My worst fear was going to the hospital. Pregnant at last at age 36 and preparing for motherhood at 37, I wanted everything to be conscious, natural and easy. As a body-centered psychotherapist who had seen first hand the emotional artifacts of the schizoid wound, ever so prevalent in our culture, I wanted to avoid prenatal and birth trauma in even the smallest ways. I wanted my baby to feel wanted and welcome, that the world was a safe and supportive place. Having read and embraced Jean Liedloff's Continuum Concept, the last thing I ever wanted was to have my child suffer a technological and traumatic birth.

My pregnancy had been a joyful experience for me. I think I felt more grace during that time than at any other time in my life. I was healthy, fit and on top of the planning. My husband and I had gathered a birth team to help us welcome our son into the world, chosen the spot in our house that would be most conducive to a warm and comfortable birth, and put together a birth plan, with contingencies, just in case there were any complications. My baby was in the perfect position for a smooth delivery. Neither pain nor the deep psychospiritual journey birth portended scared me in the least. I felt ready emotionally, physically and spiritually.

When my mother had given birth to me, there were complications. She never went into labor. Once she was two weeks late, labor was induced. My mother was unconscious, drugged and surrendering to the higher medical powers that were. She neither felt the pain of labor, nor saw me enter the world, forceps delivery with a cord around my neck. She had no memory of the details of my birth and had to ask my father to recall what the birth scenario was for each of her two children. Every time I had attempted rebirthing and pre and perinatal psychology exercises, I found myself dissociating, finding it hard to breathe, feeling nauseous in my stomach and achy in my heart. My own birth had not been a pleasant experience for me.

But that was 1958 and this was 1996. I didn't have to be a passive patient. I could be an active participant in a powerful ritual of nature. That was how I wanted it. I was afraid that going to the hospital would take away my vision, my power and my voice as a birthing mother, that a medical institution would over-rule my heart and take over my body if I didn't perform according to a set of external standards. Paradoxically, the very institution that I feared ended up helping me deeply and even preventing further trauma for both me and my soon to be born child. In the old days before conventional medicine, some women died in childbirth. When labor did not proceed smoothly, there were fewer ways to help both mother and child. I realized just after the birth was over "that could have been me!"

The Onset of Labor 

I was eight days post-term, and had been receiving acupuncture, homeopathy and Chinese herbs both to strengthen me and baby and support the onset of natural labor. After my acupuncture sessions, labor's forerunning signs started to make themselves known. Mild contractions graced me one night, only to cease as naturally as they started. Now it was February 6, and I was ready. My husband and I attended an anniversary party for a small socially conscious business two friends of mine ran, and I decided dancing up a storm to wonderful music would be a perfect initiation into the journey of birth.

We left the party at 10pm and by 2am labor had started. My water broke. Contractions were mild, and so was my anticipation. I waited till morning to call my midwife and let her know the process had begun.

The first 20 hours of labor were very mild mannered. Contractions felt no worse that menstrual cramps. At 10pm on February 7th they began to intensify and were coming three minutes apart, so I called my midwife, and told her this seemed to be "it." By midnight, it was clear this was "it," and my midwife prepared to come over and usher into my home my soon-to-be born son. I called my birth team members, alerted my housemates, and pulled out the folder with the names of clients, students and friends to call once the big moment had transpired.

Nearly 24 hours into my labor my homebirth midwife arrived for the big event. "I need to check the baby's vital signs," she told me, a standard procedure she would do throughout the labor. Just moments later, a grimace appeared on her face. "Linda, I'm really, really sorry," she said. She had the difficult task of announcing, "you have to go to the hospital — there's a danger of fetal distress." The openness I had brought to the whole process eased the shock of this most unwelcome news. I quickly packed my bag, bringing a change of clothes for me, and a homecoming outfit for the baby, got into the car and surrendered that the journey was taking me where I needed to go.

The Hospital: Part One

The paradox is that my baby's heart got us into the hospital, but it was ME that kept us there. I was hypervigilant and frightened as the hospital midwife put me through intake and I faced my worst fear. I had wanted to do anything I could to avoid the hospital, and here I was having forsaken my much wanted home birth.

The first eight hours of my hospital stay were reassuring. A lot of emotion was stored in the back of my pelvis, and as I pushed, screamed and wailed, I felt a sense of emotional clearing and psychospiritual wholeness. My baby's heart responded to this primal process by getting stronger and stronger and stronger. Fetal distress was no longer an issue. My son was doing just fine. While I did not know this, at one point the hospital team told my homebirth midwife that we could go home. When I asked the hospital midwife who told me this part of the story after the birth why we didn't go home, she said my homebirth midwife said she thought we needed to stay in the hospital. She followed her intuition and she was right. 

