HBAC: Josie Helene's Birth Story

The Journey Begins

I never thought a home birth would be for me.  Only crazy people did that, right?  My best friend had a home birth, that was my first real exposure to it.  Then I joined a natural birth community in Louisiana when I was pregnant with Evelyn and it opened my eyes a bit more.  But it still seemed too “fringe” for me.  Then I had Evelyn, via unnecessarean, and home birth didn’t sound so crazy to me.  Several months later I got pregnant with Lucy.  Home birth actually came up in my mind as a viable option.  In one of my first visits with my current HCP I asked if he supported home birth.  That’s quite a change in less than 2 short years.  But I learned of the importance of quality care and discovered this kind of care is really best achieved at home with a midwife.  I must admit, some of my wanting a home birth was to prove that home birth is safe and natural.  I learned however that to HBAC in Louisiana is extremely difficult.  It wasn’t a fight I was willing to fight.  I also had doubts in my body being able to go through all of labor and birth, after all it didn’t “work” the first time around with Evelyn.  So I agreed to do a VBAC in the hospital with baby #2 and home birth should we be blessed with baby # 3.  After 22 hours of natural labor, I had my successful VBAC.  I was now a prime candidate for a home birth.  I’ve been envisioning how everything will play out in my mind for months.  Do I want to labor upstairs or down?  Do I want the girls around? Do I want a doula in addition to my fabulous midwife?  Will I like the idea of not having food delivered to me whenever I call for it, even if it is less than edible food? 

Well, baby #3 is here.  I thought the main obstacle would be cost.  Our insurance is great and so a birth for us in a hospital setting is affordable, possibly even cheaper than a home birth.  Perhaps cost shouldn’t be a major factor, but it is.  I recently learned that I will encounter more obstacles than just determining how much I want to spend.  I “proved” my pelvis, whatever the hell that means.  Because it was broken before?  Give me a flippin break!  I have to get permission from the Louisiana Medical Board.  I have a hunch how that will go: we have the highest cesarean rate in the country, March of Dimes rated Louisiana F in all areas of maternal and infant care, and the president of LACOG is a complete moron and wasn’t afraid to hide it infront of the Health and Welfare Committee on May 2.  We are also in a time in our country in which female reproductive choices aren’t left up to the women, that would just be silly, but men.  Not her husband kind of man, but of just random men who don’t know me from Adam, err Eve!  Before when I thought cost was my only obstacle I was ok with that, because I was the obstacle.  Now there is an arbitrary obstacle.  Now I’m pissed.  Now I want to cry.  Now I wish I had the where with all when I was in labor with Evelyn to say “NO” to that damned c-section.  Or at least ask for more time.  But no, it happened.  Not because Evelyn and I were in distress, but come to find out my doctor felt sorry for me because she thought I was tired!  TIRED?!?!??!!!  This recent development makes me want to fight for a home birth all the more.  So what I’m hoping this will be is a journey for my home birth, and if not that then helping another mom in this “Great” state to achieve her goal of a home birth!

Politics of birth in Louisiana:

This afternoon I had my first prenatal visit with my wonderfully supportive OB. I will leave his name out because birth can be so political.  He is a diamond in the rough and if I can prevent further criticism or scrutiny I will.  While pregnant with Lucy he and I discussed home birth, I mentioned this in my previous post.  I brought it up several other times, most recently a few weeks ago when I went in for a routine check-up.  As usual, when he entered the room, he greeted me with a warm smile, hug, and of course a “Congratulations!”  I didn’t even have a chance to mention anything about home birth when he said, “Are you still wanting a homebirth?”  Uhh…yes!  Without even asking, he offered his support.  I was shocked, never did I imagine it would be THAT easy!  Thank you Lord!  He assured me that it was a safe decision.  He was impressed with how I managed my pain during the birth with Lucy.  He also said we have a great relationship.  If he were in front of the courts he would not be so outwardly supportive and would likely discuss the risks.  But again said, but you know that so much of this decision is relational. He went on, “ If my group finds out and they don’t’ support it, that’s fine. “  I explained that eventhough my pelvis has been “proven” I would still likely have to go in front of the medical board and I would need in writing that he is my back-up.  He replied, “That’s fine, I’ll put it in writing!”  I nearly cried, I couldn’t believe it. 

It’s not all a done deal.  I now have to determine the next steps: mainly the Louisiana Medical Board.  But just like that, I have a supportive OB!  After his offer to support me I wanted to convey that I did not at all want to put him in a difficult situation.  He is a diamond in the rough for moms wanting VBAC and I didn’t want to jeopardize care for moms in the future, or even cause strife in his marriage.  If he came up on the chopping block, a whole host of moms would be by his side to support him.  While he appreciated the concern he assured me that he felt very comfortable with this decision. 

