This is the second installment of my birth story series, where I describe and compare my three natural childbirth experiences at a birth center, home, and hospital. You can read the first story here.
Second Birth: At Home with a Male OB
I got pregnant with “Dolittle,” our second daughter, shortly after moving to Illinois from Arizona. Unlike Arizona, Illinois does not allow freestanding birth centers, so I wasn’t able to replicate my great midwife/birth center experience with my second birth. I had to shop around.
I had read about homebirth quite a bit, but I wasn’t sure I wanted to go that route. There didn’t seem to be nearly the number of midwife options in Illinois, but I did find an OB practice called Homefirst. It was a group of doctors who performed homebirths. I was intrigued, but unsure if that’s what I wanted.
I met with them a few times, but was ultimately unimpressed. Two doctors I met with seemed perfectly nice, but there were some organizational issues (they could never seem to find my chart!) that irked me. And I’d read some criticisms of the practice that gave me pause. You really don’t want pause when you’re choosing someone to help you give birth, especially at home.
Then, through word of mouth, I learned about a doctor who had been with Homefirst when it first started, but had soon branched off and started his own practice. Several moms in my attachment parenting group had used him and raved about him. And he was covered under our insurance—yay! So I made an appointment.
Let me say that going in I was highly skeptical about having a male doctor attend my birth. I loved having a midwife with my first baby, largely because I think birth is really a woman’s thing. (How could it be otherwise?) I wanted someone who could understand first-hand what I’d be going through. I really didn’t think a male doctor, however experienced, could provide the same level of care and understanding as a woman who had been through childbirth herself—or at least had the ability to do so.
So I was delighted when the first thing Dr. Elvove said was something along the lines of, “Look, childbirth is a woman’s thing. I really believe a woman’s body, when healthy and prepared and comfortable, knows what to do to give birth. I’ve attended more than 3000 births—most of them at home—and I’m still in awe of the process. It’s amazing.
My job is to help you have the birth you want, and to be ready on the off chance that anything goes wrong. If you want to give birth at home, we’ll make sure that your risk factors are low enough for that to be a good choice. One of the biggest keys to having a successful natural childbirth is being able to relax, and most of my patients find that they’re best able to do that at home. But if you prefer to give birth at the hospital, we can do that, too.”
He went on to explain all of the emergency equipment he brings to homebirths, procedures for transferring to the hospital if necessary, and what we’d need to provide (plastic sheet, chux pads, etc.). I told him I’d like to try for a water birth again, and he said that we could do that with a deep blow-up pool. Coolio.
I felt 100% comfortable with him and with the decision to give birth at home. He had so much experience, and such a wonderful attitude toward the birth process. Trusting your provider is huge.
So we ordered the birthing pool and gathered our homebirth supplies. We were ready.
My mom and I are sitting in Dr. Elvove’s office, chatting with him at my 38-week appointment. Everything’s looking great. My mom is a labor-and-delivery nurse by profession, and we joke that she could do my checks when I go into labor. Dr. E asks if we want some sterile gloves so she could do just that if need be. “Uh, sure, why not?” We take the gloves and go home.
A few days later, I wake up around 3:00 in the morning with contractions. I quietly slip out of bed to time them. They’re quite uncomfortable, so I sit and roll around on the exercise ball a bit. I find it’s hard for me to concentrate enough to time the contractions. My mom wakes up and comes downstairs. She watches me through a few contractions, furrows her brow, and says she thinks I’m farther along than I think. We decide she should go ahead and check me.
We wake up Havarti, and mom gets out the sterile gloves. While I’m ignoring the weirdness of having my mother check my cervix, she says, “Um, you’re at about 7 1/2 cm, Annie.” Holy crapoley.
Havarti calls Dr. Elvove, and he groggily says he hopes he gets there in time. Hard to explain that I literally woke up this far into labor.
Havarti starts filling up the birthing pool while I keep working through the contractions. They’re uncomfortable, but not horrendous. I’m able to laugh and joke in between them. It’s calm and comforting to be in my bedroom, and I can see how the home environment really is conducive to relaxation during labor. Having to get into a car at this point would really suck.
I get in the pool about the time Dr. Elvove and the labor nurse arrive, around 30 minutes later. He has Havarti boil some water on the stove (how quaint!) and he checks me. Still about 8 cm.
I stay in the pool through several contractions, and again I’m surprised at how little relief the warm water offers.
I’m also surprised again when, a few contractions later, my body wants nothing to do with the water. What is with me and my body’s aversion to water birth?? Dry land! I want dry land! So I get out of the pool between contractions and continue laboring on the bed. I remember some advice I read to make a sound through my lips like a horse braying, to help with relaxation. I try it during a contraction, and it works wonders. I even start to laugh a little, despite the discomfort.
And now things really start rolling. Dr. Elvove checks me and I’m about complete. And now I find out what the boiling water was for. He’d had Havarti add some clean washcloths to the water and turn off the burner shortly before, and now he takes out the piping hot cloths to lay over my perineum.
