Homebirth transferred to hospital

[allisonrose]

I had my second son on January 18, 2011. It was a long labor and this will be a long post. I am still processing the experience and would be interested in reading anyone's thoughts about it if you can manage to get through the whole story!

My first son was a hospital birth with a midwife. I'd hoped for a natural birth but I was GBS+ and my membranes broke before my labor began. I ended up getting pit and then an epidural to deal with the contractions. I luckily had a vaginal birth and healthy baby but I was disappointed with all the interventions. I knew I wanted a homebirth with my second. I live in an isolated area and was thrilled to find out there was a recently licensed midwife who lived just 30 minutes from me. The next closest midwives willing to attend my birth were 1 hr 45 minutes and 2 hours away. I chose to go with the close midwife (without interviewing the other two) due to concerns about traveling to prenatals with an rambunctious toddler.

My pregnancy was uneventful. I was getting a bit impatient as I approached 39 weeks - my first son was born at 39w2d. On Thursday (38w6d), I had a bit of bloody show in the morning. On Friday, I again had a bit of bloody show in the morning. In the very early am hours of Saturday, I woke to contractions. I timed them and they were irregular in interval and length. I managed to get some sleep listening to Hypnobabies. When my husband got up for the day, I told him about the contractions and he told me I should call the midwife. I did so at a reasonable hour (9 or so am). She said she would be on stand by and keep her updated. She reminded me to eat, drink, rest and pee. The contractions petered out for the most part as the day went on. I did a bit of light "nesting". I'd have a random contraction here and there.

Went to bed Saturday night and woke up again with contractions in the very early am hours of Sunday. Again the contractions were a bit on the short side and a bit irregular in interval. Again I managed to get some sleep in listening to Hypnobabies. The contractions continued throughout Sunday and started to get more intense in the evening. I spoke to my midwife who left it up to me when she would come out. I decided to try to get some rest (and let her rest). Listening to Hypnobabies wasn't helping this time. Finally around 2:30 am, I called the midwife to take her up on her offer of keeping me company. She got to my house about an hour or so later. We sat and chatted a bit and she casually observed me. She offered to do a cervical check to see what was going on since my contractions were still a bit short and irregular. I turned out to be 5-6 cm dialated which surprised us both. She contacted her assistant (a student midwife) who lived an hour or so away to come out.

(My memories get a fuzzier as time goes on.) Monday morning, the midwife made scrambled eggs for all of us since she wanted me to eat some protein and my hubby doesn't cook. Contractions were about 2-3 minutes apart. My hubby was going to run an errand and stop by the market and the midwife recommended that he not because she worried he'd miss the birth. I got into the birth pool at some point but my contractions slowed down so I got out. At some point, the midwife checked me and said she couldn't feel the cervix but then declared that I had an anterior lip and was approximately 9 cm. The birth assistant was a bit vocal about how she felt I really needed to sleep. I would try to lay down and rest between contractions but the contractions hit me like a ton of bricks when I woke to them. The midwife tried some herbal remedies to help the lip go away, to help the contractions be productive and later to slow contractions to try to get me some rest. She also had me breath through some contractions, changing positions after two to try to get the lip resolved. The midwife decides to try to have me push beyond the lip. She tried holding it back for me but it was so painful I couldn't even try. She had me sit on the birth stool to try some pushing. His head moved just a teeny bit.

At some point, she laid out some options and I went with herbs and attempt to sleep. It worked only slightly. Now it was Tuesday morning and the midwife suspected that the baby was posterior. The midwife tried checking during an exam but it was incredibly painful for me and she was unable to determine for sure. I had mentioned that the midwife may call her mentor who has been a midwife for decades for her opinion. An option that came from that phone call was try to turn the baby and then break my water. I said okay. I had closed to about 5-6 cms while resting. After my water was broken, some contractions felt a bit more productive but others were similar to the day before. After two or so hours, I was a 7. An hour or so later, I was really struggling through the contractions. The midwife said we can try one last time to get baby repositioned properly and he might be born very quickly. I decided it was worth a go but it wasn't productive and I was seriously breaking down under the pain. I said we should transfer and then sobbed on my husband's shoulder for a few minutes.

