A Mother's Unplanned, Unassisted Homebirth VBAC in Pittsburgh, Pennsylvania by Jessica Thomas

I'll admit it, I read this and cried.  Big giant tears.   In this mother's own words, she tells us how she delivered her baby, at home, alone, with her doula and birth photographer on the other side of her locked apartment door.  Her birth story is captivating and Jessica does an amazing job of documenting the day as a photographer and supporting mom as a doula.  She even got to cut the cord.  The ultimate honor! 

Name: Jessica Thomas

Website: http://www.undermyheartbirth.com/

Facebook: https://www.facebook.com/undermyheart/

Instagram: @pittsburghdoula

Words by Momma

My birth story begins 3 years ago while pregnant with my first born (a daughter) when at 35 weeks, after a completely uneventful, straightforward and healthy pregnancy, we discovered my baby girl was in a Frank breech position. Following a consult with maternal-fetal-medicine (MFM), we ultimately decided against moving forward with an external cephalic version (ECV) and instead opted to wait and see if she would turn on her own. Unfortunately, as the weeks passed, baby girl remained snug inside, head up and bottom down. Not once did the option of a vaginal breech birth present itself and I was told the protocol was to schedule a cesarean section at 39 weeks. Although I hadn't made any specific plans for an intervention-free or non-medicated birth (my personal philosophy was a more "go-with-the-flow" approach), something deep inside me (call it a mother's intuition) told me labor was an important part of the birth process for me and for baby, even if it ended in a surgical delivery. 

Although maternal-fetal-medicine supported us in not doing the version and instead awaiting spontaneous labor, my regular OB was not supportive of our wishes threatened me to either schedule a cesarean or sign a waiver ("Against Medical Advice"). I left that appointment feeling bullied, powerless and unheard. Eventually, after push-back from my end along with the support from my MFM OB, my regular OB backed off and agreed to us awaiting labor as an acceptable alternative to scheduling a cesarean at 39 weeks’ gestation. 

At 40 weeks and 1 day I woke around 3 o’clock in the morning to a ping in my stomach that resembled a period cramp. I told my husband I thought I might be in labor but that he could keep sleeping since it would probably be awhile until we'd need to head out for the hospital. Around 6am I decided to call the hospital when my contractions were about 7.5 minutes apart. By the time we got checked into triage at 7:05am contractions were closer and a lot more intense. It had been about 4 hours since my first labor pain; after a cervical check, the attending OB shouted out, “she’s an 8!” From there, I was prepped swiftly for labor and delivery and although my OB told me she didn't have time to check me again, she said she suspected I was 9-10cm dilated. My beautiful daughter was born in a belly birth with Apgar scores of 9 and 9. She weighed 6 lbs., 3 oz., and measured 18.5 inches long. Surgery was respectful and straightforward; the OB explained to me what she was doing at every junction; she even told me as she sewed me up I was "the perfect candidate for a VBAC." I knew my body could birth a baby and I was already planning my VBAC in my head.

Skipping forward 9 months, I watched the movie "The Business of Being Born" for the first time. I was so moved by the film that it spurred me to search out more information about midwifery care and natural childbirth. The more I read and watched, the more and more I realized how little I actually knew about birth and maternity care in the United States. I was more determined than ever to attempt a vaginal birth when I fell pregnant again (which I did another 10 months down the road) and I knew I had to re-educate myself if I really had a fair shot at a trial of labor and a VBAC.

When I found out we were pregnant again in March 2016 my next big step was changing providers; I switched from the OB/Gyn practice I had been with while pregnant with my daughter to a midwife practice. As part of my care plan, I was required to meet with an OB from the midwives' consulting obstetrician group. I specifically scheduled a meeting with the head OB from that group who I had heard good things about and who I was told was very VBAC-friendly. Upon reviewing my health records, the first question he asked me was, "So, why didn't you have a vaginal breech birth the last time?" My jaw dropped. I couldn't believe he had asked me that since the topic never came up once as a possible option. I knew this time around I was with the right group of providers; a huge weight had been lifted from my shoulders and I felt I could finally start to enjoy my pregnancy.

From that point on, my pregnancy progressed much like my first (complication-free and uneventful). Starting around 14 weeks I began doing twice-weekly prenatal yoga to ensure better body balancing in hopes of giving baby the best chance of getting into an optimal position. Around 30 weeks I started seeing a chiropractor certified in the Webster technique for 1-2x weekly adjustments. Baby luckily got into a head-down position around 28 weeks and we never looked back. We also hired a doula/birth photographer. In the final weeks before my baby was to be born, I felt I was as prepared as I possibly could be for a trial of labor and knew every single person on board supported me and believed in me. Although I felt deep down in my core I was going to have a VBAC, I still came to peace with the possibility of having another cesarean section (I even created an amazing cesarean birth plan if we needed it). 

