Birthing Lucas: A home birth in the Bronx

Raquel contacted me towards the end of her pregnancy and was hoping to have the home birth of her 2nd child documented– she and her family live up in the Bronx, so I was nervous about how long it might take me to get there, but she contacted me early in the labor (yes!) andI got there with hours to spare, and was able to document the whole birthing experience for her and her family.  I was so moved by her young daughter’s curiosity and sweet support throughout this amazing day.  I would put my money on this little girl growing up to be a doctor or midwife!  Her husband was incredibly supportive too, and the amazing midwife and her assistant and the Doula were all wonderful to watch work.  I was honored to be there to capture Raquel’s experience and document Lucas’ entry into the world.  As part of my ongoing body of work on home birth (which will culminate in a photography book) I ask the mothers to reflect on their experience and answer some questions before and after the birth.  Below the slideshow are Raquel’s own words!  My questions are in bold.

 

How did you come to choose this path?

I came across this path of planning a home birth because I believe women lost their natural given strength and encouragement of birthing the way we were built to do. Our society has instilled fear in women who want to give birth. Experienced mothers, such as grand mothers and great grandmothers who came from a time when laboring at home or in a facility with a midwife was the norm, have little to no voice. Their stories, experience and advice for laboring during that time, has been drowned with negativity. Meanwhile, these same powerful women probably gave birth to 10 kids at home. The younger birthing generation of women need to hear their stories and advice of how the were able to cope with their multiple births at home. Over the years, hospitals and medical professionals have become more involved in labor and delivery. They have created a world that women can pass down and/or surrender the power of giving birth. I don’t judge women who chose hospital births. Some women may have or develop health issues prior or during pregnancy and thanks to those facilities and the care of medical professionals, these women are able to give birth and become mothers to healthy babies. Giving birth in a hospital is not something that interest me because I have a healthy pregnancy and a healthy baby. My body has been preparing for birth for 9 months so I should be capable of giving birth.

Please describe your prior birth experience…how did it compare to your expectations/hopes/fears?

This is my second child. I have a little girl. She is 4 years old and excited to become a big sister.

I had her in a hospital setting with a midwife. Her birth was very exhausting because I had strong on and off contractions for 5 days. on the first day of contractions, I went to the hospital. When I arrived to the hospital, my contractions stopped completely and wouldn’t start up.I tried walking around, going up and down the stairs and nothing happened. I was then given the option by my midwife of intervening with pitocin, a foley ball 9help dilate the cervix), or Demerol to (relax me and sleep), break my water or go home. I ran home. I did not want any of those interventions! During the next 4 those days, I labored at home. it was tiring but peaceful. On the day of her birth, I made sure the hospital and midwife allowed me to be free from cables or monitors.  I  labored up and down the halls, in my in-room shower, and a birth ball. This hospital also offered in suite birth pools which was part of my birth plan but those rooms weren’t available to me because they weren’t offered to me or they were in use at the time I came in.

My contractions were going very well, strong and steady. Unfortunately, I was presented a situation which caved me to accept my waters being broken. My midwife was going off shift and said if I wasn’t able to give birth before 12 noon, her backup (also a midwife but I had no relationship or attachment to her) was going to deliver the baby instead of her. When my waters were broken, it was noted that the baby had passed a bowel in the uterus.  I knew that was quite common since the baby is being squeezed and pushed with contractions during down the birth canal. The color of the water was a bit green or yellow but nothing thick or black which would be alarming. But since I was in a hospital, under their rules, it was mandatory that a neonatologist was present in the room to examine the baby. That changed my birth plan. Delayed cord clamping was now off the table and no longer part of my birth plan because right after the baby is put on my chest for a few seconds, they need to cut the cord immediately and examine her (in the same room).  I pushed for 20 minutes and she came out “sunny side up”. No wonder why I had so much back labor! After the quick examination by the neonatologist (I knew she was fine), she was put back on my chest to bond. During that time, I remember my midwife leaving me in the hands of her back up midwife to deliver my placenta. She was very rough with me. She kept rubbing and pushing down on my sore abdomen and uterus to “force” the placenta out. It comes out on its own and their was no need to rush it or further hurt me. I guess at that point, everyone was just tired of me and my husband standing our ground when it comes to our birth plan.

