Homebirth?! What, Are you NUTS?

By Emily Hecker, CNC, DC

Everyone has a bucket list, right? A desire to do something that may seem unattainable, fun or just plain crazy. I have accomplished quite a bit on my bucket list:

  • -Ran a marathon
  • -Got my pilots license
  • -Skydove
  • -Scubadove, is that a term?
  • -Owned a motorcycle
  • -Constantly got degrees (BS, MBA, CNC, DC…)

A few items that were still on my list is to exclusively breast feed my child (was not able to do that with my first son) and to have a natural, un-medicated, peaceful & relaxing birth. Relaxing birth may seem like an oxymoron, but that’s exactly what I wanted after I had the birth that I had with my first son.

I am blessed to have two healthy boys 18 months apart with very different birth stories. I had two low-risk pregnancies with no complications in either birth that required immediate attention.

My first son was born in a hospital with multiple interventions. My second son was a planned home birth with two midwives, a midwife in training, a doula and a back-up OB who supported my decision for a homebirth. I know my friends and family think I am nuts for not delivering my second son in a hospital, but the research is out there, and for a low-risk pregnancy a homebirth is very safe. Time are a ’changing folks.

Max’s Hospital Birth Story

I had a great pregnancy. I was married, just finished chiropractic school, had a new dog and starting a new life & career. My husband and I prepared for a total natural, unmedicated birth with reading many books and attending a 12-week natural Brio birthing class. For my “41 week plus 3 day” check up, I went in in the early afternoon to expect a clear bill of health. Everything looked good for my health, and even the babies health. Except when it came time to check my amniotic fluid levels in all four quadrants of my placenta. Using ultrasound, I came up short. Instead of the minimum number of 5, I was measuring at 4.5cm. Shit. I should have drunk more water! Mind you, on the ultrasound you could see my son had a very full bladder and we even commented on it during the ultrasound. If he would have urinated, would it have been enough to measure 5? Because my fluid was measuring .5cm low, it was enough for my OB to want to induce me that night. Exactly what I did not want.

I felt completely defeated on our way out of the office driving home to back our bags. We went out to a nice dinner at Ya Ya’s before we went in for my birth. It all seems rather comical to me. It felt so fake and unnatural. I could barely eat I was so upset. Our OB wanted us to get to the hospital at 7pm and we didn’t arrive until 9pm, I was on edge. My husband could see I was stressing about this and he very jokingly said,

“Really, Emily, You are worried you are going to be late to your own birth?”

I was so nervous going into the hospital room and my first (of many) nurses hooked me up to the monitor and immediately saw I was having contractions. Oh. That’s what those sensations were. My contractions were so strong on the monitor I was able to talk the staff into letting me wait and see if they picked up on their own. This was the beginning of a never-ending battle of compromises.

For the next 40 hours, I felt like I was at a car dealer, with my guard up and tying to haggle for the best natural birth, when my baby and I were perfectly healthy.

Finally, 36 hours after I went in, my OB had had “enough”, and I was mentally exhausted. I was handling my contractions just fine, dancing to Michael Jackson via iPhone and was dilated up to 8cm on my own. It really seemed very easy if this is what labor was! My OB requested I have Pitocin to speed things up and I knew that would be so painful I would need an epidural. I received both medications and my healthy baby boy was born vaginally, measuring in at 8lb 13oz 21.75” long just four hours later.

Leo’s Home Birth Story

Leo was a wonderful surprise gift to us that God decided not to tell us about, due right around Christmas. The greatest gifts happen that way. Leo was a Paleo baby, meaning I had been eating a Paleo diet, the PERFECT diet to eat for fertility and health during his whole gestation. I had met with 6 health care providers to try and find the perfect fit for what I wanted for our birth.  I interviewed 3 midwives and 3 OBs. It took me 16 weeks to decide between a hospital or home birth. My husband was supportive of what ever I decided.  I chose a homebirth. At this time, there were no birth centers or midwives that worked out of a hospital in St. Louis.  I found a great OB that supported midwifery and all it stood for. He ended up my back up for my homebirth incase I needed to transfer to a hospital. He had a great relationship with my midwife.