My "due date" of 11/24/16 came and passed along with the Thanksgiving holiday. We had family in town and everyone was excited and eager to meet our new addition to the family. I had been having increasing Braxton-Hicks contractions the couple of days surrounding the holiday, but nothing that took up a consistent pattern. Early morning on 11/27/16 I woke up around 3:30am with period-like cramps. I got up and decided to start timing to see if these were the real thing or just pre-labor. I woke my husband and told him I was going to the living room for a while to time them and I'd come wake him if it looked like they were turning into something more consistent. After timing contractions for about an hour, I texted my doula to let her know I was awake and contracting but that there was no distinct pattern. She suggested I have some water and lay down to see if they might go away. I took my doula's advice and eventually contractions dissipated around 6am and I was able to catch about 2.5 hours of sleep before getting up again to officially start the day.

I woke again around 8:30am on 11/27/16 and contractions picked back up soon after, although still spaced out and not very intense. I called my doula in the morning and gave her an update. We decided since they were still infrequent and mild to keep an eye on them to see if they would turn into something more consistent. Around 1pm my husband, daughter and I headed out for afternoon brunch. At around 2pm while at brunch, the contractions started to become more uncomfortable, coming about every 15-20 minutes. This is when I suspected it was the real thing. My doula called me while at brunch and I filled her in. Since contractions were still 15 minutes apart, we decided to stay in touch about progress. She suggested I go for a walk and see how they progressed from there. So, after brunch we gathered our daughter and decided to head to a nearby reservoir that also had a big play area and park. It was an absolutely picturesque fall afternoon; it was crisp and cool and the sun was shining. The multi colored leaves on the trees provided a beautiful fall back-drop to my labor. After we got parked and unloaded, we enjoyed a stroll and fed the ducks in the park. As contractions got more painful, I began to hang back a bit from my husband and daughter to work through them. From behind, I watched them playfully frolic in the afternoon sun as I labored. As we made our way for the play area in the park, the contractions began to intensify and started getting closer (about 13 minutes apart). As we approached the playground, I told my husband I was going to follow behind them so as not to cause concern for my daughter. As they came and went, I began my deep breathing, moaning, and movement to handle the intense sensations; I was squatting on park benches and leaning on park structures while swaying my hips from side-to-side. After arriving at the play area, I continued to explore on my own; I remember watching the colorful skyline and thinking that the energy I was feeling was helping to bring my baby into this world. Around this time, I felt as though I couldn't be in public any longer and needed to go home. I tracked down my husband at that point and told him we needed to go soon; I asked for the key and told him I'd be waiting for him and my daughter in the car. Once in the car, I texted my doula that we were heading home and that contractions were about 9-11 minutes apart. During the 15-20-minute wait for my family, I had to get out of the car to work through my contractions; I squatted and held onto the car's frame near the foot of the car and moaned deeply as they came and went.

On the way home I had several other intense contractions that required me to unbuckle my seatbelt in order to move through the surges. I knew this was the real thing and we were having a baby that day. As we approached our home, I told my husband that since my contractions were still rather far apart (about 10 minutes) we still had some time and so I wanted him to take my daughter out for a car ride to see if he could get her to nap before we left her with my cousin to head to the hospital. Once we pulled into our garage, my husband told me he needed to run up quickly to use the bathroom; in the 10-15" I waited in the car with my daughter, I had another strong contraction that required me to get out of the car. Once my husband got back to the car, I said goodbye to him and my daughter and told him I’d call him when it was time for him to come back home. As he headed out with my daughter I hurried up the stairs to get our final items together for the hospital. I also called my doula and told her contractions were about 7-8, minutes apart by that time but were very intense. She said most likely today was going to be the day and that I should start making the necessary calls to arrange for my daughter's care. She also said I should try to relax and use the last little bit of time before we left to reflect on my pregnancy journey. After I hung up, I plugged in our Christmas lights that hung across our living room windows; as I was about to put on some relaxing music. Then I had a monster contraction that shook me to my core; all of a sudden I felt a trickle of fluid and then a full gush; it was my water! Simultaneously, I felt a major shift inside of me – the baby was crowning and I was home...alone.

As the physical sensation overtook me, a moment of panic set in; I guided myself down to the living room floor into a side-lying position; I quickly spotted my cell phone on the couch and reached for it immediately. I dialed my doula to let her know my water had broken and the baby was coming. Sensing the panic and urgency in my voice, my doula told me she would be there in 5 minutes (luckily, she literally lives 5 minutes from me). I told her the front door to our apartment building was locked, but to ring every neighbor's bell and that someone had to be home who could let her in. As I laid on my side, my contractions started to space out. I reached my hand down and could feel the top of my baby's head; I could feel he had some hair and remembered that my daughter was also born with hair. There he was! Right there! I knew this VBAC was going to happen.