The Hospital: Part Two

As my second eight hours of hospital time approached, I thought I was fine and all would go smoothly. The wonderful hospital midwife worked collaboratively with my birth team and homebirth midwife, and I felt safe and secure. I had dilated to three centimeters, and felt pushing urges just around the bend.

To my surprise, I discovered that hospital staff worked in eight hour shifts, and the people I had learned to trust and bonded with were about to turn the job over to a team of strangers, and I had to start the "getting to know you" process all over again. I did not take this well, and shut down. My contractions calmed down as my anxiety level increased. The new hospital midwife had a completely different style from the first one. It took a long time and a few confrontations for me to learn to appreciate her different competence.

In the meantime, the clock was ticking. I knew hospitals frowned upon labors where the water had been broken more than 24 hours. Here I was 32 hours into my labor, and clearly along way from the end. My second hospital midwife was feeling pressure by the doctor on the shift who wanted to end my stubborn struggle with nature, and either put me on pitocin for the fast track or cut me open and be done with it. She protected me both from this doctor and from the knowledge that this was happening behind the scenes.

When it was clear I was not progressing, she did an internal examination and found a sac of water blocking the baby's head. She asked my permission to pop it, hoping it would move things forward. She warned me the contractions would become severe, and I agreed to this procedure, hoping things would open up and move. I had no idea how severe the contractions would be.

I had no idea how long this next painful phase would continue. Had I known then what I know now, it would have been hard to consciously endure the level of pain I experienced for the next seven hours. I entered into a "dysfunctional labor" as they call it in medical circles. At the time, all I knew was that the level of pain felt more extreme than I intuitively felt it should have been. Something felt very wrong. In retrospect, it appears that my baby's head was unable to make the turn down to the birth canal, and we spent seven hours in a painful dance as his head bumped against my sacrum and tailbone.

What gave me strength to endure what felt like death-defying pain — and I am no wimp — was the vision that my baby would emerge naturally and intact soon, if not sooner. After seven hours when I could take it no more, an internal exam was done. The news was not good. When the hospital midwife told me I had not dilated any further, I nearly lost it. 

"You have a choice to make now," she told me. "Birth is not progressing naturally and we have to intervene in some way. We can try an epidural, we can try pitocin and if nothing works, we will have to do a C-section." My eyes nearly burst out of my head. A C-section was the LAST thing I ever wanted. I could not bear the pain another moment, pain that had not even been fruitful and had just spent precious time. I was nearing 40 hours in labor, and about to wear out emotionally. I agreed to an epidural with a homeopathic dose of pitocin. My contractions had been plenty strong. I just hadn't progressed. 

The Hospital: Part Three 

I was hooked up to the epidural, just getting started on this new leg of the journey when my second hospital team bid adieu. I was faced with yet another team to usher in the third eight hours of hospital labor. My homebirth midwife and her apprentice tried to catch a few winks of shuteye to prepare for the big moment of baby's arrival. My husband and friend Nancy held vigil in the room. My friend Brian had left to do a day's work, asking to be summoned when we got near the birth. 

While hesitant to bond with yet another team of professionals, I was grateful for the epidural to at least take me out of the death defying pain. I lay back, relaxed, and prayed that the Gods and Goddesses would be kind. 

In just a couple hours, the hospital midwife did an internal exam and said, "you're never going to believe this." My heart turned to ice. My stomach knotted as I braced myself for more bad news. "You're dilated to nine centimeters!" she announced. I burst into tears. Finally, finally, something was going right. A natural delivery was just around the corner. The hospital team let me keep dilating for another hour and a half, since several women in the hospital were all ready to give birth. When pushing time came, I pushed my son out in just one and a half hours, and there before me was my newborn babe. My homebirth midwife delivered my son. I was excited the hospital team could collaborate with my midwife of choice. 

Post-Birth Complications 

The state of shock I was in told me that all was not over. I had scarcely gotten to hold my son for five minutes when he was taken away. My placenta had not fully detached. Another two hour ordeal was in store, marked by more epidural and a doctor's manual extraction after my homebirth midwife and the hospital midwife worked together to try to coax the last bit of placenta to come out. My husband and friends held my newborn son, and I cried inside. This was not how I wanted it. Where was my opportunity to bond with my baby? Where was my chance to go into a quiet room and nurse him, to look into his eyes and for him to look into mine? It was nowhere in sight. 

