Are you ready for a birth story? It took me a while to come to a place mentally to write my birth story of my fourth babe. There are a few reasons why it took a little longer to put everything down in black and white. One, I’m still processing the birth, but I think I’ll be processing it for a while. There were interventions done during my labor that are normal in the home setting and rarely seen in the hospital setting. It was strange to be on the patient side of those interventions. Two, not to spoil the surprise, I unexpectedly birthed a ten pound baby! And three, I spent a lot of time thinking about my prior three births and comparing those births to this birth.

I’ll go into those teasers a little more later, for now, here’s the birth story!

This is me at 38 weeks – one week prior to birth. I’ve never done professional maternity photos before but we did some family photos that weekend and the photographer snapped up a couple of me solo.

The week of my labor and birth, I had seen my midwife team at 38 weeks and 6 days. (My main midwife was a seasoned certified nurse midwife that works in the area I live and attends births at home and a birth center. She takes midwifery students that train as certified professional midwives and as certified nurse midwives. She had a student that was training as a certified professional midwife that was at the end of her training that attended some of my prenatal appointments as well as the birth. You can read more about the different types of midwives here.)

At my last appointment, I didn’t have my cervix checked. I don’t believe there is a point to a cervical exam unless you are wanting to perform a membrane sweep or you are having contractions that you think might be labor and the cervical exam is going to change the plan of care or give you information that you want or need. My midwife scheduled me out to 41 week visits, to include a non-stress test if I needed one.

I confidently told her there is no way I would be pregnant at 41 weeks. I was confident I would labor beforehand.

I worked my last 24 hour shift at the hospital at 39 weeks 1 day. I’m certain the patients all thought I would go into labor while caring for them in labor…but I managed to catch four babies and get a little nap before leaving the hospital the next morning and hoping that I wouldn’t be back for 3 months.

A few days past with no signs of labor. Saturday arrived and my husband took the other littles on some errands while I decided to clean my carpets with our carpet cleaner. Consider it an act of extreme nesting. I spent 3 hour cleaning the entire upstairs floor. Then followed that with the usual cleaning of the house – laundry, downstairs vacuuming, dishes. By the evening time, my back was hurting a little more than usual and I was tired.

I told my husband I was going to take a hot shower and lay down with the heating pad. I woke up about an hour later and realized my back pain was contraction pain that was occurring every 7-10 minutes. At this point, it was 10 o’clock at night. My husband was still awake and I told him I think I might be in early labor, but that he should go to sleep since he was on dad duty in the morning (we hadn’t arranged for childcare during my labor; we planned for my husband to take care of the babes). For my first birth story, I went into labor at 39 weeks, 4 days, and that was my gestational age that night. I was hopeful.

I was too uncomfortable to lay down, so I started to walk around the house and tidy up all the random kid stuff. I continued to contract but didn’t want to call my midwife yet because I wasn’t sure if it was true labor.

At about 1 am, my contractions were every 3-5 minutes, getting more intense, and I was having to breath through them or stop and sway during them. At this point I called my midwife. She was at another birth across town and after speaking for a few minutes, we decided I didn’t need her now, but we were confident this was labor. She was hoping to finish up at the other birth before coming across town.

With my prior births (2 spontaneous labor, 1 induction), the babes had come quickly after my bag of water broke (2-4 hours depending on the birth). I told my midwife that if my bag of water broke, I would have her come sooner, otherwise she and I would text often on how the contractions were progressing.

I put on my birth playlist and went to walk outside on my driveway and curb. It was nice and cold outside so the fresh air felt good and was a nice distraction between contractions.

About 90 minutes later, I was leaning over my banister upstairs, breathing through a contraction, and my bag of water gushed down my legs like a tidal wave. All over my freshly cleaned carpets. I woke up my husband because I thought labor would start to pick up and texted my midwife that my water had just broke.

She was about 30 minutes away, but on her way.

Instead of my contractions picking up, they started to space apart. I continued to walk around the house and outside. When my midwife team arrived, they came sprinting in the house and went up the stairs thinking I would be laboring more intensely. I was standing in the kitchen and walked to the foyer to say hello.

We talked about my contraction pattern while they listened to the baby with the doppler. Everything sounded great with the babe and I decided to keep walking around to see if my contractions would pick back up. Every so often, I would have a HUGE gush of water again and have to go change my pads or pants because there was so much leaking. (This is why people recommend depends underwear for labor!)