    –How has your experience of the previous birth may shape/inform your present plan?

My previous birth experience taught me that I am able to labor beautiful own my own with no interventions by applying relaxation and breathing methods. Knowing the stages of labor was of great benefit because it plays out exactly as described. (For example, the hopeless feeling of giving up and self doubt are signs of getting really close to second stage of labor which you are fully dilated to 10 cm and ready to push)

With this pregnancy, I am looking forward the benefits of delay cord clamping which I wasn’t able to do with my daughter because the hospital rules were to cut the cord so that the neonatologist can examine her. I can keep him on my chest as long as I want because any examinations that needs to get done such as his breathing or heart rate can be done on while he is in my arms. I also don’t want my placenta to be rushed out. Its was unpleasant and painful for me. My midwife Barbara and I are on the same page with all of my wishes and I feel a peace with giving birth at home. She will be with me from beginning to end. She doesn’t have a place to rush out to afterwards. I won’t be “put on a clock” as they do in hospitals with shift changes. I also won’t be rushed in my laboring. I am at home no one else is laboring or using the birth pool but me. As oppose to hospitals, women are to “progress” fast enough in order to get her in and out as soon as possible so the next laboring women can come in behind her to use her room.

Interestingly, I also don’t plan on telling other family members or friends that I am in labor for this birth. For the birth of my daughter, I remember,my mom and my husband taking calls and texting in the hallways or their phone always vibrating or ringing. Also friends and family came and showed up to the hospital waiting for hours in the waiting room waiting until I gave birth. That put me in a lot of pressure and made me nervous that all these people are waiting on ME!!! “Hurry out that baby!” That isn’t something that came across that would happen but I didn’t like that experience because it took my birth partners (my husband and my mom) away from me multiple times while I was in labor.

Describe the journey you’ve been on (during her pregnancy) a bit…

It was a rough pregnancy. I had every pregnancy symptom known to…women. Vomiting, nausea, fainting, migraines, hemorrhoids, sciatica pain, tiredness, sleepy, back pain, panic attacks, sadness, sleepless nights, anxiety, tears…tears and more tears.

It was hard to enjoy this pregnancy as i did with my daughter.  She was a dream pregnancy! No symptoms at all! With this pregnancy, I had my good days and my tough days. But on those good days, I made sure I put the extra effort and strength to show this little boy growing inside me that we all love him so much and can’t wait to meet him.

How did your labor go?  Describe your birth experience as you remember it…

Oh my goodness! I did not expect to give birth the day I did. The days and weeks prior, I had absolutely no sign birth was near! It just happened all of the sudden…like the flip of a switch. That night, I went to bed as normal and around 2:30 am, I started getting strong constant menstrual cramps 8 minutes apart. The pain woke me up from my deep sleep! “No this can’t be it!” I stood in bed for like an hour quietly observing these menstrual cramps that wouldn’t go away.  “Ok..wow…these cramps are closer together ” i woke my husband and told him I been having cramps for at least an hour and I think we need to time them. But unprepared for the birth to happen that day, we totally forgot to download a contractions counter app! So we quickly downloaded like 3 different contractions app to see which one was best. Once we found one we liked, we each started counting the contractions in the app. It was 3 am almost 4am, we both were so tired we counted contractions in bed. My daughter had snuck in bed with us and in between us, so to keep things quiet, every time I had a contraction, I tapped my husband. While I was being kept awake with the contractions, my husband kept dosing off and missing inputting the contraction in the app! “I should’ve pinched him awake!” So i also kept track of contractions as a back up for him. We noticed the contractions were getting closer and closer together and decided to call my midwife Barbara and let her know I might be in labor. She asked me a few questions and said that it sounds like I was in the beginning stages of labor and that I should try to get some sleep. Even after hearing her say that and the contractions I was having, I was still skeptical that I was in labor. So, I followed my midwife’s advice. I went to bed and actually fell asleep!

