by Rachel Conley, CBD(CBI), ICCE (ICEA)
Most of the time, a birthing person experiences childbirth as intense, but doulas, nurses, midwives and obstetricians are familiar with the process; we’ve seen it all. But there are rare times when birth is not traumatic for the mother, but is especially intense for the caregivers who are aware of medical things happening unbeknownst to the mother.
Such was the experience of my first homebirth.
I was preparing to attend Rebecca’s birth as a doula. I met Carol, her midwife, a few weeks prior and told her that I was seriously considering midwifery; I had already completed my science prerequisites. Carol was a very experienced midwife, and I looked forward to working with her.
When I arrived, Rebecca was moving into active labor. She had prepared well for a natural birth. She and her husband were having an intimate time singing, breathing, and rocking. They were coping so well that they asked me to step outside the bedroom to give them a little privacy. I sat on the living room couch chatting quietly with the midwife’s assistant.
After about an hour, I could tell the noise of her contractions was changing; she was entering transition. The assistant called Carol and explained that she needed to come quickly, but Carol was still 40 minutes away.
Rebecca was hanging on her husband, squatting and pushing powerfully. James stood with his back against the wall for support. Rebecca could not hear us or respond; she was in the “otherworld.” The otherworld is the place some women go to during natural childbirth where they are so inwardly focused that they are blissfully unaware of everything around them, riding the waves of contractions with closed eyes and focused breathing. Some women train for months to reach this state of self-induced hypnosis; A few women, like Rebecca, channel it intuitively. No doubt her state of relaxation allowed her to dilate very quickly.
Soon, the baby was crowning. We were laying underneath Rebecca and could see the head. But the assistant could not find the heartbeat. I could see her hands shaking and the panicked look on her face. Rebecca continued her powerful pushing, but the head just would not come out. Something was wrong.
When Carol finally arrived, she flew up the stairs and threw her bags of medical supplies on the floor. She got onto the floor with us with a doppler, but she also could not find any heartbeat. She began forcefully chanting out directions.
“Move to the bed…. Legs up.”
“Gause. scapula. knife.” The assistant froze for a second, stunned.
Then Carol whispered in my ear, “Call an ambulance. Quickly.”
I stepped into the hallway. My hands began shaking so it was difficult to press the buttons.
“911 – What’s your emergency?” I hesitated.
“Nevermind, Rachel! We’re OK!” Carol shouted from the bedroom!
This whole scene only lasted a few seconds, but they were the kind of seconds that seem to last for eternity. Time stops still in a crisis.
Later Carol explained to me that this baby had a nuchal arm preventing head flexion. She had performed a deep episiotomy, while almost simultaneously using her fingers to manually force the baby’s arm to move. The baby was safely born, but unfortunately, Rebecca suffered a fourth degree tear and needed vaginal reconstructive surgery.
Some might think that this happened because Rebecca chose a home birth. But Carol was one the most skilled midwives I have ever met. Research shows that homebirths, with qualified midwives, tend to have comparable positive outcomes than hospital births, and women report very positive experiences(1). Having a cesarean was Rebecca’s greatest fear, so she was incredibly grateful to have a midwife who acted skillfully to avoid this.
The midwife, assistant and I walked out of the bedroom. Carol sat in the hallway, hunched over with her face in her hands, rocking and trying to restrain her emotions.
There was no way to know what had really happened. Was it the baby’s low position causing the heartbeat not to show up on the doppler? Or had Carol saved the baby’s life? What would have happened if she had arrived 5 minutes later? Would Rebecca have permanent damage?
My heart was beating fast and I felt a wave of nausea. But I steadied myself on the wall and took slow, abdominal breaths. “You were great in there,” I said quietly.
She looked at me directly and said, “Rachel, you need to think very carefully about how much responsibility you want. This is not an easy job. You will have to make split-second decisions that can determine the life or death of a mother or child… And you may never get to know if you made the right call.”
A heavy word, timely delivered.
We sat in silence for a while before the three of us went back to the room. Carol assessed the tear and cleaned Rebecca. She and James were snuggling with their beautiful baby girl, in those wonderful moments of post-birth bliss.
In a debrief later, Rebecca would share, “Oh, I was never scared. I felt God right there with us all.” Her experience of childbirth was peaceful, serene, and powerful. Many women in the otherworld describe it as a deeply spiritual experience. I was in awe of her faith, intuition, and her ability to trust her body.
I’ve thought many times about Carol’s words. Part of me still wants to become a midwife, but I’ve counted the costs. I’m cherishing the little years with my children, and I don’t want to be too emotionally drained to enjoy their puppet shows and ninja moves. And honestly, I’m not sure I ever want the responsibility that Carol was referring to.
I’m learning that the best way for me to be a birth worker is to set healthy boundaries, because it’s demanding. As a mother, I’m learning (and sometimes struggling) to find balance in the many hats I wear. But I can’t give up birthwork, because I love it. As I get to help women bring new life into the world, it’s life-giving for me, too.
Source:
