homebirth | Two Rivers Childbirth

Every Question You Need to Ask Your Homebirth Midwife

By Two Rivers Childbirth
February 4, 2018
Birth Prep,Education

45+ GOOD QUESTIONS — for you home birth midwife

This is a list of every question we could think to ask your homebirth midwife. It’s another freaking huge list of questions, guys. You won’t need all of them at first. In fact, most of them you will most likely use as a reference for your choices and options and an understanding of how your midwife practices along the way. We *starred the ones that might be most useful during an interview, but feel free to use this guide as a way to jog your brain to ask the questions that are most important to you.

We suggest you ask open-ended, rather than yes/no questions, wherever possible. “How often do you see…?” “What do families who birth with you usually choose…?” “How will you support us during…?” “What are your policies regarding XXX procedure or situation…?” Home- and birth center-based care tends to be far more flexible and personalized than hospital-based so these may give you a better understanding of where your midwife’s experience lies.

1. *How long have you been in practice? How many births have you attended? How many of those births were you the primary midwife?

2. *What is your training and certification (CNM, CPM, PM or Lay-midwife)? What professional associations are you a member of? If you are a CNM how long were you a nurse before becoming a midwife? Did you do other birth or pregnancy work before becoming a midwife? What other services do you provide?

3. *Are you licensed to deliver in my state? If no, why not? Does your status affect your transfer protocol? (Midwives have different reasons for choosing to be licensed or not, make sure their priorities align with yours)

4. *What is the cost of care and what is included? How often are clients reimbursed the full fee by their insurance? Do you work with a billing agency? Do you offer payment plans or discounts for early payment in full?

5. *How do I contact you for questions and concerns during pregnancy? How do I contact you during labor?

6. *How many clients do you take per month on average? Do you have a cap on how many you will take? When do you consider yourself “on-call” for me? What do you do if two families are in labor at the same time?

7. *Do you work with other midwives? Who is your back-up? Who are your assistants and what is their training? Can I provide my own birth assistant? Do you work with a student? How many people can I expect to be on my birth team?

8. *Are you and your team neonatal resuscitation certified? Have you ever had to resuscitate a baby? Are you and your team CPR certified? Have you ever had to resuscitate a birthing person? How recently have you recertified?

9. *Do you recommend doulas? Do you recommend childbirth education classes? Do you work with birth photographers?

10. How often do you recommend acupuncturists, chiropractors and massage therapists?

11. Do you attend VBAC/ VBA2C/ VBA3C / Multiples/ Breech births? How many have you attended? Have you completed extra trainings for those scenarios?

12. *Do you offer water birth? How often do your clients deliver in the water? Does a tub rental come as part of my package? Do you have a recommendation for where to rent or buy your favorite pool? Are you comfortable delivering in my bathtub?

13. *What are your prenatal visits like? How long are they? Where do they take place? How often are they scheduled? May I invite friends and family members to attend?

14. What are your policies or recommendations regarding urine dips, basic blood tests and labs, genetic testing, routine ultrasounds and growth scans, gestational diabetes testing, group beta strep testing, iron levels testing? Are there any you don’t recommend declining? Can you draw blood or will we need to use an outside lab?

15. What is your philosophy on weight gain, nutrition, prenatal supplements, and exercise? We will receive counseling or education on those topics?

16. *Do you provide our birth kit? If not, do you have a preferred supplier? What else will we need to provide?

17. Are there any induction methods that you are comfortable using (stretch and sweep, foley bulb, castor oil, black and blue cohosh, breaking waters) and when might you suggest them? How often do you transfer care for postdates induction?

18. *What is the most common reason that your clients transfer to the hospital? What is your transfer rate?

19. *What is your relationship with area hospitals? Have you been to my nearest hospital before? Are there any local hospitals that you are not comfortable transferring to, and why? Will you remain present if we transfer, and if no, why not? How would my medical records be transferred (digital, on paper, faxed, hand delivered)? Do you have an OB or practice that you refer to for transfers when complications arise during pregnancy?

20. *What do you consider “high-risk”? Under what conditions would you absolutely transfer care? What conditions would make you consider transferring care during pregnancy? During labor? After birth?