I then called my husband. Twice. But he didn't pick up. So then I called my cousin who was supposed to watch our daughter when we went to the hospital. She answered, and I immediately blurted out, "the baby's coming!" I also told her the baby was crowning and that I couldn't get a hold of my husband; she told me she was on the way before I hung up and tried calling my husband again (to no avail). In that moment, I realized I needed to calm down and pull myself together. I told myself someone would be there soon, but that it was likely I was going to have to deliver my baby on my own. I knew I needed to be focused for my baby and remember telling myself to breath, that I needed to be there for him. Then, I remembered the breathing exercises I had learned in my prenatal yoga classes. I found my calm and tried to take some good, deep, cleansing breaths. During this time, my cousin called me back and stayed on the phone with me as my body began to push. I remember my cousin trying to help me with words of encouragement while I started pushing, but she was understandably at a loss for words and just continued to listen from the other end of the phone. Then, all of a sudden, I heard a pounding on the door - it was my doula. The college-age girls that live across the hallway from us had let her in our building, but I had forgotten the door to our apartment was locked as well and my doula didn’t have a key! She shouted that the door was locked and that she needed me to let her in, but, at that point, there was no way I could physically stand up to let her in; the baby coming then and there and my body was pushing all on its own.

Locked out on the other side of the door, my doula continued to talk to me. When she realized I was bearing down, she told my neighbors to call 911 for an ambulance. At a certain point, I stopped registering the words she was speaking and completely focused in on the task at hand. It wasn't more than another push and my son's head came out. Almost simultaneously the rest of his slippery little body followed. Incredibly, in that moment I don’t remember feeling any pain but rather relief. As he slipped out and softly landed on the carpeted living room floor, he began to immediately cry; I remember being so incredibly amazed that he came out of me so quickly and easily; the second I saw him land softly on the carpet, I scooped him up and shouted to him, "I got you! I got you!” I brought him immediately to my chest, hugging him tightly since I didn't want to drop him (he was so wet and slippery!).

Then, it was as if my mind transported back from whatever far- off planet it had traveled to during the delivery, and I heard my doula ask me, whenever I could manage, to get up to unlock the door to let her in. After drying my feet, I quickly headed for the front door. In almost the same motion, I unlocked the door and headed back to the living room floor to lay down with my baby boy. My doula came in with the happiest glow on her face; she quickly helped guide me back down to the carpet and grabbed me 2 pillows from the sofa to help prop my head up. She also grabbed the throw blanket off the sofa and thoughtfully covered me up while doing a very quick check down below to make sure I wasn’t showing signs of excessive postpartum bleeding. After a quick glance over, she told me we both looked great and that the paramedics were on the way. She kept telling me how awesome I was, how proud she was of me, and what a rock star I was. She also assisted me with our first breastfeeding session, and the energy in the room was incredibly peaceful and serene. I felt an immense sense of calm and accomplishment that we both felt as we waited there for the paramedics. As we waited, my doula warned me that when the paramedics got there it could be a little crazy; luckily, though, when the paramedics arrived (about 10 minutes after the birth of my son) they were incredibly calm and professional (because both my doula and I were calm and everything was stable). The three older men looked me over to make sure I wasn’t showing any signs of hemorrhaging; luckily, other than the blood from the delivery, I wasn’t bleeding. They also looked at the baby and saw he was breathing great and was pink in color. One of them even commented that you never see babies look that good after birth.

When it came time to cut my son’s cord (all of his cord blood had transferred by that point), I asked the paramedic if my doula could cut the cord instead; he had no problem with letting her cut the cord, and she happily accepted the honor. After a few more moments, my husband arrived with my daughter in tow and my cousin arrived just a few minutes later. As I glanced up at my husband, I could see my daughter, fast asleep on his shoulder. Within a minute or two, my daughter awoke in a sort of fog; she was quiet but curious about the strangers in our home but did not appear scared or frightened. It was at that moment I especially appreciated the calm and professional demeanor of the first responders. Then, I could hear my husband ask my daughter if she wanted to see her brother; without hesitation, said, “Yeah!” She gave him a look over as the paramedics got my son buckled into his car seat and got me strapped onto the gurney.

As we arrived at the hospital, I was greeted with the same professionalism and calm from the ER team. After a quick look-over, my son was returned to my arms; I was congratulated and told he was beautiful and perfect before they took me to my labor and delivery room to deliver the placenta. Once in my room, the team began to transfer me to a bed from the gurney when, all of a sudden, I felt a dull but intense cramp that pushed out my placenta. Finally! The sense of relief was immense and I realized not only did I birth my son without drugs, but my placenta too!

Although I had not planned for an unassisted home VBAC, I felt I was as prepared mentally, emotionally, and physically as anyone could be for this kind of experience. I am in absolute awe of the female body and am certain all women have the same instinct and ability to birth their babies unhindered. The love and respectful care I received from the first responders, medical team, doula and family was priceless and I have never felt more, powerful, capable, transformed and healed as I have as a result of this birth. I hope, if anything, my experience shows other moms who are on their VBAC journey that their bodies are not broken and that we all have the intuition and strength to birth naturally.