Unassisted Birth Interview

By accident, my husband ran into an old acquaintance we hadn’t seen in years. I’ll call her Tina (all names have been changed). I used to work with her husband Mike at a joke of a software company many years ago and we bonded over our collective work misery.

Much has changed between the four of us in those years, including the fact that Tina recently delivered her second baby unassisted at home, while her husband was on the highway and her 3 year old was watching TV. All this was according to plan, with the exception of Mike not being there.

With her first baby Aura, Tina chose a hospital birth with an OB/GYN. After 3 hours of painful contractions they went to the hospital only to be told she wasn’t really in labor and it would be another few weeks before delivery.

Tina labored by herself believing what the hospital said and wondering how she was ever going to live through the next few weeks with these “fake contractions”. Tina said, “I threw up. I cleaned it up. I went to the kitchen to drink water. Then back to the bathroom.” This happened all night.

The next morning Tina phoned the on-call OB to ask for pain medication to take over the next weeks and was told that she actually was in labor and to come to the hospital right away.

She was wheeled to the exact same room where she was the night before when the doctore told her to go home. The nurse asked her to spread her legs after forcing her to lie on her back. When she was able to take a closer look at Tine, the nurse hit the emergency button saying that she could see the baby's head.

Tina tells the rest of the story like this: “I said "Can I push?" She said "No. The doc isn't here yet." Well.. that meant to me that I could push. Thank God! Nothing felt better. The doctor got there in a skirt suit and a nurse threw a gown on her. Three pushes later and Aura was out. All 6 pounds 6 ounces of her with Apgars of 9, then 9. We were in tears of joy.”

A few years later and Tina knew she did not want the hospital experience again.  She also did not want to share her birth experience with a stranger. Tina, being practical and absolutely competent, did her research and decided to work with the same OB/GYN she did the first time but secretly plan to have an unassisted birth at home.

When she went past 41 weeks, her doctor gave her a speech about being induction and they decided that they just had different opinions about birth. Tina filled out her registration papers for the hospital "just in case" and so her OB didn't suspect anything was up.

At 42 weeks, Tina went into labor while driving from the suburbs in traffic to her Portland home. Her 3 year old was in the car and her husband was at work. She called Mike and insisted he leave work. She knew this was the real thing.

At home she took Aura to the potty, pulled the plastic sheet over the couch and squatted over it while Aura watched the “forbidden TV”. She called Mike again, almost 2 hours later and told him she was close to having the baby. She pushed twice and Rose was born 2 hours and 20 minutes after contractions began, 11 minutes before Mike got home.

Tina didn't tear and she gave Rose Apgars of 8 & 9. She left the cord attached as she birthed the placenta, 3 minutes before Mike arrived at home. Everything was perfect.

Below are some questions and answers between Tina and myself.

1.  What preparations did you make to ensure a safe delivery?

First and foremost I had prenatal care to ensure I was having a healthy pregnancy and (probably) a healthy baby. I had a Level III US at 20 weeks to look for any potential problems. Even though these things aren't always detected, I knew the likelihood of having a baby with a major defect was low.

For Baby: A Doppler to monitor heart rate during contractions intermittently. Her HR held steady with accelerations during contractions. She had some late decels during the pushing stage, but since they didn't dip below 120s and it recovered well, I wasn't worried. I had a neonatal resuscitation kit that included an intubation tube, bag/valve mask, oxygen tank with tubing, and a suction kit (beyond the usual squeeze bulb). 4 sets of cord clamps, surgical scissors, and of course the usual stuff like a thermal cap.

For Me: Methergine to be given IM in the case of bleeding.

In addition, I wouldn't have hesitated to dial 911 at any point in my labor or delivery. I'm also trained in neonatal resuscitation and Mike is trained in infant, child, and adult CPR.

2. What were your fears about the unassisted labor and delivery?

My fear was that Mike wouldn't make it in time for the birth (and he didn't). I also had some fears in the back of my mind that maybe I would be in that small % who did not have an uncomplicated delivery and I'd kick myself for something horrible going wrong.

3. How did your family (including husband) react to your decision?

I did not tell my family other than my husband. They all knew I was receiving prenatal care from an OB and assumed I'd be delivering at the hospital. I had also pre-registered with the hospital and had taken a tour just in case. Funny enough, though, they all joked that I wouldn't make it to the hospital in time. My coworkers (nurses and doctors) absolutely had no idea and I would've never heard the end of it had they found out my UC was on purpose.

Mike was receptive to a homebirth, but really had to warm up to the idea of a UC. He was concerned with safety of me and the baby. He also didn't want to clean up the yuck and not have help with it. I had him read some articles on UC and also a lot of birth stories. We also talked with a friend of mine who UP/UC'd all 4 of her children in the 90s and that sealed the deal.

4. What would you have done differently?

Had a place in my house all set-up 24 hours a day and not have ventured so far from home being as post-date as I was. Maybe I might have asked Mike to take time off from work early so he would've been around. I also feel, though, that he would have missed a hospital birth as well.

5. Do you have any advice for mothers considering an unassisted delivery?

Look into all your options and make sure to take responsibility for your birth. UC IS more risky than a hospital birth or even a homebirth. Accepting the risks and owning your decision is so important for going into labor and birth with confidence.

6. Is there anything else you'd like to add?

I'm not opposed to women who UC and UP, but I felt like I did not want to UP for the "just in case" reason. I wanted to have the best possible outcome in my own home with my own body without any other factors.

Aura's first words as she sat on the couch watching me squat, were "Hi Baby!" She didn't seem bothered by it at all and took it in stride with the cartoons on the TV. If I ever have a baby again, I hope to have my family there, without outside distractions such as TV, and involved in the process a little more.

What were the reactions from your doctor and family?

I called her (the doctor) office the Monday after, she said "Well that was one expensive home birth!" She was congratulatory and expressed interest in seeing the baby. She also had me come in the Monday after she was born (born on a Friday) for a check (as if I were discharging from the hospital). 

As for my family... They all said that it was Mike's "fault" that I didn't get to the hospital in time since he didn't get home to take me there. Poor Mike. They all wanted to know details like what I gave birth on and what I used to clamp the cord. That's when I told them the truth that I had been planning on birthing at home alone all along. They were all very surprised and said things like "You're lucky it worked out that way." My mom even said "Wow! You could've had a dead baby." It only reinforced my decision to not tell them in advance. They've also expressed concern for if we have another baby (we're not planning on it) and how I BETTER go to the hospital this time.