 

I know two of the OB nurses in the local hospital from the breastfeeding support group and am friendly with a third as a fellow mom. I had texted her in the middle of the night to ask if she was working - she typically works night shift. She responded to me around 6:45 am to say she was leaving shortly. I told her we might need to transfer and she spoke to the morning nurses and let me know about me and told me that they were some nice ladies and would treat us kindly. 

 

It was around 11 am or so when we left. We got to the hospital, got checked in. They started an IV and took some blood. I requested pain relief and the midwife asked for something in particular. I stated that I thought I would want the epidural. After all the pain, I longed for numbness. The IV meds worked quickly and made me sleepy. I napped for a while. It must have begun to wear off because contractions woke me. The nurse asked about the epidural and I said to give me a little while. The contractions intensified and then I asked for the epidural. They called the anesthesiologist who was at home. When he arrived, he waved our birth plan in the air and stated that giving me an epidural was contrary to our "demands". The nurse had checked me and found that I was 9 cms so he told me that I likely would have the baby before the epidural could even take affect. I started wavering on my desire for it. (Even though I remembered being 9 cms for quite some time the day before.) I got out of bed to use the bathroom. The anesthesiologist agreed to wait out in the hall for a few minutes.

 

While in the bathroom, I got up the resolve that I was going push this baby out. I came out and stood next to the bed and began pushing with contractions. The OB told me that I should get into bed to push. I said no. He again suggested it and mentioned I'd be less likely to tear in bed. I thought about how that was BS and declined again. Finally he admitted that he wasn't sure how to deliver a baby with me standing like that and looked at the midwife and asked if she "knew any tricks". She requested gloves and began coaching me. After a couple of contractions, she asked if I wanted to get back in bed and lean over the top and push like that. That sounded okay so I did (even though part of the reason that I didn't want to get back in bed was because it was high and getting in was difficult with my achy hips). But I didn't really like that so much. She suggested lying on my back and we did that. We got progress so we stayed like that. Eventually I did truly feel like I was pushing uphill but I just didn't feel like I could move! The midwife later told me that normally she would have encouraged me to move positions more but she caught the edge of urgency in the room and didn't follow her normal routine.

 

Although the OB gave up catching duties to the midwife, it didn't stop him from telling me to push, push hard, keep pushing. He told me to do three long pushes with each contraction but it was so hard to do. I had to stop to breath in between pushes!

Grant was finally born at 3:26 pm. They let the cord finish pulsing before clamping. The OB stitched up my tear which the midwife told me was a second degree (I had a third degree tear with my first). They left us alone for over hour to bond. Came back to do the weighing, measuring and a bath since he was quite bloody and gooey in general. They released us a bit under 24 hours later which I was happy for because I wanted to go home and be a family.         kjihbiiubgvtuciyciytgvbiomdv'ljknfdpiusvboguqwgbhrpio

[allisonrose]

Something funky happened at the end of that post!

Anyway, the things that bug me about the birth:

We tried to "Skype" the birth with my mom. It was my hubby's idea and I wasn't super comfortable but went along with it anyway. I wonder if I missed an opportunity there due to the sphincter law.

I also wonder if a more experienced midwife could have managed my birth better.

I had a checkup with my midwife last week and she said that she has a plan if I have another child, now that she "knows how my body works". I worry that my body is incapable of a natural birth. I don't want to believe it but I feel like I've "failed" twice.

Oh and my son had swelling on his head within a day of his birth which the midwife said does indicate that he wasn't properly positioned. (From what I was told, the nurse did call for an ultrasound to determine position but the person never came in.)

ETA: Somehow I forgot to write down that they gave me pit in the hospital.

[Tumble Bumbles]

First, congrats on your baby!!

I'm sorry things didn't go the way you desired. I'm grateful for you that you did have a vaginal birth though,  instead of them pushing and pressuring for a c-section. Because you expressed some concerns surrounding what happened, I want to just offer some thoughts I had while reading your birth story. If it's inappropriate to do so, I will happily edit. I would in no way want to contribute to any upsetting feelings you may have about your birth! 

