Journey of A Homebirth Mama

I am not a medical professional. The experience shared here is my own. Please research your options to make your own well-informed decision. See full disclosure here.

Dear mother and father exploring homebirth for the first time,

I see you

I see you desiring a natural, undisturbed birth, hoping for a meeting with your baby that’s sacred and joyful and unhurried.

I see you nervous and anxious about giving birth in a hospital setting with its bright lights and policies and no guarantee of being attended by a professional you know and trust, by the one you’re perhaps building a relationship with right now.

And I see you nervous and anxious about giving birth at home too, with all the unknowns and what-ifs and wondering what your people will think.

I see your careful questions and cautious exploration, your conflicting fears and desires, and the anxiety that comes with the responsibility of choosing.

And I’ve been right where you are

I have given birth to two babies at home. I loved having my babies at home. I am now a committed advocate of homebirths for women who want them. But the journey to get here was long and arduous.

I first heard about homebirth in college when I watched the documentary, “The Business of Being Born”. At the time it seemed like such a brave and beautiful way to bring a baby into the world, yet fear and lack of knowledge kept it like a lovely trinket in a little box, something kept high on a shelf and left unopened for fear of breaking it.

I thought that birth was too risky and too complicated to safely do at home.

Fast forward several years and I was married, hoping to soon start a family. I was nannying for a doula who became a dear friend, and as she was spending nights supporting mamas birthing their babies, I was spending nights on her couch, voraciously reading her library of birth-related books.

Fascinated by birth since childhood, I devoured every bit of information I could about homebirth, evidence-based care, and the physiology of labor. I watched all the documentaries and read all the Ina May. It’s always interesting to me to see how my interests as an adult have just been a continuation of what fascinated me as a child.

With Megan’s encouragement I soon trained as a doula. I attended births, and was on the board for the local birth network. As I learned more and more about normal, physiologic birth, I became more comfortable with the idea of giving birth at home. The lower risk of interventions, c-sections especially, along with the relative safety for low-risk mothers, was very appealing, yet I still had a nagging fear.

I was perhaps most afraid of making a selfish decision that would ultimately put my baby at risk.

I always say Megan “pre-doulaed” me through my fears around birth in general and homebirth in particular.

She met me where I was at, asked me the hard questions, and helped me figure out what was really valuable to me.

I was all about research and statistics and evidence-based care back then. And I still am, but now with a solid dose of valuing my own intuition and heart desires as well.

First Trimester Birth

About a year into my birth obsession, and after a PCOS diagnosis and a year and a half of hoping, I was thrilled to find out I was pregnant. I started researching care providers right away. I would be six months along when my husband was supposed to get out of the military and we would move back home to Michigan, so I knew I wouldn’t have a lot of time to find someone before my baby arrived.

At ten weeks, I went to the urgent care on base due to the light but constant spotting I had been experiencing. Follow-up appointments determined that I was experiencing a molar pregnancy and a d&c was scheduled immediately.

I was devastated.

After the procedure, while I was in recovery, the obgyn came back and told me that though the ultrasound the day before had shown a complete molar pregnancy with no developing baby, the ultrasound they had performed after administering general anesthetic showed a fetus with no heartbeat, measuring 7 weeks and 5 days

In a way I felt more at peace. The debilitating nausea and vomiting I had been experiencing for the last two months had at least been for a baby, not just an abnormal mass of fast-growing, possibly cancerous, placental tissue.

But on the other hand I felt robbed. I hadn’t been able to see my baby. No one had thought to take a photo. If I had known an ultrasound could be so wrong I would have asked them to wake me up, to let me see my baby, heartbeat or not, to have a chance to have something to keep of that baby besides an old faded pregnancy test and a handful of photos of me while I was pregnant.

But I was asleep and unaware and unable to advocate for myself.

I know medical professionals have to make a call in that sort of situation, that it was probably just a standard procedure and that for some women it would have been best. But it wasn’t for me. And I’m the one that has to live with it for the rest of my life.

The first trimester birth of that first baby had a powerful and unavoidable impact on my future births. It felt so violent, and I now know that at some level I processed it as sexual trauma.

I knew that in the future I would do everything I could to never be that powerless again.

With my first baby’s birth my general discomfort in hospitals became complete terror. Every week I returned for bloodwork to ensure my hCG levels were dropping appropriately, and by the time I left I was shaking, nauseated, and vomiting. I jumped at my own reflection in the glass doors. I had nightmares for well over a year.

While I became more afraid of hospitals, I also became increasingly concerned for safety in future births. In the wake of intense grief following that baby’s birth, I knew without a doubt that I would have taken all the unnecessary interventions and their accompanying risks to be able to hold that baby for a minute. I had never doubted that I would do anything to protect the life of my child, but now I was on the other side of loss, knowing firsthand the value of skilled medical help along with the potential for harm even with the best intentions, and the ultimate powerlessness we sometimes have to sustain life in a world of sickness and death and babies born too soon.

Rainbow Baby

Fast forward another eight months and I was pregnant again. I was shocked, ecstatic, hopeful, and full of anxiety all at once. We had recently moved home, and initially I saw an obgyn resident practice. They were the first ones I could find who would accept my insurance, and I was eager to know everything was alright. They didn’t do an ultrasound until 20 weeks, so I was in constant worry until our ultrasound showed a healthy baby boy.

Although I still knew in my heart that I wanted a homebirth, I had set my desire aside because there was simply no way it was possible financially. But as I drew close to my third trimester, my husband got a new job, and a cautious hope started to take root. If I could find a midwife who would take payment plans, maybe a homebirth would be in reach.

Meanwhile, red flags in my care at my obgyn practice made my desire for a homebirth even stronger.

One particular incident sticks out in my mind. I had been slowly going through the items on my birth plan that were most important to me, trying to simultaneously be honest about my hopes and also feel out a realistic idea of what to expect in a situation I knew wouldn’t be quite ideal. When I came to birthing positions I indicated that I wanted to be upright unless there was a medical necessity to do otherwise.

