Born in Triage | Home Birth turned Hospital Birth | Asa's Birth Story

My pocket-sized yellow notebook lay open in my lap, the page scrawled with dutifully recorded blood pressure readings taken throughout the week-- all within normal range. I had been monitoring at home after several elevated readings at my prenatal appointments-- a phenomenon I chalked up to white coat syndrome.

At thirty-nine weeks, I felt confident that I would still have my home birth. I had set up a small birth altar in the room where I planned to labor (you can read about how to make your own HERE). It included specially selected objects representing each of my children, favorite photographs from my pregnancy, an early ultrasound, a candle, and a scrap of paper scribbled with my vision of an ideal birth. I even hung twinkle lights from the ceiling for a touch of ambiance. 

I was unprepared at that appointment for the heartbreak of having my home birth plans dashed. Why was it that in the chaos of my house, filled with kids and noise and mess, my blood pressure readings were perfectly normal; but in the calm, quiet peace of my midwife’s office, they spiked to ridiculously, even dangerously, high levels on both our cuffs?

I wept what felt like selfish tears. My personal desires and feelings felt indulgent in the face of medical necessity. The decision to give birth in a hospital was about keeping both me and my baby safe; and yet, I couldn’t stop mourning the birth I had imagined. I grieved that my five-year-old would no longer be able to cut the cord, something he had been talking about for weeks. I grieved that my fourteen-year-old wouldn’t be catching this baby. There would be no homemade perogies shared by family and the birth team after this birth. I grieved that other wishes wouldn’t be honored because they might conflict with strict hospital policies.

In many of the books on natural childbirth I’ve read, there is a lot of talk about surrender-- allowing your body to take over and letting the process of birth unfold. I have followed that advice before, surrendering to the intensity and of labor during my previous births. But now, I realized, I would have to surrender to something entirely different.

This process of accepting that I had risked out of a home birth would become its own exercise in surrender. There were so many unknowns ahead, as a hospital birth had never been part of my experience before.

I felt failed by my body. I had done all the things! Careful nutrition, gentle movement, rest, acupuncture, education, affirmations-- everything meant to support the birth I had envisioned. And now I was left woefully unprepared for this entirely new expierience. Here I was, faced with a drastic change of plans and little time to prepare.

We decided to transfer care to Jefferson University Hospital in Philadelphia as my midwife had a relationship with the midwives there and past clients had reported having empowering births there.

I was given some herbs to help manage my blood pressure and others to prepare my body for labor. I agreed to a membrane sweep and scheduled labor-encouragement acupuncture, hoping that my body would begin labor on its own before a hospital induction became necessary. More than anything, I wanted my baby to come because he was ready and because my body was ready.

The next couple of days passed. I packed my hospital bag, drank my tinctures, rested when I could, and tried to stay grounded in the idea that my body would still know what to do, even in a medical setting.

And my body did feel like it was getting ready. My cervix was crampy from the membrane sweep, I was having frequent Braxton Hicks, and I could feel myself retreating inward and growing guarded like a wolf mother searching for a safe den to give birth to her pups.

Thankfully, we were able to coordinate with my parents, who rearranged their weekend plans so they could watch our older children if we needed to leave for the hospital. On the day before my scheduled induction, I slept in, ate well, and decided it was the perfect day to begin The Lord of the Rings trilogy. About halfway through the extended version of The Fellowship of the Ring, I started to wonder if I might actually be in labor. By the time the four-and-a-half-hour film ended, I decided to draw a bath to see if the contractions I had been feeling would fade or keep coming.

They kept coming.

I called my midwife to let her know I was indeed in labor and to ask her to call ahead to the hospital to let them know that we were on our way. My husband and I both took showers, and kissed the kids goodbye, and headed out into the night. 

We drove in my husband’s first-gen Toyota Highlander, which always smells faintly of yesterday’s lunch and proudly displays a sticker that declares it was “Made in Japan.” I cleared the passenger seat of miscellaneous loose tools and its small collection of (thankfully sheathed) machetes, then reclined the seat as far back as it would go.

I had been laboring side-lying for most of the afternoon to stay relaxed and keep my blood pressure in check, so I had already found my rhythm in this position. I propped my feet up on the dashboard and focused on relaxing the tension in my shoulders and jaw, unclenching my hands, and uncurling my toes as each contraction came and went. I tried to let my body do its work and gave all my energy to the process of softening and opening. 

There was something strangely comforting about hurtling through the dark, somewhere between the birth I had imagined and the one waiting to unfold. It was a quiet Sunday night, and I-95 was mostly clear. I watched the city of Wilmington pass by, glancing into the cars beside us and wondering how many other women might be in labor, driving to hospitals of their own. Were they timing contractions in the car too?

As Philadelphia came into view, I was feeling at peace with this turn of events. That calm surprised me, because I had been full of panic at the thought of giving birth in a hospital just days before. I guess I had just accepted that this ws going to be my story. We hadn’t had time to do a drive-by of Jefferson University Hospital, but at least we knew it was in Center City. It turns out I would eventually be able to see William Penn from my postpartum room. What a view!! 

