I wish I could say the homebirth was easy and beautiful and idyllic. If this was fiction, I would have laidthe foundation of the perfect situation, the wonderful couple, the right support system, and then the birth happens the way we all wanted, and I made my point about natural birth. Don't get me wrong, the labor was probably the most fun I have ever had at a labor, and that is saying a lot for being up for a day and a half. However, the birth was hard, and it shook me pretty deeply.
The most important of the physiological changes in labor to allow for a vaginal birth is the a dilation of the cervix. "10 centimeters. Complete." Those are the magic words that every woman who has suffered through labor is longing to hear. Homebirth Mom was having great contractions, which is one mechanism that encourages the cervix to dilate. However, Homebirth Baby was coming down with her little head a little cockeyed. The pressure of the baby's head against the cervix also encourages the cervix to dilate, but a crooked head does not descend or dilate well.
The labor was long. None of us, least of all the mom and I, got much sleep. Her spirits remained astonishingly high. She danced, she laughed, she played between contractions, and she focused and breathed through them. However, her dilation stalled and stalled. Finally, her cervix was almost complete. However, one portion of it stubbornly remained thicker than the rest. This is known as a "lip". It is rare, it holds up the transition from labor to pushing, and I had one during my first labor with S seven years earlier.
I watched as the midwife rubbed out the cervix with her gloved fingers as the woman screeched and moaned. Homebirth Mom never pulled away, she never sobbed "NO! No, please stop, it hurts SO MUCH!" as I remember doing. I had a day long labor too, but I was in a cold hospital room, strapped to monitors and with an IV full of pitocin to make my contractions harder. No epidural, no best friend, no doula with lavender aromatherapy spritzer, no team of midwifery students. One midwife with the bedside manner of Dr. Frankenstein, one labor nurse who was wonderful, but who I had never met before, and my shell shocked husband and mother who were not that into the natural birth thing.
Homebirth Mom endured the midwife manipulating her lip for a good two hours. It took my midwife about three and a half hours to get rid of mine as I pushed and screamed. My mom kept waiting for the nonexistent doctor to come in, put me under and take out the baby.
When I graduated from high school, I initially became an education major because I was so disgruntled with my high school administrators. I switched to being a fashion design major because I hated the way the mainstream clothing industry seemed to not be able to make cool yet comfortable clothing. I was suddenly afraid I was training to be a midwife because I hated the way my first birth went, and I thought I could (eventually) do better than my midwife. But apparently, midwifes rub out cervical lips. Some of them, including the one at my center and the one who attended my first birth, did so with no anesthetic or ice or anything. And it hurts the mom. Would I be able to do that for a mom while she screamed and I flashed back to the intense, excrutiating pain I felt?
I sobbed as I drove a car full of homebirth supplies and the placenta back to the car. Oh wait, you wanted to hear about the birth. The baby finally came out, and was perfectly fine. The mom and dad were ecstatic, and I am sure they do not regret their choice of having a natural birth. She may even have another baby and may choose to do it naturally again, as I did. But I was shaken to the bone. I was thinking how an epidural would have probably been pure mercy for her, and for me. However, about 5 % of moms have persistent lips like that. I have probably only seen a midwife have to rub out the cervix on a screaming woman twice in the roughly 50 births I have been to.
So, without my crystal ball, I will not be able to predict who will have a lip, or any other complication. I got to see two more births today, after a solid six hours of sleep and a lot of thinking. I love talking with moms and doing prenatals. I love the post partum checks with the brand new babies and cheery but sleepy new parents. Believe it or not, I love the labors, even the long ones. And I love the easy births. And the medium births. It's the hard ones that really shake you. Especially if they remind you of your own. But, that's OK. It's not really the easy births that women really need midwives for anyway. As Shari says, most of those babies would eventually fall out on their own anyway.
I wouldn't go back in time and choose an epidural for my first birth, and I really doubt Homebirth Mom would either. And women who are willing to take the hard road need midwives who are willing to walk with them. I hope to be that one day.