Home Birth with Becky

During my last year in Orlando, I had the joy of working as a birth assistant for Becky Erichsen, the midwife behind Sweet Baby Midwifery. The role of a birth assistant is to support the midwife (as opposed to a doula, who supports the person giving birth). This job fell into my lap, and was not something I had ever considered until a friend presented it as an option. It’s nice when that happens! It gave me a break from the ambulance, and allowed me to put some of my herb training to use in a new way. I had been used to responding to emergency situations that often felt stressful and didn’t end well, so after a few births where I could feel the contagious euphoric feelings of the parents when they held their new little human, I realized that I needed these happy endings. I learned a lot through this job, and would like to share a bit about labor, home birth, and the role of herbal medicine…

I have a strong belief that our physical bodies contain an instinctual tendency towards balance, on an unconscious level. Witnessing birth amplified this belief infinitely. There seems to always be a point in the birth process when the laboring person is no longer in control, but is just along for the ride; a wild surrendering to the intelligence of their own body working with the baby.

In the writings of midwife Ina May Gaskin, she emphasizes that the cervix is a sphincter, and like all sphincters, the body needs to relax for it to open. She suggests that many hospital births are stalled simply because it is difficult to relax in a medical atmosphere. For decades now, birth has been treated as a medical procedure, and a race against the clock, and is often infused with fear. We’ve probably all heard horror stories of labor interventions spiraling down to an unwanted cesarean section. Or we’ve read the NPR articles about the rise in pregnancy disasters in the US. Could it all boil down to a sphincter not opening due to stress? I think that probably plays a large part. There are also lots of theories about hormonal disruption from modern chemicals, or past birth control use affecting cervix dilation, etc. Of the many home births I witnessed, things mostly went really really well. I rarely tapped into my “emergency response” mode, and in the few times when I did, things turned out more-than-fine.

Becky, whom I often refer to as “the baby whisperer”, was a wonder to watch work. Her midwifery style is a supportive hands-off approach. She allows the process to move at its own pace, trusting the baby. Occasionally I felt skeptical glances from family members who wanted us to “do something” to move things along. This is understandable, as it is hard to watch a loved one labor; contractions become more intense and a downward pressure builds as the baby moves into position. I have heard it described as “beyond painful”. But this is necessary, and Becky, a mama of two, shared with me that her own labor mantra was, “Pressure is good! Pressure is good!” Though Becky is very hands-off, she would also be the first to recommend a trip to the hospital if it seemed necessary.

There were a few trips to the hospital over the year, and one I remember very well. Everything was going as expected: mom was fully dilated, baby was sitting low, and there was an urge to push. But with each push, the baby’s heart-rate decelerated more than is preferred. With no way to know exactly why this was happening, Becky simply said, “I don’t think the baby wants to come out here.” So we transferred mama to the hospital where they immediately performed a C-section, and it was discovered that there was an infection in the uterus. Becky said, “Well, I guess that’s why baby wanted to come to the hospital!”  If the baby had been delivered at home, it would have been more risky. There was no way to know about the infection since the mom’s vitals were stable, but the baby let us know with his heart-rate deceleration. Through her years of practice, Becky has become very present to the nuances of the process. I’ve learned so much from simply watching her evaluate each situation.

Becky was happy to let me play with herbs and put to use some of my training which still remained theoretical for me. There are many herbs with traditional labor uses, so I put together a kit of herbs whose medicinal use I was already very familiar with. At the beginning of the year, I suspected that herbs could probably be useful at every birth. But within a few births, I realized that some of my intention was to “move things along”, no different from the Pitocin drip at the hospital. It is the temptation of the herbalist to mediate every experience with plant medicine, but this can quickly become overkill and denies the body of its own self-balancing mechanisms. With this in mind, I became more patient and observant. The laboring body is, for the most part, completely competent and able. Somewhere along the way, I began to notice a “sweet spot” for labor herbs. Usually labor moves along just fine physically, but mentally, the person may come across some blocks, fears, or hesitations (Understandably, your body is pushing a cantaloupe through your vagina, and sometimes there’s a mother-in-law constantly asking, “Are you really sure you want to give birth at home?!”). In my experience, this emotional tension is where herbs really shine. There was a moment I began to notice: when contractions were increasing in intensity, but pushing had not yet begun, and fatigue was setting in. Usually the person says, “I can’t do this!” At that time, a dose of herbs could be very helpful.

The herbs I’ve used at this time are usually Motherwort, Black Cohosh, and/or Passionflower. Please note that this blog-post is not an instructional post for using herbs in birth. I will not be discussing doses, indications, or contraindications here. These herbs should be well-studied before using them (beyond this random blog), so I trust you to do so.

Herbs also have a place immediately postpartum. I have found Yarrow to be very helpful for postpartum bleeding, miraculously so in some cases. Occasionally Black Haw and Jamaican Dogwood helped for after birth pains. For some people it works really well, and for others it doesn’t touch the pain. I believe I noticed it working better for 1st and 2nd births, as the after pains increase with each birth. Here’s a picture of the kit I used:

In my time as a birth assistant, I used herbs about 50% of the time.

Beyond using herbs acutely during labor, it is worth mentioning how helpful they can be during pregnancy and for the months following birth. Especially for stress support. But please note that pregnancy is a fragile time, and herbs should not be used recklessly. I consider most herbs (especially the labor herbs listed above) contraindicated during pregnancy. Basically, I only feel comfortable using herbs that are specifically INDICATED for pregnancy.

It is strange to me that home birth is so often paired with feelings of fear. After all the time I have spent in hospitals, I can say with certainty that it is nearly the last place I would ever want to give birth (unless it is a high risk pregnancy). Stress is stagnant in the hospital air, along with MRSA. Our society’s viewing of birth as a medical procedure has disempowered us and nearly severed the ability to trust our bodies through a process as old as the beginning of time. And yet, miraculously, our instincts are there whether we trust them or not. That’s the beauty of instincts; they do not have to be developed, they are just there. (Our listening skills, however, may need some cultivating.)

After many months of working as a birth assistant, I picked up an ambulance shift, and responded to a house for a woman who had given birth. When we arrived on scene, mom and baby were on the bathroom floor, gazing into each other’s eyes. Both were perfect. The placenta had yet to be delivered. The fire department was rushing to get her onto our stretcher, take vital signs, and move them into the ambulance. “Should we wait for the placenta?” I asked. “That’s not protocol,” was the response. They requested me to drive lights and sirens. I turned on the lights, but refused to expose such a tiny person to those horrible wails in the first hour of life. It was the middle of the night anyways and no one was on the road. Along the 8 minute transport to the hospital, it was raining and I noticed sprinklers needlessly watering people’s yards. I couldn’t help but marvel at the ridiculousness of the situation, and our culture in general. When we arrived at the hospital, the obviously healthy baby was taken from the mom for a significant period of time. She expected this and didn’t seem to mind. I noticed the baby’s lips were trying to suckle, and I worried that breast feeding would be more difficult the longer they were separated. Then we had to leave to respond to another call.

The next week I went with Becky to a home birth. The laboring mom’s desire was to have us there for support, but she wanted to catch her own baby. The birth pool was set up outside, under the stars. Within a few hours, her baby was delivered in the caul (meaning the birth sack was unbroken, a rare and magical occurrence). She caught her baby, with her partner holding her, and the babe had a healthy latch on the nipple within 10 minutes. Soon grandparents came over and marveled at the little creature, cooked mom some food, and tucked her and baby in for a sweet sleep. An experience like this makes me feel like humans are powerful, ancient creatures of the earth.

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