Oh. My. Heavens. The relief those hot washcloths offer is unreal. I wonder why my midwives hadn’t done this at the birth center. Dr. E also asks for some olive oil, to help with the stretching. Again, so old-school, but so immensely helpful. This is why I chose him. The man knows what he’s doing.
My body starts to want to push. Dr. Elvove says we may end up with a baby born in the caul. (Like my first birth, I’d gotten to the pushing stage without my water breaking.) He tells me I don’t need to push—the baby’s coming out all on her own. He coaches me to just breathe and moan through the contractions, and let her just ease her way out. So different from The Muse’s birth, where I pushed and pushed almost to exhaustion. This time, I relax my entire lower body and let it happen. It’s not easy—it’s actually really hard not to push—but I trust Dr. E’s experience. So I hum and moan, and try to imagine the baby slipping out like butter.
The video below shows the five remaining minutes of the birth from this point on. I debated whether or not to show it, but whatever embarrassment I might feel about my goofy sounds (I was in labor, after all) is outweighed by how interesting I think it is. Movies and TV shows always show moms in labor screaming and wailing, which is a pretty natural instinct, but immensely unhelpful in pushing a baby out. I know, because I let the yelling fly during my first birth. It’s amazing how much having someone help you control the pitch of your voice can help in labor.
I apologize that the video is very, very grainy. There’s nothing graphic in it—I edited out the few seconds that panned over my lady parts, for everyone’s comfort. 🙂 It’s mostly my head, and then the baby as she’s being pulled out. There are some slooshing sounds when that happens, as my water didn’t break until she was on her way out. If that might bother you, don’t watch. But otherwise, it’s G-rated.
So, our sweet Dolittle was born at 6:08am, three hours after I’d woken up with contractions. The reference my mom makes to her “little fist” in the video was due to Dolittle having a nuchal arm, which meant her fist was up by her face as she came out. Even with that, I had absolutely zero tearing and my recovery time was practically non-existent. I credit Dr. Elvove’s expert prep and protection of my perineum for that. That man was a gift to birthing women, truly.
We had discussed whether or not to have our first daughter, who was almost 4 years old at the time, attend the birth. We invited my sister-in-law to come and take care of her if it seemed like a bad idea when the time came. But we never had to worry about it. She slept through the whole thing, and woke up that morning to a new baby sister. It couldn’t have turned out more perfectly.
– States vary widely in the legality and availability of childbirth providers and facilities, so choices are greatly limited by where you live. I found the fact that homebirth is legal in Illinois and birth centers aren’t quite a bizarre combination, and the fact that I could have a doctor-attended homebirth covered under my insurance even more bizarre.
– It is possible to have a male birth attendant who is every bit as compassionate and caring as a midwife. I imagine the Dr. Elvoves of the world are fairly few and far between, but they’re out there. I’ve since talked to several other moms who had birthed with Dr. Elvove, and all of them speak about him with the same wistful reverence in their voice. He was really that incredible.
– Hot washcloths + olive oil = MIRACULOUS.
– Water birth really isn’t for everyone, even when you think it’s something you want. Both times, my body screamed for dry land when it came time to push. Still have no idea why, but it was clear that water birth wasn’t for me.
– It’s possible to push a baby out without having to actually push at all. Weird, but true.
– Before having a homebirth, I had questioned whether it really is easier to relax at home to give birth. Some women say they feel more relaxed at the hospital because they feel safer in the event of emergency. I have some thoughts about this that I’ll share in my hospital birth story, but I learned through this birth that being 100% relaxed and comfortable does make a huge difference. Even not having an uncomfortable car ride like I had with the birth center birth made a difference in how I labored.
– Part of relaxing at home is understanding all the possible scenarios in case of emergency. I think people picture homebirth being entirely non-medical, which mine turned out to be. But homebirth midwives and doctors come prepared. Dr. Elvove brought basic resuscitation and emergency medical equipment with him that would handle the vast majority of scenarios. And most greater emergencies make themselves known far enough in advance to get to the hospital in time. Even in an emergency c-section scenario, the standard “decision to incision” time is 30 minutes, which means in our scenario the OR would be prepped during our travel time to the hospital. Dr. Elvove had attended thousands of births at home and in the hospital, so I completely trusted his judgment.
Of course, there are a few scenarios that could end tragically, but that’s true in the hospital as well. As my mom pointed out, even in the hospital, sometimes there’s nothing that can be done. Some might ask, “Why take any risk, though?” to which I answer that after loads of research, I felt the risk of unnecessary hospital interventions leading to emergency situations was just as high, if not higher, than the risk of a low-risk birth at home, especially one attended by an experienced OB. Knowing what we’d do in any scenario helped me feel relaxed and comfy in the familiar environment of home, and ultimately facilitated my easiest and most peaceful birth.
Whether this birth was my easiest because I was at home will always be a question mark. I do feel like the labor itself was easier because I was home and free to handle my contractions however and wherever I wanted. And I think the things Dr. Elvove did during the birth greatly helped ease that part of the process. But second births often tend to be easier and shorter anyway, so who knows. I’d only birthed at a birth center and at home, so I didn’t know what might have been different in a hospital.
However, I’d discover just what those differences might have been four years later with the birth of BoyWonder…
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