Slow then Fast Homebirth…keeps me on my midwife toes

Maya was a second time mom who came to the decision to birth at home late in her pregnancy. She had received decent prenatal care from an ObGyn and was an excellent candidate for homebirth.

Her first birth had been in a hospital and Maya had found it a traumatizing event. She felt not listened to and had had things done to her that she didn’t want or agree to. She told me how she was left laboring for hours in a cold corridor as she wasn’t given a room until late on in her labor. As she neared the end of this pregnancy, the thought of delivering again in the hospital system, made her very afraid.

Luckily for her, even though she was late to book, I had an open slot in her due window. We arranged a meeting and went through all the necessary steps to sign her up for a homebirth (checking blood tests and scans, history taking and understanding risks and complications). Then we spent some time getting to understand what she wanted different in this birth. Her main request was for calmness and patience. Well, I can do calm and patient, so we were on to a good start.

We managed to arrange another meeting on Maya’s due date where we got a chance to go deeper into preparations for home birthing and then the next day she went into labor.

Being that Maya’s first birth wasn’t particularly long, I was wary of a potentially fast second birth (these are usually the one’s that surprise us!). So, once I heard that she was having reasonably strong contractions and that they were 5 minutes apart, I headed to her direction. It was rush hour, so I didn’t want to delay. Her doula was already with her and told me not to rush, but I prefer to trust my own gut feelings.

When I arrived, Maya was breathing through contractions and coping well. The doula was right, we were in early labor and active labor was hopefully not too far away. I had cancelled four appointments in Jerusalem that day and I was sorely tempted to drive back there and keep my commitments. But my instincts held me back. What if things quickly escalated and I was more than half an hour away and in the middle of an appointment to boot? I felt too tense to leave and figured the other appointments wouldn’t go well anyways if I were focused elsewhere.

So, I did what I always do. I reminded myself that birth is a process. Sometimes it shorter, sometimes it’s longer, but it is my sacred duty to do what’s right for the laboring woman, even if it is not convenient for me. And I have a mantra that I often use, so that I don’t feel time pressured “once a woman is in labor, I dedicate the whole day to her”. This way, I tell myself that it’s ok if it takes all day. And it really is ok!

Once I’d spent a little time checking Maya, and so as not to be encroaching on her space during early labor, I took myself off to visit relatives nearby, to help pass the time. It was pleasant enough and I was happy to be within a short drive. I then sat in my car and did some stuff on my phone and made new appointments for those cancelled (isn’t it great to have a mini office in the car?).

I waited for a phone call. Three hours after I had left her home, the doula said that things were picking up. I went up to the apartment and Maya’s contractions were a little stronger. There was slight progress which was promising. Maya agreed to do some position changes and exercises with her to get things moving (she had been up all night and was getting tired). We did the Spinning Babies routine, lifts and tucks, reflexology and belly massage with Clary Sage oil. The doula and I took turns taking a break and we let Maya rest for an hour and gently breathe through contractions whilst resting on her side. They still were not particularly long or intense.

Three hours later, after another internal assessment, Maya’s cervix was 1cm more dilated. Progress was slow. It was 7 hours since I’d first arrived and we were still just hovering on the edge of active labor. After Maya had rested and eaten and drunk, we tried some more exercises and her husband went off to pray in Synagogue. This time we tried some squats. After a few minutes, boom! Maya cried out that her water’s had popped and there was a big splash on the floor. I grabbed something to put under the dripping waters and quickly checked the fetal heart rate. All was well with baby. The doula and I exclaimed with joy, that now she would give birth.

Within 30 seconds Maya was doubled over, grabbing on to the both of us, crying with the pain of whopper contractions. Transition hit!

Somehow between those wild grips, we managed to fill the bathtub with warm water and maneuver Maya towards the bathroom. She requested that I apply oil to her perineum to help prevent a repeat of the horrible tears from the first birth. One foot was up on the corner of the bathtub and I looked down and guess what I saw…? The baby’s head was crowning! Maya was standing and blocking the bathroom door and there was no room to catch a baby. The doula and I somehow got her into the tub and laying down in the water and within a couple of minutes a little baby boy slid out.

He came out in great condition, pink and with strong muscle tone. We all looked at him and waited for him to cry and I assessed that he was trying to breathe but the air wasn’t filling his lungs. I quickly tried the usual tricks to stimulate him, but I soon realized that he didn’t need stimulation, he had a blockage. He was still getting oxygen from the umbilical cord still, but I knew I had to act fast. I grabbed the bag and mask which was already set up and gave the baby some inflation breaths. That immediately cleared the baby’s airways. He started to breathe a little. I helped him some more with a couple more breaths and then he started breathing independently.

The baby was resting in the warm water on Maya’s bent knees so we could keep an eye on him, but after a few minutes, we were satisfied that all was well and so she laid him skin to skin on her chest, covered with a warm towel. We called Maya’s husband, who bless him, came singing and dancing into the apartment with such abundant joy. It was vey emotional. Being a very religious couple, he wouldn’t look at her in a state of undress, so he was singing, clapping and dancing outside the bathroom door.

After a while we helped Maya out of the bath and into bed, took care of the placenta and helped the baby to breastfeed. As soon as we could, we covered up Maya and her husband came in singing and dancing and clapping again, such delight was there in his whole being! The couple were so grateful for their calm homebirth that they couldn’t stop thanking us, it was so very touching.

What did I learn from this birth? Even though I could have easily attended at least two or even three of my meetings in Jerusalem, I just never know with birth when it’s going to suddenly accelerate. Correct, I had to wait hours and hours, but that meant that when the moment came, I was right by Maya’s side, ready for doing what was needed in that moment. The sudden breaking of the waters could have happened in the same way 6 hours earlier, and had I been half an hour away, I would have missed the birth and kicked myself so badly. Patience in midwifery is a vital quality to develop and it is something I am always working on. Seeing the joy on Maya’s and her husband’s face was certainly worth the wait. Waiting is a big part of my role as a midwife and I embrace it. I also realized how much I bask in the glow of a couple bonding over their new baby. There is an additional boost of oxytocin in the air when the partner is also in the blissful birth state. If only we could bottle that oxytocin and save it for those tough days, then we would never ever feel down! This super high oxytocin affects everyone in the birth space so powerfully, it is simply ecstasy. (And it is why we are often called birth junkies!!).