From home birth to hospital delivery: The birth of Farrah

Like most birth stories, mine starts long before I ever actually went into labor.

After finding out I was pregnant I started going to the largest local OB practice, the one where pretty much everyone I knew went. The staff and doctors there were great but I felt like something was missing. I started researching natural birthing methods and, after lunch with a close friend, water births and home births. I really felt like this was the route for me but I was comfortable with my current OB choice and didn’t know if I wanted to go through the hassle of finding a midwife and changing practices. I went back and forth trying to decide what was best and my husband and I talked endlessly about our options. He was on board for whatever I decided to do and, surprisingly, was really into the home birth option also.

The more we talked about it, the more I realized that I wasn’t nervous about giving birth or becoming a mother—I was nervous about the potential chain of interventions that could occur in the hospital. I talked to a couple of friends who had had home births themselves and collected referrals. At my 20-week ultrasound we found out we were having a girl —meaning that we probably wouldn’t have any other children (I had always wanted a daughter). I knew that if I wanted to have a home birth this might be my one chance for the experience.

But I did feel bad leaving my OB practice. The four midwives and staff there were great and always went out of their way to make me feel comfortable during my pregnancy. So I decided to write them a letter explaining my decision. I wrote that I was really happy to have met them all but that this was my one chance to have a home birth and I really felt like it was something I needed to do. I told them that if their practice had offered home births I would certainly continue on with their care and that I would continue to speak highly of them and refer them to others who wanted a hospital based practice. I left on good terms and excitedly started my home birth journey.

Early morning on August 15th, my due date, I started having irregular contractions. I laid awake and timed them for a while but a pattern never really developed and by 6am they had faded so I went back to sleep. The next morning, the 16th, around 4:00 a.m. I started having the same irregular contractions. I lay in bed and tried to find a pattern and thought that they might be coming every 20 minutes or so. Finally, at 6:00 a.m. I decided to get up and time them for real. They definitely seemed to be coming every 10 to 20 minutes so I decided to take a walk before it got to hot to go outside. I walked around the yard for a bit, noticing the way the sun came through the trees to the east and watching the wildlife on the marsh coming alive. Everything was very vibrant and clean looking. I took a few pictures, thinking to myself, this was the sunrise on the day my baby would be born. Then I took a walk around the neighborhood, timing contractions every 5 to 10 minutes. They were still light though and I could easily talk and mostly walk through them. A few made me stop and breathe deeply, but all in all they were almost pleasant—made more so by my excitement that I would soon meet my baby girl.

Around 8:30 a.m. they were still coming every 5 to 10 minutes so I decided to call my midwife and doula just to let them know that my labor seemed to have started. I ate some cereal and did some light cleaning around the house. I was thinking about taking a nap (that I would end up needing dearly!) when my doula came over. We chatted for a bit and timed my contractions, which were about 5 to 7 minutes apart. By noon or so they had progressed so that I had to pay attention to breathing and relaxing through them. At some point in early afternoon my midwife came over and checked me. I was only 4 cm, which made me feel very disappointed. My midwife then told me that she had another lady in labor at the exact same time as me. Great, I thought. It figures.

She stayed a while and then went back to check on the other laboring woman. So I labored with my doula some more, practicing Hypnobirthing relaxation and visualization, which really helped keep me calm and centered. Time gets really hazy from there. I’m not sure if my midwife called or came back over, but at some point she said that I could get into the birthing pool if I wanted. The water felt so nice! I could feel my body relax and let go as I relaxed through my surges in the warm water. I have no idea how long I stayed in the pool. My husband and doula poured warm water over me during surges and put cold compresses on my head. They tried to get me to eat some yogurt, but every time I ate I would have an intense surge and throw up whatever I had eaten. At some point my midwife was back and checked me again and I don’t think I had progressed much. I got out of the pool and tried different laboring techniques with my husband’s help—leaning over the birth ball, walking and squatting during surges, laying on my side in bed. I was completely unaware of time passing and was just focusing on breathing through each surge.

My doula and husband were indispensible with helping me manage the sensations. One would give me a cold cloth while the other would press on my lower back. The next thing I remember it was 1:00 a.m. (or, I am told after the fact that it was that time—I had no concept of hours at this point). My midwife checked me and said that I was just 9 cm with a little lip and she was going to break my water. I lay on my bed and all I remember was being completely amazed at the amount of liquid rushing out of me. I still was not having strong urges to push so I stayed in bed with my doula and tried to rest between surges. I couldn’t believe it but I was actually sleeping between surges—deep sleep where I was having dreams and everything. Then I’d have a surge and be woken up and feel like I had been sleeping forever, when really it couldn’t have been more than a few minutes.