My ideal birth was in my home, in a birthtub of water, snow falling at night, full moon, fireplace roaring, candles burning, Christmas lights and tree up with the smell of cinnamon and vanilla filling the house.

After Christmas, one morning in my 40th week of gestation, I had my first contraction. They continued all day long and were so mild it felt very manageable. I ran errands, went for a prenatal appointment with my midwife, went to lunch at Ya Ya’s (we decided to make it a tradition) and the grocery store. Surely I wasn’t going to have this baby anytime soon, maybe the next day. I was comparing it to Max’s labor and thought I had a day or two left. WRONG.

That night was relaxing. I put Max to bed, ate a great dinner, took a bath, lit some candles and watched a little TV on the couch.

It started to snow and there was a full moon. This was the night.

We decided to time the contractions and they were pretty close together but I was definitely NOT keeling over in pain. I really wanted all of my birth team to get a good nights rest. I contacted my doula and she told me she was coming over. I told her not to hurry. It was midnight when she walked through the door. 15 minutes later, I was on the couch going through transition. Transition is the most intense part of childbirth in my opinion. Each contraction was on top of another for 45 minutes. I went to the restroom and once the water was turned on at the faucet, I looked at my doula and said, “I have to PUSH!, I am having this baby NOW!” …I started pushing, I couldn’t contain it! At this time my doula contacted my midwife team and they were on their way at super sonic speeds.

My husband was running around the house warming up towels, getting gloves from our birth kit, placing pads on the floor in front of the bathroom all the while holding Max, our 18 month old who awoke from my primal outbursts.  My doula was amazing. She saw that my bag of waters had not even ruptured yet but was about to and had me on the floor. This took pressure off my cervix and slowed down my pushing. I felt no pain just an urge to get this baby out safely. My body took over and my doula was on the phone with my midwife as she as instructing her on what do to.

My husband and son were sitting in the hallway with me. They placed their hands on my head, encouraging me and it was the sweetest moment of my whole birth experience.  Just then the team arrived, monitored the baby’s heartbeat, got everything ready and our son was born in the hallway, crying as he entered this world at 2AM.

My son Max was in awe, pointed to Leo and with a smile said, “bebe!”

 

I held him for a bit, got up, walked to the bedroom and then delivered my placenta. Our whole family was lying in bed with each other enjoying this new little human that was just born. It was so magical.  After the newborn exams were done, I was good to go and the team left, our whole family fell asleep for a couple hours in our own home and own bed with our dog curled up next to us. Best feeling EVER. And so thankful Leo’s birth was so perfect. Even though I didn’t get to birth in water, I did get about every other wish I had.

Laid-Back Breastfeeding, a Lesson Learned.

By Jen Jester, Birth Educator & Doula

In the dark, quiet of a hospital room I learned a valuable lesson at my most recent birth.  On this occasion, my lesson was given by an amazing doctor whom I will refer to as Dr. X. I am entering into the “seasoned” portion of my doula career, and I have realized that I always have something to learn from each birth.

This particular learning experience actually had nothing to do with birth.  This lesson was about breastfeeding and patience. 

Allowing the mother, encouraging her, to stop “doing” and start trusting – That is one of many things that I do for my clients during their labor and birth.  “Stop thinking. Allow your body to do its work,” I might say.  But, I lost that mentality regarding breastfeeding somewhere along my path as a doula who works largely in a hospital setting.

Although I know the benefits/advantages/necessity of “Laid-back Breastfeeding”, it escaped my practice with mothers.  I teach it in my birth classes, yet I have ceased to encourage the practice with my clients.

