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Why We Chose a Midwife, a Doula, and Home Birth

10 April 2015

Our thought process into natural childbirth began about a year before we got pregnant. We watched a documentary on Netflix called The Business of Being Born and learned so much about the down side of medical interventions during childbirth and the epidemic of c-sections in the United States. About a year later, we found ourselves pregnant and under the care of an OB/GYN who we liked. As we thought more about our vision for our birth, it was really shaped by what we didn't want.

We didn't want a c-section. That was far and away my biggest concern.
We didn't want to feel coerced into medical interventions.
We didn't want to be scoffed at or doubted as we discussed natural, unmedicated birth.

Okay, so now what?

I began looking into our options for birth centers and midwives.  We toured both our local hospitals and learned that they had c-section rates of 35% and 42% respectively. No matter how much we liked our OB/GYN, I didn't trust the medical paradigm she was practicing in.

Screenshot from Birth By the Numbers video

The data was pretty clear that the best way to avoid a c-section was to avoid induction of labor and to avoid an epidural. Given that both of these are offered to women during a very vulnerable time, and administered in the hospital, it made sense to me to avoid the hospital setting all together. Thus, I began looking into birth centers and midwifery care.

At first, I was more drawn to birth centers because the idea of home birth seemed a little gross to me. I wasn't sure that I wanted all the bodily fluids and "dirty" parts of childbirth happening under my roof. We interviewed a couple midwives and ultimately chose the person we felt most connected to. Secondarily, I liked that she had a birth center in addition to doing home birth...so we would have the option. At her birth center, there were many childbirth education classes, parent groups, etc and I liked the idea of joining a larger community and meeting other couples that were making similar decisions to us.

Our our babymoon in Mexico, sitting by the pool, listening to Hypnobabies


The way I decided to prepare for childbirth was using the Hypnobabies home study curriculum. My sister used this very successfully with her second child and almost didn't make it to the hospital because she had such a quick labor.  This is relatively common with Hypnobabies, because all of the affirmations and hypnotic suggestions include "a quick, easy birth." The more I thought about it, the more it seemed like a home birth made sense. After all, the only thing that's stressful about a quick labor is trying to get to the hospital or birth center in time. Why not labor in the comfort of my own home and let them come to me? No need to worry about packing a bag. No need to worry about driving with a one day old baby. So that's how we settled on doing home birth.

We transferred our care from the OB/GYN to our midwife after our 20 week ultrasound. The difference in care is pretty profound. The midwife appointments follow the same schedule as standard OB/GYN care, but they are 1-hour long. They discuss diet and nutrition, emotional state, and they engage the husband and make him feel important. At each appointment, they palpate your stomach to feel for the baby's position and growth. I'm shocked how many people have a posterior baby (face-up) and had no idea their baby was in that position. Our midwife was an expert at using her hands to understand how the baby was positioned. At 40 weeks, we went for an ultrasound because there was some concern about my amniotic fluid levels. At that ultrasound, the doctor said the baby was 7lbs 9oz. Yet, 10 days later when she was born, she was only 7lbs 2oz. By his estimates, she should have been well over 8lbs at birth. In constrast, my midwife's "low tech" way of doing things had her estimating my baby's weight at 7 and 1/4 pounds...only 2oz off from her actual birth weight.

Source


Another wonderful thing about midwifery care is true informed consent. Each decision is laid out in factual terms for the mother and father to decide. For example, they asked us if we wanted our baby to get the antibacterial eye cream that is standard for all hospital births. They explained that it was a preventative measure in case the mother has a certain STD (chlamydia I think?) which can cause an eye infection and lead to blindness in the baby. Because we knew that my STD status was negative, we declined. The cream is irritating to baby's eyes and there was no need to expose her to an antibiotic cream for no reason.  In every instance, you're empowered to know the facts and make informed decisions about your care and your baby's care.

Source


The other decision we made to support our desire for a natural childbirth was hiring a doula. Doulas are non-medical birth workers who help provide physical and emotional support to mothers before and during labor. Studies have shown that having a doula as a member of the birth team decreases the overall cesarean rate by 50%, the length of labor by 25%, the use of oxytocin by 40% and requests for an epidural by 60% (Source.)

My wonderful doula, Lara


I'm so thrilled that I was able to have a natural childbirth. I'll admit there's a part of me that likes the badge of honor and how people perceive me to be so strong and tough...but a much bigger part of me is saddened by this reaction because I truly believe that all women are capable of natural childbirth. It's what our bodies are designed to do. Unfortunately, the images of childbirth we see in the media and the current climate of Obstetrics care in the United States has made many women feel inadequate and incapable. It's so pervasive that some women don't have a single role model in their life of another woman who had a natural birth--no wonder they don't feel like it's possible. So for that reason, I'm proud that I did it. I'm thankful that I can be an example and provide encouragement to other women who intuitively believe that they shouldn't expose themselves or their babies to medication during childbirth. Please don't mistake my sentiments as a judgement or indictment of women who get epidurals and such...I have very close friends and family members whom I love and respect that had medicated childbirths. I simply feel passionately that women can do it naturally if they really want to, they properly prepare, and they have a supportive team of healthcare providers surrounding them in their birthing time.


