Gently Borne Midwifery Home** Unassisted Homebirth - "You Already Know How" ** Should Midwives Assist Unassisted Homebirths? So, You want to be a Midwife?** Midwifery Education Links** Facts About Homebirth ** Teen Pregnancy My Favorite Midwife Apprentices - My Daughters! ** Consultations with Casey**Mothers Milk Soap!! My Unassisted Home birth by Casey Makela, 1998 The subject of unassisted home birth is being talked about now more than ever before. It is a topic that is represented as an important choice in the realm of birthing options. What is being discovered by those who are unfamiliar with the concept of unassisted birth, is that it is not a “new” phenomenon. It is just a subject that is experiencing its own “coming out”, being talked and written about by many of the women who chose it for themselves and their families. While there are as many different reasons for choosing to have an unassisted birth as there are families who make that decision, there are several universal factors that are outstanding in all of them. Personal responsibility, accountability and a deep need for family privacy. Though it may come as a surprise to some, I was one of those women who made that decision to birth at home without a birth attendant. In truth, my initial reasons were influenced more by the circumstances of unavailable midwifery or friendly doctor care, but the result was an awakening to a style of birthing that I found to be the most liberating and empowering of all of my births. My unassisted birth brought to the surface an inner awareness of my complete self in a way none of my other births compared to. It has only been in the last year or so that I have felt liberated enough to come forward and talk about my unassisted home birth. I’ve shied away from joining the discussion table with my own personal experience because of the public and private controversy it created 12 years ago when I made that choice. My story has waited a long time to be told and is precious to me, every word. My last birth was 12 years ago here in Michigan. It seems like only yesterday. Every detail is still vividly crystal clear. I am fortunate to have taken careful and detailed notes immediately before, (my own prenatal care), and after the birth to keep that memory alive. What made this birth so extra-special was that it was my only unassisted birth. It was a complicated birth as well but in the end, a birth I completed on my own using my primal instincts without any help, advice or coaching from a "care-giver". I wasn't confused by any ones perspective of what my body needed to do, I became introspective and in tune with what my body was doing. I didn't originally plan an unassisted birth. I had contacted a midwifery organization, that was relatively new in Michigan -- only a few years old, encouraged by the fact that it was a group of lay midwives who founded it. I thought they could connect me with a midwife in my area. Surely I couldn't be the only midwife up here! But alas, there were no practicing midwives in northern Michigan, at least not on the east side of the state and there was no one that would make the journey here to attend my birth. I was down at first. My only other choice was to birth at a military hospital facility. There were no private doctors in our area (or within a couple of hours) accepting new clients. I carefully contemplated my situation. At first I was frustrated, then scared. Then I thought, "Well, I do have one other alternative. I can do this myself.” I discussed this option with my husband who was realistically nervous about the prospect of birthing without an assistant. He was unsure about the "what ifs" not to mention the fact that my births were always long and very painful; I don't do well with pain. I did not push the idea; I really didn't have to. We were always good at talking things out and he was very sympathetic about our pending birthing dilemma. The birth of our last child (my Marion) had been at home with wonderful british midwives but my husband was not with me for that one and despite the midwife assistance, I'd felt pretty much alone then too. My other daughters had attended Marion's birth and I wanted them with me again this time. But we knew that our family would be completely isolated from one another if this birth took place at the military hospital. So, I made a few more calls to the state midwifery organization and Doctors offices to make sure I had thoroughly checked out all options, but the choice was becoming clear. If I wanted to birth at home with my family, I would have to do it myself. There were apparently no other midwives up here but me. We began to lay our plans. We faced one large obstacle right away. My due date was July 30th and my husband had to make a trip to New England leaving on Saturday the 26th, returning late Monday the 28th. This put my nerves right on edge. Not only was I without a doctor or a midwife, I was going to be part of a game of chance as to whether I would be without my husband too! I finally resigned myself to taking all things in stride. What ever would happen would simply be dealt with in its own time. Maybe the baby would come before then. As the pregnancy progressed, I reviewed many basic birth concepts and principals with my husband nearly every evening. I wanted him to be very aware of all of the aspects of a normal birth from a