It’s easy to get swallowed up in the controversial opinions concerning home birth. Not surprisingly, the subject is touchy, as are most topics when it comes to a woman’s body and its capabilities. However, as advocates of the practice, our team at Lotus strives to accomplish two goals regarding home birth: to raise awareness about the home birth option and to empower women to make the choice to have a home birth when medically advisable. (Depending on the health risks associated with a woman’s pregnancy, home birth is not an option for every soon-to-be mommy.)
For these reasons, I reached out to Louise Brownell, one of Lotus’ clients that expressed enthusiasm for her home birth experience six years ago. As a future mother, I was eager to hear from her about questions I’ve often wondered: Would you recommend home birth? What would you have changed if you could go back? Would you do it again? Below, you’ll find Louise’s answers to these questions and many more.
1. Why did you decide to have a home birth?
I decided to have a home birth after extensively researching my options. First, I wanted to give myself the best chance to birth naturally with no unnecessary interference, especially since I had a low-risk pregnancy. I also really wanted a water birth, in an effort to reduce my chances of tearing. That option was not available to me at the hospital at that time (2011).
I believed in the fear-tension-pain theory, so I wanted to give hypnobirthing a try. It was important to me to be able to birth in a familiar, comfortable environment. I absolutely did not want to give birth in an area with other women that were giving birth, particularly if they were upset or traumatized (unless it was necessary). Also, I only wanted people I knew and trusted around me while I gave birth. I felt that strangers would not help me relax or feel safe, and these were both important to me for a smooth birthing process; home birthing was the only way to choose my birth team.
Yet, despite all of this, I was at peace with the idea that if an unexpected twist occurred in my birth journey, I would need to go to hospital and receive medical care. We lived only five minutes away from the hospital, so relocation was not a worry.
2. Did you find any obstacles to having a home birth in Bermuda?
Initially I didn’t even think it was possible. Then I found Conscious Home Birth Bermuda, and luckily, I was able to afford it. Cost is a barrier to those who can’t afford it unfortunately, and insurance doesn’t cover all of the costs. We had to find a doctor willing to sanction the home birth. Then, I had to find an obstetrician who was willing to see me prenatally while officially advising me not to home birth (due to politics around home birthing at the time). However, my obstetrician was actually quite helpful in giving me a list of good interview questions for the overseas midwife I planned to have. I then had to inform my insurance company of my intentions and sign a waiver.
The main obstacle was the community prejudice against home birthing. I had a lot of people either telling me I was “brave” or “reckless,” especially because it was my first baby. Others just believed that it was illegal! In fact, a loophole in the law was found a few months before my baby was due, and my chosen midwife was able to pass the exams set for that year and get a visa shortly afterwards. It was only then that I knew it would all be possible! I also found out two weeks before I was due that the midwife was not able to bring gas and air into Bermuda. So, I would be birthing entirely unmedicated. For me this wasn’t a barrier to my plans, as I didn’t really want the gas and air. But it may have been a bigger issue for other pregnant mums making a decision about home birthing.
My other half was quite negative about home birth when we first discussed it. It took several months, a birth preparation class and a hynobirthing course for him to come around to the idea, and then champion it! He is a bigger advocate for homebirth now than I am!
Lastly, I needed to find a doula who was happy to attend a home birth too. I was really pleased that I found an excellent team in the end.
3. Can you describe the experience – from the birthing tub setup to the people that surrounded you – during your labour?
I had a show some very mild contractions during the day leading up to Harry’s birth, but nothing that made me think that I was in labour yet. Later that evening, my doula visited my home for half an hour. The moment she left I had such a strong contraction that I ended up on my hands and knees on the living room rug. I decided to go lie in bed and listen to my hypnobirthing tracks while I had a couple of mild contractions. We started timing the contractions from 8.30pm. I actually wasn’t looking at a clock at all. I’d just call to Derek when they started and stopped. They were sporadic but a little stronger. (The timings I’ve put in here were worked out afterwards from looking at phones and photographs.)
While I was in labour, time didn’t seem to travel like it usually does. I didn’t feel like I was in active labour for 6 hours – it felt much quicker than that. I texted my birth team at 10.30pm to let them know that this might be it. (We’d had a false alarm a few days before so I wanted to wait a bit to be sure.) By not acknowledging I was in labour, I managed to avoid getting scared about what was to come. Even so, Sophia (midwife assistant) responded to say she would come and set up the birth pool. She arrived at about 11. At 11.30pm I texted my doula to say Sophia was setting up the pool. At this point, I needed Derek’s support to breathe through the contractions. Derek called the doula to come; she arrived at 11.45pm. The birth pool was ready and they started filling the pool. By 12:15am, I needed both Derek and my doula’s support to breathe through the contractions. We tried stools and birth balls but the only position I could handle was on hands and knees. I decided to get into the pool after a very strong contraction. It wasn’t warm enough but I decided to stay in. There is something very comforting about being in water, and having this little space like a safe bubble. I rested over the side of the pool in the soft glow of the little fairy lights we had strung up. We said our baby “vow” (promising to love and guide our child as best we could) together and this helped me keep calm. Sophia arrived back, and she and Derek then topped up the pool with hot water.
My midwife arrived at 2.30am after Sophia called her. She checked my blood pressure and baby’s heartbeat, etc. I believe that they called the doctor and the hospital to let them know I was in labour, but I wasn’t aware of much outside the birth pool at that point. My midwife measured my dilation at 8cm which triggered a fear of transition. I remember then that I set my intention to get to 10cm in two contractions. I felt nauseous at this point, but I didn’t vomit. I cried between the next two contractions. I was afraid of being left alone and abandoned at that point. We tried some homeopathic remedies and I got through the next contractions chanting “baby, baby” and “open” and singing along to Adele who happened to be on my music system at the time.
