Third Time's A Charm: Notes On A Home Birth
Welcome to the world, Paul Daniel Frisch! Our son joined us in the early morning hours of April 11, 2019, right in the comfort of our own master bedroom on Bissell Street, under the care of a fabulous team of home birth nurse midwives and an experienced birth doula. It was a moment well beyond nine months in the making, and it was everything I could have dreamed of. Despite being recognized as a safer option for low risk birth, in Chicago, planned home birth is virtually unheard of. Expecting parents flock to Northwestern Prentice Women's Hospital to deliver their babies, which is where we'd had our daughter and first son several years earlier. Indeed, it’s one of the five largest birthing hospitals in the nation. On the other hand conservative licensing restrictions permit only nurse midwives with the very highest advanced credentials to legally provide at-home care, which has resulted in just three tiny practices currently operating in all of Chicagoland. Of these, we selected Gentle Birth Care, the only one that accepts insurance.
Why? We’d had two normal hospital births under our belt (the second unmedicated) and we favored an intervention-free experience following evidence-based practices. At the hospital we’d been pressured to accept interventions unsupported by evidence as actually necessary or even advisable for us personally. This time we wanted providers who wholeheartedly shared and supported our goals. So we were glad to meet the low-risk screening requirements at Gentle Birth Care to be considered a good fit as home birthing clients.
Back in September, my friend Kari listened politely and nodded as I told her we were contemplating home birth. "Oh, that's wonderful," she offered supportively. "I think you're crazy, but that's wonderful!" Doctor friends gravely expressed their deep concerns with this plan, and when I told one of my own doctors, her response was "Really? Well, you might need a C-section." My sister reminded me of the first drastic moments of her son's life, when he came out entirely blue and was quickly resuscitated by the Prentice NICU team. The only ones who unqualifiedly jumped on board with my home birth idea were my home-birthing hippie friends and my husband. I credit my super-hippie sister-in-law (Emma Frisch, who lives in the home-birthing capital of Ithaca, NY) with opening Mike to the idea of home birth, together with the fact that he'd actually caught our first son very unexpectedly in the bathroom of our L&D suite at Prentice four years earlier. No medical provider had been present at that dramatic moment. We already had virtually had a home birth in the hospital, so why not save the trip this time?
When Mike and I met with Hillary Kieser this past October, we could tell just how different this experience would be. The founder of Gentle Birth Care, Hillary has overseen over 2,000 births in her career, and given birth to five children of her own. Her office in the North Center neighborhood is located in a cozy loft building, and shares its comfy, unassuming space with the new parent haven, Sweet Pea's Studio. Cushy couches, rugs over creaky floors and shelves of books on birth and breastfeeding abound. Nothing about this environment would remind you of a hospital practice, and before a few of my check-ups I had the pleasure of scheduling massages with Jenny at Sweet Pea's. I'd been seeing Jenny for years for her wonderful massage, including during my second pregnancy. So it almost felt like going over to a friend's house for each check-up with the nurse midwives.
All the same, the night Mike and I met Hillary we both needed time to get comfortable with this very different vibe. At one point she made a lighthearted remark about how one of her adult children was probably "upstairs getting high" right then, and the conservative, prudish side of me went wide-eyed. Was this going to be too far a reach? I continued seeing my old midwife at Prentice for a few more check-ups just in case. But as the weeks went by I came to appreciate the relaxed attitude at Gentle Birth Care. Even the hospital midwives tended to pathologize every little issue that came up (our brush with fifth disease, a slightly low platelet count and slightly elevated thyroid stimulating hormone level at mid-pregnancy testing), stoking the flames of my anxiety, while the second opinions I obtained from Gentle Birth Care always left me feeling reassured. Although I followed the recommendations of the hospital midwives to do additional testing out of abundance of caution, and I even completed a tearful visit with an endocrinologist at their recommendation, those "issues" each turned out to be non-issues, leaving me frustrated for needlessly expending precious emotional energy looking for trouble that was so unlikely to be there in the first place.