“Oh you can push in whatever position you want.” The ob said. “But when you actually give birth you’ll be on your back with your feet in stirrups.”

“I don’t think that’s necessary if everything is going well.” I said.

“It’s necessary so that we can help you get the baby out.” He said.

“And if you want to do something different you should go somewhere else, but don’t do a homebirth.”

“I don’t think I’m going to need your help.” I thought, but didn’t say aloud.

His mind seemed made up, and I decided against offering to bring in some studies to support my rather bold assertion. I would probably never see him again anyway.

Though that interaction was quite distressing at the time, I now appreciate his blunt honesty, his indirect observation that the care providers I was seeing simply wouldn’t be able to support the birth that was best for me.

At seven months pregnant, I hired my midwife.

Her calm and confident presence immediately inspired trust and even made my husband feel more comfortable with having our baby at home. All the evidence-based practices that I had to fight for in the hospital – delayed cord clamping, intermittent auscultation, upright birth positions – were standard for her. She had been practicing for over 30 years and had attended over 3,000 births. I felt completely confident in her knowledge, experience, and ability to facilitate a safe birth for me and my baby.

Right away my midwife recommended supplements and nutritional changes along with exercises to prepare for birth. I immediately had more energy and less stress. We talked about the things that were really important to me, the things about birth and motherhood I wasn’t confident in, the things I was scared of.

Every week she shared little snippets from a birth she had attended that week. Every story boosted my confidence, and I approached my due date with eager expectation. Even if I ever ended up needing to transfer to the hospital during birth, I believe the cost of a homebirth midwife is totally worthwhile simply in the value of the prenatal care.

My Friend Fear

Though overall I was excited to give birth, I still carried some fears as I approached my due date. I trusted the physiology of the process, but my history of PCOS and miscarriage had undermined confidence in my own physiology.

I had seen birth up close, had supported other women through it, and I knew it would require everything of me. I knew it would be incredibly challenging, and I believed I was strong enough to do it. Not because I was unusually strong, but because women have been doing it for thousands of years.

The strength to give birth, and to do so awake and present to the process, is a common and God-given strength, one that women today often see no need to access, but one that has been vital to the survival and sustenance of life for all of history.

I was confident in that, that women were designed to give birth. And when I doubted that I was designed to give birth, when my fears started running amok, no one fed the fears. My midwife sensibly confronted them with truth and then let them be. They became a means to a safer and better birth, not a facilitator of disengagement and helpless anxiety. Should the fears require action we had a good plan, but no one used my fears against me. I trained them for my own purposes.

And then I gave birth to my son. And the fears didn’t come with me. They stayed outside the sacred space of giving birth, like well-armed knights around a castle, ready to protect in danger. I was not only able to feel safe, but BE safe, because of their presence with me as I carried my baby.

Birth that Heals

I labored gently for a day and half the night. I ate and slept and spent time with my husband. In the wee hours of the morning I knew this was real and I would be meeting my baby soon.

We drove to my parents home where, due to various circumstances, we had chosen to have our baby. The car ride was miserable and I had a moment of weakness as we neared the hospital exit.

“Homebirth isn’t for everyone. I could just go to the hospital and get an epidural right now.”

Then we passed the exit, and I was committed.

We arrived at my parents’ home, and soon my doula and midwife arrived too. My mother, father, sisters, and brother were all there with me and my husband. I groaned and growled and laughed and cried my way through labor.

He was born shortly after sunrise, on a frosty November morning. My midwife passed him between my legs and lay him on the bed in front of me. “I did it!” I thought. I had a moment to look at him before I scooped him into my arms and held him, kneeling there on my parents’ bed.

The healing birth of my oldest son was intensely challenging, yet intensely joyful, just like he is. His birth was treated as the everyday miracle that it was. It was treated as the unfolding of a trustworthy process, not a volatile experiment to be managed and controlled.

Moments after my son was born, joyfully and safely.

I hold this decision of where I birth my babies dear because I think it was the first time in my life that I truly felt I had agency to not only make the best decisions for myself, but to feel confident in those decisions.

I was willing to fight for what was good for me and my baby when just going a conventional route would have in many ways been easier and certainly would have been more comfortable for the people around me.

Having a beautiful, transformative, empowering birth wasn’t because I was just “lucky”. Yes, in birth there are things outside our control, but what we do have control over is the way we prepare and the decisions we make. My decisions mattered.

And your decisions matter too.

The way you prepare matters. The stories you listen to matter. The values you take hold of and the values you reject matter. The hard work you do before birth, the decisions you make, before conception even – it all matters.

You don’t have to have your baby at home to have a good birth, and a few women will end up with a great birth even without much preparation. But approaching giving birth in a thoughtfully engaged manner, knowing what you want and making decisions accordingly will always be good for you and your family.

So dear mama and father, keep learning, keep searching, keep exploring.

If you’re afraid, train your fears to serve you. Treat them with care and respect, lest they use their power to defeat you instead of protect you.

Learn about evidence-based care. Learn about the physiology of birth, how labor unfolds when it’s undisturbed.

Listen to women who have had good births. Talk to women who have had homebirths.

Find out what’s available in your community. Find a care provider you can really trust.

Know what you really want. Don’t be afraid to state it clearly to yourself and to others.

And then make your decisions about where to give birth based on what YOU know is best for yourself and for your baby

You call the shots. The power to make thoughtful decisions that positively affect your birth experience, your baby, your motherhood and fatherhood, and your whole life as a family – that power is yours. Whether you choose to exercise it is up to you.

You’re the only one who can empower you.

If you’re feeling overwhelmed with information or unsure of how to make the best decisions for you and your baby, please seek out support from a local birth professional or contact me. I offer very individualized support and education for expectant parents with varying levels designed to accommodate any budget and need. This is a brief, precious, and sometimes scary stage of life, and the decisions you make now can impact your family for years to come.

