Why Out-of-Hospital Birth?

More than 3 years ago, pregnant with my fifth baby and just over 41 years old, I decided to really look into my options in having an out-of-hospital birth. I trusted my body. I had two unmedicated VBA2Cs in the hospital behind me. I loved my hospital based midwife (and still LOVE her), but I really wanted to experience the difference in giving birth in a home. This plan led me to pursue co-care, continuing to see my hospital based midwife throughout my pregnancy, as well as crossing state lines to where homebirth after cesarean was alegal.

There is no situation that is risk free. In my experience and in my research, I accepted the risk I was comfortable with. I had a plan in place to control what I could if things became emergent. I communicated honestly and openly to my care team, nurtured my body, mind and spirit throughout my pregnancy and prepared for another empowered birth experience; this time, just not in the hospital.

In the weeks leading up to labor, I was ready. Over it. Ready to meet my baby, to be finished being pregnant, and ready for the mental game of “when will this labor begin?” to be finished. One day, with the early morning sun, I woke up to three strong surges (nearly identical to the beginning of my labor with our third and fourth babies), and I knew this was finally our new baby’s birth day. I labored at home with my husband. I breathed, did hip circles on the birth ball in our room, moved to hands and knees, rested in my own bed. I notified my team, including my mom, our birth photographer, Kalla Elwell and my doula Steph Swasey (so grateful for them) who came over quietly, calmly, happily one by one. My husband made homemade pizza in the kitchen for everyone to eat as they wanted to, including me. I paced outside in the sun barefoot, feeling the heat of the pavement on my feet, breathing in the fresh air. Our kids were all with family members, taken care of and enjoying their day as, dare I say, I was surely enjoying mine. Labor isn’t easy. For me, that never meant that I wasn’t going to find joy in it. Connecting to the power inside and outside myself, breathing deeply, sending love to my baby, and surrendering to something far greater. Yes, it was hard, but it’s also so incredibly meaningful. This is not just a physical experience. This is not just a means to an end. It is affirmation. It is self-discovery and transformation. It is deeply personal.

When my surges grew more intense, I moved to my shower, allowing the warm water to wash over me. I breathed and moaned and swayed. My husband came up into the bathroom and sat nearby. Listening to and observing me, he suggested that we may want to think about making our way to our birth space. Slowly, in my own rhythm and time, I got out of the shower as my doula, mom and husband prepared the car and brought our things. My doula sat with me during the car ride as I moaned and swayed on hands and knees, leaning on the back seat. In between surges, she would gently jiggle my sacrum, and I remember it feeling amazing though I could not tell her. I could not and did not want to speak. From her, knowing full well what she was witnessing, came constant, soft encouragement. I felt consistent support and love. Slow and steady, moving through my labor.

Once we arrived at our birth space, I remember a moment of mental clarity and looking out the window to take in the woods and trees around me everywhere I looked. It was beautiful. The sun was still shining as early evening hours were approaching. My surges intensified, my moaning grew louder. I held my husband and swayed. I cried as the faces of my other kids kept coming into my thoughts—their beautiful, innocent faces. Not crying in pain, crying to release. Crying in response to whatever needed to come out. At a certain point, I distinctly remember feeling like I wanted to roar, which was not a feeling I had with my previous experiences. Again, not roaring because of pain, roaring because everything felt so primal. Still, the people around me moved as they needed to in support and in attending to my and my baby’s well-being, always quiet and always centered in calm and love.

I moved to the shower in my birth space and soon after, felt my water release. In minutes, I felt the urge to bear down. I moved in any position I chose—sitting on a birthing stool in the shower at first, hands and knees in the bathroom, birthing stool in the bedroom, side-lying in bed, hands and knees in bed. Baby was descending slowly, which was normal for me in labor. No one position felt spectacular, which was frustrating and annoying. I just kept moving and searching for what position was going to provide relief. My previous experiences had taught me the same. I remember struggling to keep mental stamina. I had to remind myself to breathe. I had to affirm myself in my head—I could do this. I have done it before. Keep going. Keep listening to my body. When I asked for suggestions from my team, they were given. Water was given. Cool rags were always there on my head and neck. I was always supported. Someone mentioned trying to walk to the bathroom. No way. I could not do that. There was no way I could get up from sidelying on the bed. Everything was too intense. I couldn’t find the break between surges. They just kept coming. My energy was waning, and I said as much. My team gently encouraged me. Reluctant, hot, sweating, exhausted, I got up out of bed. Another surge. Why was this taking so long? Aren’t subsequent babies supposed to come faster? All the doubt was flooding. I leaned over and put my hands on my knees. I took one giant step with my left leg, another giant step with my right leg, and then my surge ended. Ah, relief. I straightened up and walked quickly across the room into the bathroom before the next surge began. I sat down on the toilet, and almost immediately felt my baby’s head descend and crown as I relaxed my pelvic floor. The baby is coming. I told my team. I kept my hand on my baby’s head as my uterus contracted and my breath eased his head out a little more, a little more. Gentle. Slow. I stood up, my care team all around me, waiting patiently, expertly. No yelling, no urgency—watchful and ready. My knees slightly bent, my hand still on my baby’s head as his head came all the way out. I lowered my other hand, eased out the rest of his body, felt both of my hands on his body. I had him. I knew with confidence, with everything in me that I had him in my hands. With gentleness and with all of my love flowing through my hands into him, I brought his little body up to mine just as one of my sisters arrived to witness. And just like that, intensity over. No more surges. Just elation, disbelief, ecstasy flooding through and around me.

I sat back down on the toilet, holding my baby and looking around the room in disbelief. Did I really just catch my baby? Standing? That was not how I ever pictured it, but I sure did love that that was our story. After I collected myself, my care team ushered me gently back to the bedroom. Once in bed, they covered baby and me from the waist up so they could observe me for the birth of my placenta. All around me, everyone was smiling and calm. Alicia Keys was crooning in the background, candles were lit, and every touch from my care team was gentle. My placenta came within 20 minutes or so. My bleeding was normal. My perineum intact. My care team ordered soup and made tea. My family ate with me and loved on our new baby. It was quiet and slow and dreamy. When I was ready, they helped me into the shower where only two hours before my waters had ruptured. I got dressed in comfortable PJs, and slowly, we loaded our things in our car and drove home. Our doula helped get us situated at home. She stayed at my side as I got into bed and got comfortable while my husband brought in our things. Eventually, she said goodnight. She and my care team would be back the next day to check on us. My husband, our new baby boy, and I were all alone in our bed—safe, quiet and surrounded by love. Uninterrupted. Undisturbed, and so very grateful.

Every birth experience I have had taught me so much. This particular experience showed me how gentle birth can be. It showed me what it feels like to be surrounded by calm and love throughout labor, birth, and after the baby is born. There was no chaos. There were no loud voices. There were no commands. My hospital midwife is the best I have ever seen. She also is a consistent loving, gentle, encouraging presence in labor. She is the best. This last birth was different because even after the baby was born, the environment did not shift to a hurried and frenetic pace by others. It stayed calm. Fundal massage was gentle. Any hands that touched my baby other than mine were gentle. My baby and me were the center of the experience. Our needs were ever attended to with ease and calm. It was a truly beautiful experience start to finish, and it was a sweet closing to the various birth journeys for our family-from primary cesarean for breech presentation to a “failed” trial of labor and a repeat cesarean, to our first unmedicated VBA2C in the hospital, to a second unmedicated VBA2C in the hospital, and finally to our out-of-hospital birth. As always, I remain in awe of birth, of our bodies and all they are capable of, and of the power we have when we just surrender.