Birthing on Her Terms

After losing her first baby in the second trimester, Megan was deeply impacted by this experience and even questioned if she wanted an opportunity to become a mother again. Once she decided to get pregnant, she found herself “so hungry for knowledge – for anything that might help make this outcome different”. The more research she did, the more Megan wanted a natural childbirth and in the end stay away from hospital interventions. She planned for a natural birth in a birth center with a midwife. Then, one month before her due date, she was confronted with the possibility that her plan might go out the window. Her baby still presented breech (butt down) and was left with two options: plan for a scheduled cesarean with her back up doctor or continue care at the birth center and hire the only doctor in Southern California who attends out-of-hospital breech births, Dr. Fischbein. Going with her gut, she chose the latter and had the empowering birth experience she knew was possible. 

Tell me about your first pregnancy and how it impacted your decision to choose a midwife/birth center birth?

My first pregnancy was completely different than my second. I got pregnant as soon as we started to try and I was completely naïve about the whole process of childbearing. I didn’t know anything about being pregnant so I went by the book. I went to the OB-GYN who I had been seeing since college, and although I hadn’t begun to think too much about the birth, I am almost positive that it would have been in the hospital. It’s all I knew and I wasn’t in the mindset of going against the grain.

When we lost the baby, it rocked my world more than anything in my whole life. Our first baby had an extremely rare genetic condition, but in the back of my mind I was worried that maybe it was something I had or had not done that caused this. There was also a part of me that felt like my body failed me.

Since I had gotten pregnant quickly the first time, I hoped that that would be the case again, but it wasn’t. It took awhile and I started to doubt that I would ever get to experience another pregnancy or birth. When I finally got pregnant again, I was determined to do everything right. 

I also did not take one second for granted and from the very beginning, I decided to trust the process and have faith that my body would not fail me and that this outcome would be different. While I had a newfound trust, there was certainly fear though. In fact, there was a lot of fear that I had to work through.

The beginning of my pregnancy was very medical. I went back to the same doctor and was immediately labeled “high risk”. I alternated between that doctor and a perinatologist. I had a lot of appointments, ultrasounds, and tests. Every test and ultrasound came back perfect, and the further along I got, the more the fear of something going wrong with this pregnancy diminished.  

The real turning point happened at 22 weeks when my husband and I went on a road trip up the coast of California over the holidays. We needed some entertainment so decided to download an audiobook. We did a quick search for baby books and both took interest in a book called “The Business of Baby” (basically a more in depth version of Ricki Lake’s “The Business of Being Born” documentary).

This book went into detail about every aspect of pregnancy, birth, postpartum, and baby care in our country. The facts were both shocking and disturbing. So disturbing that at points I wanted to just turn it off and go back to my “ignorance is bliss” state of mind, but I couldn’t. My eyes were open and there was no turning back.

This is when I seriously started to think about a birth center or home birth setting. We returned from this trip with a completely new mindset and a list of questions to ask my OB. About three questions in at our return appointment and I could tell I was never going back. The big red flag was when my OB said that anyone who would consider a home birth is a “whacko”. Ha! We were definitely not a match.

Not long after this appointment, I decided to transfer my care to a midwife and prepare for a birth center birth. It definitely was not an easy decision and took a lot of soul searching but ultimately, I decided that there was no indication that this pregnancy was going to turn out like the last so I needed to go with my gut and have the pregnancy and birth experience that I (and my incredibly supportive husband) felt was right for me and our baby.

It was this mindset that allowed me to make the decisions I did later on when we found out that the baby was breech.

How did you know a vaginal breech birth was an option? 

Early in pregnancy, I read Ina Mays’ Guide to Childbirth. In it she talked a little bit about breech birth.  This was the first time I had really heard of it. At this point I was early in my pregnancy and didn’t think much about it.

Around 28 weeks, my midwife told me my baby was breech. We still weren’t very concerned since we had some time. Then at 32 weeks my midwife was pretty certain that my baby was still breech so she sent me to my back-up doctor (not Dr. Fischbein, who delivered my baby) for an ultrasound. He confirmed baby was in fact breech. At this point, I started trying everything – weekly chiropractic visits, acupuncture, inversions, swimming, even burning my toes with a moxa stick. 

At 36 weeks when baby was still breech it was time to really consider my options. My back-up doctor suggested that we schedule a c-section. My midwife and chiropractor were the ones who encouraged me to talk to Dr. Fischbein about the option of a vaginal breech birth. 

What helped assuage any fears around having a breech baby outside of the hospital? 

My consultation with Dr. Fischbein is what really assuaged any fears I had. He has a long list of boxes that must be checked off before you’re even considered a good candidate for a vaginal breech birth. Every one of those boxes were checked for us and he looked at us confidently and said, “There is no reason you shouldn’t have the beautiful, out-of-hospital birth you desire.“

For me, that was really all I needed to hear. From there, I spent the next few weeks watching breech birth videos and finding positive affirmations to remind myself that I could do this. 

