For years I had anticipated a home birth. But that dream was shattered when I discovered that I carry two genetic blood disorders. One trait, called Protein S deficiency, I inherited from my father; Factor V Leiden came from my mother. Carrying both disorders meant my pregnancy was classified as “high risk,” and a home birth was discouraged. I was heartbroken.

I was closely monitored for blood clotting by the perinatology department, and my doctors insisted I begin anticoagulant medication immediately, continuing through six weeks postpartum, when the risk of blood clotting would be at its highest. I thoroughly researched the clotting disorders and challenged the doctors, requesting that they consider my research and allow me to proceed with a non-medicated pregnancy. The perinatolgists made several comments about how impressed they were with my research and proactive stance. They ultimately “agreed to disagree” with me and allowed me to take my own chances, under two conditions: they would monitor me closely throughout the pregnancy; and I had to agree to take anticoagulants, starting at 36 weeks and continuing through six weeks postpartum. I was satisfied with this compromise and agreed. It was a frustrating process at times… the close monitoring, ultrasounds, Doppler scans of my veins, and non-stress tests twice a week for the last month. Deep down inside I knew everything was OK, and that feeling never left me, not once.

For 40 weeks my husband and I had awaited the estimated due date of April 13. As that day approached, I anticipated any and every change that my body could go through to show me signs of labor. On a day of reflection, as I looked back over the entire pregnancy with amazement, I sat and talked with my baby about how we would be meeting any time now. I imagined my labor and birth, and talked to my son about how very important it would be to work together through the labor, and that we needed to communicate with each other to help his birth move as smoothly as possible. I told him that there could be some discomfort, but promised that it would be short lived in comparison to the enduring, immense love that I would give to him for the rest of his life. The day ended with no signs of labor, but I felt a deep sense that it would be starting soon.

 Anticipation grew throughout the week until finally, on the morning of April 19th, I awoke with mild cramping, very similar to menstrual cramps. My family was in town, so I wanted to keep everything between my husband and I, to avoid too much focus on me. My experience as a labor doula had taught me about the problems that a laboring woman could experience when under the well-meaning but intense scrutiny of family members and friends. So much attention from others can be very distracting, and often keep a woman from completely surrendering to her labor. It’s as if the birth becomes an event, instead of the truly intimate and serious process that it is between father, mother and child.

As the day proceeded, the cramping stayed very consistent and then I developed some spotting. I called my labor support midwifes, Michelle and Gerri, to let them know what I was experiencing; we agreed to keep in contact throughout the day. I had planned on doing a lot of walking around in labor, and I did… to the bathroom! I wanted to see if I was still spotting, which reassured me that this was the real thing, and I knew that the more frequently I emptied my bladder the more room the baby would have to move down. Little did I know, my sister was keeping a mental note of how often I was using the bathroom, and the amount of attention I was giving to my cramping. I thought I was being so sneaky. At 1:30 p.m., during lunch at a local restaurant, I told my husband it was time to go home. Labor was definitely picking up to the point where I needed to get comfortable in my home environment. By then the entire family had figured out that I was in labor, and our excitement danced throughout the conversations.

Once we were home, we lit some nice candles, turned on relaxing music, and moved into the active stage of labor. I had a good idea of what I needed to do and which positions would be most effective, so I managed to flow with the rhythm of labor.

My plan to keep my family involved during my labor did not go as well as I had hoped. My husband and I had made arrangements for my mother and sister to stay at a local hotel while I was in labor, but when we asked them to go they got very angry and aggressive, giving ultimatums and threatening to leave town. No laboring woman should have to deal with family politics between contractions – I needed to focus. To minimize the stress, I decided to just go with the flow and allow them to stay present, but told them they either had to help or stay out of the way completely.

