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Gloria Lemay

Marsden Wagner, MD

Gretchen Humphries

Sarah Buckley, MD

Gretchen's Beautiful Home VBAC Waterbirth

-Written by Gretchen Humphries within days of her baby's birth. Note that all photos were taken by Lori Peterson.

Cast of characters:
Brad = husband
Lori = very good friend and labor support
Micky = midwife
Kerry = sr. apprentice (doula and HBAC- homebirth after cesarean- mom)

A bit of background: I conceived twins after over 2 years of infertility and treatments in October of 1997. I was committed from the very beginning to a natural, drug-free vaginal birth for my babies, I knew it was the best thing I could do for them. However, they were "delivered" via "elective cesarean" at 39 weeks, 4 days- basically because my doctors were afraid. The babies weren't in the "optimum" position for a vaginal birth and so, in spite of my weakening insistence on a number of things, I eventually ended up on the operating table with nothing left of any of my hopes, plans and dreams.

A lot of intense psychological manipulation on the part of my "caregivers" went into pushing me to make the decision to schedule, I prefer to say that I had a coerced cesarean, because it sure didn't feel "elective". It felt like an assault, it was an assault. This was an incredibly traumatic experience for me, made even worse by the complete lack of support I had in my recovery, both physical but mostly emotional.

It was obviously traumatic for my children as well, that will always haunt me. My son Alek screamed in terror as they ripped him from me- he had no idea what was happening. He was a strong child and fought the nurses as they tried to suction him out and wipe him down and wrap him up... I can still close my eyes and see him screaming, flailing, grabbing hold of the cable on the warmer so tight they had to pry his newborn fingers off of it just to get him laid down. He pooped all over the “team” that was “working” on him. His brother Daniel fared a bit better, I think he at least had a little warning that something was happening when his brother so abruptly disappeared from their place.

When I walked into that room and climbed up on that table all by myself, I felt like I was laying myself down on some perverted altar, ready to be the sacrifice of the day. I felt horrified and humiliated, like a piece of meat. And it was all so “normal”. This started me on my journey to finding a better way to birth, if we happened to be blessed with more children.

Brad was cautiously supportive of a planned homebirth at first, I think his comment was "well, most of the babies on this planet are born at home, seems to me like it works well enough" or something to that effect. I think he knew he'd have a huge battle on his hands if he did oppose me on this one. But, for the sake of completeness, I did interview an OB (with whom a good friend had just had a hospital VBAC) and my own Family Physician. The OB was as encouraging as I think they ever can be but she kept talking about "unproven pelvises" and protocols like "hep locks" and "electronic fetal monitoring". She wouldn't "allow" me to deliver breech, and that was a big fear of mine since both my boys were breech. Our Family Physician is a wonderful woman and I really like her, but I could tell she'd be constrained by those same protocols- plus her privileges weren't at the hospital that I felt would be more favorable.

We interviewed a local midwife practice, and that was it. They laughed and said that they though all pelvises were innocent until proven guilty- they had experience in both encouraging breech babies to turn and in delivering them vaginally. They weren't in the slightest bit worried by my "scar", had done a number of VBACs. They were very encouraging, but also very professional. I think Brad was a bit surprised- he expected something more "granola crunchy", I suppose- the fact that they were obviously committed to safe birth as opposed to homebirth (the fact that the two are almost always equivalent notwithstanding) really impressed him. I soon found out that a number of families from our church had had births with them- and without any exceptions, everyone was really really happy with the care they'd received. We were sold.

Because of my underlying medical condition, conception was not a given by any means. In fact, we had waited 5 months to see a Reproductive Endocrinologist, to see about the newer treatments for my condition. The weekend before my initial appointment, I discovered that I was already pregnant! This really set the stage for the entire pregnancy and for the birth itself- it was obvious from the very very beginning that this child was a gift from God and that He was in control of the whole thing. We had a responsibility to make wise choices and plans, but ultimately He was in control.

I was very glad we had already selected a homebirth midwife, because I didn't want to be stressed about wondering about my birth attendant. In spite of my trouble conceiving, once I get pregnant, I seem to have very pleasant pregnancies overall- I truly do enjoy being pregnant (at least up until that last month or so, like anyone!). My prenatals were a joy- 45+ minutes of time spent with women that really believed I was normal- very little time spent on the actual physical part of pregnancy (weight, blood pressure, urine checks). Much more time spent on me- such a difference from the last time, when I felt like it was a constant battle just to stay "low risk" (my twin pregnancy, by the way, was absolutely and completely without any complications. But that didn't impress the physicians, who just must assume you have problems until you prove them wrong- which I did!).

