Even complication-free homebirths can come with complications

Guest post by Eliza Oakes

Grr, arg! My husband tells me I think too much in black and white. And until recently, I thought he was probably right about that when it came to my opinions on religion or customer service, but choosing where to birth our baby really did seem like a no-brainer. For a normal and healthy pregnancy, hospital with doctors equals bad and home with midwife equals good. Whenever I’d read somewhere about a doctor or nurse pooh-poohing an expectant mother’s birth plan on the grounds that birth is unpredictable, I’d think, “Well. Sure. The big, evil hospital doesn’t care what you want. ‘Birth is unpredictable’ is a way to justify all the things they do to you. The only way to make sure you get the birth you want for you and your child is to have a homebirth.”

According to me, in the hospital laboring women are poked and prodded and hurried along, their babies are damaged with drugs and forceps and then taken away from them. And oh yes, these things are the reason, along with unhelpful labor and delivery nurses and pediatricians, many mothers and babies have trouble with breastfeeding. I was sooooooo sure. Nevermind that two weeks prior to my son being born, a friend of mine had a perfectly lovely, intervention-free birth at a hospital. I figured she just got lucky. It may seem like this story is going to end with my son’s birth needing the help of drugs or surgery after all. Thankfully, it didn’t. But it turns out I need to stop being such a buttface about that whole “Birth is unpredictable” line. There is so much more to it than episiotomies.

So there we were in our apartment with our midwives, at the end of roughly twenty-one hours of labor. The pain was bearable, the music, food and company were good. I was on the floor in front of the bed in proposal position (kneeling with one knee down, you know), pulling on my husband’s arms, when Atticus finally popped out after two hours of pushing. But what was this!? Someone had beaten him up! He’d come out forehead first, so his noggin-bones hadn’t molded into that nice cone shape. Instead, he had a giant, swollen bruise on the right side of his forehead. He came out whining and continued to fuss and furrow his brow for two hours before he fell asleep. He wasn’t able to latch onto my breast in that time, but our midwives said he might be a wee bit sore right then, and not to worry.

Oy, me 'ead.

The next day, the swelling had gone down but he still had that pained look on his face whenever he’d try to latch on. One of the midwives, now worried about his skull, recommended we call a craniosacral therapist to come over and manipulate the tectonic plates of his head to make sure they all got to where they needed to be. We called, she came. After rubbing his head a bit, she declared that although he’d sustained trauma similar to a forceps delivery, his little melon was fine and would I like her help in getting him latched on? Sure, the more the merrier. We couldn’t get him on. She told me I had short nipples and that was our problem. Well then.

On day three I started pumping colostrum, and because he’d started to turn a little yellow, one of the midwives suggested we give him a little formula in addition to the colostrum in order to get him pooping. She gave us a syringe to use while he was messing about at my breast so that he wouldn’t end up preferring a bottle, but we had trouble using it as he’d mostly just put his little lips around my nipple and then fall asleep. We went for the bottle, as it felt like time was of the essence if we didn’t want him to have to go into the hospital to lay under the jaundice lights. Every two hours we’d wake him, feed him the pumped colostrum and then top him off with an ounce of formula (if he took that much) before he fell asleep again. This got him pooping like a champ.

However, the next day at his very first doctor appointment with a doctor who was not to be his going forward (Here’s a tip: do not have a baby in August. Everyone you need to see is out of town.), we were told we needed to head to the ER immediately because this baby was very jaundiced. The big ol’ bruise on his head was way too many red blood cells for him to break down on his own. And here’s where I really shine … my first thought was that they were trying to punish us for having a homebirth. Oh my lord, Eliza.

Unfortunately, my husband had met this doctor once before and he didn’t like her either, so we said we’d go home to wait for the results of his bilirubin test before we went to any ER. We called our midwives after getting the result and they agreed his levels were high and we really ought to go in. Fine.

