A nine pound, twelve ounce baby boy with a fifteen inch noggin was born vaginally at home through the afternoon of a warm summer’s day after the baby’s brother, a boy who tipped the scales at nine pounds even, was born by cesarean in the hospital some three years earlier. This was my first primary VBAC as a full-fledged midwife.
I thought this week would be just about the right time to tell this story, with the American College of Obstetricians and Gynecologists currently working to ban home VBACs in Colorado – in spite of all the evidence that home VBAC is successful, safe, and far preferable to repeat cesarean section.
Eleven years ago, Ingrid and Matthew, a charming Amish couple living at the distant reaches of the area I served in those days, called me one morning in February to see if I’d be willing to come visit with them to discuss the possibility of a birthing the child she was carrying within her at home. They’d intended to birth their first child, now a toddler, at home with a midwife, but they ended up in the hospital. At a week after her baby’s due date, her waters had broken, and then hours and hours and hours passed without a hint of labor. Her midwife took her to the hospital, to Roger Beyer and Sue Wright, a wonderful doctor/midwife team who never failed to receive our transports from home with compassion and competent care. Dr. Beyer got an induction going, then hours and hours and hours passed without progress until, at last, a cesarean section was performed.
Ingrid and Matthew were from two sets of families I’ve served either as an apprentice or as a midwife since 1993. The members of both families are notable for their inquisitive and analytical minds. Ingrid and Matthew were no exception. They’d explored their options per future births with thoroughness and, even before they’d conceived again, as Dr. Beyer and Sue were so incredibly supportive of VBAC birth, they’d decided to attempt their primary VBAC in the hospital with them.
However, when Ingrid actually became pregnant again, both she and Matthew realized Ingrid would have difficulty relaxing sufficiently in the hospital to bring her child to birth. Ingrid was a private person, and she couldn’t imagine accomplishing her VBAC in a strange place surrounded by strangers, especially with some of them being male.
They called their midwife to request a consultation, but she, for reasons I can no longer remember, elected to refer them to me. I was surprised they called, as I was such a puppy of a midwife at the time and we all knew it, but they desired to meet with me regardless, so we made an appointment.
When I pulled into their carefully shoveled driveway a snowy week or two later, Matthew met me and requested I pull all the way around behind the house, saying with a shy smile, “We don’t need folks to know you’re here, you see.”
I followed him up the walk and through the rear door of their old stone farmhouse and soon was seated near a crackling fire with a cup of hot tea in my hand. I listened to their story and heard their concerns and answered their questions, and my respect for this bright couple grew with every minute that passed. They were a cautious pair, too. As the conversation neared it’s end, Ingrid asked, “Kim, what primary criterion would you need met in order to agree to help me have this baby at home?”
I explained that as, physically, Ingrid was an excellent candidate for vaginal homebirth, the only real requirement I required was peace of mind and heart. The two nodded, and sat in silence a moment or two. The stove sputtered and popped while the grandfather clock kitty corner to it ticked and tocked and ticked and tocked.
“But what if we don’t have peace yet?” Ingrid asked, reaching for Matthew’s hand. “What do we do from here?”
I suggested that, from there, I could just come by every four weeks and do a prenatal visit with them. “Then, if you one day cut me a check for the birth, I’ll know you’ve found the peace you need to stay at home. If you don’t, I’ll meet you at the hospital when you go into labor.”
“You’d do like that with me?” Ingrid asked, with tears welling up into her eyes, “You’ll go on with me without any assurance which way I’ll choose?”
“You bet I will,” I said, “and don’t you worry one bit about it.”
So, week followed week, winter made way before glorious spring, and spring morphed into summertime. One afternoon, at the end of another of our nourishing visits, about three weeks before Ingrid’s baby was due, she handed me a check made out in her old-world cursive script. “Oh!” I said, realizing I’d forgotten she hadn’t yet communicated her decision with me, “So, you want to stay at home?”
“I guess I do,” she said, even still a bit doubtfully. “But what if what happened before happens again? What if I go overdue? What if my waters break before my labor starts?”
I said, “You know, really, I wouldn’t be surprised if it goes very much the same way as it did last time, nor will I be alarmed. I know and I understand that your entire life’s experience so far is overdue plus broken waters minus labor equals cesarean, but the way it went last time was mostly very normal. My way, even with women who’ve already birthed by cesarean, is to assume they’ll birth just beautifully, and to treat them accordingly. I believe with all my heart that, even if you go past your dates, even if your waters break before your labor starts, you’re going to have a beautiful, beautiful birth.”
We hugged and I went home.
Three weeks passed, and one midnight, just as the fourth week was near to dawning, Ingrid rang, “Kim? Kim! My waters just broke!”
“Oh, Ingrid! Yay!”
“Yay? But I haven’t had a single contraction…”
“You’ll start your contractions soon, Ingrid.”
“You really think so?”
“Yes, I really, really think so.”
