Mila

It was a long time before I could read or watch anything about birth without crying. At least four or five months. I still felt very raw and affected by my experience with my first born, Micah. When I was ready, I started to follow through with the commitment I had made to myself about birth education. My husband, Daniel, and I had no plans for a second baby anytime soon, but it seemed right to take steps forward.

The first thing I did was reach out to a friend in Oklahoma City who had become a Birth Doula after her own experience with an unplanned C-section. Taryn was so wonderfully supportive, related to me, and suggested I begin by checking out the ICAN (International Cesarean Awareness Network) website. After a quick browse, I knew I wasn’t alone and that my feelings were valid. She also recommended watching a documentary called, The Business of Being Born. I’d heard of this documentary before. Another good friend, Darren, advised me to check it out toward the end of my pregnancy with Micah, but I brushed it off as unnecessary. I was so wrong – this documentary would change my whole perception of birth. Finally brave enough, I watched. And it was devastatingly on point. I knew immediately after watching that my next birth would be a VBAC and it would not be in a hospital.

In the following few months, four of my friends who otherwise had very normal, uncomplicated pregnancies ended their labors with unplanned C-sections. This was alarming to me. Something was wrong with the system. Seeing it affect those close to me was sad, but also helpful in solidifying my decision to do something radically different if I became pregnant again.

In the summer of 2011, we moved from Brooklyn to Houston, Texas. I left New York kicking and screaming, but ultimately knew it was best for my family. Both Daniel and I had family members in Houston and we were excited to be close to them. We settled in to our new life fairly quickly, and it wasn’t long before we were peppered with the question of when we would try for another baby.

I reached out to Taryn again. This time asking for her experience with VBAC rates in Texas. Some old demons had crept back in, and I was losing my nerve to choose the birth I knew I wanted. She provided me with a number of helpful statistics and encouraged me to start making connections with the birth networks in Texas, even if I wasn’t pregnant yet. So I did. I contacted my local chapter of ICAN and started researching midwives with high VBAC success rates. I watched the follow up documentaries, More Business of Being Born, which were equally as brilliant as the first. I felt better prepared and more capable of facing my fears; ready to do what I knew was best for my baby and me when the time came: a home birth.

In late winter of 2013, Daniel landed an awesome job working from home. We decided it would be a good time to at least stop not trying for a second baby. I confided in my good friend, Megan, and she recommended that I contact a local Doula that had been an excellent advocate for one of her friends. I called Amanda and loved her right away. Daniel and I met her for a consultation in early March. She had recently given birth to her fourth baby, her second VBAC at home. Amanda had an unplanned C-section with her first and VBAC’d in a hospital with her second. I felt comfortable and connected with her because of our shared experience, and I looked to her empowering and transformative VBACs as examples of what I wanted for myself. After a long, emotional talk, I knew I wanted to work with her when I became pregnant. Coincidentally, I already was.

A few weeks later we had a positive home pregnancy test. Again, I wasn’t surprised with the result. This time I could detect small, nearly unnoticeable changes in my body shortly after conception. My son had also run up to me a week or two prior, put his arms around my waist, kissed by belly and said, “You have a baby in your tummy!” Amazing how perceptive our little ones can be.

Some old financial fears popped up, and again, we didn’t have health insurance. This time we didn’t have a choice. In Texas, maternity care was only covered through group insurance. Since my husband was an independent contractor, we did not qualify. Additionally, our family income was slightly too high to qualify for Medicaid. We needed to pay out of pocket. Fortunately, home birth expenses were less than a third of the cost of a hospital birth. We shared our happy news with immediate family members, and despite some expressed concerns about our financial situation and plan to birth this baby at home, everyone was excited.

I called Amanda and signed a contract to book her for our home birth. I also asked for midwife recommendations, specifically care providers who were very familiar and supportive of VBAC. I continued with my own research and started making calls. Because my due date fell during the holiday season, I had some difficulty finding someone to take me on as a client. In the end, I was able to set up consultations with three women. All of them were wonderful, but we chose Sandra as our top pick. She was so calm, understanding and supportive. Exceedingly experienced, and passionate about natural birth. She also happened to be the midwife for Amanda’s first home birth, which I didn’t find out until after we hired her. Another happy coincidence: our birth photographer, Nicole, had worked with both Amanda and Sandra before. There was something so serendipitously sweet about building a birth team who had all worked, and/or birthed together in the past. I felt like I was in very good hands.