Atticus spent all night under the lamps in a box in the NICU, where at 7lbs he was the biggest baby there and I finally started to feel like a bit of an ass for assuming all hospitals wanted was to mess up your baby and take your money. We spent that night apart. My milk had come in at that point and I began to pump and bring it into the NICU for him to have in a bottle.

In the morning they turned off the lights and the blanket and waited to see if his levels would come down any more on their own. Since we were now allowed to go and hold him as often as we pleased, we tried a few more times with a couple of lactation consultants to get him onto the boob. No luck, he’d get on, suck a few times, then pull off and fall asleep or cry. They let us take him home that evening. As his bruise faded, we made progress in the breastfeeding arena. By two weeks he was off the bottle and onto a nipple shield, and by three weeks he was on the boob!

So yes. I had my relaxing and empowering labor and birth in the comfort of my own home. But I still got some other things I definitely would not have put in my birth plan: a banged up baby, separation from each other at only a few days old, the introduction of the dreaded bottle, but not because any evil hospital was out to get me — but because birth (and babies) are unpredictable. His two month appointment is on Monday and I promise to bring my logical hat instead of my paranoid, judgmental, everything-is-black-and-white hat.

Comments on Even complication-free homebirths can come with complications

  1. This was a great piece- thank you! It helps keep things in perspective.

    It especially hit a chord with me because, like you, I had a really easy pregnancy, but everything after my son’s birth was anything but easy. I labored at a hospital (I felt so rushed!) and when my son eventually had to be delivered via C-section, I blamed the hospital for robbing me of the birth I wanted. Now, though, with “my sensible hate” on and reflecting on the minor complications we had after his birth, I can accept that we made the best decision we could based on the circumstances. And obviously, nothing is guaranteed, so we most likely would’ve had the same problems or worse if I had the birth I wanted.

    So you’re right. Pregnancy, childbirth, post-pregnancy and childbirth are all too unpredictable.

  2. I couldn’t agree more with this post. I was also in the home births good, hospital births bad camp.

    After a relatively easy pregnancy along with eight months of prepping for a home birth we ended up at the hospital. My midwives actually recommended I go into the hospital to be induced! My husband and I grieved for the imagined beautiful home birth we weren’t going to have. But our hospital experience was just lovely. The staff left us to labor at our own pace, and when our 10lb. 9oz son came into our world (naturally) he caused so much damage that I would have had to go into the hospital for stitches anyway. We had parallel care throughout our pregnancy and when our son’s birthday came I was so thankful to be informed at least enough to ask them to not bath him, to leave him on my chest until I was ready to let him go and whether or not he needed a Vitiamin K shot.

    Now we are dealing with our own set of breastfeeding issues. And while we work it out have been supplementary feeding him with the dreaded bottle! But it was such a relief to have him be full!

    My Husband and I just keep telling ourselves: Do the best you can.

  3. See!? Natural hospital births TOTALLY HAPPEN! 🙂
    Re: the Vitamin K shot. At first we were going to skip it, but a friend of mine mentioned that her son was a little bruised after birth and she was glad to have the Vitamin K handy. So we decided to procure it. And of course, Atticus came out with the Super Bruise. You never know! I’m glad we had it!

  4. I had a wonderful homebirth, but my daughter came out really fast, causing me a 3rd degree tear. My midwife prefers to leave the 3rd and 4th degree tears to the experts, so we ended up going to the hospital anyway. It was the most disruptive part of Aspen’s birth. My tear was sewn up beautifully, healed beautifully, and has had no lasting repercussions thankfully.

  5. My beautiful homebirth also came with complications having nothing to do with birth. I think part of me still grieves for this imagined postpartum period I had in my head. Great piece of writing.

  6. I really related to this post… We didn’t have the option to have a home birth, but planned and planned for a natural hospital birth. I ended up semi-induced and with an epidural. My little lady had a really hard time breastfeeding and we went through pumping/formula then nipple shield then breast. If I ever have another child, I’ll definitely still plan for the “ideal” natural birth (hopefully at home!) but I’ll be a lot more aware and accepting of MY own limits and the unpredictability of childbirth!!