From about 3 am to 6 am, the contractions continued, but remained every 5 to 7 minutes instead of every 3 to 5 minutes as they were before my water broke. I continued to drink water but also ate a few bites of honey on a spoon. I was walking and walking and walking. I walked outside, around my house, up and down my stairs. My midwives would listen to the baby periodically and he continued to sound good. (Photo note: How did we not know there was a 10lb baby in there…look at that belly during heart tones!)

At 6 am, I was so tired. Because of insomnia during the pregnancy, I had been awake since 3 am the prior morning. So I was tired from labor and being awake for 24 hours. I talked to my midwife about being tired and she recommended that I rest. She said, if you think you can go to sleep, what your body may need most is rest. So I laid down in bed and took a nap for 30-45 minutes. I had contractions during that time but was able to sleep in between.

At 7 am, my daughter woke me up. I had her go find her dad (he was sleeping downstairs on the couch; the midwives were sleeping on my office floor). And I asked for the midwife to check my cervix.

The recommendation was this: Checking your cervix isn’t going to change anything and knowing the dilation won’t get the contractions regular or more intense.

I knew this in my heart. But I was frustrated that 5 hours post-water breaking, my baby wasn’t here yet and I was having a different labor and I didn’t know why. I also would have told a patient the same thing had I been managing the labor.

So when the midwives recommended some interventions to get the contractions going over performing a cervical exam, I said okay.

The first intervention they recommended was a Miles Circuit. This is an intervention you’ll see done in the hospital for stalled or slow labors – especially for malposition of the baby – but you also see a lot of chatter about these moves on social media.

First you start out in an exaggerated open knee chest post that is similar to an elevated child’s pose in yoga; you hold this position for 30 minutes, including during contractions. My contractions were getting more intense at this point and lasting 2-3 minutes. I only know this because I was counting through them and would get to 100 before they went away. The spacing was still irregular but they seemed to be every 7-10 minutes instead of every 7-15 minutes.

After 30 minutes in child’s pose, you do 30 minutes laying on your right side in an exaggerated pose with some pillows for support. And when you’re done with the right side, you roll over and do the left side for another 30 minutes.

The contractions during the Miles Circuit were hard. It’s hard to lay in one position in labor and even though the rest was nice in between, those were some of the hardest contractions I breathed through all day.

After the Miles Circuit, I was hungry. I asked my husband to bring me some toast and some ginger-ale and I asked the midwife what was next. She suggested Lift and Tucks for 10 contractions. This is a Spinning Babies intervention but I hadn’t used it personally in a labor. For me, I stood with my heels and back against the wall, then during a contraction, I would put my hands around my lower belly and lift my belly up and into my pelvis. Mind you, the lifting is during a contraction. It doesn’t feel great and those contractions were intense as well. The contractions picked up to every 3-5 minutes during that intervention and I was doing my best to stay controlled and breath through them.

Funnily enough, I was so hungry, that between the Lift and Tucks, I would eat a few bites of toast before the next contraction started.

At the end of the Lift and Tucks, the midwife suggested some forward leaning inversions. I definitely hadn’t seen or done these during labor – only for trying to spin breech babies prior to birth. This is another intervention from Spinning Babies.

In truth, at this point, I remember standing in the doorway of my office and looking at my midwives. And I was thinking, I am tired. My labor is abnormal for a reason I don’t know. And you want me to hang upside down during contractions.

My midwife simply said “I know you are miserable. And we don’t know why labor is different. But it is and we’re going to keep trying to get it back on track.”

These were such simple and perfect words.

So I moved into 3-4 inversions off the edge of my office couch. And I do regret that I don’t have pictures of me doing this because I almost don’t believe it. For one of the inversions, my husband came to the door to find his wife upside down on his office couch breathing through a contraction. That’s an image he will never forget.

The inversions were easy enough to do, although I was really tired. The funny thing was while I was upside down I was leaking tons of amniotic fluid everywhere. So I leaked on the couch and on the clean carpets of my office too.

And after the inversions, the midwife suggested stair walking as long as I could go. I remember my 1 year old showing up at some point and walking up and down the stairs with me. I was moving at the perfect toddler pace and he was a great little companion.

I did some stairs for 20 minutes and at that point, was ready for a cervical exam. I wasn’t feeling the urge to push. I had done about 4 hours of interventions. It was around 11 am or so. And I was still tired.

