Home birth is on the rise in the United States, according to these stats from the CDC's NCHS Data Brief published in January 2012. This is great news! While home birth is not for everyone, for those that are interested there are specific questions that need to be asked while interviewing midwives for home delivery. I have found some great compilations online addressing the questions for home birth midwives, but have not found one that I think asks everything important to me. So, for those interested, here are what I would ask!
The safety questions
1. What kind of education and/or training have you done to become a midwife?
2. What is your transfer rate? What are reasons you would choose to transfer to hospital? Will you stay with mother if transfer is necessary?
3. Tell me about your experience, and births attended. I would specifically want to know about certain situations that arise and how they handle it. (examples: long pushing phase, surprise breech baby, posterior baby, nuchal hand, meconium, malpositioned baby, non-reassuring heart tones, stillborn, etc)
4. What emergency equipment do you carry, and can you describe situations these might need to be used in?
5. Talk to me about your client load, and area of service.
6. How do you feel about pre-term or post-term dates? What do you consider a safe time period? What would you suggest should this situation arise?
7. Who is your backup, what are her credentials, and how far is she? Do you have a doctor back-up?
8. What neonatal resuscitation trainings have you attended? How long ago?
Birth philosophy questions
1. Why did you become a midwife?
2. What is your personal stance on birth in general (your philosophy)?
3. Talk to me about the legality of home birth in this state, and how you feel about it.
The other important questions
1. How many times will we meet during my pregnancy?
2. How will my partner get involved?
3. Do you welcome a doula?
4. How do you feel about the procedures/tests I do or do not want done during my pregnancy?
5. What are my pain relief options at home? What about comfort measures?
6. What are your fees? What does that include?
Honestly, I have found the really good midwives end up answering all your questions before you even get to them. I think it is important to come prepared, and sometimes ask the hard questions to make sure you feel comfortable and assured. I know there are tons of other questions to ask. What are some questions you might add to this list?
It was around 8:30 am, I had just been up with my sick toddler all night, but the rest of the family was up and ready to go! First instinct, COFFEE! I start heading to the kitchen to attempt such a task and I heard it. THE phone call. The one I have been waiting for, the one for which I had been on call for the past two weeks or so. I always get this incredible feeling deep inside me when I know it is time. It feels like a roller coaster, lovely fun butterflies flutter around in my tummy. I rush outside and call the number back immediately. It is Phil, the super-husband calling to tell me what I knew already, it was time! Quickly, I hang up and promptly call up babysitter to see how fast she can come to my house. After all the phone calls were finished it was time to hurry up and get ready. Doula bag was already packed, and had been for some time. In my bag you will find extra snacks, gum, change of clothes, rice pad, a rebozo and some oils, just to name a few things.
I just threw on some new clothes, brushed hair and teeth, changed baby and packed his backup things. The exciting thing about getting ready for this birth was that my 4 month old baby would be attending with me! I brought a few carriers so that I could wear him on my back while supporting the mama-to-be/my amazing friend, Tammy.
After I finished getting ready the babysitter arrived around 9:30 am. I was super rushing at this point, anxious because Tammy had fast labors previously and I wanted to get there to help support her as her Midwife had not yet arrived. I tripped up my stairs in haste to say goodbye to my boys one last time. Left a nice goose-egg and bruise to remember it by. ;)
Once in the car I did my usual deep breathing and relaxing that I like to do before heading into a birth. I do not want to have an over excited presence with a laboring mama who is usually trying to focus hard. I stopped real quick to get some caffeination and a snack. Played some fun music and drove exceedingly fast to get to her house.
Pulling up to her house, decided not to park in driveway as I was the first to get there. Brought in baby and took a video of when I walked into the house. This is what I saw:
Tammy was already laboring beautifully, her two girls were very excited, and her husband was running around like crazy doing EVERYTHING he could to get ready. He had three pots of water boiling, and the tub set up, and half way filled with water already! I was incredibly impressed!
As soon as I settled in Phil and the girls hopped in their van and ran over to Tammy's Mum's house to fetch her. She was going to help watch the girls and support Tammy. It was nice and quiet with just Tammy and me in the house. She has some very strong contractions. I sit quietly next to her during it and whisper encouraging words to her. I add another big pot of boiling water to the tub and do a little pressing on Tammy's lower back, but am not sure she was wanting the hands on since she had told me previously that she prefers to labor on her own.
The next couple hours were beautiful and magical. It is always so amazing to watch a woman persevere through labor. I feel blessed to watch her loved ones interact with her as she moans, sighs, and yells a little bit through the intensity. Her girls are curious. They ask questions, feel the water, they want to help! Her sister sent her an encouraging video, which Phil played while she was in the tub. The Midwife and her assistant are also very encouraging. They take fetal heart tones, record notes, and assure Tammy that all is OK and normal. Phil brought her drinks, put cool rags on her head, and sang songs to her. Watching them together made me teary eyed a few times, you could feel how much he loved her and wanted to help her! It feels like a party. A beautiful, peaceful get together in which we are witnessing something miraculous happen!
