#normalbirth

Introduction

Birth used to traditionally be a community and family event and not a medical event like it’s now become. Yes, there are times when medical help is required but at its very core it is a normal function of the body – a process that unfolds given the proper preparation of the body and the mind, the right environment, and proper support. With the advent of hospitals and modern obstetric care, it has become more and more medicalized. And with all the medical rigmarole and jargon surrounding it, women often feel like disempowered subjects in their own labor and birthing process. This post is a great starting point in understanding the basic physiology of a normal birth.

What is a normal birth?

A normal birth or delivery, alternatively referred to as a vaginal birth or vaginal delivery, pertains to the natural childbirth process in which the infant is delivered through the birth canal (vagina), without the aid of surgical procedures like a cesarean section (C-section).

What is the difference between a natural and a normal birth?

After dilating quite quickly from the time labor started, Jessica arrived at the birth center expecting to have her baby in her arms in no time. However, the nature of childbirth isn’t always that predictable and labor carried on. Despite Jessica’s own annoyance as to how long the birth was taking, she was reassured by the calm presence of her birth team, which helped her stay positive and patient. 10 hours later and laboring in every imaginable position, she pushed through and gave birth to her baby girl.  

What interested you in a birth center birth? 

In addition to seeing the Business Of Being Born, I have a few friends who had birth center and/or home birth deliveries. In fact, one of them had her youngest at Del Mar Birth Center. From what I heard and learned, I liked the idea of having more options, a quiet and calm delivery room and best of all: midwifery care!

You started your care at the birth center almost half way through your pregnancy, how did you make this switch? 

I started at an OB/GYN for monetary reasons. I wrongly assumed that my insurance wouldn't cover midwifery care. I didn't get to meet my doctor until right before I transferred, and when I did it just didn't feel right.

Harper was due around the holidays, and my doctor said he probably wouldn't be available to deliver her unless I scheduled a cesarean or induction beforehand. This was moments before I was about to tell him about my wishes for a natural birth. I called Del Mar the next day. 

I had actually toured the birth center before I conceived, so I knew when I called that I wanted to make the switch there and then. I requested to have my records transferred and had an appointment a few days latter. It was easy! 

What was the difference of care between an OB/GYN and a midwife. 

It's very different. You see nurses at an OB/GYN’s office and very rarely meet with the doctor. Everything is rushed since they have so many patients.

At the birth center, every appointment was with one of the midwives who would potentially deliver my baby and thus a relationship and trust was built in their care for me and my baby. It's such a safe feeling getting to know your care providers.

Also, you don't do a urine test every appointment at a midwife’s office and only do a few ultrasounds in the whole pregnancy. Our appointments consisted of acquiring vital signs for both me and the baby (hearing her heart beat via the Doppler was my favorite part), but mostly it was a nice chat about how I was feeling, my diet, exercise, sleep, work, etc. I even had a cup of tea brought to me during our meetings. This care for women by women was the most important thing to me. I never feeling rushed which was a bonus in the trust and safety in knowing your care provider. 

You took an 8-week childbirth education course. Can you talk about the benefits of a series of classes like this in preparation for a natural birth outside of the hospital?

My husband and I took Kathy Killebrew’s class. It’s a preparation course for natural birth and child care for both in hospital and out-of-hospital settings. 

Kathy covered all the stages of labor, breastfeeding and early home care. My husband started calling it “Baby University” as it was a lot of information! But knowing all the stages and gritty details of labor and birth as well as ways to relax through contractions was so helpful. I knew what my body was going to do (for the most part!) and it was empowering to allow it to do so without being afraid or wanting to control it. 

You tested positive for Group B Strep (GBS) in the pregnancy, which is typically treated in labor via IV antibiotics. While 30% of women are colonized with GBS, there's a 1-2% chance that if left untreated, a baby could become very sick from being exposed to the bacteria while coming through the birth canal. However, treatment with antibiotics come with its own host of issues. How did you receive the news that you were positive? How did you navigate all the information out there and come to a decision regarding treatment that you felt comfortable with?

When I got my test results, I was crushed. I phoned the on call midwife and cried. I'd been working so hard to have a healthy pregnancy, so this just felt like a failure. She reassured me I probably had GBS the whole pregnancy and that it’s pretty normal and common.

My husband Max and I studied the options together and ultimately decided against IV antibiotics. We read a study by Evidence Based Birth, which showed how other countries handle GBS in addition to speaking with a few of the other midwives.

In the end, we decided to use am antibiotic soap called Hibiclens. When applied to the vagina every few hours, it kills the bacteria where it counts and was much more appealing to me than an IV drip every two hours. 

Tell me about your birth experience.

I went into labor just a few hours before Christmas Eve. I had some mild early labor contractions after dinner and followed the advice from the on call midwife, Callie, to try and go back to sleep. Right around midnight I woke up just as my water broke! After that things moved very fast.

