Archives for home birth

Our Little Boy’s Birth Story by Marisa Soboleski

Marisa has generously agreed to share the birth story of her son, born late March in her home in Vermont with no midwife or medical professional present. Marisa and I met at a playgroup in Ashland, Oregon when my youngest daughter and her oldest daughter were both babies. Her daughter’s name is Sierra, mine is Leone. Sierra Leone. No wonder they took an instant liking to each other.

I’ve never believed in due dates.  A due date is an estimation, not an expiration date.  Babies come when they are ready.

Feeling the changes in my body, I was pregnant again.  I learned about the new midwife insurance mandate that just got passed in Vermont, and was thrilled.  I searched for a local midwife who was hands-off and wouldn’t intervene unless absolutely necessary.

I had an intensely wonderful experience giving birth to your sister, Sierra.  We labored outside on a beautiful day at a friend’s farm in Oregon. Her birth was completely unhindered.

I wanted the same for you.

Over time, I met with several midwives only to learn that the Vermont state laws regarding homebirth were somewhat rigid:  they didn’t allow midwives to assist “postdates,” twins, or breech births. There were many restrictions. I loved the idea of having a comforting circle of sisters helping me trust my body, but the state and medical perspective would not allow that. Interference can be very risky.

I needed to look deeper within and to trust my body.

So knowing that only I could provide the best prenatal care for myself, I had an unassisted pregnancy.  I took this time to nourish my body with fresh food, listening carefully to responses in my body.  I educated myself as much as possible, through mentors and many other resources. Other than fatigue and occasional heartburn, my pregnancy was serene.

Right around 36 weeks into the pregnancy, I had this sudden irresistible urge to nest.  Family and friends were coming over that weekend for our Birthing Way celebration.  I scrubbed the floors furiously and scoured the kitchen.  Still rushing, I heated over leftovers while pacing around the house.

When I finally sat down, I felt a pop and then a gush. Oh, did my water bag just break?  I took my pants off, expecting clear fluid. Instead, there was bright red blood.

Initially, my intuition told me everything was fine.  However, once I typed in a quick search on the Internet, there were all these horror stories involving third trimester bleeding.

I reached Sierra’s midwife in Oregon and we discussed my options.  In this case, the bleeding could either be coming from the placenta or the cervix.  We were both really hoping for the latter.  A local midwife assistant rushed to my house and we listened to your heartbeat. It was very strong. Your kicks were firm and strong. The bleeding turned light brown and then went away. Still, I kept a very close eye on you.

The next few days were confusing.  My head was spinning from all these notions. Exterior self-doubt was fighting at my intuition. My mind was doubting my spirit. I was in search of some kind of guidance. In solitude I felt confident and comfortable, but the more time I spent on the Internet, the more uncertain I felt.

Here I was, going through a pregnancy without the attention of any medical provider, something totally outside our cultural norm. What if I was making the wrong choice? What if something was really wrong?

It was a beautiful, placid day.  Yet, I couldn’t shake off that tense, on-the-edge feeling.  I decided to call a local midwife to see if there were a mama/baby friendly hospital where the doctors would empathize with our needs…or perhaps an imaging studio so that we could just check on the placenta’s position and condition. I wanted to make sure there were no signs of previa or abruption. I was not supportive of medical intervention, including ultrasounds, unless there was a good reason.  Bright blood was one.

The midwife went ahead and called the hospital, giving them information about me without my consent. When I called, the nurses were already expecting me.

Once Jesse came home from work, we all got in the car and headed out. The moon was full. A threatening storm was coming in fast. Once we arrived at the hospital, we felt intimidated by the large, dark institution. We fumbled around, searching for the women’s center. When we found the clinic, an ultrasound technician greeted and led us to a cold room. It felt so unnatural seeing you on screen for the first time. You kept turning away from the transducer and I wanted to keep the exposure very brief. Your placenta was up high in the uterus. All good. You were suckling away at amniotic fluid, and we could see that you and Sierra had the same nose.

Now that the anatomy scan was over, your dad glanced over and sensed how uncomfortable I felt. He suggested that we just leave. But the nurses had a different agenda, they urged that we discuss my options with an obstetrician. The nurse coldly told me to get undressed and informed me that the doctor would be looking at my cervix. I told her that it would not be necessary and that I was keeping my clothes on. She was taken aback by my assertiveness.