Encouraging a supportive mate:

Initially, Taylor was nervous about the idea of a homebirth, understandably so.  He wasn’t shocked at the idea because we began talking about the possibility of a homebirth during Lucy’s pregnancy.  But he didn’t spend the hours upon hours that I did researching the risks and benefits of homebirths.  For several weeks in a row, after prenatal visits with our OB and midwife I asked if he was sure about a homebirth.  I think midway through the pregnancy something in him clicked.  After a visit with our midwife he said, “It just makes sense.  Why wouldn’t we have a homebirth with Sherri?  She has so much experience.”  Through the rest of the pregnancy he would continue to make comments about this.  My mind had been made up months prior, but if he was truly not comfortable with the situation then I was open to a birth at the hospital with our OB.  Eventually, his main concern became being sure the window in our carport was covered.  (things went too quickly for that to ever happen).  One night in bed  to we talked about who would catch the baby.  He was resolved to be the one.  I was surprised.  With Evelyn’s birth I don’t think he had much desire to see the actual birth and the thought of cutting the cord was a bit much for him.  Then with Lucy, he watched the birth and eagerly cut the cord.  And now he wanted to be the one who caught our baby girl.  I find it interesting that in our own way both Taylor and I evolved from one pregnancy to the next.  Thankfully, we evolved in the same direction, with the same common goal.

Prenatal Visits:

My midwife attended Lucy’s birth as my montrice and already had a working relationship with my OB.  As labor support teams go, they were dynamic and very supportive.  They also have a great deal of respect for each other.   As an HBAC, with a proven pelvis, there were certain guidelines I had to follow with regard to prenatal visits: how many times I had to see the OB, labs, tests, etc.   As evidence of their great relationship my midwife said, “do whatever tests and however many visits the doc wants you to,” and my doctor said, “what does Sherri want you to do?”  I never received care or information that contradicted each other, in many ways they were merely an extension of the other person. 

Given that my midwife is the director of the midwifery program at SLCC in Lafayette, prenatal visits went differently than most homebirth prenatals.  In the beginning, the girls and I drove out to SLCC and did our visit in a small classroom with my midwife and about a dozen student midwives.  I loved it, the girls did too.  I love talking birth and so to be in a room with that many women who view birth the same way you do and you are the main topic of conversation, what’s not to love?  I had no problem letting 13 sets of hands feel the positioning of the baby, ask questions, and then return to feel again.  Goodness knows we need more midwives and I had no problem being the mom they could practice their skills with.

In the 3^rd trimester we began having prenatal visits in our home.  The girls loved when Sherri came over.  She let them each use a measuring tape and even borrow her stethoscope.  It became commonplace at our house after visits that Evie would take my blood pressure and Lucy would try to measure me.  They spoke very affectionately about Sherri and when they discovered that they missed out on a prenatal visit they were not all that pleased with me.

The Birth

My EDD was January 16.  Sherri expected that I would go about a week late.  I went late with Lucy and she also found that first time home birth moms  tended to go late.  This very likely probability made it easy to make a surprise visit up to Ohio at week 37-38 of the pregnancy.  Being that far along made my family a little uneasy but I assured them that this baby was coming late, so I had WEEKS to go.  I was back in Baton Rouge on January 5.  The next day I attended a beautiful shower thrown by two wonderful girlfriends for Melissa and I.  January 13 Josie was born.  Everyone was shocked.  Good thing I didn’t extend my trip to Ohio!

Friday, January 11

The week leading up to Josie’s birth I was a nesting machine and thankfully Taylor was on his regularly scheduled 7 days off.  Here’s a laundry list of what I accomplished:

*grocery shopping to prepare for the apocalypse (snacks, produce, towels for the homebirth, diapers, breast pads, etc)

*2 batches each of jambalaya and red beans and rice

*homemade honey sticks and laborade for myself and 2 girlfriends

*  finished Josie’s quilt and attempted to finish her afghan (carpal tunnel got in the way)

*put away 6 baskets of laundry, washed another 10 loads

*organized two closets, cleaned out the toy room, cleaned our upstairs living room, cleaned our bedroom

*somewhat cleaned out the van and wrote out directions for my friend who would keep the girls when I went into labor

*solidified arrangements for my MIL to come into town MLK weekend to help even if there was no baby

And of course the regular day to day mother/housewife type stuff.  We even managed to go to the library, attend MOPS, go to a birthday party, clean up a friend’s son’s vomit, and best of all have a wonderful date night with my husband to celebrate our belated 5 year anniversary.  Needless to say we packed a lot in! 