more attentive perspective. We often sat up late studying together and hashing out those "what ifs". We created a nice, workable birthing room and even had all of my equipment including oxygen tank. During my last trimester, I kept track of my vitals to establish a postpartum record. Frankly, I felt great! However, I begin to gain a considerable amount of weight...fast. But, I also had to be personally accountable for the free license I was taking with my diet and the romance I was courting with my refrigerator! I knew better but my cravings counter balanced all good sense and I plowed ahead “fork-in-mouth” so to speak. I won't divulge my starting weight for this pregnancy...no one would believe it...suffice it to say I was a size 12 having birthed Marion only the year before, but I will admit that I weighed 225 pounds on the day I birthed this child. We had also hired a woman, Raylynn, to come care for my other 4 children on the day I went into labor. She was to keep them occupied and entertained and be available to run any errands that needed to be done. She was nervous about being at a home birth but agreed to take the job. Raylynn wasn't a Doula or any sort of childbirth/health professional, just a family helper so my husband could be with me. But, would he be there after all? When my husband left on Saturday my heart was resigned to the fact he would probably not make it home on time for this birth. My Braxton -Hicks were impossible to ignore and I had heavy mucus discharge the whole day before. But I kept it to myself, he had enough on his mind with his commitment that could not be avoided. After he left early in the a.m., I put myself to bed with a nice glass of wine and took it easy for the whole day. My daughters were wonderful little "mothers helpers". We read stories together and played games. For fun, we ate cereal for supper (an easy just pour milk sort of thing) and watched movies until bedtime. The next day my bowels became loose and again I spent a lot of quiet time lying down. I took a mildly warm bath and visualized and meditated on not going into labor until my husband returned home. My girls and I spent time outside in the sunshine talking about their new little sister who was about to come out, it would surely be another girl...we had come to accept the fact that boys were not our specialty! Wine and meditation became important relaxation tools for me. I tend to be a very high energy person and it takes a lot to tone me down. As a matter of fact, I have an extremely high tolerance to pain medications or anesthesia. It takes a lot to do the job!! By Monday night, I couldn't ignore the fact any longer that labor had started. I retired early to doze as much as I could. Finally my husband returned home late that night and I could relax in his arms and worry no more about his safety or my being alone. Tuesday morning we just took it easy. Contraception were regular. We decided to watch a movie and I laid down on the couch only to surrender soon after to the fact that I needed to go to our birthing room because I wasn't able to effectively ignore the pain any longer and I didn't want to scare the girls. It was mid-morning. We called Raylynn and she arrived and took over mothering my children for me. By early afternoon, my older daughters would come upstairs and peek in on me periodically and ask if I was OK. I told them yes, and assured them not to worry no matter what I "sounded" like. Do the childbirth books describe labor contractions as "intense", "rushes", "strong" or "sometimes overwhelming"? Right. They hurt. That is my description and analysis. OOww. Pain. Period. When my water finally broke, it became impossible to get comfortable. I paced, sat on the commode and tried to lie down. But there was no one place that was satisfying. The contractions were really painful, in my back, down my legs and generally a lot of no fun. I tried hard to work with each one but couldn't always stay on top of them. So, I gave in and vocalized when I couldn't tolerate the pain any longer. This helped me, but didn't comfort my husband any! When the pressure in my lower back and bowels became overwhelming I knew it was time to push a little. I started with forceful blowing. I didn't want to blast the baby out, I wanted to ease her out. I sat up and worked on bringing her down. The pain had started to erode my confidence. Yet, once the head became visible, I felt more confident and sure of myself. But something was wrong. The awareness that something wasn’t right dawned slowly and became steadily more clear from deep inside my mind. I could actually feel the realization of danger manifest itself, almost cloaking me. With each push, my baby's head would come down a little and then recede back. I could not see it and couldn't exactly understand the feeling until my husband told me after several pushes what was occurring. I quickly changed positions to squat and rock a little. That helped. The baby's decent was more progressive. I had to work really hard and stay focused. "It hurts." That was the constant reoccurring truth I could not escape and could barely cope with. After a while, I sought the comfort of changing positions and reclining back again. With a few more steady pushes her head crowned and I reached down to feel hair, warm wet gooey hair. I knew it was almost over and I felt relief wash over