Around 5:30 p.m. my wonderful midwife/doula arrived, and a very strong sense of confidence came over me. I believe it was because I felt so safe and well taken care of. I labored in the bathtub, in the shower, on my knees with a birthing ball, sitting on the birthing ball, hanging on to my husband, and leaning on the back of the sofa... we moved around a lot! Between contractions I rested deeply, almost asleep, taking advantage of the well deserved breaks. I listened closely to my body as it labored, staying active and hydrated to avoid exhaustion. I had to take it one contraction at a time, and allow the experience to be whatever it needed to be – to let go of the need to control the situation.

I learned along the way to relax everything in my body, including my excitement, and let my mind stay steady with thoughts of the baby moving down. I was actively visualizing his birth, over and over, and over again. I kept the steady mental and physical relaxation through deep breathing and moaning with each contraction. Moaning allowed me to take long breaths, and to follow my voice instead of my thoughts. I know that these coping strategies, as well as my confidence in the people surrounding me, contributed to a relatively short active labor of 11 hours.

My midwife checked my dilation and the position of the baby around 9:00 p.m. – I was five centimeters dilated and the baby was very low. We decided it was time to go to the hospital, based on my steady progression and the need for time to adjust to a hospital environment. Shifting into a “managed” environment, I really didn’t know what to expect. I knew anything could happen and I reminded myself to stay strong, informed and focused.
We arrived at the hospital by 10:00 p.m., and as we walked through the hospital, I did not rush. I continued to hold my “meditation,” not letting the new environment disrupt my progress. During the admittance process, if I was asked a question during a contraction, I let them know I would answer in a moment, and I paced myself the entire way through the emergency entrance to my laboring room. Once in my room, everyone worked together to keep me comfortable and recreate the environment we had at home. The nurse did a vaginal exam and let me know that I was at seven centimeters.

I utilized every space available in my laboring room, including the birthing ball. Two hours later, another exam confirmed that I was nine to nine-and-a-half centimeters dilated. Almost there! I followed the cues of my labor support midwife to do some light pushing in a squat position, and all of a sudden, I felt my son’s head do an unforgettable slide down and under my pelvic bones. The doctor on call was not nearby, so my midwife grabbed her gloves and guided my husband’s hands into position, in case birth was moments away. At that point I was asked if I would like a mirror to see my son. I declined, focusing intently to keep my thoughts away from any discomfort… the sight may have just been too real for me. The doctor arrived, suctioned my son’s nose and mouth, and with one more gentle push my son was born into his father’s hands at 12:42 a.m.

My first sight of my son will never leave my memory. As I write this, tears are welling up in my eyes. Only at that moment did I really unconditionally love. I had never known the feeling in my life. His beauty radiated within my husband’s heart and mine. His first cry was like a psalm, and his scent was just as heavenly. He settled quickly to my voice and looked at me with the most loving stare, and then closed his eyes and rested peacefully. I would labor and birth a million times over just to see my son for the first time again. It was incredible! I have entered into a part of my life that only the hearts of other mothers know, and it is unexplainable.
 
Notes from Michelle, the midwife: I accompanied Leanne to her first perinatologist consultation; she asserted herself intelligently and was received by the doctor as such. They interacted well and the doctor became empathetic to her concerns, leading to mutually respectful negotiations. They worked together on a plan that satisfied the doctor’s concern for the mom and baby, while keeping intervention to a minimum. In my spirit I knew she would have a perfect birth and that she would not have a problem from her inherited blood traits, but we all agreed that we must put the mother’s safety first and yield to caution. As a result, she had the perfect hospital birth. It was the most amazing, peaceful, nurturing, respectful hospital birth that I have experienced in my twenty years of attending births.

A Mother’s Guidance: At the end of my pregnancy, I read the book Active Birth: The New Approach to Giving Birth Naturally by Janet Balaskas. It gave me the confidence that I could do this. This birth experience showed me strength, courage, faith, love and confidence. It was an education in the value of a good relationship with your caregivers, and being able to express to them all that you want and don’t want, even if you have to meet in the middle.
 
Leanne Mitchell and her husband Patrick live in Vista, California, with their son Jahsiah. Leanne is a massage therapist as well as a labor and postpartum doula. Patrick owns Quashi Surfboards