Author's Note:  names (of people and of places) have been changed because I'm still holding on to the pretense of privacy.  Ironic, then, that I should choose a naked photo of myself in my most vulnerable moment.  In any case, I chose home birth after doing A LOT of research, and if you're interested in engaging in a discussion about it, I'd love to hear from you.

One Pool, No Drugs

When I was pregnant with my first child, and not knowing any better, I sought concurrent care between a female OB and Penelope.  I would make the 2 hour drive from my home in the mountains to the big city of Chula Vista, wait an hour for the OB to see me, visit with the OB for ten minutes (tops), then head over to Penelope’s home office.  It was there that I could finally relax while getting to know the person who would participate in the most profound moment of my life.  Penelope gathered the same information that the OB had and expressed sympathy for my having to repeat the whole process.  She did not, however, try to dissuade me from continuing my meetings with my other provider.

Eventually, the 38th week rolled around.  The plan was for me to hang out (and eventually have the baby) at my mom’s house in Chula Vista where we would be significantly closer to medical intervention if necessary.  Because the little fetus had been growing so steadily, my last ultrasound technician had predicted it would be out by the fourth of July.  (My official due date was July 11th.) Independence Day came and went, and my grumpiness at being pregnant grew.  By the time July 11th arrived, I felt like I was two weeks past due.  I remember distinctly:  it was a hot Saturday morning when I called Penelope to beg.  “Please come induce me,” I asked.  She calmly, empathetically explained that she was having twenty 4-year-olds over to her house for a birthday party the next day.  “If you go into spontaneous labor, I will drop everything to be with you,” she said.  “But if you don’t, why don’t you call me first thing Monday morning?”

I took her up on the Monday morning offer, and rang her up as she had suggested.  “Okay, Penelope, let’s get this baby out!”  She came over almost immediately and laid out the plan:  I would spend the morning getting my membranes stripped, taking homeopathics, using the breast-pump, and walking, all assigned at regular intervals.   She stayed with me for the first rotation, making sure I understood my assignment, then bustled off to her other midwife tasks.  I took the pills, pumped colostrum, and walked around the block over and over again all morning long.  By lunchtime, nothing had happened.  I called Penelope, discouraged, and asked what to do.  “Eat something and take a nap,” she said.  “Hang in there.  I’m 100% sure that no woman has been pregnant forever.”

I followed orders, but when I woke up at about 2 pm, I wasn’t feeling anything close to labor.  A few hours later I called my sister-in-law to complain, but I ended the conversation with a revelation:  “Um, I think that was a contraction!  I should probably go!”  It was about 5 pm, and I was feeling something similar to menstrual cramps.  It wasn’t what I was expecting, but it was close enough!  I called Penelope when the contractions became regular: they were coming every 10 minutes or so, and lasting almost a minute each.  She dutifully drove to our house, checked my dilation, and told me I was 2 centimeters.  (“Two lousy centimeters!  Impossible!” I thought.)  She told me to take a bath, try to eat, and get some rest.  “Call me when the contractions are coming every five minutes and lasting a full minute,” she advised.

The night wore on.  My mom and dad, my husband and in-laws (who had flown out from Pennsylvania), had all gone to bed.  I was laboring by myself, trying to let the house rest but feeling sort of abandoned.  The labor did not dissipate, as Penelope warned me it might, but continued with regularity.  I was pacing the length of the downstairs rooms, moaning and grabbing furniture with each contraction.  I hadn’t truly rested since my lunchtime nap, and I was getting sleepy.  It was about 1 in the morning when my mother-in-law came down the stairs, surely having been awakened by my labor ‘songs.’  “I think we should call Penelope back,” she suggested.

I like to think that I can tell the rest of the story chronologically, but let’s face it:  during labor one’s mental energy is not reserved for a proper sense of sequence.  At some point I remember having a contraction immediately after the previous contraction.  I was panting so hard through this double-whammy that I ran to the toilet to throw up.  After vomiting, I asked somebody to bring me a pillow and I promptly fell asleep kneeling on the toilet lid.

I remember Penelope checking me when she arrived and saying that I wasn’t far enough along to get in the pool; I had to be four or five centimeters dilated (I can’t remember which!) and I was only three.  If I got in the pool too early, she warned, it could relax my uterus and reverse labor.  “But I’ve come all this way and worked so hard!” I thought.  “How can I only be three?”

Penelope was reassuring in a way that was succinct and empowering:  “don’t worry,” she said, “it takes longer to go from zero to four than it does to go the rest of the way.”  Armed with that tiny bit of information, I felt hopeful and able.  It was like she subtly shifted the winds of the storm, and in doing so sent my mental focus sailing into optimism.