Read our birth story here.

Birth Story Continued

Start by reading our birth story here.

Our immediate post-birth experience was wonderful. I'm still so touched and grateful for the incredibly loving care that Faye and I received. One of the benefits of doing the birth without any drugs was that I felt completely alert, energized, and ecstatic. I felt completely in the present moment, talking to my baby girl and welcoming her into the world. "We are so happy you're here baby girl. We did it! You did such a good job sweetie. Mommy loves you so much." 


Listening to her heart and breathing
Smiles from our amazing midwife, Amy


Faye didn't leave my chest for more than two hours. They lifted her above me briefly to help clear some fluid from her mouth and lungs. Every action was explained to me and to the baby.  They would talk to her and tell her what they were going to do and why. I loved that. Each task was done with such loving care and infinite patience. Nothing felt rushed or robotic.

Clearing fluid from her lungs


We allowed Faye to self latch and start breastfeeding. It was so fun (and funny) to watch. It took her about a half hour to really get latched and start drinking. During that thirty minutes she would bob her head and kick her legs to get repositioned and find the boob. Then she would get tired and just start sucking on her hand for awhile before getting serious again. (More information on the benefits of baby-led latch found here.)



Holding Dad's hand while trying to latch

After birthing the placenta, I lost a fair bit of blood. Unfortunately, that just happens sometimes and there isn't a real reason or way to avoid it. I actually had no knowledge of this in the moment. It didn't hurt or bother me. I was talking to Jeff, my sister, my friend Renee, the midwives, and baby Faye. Faye was breastfeeding and I felt like a million bucks :)  They put the placenta in a bowl right next to me so that Faye could get all the cord blood until it stopped pulsating. I really recommend insisting on delayed cord clamping if you birth in a hospital setting, there is solid research showing the benefits. Studies have shown that infants who have delayed cord clamping end up with a whopping 32% more blood volume than infants who have immediate cord clamping – without any increased risk of problems. (More info here.)




When the bleeding stopped, Amy determined that I had a second degree tear from the birth. She began stitching me up. This was slightly uncomfortable, but truly nothing compared to childbirth (ha!) so I was still able to interact during this time. She really took her time and was incredibly meticulous--something I truly appreciate. 

About two hours post-birth, it was finally time to cut the cord and start the newborn examination. Jeff wasn't interested in cutting the cord, and neither was I. My sister did it and she also helped gently clean up Faye's skin. This was the first time Faye left my arms. She was weighed, measured, checked for symmetry, step reflex, and more. 



Little feet while getting weighed

7lbs, 2oz

Checking her step reflex

Getting cleaned up by Aunt Beth

When she finished her newborn check, it was time for skin-to-skin with daddy. It was also time for me to go pee. My midwives helped me sit up, and they told me that I lost a fair bit of blood when the placenta separated, so I might feel woozy. Once I adjusted to sitting upright, I stood up with their help. Immediately I felt ringing in my ears and had to lay back down with my feet up for a bit. We tried again awhile later and I successfully made it to the bathroom, but still felt very dizzy.  I told them I couldn't make it back to the bed and asked to lie down on the bathroom floor. We agreed on a compromise that involved me crawling on all fours back to bed. I wish I had a picture of that, I bet it was pretty funny. Once I got back to bed, they offered me an IV of fluids to help me recover faster from the blood loss. I accepted and got setup with a bed side IV, which went for about 30 minutes. During that time, the midwives cleaned up the whole house and took down the birth tub. 


Daddy skin-to-skin time

At 4:30am, they tucked us into bed and left.  They returned Saturday morning (roughly 24 hours later) for our first postpartum visit. They checked to see how I was healing, they weighed Faye, and asked lots of questions about breastfeeding, etc. In our discussion, they gave me a few tips about getting a great latch which proved to be so helpful (and the reason I never ended up with crazy sore nipples!) We reminisced about the birth and what an amazing experience it was.


All tucked into bed for our first "night" sleep (at 4:30am)

Three days later, they returned for another visit to check on me and do Faye's PKU heel prick test. They weighed Faye again and she was already back to her birth weight--a great sign that she was eating well.  I was dealing with some armpit swelling and breast engorgement. The midwives gave me a couple homeopathic remedies and the problem cleared up within two days.  I really cannot emphasize enough how amazing those two home visits were. There is so much self-care that needs to happen after childbirth and it's wonderful to have the support and care of knowledgeable healthcare providers in your own home. You don't have to change out of pajamas or deal with transporting the baby--it's fantastic. It also meant that we were able to nip problems in the bud and proactively discuss any potential issues.  In standard OB care, you don't see your doctor once you leave the hospital until 6 weeks postpartum!