The OB walked in, and the energy in the room turned incredibly frigid. He stared at me with a stoic expression through his glasses, with his nose turned up. I nervously cracked a joke, and he wasn’t amused at all.

He claimed he was incredibly concerned about my lack of prenatal history. Since the office was closing down for the day, he wanted to transfer us to the Labor & Delivery floor for a non-stress test. He said that your heart rate was a bit high.

Well, absolutely. It was full moon, I was nervous, and goodness knows what kind of sound waves were coming from that ultrasound transducer, and you were really active. Of course, your heart rate was high.  

The doctor wanted to order a NST based on the heart rate, and nothing else. He couldn’t find anything else wrong with the ultrasound. I told him that I would prefer to go home and do some research on the NST before making a decision. I informed him I would make an appointment if my research showed the test would be helpful and necessary.  When Jesse asked him what would happen if we didn’t do “well” on the NST, the OB laughed arrogantly and said that he would have to discuss options.

He didn’t say it, but he was clearly thinking INDUCTION. Perfect, a woman coming in with absolutely no prenatal history, nearly to term of her pregnancy. Let’s find every little reason to get her to stay in here.  

My heart was beating hard. Before I could say anything, he went into his office and called the L&D department to set up a bed for me. I knew the test was unnecessary, and we wouldn’t benefit from my tension and discomfort. Jesse looked at me and asked what my intuition was telling me. I calmly gathered myself back together and walked into his office to tell him that we decided that we were going home. We would make an appointment if I felt it was necessary.

The doctor’s face turned fire-engine red. He furiously argued with me, saying that I was putting myself and the baby at risk … that I was an irresponsible mother. That the baby would die overnight. What was he thinking, inflicting unnecessary fear upon a woman? Why was a stranger using everything in his power to order me around? Yet he was expecting me to trust him? He has never given birth. When was the last time he saw a birth that wasn’t messed with? He didn’t even know me.

We got out of there as fast as we could.  Contractions became harder that night.  I wasn’t ready.  Very relieved, but not ready.

I got a call from the doctor’s office the next day, wanting to discuss the ultrasound results and to push for a NST. I thanked them for their concern and declined. Many of the tests aren’t at all accurate.

It was time to trust my intuition more than the system.

A few more weeks went by, with lots of contractions.

We spent a lot of time in the thriving garden and went on many peaceful walks around our land.

I had a dream that you stretched out in my belly and reached out far. I pushed your hand back inside. I wasn’t ready yet.

Then I immediately remembered my dream with Sierra the night before she was born–she reached out in the same way in utero, and my hand met hers and there was a luminous, brilliant light.

That day we did various chores around the house and picked up a truckload of compost for our garden.Contractions were irregular … still very far apart, but becoming very intense. By bedtime, Sierra and I read a book about the farmer’s market and I watched her calmly fall asleep, wondering what it would be like when Sierra wasn’t my only child anymore. I crawled into bed and tried to get some rest.

There was still no pattern in the contractions, but I knew for sure that I was in labor. I asked Jesse if he could come into the bathroom to keep me company. He held my hand through every groan and grimace.

The contractions became much closer together. It was time. Jesse went downstairs to set up the birthing pool and lit a few candles. It was a very cold night so he built a fire in the woodstove. Once the pool was half full of water, Jesse got in and I joined him. It wasn’t long before my body was uncomfortable with the heat in the pool. I listened to my body and went back upstairs and labored some more on the toilet.

There was no rhythm, but absolutely moving along. Then it got to the point where the rushes were coming one after another. The contractions were on top of each other and I felt like I was about to birth right there on the toilet.

Before we knew it, it was three in the morning. Sierra woke up and groggily walked into the bathroom. I knew I needed some more time and space so Jesse went back into her bedroom with her and encouraged her to go back to sleep. I slowly walked back downstairs alone in the dark and bent forward kneeling on the couch.

All of sudden, the contractions completely stopped. Nothing. My body completely stalled. After a while, my legs started shaking uncontrollably, and I felt a huge wave of nausea.  I immediately thought: Oh, this must be transition …  

Then I had an incredibly strong bearing down sensation following one HUGE contraction. Almost like you were coming right there and now. I wasn’t ready! Not at all!! Jesse and Sierra were both upstairs and I was alone. I told you to WAIT!!!!

