On Tuesday, May 7, 2019, The BIRTH Project Network held its first-ever online meet-up. This inaugural meet-up covered the topic of home births, and featured an experienced home-birth midwife as the subject matter expert.
The conversation covered the home-birth process from pregnancy, to labor and delivery, and through the postpartum period. You can watch and listen to the whole conversation above, or see time stamps for highlights listed below.
Learn About the Subject Matter Expert
Kelly Olmstead, LM, CPM, is an Iowa native who has been in Santa Cruz, California, for 17 years. A mother of three, she has been active in the Santa Cruz birth community since shortly after the home birth of her third child, Henry, in 2002.
Her particular passion is ensuring that women understand they have options in birth—and the benefits and risks of various choices—so they can make the best choice for themselves and their babies.
After four years of midwifery school and apprenticeship, Kelly was licensed by the Medical Board of California in March 2010. By the close of 2017, she had attended more than 450 births. She’s also served on the board of directors for Birth Network of Santa Cruz County for several years.
Additionally, Kelly is the co-founder of a midwifery advocacy group called Birth Santa Cruz. Check out BirthSantaCruz.com on Facebook—it’s a great way to stay up to date about what’s going on with birth locally and nationally.
More recently, she joined forces with two other amazing midwives to create Pacific Community Midwives. They each have independent practices but collaborate and back one another up.
From 2011-2014, Kelly was Regional Co-Rep for the California Association of Midwives (CAM). She remains active on projects with their sister organization, the California Association of Licensed Midwives (CALM), including keeping midwives updated on continuing-education opportunities, meeting with state legislators on midwifery issues, and creating welcome packets for newly licensed midwives in the state.
Highlights and Time Stamps
19:07- Kelly discusses an effective written home-birth birth plan.
13:00- Amara shares her takeaways after experiencing a home birth turned hospital transfer.
24:00- Katy shares her home-birth takeaways.
28:15- Kelly suggests what to look for when trying to find the right midwife for you.
29:20- Katy shares the story of when she got in a car wreck at 8 months pregnant.
31:45- Katy shares her biggest insight after working with a midwife and experiencing a home birth.
34:00- Participant question about not wanting any ultrasounds, but suspecting she’s carrying twins.
38:00- Participant question about a safe distance from home to hospital when planning a home birth.
41:50- Participant question about responding to family who are hesitant about home births.
47:15- Kelly discusses the hospital vs. home-birth experience.
49:08- Kelly addresses how she remains confident as a midwife.
51:00- Kelly discusses how she handled an emergency with a patient who had Hellp syndrome
54:20- Participant question about assuring women that their births will work out the way they want them to.
At 39 weeks and 6 days pregnant, it certainly is not following my plan. Tonight, per my doctor’s strong recommendation, I am getting induced. The primary reason is because I have a velamentous cord. This means that the umbilical cord is not fully on placenta and therefore, not 100 percent protected by Wharton’s jelly. I also have an accessory lobe placenta and being 35 (geriatric pregnancy), they are being cautious and I’m accepting it (sort of).
I get that my birth plan is not a guarantee—in fact, I’ve been calling it my “wish list,” instead of “plan.” What has been most frustrating is that they did not tell me about the recommendation to induce until 38 weeks. I asked when we found out about the velamentous cord if I could still plan on having an intervention-free birth. I was told yes, and continued doing what I do unless they said otherwise. They never said otherwise, and the word “induce” did not come up until just over a week ago. Then, after reluctantly scheduling the induction for Dec. 24, the doctor called me on Tuesday, Dec. 19, saying the nurses are giving her a hard time for scheduling the induction on the 24th. I was with her when she made the call to the hospital to confirm they would take us on Dec. 24. Also, due to the holiday, they are concerned about staffing. Oh, and after the last ultrasound, the recommendation was to induce by week 39.
If I had it my way, we would wait until Charlee is good and ready. However, that is not the case. Overall my pregnancy has been great. Other than working through learning about the velamentous cord and accessory lobe placenta, I have felt good and have kept my energy up throughout. I think a lot of this has to do with my regular chiropractic care, eating well, and staying active. I haven’t done as much working out for the past couple months, but I have continued to walk when I can and attended prenatal yoga 1 – 2 times per week throughout. That class has been a savior! I love the teachers and the community it creates. I’m not sure this pregnancy would have gone so well without that, not to mention the physical activity on Tuesday nights and Saturday mornings!
