Bellies to BirthCast

Bellies to BirthCast  |  Week of December 1 |  Episode 4  |  Subscribe

Choosing Homebirth After Emergency C-Section

Heidi Sylvester joins the Bellies to BirthCast to discuss her decision to have a homebirth at age 39 with her first child.

A full transcript of the interview appears below:

CATHERINE:  Thank you so much for being here, it's a pleasure to have you with us.

HEIDI:  Well, you're very welcome.

CATHERINE:  Could you tell us a little bit about yourself and your first birth experience?

HEIDI:  Well, I was a relatively young mother and I was pretty naïve, although I didn't realize quite at the time how naïve I was.  I had witnessed a few births of relatives at hospitals, and had seen very much the standard host of obstetric interventions with those births; all the way up, not including C-sections.  So they had been vaginal births, but they had had a lot of interventions.  That to me was normal, and that was what I expected pretty much, was to have the doctor and the hospital take care of it.  I didn't really own my birth so much with my first baby.  I just didn't look at it that way, and I planned to have an epidural; that's entirely the norm here in Utah, where I live. They have extremely high rates. 95% of births are with an epidural.  I really had no concept of doing it any other way.  I was a little concerned about being able to push my baby out or having an episiotomy; didn't want an induction.  And those were things I'd gathered a little bit about with my reading, but, I didn't read a lot of things, and I read very main stream type of book; what to expect type of stuff. And, I didn't take any birthing classes with that first baby.  Yes, I went into that just sort of expecting it to go like all of the other births that I had seen. It didn't go like that at all.  So, it threw me for a loop.

CATHERINE:  Can you tell us a little bit more about the actual birth?

HEIDI:  Yes, it was pretty fast after sort of all that going, I slept through early labor probably and woke up to some contractions; and then before ten minutes had passed I'd been awake that my water broke with a big gush. It was “okay, very clearly you're going to have a baby today.”  It was a few days before my due date, and my doctor was not around.  He was out climbing a mountain, so I was going to have his on call doctor.  So that was kind of drill and kinks right off the bat.  I was not too worried but I figured whoever I go was going to be fine, and it really turned out to not matter at all.  I went right in the hospital, because I had the group B strep positive, and I was told to go right in and get antibiotics. By the time I got there, I was having contractions three or four minutes apart.  I probably would have wanted to go in anyway. I was four centimeters when I arrived, and they did all the very normal things that they do to women.  Take off your clothes and put on this gown; and put an IV in; get on the monitors and lay in bed.  I did all that.  My husband was just right there with me. I was having really good strong active labor and I didn't have any idea what to really do. But they told me I needed to get a bag of IV fluids run in before I was going to be able to get an epidural.  It was kind of like “okay you're all hooked up to everything and here you go.  We'll just wait.”  They left us alone.  Labor was steaming right ahead.  I was miserable in the bed and that was pretty bad suffering time for me.  I eventually got to the point where I was kind of vomiting and sick, and I was entering transition. But I didn't know enough to realize that, and nobody was with me except my husband who knew less than I did.  Finally after about an hour of being at the hospital and being alone in the room, it was nine thirty in the morning and my water broke at seven thirty. Not too long a time had passed before they came back into the room.  My bag had finished straining so I had received enough fluids that they felt comfortable giving me the epidural. I'm sure that it was just the time of the morning that the anesthesiologist got there and started doing rounds; and so he came in to give me my epidural. For the first time in the room with me was the nurse and she was like, “wow you know you're really laboring.  I thought you were going to be like a first time mom and just barely be getting going here.  In this hour I've left you alone you seem like you made a lot of progress.”  She noticed that I was leaning over the tray while they gave me the epidural and so right after, she said “we should probably check you and see where you're at because you're, you seem like you're really far.”  And so she did check me and I was eight centimeters then, so I was going into transition. At her exam, she couldn't feel the head anymore and she wasn't really quite sure what she was feeling.  So she called in I guess maybe the charge nurse, a different nurse, and she also checked, and she thought that it was a foot.  She was pretty sure it was a foot.  So they started kind of preparing us. “Okay, your baby is breach. We're going to have to do a C-section.”  So they brought in the clothes for my husband to put on and kind of started prepping me.  I think they might have done the shave; I'm not sure; because it all was happening fast.  It was like, okay, we're going to have a c section now. We're going for it.  But before we could really get too far gone, the heart rate started to go down too.  So, then it was rolling me on to my side.  Then rolling me on to my hand and knees and trying different things to see if they could get the baby's heart rate to go back up.  Nothing was working.  It was down to like 80; so pretty low.