The midwife checked my cervix in bed and goes “The baby is right here!” The midwife in me asked “How many centimeters am I and what’s the station?” She said I was about anterior lip or about 9 centimeters.

I got out of bed and slid into a lunge on the floor next to the bed. I felt a little pushy but not like I was an anterior lip. In my mind, I thought, okay, you’re almost there. This is the fast part.

And I asked to get in the tub.

The warm water felt great. I tried to relax but the contractions got intense quickly. I went ahead and checked my own cervix and could easily feel the baby. I was 8 centimeters, 80% effaced but not super stretchy, and about 0 station. I even tried to palpate for sutures to feel position but couldn’t. I was able to feel that he had hair!

My husband showed up in the bathroom around this time (and he was able to snap this one picture real quick but it’s the only picture I have in the bathroom). The midwives had told him it was getting close, so he put all the kids down for their naps – which worked out perfectly. He was asking me is I wanted some water when I felt a strong contraction and a strong urge to push. I was trying to tell him I think the baby is coming when I reached down and felt a large crowning out the vagina.

I tried to breathe through the contraction and the pressure and the midwife said “Breathe, let everything stretch.”

I quickly realized I couldn’t push in that position and stood up.

I pushed with the next urge and the head birthed to the nose. I could tell something was a little off because I asked if he was out and they said “Just to the nose!”

I pushed again and he birthed to his chin.

At this point, I was feeling all the intensity of stretching, pain and fatigue. I took a deep breath, went into a small left lunge and pushed as hard as a could. About 8 seconds later I felt a huge relief of expulsion and he was here.

I was helped to the side of the bath tub and after sitting, took the baby. He was appropriately a little limp and blue and I asked for a towel to dry and stimulate him. He came around nicely with some drying and stimulation and I breathed a huge exhale of thanks for labor coming to and end.

My bleeding seemed a little more than normal so we quickly moved back to bed. Bleeding with out of bed birth is always messy and hard to quantify. My bed was a mere 15 steps away and although I remember moving, I’m not sure how my legs got me there.

Once in bed, this photo was taken! Clearly a tired mama and a new baby!

My bleeding turned out to be just fine and normal. My placenta birthed without complication and they simply placed it on a chux near the baby so as to keep the cord attached. (I didn’t ask for this but it’s a common home birth practice and one that I was fine with).

After the placenta, the midwives took a look to see if I had any lacerations. I had a tear in the skin that was approximated on it’s own (most likely it was a tear from prior scar tissue) but no tearing into the muscle. Being the midwife at my own 4th stage, I asked if it wasn’t bleeding, it appear symmetrical and it was just skin or mucosa, that it not be repaired. I have a lot of faith in my vagina to heal itself and have some trauma from prior births.

At this point, we did talk about doing a rectal exam to assess for any trauma to the fistula – but since there was only skin torn, not muscle, we decided that it wasn’t going to offer us any information. I also didn’t think the fistula was going to be affected based on my last birth (it didn’t change) and based on conversations with my colo-rectal surgeon last year.

After that, the babe latched himself right away and we hadn’t weighed him. While we were snuggling, I downed another ginger-ale followed by a plate of chocolate chip pancakes provided by the wonderful husband. This picture is right after pancakes were consumed.

At this point, the midwife team is doing routine vital signs and mama/baby assessment. That includes blood pressure, pulse and fundal rubs for mama, heart rate and respiration rate for baby. One of my favorite parts of the birth is that the team does these assessments right on the edge of your bed. I’d never thought of my king sized bed as a working space until this event!

At some point, they weighed the baby and someone called out 4630 grams. In general, 4500 grams is a 10 pound baby and I cried out “What?!? He weighs 10 pounds!!”

I was shocked to say the least and am still shocked one month later. (For those wondering, I passed my glucose test with flying colors and did not have any gestational diabetes or a history of this in a prior pregnancy.)

At some point, my daughter woke up from her nap to find that she had another brother that arrived! This is my favorite picture because her smile is simply glowing.

Since he was so big, he needed glucose checks every hour and he passed those without any concern while continuing to breastfeed like a champ. An hour or two after birth, I was assisted up to the toilet and then into my shower for a quick rinse off. I was helped into my postpartum diaper and then back into bed. While in the shower, the midwives had stripped the dirty sheets off my bed and replaced them with the new set. It was like getting into a hotel bed and was so comforting to feel after the morning labor and subsequent birth.

