2100 Words
Trigger Warning: This blog has lots of references and perspectives concerning birth and c-section. If you have any sensitive experiences with birth or c-sections, please remember to take care of yourself as you read and stop reading if you need to.
Home Birth
Choosing home birth was one of the biggest acts of self-care that I have ever given myself up to this point. It was the best thing that I could have done for myself for so many reasons.
It’s important to note that “natural” birth isn’t what I was going for - whatever that means. All birth brings natural life - some welcoming (or requiring) more intervention than others.
What I wanted more than anything was holistic care and to not be railroaded into procedures that are rationalized by fear, partiality, or misinformation. I especially did not want to participate as a casualty in an industry that ultimately creates solutions that are most lucrative even if compromise my quality of life.
I didn’t fear for my life, but I did make my choice with a consciousness of the maternal mortality rate among black women in America.
Choosing home birth changed my perspective of birth, entirely. I was introduced to childbirth with the saying, “When a woman is in labor, she’s got one foot in the labor room and one foot in the grave.”
From then on, birth has always appeared to me as something dangerous, sorrowful, and wild. I have since learned that it doesn’t have to be any of those things, but what else is there to believe with such limited information on physiological birth?
I mean, birth is wild (no matter how you slice it), but it doesn't have to be traumatic and I welcome that truth into my life.
The obstetric care industry performs well when there is a need for life-saving surgery or heavy human intervention. It's a blessing to our society that we get to have options when it comes to birth.
However, the same industry makes an enormous amount of money off of the ignorance of the expecting families who think that birth can rarely be done without vacuums, knives, high-risk medications, and heavy machinery.
Receiving midwifery care meant that I went through the entire process knowing what my options were, both in and outside of mainstream obstetric care, and it meant that I got to choose my own path with the guidance of my midwife.
This being said: There was just as much, if not more, precaution taken when we observed that my baby was breech. It was my personal decision to learn as much as I could about vaginal breech birth, including the risks and facts associated with those risks.
The first order of business, though, was to try to get him to turn.
My midwife let me know all of my options. The most mainstream options included C-Section and external cephalic version (with or without epidural). She also informed me of treatments and routines that could encourage turning included chiropractic care, moxibustion, acupuncture, Spinning Babies, and good old fashion walking.
In three weeks' time, I had been to a total of about twelve appointments that were specifically centered around getting my baby to turn.
The plan was that, in the event that the baby did not turn and it was safe, she would have other midwives working alongside her for healthy vaginal breech birth.
I could see that I had more work cut out for me than I was prepared for with the realities of entrepreneurship, toddler-mom stuff, and managing third-trimester fatigue and hormones.
In the past year or two, I’ve learned not to just accept what I’m given as fate, but after weeks of effort, my soul questioned, "Why do I even try?"
Ultimately, I wanted to not feel forsaken by God in the event that I found myself in an operation room at New York-Presbyterian for a planned cesarean due to a breech baby.
I wanted to be okay with it.
In the middle of my trying to nestle into acceptance through prayer and meditation, I heard the Lord whisper something that stopped my thoughts in their tracks. That word was, “Wait”.
It was so quick and quiet that I might have missed it, but it brought an abrupt end to my thoughts which made it hard to ignore.
A couple of days later, my husband and I were in prayer about what to do, and as I write this, I can recall that part of my prayer was that the Lord “show us how to tell the story” when it was all said and done.
Throughout the entire process, I had kept notes about the experience documented on my phone.
At 36 Weeks (give or take): Doctors who did my sonograms told me that my fluid was "very, very, very, very very" low, suggesting that I would need to be induced or immediately taken in for c-section. For the record, I found the repeated use of the word "very" to be both obnoxious and insulting.
Needless to say, my fluid levels had doubled by the next week and I was later informed that fluid levels can measure differently depending on where the scan is taken.
At 37 Weeks (give or take): Doctors who did my ECV had strong recommendations against home birth due to their unsuccessful attempt at turning my baby into the head-down position.
At 38 Weeks (give or take): I heard of many fears and concerns about the baby becoming too big, getting stuck, or something else going terribly wrong due to his breech position.
Time would tell.
Breech Birth
In both my children’s births, I saw the merciful hand of God. Both of them were born about two weeks past their original due date, but completely healthy both during my pregnancy and after delivery.