Tammy's contractions get stronger and the tone is more serious. She cant wait to hold her new baby and for the pushing to begin. I continue snapping pics left and right. She looks amazingly beautiful in the water with so much love all around her. I tell her so...and Phil agrees.
We all encourage her to keep drinking and try to eat something for some energy.At home births you rarely have cervical checks like they do so routinely
in the hospital, but Tammy wanted some reassurance, so around 12:45 she
asked Midwife to check her. She was about 8 cm, and baby was still a
little high up in her pelvis. I know the water feels like bliss and she does not want to get out. Eventually though the Midwife says what I was thinking... that she should get out for a bit so she can use the bathroom and also so the change of pressure could bring baby down a bit. Tammy slow danced with Phil a little bit after getting out of the tub. He held her tight as she worked through a few strong contractions, encouraging baby Des to move down.
Then we all followed her into her room down the hall where she laid on her side, and we could all visibly see the contractions get stronger and a little bit longer it seemed. I took Marsden off my back and laid him in the crib next to Tammy. There was an adorable moment where he seemed to be mimicking her sounds, he was just babbling away! I smiled so big!
Then there was this moment.
It was in this moment that things changed. This moment is what birth workers just know to listen for, it is when her sounds change. Her roars and moans changed to where she added this liiiiiiitlegrunt at the end! OOOOh, I smiled so big when I heard that and looked over at the Midwife, she was also smiling and encouraged Tammy, "That's right! Good job!" Pushing time was near now! I gently reminded her of her desire to give birth in water, and asked if she still wanted that. Tammy said yes, she got through another few strong grunty contractions and we quickly (and I mean she moved very quickly for having a baby so close to being born) back into the other room where the birth tub was set up!
Super strong contractions are happening frequently now with loud vocals and a little pushing. Phil got his swim trunks on in case he needed to jump in to catch baby.
Tammy called our for her Mum at this point. She became her rock as Tammy worked so hard to push her baby out into the world. This doula had tears again watching them.
And then I hear that baby is crowning, and I make sure to have video ready to capture the moments of his arrival. Tammy is working so incredibly hard, but she is doing it, and I am so so very proud!
Desmond Allen, 7 lbs 13 oz and 20" long, born on August 20th at 1:57 pm into Tammy's loving arms. Her husband helped catch and unravel the baby, her daughters and mother watched on, and everyone felt so ecstatic when she finally held him in her arms.
And then, after the placenta was delivered, cord was cut and Tammy moved back into her own bed, something else amazing happened.... life went on. Everything seemed so normal, just now there was another little life added to the mix. Two daughters and now a son. Perfect, simple and incredibly beautiful. This is homebirth! I just got to witness a family of four become five. I took my pics, I said some encouraging words, I brought her snacks and drinks, helped talk with her daughters and assure her husband, and then I went home and left them to get acquainted their new beautiful addition.
I will leave you with this video pics/video slideshow I put together for Tammy and her family. Enjoy!
Postpartum bath herbs from my awesome Midwife, and I also have more from LuSa Organics
Peri bottle (yes!)
Wishgarden Afterease tincture
MegaFood Blood Builder for my iron levels after birth
Cord clamps
Bulb syringe
Lots of towels, and lots of washclothes
Bendy straws (for easy drinking in labor)
Healthy and yummy labor snacks and drinks (water, coconut water, juices, fruits)
These are just the supplies that I have listed from my midwife to have on hand, or that I thought may be handy from past experience. This does not include the awesome bag of tricks that both my Midwife and my doulas will have on hand. But in the end, really, these are all mostly just precautionary type supplies. Let's let birth unfold without messing with it and see what miraculous things take place!!!!
What would you add to this list? Is there something you think would be super handy that I have forgotten?
Excuse my crazy crazy hair and clothes. This is how I roll most of the time these days.
It is almost time! I am a crazy mix of emotions for my next upcoming birth I am attending as a doula. See, this one is going to be a different dynamic completely, I will be a doula for my best friend at the birth of her first baby. I am going all the way up to Ohio for it, hoping to be there from 38 weeks until after her baby is born.
Heather, my sister, and I have been a trio of friends for over 10 years now! We have been through so many things together, including our crazy rebellious teen years, my marriage, and the birth of my two sons. She has been an ever faithful ear to listen to all my crazy birth rants and has taken it into her own hands to become educated and aware of her options for her first birth.Seriously, this girl new more about birth before ever even conceiving then most people do that have children of their own.
