Unassisted Family Birth after Cesarean
Charlotte’s accidental unassisted HBAC (H/T to Mama Birth)
For my first child, I went to a freestanding birth center, where my water broke first, contractions were slow to start, and I got sent home once for being in so much pain, only to be told I was just a 2. I was devastated despite knowing you could go from 2-10 really fast. I labored over 30 hours, tried every trick in the midwifery model, played the “what Would Ina May Do?” game, and decided a transfer for a mercy epidural was prudent. I had been doing deep squats, climbing stairs, walking in the Southern June heat, etc. and was delirious.
It ended in a non-emergency cesarean at hour 42 after my water broke with baby still at a -1 station the entire labor, but with me at 100% effaced and a 9. Her heart tones were great the entire labor. The midwives suspected she was honestly stuck. When she was born, sure enough–her arm and elbow had gotten into a really funky stuck position that hadn’t responded to our deep squats, spinning babies, yoga positions, etc. I got to breastfeed right away in recovery. I won’t say much else about recovery since this is a positive spin on things, but I did just want to note that while I was disappointed I didn’t have her the way it was planned, the actual birth experience was not traumatic for me, and I felt empowered at every choice to increase intervention. I do not believe I had an “unnecesarean.”
For my second baby, I knew for sure I wanted to have a HBAC since I had a non-emergency C-section and a fantastic looking scar. I did not want to be continuously monitored, put on a time clock, or be bullied into doing anything out of fear. I felt like a HBAC with competent care providers would be the safest and healthiest way to bring my baby into the world. That’s why I went with a midwife who had taken on successful HBACs and was very supportive. I will say I am a 6-minute car ride from a hospital with a Level 4 NICU.
For name references, Nancy was my CPM, and her assistant is Andrea, a CPM. Mike is my husband.
I had been crying and emotionally nutty the last 2 days, before my 39-week appointment, thinking I would be pregnant forever, and getting frustrated when I tried to fold my enormous boob into my beautiful new 38HH nursing bra and it wouldn’t quite go—I was just tired of these huge boobs and cried even harder when my left one wouldn’t fit into the cup, and I knew they’d get terrifyingly giant when my milk came in. Everything made me cry.
Lately I had a few issues with fasting morning sugars-they were high enough to be of concern, but not so high as to qualify me for a GD diagnosis. I went on metformin twice a day and followed a strict GD diet. My midwife and family practitioner would correspond and see me both once a week to coordinate care, as the FP is also Charlotte’s doctor. The FP also had a HBAC, so it was a great team who were both trying to do care to allow me to homebirth. We made a plan that we’d give me until the second due date (March 6) to just go ahead and have the baby on my own, but after March 6, we would need to figure out what to do about a possible induction. That would obviously change the homebirth plan completely, but I was very firm I would do what I needed to do about the health of the baby to make sure her transition was the best possible, as she might require extra monitoring for her sugar levels. My midwife was very glad to hear I didn’t shut out options and said we will just cross that bridge when needed.
Andrea checked the position of the baby to see how far down she was in the pelvis, and she was 3/5 of the way in using some sort of 5ths rule British midwives do. That means she was as far down in the canal as she could get before active labor began. I was so happy to hear this, because she was already further down than my first baby was when she was born! Being as how I was near my first due date (2/28) and her position, Nancy told me I could go ahead and pump colostrum to 1. save for the baby in case I needed to help regulate her sugar right away and 2. bring on contractions. She also asked me to get a hold of some donor breastmilk, about 20-30oz., to also help with potential baby sugar regulation if needed.
Sunday: I sent out an email to my playgroup and get some breastmilk to be delivered to me Monday morning! I pumped around noon and got 20ml of liquid gold. We went putzing around the neighborhood from 3:30-4, but not a brisk walk at all. We met my brother at the dog park to let the doggie cousins play, and then we went back to my house to hang out. Around 7 I decided I was going to make a delicious homemade stroganoff, so I did, and wolfed it down. I then realized I had been having fairly regular contractions about 8-10 minutes apart that were different from the BH but not even notable enough to call anyone about them. I remember laughing because how do you not know you’re having contractions after a previous labor of like 42 hours?
