Why Choose Home Birth? Part 1 of 10

Editor’s Note: Due to the overwhelming response from families wanting to share in their own words about why they chose home birth, “Why Choose Home Birth” will be published in a 10-part series. Please explore the blog for the other posts where mothers, fathers, partners, and even a grandmother answer the question, “Why did you choose home birth for your family?”   Thank you to Emme Corbeil of Trillium Midwifery for posing this question to all the families she has served over the years. 

Part one written by Emme Corbeil, CPM, LM

Photo Credit: Alisa Blackwood

When a woman and her partner enter the world of pregnancy and birth, the choices available to them are ever-expanding. Women birthing where I practice – in the Twin Cities area of Minnesota – are rich with choice. Not only are many area hospitals offering midwifery services, water birth, and other supportive options for normal physiologic birth, but there are now three freestanding out-of-hospital birth centers right here in the Twin Cities and several more in the greater Minnesota area.

With the choice of hospitals and birth centers, what drives a woman to choose to birth her baby at home? Why are an increasing number of mothers going against the current cultural norm and choosing home birth?

I have been attending home births for the past ten years, so I have a large client base to pose this question to: Why did you choose home birth?  It has been delightful and enlightening to read the responses that poured in. The reasons that mothers and their partners are choosing home birth fall in to several categories: safety, privacy, knowing the provider, taking personal responsibility, trusting the process, wanting to avoid unnecessary interventions, having family-centered care, and wanting supportive vaginal birth after cesarean birth (VBAC). The reasons are multi-faceted and deeply personal.

One mother who has birthed all three of her babies at home simply stated, “ I chose home birth because it just made sense to me.” Other moms went straight to the research and stated facts, “After an unnecessarily interventive hospital birth with my first child I started doing research into home birth at med school. I had free access to the Cochrane Database (best meta-analysis resource for well designed studies in prenatal/birth care) and I discovered that given these three things 1. Healthy mom 2. Healthy baby 3. Healthy pregnancy, birth,  out of hospital has as good or better outcomes than in-hospital birth throughout the world. I switched to home birth for my second and third births.”

One of the most profound responses I received was from a second time mother who started care with my team well into her second pregnancy. She knew she wanted something different from the hospital experience she had with her first baby. I honestly don’t remember the exact details of her first birth but it probably went something like this. Pregnancy went past due date, advised to plan an induction, anxious, scared, didn’t have labor support, wasn’t progressing fast enough, exhausted, pitocin offered, artificial rupture of membranes, couldn’t cope, couldn’t get into birth tub, chose epidural, more pitocin, baby wasn’t tolerating labor augmentation, blood pressure dropped, fetal distress, vacuum/ forceps/cesarean, mama baby separation, difficulties breastfeeding, postpartum depression. I am drawing very big generalizations here but versions of that story are what bring many mothers to home birth…..dissatisfaction with a hospital birth experience. What this mother wrote sent shivers down my spine and keeps me doing the work I love to do. “I chose to birth my baby at home because home birth gave me something I did not even realize had been taken away. A gift beyond imagining, as a woman, as a mother, as a human being. It is an awesome gift in every respect; to the whole family, mending one mother at a time all the losses humanity suffers. A deep healing connection in a culture bent on disconnecting us from our souls, ourselves and each other.”

It’s powerful stuff, this choosing!

I was surprised that from the dozens of responses I collected, only one of the families mentioned the financial aspect of birthing at home. Even though most families pay out of pocket for their home birth care and hope for insurance reimbursement many families we meet today have high deductible insurance plans and choosing home birth is a more economical choice than hospital birth with large deductibles, co-pays and 80%-20% splits.

For a healthy mother, having a normal pregnancy with a healthy baby, choosing to birth at home with a trained and experienced provider is a viable and wise choice and one that the mothers who responded to my question write about with so much love and passion. In the coming days, follow this blog to read in their own words what drives many families to birth in the safety of their own homes. You will hear from moms and partners, dads and even a grandma. Most of the respondents were overwhelmingly happy with their decision to birth at home but not everyone. There are a few partners who were scared during the unexpected and moms who still question why they chose home birth and aren’t sure they would choose it again. What it boils down to for me as both a woman and now as a provider is that women are given a choice.

