Need some encouragement after homebirth transfer - Page 2

[nabisco]

Hi Heather, I can relate so well to your experience and feelings.  I had a similar labor with my first son, but what resonated the most with me was that your confidence is shaken.  We try to believe that our bodies can do it... we are strong... birth is natural.  I meditated, did yoga, read everything I could get my hands on, and prepared in every way I thought possible to have a natural, intervention-free home birth.  Afterwards, I wondered -- what did I do wrong?  why was my baby posterior?  Did I not walk enough?  Did I not do enough yoga?  Did  my midwife miss anything?  Why didn't I have a back-up plan?  (I was completely unprepared for a hospital transfer -- during my pregnancy I naively thought that such considerations would detract from my experience, as I didn't want to express any fear or doubt in home birth.  I also lived 5 minutes away from a hospital, which provided some comfort.)

I am pregnant again with my second baby, and can not decide whether to try to have another home birth.  I have little confidence in my body or the birth professionals around me.  And this time I am scared, because I know how painful it can be.

I think the home birth community has focused on advocating home/natural births, and we have not talked enough about the hospital transfer.  We have tried to take the fear out of birth, to reclaim power over our bodies, to reclaim our strength.  I understand all of this in a historical context -- births had become so hospitalized, sterilized, medicated, feared, etc., and we want an alternative!  Of course, we first want to normalize home/natural birth.  We want people to know that it is safe, and that this can be a responsible decision for a mother to make.  And all of those things are usually true. 

But, I think it's time to talk about the complexity of home birth.  We need to have a sub-community of women, just like the one you have started in this conversation, to pull together and encourage one another.  How can we help other women prepare for home/natural birth, including a scenario with a hospital transfer and interventions, without fear?  How can we tell ourselves that we are strong, that our bodies are made to do this, and then not feel like a failure when it doesn't happen? 

After my labor I would look at my books and magazines and think, why didn't that work out for me and my baby?  It was like the natural birth community had created a standard that I couldn't live up to.  I do not blame the community for this -- I just think we are part of a movement in its infancy, and it's time to dig a little deeper. 

I have heard from numerous midwives and birth centers that 1 out of every 8 home birth patients transfers to a hospital.  That seems like a lot to me (although when I was pregnant with my first, I brushed it off -- thinking I'd be fine...)  In my state, midwives are not required to have a back up OB.  (I ended up in the emergency room of a teaching hospital.)  I think that's a problem, but I'm not sure how to fix it.  But I don't feel like anyone is even talking about it.  I feel like the focus is still on hey, home birth is on the rise, it's natural, it's ok!  And that's great.  But there's more to it than that, which apparently 1 out of 8 of us can attest to. 

Heather, your post was incredibly encouraging to me.  I only know a handful of people that have tried home birth, so there aren't that many people to talk to about this.  (I mean in real life, not internet life.)  When I read your story, I felt a connection and a relief -- it's not just me.  When I talk to most of my friends and family, they see my hospital transfer as normal and inevitable, and don't understand why I have struggled with it.  They keep telling me -- we have no control over birth.  As in, what made you think you could control it in the first place?  (Of course, choosing home birth is not an exercise in control, quite the contrary.)  So thank you for posting what you did, and hopefully, we can keep this conversation going.

Edited by nabisco - 3/19/12 at 1:43pm

[BMDoula]

Firstly, I just want to say that you are an incredibly strong mamma for going through that, and doing what was best for you and your baby. You tried your best to have the healthiest birth you possibly could... and in the end, you did.

I am a huge advocate of home birth, but I also think it is wise for all pregnant mothers to mentally come to terms with the possibility of hospital transfer, and the possibility of c-section. It shouldn't be seen as something that will cast a shade of negativity on the birth, or question the woman's ability to give birth naturally. The fact of the matter just is that sometimes things happen that are out of our control, and those medical back-ups are there for a very good reason. The majority of the time and woman can birth on her own, but on rare occasions there are complications that can arise. Reaching a state of acceptance with any potential outcome is vital to a mother's happiness after the birth. 