WHY? Well, in the hospital births that I’ve participated in – even the most “natural” births – the baby is usually placed on the mother’s abdomen for “immediate” breastfeeding. *And they mean it!*  I learned early on that if I didn’t dig in and help that mother latch her baby on right away, a nurse in the room would assume my incompetence, roll her eyes, grab the baby and a breast, and set to teaching that kid how to latch on.  She’d typically lay the baby horizontally across the mother in the “cradle” position, grab the mother’s breast, and force the baby to nurse by encouraging it to open its mouth, then shoving the mother’s breast in.  This was contradictory to the education that I had and the reading I had done, but most of the time it worked and everyone was happy.  The nurses are really good at and trained to get their tasks completed within a prescribed period of time for each patient in a very effective and methodical manner.

  • Baby latched on? Check!
  • Mom nursing immediately? Check!
  • Countdown to postpartum floor admission?  Check!
  • Countdown to newborn procedures? Check!

So, I learned to jump in BEFORE the nurse, and get that baby latched on!  My clients were paying me to help them breastfeed after all.  I wouldn’t want them to think I’m falling down on the job, right?  Well, I believe my actions actually did my clients a disservice.  I knew in my heart I wasn’t doing the best for mom and baby, or that initial breastfeeding could have been a better, more natural experience, but I felt limited or trapped by the system around me.  Imagine how my clients felt.  Perhaps they didn’t think twice about the “help” the nurses or I were giving them.  So it was.  I was a cog.  I would get to help the mother breastfeed before the nurses.  Healthy attitude, right?  Not. At. All.

BUT, what if breastfeeding doesn’t magically happen within our postpartum time frame of one hour?  What about those babies who don’t like to be force fed?  I have seen this play out, and it usually results in a crying baby, a crying mother, and feelings of inadequacy. Sometimes the baby is carted off to the nursery traumatized and hungry for newborn procedures.

At one point, I decided to only encourage “laid-back breastfeeding” with my clients that were new mothers; to help set the stage for their future breastfeeding experiences with subsequent children.  They had no breastfeeding baggage.  I quickly dropped that when at a homebirth the midwife poo-poohed my laid-back breastfeeding “idea”.  She watched the baby working hard to get to the breast, and then jumped right in with the scenario I described above.  I felt foolish. Was I losing my mind?  Did no other birth professional know about laid-back breastfeeding?  Was I wasting valuable bonding time?  I wonder if the laid-back approach was just taking too long for these professionals’ comfort.  I wonder if they truly thought the baby was struggling unnecessarily with its head bobbing as it made its way toward the breast.  Perhaps it makes them uncomfortable.

With my clients that have nursed previously, I resigned to letting them choose their method of newborn nursing.  They have wisdom, right?  I didn’t consider that perhaps these mothers did not learn laid-back breastfeeding, or that it had been so long since they had a newborn to the breast that they may not recall the best way to handle this tiny new baby.  I saw most of these moms holding their newborn like a 6 month old veteran nurser.

So it was for my most recent birth.  I was aiding this mother in the delivery of her third child, a daughter, in a quiet hospital room.  The doctor quietly encouraged this mother to follow her body’s instincts for labor and birth.  There was no rush.  No bright lights.  No noise.  An already unfamiliar scene at the hospital, but it felt right.  The room was filled with love and encouragement for this mother.  She was surrounded by a team of 4; the father (feeling comfortable enough for the first time to watch his wife deliver their baby!), her nurse (following the doctor’s cues to be respectful, quiet and hands off), me (at the mother’s head giving hushed encouragement and physical support), and Dr. X.

What was Dr. X doing?  Nothing.

Well, she was really doing something by “doing” nothing.  She was observing; keeping a watchful eye. She knew this woman would deliver her baby just as she needed to.  She trusted the baby would find the right position, like a key in a lock, as she descended down her mother’s canal.  Patience.  Dr. X applied a warm compress and a soft voice when needed.  Not my typical delivery experience.