21. To what gestation are you comfortable waiting? What is your standard protocol for clients going over 40 weeks?

22. When can I expect you to join me in labor? Will you ever leave a labor? How will you provide support during early labor?

23. How often do you monitor the baby during labor? Is your doppler waterproof? What do you consider a non-reassuring heart tone? How often do you take the birthing person’s vitals?

24. How often do you perform vaginal exams during pregnancy? During labor? What would you say if I refused a check?

25. What tools do you use to help families through the intensity of labor? What would you say if I asked you for pain relief or to be transferred to the hospital for pain relief?

26. Do you carry and administer any herbs and in what situations? Do you carry and administer any medications (Pitocin Cytotec, Methergine) and in what situations? Do you carry and administer IVs and in what situations? What other tools do you bring to births (birth stool, rebozo)? How do you handle a hemorrhage?

27. Do you have any additional training in herbs, homeopathics, essential oils or acupressure for labor and birth?

28. How do you handle a very long labor? How do you handle a precipitous labor?

29. How do you coach families through pushing? What do you do to help minimize tearing? Do you ever let the birthing person or another member of the birth team catch the baby?

30. How long do you usually leave the cord intact? How long are you comfortable waiting for a placenta?

31. What is your philosophy on placenta encapsulation?

32. *Are you comfortable suturing? Under what conditions would you feel a repair requires a hospital transfer?

33. What would it look like to transfer a baby to the hospital if needed after birth? What would it look like to transfer a birthing person to the hospital after birth?

34. Have you ever lost a baby or birthing person and what were the circumstances?

35. *How long do you stay after birth? Will you help my family clean up/break down the birth pool?

36. *How many postpartum visits can I expect? Will all of those take place in my home? What changes if I transfer and deliver in a hospital? Does your visit include care for the baby? Will you be available for well-woman visits?

37. What other postpartum resources do you offer your clients?

38. Can you administer Vitamin K and Erythromycin if we want? Can you administer the PKU test or will we need to see our pediatrician? Will you administer Rhogam if needed? Can you provide us with a hearing screening, and if not, where do you recommend clients go?

39. Is there anything you will need from us to file the birth certificate?

40. What kind of breastfeeding support do you offer? Do you have any extra breastfeeding training or certifications? Do you have local IBCLCs that you recommend?

41. *How would you describe your style of midwifery?

42. *What inspired you to become a midwife?

43. How do your personal birth experiences inform your midwifery work? (Great midwives don’t need to have had children)

44. *What is your philosophy on continuing education?

45. *What are your expectations for your clients?

Questions to ask yourself:

How does a visit with this midwife make you feel?
Is the midwife able to fully address any concerns you have? How about the concerns of your partner?
Do you feel comfortable in their presence? With them in your home?

I also like this list of questions to ask yourself to discern if homebirth is the right choice for your family.

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If you think we missed anything please drop us a line and let us know what to add!

If you aren’t planning a homebirth, or you are doing co-care with an OB or just want to be prepared in case of a hospital transfer you might enjoy this post on Every Question You Need to Ask on Your Hospital Tour

Photo: Bergen Howlett Photography

Community Birth Story: Liesel Florette

By Two Rivers Childbirth
August 28, 2017
Birth Stories Project

As told by Lauren:

Liesel entered our awareness about two weeks after our second baby was born, in the fall of 2014. So we knew another soul would be joining our family in the future. We could hear her knock become stronger and stronger, and in the spring of 2017 my husband and I were both ready to add to our family, and in the summer of 2017 she was conceived.

The pregnancy was easy and enjoyable – I love being pregnant! At each prenatal appointment, Liesel would swim away from the doppler until asked if we could listen to her heartbeat. Then she would pause long enough to get a good reading and then move away. She was teaching us early about asking her for permission on things that affected her and this would be really important during her birth.

With both of my other pregnancies, I went well beyond 40 weeks – 41+6 with Emily and 43+6 with Winfield. I joked that I am a long gestater. However, as the time drew near for Liesel to join us, I felt like she might come sooner than the others. I was wrong. Because of my history of long pregnancies I worked longer this time around – until 39.5 weeks. With Emily I stopped around 37 weeks and with Winfield I stopped at 36 weeks.

