Posted by: Liza Rosenberg | July 3, 2009

The best-laid plans

When I gave birth to the Little One, I almost died. The pregnancy itself had been a difficult one. Questionable genetics combined with a bad obstetric history (and that would be putting it mildly) dictated that I would be watched carefully, and that we would always err on the side of caution. Once we cleared the initial genetic hurdles, I found myself faced with such issues as the unexpected discovery at week 16 of an incompetent cervix (resulting in urgent surgery to put in a cerclage and me working from home for the remainder of the pregnancy) and the subsequent diagnosis of gestational diabetes. To make matters worse, I was utterly depressed. Despite the fact that the pregnancy was progressing relatively decently – if not smoothly, the fear that something would somehow go horribly wrong was never far from my mind. Four failed pregnancies led me to believe that the odds were not in my favor, which meant that I basically spent my entire pregnancy holding my breath and waiting for something to go wrong.

Nothing in my wildest dreams – or nightmares – could have prepared me for what I experienced when I gave birth. The bleeding began once my son was out, and it simply wouldn’t stop. The placenta wasn’t coming out and my uterus wasn’t contracting as it should have. In short, I was hemorrhaging. I suddenly felt weak and sick, and as the blood drained from my face and I turned white, I heard my husband pleading with me to stay awake.

As the medical team worked feverishly to get my body to do what it was supposed to, I was consumed by sheer terror; I was sure that I was dying, and even began to think about my husband having to raise our son as a single parent. An anesthesiologist was hovering outside the room, ready to rush me into surgery in the event that the doctors wouldn’t be able to stop the bleeding, which would have necessitated the removal of my uterus in order to save my life. Fortunately, we didn’t reach that stage. The doctors managed to stop the bleeding, employing a number of often painful techniques and persevering until it worked. I received four units each of blood and plasma, and was hooked up to oxygen after they discovered that my oxygen saturation levels were low. I remained in the delivery room for approximately twelve hours after giving birth, at which point I was moved to a room in the maternity ward that was directly across from the nurses’ station.

While the doctors in the hospital refused to discuss it, my own doctor confirmed what I already assumed to be true. My life had been in danger, and I could have died. While the birth itself had been fairly routine, my condition deteriorated rapidly within an hour. There was no indication that what I had experienced was in any way related to the problems I’d had during the pregnancy. What had happened to me could happen to anyone, without any prior warning.

And that’s why I was so utterly appalled by this article in last Friday’s Haaretz Magazine about unassisted home births. Don’t get me wrong – I can certainly respect that there are some women who are turned off by the hospital experience, or that some women wish to give birth naturally and with no painkillers (I, on the other hand, informed the nurses every ten minutes or so that without an epidural, I wouldn’t give birth…). I also realize that most births tend to proceed as they should, and that complications are minimal. But what about those few births that go wrong, those births that go so spectacularly off course that the lives of the mother and and/or the baby are in danger? What do you do when you’re giving birth alone in your bathroom and your baby won’t come out? What do you do when the bleeding just won’t stop?

I was shocked by the women in the article, angered by what I perceived as being ignorance and misguided priorities. Isn’t it more important to survive a birth procedure that might not be precisely to your liking than to die as a result of the “perfect” birthing experience? I realize that given my own background, I may not be the best person to judge. Perhaps I am overly sensitive when it comes to such issues, but I cannot help becoming incensed by women who naively believe that nothing can happen, that despite all of the medical technology placed at our disposal, they are prepared to turn their backs on modernity in the most extreme manner possible. Some of you will condemn me for being judgmental, and I accept that there’s truth in that. I just cannot help but think that had I chosen this path, my son would not have a mother.

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Responses

  1. I completely agree. While I support a woman’s right to a homebirth if she so chooses (and if her pg is deemed low-risk), and while I’m a very strong supporter of a woman’s right to a non-interventionist natural childbirth if she wants one (and I did), I just can’t see an unattended homebirth as anything less than negligent. My own daughter was nearly born on my living room floor as things progressed faster than anticipated. Our doula, who was also a certified homebirth midwife, offered me the chance to stay home. I refused. (You can also view this as a poor choice, Maya ended up born in the back seat of my car in the hospital parking lot.) However, a few hours after her birth (and possibly avoidable if the staff hadn’t freaked the eff out at the idea of her being in a car and rushed the completion of her birth to an extreme degree (something I’m still very bitter about, given the apparent consequences)), she developed polyscythemia. Her blood was too thick, and she needed emergency transfusions in the middle of the night to thin her blood before she had a stroke – or died. She ended up in the step-down unit of the NICU for several days because of this, on an iv and forbidden to take anything by mouth. The only indication that she had developed this life-threatening condition was the overly red color of her skin, which didn’t appear right away. Had she been born at home, unattended, we would never have known. We’d probably have laughed that she was “blushing”, and our daughter could have died, without us ever knowing anything was wrong.

    So yes, I agree with you. Unattended homebirth is playing Russian roulette with your baby’s life and your own, and is irresponsible in the extreme.