I did occasionally struggle with fears about "what if"- especially uterine rupture during labor, because this is the big scary complication that the OBs like to harp on- but kept coming back to my knowledge that such complications are exceedingly rare (about 0.4%), especially in homebirths where you aren't pumped full of drugs and stressed out. Even more importantly, God was in control- He'd confirmed the rightness of our homebirth plans by miraculously providing the funds to pay for it. We knew we were on the right track.

And so my pregnancy continued, everything "normal", and me reveling in the feeling of being so supported and cared for. I think the most stressful part of the whole thing was our decision to not tell Brad's family about our plans. My family was quite supportive but we knew his family would be pretty freaked out by the very idea of homebirth- and we did not need the grief of 9+ months of worry and argument from that side of the family. It was a tight line to walk to not reveal our plans but not actually lie to them either. I was "prepared" to go "late" and as a result of that, refused to tell my "due date"- this is kind of fun to do, it really drives people nutty. I figured that since I'd carried two normal birth weight babies 39+ weeks without a single contraction, it was unlikely that this baby would come early. It was great to know that I wouldn't even hear the word "induction", much less have to worry about fighting off an induction.

And so we passed through the holiday season and into the new year...

January, 2001

I'd been struggling with increasingly intense prodromal labor for several nights. Plus there were emotional issues associated with when my mother would be arriving in Michigan. After a very rough night Tuesday/Wednesday, I decided that I actually did want her to come help, because I wasn't getting any sleep at night and Brad couldn't keep taking time off from work to watch the boys while I slept during the day.

Late on Wednesday afternoon, Micky called to let me know that I was totally normal to be struggling with all of this, that prodromal labor was very difficult and she validated my decision to go ahead and have my mom come out, in spite of the concerns that I had about her being here before the baby was born. She then suggested that I go ahead and drink a glass of wine before bed- if it was prodromal labor, that might relax things enough to let me sleep some, if it was the "real thing", then it wouldn't stop anything. I was exactly 41 weeks pregnant.

By bedtime I was contracting the usual 2-3 times an hour. Decided to go to bed (without the wine) and see what I could deal with. At about 1 am, I decided to get up and drink that wine. Thoroughly enjoyed it, I might add, I love a good glass of red wine and giving it up for pregnancy/lactation is always a bummer for me. Went back to bed and slept a little bit more but not much- and at 3 a.m. realized that the contractions were coming at about every 10 minutes.

Lying in the bed was not a good thing at that point. I decided to get into the shower and see if that would relax me enough to sleep (denial is a strong suit for me sometimes). Ended up spending an hour in the shower (was already losing my sense of time, I had NO idea I'd been in there that long!). Got out and they hurt more- I was kneeling by the side of the bed, kinda breathing through them and Brad woke up. Asked the classic question "honey? are you alright?". Of course I answered that it sorta depended on what he meant by "alright". I then told him that maybe he ought to try timing some of them- well lo and behold, they were about 3 minutes apart!

So, I didn't want to call anyone yet at that point because I was still convinced they'd stop with the dawn but I did tell him to go back to sleep (which he did!) and frankly, I don't remember what I did at that point. At about 5, things were still happening so we decided to call Micky and tell her that while we weren't willing to commit yet, things were more intense than they'd ever been before. We decided to call her back in about an hour.

At about 6, I decided to call Lori and give her the "maybe this is it" so she could get her husband home to watch her daughter. And we called Micky back and said, "well, we're gonna say this is real, so head's up". She asked if we wanted anyone at the house yet and we said no, we'll just keep letting you know how things are doing. Then we called the family that would be watching our boys for the birth- they live about an hour away. So, I just kinda hung out and breathed and it wasn't too bad. Was a little nervous because I'd had no show or plug or anything but the contractions were plugging along so it was cool.

At about 7:30, our childcare showed up and everything came to a screeching halt. The sun was also coming up. I cannot tell you how freaked I was about this. But, I did remember that for some women, especially in early labor, changes in the environment can really throw you off, so I hoped that was what happened. The boys left and I got back into the shower. By the time I got out, the contractions were back to every 3 minutes- funny to feel so relieved about being in pain, but there it was! Somewhere in this, I did lose the plug- and that really excited me (does it strike anyone else as odd that we get excited about pain and bloody slimy stuff coming out of our vaginas? What a trip birth is!).