Friends gathered and surrounded me with love at a lovely mother blessing to prepare for the birth and release fears. I prepped our birth room with fairy lights and affirmations and art and the whole family contributed to Liesel’s table – full of special things. Around 39 weeks, Liesel’s pattern was to wake up and be incredibly active from 11pm-2am – so I would wake up with her and work on positioning (since she was moving around so much) – so lots of hands and knees, sitting on the ball, and dancing – lots of dancing. Her playlist was ready to go. She liked lyrical, jazz, and pop music. This late night dance morphed into prodromal labor each night for several hours, the uterus was doing lots of things although no noticeable patterns emerged, much like jazz. I would eventually go to sleep and wake up a bit disappointed that labor hadn’t begun.

The birth itself is best told by the time stamps of text messages and phone calls to the birth team. I should mention that my birth with Emily spanned 2 days and was over 40 hours and Winfield’s was about 20 hours.

In the early hours of May 4th, I had Aaron feel Liesel’s nighttime movements and I told him, “I feel like she is going to bend her knees and shoot out of me like a rocket.” And that is pretty much what happened later that day…

On the morning of Thursday May 4th, I woke up early, disappointed that I wasn’t in labor yet and read three birth stories of friends birthing their 3rd babies. Two of the three stories involved pretty quick births and those two birthing mamas were part of the birth team – this was preparing me for later in the day. At 12:47pm, I was texting with my friend and birth photographer, Lindsey. She was going to be out of town the coming weekend and she sure hoped Liesel wanted her at the birth. I told Lindsey that there was “definite uterus activity each day and night, but no patterns yet.”

A short time later, around 2pm, I told Aaron that there might be a pattern emerging, and I was going to start timing what was happening. At 2:30pm, I told him the uterus was warming up with small contractions every 2 minutes. He gave me a look, but I said they were no more than 30 seconds long and I could walk, talk, and do life so no big deal. Just the warm up. I called my midwife and spoke with friend and midwife assistant, Shawna, and just told her the warm up was beginning.

We decided to go for a ride to get a part for the birth pool and so that our two older kiddos could nap in the car. The 2 minute pattern continued and I decided to give the rest of the birth team a heads up that the warm up had begun.

So at 3:15pm I texted that I was having easy regular contractions every 2-3 minutes, 30 seconds long, easy to talk and breathe through, no bloody show and that I would keep everyone updated as things progressed. I spoke with my friend and midwife Nannette as well, who was just leaving a birth.

We got home around 4pm and I went inside while Aaron stayed in the car with the napping kiddos and to take a short nap before getting the birth pool ready. My mother-in- law helped me get the bed ready with plastic and sheets on top and we got the pans out to boil water to warm the birth pool. I made a snack (cinnamon toast and honey roasted peanut butter – yum!), texted a few friends letting them know that I “thought” I was in early labor and that I was going to take a nap, but not to worry if they didn’t hear from me for a while, after all my other labors were 40 hours and 20 hours. My friend Tania pointed out that if it was the 4th or 5th of May, she would have a fun birthday :)

At 5:20 or so I woke up from my nap and when I stood up it felt like I most likely had some bloody show – woohoo! I needed to go to the bathroom and sure enough there was a little blood. I also had to poop. It was a messy poop and then the contractions started coming quicker and I needed to breathe through them a bit more. As I was sitting on the toilet I texted Aaron something like, “I hope the birth pool is set up and you aren’t still asleep.” I didn’t get a response or see that he read the message, so I called him and a very sleepy sounding husband answered the phone. I said he needed to set up the pool and he sprung into action.

I kept trying to wipe my butt clean in between contractions but I never had enough time, so I would wipe wipe and then sit for a contraction, and wipe wipe, sit for a contraction. I eventually got it clean. I just remember thinking that I didn’t want to birth the baby in that bathroom and I needed to get downstairs. I also remember thinking that if I get in the water, everything will slow down. By now the contractions were 1.5 minutes apart and lasting 45 seconds to a minute long. With my now super clean butt, I headed downstairs, Aaron takes one look at me and says “is anyone on their way?” I say “I don’t know, just light the candle.” (the candle was from my blessing way and meant to be lit during labor).

