When Your Home Birth Doesn’t Go As Planned

Everyone who follows my blog knows I planned a home birth. “Plan” is the operative word. Even though a home birth was my first choice, my birth plan included backup plans in the event I transferred to the hospital (separate plans for hospital vaginal and C-section deliveries). I imagined the major scenarios, so I wouldn’t be forced to make difficult decisions under the duress of labor or in an emergency.

On Thursday night, I started dripping water, no gush like you see in the movies. An hour later, I started to feel light contractions. I continued to labor. It wasn’t bad either. Kind of fun. We had the lights off except for the orange glow of the salt lamp. I had soft ambient music playing. In addition to my husband, I had a crew of women there: mom, mom-in-law, three midwives and two doulas.

In hindsight, I’m not sure it was best to have so many people attending my birth. I wonder if having so many eyes on me was unnerving and delayed my labor. I was excited for everyone to arrive, but I noticed that my labor slowed down once it wasn’t just me, Greg and my mom. I’ve read this can happen in the hospital because of bright lights, rotation of doctors/nurses, etc., but I didn’t expect it with my birth team, in my own home.

Before I knew it, many hours passed. But during that time I was cruising right along, doing hypnobirthing, handling the contractions. Then something changed. The labor became agonizingly, torturously painful. Friday morning turned into afternoon, and I was experiencing hour after hour of excruciating pain that was becoming impossible to handle. The hypnobirthing techniques?  Not a chance. I tried a bathtub of warm water … didn’t help. I tried different positions … didn’t help. I began to fear something was going terribly wrong. It was then that I started contemplating going to the hospital.

As my intuition continued to scream at me that I needed to go to the hospital, I hate to say this: I was afraid to tell my birth team. Afraid of looking like a wimp, of letting them down, or of making them think they had let me down. Finally, I got the courage to say it. (With the benefit of hindsight, I realize I should’ve never felt ashamed for wanting to go the hospital, but my home birth had meant so much to me, and such a radical change takes time to process.)

My instincts told me something wasn’t right. My birth crew tried to talk me out of transferring, told me that everything I was feeling was normal. My husband looked worried though; he knew how badly I wanted a home birth and that something was probably not right. At this point, my midwife checked my dilation and found that I was only four centimeters! In that instant I knew that I had to go to the hospital. Knowing that I might not even be halfway there, with many more hours of hell to go was all it took for us to switch to Plan B. My midwife seemed surprised by my lack of progress and supported my choice to go, but technically, this wasn’t an emergency transfer. Instead of transferring to the nearby hospital 15 minutes away, we opted to transfer to a hospital 45 minutes away, but much friendlier toward home birth transfers. Most of all, it had lower C-section rates.

At the hospital it was another agonizing hour until I received pain relief, which by then was an incredibly easy decision. At that moment, my concern was for getting my baby born and being helped to do it. Two days before, I would’ve never dreamed I’d accept drugs for pain, but when new information presented itself, I knew I had to be flexible. My overriding concern at that point was to have a vaginal birth, not a C-section. That would require all of my strength. After being relocated from triage to my comfortable delivery room and receiving pain medication, everything was better. I was able to relax a bit, to be myself again. I was able to focus on my baby.

In spite of my previous concerns about hospital births, this experience largely proved me wrong, and tells me that not all hospitals are the same … in fact, far from it! At the hospital, I started to relax, get rest, and I was able to eat. Yes, eat. The hospital did allow that. In fact, my doctor brought me food! My labor was still long once I was at the hospital (about 12 hours more), but it was more manageable. When the time came for pushing, the epidural had mostly worn off, and it was hard work, but without pain. When Kamea came out … that part wasn’t painful at all. It was super cool.

For the past year, I’ve been hard on hospitals for birth. I’ve learned that not every hospital deserves that. The hospital we chose was amazing. They explained the different options I had through every step. They encouraged breastfeeding. They answered my questions. They were patient. They accepted my birth team and collaborated with my midwife, who was my staunch advocate. They respected my birth plan. They didn’t pressure me with anything (except for one formula-pushing nurse). The attending doctor even said something in front of his staff that amazed me: “We doctors could learn a few things from midwives.”

What I’ve walked away with is this: I had the chance to experience part of a home birth, as well as a hospital birth. The birth team believes that Kamea was presenting with her elbow in the up position, explaining the slow progress and extreme pain. I suspect if Kamea didn’t have an elbow up, my labor would’ve progressed faster and might not have been as painful. But she did. And as her mom, I made decisions that I didn’t expect to make, but I was happy to make them. They felt right in my gut. And the other thing I learned: Don’t be afraid of the hospital if that’s the route you need to go, yet you had planned a home birth. Choose a hospital that is midwife-friendly, if possible. Otherwise be sure to have your birth team there to advocate on your behalf.