  In that danger zone.

HEIDI:  Yes, definitely in the danger zone.  Not gone, but not okay obviously; so then they're really moving quickly. A doctor came in, and he checked me. Now there was definitely a foot protruding and a cord.  So, somehow the cord had slipped through or she kicked it through or who knows.  It was coming now. Then it was stat; we're going down the hall.  We're doing it right now and …

CATHERINE:  A true emergency.

HEIDI:  Yes, like we're I'm not really sure because it happened so fast. He even ever took his hand out.  It just kind of seemed like my bum in the air flying down the hallway.

CATHERINE:  That would be pretty typical of that duration. Yes, to keep the cord in.

HEIDI:  Yes, exactly.  It was just rushing down the hall. Very fortunately, I just rolled into the operating room in place of a woman who was about to have a C-section. Her doctor was standing there scrubbed in. He was an OB, and I had been cared for by the family the practice doctors; and so they were more than happy to say “go ahead and do the C-section.  You're all ready to go and you can do it faster than I can anyway.”  So it was probably three minutes after I was in the OR when he was checking for numbness. This had all happened so rapidly that I hadn't gotten any pain relief from the epidural or not nearly enough obviously for surgery.  He pinched me and I yelled and they said “we're sorry you're going to have to go to sleep.”  So I was, asleep and my husband was told that he had to stay out because they incubate and do all that, where they won't let the husband see you in surgery.  She was born pretty rapidly, within ten minutes of the cord prolapse being discovered.  So that was like amazingly fast record time response.  And I was very fortunate.  I didn't even have time to get scared really, before I was already asleep.  My husband got a lot more scared and kind of had to wait and see; and they brought the baby out to him.  He was able to go with her to the nursery and get her bath. Eventually I woke up and had to ask the nurse “what was my baby?”  Because, we hadn't found out the sex; we were waiting for that surprise. So it was kind of like “what did I have?”  In a groggy way; and I remember kind of smiling about that and going back to sleep, and being really in and out of it for the next probably hour and a half.  And then they took me to my room, and I guess they waited for me to get awake for awhile, and they left the baby in the nursery.  My husband was in the room with me, with my mother in-law. I woke up at some point and asked them, where was she.  They told me how beautiful she was, and I fell back to sleep.  Then eventually they brought her to me, and I sort of remember getting to hold her, and not being able to breast feed because I was just super out of it. Yes, that's pretty much the end of that story.

CATHERINE:  You had one of the rare true complications of births.  A cord prolapse can be definitely frightening and…


CATHERINE:  Being an emergency, what was your reaction?  You said that while this was happening you didn't even have time to react, it was just too fast.  Looking back, what's your reaction to that experience with your first child?

