Home Birth

Alice Gilgoff

• Publisher: Open Road Distribution
• Year: 2016
• Print ISBN: 9781504029605
• eBook ISBN: 9781504029421
• Topic: Medicine
• Subtopic: Gynecology, Obstetrics & Midwifery

For women who believe that childbirth is a normal event, and that hospitals are places to treat illness, home birth with a licensed professional midwife is a safe and viable option. Unlike the rest of the world where home birth and midwifery are the norm, Western society has captured the traditional childbirth model and recreated it as a high-tech pathological event fraught with dangerous interventions. Yet, the United States continues to rank 20th or worse in United Nations statistics of maternal and infant mortality. When this book was first published in 1978, the convergence of the back-to-nature and feminist movements—and the rise of consumer advocacy in health care—contributed to a growing home birth movement. Today, a 40% cesarean rate and the universal acceptance of stay-in-bed electronic fetal monitoring, an unproven technology, are just two of the common hospital occurrences that keep some women at home for childbirth. Midwife comes from the German word that translates as "with woman." Research has shown that the close observation of an educated and caring woman makes birth complications predictable or preventable. Studies published in medical literature have documented that the care of educated, professional midwives is equal to or better than that of medical doctors, whether the birth takes place in the home or hospital. Home Birth reports on this research, as well as personal, practical stories of real childbearing families. The book reviews typical birth practices and gives advice on preparing both the family and the home for the event. There is also a chapter on preparing for hospital birth, should a transport in labor become necessary.

A Look at the Hospitals

Sheila Willis, also known as Patient No. 34688527, arrived at the University Medical Center with her husband, Tim, at 2:10 A.M. Actually, she was dropped off at the front door since he had to find a parking space for their car. This wasn’t always easy in the big city, even at night. It was no telling how far she’d have had to walk from the parking spot, and walking did not appeal to her now since she was in active labor.

It was their first baby and Sheila knew she would probably not have a fast birth, so they had stayed home for early labor, as the Lamaze teacher had suggested. Labor had begun eight hours earlier, with the sudden warm gush of the bag of waters as Sheila had been preparing dinner. Tim had eaten both their portions since Sheila had been warned not to eat anything during early labor but simply to drink a cup of warm tea. Now contractions were about five minutes apart and Sheila’s doctor had told her over the phone that it was time she headed down to the hospital for a “look-see.” Sheila’s heart had pounded excitedly when she left for the hospital. It seemed hard for her to believe the baby was really going to be born this day.

Sheila felt afraid, waiting on the barren sidewalk, so she entered the hospital’s main lobby. Having entered, she had a contraction and began panting as she had been taught in Lamaze class. “Can I help you?” asked the woman at the reception desk. When the contraction had passed, Sheila said, “No, thank you. I’m waiting for my husband.” The woman smiled and said, “No time for that. I’ll call for a wheelchair. Come here and give me your name.”

Sheila went over to the desk, sat down, and gave the woman her name. The woman found her file and began asking Sheila questions which hadn’t already been answered on the form, such as if and when Sheila’s amniotic membranes, which Sheila knew meant bag of waters, had broken. Twice as Sheila answered she’d had to lean over at an angle and grip the table edge as a contraction took hold of her. She wished Tim would arrive. The wheelchair came and Sheila sat in it. “Thank you,” said the orderly. “Last week a lady tried to refuse my ride. We had some time convincing her that no lady comes on the maternity floor without a wheelchair. We can’t take that responsibility.”

He wheeled Sheila into an elevator and then upstairs to an examining room on the maternity floor and left. A nurse greeted Sheila by name, helped her from the chair to the examining table, and placed her feet in the stirrups. Two men dressed in surgical greens came in. One nodded a greeting and held out his hand, which the nurse covered with a sterile glove. He inserted it into Sheila and spoke quietly to the other man. Then he pulled out his hand and let the nurse take off the glove. Sheila had another contraction and began panting and blowing. She remained in the same position on the table while the resident, as he must have been, made a phone call from the corner of the room. “I have your Mrs. Willis here,” he began. Sheila heard words like “start the ‘Pit.’” The doctor hung up and turned around to the nurse. “Take Mrs. Willis to the labor room,” he said, giving Sheila’s leg a couple of friendly slaps. “She ruptured a long time ago. I’ll write the orders for the IV.”

The doctor left and the nurse took Sheila’s feet out of the stirrups. “Is my doctor here?” Sheila asked. “That was him on the phone,” said the nurse. She helped Sheila back into the wheelchair and wheeled her to another room that looked like the first but a little smaller. Sheila was relieved to find Tim already waiting there. She immediately had a contraction, but this time she just panted. Tim stared at her with a worried and loving look.