Overall, my pregnancy was easy. I did notice that my morning sickness was more severe this time, but didn’t fixate or even think about being pregnant much. Sometimes I’d forget I was expecting at all since I didn’t start to really show until six or seven months. I was keeping up with a lifestyle change I’d started at the beginning of the year: a healthy diet of mostly whole foods, no refined sugars, no wheat, and no dairy five days a week, plus walking three miles a day with light strength training and calisthenics fives days a week. In five months I lost over forty pounds and had never felt better.

We found out we were having a girl. Sandra visited us once a month, every two weeks, and then weekly in our home for prenatal check ups. Baby was growing and her positioning was ideal, my weight and blood pressure were excellent, and Sandra answered every question we could come up with. My friends hosted a beautiful baby shower and blessingway for me. My husband and son showed me such fondness and affectionate care. I felt so much positive encouragement and love from those around me that I thought my heart would burst.

I was feeling more and more secure with my decision to birth at home, but couldn’t shake this feeling of unpreparedness and that I wasn’t doing enough to give myself the best possible chance of a successful VBAC. I talked with my birth team and friends about these feelings, and all reassured me that I was doing so well and should be patting myself on the back for everything I was doing right. Always the overachiever, I booked two appointments with an amazing chiropractor, Dr. Long, who specialized in prenatal adjustments. I started reading the birth stories from Ina May’s Guide to Childbirth. I listened to and read birth meditations and affirmations. Most importantly, I accepted some very good advice from my friend, Taryn, who explained that some of my worries and fears might never completely go away. That the most important task was to keep replacing negative thoughts with positive ones. I could do this. My body was built for this.

It was Friday, one day shy of forty-one weeks, and I began to feel some minor, but regular contractions. They were practically ignorable, and I was able to go about my day. I attended my second appointment with Dr. Long for another adjustment, went out to dinner with my family, and had a biophysical profile sonogram to ensure that all was well to continue this pregnancy postdates. Everything looked great, and I felt good about allowing this baby to choose her own birthday.

That night, contractions intensified slightly and became steady, lasting about thirty seconds and coming every ten to fifteen minutes. Let’s be real: it hurt. I thought I was prepared to be Zen and wanted so badly to be one of those ladies in the birth stories whose “rushes” felt empowering. Nope. Mine just hurt. I breathed through them calmly, took baths, squatted and rocked on a birthing ball, but felt I had to work through each one and got very little sleep that night. By morning, intensity and frequency had subsided and I was able to catch up on some rest. This less intense pattern continued for most of the day and I did my best to ignore them. I was tired, emotional, and had no appetite. I was tolerating the contractions as well as I could and I knew it was highly likely that this was just pre-labor; my body revving up for the big show.

Saturday night was more restful than Friday, but still uncomfortable. I managed to breathe through contractions in bed and slept through many of them. Sunday afternoon brought with it a welcomed break. My contractions became so spaced out and mild that I hardly noticed them. I still didn’t feel comfortable enough to leave the house, but was able to eat a little and participate in my normal Sunday activities at home.

I was looking forward to a night of uninterrupted sleep, but by midnight I was in a pattern indicative of active labor. Contractions were now coming every three to five minutes and lasting for a full minute. I did my best to rest, but these were impossible to ignore. I found myself working hard again to get through each wave. For the first time, baths didn’t seem to alleviate the discomfort. With each contraction I would jump to my feet to lessen the pressure on my pelvis. Daniel stayed awake with me for support. The hours passed surprisingly quickly and by Monday morning I was pretty sure this was the real deal.

At 7:00 AM I checked in with my birth team to keep them in the loop. Everyone was excited to hear about my more promising labor pattern. I continued to labor, sitting on my birthing ball in the master bathroom. Contractions remained consistent and intensity was building. I asked Daniel to start preparing Micah’s things so Grandma could pick him up when he woke up. Daniel offered to make me breakfast, but eating was the last thing I wanted to do. An hour later, I was beginning to feel at my limit for coping without more labor support. Sandra suggested I call Amanda and ask her to come over. At 9:30 AM, Amanda arrived as I was saying goodbye to Micah. I had expected this moment to be an emotional one for me, but Micah was so excited to spend the day with his grandma that feeling sad didn’t seem like the appropriate reaction. I gave him a hug and a kiss and he skipped out the door.

Amanda and I got to work immediately. The first thing she did was shift my pelvis forward on the birthing ball with the next contraction. This went against everything I had been doing during labor so far. This new position intensified and engaged the pressure I was feeling. Amanda basically took away my crutches and helped me face what I had been running away from. She encouraged me to vocalize with low tones, getting louder as the contractions peaked. She breathed every breath with me. She rubbed my back and my shoulders. She talked me through mental blocks. She was absolutely essential. For the next two hours, she had me labor in several different positions: hanging my arms around Daniel’s neck while swaying my hips with bent knees, doing a similar motion while leaning against my piano or a door frame, and seated on the toilet. This last one was the most challenging for me and it took every ounce of willingness I had to not jump up with each contraction. At the end of a cycle of contractions on the toilet, I was feeling pretty depleted. It seemed clear that I was in active labor and that it was time to let close family and friends know. We lit my blessingway candle and Amanda suggested calling Sandra over to check my progress.