Another note: I had been listening to Hypnobabies CDs, attempting to learn to hypnotize myself, but I had no idea if it was “working” or not. I finally just gave up trying to figure out if I really was hypnotizing myself and just enjoyed listening to them while trying to relax or fall asleep for about 2 weeks or so. From about 10-11 I laid on the couch and listened to some tracks.
Around 11 I went to pee and saw pink on the toilet paper and got excited because it was bloody show. I figured I probably would give birth in the next 2 days. Haha, great assumption, right? I called Nancy, who told me to take a shower and go to bed to get some rest, and my doula Julie, who said to call her whenever I needed her.
I showered and shaved my legs, something I hadn’t done since October. I also dried my hair with a round brush just passing the time. I dusted the bedroom and Mike started a load of laundry and dishes and then we went to bed.
From 1-4ish I laid in bed, listened to Hypnobabies easy first stage labor track, sipped water, peed, began to vocalize through some contractions with low moans. I don’t know what it is about the lady’s voice, but she just kept telling me that with each “pressure wave” (contraction) it was bringing me closer to meeting my baby in my beautiful birthing time (I’m telling you, they can get quite cheesy) but at that time I was all like, “Right on, this woman knows what she is talking about, so I will just listen to her tell me these things. And dammit, my uterus IS a special snowflake and knows what it is doing.”
But sometime after 4, the lady was annoying me, and so were the contractions oops! pressure waves. I decided I needed a change of location and Mike said to let him know if he needed me. I made my way to the living room and had these intense sweats and chills, so I went to lie down under my homemade buggie snuggie to watch some guilty pleasure mindless TV recorded on the DVR all geared up for future marathon sessions, and felt my water broke as soon as I was supine. So I hefted my way over to the toilet off the living room and near the kitchen and called for Mike. It is around 4:45am at this point. He comes in with the phone and laptop to start timing contractions at contraction master, and the midwife on the phone asked about baby moving around, color of the water, etc. and said she’d start heading over and she would call Andrea.
I didn’t think to call the doula yet because last labor when I felt like this and went into the birth center, I was only at 2cm. I didn’t really need help through them, and they really were just at the mildly annoying level before my water broke. She also has kids and I didn’t want her to have to leave if I didn’t feel like I truly needed her.
Mike starts putting up dishes and locating the hot water connection in order to fill up the tub the midwife will bring over with her, and I would just call out “s” for start contraction so we have a record to show her. I don’t think to call my doula because I thought I’d wait at least until 6:30 or so so she can sleep. Also, my first child was born 42 hours after my water broke last time, so Mike and I both ASSumed we had plenty of time to let people sleep. He calls my mom and dad to come get my 20 month-old so they’d be here when she woke up to hand her off, as we had decided we didn’t want her at the birth.
5:20ish I tell Mike to start up the tub because I feel like I can get in the tub to wait for them to show up by assuming I was over 5 cm. I really wanted a water birth for the first one, and thought it would be great to have one for my second. I remembered we had some delicious, giant, cold green grapes in the fridge. Mike got me grapes, water, and cold washcloth. I felt like I was going to pass out or throw up. I couldn’t stand up all the way, but felt like maybe I needed another change of location instead of the toilet, as the contractions were at least 1.5 min in length and 1 min. apart. In between, I ate those amazing grapes and sponged myself off. I also just sort of sat there and looked at my weird felted artwork I had made the previous spring. I really was just chillin’ in my own zone. During each contraction I would sort of sway on the toilet and make a low, loud aaaaooooaaahh sound.