HEIDI:  Well, it was pretty devastating for awhile, emotionally. I kind of didn't feel - for a little while I was in a numb state.  But then it was creeping in more and more and I had some pretty severe post partum depression. I had a lot of confusion about it.  Like, not understanding really what had happened, and not really understanding why it had happened too.  I kind of reacted to that; and maybe it's because I'm just the kind of a studious person. By going to the internet and to books, and trying to read every birth story I could get my hands on.  Trying to understand, first of all if it ever happened to anyone else; which of course women have experienced emergency C-section.  There was a lot of that I could identify with there. But, also why does a baby turn breach right at the very last second like that?  Had she been breach all along?  Why did her cord come out?  What could I have done about it?  Was there something wrong with me?  I had a sense that maybe my uterus was shaped funny or you know what I mean.  Back then I didn't know anything about uteruses, but I had been told at some gynecological appointments somewhere along the line that maybe my uterus was a little heart shaped or that it was tilted.  Now I know that everybody's uterus is tilted one way or the other.  But, at the time I thought well “maybe mine's tilted funny where my babies will always do that; and I shouldn't even try to have another vaginal baby, because I'll just need a C- section again. I should just plan this and be in control of it, because at least I could be awake.”  That was kind of the direction at first.  I have to learn everything about this, because I don't understand what happened to me, and I'm sad.  

CATHERINE:  Right.  Do you feel, looking back and having educated yourself more and what have you, do you feel that there was any way that maybe the breach hadn't been detected and she'd been breach all along?

HEIDI:  Well, I, that's a hard call. Because, it's hard to say what, if someone missed something in exams.  I know that very experienced people can sometimes feel a bottom and think that it's a head, and that's not the first time that's ever happened before.  But, obviously, she wasn't a footling to start with.  Somehow she had converted to having the foot out first.  I'm still not quite sure how she managed that, with broken waters and a contracting uterus and all the things that were going on.  A strange part of me just feels like it was just the universe coming in there and zapping this thing to happen, so that my life would be different, because I would never have done my second birth the way I did it if the first birth hadn't gone that way.  But then, part of me also says a doula or a midwife presence would have been all the difference in the world, because they would never have laid me in that bed reclining, and in such a completely unfavorable position for getting your baby to come down through your pelvis.  Anybody who was doing natural labor support would get you upright and get you symmetrical upright, not just lounging in the bed, which is just the absolute worse position that you could pretty much be in.  So, I wonder if I had been able to follow my instincts to get up an walk around the room, which is what most women do is walk and move their hips and things like that, if she would have come down into the pelvis and not been able to make that big spin.  

CATHERINE:  So, do you feel that some of the interventions you had in the hospital may have contributed to your prolapse?

Well, the big thing to me is the laying in the bed.  But, I also wonder about the position that I was in for the epidural.  It was - they got you bent over…

Hunched over…

  Yes, with your back sticking out, which is not really a position that women choose to labor in, normally?

CATHERINE:  Not the most comfortable…

HEIDI:  No, not really. From what we can tell, she wasn't in distress until after that.  So, you kind of have to wonder if that bending over and leaning had somehow contributed to her wanting to make that spin or flip.  It's pretty hard to say, but, it certainly didn't help to be lying down in the bed where gravity wasn't getting her down.

CATHERINE:  Right, but it definitely sounds like now you have questions.  Questions I want to have, is it one of those things; or…

HEIDI:  It's really hard to say because strange things do happen sometimes even under the best of circumstances.  With gravity pulling a baby's head down into the pelvis, it seems like it would have been a lot harder for a baby to do a somersault than laying down in bed where the angle is going to drive her head just basically into my pubic bone instead of down through the pubic bone.

CATHERINE:  Right, absolutely.  Now given your first birth experience, you'd initially said that you thought to plan it. Have that scheduled C-section so that you could be awake, so you wouldn't have the emergency conditions. But ultimately, you chose a home birth. Ban you tell us a little bit about how that came to be?

