TWO HOMEBIRTHS, 14 MINUTES APART
by Gloria Lemay
The midwife had been sleeping at Carla’s for the past two nights. Carla was due to have her third baby and had been feeling slight, regular sensations for the past few days as well as having some blood, which indicated that the baby would arrive soon. Gail, her midwife, lived one hour away in the city so Carla wanted to shorten the highway distance in case the birth advanced quickly. It was very important for Carla to have Gail with her during this birth. The baby’s father had left the relationship during the pregnancy and Carla was living with her mom again. In both her previous births, Gail had been there to guide her and she felt that she couldn’t have a baby without Gail’s calm presence. Even though she’d had some heavy bleeding after her last two births, Gail had known just what to do and had kept a calm, serene vigil over mother and baby in the hours and days following birth. Carla’s mom had been present at the other two home births and she, too, felt confident now that Gail was at the house.
Carla’s mom was a realtor and had purchased her “dream” house overlooking the ocean. It was an older, modest home, but spacious enough that taking her daughter back in with the two children and new baby on the way was not a problem. She was young to be a grandmother and she knew how hard mothering can be. She, too, had been a single mother. Carla was her only child and the light of her life. She had wondered about the prudence of homebirth when her daughter first shared the idea, but after meeting Gail, all her doubts had disappeared. Gail was open, honest, professional and genuinely loving to Carla. Carla’s mom often reflected on how different her own hospital birth experience was from her daughter’s home water births.
Around midnight on the third night of waiting for the birth to move into high gear, Carla heard Gail’s pager beep. Gail was moving around and Carla called out to her “Gail, you’re not going to another birth are you? I feel my sensations getting stronger in the past hour!” Gail opened the bedroom door and whispered “Listen, I have a young mom who’s having early birthing sensations over in Greendale. It’s her first baby and the dad sounds worried. I’m going to go over there and just reassure them that it’s early. I’ll only be an hour away.” Carla thought this might work and made her parting remarks to Gail “Well, I want you back here for my birth, no matter what! I can’t have a baby without you.” Carla was happy that Gail had inflated the pool downstairs and had organized all the supplies for the birth that afternoon.
Gail’s car whipped along the freeway in the hot night air. The past few days had been sweltering, and even in the wee hours of night the heat radiated off the blacktop and felt like a furnace. She fantasized about buying a car with air conditioning but knew that luxury was relatively low on her list of what to spend her money on. The Pacific Northwest has a fairly mild, temperate climate and air conditioning was needed for only a few weeks each year. Still, driving long distances by car in this heat was not her favorite pastime. She spotted the Greendale exit and made the turn.
Monica and Robert lived on a hillside in the suburbs. Their family already included two Doberman Pincer dogs that she was nervous about dealing with as she arrived at the gate in the rear of the house. Luckily, Robert spotted her as she pulled up and came out of the back screen door with an ear-to-ear grin on his face. “I’m glad to see you,” he said. “It’s more painful now and I think the baby’s coming soon.” Gail knew that the birth would probably take longer than he thought because it was a first baby, but she also knew that the excitement and joy of a first birth is something that this man would carry with him for the rest of his days.
She handed a bag of equipment to Robert and reached out to give him a hug. They had met and talked so much in the past nine months that now everything was ready and all that remained was to meet this baby. The house was dark and quiet as she followed Robert down the hall to the master bedroom. Monica was very tiny and exotically pretty. Her long, dark hair and deep brown eyes were movie star material. She lay on her side in the big bed, stripped naked in the heat. Gail stood very still adjusting her eyes in the darkness and craning her ears for the sounds that would tell her exactly what was happening in Monica’s body. If the sensations were longer than one minute and close together, progress was being made. If they were spaced out more than that and very short in duration, she could safely go back to Carla’s and know that it would take some time before she must return to Greendale. All this could be assessed simply by listening to the breathing of the mother. With her practiced ear, she didn’t need to do vaginal exams.
As she quieted herself and listened intently, she realized that this baby was in a bigger hurry than most first children. Monica was definitely responding to the birth sensations like a woman who meant business. It seemed like the new moon in the sky was pulling at the water surrounding the baby and willing it into the world. The lovely young woman was deep inside herself and made no acknowledgement of Gail’s presence. Monica had known from the very first time that Gail put her big, warm hands on her belly that she would be able to dilate and give birth easily in her presence. Gail had a quality of being self confident and inwardly quiet that Monica appreciated right from their first meeting. Now that her body was urgently working to get the baby born, there was no need for pleasantries or chit chat.
As the night hours flew by, Gail wondered how things were going out at Carla’s place. At 6:30 a.m, the beeping pager notified her that, indeed, things were moving on the ocean front as well. A call to Carla confirmed that, yes, things had picked up right after Gail left and were even stronger now. Could Gail please come right back? Gail explained to Carla’s mom that Monica, too, was in high gear with her birth and now Gail had to do some rearranging of plans. She’d phone back in a few minutes once she’d figured it out and let them know what the plan was.
