intensely trivial



Doula’s first homebirth: Labor, Part 2

Thanks for coming back to read the rest of my first homebirth story, or what happens when birth occurs undisturbed. We pick up the story at about midnight, with Rhiannon having labored for about 20 hours so far. Rhiannon’s tired. Her contractions have spaced out to every 5-6 minutes average, whereas a couple hours ago they looked like transition-level contractions. Arlene, the midwife, has decided to do her first internal exam, hoping to find out what is going on with Rhiannon’s labor. Rhiannon and James are sitting in their bed; the lights are on but pretty low, and it’s quiet in their house. The dogs have been picked up by Rhiannon’s parents a few hours ago.

After Arlene finished checking Rhiannon’s cervix, she sat quietly for a few seconds, composing her thoughts before speaking. She looked at me with an expression like “You don’t wanna hear this.” We were all steeling ourselves for the news. She said to Rhiannon, “You’re 3 to 5 centimeters, about 90 percent effaced, and the baby is a little lower.”
As that disappointing news settled in, Rhiannon stayed calm.
I can’t resist making my own confession. Here’s what I thought: “Oh, no. She’s not progressing. Something’s wrong. Her labor has stalled. We’re going to have to transfer to the hospital. Please, God, don’t let this turn out to be a cesarean.” My dread was nauseating. You see, all the births I’d done up to this point had been hospital births, and that’s probably where this would have gone, had she been at a hospital. Well, if she’d been lucky, the doctor would have sent her home from the hospital. But after 20 hours of labor, everyone would have assumed this was going nowhere and she needed some significant help to get the baby out, let’s start with pitocin. And the dominoes would have started to fall. They had already fallen, in my mind. I know that fearful route too well. I’m almost embarrassed to confess that’s what I thought.
I don’t know what Rhiannon was thinking at that point. But here’s where Arlene the midwife’s practice ran orthogonal to my thought process. (Remember skew lines from high-school geometry? They’re in two totally different planes; they cannot ever intersect. Medical model and midwifery model were skew lines here — two totally different worldviews.)
Arlene said quietly, “Let’s talk about labor a little bit.” And she (and I, when I’d recovered from my dread) proceeded to share what she knew about labor: that it is not a manageable process, and that you have to stop trying to manage it; that a woman has to just give up; that it’s always more than you can handle; that pretty much every woman laboring without pain meds gets to a point where she realizes, “Oh, crap, what am I gonna do now? I. Can. Not. Do. This.” (Actually, the words, if there were words for it, would be much more colorful and expressive than that.) And that you have to willingly enter that place of (yes) pain and let your body do its work. Arlene thought maybe Rhiannon was afraid to go to where labor became unmanageable. As tired as Rhiannon was, she needed to stop thinking about labor for now and try to get some sleep (yes, between the contractions) with James, and Arlene and I would go out to the living room and get some sleep, too. She thought Rhiannon’s labor would probably pick up again in an hour or two.
Arlene made an herbal potion (with tinctures of skullcap, hops, black haw, and something else) to help Rhiannon relax enough to sleep, and then we shut their bedroom door and left Rhiannon and James alone. We found ourselves some blankets and went to sleep, Arlene on the couch and I on the recliner. (My neck is still protesting that posture.) James came out after an hour or so, waking us up, to say that Rhiannon had thrown up (after taking the herbs), and Arlene said, “Oh, shoot!” and went back to sleep. So James went back to bed, too. I didn’t hear much the rest of the night from that end of the house, which was good, because that meant Rhiannon was getting some sleep. I drew my calm from Arlene. She certainly didn’t act worried, so I tried not to, either.
At 7:50 a.m., James sleepily stumbled out in his shorts and said, “Rhiannon’s pushing at the beginning of contractions.” Arlene desperately tried to wake herself up. I went to brush my teeth (I can’t imagine much worse than your doula having morning breath), and by the time I was back, Arlene was shuffling into the bedroom. Sure enough, there was Rhiannon on her side in bed making those “Nnnnnnn” sounds, her body curving involuntarily into a pushing posture. Arlene put a glove on and quickly checked her dilation, and sure enough, Rhiannon was completely dilated! (I know she had to be working hard during the night, but somehow turning off her brain and just trying to sleep instead of thinking about labor had done the magic, and here she was ready to push her baby out into the world! It was the most magnificent moment, from my point of view.)