About an hour later (again, I know this from my doula’s notes) my midwife came in and told me that she had to go attend the other mother in labor because she was about to give birth any minute! Looking back on it I am surprised that I wasn’t upset by this but my midwife’s assistant stayed with me, and I had my doula and husband, so I felt secure. And I just wanted to have my baby already, I really didn’t care who was there to catch her! A backup midwife came over and stayed with me for the couple of hours that my midwife was gone. I stayed in bed during this time and only remember having my vitals checked frequently and wondering when I was going to get to push this baby out. I was feeling a little frustrated by this point and my midwife’s assistant came in and told me that I was almost done and that for her, pushing was the fun part. I was looking forward to some fun at this point!

Around 4 a.m. my midwife came back and checked me again. I still had a little lip so she pushed it back during my next surge—OWWW! She finally gave me the okay to push and I was so excited because I thought I’d get to meet my little girl soon. So I pushed, and pushed, and pushed. I pushed on the bed, on my hands and knees, on my side, pulling on my doula and husband’s arms, standing, squatting, sitting on the toilet (which was so intense and I hated!) They all said that they could see long dark hair when I pushed—my little girl’s hair! But no matter how I pushed, I just wasn’t making any progress. I remember looking at the window and realizing that it was light out again and I felt my heart drop. It was a whole other day and still no baby! I was definitely feeling discouraged. My MW says that I even told her to just go get a big knife! Everyone kept telling me that I was almost done but I really didn’t believe them at this point. I know that I gave some dirty looks but I was really trying hard not to lose my cool.

I really credit Hypnobirthing for allowing me to maintain myself throughout my entire labor, but especially at this point. I just kept trying to concentrate on breathing through the surges and thinking positive, open thoughts. I was thinking about opening with each surge and tried to picture my baby moving down and out through the birth canal. We decided to get back in the pool and try pushing in there again. I really wanted my daughter to be born in the water so I tried to do my best visualizations and positive affirmations. During each contraction I would vocalize “ I CAN push my baby out,” but eventually the pushing was just tiring me and still not getting the baby out, so we decided that I should rest for a while in the pool. Again, amazingly, I was sleeping between surges.

Eventually we decided to resume pushing. First I walked around the house, hanging on my to my wonderful husband and using him for support as I squatted during surges. After doing this for what seemed like forever, my midwife decided that I should push on the birthing stool. That was intense! I would push with all my might during a surge and then my entire body would shake afterwards and the only relief I could get was a cold washcloth on my forehead. Someone had to be positioned to give me the cold cloth as soon as I finished pushing or else I’d feel like I was going to lose my mind and had a hard time getting my breathing back under control. I still wasn’t making any progress though so my midwife gave me some blue and black cohosh to get my surges closer together. She said that they were to spaced out and that every time I’d make some progress the baby would slide back up before I was ready to push again.

Someone brought me a hand mirror and asked if I wanted to see the baby’s hair that came out when I pushed. I think my reply was something along the lines of, “I don’t care what it looks like I just want her out.” We continued to use the birthing stool and between surges I would get up and pace between the stool and the kitchen, hoping that gravity would help get the baby out. The cold cloths were very important at this point! My midwife kept trying to use her hands to help pull on my pubic bones so that the baby could come down but having her hands there during surges was just to intense for me. Every time she’d put her hands in me I’d say, “What are you doing?!” Or something to that effect. At some point during this I was using my husband for support as I was walking around and I looked at the clock in the kitchen. Up until then I had purposely not looked at any clocks because I was afraid to know how long I had been in labor. It was 2:00 p.m.! I had been in labor for almost 34 hours and had been fully dilated and “almost done” for 12 hours.

I pulled my husband aside in to the kitchen and told him that I couldn’t do this another night. Itold him I’d stick it out for the afternoon, but if it got dark out again we would have to transfer to the hospital. He reminded me that I really didn’t want to do that and that if we went to the hospital then I was be at risk for a Cesarean. I told him Iknew that was what Isaid, but that I couldn’t keep going on like this. (At this point I had thrown up everything I ate and hadn’t slept in 36 hours. I knew I didn’t want to transfer but I honestly knew that I couldn’t keep pushing without a rest.) I guess he discussed my request with my midwife. I really don’t know what happened for the next two hours. The next thing I remember I was laying on my bed, pushing, and my midwife said, “If you really want to transfer I think it would be best to do it now while you and the baby still have strong vitals.” She told me that she didn’t think I was giving up and that I was doing great, but that she agreed that I was just to tired to push effectively and that if I went to the hospital and got an epidural and was able to rest than I would be able to push my baby out.

