Birthing in Community

When I say it takes a village to raise a mother, I’m not using empty words nor am I speaking about something that I don’t practice giving and receiving myself, though it is an ongoing practice to dismantle the ingrained people pleaser that still lives and breathes in my own body and yours.  

I want to share a story about what community birth care looks like in my single-mama-midwife world.  

This particular client was super committed not only to a home birth she also strives to live a low carbon footprint lifestyle.  Her home was very small, with no space for a birth pool and limited access to hot water.  She had also been struggling with a condition called cholestasis of pregnancy which generally puts one into a high risk category and excludes them from homebirth. 

It felt unfair that this would be her fate since she had an extremely healthy diet and lifestyle and had taken great care of herself during her pregnancy.  But sometimes life gives you unwelcome and undeserving surprises.  

Anna had been having all the classic symptoms - indigestion, heartburn, dark urine, and severe itching on palms of hands and soles of feet as well as her belly. We did the appropriate labs and sure enough her values confirmed that she had cholestasis and referred to the local women’s clinic that we collaborate with and they referred her to a high risk specialist.  

Meanwhile, the couple did their own research and found studies from Sweden showing that folks with bile acids in their range were able to stay in the care of midwives and that the risk for the scary potential outcomes of cholestasis (namely fetal demise, stillbirth and preterm labor) were not increased until bile acids were 4x as high as hers.  

She decided to seek the care of an alternative medicine doctor and got on a strict diet and herb regimen.  Within a few days of doing this her symptoms diminished and then disappeared.  

I had never heard of anyone reversing this condition and lowering their bile acids, but why else would her symptoms have disappeared?  We drew more labs and sure enough all the levels were in the normal range!  It felt like a miracle.

She would get her homebirth after all.  Well...sort of.

At 38 1/2 weeks her symptoms started to rear their ugly head again.  She had recently gotten sick and had laid off the diet and herbs a bit and now it seemed she was paying the price.  She was also having lots of contractions but nothing that was very organized or turning into labor.  I was concerned that her symptoms were coming back and felt intuitively that the solution was to have the baby. 

I also started to worry about how far her house was from any emergency help, should  that become necessary.  After all, I had never done a birth for someone with cholestasis and we were in unchartered territory.  

Serena, my lovely assistant and apprentice, was also not thrilled about doing the birth at Anna's house.  With only one bathroom and very little privacy or space it would not be a comfortable situation.  And with the growing concerns about her cholestasis coming back I was feeling nervous about attending her birth at home.  

I decided to offer her my house.  My oldest was out of town (she would never have approved!) and my littles wouldn’t be phased by it.  Plus she would now have the option of the birth pool, which was a big plus.  I presented the idea to them and they liked it.  They packed their bags and headed over though she wasn’t really in labor.  They wanted to get settled and then try to induce labor with Serena’s breast pump.  


They arrived at 8 pm on a Saturday night.  I had already set up the birth pool and cleaned up the house a bit.  The girls had a friend over and they all had fun jumping in the birth pool before it had any water in it.  My first instinct was to say no, but it was just too enticing.  Of course they had to jump into the larger than life inflatable birth tub!  I couldn’t deny them that fun, but I did limit it to a few minutes and no jumping.

She was 2 cm and, with her permission, I did a membrane sweep and then she got onto the birth ball and started pumping.  `

I banished the littles to the second floor.  They had been with my friend Ada all day so that I could sleep since I was fighting a cold and knew I had a birth pending.  Now I had Ada's daughter for a sleepover so her and her husband could go out.

This is what community care looks like.  

The girls were happy to hang out in the large livable attic that makes up the 3rd level of our home, thus giving us a cushion of the second floor, where our bedrooms are, and the bottom floor where mama was laboring.  While they were upstairs making forts and obstacle courses for the cats, Anna was downstairs doing all she could to get into labor.  


By 10 pm my energy was seriously waning. I was fighting a sore throat and a dry cough.  I went upstairs to own bedroom to lie down.  Being able to sleep in my own bed felt so luxurious and really allowed me to get some real sleep that night.  Her husband also got some rest, but Anna was steadfast in her efforts to shift into active labor.  


I turned the lights out for the girls at midnight and took all devices away and then promptly returned to bed for the night.  It felt so comforting to sleep in my own bed and have my girls sleeping above me, all the while providing a cozy and somewhat private space for the laboring couple - especially since I was nursing a cold and would lose my voice entirely by the end of this birth.  Having access to my own kitchen was also a huge plus.   

By mid-afternoon the next day, Serena had arrived and Anna was in a good laboring pattern and had reached 6 cm dilation - incredible progress and she had earned every bit of it with each 10 minute breast pumping session.  