Arlene placed a flat hand against Rhiannon’s bottom to give her a general idea of pushing direction, and then stood back to let Rhiannon do the pushing. That was all the instructing Arlene did. Rhiannon was never confused about pushing. She just listened to her body and followed her own cues. First she pushed on her side in bed for a few minutes. After a little bit, she needed to use the toilet, so she went into the bathroom, and sat there and pushed for a while, maybe 10 minutes. Her water broke while she was on the toilet, but we didn’t know that until later. It didn’t really matter. She said it felt good to sit there and push. Instinctively, she reached down and felt her baby’s head coming lower and lower, and she was worried the baby would come out while she was on the toilet, so Arlene suggested she sit on the forward edge of the seat. Rhiannon ended up squatting on the floor for one contraction, but it was too tiring, so she went forward on hands and knees in front of the toilet.
Things were still very quiet. Rhiannon never complained of pain while pushing until the baby crowned. All we could hear from her were grunting sounds as she worked with her body. No one counted or encouraged excessively. We just watched her do her work.
Arlene got her packet of birth instruments laid out on the floor and squeezed between the toilet and Rhiannon, ready to attend the baby’s emergence, and James squeezed between the wall and Rhiannon. Except for the top half of Rhiannon’s body, we were all packed into a space about three feet by three feet. It was cozy and comfortable.
And then there was baby hair (dark), and then there was more head, and Rhiannon whimpered and said it burned as her perineum stretched to accommodate the baby’s head, and and she didn’t try to force anything along, and then the baby’s head was out. Arlene asked me to give her the suction device, and she suctioned out a little mucus. The baby was a really healthy color. And Arlene had James get ready to receive the baby into his hands. And with a final push, out came a perfect baby girl into her daddy’s hands. The baby pooped as she came out. And there was this miraculous moment as this new family got a look at each other in the soft light of the warm bathroom.
The umbilical cord was shorter than usual, so Arlene and James carefully choreographed passing the baby up through Rhiannon’s legs, while Rhiannon went from hands and knees back to kneeling and holding her baby. The baby cried a little, but besides that, everything was quiet and almost sacred.
By the way, Rhiannon only had a teensy-weensy tear, about a quarter-inch, for this, her first birth, thanks to an unhurried pushing stage and that lovely hands-and-knees position. By the time the placenta came out, it was already healing itself up, no stitches needed.
Arlene had Rhiannon walk to the bed, which was quite the picture: brand-new mother, holding her baby, umbilical cord still disappearing into her vagina, walking to the bed and getting in. No problem. And then Rhiannon and James sat on their bed, cuddling and welcoming the new addition to their family. Within a few minutes, Rhiannon put the little girl to her breast, and she snuffled her way to a latch. This was Rhiannon’s first time, and obviously the baby’s first time, too, so there was some trial and error. Once she latched on, she nursed off and on for at least an hour. Arlene lightly held the umbilical cord to feel when it stopped pulsating, and at about four minutes after birth, she clamped it and handed the scissors to James so he could cut it. Arlene sat quietly, waiting for the placenta to come out — which it did within an hour, no urgency — and Arlene put it into a bowl. Arlene inspected the placenta to ensure it had all been expelled. It was in great condition, and Arlene congratulated Rhiannon on taking such good care of herself during pregnancy.
Meanwhile, I thought Rhiannon and James deserved a good breakfast, so I dug around in the kitchen, finding the fixin’s for pancakes and eggs. And when Rhiannon said she liked her pancakes with syrup and chocolate chips, by golly, she deserved every empty calorie on that plate. James fed her breakfast in bed, while she fed the baby.
By the time the placenta came out and the baby had suckled for an hour, Rhiannon needed to use the toilet, so she handed off the baby to James and walked to the bathroom. While there, she took a shower, sitting on the birth ball. Fresher than before, she returned to bed, and Arlene got ready to do the newborn exam, two hours after birth. So gently, so kindly, she took the baby and weighed her: 8 lbs. 2 oz. Arlene noticed the baby wincing away when Arlene touched the small caput on her head, so she rubbed some Traumeel on that. She examined the baby thoroughly, not in a hurry, speaking lovingly to the baby the whole time.
Arlene and I tidied up a bit more, doing dishes and laundry, and James treated himself to a shower, too. Rhiannon’s bleeding had been great ever since the birth — that is, very limited. Arlene and I were there a total of three hours after the baby was born. Rhiannon’s parents were coming to visit soon, so we left Rhiannon, James, and the baby alone, hoping they could get a little sleep before guests arrived.

