In the Breech, But Avoiding the Hospital
By Julie Kosker

I don’t consider myself to be particularly brave and I’m certainly not the hippie people think I am when I tell them that I had a home birth. However, I do consider myself to be wise and a good mother. In the past, when I met people who had home births, I was shocked and couldn’t fathom why someone would do something like that! But then….

I made it through my first labor and delivery without any medications and realized that I didn’t need anything provided by the hospital; in fact, I suspected that I rushed the delivery in an effort to please the hospital’s schedule and my discomfort in that setting.

So, when I moved across the country before my next pregnancy and discovered that what the medical community wanted/required of me did not jive, I realized that the idea of a home birth brought me peace, joy, and excitement. Isn’t that what birth should be about? Wow, talk about coming full circle on my idea of a perfect birth!

The Story Begins

Our story begins Sunday morning, March 27th. I was almost thirty-six weeks into my second pregnancy. It was my morning to sleep in and I was enjoying lounging in bed, listening to the sounds of my husband Jake and daughter Hazel (twenty-plus months old) make breakfast. I turned in bed and felt a rush of warm liquid. My water broke at exactly thirty-five weeks with Hazel, so my initial thought was excitement as I yelled for my husband. That excitement turned to horror as I looked down and saw a pool of blood.

I jump out of bed, calls for husband becoming frantic; as the blood continues to gush out of me… pooling on my (new) carpet, splashing in the toilet, and into the tub where I finally decide is the best place to contain myself. Jake immediately calls 911 and my parents. Parents arrive within minutes; they live up a short path through the woods...one of life’s biggest blessings! At this point, it’s probably been twenty minutes and the bleeding is slowing. My mom helps me sponge bathe and dress for the ambulance, Jake gathers necessities, my dad helps Hazel finish breakfast. The ambulance arrives and off I go...to our local hospital.

The EMT who is with me is very calm and we have a great conversation about midwives and home births. (His kids were born in a natural birthing center). The bleeding has about stopped. I’m anxious to feel movement and hear heart sounds. They wheel me into the OB section of the hospital and immediately things begin to stress me out. The nurse is cross with me for not having current labs/ultrasounds/all the unnecessary tests they automatically give to all pregnant women. The doctor is lecturing me on the risk of home births. They strap monitors to my belly and I ask, “Is that the baby’s heartbeat?” YES! Instant relief.

I Need Respect

My husband politely asks for a different nurse, one who will not appear so judgmental and he has a heart-to-heart with the doctor about how I need to feel respected. So, the doctor returns and is much more polite and kind. He informs me that my waters are still intact, that I am two centimeters dilated and that they don’t know what caused the bleeding. We request an ultrasound, but he declines, saying it most likely won’t show anything. He guesses that my cervix might have torn slightly or that my placenta tore slightly due to overwork in the previous days (darn nesting instincts!). No answers.

In retrospect, I wonder that because I sponge bathed before I arrived at the hospital, they didn’t understand the gravity of the bleed. We told them that we thought it was a “couple of pints” of blood, but clearly they didn’t respect our intelligence level...and they didn’t know that my husband is a nurse himself.

We returned home with orders to stay on modified bed rest until my scheduled appointment on Tuesday with my midwife. In the meantime, my parents had entertained Hazel and successfully auditioned for a HazMat team. They had cleaned and cleaned and cleaned (even broke out a carpet steamer!). I can’t imagine the horror of cleaning that much blood from a daughter’s bedroom and bathroom. But they did it and how wonderful it was to come home and be tucked into clean sheets and not have to deal with the morning’s trauma!

Jake and I talked and felt really uncomfortable with the lack of tests/insight about the cause of the bleed. So, I scheduled a visit to the local pregnancy clinic (I’m on government insurance for pregnant women and therefore use the local clinic; another big difference from my first dual-covered pregnancy!) for Tuesday morning.

I arrived at the clinic and the nurse scheduled an ultrasound for Thursday morning. My first thought was, “I hope I make it until then,” but then I chide myself because although I’d been having contractions since Monday dinner, they were clearly Braxton Hicks contractions because they’d be steady for hours and then disappear for hours.

Then I went to an exam room. Now, without seeming too judgmental, let me say that I think I am a very rare patient for this clinic. One, I am not a teenager. Two, I am not a sheep. I am an intelligent, educated woman who has read countless books on pregnancy and birth. So perhaps I’m being harsh on the doctor who reduced me to tears. He informed me that there’s no way to know why I bled and an ultrasound wouldn’t help, but I could still have one if I insisted. Although I was sitting there naked, covered with a sheet, he did not exam me or even listen when I mentioned having “regular” Braxton Hicks. I could have been more insistent, but I was feeling tiny and insignificant as he “informed” me that I was most likely going to kill or brain damage my baby and myself by attempting a home birth.

