F.A.Q. about homebirth

When I told people I was going to have baby Roger at home, a lot of people asked questions. I answered the best I could, but I think I can answer better now. The only problem is I'm not sure if I remember all the questions. If you have any other questions, let me know in a comment and I'll update the post with my answer.

*I have decided to edit this post to include sources other than my own experience and knowledge.

Q) How do you deal with the pain?
A) I took hypnobirthing classes and stayed relaxed. I didn't want an epidural anyway, and being at home allowed me to be more relaxed. The more tense you are, the more pain you will experience. Most of my labor was very relaxed. One of the best helps for me was the pressure points that my husband and mother used that we all learned about in "Daddy Doula" training. The most intense part, where there was actual pain, was the pushing part, and it only lasted about 10-15 minutes. The most pain I experienced that day was getting the lidocaine shots so I could get stitched up. I was screaming for that part. My hypnobirthing instructor keeps track of her mothers (clients), and reports that even though most of her clients birth in a hospital where they have the option of an epidural, 82% of them (as of 1/1/2015) labor and birth without any pain medications or epidurals.

Q) Won't it be messy?
A) As part of the birth kit I needed to buy 3 plastic shower curtain liners. I also needed to have several towels on hand. I had chux pads and depends for after the birth. My midwife and her assistant (and possibly others, I'm not really sure) cleaned up everything after Roger was born while Chris and I were cuddling with him in our bed. I wore a navy blue swim skirt (without sewn in panties) and a black tank top, and both look great. There's no stains on my towels, and my midwife and her assistant even did the towel laundry. I honestly didn't have to clean anything up. The only thing that got any blood on it was the bathroom mats, and that happened long after the birth. Luckily, everything I buy is machine washable :)

Q) Isn't it dangerous?
A) Not in most cases. In most cases, you will be less likely to have interventions. Interventions can cause complications. Most homebirth midwives report a 1-2% transfer rate (that is, when the birth is transferred to a hospital), and when I asked about it I was told even then, it's usually because the mom decides she wants an epidural after all. In Europe, homebirth is a lot more common. This blog post explains data from a study in the Netherlands (where homebirth is even more common than hospital birth) showing that at least in the Netherlands, homebirth was less risky. The study, which appeared in the peer-reviewed journal BMJ, is linked at the bottom of the post.

Q) How do they know how the baby is doing if they don't have you hooked up to a machine?
A) Continuous electronic fetal monitoring, which is the norm in hospitals, is not necessary and is actually contrary to scientific evidence. At home, or in a birth center or even a hospital if you are birthing naturally, you have the option to have intermittent fetal monitoring, where your provider checks the baby's heart rate a few times an hour until the pushing stage, and then more frequently. Here's a great article explaining why intermittent fetal monitoring, by hand, is preferable to continuous fetal monitoring, by machine.

Q) What if the cord is around the neck?
A) This is called a nuchal cord and happens in about 1/3 of all births, so midwives see it all the time. It happened when I was born (at home) and I was fine. Recent studies show that nuchal cords are not associated with many adverse outcomes people typically think of. Here are some great reads on nuchal cords.
Abstract of a study showing absence of adverse effects with nuchal cords (quick read).
Blog article based on a PhD thesis exploring best practices for nuchal cords.
Comprehensive article with many references on nuchal cords.

Q) What if your baby needs oxygen?
A) My midwife brought an oxygen tank and administered it to my baby. If you are thinking about a home birth and are concerned about this, ask in the initial interview/consult with the midwife if she brings oxygen to births.

Q) What will they do with the placenta?
A) I chose to encapsulate my placenta. My midwife's assistant took my placenta to a woman who encapsulates placentas. A few days later my husband went and picked up my placenta which had been encapsulated (turned into pills). All mammals except humans eat their placentas because it's good for you. It stimulates milk supply and helps with hormonal balance (all those hormones in the placenta suddenly leave when you give birth. What then?). People who choose not to encapsulate their placenta can discuss with their midwife what is usually done (remember, this is very routine for a homebirth midwife). Here's a web site about why ingesting your own placenta is beneficial.

Q) Is it expensive?
A) For us it was actually cheaper than hospital birth. The total fee from the midwife, for prenatal care, birth, and postpartum visits, was equal to our hospital deductible, after which our insurance would have covered 80% of everything else. My guess is that we would have spent about $500-$1500 more on a hospital birth.

Q) Why not just do a birthing center?
A) I considered it at first. It was more expensive, and there was no certainty about who would deliver my baby, since our local birthing center is run by a group of midwives. Plus, they make you go home a few hours after giving birth, and I wouldn't have wanted to sit in a car. I was pretty sore until I got my stitches out a week later. I am not against birthing centers (or hospitals, for that matter), but it wasn't a good fit for us.

