Third Time’s the Charm

By Christina Wypijewska
Issue 129 March – April 2005

After laboring at a birth center and in a car, this mom finally found her way to birthing at home.

Three children togetherEvery woman should have the opportunity to . . . give birth as she wishes in an environment in which she feels nurtured and secure, and her emotional well-being, privacy, and personal preferences are respected.

—Coalition for Improving Maternity Services

My water broke one sunny afternoon—a week before the due date for our third child. Not knowing quite what to expect, I realized that our family was about to experience something truly sacred. While anticipating the onset of labor contractions, my husband, Martin, and I made some phone calls to family and checked the supply list to make sure we had everything we needed for our long-awaited homebirth. Although we didn’t realize it, we had been planning for this day for more than six years. The natural births of our first two children had allowed us to fully experience the calm of a freestanding birth center and the frenzy of an emergency birth on the side of a highway. Despite the obvious differences, both events taught us the importance of balancing the need to be knowledgeable with the need to surrender to the power of birth. The lessons we learned from the combined experiences gave us the courage to choose a homebirth in a culture that doesn’t necessarily make it easy to do so.

Our journey began with the birth of our first child, Maya. Martin and I prided ourselves on being informed healthcare consumers, and we knew that we wanted to be significantly involved in all the major decisions facing us. We were strongly committed to the idea of receiving continual support during pregnancy, labor, and delivery, and we believed that midwifery care could help protect us against unnecessary medical interventions such as routine episiotomy, continuous electronic fetal monitoring, or artificial induction of labor. Although we were determined to find a midwife, we didn’t know much about choices of birthplaces and assumed that we would have a hospital birth.

We learned that our insurance provided full coverage for BirthCare & Women’s Health—a group of certified nurse-midwives operating a freestanding birth center and homebirth practice. As we set out to learn more about where we should have our baby, we discovered that for healthy women with low-risk pregnancies, planned births in birth centers and at home are just as safe as, if not safer than, hospital births. Indeed, hospitals often have policies that encourage interventions or that restrict movement—factors that may actually complicate normal labor. During our first visit with one of the midwives at BirthCare, we learned that it had a rigorous screening process. Even after being accepted as a patient, my health would be carefully monitored throughout the entire pregnancy. For problems that might arise, the midwives work with backup physicians and are sometimes required to transfer patients to the nearest hospital. They also are trained to carry out emergency procedures. Because of their thorough, skilled, and comprehensive care, they demonstrated low rates of medical interventions and had superb birth outcomes. We were convinced that birth outside a hospital was safe, supportive, and far more appropriate for us. In the end, although we saw little difference between homebirth and the birth center, we felt more comfortable choosing to have our baby at the center, primarily because we were first-time parents living in a rented city apartment.

During the pregnancy, we looked forward to our prenatal visits and became true partners in our own care. The visits were never rushed, and the midwives took time to answer all our questions. We also educated ourselves with stacks of reading material and 12 weeks of Bradley childbirth classes, but nothing could prepare me for the intensity of becoming a mother. Although labor progressed smoothly and according to the stages outlined in the Bradley workbook, there was nothing ordinary about Maya’s birth. Every event of that night is forever etched into my mind.

Soon after the contractions began, in the middle of the night, they became regular and progressively stronger. By the time I could no longer tolerate any distractions, we had decided to drive out to the birth center to meet the midwife. Because the only comfortable position for me was kneeling on all fours, the 20-minute drive from Washington, DC, to Virginia was surprisingly difficult. We arrived at the birth center at 5:00 a.m.—just three and a half hours after the first contraction. We were the only ones there, and the midwife gave us the space we needed to progress. At first I spent a lot of time sitting on the toilet, flushing my body of the Thanksgiving dinner from the previous day—uncomfortable but necessary. Eventually, the midwife suggested that I climb into the bathtub to ease the pain. This was something we hadn’t considered ahead of time, but laboring in the bathtub was remarkable. The warm water enveloped my aching body, providing the necessary relief and support.

I labored in the soothing water until the very end, when I felt the need to climb into bed for some much-needed rest. As soon as my head hit the pillow, however, I was overcome with a force so powerful that I lost myself to something greater than any of us in that room. I was surprised that the loud moaning I heard was coming from somewhere deep inside me. Although I didn’t know it, I learned from the midwife that my body was finally pushing the baby out. As she placed warm compresses against my perineum to encourage stretching, she let my body lead the way.

After what seemed an eternity of burning pain that did not let up, even between contractions, Maya came gently into this world. She was healthy and perfect, and my body was intact. Other than a few minor abrasions, there had been no tearing. Although I was tired, I felt strong and ready to be a mother. We rested quietly as a family and left the birth center later that day. The midwives visited us at home several times during the following week to monitor our recovery and assist with breastfeeding. The entire experience was so empowering that we were hooked on midwifery care and the birth-center philosophy.