Check back tomorrow for words from the families on why they chose home birth!

Emme Corbeil CPM, LM

Emme is a Certified Professional Midwife, Licensed Midwife practicing in the metro area with her sidekick Clare Welter, CNM. Emme has been attending home births since 2003. In 2006, Trillium Midwifery Care (www.trilliummidwives.com) was born. Emme and Clare help mothers and their partners birth safely in the comfort of their own homes. Emme is the mother of three big kids. She and her husband Paul live in Minneapolis with their nervous little dog Pinto.

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.

Birth Story: A long labor and a Thanksgiving Homebirth

by Stacey Plasch

I wasn’t expecting labor to start anytime soon, despite being 40 weeks and 5 days. I was actually looking forward to spending Thanksgiving, a mere 3 days away, still pregnant. But labor came creeping up Monday morning, and by that evening we knew it was more than just Braxton-Hicks contractions. What we didn’t expect was that I would still be pregnant on Thanksgiving, if only until noon. Despite knowing that our baby was still ROP, the idea that my labor could stretch for another 60-plus hours hadn’t even crossed our minds. Baby had been stubbornly in the right occiput posterior position for weeks despite me doing inversions, side-lying releases, pelvic tilts, and many other exercises from spinning babies. I had read on the website  that having a posterior baby can mean a longer and more difficult labor, but for some reason that possibility had flown from my mind.

So, thinking our baby would be born by sometime the next day, we called my mom and told her to come over. Our friend also stopped by to pick up our dog, who was so attached to me he ‘helped’ the midwife with every prenatal visit by lying next to me on the couch while she used her fetoscope or hands. We thought it would be better for all concerned if he was somewhere else during labor and birth. Our friend also had to bring us a hose to fill up the birth tub which our midwife, Vanessa Stephens Coldwater, had dropped off earlier that day. Apparently our hose’s connection was broken and we didn’t realize this until my husband, Ryan, tried to attach it to the sink! So our friend had to go to two different stores at 8 pm in the middle of November to find an outdoor garden hose!

Then we called Vanessa who said I should try to sleep as much as possible and that she wouldn’t be coming over until labor was further along. Sleep!? Who could sleep with these contractions every 10 minutes?! With Ryan in bed beside me, I lay on my left side and was surprised to find myself easily falling asleep between every contraction. We had taken the Bradley Method of Natural Childbirth and I concentrated on fully relaxing physically and mentally during each contraction. It was sure a long night though!

Come Tuesday morning Vanessa stopped by to check on us and said that baby’s heart tones sounded good. Vanessa was very encouraging and supportive. She checked baby’s position and said she had finally engaged in my pelvis and that all the contractions I was having were “turning contractions,” getting baby to move into a more optimal position. Vanessa showed me a few more exercises to do to help this process along. I really hated the customized inversions. I had to kneel on the bed with my chest touching the surface and my arms at my sides for an hour at a time. I just wanted to keep moving around and staying still made me antsy. In a way, I believe I was trying to escape from the pain by keeping active. It was easier to ignore that way.

I ate and drank as normally as I could that day. Ryan helped by offering me water between contractions and my mom made food and cleaned. We watched a lot of bad courtroom tv shows (“Judge Joe Brown! Now it’s Joe Time!”) and I remember the commercials annoying me. One in particular was repeated several times throughout the day. It was advertising a culinary arts college and asked “Why are you still sitting on the couch? Call the Culinary Arts Institute today!” I yelled back, “I’m in labor!” I also spent a lot of time sitting and bouncing on my birth ball. The best $20 I ever spent at Target!

The contractions had spaced out to about every 20 minutes during the day, which Vanessa said was normal. She said they would probably pick up in frequency come nightfall and they did! I was very anxious to get into the birth tub this whole time and Vanessa suggested I take a warm bath or shower. I finally did get in the tub for awhile to try to help me relax before bed. That night was more difficult and I needed Ryan’s help to manage contractions. I was starting to need some counter pressure on my lower back as well, which was encouraging!

