Birthing at Home – A Personal Journey
By Fiona Lohrbaecher
I have had two wonderful home-births. The first was in Germany. We lived in a small country town in the Black Forest where the nearest hospital was a half-hour drive away. Home-birth is quite usual in Germany. Even in the hospitals they promote natural birth with most hospitals having a birthing pool, although, like here, the Caesarean rate is on the increase. For my ante-natal care I saw a frauenarzt – a women’s doctor. It was a one-stop shop, check-ups, blood tests, ultrasounds, everything happened in the one place. Germany has a contributory State health-care system that covered all of my pre-natal care, the home-birth and post-natal care. We only had to pay $200 to the midwife to be on 24 hour call-out.
I had been set on a home-birth ever since attending a seminar on natural childbirth three years previously. For me, hospitals were places for sick people. I was torn, however, because I had always wanted a water birth and there was no room in our apartment for a birthing pool, although my midwife assured me I could give birth in the bath if I wanted to. I had a healthy, straightforward pregnancy and was very confident about giving birth at home. My doctor would not recommend a home-birth, nor would he say anything against it, he left the decision to me.
Even though we lived in a small town I was fortunate enough to have two marvellous home-birth midwives, Beate and Petra, whose philosophies I admired. In Germany a primary midwife attends the labour and birth with a secondary midwife coming just for the birth.
I attended birth preparation courses run by Beate, who taught yoga and breathing exercises to prepare us for a natural, drug-free birth. She was inspiring. She told us that every woman has the strength within her to cope with childbirth and likened it to climbing a mountain – sometimes you think you can´t go on, but when you reach the top all tiredness is forgotten in this amazing feeling of achievement. What particularly impressed me was her view that every woman should feel totally in control of the birthing process. She had three children of her own and told us of her own birth experiences.
Petra was a specialised home-birth midwife. She was to be the primary midwife as she spoke fluent English. We met twice before the birth and I liked her immediately. We discussed the possible risks of a home-birth but were confident that nothing would go wrong. As Petra said ´´If home-birth were so stressful, I wouldn´t do it.´´
Four days after my due date, when I was feeling as if I had been pregnant forever, I awoke with slight backache twinges. These twinges continued all day at five minute intervals. Beate came round to give me a check-up and confirmed that I was in pre-labour. I was very excited. I knew that the birth may still be a couple of days away, but at last something was happening. I had been looking forward to the birth for months. I had no apprenhensions or fear. I was eager for this amazing experience and was so impatient to meet my baby. I didn´t want even a TENS machine, as I wanted to discover what I was capable of bearing. I wanted to test my limits and try the natural pain control methods I had been practising. This finally decided me against a water birth. I didn’t want even the mild pain relief afforded by the water, I wanted to experience it all. It was my big challenge.
The next day the contractions were stronger, like mild period pains, lasting almost a minute, at twelve minute intervals. I kept Petra advised of all changes throughout the day. In the afternoon Juergen and I took a long walk in the forest, bubbling with excitement. I was disappointed that the contractions seemed to disappear on our walk but when we returned they became stronger and more frequent, although still not very uncomfortable. At 5 p.m., I phoned Petra to let her know the contractions were stronger. She asked if I wanted her to come. I said I didn’t know what to expect but, if she didn´t think it was necessary to come yet, I was quite happy to await developments. She was impressed with my patience, but I found it easy to be patient, now that I knew something was really happening.
As the evening progressed the contractions became more uncomfortable and I took up some of the postures practised in the class. We were playing Yahtzee and every seven minutes I´d say “Here comes the next one” and we’d get up and do a lambada, me pressing backwards into Juergen as we rotated our hips together . Later, I changed to leaning against the wall with Juergen massaging my lower back. The pain was exactly like period pain, so I knew that I could bear it as I’ve had some pretty bad periods in the past. In fact, although I had cursed them at the time I was now grateful for them. They were good preparation for labour.
