Jack's Birth Story

It has been 2 weeks since our little guy entered the world and I am feeling clear enough to get Jack’s birth story out into words. If you are a patient in my office, you were likely aware that we had decided on a home birth early on in our pregnancy ( actually I had decided on this long before even conceiving, but my husband jumped on board right away!). There were a multitude of reactions when I would share this choice with people, while mostly positive, there was almost always a “shock” factor. The reality is, that even though home birth was once the norm, it is now considered unconventional and even “dangerous” by many people and even some providers. However, I found that for most people it is just unfamiliar. Most people have not heard stories of home birth in the modern day, so I am choosing to share my story.

At 40 weeks and 4 days I woke up around 1am with some pretty intense pressure in my pelvis, I believe I told my husband that it felt like my “butt was going to explode”. This happened twice in an hour but subsided after a minute or two. I went back to sleep and woke up a few more times to less intense cramping type pain but it was inconsistent. I thought it might be labor, but having never done this before, I was unsure. It was a Monday which meant I started seeing patients at 2pm and had the morning to figure out what I was going to do. I laid in bed till about 9:30am and decided it was time to take a bath (my solution to everything!). At this point, the discomfort I was feeling was very sporadic, maybe once or twice an hour lasting 30-90 seconds. I decided after my bath that I would still go in to work that afternoon. I could function through the discomfort and felt like the distraction would be nice. My husband, who works overnights, had decided he was starting his paternity leave that day after struggling through the night before thinking I was home alone in labor. I was supportive of this decision but I still wasn’t sure that this was early labor and not “false” labor. So I went to the office and adjusted a full schedule of people, only stopping once to let a contraction pass (Sorry Stacy!). I got home from the office that day, made dinner and ate dinner with my husband and then we headed up to bed around 8pm. He had blown up the birth tub during the day and gotten our room ready (nervous energy). I laid in bed for a few hours having contractions about every 15 minutes. I fell asleep around 10, woke up at 11 and realized I hadn’t had a contraction during this time. I was disappointed, assuming this meant it wasn’t true labor and that we’d be waiting a bit longer for our baby to arrive. I got up and took a bath, again my go to for everything. When I got back in bed just after midnight it had been over 2 hours since my last contraction. I got in bed next to my husband and started practicing some breathing to help me sleep. At 12:30am, at 40 weeks and 5 days pregnant, my water broke in dramatic TV show fashion. I felt a pop and then a sudden gush of fluid. I sat up and reached over to wake up my husband “ My water just broke, can you get me a towel!”. I repeated “ I can’t believe how much fluid came out of me” multiple times over the next several hours.

Just after my water broke, I called my midwife to give her a heads up, she lives just over an hour away. She told me to get some sleep and call her when the contractions were so intense that I had to stop what I was doing to breath through them. At 12:50am my first contraction came after my water breaking, it was strong and i remember holding on to the side of the bed and swaying my hips in a figure eight motion. I started having my husband time the contractions after that one and they were 6-8 minutes apart right from the start. We continued to get the room ready, putting down plastic coverings on the bed and setting up the camera (we had decided to use a Nest camera to record the birth). Around 2:30, contractions were closer to 5 minutes apart and fairly intense so I called the midwife and she agreed it was time to come. We started to fill the birth tub ( again warm water is my favorite way to manage discomfort). I got into the tub just after 3am and my birth team arrived around 3:35am. My midwife, Andrea, was assisted by another midwife, Joyce, for my birth. I had a contraction shortly after they arrived and they patiently waited for it to pass before Andrea used the doppler to check baby’s heart rate. The team settled in and let me do my thing for the next few hours. I found contractions to be very manageable if I stayed on top of them. When I felt a contraction coming on I would move to my knees and start focusing on my breathing. I practiced a 4 count inhale and an 8-10 count exhale. I also used movement and vibration to help me ride the waves of contractions. In between contractions I would lay back in the tub and relax. The 4 of us made small talk and watched The Office while I waited for the next contraction to start. The team checked the water temperature after a few hours and determined that we needed to warm it up a bit, my husband had been boiling water on the stove and periodically adding it to the tub (carrying boiling pots of water up the stairs several times during the night!). They worked together to drain some water off the tub and add some more from the hot water heater with the hose.

I continued to labor in the tub with. contractions rolling into each other with little breaks between, as I was transitioning into the “pushing phase” of labor, I would need some gentle reminders to correct my breathing. The midwife assistant, Joyce, was excellent at giving me direction during these times and it always helped me return my focus to my breathing. Since this was my first baby, I really wasn’t sure what pushing would be like, I remember asking my team “how do I know when to push?” they told me that I would just know. I had a lot of pressure in my sacrum at this point and it maybe felt like an urge to push, so I tried some gentle pushes, eager to meet my baby. Things started to slow down a bit after this, with my contractions getting further apart instead of closer so the team suggested I get out of the tub and move to the toilet to see how my body would react to that. They left my husband and me alone in the bathroom for some time (I’m really not sure how long) this was when I needed the most physical support during the labor phase. I hung my arms over Phil’s biceps and tried my best to just let my body completely relax.