By 4 am, my contractions were super close together and very strong, so after speaking with the midwife, we decided it was time to go the birth center. When we arrived, I climbed right into the tub to relax in the warm water and have my cervix checked for dilation. I was pretty excited to be nearly 8 cm dilated! Max and I figured the baby would be born in no time!

Laboring in the tub felt great, but after a few hours things (contractions and progress) had slowed down. By this point, I was pushing so I moved to the toilet to try a new position – followed by moving to the bed and back in the tub. It felt like my baby was taking forever to come! 

Callie’s shift ended and Shayna came in. We realized I still had a tiny bit of cervix left – what the midwives call “a lip” – which was most likely getting in the way of my baby’s descent. So, in order to remedy the situation and get this show on the road, I lay on one side for three contractions without pushing and the switched to the other.

It’s hard to explain how hard that was. I was fighting every impulse to not push, as that was also when I realized pushing relieved the pain of the contraction. Thankfully, my hard work paid off and the lip went away.

But labor still dragged on. At some points I felt like I was so close and then something would stall.

All during this time, I felt I handled the pain okay. I knew going into it that it would be painful (and it was). Each contraction brought this whole body pain, but I knew it only would last a moment and then I would get a break. What got me though was how tired I was getting. Max was giving me water after every contraction and as the night wore on the midwife and nurse were getting me to eat some fruit for some energy.

I moved to the squat bar/ladder and started to make some real progress. I moved between the bed and bar for the last few hours. Finally, I got to the point where I just knew she was coming. I could see it in my midwife’s face and hear it in Max's voice. But then I saw this look of disappointment on Shayna's face – my body was stalling again! No way! I got out of bed and waddled over to the squat bar with everyone's help.

After just a few contractions it was finally time. One contraction on the birthing stool and my beautiful daughter was born. I've never worked so hard in my life! It was amazing to see her come into the world and to have Max right by my side as it happened.

You dilated quite quickly from the time your water broke, but then pushing took some time. What was going through your mind at this time? 

I was annoyed as I had this idea that she should have been born in a certain amount of time. I knew I could do it but my body seemed to be taking forever to push her out! I was starting to get so tired by the end, but I refused to give up. 

How did you stay present and positive? What kind of support was helpful?

Max really believed in me, and I did too. I think the whole birth team taking care of me is what did it. I didn't feel rushed and that allowed me to stay positive. If everyone was letting my body take its time then I knew things were okay.

Specifically, when Shayna helped direct my pushing efforts was very helpful. She put her fingers in my vagina and told me to push against them. Holy cow did that make a difference! Once I knew where to push into, my mind and efforts were much more focused. 

Did you think you were going to end up transferring? Did you want to transfer at any point? 

I didn't. In my mind as long as Baby and I were both healthy transferring was not an option for me. Later in labor the midwife or RN checked her little heart rate after every contraction so I knew we were both safe as we could hear it was at a solid rate.

I knew I could work through the pain – I just had to keep up my strength. I actually used her name as a battle cry towards the end. Ha! 

There needed to be a little resuscitation for the baby after the birth? Were you nervous?

This is funny to look back on as I was so high from the rush of endorphins after the birth that the building could have been burning down around us and I would have told you we were fine.

I saw the little mask go on her face, and heard Max's concerned voice but I just knew she was okay. It must have been a mix of mother intuition and total trust of my birth team that I didn’t feel fear or anxiety. We had been through so much together. She was also on my tummy skin-to-skin the whole time, so I could see and feel her making breathing efforts and knew she would come around. 

How did you feel a few hours after the birth going home? 

It was like waking up from a dream. I'd been pregnant for 37 weeks and now she was here – on Christmas Eve of all times! She was born at 4 pm, so by 9 pm, we were on our way home. We just crawled into bed and slept that night with Harper on my chest skin-to-skin.

We woke up the next morning and had our little Christmas traditions. While I was in early labor the day before, I made my Christmas cinnamon rolls from scratch. So Christmas morning I frosted them and we opened our presents as usual. It was a lovely quiet time to bond with our new daughter.

How do you think your experience being pregnant, giving birth and as a parent has changed the way you view yourself? The world?

I’ve been learning a lot about myself since even conceiving Harper. The pregnancy was all about being the best little vessel I could be for her: relaxing and eating a balanced diet.

Since her birth it's been learning to go with the flow and to take the little quiet spaces in my day to take care of myself. I love being a mom, it's a lot of work and there have been frustrated tears, but I wouldn't trade it for anything.

Knowing all of the hard work it took to bring this little girl into the world makes me feel really proud of myself. I feel strong and more connected with my body than ever before. I wish more women would consider going route of having un-medicated, out-of-hospital births. It’s not scary as some may think, and most of our bodies are made to do it!

I’m amazed at how my body has changed, what's already sprung back into shape and what I’ll keep as a souvenir of Harpers time in my womb.