Sandra arrived at 11:30 AM, along with our birth photographer, Nicole. I was working through a contraction when she approached me and as it subsided I looked at her and said, “I’m so glad you’re here.” She gave me a hug and said she was glad she was here too considering another client had gone into labor and had her baby that morning. She didn’t want me to worry, but that was the reason she was unable to come sooner. After a few more contractions, I got in bed for my first pelvic exam. I was 4 cm dilated and sixty percent effaced. We were thrilled with this progress considering my cervix was completely closed a few days before. Baby’s fetal heart tones sounded great. She was tolerating labor well. After my exam, Amanda encouraged me to stay in bed and labor while side lying. She laid with me for a while, breathing and vocalizing through each contraction. I was exhausted and drifted to sleep between them, but at some point I couldn’t sleep anymore. Amanda made me an english muffin, which I was barely able to eat half of. It became clear that we probably had a long day ahead of us and my birth team needed rest as much as we did. Sandra and Nicole left first. Amanda left after coaching Daniel on how to create counter-pressure to relieve contraction discomfort. She also gave us a game plan of activities to cycle through on our own: walks, food, different labor positions, showers, and funny movies.

For the next six hours Daniel and I worked together, but I felt concerned that my progress was only the result of Amanda’s magic touch. I had also reverted back to some of my bad habits of avoiding anything that felt like too much pressure. I began to feel like I couldn’t do this anymore. We continued to communicate with Amanda via text and she suggested we ask Sandra to come back to check me again.

Sandra returned around 5:30 PM and performed another pelvic exam. My cervix was 5 cm dilated, thinner and very stretchy. Even though this was progress, my heart sank. Old fears of “failure to progress” surfaced along with new fears of my ability to handle multiple more hours of natural labor. Sandra encouraged me to relax and yield to the contractions. To let them feel heavy and strong. To soften my face, my shoulders, my hands – not to tighten my leg muscles or curl my toes. She explained that this extra rigidity was working against what the contractions were trying to work toward. She reminded me that even though this birth was on my terms, it was not within my control. That it was ok to have a good cry – perhaps it would help release some of the tension that was holding me back. I had been extremely emotional during the three days of early labor, but I hadn’t cried once during active labor and didn’t feel like anything would well up anytime soon. Sandra left again and I continued to labor.

I asked Daniel to call Amanda and ask her to come back. The timing was terrible. If she had left her house then, she would have sat in traffic for over an hour trying to get to us. She said she would delay leaving until rush hour passed, but would come as soon as she could. During the two hours between Sandra’s departure and Amanda’s arrival there was a notable change in my contractions. At their peak, I felt my body spontaneously pushing. This concerned me, because I knew I wasn’t fully dilated. I did my best to breathe through these powerful urges, but it was often beyond my control.

Doubt flooded my head. I felt less and less hopeful that this baby would be birthed at home and that it would be birthed vaginally. I didn’t feel like I could go on for much longer. I started imagining a transfer to the hospital, another unplanned surgery, and all of the medical bills that would pile up. I felt like I was failing.

Amanda walked in the door around 8:00 PM. She asked how I was and I responded, “Miserable.” She smiled at me and said, “Now you look like a woman in labor. The difference between how you look now and how you looked this morning is huge.” I expected her to jump right back in to working through contractions with me, but she wanted to talk first. She asked if I had cried yet, which I hadn’t. She asked what I was most afraid of, what was holding me back, what was keeping this baby from being born. I felt so disconnected at that point that most of my answers were “I don’t know.” I was able to articulate my fear of failing and of having another C-section. I told her I wasn’t sure if I could do this anymore. She responded that there were other options. I shook my head and said I didn’t want to give up. Amanda said she wouldn’t view choosing an alternative option as giving up, and then suggested talking through what a repeat C-section would look like for me. I sat on the birthing ball in my kitchen and stared at the floor as she described transferring to a hospital, checking in, getting prepped for the operating room, getting an epidural, lying down behind the blue sheet. She talked about how Daniel would be right there, holding my hand and kissing my forehead. That she and Sandra would be there, advocating for me. Nicole would be there to document the whole experience. That our baby would be born and it would be beautiful.

