Kara is a successful blogger on motherhood and parenting where her VBAC story was originally featured.
Why I Chose a Midwife and Homebirth
Two and a half years ago I was preparing to welcome my oldest daughter into the world. I wanted to have a natural childbirth, but due to circumstance I wound up having an emergency cesarean after working so hard to naturally birth a frank breech baby. My doctor told me the morning after delivery that I was a strong woman and was not a wimp and he fully expected me to TOLAC (trail of labor after cesarean) and have a successful VBAC (vaginal birth after cesarean).
Knowing my OB was likely to retire before baby #2 came along, I knew that I wanted to find a midwife home birth option this time. Fast forward and today, having accomplished my homebirth VBAC, I can honestly say it was one of the best decisions I have ever made.
Why did I Want to Have a Homebirth?
I worked very hard with my first child to have a natural childbirth. My husband and I went through the 12 week Bradley Method Course and were well-equipped and prepared to have a baby without medication or unnecessary intervention in the hospital. However, when got into a car accident on the highway when I was 8-9 months pregnant, I finally convinced my doctor to do an ultrasound only to find baby was frank breech (I had been telling him I thought this for weeks). Giving me no other options but a planned and scheduled cesarean, I switched doctors at 38 weeks.
My new doctor was amazing. He was such an advocate for birthing and trusting nature and the mom. He told me I could give birth naturally to my breech baby and was my biggest cheerleader. He told me not to even step foot in the hospital until I was 8cm dilated (and in transition) unless I wanted to have the hospital tell me I need to go straight to the OR. So that’s what we did. We labored at home for over 10 hours.
And it was peaceful.
However, once I entered the hospital I became the spectacle. With so many eyes on me, nurses in and out, and having labored for over 14 hours with my water broken, a breech baby, and a posterior baby, I had nothing left in me to push forward. I was carted in for an emergency c-section after I ultimately had mentally just collapsed.
Am I crazy for having a home birth (even after a cesarean)?
Much research has indicated that home birth is just as safe of an option as having a hospital birth with only approximately 11% of women having to transfer care. Home Birth has been shown to be a viable option for both first time and veteran mothers who are low risk and decide on a planned homebirth with the assistance of a midwife and has also shown to have positive outcomes for the newborn; only 1.5% had a low APGAR score, only 2.5% were admitted into the NICU within the first 6 weeks of life, and incredibly 97% were at least partially breastfed at the 6 week mark.
Even women with variations such as breech, twins, and even previous cesareans have the option to find a midwife that is willing to take them as a patient. While not all midwives specialize in these variations, there are always options in finding someone else. In fact, as my second daughter was also breech at the beginning of my 3rd trimester, I connected with a midwife that was 3 hours away from me that was willing to deliver her breech (even as a VBAC) in her birthing center with my own midwife in attendance. Midwives are skilled at what they do and have a track record to show their success rate.
So for me, an HBAC was not a crazy decision, not in the slightest. First, all of my own medical records checked out in terms of having a transverse scar, proper healing, and minimal scar tissue. Second, I live less than 15 minutes away from the state’s leading Children’s hospital and maternity ward. And finally, I had a midwife who has attended multiple VBACs and made me feel extremely comfortable in her care, but I also had a contingency plan for when my child was breech.
Ultimately, home birth (whether after a cesarean or not) and VBACs (even in the hospital) are a mind games in our society. We’re told it’s dangerous and not normal, but research indicates otherwise. And the comfort level of the parents is ultimately what is most important. It’s a decision that we made based on what is appropriate and right for our family and one I encourage others to make after thoughtful consideration and much research.
Would I choose a Midwife Home Birth again?
Absolutely. Hands down it was one of the best decisions that we have made. I asked my husband the next morning what he thought and he agreed that it was such a wonderful experience. It was so peaceful and not only was it a great environment for me, but it also was wonderful to know my older daughter was home, being cared for, and that we got to bring her in when my younger daughter was less than an hour old (but it was after midnight, so she was sleepy and not quite coherent).
While I know having a midwife home birth is not for everyone, I will forever and always be thankful that we chose that path. It was a peaceful and almost magical to experience it comfortably at home. So in the end, I will always encourage parents to do their own research and find what works best for their family, regardless of what they choose as being right for mom and baby.
My Successful VBAC Homebirth Story
It was 11:53pm the night before my birthday. And the next day would become the most unforgettable birthday of my life. I didn’t receive a single gift that day, didn’t eat any cake or blow out candles, and almost entirely forgot that it was “my” day because all I was focused on was bringing a baby into this world after nine months of an exhausting and frustrating pregnancy. I was focused on having a home birth and a successful VBAC.
I started having contractions like small waves, coming and going. 8 minutes, 7 minutes, 7 minutes, 8 minutes, 14 minutes… I held my breath for a second hoping I had just missed timing one… 8 minutes, 8 minutes, 8 minutes… I finally went to sleep. An hour and a half later, the waves hit me harder and stronger and the only thing I could think about was cleaning my house.
