My Home birth Failed... Except it Didn't

By Dr. Kelsi Belz

If you followed along during my pregnancy, you knew I was planning a homebirth. So I know the birth announcement photos of me and my newborn in a hospital bed probably came as a little bit of a shock. That wasn't the plan...

There can be a surprising amount of pressure, especially in the birth world, to be the person who gets it “right.” Homebirth. The unmedicated birth. The low-intervention birth. The birth that looks exactly like the one you spent months preparing for. And as someone who works professionally with pregnant women and birth, I felt that pressure too.

So yes, the title is intentionally a little provocative. But I think the word failed is important because I want to talk about something that doesn't get discussed nearly enough: sometimes the plan changes, and that doesn't mean the birth was a failure.

My transfer to the hospital was actually pretty calm. It wasn’t an emergency or a scary situation. After about 24 hours of really intense labor, I was simply exhausted, and with my water having been broken for quite a while, I knew I needed a change. But let’s start from the beginning…

I'm fairly certain my water broke early Wednesday morning, but it was unclear (this is super common). Then Thursday morning at 9:00 a.m., there was a definitive gush. My water was 100% broken now. I went the whole day Thursday with no signs of contractions. That afternoon, my birth team and I wanted to give my body some encouragement to get things moving, so we started with herbs. No change. By Thursday evening, I still wasn't having contractions, so I decided to try a small amount of castor oil.

About two hours later, around 11:00 p.m Thursday evening, contractions started. And they were strong and consistent from the beginning.

My doula and my sister came over during the night to support me, and they along with my husband helped me labor through those early hours. My midwife came in during the early morning, and that was when I got into the pool and really settled into labor. At that point, I was completely in it. There wasn't much thought involved. I was just focused on the work in front of me.

About 8 hours into labor, I decided to have my first cervical check. I was 4cm dilated (out of 10), and I was already tired. Despite the minimal dilation my contractions were intense. After the check, I spent the afternoon trying to rest as much as possible between contractions. I rotated between the shower and the pool, my husband provided hip squeezes, and I was relying on all of the other tools I had prepared for managing labor.

One thing I remember very clearly is that I had a consistent desire to be on my hands and knees or leaning forward during every single contraction. Any other position just felt unbearable. Looking back, I think this may have been a sign that the baby wasn't moving much and that we were really stalling at this phase of labor. You may prepare for positions that are ‘preferred’ or ‘ideal’ during labor and when you are in it your body decides!

As the evening went on, the pain changed. It became a very specific burning sensation right over my tailbone/sacrum. This was when I started to struggle more with managing the pain, even though my contractions were actually spacing out. At the same time, my fatigue was becoming more and more significant. I was approaching the 24-hour mark of labor, and my water had been broken for roughly 36 hours.

But the biggest shift wasn't actually physical. It was mental.

Until that point, I could face each contraction. I could focus on the one I was in and get through it. Riding the waves. Then, at some point that evening, I noticed that I wasn't just experiencing the contraction I was having. I was starting to fear the next one. No wonder my body slowed down the contractions.

That was when I knew something had changed.

I consented to a second cervical check, and honestly, I already had a pretty good feeling that there hadn't been much progress. That was confirmed. And this is where I think the distinction between trusting your body and being committed to a specific birth choice became really important for me.

I fully trusted that my body and my baby could do this. I didn't suddenly believe that I was incapable of giving birth. I just knew that I needed something to change. In my mind, I needed rest. I knew that if I could sleep and allow my body to reset, I might be able to come back to the work of labor in a completely different state.

So I asked for a serious conversation about going to the hospital for an epidural.

After the birth, my husband and I were talking about this decision, and I asked him what he had been most afraid of in that moment. He told me that he was afraid I would regret it because he knew how badly I wanted to give birth at home. I was actually really thankful that he shared that with me because I didn't regret the decision.

The reality is that after 24 hours of labor, I was not processing things with the same part of my brain that shows up to work every day. The intelligent, analytical Kelsi who makes decisions for her patients was not exactly running the show anymore. I was in a very primal state, and decisions feel different from that place. I was incredibly decisive, and that decisiveness gave me a tremendous amount of confidence in the decision.

I wasn't going according to Plan A anymore, but I still had a choice. The baby was not in distress. I could continue laboring at home with slowing contractions, increasing fatigue, a mindset that had shifted toward fearing the next contraction, and my waters having been broken for quite some time. Or I could make a move to the hospital, get some rest, and hopefully give myself the best chance of still having the low-intervention vaginal birth I wanted.

Ultimately, it was the fear of the next contraction that made the decision for me. What was the fear about? Pain?

I knew that my perception of pain was one of my biggest tools in labor. The fact that I was feeling afraid told me I was no longer managing my perception of pain well. I also knew that getting from where I was to complete dilation and pushing felt like a pretty steep uphill battle. I didn't want to spend several more hours fighting my own body because I was too exhausted and overwhelmed to work with it. I also knew that at this point, I still had all of my options available, and waiting longer could potentially change that. So we made the decision to transfer.

My homebirth midwife called the hospital ahead of time and provided my records, so when we arrived, I was able to go straight up to Labor & Delivery and be cared for by a midwife there. I remember genuinely fearing the car ride to the hospital but it was short and I only had 2 contractions. 

Once in the room, they did the basic checks on me and the baby, and everything looked great. We happened to go in on a relatively slow night, so I truly could not have asked for a smoother or quicker process. And then I got my epidural. The relief was immediate. I fell asleep and barely woke up for the nurse checks throughout the night. After about five hours of sleep, I woke up feeling like a completely different person. I could also tell that my epidural was stronger than I needed at that point. Eventually, we got it turned down enough that I could feel and had decent control of my legs. Soon after that, I felt the urge to push. I was 40 hours into this now.

I pushed on my side for about 30 minutes. This was the part that surprised me most. I wasn't working hard at all. My push prep with pelvic floor PT served me so well. With the light epidural, I could feel and control my pushing. Honestly, I was shocked when all of a sudden they were lifting him to my chest. I thought I had quite a bit longer to go, even watching myself progress in the mirror.

And then Conway was born.

Brian announced his gender, and he went directly onto my chest. Our little boy was finally here. I did have a second-degree tear that they repaired, but otherwise, I had no other complications.

Because of how low we had turned the epidural down, the effects wore off relatively quickly, and I was able to get up and move around quickly. We ultimately decided that we wanted to go home as soon as possible, so we signed out AMA and were home about four hours after Conway was born. We left so fast the hospital forgot to fill out the birth certificate paperwork.

That decision felt very comfortable for us because leaving the hospital didn't mean leaving our care. Our care simply transferred back to our homebirth midwife, who had already planned to check on us at 24 and 72 hours. We had also established care with our pediatrician before birth, so we knew exactly who to call if anything came up.

And because apparently we are exactly who you would expect us to be, Conway received his first chiropractic adjustment at about five hours old from Dr. Goodman. Mom got adjusted too.

Looking back now, I don't view this birth as my homebirth plan failing. I view it as my birth plan working the way I hoped it would. The goal was never to prove that I could have a homebirth. The goal was to trust myself and make thoughtful, informed decisions along the way.

Birth is not a performance, and there is no award for sticking to Plan A. For me, the most empowering part of this experience wasn’t that I gave birth at home, because I didn’t. It was that when the situation changed, I was able to change with it. I trusted my body enough to labor at home, and I trusted myself enough to recognize when I needed something different and say, this isn’t working for me anymore. I trusted my team and my husband to support my needs and my decision.

Both decisions came from the same place: trust.