I head over the couch, knees on a pillow leaning on the seat and begin to call nannette and text the rest of the birth team in between contractions, as Aaron is trying to get the birth pool ready..

This was all around 5:45pm – I spoke with Nannette who heard me breath through two contractions and she said she was on her way and would be here within the hour. My text to Lindsey and Andrea (friend and doula) at this point said, “Contractions much more intense, a little blood, 1.5/2 min apart, and 45 sec to 1 min long or so. no vocalizing yet.” So I still wasn’t actually telling people that they should come. A few contractions later, I then added to Andrea “Can you come?” and to Lindsey “I’m so hot.” So they were on their way.

The contractions had picked up and were more intense and I needed some counter pressure. So, Aaron, in between caring for Winfield (who had woken up, Emily was still asleep) and setting up the birth pool would come over and press on my back. He had a minute of helping me and then a minute to do other things. His mom had to help through one contraction as well (thanks Sharon!) as he was busy doing things. Eventually he had to give up on the birth pool (he forgot to put the liner in and so was emptying the water already in the pool and was about to start again) and just stay with me because things were happening fast. I started vocalizing, loudly. And then things were just happening. I felt something come out and I said “something is happening” and it was my water bag coming out and bursting. I switched positions and was leaning on the birth ball at this point with Aaron behind me on the couch. He could actually feel where Liesel was moving down to, so could really help me direct my energy to the specific place in my body as she moved through. It was crazy and fast and then I was pushing with no way not to push.

Aaron didn’t have gloves or pads down or water or oil or a trash can or anything (and apparently there was lots and lots of poop (sorry babe!). I was aware that I was birthing this baby and wondered how my perineum would do without oil or a warm cloth. At 6:45pm, Lindsey arrived. Her presence was wonderful as she let us know she was there, holding space as Aaron continued to guide my energy and I let go into the beautiful chaos of this birth. I was pushing, Liesel was coming. About 5 minutes later, Nannette and Grace arrived to find Aaron touching and holding the head of Liesel as she was crowning. Her head was out, he switched places with Nannette as she instructed me to another position to help Liesel maneuver her shoulders out. Shoulder dystocia is rare, but not necessarily a surprise in precipitous births. Nannette calmly did her thing and with two hands inside my vagina working the shoulders, she asked Liesel to move her shoulder in order to come out. I heard her ask and knew in that moment that all of the prenatal visits (every single one of them) where Liesel would only let Nannette hear her heartbeat after being asked had led to that moment in the birth. And sure enough, with the asking, permission was granted, she moved her shoulder and out came my beautiful flower, Liesel Florette.

She was here! In 1 hour and 20 minutes my baby was here! It was insane and wonderful and hilarious and crazy and adrenaline filled. It was letting go and not thinking and being wildly grounded in the sacred journey of birth.

Her cord was crazy short or tightly wound (I didn’t see it) and so she could only be on my lower belly. I looked around and saw Andrea (hi! – I had a baby) and the team and my son and older daughter and husband – who said “that was easy” to which I laughed and said “so easy”.

Liesel Florette, 11 pounds 4 ounces and 23 inches long. So glad she arrived safely, and so thankful for the perfect timing of the birth team and the amazing birthing skills of my husband. Thank you Aaron, Sharon, Emily, Winfield, Nannette, Grace, Shawna, Andrea, Lindsey and, of course, Liesel. What a crazy ride!

Birth photos credit: Lindsey Welch Photography

Read the birth story of Liesel’s big sister Emily

Read the birth story of Liesel’s big brother Winfield

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Click HERE to learn more about the Community Birth Stories Project or to submit your own birth story

Community Birth Story: Saoirse

By Two Rivers Childbirth
May 12, 2016
Birth Stories Project

As told by Nannette:

I have to tell some back story first. I never wrote my birth stories for my first two children, which I plan to rectify starting here.