I felt a huge burst, a dramatic explosion. Warm fluid streamed down my legs, all over the couch. So this is what it feels like when the amniotic sac breaks…

Too late, Sierra already saw all the excitement. The shiny blue birthing pool and all these beautiful candles around and she was not about to go back to sleep at all! She gleefully peeled her pajamas off and jumped into the birthing pool, splashing around.

I didn’t have any contractions for a while, but I was still shaking. Jesse patiently rubbed my back. Sierra marched around the living room loudly and tried to throw our cat, into the water.

The contractions slowly came back. They were strong. I vocalized and held Jesse’s hand through every one of them.

The pool wasn’t that appealing, but I joined Sierra in the pool anyway. She swam around with me for a little bit–and then it was time for her to give me a little space. She found a spot next to the pool to settle down and watch quietly.

Your head was very, very low. I could feel you and the enormous pressure. The sun was beginning to rise. The rays were coming through the early morning clouds. The trees were calm outside the glass sliding doors. The fire was starting to settle down a little bit.

I was starting to have that feeling–like I was being turned inside out. It was that fetal ejection reflex. I had no control and felt like I had to involuntarily bear down and throw up at the same time. I was still not ready! I was holding back. I reached in and I could feel fuzzy hair on your head and it was so relieving being able to touch you, knowing that you were right there, almost out. That it wouldn’t be very much longer.

Jesse patiently looked at me and held me. Marisa, let it all out. You don’t need to hold back anymore. Let go. With the next few huge surges, I screamed as loud as I could. Jesse stood up, held my hands up high and let me hang down from him. I swayed my hips in rhythmic circles. I was in a battle with myself- feeling that I was ready to surrender. Then the next second, I’d tell myself, No, no, not yet!  Nevertheless, your head made its way down. Oh, this is why people call this the ring of fire. I felt my body bear down through the next few contractions. I tried to stand up, out of the water a few times. But every time I tried, I would stumble back in the water. The air felt so brutally heavy.

Your head was out, and we were still in the water. My contractions were not rhythmic and felt overwhelming. I tried pushing without a contraction and it was no use. I knew I had to wait until the next one for your shoulders. I took a deep breath and drank some water. Ready, let’s try again! Together we pushed your shoulders during the next surge. The rest of your body out. You floated in the water before I brought you to my chest. You seemed so calm.

Welcome earthside, our sweet little boy.

Your birth was peaceful, unhindered, and the way it’s been since the beginning of time.

Midwife Arrested in Indiana, Released on $10,000 Bail

When a car pulled up to her house a little after 10 a.m. on Saturday, March 31st, Ireena Keeslar was still in her pajamas.

Ireena and her husband, who keep the Sabbath from sundown on Friday to sundown on Saturday, were just finishing up a late breakfast.

They weren’t expecting any visitors. They certainly weren’t expecting the police.

But Keeslar, who is 49 years old and lives in Howe, Indiana, was put into handcuffs and taken to jail.

She was arrested for practicing midwifery.

Certified professional midwifery, as well as direct-entry midwifery, is illegal in Indiana.

Though certified nurse midwives may practice in a hospital setting, professional midwives, regardless of their training or experience, may not deliver babies at home or in the hospital.

But since LaGrange County, where Keeslar lives, has a large Amish community, demands for homebirth midwifery services are high.

Just over the border in Michigan, where she delivers most of her babies, homebirth midwifery is unregulated, being legal by default.

She couldn’t stop crying on the way to the county jail, Keeslar told me today when I spoke to her on the phone. A diabetic and a mother of five, Keeslar explains that her own mother died this past October and her only brother died last year of cancer, and that being arrested was completely demoralizing.

Keeslar was a nurse and worked in obstetrics before deciding to become a midwife.

She has participated in over 1,700 births, about 400 of which have been babies born at home.

Homebirth midwives in Michiana, the area of northwest Indiana and south central Michigan, charge between $900 and $3,500 per birth, which includes prenatal care.

Nationally, the average hospital birth costs between $5,000 (for an uncomplicated hospital birth) to $20,000 (for a C-section with complications). This does not include the price of prenatal care.

Keeslar’s arrest was not associated with any bad outcome. But she is the second professional midwife to be arrested in the past two months.

Keeslar, who has been working as midwife for about eleven years, is not sure what prompted authorities to target her now. But it is clear that while women in Indiana want to have a choice about where and with whom they deliver their babies, many obstetricians in the state openly oppose midwifery and homebirth.

