Planning for an Unmedicated Birth at a Birthing Center
My second pregnancy was a rough one. I had a five-year-old, was working full-time and let’s be real…I was no longer in my 20s.
Even though I was much more exhausted during this pregnancy than I had been with my first, I still felt healthy overall. I had set my sights on giving birth at Our Birthing Center in Morristown, NJ. I was ecstatic about using the birth center because it wasn't open when I had my first son, although it was in the works. This time, I was determined to have the waterbirth I had envisioned and go home the same day!
But life and pregnancy can be unpredictable.
Around 35 weeks, I started to notice something unusual—an intense, almost uncontrollable itching in my hands and feet. It was the same symptom my sister had experienced with her pregnancies, and I immediately suspected cholestasis or Intrahepatic Cholestasis of Pregnancy (ICP). Although I wasn't a doula then, I had done my research and knew enough to bring it up with my midwife. She ordered lab work to confirm my suspicions.
Facing Cholestasis and Preparing for Induction
I received the call while heading home from cheering on my husband at his half-marathon in Central Park: the results weren't good. My bile acid levels were high, and I would need to be induced the very next day. I was 36 weeks and 2 days pregnant, and though I had hoped to wait until at least 37 weeks, my midwife felt it was too risky. I knew from my research how serious cholestasis could be.
Grieving the Birth I Had Planned
I was heartbroken. My unmedicated, water birth at the birthing center was no longer an option. Instead, I had to face a medical induction—a scenario I had feared because of the stories I had heard about the "cascade of interventions." It was incredibly emotional. I wasn't just scared for my health and Vienna's; I was grieving the loss of the birth I had envisioned.
I sat with these feelings, and after talking with my midwife, I decided to take control of what I could. I started reading positive induction birth stories, researching the different methods, and asking my midwife all the questions I could think of. If this was the birth path I needed to walk, I was determined to walk it with strength.
The Induction Plan
I spent the entire night before my induction rewriting my birth plan, absorbing as much information as possible about the process. Those who know me know I am a planner if nothing else. Learning all the things helps me feel better. I would not recommend that approach—I didn't sleep a wink and learned the hard way that you can't prepare for everything. That's something I always remind my clients of now: Let's have a plan for all different outcomes, but know we cannot predict what will happen!
Thankfully, my midwife suggested we try something a little different to avoid immediate medical intervention: she recommended taking castor oil at home and pushing the induction by one day to see if labor would start naturally. Though I was hesitant, I agreed to try one round. It was rough. I won't go into detail, but let's just say I spent a good amount of time in the bathroom! After that, I decided not to try castor oil again. We planned to meet at the hospital the next night to start the induction.
When we arrived that night, the induction began with a low dose of Cytotec (misoprostol). I tried to get some sleep and mentally prepare for the long journey ahead, but sleep never came. My nerves were still running high. In the dark, I talked to Vienna, telling her how much I loved her, how scared I was, and how I knew we could do this together.
Managing Labor: Deep Breathing, Swaying, and Showers
A few hours later, at 6am, I woke up to a loud pop—my water had broken. I called my midwife, but she was attending another birth and would come as soon as she could. Contractions quickly ramped up, and I leaned into what I knew at the time, using deep breathing, rhythmic swaying, and rituals to manage the intensity. I also utilized the shower for relief, but the contractions were relentless, pushing into one another with hardly any space in between.
At one point, as the pressure and intensity grew overwhelming, I had the classic thought: I need to give up. It's something I've seen many women experience—a telltale sign that you're deep in transition, even if you don't realize it yet.
Vienna’s Fast Arrival: A Suprisingly Quick Delivery After Transition
At 9:12am, just about 3 hours after my water broke, Vienna was born. No one, including me, realized how quickly everything had progressed. Inductions are known to take hours, even days, but before I knew it, baby girl was in my arms. Her arrival was swift, and looking into her beautiful blue eyes was everything I had imagined.
Despite the unexpected twists and turns, Vienna's birth was beautiful in its own way. It wasn't what I had planned, but it was more empowering than I could've imagined. It created a whole new part of me, stronger and more whole than I was before.
Reflections on Choice and Flexibility
Looking back, what I've learned is that flexibility and self-trust are key when it comes to birth. Things don't always go the way you expect, and that's okay. Cholestasis threw my original plan out the window, and I had to grieve that. But I also embraced what I could control—staying informed, asking questions, and finding ways to make the experience as positive as possible.
The Importance of Doula Support During Labor
One thing I will say: this experience really highlighted why doulas are so necessary. My midwife was attending another birth when I needed her most, and that gap made all the difference. Doulas offer continuous support and focus that can make these unexpected moments feel less overwhelming.