born at home.

Written by Alex Louise
10.1.2010

This is not solely a story about hours in labor or number of contractions. It is actually less a story about our son’s birth and more about the winding path that led us to that Sunday in March 2009. For as always, the road less traveled it is not a straight path but instead one that is full of road blocks, detours and speed bumps. And it all began 16 years ago. 
 
On a rainy Sunday evening, my freshman year in college, I ended up in the student union listening to a group of local women sing the accolades of the midwives who had helped birth their children. Unexpectedly and for the first time I was hearing a language I had known all my life but had somehow forgotten. That evening, as the rain rhythmically beat down upon the glass skylight above, a seed was planted. At 19, still convinced that I need not marry but certain that I would have children one day, I instantly knew that my babies would be born at home.
 
And that was that. I remained interested in women’s issues surrounding health and reproduction but it wasn’t until years later when I found myself signing up for a post-partum doula training that the seed would finally would get some water. Enthralled but a bit put off by the “hippyness” of the class materials and the other attendants, I kept my attendance in this class to myself. I had just returned from working in the fashion industry in New York City and was now sitting on the floor, drinking herbal tea and learning about sitz-baths and perineum care in the musty back room of a natural childbirth resource center in San Francisco. I was 25. 

For the next 5 years, I took doula trainings and flew to international midwifery conferences. I read birth books and watched badly made home birth videos. I became home births greatest verbal advocate. In action, I was restrained and immobile for two reasons: First, I had not yet given birth and second, no role in the birthing community seemed to suit me. I often asked my teachers if they felt it mattered that I did not have the visceral experience of giving birth and ultimately they all side no. But it mattered to me and that was enough. I continued to passionately support homebirth, denounce medicalized hospital births and haphazardly walk through the maze of the birthing community in the Bay Area. The closest I got to a role that suited most parts of me, was as manager to that same small resource center that had now moved and gotten a coat of paint and a breath of fresh air. There I learned that the organized and aesthetically able parts of myself had a home in this community as well. But I quickly grew frustrated with the lack of funds, lack of organization and lack of medical community support for midwives and natural birth and out of sheer overwhelm, threw up my hands. “I am out”, I proclaimed - I can’t be a pioneer and pay off my student loans. 

Somewhere during this time, I met the man whom I would later marry. When I was still dating him, at one point I found it necessary to tell him that our children were going to be born at home and I was simply giving him ample time to get used to the idea. He looked at me with that glassy look of disbelief and then approval that happens when someone you are dating says something that you know might affect your life significantly but you haven’t been together long enough to make too much out of it. I was satisfied that this important man now had heard my important news and with that I stopped paying attention to birth altogether. 

Until one day in late June 2008. We had returned in May from 10 months of travel around the Pacific Ocean – our hearts were wide open, our minds were still and calm and we had the renewed sense of clarity that comes from removing yourself geographically from jobs and old habits that no longer suit who you are. Open to the idea that we could potentially be ready to start our family and believing that as with many of our friends it could take a while, we threw caution to the wind. I think the final words were something like, “Let’s just see what happens.” A few weeks later, driving on the non-descript section of Highway 101 between Monterey and San Francisco that I had driven hundreds of times in my lifetime, I just knew. I knew that if I took the next exit and went into Target and bought a pregnancy test and peed on the stick that there would be two pink lines. 

Two pink lines, an OB appointment to confirm and a conversation with a surprised yet ecstatic father-to-be later, I was standing like a deer in the headlights. “And what the *$^# now?” I thought. I was totally removed from the birthing community, we were still using our travel insurance that was about to expire, Natural Resources had been sold and had moved, our apartment was so not the home I imagined having a baby in, I thought had forgotten everything I had learned and I was scared – because now every decision I made was no longer just “in theory”. 

I went straight to Natural Resources asked for Cara (the owner at the time) and blurted out "Help, I have forgotten everything I know and I have no idea what to do. Is Yeshi still doing her thing at St. Lukes? We can't have a home birth because our apartment doesn't feel like home and it’s too small." She smiled, assured me that all my knowledge would come back, that Yeshi was in fact not involved at St. Luke’s anymore and that my best bet for a midwifery assisted hospital birth was with the nurse midwives who were working at CPMC. I got in the car, looked at the piece of paper in my hand and couldn't believe that I was thinking of having my baby at a hospital and that that hospital would be CPMC*. 
 