While my team scurried around the labor room, filling up the pool and preparing other vague necessaries, I labored in the living room, exploring different laboring positions.  Before labor I trusted that my body would know what to do, and that I needn’t get attached to a specific birthing philosophy.  Getting the baby out was my philosophy.  I found myself kneeling down in front of the couch with my arms on the seat cushions, swinging my pelvis from side to side.  (I remember thinking of this technique as ‘wagging my tail.’)  Then I would walk to the back of the couch and lean my weight there, as if I were stretching to go for a run.

Eventually, Penelope checked me again and gave me the green light to get in the pool.  I was so relieved that I wasn’t still three centimeters that I didn’t care how far along I was.  It wasn’t until my first post-partum visit that I learned I had been eight centimeters at that point.  As I relished the freedom of laboring underwater, Penelope quickly and quietly stepped out of the room and called her assistant.  “You better get in your car right now if you want to be here for the birth,” Penelope told her, out of earshot from the rest of us.

I labored in the pool on hands and knees into the wee hours of the morning.  What I remember most distinctly is that my wrists were sore.  I also remember rocking back and forth, coming so close to the bed that I would count the tiny flowers on the sheets; it was a technique that helped my mind wrap around something other than the extreme intensity of the physical sensations.  At one point I said quietly (at least for a loud mouth like me), “it really hurts.”  The women in the room, who were all mothers themselves, nodded their agreement.

Eventually, I thought, “maybe I could push now?”  It wasn’t like I had the urge to push as other women do; it was merely an idea, an experiment.  So I tried it.  I heard Penelope say, “she’s pushing,” and my step-mother (yes, I had three mothers there) ask, “but how do you know she’s ready?”  Penelope said, “if she’s having the urge to push, she’s ready.”  Overhearing this respectfully quiet interaction was the vote of confidence I needed.  As I began to push, I felt like the purpose of contractions made sense.  “Aha!”  I thought.  “These aren’t just an experiment in pain tolerance.  They’re my body’s involuntary attempt to get this baby out.  Now I can voluntarily push and work with my contractions to get this baby out!”  I felt like I had made a deal with my body.  Okay, body, you contract without me telling you to, and I’ll consciously squeeze along with you!  Go, team!  My mother later expressed surprise that I was thinking such coherent, rational thoughts.  “I had no idea you were present,” she said, “because you seemed so far away.” 

A few pushes later, I found the energy to ask Penelope, “so how did you know I was pushing?”  I hadn’t told anybody I was going to push, I just started.  She refrained from laughing at me,  “We could hear it,” she said.  I guess my involuntary vocalizations were my giveaway. 

Yet another few pushes later, I realized I wasn’t getting anywhere.  This was the hardest work I had done in my life, but I could feel that the baby would move down with every contraction and then slide back with every break.  “You could wait an hour,” I said to myself, “but this won’t be any easier.  You need to push and hold.”  This voice inside was animalistic but rational.  So I pushed and held, pushed and held.  Now the adrenaline was coming in because I could literally feel that baby coming out.  Penelope reached down to take heart tones and I heard her say to her assistant, “I’m not getting anything.”  The baby was so far down in the birth canal that her doplar couldn’t reach.

Another note on my surprising rationalism:  I had seen videos of women giving birth on hands and knees, and the rear catch, the standing up and the passing of the baby through the legs seemed cumbersome and awkward.  I was determined to have the baby in front of me, so when I felt it crowning I leaned back.  The next few things happened in slow motion:  I felt my body stretch around a head the size of a planet, I saw Penelope swiftly, dexterously unwrap the umbilical chord from the baby’s neck, and I received a soggy, gorgeous baby on my bare chest.

In what felt like a millisecond, Penelope had the baby covered with receiving blankets and a cotton hat, and was complimenting the intensity of his cry.  One of the moms reached under the blanket to feel the baby’s parts and announced that it was a boy.  I had always expected to have a daughter, but after the intensity of labor, the only thought that came to me was joyous: “I have a little boy!  I have a son!”

I Need Your FACE

Fast-forward two and a half years to the labor and delivery of my second child, also at my mother’s house in Chula Vista and also under the primary care of Penelope.  This time around I didn’t bother with an OB, and as I closed in on 42 weeks of pregnancy, I was quite glad about it.  As ever, Penelope was amenable to my desperate pleas to get the baby out, but after two weeks of inductions I was convinced that I would be the first woman who would, in fact, be pregnant forever.  We tried all the same things that had worked the first time around, and when they didn’t work, we tried castor oil.  We tried acupuncture.  We tried sex.  With each attempt I would have a few hours of mild contractions that would ultimately peter out.  “Peter out,” became my theme song, if a constantly looped phrase counts as a song. Penelope suggested I get a late-term ultrasound, just to make sure I had enough amniotic fluid and a functioning placenta.  I did.