Lori showed up about 9 and I was upstairs rocking in the rocking chair- it was this pretty surrealistic experience- we'd be talking about something trivial and then I'd stop and breathe and she'd time and remind me to relax and then we'd just pick up the conversation. Micky called and I decided that I'd like to have someone out at the house, mostly just to check on the baby every once in a while, I wasn't feeling particularly in "need" of help or anything. So she said she'd send Kerry out- she got here at about 10 and set up some of her stuff and came up to check on how I was doing. Then I wanted to be alone, so everyone left and I just kinda chilled out some more. Through all of this, Brad was puttering about keeping himself busy- doing the dishes, cleaning up the toddler tornado in the living room, calling the people we wanted called, doing the email thing- and finally! Blowing up the pool!

I really don't remember exactly when I first got in the pool but it was heaven. We had the fishy pool that many homebirths use and it was really great for us- I was able to assume any position I wanted. For me, water was HEAVEN; although I reacted to it differently than some women. While it definitely helped me cope and relax, it always kicked my labor into a higher gear. That happened in the shower too.

At this point, I'd yet to have a vaginal exam- my midwives were SO cool about this. Kerry asked once if I wanted to be checked, and when I said no, that was the last I heard of it from her. Actually, what she said was "Okay. This baby will be born whether we check or not." I was really afraid of the vaginal exam because I just couldn't deal with the idea that I might only be 3 cm or something, plus, laying on my back just for the checks on the baby was bad enough, even in the tub.

At some point, I'd been in the tub for a while and everything clicked up a notch. I was having trouble all of the sudden- that's when my support made a difference. I was shaking uncontrollably, and started to cry and Lori was great... kept reminding me that it was all normal and I was doing great... they got a cool cloth with some lavender oil and rubbed my face with it. I was a little worried about Brad, mostly because I knew he was puttering- which was fine with me, if that was what he wanted, but I didn't want him to feel "closed out" by all the women. Kerry had him come in, I was glad to see him, he wiped my face for a bit.

Then came the first time I thought about being "non-compliant"! Kerry asked me to get out of the tub- she said that I was showing signs that I needed to get out and get upright; she wanted me to hang onto Brad and walk around, swivel my hips during a contraction, that sort of stuff. On the one hand, I knew everything she was suggesting was a good idea to keep things moving, on the other hand, I knew it was going to hurt and I really liked the tub! But I did it and I was right, it hurt like hell.

I think Micky showed up shortly after that. The first thing she said to me was "I hear that you officially don't want to be doing this anymore" (yes, I'd already said that!). For most of the labor, I didn't really want people around me much and I NEVER wanted anyone touching me anywhere other than to wipe my face. All the pain was up front, in my cervix and across my lower belly- never anything other than tightness across my back (THANK YOU GOD!!!). Lori told me later that shortly after Micky got there, I had a little "rest" sitting on the couch, and then I announced "I'm going upstairs, I want to be alone". I got in the shower, things got hairier pretty fast and I ended up in my bedroom by myself.

By this point, I was getting loud- okay, I'll be honest, I was pretty stinkin' loud the entire labor- that really surprised me, by the way, I'm not normally a loud person at all- I was doing lots of low moaning and groaning. But this was an entirely different thing. I was kind of sidelying on the bed and the contractions were coming one after another, and they just would not stop, and I was definitely losing any semblance of control. I couldn't keep my noises low and frankly, didn't give a flying flip about control after too long. Lori came in, and sat down and just was "there" with me- and then it happened, the moment that Brad will never let me live down (because it is just so darn "not me")- “NO NO NO NO OH GOD MAKE IT STOP!!!!” (Remember, I've yet to have a vaginal exam, I have no idea "where" I am in labor and am afraid to believe it might be what I suspect and hope). Micky comes flying up the stairs and sits on the bed. She says something about it getting pretty intense.