Here are some other things that were awesome about homebirth, that you may not get in a hospital:
-Less interventions.
-Dad is involved. Chris was super helpful throughout my labor and birth and I think it helped him bond with Roger.
-Lots of time with baby immediately following birth. We got to hold Roger for about 2 hours after he was born before they did anything. At that point, they did his checkup, including weighing and measuring, and my stitches.
-Have in attendance who you like. Sometimes hospitals are great about this, and sometimes not. My nieces and nephews got to see the baby a few hours after he was born, and my husband, mother, sister-in-law, and a baby niece were present throughout labor and birth.
-Be with your provider for a long time. My midwife was there for many hours. In a hospital, if you are lucky enough to have your doctor be the one who delivers your baby, they usually don't stay for very long, and you just have to hope your nurses are awesome.
-Labor how you like. I didn't have an IV or constant monitors tying me down (though they did check baby's heartbeat probably about once an hour). I was free to eat, drink, and move around except for one hour when my midwife administered evening primrose oil to me (not orally) and had me lie down for an hour for them to dissolve.
-No car trip home. You're already there.

While you're at it reading about natural birthing, watch this video to see why it is so vital to NOT cut the umbilical cord immediately after giving birth. I feel more strongly about this than about anything else birth related. Watch the video about optimal cord clamping.

Home Hypnobirth - Baby Roger

This is the story of my home hypnobirth. It has pictures. I promise it’s rated PG. Unless you’re offended by tank tops, swim skirts, pregnant bellies, or birthing language, you should be okay to continue.

All pictures were taken by Amy, my sister-in-law (she is a professional photographer). Even more can be seen on her site here. 

Hypnobirthing language: a surge is a contraction. Waters releasing means water breaking. We also say “breathing the baby down” instead of pushing, but in my case it felt like pushing so I’m using that.

I guess it really all started with being forced onto maternity leave. I didn't want to take maternity leave because my baby wasn't here to enjoy/take care of. Why stay home and "enjoy myself"? But because the principal thought it was too great a risk factor now that I was overdue, I was asked to stop coming to work.

No baby, no work, no desire to do anything productive, and ridiculously pregnant. I can’t tell you how bored I was that Thursday. I remembered something about pineapple and labor, so I looked it up online. Some women swore pineapple brought on labor. Others swore it did nothing – but they were mostly 37 weeks along or so when they tried it. I was 40 weeks, 4 days (or something like that). And there was a whole, fresh pineapple on my counter. You know what I did. I ate an entire half of a pineapple by myself that night. It was delicious.

When I woke up, I googled “how long after the bloody show did you go into labor?” because guess what happened in my sleep? It seemed I would probably go into labor within a day or so. YAY! Except here I was again with no work, and my husband was at work, and I was just waiting for something to happen. I had an appointment with my midwife at 3:30 and wasn’t sure if I should keep it since I would probably go into labor, but I decided I might as well. When I got there, I went into labor. Hah! I wasn’t sure if it would continue or not, because I’d had a few times where I’d have a couple surges and then it would subside, but this time it continued. I wasn’t in pain. I was uncomfortable. When my husband Chris got home from work, I was pretty excited and asked him to help me time the surges (he had downloaded an app on his ipod touch). They were about 5 minutes apart, lasting just under a minute. After dinner and a lot of bouncing on my birth ball, we decided to play an online video game, League of Legends, with my brother Ben. I was kind of distracted throughout the game and hadn’t played in maybe a year, but I was still the best player on the team. I was amazing. Just thought I’d throw that in.

So then it was about 10:30 pm, and I didn’t know if I should sleep or not. I called my midwife, Melody, and let her know what was going on. She said I should try to sleep, so I told her to sleep too – and my husband, and my mom, and my sister-in-law Amy (who was going to be there taking pictures). Well, I found out that while my surges were only a minor discomfort while sitting, it was pretty much torture to lie down (on my side of course, not my back – that would have been far worse). I didn’t know what to do. Amy suggested I sleep sitting. DUH! So I sat in my soft rocking chair and slept until 1:30 am.

I went to the bathroom and realized my waters had released – not all at once, though, it was just a slow leak. I put on a diaper (well, “Depends” I guess, but it felt like a diaper) to monitor whether there was meconium. There was, but it turned out to be ok. My surges had gotten much more intense, which must be what woke me up, so I woke up Chris and my mom and my midwife and Amy. I can’t remember for sure, but I think my surges were 4 minutes apart and lasting 1 minute at that point. Anyhow, everyone came. There was my husband, obviously, and my mom came, and Melody (midwife) and Shauna (her assistant – a midwife in training), and Amy, and Amy’s baby because obviously little babies need to be with Mom!

