Birth Center Birth over Hospital Birth: Insight From A Black Doctor

Dr. Brianne Hull has taught at Louisiana State University (LSU) and at Yale University; and is currently Assistant Instructional Professor of Sociology at the University of Chicago.
“I be educatin’ ya children once they can vote,” she jokes.  At the time of this interview, Brianne had been a mom for 5 weeks and 4 days.  She had a natural, unmedicated birth at a birthing center and she joined me on the Listening to Black Women web series to talk about her experience.
Below is a creative paraphrasing of Brianne’s transition from single career woman to married career woman and mom, and how she took measured and calculated steps towards her goal of achieving an unmedicated Birthing Center birth.

THE PLANTING OF THE SEED

As I got further along in my career and earned more degrees in the field of sociology, I started to see more space for mom stuff.  I had professors who would bring their children wrapped around them to school. 

I saw women making space to successfully pursue their careers and bring their children along with them at the same time. Seeing those instances helped me to see that I could pursue motherhood much earlier alongside my career than I had initially feared. 

That’s when my husband and I began having serious discussions around planning our family and imagining the number of children we want to have.

That being the case, I approached the road to childbirth with the same tools I utilize daily in my career as an educated woman, as an educator, and as a researcher. 

I couldn’t see myself going into a process as big as childbirth and family without conducting research. 

Luckily for me, I had very close case studies that I could also look up to.  Seeing yall (Shayla Brown, the interviewer, and her husband) have lots of kids and have natural births and having a family member who I’m really close to deciding that though she would have a hospital birth, she would have it unmedicated. 

I was there to witness her birth and it gave me a first-hand perspective. 

It’s important to note, too, I think, that she and I are close enough in age that both of our desires for an unmedicated birth countered what has traditionally been done and traditionally championed in our family, which is medicated births.  Up against these odds, I saw her choose to do things a different way.

THE FAMILY NARRATIVE OF BIRTH

My mom told me the same thing that her mom had told her: that “childbirth was like having one foot in the grave and one foot on a banana peel.” 

Granted, my grandmother had 6 kids and was poor in the city in the 50s and 60s so who knows what happened?  All I do know is that because of whatever her experiences were, all of her daughters and daughters-in-law were traumatized during their own childbirth experiences even though they took advantage of their choices as more modern women.  “Now,” they celebrated, “we have medication; now we have insurance.”  They still ended up with, however, traumatic experiences–potentially more traumatic than their mom’s experience. 

My mom and my aunt, 2 major women in my life, each only had one child and I think their childbirth experiences had a lot to do with that.

My mom almost died.  After she birthed me she started hemorrhaging.  My aunt was medicated but it didn’t take so she could still feel everything.  Other women around me just had story upon story of near-death experiences.  If it wasn’t near death it was just highly unpleasant; something to grin and bear and rejoice over once you had your baby.  That’s generally the birth background in my personal community.

Outside of my community, though I was able to witness through great examples, through youtube and social media storytelling, black families birthing naturally and in homebirth environments.  Seeing these videos of the births themselves and hearing different black women telling their stories helped me to see natural, out-of-hospital birth as an experience that was possible for me as well.

THE PROCESS

I found out I was pregnant 3 days after I got married.  Initially, I planned to go to a hospital and birth unmedicated so I secured a doula immediately.  I hired an OBGYN and I felt very listened to during my appointments which I loved. 

However, during my 20-week appointment to plan my waterbirth, my OBGYN informed me that while I could labor in the tub, I wasn’t allowed to birth in the tub because of the possible risk of infection. 

After that appointment, I spoke with my doula and she asked “how do you feel about that”, to which I shared my disappointment.  She also informed me that I could birth in water at the birth center she helped found and that waterbirth was allowed at a major city hospital so the risk of infection was likely more of the hospital’s preference than an actual threat I should worry about.  That’s about when I decided to tour the birth center.  Once I did that, there was no way I could birth anywhere else. 

THE BIRTH CENTER

There were three rooms and three midwives. I met with all three of the midwives there before having my baby so that whoever would be on call during my birth, I would have seen them before. 

I loved the environment; the fact that I could birth however I wanted, whenever I wanted with only my birth team and my husband, and my stepson in the room. 

No one else that I did not allow in the room would be there.  That’s very different from the hospital where, depending on how long you’re there, shifts happen and rotations change and every 12 hours you’re introduced to a new medical team.  All that in mind, I decided to leave my OBGYN and birth with the midwives at the birthing center.

Once I switched providers, I enjoyed 30-minute appointments–every single time–with my midwives unlike at the OBGYN office where I would go in, get my ultrasound, wait for my provider and then just leave.  The birthing center was just an overall better experience. 