It was 2:30am and I was scrubbing counters, putting away toys, and folding laundry. And that’s when I realized I was truly in labor.
My contractions were all over the place from 14 minutes to 4. I had eaten a protein bar, munched on some hazelnut butter, and sipped on chlorophyll water. A couple hours later, I put on my birth affirmation shirt, ate some eggs and toast, rested while timing contractions, and sent a text to my midwives, Faith and Sarah. Between the intense contraction that came every 5th or 6th time, the fetal shaking I had experiences, and my lack of sleep, I woke up my husband and asked him to pray with me because I was just not feeling very confident.
9:30am rolled around and my mother-in-law drive me to an “emergency” chiropractic appointment where I paced the lobby waiting my turn. The receptionist brought us a tennis ball to use as counter pressure and in my misery of unending tail-bone pressure, I squatted, holding on to anything that would support me.
My chiropractor finally called me back where she adjusted my hips, did a tailbone release, got my pubic bone aligned and in place, did a diaphragm release, and showed my MIL different ways to teach my husband how to apply pressure for when I might need it during labor. And I felt amazing. So much pressure relieved, but now my contractions were even more erratic spanning from 21 minutes apart to less than 40 seconds.
We left and went to the Walgreen’s across the street to pick up some last minute things (you know, like a thermometer battery that should have been purchased months ago…). In this very easy trip into the store, I started feeling a really tight and heavy spot in the middle of the left side of my back. It was like someone stabbed my through the back and into the gut. I felt so sick and could hardly walk.
This awful feeling continued even when we got home and I remember texting the midwives telling them I felt better and worse all at the same time. I ate, I tried to nap, and I tried to focus on anything I possibly could that wasn’t the pain in my back. It felt like I was going to be sick about 80% of the time and that was something I wasn’t prepared for in the slightest and I was so uncomfortable that I couldn’t focus. (Which is probably good because even though I wasn’t focusing on the positive, I also was not thinking about the fact that I was attempting a VBAC or that I might fail).
It was 2pm and I was sitting backwards on the toilet. It’s the only thing that made my tailbone fall into a better place and be able to rest my head. And my contraction pattern improved like this. But I sat there for 3 hours. Alone. It was mentally the hardest part of my labor and I was doing it by myself. I wrote a sign that is still hanging behind the toilet that declares “You are my strength when I am weak”. I sat there trying to sing to myself and was fighting back tears. In a moment of desperation and loneliness, I posted in my blogger network what was happening. And in an instant I was flooded with support, encouragement, and virtual hugs from around the world. And suddenly I felt motivated and so uplifted.
My husband got home and I tried going for a walk with him (more like a shuffle) and I could hardly move. It was excruciating. And my contractions fell back into a sporadic pattern. Labor was not supposed to be like this. It wasn’t with my first and beyond that I knew I shouldn’t be in so much pain. I knew I shouldn’t feel sick. Not yet anyway.
Somewhere around 7-8pm, Faith and Sarah showed up to check on me (they are about an hour to an hour and a half away) and I was laying on the couch just praying not to die… because I really felt like death. They asked to check me so they did.
And my cervix was pointed to the left.
What?! I didn’t even know that was possible. I was hating my body right about then and cursing the discomfort that came along with my midwife center-aligning my cervix. I think I almost passed out when she said that I was only 2cm dilated. I had been in labor for over 18 hours and was at 2 cm. It was a cruel joke; it had to be.
How was my midwife experience different from an OB
and my home birth different from a hospital birth?
I had 24/7 support with my wonderful midwives, Faith and Sarah. They were available for me to call or text any time I needed them. So if I had something unsettling going on, I could ask the question at 9pm or whenever. With an OB, I would worry about it until 8am the next morning (or heaven forbid is happen on the weekend and I would have to wait longer), call, leave a message with a receptionist only to get a call back several hours later (after more worrying) and it would be a nurse and not even my doctor.
My midwives also were great about checking in on me even between appointments. So if I had said I was not feeling the best or was getting headaches at one of my appointments, I might get a text later in the week asking how I was doing.
When I had an emergency situation, one of my midwives came to see me and check on me. I did not have to go to Labor and Delivery and wait to be seen and then sit in a room forever like I did with my first. Beyond the stress of the situation, there was no added stress.
My midwives were well versed in abdominal palpation so that every appointment after the baby was large enough, they could track the baby’s position and they actually knew when baby was breech, posterior, anterior, etc.. It didn’t take having an ultrasound for them to know one way or another and I got checked at each appointment.
They provided child birth classes specifically geared towards having a home birth and laboring as a team and with a husband/significant other/coach.
I had no unnecessary checks. So no one was checking for dilation unless I wanted it and I was being informed of everything happening, every step of the way.