I decided I wanted to get back in the water as the pressure in my sacrum was building, on my way back to the tub Andrea asked if I wanted to be checked before getting back in. This would be my first cervical check of my pregnancy. I consented to the check and laid on the bed. When Andrea checked me, she identified a cervical lip. This is a swelling that can occur around the cervix. It is likely that this was caused by those pushes I attempted before my body was really ready. Andrea also found that the baby was in a posterior position, meaning he was facing up toward my pubic bone instead of toward my sacrum. This positioning was causing that pressure in my sacrum and was also making it more difficult for me to progress. My body had dilated to 9.5 centimeters but was struggling to progress further due to the swelling and baby’s position. Andrea asked me if I would be ok with her inserting evening primrose oil to soften the swelling in the cervix. I consented to this and we discussed a maneuver to push the cervical lip over the baby’s head during a contraction. I agreed to let her try, but found it much too painful (the first real OUCH! moment of the process so far). We talked about just letting me rest and waiting for the swelling to go down. But first they had me lay on my side and Joyce worked on loosening up the muscles in my pelvis to try to get baby to turn his position (this is called a side lying release). After this, the team helped make me comfortable in bed and decided to go for a coffee run. I got a strong contraction that was very painful just moments after they left the bedroom. I told Phil, who was laying next to me in the bed, to go get them. Thankfully they hadn’t left yet. We agreed to try the maneuver to push the cervical lip out of the way again, this time with me laying on my back. It was much more bearable this attempt and they were successful at getting the cervix over his head.

At this point, I moved back to the birth tub, it was time to push. And just like they had said…you just know. My body began pushing on its own. It was primal (and so were the sounds coming out of me!). Pushing was HARD. The warm water in the tub was soothing, so soothing that my once rolling contractions slowed down to almost 5 minutes apart. While the rest was welcome, the distance between my contractions could pose a risk to baby if his head was born too long before the rest of his body. So we agreed to get out of the tub and back on to the bed, my body contracted when I stood up, not my favorite moment of the process as I instantly worried my baby was going to fall out of me (I was tired!). I started to lose my cool a bit during this part of the process, I began to worry about the safety of my baby for the first time, repeating “ I just want him to be ok”. I was reassured by my husband and midwives that he was going to be ok. I laid on the bed in a side lying position and my body took over. Each push brought my baby down further. Gripping both of my husbands hands and bringing my chin to my chest with each surge. One of the midwives suggested I feel my baby’s head, I reached down and touched his surprisingly soft and wrinkly head. Within minutes I pushed his head out and exclaimed “his head is out!”. At 9:59 am my baby attempted his first cry with his body still inside of me, he was so ready to be here. One more big push and he was out and up on my chest. It’s impossible to describe the way that feels. If you know, you know. Jack Ian Titman was born and so was I. I instantly knew I would never be the same, that moment also marked the birth of me as a mother.

Jack was placed on my chest and my husband and I just got to stare at him and into each others eyes, reveling in what we had created. My midwife team helped me birth my placenta once the cord had stopped pulsing. With a gentle push my placenta slid right out. Andrea commented on the length of the cord, which explained why Jack was able to have such large movements inside of me right up until the end. Jack was allowed to discover my breast on his own in this hour following birth, this is an important part of the breast feeding and bonding relationship. During this time, my midwives assessed me and repaired my tears with glue. After Jack latched for the first time (all on his own!) I passed him over to my husband for some skin to skin time while I got cleaned up.

Andrea and Joyce walked me to the bathroom where they had prepared a perineal spray bottle with an herbal tea to help soothe the area, They gently wiped down my legs and chest (and even between my toes where there was some blood from the birth). As Andrea helped dress me, Joyce stripped and remade the bed, collecting all the laundry and birth supplies. I was able to get back in bed and feed my baby for the first time. Shortly after this, Joyce performed a newborn assessment, this was the first time that someone besides my husband or I touched my baby, nearly 2 hours after his birth. He was weighed and measured, his heart rate and respirations were assessed and he was returned to my chest.

We made plans for Andrea to return in 48 hours to check on me and baby and the pair left (to get some coffee no doubt!). The rest of the day was spent snuggling and staring at this life we had created and recounting the 9.5 hours prior that changed our lives forever and we even talked about “next time”.