I was Made for This
By Erica Evans
Sitting on my couch with a beautiful baby girl snuggled up on my chest, cozy and happy, how do I describe the incredible joy, beauty, and strength of a home birth, particularly amidst the turmoil outside our home?
My birth story begins in a pandemic – the coronavirus pandemic of 2020. I found out that I was pregnant in January, while traveling in China with my husband on one of his business trips. We travelled blissfully, excited about our new secret. When we arrived home, we heard there was a virus in China called the coronavirus that was spreading rapidly. You all know the story, in a few months the world had shut down. While some components of my pregnancy were different than expected – no big baby shower + worry about contracting coronavirus and how that would impact the baby – overall we were lucky and I had a beautiful, healthy pregnancy. I marched through all the milestones of extreme nausea and fatigue, followed by my belly expanding gloriously, and eventually a cute but awkward pregnancy waddle associated with difficulty sleeping and low back pain. I felt flutters and rolling movements and a tiny little foot poking out near my right rib. I both loved and disliked being pregnant. I loved growing this tiny human and feeling her inside me. I loved knowing I was able to bring my baby with me everywhere I went. I loved watching the shape of my body change. I loved how caring and attentive my husband was and I rejoiced in his excitement about the pregnancy and the baby. But pregnancy is physically demanding too, and I work many hours, including night shifts, which made pregnancy pretty exhausting. And while its beautiful to share your body with another, it can be challenging at times too.
As a pediatrician who has spent a lot of time working in the Neonatal ICU, I always assumed I would deliver via an unmedicated birth in a hospital. I know all the statistics around induction and epidural, so the choice to have an unmedicated birth was fairly easy. Regarding the pain part, I have a pretty strong character and have always been curious what natural childbirth felt like. However, I have also attended many births to resuscitate babies who needed a little extra help when they came out. And I have cared for babies born at home and at birthing centers who needed to transfer to my hospital for higher levels of care. Thus, I assumed based on my experience that a hospital with a first class NICU was the best place to deliver. (I primarily care for the worst case scenarios, the 1% that we all hope not to be. The majority of babies are delivered safely and happily without ever needing a pediatrician to be present.) Despite my background, I didn’t end up delivering in a hospital, and in this respect, I am grateful to the pandemic for pushing me toward a home birth.
Because of coronavirus, my husband wasn’t allowed to attend any of my prenatal appointments at the hospital, he never saw an ultrasound, my providers were all masked, rumors floated about moms and babies being separated, dads not allowed at births, moms forced to wear masks throughout labor and pushing, moms not allowed to walk around during labor. The hospital had constantly changing rules and it was unclear what you might face when you arrived in labor. Working in the hospital, I watched the rules constantly changing, sometimes based on evidence, but often there wasn’t enough evidence to make an educated decision. And with all of the new rules, the hospital that previously had been my home away from home began to feel impersonal and strange and even scary. Furthermore, my baby was measuring a bit bigger than average on ultrasound, and the hospital was recommending induction at 39 weeks to ensure the baby wasn’t “too big for me to deliver vaginally.” I really didn’t want an induction unless absolutely necessary. At this point, around 36 weeks of pregnancy, my husband and our doula encouraged me to meet a woman named Maria and to consider a home birth.
Maria, our midwife, was amazing. From our first visit she was kind, warm, professional, smart, and made me feel so comfortable. Even over zoom or with a mask on, she made me feel cared for and provided the personalized healthcare experience I was craving. She encouraged me to feel confident in my body and its ability to deliver this baby. She told me I would be a birthing goddess and she would be with me every step of the way. She had no doubts in my ability and she reassured me that if anything looked concerning we would immediately transfer to the hospital. After learning more about the home birth process, my husband and I weighed the pros and cons, and decided to go for it.
On a Friday at 38w6d I began having what felt like menstrual cramps that persisted throughout the day and were strong enough to wake me up a few times overnight Friday night. Then Saturday morning the cramps got stronger. Saturday was a beautiful day, early September in San Francisco, with blue skies, sunshine, and 70-80 degree weather. I made some homemade broth, ginger lemonade, and a sugar scrub in the morning, then we went and walked around the city with our dog, drank a fancy green juice, stopped in at Natural Resources for some supplies, and generally enjoyed the day. I remember throughout the outing having to stop periodically as a stronger contraction would come through. But the day was so nice I think I was largely distracted. When we got home and I sat down I noticed the contractions were much stronger than they had been in the morning. We timed them and they were lasting 1 minute every 5 minutes. They proceeded to be 5:1:1 all evening. My husband and I chatted, tried to watch a movie but the contractions were too strong for me to focus, listened to music, bounced and breathed on the exercise ball, and at one point I went on a cleaning spree and tried to clean my house between contractions. My husband kept saying we should call in the doulas or the midwife but I was hesitant. I wasn’t sure this was labor since it was a week before my due date and I had never done this before. I read a lot of birth stories in which the midwife arrives and checks you and you are only one centimeter dilated and have ages to go, so I didn’t want to call anyone too early.