So, back to Friday.  Friday afternoon my husband returned to work for his weekend of nights.  That evening I began feeling quite a bit of pressure on my cervix and what I thought might be contractions.  I refused to post anything on facebook about this progress because I didn’t want to get ahead of myself.  After all, my midwife and I were expecting that I go 1 week late, not one week early. So while I didn’t post anything on my own page I had a moment of weakness and posted in the mother to mother ICAN group.  They were all supportive telling me things like: enjoy your last few days as a family of 4, rest, etc.  All through the pregnancy I told myself that the baby would come around Jan 24, not the 16, so when it came close to my due date I wouldn’t be making “impatient” facebook posts.  Yet here I was doing just that.  So while I slipped in this one area, I wasn’t letting myself do any sort of “do it yourself” induction methods.  There was no intentional eating of spicy foods, no pressure points, no pineapple, and I really didn’t even give much thought to whether I was taking my EPO.  I really was comfortable with the baby coming whenever.  But of course if she wanted to come early that would be fine.  Late that night I thought, “maybe she isn’t coming because I haven’t given Kate directions for the girls.”  So I sent her an email with our routines.  She would be borrowing our van and I knew I clean it out, but 11PM was a bit too late for that.  No baby.

Saturday, January 12

Saturday morning, after spending another evening kind of sleeping on the couch, I awoke to discover I had lost my mucous plug.  I was pleasantly surprised.  But remembered it didn’t necessarily mean all that much.  I could go into labor hours later or not for 2 more weeks.  But, it was progress and it was a sign that I wouldn’t stay pregnant forever. 

The girls and I went over to a friend’s house for a birthday party.  I continued to notice discharge when I went to the bathroom and I still had some contractions, but not like the night before.  I took it somewhat easy and didn’t feel totally bad letting my friends keep an eye on my girls.  At one point a friend’s boy threw-up.  She wasn’t in a position to clean it up so I helped.  It took sometime for people to realize what I was doing and my friend Bethany said, “I just realized you’re cleaning the floor.  Why are YOU cleaning the floor?!”  I jokingly yelled back, “I want to have this baby, leave me alone!”  When I got home Taylor put the girls down for naps.   I dealt with the homebirth linens: sheets in brown bags, folded 6 towels, 6 washcloths and 6 blankets.  I gathered the outfits I would want the baby in first.  I organized the birth basket: honey sticks, peri bottles, lidocaine, chapstick, etc.  Lastly, I did a half-ass job of cleaning out the van.  Upon completing that I thought, “now the baby can come.”

That evening I remember spending a little bit more time with Evie than usual when I put her to bed.  The thought crossed my mind, “what if this is the last time I put her to sleep before the new baby?”  Weird how I had these little inklings.

Sunday, January 13

I spent another evening sleeping on the couch.  I woke up around 5:30 or so and had to use the restroom.  I returned to “bed” and had a feeling something may happen today.  But I still wasn’t convincned.  Statistically natural birthing moms go into labor at night, so I thought at the very least I had 12-14 more hours before labor of anything started.  6AM:  Laying on the couch, watching HGTV, I felt a small “pop.”  As someone who has had a cesarean, the first thing that came to my mind was, “oh great, hope that wasn’t my uterus.”  I stayed still and didn’t really feel anything else.  Then I had the urge to go pee.  As soon as I sat up I felt a gush, it stopped me in my tracks.  “Oh crap!”  Not only had my water broken but I only had on a panty liner and I did not want amniotic fluid on my couch!  Walking as quickly and awkwardly as possible, so as to not leak everywhere, I made my way to the bathroom.  Sure enough, once I sat more fluids came and my underwear was soaked.  “Oh crap!”  I turned on the shower, my hair was in desperate need of a washing.  Almost immediately I began crying.  Evelyn’s birth started with broken bags of water and ended in a very unnecessary cesarean.  I began to tearfully pray: “Lord, you are over this birth.  You will do what is best.  Please, Lord.  Please, Lord.”  I began thinking, “I had my VBAC, maybe God’s will was only 1.”  I finished my shower and let that be the end of those thoughts.   And I slipped into a pair of depends.

