Meditation, procrastination, a hot cup of coffee: the birth of my third child

<The background on why we went to hospital instead of another home birth>

For me, the key to labor, much like – spoiler alert – the key to early parenting, is to take each minute at a time. That is probably my number one piece of unsolicited advice to all procreational people.

So I had assumed that last Friday and Saturday, in my 39th week of pregnancy, would be a lovely time as any to give birth since I’ve managed to do just that during the weekends of my last two 39th weeks. And I actually felt like things were moving, all throughout those two days – even though it would stop, and I’d sigh, and consider how frustrating it would be to have to face my obgyn for a post-term check.

By Saturday night nothing was doing so I waved my huz and potential babysitter brother goodbye as they left for drop-off at the train station. And not 15 minutes later, as Murphy would have it, I realized… oh. I called them back, we ate a pizza, I took a shower and figured I’d attempt a nap since I probably had a few hours.

Except I didn’t have a few hours, because after the shower it got quick. And my gut told me we should go before the contractions got worse – the horrendous car ride is one very clear memory I had of my first birth in a hospital. We gathered our stuff and headed to the car.

One thing I had prepared differently, in anticipation of a hectic hospital birth, was meditation material. A week or so before labor, I had expressed my concern and received advice related to hypnobirthing and mindful birthing. I read a lot about both and practiced my own little exercise, mainly breathing and clearing my mind, based on a color meditation I found online. So when we got in the car with a 20+ minute ride ahead of us and contractions 5 minutes apart, I took out the earphones and started “breathing in the color red.”

It helped. I wouldn’t say it was easy (extra pain radiating down your thighs because you’re sitting upright instead of moving, anyone?), but I felt focused and the pain was managed as we made our way down the windy Jerusalem hills.

As soon as we parked, I jumped out the car to be able to stand for the next one. And the next one, and next one on the way to elevator. We ran into a midwife coming back from a coffee run so she took us into the maternity reception area.

“How are you feeling?” they always ask you. I guess I didn’t seem that bad; I answered her. Next thing I know she’s looking up at me wide-eyed.

“You’re 9.5!”

First I heard 6.5 and then I heard… “What?!”

“You’re 9.5. Let’s go.”

So about 2.5+ hours after I called the huz back home, the two of us plus midwife were stunned as we rolled me into a labor room, seconds from pushing.

Yeah, too late for walking, so I was laying on a bed being wheeled into the next room. On the way out, another midwife called to us to stop.

“You forgot your coffee!”

My midwife called back that she couldn’t really take it right now. The very concerned coffee-holding midwife brought it over and looked from her colleague to my husband, who were both steering the bed.

Then she did something – that even then, in that moment, in my head, I was already laughing about – she looked at me.

And handed me a size-large, steaming, fresh cup of Hillel coffee.

And lord bless me, I’ve been here over nine years, and my first thought was: Only in Israel.

So I’m carrying my midwife’s coffee on the way to the labor room, distracted by a new meditation of ‘don’t start a contraction – don’t start a contraction…’ Maybe there’s a new childbirth method in this somewhere.

We get in and I shove the coffee back at the (now very decaffeinated) midwife as we begin the end.

Another midwife started fumbling to get the IV inside me – remember I needed antibiotics at least an hour before birth? – and cranked it on high drip.

Whatever it was, it wasn’t enough. They said I did get the whole unit. They said it might have been for a total of five minutes.

Whatever it was, minutes later, after a total of 3 hours in active labor, I gave birth to our daughter.

Just under 3 kilo, and 3 for 3 with a head full of dark black hair. Bless the midwife, who knew my deal, she put my newborn straight on my stomach, I wrapped my hands around her, and we locked eyes.

As the rest of the room whirred around to record details and whip out paperwork we hadn’t had time to deal with before (my bra hadn’t even been unhooked for feeding!), huz and I could not get over how quick it was. From when we left the house to when we met our daughter, in under an hour and a half.

In a way, each time I’ve done this, I’ve became more and more in awe of my body. In a way, you’re attached to it, and in another way, you’re two separate entities. Most of the time I think we hang back and watch it move, walk, talk… while we’re actually up here; thinking, feeling, being.