With hopes of a joyful birth,

Rebekah

Birth of My Second Rainbow Baby

My second son’s birthday was several weeks ago, and for those weeks I have struggled to know how to write his story. Do I write it as a combination of my own memories and what I was told? Do I write it based on my memories alone? Do I write it as a perceive it a year later? With all I’ve processed? Or do I just write it as a timeline of facts?

I have decided to write it based on my own memories, my own experience of it, perhaps with a bit of how I now perceive the experience, a year later. I had a great birth, and this is me honoring and protecting the memory of that birth.

A Second Rainbow

Before the births of Colt (my oldest son) and Abe (my second born), I experienced a devastating and traumatic miscarriage. That experience has left an ever-present mark on every area of my life. I wasn’t sure how my loss experience would affect my second live birth.

After all, I’d had one live birth and though my pregnancy had been fraught with anxiety and uncertainty, the birth had gone well. I’d had one empowering, confidence-building, joy-filled experience under my belt. Would that somehow balance out the fear and the sadness and the need for control that my first pregnancy and subsequent loss had bestowed upon me?

The answer is no. The uncertainty was still there. The anxiety was real. But perhaps for different reasons.

When I discovered I was pregnant with my second rainbow baby, my husband and I were thrilled. I had purposed during my first son’s pregnancy that I would hold onto happiness for as long as I could. That I would let myself feel all the joy, despite the possibility for loss and sorrow inherent in every pregnancy.

Pregnant!

I would feel the anxiety right along with the joy, of course. Because it was so very real too. But I wouldn’t try to shut out the love and the joy out of a desire to protect myself from the possibility of sorrow.

I conceived my son on day 95 of a my third postpartum cycle. I had hoped that once my fertility returned after my first son’s birth, normal cycles would resume. But instead my cycles were long and irregular, as they had been for most of my life, all of it, in fact, except for the three cycles before conceiving my first son.

Fertility awareness charting allowed me to determine an accurate due date despite having not had a period for three months! If you would like to learn to chart your fertility, fill out a contact form or check out my services page.

 

I knew the risk of miscarriage was higher with a later ovulation, and what about the dreaded possibility of another partially molar pregnancy (which my first miscarriage had turned out to be)? My due date was the 20th of June, just 5 days before the fourth anniversary of the loss of our first baby. Colt had been born 4 days past his due date, so I knew the possibility of this baby being born very near or on that anniversary was high.

A Stressful Pregnancy

When we found out we were expecting, it was in the midst of a very stressful year for us. This baby was a definite bright spot.

As with my first two pregnancies, I experienced constant nausea and vomiting multiple times a day. This time it held on longer than it had with my first son, and I was far more uncomfortable than I had been with him.

I was also bigger than I had been with Colt, and more people than I care to recall commented on it. Making the observation didn’t bother me; it was true, and I’m pretty comfortable in my own skin. What bothered me was the assumptions people made because of how big I was.

“There’s no way you’ll make it to your due date.”

“That’s a big baby!”

“I hope that delivery goes ok…” (with the voice filled with foreboding…)

“They must have your dates wrong!” (Actually, THEY don’t determine my dates. I tell THEM when I know I conceived – thank you fertility awareness! And THEY, being my midwife, trusts me as a woman highly aware of her own body and fertility.)

I found myself caught off guard by my anxiety about my upcoming labor and birth. Again, I thought I would be more confident since my first birth had gone so well. But this pregnancy was so different. Would my labor be different too? I’d had a great birth. Maybe now it my “turn” for a crappy birth…

“The second birth is often as virgin as the first.” my midwife said. How right she was!

The last selfie I took before going in to labor!

Prelabor

As with my first son, I experienced frequent Braxton Hicks starting early in my second trimester. With my first, this had alarmed me, but my cervix had stayed closed and my baby safe, so I barely gave them a second thought the second time around.

Colt had been born 4 days past his due date, and his story is for another time, but my logical head said that this second baby would likely go a bit late too. My heart, however, thoroughly enjoyed the feeling that he would be a bit early. My head was right.

Four days past my due date, my husband was the best man in our dear friends’ wedding. I was so glad I wasn’t in labor. If I was going to go past my due date I might as well get to do the fun stuff! We danced to a bunch of our favorite songs, and I hoped all that activity would jumpstart labor. The next day when my muscles were aching I was glad that it hadn’t!

After the wedding I decided to stay at my parents’ house until the baby was born. As with my first, circumstances dictated that their home was the best place for me to give birth, and I had been feeling some anxiety about getting there once I knew I was in labor. Due to my nearly constant Braxton Hicks, by the time I’m sure I’m in labor, I’m far too uncomfortable to drive, and birth is too imminent to feel comfortable with the possibility of needing to wait for someone else to drive me. Also, the car ride in active labor with Colt really sucked. I wanted to be able to stay put this time.

The wedding was on a Saturday, and on Sunday when I got home from church I had some bloody show. That afternoon I napped with my husband, and in the evening I made brownies with Colt. I knew it was likely the last night we would go to bed just him and me, and I wanted to savor those bittersweet moments.

Colt fell asleep holding my hand

The next day, I felt tired and a bit crabby. I went to Meijer to get some snacks and had frequent, slightly more intense contractions as I walked around. I was a bit hopeful, but not too hopeful since I’d had that sort of pattern other times.

I came home and tried to take a nap with my son. He was struggling to wind down, so I ended up only sleeping 30-40 minutes, but I woke feeling a bit more refreshed.

Active Labor

That evening my mom made tacos and I was chatting with my sister and her fiance around 9 p.m. when I noticed a change in my contractions. “It’s real now.” I thought. I didn’t often get Ash and David to myself, so I chatted with them a little longer, ate three more tacos, and brewed myself a cup of red raspberry leaf tea. Then I went upstairs to my brother’s bedroom and did about 40 pelvic tilts and 20 lunges and called my husband, my friend, Abby, and my midwife.

“It sounds like you’re in early labor,” my midwife said “so try to get some rest.”

“I can’t sleep through these.” I said. She encouraged me to rest my body even if I couldn’t sleep so I had enough energy as labor intensified. “Ok, I’ll try.” I thought. “But first, tea and a shower.”