Ultimately Hillary's attitude toward birth as being a normal, healthy process for her patients led me to select her team as our provider. We also appreciated how they would fully support the various evidence-based yet non-traditional aspects of normal birth that felt aligned with our values, including delayed cord clamping, care in the event my water broke without active labor, and avoidance of unnecessary medical interventions whenever possible. Still I wondered... would this all work out? Even the lowest risk pregnancy carries unknown, and even though we were confident that we would birth normally (cue Hypnobabies birthing affirmations), we knew we were taking a bit of a leap of faith.
The Wednesday I went into labor I was still three days from my EDD, my kids had the day off school for parent-teacher conferences, and my cat went to the groomer for his annual lion's cut. I had a strong suspicion things were starting to happen when I woke up, and began noticing period-like cramps and pinkish mucus each time I used the bathroom. Could it be bloody show or just the mucus plug? By midday I was suspicious enough to let my midwives and doula know that it seemed I was in early labor. But I continued dashing around on errands and teacher conferences, fed my kids dinner and got them into bed while noticing the cramps slowly getting stronger, and eventually radiating down my outer thighs. Mike doubted I was actually in labor and went to bed early nursing a cold. Around 10:30 I dragged him up when I was no longer comfortable lying down. By midnight the midwives and doula had arrived, and found that I was already 8 centimeters dilated! What a surprise to all of us as the birth waves stayed around four minutes apart, and never felt overwhelming-- night and day compared to my previous pitocin labors. Mike and our doula Victoria (of 312 Doulas) gave me massage and counter-pressure and I hung out in our bathtub listening to Hypnobabies birth hypnosis tracks. When I started feeling like I was having too easy of a time I jumped out of the tub and proceeded to shimmy and stair climb, determined to get on with pushing!
Around 3 AM the team encouraged me to try a few pushes to see what happened. As I stood in a half squat leaning on Mike my water suddenly broke, splashing dramatically at our feet just like in the movies! The midwives noted that there was light meconium present, but reassured me this wasn't worrisome as the baby's heart tones continued to be strong. After trying out several pushing positions, we settled on side-lying in bed. Victoria encouraged me to rest between waves, and coached me through pushing at the height of them. Pushing had been the easy part of my previous two labors; I hadn't even consciously pushed with Ethan! This time it took 13 minutes of very real effort. Paul's head emerged, and Hillary discovered that the cord had been wrapped tightly around his neck--twice! She skillfully slipped both loops over Paul's noggin before directing me to complete the final push. And then there he was, after a peaceful natural labor of under five hours! A little bruised from the cord but still receiving an 8/9 apgar score, and easily initiating latching within a few minutes on my chest.
I was so impressed with Hillary's composure throughout the pushing phase, especially while she wrestled with releasing the cord. From my perspective the entire time, the room was calm and the birth was nothing other than normal and healthy. We delayed cord clamping until pulsing had completely stopped and comfortably delivered the placenta, Mike cut the cord, baby received his vitamin K shot at our request (we declined the eye drops), and we retired to the comfort of our bed to take him in. Paul was serene, and nursed happily even while he received his shot; he weighed in a pound larger than my other two babies, at 7 lbs 12 oz!
The midwives stayed with us another couple hours to ensure we continued to do well, and Victoria made me a lovely plate of scrambled eggs, fruit and avocado (she even remembered to bring me dates to help prevent excess bleeding). Everyone hugged us goodbye as the dawn broke. Soon enough we heard footsteps on the stairs, and had the joy of introducing Ethan and Julia to their new brother.
Our big takeaway on home birth has been-- it's amazing! Avoiding the disruptive transitions to and from the hospital removed so much stress from the process, and added space for a whole lot of peace, empowerment and comfort. We felt respected, heard and fully attended to at all times, with providers who supported our values and with whom we had enjoyed a continuous relationship. Truly, it felt like a real family event, with my husband by my side in the home we built together ten years earlier, our two big kids sleeping contentedly upstairs and our cats underfoot. I just couldn’t imagine a calmer way to begin this new chapter of family life. It's not for everyone, but I believe everyone should at least consider its benefits within the context of their health, birthing values and personal circumstances. I feel incredibly grateful to have experienced it for myself, and would do it again (and again!) in a heart beat.