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Sunday, December 18, 2011

Changing the plan: From Unassisted to Hospital Birth?

     Each of my childrens' births were unique -- I was completely alone for Kyle's birth; Jason II was posterior and his birth was extremely painful; Logan came so fast we only had time to half-fill the pool -- but for all three I had regular professional prenatal care and planned unassisted waterbirths.  Despite my birthplans being unconventional and taboo, I knew I was making the right choice for each of my births (you can read more about why Here.)
     In the three years since Logan's birth I've grown more as a woman, mother, wife and spiritual being than ever before.  I'm more connected, more aware and more in touch with my intuition.  I'm more experienced and more confident and everything seems to be in my favor to plan another beautiful, private birth at home.
      When I found out I was pregnant again, I felt I was ready to take a less clinical approach; I planned to do my own prenatal care and I looked forward to my first pregnancy with no ultrasounds.  This time, I'd rely on my intuition and my connection to my baby for information.
     But the thing is, being intuitive doesn't mean things are going to go your way. You're bound to the same reality, even if you're able to sense more of it.
     From very early in this pregnancy I found myself imagining giving birth in the hospital.  Something also felt clearly different this time.  Around 8 weeks I became confident I was carrying twins and it all made sense. Even though I know that twins can be safely born unassisted, it didn't feel right for these  babies. In a bit of a panic, I started looking at what my hospital birth options would be.  We decided on an ultrasound to confirm the intuitive feeling that we were expecting twins, and to learn what type of twins (identical twins sharing an amniotic sac face considerably higher risks during birth and also throughout pregnancy.)  The ultrasound showed twins, but only one surviving (vanishing twin syndrome) so the pregnancy would continue as a singleton.  My feelings again became confusing.  The feeling that something was different didn't go away and I started to question whether there was some problem with the surviving fetus.  Then, I started to wonder if the ultrasound was wrong and both babies were in fact healthy.  But after about a month (I'm guessing this is how long it took for my body to level out hormones, absorb the remains of the second fetus, and accept the loss,) the sense that I was carrying two babies melted away -- I can only describe it as feeling less pregnant -- and for a brief time, I felt very much like I had during my other pregnancies.
      I had mixed feelings about getting a second  ultrasound, still having high hopes for an independent pregnancy, but it helped me feel closure to see that one growing baby and I really did fall deeper in love when I saw her (no, the sex is not confirmed, I'm just speaking with my guess in mind) kicking and wiggling and sucking her thumb.  I was on the fence about continuing prenatal care with the midwives now that everything is back to 'normal,' and I started thinking about another unassisted birth, though the thoughts of birthing in the hospital never fully went away.
      Then, I started re-examining a few of the increased risks faced by survivors of vanishing twin syndrome... None of them were particularly concerning to me, especially since the loss was so early, but I noticed something: I was looking for something to be wrong. I was grasping  for a reason to birth in the hospital this time. I've never fixated on hospital birth before.  This feeling was demanding my attention.
     As I shared my thought process with some of my online networks, the feeling became stronger -- in much the same way the twin feeling had grown very intense after I began to put it to words. I don't have a clear sense of something being wrong, I don't feel like I need to be in the hospital "just in case,"  I don't even feel entirely safe or comfortable going.  But the feeling is very clear: "You will birth in the hospital. Prepare for it."
       Trusting this feeling is scary for several reasons.  It's inconvenient, new, out of my comfort zone.  It means traveling to the hospital, riding in a car during labor, deciding when to leave, what to bring, where to take the kids.  It means trusting other people to be in my birth space -- trusting other people with my newborn baby.  But the scariest thing about trusting this feeling is that it means trusting that something will most likely go wrong and I don't have any idea what that will be other than that me or my baby will likely need urgent medical help or lifesaving technology.
      I have to leave a little space in my heart for the possibility that everything will unfold perfectly and we'll just stay home, but I've let go of my ideals for this birth and I'll pack a bag for the hospital well in advance. It's going to happen how it needs to and I'll understand more as the pregnancy progresses.  I've committed to prenatal care with the midwives, and probably a third ultrasound.  If something is wrong, having every possible bit of information (including the 20 week scan) could prove valuable.  I expect to spend most of my prenatal appointments discussing (very possibly negotiating) how I can maintain a self-directed birth in the hospital setting.  I know this process is far from over...


  1. You are doing right to trust your instincts. Birth tests our limits, pushes our boundaries. We never know where it will take us or why. But it is, as you say, about being tuned in and connected - and following that guidance. Sending you very warmest wishes on connecting with the right care providers, and for strength and peace in your birth whether home or hospital.

  2. Thanks for a beautiful post. I think it's hard sometimes for people to recognize what is best when their hearts on set on something specific, or to recognize that other people are making the choices that are right for them. The whys and whats and hows change everytime. My first was in a hospital, my second unassisted. Both were beautiful, both were right. Props to you for trusting your intuition as it leads you.

  3. Wow, thank you for this. A friend directed me here because I'd been planning my second homebirth and "suddenly" transferred in labor (which, at 42 weeks with a breech baby, waters broken, heavy mec, and 8cm dilated, meant a c-section almost immediately, and which I knew when I opted to transfer). I can't explain it, just to say that all along I had a feeling something was wrong, and I did keep imagining a hospital birth--even typed up a birthplan and had a list of what to bring in my bag there. In labor my feeling became impossible to ignore, but it had been there for a long time. Nothing was obviously wrong with my baby, the cord, the placenta--anything. Everything went perfectly--I'll never know if that was _because_ I followed my gut feeling or in spite of doing so, but in any case, I appreciated your post.

