Phoebe’s Birth Story


My husband, Paul, and I were planning on having a home birth with MAMAS, and everything with my pregnancy was normal and healthy. But then, about a month before the due date, my feet started getting itchy. Like, really itchy. It was so bad I couldn’t sleep. One night, while not sleeping, and with cold packs wrapped around my feet for relief, I googled “itchy feet during pregnancy.”

Turns out, itchy feet is one of the only symptoms of a rare and serious condition called cholestasis of pregnancy in which the pregnancy hormones cause the mother’s liver and gallbladder to stop functioning properly. It can cause severe problems for the fetus, including death.

Naturally, I freaked out and called Mairi the next morning. I was worried that she would think I was being a self-diagnosing, paranoid person, but both she and Katie were super sweet to me about my concerns. They said cholestasis was extremely rare, but if it was keeping me up at night (both the itching and the worrying) then I should absolutely go get tested to make sure. So I went to get my blood drawn.

Unfortunately, Labcorp botched my first blood draw, and I had to go back for a second time two days later. I tried to convince myself that I didn’t have cholestasis and that everything was fine. The cure is delivery, so if the blood work came back positive, I would likely go to the hospital to be induced, thus putting an end to our dream of an intervention-free birth at home.

To make a long story slightly shorter, guess when I found out that I DID have the beginning stages of cholestasis… About twenty minutes after my water broke!

“It looks like your body is taking care of business on its own,” Mairi said when we called her. Then we told her that the amniotic fluid looked yellow-green and chunky – a sign of meconium staining, which we knew from our Bradley class. “Let me come over and take a look,” she said.

By the time she came over and confirmed it was meconium, I was starting to feel contractions, but they just felt like normal period cramps. I ate a muffin while Mairi talked to us about our options. She told us it would probably be fine to have the baby at home, but cholestasis is so rare that in her twenty-five years of practice, she’d only ever had one other patient with the condition. “There’s not a lot of information about it out there,” she said, showing us an article in a medical journal that had only managed to round up thirteen cholestasis patients for the study. She sort of talked her thoughts out loud. “If it was just one thing… But there’s the meconium staining and the cholestasis. I always say that home birth is perfectly safe for a normal birth, but it’s becoming clear to me that this is not a perfectly normal birth.”

We decided, to be safe, that we should go to the hospital where they could give me an external fetal monitor. Mairi called GW and talked to the midwife on duty to explain the situation. We also decided to take Kathy with us as our doula.

“When should we leave?” Paul asked. “Should we take showers first?” (Everything we’d read about labor stressed the importance of not going to the hospital too soon.)

Mairi gave him a strange look. “Um, I think you should go right now.”

So we headed to George Washington University hospital and met Kathy there. By the time we arrived and got checked in, my contractions had gone from mild period cramps to very intense.

It was a bit annoying being in the hospital. (The room was cold, they made me get an IV port, and the nurse had to adjust the fetal monitor every five seconds – often while I was having a contraction.) But otherwise, it wasn’t too different from home. We listened to music and dimmed the lights and Kathy suggested different positions. The GW midwife, Ashlee was great, though. She went over our birth plan point-for-point with us, and then she left us alone for the most part to labor in private.

I labored in different positions; first side-lying until that got too uncomfortable. Then we did “middle school dance” for about an hour, with some squatting in between.  As the contractions got more intense I used my yogic breathing and deep moaning. I could definitely start to understand why people get the drugs. It’s like, I can handle the pain of this contraction, but then I’d think ,“Oh no…there’s going to be another one soon!”

Kathy and Paul worked well together. Paul was really wonderful. Kathy would suggest positions and suggest things to me verbally and Paul would accompany her words with massage and touch.

For most of the active labor I was having contractions every 2 to 4 minutes, with increasing intensity.  Kathy suspected that there was a cervical lip that was inhibiting the baby from dropping down.  She said to do a standing position with Paul standing behind me and pulling up on my belly.

“I’m not going to lie – this position is rather intense,” Kathy said. “But it’ll speed things along.”

And she was right. It was NOT comfortable. I wanted to stop right away but Kathy said you usually need to do a position at least a few times – it might get easier. We did it a few times and then I went back to a seated position on the birth stool. But I could tell that the other positions, though they were less painful, were not as helpful.

