There are some women who embrace the homebirth paradigm prior to them even falling pregnant. They understand themselves and have tuned in to that knowing. From the minute they receive a positive pregnancy test, and sometimes even before, they are calling midwives to secure their ideal homebirth provider.
Then, there are some women who come to the idea of homebirth later in their reproductive journey. They have gone through a process of self-discovery and during each birth they learn more about themselves, until they understand that homebirth is right for them.
Aliza was from the latter category.
Her first birth had been a standard hospital birth and it had been, in her words, ‘a nightmare’. It was a fairly typical first birth, nothing went dramatically wrong, but the whole thing from start to finish was very difficult and left Aliza with a sense of trauma.
The first sign of labor was when Aliza’s waters broke and she dutifully and promptly turned up to the hospital to be assessed.
Instead of expectant management which would have allowed her body to labor naturally, Aliza was pushed into an induction. Without really realizing what process she was entering into, she had just signed off her chances for a ‘natural’ labor, which had been her dream throughout her pregnancy.
Aliza did not understand her choices. That she could say ‘no’ or request to wait. She just went along with the hospital’s recommendation for induction.
Before she knew it, Aliza was strapped to a monitor and forced to lie still in order to obtain a ‘good’ monitor read out. Because she could not use movement or water to aid with pain relief, she required an epidural to cope with the pain of artificially strong contracions. Her labor lasted for many hours. Her husband by her side felt as helpless as Aliza did, he did not understand what was going on and all he could do was sit and hold her hand and whisper encouragements. After what seemed like an eternity, Aliza was instructed to push her baby out, in the supine (lying on her back) position. This proved to be extremely difficult as Aliza couldn’t feel her body in order to push effectively and the baby had to exit the birth canal fighting against gravity. The birth ended with a difficult vacuum extraction and a large episiotomy to Aliza’s perineum. Mother and baby recovered well physically, but this was not even close to the experience Aliza was expecting and it took her over a year to recover from the mental trauma. Plus she blamed herself for not knowing better and requesting expectant management after her waters broke.
This story sadly repeats itself every day in hospitals across Israel and the world.
Aliza’s grueling first birth triggered the start of her journey to understand her needs and work with her birthing body. She took an empowering childbirth class for her next birth and learnt that arriving at the hospital early in labor is not always wise. Each subsequent birth was better than the last as Aliza poured more effort into discovering birth and the mother’s central place in it. By her fourth baby, she was so calm and confident in her birthing ability, that she almost didn’t make it to the hospital in time.
She knew then that she would plan a homebirth for her fifth child.
Aliza contacted me at the beginning of her pregnancy and told me that this time she was having a homebirth, no doubts. After the statutory conversation about potential risks, she signed up without a second thought.
We had a few challenges upon the way, with a low hemoglobin count that needed to get within a safe range and a scare when the baby was temporarily breech. However, we got to her due month and got prepared to go through this experience together.
The birth pool and all the birthing supplies were ready to go, we just needed to wait for labor to start.
You are probably at the point in the story where you’re thinking I say that everything was quick, easy and relaxing…!!! But no, birth is different for each baby and Aliza told me afterwards that it was her most challenging birth (apart from the first). It was exceptionally long and tiring, longer than her previous three births. Possibly the baby’s position was not ideal. Despite doing spinning babies for optimal fetal positioning, sometimes babies can get themselves into an awkward position and the uterus works extra hard to get baby lined up.
Aliza had requested I not perform an internal examination of her cervix and I honored that wish. However, when progress seemed to have stalled at a very intense phase, and Aliza was becoming exhausted, I offered an internal exam to see if it could shed light on the situation. Aliza agreed, as she was seeking solutions by then too.
Thankfully, it gave me the information I needed to help move things along, and after some deep squats the waters broke naturally. Aliza promptly felt the urge to push her baby out, which she did, beautifully, into the water of the birth pool.
Aliza’s baby was lifted into her waiting arms and chest and Aliza beamed with gratitude that she had succeeded in having an empowered and redeeming birth at home.
Afterwards, when it came time to debrief about the birth, Aliza had no regrets. She mused to herself; how much more difficult would it have been to go through that long labor in hospital? She would not have had the use of the birthing pool to ease the pain, would have had an irritating IV placed, been strapped to the monitor and had medical staff insisting on regular internal checks. Most likely they would have demanded artificial rupture the membranes to move things along (which she did not want). She wanted this birth to be all hers, from her body and with her power. Even the intervention I offered was done by her, not me.
Would she do it again? Aliza said that from now on, as long as there are no pregnancy complications, all births will definitely be happening at home!
*Aliza is a pseudonym and details have been change to protect her identity.