Surprised that I was able to sleep, I woke up around 7:30am. I was still having contractions. I guess my mind and body got used to them and they didn’t wake me up as much to interrupt my sleep. By that time, all 3 of us were awake but still in bed. I took my phone out and recorded a video asking each one of us what time do we think the baby will come. It was a nice sweet memory to have and look back on. When I got out of bed, I was hungry but not sure what I ate, most likely something quick like cereal. My midwife Barbara called around 8am to check up on how I was feeling. I told her “my cramps” are still consistent (In my mind, I kept calling them “cramps” because I still couldn’t believe i was truly in labor). After a few questions, she said “Hmm, I think we might be having a baby today”.  I still couldn’t believe it but she knows best so i’ll get things ready. I checked to see what was in the fridge to eat and drink for labor. I took out and set up try baby’s first outfit.  I know this sounds silly but I did my makeup! I remember with my daughter, I didn’t have anything and I looked so defeated in pictures. I also pushed so hard that I burst my capillaries in my face and arms and I looked like i have thousands of little freckles all over! After, i finished my makeup, i needed to go to the bathroom and my mucus plug was starting to shed. It wasn’t until THEN that I actually believed I was in labor.

I spent the morning, walking around the house distracting myself from the contractions while concentrating on my breathing. I played with my daughter and did her hair. I explained to her “today your going to meet your baby brother”. She was super excited and she put on her bathing suit because she knew he was going to come out in the pool she’s been drooling to try out ever since we bought it. My husband started filling up the pool with air and water. We realized that we didn’t get a chance to buy a hose to fill the pool with water.  I was a little nervous that we forgot that important part to filling up the pool but my husband assured me everything was going to work out. He made so many trips to the bathroom filling up the biggest bucket he could find until he finally filled the pool. I could tell it was hard work! Around 1pm, my midwife Barbara calls again to check up on me. My contractions around that time was around 5 minutes apart. She said I was doing great. Keep doing what I was doing and that she will start heading over to my house around 4 or 5pm.

Around 5pm when the doorbell ran, I got super super nervous. It was my midwife with her 2 birth assistants Ellen and Victoria. Seeing them come thru the door with luggages of equipment and gear gave me a little anxiety. “Oh my goodness this is actually happening! Everything I envisioned for this birth was taking shape here in my house!” It was a shocker for me but quickly fizzled and I became excited to get the show going! Once my midwife unpacked a few things and changed into a fresh pair of scrubs, she asked to check me to see my progress. This was the first time in the pregnancy I was examined vaginally. With my daughter, I started getting checked at 39 weeks and hundreds of times every hour in the hospital while in labor and that was very uncomfortable…sometimes painful. When Barbara checked me, I was 7cm! I could not believe it. I was ecstatic and overwhelmed with joy! I could be having my baby run my arms real soon!

At 7pm, I was still laboring quite well with strong contractions but nothing unbearable. Barbara wanted to check me to see how things are going. I was 9cm! Almost fully dilated! But, I was at -3 station, which means the baby hasn’t descended much. That was a concern for Barbara. She had a discussion with her birth assistants as to what we can try to get the baby further down the birth canal. They decided on various exercises for me to try in order to get the baby down. One exercise, I was on my bed on all fours with my head down and Ellen and Victoria  took turns massaging vigorously with a long scarf the lower part of my back. The purpose of that exercise  to shake or shimmy the baby in position to go further down the birth canal. It was quite relaxing for me to be off my feet. Another exercise we tried were lunges. Lunges sounds easy but imagine doing lunges while having strong contractions! That was no fun. Ellen and Victoria held me and spotted me to make sure I don’t fall over while contracting. The last exercise I did with Victoria was going down the stairs but side stepping. It was a muggy day so you can only imagine the staircase with no windows!