After Maya’s birth we moved twice, finally settling in New Jersey—closer to family. Because we were hoping for a repeat performance of Maya’s birth, we chose to have our second baby, Max, at the nearest freestanding birth center. However, labor with Max was so fast that we didn’t make it to the center in time.

I awoke with the first contraction at around 1:30 a.m. and was immediately flooded with memories of laboring with Maya. Although the contractions felt very low in my abdomen, I thought that labor would progress at the same pace as before. Indeed, at first I wasn’t even sure if I was in real  labor. But as I became more  alert in the shower, I felt my contractions grow significantly  stronger. I came out of the shower shaking uncontrollably. I managed to get dressed, and we bolted to the car.

I climbed into the backseat of our Subaru station wagon and sat on the Chux pads and towels that Martin had prepared in case my water broke on the way. Three-year-old Maya was sleeping in her car seat next to me. As we drove the familiar roads, the contractions came fast and furious, piling one on top of the other, leaving me no time in between to recover. I knelt over the backseat, pounding my fists to release the energy. I was alarmed that I was getting no relief. Although I was trying to control what was happening, there was no way to delay the inevitable. By this time, Maya had awakened, wondering if the baby was coming soon.

I needed to focus, but the speed of the car was making me dizzy. I begged Martin to stop, but he kept driving faster and faster. The flashing lights of a police car on the side of the highway ahead signaled potential help, and Martin was finally convinced that it was OK to pull over. In the seconds it took the state troopers to move Maya into the front seat of the car, Martin could feel the baby’s head ready to emerge. The urge to push was unstoppable, and with Martin holding me up, I was able to completely let go. Everything happened with remarkable speed—the baby came out with the force of a rushing river. Martin’s steady hands guided him onto my chest as the state troopers looked on in amazement. We wrapped him in towels. I was exhilarated to be holding this tiny miracle—a mere 90 minutes after labor had begun. Cramped together in the backseat of the car on that hot July night, we marveled at Max’s arrival and felt truly blessed.

The paramedics appeared on the scene in time to cut and clamp the cord. Although we pleaded with them to drive us to the birth center, the ambulance crew took us to the nearest hospital. Arriving at the hospital, which is known for delivering more than 7,000 babies a year, we were confronted with blinding lights, blaring televisions, and the usual commotion of an emergency room. The hospital staff ignored my protests at being separated from my newborn baby, and I was left alone as they whisked Max away to the nursery. I delivered the placenta on my own into a metal pan that I requested from the overworked emergency-room nurse. While Martin monitored the care that Max was receiving, he also worked tirelessly to get us all back together. Not only did Max miss the opportunity to breastfeed during those first hours of life, but he was bathed and subjected to repeated blood tests without my knowledge. Several hours later, reunited at last, we were relieved to leave the chaos of the hospital to recover peacefully at the birth center.

By the time I was pregnant with our third child, Martin and I knew we were ready for a homebirth—it would enable us to experience birth naturally, with dignity and respect. We wanted to be able to make informed choices about everything that happened to my body and to the baby. We relished the privacy we had experienced during Maya’s birth and wanted to have access to all the comforts available at home. Most important, we wanted Maya and Max to have the opportunity to welcome the baby in familiar surroundings.

Finding a skilled and caring provider to support and advise us during pregnancy and childbirth was a key element of making homebirth a reality. Our insurance did not discriminate against midwives or homebirth, and we were extremely lucky to have found Judith Hagan, a knowledgeable, skilled, and devoted certified nurse-midwife. An oasis in northern New Jersey, Judy’s thriving homebirth practice is one of the few of its kind in the entire state. With reliable backup doctors and an impeccable track record, Judy is extremely thorough, and she fully respects her patients and the boundaries of homebirth. Under her care, we were as ready as we were ever going to be.

Near the end of my pregnancy, when my water broke unexpectedly, we were unsure about what would happen next. Maya and Max had both been born after their due dates, and with those births, my water hadn’t “broken” until they were actually being born. After a phone call to Judy, we were assured that contractions would most likely begin soon. An hour later, they did.

While waiting for the contractions to begin, we called Martin’s mother, who drove over to help take care of the children. We waterproofed our bed with plastic sheets over the mattress and under our own cozy flannel sheets and made sure we had plenty of towels and blankets readily available. As we carried out these last-minute preparations, it became clear that we had made the right decision: with nowhere we had to drive to, we were able to prepare for the birth in a relaxed, unhurried way.

Even after the contractions began, I was able to spend some quiet time with Maya and Max. We read stories and talked about welcoming the new baby. For the next two hours, my contractions were predictable and bearable. I managed to move around easily and felt comfortable. As the contractions grew stronger and more frequent, Judy and her assistant arrived. Judy quickly and quietly set up her equipment and unobtrusively checked the baby’s heart rate at regular intervals. Although she gave me the privacy that I needed, she was also acutely aware of and in tune with the progression of my labor. Her assistant, a doula with years of experience supporting women in labor, provided hot rice packs to soothe my aching back and suggested I rock my pelvis to help move things along. Together with Martin, she and Judy made sure I was comfortable and well hydrated.

