Water Birth at Home: Two Perspectives

Abstract

In this column, a grandmother, with a long history as an author and activist for normal birth, and her daughter, a new mother, offer their unique experiences of a water birth at home, attended by family members and midwives. Their unique perspectives demonstrate the trust in the normal birth process that is possible for every birth.

ROBERTA'S (GRANDMOTHER'S) PERSPECTIVE OF SAMYAR'S WATER BIRTH

Three separate times during my daughter's pregnancy, I asked her, “Would you like information [on a birth topic]?” The third time, Amanda looked me in the eye and said, “Don't you think I was listening all those years?” She was born at home to a maternity care author and activist (me). She grew up listening to me counsel moms in breastfeeding and birth. Nine years ago, when Amanda was 21, she accompanied me on a 10-day speaking tour of Japan. The next year, I asked if she might be interested in attending a Midwifery Today conference at which water birth would be discussed. She was. Jan Tritten, the founder and editor of Midwifery Today magazine, graciously offered her free registration. At the conference, Amanda met and heard Barbara Harper, the founder of Waterbirth International, and saw Greg White, MD, a Chicago home-birth doctor, present films of some of the many births he attended. Such incredible luminaries in the birth field influenced her at a prime time in her life.

Still, this was her pregnancy and her baby's birth. So, I felt pleased when, as the months went by, she decided to explore having a home-birth midwife and a water birth. She chose Elizabeth Moore for her midwife. (It helped that Elizabeth lives two blocks from us.) Elizabeth is also the MANA (Midwives of North America) regional representative for our area. Together, they decided Amanda's due date was October 27.

In our family, the due date was when we start thinking we might give birth in the next week or two. My sister, Bev, flew in on October 31. For the next week, while Amanda's husband Ashkan worked or went to school, the three of us women shopped, played cards, and took nice long walks. Every evening, we all went out to a great place to dine.

So, why did I feel so anxious on Tuesday, November 6? As I explored my own feelings that morning, I felt anxious because of what I knew about the culture of induction and intervention awaiting Amanda should she have to go to the hospital. She was now officially 10 days overdue, and I did not know the Colorado protocol for postdue dates for home births. That morning I called my dear friend, Rae Davies, whom I first met through the Coalition for Improving Maternity Services. Rae listened empathetically and helped me stay focused in the present. Next, I walked the labyrinth, a biweekly meditation of mine. As I walked, I released my fear of the potential need to transfer care. When I got to the center of the labyrinth to meditate, I called on my angel friends above, Mary Kroeger and Sharron Humenick,* to help Amanda have an empowering home water birth. Immediately, a banner appeared in my thoughts with the word “trust” in huge letters. I laughed out loud at the quick, loving, and appropriate response. I felt at peace.

The next morning, I awakened to Amanda's dog, Sophie, bounding up the stairs. I have the upstairs in the home I share with my daughter and Ashkan. It was 8:00 a.m., too early for Amanda's usual arising time the last few weeks, so I knew labor had started. Feeling excited, I ran down to their bedroom to find Amanda quietly laboring in Ashkan's arms. She said she had awakened with contractions at about 2:45 a.m. and had dozed off and on until 6:00 a.m. when she felt she needed Ashkan awake.

Amanda had an intense and long labor. She spent the morning wandering the house, bossing us, and saying the midwife said by phone that she'd labor all day, so we should not fill the tub. Ashkan and I looked at each other and started filling, because it takes 2 hours to fill. Soon, Amanda was stopping and leaning over a couch, wanting Ashkan to press on her back during the contraction. Bev and I kept Ashkan fed, and sometimes I massaged his back while he pressed on my daughter's back. Amanda's dad arrived early afternoon, and while the couple labored, we three played several card games of Hearts. Amanda tried the water late in the afternoon, but after a while got out, saying it was too hot. In the early evening, I suggested to Ashkan that he take a nap (he can sleep anywhere, anytime) while Amanda's dad took over pressing on her back. Ashkan agreed, instantly falling asleep.

Before Amanda started labor, I wondered how I was going to react. Much of the time, I simply sat quietly, feeling complete trust in her and the birth process. That confidence in her grew stronger as the day turned to evening and the evening turned to night. Sometime in there, Amanda decided to go back into the tub, and she stayed there, soon laboring on hands and knees in the water or leaning over the edge of the tub, as Ashkan continued to press on her back. Amanda's dog, Sophie, was certainly a doula for her that day, staying by her side or standing under her as she leaned over a couch during a contraction. After Amanda got in the tub, Sophie would walk over and sniff her. At one point, after Amanda started vocalizing in a low, husky voice we had never heard, Sophie threw up. I cleaned it up and then talked to Sophie, telling her Amanda was fine and doing what she needed to do, and Sophie shouldn't worry. Sophie was fine after that.

