** WARNING: Birth is graphic. View the following at your own risk.
Scarlett Rose Morguess
June 23, 2012 6:46 p.m.
7 pounds 5 ounces, 20 inches
I became pregnant with my seventh baby at the age of 44, this after my husband, Michael, had undergone cancer treatment for stage 3 colorectal cancer two years prior, which included intensive chemotherapy and pelvic radiation. To say that this pregnancy was a surprise would be quite an understatement; my age alone made it seem somewhat unlikely, but we were under the impression that his cancer treatment had left him sterile. Our family felt complete with six kids, and we were thankful that Michael’s cancer was in remission, so the idea that we would have no more children was fine with us.
After a week or so of mood swings and crying jags last October, however, I decided to take a pregnancy test just to rule that out as a cause of how strange I was feeling. I was absolutely certain the test would be negative, but I needed to see that just to be sure. It was positive.
I cried. How could this be? I was too old, I had no business being pregnant. There was no way this could end well.
When I called my midwife, Sue, who had been here for Lilah’s and Finn’s births, and who had also become a dear friend who gave us so much support through Michael’s cancer treatment, she laughed. She was sure that this was a miracle baby who would someday do something phenomenal.
I spent the entire first trimester being really scared (and nauseous), sure that I would miscarry, or that it would come to some other bad ending.
But it didn’t.
By the time the second trimester rolled around, I was feeling much better physically, and I felt myself relax and stop thinking about bad omens. Right around the time my nausea disappeared, I began to feel those little flutters of movement. Wow! I was really going to have another baby.
We opted not to undergo any prenatal screenings to detect disorders or birth defects, despite my advanced age and the fact that Finn, born almost four years ago, has Down syndrome. It wasn’t a difficult decision for me; I didn’t feel that knowing anything ahead of time would be of any benefit to me or to the baby. I was glad to have not known about Finn’s Down syndrome until after his birth, and I wanted the same opportunity to just enjoy being pregnant this time around. I figured that our family was strong enough to deal with whatever surprises this baby might be born with as well. We did opt for a mid-pregnancy ultrasound just to rule out obvious physical anomalies that would preclude a safe home birth, and it was then that we learned we would be having another little girl.
The whole pregnancy went by really quickly. I guess that happens when you have a passel of other kids to keep you busy. I settled into being pregnant and reveled in it. I felt really good and could hardly believe how smoothly things were going.
The biggest concern was my blood pressure. I’ve had blood pressure issues throughout my last few pregnancies, and I was diagnosed with chronic hypertension about two years ago – hereditary (my dad had it) – and have been on meds to control it for about that long. With medication, a high protein diet, and supplements suggested by my midwife, my blood pressure stayed in a nice, healthy range throughout my pregnancy – until the last couple of weeks.
Around 38 weeks, my midwife went out of town for a few days, my blood pressure started rising, and I came down with the flu – all at the same time. That was stressful! She was in Nashville, and she and I were in constant contact via text about my blood pressure, and I was able to bring it down somewhat after a couple of days, but from then on it continued to go up and down and remained a big concern.
On Wednesday, June 20 – two days shy of my due date – I woke up with some bloody show. This was a promising sign; it meant that labor probably was not very far off. I happened to have a prenatal appointment scheduled with Sue that morning, and she checked me and said I was dilated to 1 cm – which really means absolutely nothing, but at least it satisfied my curiosity.
My blood pressure continued to rise and fall. By Friday, June 22 – my due date – the Braxton-Hicks contractions I had been experiencing for so long were finally becoming real contractions, but they were pretty irregular, ranging from ten to twenty minutes apart. Still, I thought it was a sign of progress, and I went to the bakery and bought a “birth day” cake in anticipation of the big event and put it in the fridge.
Sue came over again late in the day. She and I talked and I agreed to have her check me again and if I had dilated any further, she would strip my membranes to see if she could get things moving. I had, indeed, dilated a little more, so she did a membrane sweep.
For a few hours after that, my contractions picked up. They were definitely more intense, and consistently ten or so minutes apart. Michael and I went to bed, half expecting things to really pick up during the night. I slept fitfully; the contractions were waking me up from time to time, but they actually had gotten farther apart. By morning, Saturday, June 23, it seemed that whatever had started up had now mostly stalled out. I was feeling a little frustrated – was this going to be another drawn out start-and-stop labor like I had had with Lilah? – but also sort of okay with it; I figured the baby would come when she was ready.