    Thank you so much. 🙂

  7. My wonderful homebirth also had a hospital visit – two weeks later for a weird abscess on my son’s leg that had to be drained by a surgeon. I was so, so disappointed that we had to go to the hospital. I was maybe a little brainwashed that the nurses would swoop in to give him formula or a pacifier if one of us wasn’t there to watch him like a hawk, so I never left (they seemed respectful of my wishes but I didn’t really know for sure). My only complaint was that the surgeon presumed that a midwife doesn’t provide regular prenatal care (ugh!).

  8. Thank you so much for this post. I recently watched “The Business of Being Born” and it pretty much stated word for word what went wrong with my hospital birth. I was induced, too numb from the epidural to push, had an allergic reaction to the epidural, my son’s heart beat would sky-rocket with every contraction, I got an infection in my uterus, and I eventually had to get a c-section after which I couldn’t hold him for about 20 minutes. My son and I didn’t get the bonding time we needed in those first few minutes. After watching this I felt like a terrible mother for not educating myself until it was too late. It also made it seem like using a midwife and having a home birth is the only way to have a safe birth. I just feel more comfortable knowing that there is no way to ensure everything will go perfectly when giving birth. I now have a beautiful, healthy son I am completely in love with.

  9. Among those of us who aren’t terrified or grossed out by them, there seems to be a little bit of a tendency to romanticize childbirth and breastfeeding. It is all beautiful and natural and wonderful and awe-inspiring, but it’s also just a down and dirty bodily function with one goal–healthy baby and mama–and many ways to get there. This article is a good reminder that the birth and post-natal stages are where a lot of us learn our most important parenting lesson: Be Flexible.

  10. Thanks for sharing your experience! I was so turned off by the home birthing crowd when I was pregnant with my son in the same way I’m turned off by a lot of things — the proponents (I knew) for it were so, “Your birth is going to badawful! Hospitals are evil and just want your money! Home birth is the only right way!” It isn’t to say that I had issue with home birth, but I have a very instinctive, “Hey, f- you!” when I’m told what to think/do.

    I had a fantastic (medicated) birth at our hospital, and while I don’t have a single complaint, I consider doing a home birth for the next child. It’s good to hear that it’s not all sunshine and roses. (Not to say that it’s good that your experience was good!)

  11. I’m firmly in the camp that the only thing you can control is the knowledge that you’ve gained beforehand. This will help you with whatever decisions come your way and there will still be things that you won’t know!

  12. I’m wary of ANY person who is fanatical one way or the other about a particular birthing method (or anything in life for that matter). My sister-in-law had two wonderful home births with little to no complications that produced my two gorgeous nephews. But even though it worked for her, I just don’t think it’s going to be the best decision for me, my husband and our baby (due in March). I have a general idea of what I would like the birth of our baby girl to be like and how I would like to initially feed her and such, but at the same time…I want what is medically beneficial for my baby and for myself and that doesn’t mean things will go according to MY plan. I just want a happy, healthy and chubby little girl – at the very end of the day how she gets here is not as important as who I raise her to be. I am from the camp of “whatever you think is best for YOURself and YOUR baby.” Because in the long run, it doesn’t serve any good to be judgmental (either for or against home births or hospital births), it will only alienate people of the opposite belief. And I think…the woman and her partner are the only ones that have to live with the benefits and the consequences of a birth…why not let them make the best decision for themselves and have us just be supportive and love on that beautiful baby?!

  13. I’ve read some articles about homebirthing that scare the crap out of me (such as http://www.smh.com.au/lifestyle/wellbeing/home-birth-triples-neonatal-death-risk-study-20100701-zq1j.html). I know that the risk factors in industrialized countries are small anyway, but I’d rather get the best care for me and my family! Also, if that old saw about looking to your mother’s birth to see what your birth is like is true… I want to be close to medical intervention because it was necessary to get me into the world.

