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Birth Around the World: A Tale of Two Births in Canada

Joanne is a software engineer in Ontario, Canada. Her first child was born in 2007 at Kitchener Ontario's Grand River Hospital, which sees about 4,000 births per year. She chose a midwife-attended homebirth in 2010. This post is lengthy, but it’s really two birth stories in one! It shows two contrasting styles of maternity care available in present-day Canada.

When I became pregnant with my first child in 2007, I had no reasons to distrust the latest technology and knowledge of the Western medical establishment. My family doctor referred me to an obstetrician, who are in short supply

in my area, so I “got who I got.” My pregnancy was highly normal and my care was fine (sparse but sufficient) up until the time my due date came and passed, and I waited... waited... waited to go into labour. My OB scheduled me for an induction at +10 days (a Friday--coincidence?) without discussion. I was worried about how I’d be able to handle an induced labour and thus mentally felt increasingly desperate as the fateful day approached.

The night before, I awoke with increasingly strong and regular contractions which I was pretty sure was finally it. When I arrived at hospital the next morning on schedule, the nurses confirmed I was 4 cm dilated and cleared me for continuing since I was in labour already. At noon my OB showed up and was quite annoyed with the nurses (and me) for not following his induction orders.

"We've got to get this baby out now."

"Why?"

"Because it's been long enough."

"I'm concerned about the pain with Pitocin contractions."

"It's called LABOUR for a reason; it's going to be painful. Look, you don't have to do it but I highly recommend it."

Seeing as I was contracting strongly, in pain, I wasn't expecting this, and I didn't have experience going against my primary care provider, I reluctantly agreed to let him break my water and start the Pitocin drip. Of course then I required continuous fetal monitoring, which made every little movement quite an event. The contractions quickly grew stronger, stronger, and more painful. I lasted another 4 hours and with such pain, the tension in my body hadn't actually let me progress past 4 cm. Discouraged, I agreed to an epidural. Admittedly it was a tremendous relief and I wanted to hug the anesthesiologist. Now that I could relax some, I actually progressed to 10 cm in a couple of hours. I also found out something I didn't know about epidurals--i.e. they don't provide total pain relief, at least not for me. Much of the time I could feel most of one side of my body, and the nurse would regularly have to call for permission to top it up.

Naturally I was confined to the bed, so I couldn't move around to deal with the pain. So pushing HURT. I was a good pusher and the baby descended steadily. At some point, the head nurse came in to say "she's got to stop pushing." It turns out (since it was now Friday evening) there was only one OB on the floor and she was busy performing an emergency C-section. And of course, my baby couldn't be born without a doc present. So they turned the Pitocin and lights off and rolled me on my side. What utter agony--I thought my body was going to push out the baby whether we were ready or not!!

There was some meconium in the fluid by this point (likely from the stress) although we could "hear" on the fetal monitor that baby's heartbeat was still reacting well. I was whimpering and at this point my partner secretly believed I was headed for a C-section too. He whispered to me "think of the other family" and I tried to. But eventually the OB and staff appeared, and another 2 pushes, and Alice was out. What relief--I simply cried tears of joy and relief.

The pediatrics team pumped the meconium out of baby’s stomach and luckily she was fine to stay in the room with me. So, in the end, despite all the "help" from the medical establishment, my body did what it was supposed to and I pushed my baby out. Looking back now, I realize I was probably lucky: this combination of Pitocin, epidural, and baby-stress can doom many a woman to an unwanted C-section.

I learned a few more things. I bled heavily after this birth and became anemic.... I learned later this can be a side effect of all the interventions. My tear/episiotomy site became infected, and I can’t rule out the possibility that the cause was from being in a hospital. But: my birth went well, didn't it? I had a healthy 8 lb. 10 oz. baby, delivered vaginally, no NICU visit, and all the nurses were really nice and helpful with breastfeeding. So, I should be satisfied, right? Right?? I had myself convinced for a while.