Elizabeth came twice during the day to check in with Amanda. She came for good at about 6:00 p.m., calling her partner, Flame, to come at about 11:00 p.m. No one told Amanda how to labor or when to push. Before midnight, Bev and I both heard her make a small pushing sound for the first time. By this time, Amanda was staying on her hands and knees in the water. It wasn't long until Elizabeth shined the flashlight so we could see the amniotic sac protruding, then she formed a nice circle with her hands to show us Amanda was fully dilated. We could see the water cloud near her bottom, as the amniotic sac broke on its own. At one point, I heard Elizabeth say to Amanda,“ That push brought the baby down nicely. If you want to, you can push like that again.” Soon, she said, “Get ready to receive your baby, Amanda.” At 12:47 a.m., November 8, 2007, Samyar Ardeshir Angha slipped into the midwife's and Ashkan's hands. They passed the baby to Amanda through her legs. She sat back on her heels as she brought her baby up and out of the water for his first breath on her breast. We were all awestruck. I felt a lovely complete circle as my magnificent and courageous home-birthed daughter gave birth to her son in the water at home. My feeling was physical—a visceral, ecstatic joy in my gut with a connection to all my women ancestors.

I felt a lovely complete circle as my magnificent and courageous home-birthed daughter gave birth to her son in the water at home.

My feeling was physical—a visceral, ecstatic joy in my gut with a connection to all my women ancestors.

Bev stayed another week as the two of us took care of the couple's needs. The morning after Samyar's birth, we cleaned their room, changed the bed, and made a brunch. We ate outside because the weather was gloriously spring-like. After Bev left, I continued to prepare meals for the new family. Ashkan took almost 3 weeks off from work to be with his wife and new baby.

I have plenty of baby-holding time, too, and soon after the birth, I experienced a memory unknown to me until then. I knew that my great-grandmother had lived with my parents until she died when I was 17 months old. My mother told me how she would read to my older sister and me. But now, I also knew how she had held and loved me a lot, just as I was holding and loving Samyar. The memory was a precious, sweet, and unexpected bonus.

As I write this, Samyar is 3 months old and completely breastfed. As of a week ago, Amanda works three quarters of the time from home. I am proud of what a loving, responsive mom she is. Because we all live together, I get to see smiley Sam every day!

AMANDA'S (MOTHER'S) PERSPECTIVE OF SAMYAR'S WATER BIRTH

Some of my first memories are of when my mom was at home writing her book. As a small child, I also remember attending La Leche League meetings in our home. I watched birth videos with her and went with her to countless conferences. Entering into my own birth experience, I had been immersed in the world of natural childbirth, and choosing a home birth seemed the logical choice. I had been born at home, and I had seen many women in videos giving birth naturally in homes, tubs, and even in the ocean. I would have my home birth and have a birth tub set up in hopes that it would be where I was when the baby decided to come.

I had been born late, so I expected that my baby would do the same. Sure enough, my due date came and went with no signs of a baby. When he was 4 days past due, we decided to have my aunt come from out of town. She had asked if she could be present at the birth, and we were delighted to tell her yes. I would have my parents, my aunt, my husband, and two midwives at the birth. My aunt arrived and commented on my protruding belly that clearly would produce a baby any day. We went on walks, with me dragging her and my mother up mountain trails. Still, no baby. A week passed, and she and my mother started accusing me of pulling a Bree Van De Kamp from the television series, Desperate Housewives, and having a false pregnancy. However, 10 days after the baby was due, I lost my mucous plug. I thought it might mean something was finally happening, but did not say anything in case the baby had other plans.

At 2:45 the following morning, I woke up and was very uncomfortable. Something told me that this was different than other nights of finding a new position and going back to sleep. I continued to wake up frequently and realized that my first intuition was correct. I watched my sleeping husband and waited for the time that I would tell him that he was not going to work that day. I finally got out of bed around 5:00 a.m., unable to bear lying down any longer. I went out into the kitchen so as not to wake my husband quite yet. By 6:00 a.m., I was feeling frequent contractions, and I was sure that I was going to have the short labor that my mom had with me. I confidently called my midwife to tell her that the baby was on the way. She asked a few questions about how I was feeling and told me to call her back at noon and that I would have the baby around 2:00 a.m. What?! That was forever; she had to be wrong. My husband was up by that point, and the first words out of my mouth were that he wouldn't be going to work that day and that I needed his help.