Then he touched my belly for less than a second and declared her breech… Look out! Now he is asking me who is going to raise my other daughter when I kill myself trying to birth a breech baby. And didn’t I know that no doctors will birth breech babies because of the high risk and what was I thinking?…. He didn’t say anything I didn’t expect a Western doctor to say, but it was still terrifying to hear all of that. Of course, I in no way wanted to risk the health of my unborn daughter or self...and yet...putting my hands in the air and saying, “Please perform major surgery on me,” just did not seem like a “risk free” solution.

After I had a tearful conversation with Jake, he left work early and we began to discuss our situation, only to feel completely unsure of every decision we had ever made in this pregnancy. I was seriously considering loading up the car and driving the 2,600 miles back to the supportive, open-minded, gentle family practitioner I had for my first birth.

Midwives to the Rescue

Fortunately, my midwife was to arrive around six o’clock for our regular appointment and we felt that after discussing things with her we might have more clarity. When she arrived, she brought an aura of peace to our home. She was willing to discuss all of my “risk factors,” although every time she asked if the hospital/doctors had ruled out (blank) cause of bleeding and we said no, we began to regain our confidence in her and our shock at our treatment with the “traditional” medical facilities. Because I had had “Braxton Hicks” for the past twenty-four hours, she wanted to check my cervix (something she rarely does because simply checking a woman’s cervix can induce labor and is typically unnecessary). Hello: I was six centimeters dilated! (FYI: at ten centimeters, baby arrives).

Once again, my dear father received a frantic phone call from us to please come right away. He took over with Hazel and we hopped into the car to drive thirty minutes to another midwife’s home who has an ultrasound machine. We wanted to look at the breech positioning and at my placenta so that we could make the most informed decision possible because our baby would be arriving one way or another very soon.

We were disappointed to learn that yes, everyone was right in their breech position diagnosis. The placenta had some irregularities, which concerned both midwives, but it was positioned at the top of the uterus, which was good because it wasn’t in the way of the cervix. The midwives were both confident of the safety of birthing a breech baby, but they also had concerns about my unexplained bleeding. Jake and I felt totally lost. I cried and cried as no solution seemed right. We could return home with our midwife and attempt our dream home birth or we could walk into the local hospital, raise our hands in surrender, and undergo an immediate C-section.

Then one midwife began talking about an excellent OBGYN (about sixty miles away) who is very supportive of home births, so going to her hospital might be an option. Then my midwife reminded us that she lives a mile from that hospital and that she has a birthing apartment in her basement that we are welcome to use. Answer to our prayers! We immediately felt calm and at peace with that scenario.

Hanging Out and Waiting

We arrived to our midwife’s home around nine o’clock. My contractions were still ranging from five to ten minutes apart and lasting thirty to sixty seconds. I was calm and able to talk and smile through the contractions. In fact, I think my midwife’s husband, who was lovingly putting the birthing room in order for his unexpected houseguests, did not quite believe that I was in labor. So the night began. Much to my chagrin, the contractions got a little more intense, but not too uncomfortable and not any more frequent or longer in duration. I walked up and down steps, I lunged, I squatted, I tried to rest… tick tock tick tock. My midwife informed me that because the baby was not head down, there would not be as strong of a pressure on my cervix, so I needed to be patient. We needed this breech birth to go slowly and in its own time/rhythm.

Good morning; six am…really, I’m still just hanging out? I had had Hazel in my arms eight hours after my water broke all over my living room! I had now been in “active” labor (contractions five minutes apart...kinda) since nine pm. Time to get this show on the road! Valerie, my midwife, checked my dilation and I was at nine centimeters, so something was happening. Valerie even felt the toes of my daughter through the bag of waters. Which is really cool, but not ideal to birth the butt and the feet together. Oh well, it’s been done before; I could do that!

We began to fill the birthing pool, thinking a change might ignite my body to really begin labor. Into that blessed pool I went and, oh, it felt wonderful. Too wonderful, in fact, because the contractions basically stopped. In and out of the pool, steps, birthing ball, toilet… come on baby. I was tired from a sleepless night and beginning to doubt that I’d have the energy when it mattered most. Our second midwife (she and my midwife often assist each other) arrived around eight am; she had been at another birth for the previous twenty-four hours. I was hoping her presence would push away the last of any doubts I had in myself and the birth. Tick tock tick tock. She had to leave to take her daughter to school, but would be back promptly. I asked Valerie to check my dilation again....Ten centimeters! WOO HOO… surely this baby would arrive any minute, right?