COMMUNITY REACTIONS

My family freaked out about my decision to birth at the birthing center.  They weren’t so much bothered by the unmedicated part of my birth plan, just the part where I chose to birth outside of a hospital.  To them, this decision was the equivalent of me going into the woods and just dropping my baby off somewhere with a Shaman.  My mom particularly voiced her concerns. 

“What if something goes wrong?  Haven’t you been paying attention to all the black women who have been dying in birth?”  As she’s saying this I’m thinking: 1) No.  I’m trying not to, actually because I want to live, and 2) yeah, they are dying in hospitals though. 

To make a long story short, she was really tense about it.  However, because my husband worked during a lot of the appointments, my mom came to the majority of them.  She got to see the birth center and meet the midwives and that quelled her anxieties which made my interactions with her much smoother.

Other family members were somewhat encouraging or at least not discouraging.  They said things like, “well that makes sense,” or “that’s a very brave thing to do; trying to have your baby in the water in a birth center with a mirror.”

My husband’s family was a little puzzled I think but they are a more reserved family so they were more reluctant and less prone to voicing too many concerns.  Whenever they talked to me about the birth they were more like, “well, girl if that’s what you want to do…” 

With some of my husband’s co-workers, though, he kind of got flack for our decision to birth our baby in a Birthing Center instead of a hospital. When he would talk to them they would share that they just couldn’t imagine dealing with the pain of labor and childbirth and they dreaded, for me, the amount of pain I would experience. Still, he became an advocate for unmedicated birth though.

When [my husband] talked to other men who were expecting, he’d advise them to consider an unmedicated hospital birth.  Having one child already, he had seen a medicated hospital birth that left him deeply traumatized.  It wasn’t until he and I started taking childbirth classes that he started to realize that much of what he had witnessed didn’t even have to happen.

OUR EDUCATION

Our birthing center required us to take a natural birthing class as well as a breastfeeding class and we also took a comfort measures class, all taught by my doula. 

We met with my doula regularly before we had the baby and probably the most affirming thing outside of positive encouragement from some people, was following all the Instagram accounts and reading Ina May’s guide to childbirth.

  That book, in particular, exposed me to all the things surrounding natural childbirth.  It gave me tools to better understand my goals and it also painted a picture of medicated birth that allowed me to better understand what I was avoiding. 

Reading that book and seeing thousands of women have their babies in cabins in the woods and just having a grand old time and being very excited about birth and having kids inspired me to adopt the same excitement around my own birth.

We spent the whole 10 months of the pregnancy training for the marathon of labor and birth.  We did a whole bunch of research.  My husband was very involved and very graciously followed my leadership in the process.  We both could see that this was the best path for the health of our family: the health of our baby and for me.  We very seriously understood that I am a crucial part of this process and I needed to not die during the course of it.  That being the case, we did a bunch of research and were very intentional about everything.

RECOMMENDATIONS

Hire a doula, get a birth team, and be informed.

Going through labor you can’t be cognitive enough to advocate for yourself.  You might say one thing and hand the staff your little printed birth plan, but in the event, that plan is not honored or if something comes up, someone outside of you, someone other than your husband needs to go toe to toe with your doctor because if you have to, that’s going to shut labor down. 

I did all of that and I can truly say that I was happy with the whole process.  I have no regrets and that’s important for women to understand–that you can have regrets.  It is also important specifically for black women to understand that birth can also be fun like any other birthday and it can be enjoyable.  It doesn’t have to be 10 months of misery.

THE BIRTH STORY

Originally published  by b. alexandra, in for the culture

On November 29th I was officially 41 + 2 days pregnant. Said another way I was 9 days past my due date—much to my chagrin. I was fairly done with the difficult sleep, the slowed movement, and the inability to move from a seated position without rolling on my side and pushing myself up. The anxiety that I would have to be induced if I made it to 42 weeks, a mere 5 days away, was not making the end of this trimester any more comfortable. But per the advice of my family and my doula, René, I was trying not to get too worked up about it and was patiently awaiting the arrival of my first child. Around 4 PM I felt a tightness in my back that would come roughly every ten minutes. The duration was irregular—the spacing of the sensation even more so—and  I decided to not mention anything to my husband until it became more pronounced. About three hours later we decided to take a walk around the complex to see if the sensation picked up or at least stayed consistent. At this point, we were both unsure if this was the real thing, but I began to feel tightening not just in my lower back but in my lower abdomen and my pelvic area.

When you’re unsure if you’re real labor or not

            The contractions were coming consistently but in no set frequency. We began timing them around 8:30 to keep an eye on the frequency. We turned on Sunday night football and decided to wait until they became a regular five minutes apart to call our doula and midwife. As the contractions got more intense, I quickly learned riding them out in all fours was my best bet. My husband would massage my hips as I yoga breathed and ‘ohm-ed’ my way through the discomfort. We went on in this pattern from 9 to 11:30 where my contractions went from 6-10 minutes apart to 2-3 minutes apart. We called René and the midwife on call at the Birth Center of Baton Rouge and let them know things had picked up and they told us to watch them for another 30 minutes to see if they stayed at this frequency, particularly since they weren’t lasting more than 45 seconds.