With all that being said, I still want to be sure we make the right choice to ensure our daughter arrives safely, so tonight, in about 45 minutes, I’ll call Mercy Hospital to make sure they can take us as planned at 7:30 p.m. Then we will head into town (through a snowstorm no less!), stop and pick up dinner, and go to the hospital. I have tried everything I can to get this baby to budge. Acupuncture, acupressure, additional chiropractic visits, bouncing on my exercise ball as often as possible, and moving as much as I can without exhausting myself (I did some walking hills in the snow this afternoon!). Clearly, she isn’t ready to come on my terms and I’m OK with that. It tells me that we are doing the right thing by starting the induction process. Step 1 will be cervadil when we get there. After that, we will sleep overnight and see how things are in the morning. If things aren’t progressing, I’ll try pumping. If that doesn’t work, we start pitocin. We shall see what happens! Our birth team is on call for when we need them. Our team consists of Brandon’s mom (a trained doula) and my mom.
I just called the hospital—they’ll take us at 7:30 p.m. as planned.
Charlee Elaine Sperrey arrived on Dec. 25, 2017—yes, we have a Christmas baby! Don’t worry, she’ll be fine and won’t miss out on having her birthday celebrated. I’m excited to share our birth story because it’s nice to get it down in writing and maybe my experience will provide insight to other moms giving birth down the road.
Getting to Dec. 25 was quite an adventure. We arrived at the hospital a little after 7 p.m. on December 22. We checked into room 3005 and the nurse told us to eat our dinner and she would be back in an hour or so to start the first round of induction drugs. Cervidil is the first drug I would be getting. It is a drug on a vaginal insert meant to help your cervix gradually open. I was told the reason they started with Cervidil is should I start contracting heavily from it, they can remove it and I would be intervention free from there.
We ate our dinner, a steak bomb on a gluten-free sub for me—man, was it good! I put on my pajamas and we settled in to enjoy some cable TV (we don’t have it at home). The nurse checked back in stating they had gotten busy with labors, so it might be a few hours before they could start anything. OK—understood (kind of—we were super anxious to get things rolling). She said she’d be back to check my blood pressure and the baby’s heart rate. More hours went by with a couple check-ins from the nurse at 1 a.m. and 5 a.m. Neither of us slept well in anticipation of getting things going.
Around 7 a.m., the nurse came in to let us know she was switching shifts and said it was likely I’d get the Cervidil in a couple hours. The Cervidil was inserted around 8 a.m. and it would stay in me for 12 hours, unless I went into labor. It is essentially a string and small piece of what looks like cardboard—not as big as a tampon. It did hurt and cause some discomfort when inserted, but once in, I barely noticed it. I had to lay still for an hour or so. They also put monitors around my stomach to watch contractions and Charlee’s heart rate.
We gave Theresa and my mom an update. Theresa had stayed at our house in case things got going during the snowstorm, so she arrived around 8:30 a.m. My mom started driving down arriving around 10 a.m. Our expectations at this point were that we might have a baby by the evening.
Twelve hours of Cervidil did result in some contractions toward the end—no lion, but more than I had felt. I walked and walked, did some yoga stretches, squats, bounced on the ball and had acupressure done on the small pins my acupuncturist had left on me. I was able to walk the floor while the nurse watched Charlee’s heart rate and my contractions because the monitors were wireless (thank goodness!) However, every now and then, the nurse would come looking for me because they lost the signal. It was kind of humorous, but also annoying.
At one point, they told us a concern was Charlee did not have consistent fluctuations in her heart rate. We learned that fluctuations in the heart rate signify she was thriving and moving around inside me. From time to time she would do well, but then she would not. Because of this, at one point, they made me get back in bed and lay on my right side on wired monitors. I wasn’t overly concerned because I could feel her moving, but of course, it became an obsession to watch the monitors when in the room.