HEIDI:  Well, a lot, a lot of education.  A whole lot of reading and changing my level of knowledge about what is good for babies and what is good for moms, and what risk levels there are.  I had to really read and understand how rare it is in fact for a cord to prolapse, and how rare, even more rare, for a baby to convert from vertex to breach; and then also on the other side of the coin, learn the statistics about how cesarean birth affects the baby for the rest of its life.  The increased risks of asthma, immune system problems, and then that weighed against the very, very small risk of something going wrong.  I became very much aware of what the risks of rupture were, and what sort of things contributed to that. Pitocen and augmentation and those sorts of things that I really wanted to avoid.  Obviously, cesareans aren't fun, they are really painful to recover from and I didn't really want to do that again. As much as I wanted to be able to control the experience.  That's a pretty big thing to do to your body just for the sake of being able to control it.  I just changed everything about the way I thought about birth.  I didn't want my child to be born that way.  I didn't want to be separated from my child when it was born.  I wanted it to be in my arms. It became a very big deal to experience the whole thing.  I felt so gypped by my first experience, like I'd missed out on everything.  And so I kind of had a passion to really, really experience it, the second time around.  And we were only going to have two children. It wasn't going to be like something I'd get to try over and over again until I got it right.  It was sort of learning, “this is the way I really want it to be, and I really, really want to experience this.”  And when I start to add all the pieces of the puzzle together, for me, the ideal way, the best way for this child to be born was at home with no intervention.  So as far as, and as long as that was possible, to do that, that's what I wanted. Fortunately everything was healthy.  My pregnancy was normal. There was no reason why I shouldn't be able to give birth at home.  And I did.

CATHERINE:  Was VBAC an option in your area?  And, was that something you were considering as well?

HEIDI:  Well, it wasn't an option.  I didn't know as much about who would have been able to give me that VBAC at the time.  So I felt very limited in my options.  I didn't know any nurse midwives who would be able to attend me in the hospital.  I've since learned of them and that they do exist.  But, at the time I didn't know that they did.  I would have liked to have given birth in our local birth center, because those were midwives that I knew from other experiences, and I was very comfortable with them, but because they have a regulation policy, whatever that they can't take VBACS.  That wasn't an option for me.  So I felt like I wouldn't have been able to give birth in the hospital that I wanted to. I didn't feel like I would get midwifery care, and I also knew that I was going to be on a monitor the whole time, and that there was no way out of that.  I really wasn't comfortable, because I knew that definitely increased my odds of just having a C-section that was truly unnecessary just because the monitor gives false positives so often.  I also just didn't feel comfortable with the fear that is in hospitals about VBACS.  I didn't want to be treated like an emergency waiting to happen. 

CATHERINE:  Absolutely.  I definitely agree there's a big misperception that a VBAC is a scary risky thing.  When we look at the research, very few complications typically happen from VBAC.  Most women can be successful but, you're right in a hospital, it is much more often viewed as an emergency waiting to happen.

HEIDI:  Yes, There are some good doctors out there who do a great job of attending VBACS, and I'm really grateful that they do that.  I didn't know them at the time, and I really didn't feel like there was someone out there who would truly support me and leave me to VBAC without all that fear.

CATHERINE:  Were there any other reasons that you chose a home birth for your second child?

HEIDI:  Well, probably top on the list would be the protection of the mother and newborn's bond after the birth is over.  The really, really, really leave the baby in your arms at home for as long as you want that baby to be there.  And as much as humanly possible, they don't mess with you and they don't bother your baby, and they just let you bond; and start breast feeding and just do what just comes naturally, and there's not that rushed feeling. That was important to me, to make sure that my baby wasn't taken out of my arms for any reason that wasn't a really, really good reason.  So, I had a lot more trust in that happening for me at home.  Another part of that was the ability to labor in the water and to have the kind of freedom of movement and comfort that I wanted to have, I didn't feel real confident in my ability to give birth without medications if I didn't have the birth tub and things like that.  And also, I'm a really big believer in the hormones and the emotional aspect, psychological aspects of birth. I think that women need to feel safe, and they need to feel comfortable; and so when I would think about giving birth in the hospital and I would feel those panicky feelings take over me, that for whatever reason, it just freaked me out to go there.  I felt the adrenalin rush.  I knew that that would not be helpful to my laboring to have that kind of fear. I needed to have only comfort and peace around me during that laboring time, just to make sure that those hormones worked the best, the way that they could.  Those would probably be my top three reasons for staying at home.