She decided on a wonderful Certified Nurse Midwife and a hospital delivery with a doula (me!) and taking a really wonderful homebirth friendly childbirth education class. I am super excited for her to experience this.
I know it is going to be hard. The hospital we are going to is not exactly known for being natural birth friendly. I know that we will have to fight for her right to birth her way. I know that she will be surprised to feel how labor really feels, but I have confidence in this girl! Heather is an extremely strong willed person, always has been, and I know that she will fight for her birth with all she has, and I will be there to support her in whatever she does. Birth is such an unpredicitable thing! I can not even guess how hers will be: long, short, easy, or harder. But my job is to be there for her no matter what, and to support her in every decision she makes.
The toughest part though, is going to be what my "job" entails when it comes to being a doula for my best friend. Am I her doula first, or her friend first? Because as her friend there are definitely some things I would do and say that a doula would not! So this is where I am struggling for the moment. Finding the right balance and choosing whether just to wear the "friend" hat in the delivery room, or the "doula" hat at all times. I will post again about her birth experience. I am beyond ecstatic for her to experience this life changing event! I know it will blow her mind away! :) (Birth is kinda like that....mind blowing!)
I officially published my website, and wanted to share it! I link to this blog from it as well so people can look into my personal life a little bit. I am tweaking it a bit here and there but this is it, essentially! Thoughts?
I have now attended four births, and am about to be on call for my fifth. I know I am still a newbie, but each experience has been life changing and such a learning adventure. I have learned four life lessons. Let me summarize what I learned with each in one or two sentences.
Birth is beautiful, and women are strong. Birth can be quiet and surreal, and still epically powerful.
Some doctors who catch babies do not love birth, it makes for a tense environment, to say the least. But a woman will face any and everything for her baby, and she becomes a different person the second that baby is in her arms.
Birth is spontaneous and so very different for everyone. Trust the woman, she knows herself best.
The mind is a powerful thing when a strong woman has her mind on something it is pretty awesome to watch her stick to her guns. Also, medical interventions can still = a totally epic natural hospital birth.
I love each experience so far. I learn new things with each one and become a different person myself because of it. I love being in the birth field, I would not change a thing. I feel so passionate about birth and how I fully believe it shapes and changes the world. I am so excited for the next four, forty, and one hundred and forty births that I attend and I hope I never lose my passion for it, and that I continue to learn life lessons from each and every birth I attend.
these two paintings were done by: www.amandagreavette.com/ Simply amazing and inspiring birth art. I want to some day have a room full of her art among a few others that I just adore.
Dearest Dana,
First we want to thank you for inviting us to be a part of this special moment in your life. We will remember it forever! Here is your story as written by us, your doulas, Jessica Pace and Bridget Riley.
~Your Birth Story~
You were so ready to meet your baby. From 37 weeks on, hoping that today would be the day. Bridget and I were excited and anxious as well, so happy to do a water birth, and to be there with you and your family.
Our prenatal visits with you and your family made the upcoming birth so exciting! We would leave each one with such a wonderful "birth high" pumped up and so elated. You would text me the morning after each prenatal saying that you had some contractions overnight (maybe it was the birth positions we practiced or all the talk of birth that did it).
On February 17th we had a birth pep talk at Chickfila with Dusti, Jade and I (Jessica).
On February 18th You had some 4 am contractions and you were so bummed that they quit coming. We were so excited we knew it would not be long now. The way you described them as nice and crampy and strong, it sounded like your body was doing some nice work to prepare for labor! We both slept with our charged phones next to us that night!
On February 19th (THE DAY!!!) I (Jessica) get a phone call from you while I'm watching cartoons with my boys, at 10:06am. I knew as soon as I saw your name that it was time. I got all fluttery in my tummy. We talked about how the contractions were feeling, I wanted to stay on the phone and listen while you were breathing through one to see how intense it sounded and how you were coping. You had been having some irregular ones for almost 4 hours already that morning, some coming around 5 minutes apart or so. But you sounded so very calm and when we talked through the first contraction your breathing was pretty light and almost normal. I was pretty certain it was the real thing, though probably early labor. I hung up and called Bridget right away, I was only 20 minutes away but had to drop my boys off pretty far away before heading over. I called you back right away to let you know I wanted Bridget to come check right away to see how you were, and this time when you breathed through your contraction on the phone with me (less than 15 minutes from our first phone call) it sounded much more deep and you were even moaning a little with it. I knew it was go time and started rushing hardcore to try and get my boys ready so I could be by your side!
(Bridget's POV) I was sleeping at my friends house down the street from your house when my phone rang and I saw it was Jessica's name on caller ID. My heart raced and I just knew that it meant today was the day! After hearing how your contractions were seeming more like the real deal I got up fast, headed to my car and made sure everything was ready. I text you to let you know I was on her way, and arrived within ten minutes to your house. It was 10:40am when I got to your apartment and you looked radiant!