After a few hours of assessments, rest, and congratulations, the team said their goodbyes with a promise to return the next night to check on us both.

I spent the rest of the day in bed and ate at least three entire meals that afternoon while I rested. We shared good news with family and were so thankful for a safe home birth – praise to Jesus!

My husband snapped this picture in the evening after the other kids had gone to bed. I still have “birth hair” and I love how pink the baby is!

I have a lot more to reflect on and share about the birth.

For that reason, I’ve included some common questions I received and reflections that I have had below if you’d like to continue reading.

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Would you do another home birth?

Yes.

But I would be sure to use a CNM, CM or CPM that is certified, trained and SEASONED in home birth. Although out of hospital birth is a small percentage of births in the United States, there is a lot of misinformation and stigma associated with the practice. Part of this is due to some individuals that are not properly trained and who offer services for home birth; the outcomes of these births or pregnancies often make the news (often times for bad outcomes) or are dropped on the doorsteps of hospitals with prolonged labors, maternal or fetal distress, etc., and commonly without a safe hand off of care from one provider to another.

My midwife and I had discussed and filled out a plan for transfer to the fire station or to two local hospitals if needed. I was okay with transfer to the hospital as an option or necessity throughout my entire pregnancy, labor, birth or postpartum period as needed. I think this is an essential and safe part of home birth care. Most women won’t need to transfer but 10-15% will need to transfer. The expectation and genuine understanding of this fact is of the upmost importance for the patient and the care teams (both. the team for home birth and the team for hospital care).

The other thought I have had is this: the first birth should have been a home birth. This is a really heavy thought for me because if that had happened, I don’t think I would’ve had a fistula because I would have likely planned a home birth for the second baby. Hypotheticals are a dangerous slope to tread up, but I think there’s some truth to that thinking.

Last, I asked my husband what he would want to do if we had a 5th babe and he offered a resounding “Why the hell would we do that?!” There you go.

What went well?

The thing I am most grateful for is that my labor started spontaneously. Or maybe the carpet cleaning was my mode of induction? I didn’t have a worry that I would go far past 40 weeks based on my past labors, but the babe would have been even bigger if we hd gone farther!

Birth interventions were also spot on. Total truth: I was miserable through some parts of the labor when things slowed down and when things were amping back up. The midwives proved exceptional with the Miles Circuit, lift and tucks, forward facing inversions, stair walking…all of which got my labor restarted. They encouraged rest when rest was needed, food and drink frequently, and ambulation with frequent position changes concurrently. These are the hallmarks of supporting physiologic birth and I am grateful these helped my own labor.

What did you love about the home birth?

There is a lot to say here but these are my favorites.

Walking around your house in labor is so much more comforting than walking about the hospital. (This is one of the reasons I often tell mamas or families to wear whatever they want during labor. A hospital gown is almost never a necessity for birth – even in emergencies.)

I loved eating whatever was around the house even if all I actually ate in labor was some spoonfuls of honey, toast with butter and ginger-ale. Most women don’t want to eat a lot in active labor. andI found this to be true in my own labor.

After the birth, I loved sitting on my own toilet, then getting in my own shower and exiting the shower into the embrace of my own giant white bath towels. It was bliss.

Getting into my own bed, also amazing.

The care of the home birth team was so supportive and helpful. I was so impressed at how that care stretched from the moment they arrived to the moment they left.

And last, having my family there. We didn’t plan to have the kids there at the birth – they’re all too little and my transition stage always becomes a little primal. Walking up and down the stairs with my two year old was a sweet memory I’ll always remember and cherish. I also loved how delighted my 5 year old was to meet her brother as soon as she woke up from her nap.

What would you have done differently?

For birth, I would have taken more pictures…story of my life. This is my fault because I remember my midwife team asking if you want pictures of your labor and birth and I said “Oh, no thank you.” But my sneaky husband took some along the way and I’m so grateful he did!

Did you think about transferring to the hospital?

Yep. At some point in the morning after 8am, probably during the Miles Circuit, the pain started to pick up. At that point, I started to think about my contraction pattern and lack of progress. My mind would drift to the idea of an epidural – I had an epidural with my 3rd babe but not with my 1st or 2nd. I countered that thought by telling myself that an epidural may not fix the protracted labor.