Judy’s unassuming confidence and compassion were a source of strength for me as the labor quickly progressed. Being at home gave me a heightened sensitivity to the intense changes occurring within my body, and I was glad to be laboring in the familiar, candlelit atmosphere of my own bedroom, surrounded by the people I loved.

When my body was finally ready to push, I crawled into my bed. As each contraction took over my entire being, I could feel the baby moving through me. My energy was entirely focused on pushing the baby out, to end the intense feeling that had overtaken me. The pain was bearable because I knew it would soon end. The hard work culminated in the birth of Lukas.

With pride, Maya informed the rest of us that the baby was a boy. She marveled at his existence and was giddy with excitement. Although Max slept through the birth, Martin’s mom brought him to our bed just minutes later. When he greeted “his baby,” it was love at first sight. The five of us never had to leave my bed, and I was grateful to be holding Lukas during his first hours of life. As we enjoyed these peaceful moments together, I knew there was no place like home.

FOR MORE INFORMATION

To learn more about the homebirth practices mentioned in this article, contact:

BirthCare & Women’s Health, 1501 King Street, Alexandria, VA 22314; 703.549.5070; www.birthcare.org

Judith Hagan, CNM, Mother and Child Midwifery Associates, 33 Mount Pleasant Avenue, Rockaway, NJ 07866; 973.983.7560; www.babycatcher.com

For help in finding a midwife, contact:

American College of Nurse-Midwives, 8403 Colesville Road, Suite 1500, Silver Spring, MD 20910; 240.485.1800; www.midwife.org. ACNM provides an on-line search service to help you find midwifery practices in your area: www.midwife.org/find

Midwives Alliance of North America, 375 Rockbridge Road, Suite 172-313, Lilburn, GA 30047; 888.923.MANA (888.923.6262); www.mana.org. MANA’s website has a comprehensive list of references addressing homebirth, including studies documenting the safety of homebirth: www.mana.org/hbref.html

For help in finding a doula, labor assistant, or childbirth educator, contact:

Association of Labor Assistants & Childbirth Educators (ALACE), PO Box 390436, Cambridge, MA 02139; 617.441.2500; 888.222.5223; www.alace.org

Birth Works, Inc., PO Box 2045, Medford, NJ 08055; 888.TO.BIRTH (888.862.4784); www.birthworks.org

The Bradley Method of Natural Childbirth, American Academy of Husband-Coached Childbirth, PO Box 5224, Sherman Oaks, CA 91413-5224; 800.4.A. BIRTH (800.422.4784); www.bradleybirth.com

Doulas of North America (DONA), PO Box 626, Jasper, IN 47547; 888.788.DONA (888.788.3662); www.dona.org

Lamaze International, 2025 M Street, Suite 800, Washington, DC 20036-3309; 202.367.1128, 800.368.4404; www.lamaze.org

For help in finding a birth center in your state, contact:

National Association of Childbearing Centers (NACC), 3123 Gottschall Road, Perkiomenville, PA 18074; 215.234.8068; www2.birthcenters.org

Other Resources

Coalition for Improving Maternity Services, PO Box 2346, Ponte Vedra Beach, FL 32004; 888.282.CIMS (888.282.2467); www.motherfriendly.org CIMS is a coalition of organizations and individuals committed to promoting mother-friendly birth services. The Mother-Friendly Childbirth Initiative, a consensus document providing guidelines for a wellness model of maternity care, is available on its website.

International Childbirth Education Association, Inc., PO Box 20048, Minneapolis, MN 55420; 952.854.8660; www.icea.org ICEA is an international organization committed to freedom of choice in family-centered maternity and newborn care. ICEA offers certification programs and publishes educational resources, including the International Journal of Childbirth Education.

Midwifery Today, Inc., PO Box 2672, Eugene, OR 97402; 541.344.7438; www.midwiferytoday.com Midwifery Today promotes midwifery around the world and publishes a quarterly magazine, Midwifery Today, and a newsletter, The Birthkit, as well as books and other educational aids. Its website has information about homebirth and resources for finding a midwife or doula.

Christina Wypijewska, MPH, and her husband, Martin Scheidl, live in Mendham, New Jersey, with their three children, Maya (10), Max (6), and Lukas (4). Although mothering is Christina’s greatest passion, she also advocates for women’s health through her work with EngenderHealth, an organization dedicated to improving reproductive health care worldwide (www.engender health.org).

Susan Yoder Ackerman is a writer, teacher, and school principal. She lives with her husband and her cats in a farmhouse built by her grandfather in Newport News, Virginia. “After our third child’s birth in the snowy Virginia mountains,” she writes, “our family faced challenges in other places, including years in the savannas of the Congo and the fringes of the Sahara in Mauritania.”