I wonder if the labor was protracted because she just wasn’t ready to come out. Three days prior to my water breaking, I took measures to “support labor starting.” I underwent two aggressive acupuncture treatments. I now wish I hadn’t done that. I wish I had let Kamea come on her own time. I did it because she was almost two weeks past due, after which my midwife technically wasn’t allowed to do the delivery. Because I wanted a home birth, I was willing to speed things. I wonder if this contributed to my long labor.

In the end, I have a happy, healthy baby (that’s what matters), and I love her so much!

My Home Birth Team

It’s a beautiful time in my life. I’m six months pregnant and feeling blissful beyond belief about my plan to have a home birth attended by my husband, midwife and doula. It’s going to be the ultimate birth team! I have no fear of childbirth and actually view it as an exciting rite of passage. I have confidence in my body and baby to do what we women have been doing since the beginning of time. A home birth is natural, healthy and empowering.

Midwives have been helping with home births for a long time. In fact, a majority of births in many parts of the world are home births assisted by midwives. Hospitals may be necessary in some cases, but not all. Most healthy women can birth successfully in the comfort of their own homes and in some cases have better outcomes than if they went to the hospital.

When I tell people I’m planning a home birth, I get looks ranging from shock to disbelief. Then I find myself rattling off statistics to support my choice–one of which is that the United States has some of the highest infant and maternal mortality rates in the developed world. Furthermore, US Cesarean section rates continue to climb at an alarming rate accounting for almost a third of all deliveries. That’s double what the World Health Organization says is safe for moms and babies.

The bottom line is that I feel a home birth is the best thing for me to do. I am so excited to bring our baby into this world gently and softly. It’s going to be a wonderful harmonious experience. On the contrary, the pain we often see portrayed on TV, or from women birthing in hospitals, isn’t an accurate picture of what the human body is capable of in a more relaxed, comfortable and secure setting. There might be pain, but there might not be much pain. I don’t mind either way. I’m confident that if there is pain, it won’t be the kind seen on TV or heard about from women with hospital horror stories. One of the reasons for this is simply that stress – of any kind – prolongs or even suspends labor.

As a home-birthing mom I can avoid stressors found in a hospital such as, an unfamiliar uncomfortable environment, harsh lights, cold hands, poking and prodding from total strangers when personnel change shifts, or the pressure to undergo surgery. The home-birthing mother can change positions when she’s in labor, walk around, take a bath (whether to lounge or even to give birth in water), dance, sing, eat, drink, wear her own clothes (or no clothes at all), be romantic with her husband, listen to music playing softly with candles lit and dim the lights (or heck, she can even have Nine Inch Nails playing in the background if she wants). She can have her doula or birth partner use acupressure or massage to help relieve pain. Mom and Baby can do things on their schedule, not the doctor’s, not the hospital’s. Baby can come when Baby is ready, and Mom is empowered.

Having a doula attend my birth is important. I would hire a doula whether I planned a home birth or hospital birth. A doula’s calming effect on birth is impressive. According to DONA International, “The word doula comes from ancient Greek, meaning ‘a woman who serves’ and now refers to a trained and experienced professional who provides continuous physical, emotional and informational support to the mother before, during and just after birth; or who provides emotional and practical support during the postpartum period. Studies have shown that when doulas attend birth, labors are shorter with fewer complications, babies are healthier, and they breastfeed more easily.” I hired our doula months before we even tried to conceive! I’m glad I did. Over time, we’ve built an amazing relationship with a bond that is hard to describe. I’m so grateful she’s been a part of our journey and will be there when our baby is born.

I mentioned previously that my birth team consists of my midwife, doula and husband. A lot of people think they won’t need a doula because the husband is present, but this idea underestimates the doula’s role.. The doula not only supports the mother during birth, she is there to support the father as well. My husband will be my main birth companion, and I will lean on him a lot. As a result, I suspect he is going to get tired and need a break (or two!). Our doula can step in during these times. But that’s not all. Our doula has many tricks up her sleeve and plenty of experience in childbirth, which my husband doesn’t have. This makes her a special part of our team with an important role.

Although my plan is to birth at home, there might be circumstances that require going to a hospital. In that event, I have created a birth plan to be followed. My doula and midwife will serve as advocates on my behalf. If the hospital is resistant to any of my requests, no big deal; let ‘em talk to my team while I focus on other things.

I want my childbirth to be a beautiful and amazing experience. I’m stacking the deck in my favor by taking control of the situation, my environment and my team by having my home birth attended by a midwife, doula and my husband. And I’m doing many other things that are not widely known, or are considered “alternative,” such as eating an extremely healthy, high raw, vegan diet, having my birth plan written in advance, taking hypnobirthing classes and more. For pregnant women reading this, or women who may become pregnant in the future, realize there are many options to consider and that you have much more control over your birthing experience and outcome than you may have been taught.