Around 9 p.m. the plug came away. I was pleased because I knew labour had really started now. The contractions were quite strong and I went to bed but didn´t manage to sleep. A hot water bottle for my back helped a little. Around 1 a.m. the contractions were getting pretty hard to deal with. Juergen phoned and asked Petra to come and she arrived an hour later. I was sitting on my gym ball, rotating my hips with Juergen pressing my back. Petra asked how I was, examined me and found I was one centimetre dilated. She said it could take a long while yet and suggested I have a bath while she went to lie down on the spare bed. I had a bath but I wasn’t comfortable there, I found it too restricting and too hot. I went back to bed and lay down between contractions, getting on all fours and rotating my pelvis during the contractions. Although they were hard to bear they didn´t last for long and the pain-free gap between each one gave me an opportunity to rest and recover.
Petra came back in at around 3.15 a.m. The contractions were now very close together and it was twenty minutes before I let her examine me again. She didn´t think much would have happened and we were all surprised and thrilled when she found I was now 7 cm dilated. This gave me a real boost. I knew it would not be too much longer now, although I didn’t expect it to be as quick as it was.
Petra went to lie down again, telling us to call her when I got the urge to push. Less than an hour later I felt a strong need for the toilet. As I got up from the bed I felt a pop and my waters broke. I went to the toilet and threw up. I´d already thrown up several times during the night, but I had read that it helps the cervix to open, so it didn´t worry me. Juergen called Petra. While sitting on the toilet I had such an incredibly strong pushing feeling that I screamed. Petra said ´´Good, but make your voice deeper“, which made me laugh. When Juergen prised me off the toilet and brought me back to the bedroom a few minutes later, Petra had already placed blankets and sheeting on the floor in front of the bed. She asked if I wanted to kneel in front of the bed. I didn’t have time to think about birthing positions or anything I had learnt in my class, I was just concentrating on getting through each contraction, although I did remember my breathing and to keep my lower jaw loose, and therefore the perineal muscles, relaxed.
I knelt, leaning forward on the low bed. The room was dim, just a few candles burning. Petra had a head torch. I had planned on having relaxing music but had forgotten about it. I wouldn’t have noticed it anyway.
The urge to push was irresistible and I had heard that you mustn´t push until told. That was the hardest part. I asked Petra ´´How do I cope with this, I just want to push?“ She said ´´Push.´´ The relief was incredible. All tiredness was forgotten now. I pushed, one long, slow, strong push with each contraction, grunting loudly and deeply. The feeling was indescribable, but it was, to bring up an old cliche, like pooing a football. Juergen, who had been so calm and strong until now, was sitting on the bed, sobbing and laughing.
Petra told me to reach in and feel the baby´s head, so I did. It was incredible, it felt so soft. As the head crowned it did hurt, but I knew this baby had to come out, and I wanted it to come out so, after the first instinctive recoil from the pain, I mentally grit my teeth, (while keeping my jaw relaxed) ignored the pain and pushed, and the pain was soon forgotten in the effort to birth the baby. I was determined to keep the momentum going, not to let the baby slip back in. I felt the head coming out with my hand. Beate had arrived by now and she reminded me to pant to slow down the birth of the head. Then, after one more long push, the head was out. I couldn´t believe it, the relief was incredible. I looked down and there was this baby´s head underneath me. There were two minutes’ rest before the next contraction; a couple more pushes and the body was out, helped onto the blanket by Petra. There was a real live baby lying underneath me, screwing up its eyes and gasping. I said ´´Oh, it´s a baby!´´ as if I´d been expecting a melon or something, but it was so hard to believe that this perfect little person was the one who had been kicking inside me all these months.
I asked for my glasses and picked up my baby. It was all slimy and I was afraid I would drop it, but I didn´t. Petra and Beate spread towels on the bed and helped us onto it and I lay there holding my baby. It was the most wonderful feeling. I was the first to see that she was a girl. I was surprised at how beautiful she was, I had expected her to look like Winston Churchill. She wasn´t red or blue or wrinkled, her head wasn´t a funny shape, her nose was a little squashed and her eyes a little puffy, that´s all. She was born at 5.36 a.m., just an hour after my waters broke. She lay on my chest while her nose and throat cleared. When she could breathe easily I put her to the breast and, with some help from Beate, she was soon suckling successfully.