So that’s the story of my first homebirth as a doula. I realize I lost all objectivity somewhere around the baby’s arrival in the world, but I don’t really care about that now. It’s sacred and miraculous. Objectivity doesn’t matter at that point. I cry every time.
In the first few days after birth, Arlene and I stayed in close contact with Rhiannon and each other. The first night with the baby was trying, as she cried practically all night long, and nursing didn’t seem to be easy at all. And when daylight arrived, she would barely wake up. I went to visit Rhiannon and James the day after she was born, and later that day, Arlene drove 1 1/2 hours back to check on them, too. A couple of days later, Rhiannon and I talked again. Rhiannon’s milk had come in, thanks to lots of nursing, and she was engorged. We talked about some ways to ease the bowling-ball pain. The next day, in an email to me, Rhiannon said breastfeeding was turning out to be much easier than she had thought it would be.
I could write a whole post highlighting the differences between this birth and the typical birth I attend, even the typical unmedicated hospital birth. Let me know if you want that. But I bet you can do your own comparison. You could even do some birth-story math: how many hours of labor, how many vaginal exams, how many stitches, how many needles, how many minutes the mother’s practitioner spent with her, how many minutes the baby spent out of her parents’ arms.

Thanks for hanging in there with me through such a long story. I hope you enjoyed it.

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Trackbacks & Pingbacks

  1. Excerpt from Rediscovering Birth « intensely trivial pingbacked on 7 years, 4 months ago

Comments

  1. * Morgan says:

    Thanks. My first homebirth was a couple of weeks ago, and it was very very awesome as well. 🙂

    Posted 7 years, 5 months ago
  2. * Laura says:

    Beautifully written and experienced, Rachel. I’m thankful they were willing to share and for your gift of writing as well!

    Posted 7 years, 5 months ago
  3. * Jessica says:

    Beautiful!

    Posted 7 years, 5 months ago
  4. * Shelley Camba says:

    Will you ever be able to return to a hospital birth? That was really beautiful. We were meant for THAT experience.

    Posted 7 years, 5 months ago
  5. * Brianna says:

    Such a beautifully detailed story! I am massage therapist in my mid-twenties, expecting my first child, and a friend of mine referred me to this blog post. I grew up in a very medically-minded family in a state where midwifery is not only illegal, but it is very much looked down upon. However, I’m on track to a natural birth with a midwife in a Christian birth center (my apartment is too tight to be comfortable for a homebirth). This is a new world for me, with a completely new mindset. But I am continually amazed and excited each time I read of an experience like you just shared, and I feel more and more confident that this is what birth should be like. Thank you for sharing! It means a lot to people like me.

    -Brianna

    Posted 7 years, 5 months ago
  6. * kristengeri says:

    What a great story, Rachel! It makes me want to have a homebirth. If only the hospital were closer (in case we needed it) and not 25 minutes away. I’m hoping at least to have a more natural birth and a doula present, though (thanks to your influence). There are apparently some very good doulas here in the Bellingham area, and one of them even attends our church. Although I wish we could somehow come to Manhattan for the birth so you could be our doula! 🙂 Anyway, I appreciate your sharing. Hope you’re well!

    Posted 7 years, 5 months ago
  7. * Melissa says:

    It made me cry reading about it, let alone actually being there. Birth is so amazing, God has designed it (minus the pain part of course) to perfectly do what needs to be done. Amazing!

    Posted 7 years, 5 months ago
  8. * Natalie says:

    Thank you for sharing that beautiful birth story. Thank goodness I am past the point of bearing more children, because the fond memories of laboring it triggered made my uterus twitch.

    Posted 7 years, 5 months ago
  9. * Marie says:

    Hey Rachel,
    I am not sure if you would remember me. We went to New Hope for a time many years ago (I actually have some fun memories of watching your daughter Ellie in the nursery!) and have some friends in common. Anyway I found your blog from Carmen’s page and thought this birthing story was truly amazing (and beautiful).

    Posted 7 years, 4 months ago
  10. * Angel says:

    Wonderbar! I’m so thrilled you finally have this experience! And so grateful you took the time to share. Here’s to many more in you future! xoxoxo

    Posted 7 years, 4 months ago


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