            After those phone calls, I got in my bathtub and labored there for a while. Of all the places I labored until this point, the tub was the only place I could get sufficient rest in between contractions. After a while, I decided to move back ‘on land’ as the contractions did space back out…temporarily. Within the hour, things picked back up and I got back in the tub to rest out the next phase of contractions. I couldn’t keep anything down but was trying my best to keep something on my stomach.  Sometime around 1 AM I asked my husband to grab some pickles from the kitchen so I can get some electrolytes to power through the rest of labor—however long it was going to be. Spoiler alert, I never got to eat those pickles.

            Once my husband left the bathroom there was a significant shift in my contractions. I could no longer float or ‘all fours with an ohm’ my way through them. All I felt compelled to do was push. I stood up in the tub, propped my right leg on the edge of it, grabbed the towel rack and pushed. Once this contraction was over, I stepped out of the tub and noticed a significant increase in bloody fluid. It was at the sight of this I realized it was time to go to the birth center. My husband walked back in and I told him to call the midwives because we needed to go. He quickly confirmed with René and Elizabeth—the midwife on call—that we were headed that way. The next 30 minutes were a blur of throwing bags in cars, waking up a sleeping 8-year-old, and hauling ass to the birth center which was 15 minutes away with no traffic. I’m pretty sure we made it in ten minutes.

            We made it to the birth center and were the first ones there. I hopped out of my husband’s truck to continue pushing until someone else arrived. René pulled up about two minutes after us and immediately jumped into birth support mode. She asked me how I was feeling to which I responded with all the grace of a Southern woman in the late stages of labor, “I feel like I have to shit!” René immediately assured me I was doing a great job and that was exactly how I was supposed to feel. A few more pushes passed, and Elizabeth arrived and unlocked the birth center. René informed her what room I wanted and that I was pushing. Once I got through my latest contraction, I made a very wobbly beeline to my desired room while René began running the water in the birthing tub as she knew I desired a water birth. Second spoiler alert, I never got in the tub. Once I made it to the room I grabbed one of the posts on the bed and rode the next pushing contraction. I cannot say I consciously knew these were pushing contractions, I just knew they were a lot more involuntary and a lot more productive feeling than the ones I experienced earlier in the evening. They were strong, intense, and uncontrollable, but felt leagues better than the prior hours of what I now know was transition.

            As I moved from standing to the bed where René had stacked pillows for me to prop myself up on, Elizabeth rolled all her delivery tools into the room. One glance at my rear and she stated very plainly “oh she’s crowning.”

Crowning??!!

It was at this moment that I knew I would not make it to 41 + 3 days pregnant. My husband soon joined us in the room after bringing in all our necessary bags and resumed his position behind me providing counter-pressure to my hips. Within the next five minutes, I felt the strongest urge to push. It was in this push that I felt my son’s head present itself at the opening of my vagina and then go back inside. I never wanted to push something out so quick, but Elizabeth calmly told me to slow down my pushing with René reminding me to continue breathing through the contraction. After this push, Elizabeth stated that in 1 or 2 more pushes I’ll have my baby. I asked her if I could change positions and she stated she’d help me move into whatever position I wanted. Before I could say anything my husband asked if I wanted to do the Captain Morgan—meaning lifting my right leg up on the bed—to which I nodded. It was in this next push that my son’s head came completely out—as confirmed by my midwife—and one push after that out were his shoulders. I looked down and saw a blur of blood and fluids and a squirming little person who had no problem announcing his own arrival—at 2:42 am—with very strong and loud cries. And with that Malcolm Alexander was here—12 minutes after we pulled into the birth center parking lot.

            In a time when black birth is under scrutiny due to the historic and contemporary perils to black birthing persons, it cannot be overstated how happy I was with my labor and birth. My immediate post-partum experience at the birth center was delightful. My stepson was able to nap in a neighboring room and immediately meet his younger brother. All of Malcolm’s exams were done in the room and he was never separated from us the entire 6 hours we were there. After his exams, we were given time to sleep as a family, and I must say this was my favorite moment of the whole experience, resting with my husband and hours old son in the darkness of early morning under a full moon and an eclipse. There was no better way for my labor and delivery to go. I was listened to, affirmed, and cared for throughout my pregnancy and I was honored and encouraged once my son was here. To say things escalated quickly would be an understatement but they went exactly as they should.

Baby #1 done!

About B.Alexandra

B.Alexandra is a Ph.D. in Sociology. Research interests include: Black Feminism; Race, Gender, and Religion; Sociology of Religion. Personal interests include but are not limited to: reading, writing, lifting weights, and resisting oppression. Your resident spiritual Black Feminist here with a word.

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