And then when it matters most, when everything else is brushed aside in the urgency of the moment, you are your body, and that’s how you know you’re made from something amazing.

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Where was your daughter born?

So while initially, after giving birth to my daughter, I was asked very often ‘where did you give birth?’ that question has definitely waned in the last 15 months. It just becomes the sort of question doctors ask you at initial check ups, I guess.

And so, oddly, despite everything, I kinda forgot where my daughter was born.

And then today, I was in Hadassah for a pediatric ultrasound (for… daughter, not me). The receptionist asked a bunch of questions for the computer.

What’s her name?

Your name?

Father’s name?

(You kept your last name?)

Your phone numbers.

Address?

And where was she born?

I puzzled at the question. I must have looked ridiculous. Are you her mother, ma’am? You don’t even have the same last name and now you don’t know where she was born?

And yet. The answer… I dug in there… no, it wasn’t at Hadassah, like her brother. It was…

“.בבית”

And as I said it… I felt compelled to look down… brace for impact… supplement it with a “in Tzur Hadassah,” as if having Hadassah in the answer might make it more acceptable to this woman.

But actually, she was pleasantly encouraging. Good for you! That must have been great! Was it a positive experience? Did you have a midwife?

Huh. So it’s all coming back to me now. That’s where my daughter was born.

New Israeli homebirth restrictions drafted (where’s midwife trust?)

From Haaretz:

Israel ministry drafts new rules to restrict home births
A woman planning to give birth at home will have to obtain a letter from her family doctor testifying that she is both physically and mentally sound, under new regulations being drafted by the Health Ministry that many believe are aimed at curtailing home births.

The letter would have to be submitted to the midwife or doctor attending the birth before the home birth can take place.

The thing is, I could be ok with some of this if it wasn’t such a clear witch hunt against midwives. If midwives had more of the benefits they deserve, if homebirthers got similar benefits, if the balance was more even – do what helps make it a safe homebirth while offering it as a totally doable option – that’s something to get on board with.

This seems pretty aggressive though. Maybe it’s not. No midwife should do a birth if it’s more than 30 minutes from a hospital anyway. A midwife’s license should include more rights, even if it means making it harder to become one (meaning, higher quality midwives). Does a doctor need to be involved in this? There should be more trust and support for midwives instead of paralyzing them further.

My home birth story: Israel, Tzur Hadassah, apartment, bedroom.

In the months leading up to labor and childbirth, I think we all spend significant time organizing our expectations, fears and hopes.

For this birth, my expectation was it would be at least slightly easier than last time, my fear was that it could become complicated due to complications from last time, and my hope – that I would deliver my baby at home.

I’m still in shock that this birth went so smoothly… That my expectations turned out to be low, my fears unrealized and my hopes – reality.

Dealing with stigma

There’s a lot of stigma around home birth. That’s actually an understatement, of course. Which is why for almost the entire nine months, I told not a soul that we were planning it, save for a friend who did it herself and recommended her midwife to me last time (when I contemplated a home birth).

Since my first birth, it was something I wanted to do. I didn’t want my time spent arguing about it, defending my choices or getting annoyed by people who would object. I totally understand that it’s not to everyone’s taste, and something not everyone agrees about – and I would never judge someone for not doing it themselves. But there was no way I was going an entire pregnancy having to hear from other people. So I kept it hush (which I recommend to anyone who thinks they’d be in the same position).

There are tons of articles and blog posts dedicated to explaining how home birth is as safe – if not safer – for healthy women with normal pregnancies. So I don’t have to go into all that here. We fit the criteria for home birth – and yes, there are criteria. Proximity to Ein Kerem hospital (20 minutes), weight of the baby (over 2.5 kilo), health of the mother (no diabetes, etc), week of pregnancy (over 37), etc. And then there is a list of events that could happen at the start of a home birth that are an automatic transfer to the hospital. Trust in your midwife – and her confidence – are key to feeling good about it from the start.

Why home birth?