I really hope that you can forgive fate for derailing your ideal birth, and realize that you are an incredible woman who tried her best to have the most gentle, healthy birth she could. 

Big hugs!

[Partaria]

YES to everything Nabisco said. I totally completely agree. I've recently been contacting homebirth midwives in my area (I had a planned HB turned transfer) why there are never any transfer stories or talk of transfer on their websites. Seems like there should be, since transfer is part of the spectrum of safe homebirth. 

I agree with everything you said, and you put it so so well. 

[mommymcnair6]

You are not alone. I have seven kids. Four were sections (2 of these were homebirth transfers) and three homebirths. It is disappointing to have something not go the way you plan. But I realy believe we do thievery best we can in every situation. Hugs to you!

[Heather Lyn]

Thank you all, belatedly, for reading and responding to my post from a few months ago.  I had no idea you had all read and commented, and I read every one of your messages.  I agree it is a good idea to have these sub-conversations in the home birth community.  I know a few people who have transferred to the hospital - emergency transfers, non-emergency transfers that in retrospect were medically necessary (like mine), and those where the mother got exhausted or was in too much pain to continue unmedicated.  A few turned out to have malpositioned 11 pound babies.

Even though I felt 100% welcome in our weekly homebirth group after having a hospital birth, I found myself avoiding it after my son was born.  Not because I didn't want to hear other peoples' homebirth stories, but because I just didn't feel "at home" there anymore (no pun intended  :)  ). 

I feel a little bit foolish, like I had this really rosy image of what natural birth would be, and was told how wonderful and empowering it is, and then ..... For me, not so much.  It has been hard to talk about it to other pro-home-birth/natural birth people.  I echo what Nabisco said, that it's time to talk about the complexity of home birth without fearing that we're undermining efforts to normalize it.  For me it's about being honest about unfortunate truths: 'it's rare, but sometimes babies really ARE too big to fit through the birth canal' ....  'It's much less common than mainstream culture would have us believe, but sometimes you really DON'T make enough milk at first.'  Can't we support and advocate things and still admit that things go wrong at times?  I am horrified by the c-section rate, routine interventionist culture and TV portrayals of birth.  But many women throughout history who died from natural birth would have loved pain relief and c-sections, and I'm a little more aware of that now.  I am sickened by the way normal laboring women are treated in most hospitals today.  But I'm gonna be honest - I'm more sickened by the thought of all the women who went through what I went through with no access to pain relief or safe intervention.  None of this has anything to do with homebirth - I'm still all for it in the hands of competent midwives - but I also appreciate hospitals a lot more than I thought I ever would.

I had a lactation consultant tell me "I don't think hospitals are safe places to have babies," and before I had mine, I was thinking, yep, totally agree, why would you ever want to birth in a hospital?  Twenty four hours into my awful labor, I was thinking that my previous attitude was pretty naive and smug.  Hospitals, it turns out, aren't just for emergency births.  They also look pretty good when you have been in labor for two days and feel like a giant steel claw is trying to mangle your spine.  :)  The same lady later asked me why I got an epidural, and I just stared at her, like, are you kidding?  Do you have ANY idea how much pain I was in???

A common statement among doulas is "when I was a new doula, I tried to get my clients to have the birth I thought was best.  Now, with more experience, I support them in having the birth they want, even though it's not the birth I would want."  I want to say "hate to break it to you, sweetheart ..... Sometimes you don't know what birth you want until you're having it."  Even if there are no medical problems.  Sometimes you just don't want to be in that much pain anymore, and you don't have to, because you live in the U.S. and it's 2012. 

So, yeah, I'm still feeling a little cynical and yucky.  But I'm getting over it.  Thanks for all your support.