After coming back from going down the stairs, Barbara checked me again. I was 9 cm almost fully dilated but the position of the baby was still the same. Very high up! That was discouraging to hear. I felt like I was doing something wrong and my body was letting me down. Barbara said I was doing excellent. I am doing everything I possibly could to get the baby out.  It was up to my body and the baby to move further down the birth canal. Barbara prepared me for the idea of a possible emergency transfer to the hospital if the baby doesn’t come down on his own within 2 hours or so. That was something I didn’t want but I knew we were all trying as a team to move this baby down and we all tried our best.  But, I was truly devastated that those exercises I did didn’t move my baby down at all. As tired as i was, i pushed myself to repeat the exercises on my own. Moving more and more faster through them. Pushing thru the contractions.

At 11pm, I was checked again to see if the baby dropped. He did drop a little bit. At this point, I was so tired. Gravity wasn’t my friend today. Gravity did not help bring my baby down and gravity didn’t help my water break. My feet was achy. Since I was fully dilated and still laying down after the check up, Barbara and her midwives recommended me to start pushing. Pushing??? Like push the baby out? But I have no urge to push! But I did what I was told. With each contraction, I pushed. The pushing was more annoying than painful because my abdominal muscles were tired. During one of those contractions, Ellen and Victoria said my water was starting to break slowly. After 20 min of pushing, I started to feel the “urge” to push for real! I was now ready to move on to pushing in the pool.

When I got in the pool, the water was nice and warm. In my mind, I planned on pushing in a squatting position because I read squatting shortens the length of the birth canal. My contractions coming closer together, I knew it was almost time to meet my baby boy. Then all of a sudden I started to growl and roar with the contractions. My mind and my body was out of my control. And in one of those contractions I felt a pop. My water had finally broken. I broke into laughter because of the pleasant relief. After about 20 minutes of pushing, the baby’s head came out. It happened so fast I barely felt it. I was so happy when his head came out because it was almost over. The next contraction came and his shoulders couldn’t get out. In order to get the shoulders out, Barbara said I needed to go on my back and give one more push. I gave one more push in the next contraction and his shoulders came out with the rest of his body. I was so happy to catch him and placed his very warm slippery body on my chest. He was a bit purple but after a few seconds he gave a big angry cry almost as if he was angry to come out from his cozy womb. It was love at first sight!

Did you feel safe?  What went well?  What didn’t?

I really liked the caring and maternal care of having a home birth. I feel absolutely no fear. I wasn’t afraid of being poked by needles or and bothered with the people around me. I knew the people around me supported me and upheld my interest and wishes. What surprise me about this birth is how knowledgeable my midwives and her birth assistance are. In my mind I expected things to go nice and smooth the way I planned it. But every breath and every baby is different and he was a little surprise. A little surprised that they didn’t want to come out. My body fully dilated, strong consistent contractions  and this little boy did not want to come out at all. My midwife and her birth assistance came to the rescue with their exercises and techniques to move the baby down. I couldn’t have done it without them.

The only thing I would’ve liked different was having my husband more by my side. When I gave birth to my daughter, he never left my side. What with this birth, it was different.  We had a huge hiccup with the birth pool. We forgot to buy a hose and my husband fill the pool up manually with a bucket. Looking back it was quite comical seeing him going back-and-forth with buckets wetting the floor. He did a great job filling it up but since it was the hot month of July the air conditioning cool the water from the pool drastically that was uncomfortable for me to get in. My husband had to run out while I was 9 cm dilated to buy a hose and a water pump to empty out some of the cold water and replace it with hot water. My biggest fear was him missing the birth but my midwife was so knowledgeable she guaranteed that I wasn’t going to give birth by the time he came back. I was skeptical but I trusted her and it worked out he was back in time with much time to spare in order to prepare the pool. He made my dream come true because giving birth in a pool was my top priory and he made it happen. With all this funny shenanigans with the pool, my midwives made sure my husband was by my side when it was time for pushing. They helped him position himself outside the pool and the way that I can lay and support some of my weight on his arm and his shoulders. My daughter was also next to him and I was able to look at her face of excitement when she met her brother. It was a beautiful intimate moment between all of us. I loved it.

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