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Special Delivery: Twins, A Tub, And A Team–Interview by Jacki Christopher

“I told my husband I would never have a home birth.”

That’s what Leah* said when I asked her if she had always planned to deliver at home. Leah, a Welcome Baby Care client, is the mother of twin baby boys. I caught up with her recently during the afternoon “feeding frenzy” to ask her a few questions about her out-of-hospital birth experience, and to find out what kind of personal evolution had taken place to bring her and her husband to the realization that delivering the twins at home was the right decision for them.

I assumed that the twins were the first pregnancy for Leah. No—this was actually pregnancy number four. Her two previous single births were delivered in the hospital, standard protocol. “Traumatizing” was the word she used, but nothing out of the ordinary as far as deliveries go.

Though she’s a little ashamed to admit it, prior to her own experience, home birth was something she’d associated with a country-girl mentality. She didn’t identify with the moms who were proponents of the home birth. She questioned if it were safe.

But the experiences of the first two babies, born in a hospital, was scarring. Her midwife was less than attentive, she couldn’t get warm water to soak in the tub, and she felt generally unsupported. It seemed that they “were ill-equipped to deal with a laboring woman.” When she found out that she was having twins and was told that it was more than likely that she’d be slotted for a cesarean delivery, she started considering other options.

“I knew I would probably end up having surgery if I delivered in the hospital and I couldn’t see how that would be in the best interest of my babies. I didn’t see how I was going to be able to recover from surgery and try to care for twins.”

Leah started looking into out-of-hospital birth centers. When she found one that she thought would meet her needs, it happened that due to their particular accreditation, they would not be able to deliver twins on-site. She had two options—work with their midwives, but in a hospital, or opt for home delivery.

When I asked her about her initial reaction to the suggestion of delivering at home, her response was about what I expected: “It was scary. I had all the risk factors rattling around in my head. I was initially nervous, but ready to take the risk.”

Her midwife from the birth center was indispensable at this point. She suggested that Leah write a letter, itemizing exactly how and why she came to her decision. All of the fears, anxieties, risks, and apprehensions went on the list. Together they started to consider them one-by-one. This exercise was liberating. Leah and her husband could see what it was that they were most anxious about, and could then focus on working through those fears specifically. They could see what elements of the process they could control, and what they had to surrender. Leah began to see that she could trust her body, trust God, trust her providers, and trust the babies.

My next question was about logistics. Once they had decided that they were going to go through with the home birth, what happened next?

Leah and her husband had an interesting approach involving several birth plans. If she delivered before 34 weeks, she had a plan to go to a larger, trauma-focused hospital with the most competent NICU. Her midwife wouldn’t be able to deliver her at that point. If she made it to 34 weeks, she’d deliver at a hospital closer to home, where she believed they would be less likely to turn a slightly pre-term labor into a medical emergency. At 36 weeks she’d deliver at her doctor’s smaller facility, and if she did make it to that 37-week ‘sweet spot’, she was in line to deliver at home, attended by a team of midwives.

They rented the tub, purchased the birth kit and supplies, and started setting up the birth room. They practiced filling and heating the tub so they’d know how long it took to get it operational when the time came.

At 5:38am on August 3, 2011, Leah’s water broke. She called her midwife, checked the heartbeat, and went for a walk. At noon she called back–she was getting closer. She got in the tub. When her team of three midwives and two assistants arrived an hour later, she was on the brink of birth. Baby number one came at 2:30pm.

But then she hit a snag—and this is a critical part of the story. Baby number two’s heart rate started to dip. What would have certainly been immediate surgery in a hospital setting was simply a part of the process at home. “I know if I had been in the OR those few minutes when his heart rate dropped, they would have sliced me open. The midwives were urgent, but not overly ‘emergency’ about it. They just handled it and kept their heads about them.” As she put it,  “they helped him to recover and be delivered normally. It would have been more stressful for him to be separated and delivered [by cesarean]. The baby was allowed to resolve the issue in utero.” A little less than an hour later he was ready to come into the world.

Each midwife and assistant had a role in supporting Leah, and helping her to bring these babies safely into the world. Said Leah, “There was no comparison with my other births. It was 100% better.” While reflection on her previous births had often brought tears and pain, she contrasted her home birth: “There was no trauma…I remember thinking to myself after I delivered them: I cannot imagine being anywhere else but home right now.”

I couldn’t resist including a few of Leah’s comments as we finished up our chat. She recalled, “One of the things I got asked a lot was: how long are they going to let you go?” This irritated her. “Who are THEY?” she stared to ask. “This is MY pregnancy and MY babies.” Delivering at home and under the care of a team of midwives, “I felt empowered and in control of my healthcare, rather than being railroaded around by THEY. Had I been Under THEIR care and recommendations, I would have been induced, or had a scheduled cesarean around 38 weeks. Had [the babies] been taken early they would have been underweight. We let the babies pick their birthdate, rather than let the doctor decide.”

Leah and her husband did extensive research (not to mention soul-searching), as well as the due diligence from a medical standpoint, before making the decision to deliver at home. In the end, she says, “This was the decision that was right for us.”

*Name has been changed.

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