Jonah was my firstborn. I had just finished my nurse-midwife training program and taken my board exams. That was a long grueling 3 years, during which I got pregnant and miscarried. I discovered I was pregnant with Jonah just weeks after I passed my midwifery boards. The news arrived the same day our miscarried baby would have been due. Bittersweet. I was a young midwife just starting her homebirth practice, and I knew immediately I would have a homebirth with my son. My mother had cesareans for all 3 of us. But it was for a known problem related to an auto accident messing up her pelvis. I never doubted that these strong Irish hips could handle childbirth. There were not many choices of midwives in my area, but we settled on a very nice midwife and started the journey. I convinced my husband, who had just started his first full time job, to invest the time in Bradley classes (along with my best friend who was going to be at my birth as support and photographer). Things bumped along, I was having a healthy pregnancy and was busy with side jobs while I started my little homebirth practice. My due date came and went, but no biggie, I was a primip. Weekly visits with the midwife became concerning, though, as my son did not engage in my pelvis as he should have. When I passed the 42 week mark, and he was still not engaged despite regular bouts of prodromal labor, I went to see my “backup” hospital midwife on a Wednesday afternoon at 4pm. We had a BPP done, and it wasn’t great. And they told me Jonah (I found out he was a boy at this point) was 12.5 lbs, which frankly scared me as a first timer. And he was still not engaged. And my hospital midwife, who had been my preceptor in midwifery training, looked at me and bluntly said, ” you know the answer, Nannette. You just need to make up your mind.” I cried and asked to be induced (which wasn’t a good idea because he was so high in my pelvis and showing signs of stress), and then I accepted that my son was going to be born by cesarean. I looked at the doctor and asked to have it done right away. “If I go home, I don’t know if I can make myself come back.” So Jonah Graham was born at 7:21pm on June 29th by cesarean section weighing 10lbs8oz. It was a surreal experience. I was on automatic pilot for a lot of it. One thing I remember the most was how I panicked and almost cancelled the plan when I was getting the spinal anesthesia (they stuck me several times and kept hitting a nerve, which was excruciating and nearly sent me into a panic attack). The spinal finally took, I got draped and swabbed, the docs did their thing, and when I heard them lift him out of my stomach I didn’t breath again until he cried. And then I let myself break down. That was the start of a long, dark slide into postpartum depression. A story for another day.

Fast forward 10 months. I am in the middle of getting help for the PPD when I become pregnant again. We had treated Jonah for torticullis and we linked his malposition to an injury that I had had around 36 weeks that apparently had really torqued my pelvis. So with regular chiropractic care I was confident this was a problem that would not repeat itself. I was working with a midwife that was confident in VBAC (vaginal birth after cesarean), and I decided to plan a homebirth for my second baby. I worked through the PPD and the emotional issues that surround having a VBAC, and reached 36 weeks with our baby girl. She turned breech at that point, and it forced me to stop working and pay attention to her. We did 2 weeks of alternative/complementary techniques and successfully turned her back to head down. I then got extremely ill from the flu about a week before her due date. Not cool. In hindsight, I should have been hospitalized. On Easter Sunday, my 40 week mark, we were eating dinner with my husband’s mother, and contractions began. They felt like the prodromal ones I’d had with Jonah, which was encouraging! They slowly intensified through the night, and at 7am the next morning I was dealing with them in the living room and prayed for a clear sign because I wasn’t sure if I was being a wuss about them or if I was really in labor. Than, hallelujah, my water broke! It was on! My labor had started spontaneously at 40 weeks and 1 day! Major VBAC milestone! I was in active labor by late morning, but it was a really rough day. I constantly vomited and became dehydrated, and also had some terrible pelvic pain which even the chiropractor could not resolve with a visit while I was in labor. I reached 8 cm and the contractions started to wane. I nearly fell asleep in the pool. And it wasn’t the good sleep that midwives are thankful for, a pause to gather yourself. It was an exhaustion borne of utter depletion. I called my birth team and said, “I know I can do this. But I don’t think I can do it here.” And with that we called the hospital, praised God that Dr. Baltierra was on, and I counted in my head the 4 contractions I would endure in the car for the ride to the hospital. I got to JMH, checked in, got an epidural, eventually got an IUPC and pitocin to get contractions going again, and about 5 hours after I arrived at the hospital I woke up in a panic because the epidural WASN’T WORKING ANYMORE!!! And lo and behold I was complete and ready to push! They hiked me up and got out the mirror and at 5:39am on April 2nd, 2013, I pushed my beautiful 10 lb daughter out in 20 minutes! I did it! I birthed vaginally! And then I blacked out when I sat up to nurse and we discovered I had been severely anemic, probably an effect of the severe flu I should have been hospitalized for, and I had to get blood transfusions even though I had hardly bled with the birth. I also suffered some SPD damage and couldn’t walk normally for several weeks. But it was worth it for my VBAC!!