Daniel and Leeland were there and the energy was great and birthy! We started timing your contractions because you hadn't done so yet. After a few strong contractions we discovered they were 5 minutes apart, lasting 20-30 seconds, and you thought about a 6 to7 pain level scale. Pretty good for walking around all morning with Leeland and making breakfast for the family! After your friends came over to watch Leeland we called the midwife, and she said you could go in when you felt like it. The thought of getting the tub set up and sitting in the water sounded great to you, so we got ready to head out (after a brief visit from your in-laws). It was rainy and cold out, but we didn't really notice too much. Since you had such a nice rhythm going so well at home (swaying back and forth during contractions and squatting in between them) , we knew the car ride would be uncomfortable. I rode with you and Daniel for the ten minute car ride to Women's Hospital. You did your best to get into a place that was okay for the FOUR contractions you had in the car. I remember Daniel slowing down for a yellow light and you wanting him to make it so badly. Finally after what seemed like forever, we arrived at the hospital where Jessica was there waiting for us. Finally the happy birth team was together and excited for what was to come in the day!
(Back to Jessica's POV) After rushing back from dropping my boys off at Dusti's house, who was surprised by my showing up at her door, I was going to meet at your house, but things were progressing at what seemed like a little bit faster then we thought, so it was time to meet you at the hospital! I only arrived at the hospital about 5 minutes before you all. I was carrying the big water tub and all the supplies that go with it, lugging that around the hospital is no fun! Daniel pulled up right to the front of the admissions it was about (about 11:55am now), and I immediately rushed to your side. Its like I felt incomplete and freaking out until I was by your side. I needed to be with you, I think because I felt so invested in the whole thing and was missing out on the whole first part by driving my kids across town. Anyways I rushed to your side to help you out of the car. I could tell you were a little in panic mode, much different than when you were established with labor in your home. You seemed to start freaking out a little only because sitting in the car during intense contractions is SO HARD. But you breathed and calmed down and walked to the front desk to start paperwork while laboring.
I was rubbing your back a little bit while you finished that all up, you got back to swaying and doing this crazy hip pop thing after each contraction while leaning on the front desk. We were just all chatting and trying to help you through. Then came the hard part for us, they took you back for check-in with Daniel, while Bridget and I just waited in the waiting room for yall. It took them close to 30 minutes to get you into the hospital gown and check your cervix and vitals. You said it was because they were working around your laboring. You just did not want to sit down!!! After they finished up we saw them whisking you down the hall in a wheelchair (looking back, it was a good thing they were booking it!) we jogged after you with all the birth stuff and started setting up the birth tub and all the stuff in the room. Right now its about 12:35 and you were doing some nice hard work! Nurses were trying to get in there and listen to the baby, asking tons of questions and you were leaning over the bed in the room just swaying and deep breathing. Doing your thing! It was awesome seeing you work hard and labor in such an intense way.They said you were about 5 to 6 centimeters dilated when they checked you about 10 minutes ago (if that). But your labor was swiftly progressing.
I started noticing you were sweating so hard, you started shaking with the contractions and couldn't even sway with them as much. I could tell you were going to need the birth tub soon because it looked like maybe this was going to be some intense laboring. I SHOULD have seen that this was transition!
You would look up in between a hard contraction and look right at me and Bridget, the look in your eyes said so much. You were doing this, it was HARD, and you were not sure how much more of this you could take. I held your hand, put cool rags on your head, and Bridget was working hard on encouraging you all while we were trying, with Daniels help, to get the birth tub set up (it was a failed mission).
Here comes the CRAZY PART! It was 12:47 or so, only about 10 minutes from getting into the room. I was beside you, Bridget in front, and a nurse on the other side of you. All the sudden you said I'M PUSHING, he is coming out, I can feel his head down there!!! I do not think any of us believed you at first but your body language was saying otherwise. Tail tucked under and you seemed to involuntary be pushing a baby out on your own! The nurse agreed and from there it was CHAOTIC! The midwife came running down the hall with the team of nurses. I rushed for the camera. Daniel came to hold your hand. You crawled up onto the bed on all fours and within two minutes your baby boy's head was out. His little hand was born right next to his head, a nuchal hand, I think it was the left side. And then his whole body just sprang out. Everyone was shocked and overjoyed! You were a little stunned. We were trying to figure out how to pass you the baby since he had a pretty short cord. You just flipped around and grabbed him up! Seriously it was amazing and I loved witnessing this rock your socks kinda hospital birth!
You went from 5/6 centimeters dilated to 10 within 20 minutes!
Your body started pushing Hayden out ALL on its own!
You didn't give up, and you seriously amazed us all!
Hayden was beautiful and so plump and pink right at birth! Such a beautiful story, strong mama, and cute baby boy.
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