I sobbed. I sobbed like a baby. Amanda hugged me tightly. Through choked back tears I explained that what she was describing was the complete opposite of my C-section experience with Micah. That it was hard for me to see a C-section as anything but traumatic and lonely. She made it clear to me that it didn’t have to be that way again. In that moment of release, I accepted that I could find healing through this birth, no matter how she was delivered.

We began working through contractions again. Cycling from the birthing ball, to the toilet, to standing, to side lying in bed. I described the urges I was experiencing and how I was afraid I would hurt the baby or myself if I was unable to stop. Amanda explained that these impulses might be beyond my control and that it would be a good idea to have Sandra come back to check my progress and determine whether the spontaneous pushing was safe.

It was a little after midnight when Sandra returned. I was in bed with Daniel and Amanda, squeezing their hands and gritting my teeth through these particularly challenging contractions. I was able to get through some without pushing, but for others not pushing felt impossible. Sandra prepared to give me another pelvic exam. It was difficult to stay positive. I expected more slow progress, if any. After checking me, Sandra looked at me and said, “I wasn’t optimistic on the drive over here, but I am now. You’re 8 cm with a cervical lip, fully effaced and very stretchy. You are going to have this baby at home tonight. I’m going to get my birth supplies from the car.”

I was ecstatic – and in transition. Amanda brushed my hair back off my forehead, locked eyes with me and excitedly said, “No wonder you were losing your shit!” I smiled and even though I wasn’t able to show it at the time, I felt hope again. My body wasn’t broken. It progressed this far on its own. No induction, augmentation, or medication. It was working hard toward this birth, just at its own pace.

Another wave of difficult contractions hit. They felt like they were overlapping each other. My ability to ride through the peaks while managing my urges to push lessened as time went on. Daniel was instructed to call our photographer and begin filling the birth pool as Sandra set up her supplies in the living room. The noises coming out of me became more primal and shrill with each impulse to bear down, and must have sounded urgent because Sandra came back in to help support. Amanda and Sandra encouraged me to try different vocalizing and breathing techniques, which were sometimes helpful, sometimes not. Trying to restrain seemed impossible again.

Sandra sat down at the foot of my bed and suggested we try something different. She mentioned again that my cervix was very stretchy and that with all of this pushing she’d like to try holding my cervix open through the next few contractions to see if baby’s head might pass through. She explained that the process could be pretty uncomfortable, but I couldn’t imagine anything less comfortable than what I was already experiencing. She also clarified that if my body wasn’t ready, this wouldn’t work – but if it was, it could mean the difference of having this baby tonight or sometime the following afternoon. I wanted to try. I was exhausted and ready to have this baby.

We proceeded with the experiment, and on my next contraction I was instructed to pull my knee to my chest and go with my impulse to push. I felt no additional discomfort, other than what I was already feeling. I kept my eyes shut for the majority of the contraction, but happened to open them in time to catch a silent exchange between Sandra and Amanda that gave me confidence. After a second contraction Sandra checked fetal heart tones and said, “You are a champion pusher. You just moved this baby down in two contractions what takes some women an hour and a half to do. Your cervix is gone and your water bag is bulging. You could shoot this baby out, but when the time comes I want you to hold back so you can stretch. Baby sounds great – she doesn’t know it’s her birthday!” After a few more contractions, my water finally broke. It was a dramatic gush, but Sandra was prepared for it and had been holding up an absorbent pad. The amniotic fluid was stained with meconium. I knew this wasn’t ideal, but didn’t let it worry me. A few minutes later I felt ready to move to the birthing pool.

I stood up and took a few steps before the overwhelming pressure stopped me in my tracks. Hobbling those few yards from my bedroom to the living room was a challenge I had not expected. I climbed into the birthing pool and heard the front door open and shut. Nicole had made it just in time. It was difficult for me to find a comfortable position in the water, which didn’t matter much since Sandra wanted to listen for heart tones again. I could hear on the Doppler that her heart rate had slowed and Sandra asked me to use an oxygen mask while continuing to monitor her heart rate. There was some rebound, but it was followed by a dip to 90 bpm. Sandra said she might need to move me back to the bed and that we needed to get this baby out now. She told me to forget about holding back and to push with everything I had.

