Endurance Riding

I recently went to a film screening of the documentary Why Not Home? I knew the gist of the movie. I knew the movie would make a case for home birth. What I didn’t know was that the movie chronicled health care workers who had chosen home birth. There was a registered nurse, a nurse practitioner, and even an obstetrician… all chose home birth. Why? What is it that we as health care workers know that sways us towards a decision to have a home birth versus a hospital birth?
 
What I can tell you is that I always knew I wanted to have a home birth. Even before I became a registered nurse. The deal was sealed for me after my birth experience with Declan.
 
Declan was a beautiful hospital birth, with an unmedicated labor and delivery. But a few things happened that made me realize next time I didn’t want to deliver in a hospital.
 
I was barely 23 and surrounded by my husband and two of my closest friends during Declan’s labor. I had had an uncomplicated, healthy pregnancy (except for the normal morning sickness, which was more than I would have liked). My labor with Declan was textbook… my water broke, contractions started, and I dilated regularly, progressing at a “normal” rate. I had developed a great relationship with my OB/GYN during my pregnancy and he knew my birth plan. However, on the day I went into labor, he was at a men’s retreat with his church (imagine that!) and so the on-call obstetrician showed up in my labor room. He walked in to introduce himself while I was on the toilet and said, “Let’s get her off of the toilet and back in bed.” He clearly didn’t want to be delivering a baby while I was sitting on a toilet.
 
I got off of the toilet and climbed into bed and was attached to the fetal monitor. I continued to labor until finally I felt the need to push (I remember gripping the side rail of the bed and wanting to jump out of my skin when I went through transition). The OB/GYN I had just met walked in, gowned up, and turned on those bright lights, spotlighting my vagina for the world to see. Gary was right there with him, and was allowed to assist in delivering Declan, but he too, had to gown up and stand under those hot, bright lights as if he was performing on the opening night of Broadway.
 
I was in the classic delivery position for a hospital birth — on my back, semi-reclined, my legs in stirrups. I felt like I was on display, I was uncomfortable, and I could feel everything. Everything. I could feel the doctor’s fingers when he put them inside me, without permission, in an attempt to stretch my perineum. I could feel that “ring of fire” intensely as the baby’s head stretched my vagina, opening it like a wide-mouth bass. And I felt that shot of IM Pitocin hit my thigh, the nurse pushing the drug before my friend Heather could even finish telling her that I was against IM Pitocin post-delivery, except in the case of postpartum hemorrhage (as stated in my birth plan). That shot of Pitocin was classic protocol, treating the patient before there was a real need just because it was hospital policy.
 
After delivery, Declan needed to be warmed up. While he had initially been placed in my arms, he was soon put into the isolette, with the warming lights on him, heating him up. It wasn’t long before he was back in my arms, but skin to skin contact was not initiated (placing a naked baby directly on mom’s naked chest has many benefits, including regulating the newborn’s body temperature).
 
Fast forward to Asher’s birth: no bright lights, no sterile gowns (Gary caught Asher bare-handed!), no being told what position to push in (in fact, my midwife would have caught Asher wherever I had been — in the bathtub, on the bed, standing up walking around, even on the toilet — and being able to push how I wanted alleviated that painful ring of fire), no unnecessary medication (didn’t need that postpartum Pitocin after all), and immediate skin to skin contact.
 
Here’s what we as health care workers know: there are a lot of unnecessary interventions that occur in hospital births. Inductions often lead to epidurals because the pain associated with Pitocin-induced contractions is too great. Epidurals increase the need for more Pitocin and other interventions (artificially breaking the bag of waters, for example), all which lead to an increased risk of having a Cesarean section. It is difficult to keep our hands out of the labor process when we are taught in medical and nursing schools to fix something — we are supposed to fix what’s wrong. What the hell are we supposed to do if nothing is wrong??? We are taught to monitor patients, to read rhythm strips, evaluate blood pressure and oxygen saturations, to give medications. And anything outside the norm must mean something bad is about to happen. But not every deceleration that shows up on the fetal heart rate monitor means something is wrong.
 
And what’s more… when labor isn’t progressing steadily in the hospital, we have to step in. We can’t hold a woman in the hospital to labor for days. We need our hospital beds for the next patients, just like turning tables in a restaurant…
 
The more we learn about home birth (and hospital birth too, for that matter), the more it should be recognized as a safe option for healthy women with low-risk pregnancies. But while home birth is encouraged in other developed countries for women with uncomplicated pregnancies, it is frowned upon here in the United States. And what’s worse — women who end up needing transport to the hospital during or after their home birth are referred to as having a “failed home birth,” experiencing a less than smooth transition from home to hospital.
 
Choosing a home birth is an extremely personal decision, one that each expecting mother puts a lot of thought into. While it may not be the right choice for everyone, it should be a respected decision for those of us who chose to go the home birth route.
 
For me, laboring and delivering at home was a powerful experience, one in which I was allowed to be in the driver’s seat. In partnership with the expertise of my midwife, I was able to make educated decisions regarding my care and that of my unborn child’s. I believe that giving birth is a rite of passage — a spiritual, mind-blowing experience that every woman should be able to experience in the way she wants (barring any actual emergencies, of course — and I mean, actual clinical emergencies, not emergencies that were created because of unnecessary medical interventions).
 