I was getting exhausted, so I asked Kathy what I should do.

“Well, what do you want right now?”

“I want to have a baby.”

“Well, then I think you should do the standing position again.”

I sighed, resigned. “Okay. Let’s do it.”

By this time it was about 11:30 in the morning, and the new midwife on duty wanted to do a vaginal check.

“You know,” Kathy said, “I’ve been watching her, and I think she’s about ready to push.”

The midwife seemed doubtful. “Has she been grunting?”

“No, not yet.”

Everyone then looked at me and asked if I feel the urge to push. “I feel a lot of pressure,” I said.

“Do you feel like pushing?”

“I don’t know. I don’t know. I feel a lot of things,” I said. I was too tired to make much sense, but Paul and I convinced the midwife to come back in a half an hour to check me.

“We’ll do a few more of the standing position,” Kathy said, “and then a few more of the squats.”

But we only had to do the standing position another few times and then I said, “I have to go to the bathroom NOW.” I made a waddling bee-line to the bathroom. I felt like I was going to vomit and have explosive diarrhea and I started moaning/wretching. Meanwhile, there’s blood all over my pad and I freaked out, but then someone reminded me that it was bloody show – a good thing!. Outside in the room, I heard someone say, “well, that sounds like grunting to me.”

They got me to the bed to do an exam, and I’m +2 (!!).  Basically, without touching me, Kathy was able to figure out exactly where I was in labor and tell me what to do to make it progress. I’m sure if she hadn’t encouraged me to do the standing position I would have been in labor for a lot longer.

I did a sitting squat on the bed with a squat bar, and the baby’s head appeared in two pushes.  They were good pushes because the baby didn’t recede at all after each contraction.  I was worried that I was going too fast – I didn’t want to tear. But Kathy and the midwife and everyone kept telling me I was fine and to keep going.

About eight pushes later the baby’s head was halfway out. “Should I push?” I asked, and they told me to push on the contractions, but I honestly couldn’t tell when I was having a contraction anymore because there was just too much sensation, so I just pushed at random times – I was getting to the point where I just wanted it to be over.

“The NICU team is going to come in,” the nurse told me at one point. “But as long as they hear the baby cry, they won’t take her away. They just want to make sure she’s healthy and then they’ll leave you both alone.”

So there I was, pushing out a baby with Kathy, Paul, the GW midwife, two nurses, the NICU doctor, and a handful of medical students standing around watching.

“Um, how long is this going to take?” the NICU doctor asked. “Should we come back later?”

That’s when I gave a final grunting push, and my daughter (all 6 pounds 13 ounces of her) was born. The nurses placed her on my chest, and she looked up at me, cooing. Only a few minutes old, and she was so alert!

Paul cut the cord and a few minutes later the placenta came. It was pretty incredible. It didn’t happened like we planned, but it had happened all the same. I keep telling people that the birth was the best possible hospital scenario – no drugs, no interventions. Kathy said we basically had a homebirth in the hospital. So, in a way, we got to have the birth we wanted, just in a different location.

Now, postpartum in the hospital is another story… Ugh. Nurses coming in every twenty minutes all night long. That’s when we really wished we were at home. But, we managed to get out of the hospital and head home about 27 hours after her birth, and that’s when the real challenges began!


Phoebe arrived yesterday at 12:15 PM.  The story is a lot of fun (well, at least we think so) and a bit dram dram.

About two weeks ago Eva started having some really bad itching on her feet, which can be an indicator of liver disfunction called cholestasis.  Long story short, we had a bunch of labs done that didn’t come back until Tuesday at 11:30 PM (that time’s important … remember it).

So Tuesday around 10:30 PM, we’re in bed watching little Poebe (that’s what we call her) move around, and Eva’s stomach starts getting hard.  They were obviously contractions, but they weren’t painful, so we thought they were Braxton hicks.  So we go to bed.  As I’m dozing off around 11 PM, I vaguely hear a pop-whoosh.  Eva sits up and says, “I think my water just broke.”  I sat up and said, “I forgot everything.  What do we do now?”