Michael and I ran some errands in the morning – mostly to kill time, I think. We came home and fed the kids lunch and then decided to go for a walk. While we were out walking, Sue called me on my cell phone. She was still very concerned about my blood pressure, and talked to me about risks associated with maternal hypertension. Placental abruption was the biggest risk and the biggest concern. She emphasized that the best thing would be for the baby to be born as soon as possible, and she wanted it to happen that day if possible. Suddenly I was scared. Placental abruption? Now I had to consider the possibility of death for my baby and/or myself? Sue said, “I love you guys too much, and have watched you come too far, to allow a bad outcome.” Michael was scared, too. Was this a situation that required transferring to the hospital? I didn’t want to do that unless absolutely necessary – I knew without a doubt that if we went to the hospital, my blood pressure would shoot through the roof just from stress and anxiety, and they would immediately put me on Pitocin and probably Mag/Sulph, and the entire thing would spiral downhill with interventions and it would break my heart. I trusted that Sue would send us to the hospital if necessary, and she hadn’t, so it wasn’t necessary. But we needed to give my labor a kick-start and encourage this baby to come out and meet the world.
When Michael and I got home from our walk, we figured we had better get things set up just in case.
Sue came over mid-afternoon and she, Michael and I sat down and talked about our options. I was having strong but sporadic contractions, and she checked me again and found that I was dilated to 5 cm. I asked her about breaking my water, and she said that she’d rather not unless I was in active labor. She suggested castor oil. I wasn’t thrilled with that idea because I had taken castor oil to get things moving with Lilah and remembered the effects. Sue said that her experience has been that castor oil gets active labor going within two hours usually. I absolutely didn’t believe that was going to be the case with me – my contractions were twenty to thirty or more minutes apart at this point, and I just couldn’t imagine that things would pick up considerably that quickly. It was worth a shot, though, so I agreed.
So we sent Michael to the store for the ingredients for Sue’s Special Kickstart Labor Shake: castor oil, OJ concentrate, and vanilla ice cream. She threw it all in the blender, and I drank it at about 4:00 p.m.
Then we waited.
Kevin was down the street at a friend’s house, Joey was running around the neighborhood from one friend’s house to another, and Michael took the girls to swim at a neighbor’s across the street. To kill time, Sue and I chitchatted for a while, and then we started watching home birth videos on YouTube.
Michael texted me a few minutes after 5:00 from the neighbor’s house to see how I was doing, and I told him my contractions had picked up a bit but they were still 10+ minutes apart. My friend Lisa texted me at about 5:30 and I told her that my contractions were picking up some. I still thought it was going to be quite a while, and I was prepared for it to stall out again.
Michael came home with the girls at around 5:45, and Daisy got into the shower. Suddenly, my contractions started coming on stronger and closer together. By 6:00 they were no more than a couple of minutes apart and incredibly strong. Every time one would hit, I would drop down on all fours because that seemed like the position to assume to deal with the contractions best.
In no time at all, the contractions were coming fast and hard, one right after another. I began to panic. I yelled for Daisy to get out of the shower because we needed the shower connection to fill up the birth pool.
I was trying to get undressed, but the contractions were coming so quickly. “Shit! Here comes another one . . .” I moaned. “Fuck, another one . . .” Sue said, “Why don’t you let me check you just to see where we are?” “No, there’s no time, I’m there!” I said. Clearly, the baby was coming. Sue helped me get a bathing suit top on and into the pool, and being submerged in the warm water was a relief.
I remember thinking, “I hope it just stalls out now, I hope it just stalls out now . . .” but the contractions kept coming, one right behind another. I couldn’t believe how fast this was happening.
We sent the girls out of the room so I could focus, and because I didn’t want to scare them with all the noise I knew I’d be making. I had screamed my way through Lilah’s and Finn’s births – the truth is, as big a fan I am of natural birth, I’m not one who will claim it’s a peaceful or serene experience.
I felt my water break in the pool, and suddenly my body took over and the pushing started. It is the wildest thing – completely beyond your control, that bearing down with everything you have.
Somehow I managed not to scream through this one. I moaned – loudly – “No . . . no . . . no . . . I can’t do it . . . I can’t do it . . .” while Sue and Michael kept saying, “You are doing it.” I just wanted it to stop, to be over. I was on overload, every cell of my body working to get this baby out, and truly feeling like there was no way I was going to survive this. Melodramatic, I know, but damn – giving birth just pushes you to your limits.
I could distinctly feel the baby – especially the round, hard shape of her head – moving down and out. Though it felt like it took an eternity, the truth was that I pushed through two contractions – just a few minutes – before my daughter was born.
Sue’s labor notes read: “6:45 – head out; 6:46 – body out.” Scarlett was born with a nuchal arm, meaning her hand was up against her face, so her head and arm came out at the same time. I don’t know if that added to the intensity of it, but I can’t imagine it didn’t.
Sue went out to tell the kids that their sister had been born. They were all playing in the front yard and didn’t hear me make a peep, and it had happened so quickly from the time they had left the bedroom that they couldn’t believe she was really here.
