Miranda's Birth Plan for Delivering at Home in Comfort
A special interest in water birth led Miranda Bryan, 25, of Hampton, Virginia, to create a plan to give birth at home. Her birth plan was full of comfort measures and strategies to help labor along. Some parts of Miranda’s plan came true, but an unexpected emergency changed her post-birth plans quickly.
Here, Miranda shares the birth plan, how she wrote it, and what happened when she delivered baby Sage and found out she needed special care.
Why Miranda Wrote a Birth Plan
Miranda, a nanny and a bridal hair stylist, was fascinated by water births even before she was pregnant. She had watched videos and read books about giving birth in a tub of water and about delivering without pain medication.
“I read a book that describes how your brain is so connected to your body,” she says. “It says that how you’re feeling is correlated to how you’re dilating [during labor]. I know I wanted to feel comfortable in the space [where I’d give birth].”
For her, this meant delivering the baby at home. “I knew I would be in a situation where I wasn’t comfortable at a hospital,” Miranda says. She thought feelings of anxiety might interfere with her ability to dilate and to avoid interventions, such as getting an epidural.
Finding the Right Provider
Miranda had been following Jeni Rector, a certified professional midwife who runs The Village Midwife in Newport News, Virginia, on social media. When Miranda learned she was pregnant, she called Rector the next day.
Miranda liked the personal attention a midwife could provide. “Appointments weren’t five to 10 minutes long,” she says. “They were 45 minutes to an hour. We were building a relationship.”
Learning Ways to Manage Labor
While she was pregnant, Miranda learned a lot about ways to feel more comfortable while giving birth. A student midwife held a birthing class at Miranda’s house, teaching her different positions to use during labor and how to use pain management tools such as a yoga ball. She learned that dimming lights could help her feel more relaxed.
She also got some ideas from her mother, who’s a registered nurse, and who she wanted present at the birth. “My mom kept asking me what I wanted during birth,” Miranda says.
Though Miranda felt comfortable with her midwife and had communicated her preferences with her, she thought it would be helpful to also have the birth plan in writing. “That way I wouldn’t be putting into words what I wanted while I was in labor,” Miranda says. “They could look at the birth plan instead of asking me in the moment.”
Miranda’s Birth Plan
Miranda typed up her birth plan, listing her preferences in six categories:
- Overall desires: She wanted a water birth at home where she could move around freely and use techniques of Hypnobirth, a mindfulness-based practice for managing the pain of childbirth.
- Labor techniques: She wanted to try different positions and locations during labor, including sitting on the toilet or a birth ball, or standing in the shower with water spraying on her back.
- Transition comfort: Transition is the last phase of active labor before birthing, and it can be intense. Miranda brainstormed some comfort measures that would help her not to tense up, including having a fan on and placing cold washcloths on her forehead. She thought it might help to hang onto her husband for support.
- Pain relief: Miranda didn’t want to use medication during the birth and instead wanted to use movement and massage to help her handle pain.
- Environment: She detailed that she wanted dim lights, her music playlist playing, and Friends on the TV. “It’s my comfort show, so it keeps me calm,” she says.
- Delivery: At birth, she wanted her husband to catch her daughter and for both her and her husband to have time for skin-to-skin contact with the baby, a practice that can help promote bonding and well‑being in a newborn.
Miranda knew that her birth plan was a list of preferences and that she would need to be flexible during labor and delivery. “If anything happened, I knew I had to roll with it,” she says.
And while she knew that having a water birth might or might not happen, she really wanted to avoid going to the hospital if possible.
“At the end of the day, if I had to be sent to the hospital and go against my birth plan for the safety of the baby or myself, I would have been okay,” she says.
Miranda’s Birth Story
Miranda had been having Braxton Hicks contractions for several weeks. Every night, she woke up at 1 a.m. or 2 a.m. and wondered if she was in labor. But when she closed her eyes and focused, the contractions went away on their own.
On August 19, at 40 weeks and 4 days, Miranda woke up as usual. But this time, it felt different. “I had to move when the contractions happened,” she describes. “I realized this feeling is what it means to be in labor.”
She found her husband James, who was outside smoking meat and about to go to bed. “I told him that this was it,” she says. “The baby was coming.”
Handling Labor Pains
The midwives came around 9:30 a.m. Miranda had been walking up and down the stairs to try to help speed things up. She listened to her music playlist and looked at the pictures of ultrasounds and affirmations she had tacked up around the living room.
“I was naive and had underestimated how painful it can be when you experience a real contraction,” Miranda says. “Some women claim to have a pain-free experience, but I definitely did not.”
“I thought I would be so quiet, relaxed, and peaceful,” she says. “But I was moaning, grunting, and making other noises during contractions.”
She tried a variety of things to help speed up labor. She got in the tub and her contractions slowed. She sat on the toilet, but that didn’t work either. At one point, she even questioned her decision not to get an epidural.
Finally, Miranda moved to the bed, and labor progressed. “My body started pushing on its own,” she says. “The midwives kept asking if I wanted to get in the tub. They knew how much I wanted a water birth. But I said, ‘She’s coming, and I’m not moving.’”
Meeting Baby Sage
Around 4 p.m., 7-pound Sage was born. James and the midwife caught her. “I was definitely in shock when she was born,” Miranda says. “She was so alert and staring at me. She was wide awake and looking around.”
An Unexpected Emergency
Miranda held Sage skin-to-skin on her chest for 20 minutes. The baby was about to start to latch to breastfeed. “Then she started going limp,” Miranda says. The midwives gave Sage mouth-to-mouth because she wasn’t breathing. They called 911, and an ambulance took Sage to the hospital.
Doctors at the hospital did CPR on Sage and then put an oxygen mask on her. It wasn’t helping as much as they hoped. But it did bring her color back and kept her as healthy as possible for the time being.
“But they couldn’t intubate her since they don’t have a NICU [at that hospital],” says Miranda. Intubation is when they insert a tube to help a person breathe.
Miranda was emotional when at the hospital. “All I thought about was having a healthy baby. I was mourning what I thought having a newborn would be like,” she says. “Something was wrong with Sage that was completely unpredictable and unexpected that was so hard to grasp.”
Sage was then transported to a children’s hospital. Once there, they tried putting a tube in her nose, but it wouldn’t go down either side. It turns out the airway between her nose and throat never opened. She was born without airways, which is rare.
Sage was in the NICU for 30 days. She’s had two surgeries to help her breathe and needs a third one.
Since she was born, she’s improved quite a bit. “Sage is doing great now,” says Miranda. “People with this condition often have hearing, eye, and neurological problems. But all her tests and development have been perfect.”
Miranda’s birth didn’t go exactly according to plan—but the most important thing was that Sage was cared for.
Sage was once hooked up to machines and needed oxygen, but now she’s home, breathing on her own. Miranda likes to watch the baby fall asleep and then will get some sleep of her own.
Sage eats and sleeps well and loves her swing. Her parents are cautious about exposing her to germs since she can easily pick up a cold. “But she can live life normally now,” says Miranda. “She’s our little rock star.”
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