    • I’d never heard that about looking to your mother’s birth! Now I’m curious. I was breech so she needed a c-section. Maybe I looked to my grandmother’s birth – my mom was born at home!
      Also, I don’t know if this is the case for the study you posted, but I’ve heard there are a lot of problems with studies on the safety of homebirth because they don’t filter out unplanned homebirths, which could really skew it toward the unsafe side.

    • For me, a homebirth and “close to medical intervention” won’t necessarily be contradictory. I live in an urban area and so am less than 10 minutes from several hospitals–it’s exceedingly rare that an intervention needs to happen quicker than that. It’s certainly good to know that one of the things we should be asking midwives about are their transportation plans, relationships they have with local hospitals, and training they have with infant resuscitation as well as maternal care, but at least in that particular article I see a lot that reassures me as much as it scares me.

  14. What a wonderful piece!!! I will make sure all my clients read this. Moderation in everything, right?

    Really… beautifully written and extra thrilled your baby is healthy and whole.

    Oh, and I wholeheartedly recommend Vitamin K for our homeborn babies with bruises. You did good. 🙂

    Thank you for taking the time to write this. Many women/families (and babies!) will thank you.

  15. I had read so many stories of how “hospitals are evil” and what their normal practices are that I was scared to death to birth my child in one. In fact I had a panic attack during our hospital tour when in the birthing room. However, what I forgot was, I’m in Canada! Most of those stories are U.S. stories! During our hospital tour we learned that most of the things people were posting about that hospitals don’t do, our hospital does as routine. So, yeah Canada!

    My baby was a week and three days late, so he was induced (with cervidil cream, no shot, no breaking water, nothing like that). I needed a shot of Morphine because I was not able to breath through contractions (which had been 3 and then 2 minutes apart since the beginning) and my doctor refused any other type of drug due to risks. No epidural, even though I “gave in” and asked for one, because the anesthesiologist was busy in a leg surgery (and thank god! I was glad to be able to feel my baby come down, and would have felt so disheartened with the pushing if I was numb through that process). My baby was born after 11 hours of labour (counted from when contractions were stable), and an hour of pushing. My baby, despite his heartrate being perfect until he crowned, did not want to breath for the first several minutes of his life. He was given oxygen and some sort of anti-morphine shot (even though the Morphine had worn out several hours prior to the pushing stage, this was precautionary). His Apgar score was 1 at birth, then up to 3 five minutes later. He was in the care unit for 4 hours monitoring before I was asked to come to pick him up. However, my baby (after learning how to breath) has been in great health since then. My baby would not be alive if I had not given birth in the hospital.

    Beyond that… I did tear, but my doctor was a great seams-person (?) and I have had no issues and you can’t tell I had a tear at all. I was in the hospital from Wed to Saturday, receiving advice and training (diapers, bathing, dressing, personal care, etc.) and getting better food that I would have eaten at home (and thanks to Ontario Provincial Heath Care, paid for by my tax dollars, not from my bank account). Even my Mom was impressed with the information and training they provided to me in hospital for how to care for myself and my new baby, information I would not have had with a home birth or a short hospital stay.

    I intend to have one more child, and I plan for that one to be birthed in the same hospital that saved my first baby, who is now a happy and healthy 10 month old.

  16. Thanks for this–I sort of collect “we had a homebirth, something at some point went wrong, we saw a doctor–all good!” stories. My grandfather’s mother (so my great-grandmother) “died in childbirth”–in a time and place when that sort of thing was common enough that people came up with phrases like “died in childbirth”. He is therefore VERY negative about homebirths. In mind, the reason he lost his mother at 6 years old was that she wasn’t “near a doctor” when she was having a baby. My mother had a very difficult labour followed by an emergency c-section with me. She would have followed in her grandmother’s footsteps with out it. So she too is a bit paranoid about the homebirth thing. I like having these stories to share with them.

  17. You’re not really wrong, though, about what birth is like in the vast majority of hospitals. I know doctors and nurses who do try to punish parents for having a home birth, and my friend had two doctors refuse to treat her or her son (a family practice doc) because she had a homebirth, so you are not unnecessarily paranoid.