While in the shower in the bathroom off my parents’ room, my contractions started to intensify and I started breathing through them. I checked my cervix and thought I was probably 4-5 cm dilated. Looking back, and after more recently seeing a dilation model, I’m guessing I was probably more like 6-7 cm.

By the time I got out, my contractions were about 4-7 minutes apart and becoming steadily stronger. I had to pause several times as I got dressed and resting in bed was actually starting to sound like a pleasant prospect. I lay down on the bed in my parents’ room and my contractions spaced out to 7-10 minutes, but continued to intensify.

Around this time I started texting my friend, Emily, whose due date was just a week after mine. We had shared our pregnancy news with each other early on and during our whole pregnancies had been joking about having our babies on the same day. She was just starting to have some mild contractions, and it was so cool to be sort of “laboring together”. It was also a welcome distraction! By the time I could no longer focus on texting her, she had arrived at the hospital and was 4 cm dilated.

Waiting for the Midwife

During the time I was “resting”, my sister, Ash, was there with me. In between my contractions I lay on my side, and during them I got on my hands and knees and Ash lifted my belly with a scarf or gave counterpressure on my lower back. I was having a bit of back labor this time around, which was different than Colt’s birth. It was really special to have that time with just her and me just shortly before she got married, and her calm and quiet presence was truly a comfort.

Eventually I felt the need to get up and move around and go pee, and as I stood leaning and swaying against the bathroom counter, I started feeling quite a bit of pressure. I think I called my midwife around that time, and after listening to me through a contraction she said she would start heading my way shortly.

Soon my mom heard the tell-tale grunts at the end of my contractions, signalling that I was starting to give some small, involuntary pushes. At this point she became a bit alarmed, and somewhere in there, Ty, Abby, and my other sister, Erin, had come into the bedroom. They were all quiet and unobtrusive and I hardly noticed their presence. Somewhere in there my water broke too.

I knelt beside the bed, which allowed me to still rest a bit between contractions, but I was definitely starting to feel the urge to push. My mom called the midwife again, and she instructed me to lie down on my side to try to slow things down. Soon the urge to push was overwhelming, and despite my mother’s pleas not to push, I couldn’t help at least pushing a little. My mom and her own birth stories and positive attitude toward birth has been an inspiration to me, and she has attended at least 5 other births, but I know being present for her daughters giving birth is quite a different thing for her, and she did not want me to have the baby before the midwife arrived!

My parents have a very long driveway, and it’s easy to miss, especially in the dark, so when my midwife called to tell us she was getting off on the exit to our house, my sisters raced to the end of the driveway with flashlights so that she wouldn’t miss the driveway. This was especially memorable to my midwife.

The Midwife Arrives!

She arrived and quickly began to set up. I was still being encouraged not to push, and I said, “She’s here now – I’m pushing!”

Soon someone said something about the baby having a lot of hair, and I was thrilled that they could see the baby’s head. At this point, labor was incredibly intense, and I was yelling, crying, and growling my way through contractions. I had pushed for an hour and a half with Colt, and wasn’t sure what to expect this time. The prospect of being almost done was so incredibly encouraging and gave me a renewed energy and strength.

Within minutes, the baby’s head was born. The cord was wrapped once around his neck, and my midwife calmly unwrapped it. With the next contraction I was being rather forcefully encouraged to push, but wasn’t really feeling an urge to, which makes pushing incredibly difficult and unproductive. I felt like if I could just get a good breath I would be able to have more force behind my pushing, but finally the baby’s shoulders were out. I still question this part of my experience, wondering if it’s really necessary to push before I feel any urge. Perhaps I perceive it as being far more urgent than it actually is, but in both my sons’ births, this part has been very stressful for me.

I was in a side-lying position when I gave birth. I had anticipated being in a hands-and-knees position again, but by the time the midwife arrived and I was free to just push, trying to change positions just didn’t seem worth it. But I can say, I definitely like hands-and-knees better. When they handed the baby up on to my chest, I was lying back flat and it was really hard to see him, whereas with Colt, they had passed him between my legs and set him on the bed in front of me. I was upright and had a chance to look at him before lifting him up to my chest myself.

We were going to be surprised by the baby’s sex this time, and I didn’t have the strength to move the baby around to check, so I asked Ty too. “We’ve got another boy, babe!” he said.

A “Big Baby”

My family helped me get propped up with some pillows, and the placenta was delivered uneventfully. Within probably 20 minutes of birth, our baby boy had latched on and was nursing easily. I was startled by how simple breastfeeding was this second time around!

Bonding

After an hour or so of skin-to-skin, my in-laws  arrived to be present for the newborn exam, which is one of my favorite parts of the homebirth experience. My midwife carefully checked baby Abe’s reflexes and joints and then weighed him.

9 lbs. 6 oz.

“9 pounds 6 ounces!” she said. I thought for sure the scale was broken. There was no way he was 9 pounds. He sure didn’t look like it to me. But a few days later we went to the chiropractor and he was 9 pounds 10 ounces, so I guess it was correct.

She measured his head and chest circumference. “He’s got a 15 inch head and no moulding!” she said. “You were built to birth babies!” I was pretty happy with that assessment and pretty proud of my 5’4”, 112 pounds not pregnant self for giving birth to such a good-sized baby. I have a pretty strong trust in God’s design for women and babies and the whole birth process, but I do wonder if I would have had more anxiety going into birth had I known how big Abe was.

Soon Colt woke up and sleepily met his new baby brother. He had the most fantastic bedhead, and of course he was hungry, so my mother brought him yogurt which he sat on the bed and ate.

Brothers!

Shortly after he was born, Emily texted and asked how things were going. I responded with a picture of Abe and “He’s here!” Several hours later, she gave birth to her second daughter, and I love that our babies share a birthday.