Gail’s mind started swirling at high speed now. All night long she had been thinking about contingency plans for both families. She wanted so much to meet her obligations with both. She could see why doctors liked the hospital system, with everyone under the same roof and only a short walk from room to room. She thought about ways to hurry up Monica’s birth in order to get her baby born and rush back to Carla’s. The minute she had that thought, another voice in her head said, “You idiot, if you do anything to rush this one, you’ll screw up this birth and miss the other one, too. Get a hold of yourself!” She had to get a grip on the right plan.
One woman was having a third baby, the other a first. The first-time Mom needed the most experienced caregiver. The problem was that her third-time Mom had bled heavily in the last two births. Giving that problem to other midwives was not really fair and, besides that, Carla had been so adamant about wanting her there. In her heart, she knew that no matter what, she had to stay with Monica and focus on having her first birth be the height of excellence, with no other agenda whatsoever.
She called her sister midwife, Lisa. “Lisa, I need you and Carol to go out to Beachside for a birth. This client is very special to me. I’ve been at her last two births and I’m sick that I’m going to miss this one.”
She went on to explain to Lisa the directions to the house, the setup of the equipment, the mother’s health history and the family dynamics in the house. Lisa reassured her that she would take excellent care of everything but Gail felt out of control knowing she was turning her client over to a caretaker that Carla had never met before. Gail had been called out by other midwives in this predicament herself and knew that the mother always got the very best of care because the substitute midwife wanted so badly to please both the client and the other midwife.
She called Carla’s mom and explained the plan. Carla’s mom told her what she already knew. “Okay, but you know she’s not going to be very happy about this.” Gail didn’t need to be told that and she hung up the phone with a heavy heart knowing it had to be done but cursing the rotten timing.
Now that the die was cast, Gail focused clearly on the birth at hand. Monica had moved from her bed to the tub that was inflated and filled with warm water in the living room. The two dogs lazed in the morning sun on the kitchen floor and Robert was catching a much-deserved nap in the bed while his young wife faced her birth process with grace and dignity. All was set up in readiness—clean linens in brown paper bags, herbal tea on the back burner of the stove to help expel the placenta after the birth, sterile scissors and cord clamp carefully wrapped in a sterile towel, and the couch made up as a bed with a plastic lining underneath the sheets..
Monica began trembling and said to Gail, “I’m going to be sick!” Gail grabbed a small plastic bucket and got it to Monica just in time to avoid a mess on the carpet. Monica had only been drinking diluted juice through the night but all of that came out as her body purged, getting ready to push the baby out. At the height of the vomiting, her membranes released sending a cloud of milky amniotic fluid into the water tub. Gail quietly said, “That is so good. Your body is working perfectly. The baby’s waters are clear so we know the baby’s happy, too.”
Monica felt like she couldn’t go on but she also knew that there was no turning back. The only way through the pain, sick feeling and pressure was to surrender and let the baby do whatever it was going to do. She was glad that all this weirdness was familiar to her from all the reading she had done during her pregnancy. She had known to expect to shake, vomit and feel overwhelmed. Healthy birth is like that and she had prepared fully to give birth under her own power.
Gail began to hear the familiar “grunting” in Monica’s breathing which told her that the cervix was almost fully dilated and the expulsion of the baby was commencing. She knew that great patience was needed at this time. Any rushing of the pushing phase could cause problems for both mother and baby. She applied a cool cloth to Monica’s brow and cajoled her, “Listen deeply into your body. I want you to go as slow as possible with the pushing. Let the baby push. . . you get out of the way.” Monica nodded.
Gail’s words fit right with what her body was telling her. “Go slow, let everything be loose, surrender to the forces.”
She was so excited that she was nearing the end of her journey to motherhood. She felt relief that everything had gone so smoothly. It all felt so right but, in a strange way, unreal.
Half an hour later, the sounds of expulsion were unmistakable. At the beginning of each sensation, Monica would awaken from a deep snooze and begin pushing down urgently with the same vocals as a little child sitting on a potty. The grunting pushes produced a flaring of Monica’s anus as the baby’s forehead passed over it and Gail saw a small amount of very dark baby hair as Monica’s vulva began to open. She went into the bedroom and gently shook Robert awake. “Are you ready to catch your baby, Robert?” she whispered to him. Eyes wide, he roused himself and followed her to the living room.
She held a plastic mirror under the water to show him the baby’s emergence. He stripped off his shorts and stepped into the tub to hold Monica. She was in a world of her own.