This detour lasted almost 5 months. After only two appointments, I was informed that the first nurse midwife I had been seeing was leaving the practice. Okay, I thought, there was still one left and I really liked her and this would be fine. I buried moments like when I was in the waiting room and another expectant mom leaned over the appointment counter and in hushed tones asked, “Can I see a real doctor for my next visit – I’ve only been seen by the midwives?” I kept reassuring the now screaming internal voice of mine. At least I thought I was reassuring it. But something was cooking and it wasn’t just the bun in my oven.

I suppose I knew something was up. I extended my toes into the midwifery waters and found myself on the phone with a rather straight forward, no bullshit German midwife. Yes, she would do my pre-natal care and then assist me in having a hospital birth. But she was insightful and immediately clung to the homebirth fire that was buried somewhere inside me and she didn’t let go. I think she said, “If your apartment isn’t right for homebirth, then move.” The tower of excuses I had built was crumbling, right there on the phone. And what came brutally aware to me was that I was concerned more with having control over the first precious hours of our baby’s life than the actual birthing process. As I pressed End, the decision to birth our baby at home was gaining momentum. 

Several regular appointments with the remaining nurse midwife and the big 18-week ultrasound later, I was informed that this second nurse midwife was leaving this CPMC practice. Ironically, it was our relationship that had reminded her of own homebirths and her true philosophy that was being squelched within the confines of this particular OB practice.  She told me that I could stay on with the regular OB physicians but that I should know that they would not be adding any new nurse midwives to their practice. Several horrendous Yelp reviews of the OB’s in this practice and my inability to relax every time I got near the hospital helped me to say, "Alex, run home.” 

And so I ran, straight to the Bay Area Homebirth Collective. And here is where I had an advantage. You see, I knew these women, I trusted these women, I had recommended these women, I had learned from these women. I wasn’t starting from scratch and that was a truly divine gift reconsidering I was changing my prenatal care only a few months before I was expected to give birth. I already had the relationship, now I just needed a bit of pre-natal care and some instruction on when to push. And I needed my husband to trust my choice as much as I did – with the care of his wife and unborn child.  And all it took was one meeting. 

Aside from several aggravatingly bureaucratic conversations with Blue Cross, morning sickness that turned into most-of-the-time sickness and debilitating sciatic pain that finally was relieved with cupping (a Chinese healing modality that leaves you temporarily tattooed like an alien), the remainder of this pregnancy went without controversy and problem. My prenatal visits morphed into total self-care as they went from barely 5 minutes to almost an hour. My nesting instinct jumped into hyper-drive, for now home suddenly meant home in a whole new way. Our attendance in the Mindfulness Based Childbirth Preparation class not only empowered us to use our mindfulness practice during birth as a powerful pain management tool, it solidified our commitment to each other and our decision to have our baby at home. 

Most applauded our decision and were far from surprised. We only heard the “we were so nervous for you and kind of uncertain about your decision” after our son's birth – which I suppose is a better time to hear it than before. Regardless, our experience moved some to tears, others to question everything they knew or thought they knew about birth and others to birth their own babies at home, only weeks later. 

This was all how we go to the at home part of this story. Here's the born part - written by me, a year afterwards.

It's a day in March 2010 and I am sitting in our living room, looking at the corner that changed my life. 374 days ago, on March 22, 2009, I gave birth to a little boy in that exact corner. And it went something like this.

It was Friday night, a week before my determined due date. First babies come late – everyone knows that - everyone but my mother that is. She was convinced, as I was a week early, that this, her first grand-child would be no different. And yes, she was right. We were watching some movie and just like that my water broke. There is no question – you can’t not know, because suddenly you are leaking and leaking and leaking some more. All the way down the hallway, into the bathroom and then some. I was overcome with this euphoric sense of giddiness and sheer terror – knowing that I was about to embark into the land of “who knows what the hell is going to happen.”