Sheila was helped out of the wheelchair and asked to undress and place her clothes and personal belongings in a brown bag. She was given a short hospital gown to put on and directed to the bathroom. Sheila changed in there and came out holding the back of the hospital gown to make the two sides meet. The nurse helped Sheila up onto the bed and pulled up its side. Sheila felt like an overgrown baby in a crib. The nurse left and Tim came over and held Sheila’s hand.

Another nurse came in and Tim backed off. The new nurse said, “Time for your miniprep.” She pulled down the side of the bed, separated Sheila’s knees, placed her feet flat on the sheets and pushed them back toward her thighs. Sheila had to fall back on her elbows to catch her balance. The nurse began shaving Sheila’s pubic hair. Sheila was glad it didn’t take long and that she didn’t have a contraction because she was afraid she would move while the razor was there. When the nurse finished she left and Tim came over and helped Sheila back to a sitting position.

Then the nurse returned and Tim moved away again. “Here is your enema,” said the nurse. She administered it to Sheila and then quickly helped her off the bed. The hospital gown was falling off the front of Sheila’s shoulders, but the nurse was rushing Sheila toward the bathroom again. “Now I want you to sit there a full twenty minutes,” she told Sheila “I don’t want you out one minute sooner. I want you all emptied out. Don’t forget now.” The nurse closed the bathroom door. Tim asked Sheila if she’d mind if he got something to eat so he wouldn’t feel dizzy later and she agreed.

Sitting on the toilet, Sheila tried to lift her feet onto the edge of the seat because she felt uncomfortable with them on the floor. They seemed too low down. During her first ten minutes on the toilet she’d had two contractions. Each time she blew out she heard water spurting into the toilet. She wasn’t sure if it was coming from her vagina or her anus. After the second contraction she began to wonder how long twenty minutes would be. She had put her watch in the brown bag. She decided to count to sixty ten times and then leave the bathroom. She counted through two more contractions, panting as they came. She enjoyed counting and panting in rhythm and was glad the enema wasn’t as bad as someone in the Lamaze class had made it out to be. After the second contraction Sheila left the bathroom in a happier frame of mind and climbed back into the bed. She decided she would count and pant in rhythm for all the contractions she would have until Tim came back.

But thinking of Tim eating produced a strong wave of nausea in her. When a contraction began, she didn’t start to pant because she was afraid it would cause her to vomit. Instead she grabbed the bars of the bed and sucked in little breaths of air, a sort of reverse panting, which she thought would prevent her from vomiting. When the contraction ended and her eyes cleared, she realized the nurse was at the door looking at her. “I’m nauseous,” Sheila said, louder than she thought it would sound. The nurse smiled and said, “It’s too soon to be nauseous now. Most girls get it at the end.”

The nurse wheeled in a table with a machine on it and several other things, including two straps, or belts. The nurse wheeled the table to the side of the bed where Tim had been standing when he took her hand. “Here is your fetal monitor,” said the nurse. “Now you’ll have to lie down.” Sheila lay back. The nurse pulled up her nightgown above her breasts. Then she took each of the belts, and placed them around Sheila’s belly. While the nurse was placing the belts, Sheila had another contraction. The nurse was kind enough to stop her work until the contraction was over. Sheila panted and found the contraction felt different than the others and caused her to try and arch her lower back away from the bed to try and relieve the pressure there. When the contraction was over the nurse said, “Now I’m going to have to ask you to lie very still. Every movement you make shows up and it interferes with what we’re looking for.” She smiled and left. Ever so carefully, Sheila turned her head to see the lights and noise and the paper coming out of the machine. What she saw reminded her of a brain wave device she had seen once in a film in her high school health class. When Sheila had the next contraction she tried very hard not to arch her back away from the bed, but at the height of the contraction she grabbed the bars and had to lift off. After the contraction she thought to herself that it was all right to have done it because the patterns on the chart seemed the same even though she had moved.

Tim came back and told Sheila she looked different and he could see that a lot more progress had been made. He couldn’t come close to her to hold her hand again because the table was in the way. Tim stayed behind it and timed her contractions.

The nurse came back wheeling a pole with a plastic bag of fluid hanging from the top of it. She maneuvered it up the side of the bed that was close to the wall and not only attached a needle to the vein on Sheila’s hand but also taped and wrapped her entire hand to a wooden board. Sheila had two more contractions while the intravenous drip was being set up. “Now we should really get moving,” the nurse told Tim with a wink when she left the room.

Sheila’s next contraction came on quite suddenly and so strongly that Sheila was not able to keep control with her breathing. She yelled out a few times and clenched her teeth the rest of the time. When the contraction was over Sheila felt very frightened and Tim looked frightened, too. He felt for Sheila’s toes under the sheet and told her she was probably not very relaxed. He told her he would count out loud the seconds of the next contraction and that maybe this would help her. Sheila was very frightened of the next contraction starting and made a false start at the breathing, and Tim began counting in anticipation. Soon after they stopped, the real contraction came and Sheila was able to breathe through most of it although at the end she had to clench her teeth and squeeze the bed bars again.

