Category Archives: Monday Musings

About a week and a half ago I doula’d a wonderful sista…  We’ll call her Baby J’s Mom.  It was FABULOUS.   She had no medications during labor.  Her significant other was present and cut the baby’s umbilical cord. She nursed her newborn shortly after birth. She expressed satisfaction in the way her labor and birth happened as she got pretty much everything she wanted except the use of the large labor tub at the hospital which she didnt use because she delivered within an hour of arriving to the hospital.  She gave me permission to write a post about her birth and so here it is. I wanted to share her story because while she was happy with her birth experience, it was a perfect example of why many women should and do stay home to birth their babies…. Following is not the complete birth story but hopefully it’s enough to paint the picture. This is indeed a post In Support of Home birth.

Baby J’s Mom initially called me around 2:30 am. “I think it’s starting. I’m having contractions,” she told me.  I offered to join her and she declined at that time saying she would be okay alone.  She called me back almost four hours later and I could hear the difference in her voice. I jumped into action.  I arrived to her home around 6:45 AM. She was rockin and rollin!! Around 8 AM she wanted to be checked.  She was 8 cm.  We headed to the hospital where the basic routines ensued.

A medical history/interview was done with what seemed like 100 questions…  most not pertinent to the immediate business at hand.  There were a slew of papers to sign “Hold off on that one… you said you wanted to wait until the pediatrician’s office to ask about that remember?”   Oh yea she replies and then decides to give consent on the spot anyway. The Electronic Fetal Monitor was applied and her IV was started.  She told me, as many women in transition do, that she sort of, kind of, wanted an epidural. With that, her nurse started an IV Bolus and ordered labs.  I could tell by the speed of the nurse’s activity that she was going through the motions with little hope that Baby J’s Mom would be in labor long enough to actually get an epidural.  And she did not have to worry because before the labs were even drawn, the doctor was there ready to “get her into stirrups.”

He arrived ready for delivery even though no one… not Baby J’s Mom, not the nurse, not me, no one called him for delivery or led him to believe that Baby J’s Mom was ready to birth her baby.  Aw no need for an epidural he said.  You can just get this all done and be finished with the pain.  Initially, from the outside it may have seemed like he knew her plan for an un-medicated birth and was being supportive.  BUT…  if you know like I know…. You understand that he was really being impatient.  He knew if she proceeded to get the epidural, her delivery would have been delayed at least an hour, possibly more as we waited for lab results to be obtained and the epidural to be placed.

He had no patience for birth and after doing one vaginal check on Baby J’s Mom he began coaching her to do long, closed-glottis, purple-faced pushing even though she had NO.   URGE.   TO.   PUSH!!!!  As she pushed, he placed his hand inside of her vagina and gave counter pressure against her cervix to make her dilate faster. His hand, and the counter pressure he applied caused more pain than the baby and the contractions themselves.  I made a few comments and asked a few questions out loud to encourage Baby J’s Mom to speak up about the pain and to remind the doctor that she was not a vagina. She is a woman, and while yes she is a STRONG woman, she is a woman with feelings in spite of the fact that she was not yelling out in pain.

After a few contractions this way, Baby J’s Mom had an urge to push and in a few pushes Baby J was born.  “A” (her significant other) cut the cord, which was one of the biggest goals for this birth, and Baby J was placed on mom’s chest.

In spite of having NO medications on board, the baby had a difficult transition after birth and needed a little help to get her to breathe.  Some may argue that it was good that we were in the hospital because they had the necessary oxygen set up to help the baby.  For those of you who don’t know, that same oxygen set up IS available during a home birth and the midwives who do home births are more than equipped to handle such a situation.  What’s even more important to note here… as we speak in support of home birth … a mother without medication, except for the VERY  VERY  VERY  rare occasion needs no coaching or instruction on when or how to push.  Women know when and how to push and waiting and allowing the woman to guide the second stage of labor as she feels an urge to push changes things and as she follows her body’s direction, her pushing will not usually include the long closed glottis “purple pushing”  that can effectively cut off oxygen to the baby for thirty seconds or more.  I’m sure that had something to do with the way Baby J responded after delivery.  Additionally, if we had waited until the cord stopped pulsating Baby J’s transition may have been a lot easier.   The idea of waiting for the cord to stop pulsating is not done routinely in hospitals here.   At home Baby J’s Mom would not have been pushing without an urge. She would have followed her body’s cues of when to push. Her pushing stage would have been shorter.  The cord would not have been cut until after it stopped pulsating.   I can’t say for certain how Baby J would have done with these changes.  What I can say is research supports the notion that the resuscitation would not have been necessary.

Moving on… I was still at the head of the bed with Baby J’s Mom and I noticed the physician was doing a LOT around the delivery of the placenta and I thought… Is she bleeding?? Then, I realized the placenta had not been delivered and in his haste he had pulled the umbilical cord and it completely detached from the placenta.   Now he was attempting to remove it manually and until I made a statement to question what was happening he wasn’t even interested in telling her.  A mother without an epidural can certainly birth her placenta spontaneously, even if the cord has detached. In the hospital world however, when this happens the solution is always manual removal of the placenta… this means the doctor has to place his hand and forearm into mom’s vagina to remove her placenta from the inside of her uterus  with his/her hand.   This is NOT a pleasant experience as one can imagine. Had he been patient and simply waited for signs of placental separation instead of rushing to pull it out this would have been avoided.  During home birth this would not have happened.  Yes women have retained placentas during home births. But not because the midwife was impatient and pulled off the cord within minutes of the birth.

Baby J’s Mom expressed satisfaction with her birth experience.  She felt empowered.   She was happy her boyfriend cut the cord.  She was happy she did not get medicated. She was a rock star! And when it was all over I said to myself…. She DEFINITELY could have stayed home and next time I hope she will.  Her birth story IMO is a great example of how many of the birth “emergencies” we hear about are iatrogenic supporting the FACT that you may truly be better off at home. I hope you will consider these things as your plan your next birth.

Did something happen during your birth that you know was iatrogenic… caused by the doctor or hospital staff… something that would have been avoided had you stayed home?  Share your story… In Support of Home Birth.