Chani was a first time young pregnant lady of 20 years who had been through a difficult upbringing. She was so shy and quiet, that even my warmest comments barely elicited a smile from her. Deciding on a homebirth came more from a fear of the unknown, hospitals, strangers and being out of her comfort zone than actually desiring a homebirth. She was anxious of the hospital and wished to stay at home if she could. Her husband was the most supportive guy you could meet, who was willing to do anything he could to help his sweet and gentle wife.
I met Chani early in her pregnancy and we had many prenatal meetings. She was very quiet during her meetings and didn’t engage in much conversation. I talked lot! She found it hard to bare her abdomen to me for checking on the baby’s growth and listening to the fetal heart as she was so sensitive, and I pondered how she would manage with the rigors of the necessary body exposure during birth. Chani was very diligent in doing the required pregnancy tests. As the pregnancy neared its end, the couple bought the birthing pool and the supplies needed for homebirth as we eagerly awaited the start of labor.
I so wished for Chani to have her homebirth as I was concerned how she would handle it if we needed to transfer to hospital, so I prayed to Hashem to grant her a straightforward labor.
Labor started gradually, as it is wont to with first births. The couple went through a full night of spaced out slight contractions that were enough to keep Chani awake but not yet significant labor. Despite my encouragement to take some wine to sleep, or some acamol to ease the pain, Chani didn’t and she missed a whole night’s sleep. The following day, things continued in the same vein, and I encouraged her to try and rest. This unfortunately didn’t happen.
By the same evening, the contractions had ramped up somewhat and I was preparing for attending Chani during the night. Chani’s doula arrived late in the evening and started working with her to help her work through the contractions. They called me to attend at about 1am.I arrived and Chani’s husband met me outside. He told me how this was the first really big thing Chani had attempted, and it was so important for her to succeed. That so much of her self-worth depended on this. I assured him that I would do all I could to encourage her, help her and keep her spirits up. And that he should pray for an easy birth. It was a lot of pressure to put on the situation, but I said I will do my very best. We had discussed transfer to hospital as a potential scenario during our prenatal meetings – so the couple were aware, and I didn’t revisit it at that point.
Chani’s labor was tough but progressed steadily throughout the night. She spent a lot of time laboring in the birth pool which seemed to ease the pain and help her cope better. She didn’t talk much, but called out each time she had a contraction so one of us could apply counterpressure on her back. At one point the baby’s heart rate was a little on the low side. We did not want to transfer, so we had to fix this! We fed Chani 2 cups of sweet grape juice and that brought the baby’s heart rate back up to within normal limits to everyone’s relief. I kept a real close eye on the baby and he didn’t give us any further reason for concern.
During an internal exam I noted that the baby was posterior facing. That means that although baby is head down, the face is facing the mother’s abdomen instead of her back. This makes for what is known as back labor and is much more intense than regular labor. At that point the doula and I got to work trying all the tricks we knew to get baby to turn over.
By 7am Chani’s cervix was nearly fully dilated and the baby had blessedly turned. I called the second midwife to join us. Chani was in the pool but not finding it conducive to the pushing phase. So she got out the pool and we continued to labor on the bed. We applied almond oil and hot water compresses to her perineum throughout this stage to maintain the benefits bestowed on her tissues by the warm pool water, namely softening and loosening her tissues.
After an hour and a half of mother-led pushing, Chani’s beautiful baby boy arrived in the world with a loud squall, and he was placed directly on Chani’s chest. Chani was totally shell shocked and dumbfounded! She couldn’t believe what she had managed to achieve! A nearly 36-hour labor at home is no mean feat! After a while the placenta made its appearance and all was well with the perineum – no stitches required- yey!!
Chani’s recovery was about as good as it can get for a first birth; the nursing went smoothly, the after birth pain eased quickly and the baby started sleeping through the night from day 4! Chani felt well and all was good in the world. I made two postnatal visits during the first week and kept in touch by phone as needed.
Personally, I got a ton of satisfaction from escorting Chani throughout her pregnancy, birth and postpartum. To help bring a woman through that process safely (mentally and physically safe) and out on the other side without damage, is a true blessing for her, her family, and the future of her mothering. This is what midwifery is about and this is my shlichut (mission in life).
Names and details have been changed to protect privacy. Photo is of another baby, Thank you Bat Chen for permission!!
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