[LiLStar]

Oooh your story reminds me of my first. Op, asynclitic, transfer after nice long labor. Only vacuum was never attempted, straight to cs with me. It was humbling and eye opening for me. I spent my pregnancy believing c sections occur for one of 2 reasons: a serious, life threatening emergency, or Cascade of interventions/hospital environment (flat on back in bed, etc) and then I had a non-emergency one which occurred after I did what I considered "everything right" and then I learned it is soo not that black and white! Metal claw on spine indeed. I'm happy to report that, for me at least, malposition labor is more painful than OA baby in transition

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[mothercat]

First, you can't fail at things you have no control over. As much as we would like to think that if we do everything correctly that the baby will cooperate, it just isn't true. You have no way of knowing what position the baby is in, and more importantly, why. Sometimes asynclitic is because the baby is protecting the cord, or was sucking on fingers to comfort him or herself, or half a dozen other reasons. Sometimes it is just their personality and how they will carry themselves: proud with their shoulders back. And you have no control over any of that.

Second, have you been to any of the birth trauma sites like solace for mothers? These are sites where you can talk about your experience with other women who have also had traumatic or disappointing births.

Third, I am a home birth and birth center midwife. There is currently a thread on my birth center's FB page where a first time mom considering  OOH birth asked about transfers to hospital. She received responses from several of my families and some others talking about their experiences. The comment was eventually made that there seemed to be a lot of transfers and why so many. I think the problem is not why so many transfers but why aren't women talking about it? The American Association of Birth Centers keeps statistics on all aspects of birth center care. We know that about 10% of women will need to transfer to a hospital birth during the pregnancy before labor even starts. Another 10 % will transfer during labor for the reasons mentioned in earlier posts. Of the 10 % who transfer in labor, about 40% are women having a first baby.

I think the problem of women not talking about it is as Nabisco and Heather Lynn have stated. Partly afraid that it was a personal failing on their part, that talking about transfers sullies the reputation of OOH birth being safe, and not wanting to deter other women from attempting the birth they want. I think we need a dialogue about discernment in labor and birth. We need to spend time in childbirth classes and as doulas and midwives talking about this. There are times when labor isn't simple and straightforward, when a bit of pain medication or an epidural will relieve suffering, and it's a good thing. There are times when interventions are a good thing and rather than fear that we are will look like we have sold out to a medical model, we need to talk about when the labor has crossed the line from normal to not normal and the interventions are not routine and unnecessary, but have become necessary to avoid a bigger problem. Discussing these things does not mean we  don't believe in the power of a birthing woman or the potential for a natural birth, but that we are realistic about the sometimes need for these things.

Heather, I think you are brave for bringing this subject up and being willing to talk about it.

[Cindi Thompson]

I am sorry you are feeling sad. It is an area that I feel women do not get enough support in. Sometimes we need help to get our babies out and sometimes that help would be torture without pain management. You sound like you had a good birth team and I am glad you delivered vaginally because many OBs would never have let you push that long and agree to a VE. They would have sectioned you. You have a lot to teach women because you have gone to a very hard place to get your baby out. When women ask you about your birth you tell them your story in honesty and they will hear how much you wanted to stay home and naturally birth your baby and they will respect your strength in trying so hard for that. They will know when they are in the throws of a difficult labor that you are their guide. Keep talking about it. The pain and sadness will become less raw as you move into healing.
 

[joyfilledmama]

You are incredibly brave!  I think you just need to give yourself some time to work this all out in your head.  I think time will be the best healer.

[Alenushka]

You are alive. The baby is alive. You did not have a c-section which you wanted to avoid.

How we  feel after some event is to large degree connected to our perception.

 Two different people can have opposite feeling abut the same event. One can feel that she was failure and another one can feel that she achieved something important.

It is really up to you.

I am stranger on the Internet but I am at awe at your strength,/

Yes, you did not have the same experience as your friends. It is because you are are not your friends. Also, birth is biological event and regardless of what many people like to preach, we are not in control of it event. The body and the baby will do what they will do. Some babies get stuck. Sometime babies are in eh wrong positron. Sometime contractions are not strong enough. Sometime the pelvis is too small.  That idea that your body is made to birth or is supposed to do a right thins lead to dissapointmen. Body is not supposed to....evolution does not care about your individual survival or that of your child, and nature is kind of a bitch

None of it has anything to do with you because it is not more under your control then how your gall bladder produces bile.

There is reason why before the advent of modern obstetrics and hospital 20 % of moms and large number of babies died. We are not in control. We need help sometime.