At 8 p.m. the Cervidil was removed. The doctor checked my cervix to see how far I was dilated—not fun! She had to reach way up in me to do this—whoa, painful and hopefully good practice for contractions (come to find out, it’s not nearly as intense as contractions!) I was 2 centimeters and 80 percent effaced. The small dilation was discouraging, but being 80 percent effaced was encouraging. Effacement is the measurement of how stretched and thinned the cervix is. When you are 100 percent effaced, labor is said to be right around the corner. The doctor said my progress was not enough to break my water.
The next step, because of my goal to have as little intervention as possible, was to pump. Pumping can induce labor, so I wanted to try this versus Pitocin first. Pumping didn’t really do anything. So, around midnight, they gave me my first dose of Pitocin. This meant continued constant monitoring. They started with a low dose, increasing it slowly every half hour. After having the Pitocin pumping through me overnight … NOTHING! Contractions actually slowed down from when I was on the Cervidil. Clearly, Charlee did not want to come out on demand! We were all very disappointed and more frustrated because regardless of my progress, I had to stay in the hospital because they wanted to be able to monitor me as soon as my water broke due to the velamentous cord.
After the Pitocin, the doctor checked my cervix again and a little glimmer of hope was that I was now 3 centimeters dilated and 90 percent effaced. This was still not enough to break my water, but a sign that things were at least moving.
It was now Christmas Eve. My sister Nellie had flown in from Atlanta the night before. Her and my Dad were hanging at my house, likely a bit bored, waiting for Charlee’s debut, and wanted to come by for a visit. Originally, Brandon and I said no visitors while going through the laboring process. However, it had been a rough couple days, so I opted for the distraction of visitors.
As soon as Nellie and my dad walked through the door, I started crying (just writing about it brings me to tears!). The emotions running through me were incredible, I’m sure all the extra hormones helped, too! We had come into the hospital more than 36 hours prior with very little results. Not to mention the holiday—I really felt like we were screwing everyone’s Christmas up (even though deep down I knew they were fine). Their visit was a great distraction, helping to burn an hour of the day.
After they left, we continued to wait for the next step due to another influx of deliveries coming in the door. We spent the early afternoon doing laps around our floor, trying to get something to happen. Still nothing. We continued to wait around due to other deliveries coming in the door as a priority. At one point, Brandon and I were walking and we saw a woman, in a wheelchair, looking to be in immense discomfort, most likely in full fledged labor. I told Brandon that I was incredibly jealous and broke down into tears. We went back to the room and we were all very frustrated as we continued to wait around.
When we got back to the room, Theresa and my mom had been chatting about how ridiculous it was that we continued to wait. After nicely complaining to our nurse, we decided to call Theresa’s partner’s brother, Ray, who is a doctor, to get his perspective.
This was a great move due to the frustration (the poor nurse who was getting the brunt of it!) Ray helped us understand that the reason we had to wait around is because they needed to monitor us 100 percent of the time. What they were doing was for the wellbeing of both Charlee and me. He said based on the influx of unanticipated deliveries, it made sense that they were holding off. We all understood and it was incredibly helpful to get his perspective.
Around 4 p.m., the nurse came in and gave me about a quarter of a pill called Misoprotosol. To summarize, it is another induction method similar to Cervidil, and it helps to soften the cervix to induce labor. The difference is because it’s in a pill form, you can’t slow it down like you can Cervidil. If contractions come on heavy, you can’t take away what you swallowed versus you can take out the Cervidil. Four hours after taking the Misoprotosol, there was no change in contractions.
Around 8 p.m., they gave me another dose. At that point, we were all incredibly exhausted. Our moms decided they were going to give us some space and camp out in the solarium room down the hall. Brandon and I settled in for the night and actually got about 10 hours of sleep (other than a few vital checks).
The next morning (Christmas Day) there was still no major change. At 7 a.m., the doctors switched out. We met with the new doctor who explained how she saw the day going. She said that they had a c-section they had to perform and a delivery on the way in. After each of these, if no other unanticipated labors came in, they would start me on a higher dose of Pitocin. They would see how that went, and then most likely break my water.
Things get a little fuzzy here. They started me on the Pitocin and around 2 or 3 p.m., as promised, they broke my water. Just as uncomfortable as having your cervix checked followed by a gush of warm water! There was meconium in the water. Meconium is the baby’s first poop. When it’s found in the water, it’s a concern because of the potential for the baby swallowing it through the amniotic fluid. There is a high risk of it blocking the baby’s airway, so they are unable to take their first breath after delivery. What this meant was they would have more hands on deck when she arrived should there be any issues.