“So, what should we do?”
“We should go to bed!”
“Go to bed? Really, Kim?”
“Absolutely, Ingrid. Let’s sleep while we can. We may only get a few hours. If we don’t sleep now, we may be sorry by this time tomorrow!”
“Okay, I’ll try. Thank you, Kim.”
We reviewed the ruptured waters protocol, and hung up. Though I’d meant what I’d said to Ingrid, I wasn’t quite so relaxed as I appeared, and I laid awake in the dark for a long while, thanking God for Ingrid and her baby, and expressing my faith that she’d have a glorious birth, just as we’d asked that she would.
I must have drifted off, for I woke with such a start when the telephone jangled at seven in the morning that I ran right into my bedroom door and wound up with a badly bruised cheek! But I was pleased to learn Ingrid’s contractions had begun within half an hour of our earlier conversation, and that they’d become strong enough and long enough and close enough for to want me to head her way.
I drove through the early morning, dodging a little cluster of deer along the edge of Fulton Road just south of Leonidas. Ironically, nine and a half years later I’d demolish a poor doe at just that spot in the road on the way to Ingrid’s fourth VBAC birth. And, yes, thankfully, I still made it to her birth in time.
But I drove through the early morning, resuming the prayers that had sent me off to sleep the night before, and wondering what the day would bring.
I arrived at Ingrid and Matthew’s, pulling behind the house and well out view from the roadway, and bundled myself and my gear inside. Mary, my apprentice, was already there. Mary was a tremendous encouragement to Ingrid, as Mary had birthed several of her babies after two cesarean sections. Mary’s story is one of a kind! I’ll see if I can get her to tell it for us some time!
But where was I?
So, I arrived, I tumbled through the door, I smiled my hello to Mary and Matthew, and I was delighted to find Ingrid flushed and sweaty and possibly ruing her desire to be in labor.
Oftentimes we spend our labor attending hours tucked into the nooks and crannies of our clients’ homes in effort to preserve the intimacy of birthing, but Ingrid and Matthew craved our presence and our active encouragement, so we spent the day crouched near to wherever they were – next the bathtub for awhile, for awhile circling the kitchen table, at the foot of their bed for a spell, and even one of us at each knee as Ingrid sat awhile on the toilet – stroking and rubbing, whispering praises, smiling and nodding as Ingrid sweated and breathed and rocked her way through her labor.
Once she said, “I need you all to pray for me!” Matthew told her we all were certainly praying.
“But I need to hear your prayers!” she said, and so we each said our prayers aloud, and she was pacified.
Another time she said she needed a song, and Matthew wove such an indescribable enchantment with his rich, deep voice that we were all soothed.
Morning passed into forenoon, and from forenoon toward evening as the sun lazily made his way from Ingrid and Matthew’s front stoop to peep in through the mud room windows in back of the house. We opened shades and shut shades, closed windows and cracked others in an effort to shield ourselves from the smothering heat of his rays. And we continued following Ingrid about her house, stroking and rubbing, whispering praises, smiling and nodding as Ingrid sweated and breathed and rocked.
Ingrid had begun to push gently around noon. Toward four, she moved to kneel before her sofa and, there, began to push in earnest. Ingrid had expressed an intense fear of tearing, so I’d intended to work with special care to support her tissues as her child came forth. I sighed inside as she knelt there, anticipating the calamities I’d be sure to suffer as I caught her baby with my cheek on the floor mere inches from our focal point.
But there, for all the indignity of my vulnerable cheek, plus my hoisted derriere besides, I watched with an awe that spread through the room like a warm, salty wave as Ingrid groaned and grunted and eased her baby into my hands.
The child was nine pounds, twelve ounces. His head was fifteen inches around. His mother went six days past his due date. Her waters broke before her labor began, and she labored for fifteen and a half hours. She pushed then for four hours and six minutes. She delivered her child over intact tissues. She was never the same again.
I was blessed to be invited to attend Ingrid and Matthew at the births of all four of their VBAC babies. I nearly missed the next birth, a ten pound baby girl, and, thanks to that deer, I nearly missed the last baby, too.
Over the course of my 23 years attending births, I’ve helped with thirty VBAC moms and babies. Twenty-six of those babies were born vaginally. Of the four born by repeat cesarean, one of those cesareans was elected by the mom prior to labor. All thirty moms and babies came through their experiences in excellent health, though the three mothers requiring subsequent surgery suffered considerably in spirit.
In fact, I believe I’ll dedicate this post to them, and to those like them.
My sisters – to your hopes, to your dreams, to your courage, to your remarkable efforts – in recognition of your pain and your sorrow – in memory of your loss – as grateful as we are for your healthy baby ♥
As ever, the names in this story are changed.
The photographs are of the letter Ingrid wrote to me around a year after her first homebirth ♥
Thank you so much for the gift of your time!
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Kim Woodard Osterholzer, Colorado Springs Homebirth Midwife and Author
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