The nurse came back and checked the strip chart on the fetal monitor and made an adjustment to the intravenous drip. She asked Tim to try not to lean against the table where the monitor was. She left the room for a moment and came back with a chair for him to sit on, then left again.

Sheila had three more contractions and at the end of the third she began to cry. Tim rose to his feet and asked her what was the matter. “My back,” sobbed Sheila. “I can’t stand the pain. Get the nurse.” Tim left to find the nurse. Sheila had another contraction and this time didn’t bother to do a breathing exercise at all but just squirmed around the bed, squeezing the bars and keeping her mouth closed trying to keep from screaming. Her eyes were filled with tears and she felt very ashamed.

The nurse and Tim came in and Sheila began to explain how she felt. The nurse said understandingly, “We can do something for that. We’ll give her something to take the edge off,” she told Tim.

Sheila had another contraction during which she did a little breathing and a little yelling. The resident doctor she’d seen earlier came in and looked at her face. “Why so worried?” he said. Then he held out his hand on which the nurse put a sterile glove. He examined Sheila and said, “Good.” Then he gave the nurse some instructions. The nurse left, came back, and made an injection into the intravenous tubing. Sheila immediately had another contraction but was surprised to notice no difference in sensation so she squirmed around the bed a lot and gritted her teeth. “You can’t be moving around so much,” the nurse told Sheila while eyeing the fetal monitor printout. “Do your breathing.”

Tim worked hard helping Sheila to keep up her breathing and she was able to complete most of her next four contractions without much squirming, gritting, or grabbing. She decided the medication must be working. She certainly felt more sleepy in between contractions. Tim also reported to her that her contractions were coming closer together and lasting longer. “No kidding,” said Sheila.

When the nurse came in to check the monitor next time Sheila asked when her doctor would be coming. “You’re not that far along yet,” the nurse answered. “But he should be on his way.”

When the nurse left, Sheila told Tim she was depressed that the nurse had said she was not very far along. The next half hour of contractions were very painful. After the last one she began to cry again. “I don’t know how much more of this I can take,” Sheila told Tim.

The nurse came in to check the monitor and Tim asked her if there wasn’t anything more that could be done for Sheila’s pain. “If we give her anything stronger, you’d have to leave,” the nurse told him. “You’ll have to wait till her doctor comes.” The nurse adjusted the intravenous drip again.

Sheila and Tim were quite unhappy during the next hour. It seemed harder and harder to keep on top of the contractions with the breathing. Sheila ached to turn over, but the belts seemed so heavy on her belly. She felt as if the feeling would last forever.

Sheila brightened when the doctor arrived. He came in quickly and Sheila thought it was a good sign. “How are we?” he asked her.

“It’s more painful than I thought,” Sheila told him.

“It always is,” he said. “I’ve decided on an epidural.” Sheila was happy she could still be awake for the birth. Her doctor held out his hand for a glove and examined Sheila.

“How far along am I?” asked Sheila.

“Oh, about six centimeters,” said the doctor.

Sheila found it hard to believe she was only a little more than half dilated. “How much longer do you think it will be?” she asked him anxiously.

“There’s no telling, I’d like to have you delivered soon, before infection sets in,” he told her. “There’s an increased chance of infection because her membranes ruptured so long ago,” he told Tim. He gave the nurse some instructions and they both left. The nurse came back and adjusted the intravenous drip and told Sheila that the anesthesiologist was busy in the operating room and couldn’t place the epidural yet.

“This doesn’t mean I have to leave, does it?” Tim asked.

“Don’t worry,” said the nurse. “Not unless she really gets out of control.”

The next hour seemed forever to Sheila. It seemed as if everything was out of control; at the same time everything seemed slower. Tim left his chair and leaned near the table anyway and began to breathe along with Sheila and rub her feet. They got through two whole contractions with just breathing, but the others were combinations of breathing and loss of control. “I don’t know how much longer I can stand this,” Sheila said again.

Tim noticed that the next time the nurse checked the monitor she looked concerned. She came back soon after with what looked like some plugs. The doctor came back this time, too. “We’ll have to do some internal monitoring to check further,” the doctor said. The plugs were inserted up Sheila’s vagina, and they felt like needles.

Sheila kept screaming, “Ouch, ooh,” while the doctor asked her to keep still. After about five minutes the nurse left, carrying something. The doctor listened to the baby’s heartbeat. Sheila became more frightened and yelled through her next contraction. “We’ll take care of things soon,” the doctor told her. He asked Tim if he could use his chair. “I’ll be staying with your wife from here on in,” he told Tim.

