Robyn.Bowles.es

I’ll start out by publishing what I wrote 5 weeks ago about our decision to pursue a home birth:
Our Prenatal Home Visit
Some couples decide to keep the sex of their babies a surprise or “secret” from others – and some, even from themselves. Others (as we did with Josiah) choose not to share the name they have chosen until after the birth. The reasons for such decisions are many and personal and may include the desire to avoid hearing others’ opinions about such a personal decision (such as a name).

At least for now (I write this at 34 weeks), I have decided not to publish our decision to pursue a home birth. But it is with great joy and excitement that we look forward to it! We made the decision in early April after we attended a presentation/discussion about it at the “Encuentro Alternativos” weekend. A group of about 40 people attended the meeting which was led by the two midwives with whom we have been taking classes.

We spoke about the medical system – the medicalization and emotional trauma of many (most?) births that take place within it. We also spoke of the beautiful, tranquil, respected and intimate experience it can be, and most often, is when at home.

I fought back tears as I listened, my heart aching for such an experience, and the healing I believe I could receive from it. At that point, however, I didn’t think Samuel would go for it.

So it was to my great surprise, relief and encouragement when he turned to me after the presentation and asked if that was something I’d like to do. I immediately said, “Yes!” and we excitedly told our friends who were there at the fair with us that we were going to look into it.

I have never doubted this decision we’ve made. We’ve thought through it, researched it and prayed through it a lot and have received much encouragement and support. I do understand and respect the doubts and fears that many have about home birth, and after receiving a few such responses, have decided to keep this decision a “surprise” for now.

We are very aware of the risks – which in all reality, as long as I don’t develop complications such as pre-eclampsia – are actually fewer than what I would likely face in a hospital. For example, the risk of uterine rupture due to previous C-section is about 0.5% overall, and increases with certain routine hospital practices such as oxytocin or prostaglandin induction or instrumental delivery. But we also have a large, University Hospital literally across the street from us in case of emergency.

Our midwives are well-trained, well-experienced and very confident. They’ve worked in hospitals, and now for about 10 years doing home births.

I love the personal attention they give us and the level of relationship we are able to develop with them. They are never hurried or impatient with our Spanish.

And today, Maite came to our home for our prenatal home visit. She encouraged me to invite those who may be present for the birth or to help, so Helen and Heather joined us. She was here almost two hours and interacted beautifully with Josiah, showing him where Isabela’s head and butt were and showing him where to listen for her heartbeat. We talked about the layout of the house and where she could set up the birthing pool if I desired it, and gave me a list of things to have ready.

Helen and Heather enjoyed the visit, too; and commented on how beautiful it was that we were receiving such care.

I desperately hope and pray that Isabela will be able to be born into our loving hands here in our home.

Four Weeks Later. . .
God answered our prayer! Isabela was born at 8:26 a.m. on Thursday, August 7 in our living room! I was attended by both midwives, a doula, Samuel, and even Josiah. I needed and appreciated every one of them! It was absolutely the hardest thing I’ve ever done (running repeat hills in High School Cross Country was nothing!), there were moments when I thought it would never end!

Earlier that afternoon the contractions I had been having died down, but started to pick up again around midnight. They were strong enough that I needed Samuel to help me through them by massaging my back. Around 1:30 a.m. I went to take a bath and Samuel went to get some sleep on the couch with the plan that I would call him if I needed him. The bath helped, but soon after the contractions picked up again and at 3:30 I called Samuel. He encouraged me to come out to the living room so as not to awaken Josiah (I don’t think I realized how loud I was being , then he decided it was time to call the midwives, though I still wasn’t sure, and feared a “false alarm.”

The three women arrived at about 4:30 a.m. Maite checked me and I feared that she would tell me I hadn’t yet dilated, then to my surprise she then told me I was already 8 cm! The first thing I thought of was that even if I then wanted an epidural, I was too far dilated – there was no changing my mind now (not that I wanted to).

My water broke at about 7:30 a.m., I was still at 8 cm and I remember being discouraged that I hadn’t progressed further. But as soon as I was told that I was 10 cm I wanted to push – not that I felt the urge to push, but I wanted progress so I decided it was time!

I moved around into different positions – from squatting to kneeling on the couch and eventually to the birthing stool. Maite put a mirror below me so I could watch the progress. It was so amazing to be able to see and touch her little head as it came down. It was surprisingly soft!
And to finally be able to see the progress, and more head and her little hair was so encouraging!