Around 10 or 11pm my husband and I took a bath together and scrubbed each other down with the sugar scrub I had made. The warm water helped me relax through the contractions and it was romantic and intimate and special. We felt so excited to be this close to meeting our baby. After the bath I remember trying to take a nap – we thought I should rest so I would have energy for when the pushing happened. I think my husband may have slept a bit, and I did rest, but the contractions were so strong and so frequent that I couldn’t sleep. The sensations kept getting more and more intense and I became very focused on breathing deeply and slowly through each contraction. Around midnight my husband looked at me and said “I’m calling Maria.” After that things are a bit of a blur for me. I think when you are deep in labor you enter a bit of a trance-like state. I was so focused on my body. With each contraction I would imagine my cervix opening and thinning and dilating. I would breathe. I don’t remember this but we have a video of me moving my hands back and forth in a stroking/wave-like motion through the air with each contraction. I wasn’t using the cognitive part of my brain or thinking about what I should be doing; rather, I was solidly in my body, in each sensation, feeling and opening, connecting with my baby, breathing. The doulas, midwives, moms, and my sister arrived. The midwife checked me and I was 8 cm dilated. I was in transition and boy did it feel like it. I remember feeling grateful at least that I was so far along. I continued to labor in my zone while the rest of our birthing team was busy. The birthing tub was inflated and filled in our nursery, the doulas hung affirmations on the walls, candles were lit. Eventually my husband and I got into the tub. Very soon it was time to push.
I had heard before that you would know when you were ready to push, you might feel relief to push. I knew it was time because my uterus and abdominal muscles started contracting and pushing involuntarily, without my brain wanting to push. Maria asked me if I was pushing, and my response was “I’m not trying to!” I pushed for 2-2.5 hours. I was in the birthing tub, my husband sat behind me, and with each contraction he would support my legs and I would lean back against him and push with all of my strength. At first I was worried about when to push and how to push, but Maria helped me to stay in tune with my body, trust my instincts, and push when it felt right. I think this was a huge part of why my home birth was so empowering – it was all about trusting myself and doing what felt right. Pushing was hard work. The doulas supported me with a fan and ice chips, sips of lemonade and coconut water straight out of a coconut. At some point I was starting to feel weak, like I wasn’t able to push as strongly as I could before, and then they brought out some honey and each tiny sip of honey made me feel rejuvenated and I pushed a little stronger. I pushed with each contraction and relaxed against my husband in between. I remember opening my eyes sometimes and seeing an incredible team of women supporting me – my doulas, midwives, my mom, my husband’s mom, my sister. Occasionally the sensations would get too intense and it felt like I was going to be overwhelmed by pain. But then Maria would get close to me and lock eyes and tell me to breathe. I would breathe and feel the energy move back down from my head to my belly and they would become manageable once more. As I neared the end there was a new sensation as my skin stretched around her head. I had to push, but pushing now hurt. It was hard and it was intense and yet you find this inner strength inside of you that you didn’t even know you had.
A number of mantras went through my head during labor and pushing, but the one that most spoke to me was “I was made for this.” Western society steals women’s innate power by telling them that they can’t do it without help – that they need an induction, an epidural, a nurse to tell them when they are having contractions and when to push. My doctors made me afraid that my baby would be too big for my body to push out. But my home birth gave all that power back to me. Of course I didn’t do it alone, I had an immense amount of support – 8 women and 1 husband giving me love and energy and words of encouragement. But they were lifting me up and telling me to listen to my body and trust myself. And at the end of the night, it was me who pushed this beautiful baby girl out of my body and into the world at 6 am as the sun rose on Sunday morning.
I have never felt so supported and loved as I did in those first few days. I’ve never felt so much love for another as I do for my baby and my husband after giving birth. And in those early days my love felt endless - stretching outward to my community, my family, friends, neighbors, colleagues. I was filled with joy as California was ravaged by fires and smoke turned the sky orange, a virus blazed through the world taking lives young and old, and America was plagued with violence, protests, racial divides, and a long pain of inequality and fear. I wished the world was different for my child, but I also felt so much hope. Can you imagine a better way to start life? Surrounded by so much warmth? I wonder if this is how women used to feel giving birth. I wish all women could experience this. What joy, strength, love, power, happiness, beauty, and gratitude you can find in a birth. It’s strange that something so intense and hard can also be so amazing that I already want to do it again and I’m only a few weeks out from the first one.
There are many challenges yet to come – breastfeeding, sleep deprivation, returning to work, temper tantrums, teenage angst, and of course how to teach your child to find their values and live them to the fullest. But I feel hope, and a little bit of excitement. Parenting is hard, but I was made for this.