CATHERINE:  What role did your husband play in this decision?  Was he immediately supportive?  Or did he have some reservations about birthing at home?

HEIDI:  He definitely had some reservations about birthing at home.  I still wish that he could have been able to be more comfortable with the birthing experience.  He had trauma from the first experience.  A certain amount of fear that wasn't going to be able to be overcome. It was scary for him.  

CATHERINE:  I can't even imagine.

HEIDI:  Yes, it was really scary. Unfortunately, both births ended up being scary for him. Because it was so imprinted from the first birth that even the second birth, where it was very peaceful and nothing urgent, and all of those things no one else felt, he still felt scared.  But, he was a trooper and I gave him lots of reading assignments, and I said “here's this study and here is that study.”  I made my case for him, I guess. Enough that he said “you have to give birth.  It's your body that has to do this and I'm not real comfortable with it.  It is still kind of scary for me, but I trust you enough to know you've done your research enough to believe this is an okay thing to do.”  We talked to midwives.  It helped him a little bit too… kind of as her questions and knows “what would you do if this happened?  And how would we handle that?”  Midwifes know how to answer those questions, and they can help you feel a lot better.  That did help some, and he was still scared going into it, and he white knuckled it through. But, he made it.  He made it.  He was a good support.  He ended up being right there with me the whole time.  

CATHERINE:  But in retrospect, when he looks back, has his perception changed at all?

HEIDI:  I think that he appreciates how much it meant to me.  I think that he sees the difference with just the way that our relationship was; me and my son, that it was a much less traumatic experience for me. For that part he is very grateful about.  It's obviously nice to have a wife that doesn't have post partum depression, and is feeling empowered and happy about her experience instead of devastated and emotionally distraught. 

CATHERINE:  Right, especially when there are two kids to take care of instead of just the one. What types of challenges did you face as you started preparing for your home birth?  Were there any obstacles you had to work through like insurance or laws, restrictions in your area” Is there anything of that nature?

HEIDI:  Well I mean I did my research a long time before I was pregnant to kind of search out the midwives who would help me out with the insurance. I was fortunate, I guess, at that time just to have been on a plan that had actually semi-decent coverage for out of network.  I knew that I couldn't go to the birth center, and that was kind of a disappointment.  It was probably the one legal restriction that affected mainly, because I think the birth center might have been a little bit of a half way ground that would have made my husband feel a little bit better.  That wasn't an option, so I just researched midwives locally and found one that I was very comfortable with that had a lot of education and a lot of experience; the certification that I wanted her to have as far as knowing that she was a well qualified midwife.  It's not too bad around Utah to have a home birth, because we have a long tradition of home births. It's kind of never gone away here like it has in some places.  

CATHERINE:  So in some ways you might have had more options than had you been in a different area…

HEIDI:  Yes, I think there's a few more practicing midwives here than maybe in some other areas. I don't live out in the boonies. I live basically the urban areas of Salt Lake.  So that helps too.

CATHERINE: Now, given your history, did you encounter any resistance from friends or other family members to your decision to home birth?

HEIDI:  Oh yes, sure.  Everybody says you're crazy when you tell them that.  My husband got even more earfuls from the guys at work.  “How could you even think of letting your wife do that? Why would you ever do that?”  Actually one of my biggest opponents was my grandmother who's given birth at home herself in rural Utah. She just had changed to that mindset that the hospital was the safest thing and thought I should do that.  She wasn't in charge.  It was just kind of like “I'm sorry that you feel that way but this is what we're doing.”  The few people that were very close to me like my parents and my sisters; they all had been somewhat educated as I was going through this path of learning.  I read about this thing last week and can you believe that?  So they had been hearing this stuff for awhile.  Information was kind of getting presented.  But then when it came down to it, I'm definitely having a home birth.  It made my parents nervous more so than other births, that their children had had and other grandchildren been born and they were more concerned and so I did a few things to kind of accommodate them and make them feel a little bit better about it.  I met with a midwife that my mom knew; just to make her feel better.  I talked it over with her even though it didn't really change what I ended up doing.  I tried to humor them some.  But in the end they kind of know that I'm a stubborn person and that when I make up my mind to do things my way, that they're not going to change my mind. 