Petra and Beate left Amber, Juergen and I alone together until I felt contractions for the afterbirth. The placenta was born, Petra clamped the cord and Juergen cut it. Later, she showed us the placenta and explained it all to us. We kept it in our freezer for a while before burying it in the garden. When Amber was an hour old I suggested she´d like a bath. Juergen bathed her with help from the midwives and she really enjoyed it.
I had thought that I would be emotional and cry, but I felt very calm and contented. The pain had ceased immediately the baby was out. I was a bit stiff and sore, but that was nothing. I hadn´t torn so didn´t need stitches. I felt very pleased with and proud of myself. It had been hard work, but I had never felt scared, never felt ´´this is too much, I can´t bear it´´. I knew that I had to bear it, there was no going back. I just had to get on with it, so I did. It had all been as relaxed as I had wanted. I had felt in control. Petra had guided and assisted with occasional advice but Juergen and I pretty much got on with it ourselves. It was wonderful to be in my own home, to lie in my own bed, to have my own bathroom and kitchen, my own schedule and food, and for Juergen, Amber and I to all sleep together that afternoon. It was so fantastic as well not to be pregnant any more. I could tie my own boots again, eat tomatoes and not be sick on buses.
My second home-birth, here in Australia four years later, was very different. I was struck by the inconsistent attitude towards home-birth and pre-natal care across the country. When we first arrived in Western Australia I was heartened by a newspaper article, which stated that the WA government wanted to encourage home-births, to free up hospital beds for those that really needed them. We lived in Denmark, WA, a small town of 3,500 inhabitants. There was a small local hospital that offered a midwife run ante-natal clinic, a birthing centre and a marvellous home-birth service that I was looking forward to using. An early miscarriage put paid to that.
Then we moved to Coffs Harbour, NSW. Here, in a town of over 60,000 people, only two GP’s and two obstetricians, one private, offered pre-natal care and there was no ante-natal clinic at the shiny new hospital, although the midwives were campaigning for one. As for home-birth? Forget it. It seemed to be a dirty word in Coffs. One GP told me “Home-birth’s alright in Europe but not with the Australian geography”, a rather illogical argument if home-birth is alright in WA, which is far more rural than coastal NSW. However, I was so determined to have a home-birth I would have done it alone if necessary. I was convinced that Juergen and I could handle the birth no problem, but I wanted professional help afterwards, to check the baby and the placenta. I discovered a home-birth group in Bellingen, 55km away, led by a couple of dedicated and experienced lay-midwives. A second miscarriage meant I didn’t need their services after all and I now had a strong respect for hospitals. When you need them, they’re fantastic, although I still believed they were not the place for a normal birth.
We moved again, to northern NSW, between Lismore and Nimbin. Here again it was a different story. The Lismore hospital offered an ante-natal clinic and the shared-care option meant that all GP’s offered pre-natal care. I found a wonderful, highly experienced home-birth midwife, Jillian, who also took care of all pre and post natal care. She recommended a lovely female GP who was quite happy for me to have a home-birth and see Jillian for my pre-natal care. I just had to check in with her every six weeks or so and she organised my blood tests. The midwives at the hospital were also happy with my plans, wished me a good birth and hoped they didn’t have to see me there. Going to Jillian’s home for my pre-natal check-ups was far more relaxed than going to a doctor’s surgery. It was private but we considered the cost well worth it.
The birth was very different to my expectations. For the past two years I had been longing to re-experience the wonder of giving birth. I was particularly looking forward to the exciting experience of pushing the baby into the world, feeling it slowly creeping forward, putting in my hand to feel the head. Again I decided against a water-birth but for different reasons. I had tested my limits and this time I would be happy with the relaxing effect of the water but water was limited where we were living. Plus I had recently heard and read about many quick second births and had a strong feeling that this was going to be a quick birth and I would hardly get to use a birthing pool. My instinct was right.