I will say that based on the information you provided, that to me, I think the midwife could have handled things differently regarding the checks, telling you to try and push etc. I firmly believe a woman should be doing whatever she feels comfortable with, when she feels comfortable with it, through her entire labor/birth. Things like "declaring" lips, even cervical checks, suggesting when or when not to push can impede the natural process of labor birth and can, for some women, be way more harmful to the progression of their labor than helpful. I don't believe your midwife had any ill intent, but I believe her inexperience coupled with her and her assistant's strong requests for you to be doing things contrary to what you may have been feeling in the moment could have contributed to the transfer. The part about sobbing on your husband's shoulder, asking for a transfer, and the contractions becoming unbearable may have been "malpositioning" but it also sounds a heck of a lot like transition to me and I wonder if they were not hasty in the transfer. Now, obviously if a woman wants to transfer, by golly she should get one! -- but if it were transition (which of course happens so close to pushing) a more experienced midwife may have be able to deduce that and given you a more informed opportunity to choose.

I'm not sharing this so you'll beat yourself up with 'what if's' -- hindsight is 20/20 and if you choose to have more children, perhaps this examining this experience can serve to help build confidence in your body and what it is capable of doing rather than using it to confirm the fear that you can't birth naturally. I believe you can. Given the info above, I don't believe your body failed you. If anything (and again, not having been there) it was a culmination of a long labor coupled with an inexperienced midwife who was over-managing and being way too 'conservative' with your care as a result of her inexperience. No one can say for sure 100% if the outcome would have been different (not having been there) but it seems to me that had things been handled differently -- namely reassuring you of your capability, allowing you to do as you felt, to push or not push based on what your body was telling you, and limiting the cervical checks ( I'm really not a fan) may have made a difference. As an aside, I don't think any midwife can make the assertion that they "know how your body works" now. Labors can vary from pregnancy to pregnancy in the same woman so much that a statement like that may be a self-fulfilling prophesy for a difficult labor again!

Again, in the hospital, you did GREAT advocating for yourself and doing what you felt was necessary to help your baby out! I felt like there were times you were pressured during the home portion and hospital portion that may have hindered your labor, and that stinks.

I have to repeat, I think you did GREAT. You did the best you could with what info you had at the time and in the moment and your body DID succeed in bringing your son into the world and that alone is awesome.

Congratulations again :)

[KyrieNioMama]

Congratulations!

Something very similar happened with my first baby. She was a planned homebirth, but I developed a cervical lip and began reverse dilating just like you did because her head was presenting improperly. We ended up in the hospital where I got an epidural so that I could rest while I re-dilated to a 10 and have enough energy to push her out. It was a disappointing labor experience, but sometimes that sort of thing will just happen! I do think that my midwife's assistant encouraged me to push too early, and not being aware that the baby's head wasn't presenting properly, I ended up causing more harm than help by pushing when she prompted me to. With my second child, nobody told me when to push, and if they had told me to before I felt ready, I would have ignored them!

Congrats again on your new baby, and don't feel bad that the process wasn't what you envisioned. The outcome of a healthy baby is still the most important thing!

[allisonrose]

Tumble Bumbles - Transferring had been on my mind since the night before. The pain was quite intense. At one point, the midwife had my hubby and I go for a little walk outside to get some fresh air. I came close to asking her to come with us because I was afraid I'd break down and tell my hubby I wanted to transfer. Instead he was incredibly supportive (much more than I thought he was capable of).

I do wonder if the cervical checks were a good idea but I didn't know what was going on with my body. Sometime in the middle of pushing my son out, my body finally did kick in to pushing mode. I'm not sure when that would have happened if we would have stayed home. (I realized I forgot to write that they gave me pit in the hospital so my labor was tampered with.)

You are right though - I am so glad that I did have a vaginal birth.

Oh and you also hit on another issue: the assistant definitely had a strong opinion. Funnily she mentioned to me early in the labor that she and the midwife are both fairly intuitive and neither of them felt anything bad about my birth but rather that I would have a smooth birth. So much for intuition!

My midwife also said that she watches for an adrenaline rush to signal pushing stage but that I had a determination that was making that difficult for her.

KyrieNioMama - I'm very curious to hear how your second child's birth was, if you don't mind me asking?

[Tumble Bumbles]

Blaming you for her not seeing the "adrenaline rush" to push is...odd (at best). I've never even heard of that and it certainly isn't universal for all women, if it does exist.

That having been said, the few things you've revealed about your midwife, her assistant, and the things they've said and claims they've made, coupled with her inexperience-- it sounds like someone else might be a better fit should you choose to have more children.