One of the greatest gifts I received from my home birth was the relationship and friendship I developed with my midwife, the woman who shared in this single most intimate experience, the birth of my third child. It is a relationship that I believe is fostered through the time a home birth midwife takes with her client, the trust she puts in her client, and the advocacy she voices for the mother and her developing baby.
 
Below is the beautiful account of Asher’s birth that my home birth midwife wrote just a few weeks after Asher entered our lives and changed them forever…
 
It was a typical Wednesday night, I had cleaned up the kitchen from dinner when I noticed a missed call from Jaya on my phone. I quickly called back and wasn’t surprised when Gary answered the phone. (It’s not unusual for homebirth partners and husbands to call when their sweetheart is in labor. They usually have a lot invested in the process and outcome.)
Anyways, Gary was very calm and asked about Jaya’s ‘Braxton Hicks’ contractions that were coming every 5 minutes and lasting about a minute. In the background I hear Jaya let out a moan with a contraction while I’m asking Gary what time the ‘Braxton Hicks’ started. I think I interrupted him and said “let me speak with her.” He laughed and handed her the phone. Her voice had what I call a dark color ( I can’t help but describe sound with color after two music degrees) and she sounded distant – well on her way into Laborland. Jaya handed the phone back to Gary and I asked him to prepare the birth room – taping plastic onto the carpet in their bedroom and a layer of protective plastic underneath sheets on the bed.
It was go time for Jaya and baby Lefty’s birth! Even before hanging up I had loaded up my oxygen tank bag and birth stool-the first things I stash in my truck when I hustling off to a birth.
I should also say I’m proud of the fact that I’ve never missed a birth in 5 years of private practice. I’ve caught babies that were crowning as I ran in the door, babies whose mothers were dilated to 5cm for weeks without going into labor, a baby with a 10 minute labor…even a baby sneaking out in the water without the mother or birth team knowing! But I’ve never missed one yet. But when I heard her discomfort and how far into labor she sounded over the phone I had a sinking feeling this might be the one that got by me!
I was tempted to tell her not to push as I was hurrying out my front door – maybe it would detract her attention from the fact that she was so close and buy myself more time to race up the hill.
—Fast Forward 40 minutes of intense speed limit pushing driving up Skyway–
As I bustled in the Gregory’s front door Gary met me and helped me carry things. I ran into the back bedroom and settled my birth bag while Jakob and Gary finished taping the remainder of the plastic down on the floor. Jaya was on hands and knees in the front bathroom and working through some heavy contractions. I had a feeling she was close – sometimes super athletic mamas have quick labors, could be their tolerance to discomfort or just plain being into intense experiences. Well, it wasn’t my first time seeing one of these gals progress quickly in labor.
I sat with her for a few minutes after listening to baby Lefty and then I asked if I could check her cervical dilation. She was 6cm! Wowza! Pretty good for ‘Braxton Hicks’ contractions all day!
I left the bathroom to go finish setting up for the birth just as Paula, another midwife and my assist, pulled up in the driveway. We had just finished setting up when Jaya called out saying she felt like she had to push. Haha! Surprise!
Gary helped her out of the tub and down the hall into the master bedroom. While she was on hands and knees with some pushing, the bag of water broke clear. Good! We knew Lefty was tolerating labor well. After some time of pushing and several different positions where we could see Lefty’s head but still not crowning- we got her onto the trusty Amish birth stool I carry with me to all births. Lefty was born after 2 contractions and 2 pushes on the birth stool – God Bless the Amish!
Gary caught beautiful Lefty as I put pressure on the perineum to support Jaya’s tissue. He was wrapped up pretty good in his cord-a neck cord along with a chest-seat belt like umbilical cord configuration… not unusual but he did require some detangling! Using four hands, Gary and I gently rolled and unwrapped him. We held him out to Jaya and she reached down and gently lifted him out of our hands to hold precious Lefty for the first time (this is a very tender and raw moment for me – even without having children of my own -I know this first contact is really special). I loved how it felt appropriate for Jakob to call out “it’s a boy” and for everyone to be present.
This was a wondrous, celebrated, family oriented birth with Asher’s (formerly known as Lefty) older brothers filming and holding space as witnesses and assistants. The sense of family and love enveloped my experience working with the Gregory family – even the two amazing birth photographers were close family friends.

I also want to add a special note about Gary- the man responsible for me to be writing about this birth…
Several times he had mentioned being an older father and this was later confirmed by Declan calculating Gary’s age when Asher turns 20 years old…(you do the math..)
But my impression was that Gary brought heart-centered intelligence and wisdom of his years to this experience. Every time he spoke it was with a sense of collected mindfulness and reflective thinking. He had a sharp eye and didn’t miss the details, but his gaze was one of compassion and understanding. He was quick to make a joke and laugh while lovingly parenting and guiding Jakob and Declan.
He had described himself to me as an old school, east coast, traditional authoritarian.
So thank you for being yourself Gary-so present, involved, laughing and in love with your family…I think we could use more of your type these days.

Katarra Shaw, Licensed Midwife, admiring baby Asher several hours after his birth. November 30, 2018. Photo by Kristi Carlson.

Tags: childbirth, home birth, midwifery, motherhood, parenting, pregnancy

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