My first labor did not go the way I planned and I am forever grateful for it.  Yes, I do not have bragging right that I pushed out a 8.12 baby without epidural or what not. What I have is more precious. I have 16 yo son and I have a lesson that I learned. My labor was an important parenting lesson about control or rather the lack there of. That things with my body and my child will often go as they go . I can;t control my labor, bacterias, viruses or my son;s inborn personality.

Life is not fair. Not everyone gets an easy birth. Not everyone get a mentally healthy child. Majority of people do not get to control mos of the things in their lives.

[Heather Lyn]

Alenushka, you really summed up how I've been feeling, and what I've been coming to terms with.  Birth isn't "inherently safe" or "inherently unsafe" or inherently anything.  It's just ..... life.  Or death.  And everyone's experience is different.
 

[starling&diesel]

Well put.

I've had two attempts at a homebirth.  I risked out of the first one due to pre-eclampsia, and ended up with a natural in-hospital birth.  Second time, I figured I had it in the bag so long as the pre-e stayed away.  I ended up with a transfer from home after 24 hours of painful labouring only to have an emergency c-section because baby was laying cross-wise across the birth canal.  Two fervent and committed attempts at a homebirth, both thwarted.  Happens often.  Which you find out when you start talking with other mamas about your own.  It's a very important discussion.  Even though I am a passionate supporter of homebirthing, I can't say that I haven't been jaded by my own experiences, and those of women I see as a paramedic.  Wish I still had my rose-coloured glasses.

Originally Posted by nabisco 

I think the home birth community has focused on advocating home/natural births, and we have not talked enough about the hospital transfer.  We have tried to take the fear out of birth, to reclaim power over our bodies, to reclaim our strength.  I understand all of this in a historical context -- births had become so hospitalized, sterilized, medicated, feared, etc., and we want an alternative!  Of course, we first want to normalize home/natural birth.  We want people to know that it is safe, and that this can be a responsible decision for a mother to make.  And all of those things are usually true. 

But, I think it's time to talk about the complexity of home birth.  We need to have a sub-community of women, just like the one you have started in this conversation, to pull together and encourage one another.  How can we help other women prepare for home/natural birth, including a scenario with a hospital transfer and interventions, without fear?  How can we tell ourselves that we are strong, that our bodies are made to do this, and then not feel like a failure when it doesn't happen? 

[Mamabeakley]

Originally Posted by Heather Lyn 

All I remember is exhaustion, helplessness and pain.  There were moments toward the end of my home labor, and the whole car ride, where I kind of wanted to die. . . .  it practically took a military operation to get him out of me.  I needed so much help, and by the time I got to the hospital, I was more than happy to be a medical patient, because that's how I felt! 

What if this is the gift of this birth to you?

I have not had serious birth trauma, but I have been through other extremely painful (emotionally or physically or spiritually or some combination of the three) traumatic experiences in my life.  And while I am not happy about them, I do recognize that having had them has changed me.  I have learned things from that pain I couldn't have learned any other way.   The culture of natural birth people in our society is all about making birth non-traumatic for women and a positive, life-changing experience.  I think this is a good goal in many ways, but there is also a problem with it - wonderful experiences are not the only life-changing ones.  Traumatic experiences are also life-changing, and some women will have traumatic births even if the whole maternity system is set up to empower and nurture birthing women.  Some of those will be because something actually went wrong (as in your case) and some of those will be because it can be traumatic to have our expectations not met, and sometimes no matter how a woman prepares for birth, her expectations are unrealistic and get blown out of the water.

Could it be possible that you might have a very different kind of experince with another birth and get to have wonderful transformative memories instead of painful transformative memories?  Yes, definitely.  And it is also possible that you may be able, with time and work, to accept the painful memories of this birth as simply what is.  That may not need to be fixed or glossed over for your clients or your child or yourself.  Sometimes birth is exhausting, painful, and debilitating.  Having had a birth like that doesn't say anything about who you are.  What you learn from, how you change as a result of it does say something about who you are.

[Alenushka]

Or someone can go to a hospital, have an epidural  and not have to deal with pain and transfer.

[mamaharrison]

Originally Posted by Mamabeakley 

What if this is the gift of this birth to you?