  18. I have to say I am happy to see this account of your experience up here. Although I am definitely on the liberal side of the spectrum, I often have difficulty relating to people who are so extreme in their “liberalism” that they become closed-minded instead of open-minded (which is sort of the goal of being liberal and “off-beat”, wouldn’t you say?)

    I am all for natural remedies and think that they are a great way to stay healthy and well and can sometimes even work in the case of illness. However, I also recognize that western medicine (in addition to other “mainstream” ideas, practices and so on) are not all out to get us. Prime example: I went on an international trip this summer and when I came back I started experiencing an EXTREME pain in my tongue (weird, I know!). I tried like heck to get rid of it using numerous natural methods. However, when I could barely swallow without crying I realized that it was time to head to the doctor. Good thing I did. Turns out, a tongue infection can actually be quite serious and can, very quickly, become a full body infection. (and, no, they did not tell me this just to freak me out! When they said I should get my tongue drained (ick!) and I calmly objected, the doctor actually took the time to listen and we came up with a reasonable course of action that pleased me and did not worry her. Although it DID involve traditional antibiotics **something I typically consider more harmful than helpful***, to avoid having MAJOR medical intervention or even having long-lasting, possibly disastrous consequences, I ran a little “cost-benefit analysis” and realized that a few antibiotics would probably not kill me, but the infection could.

    I guess my point is that in having our alternative views, it is important to also stay practical and to at least consider mainstream viewpoints and practices. After all, we want people to grant us the same respect for our lifestyles (even though some consider them wrong or odd). But, just because something is mainstream or popular does not *automatically* make it wrong.

    Again, so glad to hear that you and baby are 1) healthy and happy 2) that you posted your honest account 3) you realized that holding onto your ideals is great but being flexible and considering another’s method can also be beneficial as well.

    Although I in no way shape or form consider myself a buddhist (I don’t like to claim I am one religion or another, vegan/veggie/carnivore, etc) I went to a Buddhist center to have a chat and learned that a certain sect (forgot if North, South, etc) practiced the following:
    When being taught, students are *encouraged* to question their teachers. It is not considered defiant or stubborn. And just because it is being taught does not mean that it needs to be internalized and followed dogmatically. Instead, students listen to the lesson and then ask questions until they have looked at it from every angle and can then decide (for themselves!) if it resonates with them and wish to take it as their own truth or to let it go.

    To at least consider every little lesson that comes our way, popular, unconventional, or otherwise; without judgement–I find that such a beautiful concept.

  19. We have an awesome family dr, so I follow his words, “you have to look at the whole picture”. Our homebirthed baby was jaundiced (he looked like a munchkin from the Wizard of Oz) and the lactation consultant wanted us to take him to the hospital. Our family dr sent a nurse to us to test his numbers and told us all the other things to look for, brusing, eating well, pooping well, not lethargic. He said that the whole picture is what will tell you if the child’s body is processing everything on it’s own or if he needs help. He said that the numbers could be high and the baby could be processing things fine or the numbers could be low and the baby could need the extra lights, etc.

    So, everytime I hear the black and white comments, I think of ‘looking at the whole picture’ for that particular situation and I’m very grateful for our dr!

  20. I had basically the opposite experience – wanted a medicated birth and, with my daughter (now 7) the epidural needle slipped, leaving me basically unmedicated. This after I was (willingly) induced because my water had broken, I lived about an hour away from the hospital, and I wasn’t dilated at all. I just kept saying “this is so unfair” as I pushed through the 9th hour. By 5am I was saying “I can’t do this anymore” and was on the verge of asking for a C-section, but I could tell it wouldn’t matter; I was having the baby vaginally because there was no medical need for intervention. As soon as my daughter was born the nurse asked me if I waned to nurse, and I was just too tired. But she came back about 45 minutes later and insisted.

    I guess the point of my comment is that it’s not just homebirths of “natural births” that require flexibility. Babies being born find a way of getting what they need if mamas birthing them can let go of their own preconceived ideas and do what they need to do.

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