I asked her to call the hospital to see whom the on call OB was before we made the decision. She called and it was the OB group I had originally started with! They didn’t tell her who the specific OB was, but the midwife on call was one that I knew. At that point, I knew that transferring was what we needed to do and felt that having my original doctor on call that night was some sort of sign. My midwife told them that I was coming and that I wanted a vaginal delivery. The doula packed a bag for me while I took a shower and washed my hair (I really was a mess & smelled terrible!), and finally we were in the car.

The ride from my house to the hospital was less than 10 minutes, but I swear that it was the longest car ride ever! I laid the front seat back as far as it would go and curled up on my side, trying to breathe and relax through my surges. We pulled up to the hospital and thankfully my doula met me at the entrance, because as we pulled up I had an intense surge and was curled up in the car, unable to get out. My doula was trying to get me out of the car when a lady walking out of the hospital walked by and asked if I was okay, then went to get me a wheel chair. I never would have thought that I would accept a wheelchair ride to Labor and Delivery, but at that moment there was no other way they would have gotten me there!

When I got to Labor and Delivery I was happy to hear that they already had all of my information since I had been a patient of the on call practice to begin with. We got to our room and it was all set up to deliver my little one. The on call OB came in and amazingly it was the one OB from the group that I knew—she and my husband had known each other for over 15 years and had children that grew up together. YES! At that moment I felt even more blessed and thankful. She checked me, “to make sure that I didn’t need an emergency C-section,” and said, “We’ll get you the epidural and then you’ll have this baby out in 10 minutes.” Then she left. I had to answer some questions and sign some forms prior to getting my epidural, so I did so between surges. Amazingly, I was still focused enough to be able to ask questions about what I was signing and even negotiated putting off signing the form giving them permission to do a Cesarean.

This was my first time as a patient in a hospital so having an IV of fluids and being put on oxygen was a bit unnerving, but at that moment I was just focused on getting through the surges while laying in bed with a external fetal monitor on, instead of being able to move and sway like I had been prior to this. Finally the anesthesiologist came in to give me my epidural. He was a really nice guy and fully explained everything that he was doing and even answered my husband’s very detailed questions about how the epidural worked and how it was administered and the safety of its use. Having it inserted really wasn’t bad at all and I don’t remember having to struggle to keep still while he did it. I think that maybe I was just very thankful that I was finally going to be able to rest. Within a few minutes my legs felt very tingly and I was apparently having surges that I could not feel.

I made small talk with the nurses and my support group and my doula told me that this was the first time she had seen me smile all day. That made me laugh. I wanted to nap for an hour before resuming pushing but the hospital midwife told me that I could rest for 20 minutes but then we needed get the baby out because she had been in the birth canal for so long. (Although her heart rate had been steady the entire time so she wasn’t in any danger) She came back after I had rested and we resumed pushing … and pushing … and pushing … I pushed while pulling on the arms of my midwife (who had accompanied me from home) and a nurse, I pushed while pulling on my legs, and I pushed on my hands and knees. The epidural made pushing very difficult because I couldn’t feel when I was having a surge. I had to wait for the nurse to tell me that I was having one. I didn’t have an urge to push and was just pushing on command. Although I was so grateful for the pain relief, I really felt like the epidural was making pushing less effective—I could definitely understand how having an epidural can lead women to having C-sections! I couldn’t feel what I was doing at all.

The nurse told me that I really needed to breathe between surges (I think I was panting), so I concentrated on taking long slow breaths and using my Birth Breathing that I had learned in Hypnobirthing. I knew that I had to keep pushing, but in between pushes I really concentrated on “breathing my baby down” and I feel like that helped make progress. So I just pushed when they told me to and I guess my concept of time was really gone by now because when the OB came back in what seemed like a few minutes later, I initially thought that she was just coming for a friendly check-in, but then they told me that I had been pushing for two hours and they needed to use the “kiwi,” a small disposable vacuum like tool, to help get the baby out.

I really didn’t want to. The OB explained that the device wasn’t like a traditional vacuum and that it only helps reposition the baby, not pull on the baby. She said that if it pulled on the baby the suction would immediately release. She also said that this was something she would only try a couple of times and that if it didn’t work than that was it. That’s it, what? I was thinking … but I was terrified that I knew the answer and didn’t want to ask!

It didn’t work. I pushed and she twisted and still no baby. But at least there was some progress now. When I pushed we could see the top of the baby’s head emerge, but then it would slide back in. With every push it seemed like this would be the “one” that would get her out. Every time I pushed everyone would say “This is it!” or “Just a little harder, one more push!” … and then her head would go back in. But now at least it was coming out halfway before sliding back. At some point someone had brought a large mirror for me and I could see her head of thick black hair. Each time I pushed it looked like it was just about to pop out, so that gave us all incentive to keep going. Another hour went by. The OB said that she felt like the baby was stuck behind my pubic bone—the same thing my midwife had mentioned at the house. She asked if she could try pulling my bones apart while I pushed. Since I wasn’t feeling much in that area at this point, I told her to go ahead and try it. My midwife laughed at me and told me that wasn’t the answer I gave her when she had asked me the same question before.

