by Sandra Gordon
“I can do this,” Kristin says confidently as she lies in bed on her back, with Glenn supporting her from behind. Again, Cara, Kristin’s nurse midwife, checks the baby’s heart rate. It’s still stable. Later on, Kristin will ask, “Why is it hurting so much?!” to which Cara will say, “This is normal for posterior presentation.”
Why do these parents opt for a home delivery — which is still somewhat risky? What’s the experience like? To find out, we hooked up with Kristin Brooks, 36, and her husband, Glenn Meyer, 30. After careful deliberation, the couple decided their first baby would be delivered at home in a bed that they could later point to and say, “This is where you were born.”
What follows is an hour-by-hour diary of the birth of Griffin Simpson Meyer, who came into the world in the warmth and comfort of his parents’ home.
Kristin has been in labor for six hours. She paces the couple’s apartment, timing her contractions. Debra Pascali-Bonaro, her doula, and Cara Muhlhahn, a certified nurse-midwife, have just arrived. Their presence is a source of comfort to Glenn, who was skeptical of a home delivery — he became a convert after long discussions with Cara, who has a lot of experience with home deliveries and assured him that Kristin’s good health, her uncomplicated pregnancy and her commitment to home birth all made her an ideal candidate. “At home, you don’t have to worry about hospital regulations or policies,” Glenn explains. “You can focus exclusively on having the kind of birth you want.” Kristin wanted a completely natural childbirth. She hoped to deliver her baby without an epidural, an episiotomy or any other intervention. While she could have insisted on having a natural childbirth in any setting, “home is where Glenn and I feel most comfortable,” she says. “I think that having the baby here gives us the best possible start as a family.”
When Cara performs an internal check on Kristin, she finds her cervix dilated to nine centimeters — a measurement of 10 signals that birth is imminent. Within a few minutes, Kristin’s water breaks, and everyone expects that she will deliver soon.
False alarm. When Kristin’s water broke, her labor did a back slide. Her baby has moved up the birth canal, and her cervix retracts to six centimeters. Kristin is disheartened and uncomfortable. Between measured breaths, she leans against a table in the foyer and says, “I need help.” For pain relief, Debra gives Kristin a back massage. A while later, Kristin and Glenn decide to walk the hallways of their apartment building. They hope the effects of gravity and movement from walking will help the baby get back into position.
In the apartment, Kristin climbs into a small inflatable birth tub — a kiddie wading pool, really — that Debra and Cara have set up in the living room. They’ve filled it with warm water, which can help ease the pain of a strong contraction. With Kristin on her hands and knees, Glenn leans over and squeezes her hips, applying pressure to counter her contractions. Debra douses her back with pitcher after pitcher of warm water. “Why does it hurt so much?” Kristin asks, grimacing through one contraction after another. “You’re in hard labor,” Debra says. “But you’re doing great.”
Cara tries to manually turn the baby to rotate the baby’s head so that it will move down the birth canal. “That little one is moving,” she says. Cara listens to the baby’s heartbeat with a handheld Doppler monitor. Thump, thump, thump. One hundred 20 beats per minute. Perfectly on target! Kristin stands up and leans against Glenn, who has climbed into the birth tub with her. They hold each other and rock through the next few intense contractions. Soft classical music plays in the background. The scene is intimate and cozy.
Kristin has moved from the tub to the bed. To make herself more comfortable, she gets up on all fours. Cara, Debra and Glenn form a close circle around the bed. During the contractions, Cara manipulates Kristin’s cervix while Kristin bears down in an attempt to get the baby to descend the birth canal.
The slow progress of Kristin’s labor is frustrating. Cara’s concerned that the baby could be in a posterior presentation, with the back of its head resting Kristin’s spine. One in 10 babies lies in this position, which can be extremely painful though not dangerous. It’s also possible that the baby could be too large for Kristin’s pelvis, a downright risky situation. If that’s the case, or if Kristin’s labor remains stalled, she may need to be transferred to the hospital — a contingency the couple are well-prepared for. They have an obstetrician on call and have designated a hospital, alerting labor-room staff there that they may be showing up after all. “I really hope I don’t have to leave here,” Kristin sighs. “Let’s take one thing at a time,” Cara comforts her. “We’ll just have to wait and see what happens.”
Kristin decides to take a shower. Standing and relaxing under the warm water gives gravity a chance to help move the baby in the right direction. Next, Cara checks the baby’s heart rate. At 180 beats per minute, it’s much too fast — it could be a sign that the baby’s in distress. A few minutes later, it’s back to normal. Whew! Perhaps the hot water from the shower revved up the baby’s heart rate temporarily.
Another internal exam shows that Kristin’s cervix still isn’t dilated fully, and the baby’s head hasn’t budged. Again, Cara tries to manually turn the baby, which causes excruciating pain for Kristin. “Just keep breathing deeply,” she says. Soon Kristin gives a short high-pitched scream. Cara thinks she has righted the baby from the posterior position only to have it move back. To help Kristin relax, Debra asks where she would feel most secure. “In Glenn’s arms,” she says. He promptly embraces her and, with strong hands, massages her lower back.
“Please give me something to take the pain away,” Kristin says. “It shouldn’t be hurting this much.” Debra gently counters, “This is normal for posterior presentation. The baby isn’t in danger, and neither are you.” Despite the pain and the length of time she has been stalled at six centimeters, Kristin’s labor is still considered normal and safe as long as her baby shows no signs of distress. Cara gives Kristin a shot of Stadol, a narcotic that will hopefully take the edge off her pain and allow her to rest for a few minutes between contractions. Administering drugs like this at home is unusual: Cara says she’s given narcotics only twice in her career. Meanwhile, Glenn applies soothing counterpressure to Kristin’s back as she continues pushing with every contraction.
The Stadol has kicked in and given Kristin a chance to renew her strength and refocus her energy. Cara checks Kristin’s cervix, which has finally fully dilated to 10 centimeters. At last, it’s time to start pushing. “I can do this,” she says confidently as she lies in bed on her back, with Glenn supporting her from behind. Again, Cara checks the baby’s heart rate. Fortunately, it’s still stable.
Cara’s trusted colleague, Miriam Schwarzschild, arrives to assist and provide a new perspective. Miriam, also a certified nurse-midwife, does another internal exam. “Good pushing,” she says to Kristin. “Put all of your effort right on top of the baby.” Debra tells Kristin to relax, breathe deeply and try to visualize her body opening and her baby coming down. She closes her eyes and concentrates.
It’s nighttime. Glenn shines a flashlight on Kristin to avoid an overhead light. Kristin has been pushing now for two hours. During one rigorous push, the midwives get a quick glimpse of the top of the baby’s head. Miriam suggests transferring to the hospital. She believes the baby is in a posterior position and reluctant to budge. But because both Mom and Baby are in good condition, Kristin and Glenn decide to press on.
After more than 16 hours of rigorous labor and without an episiotomy, Kristin gives one final push and a boy is born. Cara and Miriam immediately plop the chubby infant — Griffin — on Kristin’s tummy. “He’s got such big feet,” the new mother says, tears in her eyes. Griffin lets out a tiny cry, and the room erupts into shouts of joy. “What a victory,” Cara says. Glenn beams.
One week later:
Griffin’s pediatrician pronounces him “perfect.” Reflecting on the homebirth, Kristin credits Glenn, Cara, Debra and Miriam with helping her make it through. “I really trusted the people who were taking care of me,” Kristin says. “We went through a labor that had a lot of glitches,” Glenn adds. “But it was worth it.” Would they have a home birth again? “Absolutely,” they say in unison.