Wednesday was very similar to Tuesday. I ate and drank normally, watched a lot of bad tv, and did several different exercises to encourage baby to move from posterior to anterior. I needed counter pressure with every contraction now and my mother and Ryan would take turns. They would use a tennis ball or a heated up corn bag and I would simply yell, “BALL!” or “BAG!” at the start of each contraction, depending on what I wanted. I also started to lay over the birth ball while kneeling on the floor instead of just sitting on it. We talked to Vanessa on the phone a few times and she stopped by to check the baby’s heart tones and to see how I was coping. She reassured us that everything was going well.

Wednesday night was the most difficult for me, and it was sometime during this night that I moved into more ‘active labor.’ The only way I could get any rest this night was to sit on the birth ball and lay my upper body on our bed. Ryan or my mom then sat behind me to provide counter pressure during contractions and sips of water in between.

I kept wanting Vanessa to come over, as I had this mindset that when the midwife comes, the baby will be born! I remember wanting to call her several times but Ryan encouraged me to wait until morning. We finally called her at around 7am and she said she would be over soon.

When Vanessa arrived we mutually decided to do our first and only cervical check, since we wanted to make sure I was making some progress. That was especially painful and I was glad I didn’t have them hourly, like many hospitals require. I was overjoyed to hear I was at a 7! YES! Vanessa then had me lie on my left side with my arms behind me and my right leg stretched over the top of my left leg. She said this position will sometimes encourage the amniotic sac to break. I don’t remember her saying this and when my water broke a few contractions later I shouted out in surprise, “My water broke!!” Although there was meconium present the amount didn’t concern Vanessa as baby’s heart tones sounded good.

I went into transition shortly after this and accidentally tensed my body against the contractions which caused PAIN and lots of screaming! My mom was essential at this point. If she held my hands, breathed deeply with me, and looked into my eyes I was able to relax well. I moved to the toilet to try to urinate before getting into the tub, but was unable to do so. My body starting to push while on the toilet but I didn’t realize this until afterwards.

I got into the birth tub and Ryan put on his swimsuit as he was planning on catching baby. I was kneeling and holding onto my mom’s hands as she kneeled outside the tub. Ryan got in behind me and provided more counter pressure on my back.

I was very LOUD and I pushed HARD, because at this point I was so done. I was very eager to meet my daughter and I just wanted her OUT. A few months beforehand I made a bet with my uncle that I would not tear at all. He’s a RN and has very conventional views of medicine and childbirth. He adamantly said that “all first time moms tear if they don’t have an episiotomy” and I wanted to prove him wrong! However, at this point I no longer cared about tearing.

Between contractions I would often reach up and feel the progress of her head. I could feel that she had hair and also wondered how something that big could possibly fit through my vagina. After pushing for almost 50 minutes she shot out and Ryan tried to catch her, but she kicked away and swam up between my legs in front of me. I picked her up and she immediately started screaming! It felt so surreal that she was finally born after all those hours! She had a ton of dark brown hair and was very alert. Both her Apgar scores were 10, so a cesarean due to the long labor or meconium-stained water would have been very unnecessary.

Audrey didn’t want to nurse for a while; she was too busy crying. Her head was moulded to the left and she seemed to be fairly unhappy about her journey earthside. Ryan and I cuddled her, caressed her hair, and I double checked her gender (we had a 20 week ultrasound to find out ahead of time). I was very grateful that Vanessa or my mom didn’t “hat, chat, or pat” on Audrey and just let the three of us be for awhile in the tub. After the cord was done pulsing Ryan cut it and then we all got into bed where I pushed out the placenta and Audrey finally nursed.

I had between a second and third degree tear. Luckily I didn’t need stitches and healed great after a regimen of bed rest, sitz baths, and frozen herbal compresses. I had heard that stitches made for painful healing so I was grateful to avoid them. Audrey was born with a nuchal hand so I likely would have torn even if I had pushed more gently. I never talked to my uncle about it as I didn’t want to further fuel that fire, and luckily he didn’t ask.

My daughter’s birth was the most empowering, amazing experience of my life. I found an inner strength I never knew I had. To have such a great outcome after a long and difficult labor is a true testament to the capabilities of a woman’s body, and to the knowledgeable skill of my midwife who understands all variations of normal birth. I truly believe our outcome would have been very different if I had chosen a different care provider.