Before my final push Menchu told me to push when they said “push” but then to blow when they said “blow” – as she knew this would be it and Maite would help ease the head out to prevent swelling and tearing (I did tear some). What an incredible feeling, and sight when that head popped out, then turned, then came the rest of her body and finally I was holding my hot, sticky, wiggly, beautiful (though cone-headed) little girl! Oh what joy and relief!

“Blessed are you, Lord God, King of the Universe, who gives new life!”

I absolutely can’t imagine having done this in the hospital! I was surrounded by loving, caring professionals and a wonderful, attentive husband who even remembered that I had wanted certain lighting and music and provided it! I never would have had the freedom to move, to express myself vocally (I did get a little loud sometimes), or have the support I needed had we been in the hospital here. I truly believe I would have ended up with a C-section had I been in the hospital because I wouldn’t have been able to do it without the wonderful support.

It was also incredible to have Josiah right there with us for the birth (miraculously he was able to sleep through all the noise I made, until Samuel went to get him). He was so calm and sweet and excited to see his baby sister born. Samuel held him and talked him through everything that was happening. Josiah was even able to touch the umbilical cord and feel it pulsating.

Unfortunately, I did have some complications with excessive bleeding because the placenta wouldn’t come out. Retained placenta happens in about 1% of births, and would have happened whether at home or the hospital, in the U.S. or in Spain. In fact, several studies have demonstrated that the risk of post partum bleeding is higher in the hospital than in home births. The midwives responded immediately when they suspected excessive bleeding: I was on my back with legs elevated and an IV in. Maite gently tugged on the cord and encouraged me to push when I had a contraction, but when she knew it wouldn’t come the ambulance was called and off I went to the hospital 2 blocks away.

There was no way to prevent or predict the retained placenta, none of the risk factors that occur with retained placenta pertained to me (no snapped cord, it hadn’t attached to a fibroid or my previous c-section scar, wasn’t preterm, wasn’t prolonged labor, wasn’t acreta, my bladder wasn’t full). So just as with the HELLP Syndrome – God only knows.

The bubble of our beautiful experience popped once I was under control of the medical system. I prefer not to focus too much on the negative part, I certainly am grateful for their attention and ability to remove the placenta and provide the blood transfusion I needed; but it was certainly a shock to go from the beautiful environment of our home to the cold, rude atmosphere of the hospital.

Thankfully I was able to return home the next day and knew that Isabela was always in the loving arms of one of her parents (or friends) from the moment she was born.

Maite visited me in the hospital the next day, and came by for a home visit this evening. Isabela is perfect – eating like a champ and suffering from hiccups occasionally. I’m feeling better every day, though the soreness “below” is taking longer than I’d like to heal! Samuel has been wonderful! He’s keeping very busy taking care of all of us: serving, shopping, cooking, cleaning, playing with Josiah, running errands, bouncing with Isabela when she has hiccups (all while I sit on the couch)

Despite the “nightmare” part of our dream, I would not have made a different decision about birthing at home, and am so glad we followed the path that we did. We may have done things differently had we been in the U.S. where I would have had more freedom and respect than is routine within the medical system here; but we chose to stay, and we give God thanks and praise for his protection and blessing. (Though I do have a few questions for him, and trust he will show me the good in what happened with the hospital experience). It was also a privilege to be able to share our faith through all of this with our midwives and doula (my doula even commented on how surprised she was that I wasn’t swearing! I prayed instead.)

I recently read a post on the Business of Being Born website that well-captured my own feelings about making this decision:

“To be in a place where I don’t trust my caregivers to make good judgement calls on behalf of me and my child isn’t a safe environment for birth. For me, birthing at home with my midwife is undeniably the safest option. I know that if my midwife suggests an intervention, including transfer to a hospital, those suggestions haven’t been swayed by any reasons other than the safety and well-being of myself and/or my baby. How could I go back to an OB or a hospital environment knowing that I don’t trust the people who would surround me?”

For more about home birth and VBAC (vaginal birth after c-section) check out:
Ina May’s Guide to Childbirth, by Ina May Gaskin
The Thinking Woman’s Guide to a Better Birth, by Henci Goer
Birth Reborn: What Childbirth Should Be, by Michel Odent, MD.
The International Cesarean Awareness Network
Creating Your Birth Plan,
by Marsden Wagner, MD, MS, Former head of Women’s Health for the World Health Organization.
Midwifery Today
The Business of Being Born, an excellent documentary by Ricki Lake and Abby Epstein about birth in America (mostly New York-focused, but also VERY applicable to Spain).

« 38+ Weeks: Signs     Isabela’s First Week »