6:15 AM: I called my midwife.  I know she was surprised to hear from me, I was only 39w4d.  “My water just broke.”  I proceeded to tell her about the contractions Friday and the mucous plug Saturday.  I was presently not really having any contractions or at least none that I would pay attention to if my water had not just broken.  She told me to go back to bed and see if a pattern developed.  She planned to come over later in the morning to see how things were progressing.  She assured me that we had about 12-18 hours before we needed things to get going.  That brought me some relief.  However,  I knew returning to bed would not be an option.  I began making myself breakfast: egg and sausage sandwich.  While waiting for the food to cook I French braided my hair, something I’ve wanted done during the other births but never managed to make it happen. 

6:30 AM: Contractions started and so I downloaded the contraction APP on my phone.  This was MUCH easier than using a stop watch and writing it all down, like I did for Lucy for 2 straight hours.  It didn’t take very long for me to have to stop what I was doing each time I had a contraction.   I started breakfast for the girls and began packing their suitcase for their stay with Jon and Kate.  Around 7AM or so Evie woke up.  I began to prep her for what would happen that day: mama was going to have the baby today, she was going to play with Haven and sleep at her house.  She was very excited about everything.  Contractions were still going strong: 5 minutes apart and approximately 30 seconds long.  I debated whether I wanted to have the girls infront of a video and then realized the contractions weren’t getting any weaker, so I got over any mom guilt.  Eventually Lucy woke up and she eagerly joined Evie at the table for breakfast and Pocoyo. 

8:19AM:  I called Kate to let her know my water had broken but I had no idea how long things would go.  I wanted to be mindful of the fact that the first service at church started at 9 and being the pastor’s wife I was sure what all she needed to do.  I asked her to come get the girls, but there was no rush.  Even if it would take hours  for labor to get started I knew I didn’t want to have them hanging around, especially since I was letting Taylor sleep as long as possible after working nights.  She got someone to cover announcements for church and was waiting on our friend Amber to come with her so she could pick up our van.

9:11AM:  I called Sherri and let her know I definitely had a consistent labor pattern: 5 minutes apart 30 seconds each.  She told me she was on her way.  Meanwhile the girls were still strapped into their chairs eating breakfast and watching Pocoyo.  Everytime Lucy saw me have a contraction she’d say: “Fussy?”  “Sleeping?”

9:40AM: The girls were still settled into their chairs eating and watching Pocoyo.  The contractions were starting to change a bit, I was feeling them more in my pelvis.  I decided it would probably be wise to wake-up Taylor.  I slowly walked up the stairs and quietly woke him.  Our conversation went like this:  “Taylor, my water broke and I’m having contractions.”  Taylor: “What?  Really?”  I continued: “My water broke at 6, contractions started around 6:30, they are 5 minutes apart and 30 seconds long.  Kate should be here any minute to get the girls and Sherri is on her way.”  At this point though I didn’t really need him to help me with the contractions, but I had a feeling things were changing and progressing quickly.  As I walked out our bedroom door I heard Kate and Amber enter the house to get the girls.  We chatted a bit and the I had to grab the chair for a contraction.  And then I directed them to all the stuff to load into the van.  Five minutes later I had another contraction.  But this contraction was a little shorter but I was feeling it in my pelvis.  A few minutes later, less than 5, I had another contraction, probably not as long as 30 seconds.  I had stopped timing my contractions once both the girls were up.  It was evident that I was indeed in labor and trying to keep track of them with the girls around was useless.  Before leaving Kate said, “Once you start groaning you know it’s gonna be coming soon.”  Within 5 minutes of them leaving I had 3 contractions.  She and Amber prayed over me, which I greatly appreciated.  I kissed Evie and Lucy goodbye in the van.  Evie was SO excited that the baby was going to be coming soon.  Taylor came down with enough time to also say goodbye to the girls.

Contractions were coming more frequently and with greater intensity.  In between each contraction I gave him orders of last minute things: clearing a space in the living room for the birth tub, put a sheet on the bed in the toy room, lay the tarp down on the floor, etc.  I had several contractions holding onto the wall by the stairs.  But then I realized that the counter in the kitchen may provide better support, plus I had a hankering for an apple. In between contractions I sliced the apple and nibbled when I could.  It didn’t take long for me to realize that I needed him to be present during the contractions.  I didn’t necessarily need him to do anything, but I didn’t want to feel alone.  After a contraction I would send him back to a task and a few minutes later I’d yell and he would come running.  I could tell I was not managing them well and I was starting to feel a lot of pressure. I didn’t vocalize it but I felt like I could start pushing.  I wanted to sway and I wanted to do light squats but it was more pressure than I could handle.  In between contractions I swayed and that helped a bit but for some reason when a contraction came it was very difficult for me to move.  I knew the baby was going to come soon and I did not want to do it without Sherri. 