I was four days overdue. The baby had been engaged for a few days, I was having strong Braxton Hicks and every time I went to the toilet I had a strong pushing urge. It was a good day and I was feeling energetic but around four p.m. I was suddenly overcome with tiredness and had to lie down. While lying down I sneezed and felt a gush. I didn’t know if I had wet myself or if my waters had broken. When I got up to go to the toilet there was another gush. I ‘phoned Jillian and asked if my waters could break before I’d had any contractions. “Oh yes,” she said, “but it could still be hours before anything happened.” She asked me to call again when I felt contractions. I was so excited and energised again. I went into the garden and did some chi gathering exercises, feeling the warm sunshine on me and singing “Let the sunshine in.” Then I felt it was time to prepare the birthing area. The contractions started around 5.30 p.m. but they were so wishy-washy to begin with I wasn’t sure they were contractions. After an hour they were more definite and I ‘phoned Jillian. She had just arrived at a post-natal visit an hour and a half’s drive away and left immediately. She arrived at 8 o’clock. I was on all fours in my birthing sanctuary, a mattress on the living-room floor with red sarongs hung around to make a cosy boudoir. Amber was so excited about the birth, she was hyper. Jillian bustled around for a while preparing her things while Juergen made her a cuppa. By now the contractions were feeling quite strong and I was sure I must have made good progress so I asked Jillian to find out how far gone I was. It was 9 p.m. when Jillian told me I was 2 cm dilated. I was disappointed but it was good to know because now I knew I needed strength for a few more hours.
The cervix was very soft, Jillian said, and if I walked around, the pressure of the baby’s head would help to open it. As soon as I was upright the pains became much more intense. Jillian was pleased, I wasn’t; it had been far more bearable when I was kneeling. Still, I walked around clutching a hot water bottle to my lower back and Jillian went for a lie-down. Amber had fallen asleep on a little mattress next to mine.
Juergen was invaluable at this time. As soon as I felt a contraction I shouted “Support me” and he supported me on his bent legs, while standing. It must have been a strong weight for him to bear but he never complained. The contractions were coming thick and fast and were really unbearable, there was no breathing space. It felt like transition but I knew it couldn’t be, it was too soon. “I don’t remember it being this painful with Amber” I said. I had to freeze wherever I was with each contraction. I knew I could not put up with this for another couple of hours.
Soon I had Juergen sitting on the kitchen chair, with me on his lap, and I couldn’t help pushing and roaring with each contraction. It was just as I was about to say “Go tell Jillian I think I’m in transition” that I felt the most almighty push, and screamed “The baby’s coming, the baby’s coming” then I put my hand down and felt that the head was already out. I hadn’t yet taken off my knickers, because of the leaking fluids and I hadn’t realised the birth was imminent. “I don’t know what to do” I wailed, “the head’s out.” Juergen kept a cool head. He dragged me over to the mattress where I knelt, leaning on the sofa, grabbed a pair of scissors and cut my knickers off. Just then Jillian arrived on the scene. She had almost dropped off, listening to my screams in contentment, thinking I was making good progress. Then she heard my roar, thought “that sounds like pushing”, and came in to see me kneeling, with the baby already looking out. One more push and Juergen caught him and I thought, “Thank goodness that was over so quickly.” And then “well, that wasn’t so bad after all.” Despite the speed of Ahren’s birth I hadn’t torn or even grazed, and he was a big fellow, nine pounds. He was born at 10.42 pm, just over an hour and a half after I was two centimetres dilated. He was a bit shell-shocked but latched on immediately and guzzled strongly. My placenta came away quickly and cleanly. Amazingly, Amber slept through the whole thing. We couldn’t even wake her to meet her new brother so she met him next morning. Again, I was so happy to be at home, where the birth had just been another part of life, rather than a big medical event.