One of the main problems was filling up the birthing pool/tub. We lined it with thick, soft blankets followed by a plastic liner, but couldn’t get the hose to attach to anything to get water into it. It ended up that Amy and Shauna filed it up with a bucket and a very large bowl, getting warm water from the tub. I think that was the first of Amy’s non-photography tasks, but she ended up doing a LOT more than take pictures.

We put on some soft and gentle music that I had picked out previously. Everybody started getting in their roles. Shauna checked on me and on the baby (his heart), Mom and Chris started helping me feel more comfortable by applying pressure to pressure points (on my back and hand), and Amy did everything in the world. Melody fell asleep on the couch because she felt ill. Poor Melody. When she woke up, she did all my dishes. Poor Melody. J

Serene Heather, Mom applying pressure to hand, Chris applying pressure to back

Chris started getting really sleepy. He sounded like a zombie. I told him to go to sleep, but he protested. We argued about it for a while, and finally I told him, “you’re so sleepy you’re making me mad! Go to sleep!” And so he did. For a really, really long time. 

Back pressure points during a surge, Chris sleeping

Chris had been applying pressure to my back (kind of above the scapula – you can see in the pictures), so Shauna took over that job. Mom stayed on the hand pressure point and made sure I got enough fluid. Amy did whatever job was needed, like if Mom or Shauna had to go do something else. For hydration, I drank coconut water, which is delicious and apparently the drink most similar to our body’s fluids. Someone brought me snacks. Shauna kept checking the baby's heart rate. Melody and Shauna used oils and herbal medicines on me, I don’t know which ones – I just took whatever they gave because I trust Melody and she’s amazing. All this time, I had no desire to be “checked.” I didn’t really want to know how dilated I was, I just wanted to keep breathing through the surges, sitting in the tub, and just letting labor happen.

Shauna checking the baby's heart

One funny thing that happened while Chris was asleep was that he kept snoring very loudly the whole time and it was kind of obnoxious so I finally suggested someone put his mouth guard in for him – he’d forgot. It’s meant to protect his teeth from grinding but a side benefit is that he snores very little with it in. No one wanted to do it and I didn’t want to get out of the birthing tub, but finally my mom volunteered. I told her to just open his mouth and pop it in. Well, when she tried to open his mouth, he snatched the mouth guard from her other hand and shoved it in his mouth very quickly – without waking up. We were all laughing for some time over how funny he looked when he did that.

Eventually, after about 5 or 6 hours, Chris woke up. He resumed his duties of pressure during surges, comfort and support all the time, and gentle touches (like light touch massage) between surges. I really can't say enough about how great he was, and also everyone there.

Chris comforting and supporting me

Then Melody asked if she could check me. I finally said yes, and that was the most painful part of labor up to that point – and I was only at a 3! I was not very happy about that. I’d been in labor for maybe 15 hours and was less than 1/3 of the way there? Not my favorite news ever. Melody told Shauna to try mental imagery with me, so I was directed to picture melting butter. It was kind of nice, though it sounds silly. More hours passed pretty much the same way – pressure points, drinks, pictures, baby’s heartbeat. Checked again. 4 cm dilated. It was 11 am. And then Melody made me mad, which is apparently a good tactic.

She said she was going to put evening primrose oil into my cervix and that I would have to lie down on my side for at least an hour (remember how lying down was horrible?) and that she was going home and that I probably wouldn’t give birth until between 8 and 10 pm. But also, she said that I have control over that. And then she put evening primrose in me while I was lying down and then she left. Amy went home too, because she had 3 kids at home that needed to be looked after. And I was very, very upset. And lying down did NOT feel good.

We put on a hypnobirthing CD, which in hindsight, I wish I’d done earlier. I listened to Rainbow Relaxation on repeat the whole hour I had to lie there. That script is magical. Even as uncomfortable as I was lying down, I fell asleep a few times for a few minutes at a time. I was pretty relaxed considering my uncomfortable position. I was still kind of mad, though. I was tired and didn’t want to be in labor another 10 or so hours.

After my hour was up, I got up and labor got more intense. I was still pretty calm, but I definitely felt a difference in the surges. Shauna sounded very positive about how things were going (she stayed even though Melody left). I think it was at about 1:30 that I called Amy and Melody to come back. Another sister-in-law, Nikki, volunteered to watch Amy’s kids while Amy finished helping with and photographing the birth. Since Nikki lives only a few blocks away from me, that was pretty convenient for everyone (except possibly Nikki, who was volunteering to watch 3 high-energy kids for an unknown amount of time). So everyone came back and things continued to get more intense.

Probably around 3:45, I threw up what felt like the entire contents of my body, except for the baby. I had been very tired before that, but after that I was completely drained of all ability to maneuver. I couldn’t sit up anymore and had to lie down (I know, my favorite position again). Chris held me in bed and continued to support me during surges with the pressure points. Everyone was so positive and kept telling me I could do this. Melody checked me again and I was 7.5 cm dilated.

Chris holding me in bed

I’d heard that when you’re about to give birth, you say “I can’t do this ANYMORE!” and was surprised to hear those words come out of my mouth about a minute after that check. My mom told me that Melody checked again and I was 8.5 cm then, but I don’t even remember that. My body took over, which was good considering I couldn’t will myself to do anything because I was so weak. 10 cm be darned, this baby was coming out. I knew that because my body just started pushing. It was the strangest feeling. I didn’t try to make it start and certainly couldn’t have made it stop. All I could do is try to breathe through it like everyone was telling me, but there was actually a lot of pain and I was pretty overwhelmed. I guess the pain had been there through many of the contractions, but it was completely bearable with the help of all these loving people, until this moment.

Melody told me I needed to go to the birthing stool (there was no way I could have got into the tub). I was like, “I CAN’T MOVE!!!!!” and she said “that’s okay, we can carry you.” I also wailed that I couldn’t even sit up because I was too weak, but they set things up so Chris could hold me up. Chris carried me to the birth stool and sat behind me, holding all of my upper body weight. I needed him so much at that moment and I’m so glad he was there. I could feel these extraordinarily powerful surges that were pushing the baby out and it was so hard for me. I didn’t know how close to the end I was. All I could do was focus on making the low sounds everyone was telling me to make and try to listen to everyone saying “you can do this! You’ve got this!” Melody told me to reach down and feel his head. I felt his head and hair! That was really encouraging.

Chris supporting me on the birth stool between and during pushes

Someone tried to show me the head coming out in a mirror. I didn’t have my glasses on so I could barely make it out, but I could kind of see it. And not very much later, Melody said, “his head’s out!” I didn’t know if she meant that he was crowning or if his head was actually completely out, but then I felt his body slide out and he was placed on my leg and started getting goop suctioned out of him. I couldn’t believe he was here! The actual pushing had only lasted maybe 10 or 15 minutes. Once he was out, I said over and over, “it’s my baby! It’s my baby!” and was so overwhelmed and happy and relieved. And I heard him cry a little bit, and then he was placed in my arms, on my stomach, and he was wrapped in a towel to be warm, and wiped clean. And there we were, with our actual baby in my actual arms, and I was in Chris’ arms, and everything was so perfect.

Receiving our baby

Shauna was trying to make sure everything got written down, but when little Roger made an appearance everybody was just so amazed and happy that nobody looked at the time. It was 4:25 by the time someone realized we hadn’t noted the time of birth, so we just guessed – it had been just a few minutes. I’m saying he was born at 4:20 because 4:20 on 4/20 sounds cool, although I’ve been informed this has something to do with marijuana – but I don’t care.

The placenta was born – which, as I’d heard, was really not that hard after a baby. Melody asked Chris if he wanted to clamp and cut the cord. He wasn’t sure he did, but I asked him to, and he agreed to. Melody helped him to do it just right. I’m glad he did it. I’m really just glad that he was so involved in everything. It was so amazing to have our little son and that we were both so instrumental in his birth.

Roger holding tight to Dad and Mom while receiving oxygen

We had some time with our baby. It was so wonderful to be with my husband and new baby, our little family. I don’t know what everyone else did – clean up, probably. Drain the tub. I don’t know, I was pretty much completely oblivious to everything except our little family. We had a long time together. I’m not sure how long, maybe 2 hours. And then my peaceful time was over, because I had some tearing, and needed some repair work; Roger needed to be examined as well.

Family time & skin to skin contact with Dad

Chris, Mom, and Shauna were a team checking up on Roger. He weighed in at 7 lbs, 4 oz and was 21” long (pretty tall for an average weight baby!) and seemed healthy in every way. I, on the other hand, was in torture. I am certain that getting poked with lidocaine what felt like a million times was far more painful than any part of childbirth and probably even than all of it put together. Maybe that’s because I hadn’t taken a hypno-lidocaine class or something, but it was awful. Of course, the stitches were no big deal once I was numb. Amy, Melody, and me were a team for my stitches. I guess it's good that Melody was stitching and Amy was helping and I couldn't see any of it, because I think I would have passed out doing either of their jobs.

Then Melody told me I needed to go pee. I was like, “what? Why?” and she said, “we need to make sure you can. And if you can’t, you’re going to have to have a catheter.” My response? “Are you kidding me? Can I pee? I can do ANYTHING!” By the way, I didn’t know that some women can’t pee after childbirth. I could, though, just like I said.

I guess you can say I was incredibly empowered by birth.

Happy family