I sat in the pool, enjoying the weight and warmth of my baby in my arms, marveling at the improbability of all this, until the placenta was ready to come. Michael cut the umbilical cord, severing the physical tie that bound Scarlett and me for all these months, and took his newest baby girl.
Sue helped me dry off and get into bed, and when I put Scarlett to my breast, she knew exactly what to do.
Sue didn’t have the flannel sling that goes on her baby scale, so she improvised with this shopping bag, which will have special meaning to my book club:
Then the initial newborn exam. She looks healthy and beautiful in every way.
I absolutely love that the kids were right there to meet their new sister right away. Home birth is truly a family affair.
Look at this old chick who just had a baby.
I look at the lines in my face and think about how far and wide my life has taken me, and I am amazed that my body can still do this, and I am thankful for all that I have.
As the time draws closer to our newest addition’s debut, I’d like to address some misconceptions that seem to run rampant about home birth. (I think there are as many misconceptions about home birth as there are about Down syndrome!) I’ve heard it all – everything from “You’re crazy!” to “Home birth is dangerous!” to “You’re so brave!” to “You know nobody gets a medal for that, right?”
So let’s just clear a few things up, okay?
I think people still generally see those who choose home birth as fringe lunatics who run around barefoot in peasant skirts and catch and/or grow all their own food. It’s just not so. Most women in the U.S. who choose home birth are educated and middle class. Speaking for myself, I slack on buying organic, I enjoy a good, cold martini, I get my nails done regularly, I drive a gas-guzzling SUV (not that I’m proud), and I don’t even own a peasant skirt. Yes, yes, I’m still one of the outliers as far as birthing choices, but in most ways, I’m very much like most of the other moms you probably know. (Okay, there’s the vaccine thing, and the cloth diapers. And I probably swear more. And I have multiple tattoos. Oh, and there’s the whole God thing . . .)
So, why do I choose home birth? A Wikipedia article on home birth states,
Women with access to high-quality medical care may choose home birth because they prefer the intimacy of a home and family-centered experience or desire to avoid a medically-centered experience typical of a hospital or clinical setting.
Many women choose home birth because delivering a baby in familiar surroundings is important to them. Others choose home birth because they dislike a hospital or birthing center environment, do not like a medically-centered birthing experience, are concerned about exposing the infant to hospital-borne pathogens, or dislike the presence of strangers at the birth. Others prefer home birth because they feel it is more natural and less stressful.:8 In a study published in the Journal of Midwifery and Women’s Health, women were asked, Why did you choose a home birth? The top five reasons given were safety, avoidance of unnecessary medical interventions common in hospital births, previous negative hospital experiences, more control, and a comfortable and familiar environment.
That about sums it up for me.
I gave birth to my first four kids in a hospital setting, and every one of those experiences was pretty negative. I felt pushed around (especially in the case of my twins’ births) and assaulted, even, and it was only over time, as I started learning everything I could about birth, that I realized that most of the protocols and procedures that are routine in hospital births are medically unnecessary and designed to maximize (a) hospital profits, and (b) the medical staff’s convenience. Maternity units are the biggest revenue makers in most hospitals; birth has become an industry. Of course they don’t want moms or babies dying on them, but the safety and comfort of moms and babies is secondary. (The United States ranks No. 39 – in the world! – for maternal mortality rates as of 2008 [and the U.S. maternal mortality rate increased slightly from 1990 to 2008], the year for which the most recent data is available, and No. 34 – in the world! – for infant mortality rates as of 2011. In case you were wondering.)
Here’s what I know:
- If I walk into my state-of-the-art hospital in labor, I will be denied food and drink by mouth for the duration. Completely unnecessary, and in fact, counterproductive; the reasoning behind the NPO protocol is that they don’t want anything in the woman’s stomach on the off chance she’ll need an emergency c-section (which would require general anesthesia as opposed to a non-emergency c-section for which an epidural is used), as she could aspirate the contents of her stomach during surgery. First off, people come in for emergency surgery right off the streets all the time (think horrible car accident). During surgery, you are intubated. You therefore will not aspirate the contents of your stomach. Furthermore, to deny fuel to someone who is doing the work akin to running a marathon is counterproductive at best, and cruel at worst.
- I will also be made to accept an IV, through which they will feed me a glucose solution in place of actual food and water. I will thus be tethered to an IV pole and will have an uncomfortable needle jammed in my arm and taped down.
- I will be made to submit to at least intermittent fetal monitoring, which will require me to lie in bed for 15 minutes out of every hour. I may be allowed to walk the halls, but I will be pulling a cumbersome IV pole around with me whilst trying to keep my ass covered by the required wayward hospital gown.
- I will be looked in on by a nurse who is also looking after numerous other laboring women. I will have no continuity of care.