CATHERINE:  They definitely saw the effort you put into this decision, that it wasn't a just “well we're going to have home births.”  You put in the hours and the homework…

HEIDI:  Yes, they learned about it as I did and got to read some of the things I brought them. You know, the studies and the books. They didn't, they weren't completely without information, and they weren't seeing what I was basing this information on.  I even brought my doula in and we watched a birth video together with my family.  So that they could see what a home birth would look like. Because I was using a self hypnosis technique for pain management, I wanted them to see what that looks like, and talk to my doula, about how you have to be when a woman is trying to be in a self hypnosis state. We did lots of things to make them aware and educated, because in the end they were coming. My mom desperately wanted to be there.  She loves birth and loves to be on the “business” end as she puts it.  She really wanted to be there, but we tried to quell some of those fears beforehand.

She said later that she expected to be nervous. Then, when it came right down to it, because the midwife was so calm, because I was so calm, because my doula was calm, she was calm and, she said, never felt afraid.

CATHERINE:  You talked a little bit earlier about that you didn't want to be surrounded in the fear of a hospital, and fear breeds fear. Whereas you're not expected to be afraid, but that comfort and reassurance spreads that, she didn't need to be afraid because she was surrounded in an environment that was supportive and accepting of births.

HEIDI:  Exactly. And my doula was aware enough, if anybody had been afraid, she would have asked them to leave. But they weren't.  It was really peaceful.  They all had a good experience with the birth.  They were just really amazed by it.  That was cool to be able to share that with them.  

CATHERINE:  Tell us a little bit about your emergency plan.  What steps had you taken to prepare in the event that some type of an emergency did arise?

HEIDI:  I had looked into the hospital that was the closest to my home as far as, how exactly do you get there and how exactly do you get into it? And, I had their numbers all posted by the phone and would talk to the midwife about it.  If this becomes an emergency situation, this is what we're going to do; and we'd gone over those sorts of things a lot.  A lot of that was just because I was still sort of afraid that I would have a cord prolapse.  It was hard to completely not be afraid of that, because it was the only thing I knew.  But, I timed the drive to the hospital a number of times, and had the numbers by the phone.  I know the plan was there and the net was there, but after like a certain point I didn't even worry about it.  I just sort of had a piece of heart that it was all going to go according to plan.  

CATHERINE:  And it really felt like you took the time to do the ‘what ifs', asked a lot of questions.  Your first birth you hadn't considered that a cesarean would be necessary. In this case you were able to…

HEIDI:  Yes, if I get plan “B” outlined, and here are the steps, then I can just know that's then and set it aside, then go back to just focusing on what the ideal will be.  But it's all done I don't have to worry about it.

CATHERINE:  Now tell us about your actual birth.  