At some point I feel like I need to poop and am happy because my body had not cleared itself out like it did last time. I quickly realize, though, that either this is the biggest turd of my life, or it is the baby descending like a train through a tunnel. I figured that out when I was all like, “uuuuuUUUGHHH!” and then the feeling kept going after I was done grunting. Mike had gone to make the bath. I reach down and feel a bulge and know I had better move or the baby will be born in the toilet “I Didn’t Know I Was Pregnant” style. I get the craziest urge to push and I do bear down and push hard while making this super animalistic noise, very much like what Chewbacca marrying a humpback whale might have sounded like at the end of the raucous wedding reception, but then realize I have got to breathe the baby out and try to chill out so I don’t rip my anus and have all my organs and the baby fall out right there in the toilet. Remember, I had never had a vaginal birth or felt anything like that before, so I was convinced I would also birth my entire pelvic floor. I then felt the ring of fire, but it was more like the sides of a cheese grater and not even fire—just scrapey and really painful! That was the ONLY painful part of labor. At this point I know I don’t have time to get in the tub. I call for Mike, who leaves the bath water running and had heard the change in my labor noises. That’s where he found me semi-standing over the toilet and saw hair–but not MY hair! I remember saying, “This isn’t poop!” and laughing hysterically. I mean, wouldn’t you after playing the “Baby v. Turd?” game in your head?
He says, “HOLY CRAP! It’s the baby’s head. What do I do?” I think he was even too shocked to cuss. I said get me a clean towel and put it on the kitchen floor, which was maybe 4 steps or 2 leaps from the bathroom. He was freaking out because I was really, really calm. I rip off my nightgown, got down on my hands and knees, thinking this would be a good position if there was some sort of shoulder dystocia issue, and my body just literally took over. At that point I really wasn’t in too much pain. I didn’t really feel anything other than a baby’s head just hanging out. It was obvious my body was in control and I was just along for the ride. I attribute being a birth story junkie to knowing what to do, since it’s not like I had previous practice. I think he called the midwife but I don’t quite remember him talking to her, and at one point he put the phone down and wasn’t quite talking to her anyhow. I remember him telling me, “Nancy says to pant!” and I said, “Too late, the baby is coming out and I will ahhhhh her down!” I told him to not pull anything out, the baby would come out on her own, and to be ready to catch.
The rest of her head came out. I asked if he could see a cord around her neck, and he said he did, so I said see if it is loose enough to remove it. It was, and said she was pink. I said wait for her shoulders to turn and she would probably come right out. I was meanwhile just sort of hanging out with a baby hanging out of me, waiting for the next contraction, checking out the tile and dried macaroni noodles that had escaped, and “ahhhhing” during the contractions with my mouth all open super low. When I felt one I pushed/ahhhed, and the rest of her just slid on out into his arms! He removed the rest of the loose cord and she looked around but didn’t cry right away—she was this great pink color. He helped me turn around so I could sit. I told him to get another towel and the snot sucker in case we needed it, we rubbed her down (not much vernix on her) and I checked her airway.
She did let out a few healthy cries but was very snuggly. I felt like I had torn on my right side somewhere and didn’t know the condition of my perineum, but knew I needed to sit in a way to allow the placenta to come out. We made sure the cord wasn’t knotted or constricted and I just held her and talked to her, stared right at her, and offered her my breast if she wanted it to see if the nursing would contract my uterus to get the placenta out while Mike called back (or maybe kept talking) to the midwife. I knew not to do anything crazy like try to cut the cord myself or pull on anything to avoid hemorrhaging, so I literally hung out until about 10 min. later when Andrea arrived first. Since Nancy was on the phone with us, she did not know we had actually HAD the baby already. She immediately got to work. She had Mike cut the cord, which had stopped pulsing, examined Charlotte, examined me, got Charlotte all wrapped up to hand to Mike in warmed up blankets from the dryer while I got again on all fours until the placenta came out about 15 minutes later. She checked that over and nothing was retained. I examined it, too. I got back on the toilet, she cleaned me up, and we made our way to the bedroom.
Nancy arrived and did my vitals while Andrea worked on Charlotte’s vitals. We got started on nursing and they gave us some family time while they both cleaned up in the bathroom and kitchen. We could both hear them in shock since I was definitely not showing any signs of urgency on the phone. I apparently was talking to them as normal as I would any other day–they noticed no sense of panic, urgency, labor lalaland speak, nothing. We ALL thought I had miles to go before I birthed. I am waiting any day for TLC to come up with a show called “I Didn’t Know I Was That Far Along In Labor” or whatever. Maybe I’ll apply to be on another episode of “Extreme Births!”