“Is there anything wrong?” Tim asked.

“No cause for alarm yet,” the doctor said. “I’ll tell you as soon as we know what’s happening.” He eyed the monitor from the chair and left it every few minutes to look more closely at the paper strip. “We might be experiencing some fetal distress,” he said at one point. “Let’s try this.” Suddenly he was lifting Sheila and turning her on her side.

Sheila couldn’t believe she was being moved. It’s what I’ve been wanting all along, she thought to herself. “Thank you, doctor,” she told him several times. Sheila noticed that her back pain subsided somewhat. The next contraction was still painful but instead of yelling Sheila just sobbed into her pillow while biting it.

The nurse came back and said, “I have the lab report.” The doctor read it over. He turned off the intravenous drip and listened to the baby’s heartbeat on two occasions. It seemed to Sheila that everything was so quiet except for the noise of the machine and except during her contractions, after which she couldn’t believe the sounds that had come out of her. In between contractions she felt as if she had never been so sad in her life. She no longer wanted to see Tim and she was hoping he couldn’t see her.

The doctor cleared his throat. “We’ll have to take steps now to terminate the labor by operative intervention,” he announced.

“Does that mean a cesarean?” Sheila heard Tim ask incredulously.

“I’m afraid so,” answered the doctor. Sheila heard their voices, but they seemed to come from a long distance.

“Will I get a shot to put me to sleep?” Sheila asked wearily.

“Of course,” said the doctor. “I wouldn’t want you to feel the operation.”

Sheila felt happy. During the next contraction she yelled a lot and kept thinking, “This is the last one I’ll feel.” But she felt a few more until people started moving her and giving her the injection. She remembered seeing Tim sheepishly wave to her and leave the room looking very white, and she remembered feeling nauseous again, and then a growing blackness.

Sheila thought she must be waking up in the operating room. The doctor said something to her. She opened her mouth to reply, but the sound from her body felt so painful that she went back to sleep.

Sheila woke up again and there was Tim looking down at her. So the operation must be over, she thought. She meant to ask Tim if the baby was a boy or a girl but she dozed off.

When she woke up again a nurse was saying, “Wake up, Mrs. Willis. Can you move your legs?”

Sheila smiled. She tried to move her leg and felt excruciating pain in her belly. She winced and fell back to sleep.

Sheila woke up in a room and this time she was determined to stay awake. She remembered someone telling her she’d had a son. She remembered her labor and couldn’t believe she could be lying so still now. When she tried to move her hand she felt pain, so she didn’t move again. She did move her eyes and saw an intravenous drip beside her.

She slept and woke up again, on and off. Sometimes a nurse would wake her to wash her or take her temperature. Her doctor came by and congratulated her. She smiled. He began talking about a “neat incision” and how she could “still wear a bikini.” Sheila didn’t tell him that she had never worn a bikini anyway.

The worst part about waking up was the pain. It felt as if she couldn’t move anything without feeling pain. Once she tried to cough and her belly shook with such pain she spent a long time swallowing to prevent more coughs from coming up.

The best part about waking was the time a nurse was standing over her holding a baby. Sheila realized it was hers. The nurse lay the baby next to Sheila and placed Sheila’s arm around the tiny bundle. She felt her heart beating strongly. The baby was really moving his face. “Is it really a boy?” she asked the nurse. Sheila barely recognized the scratchy voice as her own.

“Of course,” said the nurse. “But don’t you go unwrapping him.”

Sheila watched him beside her for many minutes. She realized the nurse was standing there to see that she didn’t drop him. Then the nurse said her son had to go back to the nursery to be fed. Sheila felt jealous.

Another time when she was awake, a nurse told her she had to get up and walk to the bathroom. Sheila felt she must be dreaming. “You must be kidding,” she said. “All post-ops must be out of bed the day after surgery,” the nurse told her. Then she added, “Don’t worry, I’ll help you.” The nurse began moving Sheila to a sitting position at the edge of the bed. Sheila heard herself grunting with every move. The worst pain was near where her stitches must be. Sheila thought of the top edge of a bikini bottom cutting into her. When Sheila was sitting at the edge of the bed the nurse put Sheila’s slippers on her and placed her hands around the intravenous pole, and told her to stand up. Sheila’s mind and body...

Table of contents

• Cover Page
• Title Page
• Contents
• Preface
• Foreword (by Gregory White, M.D., author Emergency Childbirth)
• Their Way
• My Way
• A Historical Perspective
• A Look at the Hospitals
• Doctor, Midwife, or Do-It-Yourself?
• Preparing for Birth
• Birth
• After the Birth
• Lasting Effects
• What to Do If You Can’t Go All the Way (Dealing with the Hospital)
• Dealing with the World
• Family Stories
• Addendum
• Appendix
• Copyright Page