    Here's my story if you care to read it:

  4. I think you are strong and it's wonderful you are listening to your intuition.
    We had our first two in hospital, before I knew about taking responsibility of my own births. Our third was born at home, in the water, surrounded by family and friends.
    When we got pregnant the fourth time, we started planning for another homebirth, but it didn't feel right. I kept having feelings that we shouldn't do it at home, but had nothing to base those feelings on. Finally, at 30 weeks, the feeling was so strong, we realized it was the Lord's leading and switched to an in hospital midwife. She was exactly what we needed and we had a great experience. I spent the first 3-4 visits asking questions and confirming things and talking with my new midwife, to make sure we were on the same page and I would get the support I needed. I also had a wonderful doula and my awesome husband was supportive. At 37 weeks, we found out my homebirth midwife wouldn't be able to attend homebirths for awhile. Nothing went wrong with the birth, baby or me. But if we hadn't listened to our intuition, the last four weeks of my pregnancy would have been extremely stressful. I'm so glad I listened.

  5. Thank you for sharing your experiences! I've been really exploring the polarization of Homebirth vs Hospital birth lately and I'm seeing that sharing stories like these, where intuition lead to the best interests of the family via hospital birth/medical intervention ALONG SIDE the stories where intuiton lead to staying home even when the situation *might* have been catagorized as high risk... I think this is where the bridge between the medical approach and the "woo woo" approach is. I think this is how we begin to heal & look at the real issue: Women's Choice & opportunity to express that choice & maintain dignity in childbirth, instead of the tired old debate about which is safer, homebirth or hospital?

  6. I am faced with a difficult decision the next time I become pregnant. My strongest instincts say to birth at home, unassisted, because it would be the only way to have a birth without interruption or interference. And I need a healing, un-interfered with birth after my last experience. A smaller part of me is a bit nervous because I have a chance of having a baby with a bleeding condition, especially if it is a boy. For that reason, I wonder if I am being selfish for not wanting to be in a hospital. But then the first side rages again - I am scared out of my mind at the prospect of birthing in a hospital again. My first birth did not end well. I went from a planning the birth at a birthing center in a tub with a midwife in attendance to being forced into a hospital, an induction, and ultimately, a cesarean. I have no memory of my own child's first cry, or of holding her for the first time, because the drugs they gave me numbed me beyond the point of remembering. I will never get those moments back. I cannot stand the idea of that happening again. This first year of my child's life has been fraught with postpartum depression, anxiety, and feeling like an utter failure as a woman and a mother. I feel like I missed out on my baby's first year because of this. I want SO badly to be pregnant again, to give birth for REAL this time (because I did not give birth last time - I had my baby cut out of me. Others may see it much differently, but I had absolutely NO participation in the most important event in both my life and that of my child, and that feels WRONG), but I am afraid. Afraid that my c-section scar will cause problems, afraid that my pregnancy would be difficult because of that, afraid of ending up in a hospital again... And these thoughts chase each other 'round and 'round in my head, over and over again. I have never met another woman who is in my exact position - wanting a NORMAL, NATURAL birth at HOME with a c-section behind her and a potential for a child with a bleeding disorder. There is no handbook for this, no experience to fall back on. I have my family, who have all made it very clear that the only acceptable and safe way for me to give birth is to be in a hospital, on my back with an epidural. I have my husband, who wants the birth I want - he wants to catch our next child himself! And I have me... scared to death of going under the knife again, or of being so stressed out and scared in a hospital that my body refuses to progress, leading to pressure to have all of the interventions I never wanted last time but was pushed into anyway, and ultimately ending up with a c-section again. And yet, how can I be sure that the baby would be safe? Or at least safER?
    There doesn't seem to be any GOOD choice in my situation, but my heart and spirit and soul cringe at the idea of placing myself into anyone's hands but my husband's. No one else would truly have MY best interests at heart - every single practitioner out there is also going to be carefully considering the potential risk to themselves. I'm so tired of hiding what I want, of not being able to talk openly about my wishes for fear of being called "crazy" or "brainless" again, and I'm tired of people thinking I'm selfish for wanting to give birth the way Mother Nature INTENDED for it to happen. I want support for MY needs, for what *I* want out of this process, and I want the judging to STOP. What so so wrong with taking a different path from many others? What is so wrong with determining that *I* know best for myself, and *I* know my body better than any doctor who's only met me a handful of times does? How does a medical degree make a person a better judge of what's "good" for me than *I* am?!

    1. That is such a difficult postion to be in!!! I'm very lucky in that the hospital I'm choosing to deliver at is proving to be very respectful of mom's process (I just attended my third birth there as a doula) But so many women find themselves really stuck :( I do think that when you actually become pregnant, you will be able to connect with that specific pregnancy and that individual baby and get a clearer idea of what his/her needs are. before this pregnancy began, I thought going completely unassisted would be *best* for us, but once I was carrying this baby & it was a reality rather than a hypothetical I felt differently. It's so much different once that connection is in place, you know? At that point you may find that you feel confident/safe with an unassisted birth, or you may find that you feel a hospital birth is truely neccessary for that child... Having that confidence(even when comprimise/sacrefice is involved) & really knowing that you're making the best decision given the circumstances will make going forward easier... In the meantime, I hope you find support and healing for what you went through with your first birth <3

  7. Thank you for sharing your story. It's very similar to mine. I'm pregnant with my 5th and and only my first was born in the hospital and my last were all unassisted except I did have a midwife at my last for convenience reasons. I was homeless and my midwife let me live with her for the time period surrounding the birth. For some strange reason I am feeling called to also birth in the hospital this time. This will be my last baby. I have fear around what will happen to me in the hospital and the baby. Bonding issues coming up. The only "good" hospital is two hours away and I might have to lie about where I live to be accepted there because everyone tries to birth to there and they can get crowded. So they are only accepting patients from there zip code. I'm on the fence now.