HEIDI:  It was lovely.  It was beautiful…

CATHERINE:  In a word: "lovely"…

HEIDI:  It was, it was a pretty typical birth, I guess. He went a few days over his due date.  I was ready for him by then, and labor kind of was the same as it was with my first. I wasn't really super aware that I was in early labor.  I probably should have been, but I was in denial.  “If I don't think about this, then it either will turn into the real thing and I won't be focused on it worrying about whether it is.”  I just kind of went about my usual business on that morning, even though I was having some signs of early labor.  My sister came out who was planning to attend the birth, one of my best friends and she came and brought me lunch just thinking, “you're over due and sick and tired of everything and have to cook,” she brought her little girl to play with my little girl so we could relax and have lunch.  I was standing at the counter trying to eat this lunch with her, and telling her “I've been having some contractions and some of them are kind of serious.”  She was kind of noticing me having to stop and breathe through them, and I said “yes these are pretty good, but I'm not going to get too excited…”  Before I could really get those words out my water broke; so it was like well except that we'll get excited now.  That was my water.  She took care of my little girl and I went on up to got dried.  Just like the last time, once my water breaks the contractions start up in earnest; so I called people and they started to come.  My husband came home from work and set up the tub and got that running; and my doula came and helped me to do some relaxation scripts and get into a little bit deeper self hypnosis.  Mostly I walked around my house and used my furniture to lean over the dresser, or to sit on the birth ball and lean on the bed, sat on the toilet.  Just labor. You do what you do.  And it's all just so easy, because people just show up and you don't have to do anything else, just pack your bags or worry about it's time to go.  So I just labored in a very straight forward way; midwife came and set up, and after a time. I thought well maybe I should get into the tub now that might feel really good.  It's full, and I wanted her to check me because I didn't want to get in too soon.  So she said I was at a six, and that was at maybe twelve o'clock.  My water broke at eleven thirty.  I guess it would have been like twelve thirty.  So, I got into the tub, and just labored.  In there, it made all the difference in the world to have that warmth and relaxation.  So I just hung out in there for a long time, and then started to feel the urge to push a little bit, and so I told them that. She said “do you want me to check you again?”  And I think I labored a couple more contractions and then said I would like her to check me.  So she found that I just had a little lip of cervix. The next contraction I pushed, and she kind of helped reduce that so that I could really push, because I was feeling the urge pretty strong.  So then I just let my body guide me into the different positions, and I used quite a few just in the tub.  On the hands and knees for awhile, squatting, just sitting; and I would just reach up and feel for myself, the baby's there; and when I would push I could feel the baby was coming down. I got a sense for what positions and what pushing was helping.  So I just basically guided the head down through that whole part for like the next two hours, pushing. And then I think I told them that the head was staying down now.  It wasn't rocking back up under the bone. The midwife felt a little bit, and I said “I think I would really like some lubrication.”  Because I just kind of felt like I was nothing but skin in there.  They helped me get out of the tub onto the birth stool that was right next to the tub, and my doula sat on one side, and I put my foot up on her thigh and my mom sat on the other side and I put my foot up on her thigh so that I was in kind of a squat with my pelvis nice and open on the stool.  My husband was behind me, and then the midwife got a mirror and showed me. I was like “wow, okay, I can do this, because I'm really close.”  It made all the difference to be able to see it, like I hadn't been able to see it in the tub.  

CATHERINE:  It made it so real.

HEIDI:  Yes, and also just not a million miles away.  It felt like there was inches and inches worth of skin that I was never going to get past.  But then when I could see it, it was like “oh he's right there I can see his hair!!!”  So I was just pushing really hard and holding my husband's hands, for a few more pushes on the stool that way, and he finally came through.  His head kind of popped through, and he just slid right out.  He had had his little hand by his head, and that was why it took me quite awhile to push him through.  He made it out and the midwife said “take your baby.”  And I took my baby and I said “Oh my God I did it!!! I did it!!! I did it!!!”  My husband put his arms around me. I think I bawled some and I think he was in shock.  Everybody was just like there.  My sisters were at the door. My little sister, who was in charge of my daughter, brought her up so that she could see the baby be born.  She came over to the bed for just a minute and said hi to her brother, she was like “I'm going back down to play.”  And went back downstairs to play with her cousin some more. My other sister was there; my sister-in-law, my parents.  So we had kind of a room full of people, but it was completely silent except for the very few words that I spoke.  He was in my arms, and he didn't leave them for a very long time.  And everybody thought I was mean because I wouldn't share him.  That was something that he and I weren't sharing.  

CATHERINE:  Now, during your labor, during your pregnancy at any point did you question your decision to have a home birth?