I remember he kicked quite vigorously. I felt it in the middle of my belly, so he must have been quite low already. I felt a popping sensation before I started to push, which I’m guessing was my water breaking. I then started bringing my leg back from my position (kneeling over the side of the pool), and the midwife said it was okay to push if I was feeling it. I started to push at 3.20am, but hadn’t really got back into my birth zone after I had the vaginal exam. So, I didn’t get the hang of it. I was breathing up and away rather than down. In fact, I was terrified of tearing, as the sensation of fullness was overwhelming. I was fighting against it and I discovered that I could shorten the pushing contractions if I wanted to. I was also surprised that the sensation of fullness didn’t recede between contractions, as I’d been used to recovering between contractions in the opening phase.
My midwife asked me to “lower my birth song” and she showed me how to growl like mama bear. Everyone in the room growled with me which was really helpful and supportive. Sophia (I think) began to top up the pool with hot water again. I was squatting as I thought that would help the delivery but I ended up with a leg cramp, so the midwife asked Derek to get in the pool with me and I flipped over, leaned back against him with my ankles on the sides of the pool. We interlaced fingers and breathed through the last contractions together. Then, I felt the baby’s head! While I wouldn’t have said the contractions were painful, they were definitely intense. The crowning definitely felt sore, but it was over soon enough. Our baby boy was born at 4am and the midwife popped him straight into my arms. I felt intense relief!
I saw a little grey arm and baggy skin. I’d felt baby move while I was crowning, so I wasn’t worried about his vitality and his hand was moving at that point. I experienced two small grazes that didn’t require stitching; tearing was one of my major fears and it was a big part of my decision to have a home birth. My placenta arrived quickly. The midwife took Harry very briefly out of my arms as he hadn’t had a big “cry”. He gave one cry and I took him back again. Derek cut the cord well after it had stopped pulsing. We got out of the pool around 4.20am and the midwife gave me a check over while the doula and Sophia dressed Harry. He was weighed at 7lb 7 oz and had his first breastfeed with no problems. I felt like I didn’t have a clue, but he figured it out (Clever boy!). We had breakfast – tea and scones – and I was so glad to be holding Harry and in my own bed immediately!
I was on a high all week after the birth. I felt amazed at what my body did, viscerally protective of my wee man and on day three I remember feeling a wave of love for him so strong that I was overwhelmed. I felt that my birth team had worked really well together, and that I’d been cared for and supported. The whole experience was just so empowering.
4. Was there anything you wish you had known about before you went into your home birth experience?
I would have liked no vaginal exam. Or, at least not to have been told how many centimeters dilated I was. This took me into my “thinking head” and out or my “primal head,” so I started to panic. It took a few contractions and a lot of help from the birth team to get back into the birth zone and work with the contractions again. I also decided that if I birthed again, I would like to catch my own baby. I also would not like to be separated from the baby at all when moving to the bed/sofa for the clean-up operation afterwards. I also decided that next time I wouldn’t want my baby bathed or dressed at least for the first hour or so. Skin-to-skin is really important for the bonding process and not being separated helps get breastfeeding established in the first hour. We were only separated for five or ten minutes, and I was fortunate that breastfeeding happened smoothly regardless.
5. Have you recommended home birth to your friends or family members since your birth journey?
Absolutely, yes, but I’m aware that some women feel more comfortable in alternative settings, such as hospitals or in midwife-led units/homes. What works for me might not work for someone else. And it is a birthing mum’s peace of mind that is most important.
6. Do you think having a home birth has affected your relationship between you and your son (positively or negatively)?
Yes, positively. Because I had an empowering birth experience (and because breastfeeding happened easily afterwards as a result), I found that I was mothering him through breastfeeding until he was nearly three years old. Part of choosing to have a home birth was that I wanted him to experience a gentle loving entrance into this world; breastfeeding was a continuation of that connection between us in the womb. I wanted to teach him kindness and respect by striving to be kind and respectful myself. The home birth journey we had was gentle and respectful for the most part, and soon after I realized that breastfeeding him was not just about nutrition, but about loving, playing comforting and healing. Fighting for and choosing a home birth was the first step for me to really stand by something I believed in for the benefit of my child. It is only through experiencing pregnancy, birth and motherhood that I have stood up for myself and tried to be a better person. I hope that this has helped me love him and guide him better as a result.
7. If this was an option to you in the future, would you do it again?
Yes, and I have! We moved to Northern Ireland when Harry was nearly 2 years old. While you can give birth at home with community midwives here, I had so enjoyed knowing my birth team beforehand the first time around that I hoped to be able to do it privately and pick my birth team again. My community midwives weren’t trained in water birth so I would have had to have had a hospital midwife on call too. With seven or eight community midwives on the team, I wouldn’t have met them all and had no idea who would turn up on the day. Luckily a couple of months before I was due, private home birth became possible, as insurance became available and a local company began interviewing midwives. The joy of this service was that I had the same two midwives come to my home for all my prenatal checkups after 30 weeks’ gestation and for a few weeks post-partum, as well. I felt happy and supported in my choices. In effect, my daughter became the first private home birth in Northern Ireland and Ireland! She was also the first private water birth. I had no vaginal exams and no medication. I caught my own baby, skin- to-skin for at least three hours with no separation. There were no tears beyond a very slight graze, so no stitches again. This baby was nearly 2lb heavier at 9lb 5 oz, so it was even more empowering!