The next 6 hours passed as quickly as they could. We called my dad to let him know that things had started, and he headed over. It seemed that all of the pain of every contraction was in my lower back. Every 3 to 5 minutes, I would call my husband over and ask him to press against me as I leaned against the counter, the couch, or whatever was nearby. At one point, I ended up kneeling on a pile of dog beds that were outside of our master bedroom because that is where I was, and at that point they were the best thing around. In some ways, my idea of labor had developed into the scenario of, “Oh, I think I'm having a contraction…wait…wait….oh, that could be another one. Now they will slowly get more intense, and at some point I should time how close they are together.” Actual experience: “It's only been 3 minutes…honey, can you not be more than 2 feet away because I need you to press on my back…harder.” Noon didn't come soon enough, and I called the midwife, sure that she was wrong and the baby would be here any minute. She was obviously confident in her original estimation of when the baby would come, but asked if I needed her to come over. “Please, yes, this can't possibly go on another 14 hours.” She arrived shortly after and assured me that I was, in fact, in labor, that I was about 3 centimeters dilated, and that the baby would be along later that night. Sigh.

The birth tub had been set up earlier in the day in anticipation of a quick labor. And there it sat. Finally, at around 4:00 p.m., I got in the tub, if only to have something different to do. It did help a little, but after awhile I got too hot and had to get out. We called the midwife again, and she came back around 6:00 p.m. It was clear by that point that I was exhausted, having stood for every contraction, with every other position seeming unbearable. Our midwife took my husband and me into our bedroom and proceeded to have him help her hold me down on the bed during my contractions. At least, that's what my tired mind perceived. In fact, she realized that I needed to rest and that lying on the bed during the contractions meant that I would rest in between them. In fact, I think I had the best 5-minute naps of my life. I will admit that there was one point where I had a very serious discussion with myself, in my head, unknown to those around me:

Okay, that's it, I'm done. This is way more than I expected, and maybe I should just go to the hospital and get an epidural and not be uncomfortable anymore. But wait, then I would have contractions in the car. If I'm uncomfortable here, how much more uncomfortable would that be? Then I would be at the hospital, have to deal with that, be poked and prodded all night, then have to come home. Oh, silly thought. I'm at home and that's where I'm staying.

During that 1 hour relaxing, I finally completed my dilation that had stalled when I wasn't able to relax during the entire day.

Around 9:00 p.m. (who knows, I didn't have a watch on and wasn't watching a clock anymore), my husband suggested that I might want to get in the tub again since it had obviously relaxed me before. “Huh, what, okay, whatever you say,” I responded. By that point, I was glad to have someone else leading the way. I got back in the tub and very quickly started feeling different. Now, finally, instead of pain in my back, it felt like someone was pulling a band around my belly with the contractions. I started to want to moan, and my mom and aunt from the other room heard the sounds of pushing. Things became much more predictable with a series of four contractions and then a rest in between. Finally, something different. The baby slowly descended, and I was pushing…and pushing…and pushing. Really, nothing yet? The midwife had told me in our childbirth class that it was a case of two steps forward and one step back, but they were awfully small steps. The head finally started to peek out and become visible when I was pushing.

The interesting thing was that my bag of waters had not yet broken. I would hate to disappoint the midwife with a boring birth. While I was pushing, the bag of waters came out and created a little water balloon. I was on all fours and interested to hear everyone marvel at this great thing. How interesting. Uh huh, that means the baby's almost out, right? After who knows how many more contractions with pushing, the baby's head was finally on the verge of being born. “On the verge, oh my God, on the verge,” I thought. “I can't possibly stretch any more. You know what, he can just stay in there. He likes it. I'm not going to push anymore.” This time, most of the conversation remained in my head, but I voiced enough of a concern for my midwife to assure me that I would, in fact, stretch and that everything was fine. “Okay, okay, okay, then let's do this,” I thought. Somewhere in the back of my mind, I heard her tell me that I would be catching my baby. From there, everything just happened. The head was born. Then quickly after, the body came out. My midwives' hands and my husband's hands were there to catch the baby and, as if by some primitive instinct, I reached down, leaned back, and brought the baby up out of the water and onto my chest. He looked up at me with full awareness and was peaceful. I did it…and he was perfect. It was 12:47 a.m., so I had only beaten the midwife's original estimate by a little over an hour.

I was helped out of the birth tub, and I carried my baby into bed. My bed. Everyone came into the room, marveling at the birth that had just been witnessed. The midwives took care of the umbilical cord and the placenta, while the baby remained undisturbed with me. My mom poured the special sparkling juice that I had bought for the birth, and we toasted the newest member of our family. Then, slowly, things wound down (I think by 3:00 in the morning), and eventually it was just the three of us, our new family. We were in our house, in our bed, and together we fell asleep.

Amanda's dog, Sophie, was certainly a doula for Amanda that day, staying by her side or standing under her as she leaned over a couch during a contraction.

Amanda labored on her hands and knees in the birth tub.

Amanda sat back on her heels as she brought her baby up and out of the water for his first breath on her breast, with the help of Ashkan (her husband and the baby's father) and their midwife, Elizabeth Moore.

Son and mother – Samyar and Amanda – say hello. “He looked up at me with full awareness and was peaceful,” said Amanda about her newborn son.