To reiterate from my previous post, it sounds like you did exactly what you needed to do at the time with the information you had to bring your babe into the world in the safest place and time -- you did great and you should be proud of your body and yourself!!

Congrats again!

[KyrieNioMama]

Originally Posted by allisonrose 

KyrieNioMama - I'm very curious to hear how your second child's birth was, if you don't mind me asking?

My second birth was wonderful! It was a home, water birth. The entire labor was 5 hours from start to finish and I was never prompted to push. I just did what my body told me to do. It was an extremely smooth delivery with an easy recovery. He was 9 lbs 8 oz with a 14.5 inch head and I didn't need any stitching, either. :)

[allisonrose]

Tumble Bumbles - I'm not sure if we will have more children. I do have the feeling that our family isn't complete but financially.... I don't know what I will choose in regards to birthing. My husband wasn't very much in favor of a homebirth this time around so I don't know how he would feel if I asked for another attempt.

Rachel - It's good to know that a subsequent birth can go easily!

[allisonrose]

A little update: I had my 6 week PP check up with my midwife (a couple days early). I talked to her a bit about the birth as I am still trying to process everything. I asked her about the whole "I have a plan for next time" thing. She was telling me that black and blue cohosh can augment labor naturally. She said something about not using those herbs before being sure it was real labor and how she was waiting for my body to kick into high gear basically. I pointed out when contractions started Saturday and how I was in early labor for a good part of Sunday and she said something about yeah you were in labor for a long time. She mentioned how I was so exhausted. I don't think I truly was until Tuesday morning when I had gone back to 5-6 cms and had to work back to 9 cms and hopefully that one extra cm to be complete.

I mentioned about the assistant relaying options and she said thanks and she appreciated the feedback. She seemed to easily understand what I was saying.

While talking about if there's a next time, she pointed out that I've been talking about losing weight (it came up while talking about me considering a diaphragm for contraception) and mentioned that if I lost weight and then "trained like an althete" for the birth that I wouldn't be so exhausted. That didn't sit right with me. My labor was very long. I honestly don't think there's much I could have done differently to have been less tired.

Another issue that has come up since was that my husband was very concerned for my well being and our son's well being towards the end of the labor. I knew everything was fine and knew the midwife and her assistant was monitoring us both. But he ended up crying while hugging our toddler at our friend's house. So I don't know if the midwife didn't communicate well enough to him that the situation wasn't emergent or if he simply wasn't listening. But it is unfortunate that he was so worried. Yet he did mention that if we have another child and we are in the financial position to afford it that we could try for another homebirth.

[Tumble Bumbles]

 UGH. That is so dismissive and RUDE. Even women in the best shape can get exhausted in labor. She seems to have made a lot of definitive comments that in actuality, may or may not be true for you.

Like I said in my other comments, if you do choose another child (and yay for your husband for still being open to HB even though he was so worried... that's a good man) -- I would NOT choose her again. From even what you mentioned here, she sounds like someone I would totally run in the other direction from.

 While talking about if there's a next time, she pointed out that I've been talking about losing weight (it came up while talking about me considering a diaphragm for contraception) and mentioned that if I lost weight and then "trained like an althete" for the birth that I wouldn't be so exhausted. That didn't sit right with me My labor was very long. I honestly don't think there's much I could have done differently to have been less tired.

[Maine Mama]

Originally Posted by Tumble Bumbles 

 Even women in the best shape can get exhausted in labor. 

It's so true.  My cousin's wife had her daughter at home last May.  She's a marathon runner and was an alternate for the Olympics several years ago.  She was in labor for a little less than 24 hours and felt exhausted at the end.  She was asking the midwife, "Why do people do this?!"

So that advice, while probably helpful in a shorter labor, just couldn't make that much difference for a labor like the one you experienced.   

[littlest birds]

It really makes me angry that she is trying to blame this on you, your weight, your fitness.  Her comments are awful!   And that part about knowing to use blue/black cohosh next time also sounds like she's trying to save face, and not being truthful.

It sounds like it was sloppily handled.  I haven't been involved in births besides my own, but it upsets me that you were told to push without having the urge and that your water was broken at that time.  The way the assistant used her words and opinions seems to have influenced the environment a lot.  Overall it would have been too much poking and prodding for me and it seems like slow buildup of early labor that ended up getting rushed. 