Sorrow for a Night and Joy in the Morning

Abe was born at 12:47 a.m. on the 27th of June, just 2 days after the fourth anniversary of the loss – and birth – of our first baby. Late June is always a hard time of year for me. I’m raw with emotion, sometimes traumatic flashbacks increase, but this time of year has now been redeemed. I still feel the pain and the sadness, yes, but it now exists alongside joyous memories of Abe’s birth. He has been pure grace in my life.

“Weeping may last for a night, but joy comes in the morning.” This verse (Psalm 30:5) is brief part of the psalmist’s testifying to the faithfulness, mercy, and healing of God. It doesn’t refer to birth directly, but later in John 16, Jesus says, “When a woman is giving birth, she has sorrow because her hour has come, but when she has delivered the baby, she no longer remembers the anguish, for joy that a human being has been born into the world.” Here he refers to His people waiting for His coming, but I’ve found this common theme in the Bible of sorrow and then joy to be such an encouragement in my motherhood journey.

Whether it be the overwhelming difficulty of labor followed by the overwhelming joy of holding my baby, or the overwhelming sadness of losing a child in some part redeemed by the joy of another baby born at just the right time, or of the hope of a future joy of meeting and knowing that baby in heaven, that thought was a deep comfort and encouragement to me as I gave birth. There is pain, but there will be joy. I have lost, but I am receiving a gift.

Birth and motherhood is difficult and unpredictable and full of both sorrow and joy. But we have a gracious and merciful God who is with us in our sorrow, who delights to redeem every part of our lives, a God who has given us our children, whether it be for a moment or a lifetime, and will carry us mothers through this journey He has called us to.

A year later

BirthTruths: The Truth About Birth Plans

I am not a medical professional. Nothing on this website is meant to treat, diagnose, prevent or cure any disease. Please research your options and discuss them with your care provider when making health decisions. This post may contain affiliate links. This means that if you make a purchase, I may make a small commission at no additional cost to you. Thank you for supporting this free resource! See full disclosure here.

 

Birth plans can be a controversial subject. Some birth professionals advocate for them, while others discourage them.

Some women choose to write out a birth plan to give to their care provider, some write one but reserve it for themselves and their support team, and others don’t write anything out but know what they want and are comfortable advocating for themselves.

Some women feel they don’t need a birth plan because they are comfortable with their care provider. Some think that writing a birth plan is just setting themselves up for disappointment or that it’s foolish to plan something as unpredictable as birth.

I don’t know, dear expectant mama, where you fall on the birth plan continuum. I’m not here to tell you that you should or shouldn’t write one. But there are a lot of misconceptions out there about birth plans, so I want to give you some truth to counteract all those lies, so you can know if a birth plan would be a beneficial tool for YOU.

Truth #1: A birth plan is an education tool.

A birth plan is first and foremost a way for you to learn about birth, learn about yourself, learn about your options, discern what’s most important to you about birth, and then to prepare both for the birth you want and for the unexpected.

In this way, a birth plan is very much about the process. The process of educating yourself, the process of uncovering your beliefs and values and desires around birth. Some women will go more in depth with it than others. What matters to you might not matter to your best friend.

But knowing what IS important to you about birth and then making choices that align with that is a healthy thing for any mother. And writing a birth plan helps to facilitate that learning.

Truth #2: A birth plan is not a guarantee.

You don’t hand your care provider a birth plan as if it’s a legal contract, nor can you predict exactly what will happen in your birth. Almost every mother I’ve talked with has had something unexpected happen during birth, maybe a little thing, maybe a big thing. Whether or not she had a written birth plan, she did have expectations.

It’s important to have a care provider you really trust, so that in an emergency or when something comes up that presents you with unexpected choices, you can still have confidence that the choices being made are the best ones for you.

Truth #3: A birth plan is not a substitute for face to face communication with your care provider.

As you’re learning about your options, bring up any questions you have to your care provider and talk to them about your hopes and fears for your birth well before you’re in labor. Sometimes it can be hard to have these conversations in the typical short appointments we’re accustomed to, but at least ask about the most important things. The process of creating a birth plan should help facilitate communication with your care provider, not shut it down.

Your care provider has a valuable knowledge of birth, and you have a valuable knowledge of yourself. Take both into account. You may find that much of what is important to you about birth is standard practice for your care provider, or you may discover that your basic philosophies of birth differ greatly and decide to switch care providers.

Truth #4: A birth plan starts way before birth.

It starts even before conception, with your attitude toward pregnancy and motherhood. I would argue that it starts even before that, with the expectations you build from the stories you see and hear from your mother, your grandmother, your peers, and in art, literature, and media.

It includes the very first decisions you make about your pregnancy and your care, decisions like where you will give birth and who will attend it. These decisions will dictate some of your options, so as much as is in your power (because I know sometimes options are limited), don’t choose a setting or provider that you know doesn’t support what you want.

Early on, when you first make these choices, you might not know what’s important to you, and that’s ok. But if your care provider or birth setting is no longer a good fit for you, consider changing. I know it’s a hassle, but it’s worthwhile if it’s what’s required for you to have safe, respectful care you can trust.

Truth #5: A birth plan serves as a guide to help you prepare for birth.

As you learn about birth and learn about yourself, you can take steps during pregnancy to help prepare for the birth you want. Making sure you’re comfortable with your care provider, nourishing your body, trying to keep your baby in an optimal position, learning some comfort measures (or learning lots of comfort measures if you’re planning on an unmedicated birth) – these are all things you can do that have an impact on your birth.

And then think about what you don’t want during birth. Are there situations in which that thing you want to avoid might be helpful or needed?

For instance, when I was planning my first birth, I wanted to avoid an epidural. I even chose to birth at home so that it simply wouldn’t be available to me without the significant inconvenience and stress of transferring to the hospital.

But I knew from the beginning that if labor was really long and I was too exhausted, if I simply couldn’t relax enough to dilate, or honestly, if the pain was far worse than I was prepared for and the natural comfort measure I had learned weren’t helping enough, then I would transfer to the hospital and have an epidural.