Audrey’s birth was the starting point of my incredible journey into natural birth and parenting, which I’m very passionate about. I’m also going to Bradley teacher training in a few weeks and hope to start teaching my own classes in St Cloud before the end of the year. Her birth lit a fire in me that will not be extinguished anytime soon.

Midwife: A documentary about home birth

Local birth photographer turned filmmaker, Allison Kuznia, writes about the making of her new documentary.

For the past decade, through my births, as well as in my work as a birth photographer, I have been intrigued by the world of home birth midwifery.

So I decided to make a movie about it.

My goal in making the movie was to show the art, beauty, and compassion within home birth midwifery.  But, as I went through the process of filming and conducting interviews with women and midwives from other states where home birth midwifery is not legal, a bigger message emerged from the movie as well.

I talked with a midwife from Iowa who was arrested in 2007 for practicing medicine without a license. I talked with the women behind Birth Matters in South Dakota, a state where their home birth midwives received cease and desist orders, and the women who wanted to birth at home were left with options they didn’t want to face: 1) birthing in a hospital, 2) having an unassisted birth, or, 3) crossing the border to have a hotel birth with a midwife from another state. I talked with a couple who described what they went through in finding an underground home birth midwife while they lived in Nebraska, and comparing that to how easy and accessible it was to find a home birth midwife after they moved to Minnesota.

Through these interviews, the message behind this movie started to come together on its own: Families deserve the right to choose where and with whom they birth.

While the documentary follows Twin Cities home birth midwife, Sarah Biermeier of Geneabirth, through her first year, from prenatals, to births (including a wonderful VBAC2), to postpartums, it also examines what the birth environment looks like in states where home birth midwifery is not legal and families are faced with fewer birth options. In an act that should be simple, giving birth has become a human rights issue and a political event.

Other communities around the country, especially those in states where groups are working toward the decriminalization of home birth midwifery, have requested and are hosting screenings of the film. The premiere screening will be here in Minnesota. The film will be available for purchase on DVD and online streaming after the new year.

Midwife Documentary – Trailer from Allison Kuznia on Vimeo.

Midwife is premiering at The Heights Theater on Tuesday, September 24 at 7 pm with a 30 minute Q&A following the film. Visit www.midwifethedocumentary.com for more information and to purchase tickets.

Home Birth? Me? No Way!

by Liz Hochman, CD(DONA), LCCE

If you would have asked me, newly pregnant with my first baby at age 27, if I would ever have my baby at home I would have thought you were crazy. I mean, homebirth just isn’t safe! There are no epidurals there! Only hippies and crazies would do that kind of thing!

During my first pregnancy I read everything I could get my hands on, and I mean EVERYTHING. My bedside table was 20 books deep at any given moment. Being the type A, analyze-everything, trust-the-data person that I was, I treated preparing for my childbirth like I was getting a degree in how to have a baby.   I attended a standard childbirth education class and learned all about when I could get the epidural, how the epidural worked, and any other interventions and medications that were available to me. At no point during this learning did anyone ever mention to me, “Hey, you’re planning a natural unmedicated normal low risk birth? You might want to consider a homebirth.”

Fast forward to after that birth and into the first year of parenting my sweet new baby girl. I found myself questioning a lot about the whole experience.  I began my path towards becoming a doula and found myself pregnant with my second child. It was during this process that I realized homebirth was the logical next choice for me. I wanted to KNOW who my provider was going to be at my side during this very vulnerable day. I wanted to not have to drive anywhere during the most intense parts of my labor.  I didn’t want to try and negotiate and fight with the staff regarding tests, procedures, and monitoring.  I respected those people a lot, as I worked with them nearly every week attending hospital births as a doula. But I knew that I didn’t want them to have to “make an exception” on my behalf as I asked for fewer and fewer items I knew they were required to implement.

So I began looking into this whole crazy homebirth thing.  Me! The type A, ex-research-manager-turned-doula, suburban mom – having a homebirth.  My husband had many questions about safety so we reached out to a few midwives and interviewed them.  He asked all the “what if” questions he could think of. They were all so lovely and thoughtful in their answers. They had clearly done their work, studied, learned, and were qualified to be compassionate and competent medical providers.  Each question we asked about safety was answered in a way that made total sense.