I think it also helped that I had a gut feeling that this was just how my baby wanted to be born. I talked to the baby everyday and assured him or her (we didn’t know what we were having) that it would be okay and we would do this together. I may have actually been reassuring myself of this, but either way I found comfort in it.

Were your family or peers supportive of your decision to birth at home? 

Initially no, but in time yes although I didn’t tell anyone but my parents that I was going to have a vaginal breech birth at a birth center. I only told close friends and family of my plans to birth outside of the hospital and they were all concerned but respected my decision.

I knew that everyone would have an opinion and that while their opinions would come from a place of love, they would be uneducated ones. I truly felt that only I knew what was best for me and my baby and I didn’t want any negative comments or energy filling my mind.

What did you do to prepare for a healthy and smooth birth experience? 

I exercised regularly, kept a food journal to make sure I was eating a nutrient dense diet, visited the massage therapist and chiropractor regularly, prayed, and as I mentioned before talked to my baby a lot.

I also had a rock star birth team in place. Between my midwife, Dr. Fischbein and my husband, I had so much love and support. 

Did you take a childbirth education preparation series. If so, how was it helpful in your birth experience? 

I did take a class. It was very helpful in preparing me for what to expect in each stage of labor. We also went over different movements, positions and breathing techniques that could be helpful during or in between contractions. Lastly, we were given exercises to do as a couple to help prepare us to work together during labor.

We also made a birth preference sheet for the in case scenario of needing to transfer to the hospital. While my husband I had already done a ton of research and were pretty much on the same page, this helped solidify our plans.

In addition, we had open discussions about our hopes and fears for the birth. I think it really helped to get all those things out in the open and work through them together before they potentially came up in the labor and birth.  

What activities or tools were helpful during the time of waiting for labor began? 

Walking and spending time with my husband helped a lot. Although I must admit that everyday past my due date I got more and more uncomfortable and more and more anxious for labor to begin.

Can you tell me about your labor and birth? 

I was a week and a half past my due date when I went into labor.

I had strong early labor contractions, which at first felt like intense period cramps for weeks and once I went into active labor, my daughter was born 27 hours later.

On the night of May 11th, my contractions picked up in frequency and intensity. These were stronger than I could have ever imagined. I couldn’t believe that my body was producing this sensation. It was almost an out of body experience. 

It wasn’t until the following day around 4 pm I made my way to the birth center. At this point, I was already exhausted from the labor and not having slept much the night before.

When I arrived at the birth center, I was hopeful that it wouldn’t be much longer. My midwife greeted me and I got comfortable in the birth room. Not long after, Dr. Fischbein arrived, although I didn’t see much of him until it was time to push. He let my midwife stay with me most of the time and gave me space to labor on my own. It was comforting though knowing that he was there when we needed him. 

I spent hours in the shower, in the tub and on the birth ball. I was so exhausted from the lack of sleep that around midnight I told my midwife I couldn’t do it anymore. I was so tired I couldn’t imagine mustering up the energy I would need to push my baby out.

At this point, she went to get Dr. Fischbein. As they were walking up the stairs, I heard them discussing our transfer plan and I started thinking, "Oh no, this is it. We really are going to transfer.” When they entered the room, Dr. Fischbein greeted me and very calmly and sweetly asked me how I was doing and if he may check me. I agreed. He checked my cervix and looked up at me and said confidently, “You can do this. It’s time to push. You’re going to have this baby right here, on this bed, right now.” His energy and reassurance was exactly what I needed at that moment to push through.

He could tell I was truly exhausted so he asked me to relax and look at him while he explained how I would push with each contraction. He didn’t want me to waste any unnecessary energy. Pushing was so much harder than I imagined, but once they could see my baby’s butt I had a new burst of energy come over me.

After nearly 2 ½ hours of pushing, my daughter Eloise Rae was born at 3:32 am on Friday, May 13th. I pulled her up to my chest and excitedly announced, “It’s a girl!” She was perfect. I kept telling her what a good job she did making her way into the world and how proud I was that I was able to give birth to her exactly as she wanted to be born.

With the exhaustion and fear of not having enough energy, how did you best calm your mind and body in between contractions?

Being in water helped me a lot. I spent hours between the shower and the tub. I was also very vocal. Even between contractions, making deep primal sounds was soothing to me.

What surprised you about your birth experience? 

It was harder, more exhausting, and longer than I ever imagined, but I am still amazed at what my body is capable of. The female body is truly amazing.

What was the biggest take away from your experience?

Giving birth to my daughter on my terms was the most empowering experience of my life. It reassured me that I can do anything I put my mind to. 

Also, knowing my daughter now, it makes perfect sense that she was born butt first. She is a stubborn, determined, strong, bright light who does everything her way. Her birth prepared me to be the mother she needs me to be.

What words of wisdom would you pass onto to other mothers planning a natural birth, and specifically a breech birth out of the hospital?

Explore your options and go with your gut. Vaginal breech birth is not for everyone, but if it feels right to you and you have an experienced doctor (or in some states, midwife) as your support, it is absolutely possible.

*** This story was originally published on Milk Trails; a blog dedicated to out-of-hospital birth experiences.