Then she says "I'd really like you to let me check you" and I just start crying and I'm saying, "I can't, I'm so scared because if I'm at 3 cm then I'll just die because I can't keep doing this" and she says that she knows, and it’s scary, but then she holds out the carrot: if I let her check and I'm at least 5 cm (is this funny in retrospect or what?) I can get back into the pool. Well, give me that pool- so she says "in between contractions, roll over and we'll be as quick as we can be" (in between? that's the problem, Micky, there is NO in between!). Anyway, I manage to get myself rolled over, and she checks, and I hear "oh honey, you are 9 1/2- well, no actually there's just a little anterior lip- you are just about ready to go". Music to my ears, let me tell you.

So, after crushing both their hands through a couple of contractions on my back because I was sorta stranded that way by the contractions (and later, Lori said I almost shoved her through the wall a couple of times- how do women ever do it in the hospital confined to a bed?), I finally got up and moving. Women, a word of advice- don't do transition on the stairs, it really sucks. But, by the time I got to the pool, I was pushing. The moment I'd waited for, because "it feels good after the dilation".

Well, guess I get to join the "pushing hurts like hell and really kinda sucks" club. No, it wasn't fun. It was more like being demonically possessed. And it definitely hurt, even though I was supposedly "doing" something (though not consciously, really it was being done to me and through me). I found that kneeling with my legs folded and spread really far apart (a very strange position I made up all by myself) felt the most effective- Kerry told me later Micky was really concerned because it was so weird but Kerry could tell that it opened me up even better than squatting.

I tried leaning back on my tail bone for a bit but that wasn't going anywhere, so I stuck with squatting and the kneeling thing. Kerry was pretty much doing everything- she was supposed to catch the baby (and this was totally cool with me) so she was trying to gently coach me throughout the pushing which ended up being kinda funny in the deep recesses of my brain- stayed in there because I really couldn't talk. She'd tell me to push a little bit more towards my bottom and I'd just laugh inside because it assumed that I had any control at all- the only thing I could change was holding my breath a bit longer when I pushed. I could tell that made a difference because I actually would feel Ena move down when I pushed that way (totally cool feeling, by the way, there's so much women lose when they are drugged!).

So I pushed. And I will say that it was a very odd place I went to. I just lived each contraction, and then caught my breath in between. I had no sense of time at all, it was just the contraction and then the next. It started to feel a bit burny and I gasped something about that, and Kerry felt down and said, "bulging bag" (my membranes had not yet ruptured!). So I kept pushing and she kept saying "even more bulging bag". I kept pushing and Ena kept coming down. (Aside- guess Vitamin C worked for me, I heard Kerry comment to Micky about how tough the bag felt). At this point I was leaning over the side of the tub, butt sticking out (but still under water) and trying my best to break Brad's fingers (that's what husband's are best for- physical abuse during labor! I felt bad about Lori, but not at all about Brad!).

I felt this "pop" and heard Kerry say "there go her membranes", so I decided it was time to really get serious about getting the baby out. On the next contraction cycle I felt the burn start- and I pushed as best I could. Ena crowned on the last push of the contraction. All these people are yelling "pant pant don't push just let her come easy" and I'm thinking in my head, "Shut up! I couldn't push if I wanted to and if I could I would because this REALLY REALLY HURTS" They're going on about what a great job her head is doing stretching me and I'm thinking "no s___ Sherlock, get that head OUT OF ME".

Finally, about a hundred years later, a contraction starts up and "pop" out her head comes.

They say "pant so we can check for a cord" and there is no cord so they say "push" so I start pushing and nothing. Nothing. And the contraction stops, of course. So there she is, head hanging out, under water and nothing. They ask me to push but that's pretty useless without the contraction. I hear someone say "head's been out 2 minutes" and I hear Micky say "get pads on the floor in case we have to get her out of the tub" and I'm thinking in that tiny part of my brain that never stops "Oh, shoulder dystocia. I'd better get this baby out". Contraction starts and I start shoving and Micky jumps in and fiddles with something and "whoosh" out she flies! (It wasn't a real shoulder dystocia, Micky tried to explain it to me later, basically just had to tip Ena's head up a bit and wiggle her a little- not a big deal but not something Kerry had had to deal with yet- so Micky did end up catching in the end.)

I flipped over and they passed her up to me and I held her on my chest and at that moment, none of the past 13 1/2 hours mattered in the slightest. It was 4:32 pm, just about 13 1/2 hours after I first thought "something might be happening".

She was a bit floppy, turns out that while she didn't have a nuchal cord, she did have an "occult" cord- the cord was looped up over her chest and so was pinched there at the end- I think it was only a factor at the very end because her heart tones had been perfect throughout the labor, and Micky wasn't able to check right at the end (mostly because I couldn't get myself turned over to be checked) and had given me "2 more contractions and then I absolutely have to check again" and I got things done in 2 more contractions. Ena's 5 minute APGAR was 9, so she did fine.