You may know what I’m referring to:  Although I try to encourage the staff to follow my clients’ wishes, the nurse continually checks the mother’s cervix as the mom continues to feel “pushy”.  Doctors, nurses, residents flood the room with lights, noises, loud talking, wheeling in equipment, and everyone in the room is instructing the woman just how and when to push while they watch the monitor.  Alas, routine care pervades.   Patient wishes, and an ancient wisdom are dismissed. Pressure.  Direction.  Passive process.

Not this time!

Back to our unusual scene:

The baby girl is born over an intact perineum and placed on her mother.  Baby is assessed and nursing can commence!  Since this mother has 2 other children, I wait and see how she does on her own with breastfeeding.  She struggles with the baby as she cradles her and manipulates her breast into her mouth without any cues from the child.  The baby cries.  I quickly glance at the nurse, and then jump in to the “rescue”.  I ask, “Would you like some help?” “Yes!” the mother replies.  I help calm the baby and massage the mother’s breast to encourage colostrum to the nipple.  I tickle the baby’s face with the nipple several times and wait for a nice gape.  I roll the mother’s breast into the baby’s mouth.  Baby lets go.  We repeat.  Baby lets go.  Repeat, again.  With the breast in her mouth, baby closes her eyes and stays still, uninterested.  Mom is frustrated. Dr. X – patiently watching this whole scene – gently says something like, “You know, there is something called the breast crawl that I’ve seen where the baby is placed on the mother’s chest, and finds its way to the breast, and attaches itself when it’s ready.  Want to try that?”

Of course! She’s right.  I snap out of it and everything I know spills into my conscious mind.  I step back.  No pulling, pushing or manipulating of body parts.  We adjust the baby vertically between the mother’s breasts.  I watch the ancient magic happen.  I “do” nothing.  The little one acts on instinct kicking her legs, crawling, smelling, reaching, bobbing.  All is done without instruction – without “help”.

The mother looks at me and asks, “Can I help her?”  “Sure”, I say, and I show her how to guide (not force) her to the breast.  Success!  The baby latches on, and actively suckles.  The mother releases a big sigh and melts into the bed.  She lovingly beholds her daughter.

I am surprised at the tension in my body at this time.  My shoulders.  My breath.  I had been poised and ready for action that was not helpful or necessary.  Dr. X sat and watched with a knowing look.  She reminded me that I should still help mothers nurse in a laid-back style no matter if it’s their first baby or their sixth.  She also reminded me that birth and breastfeeding in the hospital (with proper leadership and respect) can be mother-led and beautiful.  I am thankful to her for jolting me out of my hospital routine.  We need more doctors like Dr. X.  And, I need to be a doula that remembers that “doing” or helping with breastfeeding as well as birth,  is sometimes doing nothing.

Lesson:  On most occasions, letting the baby exhibit its ancient wisdom is exactly what the doctor ordered.

Guidelines for laid-back breastfeeding: Download pdf here, from the Womanly Art of Breastfeeding

Laid- back breastfeeding,  or Biological Nurturing, means getting

comfortable with your baby and encouraging your own and your baby’s

natural breastfeeding instincts. See biologicalnurturing.com for further

information.

  •  Dress yourself and your baby as you choose.
  •  Find a bed or couch where you can lean back and be well  supported— not ?at, but comfortably leaning back so that when you put your baby on your chest, gravity will keep him in position with his body molded to yours.
  •  Have your head and shoulders well supported. Let your baby’s whole front touch your whole front.
  •  Since you’re leaning back, you don’t have a lap, so your baby can rest on you in any position you like. Just make sure her whole front is against you.
  •  Let your baby’s cheek rest somewhere near your bare breast.
  •  Help her as much as you like; help her do what she’s trying to do. You’re a team.
  •  Hold your breast or not, as you like
  •  Relax and enjoy each other.

Laid-back nursing Video here: http://www.biologicalnurturing.com/video/bn3clip.html

Breast crawl video Here: