PROM, Castor Oil, Precipitous Labor, & Home Birth

When I got pregnant with my second child, my husband and I never questioned where she would be born – we both knew we wanted another home birth with our amazing midwife that guided us through our son’s birth in 2012. Aside from a small amount of erratic bleeding and a preterm labor scare that ended up being the stomach flu, my pregnancy was uneventful and flew by and before I knew it, I was out on maternity leave from work at 36 weeks and filling my calendar with social engagements to fill the days before my due date. My son was born at 39 weeks, 6 days and I expected our daughter would follow suit, give or take a few days. I had my home visit with my midwife at 36 weeks and everything was in order for the birth, which I figured was weeks away.

On the morning of April 13, at 37 weeks, 5 days, I woke up at 5:45 am after a surprisingly restful night’s sleep (I struggled with pregnancy induced insomnia the majority of my pregnancy). I rushed to the bathroom to empty my very full bladder and I noticed that there was something wet between my legs. I figured it was urine since I had been known to pee myself a few times during this pregnancy, but after I used the restroom, the liquid kept coming and I realized it wasn’t pee. I woke up my husband and told him I thought my water had broken. The instructions from my midwife stated to wait until normal business hours to call if my water broke but labor had not started, so I put on a pad and went about my morning routine, excited but also a little nervous that I had felt zero signs of labor and this was much earlier than I expected to be going into labor. My mother, who lives in another state, wasn’t scheduled to arrive for two weeks and she was going to be my labor doula and after birth support.

A few hours later, I called my mom and told her my water had broken. No sooner had the words left my mouth then she was looking up how to change her flight and arranging a ride to the airport. Her words of advice were to take it easy to avoid going into labor before she arrived that evening. I sent my husband to work and the older kids off to school, as I still had zero signs of labor. I called my midwife who said to keep in touch and practice good hygiene, etc. I realized we didn’t have any food in the house for the midwives, so I made some muffins, and took a nap, anticipating that labor would be starting at some point in the next 24 hours, as the internet assured me 95% of labor’s do, after PROM/SROM. The day went on without so much as a little baby contraction, my mother arrived and we all went to bed, expecting to be woken up overnight to some labor action. My husband stopped by my midwife’s office and picked up their labor induction protocol pack, which included castor oil, herbal tincture and a few other supplements. She recommended I start the protocol in the morning if nothing started overnight.

Overnight, I felt a few mild contractions, but I mostly slept through the night and woke up without incident. I got up early to start the labor induction protocol, which included nipple stimulation (pumping), tinctures and a castor oil compress. I opted to not do the castor oil internally and see if the nipple stimulation helped. I watched “Look Who’s Talking” on Netflix, which did not make me laugh, the tinctures were regularly making me gag and the nipple stimulation wasn’t inducing a single contraction. My husband stayed home from work and slept in, in anticipation of another long day/night. After 4 hours of pumping every 30 minutes and not a single contraction, I talked to my midwife who wanted me to come into her office to confirm PROM and do a sterile speculum exam and talk about options. My mom and I went for a quick walk around the neighborhood and I finally started feeling some back pain and little tiny contractions, which were slightly encouraging but still not what I would call labor.

As my husband and I headed to the midwife’s office, I was getting disheartened. We were approaching the 48 hour mark and I was dreading the thought of making the decision if we needed to go to the hospital or could continue to wait for labor to start on its own. The exam by my midwife didn’t help ease my mind. She estimated that I was less than 1 cm dilated and maybe 90% effaced. Considering how long it had been since my water had broken and all the labor inducers I had choked down, this was depressing news. We talked about what would happen if I went to the hospital and how long we were both comfortable waiting, the risk of infection, etc. We came up with a plan that if my labor hadn’t started by the following morning, she would accompany me to the hospital for an induction. Meanwhile, she gave me the protocol for internal castor oil and we decided I would try a dose of it when I got home, which ended up being at approximately 4 pm.

My husband and I left our midwife’s office and headed down to the beach to talk a walk and clear our (my) heads. I was feeling really down and sad that the birth I had been picturing for the last nearly 3 years (since my first son was born) was looking like it wasn’t going to happen. But as we walked and my husband made me laugh (This is why I love this man with my whole being), I had a sudden peace that no matter where my daughter made her entrance, it was going to be spectacular and that was the way it was intended, even if that was in a hospital bed with an IV antibiotic, a Pitocin drop and an epidural. We headed home where my mom had my castor oil chocolate milkshake waiting for me.

After I took the milkshake, we did another few laps around the neighborhood. Back home, as we were fixing dinner, I started getting a few regular and ‘real’ contractions. This was very exciting! I even had to drop to my knees a few times but they were still very short and not super close together so I figured this was all still pre-labor stuff. I explained to my almost 3 year old that this was normal, that mommy’s tummy had to hurt for baby sister to come out and this was a good sign. As they were finishing up dinner and starting bedtime, I attempted to do some squats on the stairs. That kicked my contractions into a much higher intensity and I immediately had to go up into our bedroom and shut the door so I could focus on relaxing through the pain. My mom and husband came to check on me and I said that i was ok but things were starting to get organized and I needed both of them to support me. The notorious effects of castor oil started kicking in and I (out of necessity) started laboring on the toilet. Although the contractions were intense, they were still short and I was getting a decent break between, where I could talk and even laugh. I was confused at why the contractions were so intense so we called our midwife. After talking to us, she concluded I was probably in pre-labor and should get some rest and baby would most likely be joining us in the morning. We took her advice and I laid down and attempted to get some sleep. I believe I slept for about 30 minutes. By this time it was about 830 pm.

I jumped out of bed when a particularly strong contraction hit and told my mom and husband that I couldn’t sleep anymore, the pain was too intense. I tried to labor on the birth ball, but it wasn’t helping. My mind started freaking out (in hindsight, I was in transition but didn’t know it, even the second time around!) that there was no way I could do this all night, the pain was too intense and we needed to go to the hospital. But then I would get another 2 minute break and I thought I was just imaging the intensity. My mom suggested I try laboring in the shower which helped dull the pain and I believe relaxed me to the point to allow sweet baby girl to descend into prime birthing position. All at once, I couldn’t stand up in the shower anymore, I nearly fell out of the shower onto the birthing ball and screamed “I HAVE TO PUSH”. That certainly got everyone’s attention. My husband started panicking and filling the birth tub while furiously dialing the number for our midwife. My mom said, “please Lord let her keep this baby in until the midwife arrives, I have delivered a baby before but I would really rather not”. The midwife was on her way and giving instructions to my husband who was still trying to fill the pool. My mother got me to lay on my side and said she could see the baby’s head crowning. With 1 push, her head was out and then immediately another push, she was out and my mother gently laid her on my stomach where she started screaming the most beautiful ear piercing scream you ever heard. She was tiny and pink with a head of thick black hair, long beautiful fingers and absolutely perfect.

I kept asking if she was ok and of course she was. When the midwife arrived, my husband cut the cord and I immediately delivered the placenta as soon as I stood up. Sweet Ella Grace started rooting for the breast as soon as she was placed on my chest in bed and began nursing like a champion (and 2 years later, still is a total mommy’s girl and loves her milky time!). I feel so blessed that I was able to have the birth I envisioned and her arrival still gives me chills when I think about it!

Story and photo submitted by Sarah W.