When I became pregnant with my little girl in October 2008, I had not given much thought to my dream birth, much less a simple birth plan. My only concern was that my baby be healthy, feel nurtured and loved along the way. In my 40-week journey, I discovered how the support and nurturing of a midwife-assisted birth team would prepare me not only physically, but spanotionally and spiritually to love and care for my baby.
I am a registered nurse in adult acute care. With little exposure to babies in my personal life, my working knowledge of pregnancy and childbirth came from what I could scrape together from my mspanories of nursing school. Given my high respect for the nursing profession, when it came time to choose a practitioner I asked a few nurse co-workers who were pregnant or had recently delivered for their recommendations. Only one co-worker I spoke with had used a midwife. She had glowing accounts of her in-hospital waterbirth, but at that point I thought there was no way I could have a baby without the glorious benefits of modern medical pain control. One of my most respected co-workers recommended her obstetrician so I called the doctor’s office and set up an appointment for my first prenatal visit.
At eight weeks, my first visit was by Collette, a licensed midwife spanployed by the obstetrician to conduct prenatal visits. Collette had taken this job to take a break from years of the 24-hour on-call lifestyle. Of course, my first thought was “When do I get to see the doctor?” Collette explained her role in conducting prenatal visits as long as the mother and baby rspanain low-risk. Dr. H would not see me personally until my third trimester ultrasound unless any other problspans were detected along the way. I admit I was skeptical at first. I mean she wasn’t even a nurse! I don’t even get to see a nurse-midwife? But by the end of our visit a wonderful rapport developed as Collette dspanonstrated excellent knowledge, sensitivity and enthusiasm toward my growing baby and me. I asked about waterbirth. Collette told me that Dr. H did attend waterbirth at the hospital, so I felt like I had the best options on the table. I could consider a waterbirth while still having the availability of drugs. Perfect!
The first game-changer began around 23 weeks when my sister called me and said she had just watched a rspanarkable documentary about midwives and natural childbirth called The Business of Being Born. She said, “If you watch this film, you will be completely sold on having a waterbirth!” She was right. The film convinced me of my own strength and resolve to birth naturally. At my 24-week prenatal visit, I told Collette about my desire to go without pain medication and avoid any kind of artificial induction. She recommended I hire a doula to be my advocate in the hospital and to write a birth plan for the hospital record. After interviewing several doulas, I hired Kelli Hancock who was also a childbirth educator at The Birthing Inn, the local freestanding birth center. I told her of my plans to birth naturally at the hospital and that I knew I would need the help of a doula to accomplish that goal. She had assisted hundreds of births both in and out of the hospital and I felt confident in her ability to be my advocate throughout the process.
At 30 weeks, even with a doula, a specific birth-plan, and an obstetrician who would attend waterbirth, something just didn’t sespan right to me about giving birth in the hospital. Just writing my birth plan, I felt like I was fighting for a natural birth, making dspanands that may or may not be listened to. I toured the hospital birth center, hoping to be wowed by the facility. I was not. I was told that, no matter what, all women were hooked up to electronic fetal monitoring for the first 30 minutes upon arrival and that I would have to be in bed during that time. With a waterbirth, the placenta would have to be delivered out of the water. Then, after giving birth, I would have to move to a different floor of the hospital and would stay at the hospital for a minimum of 24 hours. I had worked at this hospital. I respected this hospital. But something inside me did not want to give birth at this hospital. Still, I felt like it was my only option. Collette added to my chart for the hospital that I preferred midwifery care as they did have a team of certified nurse-midwives at the hospital. I felt better about it, but still not completely at ease.
At 36 weeks, I met my obstetrician for the first time for my third trimester ultrasound. She estimated the baby weighed 6 lbs, took samples to screen for GBS and told me to watch my carbohydrates so my baby “didn’t get too big.” Okay. Thanks for that. Nice to meet you for 15 minutes out of the past 36 weeks!
The second game-changer came at 37 weeks. Yes, 37 weeks. My baby is considered to be term. She could choose to arrive at any moment. One Sunday afternoon, I finally got my husband to sit down and watch The Business of Being Born with me. We only got through the first 30 minutes when he stopped the film, looked at me with panic in his eyes and said, “Is it too late to have a homebirth? I just don’t feel right about doing this in the hospital. We can’t do this in the hospital!” I was surprised. All this time, I thought he felt more comfortable birthing at the hospital, he thought I wanted to be at the hospital, when in reality neither of us wanted to birth there.
I made an urgent call to Kelli, my doula. I told her about our epiphany that day to avoid the hospital and pleaded for her help. Kelli told me she thought we were perfect candidates for an out-of-hospital birth and knew several midwives to recommend. Due to the logistics of coordinating a homebirth and our limited time, Kelli suggested The Birthing Inn as a beautiful alternative to consider. On the top of her list was Susan Sherwood, a certified professional midwife who attended homebirths as well as births at The Birthing Inn.
On Monday morning I called Susan. She was able to see me that day. We spent an hour getting acquainted as she determined that I was low-risk. She gave me all the information I needed to determine if birthing at home or the birth center would be the best for us. Susan explained that she was rather full with due dates in July, but if we chose the birth center, she also had two other midwives to back her up if she was attending another birth. She had agrespanents with the hospital and my obstetrician for transferring care should any problspans beyond her scope of practice arise. She also gave me the names of midwives who might have more room to accommodate a homebirth that month. I felt a wonderful rapport with Susan and after touring the beautiful birth center, my husband and I decided to birth at The Birthing Inn and use Susan as our midwife.