When I became pregnant with my second child I knew I wanted to try something different for care, so I called a local office of registered midwives. At first, I assumed I would go to the hospital again for delivery because that was just what people did. After processing some of the materials in the lending library, to our surprise, my partner and I independently came to the conclusion that we wanted to try a homebirth. Some of the stories about actively-managed labour with OBs in a hospital setting were simply eye-opening--this is exactly what had happened to us!! I don't know if we would have believed them had we not gone through the experience, but we had. So all of a sudden we were committed to a different kind of birth.

homebirth by reading what natural childbirth subjectively feels like. All these stories, including Rixa’s own birth stories, helped me overcome the knowledge deficit and gain confidence in my body's own ability to give birth naturally. I drank these up in my quest to "reverse" society's notion that childbirth is necessarily a medical event to be managed medically.

So, my second due date came and went with no baby in sight. Even with a midwife supportive of natural birth at home, her guidelines dictate repeated non-stress tests and ultrasounds to check on an overdue baby, as well as a "plan" for what would happen should two weeks past due date come and go. I was starting to feel increasingly desperate again as I saw my dream for a simple homebirth, at risk.

But, eventually at +10 days (again) those pesky prodromal labour contractions finally (finally!) became strong and regular enough to push out my baby. I laboured quietly at night in my bed from 2:00-6:00 a.m. which was nice actually--I could relax sleepily between contractions, which I knew was important for dilation. It was just so great knowing I didn't have to deal with going anywhere. By 6:00 am contractions were too difficult to lay through so I woke up my partner and told him it was time to call our midwife. She took her time getting ready and arrived at 8:30 am to find me 6-7 cm dilated ("and your body did it all on its own," she encouraged me). I was anxiously awaiting her arrival so I could get in the bath tub, post cervix check, for a change of pace.

I laboured alone as the others got the bed ready and brought in all the midwife's equipment. I got on all fours for each contraction (couldn't have done that in the hospital!) and actually found a semi-sitting position that was comfortable for relaxing in between. (I found that was key for me in both labours--I felt a lot of pain in between contractions if I couldn't find a good resting position, and those were elusive.)

I was off in labourland when Nicole came rushing in with "do you feel like you need to push?" Apparently my vocalizations had changed to what they often sound like when the baby is descending during second stage. It was all involuntary, which was awesome--my body was doing it all and I was just along for the ride!! My water spontaneously broke with thankfully only a bit of vernix to see. After 2-3 pushes on my hands and knees (still in the tub--not my midwife's idea of a convenient position but I wasn't willing to move anywhere!), Claire was born, nuchal hand and all. Finally I understood what I had read about it being a relief to push--on my hands and knees, it did feel better to push, almost like applying counterpressure to the contraction. (This was a definite contrast from being confined on my back in the hospital.) I didn't feel a ring of fire or any tearing, although I did receive a second-degree tear again. In fact, comparing the two births, I would say the pain levels were similar, although the first one was with an epidural and the second was obviously much shorter in duration.

It was 9:30 a.m. by this point--all the birthing and emergency equipment was barely in from the car and the backup midwives hadn't even had time to arrive yet. The tub had had to be drained (since it wasn't deep enough for a water birth, unplanned anyway) so I knelt on the floor of the empty wet tub, clutching my slippery newborn. I couldn't believe it had really happened!! A birth at home, just the way we had planned. I cut the cord myself.

Out of the tub and back to the bed for the delivery of the placenta, stitches, and initiating breastfeeding. Another healthy girl, 8 lbs 11 oz. So THAT is what birth is supposed to be like! What a privilege to have been able to experience a safe, natural childbirth at home. This is an experience I would wish for more women. It was so perfect and meaningful and to this day it’s still hard to believe it actually happened all the way we planned!! It was an empowering achievement in the way that my first birth, amazing in its own way since it was my first, just wasn't.

So yes, I join the ranks of moms who had one undesirable hospital birth experience and, as a result, experienced a beautiful homebirth subsequently. 2-5+ years ago, I would have never believed I’d be one of these women!! I try to not be judgmental of other people's birth choices, but now I encourage others to at least call a midwife early in their pregnancy to give themselves some birth choices. I remember my grad school supervisor telling me that if you knew at the beginning what you had learned by the end, it wouldn’t have been a learning and growing journey.... It’s not an end by any means, but the beginning to parenting my two girls!

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