After regrouping a bit, we noticed that Eva was leaking continuously … so this reinforced our suspicion that we were seeing amniotic fluid.  Also, it was pea-soup green, meconium staining (consistent with cholestasis, actually).  We called Mairi at 11:07 PM; she was fielding another call and called back at 11:30 PM.  When she called back she told us that Eva’s lab indicated initial stages of cholestasis.  Cure is to deliver the baby, but we were already on that route.  Mairi came over, we talked a lot about how to handle the situation.  We decided to transfer to GW because the cholestasis can sometimes be harmful for the baby, but in the absence of obvious fetal distress, natural birth is possible.  Mairi did a V-Exam and found 2.5 cm and 50% effaced.

So we collected our stuff and met Kathy at GW around 2 AM.  MAMAS has a good relationship with the GW midwives who knew that we wanted a home birth.  We met midwife Ashlee Lyvee, who is pretty awesome.  She’s super tall and has hair that may or may not have been in dreadlocks.  She’s got kind of a swarthy walk and was super chill about us being there.  She also had some hot-pink whale tail caused by a thong that rode a little too high, probably knew this, and obviously didn’t care.  Basically she said we had run of the place and could labor however we wanted, which was exactly what we wanted.  We gave the nurses our birth plan and they went over it point by point, agreed to everything.  We were pretty clear that we wanted a calm environment and time + no drugs.  The only thing we wanted was the continuous monitoring because of the cholestasis.  They also wanted Eva to have an IV port (but not an IV), which she reluctantly agreed to (was probably the right decision, given the circumstances).  This went until about 2 or 2:30 AM.

So, after getting set up the midwives and nurses mostly went away and only periodically came to check on us.  Eva labored in different positions; first side lying, then we did the “baby-Jesus in the middle dance” for about an hour, with some squatting in between and more baby-jesus.  Lots of peeing, lots of deep breathing and calming massage.  The Bradley stuff really works, it’s kind of amazing.  Kathy was also amazing, she really helped us find good positions.  We also did this position where Eva sat on a stool with one foot down and one foot on another stool, kind of like a gangster would do rap.  If she had chains and baggy jeans it might have happened.

Anyways, after doing this for about 8 hours (taking us to 10 AM), Kathy asks what Eva wanted from her contracts.  Eva says, “I want to have a baby.”  For most of the active labor (which started ~ 2 AM) she was having contractions every 2 to 4 minutes, with increasing intensity.  (Before that contractions were 2 to 5 minutes spaced with mild intensity … bad period cramps according to her).  Kathy suspected that there was a cervical lip (Rachel told us about this) that was inhibiting baby.  She said if we wanted to have the baby soon, to do this new position as follows:  I was back against wall, Eva in front of me, both standing.  I put my palms facing up on bottom of Eva’s belly and pull up slightly.  Eva sinks into my hands as per her ability to withstand.  We did this 3 times, she goes to pee, we do baby-jesus a few times.  Then we go back to this new position and do it 3 more times.  This time Eva leans really heavily into me.  The third time she says, “I got to go to the bathroom” and makes a bee-line (as much as a laboring woman can) to the bathroom.  GW midwife (different one now) comes and considers doing a V-exam, notes that Eva isn’t at the grunting stage yet.  Meanwhile Eva on the toilet starts grunting real hard, lots of (normal) bloody show.  We get her to bed, do a V-exam and she’s +2 (!!).  Basically without touching Eva, Kathy was able to figure out exactly where she was in labor and tell her what to do to make it progress (this is like a +100 moment for MAMAS, they get major kudos for being awesome).  Now it’s 11:45 AM, and everyone’s like, ‘This baby is coming now.”  So Eva does a sitting squat with a squat bar, baby’s head appears in two pushes.  Good pushes, baby doesn’t recede at all after each contraction.  I’d say about 8 pushes later the baby’s head is half way out, and then one final push and she’s out.  Tons of hair on this kiddo, she pops out real alert and goes straight to momma.  I’ll send a video of first few moments.  Really sweet.  Nice throaty cry.  Breasteeds after about 10 minutes.

She gives us hell now whenever we take her from the boob.  We suspect there’s some cluster feeding going on.  She falls asleep while feeding, unlatches, wakes up, gets mad that she’s not still feeding, head-butts Eva’s boob, cries because she’s now head-butting instead of eating, and then Eva get’s Poebe situated again.  It’s real sweet.

The Bradley Method really does work and we think that it helped baby a lot.  Also, MAMAS is a fantastic choice, if you have to transfer take one of them with you.


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