They trusted my body and my baby. For instance, when I was in the hospital and I felt the urge to push, they yelled at me to not do it and to stop. During my home birth when I announced the need to push, they encouraged me to do so and told me that they could hold back the lip of my cervix if my body was truly ready to push.
They encouraged me to find and use natural remedies for any sickness or issue that arose during pregnancy and birth as to not introduce unnecessary medications or chemicals into my body or to baby.
I knew everyone in attendance. This means no crazy nurses or a bunch of strangers coming in and out of the room while laboring. That was awesome.
The home birth environment was peaceful, dimly lit, and encouraging. In the hospital it was bright, noisy, full of questions and abrupt checks when I wasn’t expecting and even in the middle of contractions.
No one questioned our judgment as parents. We had prepared for birth and had done our research and we were trusted. It wasn’t a fight against a hospital to let me labor in a certain position or even have to worry about our baby getting carted away for tests or anything. Everything happened right there and without question.
After all was said and done, they cleaned up my bed and bedroom, helped bring me food right after labor, prepared a bath for me, helped me back into my clean bed, and made sure that my husband and I were all set before leaving.
… And they did leave. While I adore each of them, it was nice not having someone come in to take my temperature, baby’s temperature, and do the whole nine yards every so many hours. I did it myself when we were awake. This means I got to rest.
When they were done though it felt like the load of bricks I had been hauling in the left side of my back was gone and that the fog had lifted from my eyes. Who knew that I was having pain in my back from my cervix and who knew just how draining that was?!
They told me to stay on my hands and knees or at the very least, on my right side to help keep my cervix in place. And they told me to rest. That I could now do.
The midwives packed up because they had another birth that had picked up pace and it was back the other direction and would take them at least an hour and a half to get there. So I prepped myself to rest. Knowing I needed to eat and that my toddler needed daddy instead of nana time, he took her to get us some food. I drank more chlorophyll water, took some vitamin C, used the bathroom, turned on my diffuser (loaded with lavender to rest and RC to breathe since I was so congested), and fell asleep.
Five minutes after falling asleep and while I was still in the foggy, in-between stage, it felt like my pubic bone exploded and split into two pieces. There was an ominous pop and I tried to scream and nothing came out. I tried again and it sounded like a whisper. My MIL finally heard me and helped me to the bathroom where I checked my pH.
My water had broken.
And now my contractions were back after having been gone for over an hour. We sent texts and called the midwife because now not only were they back, but my contractions were so intense. They had just made it to the other birth so one stayed and the other came right back.
In the meantime, I made it out of the bathroom and had to stop in the dining room floor where I was on my hands and knees. Somehow I was coherent enough to continue to time my contractions and answer midwife texts, but I really don’t remember it much at all. I do remember my husband getting home and that I screamed at him for being too loud walking across the floor with shoes on. I should have known then that I was in transition, but thought there was no way since I was only 2 cm about 2 hours before.
In some strange moment of listening to my body and my instincts, around 11:25pm I got up after the end of a contraction and moved across the house into the bedroom. Apparently my MIL and husband had been texting the midwife during this time and she was rushing down the turnpike and said she was 25 minutes away. We have contractions timed until my midwives arrived, so 11:57pm Faith walked in the door. I remember begging/demanding the birth tub once I heard her voice.
I was in such a haze that I remember hearing the hustle and bustle of my birth team and photographer, chatter with my husband, and Faith’s soft voice encouraging me as I labored. I vaguely remember hearing Rebecca and Faith discussing that they didn’t have time to inflate and fill up the pool, but I guess at the time I didn’t think that meant I was so close to delivering.
With my first, I remember getting yelled at in the hospital to not push when I told them I had the urge to do so. Therefore, I remember feeling this overwhelming urge to push and I was kind of afraid to even say it so I told her it felt like I needed to poop (I mean really, how is that any different at this point in the game or any better? I don’t know. But laboring Kara thought it was). I thought there was no way I was even close to delivering and that I would just be disappointed and deflated if I said it. But when I announced that and said I did need to push Faith said “Then go for it!” She told me there was a small lip of my cervix left but she could hold it back.
Upon pushing she discovered that my sweet girl had her hand and arm up by her head. So oddly enough, the supine position and pulling my own legs back was the only effective way for me during the initial push phase. I remember Faith telling me that I could feel her head if I wanted. While I was still pretty hazy I do remember that being an almost magical moment for me. My husband said that I beamed, gushed, and melted in that moment.
After the head came out, everyone helped me flip to my hands and knees and my husband caught her and handed her up underneath me.
Not once did I think about my previous cesarean or the scar it left me or the possibility or uterine rupture. Not once did I ask to go to the hospital. Not once did I say or think I couldn’t do it. I knew I could have a VBAC and I did.
12:29am December 19th my VBAC baby was born.
We don’t share a birthday. My Home Birth did not go as planned. And yet it was the most beautiful moment of my life.
Photography by Dorothea Schulz Photography