So the OB pulled on my pubic bones and the baby’s head came out a bit farther than it had before. I pushed as hard as I possibly could, pulling on the arms of a nurse and my midwife (I think it was her? This is sort of fuzzy!). My whole body ached from pushing, minus the epidural-ed area, of course. As I pushed I felt like my face was going to explode but I knew that I had to get my baby out and I had to do it soon. I knew that every minute that went by was bringing me closer and closer to a C-section. So we kept pushing. I was amazed and thrilled and thankful for patience of the OB. I think she was as caught up in the anticipation as we all were and never once did she make me feel rushed—it was mostly my own fear of hospitals and protocols that was making me anxious about how long the pushing had gone on.

At some point she told me not to be surprised if the baby had to be resuscitated after she was born because the pushing had gone on so long. She assured me that they had a team standing by if necessary. So that’s what all the strangers in my room were there for! This definitely wasn’t the intimate, calm birth I had so hoped and planned for. Between pushes I kept nervously asking if my baby’s heartbeat was okay and the nurse assured me that she was fine but that I had to keep taking deep breaths of the oxygen between pushes. I remember looking at the clock and it was 11:00 p.m.—almost 6 hours since I had gotten to the hospital! I couldn’t believe it—I was going to go on to Day 3! I knew that I was on “borrowed hospital time” at this point, so I asked the OB if she could try the kiwi again. She said that she was just about to suggest that herself. She hooked the kiwi up and I pushed until I thought I was going to turn inside out and my eyeballs were going to pop out. The baby’s head came out and the OB twisted her a bit and finally (finally!!!!) her entire head popped out! It was covered in long, thick, dark hair and she was pretty purple looking. Another push or two and her shoulders were out and she was on my stomach. It was 11:24 p.m., 42 hours since I had gone into labor.

I tried to pull her close to my breast but the nurse told me to wait because the cord wasn’t long enough. And finally, my baby made a few feeble cries and started turning pink! I looked at my little girl with her big swollen cheeks and was in disbelief that she was finally in my arms. I had expected to cry, but I honestly think I was just shocked. My husband cut the cord and we looked at our sweet baby girl, all 8 lbs 7 oz of her!

I didn’t get to keep her with me for very long. They took her away after a few minutes and told me that they had to do a septic workup and give her antibiotics. My husband went with her but I didn’t have her back in my arms for 3 hours. That is really the part about the birth that I am saddened by. I understand that birth takes its own course, and I really feel that transferring to the hospital was what we needed to do in this birth and that time. But I feel like I missed out on the intimacy and bonding that I wanted for my husband, our baby, and me.

The next morning the OB came to my room and assured me that there was nothing we did or didn’t do at home that could have helped with the progress of my labor. She said that her 13.5 inch head was just a very tight fit for my frame—as much as I hate to even repeat that because it drives me crazy when doctors use that as an excuse for a scheduled Cesarean. She also told me that I was going to be talked about frequently in her practice because her letting me push that long was unheard of. If it had been anyone else but me, she told me, she would have had me in surgery long before my little one finally made her entrance. She said that her midwife reminded her that I was the patient who had written the letter and that everyone in the practice had read it and was touched by it and she knew from that letter that I was really committed to having a home birth and that she wanted to give me as natural a birth as she could. I am eternally grateful to her.

I feel like I had two births—one naturally at home, and one with a few minor interventions at the hospital. I don’t plan on having any more children, but if I did I would definitely do the home birth route again … and pray for a shorter labor! Although it was hard, there was never a point where I felt overwhelmed by the pain. I liked being able to work with my body. Having an epidural was a welcomed relief at the time, but I hated the way I felt. I couldn’t tell when I was having a surge. The nurses had to feel my stomach and watch a screen to tell me when I was surging. And I also felt like the epidural made it more difficult for me to push. I felt the pushing throughout my entire body—except for where it was really important for me to feel it. I can definitely understand why epidurals lead to interventions and complications. But for me, it was the right thing to do at that time and having it and being able to keep pushing when I thought I had no energy left saved me from a C-section.

The birth of my baby didn’t turn out exactly as planned but I am overall at peace with it. It happened how it needed to. And I have an amazing story to tell.

Ed. note:Aerin is the cover and fashion feature model from the September 2011 issue of P&N.

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