My middle sister has three children; this is the story of the birth of the middle one.
Her first birth was two years before, in a hospital with a CNM (she ended up with pitocin, but no epidural — just some injected narc like morphine or something). For some reason, that option was not available when B was born [either that CNM had moved, or the hospital had changed policies so she wasn’t allowed to practice, or something], so she opted for a home birth with a midwife. Our state does not require regulation for midwives, so I don’t know what this woman’s credentials or training were, although she had attended numerous women in our area who had chosen home birth (and eventually moved out of state, so not a possibility for me now).
My sister said that her “ideal” would be to have a midwife in the hospital — the midwife for the low-tech high-touch “natural” aspects that she wants, with the “safety net” of being the hospital should the need arise for quick action. That not being available, she opted to go with the midwife at home instead of an OB at the hospital.
My sister and her family had been living in their house for about two years at that point, and had not yet been able to afford to replace the carpet. The lady they bought the house from was elderly, senile, and let’s just say needed to wear diapers. While they had gotten the carpet thoroughly cleaned, it was the same carpet that was in the house when the previous owner was…using it. While this may seem like a completely off-the-wall paragraph for a birth story, it’s not; because my sister said that she had a real mental hangup about this carpet while she was in labor. Whenever the midwife knelt on the floor to check my sister, or anything else, my sister could only think about the fact that the midwife was probably kneeling where the senile old lady had peed. And she just felt like it was too dirty to give birth there.
Other “mental hangups” included that she was distracted by the messy closet. She told me afterwards that she kept staring at the closet door, hoping that somebody would take the hint to close it, but she never could quite get the words from her brain to her tongue, to actually tell someone to close the door. And finally, the previously mentioned feeling that the hospital was really safer, and she didn’t feel totally comfortable giving birth at home.
I don’t know when she went into labor, nor how long it was; the only thing I really remember that she said, was that she stayed at 6 cm dilation for 9 hours. As a second-time mother, that was quite a plateau! Her husband was a less than perfect labor partner, too. Let’s just say, he’s nearly the poster child for “men should go hunting while their wives give birth.” Rather than supporting and encouraging her through the difficult and painful contractions, he got irritated and tired of her “screaming” and was relieved when she finally went to the hospital so she could have an epidural. He’s a nice man and a good husband in many ways, but labor support is not one of them.
After having been stuck at 6 cm for so long (and being distracted by thoughts of urine-soaked carpet padding, a messy closet, and being not quite comfortable with the idea of giving birth at home), she finally went to the hospital. The midwife had thought about breaking her water in order to apply the head directly to the cervix, but the baby was still pretty high up, and not engaged, so she was worried that breaking the amniotic sac might precipitate a cord prolapse, so she was unwilling to take that step at home. [Note — a CNM friend said that she will “leak” the bag of waters, letting it out slowly, as an alternative to transferring to the hospital.]
So, off to the hospital they went. Perhaps it was the sitting in the car on the way to the hospital; perhaps it was that my sister was able to relax since she was away from the distractions at home; perhaps it was just a coincidence, but when they arrived at the hospital 20 minutes later, she was already dilated to 8 cm. They started her on pitocin and an epidural, and the baby was born soon after.
Lesson to learn: even when someone ought to be able to give birth at home, as far as level of risk and quality of care-provider, it doesn’t always mean that she will actually be able to. Distractions can interfere with labor in even the best of circumstances. I remember another story I read on an email list, in which a woman was just completely distracted by a drop of blood on her foot. She kept staring at it, waiting for somebody to wipe it off (I guess never thinking to do it herself, and certainly never speaking about it). La-la-labor land!