A midwife and "Birthing From Within" mentor, I am passionate about informed decision making and helping moms and partners birth in awareness. My blog chronicles my journey from cesarean to vaginal birth after cesarean and my quest for information to help families have EMPOWERING births.
I asked Arielle's mom if I could share her story since it is a beautiful story of a mom who had an enjoyable birth, despite very unexpected complications. This strong mom had her second child at a birth center and her third at home.
Arielle June Chasse
In September of 2001, right after the 9/11 disaster, I found out I was pregnant with my daughter Arielle. It seemed so symbolically fitting, life after loss. I glowed with joy, excitement and anticipation. Although she was not planned, I knew I wanted her more than anything. Being a mommy was my ultimate dream and hearing her little heartbeat in my womb brought a smile to my face and my heart like I had never known before.
The pregnancy was amazing, finally using for myself and my baby the relaxations and visualizations that I had been teaching to others; finally feeling inside my own body the little kicks I described to women in my classes; finally knowing the joy of prebirth bonding and finally using what I’ve learned and taught and practiced so many times in preparation for my own birth.
Six weeks before I was due, I developed pre-eclampsia, after having experienced a perfectly smooth pregnancy. My little ankles turned into coconuts and I was lucky if I could see my way to the bathroom past the black dots and not fall over into the toilet. After almost fainting at my mothers day lunch, I ended up in the emergency room, fighting HELLP syndrome and hoping to stay alive long enough to deliver my daughter.
Since delivery was in fact the only cure, I was induced that evening. I was a certified advanced clinical hypnotherapist. I had spent my life focusing on natural childbirth, relaxations and visualizations for birth. I had practiced and fantasized about this birth all my life. But that moment, the moment that was supposed to be the most magical of a woman’s existence, I was wired up to a cold bed and two IVs.
But then my daughter punched me a few times and reminded me that it’s okay! We are still in this together. She can still benefit from my relaxations, as could I. Suddenly the sterile room and tray full of needles didn’t matter. I began a self guided relaxation and pictured each contraction as a wave, rising and falling. I focused on the waves crashing against the shore and dissipate into bubbles, allowing my pain to dissipate and dissolve into the sand. Amid doctors and nurses all clambering about, I felt my body, felt my baby, focused and relaxed.
Being a teaching hospital, the room was full of students, interns and residents, all checking out the mama with HELLP syndrome. I floated into another world, knowing that the best thing for my baby at that point was to keep both of us calm. As they decided an epidural was necessary due to the induction, I pictured the ocean again as I leaned over to share my spine with the steel piercing my skin. Images of jelly fish floated in then faded away. The epidural took off the edge, but still, each wave came, feeling like a menstrual cramp, squeezing my baby down the canal to me.
When the time came to push, I sat up in my hospital bed and reached down to help out my daughter. I felt her tiny head, all covered in fuzzy, wet hair. So entranced by the energy, power, relaxations and love I didn’t realize until later that the poor medical students were aghast that my ungloved hand dare touch the antiseptic swabbed birth area.
As she emerged, they let daddy cut her cord and take her over to the neonatologist for her first check up. I floated down from one cloud and gently plopped onto another as she was finally handed to me. I took her into my arms and brought her tiny little body to my chest as I looked into the dreamy deep blue eyes of my little girl for the first time, and smiled. We did it.
Seems like the evidence is stacking up against inductions. "Hospital's Oxytocin Protocol Change Sharply Reduces Emergency C-Section Deliveries." And I quote "As oxytocin utilization declined from 93.3% to 78.9%, emergency cesarean deliveries decreased from 10.9% to 5.7%." (emphasis mine).1 Hopefully hospitals will soon be changing their induction protocols but in the meantime, if your doctor plans an induction, you might want to share this article with him.
1 Betsy Bates, "Hospital's Oxytocin Protocol Change Sharply Reduces Emergency C-Section Deliveries", Elsevier Global Medical News, June 23, 2009. http://egmn.idsk.com/stories_global/35_ds_7863805.jsp
My friend who helped me (and my husband!) find the way to home birth has just written a great post, copied below. It reminds me of a remark recently made by a local midwife. She noted that many of her clients come to her explaining that they want a home birth for a slew of reasons and that her comment is, "those are wonderful reasons, but I hope you are also choosing home birth because it is the safe choice." Yes home birth can be ecstatic, yes you can give birth in water, yes you can wake up in your own bed, etc. etc., but given the alarming rates of intervention in the U.S., home birth is often the safest choice. Ginger is pregnant with her fourth so please visit her blog if you would like to follow along (first hospital born, subsequent babies born at home).
