Birthing and delivering a baby at home always intrigued and interested me. I explored the option with my first pregnancy, meeting with a midwife and discussing home birth. At the time, midwives were not covered by Alberta Heath Care and the fee was more than we were prepared for. My interest in home birth was repeatedly met with blank looks and concern. My family doctor’s words when I asked about choosing a midwife for my primary caregiver were “As long as you don’t have a home birth, I don’t see why not”. This remains the dominant view of home birth by many and one I can understand. If you are trained or experienced in one way of birthing, it is likely the way you are most comfortable with. I was interested in birth from the midwife perspective as it most aligned with my view of birth. Birth, and particularly natural birth, is after all the primary focus of midwifery practice and training. However, deterred by the cost and the unknowns of first-hand birth, I chose the Shared Care Program; a midwife based pilot project that allowed women to birth in birthing rooms at Westview Hospital in Stony Plain designed for natural birth. Shared Care was the perfect choice; my first birth experience gave me the confidence in my body I needed and lessened the fear surrounding birth. I could do it at home. While I loved the Shared Care approach, by the time my second baby was conceived, the program no longer existed. It may have been the unfortunate victim of the much celebrated decision of the Alberta government to finally publicly fund midwifery services. In turn, it meant that this time I could have covered midwife care and choose a home birth if I so wished.
Finding a midwife proved surprisingly difficult. I was 6 weeks pregnant yet every midwife I contacted could not guarantee they had a space available for my due date. I was put on waiting lists and told I would be contacted. Another interesting outcome of government coverage was that midwives were in demand and there were simply not as many trained midwives as pregnant women seeking their care. I was excited when I got an email offering care and quickly responded to make my first appointment. I was fairly sure I wanted a home birth but had a lot of questions. Try as I might to ignore the disapproving comments and concerns of others, every comment made me question my decision. I went into my first appointment on the fence, as I could also choose to have a midwife attended hospital birth. I was armed with questions, and hoping to leave my first appointment clearly on the side of the fence that was right for me.
Birth can be scary. My biggest concern were all the “what ifs” of birth and the safety of myself and my baby. Each scenario I presented met with knowing understanding and case by case procedures for ensuring safety. Essentially, home birth is possible when a women and baby are considered low risk. As midwife care is very intimate and thorough, they are able to assess risk and determine where best to deliver. They also know when transfer to hospital is necessary and do not hesitate to do so if need be. They arrive at your home equipped with emergency equipment which is set up immediately upon arrival, if needed in unforeseen circumstances. They are trained to deal with the myriad possibilities of birth. I felt safe and my fears were quelled. My other concerns were more pragmatic. Was it messy? I was surprised at the amount of blood of my first birth, and was certainly glad it was not my sheets I was on. They assured me the clean up was up to them. They provide you with a list of supplies to have organized, and on hand ahead of time, in preparation for birth day. This included instructions for making your bed with a plastic sheet for minimal damage. The single most important item, I would realize after, was a lot of disposable incontinence pads; I went through many of these after birth. The thing that sealed the deal was when I asked about water birth. Water was the most effective pain relief in my first birth and the water birth of my son was something I wanted to relive. While midwives have admitting privileges in certain hospitals, water birth is not allowed (some hospitals allow labouring in a pool but one must get out when it is time to push). I wanted to birth in a pool and to do so meant birthing at home. Decision made, I called to book my birth pool rental for the weeks leading up to my due date in May.
I looked forward to my midwife appointments with eagerness. As midwives sole care is pregnancy, birth and postpartum, appointments are personal, thorough, relaxed and engaging. Appointments follow the recommended once monthly until 30 weeks, then biweekly then weekly at 36 weeks. Any concerns are addressed and relevant topics as per your week of pregnancy are discussed. All the regular lab tests and ultrasounds are available if you so choose. Of course if any thing of concern arose outside of an appointment, they were always a call away. I had both a midwife and a student midwife at all my appointments and I got to know them well. At every birth, at least two midwives and commonly three, are present to attend the birth. As the week of my due date approached, I was looking forward to birthing with them.