The next few hours were a party atmosphere, which I had no idea would make me so happy. My parents showed up, totally just expecting to get my first daughter at the door and leave, but we said, “Would you like to meet your new granddaughter?” They were absolutely shocked and it was just such a special moment to recount the story. My daughter woke up and came in and met her little sister. At first she was confused, but got so excited. I cannot believe she slept through the entire thing. We all hung out in there while Charlotte got weighed, measured, etc. My brother also stopped by before work. He was really blown away, as he had left at 9 just that previous night! They all went out as I got 3 stitches for a first degree minor tear and a “skid mark,” but otherwise, my perineum somehow survived! No organs fell out other than the one that was supposed to! My MIL came by on her way to a tennis match and brought biscuits. People left, and the midwives went ahead and had their weekly Monday morning meeting in the front yard.
The rest of the day was a nice rotation of people, all who brought food! Charlotte S. was on her way over with donor breastmilk to help with the transition if needed, and brought all this amazing food and flowers. My friend Amy brought over this whole pasta spread and some good cheer. My FIL brought a big Smithfield Chicken and BBQ spread of food, and my brother came back over to hang out after work. My doula came over later and helped with latching, brought a little birthday cake, and brought the most amazing fresh herb sitz bath. This is such a contrast to the after care I received in the hospital. Having everyone celebrate around you in your own bedroom admiring your new baby is one of the best feelings in the world, with people serving me cold coconut water with bendy straws and wild berry pie!
It literally was the craziest thing I have ever done and Mike and I were such a great team. I am just so happy he did not straight up pass out or run screaming out the front door. I never, ever would have dreamed that I would just have a baby on my kitchen floor with just my family in the house and not even miss a meal. I never actually expected to not experience pain. I kept waiting to yell the “Why did you do this to me?” and “I can’t do this!” statements during transition, but those never happened! Looking back, of course I was in transition right after my water broke. I never actually thought I wouldn’t get any internal checks or monitoring, because I didn’t want to know how many centimeters I was dilated after last birth’s ordeal with the mental devastation of only being at 2cm and being stuck at 5 cm for about 14 hours. I never, ever fathomed that overall, I would not describe the birth as painful (uncomfortable, sure, but not screaming). I also cannot have imagined 2 entirely different labors, as the first was a 42-hour ordeal ending in a c-section, and this one was about 42 minutes of intensity before the baby pretty much just slid out and said, “Hey y’all!”
I think the things that really helped this labor is that I really must have been hypnotized to relax so deeply to deal with contractions, and my body was so safe and secure at home with no one watching me or whatnot to just allow my body to open up like it was supposed to do, that she just had all sorts of factors aligned to come out. I didn’t try to fight things at all and did have confidence in my body. Fear or apprehension were not present at all in this birth. However, I had confidence in my body during my last labor, too, so it really just goes to show that labor is totally unpredictable for both scenarios! My good friend dubbed me the “freak outlier birther” and that does make me laugh.
Charlotte nursed well and we had really enjoyed just lying in bed, snuggling my baby, having people bring me wild berry pie and delicious food, and taking pictures and whatnot. It is night and day difference between my recovery last time and this time. The midwives came to my house every other day to check on us, and again at 2 weeks, 4 weeks, and 6 weeks. I hadn’t even gone outside since the walk on Sunday other than to get some sunshine in the back yard. The family doctor said bring her in when I felt up to it up to two weeks, since the midwives were seeing her so frequently. Even there, my care provider was crying with happiness when I shared my story, and had me recount it to several staff members. I really felt like I was in a dream. I stayed in bed with my girls as long as I wanted to because I knew this would never happen again, as we are done having children.
I don’t quite think it has set in for either one of us what exactly happened now 5 months later, and we sure are not thinking of the what-could-have-been type of scenarios. When people ask about the birth, there are usually 2 reactions. The first is the look of fear and horror that pass across faces, because that is their absolute worst nightmare. They all want to know why Mike didn’t tie off the cord with a shoe string or why we didn’t call 911. (Ha!) The rest are usually awestruck and say they totally wish they had that birth in the quiet, calm safety of their home with their little one not even waking up with hardly anyone poking, prodding, etc.
I do hope this story can be inspirational to others who are wishing for a homebirth, a VBAC, a HBAC, or whatever type of birth. Feel free to share it with those who you think might enjoy it!