With my water broken and a higher dose of Pitocin, the contractions started to quickly increase in intensity and timing. I now understand what they meant in my birth class when they said you go from the lamb to the lion in labor. There is a clear difference and you will know when you are there! The lion came on strong!
I started off contracting in bed because they wanted to have a consistent read on Charlee’s heart rate. Laying in bed was not an optimal position for me—my hope was to be able to move around to help with the discomfort. As the contractions intensified, I asked if I could at least move to the rocking chair. They granted my wish!
I then started to need more support from my birth team. Brandon was with me throughout. He sat in front of me holding my hand as I breathed through each contraction. Theresa was there, too, coaching and encouraging me. My mom gave us space, but I gladly felt her presence the entire time.
The experience of having Brandon be able to read me through these contractions was amazing. He seemed to know what I needed without me saying a word. At one point, he saw in my face that I just wanted him and he let his mom know. Then not many contractions later as they intensified more, I switched from focusing on him to focusing on Theresa 100 percent. Brandon knowingly stepped away and let his mom step in.
Up until this point, I stayed in the rocking chair. First squeezing Brandon’s hand then the arms on the chair. When I switched off Brandon to focus on Theresa, I felt like I had to go to the bathroom. Theresa went with me. When I sat on the toilet, I felt like I had to go so bad, but could not go. This all happened as contractions continued. Being unable to go for a few minutes, they brought in a portable toilet for me to sit on so they could continue to monitor. Not long after getting on the toilet, I told them I felt like I had to push, really bad.
It was about 5 p.m., so about 2 hours of intense labor. The nurse’s response to my need to push was I likely had only dilated 6 centimeters at that point, so do not push. She said the doctor would come in at 8 p.m. to check my cervix again. I looked at the clock and in my head I thought, “There is no way I can make it through 3 more hours of this.” I think this is also when they turned off the Pitocin drip. I told Theresa that I felt like I was going to pass out. She said focus on your breathing. The nurse told me I was doing awesome and to keep it up.
All I could think was: “Is this when I should ask for an epidural?” After one contraction, I was in so much pain, I felt like I was passing out. As another contraction came, I shook myself awake, thinking, “Did I just pass out?” After the contraction passed, I asked Theresa, “When do I ask about an epidural?” She looked me and said I was doing great and could do without. The nurse reinforced this message (awesome nurse!) They also said that Dr. Wadland was on her way to check my cervix. I looked at the clock and it was about 6 p.m.
When Dr. Wadland arrived, seeing her face relieved so much anxiety for me! They got me into bed—not easy with the contractions happening pretty rapidly at this point. I laid back and held Brandon’s hand as she check my cervix … 9.5 centimeters and 100 percent effaced!
Dr. Wadland said she wanted me to have a few more contractions before pushing. She had me get on my hands and knees in bed (thank goodness for all the cat/cows I did throughout pregnancy!) This is the moment when I felt most natural and was the experience I was expecting for my labor. I was going through the contractions, my bum and lady parts fully exposed, feeling like and saying I might poop. Thinking, “Wow, this is surreal!” I did in fact poop—most women do. When Brandon and I sat down and talked about the experience, I asked him about this. He said he wasn’t looking, but he did notice Dr. Wadland would very discreetly and quickly clean up any poop. For some reason, this made me feel better about this, so I wanted to share.
After a few contractions, they said it was time to push. She had me get back on my back. My mom came to my right hand and Brandon to my left. They both helped me bring my knees toward my head in a crunch position. When my next contraction came on, Dr. Wadland told me not to breathe now, to push through the contraction instead, pulling my upper body toward my lower body, almost a crunch motion.
Everyone was cheering me on. After the contraction passed, Theresa told me to stop pushing and coached me to breathe in between. At this point, all I wanted to do was push. They told me to wait for a contraction. I did my best, but I was outside of my body at this point, not really knowing if a contraction was happening. So whenever I felt like a minute went by and what might be a contraction, I pushed again and again.
At one point, the night nurse came in. She said hello to me and was very excited to get to see I was in full fledged pushing mode. She remembered my birth wish list and asked me if I wanted her to bring in a mirror so I could watch. I said, yes! She brought a mirror in and I could see everything. They asked me if I wanted to touch the head—YES! I touched it—surreal and motivating for me!