HEIDI:  No.  Uh, uh, no, after the last couple of weeks, I think, because I had been doing so much of the script listening, self-hypnosis script that guided me through visualizing the birth, and then all of these affirmations that “I know that I can give birth naturally.  My body was made to do this.”  It really sunk in.  So I really didn't feel any worry about it after that.  There were still a certain amount of families that were concerned but, it was just like “well this is what we're doing so…”  I definitely never felt even a moment of concern during the birth itself.  I just was in the zone of being in labor, and I never felt even remotely like anything but just “I'm having a baby.  I'm just having a baby now and it's great.”  

CATHERINE:  That's wonderful.  In retrospect, what were the foremost benefits of birthing at home in your situation?

HEIDI:  The family togetherness, just the bonding that we were able to do.  The way that I felt about the birth afterwards, the completely empowered feeling that I had done this that it was all me, and no one else had done it for me, and that it was my choice to do it this way.  I was the one in control.  Now I still just feel amazing about that because it was just such - I don't know. It was amazing how your body can do it.  Can do something seemingly so large, and yet it just, it just does it!!!  It just can, and it's actually not that bad if you allow yourself to follow your instincts.  I think that was, I can't hardly compare the different sensations between the first birth of laboring to eight centimeters in that hospital bed and how miserable that was.  And, yet, completely giving birth one hundred percent un- medicated on my own in my own bedroom. I don't have any memories of it being painful.  Intense, yes. Powerful, amazingly strong. But it never hurt.  It was just, I was able to work with that sensation so much better when I was upright and moving, and putting my leg up on the bed, and sitting in the tub, and doing what I felt was right to do.

CATHERINE:  Then what the evidence says works best.

HEIDI:  Yes.  With support. Tat makes all the difference.  

CATHERINE:  If you were to have another child, would you make different decisions the next time?

HEIDI:  No, I wouldn't do a whole lot different.  I know more of the midwives in our community now, so I might choose a different midwife. Not because mine wasn't fabulous, but because I'm better friends with some of the others now.  Just my birth team might be a little bit different, just because of who I know.  But basically I wouldn't really do anything different.  I would probably like to change the way that my husband felt about it.   If there was anything that I could do to make it, so it wasn't as scary for him throughout the whole experience.  I just think his gut reaction was to have the adrenaline release like fight or flight kind of panicky sensation, but it's not fun for anyone of course.  He had that during Eric's whole birth, and that's a shame because I was flooded with wonderful emotions of endorphins and oxytocin, so it was the most amazing beautiful experience for me, and he was just scared.  If I could do anything differently, I would want to change that for him.  And that would be a task.  I'm not quite sure how I'd manage but…

CATHERINE:  You wanted him to feel as good as you did. 

HEIDI:  Yes, I'd like that. If it all came down to it, and if I really didn't feel like I could make it feel better for him, I'd probably just send him out to hunt or something. I don't know.

CATHERINE:  Thank you so much for being with us today.  Before we end, what's the piece of take away advice you'd like to share with other women considering home births or considering home birth after having a previous cesarean?

HEIDI:  Well, they need to do some real research and talk to the people in their community about all of their options; and then they really need to check with themselves inside their gut, or heart, or instinct, or however you want to word that but, women know what's best for them. There isn't a right answer or wrong answer.  There's just what feels safe and right and comfortable to you.  For some people that's at home.  Just doing their thing with very little intervention, with very little monitoring. But for other people they really need to feel like the technology is there or that the monitor is beeping and that they can hear their little baby's heart pound.  For some of us that creates a calm feeling and for some of us that creates a feeling of panic, to be hooked up to beeping machines.  That's okay.  You just have to know that you have options.  Know what all of them are, and then use your gut to kind of tell you, “What is the best thing for you?” That's what I tell women.

CATHERINE:  Thank you so much Heidi for being with us and sharing your story.  You definitely have a lot of good information to share, having been at both ends of the spectrum.

HEIDI:  You're very welcome.  I love to share.  I'm known to talk too much.

CATHERINE:  I think today you talked just enough.  Thank you again so much for being with us.

HEIDI:  You're very welcome.

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