A birth plan helps you prepare for the birth you want and take positive, proactive steps to make it happen, while still preparing for the reality of the uncertainty of birth.

Truth #6: A birth plan serves as a guide for your support team during birth.

It’s a good idea to have your birth team know what’s important to you during labor so that they’re able to support you toward those ends. Your birth plan for your support team (partner, doula, and any other family members or friends who will be present) might be more detailed than the one you give your care providers, and it’s something they can refer to if you’re offered different interventions. You are always free to change your mind and be flexible, but they can remind you of questions to ask or provide comfort measures that you’ve perhaps practiced beforehand. If you’ve communicated your hopes, even just verbally, your support people will be able to be more helpful to you during labor.

Truth #7: A birth plan is not an indicator of a control freak mom. A birth plan is an indicator of a thoughtful and engaged mom.

Every woman has expectations and values and desires around labor and birth. Even if a woman hasn’t taken the time to figure them out, even she’s not honest about them, even if she doesn’t care about all the same things you care about, even if she doesn’t have anything written down on paper, she still has hopes and expectations and is probably at least in some way trying to prepare for what she wants. Even the decision to “not have a birth plan” is often an effort to not be disappointed in birth.

I don’t say that to criticize the moms who aren’t interested in written birth plans. A written birth plan isn’t helpful to everyone and that’s ok. I just say it because sometimes anti-birth plan voices are loud and an unnecessary point of tension among mothers. But the process of learning what you want and how to prepare for that along with how to prepare for the unexpected is a valuable one for any mother.

Know What You Want

So write a birth plan or don’t write one, but do know what you want and prepare for it. You might be disappointed, yes. Disappointment is a possibility whenever you have ANY sort of expectation, but not being honest about what you want doesn’t necessarily protect you from disappointment either. And through doing the hard work of learning and knowing what you want, you might have an amazing birth that you wouldn’t have had if you hadn’t taken the time to prepare for it now. You are the person who is most invested in your baby. Your hopes for birth, your hopes for how your baby is welcomed into the world, and your hopes for those first moments with your baby matter. Don’t be afraid to know what you want and go for it.

Want to delve deeper into the truth about birth plans? Click here to receive your Brave Womanhood Reflections Worksheet!

Dear Expectant Mama: What You Should Know About the Benefits of Vaginal Birth

I am not a medical professional. Please research your options and discuss them with your care provider when making health decisions. This post may contain affiliate links. This means that if you make a purchase, I may make a small commission at no additional cost to you. Thank you for supporting this free resource! See full disclosure here.

Dear Expectant Mama,

You might be wondering what the big deal is about having a c-section versus having a vaginal birth. Perhaps you’ve seen news articles, health organizations, or advocacy groups calling for lowering the cesarean rate, which is currently just over 30% in the US and globally is steadily climbing. Cesarean birth is so common now that on the one hand its relative safety and ready availability in an emergency is often taken for granted, and on the other hand its risks are often minimized. Some women are so fearful of vaginal birth that a cesarean seems like a desirable alternative.

So what ARE the benefits of a vaginal birth?

 

[Please note that in this post many of these benefits of vaginal birth are set in the context of risks of a cesarean birth, since cesarean birth is the other possibility. This is never meant as a criticism to mothers who have experienced cesarean birth, whether by choice or necessity.]

1 – A quicker, easier recovery for the mother.

Healing after birth is a big job for your body to complete, and so is caring for a brand new baby! Postpartum and adjusting to mothering a little human is challenging, and those few months following birth are especially significant to a mother and baby’s well-being. The better a mom is feeling physically, the easier it will be to focus on bonding, getting a good start to breastfeeding, and learning each other’s rhythms and patterns, which are all so important to your journey as a new mother.

After you give birth there is always healing to do. But if you give birth by cesarean, your body will have to heal the layers of skin and muscle where your incision was made, and, in all likelihood, this will simply take longer than healing vaginal stretching, tearing, or even an episiotomy. There may be pain or infection at the incision site, and there is also the possibility of other organs accidentally being injured during surgery. These circumstances may further prolong healing or require additional medical attention. Whether you give birth vaginally or surgically, the good news is that your body is designed to heal.

2 – A healthier microbiome for the baby.

Every human is colonized with a variety of microbes (mostly bacteria, along with fungi, viruses, protozoa, and archaea) that either helps or hinders the health and function of the body. Before your baby is born, she is for the most part protected from bacteria by the amniotic sac, but once your water breaks, your baby starts being exposed to bacteria from your vagina. Your own microbiome is passed on to her as she is “seeded” with the first bacteria she comes into contact with. As your baby is born and hopefully handed straight to your arms, she comes into contact with more bacteria from your skin. As you nurse your baby she is being fed with the perfect food to feed the right kind of bacteria in her gut, the seat of her immune system.

When a baby is born by cesarean, she doesn’t get the chance to pass through the vagina and be seeded with your bacteria. Instead she first comes into contact with the hospital environment and medical staff, so she is seeded by different bacteria. The method of birth isn’t the only factor to microbiome health, but babies born by cesarean generally have a less diverse microbiome with a less healthy balance of good and bad bacteria.

Higher rates of autoimmune and allergic diseases like asthma, type 1 diabetes, and celiac disease are correlated with cesarean birth, and microbiome health may very well be a contributing factor to these higher rates. It should be noted that correlation does not equal causation. There may perhaps be other factors that lead to an increased risk of both cesarean birth and autoimmune diseases, causing their increases rates to correlate. We simply do not know with certainty the exact factors involved in a child’s development of certain diseases.

If you have a cesarean birth…

At times, having a cesarean is due to factors completely outside your control, or you may have very personal reasons for wanting a cesarean birth. So if you do need or want a c-section, you can talk to your care provider about taking measures to help support a healthy microbiome in your baby. Vaginal swabbing, a procedure in which sponges are placed in your vagina prior to the birth and then are swabbed all over the baby, is a practice that helps to partially restore the microbiome. You may also be able to have immediate skin-to-skin in the operating room, and breastfeeding will also help create a healthier microbiome in your baby.