Indiana Obstetricians Oppose Homebirth
Dr. Kurt Wiese, M.D., an obstetrician in private practice in Valparaiso, says that he’s ambivalent about whether professional midwifery should be legal.

He is willing to work with patients who do not want fetal monitoring or other interventions, Wiese says.

He also points out that women in Indiana can give birth with midwives in the hospital.

Wiese says his concern is bad birth outcomes, not loss of business.

“I’m not worried about losing money to them,” he tells me. “The large majority of people still choose to deliver in the hospital.”

But Wiese gets angry when a homebirth goes wrong.

“From my own personal perspective, the ugliest aspect of all of this is that their train wreck or their disaster shows up at my doorstep and I become responsible for their irresponsibility,” he says.

“At two in the morning that’s what I’m dealing with. They don’t practice by a standard of care that we agree with.”

Dr. Cal Streeter, D.O., who has been practicing medicine for 37 years and backing midwives, disagrees.

“It’s all about the money,” Streeter says. “People who have money in Parkview Hospital in LaGrange County want to do away with our midwives.”

Streeter says Keeslar is a competent, experienced midwife and that homebirth with competent attendants is as safe or safer than hospital birth.

“It’s as safe to have a baby at home as in the hospital. Most of the problems in obstetrics are doctors trying to hurry the process up or slow it down. Most every problem in obstetrics is a lady getting Pitocin to fit the doctor’s schedule, or slowing the process down until he or she gets there.”

While the traditional medical establishment is fighting midwives, Streeter says Indiana women want to have choices.

“Outside the medical community, people in Indiana want midwives. Ladies would prefer midwives over obstetricians. Of course you need an OB as a back up if you have a problem. In case you need surgery.”

Indiana Moms Support Homebirth Midwives
“I think it’s ridiculous that they don’t give midwives the option to be legal,” says Stephanie Precourt, 35, an Indiana mom who had her first three babies, all boys, in the hospital before leaving her OB practice when she was 32 weeks pregnant and delivering a daughter at home.

“The law doesn’t make sense,” Precourt says.

“It’s not illegal for me to be alone and do it unassisted,” Precourt points out, “but to have someone attend my birth who’s not licensed is illegal. Ivy was number 1631. My ‘illegal’ midwife had seen everything and done it all. We just took the risk that if we had a transfer, she couldn’t go with me.”

“It just seems unbelievable to me that in the 21st century people can’t have a baby without somebody telling them how to do it,” says Patty Miller, 50, who has been good friends with Keeslar since they attended 5th grade together at Colon Elementary School in Michigan. “I think she’s providing a valuable service to women, giving them a choice.”

“They think it’s fine to schedule a C-section for convenience—doctors do that all the time—but to want to have a baby in a loving home with your family around, they look at that as the odd way to have a child,” Miller says.

“It’s so backwards.”

Released on $10,000 Bail
Keeslar spent all of Saturday in jail.

There was someone else’s phlegm in the sink in the cell.

She was forced to wear a prisoner’s uniform that was so tight it cut off the circulation in one leg and caused it to swell. She was served food inappropriate for a diabetic (she could not eat it), not given access to her insulin and other medications, and repeatedly ignored when she called out for help.

But just before sunset, Keeslar was released from jail on $10,000 bail.

She returned home to her husband, 5 kids, 2 of her 5 grandkids, 1 dog, 2 cats, 20 sheep, 2 goats, and too many chickens to count. She has homemade pickles stacked in her pantry and a large garden where she grows a lot of her own vegetables.

Friends describe her as a woman with a great sense of humor and a kind heart.

Keeslar says her belief in God is helping her through this ordeal.

A court date for a hearing has been set for this coming Monday, April 9th, 2012.

The Indiana Midwives Association is asking homebirth and midwifery supporters to meet at the LaGrange Courthouse at 105 N Detroit Street at 11 a.m. On April 9th to show their support.

For readers who want to help Keeslar cover legal fees, send checks to:

Ireena Keeslar Legal Fund
7570 East 750 North
Howe, Indiana 46746

Jennifer Margulis, Ph.D., is a senior fellow at the Schuster Institute for Investigative Journalism at Brandeis University. She is the editor of Toddler and co-author of The Baby Bonding Book for Dads. Her new book, The Business of Baby: What Doctors Don’t Tell You, What Corporations Try to Sell You, and How to Put Your Baby Before Their Bottom Line, will be published by Scribner in April 2013. Read a Q & A with Jennifer at the Oregonian’s Oregon News Network.