We circled a couple of times until we found the right parking garage entrance. Inside, a large painted sign read, “Jefferson Hospital Bridge: This way.” We followed it up a ramp. I remember turning to my husband, who was rolling our luggage and carrying my camera bag, and saying, “You are seriously going to make me walk uphill?”

We reached the bridge, crossed it, and were stopped by the security guards, who told us that the entrance was closed. Between contractions, I very politely asked which entrance was open and how to get there. Can't you see this woman is in labor?

Down the stairs, out the door-- we walked a block. The contractions intensified with all the movement, and I focused on covering as much ground as quickly as I could between each one. When we reached the next hospital entrance, it was closed too. The frustration and absurdity of the situation hit me all at once. It felt very much like there was no more room at the inn! 

We were finally directed to the Emergency Room entrance, which was another block away and across the street. My husband, seeing the ER sign, booked it across the street, but I knew another contraction might hit me mid-crossing, and I would be stopped in my tracks with oncoming cars and bicyclists heading my way.

During that contraction, my husband felt so far away. I’m not a laborer who needs a lot of physical support, but as the traffic whizzed past between us, I needed his proximity. 

Once inside, I was struck by the many inconveniences that exist for security and bureaucratic reasons in a hospital setting-- metal detectors, ID checks, waiting rooms with chairs no laboring woman is going to be sitting in, pointless questions, and the endless admission paperwork. Each step pulled me further and further out of labor-land, until my contractions nearly stopped. 

Finally, we were led to our triage room-- small and sterile and harshly lit by bright fluorescent lights-- definitly not the flickering votive candle vibes I had curated at home. My nurse was efficient and kind though. She checked my vitals-- my blood pressure was only slightly elevated despite all the walking and the general stress of being about to give birth in an unfamiliar setting and she wsn't concerned. She got me hooked up to the monitors. The following contractions eventually pulled me back into my own body, and I focused on settling back into the rhythm of my labor.

My nurse asked if I had a birth plan. I explained that my plan had been to give birth at home, surrounded by my family, but when that plan changed, I was too heartbroken to make another, but that I did have preferences-- specifically regarding the birth of my placenta and the management of my third stage.

And then she started what would be several attempts to insert an IV line. 

Now before I got pregnant, I tried to sell my plasma. There are a few local facilities that will pay you for it and the idea was that my husband and I would use this “blood money” from plasma donations to fund a romantic anniversary getaway weekend. But on my first visit, I found out my veins were too small and had too many valves. In hindsight, it was all for the best as plasma is an important component of female fertility anyway and I got pregnant soon after. I was joking about this with my nurse in between contractions as she tried and failed to put in an IV. She agreed that my veins were both small and valvey and decided to find another nurse to try her luck. 

When she left the room, I decided to take the opportunity to stretch my legs and squat by the edge of the bed. The position change shifted my baby, and I felt him click into place. All that pressure made me feel like I had to use the bathroom, and I said as much to my husband, but I was still hooked up to all the monitors, and tethered to the bed.

He got up and started moving towards the door to let the nurse know I wanted freedom, when my water broke in a small gush-- suddenly enough to give me a startle. That’s when my husband really started for the door, knowing that it meant our baby was coming. Where are you going? Do not to leave!!

With the next contraction, I felt my baby's head emerge, followed immediately by his body. AHHHHH!! I pulled my pants down just in time for my baby to be born in an explosion of amniotic fluid and meconium-- directly into his father’s hands.

The nurses arrived quickly (they had heard me cry out) and detangled my baby from his cord. Both my husband and I were in shock. I remember one of the nurses saying gently “now let’s remove this necklace.” and then they stepped back. They gave us space to take in what had just happened. I wiped my baby’s nose and mouth with my shirt and he pinked up beautifully. After a little while, my original triage nurse said, “I didn’t think you were about to have a baby. You were so calm.”

Yeah… me neither.

I had totally fooled myself.

It is really crazy to me that I could be joking with the nurse one minute and giving birth the next, but this is the way three out of five of my children have been born. Those births completely took me, and my birth teams, by surprise. My husband later checked our parking garage ticket: it was timestamped 9:30 p.m. Our baby was born at 10:41 p.m.

I’m glad we didn’t end up needing the towels I had brought in the car “just in case,” and even more relieved that my body didn’t decide to eject Asa in the parking garage-- or on the street.

Looking back, this birth was everything I needed it to be, even if it didn’t look anything like I had imagined. It was empowering to give birth in hospital in such a wild, intimate, and true-to-me way.

I’m grateful to my home birth midwife, Samm of Magpi Midwifery, for her care throughout my pregnancy. To Dr. Paige, the chiropractic doula, whose acupuncture sessions helped me prepare for labor. And to the midwives and nurses at Jefferson University Hospital, who honored as many of my birthing and postpartum preferences as they could and treated me with such gentleness and respect.