If you want to learn more about the microbiome…

Check out these resources:

“Your Baby’s Microbiome” by Toni Harman

“Microbirth” a documentary based on the book

microbirth.com, the corresponding website. They frequently offer a free webinar, “Understanding the Infant Microbiome”

3 – Better respiratory health for the baby.

As your baby passes through the birth canal, the pressure squeezes amniotic fluid from the lungs. As already mentioned, your baby’s microbiome may play an important part in her risk of developing asthma, but this process of squeezing during birth along with exposure to hormones during labor are also thought to play an important part in respiratory health, as they ready the lungs for breathing.

Some studies have shown that vaginally born babies have a decreased risk of transient tachypnea, which is abnormally fast breathing during the first few days of life. If a baby is born by cesarean before 39 weeks and without proof of adequate lung maturity, she has an increased risk of respiratory distress syndrome. Vaginally born babies are also less likely to be admitted to the NICU, but this could be due to factors that make both cesarean and NICU care more likely.  So if a baby has a known health concern that makes cesarean birth safer, that health concern may also mean the baby is more likely to need NICU care.

Here is my own experience with having a child with respiratory issues.

4 – Safer future pregnancies.

Perhaps you’ve heard “once a cesarean, always a cesarean”. The reality is in many cases if you’ve had a cesarean, a VBAC (vaginal birth after cesarean) may be a totally legitimate option for you, but finding a care provider who is truly supportive (and not just tolerant, or worse, actually opposed to VBAC) can be a challenge! On the other hand, depending on your individual circumstances a repeat cesarean may be the only safe option for you, or you may look at the risks and benefits of both VBAC and repeat cesarean and decide you are more comfortable with those of a repeat cesarean.

If you have a cesarean and still want more children you might want to think more seriously about trying for a VBAC (chances are you’ll be successful). Complications like placenta previa or placenta accreta that are more common after a cesarean also increase with each additional c-section, while the risk of uterine rupture, which is an increased risk during a VBAC, decreases with each additional VBAC. Both VBAC and repeat cesarean carry more risk than a second vaginal birth, and some studies have shown an increased risk of stillbirth after a cesarean while other studies have shown the increase to be only very slight. So if you can avoid a primary cesarean your future pregnancies simply carry fewer risks.

 

Cesarean and VBAC Resources:

ICAN International Cesarean Awareness Network

The VBAC Education Project This is a resource offered by ICAN. It contains a wealth of information about your options for subsequent births after a cesarean.

VBACfacts.com An organization dedicated to sharing evidence-based information on  VBAC and making VBAC more accesible

“The VBAC Companion” by Diana Korte

“10 Steps to Finding a VBAC Supportive Provider” by ImprovingBirth.com

5 – Less risk to future fertility.

While secondary infertility can happen to anyone, some studies have shown that having a c-section may place you at higher risk of future infertility, and unplanned hysterectomy, and adhesions that may cause long-term pelvic pain are also increased risks for women who have had c-sections.

If you’re a cesarean mama struggling to conceive or struggling with pelvic pain, I highly recommend exploring NaPro technology to try to help address your concerns. NaPro used specialized surgery and works with a woman’s cycle to try to get to the root cause of a problem and is less invasive than many traditional fertility treatments. I wish I had known about it when I was struggling with infertility!

6- Easier breastfeeding and bonding.

For years the norm has been to whisk baby away to be cleaned, weighed, and monitored after a c-section. In fact, for many years that was even the norm after a vaginal birth. Many hospitals are now encouraging more “baby-friendlypractices, and unless there is some complication you can usually hold and breastfeed your baby immediately after a vaginal birth.

Oxytocin produced during labor makes you and your baby ready to bond, so even if your labor ends in a cesarean, being in labor beforehand still provides you and your baby with some of the benefits of labor hormones. If you have skin-to-skin immediately or quickly after birth, yourbaby can start smelling and exploring and may even latch on by herself. 

After a vaginal birth you’re more able to sit in a more upright position that makes it easier to hold the baby, and your baby won’t be pressing against an incision while she’s nursing. There’s more to bonding than hormones and immediate skin-to-skin, and you absolutely can breastfeed after a c-section, but it may take more work and perseverance from you.

Gentle Cesarean

If you do need a cesarean, talk to your care provider (preferably during pregnancy) about gentle cesarean options. While it’s certainly not mainstream yet, many care providers are willing to support your wishes to have quick skin-to-skin and initiate breastfeeding without delay and without separating you and the baby while you’re in recovery. Because of the strong medications needed during a cesarean, you’ll need your partner, a doula, or a nurse to help you hold the baby securely, and you may feel too sick to hold the baby right away, but as long as you’re feeling up to it, you don’t have to miss out on those early moments of bonding immediately after birth. Whether you’re planning a cesarean or just want to be prepared in the case that a cesarean becomes necessary, you do need to make sure your care provider is supportive of this plan before your baby arrives!

References:

de la Cruz, C., Thompson, E., O’Rourke, K., & Nembhard, W. (2015). Cesarean section and the risk of emergency peripartum hysterectomy in high-income countries: A systematic review. Archives of Gynecology and Obstetrics, 292(6), 1201-15;

Donovan S, M, Comstock S, S, Human Milk Oligosaccharides Influence Neonatal Mucosal and Systemic Immunity. Ann Nutr Metab 2016;69(suppl2):41-51

I. Gurol-Urganci, S. Bou-Antoun, C.P. Lim, D.A. Cromwell, T.A. Mahmood, A. Templeton, J.H. van der Meulen; Impact of Caesarean section on subsequent fertility: a systematic review and meta-analysis, Human Reproduction, Volume 28, Issue 7, 1 July 2013, Pages 1943–1952

Keag, Oonagh E., Jane E. Norman, and Sarah J. Stock. “Long-Term Risks and Benefits Associated with Cesarean Delivery for Mother, Baby, and Subsequent Pregnancies: Systematic Review and Meta-Analysis.” Ed. Jenny E. Myers. PLoS Medicine 15.1 (2018): e1002494. PMC. Web. 18 May 2018.