I got into a squatting position in the water and planted my feet. Daniel held one of my hands and Amanda held the other. I could sense the tension and fear in the room, but I didn’t feel afraid. I knew everything would be ok and was ready to meet my daughter. With the next contraction I pushed and kept pushing, hard. Baby began to crown immediately and Daniel cheered on my progress, “You’re doing it! You’re doing it!” Amanda encouraged both of us to reach down and touch our baby’s head. As we did this, reality sunk in. I was about to have another baby, and I was about to VBAC. One more push and her head was out. I remember thinking that the hardest part was over and that birthing the rest of her should be easy, but after several more pushes she seemed to be stuck at the shoulders. Sandra told me to get onto my hands and knees. I pushed a couple more times from this position, felt intense burning, and seconds later at 2:59 AM on Tuesday, December 10, over eighty hours after my labor first started, she was born. Sandra passed her through my legs and lifted her out of the water onto my chest. I leaned back against the side of the pool, let my head fall back out of exhaustion and cried. Daniel kissed me. I looked at my daughter and she was perfect. Pink and bright-eyed. Sandra suctioned her nose and mouth and Amanda urged me to talk to my baby because she would recognize my voice. Moments later we heard her first cry.

We named her Milena Rowan. She was seven pounds, ten ounces, and twenty-one inches long. I stared into her eyes as we nestled in the warmth of the birthing pool, enveloped by the love and support of Daniel and my birth team, surrounded by twinkling white Christmas lights. My blessingway candle still burning on the dining room table. I silently thanked the universe for allowing us the birth of our dreams.

After the umbilical cord stopped pulsing, Daniel cut it. I passed Mila off to him for some daddy-daughter bonding and delivered my placenta. Amanda helped me out of the birthing pool and into my bathroom to shower. Sandra examined me and we were both pleasantly surprised that after pushing a baby out so quickly I had only sustained a couple of very minor, small tears. She told me that they would heal on their own but would heal faster if she stitched them up, so I consented to that. Meanwhile, Daniel brought Mila in to nurse for the first time. Amanda helped us establish a good latch and I successfully breastfed my baby within an hour of her birth. I felt amazing, triumphant, and so incredibly grateful not to be contracting anymore. I thanked each member of my birth team for everything they had done to get me here.

In the following days, both Sandra and Amanda came over to check on baby girl and me. I was able to happily report that I was feeling great – physically and emotionally, that breastfeeding continued to be successful, bonding seemed well established, and that Micah was adjusting surprisingly well to being a big brother. With each of them I was able to recap the birth, ask questions, and discuss the answers.

Sandra explained that baby’s heart rate dipped because the umbilical cord was looped against the side of her face and got pinched as she descended into the birth canal. That this added stress to baby could have been the cause for meconium in the amniotic fluid. Either that or a result of her being postdates. Throughout the pregnancy we had calculated my estimated due date based on when I believe we conceived instead of the standard first day of my last menstrual period. This gave me an extra week to gestate without the pressure of going past my estimated due date. Milena was born at forty-one weeks, three days. If we had calculated based on the standard, she was born at forty-two weeks, four days. Sandra mentioned how lucky we were that my water didn’t break until right before delivery – that if it had broken earlier in labor, umbilical cord prolapse would have been likely. She clarified that our circumstances would have been equally tense and scary in a hospital setting. I understood and even with this potentially disastrous situation that no one could have foreseen, was glad and completely comfortable with the fact that I birthed at home.

Amanda focused more on my feelings about the labor and delivery in retrospect. I was surprisingly emotional and shared with her that I was disappointed in myself for not being able to cope with the contractions as well as I’d hoped. I had wanted to be the epitome of serenity but felt my reality was that of a hysterical woman. She assured me that I wasn’t perceived the way I saw myself. She asked, “Are you this Zen character in real life? Or are you a passionate, emotional person that reacts strongly to what goes on around you?” Clearly, I’m the latter and told her so. “Then why would you expect yourself to be any different during labor? Labor often brings out the most pure and raw version of you. If you’re naturally intense, it is very likely that your reactions to labor will be intense.” She went on to remind me that I had made a huge leap from an induced, medicated, C-section birth in a hospital to a completely natural, unmedicated, VBAC at home. “Drastic change like that does not come without struggle.”

I think I can say with some surety that having a home birth after C-section is the hardest thing I’ve ever done. It pushed me to, and beyond what I believed to be my limits, both physically and emotionally. Birth, for me, was far from easy and there were many dark moments where I seriously questioned my ability to go forward. I am so glad that I had such wonderful advocates who had faith in me even during these times of self-doubt.

This entire experience has been a transformative one for me. Not just the victory of a successful VBAC at home, but everything that led up to it – including the C-section that started this whole journey. I have learned so much along the way, about birth and about myself. I strove for the birth of my dreams, waded through fears when some ideals didn’t manifest as expected, and subsequently grew as a person, a woman, and a mother. I will be forever grateful for the healing I have found as a result.