10:39AM:  I told Taylor to call Sherri and let her know that I felt like I needed to push.  I was still laboring at the kitchen counter.  I was moaning and praying: “Oh, Lord.  Please Lord.”

11:00AM: Sherri arrived.  It didn’t take long for her to realize that our baby girl was coming quick.  I got bits and pieces of a conversation between she and Taylor…essentially they were both surprised how quickly things progressed.  Her first thought was to fix the tub and then I said, “She’s coming.”  Sherri responded: “Ok, where do you want to birth her.”  I replied, “I don’t care.  She’s coming.”  Taylor helped me to start walking toward the toy room and stopped in my tracks right outside the door.  I started to push and yelled, “She’s coming.”  I think I had two contractions there.  My butt was aching.  Sherri urged me to at least make it to the bed and get off my feet because it would make it better for my butt.  It was nearly impossible to walk, it was such a strange feeling.  Every step was painful.  I finally made it to the bed in what seemed to take an eternity.  I hastily grabbed what pillows I could and leaned over the bed.  The pushing continued.  My pushing with Lucy was quite calm and quiet.  This experience was quite different.  I knew it would be counterproductive to yell but there was no way in hell I could push quietly.  So somewhere between a yell and a groan the words that got me through were “Oh lord Jesus.  Please Lord.  Come out.  Please.”  In desperation I inquired, “Is she coming?”  Sherri assured me that she was.  I felt so desperate, I didn’t want to push for hours like I did for Lucy.  I groaned: “It’s burning.”  I knew that was a good sign, but it didn’t help me at all.  I felt her head crown and then before I knew it I felt pressure and her going back up.  I cried out, “No!  Don’t go back up!”  And then in my mind it felt like everything stopped.  I guess that’s the break in contractions that they talk about during the pushing stage.   Before I knew it I had another contraction I started pushing her little head out again.  But things were different this time.  Her head was crowning but was moving all around and simultaneously I was feeling that same pressure that occurred when she went back up inside.  I felt like Sherri was pushing her back up inside and man was I pissed, but I didn’t say a thing.  Sherri could tell I was frustrated and she explained that her head was out but she was turning it around to get the right positioning.  I asked again, “Is she coming?  Can you see her?”  She laughed and said, “she’s here, she’s coming.”  This gave me great hope.

11:21AM:  I bared down and pushed again and could feel her body squirm out of me.  Before I knew it she was in my arms and I was crying and laughing!  My little girl was born, in my house!  Holy crap!  I was done!  5 hours and 21 minutes and my baby was born!  Apparently when all goes well my body is meant to birth quickly. 

After the birth it was great to sit relaxed in my own bed, in my own home.  There was no hustle and bustle.  No one scrubbing on the baby, no measuring tape, no whisking her off to get measurements and weight that would remain the same several hours later.  I sat reclined on the bed waiting to birth the placenta.  About 20-30 minutes later Charlotte, the student midwife arrive, and she helped with the placenta.  Once the placenta was out and the cord was cut Taylor and I were left alone.  Sherri and Charlotte were charting, cleaning up from the birth, cleaning linens, and even folding laundry from the day before.  The only time they really came into the room was when I needed to use the bathroom.  Periodically one of them would come in to check my blood pressure, but it was very peaceful and not at all the big charade it is in the hospital.  I had no tearing and likely didn’t lose more than 200ml of blood (if that’s the measurement).    

Throughout the remainder of the day I would laugh and say, “I’m SO glad I’m not still in labor.”  “She’s here, can you believe she’s here already.”  And, “If this were Lucy, I’d be laboring for 12 more hours!” 

Several hours post partum  Sherri, Charlotte, Taylor and I began talking about the events of the morning and how we all had these little inklings to do things slightly different.  We all knew something was going to happen, only God knew that our little Josie would be born.  A friend of mine sent me a message after hearing of her birth that said, “Congratulations, I knew there was a reason you were on my mind all morning.”  This was the sense that we all had. I then started thinking what would have happened if I instead planned a hospital birth.  Josie would have been born in the parking lot, if we even made it that far.  I had no way of knowing how quickly things would progress and given Lucy’s birth it took hours and hours to progress to the pushing stage.  And once I got to that point it was still several more hours before she was born.  Then if I did make it into the hospital before she was born it would have been an absolute zoo.  I could imagine how frantic the nurses would have been trying to hook me up to this, that and the other.  And that would not have been a very peaceful birthing environment.   God knew and it was all in His hands.