Healing from a Homebirth Turned Cesarean
Editor’s note: This article first appeared in Midwifery Today, Issue 130, Summer 2019.
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My first pregnancy was low risk. I planned a homebirth with a skilled midwife. As a labor and delivery nurse, I knew full well all my options. My husband and I felt that having the baby at home was the best choice for us. Labor started at exactly 40 weeks. I was fully dilated and effaced for well over 24 hours, but my sweet baby was persistently occiput posterior (OP) and not descending. Despite our best efforts, and tricks of the trade, he would not rotate/descend into my pelvis as he should have. We decided together, as a team, that transfer to the hospital was our only option as labor reached the 48 hour mark. Once I arrived at the hospital, an obstetrician I’ve worked with and trust implicitly tried to manually rotate my baby, to no avail. He was wedged firmly in my pelvis, still OP and asynclitic. So, off for a non-emergent but necessary cesarean we went.
In the days, weeks, and months that followed, I was haunted. I felt such a deep, powerful, and magnetic love for my son, but a stabbing hole in my soul. I felt robbed and eventually angry, as I attempted to process the grief. I looked for someone, anyone, to blame and found no one. Every night for months, as I nursed my beautiful baby to sleep, I would quietly cry. I did everything right. What did I do to deserve this birth? I told very few people about these feelings, and the ones I did tell, said, “Well, you and baby are healthy, and that’s all that matters.” And while that was true, I knew deep inside that it wasn’t the only thing that mattered. Didn’t my feelings matter, too? But it felt selfish to say that out loud, so I didn’t.
My dear, sweet midwife offered me the only glimmer of hope I got in that very dark time. I held my baby and cried in her home and told her I felt like a total failure as a woman and a mother. She validated my feelings with this story: A family with several children had a beloved family dog. One day, the smallest child fell into a creek by the house and was near drowning. The dog was able to rescue the boy but was then swept away in the water, where he died. Although the family was obviously sad over the loss of the dog, they were so grateful that the boy was saved.
She empowered me with this story to understand one very important concept: You can fiercely love your baby and also be absolutely wrecked by the emotional or even physical trauma of a birth, and both of those feelings are okay. They can happen concurrently. I don’t think I ever gave myself permission to feel this, before that day.
Although I wouldn’t say I really ever healed from the birth, I did learn to function—somewhat. The day-to-day ramblings of adjusting to life and then work, etc., with a beautiful new baby kept me busy enough to bury those feelings. For the most part.
The hospital where my baby was surgically born was the same hospital where I taught nursing students. About nine months after his birth, I was attending a birth that needed surgical intervention. I remember walking into that operating room for the first time after I had been there as a patient and having a full-blown, raging panic attack. I had to excuse myself and go collect my emotions in the bathroom. I knew I needed to heal from my traumatic birth, but I had no idea how or where to start.
Once I learned that I was expecting our second child, elated as I was, I was also petrified. All of my deeply buried emotions came bubbling to the surface. I decided that I really wanted to enjoy this pregnancy—not be scared of it and filled with fear—so I decided that therapy was my best option.
At therapy, I was able to fully, finally process the entire birth. I cried and cried while telling the story. I verbalized every fear I had. I learned skills to use as I moved through the past and prepared for the future. I needed to feel my feelings. I had been denying myself that. So, as hard as it was, I felt all the feelings I had! I wasn’t sure yet how this second birth would pan out for me, but I knew that regardless of how this baby entered the world, I needed to prepare myself. I owed it to myself. I’m ever so glad that I did this difficult work.
Attempting a vaginal birth after cesarean (VBAC) is always an emotional risk. There are, of course, physical components of risk as well, but for me the biggest risk was emotional. What if I failed? Again? Would I be okay? I dug deep into myself and answered my own questions with another: What if I succeed? I decided that, for me, taking an emotional risk was my best bet. If I ended up with another cesarean birth (for any reason), I would know that at least I had tried. To schedule a repeat cesarean—for me—was to be defeated.
I made birth plans for both outcomes, used my new coping skills, and proceeded through the remainder of my pregnancy with a light heart. I would be okay. We would be okay. Baby and I would get through this birth together. I accepted that I was not in control.
My midwife’s collaborating physician preferred that she not attend VBACs at home. So I saw her for my prenatal care and then at 36 weeks I switched to an obstetrician I trusted and planned a hospital VBAC. It was not ideal for me, but it was the best option I had.
Labor started at 40 weeks and 4 days. I had asked my former midwife (who was by then a good friend) to attend me at home in early labor because I was preparing for another possible marathon labor. I wanted her to occasionally monitor the baby to make sure he was tolerating labor well, and possibly check my cervix, so I would not have to spend more time laboring in the hospital than was absolutely necessary. I knew I’d have to deliver in the hospital, but I really didn’t want to labor much there.
Long story short, I went rapidly from 4 cm, to 7 cm and “start the car; let’s go to the hospital now!” to having the baby in the kitchen a short while after that—as the car was running in the garage! Luckily, my midwife travels with all of her gear so, once the baby was born, we just stayed home. Pushing was surreal—transcendental even. Holding a sweet, slippery, and beautiful baby, who I had powerfully roared out of me for the first time was nothing short of monumental. I was absolutely triumphant. And while I know that not every woman who attempts a VBAC will be successful, I can definitely say this: the reward was worth the emotional risk, for me. I did it. We did it. But the most important work I did was not even remotely related to labor. I’m confident that it was the work I did to prepare myself mentally and emotionally for whatever the outcome was going to be. I am ever so grateful I gave myself that gift.
As Sister MorningStar once told me, “
What one woman can do, all women can do.” One woman can heal; all women can heal—when we fully give ourselves permission to heal and time to process.