At 2am on February 9th, my son was whisked off for some routine examinations given to babies whose labors have been long. I roused my sleeping husband to go with my son. My birth team had disbanded, job finally done. My friend Nancy agreed to stay with me for the fifteen minutes we were told the tests would take as I awaited anesthesiology to remove my epidural rigging.

Fifteen minutes turned into two hours, and Nancy could not keep her eyes open past an hour and a half. She had to go home, thinking I'd be with my husband and son momentarily. I waited alone for the last leg of this journey, only to find my husband arriving alone, no babe in arms. "He's in the ICU," my husband informed me. "Respiratory distress." I could not take any more surprises. I was beyond disbelief. I hypervigilantly roused my spirits, preparing to be wheeled into the ICU to visit my poor baby son. 

The End of the Story 

I need not elaborate on the ICU adventure. The short story is that in three days we all went home. Thank goodness, my husband and I could stay camped out in the hospital until my son was ready to be released. While still grieving my experience, and even more so, the experience of my newborn son, I was grateful for the integrity of the work of both my homebirth midwife and her team of hospital collaborators. 

In spite of all my pre-birth planning, the organization I did to prepare the birth team, the preparation with all my clients, I could have never imagined what actually happened. It did not exceed my expectations, but was way beyond the possibility of anything I could have imagined. My experience was a total surprise and I was truly unprepared. In retrospect, given the circumstances I was very lucky to have the best of both worlds. 

In closing, I would like to underscore the importance of the collaborative care I received: 

1. I credit my homebirth midwife for both good judgment and skill in case management to both mobilize appropriate resources and integrate them with my vision, values and pace. 

2. I am grateful to the nurses and midwives on the three hospital teams for being open to and willing to work with someone committed to the home birth experience. Paradoxically and perhaps fortunately, two of the three hospital midwives were former homebirth midwives. 

3. Looking back on the experience with seven months distance, I am clear that I was given both the space and support to have the birth proceed at my pace. Only when it was both medically necessary and obviously necessary to me was conventional medicine even introduced into the birth process Even then, I still had the final word in what was done and when. A minimum amount of medical intervention was employed given the nature of my situation, and the medical intervention that was employed made all the difference in the world. 

4. This birth situation really integrated the best of both homebirth midwifery and conventional hospital birth resources. We avoided the C-section. The hospital midwives protected me from doctors who wanted to "get it over and done with." My wishes were respected. 

5. My homebirth midwife provided the continuity across the three shifts of hospital midwives and nurses. As one who has trust issues in life period, this was no time to have to wrestle with discontinuity. Birth is about letting go, and I need to feel safe and supported in order to let go. The presence of my homebirth midwife for the duration of the journey provided the emotional safety and spiritual support I needed to make the best of a hard situation. 

6. The hospital was gracious enough to let my birthing room be the community camping ground for members of my birth team to accompany me on my journey as best they could. My husband and friend Nancy were there for the entire duration. Other team members had the freedom to come and go.

All in all, I felt well cared for and respected, mentally, emotionally, physically and spiritually. 

____________________

Linda Marks, MSM, has practiced heart-centered, psychospiritual body-centered psychotherapy for sixteen years.  She is founder of the Institute for Emotional-Kinesthetic Psychotherapy in Newton, and author of LIVING WITH VISION: RECLAIMING THE POWER OF THE HEART (Knowledge Systems, 1988).  She has taught and spoken nationally and internationally, and has been a leader in the emerging field of somatic psychology.  She lives in Newton, MA with her four year old son, Alexander.  Linda's new book EMBODYING THE SOUL: DANCING INTO LIFE is due for release in the spring of 2001.  You can contact her at (617)965-7846 or LSMHEART@aol.com

Click Here For Special Profile

For more information on choice-centered birth options for women, please contact the following:  

Massachusetts Midwives Alliance
PO Box 112, Fiskdale, MA 01518 
508-376-8201
American College of Nurse Midwives
 818 Connecticut Ave, NW, Ste 900, Washington, DC 20006 
202-728-9860 
Shannon Brophy, Midwife
617-492-3088 
Mamie Cabezas-Skorupa, Midwife
617-327-8617 
Deborah Issokson, Psy.D., childbirth preparation counseling
617-489-4249