Shortly after this, Dr. Wadland said the baby’s heart rate is going down when I push, so we need to get her out in the next couple pushes or she’d have to use the vacuum. Hearing this motivated me even more to get her out. I could also sense there were a lot more people in the room at that point beyond the nurse and doctor.
They had me get on my right side again to help with Charlee’s heart rate—it is so hard to push in this position, but entirely possible! As a contraction came on (or so I thought)—everyone was cheering for me to push. My mom was there cheering me on as only she can.
A few more pushes and out came Charlee, pooping and crying! This was great news and Dr. Wadland immediately plopped her on my chest! I remember her with wide eyes looking right up at me and wailing—such an amazing moment. After the umbilical cord finished pulsating, Dr. Wadland asked Brandon if he wanted to cut the cord. He said yes—awesomeness. My mom snapped photos with my phone capturing all of this. They briefly took Charlee to the small station in the room to do her initial tests. She weighed 6 lb., 14 oz., 19.5 inches, arriving at 7:19 p.m. on Dec. 25, 2017.
After Charlee joined us, my placenta came out nicely, accessory lobe and all. Dr. Wadland said I did tear, so she needed to stitch me up. At this point, she could do anything down there, I was so focused on Charlee. She did numb me up with something and I could feel her working down there, but again, nothing mattered now that I had a thriving Charlee in my arms.
All in all, after trying to induce labor for almost 72 hours, Charlee joined us after 4 hours of intense contractions and 45 minutes of pushing. It may not have been how I pictured it all coming together, but I wouldn’t change any of it. The experience of going through this with our mothers, the amazing nurses that we got to know and appreciate, and having Dr. Wadland deliver Charlee will never be forgotten. I am eternally grateful that I trusted the journey.
A few tips that I offer to moms about to welcome their little one (or ones!) to the world:
-Cover or remove any clocks! Especially once the lion hits—you do not need to know the time, trust me!
-Get to know your nurses. We will never forget Vanessa, Brenda, Cathy, Emily, Allison and Kayla. Each of them made our experience the best it could be. I could tell they all read my birth wish list and they respected it the best they could. The timing of each of their involvement was also perfect. We didn’t meet Cathy until delivery day and she was the perfect nurse to have present at that time. When Brenda arrived when I was pushing, I couldn’t have been happier to see her face and I think we made her day as well!
-After delivery, cover up your nipples for a family photo. We have so many amazing pictures after Charlee arrived, but my nipples are out loud and proud in all of them!
-Document your experience so you can remember all the little details. It took me a month to complete and some of it was hard to remember just 30 days later. What I did find helpful is a bulleted timeline to reference as I typed this up. I’m so happy I now have it written down so I can share it with Charlee when she grows up.
-TRUST THE JOURNEY! We are not able to control how our labor goes, but what we can control is our trust in the process. If you have a bad feeling about your provider and their support for your birth intentions, find a new provider. I know a woman who changed in her third trimester. If you have trust in your provider, you will be able to trust the journey. Remember, at the end, you will have your baby in your arms and that’s all that matters! Having these affirmations written and on the wall as a reminder is one of the best things I did for our birth room.
I am so excited to announce the launch of The BIRTH Project Network! The overarching goal of The BIRTH Project is to add value to the birth community through storytelling. By publishing birth stories written by parents, I hope to spread awareness, knowledge, and connection in regards to the pregnancy, birth, and postpartum processes.
The BIRTH Project Network is a way to further connect, relate to, and learn from others in the birth community. The Network is comprised of online topic-based meet-ups with topics ranging from pregnancy, to birth, postpartum, and beyond. Each meeting is one hour in length and features a subject matter expert (SME). The SME is always someone who has more knowledge, experience, and qualifications on the given topic than I do. The SME is present to partake in the discussion, share their stories, share information, and answer questions.
Topics that are currently in the works include home births—this will be the inaugural meet-up!—postpartum fitness, nutrition during pregnancy, postpartum partner relationships, unmedicated births, c-section support, and so much more.
Please visit The BIRTH Project Network page HERE to find out how you can participate in this FREE online meet-up. I’m looking forward to chatting with you!