I’ve been planning a few Q&A posts to answer questions I am frequently asked. This first post will examine two questions that tend to come together. How did you decide to have your babies at home? What if something happens?
The answer to the first is fairly short, but needs some explaining. I decided to have my babies at home because statistically, it is the safest place to give birth. Though I enjoy stories, opinions and philosophies of childbirth, I’m more of a numbers person when it comes to making decisions that impact my health or that of my children. I’ve spent a fair amount of time looking at research on childbirth statistics and outcomes. Interestingly, every study out there shows that midwife-attended homebirths have better outcomes compared to hospital births.
Better outcomes outside of the hospital? How could that be? What if something goes wrong? It is true, there are risks involved with homebirth, but there are also risks involved with hospital birth. The most recent and largest (to date) study examining the two was published by the British Medical Journal (BMJ) in 2005. The conclusion? Planned home birth for low risk women using Certified Professional Midwives was associated with lower rates of medical intervention and no higher likelihood of death than that of low risk hospital births in the United States." This was an important piece of research because it is the largest homebirth study that also matched women for risk (meaning the hospital births were of low-risk women who would have qualified for birth at home).
This may not make sense at first, especially with all of those emergency cesarean stories we've all heard. With so many emergencies, how could it be safer to birth outside of a hospital? Pay attention, the next time you hear one of those stories, chances are, the emergency was preceded by an intervention of some sort. Common examples: Labor wasn't going quickly enough so we started pitocin and then the baby crashed and we needed and emergency cesarean. After they did several internal exams and broke my water (both increase the likelihood of infection), the mother got a fever and the baby's heart rate sky-rocketed so we needed an emergency cesarean. She got an epidural and the baby’s heart rate dropped. They put on an oxygen mask, gave her a shot of something and had her rolling from side to side, but the baby didn't recover and we needed an emergency cesarean. Hearing story after story like that, hospital birth does sound dangerous.
But sudden reactions to medications and invasive procedures don't exist at home because the medication and procedures that cause them are not used in the first place. In the absence of medical intervention, the majority of complications in childbirth arise slowly with plenty of time to notice them and seek medical care, if necessary. Common examples: The baby gradually becomes less tolerant of labor. Labor is prolonged and the mother begins to wear out. When non-emergent complications do arise at a homebirth, a skilled midwife can help resolve them through a variety of non-medical techniques; she can also provide some medical treatments like, oxygen for neo-natal resuscitation or drugs to manage hemorrhage. In the rare event that a complication cannot be handled at home, she has a transport plan and will recommend transfer to a hospital (in the BMJ study 12.1% of the homebirth group transferred to the hospital, but less than half of a percentage of women had urgent transfers).
Looking at the BMJ study, the effectiveness of this gentle approach to complications was clear: Induction or Augmentation of labor (with pitocin or prostaglandins) 4.8% vs. 39.9% Episiotomy 2.1% vs. 33.0% Cesarean Section 3.7% vs. 19.0% (it is worth mentioning that the national cesarean rate is now over 30%)
With so many risky interventions at hospitals and no improvement in outcomes, many women planning hospital births also like to "stay home as long as possible" to reduce the likelihood of unnecessary intervention. I guess my preference is to stay home as long as possible too. I just prefer to do it with a skilled attendant present to catch any signs of trouble. If my midwife recommends transferring or I just feel I would rather be at a hospital, I can always go. But if not, staying home as long as possible turns into just staying home.
As I ponder homebirth, privacy, comfort, support, convenience and a positive birth experience have been nice perks, but they are not the reason I stay home. I stay home because I know the risk of death is the same in or out of the hospital, but the risk of injury, infection and intervention are significantly lower at home. I prefer my body and my baby to be uninjured, uninfected and left alone and that is why Johannes and Willem were born at home.
You can learn more about midwives and homebirth here.