Getting ready: Two days before birth day
In the final weeks of my pregnancy, I busied myself getting the house ready for birth. I made sure I had all the things on the list and stored them in a basket in the closet. I made a batch of “birth day muffins” and stored them in the freezer. I made sure the house was tidy each day; I would need a clean space in which to labour. At what turned out to be my last midwife appointment, the day before my due date, my cervix was effaced and ripe but not yet dilated enough for a membrane sweep. I was getting impatient. A week before, when experiencing intense Braxton-Hicks (false labour) contractions, I called to have the birth pool delivered just in case. I thought maybe inflating it for a trial run would help inspire labour to begin. I made a list of things for my husband to do when labour began: call my parents to pick up our son, inflate pool and set up hoses, call midwives to say labour had begun, get birthing supplies out of closet, make up bed, remember massage and breathing support… I was ready.
It was early in the morning, the day after Mother’s Day, when the contractions began. Labouring at home felt good. I could move as I wanted to, had music and food at my disposal, and my husband was able to be in his own space while I laboured. I felt no rush to go anywhere and felt secure knowing I would be staying put, no car ride, no interruptions . We called the midwives when the contractions picked up and they arrived 20 minutes after the call. They arrived as a pair and one of them checked on me while the other set up the emergency equipment and set out their supplies. A third midwife arrived shortly after to assist with the birth. Focus was on me from the moment they got in the door. They helped me throughout my labour, checking on the baby, suggesting positions, helping me relax during intense contractions. It was an intense labour. When I moved to the pool for pushing, they made sure the water was warm, filling the tub continuously with hot water. They worked beautifully as a team.
Warming the birth pool
Checking on baby
My home was transformed into a space of birth. When our baby’s head emerged, all three women were in position for the delivery and prepared for the moments after birth. When our baby needed assistance coming out, all three knew exactly what to do without hesitation to help her out (see full birth story here). She was immediately placed on my chest, checked and warmed with a towel. As her entry into the world was a little sticky, they spent the first few minutes making sure she was doing well. Yet, their attentions never left me and they moved into coaching to push out the placenta. We decided to cut the cord after it stopped pulsating to help the placenta’s departure. Daddy did the honours and the cord was cut. I had a shot of oxytocin, pushed and the placenta was out. All the while my beautiful baby girl was nestled in my arms. After they were assured that I was not losing too much blood, our baby was handed to dad and the couch was padded up, ready for me. Weak, I was assisted up and made comfortable. I sat, relaxed, ate a muffin, drank some water, and caught my breath. Ruby was making sucking noises and I took her in my arms and she immediately latched and nursed for the first time. The midwives cleaned up, did paper work, and continuously checked on me. The atmosphere was celebratory. It was a beautiful evening and the the late day light poured into the room. I was home, she was born right where I was sitting, she was home.
At work after the birth
Cutting the cord
Skin to skin with dada
After the flurry of clean up and paperwork, and feeling well rested, I decided it was time to move to the bed to settle with my girl. My husband helped me to the room and into cozy pajamas. Fresh pads under me in the bed, I got in. Ruby was still nursing and showed no signs of wanting to stop. With the clean up complete and the supplies packed up, the final thing left was to weigh our baby. She was big and we were all anxious to know how much she weighed. Bets were on as they thought she was likely more than 10 lbs. She was not happy about letting go of her milk supply but it was time to weigh her and check her over before their departure. She weighed 9 lbs 15 1/4 ounces; just shy of 10 lbs. They did all the newborn testing of reflexes, heartbeat, skin and she was passed back to mama, a healthy, strong baby girl. My parents and my son arrived shortly before the midwives left. My son climbed into our bed to meet his little sister for the first time. It had been a long day for all and he was ready for bed himself. My husband tucked him in and my parents met their granddaughter. The midwives said their goodbyes after making sure we were well. They would be back in two days for the first of several postpartum appointments; I loved these postpartum visits, especially as I was able to nest and not worry about going anywhere. The only unfortunate mishap of our home birth was forgetting to return the hose emptying the birth pool back into the toilet and finding water on our bathroom floor and subsequently in our basement. Oops. Besides this, you would never know that a birth had taken place in our home just hours before. Ruby nursed and nursed as I gazed at her face and took in every inch of her. The moonlight seeped into our room. The first night together was absolutely magical. We were right where we belonged.
The best part of home birth is the memory of the birth etched into the spot of delivery. In the mornings when I sit on the couch with the sun making its’ way into the room, I gaze at the spot where Ruby first made her appearance in the world. It was a memorable day and our home now houses an incredible life moment in its’ walls. Very special indeed.