Sometimes I wonder what runs through most people's minds when they hear of couples who choose homebirth.
Those are certainly the kinds of thoughts I had long before my childbearing days. And my hunch is that the average person is quite similar. But while I was participating in my first homebirth this past weekend, I was struck by how normal it all seemed.
I was the first one to arrive at Mark and Karen's house at 12am Sunday morning. A post-it on the door read "come on in," and Mark came downstairs to greet me. It was dark, quiet, and peaceful. Karen was upstairs in their bedroom in early active labor (she had been contracting since 5am). She looked really good in-between contractions, and asked if she could get me anything (the true spirit of a mother!). I noticed her tensing up and straining her face during contractions, and my doula instincts kicked in as I encouraged relaxation, promising that it really would hurt less if she relaxed!
Thier midwife, Julie, arrived at around 12:30 with a calm and confident presence, and it was amazing how she blended seemlessly into this couple's labor. She got her things arranged on a chair in the bedroom, and showed me what each thing was in case she needed me to hand something to her (pitocin in case of hemmorage, suction tube for baby, oxygen tank, etc.). And then we waited. There was no unnecessary checking of the cervix, no hussle and bustle, no beeping machines.
Her mom and her sister arrived for help and support, and we filled the birth tub with warm water. Everyone was focused on helping Karen, and creating a comfortable and safe environment for her birth. Several hours later contractions started getting noticeably more difficult. At first, Karen would cope by stating simply "relax, relax"--almost as a reminder to herself. As it got more difficult to her, she would simply say "pain," or "hurt" as each contraction began, and then "relax." Since labor was obviously progressing, Julie decided to check her, and found that she was 7 centimeters! By this time the tub was full and warm, so Karen labored there for a long while. "It kills," "It's killing me," her chants shifted as she was deep into the hardest part of her labor. But it wasn't a cry of hopelessness or suffering. She remained present and in-the-moment, and was simply being raw and honest about the pain she was experiencing. We all empathized with her, and gently reminded her that it wasn't killing her, but bringing life. Her sister prayed for strength and comfort, and Karen called out to God as well.
Julie and I decided to leave the room and let Mark and Karen have some time to themselves before the birth of their baby. Thirty minutes later Julie decided to check her again, and found that she was completely dilated! Pushing was unusually long and difficult for a second-time mom, and after a while Julie wanted her to walk up and down the stairs a few times to encourage the baby's descent through her pelvis. She pushed in a variety of positions--lying on her side, squatting, and leaning on the bed. Finally the baby was close to being born, and Karen was lying on her side in her bed. During a particularly strong push, her water broke! Several contractions later, she pushed her baby down, and the head emerged! It was an exciting moment, but after a few more strong pushes the rest of the baby's body did not come. "Hands and knees, hands and knees," Julie commanded, collected but urgently. Karen turned over as quickly as possible, and Julie used her hands to help rotate the baby's shoulders, and hooked her finger under the armpit to help bring the baby out.
Audra Joy was born safely at home at 5:30 am. She was placed under her mother, who was still on hands and knees, and immediately latched on to nurse! We cleaned up all around them as they got situated in the bed. There was no rush to clamp the cord, and Julie made sure it had finished pulsing before she did so. The placenta took a while to detach, but it finally did and came out intact (and I got to hold it!!)
Today Julie wrote in an e-mail to me, "You saw a shoulder dystocia handled just fine at home. Baby and mom just fine. It is always such a big hassle in the hosp because most times mom has an epidural that inhibits her from moving onto hand and knees if needed. These situations can be hairy but resolved safely without being rough with the baby." People assume that hospital birth is a much safer option, but I observed the opposite. If this mom was in the hospital and had an epidural, the outcome could have been dire.
Mark and Karen were anything but reckless, or selfish, or extreme people; they were a kind, loving, and educated couple. They worked beautifully together to bring life into the world in the comfort and safety of their home, with the help of their family and midwife. Driving home I realized that though viewed as a radical choice, homebirth truly is extraordinarily normal event.