It pretty much comes down to two reasons: flexibility and after care.

For my first birth, I labored at home as long as I could before transferring to the hospital. It slowed things down. Being in the hospital seriously limited my freedom, though I will say I was grateful to have access to a strong shower for my pain management. When it came to the last period of labor and pushing, being stuck on my back (and monitored) was a major factor in the physical damage done, which is unfortunate as I was not in a high risk situation. It also ranged from disconcerting to frightening to be surrounded by so many people in such a small space. There were a lot of directions given and voices heard and it’s a time when you need to hear your gut clearer than anyone else’s.

The aftercare at the hospital was disappointing for me. No one checked me thoroughly before I left, and I was in for a shock for the next two weeks as to how to heal. Most of the time there was spent making me nervous and insane over my baby eating every 2 hours. It was a frazzled experience on top of the natural hecticness a first birth provides. The time I was alone was depressing and scary. Feeling like a sick patient was also depressing and scary.

Hadassah Ein Kerem tries really hard to promote as natural and positive a birth as possible – it wasn’t all bad. There were warm nurses and cold ones. Friendly midwives and serious ones. Look, it’s an institution and it has to run on efficiency. I definitely get it. But if I don’t have to get it, why make myself?

So this time, I was determined to be in as much control as I could. I spent the months leading up to this birth arming myself with confidence, an amazing midwife, and the drive to make it happen. And of course, a tiny bit of cautious expectation that it may not happen in the end.

How it went down

If this had been my first birth, the story would have gone very differently. Perhaps it would even be told over a sleepless 36 hours… The fact is, my active labor this time was relatively quick, partly due to ‘laboring’ in advance for a few weeks with a couple false starts. I’ll take 10 hours over 36 any day.

The timing couldn’t have been more perfect – it started on Friday morning when I woke up after 6, and baby girl was born at 16:38, about two hours before Shabbat. Those two hours meant we could quickly contact my family overseas, while not having enough time to let people in Israel know – which meant we spent most of that Shabbat in a tight little family cocoon in our own home, the four of us, getting to know each other in our new family structure.

Now, to get down to the ‘dirty’ details. I’m not going to get into anything spiritual or enlightening about mother earth and the spirit of the birthing room and planting placentas. It’s not who I am. But I will say: the major difference between doing this in the hospital and doing it at home is mother’s comfort, security and flexibility to sit, stand, move, groan, do whatever she needs to do to get baby out in the smoothest, quickest, most natural way possible.

And that’s exactly what I did. And the truth is, I employed the same two tactics I used at the hospital – mostly standing and leaning on the bed during contractions or letting hot water numb my lower back in the shower when it got bad.

The hardest parts went by quickly; another thing that made it smoother was that I was able to move along without interruptions – no bumpy, windy, drive to the hospital. No wait at the reception for transfer to a room. No sitting around waiting for the IV to finish. No tap on the shoulder to get back on the bed for fetal monitoring. No ‘requesting’ that I stay on it just another 20 minutes. Just another half hour. No walking in to check on dilation and note the time and how long it’s been.

At home, it just kept going. It was a train that wasn’t stopping. And that wasn’t scary. It was going fast but it wasn’t bumpy. I was the force moving my baby into the world. There were no hills. When the midwife felt it was necessary, she checked the baby’s heart with a Doppler device for a quick few seconds. Maybe it was a total of four times in the three hours of active labor and birth.

Another thing about the home birth atmosphere: there were just three people in the room – my midwife, my husband, and myself. It was quiet and I trusted every person there; no one was a stranger. No cold hands. No foreign voices.

In the hospital, I was attended by a midwife, her student, and at times, an OB-GYN employed to scare me into moving faster. That, along with my midwife-doula and husband. Try navigating a complicated physiological process for the first time with that many people watching you and barking commands.