- I will be put on the clock as soon as they get the IV in my vein; if I fail to dilate the prescribed 1 cm per hour, I will be “encouraged” to submit to augmentation of my labor by way of Pitocin and/or artificial rupture of my membranes. If I submit to Pitocin, my labor will become unnaturally intense and painful, and I will then be “encouraged” to accept an epidural. Once I receive the epidural, that’s it – I’m stuck in bed with continuous fetal monitoring and a catheter because now I can no longer get up to pee.
- I will be limited on the number of people important to me whom I’d like to be present for the birth.
- Once I am deemed “ready,” the doctor will swoop in to save the day. By this time, I have been swabbed from belly to mid-thigh with Betadine, and sterile sheets have been draped over me, exposing only the baby’s direct exit route. I will have an extremely bright light shined on my nether regions, and I will be made to give birth in a supine position (the least optimal position for opening the pelvic inlet, but the most convenient position from whence the good doctor to deliver the baby), with directed pushing (“PUSH TO THE COUNT OF TEN! NOW! PUSH! NOW STOP. PUSH AGAIN, TO TEN NOW!”).
- Once the baby is born, s/he will be placed on my chest for a few moments, and Dad will be allowed to cut the cord if he so desires. The baby will then shortly be whisked away to the other side of the room for suctioning, weighing and measuring, bathing, administration of Vit. K shot and antibiotic eye ointment (you know, just in case I have VD and don’t know it, or am holding out on everyone). I probably won’t see or hold her/him again for a good 20 – 30 minutes.
- Meanwhile, it is imperative that I expel the placenta pronto. To assist, the doctor will use cord traction to help things along – that is, he will yank on the cord. Time is of the essence; he’s got other moms to doctor and/or a golf game to get to! If I have not received Pitocin in my IV to help my labor along, I will now receive a shot of Pitocin in my thigh as a matter of routine to control bleeding, whether I am bleeding or not. The nurse will also grab my tender uterus through my now squishy abdomen and knead it like bread dough to make it clamp down. I will want to strangle her.
- Within an hour or two, I will be moved, along with my new baby in a clear plastic box on wheels, to a postpartum room. My husband may be allowed to stay the night in a narrow vinyl pull-out chair. There will be visiting hours that must be observed, and my other children won’t meet their new sibling until visiting hours.
- Throughout the day and night I will be monitored by different nurses at regular intervals who will check my blood pressure, temperature, etc. I will have to listen to all the hospital noises and people coming and going at all hours. I will be admonished if I bring my baby into my bed and actually fall asleep with him or her there. I will leave the hospital with formula samples, you know, just in case.
And all this if I don’t end up with a c-section! Just walking into the hospital in labor puts me at a 1 in 3 chance of having a c-section. Yes, that’s right, 1 in 3!
Here, in a nutshell, by contrast, is what I can look forward to when having a baby at home:
While in labor, I can wear what I want, do what I want, and eat and drink what I want. My midwife will come over when we ask her to, and from then on, she will be there for the duration, occasionally checking my blood pressure, listening to the baby’s heartbeat, and doing as few vaginal checks as necessary (I’m actually aiming for none this time around, I hate them so. I figure I’ll know when it’s time to push since I’ve done this a few times already). She will bring with her oxygen and necessary emergency medications. She’ll stay out of my way if I want her to, she’ll make bawdy jokes if the situation calls for them, and she’ll offer tender encouragement. She will mostly observe and allow me to do what I need to do to cope with labor and deliver my baby into the world. She does not deliver babies, her mothers do; sometimes she catches babies as they ease into the world, sometimes the moms themselves catch their babies, and sometimes Dad catches the baby. There will be no time limits placed on me. I can go for a walk around the neighborhood if I want to, or I can relax in the birth tub. I can labor in whatever position works for me, and when it’s time to push my baby out, I can do so in whatever position works for me. I can have as many or as few people present as I wish. After the baby is born, I can hold her for as long as I wish – there is no hurry to bathe her or do anything else under normal circumstances. The placenta will come when it comes. When everything is said and done, I will crawl into my own bed with my new baby and my husband, and my midwife will stay to make sure we’re all settled and fed. She will empty the birth pool and clean up whatever needs to be cleaned up (birth is not as messy as you might imagine – most of the mess is towels, plastic sheets on the floor, etc.) My other kids can come in and meet their new sibling right away. After she leaves, she will come back numerous times over the next week or two to check on us.
And that’s pretty much it.
Listen, if you’ve had a positive birth experience in a hospital (and I know many have), then bully for you. But just like home birth isn’t for everyone, neither are hospital births. And before you make any snap judgments about home birth, do some research. It cracks me up how many people say that home birth is reckless and crazy who really know next to nothing about home birth, and who have no facts to back up their assumptions.
I don’t do this because I’m crazy or brave. Deciding to give birth at home after four hospital births was a very thoughtful, research-intensive process. In the end, I have chosen this because it’s what’s best for me and my family.