So fast forward 2 years. I was a very busy homebirth midwife at the time. I had recently gone through some very stressful transitions in my business partnership, and was praying for a year without change, just some stability so I could heal from the pretty bad emotional trauma. My daughter was weaning, and I knew that a pregnancy was possible soon. I am lucky enough to not ovulate until my babies stop nursing altogether. My cycle started, and repeated, and as the third round was finishing I looked at my husband and said, “all bets are off, you know.” We didn’t attempt to prevent, and sure enough, there was a positive. As stressful as it was, I was also thankful for the gift of another baby. I knew I would not be able to keep up the pace I was at with another child, and made the decision at that point, after a lot of prayer and counsel, to grow my homebirth practice instead of close it. God was watching out, and at the same time I decided I would hire one or two midwives, I was contacted by 2 midwives who were just what I wanted for Riverside. So I entered the second trimester with a good plan for work/family balance and the knowledge that this time I was going to get a proper maternity leave. I was so thankful for a healthy pregnancy. It was the best of all of them. I had good help, I was getting good sleep and exercise, I didn’t gain weight until the last few weeks. My belly measurements were consistently on track, which was better than my first two pregnancies which had always measured ahead, so my midwives thought this baby was going to be smaller which was nice to think of having had 10+lb’rs. I had amazing community support and was shown so much love by truly incredible women I am blessed to know and work with! I even got a surprise mother blessing! Jonah and Tabi were in love with the baby and so interested and involved in the pregnancy. I had an ultrasound but the baby wouldn’t play the gender reveal game, so it was really a surprise! We had a boy name and a girl name, Jonah and Tabi were excited to be there for the birth, and my midwife was really wonderful for me, a great pregnancy all around. I was “due” December 29th, so Jonah was expecting a Christmas time baby which just blew his 4 year old mind with anticipation. Christmas came, and went. New Year’s came as well, and went. The week after came. And went. And the mind games that accompany going overdue began. Thankfully, this was not my first VBAC, I knew my body was quite capable. And I thought this was a boy baby, so I figured maybe my boy babies just go late. I was encouraged and supported, and got wonderful help from friends and my fellow birthworkers during this time. I didn’t do anything really aggressive to start labor as I wasn’t worried over anything. I was fine, baby was fine, it was just taking a bit. I had a cervical exam at 41 weeks or so, and it was favorable, and I got a BPP done at 42 weeks, and it was just fine. But going overdue is emotionally taxing, and I cried on more than one morning when I woke up still pregnant. I worked on a labor music list. I crowd sourced some suggestions for music with a heavy bass line that would just carry you along without thinking. I didn’t to think too much. I’m a midwife, and know a lot, and I didn’t need to go down certain lines of thought. I was fine, baby was fine, my midwives were relaxed, I was just gestating a while.