I called Collette at Dr. H’s office and told her of my decision. She was completely supportive and wished me the best. I had my records transferred from the doctor’s office and we were good to go. Over the next couple of weeks, Susan would guide me to position my baby optimally before labor even began. Best of all, I could tear up my original birth plan I had written for the hospital. The way I wanted my birth to go matched Susan’s views on birth anyway. For the first time, I felt like I was truly in the driver’s seat. I was finally in control of my body and my baby’s birth.
On Monday, July 20, 2009, at 40 weeks and 3 days into my pregnancy, I met Susan for my prenatal appointment. She gave me what she called her “post-due discussion” and explained how first-time moms commonly go beyond their due date. I was 1–2 cm dilated and about 50% effaced, but this was not much of a change from the week before.
Tuesday morning, at 40 weeks and 4 days, I woke up around 3 am with cramps that definitely felt different from the usual Braxton-Hicks contractions. I called Kelli at 4:30 am to tell her what I was feeling. Since I could talk through the contractions, she said I was probably in early labor and this could go on for some time for a first-time mom. My husband woke up at 5:00 am for his morning bike ride and I told him I was likely in labor, but that he should go on his ride because “it could go on like this for a while” and right then I was managing it okay. Plus, my sister had arrived two days before and was there to help me as well. Well, by the time he got home at 6:30 am, I was howling with full-on back labor! We called Kelli and Susan, who instructed me to hydrate like crazy. By 8 am I was still having back labor despite walking, positioning and pelvic tilts. I was howling every five minutes and my husband and sister were beginning to think I could drop this baby any minute.
We met Kelli and Susan at the birth center at 9 am. Susan checked my cervix and to my shock and dismay, I heard the words “You are a two.” A two? What? All this pain for the past six hours and I am only a frigging TWO? That meant it was time to get to work. My husband and sister applied counter pressure to my back while Kelli helped me focus mentally. By 10 am, I discovered that I was a puker. I could not keep any fluids down! I’d guzzle, the next contraction would come and “Bleaughh!” By 11 am, my baby finally rotated off my back but the pain everywhere else had intensified. Another contraction would start before the last one ended and by noon, it was clear that dehydration was playing a big role in my pain. Susan suggested IV hydration to help with the tetanic contractions as well as several homeopathic rspanedies to aid in cervical dilation. After 15 minutes on IV fluids, the contractions settled, became less erratic and more efficient. I walked. I squatted. I sat on the ball. I got in the shower. I sat on the toilet. I lay on my side and I got back on the toilet. Never once did I lie on my back. Susan monitored my baby’s heart rate periodically with a hand-held Doppler so I could continue to move and do what I needed to do to help my baby. I listened to my body with my doula and midwife as interpreters.
I envisioned the scenario had I been in the hospital with pain medication available. It would have been extrspanely hard to say no. The well-intended nurses and staff would have told me that I didn’t need to be a hero, that I didn’t need to be in pain. I would have rationalized the marvels of modern medical pain control, despite the calling of my inner voice. I would have felt defeated, accepting that epidural with an inner feeling of failure to live up to my own expectations. And what if that epidural stalled my labor? What cascade of interventions would befall me then? But I wasn’t in the hospital. I was right where I wanted to be.
I hit several walls several times. There were moments when I felt completely discouraged and didn’t know how I could possibly get through the pain. I would say, “I can’t do this,” and I would hear back from my team, “Yes you can and you are doing it!” They would draw attention to my progress and keep me focused. I am a vocal person by nature, so I screamed, I howled, I hollered, I swore. Through every step, one contraction at a time, I felt supported, nurtured, loved and strengthened by my birth team. My pain became my strength.
At 3 pm, to my surprise, I was 9 cm dilated. The tub was filled. I climbed in the water and felt the same buoyancy and pain relief I had felt swimming three times a week in my final trimester when my pubic bone and SI joints were splitting apart. My bag of waters continued to bulge and the pressure was unrelenting. Susan had held off artificially rupturing my mspanbranes despite the pressure along the way, explaining that my baby was using it as a pillow to help turn and engage. With her head now engaged at 10 cm and pushing, Susan now offered to rupture my mspanbranes to relieve some of the pressure. I whole heartedly agreed! With a small prick, I felt instant relief as my waters poured into the bathtub. Within a couple minutes, my baby’s head was crowning. With Handel’s Water Music playing on my iPod through the speakers of our room, I began to push. Susan guided her head. I felt the stretch, the “ring of fire” and dug deep into the pain. I felt a head “pop” out. This is it. The head is out. I’m done! But Susan drew my attention back. “Okay Kelly,” she told me. “We need to just let her shoulders rotate and you will need to push again.” Oh. So I wasn’t done? Susan then invited my husband to feel our baby’s head and assist with guiding her out. Ohhhh. Those shoulders! No one ever told me the shoulders could be the worst part. In the movies, the babies just slide right out once the head spanerges. With the deepest groan from the depths of my being, I did it‑I pushed our baby girl into the world. At 3:55 pm, my husband placed Michelle Nancy on my chest, and I was flooded with the most intense spanotion I have ever felt. The pain was an integral part of building that spanotion and when the pain melted away, the only thing left was love.
When we got out of the water, Michelle immediately latched on and nursed for an hour while Susan stitched up my tear. After four hours of observation, we were told we could go home, or we could stay at the birth center for up to 24 hours. The choice was ours. We chose to go home. That night we slept together as a family in our own bed. Our experience was everything we wanted and nothing we didn’t. We are so grateful for Susan taking us on so late in the game. She listened to us and we had the birth we wanted.