I'm so grateful to our amazing birth team for helping us achieve the birth we wanted and ushering us into parenthood in such a graceful way.

Read about our decision to use midwives and have a home birth here.

Faye Lauran: A Birth Story

06 April 2015



Our sweet Faye finally decided to arrive ten days past her due date on March 12, 2015. In contrast to my pregnancy which was easy, graceful, and felt pretty fast, those final ten days were agonizing and somehow seemed longer than the prior forty weeks. I still felt fine physically and continued exercising, but emotionally I was a wreck. It was so difficult to be off work, using precious leave that was intended to bond with my baby, to simply watch the days waste away with no baby in sight. I diligently studied every list of natural induction techniques and put many of them into practice. Each day would start with a renewed hope, “maybe today is the day”, I would think, but each day ended in disappointment.  I tried using logic with myself, knowing that the average first pregnancy was 41 weeks 2 days, but I still felt frustrated that my baby wasn’t coming according to my plan.

I went to my prenatal appointment on Tuesday, March 10 (8 days late) and cried my eyes out to my midwives. Waiting was so hard. I explained that my sister was flying in from Albuquerque the next day for a very short visit to meet the baby, and I was so worried that our baby girl might not be here yet. To make matters worse, we had to discuss making an appointment for more biometric and non-stress testing at the end of the week to make sure the placenta was still functioning so late in the pregnancy. We also had to discuss medical induction if the pregnancy went to 42 weeks. Just the thought of not having the natural, non-medicated, home birth that I wanted and planned for was enough to send me into a new fit of sobs.  The midwives assured me that it was normal for first pregnancies to go long, that my baby was perfectly healthy, and that my sister coming was the perfect distraction that I needed.

Me and my sister, Beth


The next day brought the arrival of my sister Beth. We enjoyed a beautiful sunny day together, going for a long walk by the ocean. We timed contractions on and off during the day, but they never formed a definite pattern and they didn’t progress in intensity or frequency. The next morning I hooked up my breast pump to try more nipple stimulation to induce labor, while my sister rubbed my feet and used pressure points that according to our Googling would induce labor.  At noon, we went back to my midwife’s for another prenatal appointment.

At my appointment, I had them do a cervical check and sweep my membranes (one of the most invasive natural induction methods.) The cervical check revealed that I was 2cm dialated and 80% effaced. The baby was a +1, almost +2, which means she was very low in my pelvis. The membrane sweep removed the mucous plug, so we were hopeful that would help get things started.  I cried my eyes out again. I was so frustrated that my baby wasn’t here. Thankfully, my midwives were so attuned to mind, body, and spirit that they were able to intuitively understand the problem and offer some sage advice. “Stop with all the natural induction techniques,” they said, “you’re trying to force things and you cannot force this. You need to communicate with your baby and let her know that she can come when she’s ready. One of the hardest things about childbirth is that you aren’t in control of the timing. You have to surrender that and it can be really hard. Just try your best to let your baby know that she can come when she’s ready.” More tears.

My last belly photo, taken at 41 weeks


We returned home for more sister bonding time. I felt so bad that my sister was here to meet the baby and Baby Girl wasn’t here. However, my sister was so reassuring that she was at peace with any outcome and happy to be visiting regardless. Around 5pm we decided to go for a walk. During our walk I could feel contractions happening with regularity, and with more intensity that I’d ever felt previously. As our walk continued, I could feel them radiating through my back and I was cautiously optimistic that things were moving in the right direction. We returned to the house at 6pm and placed an order for spicy Indian food for dinner. I told Beth that I was hesitant to start timing contractions because I didn’t want to jinx it. Nevertheless, I started timing. From 6pm to 7pm, my contractions came every 2:30 and lasted a 1:00. Wow! I was really in labor. I texted my husband that I was having contractions that were stronger and closer together, and that the baby could very well be coming tonight. He was out to dinner with a friend and immediately headed for home. 

By the end of the hour, I was no longer able to talk through the contractions. I called a midwife named Allegra (not my main midwife, but the person I was instructed to call early on) to tell her what was happening. “You sound pretty excited,” she said. “I encourage you to eat dinner, and try to get some sleep. Keep things as normal as possible, because this could last until tomorrow evening and you want to be as rested as possible.” Wow! After that call I felt like I needed to hunker down and mentally prepare for labor to last a lot longer that I was anticipating. I followed her advice and had a few bites of Indian food, then hopped in the shower. Every time a pressure wave came, I would lean against the shower wall and use my Hypnobabies techniques to get through it. How in the heck was I going to handle 24 hours of this?! I climbed into bed and labored on my side for awhile. Every time Jeff came in to ask me a question or check on me, he had the unlucky timing of talking to me during a pressure wave. It was driving me nuts!