On a Wednesday evening April 13th, 42 weeks and 1 day, I had some regular almost-contractions, and we inflated the pool just in case. But Thursday morning, I woke up well slept and still pregnant. On Friday evening, some good friends took my kids to the local Backyard Inflatables while I got acupuncture. I was relaxed, and we made plans to get some Glory Doughnuts for breakfast the next morning. You should definitely get doughnuts from them some time. Ah-mazing. So Saturday morning, January 16th, I woke up around 6am. The house was quiet, and I felt like getting up and just hanging out by myself. I had a few of the usual braxton hicks as I was sitting in my rocker petting one of the cats. I noticed they had some good pelvic floor pressure to them, which was an encouraging thought as that meant baby’s head was where it should be. But they were just BH as usual. My husband got up around 8:00, kids were sleeping in from getting worn out playing the evening before. We did a few chores, and I mentioned the doughnuts plan. So he left at 9:00 to get some. I took a picture of my sweet sleeping kids, climbing up on the bunk bed (timestamp 9:26am). No contractions. Just a nice, quiet Saturday morning. My midwives texted to check in. One midwife mentioned coming by to do some things to maybe encourage labor. I let her know I’d had some braxton hicks that had a little pressure to them, but that my kids weren’t awake yet so I didn’t think labor would start knowing they were about to get up. Then, I had one. A painful contraction. Not too long, but definitely different. Jonah woke up at 9:40, came downstairs. I had another one. I sent him to watch some cartoons and realized I had been a little short tempered with him. I had another one. I decided to go upstairs, and couldn’t get up the stairs before another hit. Well, well! I made it to my bathroom and texted my husband, “on your way back?” (timestamp 9:57am). My midwife texted a two part question, and I barely had time to text back “yeah”. (she later said she immediately knew it was time to come, that was not a usual texting style for me). Within 20 minutes of the first contraction I was in full blown labor. I could only stand, I had the sudden fear of my water breaking in my pants and undressed. I started vocalizing. I remember thinking vaguely “if it feels better to make noise then I must be in active labor?” The contractions hurt. A lot. And were fast. I couldn’t time them. I couldn’t text or call anyone. I couldn’t do anything. I tried to kneel, and couldn’t handle being bent and stood right back up. I paced around the bathroom, and kept saying in an attempt to keep myself grounded “this is how babies are born, this is how babies are born, oh God, this is how babies are born” as I experienced huge amounts of pressure with seemingly eternal contractions with hardly time to breath twice between them (later the chart said they were 90 seconds long and 30 seconds apart, so I wasn’t imagining it). My husband got up there, got the pool filling, got the babysitter and photographer on the way, texted the midwives (or called) to make sure they were enroute. In short he did a great job getting things in place and rolling. I starting feeling lightheaded and a little panicky, the contractions were even stronger. Chris, one of my midwives, arrived at 10:40. I started to cry and kept saying they hurt. She was very calm, listened to baby with the doppler, and started getting things out. She encouraged me to try to get in the pool. I felt locked in standing mode, afraid to move lest the contractions get EVEN stronger. But I managed to scoot over to the pool and climb in (at 11:00 per the chart). As I sunk into the water the next contraction crested. That was kind of awful. The feeling of my belly getting buoyant but then getting driven down in the contraction. The next one was better though, and I settled into the pool. The contractions got a little more spaced, maybe a minute apart, but then I started feeling them in my legs. Thankfully I was in the water, the pain in my thighs wouldn’t have been great with standing up. I complained. A lot. And cried, and repeated that things hurt and that I couldn’t do this forever. But I mostly had my eyes closed and my face down making lots of noise. A little after 11:00 I looked up and Lindsey, my photographer, had arrived. Grace arrived at that point, too. Grace has been with me a long time. My first birth assistant when I started catching babies while pregnant with Jonah. My doula for Tabi’s birth. My friend. And planning to catch this baby as my student midwife.

Bradley was there (I made a point to clock his presence as I had actually blanked out his presence at Tabi’s birth).

I looked up at some point and saw Jonah sitting on the side of the bed watching me labor. Mary was there, my good friend and my children’s nanny, I never worried about Jonah and Tabi being cared for.

At this point I feel like I was being dramatic but just needed to be allowed to not have my s*%^ together for once. This labor felt like a tsunami and I was just rolling around in the water underneath. I think I repeated that I couldn’t do this for 6 more hours and Grace assured me it wasn’t going to be that long. After what seemed like FOREVER my water broke (timestamp 11:10). My midwife voice automatically asked if the water was clear, which it was.