I had had no contractions. I knew this was as normal as having contractions first and the assurance of my midwife, whom we called immediately, didn’t totally satisfy me. I proceeded to make my first rookie mistake. I went straight to Google and typed in "water breaking before contractions". Women in labor should not be allowed access to Google. Nor should sleep deprived parents. Or parents of an infant who has their first cold…the list goes on. Though each search result assured me that this was in fact very normal, it also demanded I contact my care provider immediately and head straight to the hospital “because of the increased risk.” Any woman who has a tub in her living room and a supply of homebirth accessories waiting in the corner doesn't want to read these words. My trained mind knew that the risk was increased mostly by internal exams and if I had no internal exam I should be fine. So off went the computer and I tried to follow our midwife's adamant suggestion to sleep.

Sleep? Really. With thoughts like “I am probably going to have a baby by tomorrow and Google says that its high risk that my water broke and I am at home and...” running through my distracted mind, I tried to get some sleep. I can't remember now if I was able to sleep though it seems more accurate that I was feeling like the night before the first day of high-school - that eager anticipation of complete excitement and sheer terror running through your veins at the same time, which keeps you from falling into deep and restorative sleep. But I tried. And my husband tried. Actually, he didn’t try, he just slept.

Saturday morning arrived with little change: still no contractions and still no worry or concern in our midwife's voice when I checked in with her. There had been flutters of internal tremors but nothing that stopped me in my tracks. The results of the internet search from the night before were tucked into a small little alcove somewhere in my brain, where I let them rest. We just had to wait. 

The waiting and the seeing gave my husband the opportunity to go to Trader Joes and return with groceries enough for a small army. In our heads, we still had a week and since the unproven standard for first babies is overdue instead of early, we hadn't filled the tub or set up a call list. But we had time now. I made myself comfortable on the couch while my husband took on the dubious task of assembling the birthing tub. Instructions, birthing vest, water bottle, and hose - the whole adventure was more like watching someone put together an IKEA dresser for the first time. I watched, as he with meticulous precision and grounded stillness, laid the foundation, erected the walls and began to fill it with water. He was as calm and focused as a master builder working on his craft - he showed no signs of worry or distress about the fact that he would soon be watching and experiencing his wife move through the known yet unpredictable stages of childbirth.
 
More internal tremors, still no real action. We even had two friends stop by who came up the stairs wide-eyed and jaw dropped to find such a quiet and serene scene. "We thought we'd be able to hear you screaming from Haight Street" he said. And I simply laughed and said, "Oh, that might still come."
 
How and what happened next is not exactly clear as I write this a year later, but somehow we both wanted fresh air and we both wanted food and somehow the logical destination was Memphis Minnie’s, just a few short blocks from home. We figured we'd be close enough to get home if necessary. I remember walking down Haight Street and the early scattering of Saturday night party goers were starting to mingle in the open bar doors. Everything seemed exaggerated - the sounds, the colors, the movement of the Muni buses and the rustling of the trees above. And yet, nothing was different. Just another Saturday night, with a laboring woman walking down the street – nothing too abnormal for San Francisco, right?
 
In line at Memphis Minnie’s, I noticed another big belly a few people down. Please forgive the reference to the belly and not the woman, but at this point of the process, I identified only with the big round belly that was navigating most of my existence. We smiled at each other in acknowledgement and I asked when she was due. With a tinge of eager anticipation, she chimed "In a few weeks and you?" to which I replied, "My water broke last night". I wish I could have caught the image of her eyes popping out of her head on film but it will simply have to live in my memory as I remember it. I explained that we had planned a home birth and assured her that everything was fine. I wonder if Memphis Minnie’s has ever had a woman in labor eating their BBQ ribs and downing 3 glasses of their Sweet Tea, which by the way was my second rookie mistake but I’ll explain that later.
 
Regardless, we ate and giggled, slightly blown away by our present circumstance that was secret to the urban and hip dinner goers around us. Well, except the couple with the pregnant woman a few tables down from us who kept leaning in to see what we were up to. Maybe she was checking to see if I was doing some sort of special breathing. Mostly, I think she was just looking to see if I was real - who the hell sits and eats BBQ at a restaurant in San Francisco after your water has broken?
 
I guess I do.
 
Still later that night, there was no worry or concern in our midwife's voice and the tremors from my belly were coming every few hours. It had now been 24 hours. Had we planned a hospital birth, this would have marked their boundary and the required interventions would no longer be optional. Again, our midwife said to try and sleep. Without quantifying the potential of the experience, she simply said, "You need to rest. You will probably have a baby by tomorrow."
 
