Special Delivery: A Homebirth After a Previous Stillbirth
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This post is written with permission from the family involved. My intent is to inspire others to think through their choices and have courage. Deep thanks are given to Rachel and her family.
Eight years ago, Rachel was twenty-two years old, in a troubled marriage, and pregnant. Young, poor, and in a challenging life situation, Rachel did her best to take care of herself and eagerly awaited her baby. She used hospital-based midwives for her care, and had a normal pregnancy. Two weeks before her due date, her water broke. She called her midwives who advised her to come over to the hospital to be checked. She showered, got dressed, and came to the hospital. When she arrived, the heart beat of the baby could not be found. The baby had died. Rachel labored heroically and gave birth naturally after many hours to her stillborn son David. The cause of his death was never found, and the diagnosis of "unexplained stillbirth" was given to him.
The birth of David changed Rachel's life. She describes the changes as positive, because she used her grief as a catalyst for transformation. She began a profound spiritual journey, left her unhealthy marriage, and basically started a new life, listening deeply into her heart to find what was good and true for her. Rachel says "I believe that David and I had an agreement, made many lifetimes ago, that in this lifetime our time together would only last as long as it did. For whatever reason, that was what was meant for us. If it weren't for him, I would not be the person I am now."
Several years later, Rachel met Henry, a gentle, compassionate man who shared her spiritual approach to life and love of the wilderness. They married and bought property in the mountains together, to homestead and live "back to the land" . Rachel says "the urn of David's ashes stayed with me for years. I didn't know what to do with them. I often dreamed of a mountain, where I was to place his ashes, but I couldn't find that mountain. When we walked onto our property for the first time, I looked out and could see the mountain from my dream. I knew we were home." That summer Rachel climbed the mountain and scattered his ashes. A few months later, she was pregnant.
Rachel went back to the same hospital-based midwives for her care. She had felt well cared for with David, despite the outcome. The midwife explained that this pregnancy would be considered high-risk, due to her history. She outlined a plan that included multiple ultrasounds, non-stress tests for the last six weeks, and an early induction of labor. Rachel was surprised, and went home to think about all she had been told. She was now a wise, strong, healthy mother. She ate all organic, whole foods, and lived an active mountain life. Her life was full of love and joy. She listened deeply to her heart and discovered how strongly she knew that this pregnancy was entirely different from the last, that this baby was a healthy and strong girl, and that she would be born alive.
At the next prenatal visit, Rachel attempted to explain this all to her midwife. She says "With the last pregnancy I did everything I was told. I had every lab test, I had the ultra-sounds. I did all the medical stuff, and still ended up with a dead baby. Whether the baby lives or not has nothing to do with your lab tests and ultra-sounds. I intend to decline them all. The baby will live because the baby is meant to live." The midwife became tense at this response, and Rachel feared that a hostile disagreement was about to take place. But then the midwife took a deep breath, centered herself, and gave Rachel a gift. The gift was in the form of these words "I think you would be happier with a homebirth midwife. Let me give you a couple names."
Rachel came to me at the beginning of her third trimester. She shared her story, and we connected right away. She wanted me to help her have this baby, and I felt honored to assist. I was awed by her strength and clarity. We carefully selected some lab tests for her - blood type, iron, HIV, blood sugar. We did not do an ultrasound. We talked a lot about feeling fetal movement, and tuning in with the baby. We talked about her previous birth, and shed tears together. Henry came to most of the appointments, nervous but open to learning. They read Ina May's birth stories to each other at night. Again and again, Rachel clearly communicated her feelings; with a different father, her own self so evolved and changed , and everything about her life so different, she did not fear another stillbirth.
Rachel gestated away happily, and her due date came and went. She was taking evening primrose oil and a birth preparation tincture to encourage a timely labor. Her last prenatal visit was three days after her due date. This visit was different. She was starting to feel anxious, and with so much time "waiting", thoughts about the stillbirth were creeping in. I acknowledged her feelings and gave her reassurance that her feelings were normal. It is hard to wait and wait! We listened to the baby for a long time and heard the heart-rate accelerate with fetal movement, which is a sign of well-being. We decided I would come and listen to the baby every couple days until labor begins. I told her I thought she would have her baby soon.
That same night, Rachel went into labor. My assistant Amber and I arrived at her home around midnight. Rachel was sitting in a comfy chair, eyes full of tears. We sat down beside her, listened to the baby's heart beat, and then listened to her. Between contractions, she wept and told us how excited she was, overwhelmed with gladness. She told us she had been holding her excitement back all this time, just keeping that little piece of her heart safe by not getting too excited. But now that she was in labor, and was still feeling the baby move, she was suddenly feeling all the anticipation of having her real, live baby. The tears rolled down her face, and I told her how good it was to cry, and share her feelings.
Rachel labored beautifully through he night. She cuddled with Henry on a mattress on the living room floor for a long time. She was quiet and tuned inward , and we just listened to the baby every half hour and let her be. Each time we went to listen to the baby's heart, I felt a little extra charge, and then relief at the sound it beating away perfectly. I focused on taking slow calming breaths in those moments, in order to maintain a calm, peaceful atmosphere for Rachel. We gently reassured her how well it was going, how good the heart beat was. When her labor got intense, I asked her how she was doing and she said, "excited". She never complained, and seemed to enjoy the whole labor. I checked her once, and at three a.m. she was 8 cms. At four a.m. her water broke with nice clear fluid, and a half hour later she felt like pushing. She lay on her side for a while just lightly pushing as her body told her until I could tell the baby had moved way down into her pelvis. I invited her to sit on my Amish birthing stool and ten minutes later her nine pound baby girl was born. Zoe Elizabeth was born pink and healthy, and was contentedly nursing by the time she was thirty minutes old.
Rachel had been right- her baby was strong and healthy, and meant for this world. As her midwife, I trusted both her inner wisdom and her body's ability to birth. During her birth I was careful to respect who she is and what her personal process entailed. She was not just "another patient". This very personal, individualized approach is a hallmark of homebirth midwifery. I am very grateful to her for inviting me to be her midwife, and now for her generosity in allowing me to share this story with others. May it be healing to those that need healing, and inspirational to those that need inspiration!