“The membranes released a while ago and the fluid was clear. The baby’s heartbeat has been normal while you were sleeping—so we know the baby’s happy in there,” Gail whispered to Robert. She could see his back and shoulders visibly relax with this reassurance.
Gail marveled once again at the way homebirth “cemented” the marriage for many young couples. This would be a day Robert and Monica would remember forever.
As her vulva stretched more and more open with each push, Monica exclaimed, “It’s burning,” and pressed her own hand against the baby’s head to slow down the increased feeling of heat in her vulva. Robert looked quizzically at Gail as if to say “Is that okay?” and Gail responded, “That burning feeling is normal. Your baby’s almost here. I want you to just pant lightly when you feel that. It’s safe to stretch like that. Easy, easy, easy.”
After a few of the burning pushes a little dark-haired head swooshed out and seemed to stop the world with that emergence. Robert cradled his hands under the baby’s head and felt glad that he had seen many videos of other men doing this same receiving of their newborn baby. He knew it would be a couple of minutes before the head rotated towards Monica’s thigh and the shoulders freed themselves. In what seemed like a lifetime but was only a few minutes, Monica pushed again and, right then, the baby’s body was completely born into his waiting hands. It seemed like the most natural thing in the world to lift the baby up to his wife and as she took the baby to her heart, the world transformed for him into a love garden. It never occurred to him to wonder about the sex of the baby. All he knew was that the baby was pink from head to toe, looking around, making little noises and was gloriously alive! The world stood still and he embraced Monica and the baby with his own body and wanted the moment to last forever.
After a time of hugging and kissing, Monica opened up the baby’s tightly curled little legs and announced, “Robert, you have a daughter.”
They laughed, cried and couldn’t believe their good fortune. Gail seemed to have faded into the wallpaper. Robert noticed her administering a few sips of warm, herbal tea to Monica but nothing was said. The mood of the room was one of bliss and calm. Towels were ready on the futon when they were ready to move to the mattress and Monica exited the tub with the placenta still inside and the baby’s umbilical cord intact. It would stay intact until about an hour after the birth when Monica pushed the placenta out. When Robert cut the cord, he felt the significance of the beginning of a new phase in his daughter’s life. She was now a separate being from her mother but still very dependent on Monica for her food and protection.
Gail took down the water tub and tidied the house while they snuggled on the futon and enjoyed the bliss of the baby’s first suckling efforts, her soft skin and her wide-eyed surveillance of her mother’s face.
Gail had received a call from the other home that Carla had given birth at 1:45 pm, exactly 14 minutes after Monica’s daughter was born. The other midwife, Lisa, reassured her that the mother and baby were doing well and the birth had gone very smoothly. Gail whispered a quiet prayer of thanks. Two women and two babies safely through birth. She felt deeply blessed.
She prepared toasted tuna sandwiches and lemonade for Robert and Monica and served them in bed. She always made sure the mother had a good protein meal before she left after a birth. She checked Monica’s perineum for tears and checked the baby over thoroughly as part of her “after the birth” duties. Everything checked out normally and she was ready to leave at 5:00 pm. With a last “Congratulations” to the family, she started back to Beachside to see Carla and make sure everything was all right out there. The night of wakefulness was starting to weigh on her shoulders but the thought of getting to Carla’s, getting some food and sleeping overnight once more near the ocean cheered her.
As she entered Carla’s bedroom quietly, Carla flashed her a big grin and said, “I hate it when you’re right, Gail!”
“What was I right about?” said Gail.
“Well, you know how I’ve always told you I could never have a baby without you? And, you always tell me that of course I could? Well, now I know that it’s true. It is me that gives birth and I won’t ever doubt it again.”
Gail said, “So, you’re not mad at me that I couldn’t get back to you?”
“No, it was perfect. The other midwives sort of annoyed me when they came in and told me I should go for a walk.” Gail smiled, thinking that this was not a client you would want to tell what to do in birth. She knew that, but the other midwives had not had time to figure all that out.
“Anyway,” Carla continued, “when they suggested that, I just went downstairs and climbed into the water tub. I was in there by myself and I could feel the baby starting to come on his own. I didn’t say anything,… just concentrated and let my body relax. It was amazing, Gail. It was only when the head was almost there that I called and the midwives came down right away. They were very calm and just let me catch him myself. I’m so glad that it went this way.”
Gail felt the breath come back into her body. What a relief that Carla was so pleased with her birth and content with how things had gone.
Carla continued, “I didn’t bleed this time. I don’t know why but that was great and now I know what you’ve always tried to tell me—it’s me that gives birth and I could do it anywhere.”
That night, sleeping over at Carla’s, Gail slept the deep sleep of peace that comes with a job well done and two new babies safely earthside.
This story is based on true events; all names and places have been changed. First published in Midwifery Today Magazine Summer 2008