I think Tumble Bumble's post was right on.  It could have been handled better...  But it's really only the comments that offend me and made me want to post.  I hope you can find someone better if there is a next time.

[allisonrose]

Regarding the weight issue, I guess I do fall into the category of overweight, but I'm certainly not morbidly obese. I'm 5'8 and started my pregnancy out at 190 lbs. I carry a decent amount of muscle on my frame so people generally think I weigh less that I actually do.

The comment bugged me also because I did feel I put in a good amount of time to preparing for labor: Hypnobabies takes a chunk of time everyday.

Thanks for the support, ladies. I really appreciate it.

[fruitfulmomma]

I transported too due to a funny positioning with my daughters head and was worn out and in a lot of pain from pushing and then swelling. I was about the same size as you at that time too. And I had previously had an easy-peasy 36-hour labor and homebirth with my son when I was 10lbs. heavier. It was the position of my daughter, nothing to do with my weight, that made it hard. Minnie Driver also transported after 3 or 4 days of prodromal labor with her son. Don't think anyone would accuse her of being overweight and out of shape.

[allisonrose]

You know you're on MDC when a mama refers to a 36 hour labor as easy. I've watched birthing shows that make a huge deal about a 24 hour labor!

Quote:

Originally Posted by fruitfulmomma 

 And I had previously had an easy-peasy 36-hour labor and homebirth with my son

[fruitfulmomma]

You know you're on MDC when a mama refers to a 36 hour labor as easy. I've watched birthing shows that make a huge deal about a 24 hour labor!

  - Yeah, I am so glad I was at home with him. I am afraid I would have been sectioned for failure to progress or some such thing if I had been in the hospital.

[belovdlady]

Transferring to a hospital from a planned homebirth is always accompanied by a sense of disappointment and sadness.

It seems that, no matter how much we have to be thankful for, or how right the decision was for that moment, we always go over every little detail to examine whether some different detail would have led to a different outcome.  The temptation to "blame" ourselves or others is universal.  The reality is that we don't get to be in control of birth; we don't get to be in control of death.  We can do everything "right" and still have to face unwanted situations.  That is part of being human, and it's part of growing up.  As a midwife, I share in the disappointment and sadness, the processing and re-processing, when the journey with a client takes a turn to the hospital.  We don't know why everything happens, but I believe we can learn from everything that happens.  Processing with a client is much like brainstorming.  "I wondering if ..."  or  "If there's a next time maybe we could ..."

We (mother and midwife) are trying to work out a sense of what happened and how we could make it better.  Nothing in this conversation is definitive, and there is no blaming going on.  We are two women that went on a journey together, and are now sorting out how to integrate the events into who we are and who we want to become.  This conversation seems to have diverted from supporting a mom who had an unwanted experience to vilifying the midwife who has poured herself into accompanying this mom no matter WHERE her journey took her. It is an intense work and calling to be a midwife.

Yes, I am the midwife.

[CookAMH]

Originally Posted by Tumble Bumbles 

First, congrats on your baby!!

I'm sorry things didn't go the way you desired. I'm grateful for you that you did have a vaginal birth though,  instead of them pushing and pressuring for a c-section. Because you expressed some concerns surrounding what happened, I want to just offer some thoughts I had while reading your birth story. If it's inappropriate to do so, I will happily edit. I would in no way want to contribute to any upsetting feelings you may have about your birth! 

I will say that based on the information you provided, that to me, I think the midwife could have handled things differently regarding the checks, telling you to try and push etc. I firmly believe a woman should be doing whatever she feels comfortable with, when she feels comfortable with it, through her entire labor/birth. Things like "declaring" lips, even cervical checks, suggesting when or when not to push can impede the natural process of labor birth and can, for some women, be way more harmful to the progression of their labor than helpful. I don't believe your midwife had any ill intent, but I believe her inexperience coupled with her and her assistant's strong requests for you to be doing things contrary to what you may have been feeling in the moment could have contributed to the transfer. The part about sobbing on your husband's shoulder, asking for a transfer, and the contractions becoming unbearable may have been "malpositioning" but it also sounds a heck of a lot like transition to me and I wonder if they were not hasty in the transfer. Now, obviously if a woman wants to transfer, by golly she should get one! -- but if it were transition (which of course happens so close to pushing) a more experienced midwife may have be able to deduce that and given you a more informed opportunity to choose.