In my second experience with birth, though, there was a unique element of time, trust, doubt, and power that still leaves me shocked, stunned, amazed, and grateful all at the same time.
“Breech birth is a variation of normal.”
...but when you live in Manhattan, where the rate for c-section operations is as high as 39.6%, having a breech baby vaginally is unheard of - perhaps even frowned upon.
In Manhattan, there are about five midwives who practice vaginal breech delivery at home. The midwife that I hired was not one of them (at the time), so her role in preparation for delivery was to get one or more of them to assist in my home birth in the event that my baby didn’t flip to a head-down position by the time of delivery.
There were lots of options for how to approach the circumstance of having a baby that was in a breech position, but it all became compromised and complicated after my first appointment for an ECV to have him manually turned.
My midwife recommended that I see an OBGYN who had previously done vaginal breech deliveries but now worked at New York-Presbyterian in a pretty political environment. She referred me to him because he often presented as an ally to the home birth community and had first-hand experience with vaginal breech births.
In my pre-consultation with him, he asked the question, “What do you plan to do if the ECV is unsuccessful?” To which, I shared the plan to have a vaginal breech birth at home with my midwife. During the consultation, he shared all that I needed to know about what an ECV entailed and the risks of needing an emergency c-section if the baby didn’t respond well.
What he didn’t share was that his allyship with the home birthing community was actually quite shallow.
I was at the hospital for about 5 hours before the actual procedure began with the preparation and monitoring that took place as protocol. The actual attempt to turn my baby took about 5 minutes before he declared the turning unsuccessful.
His last words to me were that, because I had an uncomplicated first birth, I would be a good candidate for a c-section with this baby and then a "vaginal birth after c-section" (VBAC) for any subsequent pregnancies.
He didn’t mention how once a woman has had a c-section, they are much more likely to be railroaded into another c-section for all subsequent births.
And he didn't mention that babies are statistically more likely to be breech in subsequent births.
Empty words, they were.
Furthermore, he said that if I wanted to pursue a vaginal breech birth, he would recommend that I at least do it in a hospital.
Again, he didn’t mention that the likelihood of being able to deliver a breech baby in any nearby hospital was extremely low unless I was already so far progressed in labor that it there was no time to prepare for the c-section.
Finally, he had the unmitigated gall to reason me into a c-section by saying, “I know that you love your midwife, but…[blah blah blah]”; As if my decision to give birth at home was based on limited knowledge and superfluous emotions of love and admiration.
Later, I learned that he documented the outcome of the ECV procedure but not without explicitly stating that he did not recommend a home birth for my breech baby. As a result, the few midwives that were willing and able to birth my baby with my midwife backed out so as to avoid a liability issue.
I don’t blame them. I get it.
But, for the first time since learning that my baby was breech, I felt pigeonholed into a decision that seemed to have been made for me.
Several times over the weeks to come, I agonized over what to do.
I have made many decisions that were rebellious to the culture before without qualms. I have no issue with defying made-up rules, but I felt stuck.
Not having options did not sit well with me.
In my mind, I went from, "I guess I should just schedule the c-section now" to "but, I don't just want a good birth. I want my baby to have a good experience being born."
If a c-section was best for my baby, then I was willing to believe that it was right for me. However, it didn’t make sense to me that I would be forced to undergo an unnecessary surgery all because the professionals qualified to advise me weren’t skilled in the full scope of what they have been empowered to do.
I can do hard things. I am comfortable with a change in plans. I don’t mind sacrificing my own desires for a more safe and logical approach.
I don’t do well with being forced to do unnecessary things “just because” that’s how it’s done. I get offended when partial information is presented to me as a method to manipulate me into a decision.
I let people assume that I don’t know whatever it is that they think I don’t know, but by this point in my pregnancy, I knew too much. Two out of three OBGYN’s looked me in my eyes and tried to convince me that I was in danger of needing a c-section due to my fluid levels and the position of my baby.
The fact of the matter though, is those reasons were all they had (and barely that).
I didn’t need a c-section. The industry was only prepared for c-section. The industry was designed to benefit financially from the thousands of c-sections performed in a year.
The industry was not designed for me - a black woman who was still early (sort of) in her childbearing years.
A decision had to be made and though I felt like I only had one option, the Lord reminded me that I actually have two.
Option 1: Prepare for a C-Section
Option 2: Wait.
Read Part 2: D-Day
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