me. But it was a treacherously deceptive comfort zone. As the seconds passed (I had a clock within easy viewing), my husband alerted me that the baby's head was not rotating, not at all. He had wiped the face clean but then he asked if dark, dusky blue/black was an "OK skin color". I readjusted my position and attempted a push without a contraction. Then I felt a dull but distinct pressure pain in the arch of my pubic bone and I knew suddenly with a piercing jolt that my child's life was in serious jeopardy. My baby was stuck solid and I couldn't move her. I knew it and it made me cold with fear. In broken gasps I asked my husband to check for the cord and finding it around the baby’s neck, I told him to loop it over. He did. There are moments in life when adversity stares you in the face like a hangman daring you to overcome, all the while taunting and mocking your own inadequacies. For a fraction of an instant I felt crippling despair for that which there was no solution for. There was no one to help me or tell me what to do. There was no answer to the question "How"? I was going to lose my child and be condemned with guilt. I would fail to do the one thing my body was built best to do, right in front of my daughters and husband. My husband broke through my paralyzing haze in the next instant by calling time (how much time had passed since the head had crowned). Reality struck me hard in the face as a contraction built up. I concentrated with all of my might and commanded myself to do this impossible thing. This was my birth, my baby and my body and I would make this happen RIGHT NOWWW!!! I became instinctual. I opened my legs as wide as I could and braced my feet into the mattress. Then I reached over and behind my head and gripped the back board of the bed. Pulling on the back board, I hoisted my butt up off the bed, arched my back, rotated my hips in the air and pushed with all of the power any one woman can command from heaven and earth. I caught another breath, kept the movement of elevated hip rotation constant with the pressure of bearing down. I was not going to lose this child without a fight. The pain that always invaded my births dulled as I lost my temper and roared loudly through the pushes that brought to birth my child. Finally, I literally felt the release of her shoulder pressure from under my pubic bone as my child gushed forth into freedom. The cord had been wrapped twice around the baby’s neck, my husband had only been able to unwrap it once. I brought my baby to me sobbing and kissed her head over and over again. My husband quickly covered her and knelt down by the bed to share my tears as our child squalled in protest over the tumultuous journey. I was dizzy with relief and gratitude that my sweet baby was now safely in my arms. Our daughters had been there throughout the birth. What a sight I must have been to them with my big butt grinding in the air!!! Suddenly one of them said, "Mama, are those testicles?" Jarred back into their presence I tried to comprehend. "What"? Again she asked "Dad, aren't those testicles? Isn't that what they look like?" My husband and I just stared dumbly at each other as our new daughter continued to clear her lungs with gusto. Somehow, gaining presence of mind, he got up and pulled the blanket aside to see what the girls were seeing. His face went blank for a moment. Then, he burst out almost with disbelief, gaining momentum with each affirming exclamation as though talking to himself alone, "They are. They are? Why they sure are. You bet! Those are testicles! Oh my God, I have a SON! A SON, I HAVE A SON!!!!!" He got right in the baby’s face and whispered to him "You're a boy" with a slight tone of disbelief and amazement still lingering in his voice. Then he popped up and looked at me and said, "Honey, I'll be right back". Still on the verge of hysterics myself over what I'd just been through I nodded blandly. Less than a minute passed before he burst back into the room with wonder of wonders, (who can know the mind of a man?), a baseball mitt fitted onto his unwashed birth stained hand. He approached the bed and the baby with the same deep reverence of a priest mounting the altar. He then knelt down and got right into the face of his boy and said, "Son, this is a baseball mitt.” Tears rolled down his face as he had his first heart to heart, man to man conversation with his son, "I'm going to teach you and you and I are going to play baseball together someday." As much as I hated to, after few minutes I reminded my man that not only wasn't the birth over just yet but he really should consider at least cutting the cord before making any further plans for the Big Leagues. First things first! John James Glenn was born July 29, 1986. He weighed 9 pounds and 10 ounces. I named him after the important men in his background, thus he has 2 middle names. He was a hale and hearty baby that has been the son of our dreams. A wonderful child now growing into a wonderful and distinguished young man with a heart as good as gold! (On the right he is holding "Mr. Pibb"!) Casey & her son John in NY in 2003 I have been critically called to account for that birth many times by family, friends and even midwives. Eventually, I found it easier not to talk about it anymore because the criticism felt like a violation. But now it is time to talk because it is worth talking