I'm not sharing this so you'll beat yourself up with 'what if's' -- hindsight is 20/20 and if you choose to have more children, perhaps this examining this experience can serve to help build confidence in your body and what it is capable of doing rather than using it to confirm the fear that you can't birth naturally. I believe you can. Given the info above, I don't believe your body failed you. If anything (and again, not having been there) it was a culmination of a long labor coupled with an inexperienced midwife who was over-managing and being way too 'conservative' with your care as a result of her inexperience. No one can say for sure 100% if the outcome would have been different (not having been there) but it seems to me that had things been handled differently -- namely reassuring you of your capability, allowing you to do as you felt, to push or not push based on what your body was telling you, and limiting the cervical checks ( I'm really not a fan) may have made a difference. As an aside, I don't think any midwife can make the assertion that they "know how your body works" now. Labors can vary from pregnancy to pregnancy in the same woman so much that a statement like that may be a self-fulfilling prophesy for a difficult labor again!

Again, in the hospital, you did GREAT advocating for yourself and doing what you felt was necessary to help your baby out! I felt like there were times you were pressured during the home portion and hospital portion that may have hindered your labor, and that stinks.

I have to repeat, I think you did GREAT. You did the best you could with what info you had at the time and in the moment and your body DID succeed in bringing your son into the world and that alone is awesome.

Congratulations again :)

I agree with a lot of this and had similar thoughts as I read your birth story.  Mine was somewhat similar but ended in a c/s that we foolishly opted for. I was in a birth center. VERY experienced midwife suggested pushing at 9cm with a lip and that was the turning point. I should never have done that. I firmly believe that had I not pushed, and if I'd had a doula to be a voice for me, I would have waited and he would have been born there. I think he was posterior late in labor, and I also firmly believe that had the midwife offered different positions and some techniques to turn a posterior baby, it would have ended differently.

It's tough because we really rely on our care providers during birth. I love information and tips for birth but can't bring that to mind during labor. I need someone else who has that (and more, as a midwife or doula) to support me and lead me through. 

I left the birth feeling like a failure, and it was only in the last year or so (DS will be 2 in April) that I really came to understand what happened with his birth, that it wasn't my buckling under pain or my pelvis or my body or anything like that which lead to the [voluntary] transfer from the birth center.   Pushing before my body was ready and not addressing the posterior position are the two key things that played significantly into the end result. The same may be true for you.

To encourage you, I have EVERY confidence in this next birth (I'm 35 weeks!), I have no worries that I can't do it they way I hope. About 10 weeks ago, DH and I chose to switch from a hospital birth to a homebirth in order to have the freest and most supportive environment.  We felt confident in choosing our midwife, had already hired a doula with many, many vbacs under her belt (the midwife does too) and since the time we chose my midwife, we have since become even more confident in her abilities to be able to handle any recurrences of my last labor as we have talked with her and her assistant.

I am thankful you had a vaginal birth!! So thankful. You did not fail in any way in labor because you transferred, absolutely not.   It might take you a while until you're ready to go through birth again or you may just need to take more time to keep contemplating the events, but if you do have an interest in another homebirth, I don't think you have any reason not to go that route. However, I personally would probably want to find a different midwife. If I had the option of having my old midwife again, I think I'd have a lot of emotion and mental hangups of having her attend my birth again because of the things I feel she could have done for me.  That is just me though!

And kudos for you for standing up for yourself at the hospital. I wish I had done what you did when I got to the hospital.

ETA: I read your other posts. I don't like that your midwife referred to herbs to augment. You didn't need augmented in those preceding days, you needed an assessment of baby's position and she needed to get you into a variety of positions for 30 min or so at a time each to get baby to get better positioned.  That is the one thing I've learned in the last couple months as I read birth stories and contemplate drawn out labor - address the position, don't try to augment or induce. The body knows what to do but poor positions can greatly interfere with that.

