The Home Birth Experience

When we first arrive at your home, we walk in the door to the beautiful sound of labor.  Maybe it’s afternoon; signs of lunch abandoned, still on the table.  Maybe it's the middle of the night, one little light upstairs that shows the way.  We quietly bring in our bags, wash our hands, and pull out our doppler to listen to the reassuring sound of your healthy baby’s heartbeat saying, “Don’t worry about me, mom.  I’m doing just fine.  You and I were made for this.”

We set up our supplies.  Since we’ve already gotten organized at your prenatal home visit, we should be able to do this without much fuss.  You’ve already shown us around anything you wanted at that earlier visit so this time we just fade into the background, seeing how you and your partner are entering into the rhythm of labor together.  

Some moms have asked for all the support and suggestions.  “Drop your shoulders…loosen your jaw…unclench your bottom.”  “This is just right.  That is the feeling of your cervix opening, your baby coming down. Welcome that sensation.  Let your body say ‘yes’ to what it feels.”  “You’ve been resting in bed for an hour now, let’s try the next few contractions on the toilet and see what an upright position will do.” 

Other mothers have asked us to only assess their wellbeing as needed.  She and her husband want this to be an intimate time together--support mainly from him, the midwifery team there “just in case” for mom and baby’s safety.

Every thirty minutes we listen again to baby’s heartbeat, every few hours checking your blood pressure and temperature.   Listening for the building progress of labor.  Longer, stronger, closer together come the waves. You’re getting more serious.  This is now taking all of your effort and concentration.  You no longer stop to chat between contractions.  Your sounds change--your midwives know the sound of a baby descending lower into your pelvis.  

We’re quietly rearranging pads underneath you as the vocalizations make us feel almost like fortune tellers… “Her water might break soon.”  And then comes that magical one.  The one that, in a grueling 20 hour labor, makes us get goosebumps.  The first REAL push.  No one decides to do it.  No one “checks you” and tells you “you’re allowed” to do it.  It just comes.  It comes the way vomit comes--forcefully, without permission, with a job to do.

So then, like it or not, you’re pushing.  Sometimes no job at all.  Like a little fish, out slides that slippery baby.  But then other times the marathon has only begun.  There are hours to go yet.  It always seems to be our first babies that put us through that.  Pushing on your side, pushing on hands and knees, pushing on the toilet, while squatting, while standing.  “Just breathing the baby down” may turn into full-on pushing with every last shred of energy that God gives you.  And not one push is wasted. 

With each push, something is happening.  Your pelvis opens a little more.  Your baby rotates another smidge--on his way to that perfect place where he will fit.  And all the while, we check his heartbeat a bit more often--make sure he’s safe and you’re safe.  His head molds just a little more--that soft, cone head (which tomorrow will be a perfect little sphere) designed to do just that.  To fit.

At times we don’t see a head and then suddenly we do.  Other times we see the slightest sliver of head that becomes an only barely larger sliver over an hour’s time.  Maybe it's a glimpse we only catch at the peak of a contraction, vanishing out of sight as the contraction fades.  Slipping back up inside until the next surge.  That little bit of head becoming more and more, over hours, until the relief of finally crowning comes--a sensation that nothing but labor can make you welcome.

Baby’s head out with mother’s exclamation. Relief.  And then a little pause.  A little scrunchy face as baby sees light, in its fullness, for the first time.  A rest between contractions as little shoulders, still inside, now make the rotation that the head first made, but this time the rotation all takes place between 2 contractions, and from the outside we watch the baby’s head turn.  The nearly-not-pregnant mother starts to breathe deeply again and we know the final force is about to come.  The one that will birth shoulders, belly, toes.  Nothing slow about this part--baby comes with a burst, with a splash of amniotic fluid that has been her bath all these months.

Warm and slippery into his mother’s arms.  His mother, who sometimes cannot even take it all in.  There may be a pause as she realizes that it is finished.  Or she may have him immediately in her arms, “My baby, you’re here, my baby, my baby, I did it, we did it!”  Sometimes silent awe.  Sometimes tears of joy or laughter.

Likewise some babies bawl from first second, while others silently breathe and blink, as though Someone has prepped them for what was to come, and there is no surprise at all. Some babies do neither, and make their midwives breathe for them for a minute while they get the idea of what’s expected of them in this atmospheric place, where suddenly lungs, which seemed a vestigial organ moments before, have work to do.

And their little head, always surprising us with its strength, bobs around, looking for the milk, which that Someone had promised them.  And there it is.  Ready and waiting.  And the little tugs at the nipple cause a wave of oxytocin to be released, which floods the receptors on the uterus to cause yet another contraction to free the placenta, which is born into a ready midwife's bowl with a plop.  Cord still attached to placenta, and baby to cord, we wrap the placenta cleanly and set it next to you so as not to disturb the treasured breastfeeding that is already underway.

Baby never leaves his mother’s arms until she wishes to get up to the toilet or shower and then it's straight to his father after he cuts the cord.  And through this, we midwives are quietly assessing mom and baby--their color, their alertness, blood pressure, heart rate, respirations, checking bleeding, making sure they’re both eating and drinking well after an event that may have sapped their strength.

It's so fun to see our client, who we had come to know from months of prenatal care together, reemerge.  She is herself again, and so suddenly.  Peaceful, joking, relaxed, or bossy--whoever she was, she is again, but also changed.  She is a mother.  A mother to this baby.  With all the miracle of transformation that that entails.  

When baby takes a break from eating, it's time to weigh and measure, to examine.  Whatever the weight, it's so perfect and fun.  Whether it's the largest baby you’ve ever had, or the tiniest little one, or oh so fun that it's just like her sibling, or just what Aunt Mary had guessed it would be--we’re all in such a good mood that somehow announcing pounds and ounces feel like making a toast.  A perfect way to wrap up.  Let's add some little footprints to the certificate that will sit on your dresser until it makes its way into a baby book or file somewhere.  The certificate says your baby’s name…”born at home”.  And when you think back on that labor you can’t imagine it being any other way.

—Story Jones, CNM