  2. Absolutely agreed. At least a midwife. And be close to the hospital just in case!

  3. Wow. Liza, you have really had some interesting life experiences.

    I wanted to have the “perfect birth” too. I was definately one of those nuts who wanted to be ‘in control’ and stay at home. Even hired a doula to train us. No meds for me. Despite the fact that one of my moms friends lost her baby during a home birth (cord wrapped around the neck). Besides we lived one block from the hospital – what could go wrong?!

    That was B4 the birth. Because of gestational diabetes they induced at 40 weeks – which meant having to compromise and go to the hospital. That induction kept me in hospital all tubed up trying like hell to give birth for 4 days.
    Finally, an elderly dr walked in Friday night and told me that if I had been his patient he NEVER would have allowed me to try this long.
    I did not even argue with him.
    Great – bring on the knife and the meds baby.
    I am ready willing and able.
    My second pregnany had to be a C section because of the twins not being in place at 40 weeks. Also lost a lot of blood and bottomed out with lots of interventions.

    Some things can not be planned… no matter how much we try!

    You really write some great articles!

  4. I agree 100%. Most births are uneventful, but who in their right mind would play Russian Roulette and take a chance that theirs won’t have any problems? I’ll go a step further and say that I’m not a big fan of home births even with a midwife in attendance. I’d rather be in a hospital with all the latest technology JUST IN CASE I OR THE BABY NEED IT. One reason I feel so strongly about this is that things would almost certainly have gone downhill fast if I’d tried delivering naturally at home (all my kids have been born via C-section, for medical reasons). I shudder just thinking about it.

  5. As a volunteer MDA ambulance driver/EMT, I think home births are a terrible risk to take.

    If everything goes as planned, well, great & mazal tov. If not, the absolute best place is to be at a hospital….not at home, not in an ambulance, and not in a pool of dolphins.

  6. Holland, where I was born, is always used as an example by home-birth-supporters in Israel. I was never convinced, and do believe that giving birth in a hospital ( with or without an epidural, my wife twice had one and ‘loved’ it, once she gave birth so fast that no epidural could be given ) is definitely preferable. My sister – who has two healthy daughters – was told “Don’t worry, if something goes wrong you can be in the hospital within 15 minutes.”, a phrase that still scares the hell out of me. She and I were born at home, our elder brother was born in a hospital, I don’t know why, I will ask my mother. During the birth of my sister, my father – who has been an avid amateur musician for over 60 years now, we always had an organ at home and he also used to play the euphonium – and the GP who was there ( again, now that I think of it, I do not know why; during the birth of my nieces a midwife was there, no doctor ) and who played the organ, played music together in the pauses between the contractions.

  7. Btw, Kol HaKavod for your perseverance. After three very smooth pregnancies and relatively easy deliveries ( NB: I am the husband, my wife of course did all the hard work ) I do not think that I will ever be able to fully appreciate the fact that having children is a privilege that should never be taken for granted.

  8. I’m with you on this one as well… my midwife held the record for home births here in Norway. I was feeling like something was wrong around week 23 with my first little viking and voiced this fear. Her response was that women give birth all the time and had I considered a home birth yet. That was enough for me. I switched to a private OB/GYN and never looked back. As it turned out, the baby stopped growing a few weeks later and the monitoring that followed allowed doctors to discover when the womb was no longer a healthy atmosphere for her. She was delivered by C-section 5 1/2 weeks early at 4 1/2 lbs. If I’d stayed with the mid wife or chosen to home birth, who knows what would have happened.
    I know you know all this, Liza, since you were here the day before she was born, but I would just like to share that a woman should listen to her own body and what it’s telling her rather than be swayed by the opinions of others.

  9. Sensitive issue, I think.

    I can really relate to what you went through, Liza (we do need to meet!). I was almost there with my first birth and was spared the bleeding just because we went with a C-section and they could see that I had placenta accreta and gently “scrape” it off during surgery. Had it been a vaginal birth, I’d be there bleeding. Had it been a natural home birth, like we had in fact considered, I’d be dead. The baby would have died too, since he has the umbilical cord wrapped around his neck 3.5 times – something they couldn’t even see in the ultra sound.

    The only indication for a c-section was the fact that he was in breech, along with my doctor’s “gut feeling” if you like. I so wanted a natural birth. I really did. We took the natural birth course and even looked into midwives that will do the homebirth thing. Natural birth fans here in Pardes Hana tried to talk me into going with it, despite it being a breech, but my doctor told me this: giving birth is about becoming a mother – it’s not about heroics. And boy, was he right. So, a planned C-section and as non-eventful birth as could be… but we’re both alive and I had kept my uterus and had another baby a couple of years later.

  10. […] was born, I refused to even consider the possibility of having another. After all, it had been a difficult pregnancy and a complicated birth, one that could have cost me my life. We’d tried to have a child for nine years, and now that […]

  11. […] was born, I refused to even consider the possibility of having another. After all, it had been a difficult pregnancy and a complicated birth, one that could have cost me my life. We’d tried to have a child for nine years, and now that […]


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