We decided to call the doula and ask her to come over. Words cannot express the relief I felt when she arrived. She told me at a later date that she thought I was sleeping when she arrived. Clearly the intensity of what was happening inside my body wasn’t translating in my outward expressions. However, at one point she did ask me how I was feeling. I told her the waves were really intense. She asked if I was feeling pushy and I remember telling her “I really feel like I have to poop with every wave and I don’t know if that’s what you mean by pushy.” She asked me to get up and walk around. I was not pleased. “Where are we going?” Lara instructed me to walk around the living room, while thinking in her head that she needed to get me out of that bed in order to keep the labor progressing.  I made it into the living room and then onto the toilet in the guest bathroom. I labored there for awhile and then went back into bed, where I found that laying down had become unbearably painful. My legs were spasming and I felt like a flopping fish. I requested the birth ball and found some relief in that position. Lara instructed Jeff to rub my back in a way that felt really heavenly! I believe it was around this time that we decided to call Amy (my main midwife) and ask her to come.


Beth filling the birth tub (which we never had time to use)

By the time Amy arrived, I’d been laboring on the toilet of my master bathroom for awhile. Lara was actively coaching me through each pressure wave. Her voice was such a source of solace and strength for me. We had Hypnobabies tracks playing through the sound system, but Lara also used many of the verbal cues to help me stay deep and use my natural anesthesia. She helped me breathe through the waves and reminded me to relax my muscles, which was so hard! As soon as Amy arrived, there was a flutter of activity as they unloaded equipment. Jeff and Beth began filling the birth tub. However, after only about five minutes, I felt a strange pressure moving down and out.  “Lara, the baby is coming!” I was still on the toilet so I put my hands down to catch the baby, and I felt a warm gush of fluid as my water broke. Oh, so that’s what that feeling was! Amy noticed some meconium in the fluid so she was anxious to check me and see how quickly we could have the baby. They wanted me to move to my bed to perform the check. I was silently skeptical that I could make the fifteen foot walk to my bed because the pressure waves felt relentless—coming so strong and frequently that I was only getting about 20 seconds between them. I got onto all fours on the bathroom floor…my poor attempt at making progress toward the bedroom. I made it through a few waves in that position, before throwing up my Indian food dinner. Mercifully, Amy seemed to understand that the bedroom was out of reach, and she brought a birth stool into the bathroom. Once on the birth stool, she was able to check my cervix. “She’s complete…10cm…let’s have a baby.” Hallelujah! That was music to my ears.




After fifteen minutes of pushing, we were getting close. Faye’s heart rate was fluctuating and I could tell my birth team was concerned. They would check her heart rate between each wave and at one point, it dropped pretty low. “Okay mama, I need you to breathe to your baby,” Amy directed me. C’mon baby girl, I thought, we need your heart rate to go up. You can do this sweetie. We are almost there. Her heart rate improved. The sensation of the baby crowning was so incredibly intense, a burning feeling that made me want to avoid pushing. Lara sensed that I was shrinking away from that sensation. “Emily,” she said, “I need you to push toward that feeling. You cannot pull away from it. You need to go toward that feeling.” She reminded me to hold my breath as I pushed, and Jeff (who was standing behind me) said he’s never seen my traps and shoulder muscles grow so big and tense. Amy’s next instruction was to reach down and feel my baby’s head.  She was right there. After another wave, Amy had more guidance. “After the next wave, I want you to stand up and wiggle your hips.” Somehow, I was able to follow her instruction. Once standing, she instructed me to stretch my arms over my head before sitting back on the birth stool.




A little comfort from my doula, Lara

Standing up to stretch before the final push


The burning sensation between my legs was unbearable. With the next pressure wave, I held my breath and gave my everything to push out my baby. She flew out in one quick, slippery motion. Amy caught her and apparently Lara had to tell me to open my eyes and look at my baby (I have no recollection of that…haha…but Lara says she had to tell me twice. Apparently I was enjoying the sweet, sweet relief!) I lifted my baby to my chest and we quickly moved to the bed.





Our sweet baby girl was finally here.
After just six hours of fast, furious labor, she was here.
After twenty seven minutes of pushing, she was here.
10 days late, but perfectly on time, at 11:47pm on March 12th.
7lbs, 2oz and 20 inches long.



I hope to write another post where I talk a bit more about the immediate post-birth experience. I’ll also discuss our decision to use a midwife for our prenatal care and our decision to have a home birth.





Welcome to the world, baby Faye. We love you so much and are so glad you’re here. In three weeks time, you’ve filled our hearts with so much love, joy, and gratitude.

The birth story continues here.
Read more about our decision to use a midwife and have a home birth here.

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