in a house, townhouse, apartment, trailer, hotel, friend’s house, birth center, or even a back yard! Most homebirth midwives are pretty flexible with space needs, and can make almost any “home” work. Ideally, there should be running water, electricity, and a phone (or cell phone service), but even those can be negotiated!

Weighing the baby at a homebirth

What do all of those letters mean after midwives names?

There are two general kinds of midwives in our country. There are nurse midwives who are primarily trained in a hospital setting and most often attend births in the hospital; they are called Certified Nurse Midwives (CNMs). Some CNMs gain additional experience to offer OOH care as well.

The second type are direct entry midwives; these midwives are primarily trained in the home birth or OOH setting and provide care in this setting. Some direct entry midwives earn the national credential of Certified Professional Midwife (CPM). In Minnesota, CPMs also have the option of becoming licensed by the state, which also gives them the title of Licensed Midwife (LM). It is a good idea to ask your midwife what her credentials are, especially in Minnesota where there are so many possible combinations!

A homebirth midwife helps a mama welcome her baby earthside.

It is safe to birth at home or at a birth center outside of a hospital?

Midwives are experts in normal. So for normal, low-risk, healthy moms and babies, YES, research shows that with a trained care provider, it is as safe or safer to be OOH than being in a hospital setting. However, OOH birth isn’t for everyone. Your midwife will help determine if you are a good candidate for OOH birth, and will continue to monitor you and your baby during pregnancy, labor, and delivery to ensure that it is still safe to be at home.

If you would like to read the research available regarding home birth, a thorough review is available through Midwives Alliance of North America.

The question is often, “is homebirth safe?” but rarely, “is hospital birth safe?” This article looks at the other side of the coin.

What equipment do OOH midwives bring?

Each midwife will have a little variation in her birth bags, but in general, most midwives are certified in neonatal resuscitation and CPR, and will have equipment pertaining to those certifications. She will have medical supplies such as oxygen, suction for baby, medications for hemorrhage, a fetoscope and doppler to monitor baby’s heartbeat, a baby scale, and equipment to check mom’s vitals (blood pressure cuff, stethoscope, thermometer, a watch).

Some midwives carry IV equipment, suture and lidocaine for perineal tears, a pulse oximeter, a variety of herbal and homeopath remedies, and a birth stool. Some midwives also rent birth tubs and have additional equipment relating to the tub. Be sure to ask your midwife what you can expect her to bring to your birth.

Most midwives have families purchase a birth kit, which will have all of the disposable things that are needed for the birth, such as underpads, gloves, gauze, and a peri bottle. Families will also be asked to gather a list of supplies to use at the birth, such as towels, baby blankets, and extra pillows.

A new family snuggles in their own bed just after birth

Is homebirth messy?

This question comes up a lot! Surprisingly, birth is not at all like it is portrayed in the media and it really isn’t very messy. Your midwife uses supplies from your birth kit to help protect your bed and floor. She will start the laundry and clean up any sign of your birth before she leaves your home so your visitors won’t even know where the birth happened! There isn’t even very much trash, often barely enough to fill a kitchen sized garbage bag. You may have a second bag of trash if you are using a birth tub with a large plastic liner.

A mama meeting her baby in her own home.

What about labs, ultrasound, and newborn care options? 

When you interview potential midwives, it is good to ask if they offer routine labs, ultrasounds, and newborn care options (vitamin K, erythromycin, newborn metabolic screening, hearing screening, CCHD screening). Some midwives offer them as part of routine care, and others would refer you to your primary clinic for these services. Informed consent and shared decision making is at the heart of midwifery care. Prenatal visits will be an opportunity to discuss the pros, cons, and alternatives, and make a decision together about what is the best choice for you and your family. If you’d like to decline testing or newborn options, you can! It is your choice and it shouldn’t be a fight! But it can be nice to know what options will be available to you, since there may be some that you want for yourself or your baby.

If the midwife you choose doesn’t offer the newborn screening options (metabolic screening, hearing screening, and CCHD) most midwives who offer these options are willing to see babies outside of their practice for these screenings. You can find providers who offer these services here: http://minnesotamidwives.org/MCCPM/Newborn_Hearing_Screening.html

Does insurance cover it? 

Sometimes! There isn’t an easy yes or no answer, since it is really plan dependent. Most OOH midwives are out-of-network and will be covered based on your out-of-network benefit levels. Many of the birth centers are in-network and are covered at that level. Some midwives bill insurance, and others don’t. Midwives who offer insurance billing usually can do a benefits check to give you a better idea of what you can expect to be covered. If you have an HSA or flex spending plan, those funds can go towards paying for your midwifery care. The vast majority of the time, even paying 100% out-of-pocket for your home birth is less expensive than the out-of-pocket costs for a hospital birth after insurance processes the claim. The Childbirth Connection is a good resource for comparing costs by birth place from a national level.

 

Brand-new homebirth family.

Can I have a doula and a midwife?

Yes! Many out-of-hospital midwives encourage each woman to consider having a doula at her birth. Doulas provide continuous emotional, physical, and informational support before, during, and after birth. Many midwives offer this kind of physical and emotional support as well. However, unlike midwives, doulas don’t provide any medical care. Doulas are great at offering comfort measures and supporting both the laboring woman and her partner from early labor until after baby is born. Be sure to check out the Childbirth Collective for free parent topic nights and ample opportunities to meet with and interview doulas.

How do I find a midwife who works in a home birth or birth center setting?

Check out the midwife listings on the Childbirth Collective, view members of the Minnesota Council of Certified Professional Midwives, and check out this comprehensive list of midwives from Minnesota Families for Midwifery. Most practices offer a free consultation to see if the midwife and family are a good fit, that is a great opportunity to ask any additional questions you may have about out-of-hospital midwifery and birth!

Kate Saumweber Hogan is a certified professional midwife and licensed midwife, serving Minnesota and Wisconsin. She is the owner of Twin Cities Midwifery where she provides prenatal, home birth, newborn, and postpartum care. She sees families at clinic spaces in Minneapolis and White Bear Lake, and lives in south Minneapolis with her husband and nursing daughter, born at home in the water in December 2012.