I had some urge to push with that contraction. And then I had a blessed, blessed, 2 minute pause. I came up for air. My head cleared. I thought, and I think I said, “I can do this part. I know how to push.” Because I did. I revisited how I had pushed Tabi out in 20 minutes, my first vaginal birth. And how proud I had been (and am) of that. I had no idea how long I had been in labor for, but now it was time to push and I came back to center. Everyone was quiet. My ears were kind of ringing. I don’t know how loud I was on the outside, but there had been a whole lot going on in my head and it had all stopped. That long, blessed, 2 minute break. And then the contraction came and the deep, throat/abdomen/pelvic “HUHHHH” started. My body was pushing. A couple of contractions, and I clearly felt the round head of my baby descend. It did not feel like pooping. It felt like a large round hard thing moving down in my pelvis. That was my baby’s head! I hadn’t felt this with Tabi, being on the epidural. It was AMAZING to be aware of it. I felt some burning and said something like “am I crowning?! Please tell me I’m crowning!”, to which there was no reply. Crickets. “Crap, I’m not crowning…” Next contraction. There was some burning, which I clearly identified to be at the place I had had a minor tear with Tabi’s birth. I was ok with that. I was breathing through these. Not really on purpose. I was just trying to ride these suddenly close again contractions that were pushing my baby out. All of my energy was focused, I had to stay stretched out, one hand out on the side of the pool, body extended back. A straight path for the baby. Nothing in the way. My body doing its thing like I’d know from my first pregnancy that it could. I breathed and grunted and didn’t add any pushing effort and the baby came down and around and I felt the head birth. So amazing. I heard Jonah and Tabi’s voices, they were there at the pool side and saw the baby’s head and face. I had really hoped they would have that experience of seeing their sibling enter the world.

A minute passed, and another. I felt midwives’ hands back there. No one was worried, though I wasn’t really looking at faces, and I wasn’t worried. I did have the sudden thought that this had been long enough and it was time to push baby out. So I did push to finish the birth. And then I heard those words, “grab your baby!” I reached down, and glimpsed cord around the baby’s neck as Grace did, we turned baby in the water to unwind the cord and bring baby up.

And there she was. My baby girl. Born at 11:27am, less than 2 hours from the first recognizable contraction. “It’s done!” She took a minute to breath. It had, after all, been a fast birth. I gave her some puffs and stimulation to her back and feet she drew in her first air. Grace helped her with some postural drainage. I cried and thanked God it was over.

Tabi was absolutely thrilled that it was a girl!! “It’s a girl, it’s Saoirse!”

And she lifted her sweet little hand up and my baby was with me. Oh lordy. The tears <3

She weighed 9lbs 4 oz, nearly a pound less than my others. My postpartum experience was worlds away better. Resting in my own bed, being well taken care of, my children coming to see their baby sister. Normal, unhurried, quiet. As a midwife, I work hard to provide this experience to families. And I had finally had it myself. It was truly my best birth. And one of the best times of my life.

Something came up the week after the birth that I want to include here. There is a blog that I follow, Birth Without Fear, by a woman name Jan. Last year she had described being pregnant again; she had had cesareans, than a VBAC, than another baby, and was planning a homebirth again. She went overdue, and one morning woke up and knew it was time to have her baby and had a walk in cesarean. She felt empowered, she owned her decision and experience. But she described having an emotional breakdown just before the surgery, and how she had realized based on her past birth experiences that she was transitioning emotionally at that moment as she was getting ready to meet her baby. It was an incredibly healing read for me. I had experienced labor in all its raw, unmediated strength. I had “lost it” for a bit, felt panicky, cried, let out a lot of emotion. And I realized that I had done that before with Tabi’s birth, when I woke up panicky and ready to push. And I realized that the moment when I almost broke down while preparing for Jonah’s surgical birth HAD BEEN MY TRANSITION MOMENT. Realizing that connected all my births. It healed something I thought I had been over in my experience with Jonah. I did birth him. I went through the depths emotionally, though not necessarily physically. I realized I had carried some shame about how I almost had a panic attack with the spinal being inserted at Jonah’s birth. And with waking up all freaking out at Tabi’s birth. But those were my transition moments. It’s just what I do. I have to let go for a minute. And just let things happen. And just birth my babies.

Birth photos credit: Lindsey Welch Photography

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