And if Friday night felt like the night before the first day of high-school, this was that night on steriods. There was no way that I was going to be able to sleep. I hadn't been sleeping well for the last 5 weeks, maybe more, and now I was supposed to just go to sleep. Between the body discomfort and the frantic excitement pulsing through my veins, I had no idea how this would go.

Patrick on the other hand, effortlessly and blissfully nodded into slumber land after having asked my permission to do so. I watched longingly. I tossed. And I closed my eyes. And I wondered. And I talked to myself. And I talked to the baby. And I got up to pee. And I read a book. And I tossed some more. And then I felt it - like a jolt of lighting into the depths of my body: my first real contraction. It was midnight.
 
At 3am, we called our midwife. Contractions were still not close enough, so she encouraged me to go back to sleep and told my husband to keep track of the timing between them. But they hurt. It hurt. And it hurt between the contractions in my lower back - the pain spreading like a wave crashing against the hull of a fishing boat in a winter storm in the Bering Sea. I could not lie on my back, I couldn't lie on my right, I couldn't lie on my left.
 
For hours, we moved from floor to bed and back to floor again, he reminding me to stay in the moment. Staying in the moment was the only way that I managed to get through the many moments that happened between midnight and the rising of the sun the next morning. I cried, I "om"ed, I closed my eyes, I thought about the fact that if I were in a hospital and someone asked me if I wanted something for the pain I would have said yes, I thought about how long I would be able to handle this, I thought about the spaces in between my contractions that were supposed to be pain free but weren’t, I thought about my immediate and extreme nausea and that BBQ was quite possibly the worst choice for dinner, I thought about this baby who was working just as hard as I was and I thought about the thousands of other women who had done this before me. I never questioned our decision to have this baby at home, even as I lay on the cold bathroom floor, hoping I wouldn’t lose my dinner, again. 

Most of the night is a blur, though I remember the distinct feeling of the pile of our carpet as I was trying to find a comfortable position to sleep and the ice coldness of the bathroom tile as I crawled on hands and knees to the toilet. But what I remember most distinctly is the moment when I was overcome with the intense urge to push and I calmly yet forcefully told my husband that we needed our birthing team now. I could hear him on the phone. It was a short conversation I overheard over speaker phone that went like this: "She has the urge to push" and then “We're on our way.” 
 
For the last early hours of the morning, my contractions progressed quickly, very quickly, catching all of us off guard. I had forgotten that many women vomit at transition which marks the beginning of active labor, but at the time I was faulting myself for my dinner decision and didn't tell my husband that this was a vital piece of information for our midwife to know at 3am. Minutes after the phone call, I heard the team of 3 women walking up our stairs. The light of day was streaming through the windows and I met them in the living room, after a slow and concentrated crawl from the bedroom. I perched myself up against the side of the couch and all I remember is her saying "You are fully dilated. You can go ahead and get in the tub." And I remember hearing my husband exhale and pausing with relief that the professionals had arrived.
 
Two hours and 17 minutes later, our baby was born. It took a few moments before we actually looked and learned he was a he. 

We had not planned a water birth. In fact we had not planned anything besides a homebirth. But even that in the last weeks of my pregnancy became a fluid and malleable concept. Our birth plan consisted of two simple words – Safe Passage. That was it. And if that meant a hospital or an unplanned cesarean or the use of forceps or for that matter a water birth, that’s how it would be. And I believe that this acceptance for whatever was going to be our birth experience, allowed us to have the experience that we did.

I heard someone say once that luck happens when preparation meets perfect timing. Were we lucky with our birth experience? Certainly. But that luck may have been more the result of our intense mental, relational and spiritual practice than some kind of spontaneous cosmic happening. And that practice was the simple yet extremely difficult practice of staying in the present moment, no matter what. On that Sunday in March 2009 that practice did not come without several four letter words and some tears. But it came, and it allowed me to be there, to really be there. In those early hours, I watched the world go from darkness to light, from stormy weather to cloudless blue over the roof tops of San Francisco. This was just another homebirth in a one bedroom apartment in the city by the bay, only this time, it was ours. 

*CPMC is California Pacific Medical Center in San Francisco. It is an excellent medical establishment and many families have had positive birth experiences there. It is medically able to handle high-risk pregnancies and birth which can impact a woman’s ability to have a low risk, intervention free birth there.