Things Heat Up

I asked Jake to dry me off and sit with me in the bathroom. And now things heated up! I began to have really intense contractions...the kind I couldn’t talk and smile through...the kind I needed Jake or someone to assist me with (squeezing hips, pushing pressure points on back, letting me squeeze their hands, pulling at my torso). At one point, Jake and Valerie exchanged places so that he could eat her gourmet breakfast. I tried to get off of the toilet and immediately collapsed into Valerie’s arms as another strong contraction hit. She helped me get to the bed and they (second midwife must have returned about now) encouraged me to labor in a few positions that would be really uncomfortable, but really help the baby move down. So I experienced some excruciating contractions lying on my side and on my hands and knees. The whole time, my team of three constantly massaged my back and bum, squeezed/pressed/pulled during contractions and encouraged me. After a handful of these intense contractions, my mental mantras began to slip. I began to say, “I can’t.” I longed for a team of surgeons to simply cut me open so that I didn’t have to work so hard. I began to cry and shake. I asked to return to the tub in hopes of once again experiencing a pause in labor.

Into the tub I go. Whoa… these contractions are not being kind...no relief. Now my team has to reach into the tub to continue their support. They remind me that I’m almost there, that our baby will arrive soon, to let the contractions work through me, to visualize the baby gliding through my birth canal. I pick-up my mental mantra of “My body was made for this. I am made for this. Baby is made for this. I can do this. I can’t...I can! I am!”

All of a sudden, my body was pushing (eighteen minutes after ten on Wednesday morning). My brain did not say, “Okay, it is time to push” (like it did with Hazel’s birth); my body took over. I yelled through the pushes and the midwives instructed me to use a lower pitch. Amazing how effective that was! Pop! It felt like a solid bubble released out of me as the bag of waters broke. Push! Out came a perfect butt...the baby had spent the past four hours moving her feet into the perfect breech position. Pushing continued and I felt her body glide through the birth canal.

Heidi Rose Arrives

Now the urge to push had finished and without opening my eyes, I heard my husband’s glee/excitement/tears and thought that I was done. I mentioned that I was done pushing and heard in reply, “Oh no, you’ve still got to push the head out!” “Can I rest first?” “Nope, one more push; let’s get her out.” Push! Out she came! (Twenty minutes after ten. I pushed for a mere two minutes! Sure felt like longer, but baby and I had discussed this over the long night and “agreed” that she wouldn’t need much pushing.) Immediately I knew that she was out and healthy as I heard the joy in everyone’s voices.

Finally, I opened my eyes and they were holding her up in front of me. Sharp intake of breath as my first thought was that she looked like a mini alien, but then tears of joy arrived as I grasped my perfect baby girl to my chest. Once it stopped pulsating, Jake cut the umbilical cord and we continued to cuddle our Heidi Rose. She was itty bitty, weighing five pounds, eleven ounces, and nineteen-and-a-half inches long, but perfectly healthy!

Her umbilical cord was short, about twelve inches, and it was wrapped around her neck twice. So, there was no way she had been able to flip around! She probably decided to arrive early because I had spent two weeks trying to flip her: chiropractor, ice to the head, inverting myself...poor baby!

The Value of Patience

Four hours after Heidi Rose’s birth, I felt good enough to pack up and ride the hour-and-a-half back home. I had no internal or external tearing. What a difference that makes! I know that it’s because I truly was patient (okay, my midwives were and forced me to be) and I didn’t push until my body took over. I typed this birth story about twenty-seven hours after her birth, with my gorgeous baby girl swaddled and sleeping on my chest.

I can’t say enough wonderful things about this birth. I wish all women could see this birth and feel as empowered as I feel. All through the strength and support of my husband, the acceptance of my friends and family, the wisdom obtained from reading Ina May Gaskin’s Guide to Natural Childbirth, the knowledge and support of other women who have home birthed (Tara McGuire, author of Birth Unhindered, who wrote me encouragement about having a breech water birth mere hours before), through the prayers of countless friends/family/our church community, and my amazing wonderful midwives Valerie Rose Monterrey and her partner Jenn Bozza. I am woman… hear me roar!

Julie Kosker has a Master of Education degree in School Counseling, but now joyfully works as a stay-at-home mom to her two charming daughters. The Kosker family lives in northwest Pennsylvania where Julie finds herself taking baby steps towards becoming a farmer, her husband’s dream. Learn more about the Kosker family’s daily adventures by reading Julie’s blog at: www.koskersidlewild.blogspot.com.