about. It is and will remain a life accomplishment I never want to forget. I would do it again. The experience left me a better mother, midwife and woman. Over the years, many people have asked me if I really thought my choice to have an unassisted home birth was a good one. I can only ever answer "Good for who?" Good for me? Yes. My births all left me buzzing with accomplishment an inner strength for days afterward and my unassisted home birth was the best one of all. Good for my family? They all have said yes many times over. Good for my son? Well, his journey was a bit rough and tumble but he was enveloped into the deep love of his family right away. The only thing that further tested the endurance of this boy on his birth day was when his overly anxious and happy father gave him a bath after the cord was cut. My husband's excitement caused him to completely miss the fact that his son’s protests could probably have been quieted more effectively if the water temperature was just a few degrees warmer! But, all things otherwise were just blissful, truly. I guess it comes down to this for me. I live my ideals. I could never be a midwife and home birth/natural birth advocate today if I hadn't done it myself when it was my turn to birth. I live out those things that I really, really believe in. Birth has never been easy for me. It hurts a lot every single time. The relaxation techniques I learned about 20 years ago, and even taught before I birthed my own children, were full of bunk. The pain was not controllable with relaxation, concentration and loose lips. It hurt. Period. To live up to my birthing potential challenged me to go beyond myself, to be more than I thought I could be. I learned through all of my own birth experiences that babies don't always just serenely slide out. For some women, birth takes them to the extreme limit of sanity and they have to make their own way individually each and every time. To imply that women who literally suffer birth are in any way lacking in courage or self-control is to belittle their individuality and their birth accomplishment. As a midwife, I can't count the number of women who have apologized later for what they felt was a loss of composure during labor. So many of them read some glowing and flowering generalization of what birth is (or should be)like and how to "effectively deal with it" that they feel like they "flunked" the event somehow when the reality proved to be an entirely different story. It is sad to hear things like that from birthing women. I spend a lot of time redefining inaccurate preconceptions and working women into a place of acceptance for their individuality. Even though I spend a great deal of time educating women before their birth experiences, misconceptions are still hard to overcome especially because they are sold as popular ideas in books and magazines. I think the solution is simply this: more daughters should be involved with their mother, sisters and aunts birth experiences. Women need primal education!! I actually feel fortunate for my extreme birth experiences and what I had to go through to get my babies out. My births were never picture perfect and I never stayed angelic! Man, do I hate how it hurts!!! But I gained an enormous advantage because of it. Those experiences gave me my most effective tool as a midwife; empathy. Throughout my midwifery years, I have attended births with women who really had to rock and roll to get their babies out and I'm right with them encouraging them to surrender to the moment and do whatever it takes. It liberalizes the birth event for them because they don't feel bound to live up to any sort of pre-fab ideal. We can't all be birth-bed beauties serenely visualizing, breathing with stop watch accuracy and moaning in “loose, low tones” until, "oops, the baby popped out." Birth is an individual experience and expression of self. Midwives and attendants should support it that way. I refused to allow Hollywood or male interpretation/intervention make my birth bed insecure. And, I could never have stood in line for today's popular rescue remedy, the almighty epidural. I refuse to be intimidated into a "modern" birth experience where women can birth with less untidiness to themselves and less inconvenience to institutional staff than ever before in history. I’ve always considered unnecessary, misrepresented intervention to be a sad and shameful bill of goods. But, that was my choice to make for me and I will always be proud of my choices. I know birth as the ultimate empowerment. A place unique to me as a women. It fulfilled my sanctity of being. I am just glad I gave myself the chance to make it work and didn't let anyone convince me to do anything less! I wrote this because it is important for my daughters to remember and for my son to know; it’s a valuable part of our family history and their personal legacy. Perhaps it will help my children understand themselves better someday. I also wrote this to add my story to the discussion table of birthing options. Families who elect to have an unassisted home birth deserve to be respected. Caesy Makela, 1998 Gently Borne Home Page Member of American College of Traditional Midwives Michigan Midwives Association Director of Michigan School of Traditional Midwifery My Natural Soap Site - Killmaster Soapworks Natural Soap Company Mother Time Belly Masking