The water in the tub was getting pretty bloody so they really wanted me out because they were a bit concerned about hemorrhage (aside: Micky told me later she suspected I might bleed a bit more than "usual" just because with the twin pregnancy, my uterus really had been stretched out- so she wasn't surprised when I did bleed, although Lori tells me the apprentices were a little freaked). Got out and got sitting on the couch and the placenta fell out- a 7 minute physiological third stage! They asked Brad if he wanted to cut the cord and he said "heck no, that's what we pay you for" so they cut it and got me laid down and within 30 minutes Ena was nursing. But, I was still bleeding so we had to deal with that.

Ten minutes after the birth, the phone rings and it’s my mother, she's in town, fifteen minutes away. The timing could not have been any more perfect. Guess God does know what He's doing after all. Brad calls his mom and tells her we aren't at the hospital, we are at home. Later she tell him that she's really really glad we didn't tell her about our plans, that she would have worried the entire time, so we played that one just exactly right too.

I ended up losing an estimated 4 cups of blood, quite a bit for an otherwise uncomplicated birth. They gave me Shepherd's Purse tincture and I drank a lot and ate a lot and by the time they left, my uterus was actually involuted down almost to the size they'd expect 24 hours later so I think some of it was just that I lost a lot of blood in a few hours that "should" have come out over the next day. I only passed clots a couple more times and 4 days out, had very little lochia at all. So, while it was a bit scary (I did get really faint and woozy and had to be carried up the stairs- Brad's mom walked in as they were dragging me up the stairs, leaving a trail of clots. Micky was a bit worried about the impression of homebirth we gave her but I told her not to worry, I'd clear up any misconceptions!), it ended up not being all that serious.

No tears (at least 2 minutes of the ring of fire did do something positive!) and just a couple of minor "skid marks" on my labia. I feel so good "down there" that I forget to use the peri bottle. But no one told me how much it itches as those skid marks heal! The herbal bath that I'm using for perineal healing is wonderful (see end), and it's dried up Ena's cord like gangbusters too. Ena has no molding, probably because she was almost born in the caul, and only one little scrape by her right eye- she is just as "perfect" looking as her cesarean brother's were. I feel great, although I do have to be careful not to overdo things.

Random closing thoughts:

Did I ever think about uterine rupture? 2 times- when I first started pushing because it hurt so damn much and all low and in the front. But since the pain stopped in between pushing, I figured it was unlikely. And then when I was still in the pool but bleeding- and because it didn't hurt at all, I figured again, unlikely. Never crossed my mind at any other point.

What coping techniques did I use? In early labor, the more classic Bradley relaxation stuff was really helpful, although not in the side-lying position. Later I drew a lot on the variety of stuff that "Birthing From Within" talks about- especially vocalization and "going into the pain" - as funny as it sounds, facing and embracing the pain was the only thing that made the slightest difference during what I now know was transition. If you don't have the book, get it. Period.

Was it my dream birth? Well, actually, I didn't have a dream birth and I did that on purpose. It was exactly the birth I needed, and I find it supremely ironic that I basically had a textbook "Friedman" labor- 12 hours of dilation, 1 1/2 hours of pushing. Whoda thunk me of all people would do it "by the book"?!? Yes, I'd do it again, no doubt about it. I'm not on a screaming high but I'm happy. And having fun. That's really all I want- the first 12 weeks after the section was such a dismal, gray, unhappy time, with no positive thoughts to it at all- just to be having fun is enough for me.

Could I have "done it" in the hospital? Well, I hope never to know the answer to that question. I do know I would not have done it the way I did do it if I were in the hospital- I probably would have taken drugs if offered (I would have taken a bullet if offered there at the end although Lori says I don't give myself enough credit for how strong I am), and I would not have had the freedom to be loud, to move around, and most importantly, to be absolutely by myself when I needed to be. I think that was the single most important thing my support people did for me- left me alone.

I am so thankful that I had the support from Brad and the people that mattered when it came to planning an HBAC- it was the best decision I could have made.

-Gretchen (Aleksandr and Daniel, coerced c/s, 6/30/98, Ena Rose, HBAC waterbirth, 1/18/01)