It affects the effectiveness of what I call ‘animal mode.’ There was a point for me, both times, where it’s just me and my body. My mind had submitted, save for the little bit left to process what people around me were doing and saying. But other than that, mind caves to body’s physical power and innate knowledge of what to do. In the hospital, when I went into animal mode, I was a scared animal – frightened by threats, intimated by people standing over me. At home, I was a strong animal. Aware amongst the quiet. Able to hear myself be. Able to process what directions the midwife confidently passed to me. There was no confusion. There was only a leads to b leads to c. That’s the kind of natural spirit we are born with to make this happen. And it’s that natural spirit that gets squashed in so many life situations.

And that’s what made it amazing. By choosing to do this at home, me and my partner gave my mind and my body the confidence and the power to do it the way I was born to do it.

Post birth

It all happened so much faster than any of us – me, husband or midwife – had imagined. The doula didn’t even have enough time to get there before baby was born. So when baby was out, on my chest, all we could really think about it was: Whoa. This happened?!

But reality actually set in pretty fast; the adrenaline-riddled shock of newborn on your chest wears off quickly the second time. I held her there and a million thoughts went through my mind, ranging from amazement to stitching to Shabbat to family back in the States.

Meanwhile, the midwife worked on the rest of birth that we tend to forget about: last contractions, placenta, uterus, stitching, blood, clean up – you know, the stuff left out of the fantasies. Midwives are meant to stick around for another couple hours to take care of mom, check out baby, make sure baby feeds, clean up the room and fill out the paperwork.

And a celebratory Coke, in our case.

Myths dispelled

There are a lot of myths surrounding home birth. I’m not going to go into dispelling all of them, but there are two that stand out for me.

The first is that if you’re the type of person to contemplate a home birth, you must be some sort of crazy hippie earth mother. I can tell you, I am not that. And somewhere deep in me, I wondered: who am I? Why am I into this?

And the reason is – because this has nothing to do with hippie earth. This has to do with you and your baby. Your needs and desires and concerns and cares. Where you – a human ready to birth their offspring – feel is best to bring your child out. It’s not about lighting candles and singing koombaya songs. There is childbirth, and there are accessories to birth. And this home birth, for me, in its entirety, was about childbirth.

The second myth is a bit simpler: messiness. Before doing this myself, I was constantly trying to visualize what the birthing room (which was our bedroom) would end up looking like. Blood all over the walls? Plastic sheets over the bed? Wet rags soaking in pots of hot water? Everything in black and white, like we’re watching the 1800s on TV?

But honestly – home birth wasn’t messy at all. A couple of small mats on the bed, supplies spread out on counter tops, and otherwise – your un-ironed shirts hanging from the closet door or the same old dirty laundry in the corner of your room if that’s how you usually play.

Part of the midwife’s role post birth is to make sure that everything is cleaned up. I don’t even remember her doing it but I can say a couple hours after my baby joined the outside world, you’d have never of known that my bedroom had been used to deliver a baby. It looked, smelled and felt the same it had when I woke up with contractions that morning.

The team

Who makes up the home birth team? Here’s how it went for me:

  • Midwife: In Israel, only one midwife is required for a home birth (in England and Australia, it’s a team of two). I used Joyce Butler, a known name from her decades at Hadassah Ein Kerem and doing home births in Israel. She’s from Matta, which is about 20 minutes from Jerusalem and 10 from Tzur Hadassah. She was also my doula with  my first birth at Ein Kerem (where she is recognized by much of the staff). I highly recommend her, whether as doula or midwife or prenatal caregiver – her practical attitude, her confidence and her experience are at exactly the right balance. One of the best things about her is the way she got on terrifically with my husband. Joyce’s phone number is 02-5337637; feel free to contact me if you want more of a recommendation.
  • OB-GYN: This may seem obvious, but it’s important to keep up with your regular OB-GYN doctor and all the necessary tests. Only the doctor can give you the referrals and prescriptions you need for tests and vitamins; a midwife cannot. And while many would agree that not all the scans and ultrasounds are necessary, there is a standard that should be held to. It helps if your doctor is midwife and home birth-friendly, of course. Mine wasn’t unfriendly; from the start we learned that he ran his own birthing clinic for 30 or so years in the United States before moving to Israel. His clinic was actually managed by midwives. We still didn’t mention home birth to him until very late in the pregnancy, however. But after running it by him, his all-systems go (and my normal pregnancy) made us all the more confident.
  • Doula: To be honest, I really felt that I didn’t need a doula this time. Knowing myself in labor, and how I do with pain, I felt what I needed was another pair of hands at most. But also knowing that we have a child to think about – which was really my husband’s job – having a doula on hand wouldn’t be a bad idea. It’s also something that the midwife will require. Joyce recommended a doula-in-training from Ein Kerem who we met with twice before the birth. We totally jived – her laid-back nature and calm energy appealed to me. Unfortunately, on the day of the birth, things went so quickly she couldn’t get to my home in time to attend the laboring, but she was around right after the birth to help with aftercare.
  • Pediatrician: I prepared to have a visiting family doctor come to the house within 24 hours of the birth. We used Dr. Leora Uriel, who has a clinic in Shaarei Tzedek and works at the Maccabi clinic in Beitar Illit. She does house calls for home birthed babies privately. The cost is from 400-500 NIS and usually includes the first visit within 24 hours, and a follow up within the week.
  • Partner: We wouldn’t be in these messes without our partners, right? My husband is my support, and even though this time he couldn’t be as hands-on as last time – after all, we had another child to take care of this time – he was there when it mattered and once again, we did great work together.

Supplies you need for home birth

There isn’t much you need at home to do a home birth. The official home birth supplies check list might vary depending on your midwife, but at the core of it, it’s essentially:

  • hot water at the ready (urn or kettle)
  • a small bucket or big bowl
  • space heater or some heating source in the delivery room
  • disposable mats
  • flannel receiving blankets
  • Vitamin K drops for baby
  • newborn diapers
  • sanitary pads

The midwife brings all other equipment – from disposable utensils to emergency kits.

Other things I recommend:

  • Have coffee, tea and easy to eat snacks ready for the team.
  • Plenty of water bottles/liquids in the room for after birth, when mother needs tons of fluids. Keep a cup with a straw; easier to drink from when mom is lying down with baby on her.
  • Have your hospital bag packed and ready. You never know, and you won’t have time if you need to transfer.
  • And of course, have your camera on hand for those first new family moments created in your own home!

Telling home birth stories

When looking for home birth stories from other women in Israel, I didn’t really find much on the internet. Actually, most of the stories I did find came from the U.K. For other women who are exploring the option or want support, I think it’s important to share our experiences. Please feel free to leave your story (or a link to it) in the comments!

Homebirth in Israel.

UPDATE (April 2011): After this post was written, down the road, for my second child, we did a home birth in our apartment in Tzur Hadassah. I’ve got more info on the subject now from firsthand experience and am happy to share:

At this point, I’ve dipped my toes into the third trimester and thus far have read a lot of too much research, visited two Jerusalem hospitals and met with one home birth midwife.

Needless to say, the water’s cold.

I’m caught in this tiring cycle of not knowing whether I should do the home birth thing or not. I mean, I do know I should, but between all the reservations of the people around me and the looming status of ‘first pregnancy’, my birthing confidence is crushed.

I figure, maybe if I can hear from women who have done it/do it, as opposed to just midwives and people who are anti, I could feel better about making a confident decision. Because either way, I feel confidence is key and I need to find it in myself within the next 10-12 weeks.

So… if you’ve been there, done that, labored through it at home, feel free to chime in with a comment about the following (or you can email me if you’d rather):

  • Where did you do it? Where did you live? House, apartment?
  • Did you use a midwife and doula?
  • Was your husband/partner into it? What kind of a role did they play at home?
  • What did you do about pain relief?
  • Did you check into a hospital after?

I’d love to hear thoughts from women who have given birth in Jerusalem hospitals, too. I realize it’s a very realistic situation that I could end up choosing to be in a hospital or end up needing to be in a hospital. Talking to women who are satisfied with their experiences either way and are willing to share can really help me at this point. Unfortunately, there aren’t many Israeli birthing stories on the web, at least that I could find.

I guess the problem is right now I’m so open minded, I don’t have any direction.