I have not had serious birth trauma, but I have been through other extremely painful (emotionally or physically or spiritually or some combination of the three) traumatic experiences in my life.  And while I am not happy about them, I do recognize that having had them has changed me.  I have learned things from that pain I couldn't have learned any other way.   The culture of natural birth people in our society is all about making birth non-traumatic for women and a positive, life-changing experience.  I think this is a good goal in many ways, but there is also a problem with it - wonderful experiences are not the only life-changing ones.  Traumatic experiences are also life-changing, and some women will have traumatic births even if the whole maternity system is set up to empower and nurture birthing women.  Some of those will be because something actually went wrong (as in your case) and some of those will be because it can be traumatic to have our expectations not met, and sometimes no matter how a woman prepares for birth, her expectations are unrealistic and get blown out of the water.

Could it be possible that you might have a very different kind of experince with another birth and get to have wonderful transformative memories instead of painful transformative memories?  Yes, definitely.  And it is also possible that you may be able, with time and work, to accept the painful memories of this birth as simply what is.  That may not need to be fixed or glossed over for your clients or your child or yourself.  Sometimes birth is exhausting, painful, and debilitating.  Having had a birth like that doesn't say anything about who you are.  What you learn from, how you change as a result of it does say something about who you are.

YES, to this powerful message! I cannot LOVE this enough!! SO insightful!
I believe that we have the experiences that we have, both in birth and out of birth, that are most likely to help us grow as spiritual beings. I think it is very narrow to view any path as a potentially easier path than another. Yes, there certainly are some courses that were way more treacherous, but perhaps that is what was needed in order for you {or your LO or your partner or anyone else involved in the experience} to get the message from the Divine, to become open to the message that was needed to be heard. 
I had a long, powerful labor between home and the BC with a transfer to the hospital because I was exhausted and in too much pain to go on. Going to the hospital gave me my power back, even though it wasn't planned or wanted and was traumatic at the time. It took me a long time and a lot of deep soul work to recognize that there was an empowering experience held within that trauma and that it WAS exactly what I needed in order to KNOW my own strength and power. I did vaginally birth my DD after 70 hours and I fought hard for that--it wasn't easy like I thought it would be, but it was amazing and I learned a lot! It was exactly what I needed to help me prepare for my next birth {this december}!

Have you done any professional birth trauma work? It could really benefit you I think <3

[IdentityCrisisMama]

I also had a transfer for my first birth (a planned HB). It's OK to wish for a better birth despite having a healthy baby and mama. I also tend to agree with a PP -- the problem with birth in this country is that interventions are used before they are truly necessary -- not that they are used when a birth indicates. It sounds like you had a good use of all the support that should be there for all women, should they need. Hugs to you, mama!  

P.s. I went on to have a pretty straight forward homebirth with my second. 

P.s.s. Lots of really wise words on this thread!! I do agree that this experience can be a lesson and a chance for growth - I think my transfer was good for me in the long run. Good thoughts, mamas! 

[JudiAU]

I have had one birth with epi and one natural birth and I am planning a third natural birth. And as much as I want that third birth to be natural, I am very free about telling people that epi I had with my first was the best choice I could have made. I also narrowly avoided a c-section. My water broke first, baby was posterior, and although I dilated to ten fairly quickly the baby didn't descend for another five hours!!!! Thanks god I had the most liberal midwife on staff who gave me time.

My experience really helped me prepare for the next delivery though and I was a chiro several times how adjusted my pelvic bones and muscles (I was breech for a time) and also a acupunturist to help labor. And you they really, really did? It made an amazing difference and I actually had a two hour labor with the second which resulted in an unplanned, unassisted birth.

I loved my natural birth. It was an amazing experience. But there is a time and a place for intervention when the body and baby aren't in harmony. And that doesn't mean that you cannot be an advocate for a natural birth. It just means that you have experienced the other side of the coin. And there are good, solid reasons for interventions.

My homebirth midwives' contract specifically says they don't do vacuum or forceps? When asked about they said that yes, they know how to do it but they really believe that a birth that requires them should take place in a hospital.