That was the only time I thought about transfer, but I never spoke about these thoughts out loud. It was only after the baby was born that I talked about those thoughts with my husband and midwife.

Why do you think your labor stalled out?

Fatigue, malposition, protracted labor, feeling safe…new birth experience? I think all of these played a factor and influenced labor at different points along the way. I don’t think that the baby’s size was as big of a factor as the contraction pattern. That’s because the labor picked up quickly once the contractions were intense and regular.

For all these reasons, this is why labor is never the same management wise.

How did you prepare for the home birth?

The biggest decision was the first one. We decided to have a home birth. Second, TRICARE covered the birth because home birth isn’t offered at our local military hospital. But getting the referral was a bit of a process. After that, the preparation was minimal other than preparing mentally for the labor pain. I revisited Mindful Birthing around 35-36 weeks. This book was the main preparation I did for my first labor.

For childcare, we planned to have my husband watch the other kids. My prayer was to go into labor at night and ideally, birth at night, so that the childcare was as easy as possible. I got half of that wish!

Around 37 weeks, the midwife comes to your house to do a walk through and check up. There is a review of supplies that you have purchased and a discussion about where things are (the trash, the recycling), do you want to keep the placenta, where is your washer/dryer, etc. But also questions about what kind of support you would like in labor (either hands on, lots of coaching, etc…).

We also talked about water birth at this point. I didn’t plan to have a water birth but if I was in the tub when I needed to push, we talked about birthing the baby under water or standing up. We also talked about using a liner in the tub versus not using a liner (note: we bleached and ran the tub jets at 38 weeks in preparation for tub use if needed).

There’s a brief review of things to prep for the postpartum period or what kind of help you’re going to have as well.

How much did your home birth cost?

$1150 plus a small amount of supplies (about $75) for the actual birth. The $1100 was split into three fees: $500 initial fee for costs not covered by global fee; $250 transportation feed to cover costs related to such things; and a $400 birth assistant fee paid to the additional person that comes to the birth to help (not birth the baby).

TRICARE covered the global fee for the birth since home birth was not offered at our military hospital.

Do 10 pound babies run in your family?

No. My husband and I were 8 pound babies and our siblings were 9 pound babies. No 10 pound babies though.

How have your views changed as a CNM?

Wow. There is a lot to say here and I’m sure that my mind will continue to process the experience and the birth for a long time.

In general, my views haven’t changed a lot but I do think I’ll be able to speak a lot more intelligently about home birth.

Prior to the birth, I was very open about home birth questions in the clinic setting – even if that meant the patient might transfer out of the practice by choosing that path. I think it’s really important to educate women on the different types of midwives and the settings they practice in, but also to review the patient’s history and evaluate if they are a safe candidate for home birth care. Most women are but there are some high risk conditions that are safer to receive care in a hospital setting under midwife/OB/GYN care. I also think it’s important to tell women about the cost of home birth. Cost is generally black and white but most families aren’t aware of the out of pocket expenses. For some patients, paying the cost is empowering and for some, the cost is too much.

All that to say, I’ve always been a supporter of home birth but believe in an educated conversation with lots of shared decision-making between the provider and the family.

I do have a renewed love for The Miles Circuit and am motivated to take a Spinning Babies course ASAP.

And I hope to speak to colleagues about the experience and to offer insight that birth is not only for the hospital setting.

Do you want to be a home birth midwife now?

I got this question quite a few times! I think I would really love home birth or birth center settings. It’s not in the cards for me right now. There are too many little kids and I don’t have a spouse that can support the call schedule. Maybe one day…

If you’d like to share your birth story, I’d love to help you do that. You can read all the birth stories by clicking on the link at the top of the page.

If you’re not sure how to write your birth story, read How to Share Your Birth Story.

Whether you share your story publicly, or write it on an envelope and seal it for yourself or your family, I encourage you to write those stories down. Over time, memories fade and trends change. Stories are how we learn from and about each other. Women used to be surrounded by their communities and birth attendants. To prepare for birth, women would tell each other about birth and what to expect.

I don’t see that happening generationally anymore. You have to be intentional about asking for and sharing that information!

And to that end, thank you for reading my story.

Merry Christmas 🙂

Jamie

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Past birth stories…My First Birth Story, My Second Birth Story and My Third Birth Story