Magnus, Maria C. et al. “Delivery by Cesarean Section and Early Childhood Respiratory Symptoms and Disorders: The Norwegian Mother and Child Cohort Study.” American Journal of Epidemiology 174.11 (2011): 1275–1285. PMC. Web. 17 May 2018.

Metz, Torri D. et al. “Simple, Validated Vaginal Birth After Cesarean Delivery Prediction Model for Use at the Time of Admission.” Obstetrics and gynecology 122.3 (2013): 571–578. PMC. Web. 17 May 2018.

Neu, Josef, and Jona Rushing. “Cesarean versus Vaginal Delivery: Long Term Infant Outcomes and the Hygiene Hypothesis.” Clinics in perinatology 38.2 (2011): 321–331. PMC. Web. 21 May 2018.

Prior E1, Santhakumaran S, Gale C, Philipps LH, Modi N, Hyde MJ. (2012). Breastfeeding after cesarean delivery: a systematic review and meta-analysis of world literature. The American Journal of Clinical Nutrition, Volume 95, Issue 5, 1 May 2012, 1113–1135.

Rossi, A., Lee, R., & Chmait, R. (2010). Emergency Postpartum Hysterectomy for Uncontrolled Postpartum Bleeding: A Systematic Review. Obstetrics & Gynecology, 115(3), 1453-1454.

Van der Woude, D.A., Pijnenborg, J.M., & de Vries, J. (2015). Health status and quality of life in postpartum women: A systematic review of associated factors. European Journal of Obstetrics & Gynecology and Reproductive Biology, 185, 45-52.

Dear Expectant Mama: What You Should Know about the Benefits of Natural Birth {An Introduction}

I am not a medical professional. Please research your options and discuss them with your care provider when making health decisions. This post may contain affiliate links. This means that if you make a purchase, I may make a small commission at no additional cost to you. Thank you for supporting this free resource! See full disclosure here.

This post is the first in a series on the benefits of natural birth. I have purposefully allowed for flexibility in the term “natural”, as we will specifically be examining the benefits of each of the main components of what is usually considered a natural birth.  See full disclosure here.

Natural birth.

It’s a term that can elicit all kinds of feelings. Often seen as an ideal, women sometimes feel pressure to try for a natural birth while others are happy to avoid it at all costs. For those who do want a natural birth, there are many barriers that may stand in the way, so actually achieving it usually takes some preparation and determination.

For those who want to avoid a natural birth, there is sometimes a lack of knowledge of the benefits and a perception that a medicated or surgical birth is safer. And some are aware of the benefits but consider the benefits of medicated birth to be greater (which is fine!).

If you’re expecting a baby, knowing the benefits of natural birth is part of being able to make a thoughtful, well-informed decision about your care and your birth.

So, what makes a birth “natural”?

Usually when someone tells us she had a natural birth, we make a few assumptions.

1) We assume she had a vaginal birth.

2) We assume she had an unmedicated birth. Or that even if there was some medication involved, such as Pitocin for an induction or antibiotics for group B strep, she didn’t have an epidural or other pharmacological pain relief.

3) Some of us also assume that she had a low-intervention birth.

These are some pretty fair assumptions to make, but let me be clear, “natural” does not equal “better”. Nor does having a natural birth guarantee a joyful birth, a fearless birth, a satisfying birth, an empowering birth, or any other positive quality we might hope for. A natural birth may be all of those things. But it might not be. And having a medicated birth or a surgical birth also has every potential of being a positive, joyful, empowering experience.

Additionally, it’s pretty natural to want to avoid pain, especially here in the US where most of us are slow to embrace the value of pain and its transformative power. The pain of birth is pain with a purpose. It’s pain that you can handle. It’s pain that can empower you. But it’s still pain. And unless you’ve got some pretty compelling reasons, it’s not the kind of pain that you’re probably gonna just breeze through.

It’s also really natural to want to protect yourself and your baby from harm. Self-preservation is a normal and healthy instinct, and while medication and surgery during birth are currently overused in the US, in the face of a birth-related emergency they can truly save your life or the life of your baby. I don’t know one mother, even the most committed to a natural birth, who wouldn’t willingly undergo surgery or medication or suffering if it truly meant saving the life of her baby. We mothers are fierce protectors of our young.

So my intent here is never to cause a mother to feel guilt or shame because she doesn’t want or didn’t have a natural birth, whatever the reason. It’s not to crusade for a certain kind of birth. There are so many facets of what makes a birth safe and satisfying and joyful, and human beings are so complex with their own sets of experiences, fears, and desires, that I am not willing to say natural birth is best, or even good, for everyone. The risks and benefits of any birth choice go beyond the physical health of the mother and baby to encompass the emotional health of both of them.

I want you to be aware of the benefits of natural birth, and from there, examine your own heart and your own values and make choices that are good for you and good for your baby. You are capable of that and it is your right as a woman and a mother. Even when aspects of birth don’t go as desired, being an active part of the decision-making process is key in producing a satisfying birth experience. And what I want for you, dear expectant mama, is a satisfying birth.

Resources:

Painless Birth and Pain Perception During Childbirth podcast from Evidence Based Birth. Though the focus of this podcast is painless birth, it includes a ton of fascinating information on maternal satisfaction during birth.

References:

Romano AM. First, Do No Harm: How Routine Interventions, Common Restrictions, and the Organization of Our Health-Care System Affect the Health of Mothers and Newborns. The Journal of Perinatal Education. 2009;18(3):58-62. doi:10.1624/105812409X461243.

Goldberg H. Informed Decision Making in Maternity Care. The Journal of Perinatal Education. 2009;18(1):32-40. doi:10.1624/105812409X396219.
Cook K, Loomis C. The Impact of Choice and Control on Women’s Childbirth Experiences. The Journal of Perinatal Education. 2012;21(3):158-168. doi:10.1891/1058-1243.21.3.158.