Q. What if our baby needs help breathing?

A. We bring oxygen and everything needed to resuscitate a baby.

Q. What if there is a shoulder dystocia?

A. We would do the same thing at home as they would do in the hospital for a shoulder dystocia.

Q. What if I bleed too much after birth?

A. We bring the same medications they have in the hospital to help stop the bleeding.

The biggest selling point for me, came from the numbers – once again! The data and numbers person from my past just can not be ignored. So I found the research, and it was a clear choice.

The biggest selling point for my husband was that it was cheaper than the hospital birth and we could all sleep in our own beds after the birth.  Originally when we called our insurance company they stated that they did not cover any out-of-hospital providers for birth. So we decided we were just going to have to take this financial hit and deal with it. Turns out they ended up covering nearly 1/3 of the expenses and it was STILL cheaper than an unmedicated normal birth at the hospital.

As I lifted my second-born from the water with the sunshine pouring in my large window in my living room I exclaimed “I DID IT!”  In retrospect, I think I was talking about a lot of things when I made that exclamation.  Yes, I created and birthed this beautiful child, that part is definitely part of that “I DID IT” statement. The other part was the piece where I trusted myself, my body, my instincts, and my yearning to have birth happen a different way. A way that allowed me to be WITH my family, WITH my home, WITH support, and WITH safety.

I guess that means I’m one of the hippies and crazies now?

Liz Hochman is a doula, Lamaze-certified Childbirth educator, and mama of two sweet girls. She teaches childbirth education at Blooma. 

Citation:

http://bmj.bmjjournals.com/cgi/content/full/330/7505/1416?ehom

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.

Birth Matters: A Midwife’s Manifesta, by Ina May Gaskin — A Book Review

By Hope Lien CD(DONA)

In her influential new book, Ina May Gaskin, the godmother of natural childbirth and world renowned midwife, writes of the harsh realities of the maternity care system in the United States– with some of the highest maternal morbidity in the developed world. She compels readers to consider that every woman should have the right to positive and safe birth. Gaskin’s evidence -ased work, rigorous examination of past, present, and future maternity practices, and intimate writing style all made this a delightful read.

There were many parts of this book that resonated with me, both as an advocate for women to receive better care, and personally as a female consumer. In the beginning of the book, Ina May reflects on the way she reminds women to trust their bodies to birth. “Let your monkey do it,” is a phrase Gaskin refers to in the book, and often encourages women to remain in a sort of primal state that their body will best progress in during labor.  By staying in tune with their natural birthing state, and when placed in a comfortable environment, such as their home, women are able to avoid many interventions imposed on them by the obstetrical system today.

Birth Matters is peppered with birth stories from the Farm Midwifery Center where Ina May lives and works as a midwife. These tales of the great strength of women who have birthed their babies without the use of pain medication or surgical measures give power to the opinions expressed throughout her book. Gaskin devotes an entire chapter to discussing technological advances in the obstetrical realm and the ways in which women may have been better off without. She educates readers about the effective and safe options that were previously available before the invention of ultrasound to predict a baby’s weight, widespread c-section for breech babies, and electronic fetal monitoring, to name a few.

One of my favorite sectionsof the book speaks directly to fathers-to-be. In this section, Gaskin gently encourages partners to be familiar with the sphincter law, the idea that the cervix opens best in privacy and to follow a mother’s cues to show you how to move through the labor process. She also suggests how to help the laboring woman tune into her “monkey” or most primal state, and keep her adrenaline or fight or flight response low, while boosting her oxytocin and beta endorphins which keep labor moving and reduce pain levels. Gaskin does an excellent job of encouraging fathers and reminding them that birth is a normal process, although the media may tell you otherwise.

At the end of the book, Ina May shares her vision for subsequent births here and around the world. She maintains a hope that one day medical personnel will be more properly educated to assist birthing women, and that maternity care standards would be revised. Most importantly, Gaskin is optimistic that we can develop a better way to keep track of all maternal deaths taking place in the US, and that we could develop better practices based on the outcomes.

Birth Matters is a persuasive and enticing look at birthing standards in the US, with many traditional and non-invasive ways to improve upon them. It is certainly one of Ina May’s most far-reaching call to women and maternity care specialists everywhere to improve the care we offer to expectant mothers, both here and around the world.