Coaxing yourself into active labor is a little bit like choosing to walk on hot coals - both require intense physical and mental preparation and an altered state of consciousness. 

Anna was well into this laborland state, the only audible sounds coming from her were moans or simply her breath.   


I once heard the breath be described as our Beloved - with us through every moment of our lives.  In the realms of the underworld where we must go to bring forth our babes, the breathe is both savior and beloved.  In my own births it was the combination of the warm water and my breath that carried me through the final gates of transition and into birthing.  


By this time, Ada had scooped up her daughter and as well as my two and I could relax knowing they were in good hands and devote myself entirely to my work.  With Serena there I was able to spend some time cleaning my girls' bedroom - another plus of being in my own home!

Having my dream team of apprentices, birth assistants and mama-helpers left me feeling grateful and supported.  

This is community birth, I thought to myself, this right here.

Opening my own home to a mama in need, being cradled by my community so that I could fight this cold and support this mama, and having it all happen seamlessly while Anna labored on.

Around 6 pm she had opened to 9 1/2 cm and was starting to feel the urges to bear down and bring this baby out.  Though she had utilized the birth pool during the opening phase of labor now she chose to be on the futon for the pushing stage.  

By this time the second part of my dream team, Leah, had arrived.  Leah is like a birth angel, always arriving just when we need her.  Often just in time to breathe life into a baby and capture all the important times that we need to chart.  This time she came bringing my littles (who had been fed already by Ada) and attended to Anna with Serena as I laid down to read them a good night story.  

Being able to put my girls to bed in my own home and then come down to a birth that was imminent, was perhaps one of my deepest moments of belonging.  Midwifing as a single mama of three feels insurmountable at times and unsustainable.  But with the right kind of support anything is possible.

By 8 pm she was exhausted, shedding tears and vomiting.  Birth is an emotional and fluid-filled experience!

We offered her the option of breaking her bag, which is not something I take lightly or do often.  But Anna was so tired and had already lost one night of sleep getting herself into labor and several nights of sleep due to the uncomfortable itching in the week leading up to the birth.

I’m not sure where I heard this or who said it, but the phrase “Do not let the sun set twice on a laboring woman” has stuck with me over the decades of practicing. I wanted her to sleep tonight with her baby in her arms and releasing her waters might just save her a couple hours of work.  

Around 8:40 pm she opted for us to release her waters, which were clear - the color that all midwives are looking for.  

She labored on.  

Around 9:15 pm on Sunday she was having urges to push.  Ksepana Mudra

Anna was sitting on the birth stool, her hands instinctively taking the shape of Ksepana mudra, a gesture of pouring out and letting go.  It is used as a means of draining negative energy and attracting positive energy - Chi - life force.  The mudra stimulates elimination through skin, hair, lungs, and large intestines, and presumably through the birth canal - since it is an energetic channel.   

A perfect gesture for the situation.  And a beautiful example of how instinctive birthing women are.  She held the mudra in a triangle just above her yoni and below her big, swollen belly.  

Serena captured the moment in awe. 

Anna pushed for just under an hour and birthed a healthy 8 pound 4 oz boy that Serena received.  We watched as the three of them cried.  It was contagious and within moments there wasn't a dry eye in the room.  

The sanctity of birth is palpable.  It is one of few real human experiences left for us to experience.  Anyone who has been present at birth knows how profoundly sacred it is, how it invites you sharply and deeply into the presence.

 A new family had been born.  On their terms.  

Despite all the odds and scary statistics leveraged against her, supported by her husband she found her own way, followed her own wisdom, guided by diligent research and common sense, and birthed her baby in a way that felt right for her.

And now the golden hour was hers to enjoy. 


While Anna and her husband and baby got acquainted, my dream team and I drained the birth pool and tidied up, high on what we had witnessed, supported, and co-created together.  By 1:30 am Monday morning, they were all tucked in on my futon couch and I went upstairs to my own warm and cozy bed.

In the morning, Leah called to ask if she could come help pack up my birth bag and get the girls off to school.  Did I mention I have a dream team???  

So this is what community care can look like for a single-mama-midwife.  We all have to create this for each other and allow ourselves to receive it.  

Because sure I could have been stoic and said “On no, I don’t need help.”  Or “I don’t want to burden you.  and I could have slogged through - but at what cost?  And to whose benefit?

Mamas, its time to dismantle the Supermom and embrace the MotherFly. Hint:  We can't fly without each other.

We need each other, and that’s ok. It's not a sign of weakness.  It doesn't mean we're not enough.  

We simply aren’t meant to do this alone and it’s through being in community that we can grow ourselves and create a mother culture that we all want to belong to.



1 comment


Wonderful and inspiring. Thank you so much for sharing :)

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