Eventually (miraculously), I went into labor.  This time around I had been having mild contractions all day, about thirty minutes apart.  I remembered the nap suggestion and tried to fall asleep after lunch, only to be woken up by a contraction I couldn’t sleep through.  “That’s a good sign,” I said as I breathed heavily through the discomfort.

By 9 pm the contractions were coming ever 20 minutes, and by midnight we called Penelope.  She arrived, checked me, and with some urgency in her voice, instructed all hands on deck in filling up the pool.

I remember breathing through a contraction a few minutes before the pool was full and saying, “I feel great!  I’m really staying on top of these!”  Penelope smiled and said something encouraging about how soon I’d have this baby out and then said I could get in the water.

Confidently, I submerged myself in that gloriously warm pool.  I was ready for the next contraction on hands and knees, but as soon as it came I realized that things were different. The pain was so intense that I involuntarily stiffened my entire body, legs extended.  I closed my eyes and moaned and thought skeptically, “well maybe some people have babies in this position?”

I felt the urge to push shortly thereafter (or what passes for an urge in my experience) and again there was the blinding pain.  I looked up and Penelope, bewildered, and she was there, attentive and ready for me.  During my labor with my first son, she had given me the space I needed to navigate labor myself; she had stepped in at exactly the right times but never forced her way into my labor unnecessarily.  I recognized that I was going to need her more this time around, and she was clearly game.

Penelope modeled breathing/ grunting patterns for me and I used her face like a mirror.  When I would feel a contraction coming on and Penelope was more than a few feet away I would cry out, desperately, “I need your face!  I need your face!”  As I pushed, I shook my head at her.  “It’s not moving,” I said.

The rest of the night is sort of a blur.  I remember Penelope asking if I could labor in a certain position on the bed, but that I felt completely embarrassed about the possibility of shitting.  She suggested I labor on the toilet where I might feel a less restricted urge to push.  I did, and she was right, but the baby still wasn’t coming down.  It was generally decided that the baby’s head was turned and/ or the hand was up by the face.  It felt like swallowing a vitamin sideways.

I stood up and laced my hands around my husband’s neck.  Maybe the gravity would help, I thought.  It didn’t.  I got back in the pool.  Maybe hands and knees would be tolerable this time.  It wasn’t.

I had been pushing for what felt like hours and hours (and probably was) when I finally decided that I couldn’t do it.  “Just take me to the hospital and cut me open,” I begged.  Penelope asked if I’d like a moment alone with my husband to talk it over.   When it was just the two of us, I apologized for my failure.  “I just can’t do it,” I said.  “I’ve tried everything I know how to do.”  He supported me completely.  Having seen me go through one fairly straightforward labor, he was finding it difficult to watch me manage this new level of pain.  

Penelope came back in and I told her that it was settled.  She said, “if you want to go to the hospital, I will absolutely do that for you.  I won’t hold you hostage in your own house!  But there are two things you should know first.”  Bring it on, I thought.

“First, you’re going to be in labor during the transport.”  This shook me to my core.  I honestly thought she had a magic ‘pause’ button that would give me even a momentary break from this overwhelming intensity.  “Second, I know you’ve tried the things you know, but there are still some things I know how to do.”  Using simple but not patronizing language was exactly what I needed; honestly, I had never considered that there were things to be done that I hadn’t already tried.

Penelope instructed me to get on the bed with my pelvis on the edge.  I felt a contraction coming on as I lay down and asked if I could get up.  In an uncharacteristically bossy way, she said, “no.”  Now I knew she meant business.  With my husband on the right and the midwife assistant on the left, my legs were held open, stirrup-style.  It sounds ridiculous in retrospect, but once Penelope had her hands in me I thought she could just pull the baby out and I could be done.

She checked for a bony impediment and found none.  I heard her request the oxygen mask before telling me to push.  “Sure why not?”  I thought.  I pushed as she literally held me open, and there was a general sense of movement.  “It’s turning,” she announced.

A few pushes later and I could feel the head.  The audible oohs and aahs of the room confirmed that the baby was crowning.  I breathed in to prepare for the next push and felt the head get sucked back in.  “You’ve got to be kidding me,” I thought before giving one last, mighty push.  Through the ring of fire that baby’s head came; Penelope modeled short, quick grunts to help me push out the rest of the body.  As soon as that baby was on my chest I felt a wave of ultimate bliss.  “My baby is out, and I’ll never have to get it out again.”  It probably would have taken me hours to remember to ask, so again the gender was checked and announced by my mom.  

“It’s a boy!”  She said, but it really didn’t matter.  It was out.  It was out.  He was out.