Edited by CookAMH - 3/4/11 at 11:24pm

[1stTimeMama4-4-10]

Congratulations on a successful vaginal birth! I had a similar experience - you can read about it here if you are so inclined. Long story short, I wanted a natural birth, I labored at a birth center, and after 28 hours, I couldn't take it any more and was stalled at 8cm so we transferred to the hospital where I had an epidural and pit. I slept for 6 hours, then pushed for 2 and DD was born vaginally. I tore pretty badly in a starburst type shape.

I had lots of the same questions you did - perhaps if I had just had a little more encouragement, perhaps if I had tried another position, perhaps if my midwives had not checked me so frequently, it all would have turned out differently.  You know what? Anything is possible, and maybe if we had done things differently, it would have turned out better.  Or maybe it would have been worse. I still struggle with disappointment in myself, that somehow I failed because I was unable to have a natural birth without any interventions. But then I have to remind myself that the only reason I had a VAGINAL birth AT ALL was that I had done my research and planned and advocated for myself and had GREAT support between DH and my midwives, Had I been in any other practice, I know beyond the shadow of a doubt that I would have had a c-section.  From what you said, I think the same is true for you. 

So yes, by all means, do your research and plan for the next one, and I agree with PP that both of our issues may very well have been the result of some malpositioning, so that's certainly something to keep in mind.  But try not to beat yourself up, because you were able to have a vaginal birth and you didn't have an epidural. Be proud of yourself.  I don't know enough to say whether or not your midwife could have done better, but the bottom line is that if you don't completely trust that she did everything the best way she knew, or should have known, how, you should find another midwife. Not because she did anything wrong, but because part of birthing is about surrendering and it's impossible to completely surrender if you don't trust the people to whom you are entrusting your life and your unborn child's life.

[amlikam]

AR, as a professional and mom this story really hits home. One thing I tell my clients when they have final results which are not part of the "plan" is - you can be both happy for the amazing parts you achieved AND disappointed/sad/angry/confused about the experience- even if the disappointment was "me." I would rather a woman be disappointed in me and how I failed to support her, than for her to be upset with herself or her supportive partner.

As a professional, that is my job and if I can empower one woman to question the "truth" even better.

Indeed it sounds like the baby was in a suboptimal position and not realizing this sooner, well I am inclined to think perhaps some of this might have been due to inexperience on the midwife's part (and we have all been there- and heck I would rather a midwife not get it than an ob who would go right to a c-birth).

You felt you needed to transfer, and I always say, there are no bad interventions just bad uses- and this was not one. Transfers are an option and many experienced midwives have to do transfers as well at some point in their practice. It could have been transition- or not.

Choosing your midwife was a calculated decision you made and you made the best choice possible with the options you had at that time.

Given the comments she made at the follow-up, and the one above about growing up, I would be VERY upset. BUT I also realize we are all human and perhaps she didn't realize how it would be processed on your end, especially so soon postpartum.

Originally Posted by belovdlady 

 The temptation to "blame" ourselves or others is universal.  The reality is that we don't get to be in control of birth; we don't get to be in control of death.  We can do everything "right" and still have to face unwanted situations.  That is part of being human, and it's part of growing up.  As a midwife, I share in the disappointment and sadness, the processing and re-processing, when the journey with a client takes a turn to the hospital.  We don't know why everything happens, but I believe we can learn from everything that happens.  

It sounds like you went into this extremely prepared and not you are trying to figure out "what the heck happened." Taking the time to speak your truth about your experience is revolutionary and intensely healing. Say it loudly and peel away each layers until you can stand in the raw part of yourself and the experience and not care who else is listening.

While I feel the midwife is willing to walk the journey with you in processing, I feel from her post above it seems like both of you have some more healing to do, which is not unexpected. I would be inclined to think your partner might have some to do as well from his emotional break through and expression of not feeling supported

I think you need some space to FREELY disclose your experience and I wonder if you have a birth circle, red tent, or some other type of support group in your area you could reach out to, where professionals are not facilitating the group

As for future births, IF you decide to have more with your partner, I think 1stTimeMama4-4-10 hit the nail on the head.

Originally Posted by 1stTimeMama4-4-10 

 I don't know enough to say whether or not your midwife could have done better, but the bottom line is that if you don't completely trust that she did everything the best way she knew, or should have known, how, you should find another midwife. Not because she did anything wrong, but because part of birthing is about surrendering and it's impossible to completely surrender if you don't trust the people to whom you are entrusting your life and your unborn child's life.

Much love,

am