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Home Birth: A Mother Shares Her Story

Susena Araisa

California State University, Stanislaus

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Home Birth: A Mother Shares Her Story

Nowadays having two or three kids is becoming the norm. Huge families are rare

because of the new roles women have taken in society. Women are becoming more independent

and starting a family early in life is not the priority. This is not the case for Maria Alcaunter.

Mrs. Alcaunter is known in the small community of Newman for her child bearing abilities (M.

Alcaunter, personal communication, June 5, 2015). Mrs. Alcaunter gave birth to 14 children.

Her story behind each birth was breath taking, so talking a bit more in depth about them was a

necessity. The interview took place in the small town of Newman, CA. From the beginning, it

was expected that the interview could not be one on one. Who would want to miss her story?

Every person in the house wanted to listen to how she delivered a newborn on her own. The

interview took place with an audience. This report compares and contrasts current practice with

a birth that took place in 1964 and one that took place in 1995 by the same mother. The areas

that will be addressed include: birth setting, pain management, parental involvement, role of the

nurse, use of technology, care routine, events surrounding childbirth, cultural belief practices,

and the personal meaning of the birth experience. Besides the interview the author’s clinical

experience will be included in some of the areas addressed.

Birth Setting

Rafael Alcaunter

In 1964, at the age of 15, Mrs. Alcaunter had her first child. The birth setting was her

home in the town of Reparto, Michoacan Mexico. To ensure privacy the bed was enclosed with

long curtains. The room did not have regular flooring, it was a dirt floor and the dust in the air

was inevitable. The lay midwife had someone rinse water all over the room to help calm down

the dust around the birthing mother. After being in labor for more than four hours the lay

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midwife was pushed to the side and substituted by Mrs. Alcaunter’s mother. Her mother

delivered her first newborn. With all the suffering involved she vividly remembers that birth. In

the room, only the husband and the person delivering the newborn were allowed. Having other

members of the family would be a disgrace to the laboring mother.

Laura Alcaunter

In 1995 she had her last newborn. This time she went to the hospital to deliver the

newborn. The hospital setting did not feel normal to her. This was her only newborn that would

be born at a hospital. The bed felt uncomfortable as it was small for her heavy set body and it

was too firm for her liking. The birth setting was clean and all the furniture and equipment was

nicely organized. Having a male doctor made her very self-conscious and anxious. At the time

of delivery, her husband, one nurse and the doctor where present. If she could go back in time,

she would had never gone to the hospital. The room felt cold and the bright lights over her head

made her more uneasy with the new environment. She also remembers a loud crying mother

next door which prevented her from resting after delivery.

Current Practice

Current practice birth setting in the United States are very different when compared to

third world countries, like in the case of Mrs. Alcaunter. In today’s society, the most common

birth setting is a hospital but other options include birth centers and home births (Lowdermilk,

Perry, Cashion, & Alden, 2016). It was observed by the student nurse that hospital birth settings

have rooms suitable for the pregnant mother. Rooms are bright and full with the latest modern

equipment. The colors on the walls are light to provide a more relaxed environment. Privacy is

enhanced by providing a curtain that covers most of the bed. This curtain is commonly used to

provide additional privacy when invasive procedures are being performed. The rooms are

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spacious to accommodate family members and a few chairs are provided especially for them.

The hospital environment is cold but sheets are always an option for the mother. The beds are

wide and firm and with the press of a button can be adjusted to a position suitable for the mother.

Pain Management

Rafael Alcaunter

Pain medication was very limited for Mrs. Alcaunter during her first pregnancy. Her

only two option were herbal teas or common Mexican analgesics such as Neo-melubrina.

Chamomile, common rue, and mint herbs where used during her labor. Some teas were used to

induce labor while other where used to help her relax after labor. She believes in these herbs

more than she believes in current medicine. These herbs provided comfort while pain was

reduced from a 10 to a five. Multiple tea options were available but her favorite was chamomile.

Warm chamomile was very soothing and decreased the pain from contractions significantly.

Pain options were never discussed prior to labor. The day she felt contractions her husband ran

to go find the lay midwife and soon after labor started. Back in the days, according to Mrs.

Alcaunter, pain was not as big of a deal as it is nowadays. Women believed that enduring pain

was part of being a good mother and a way to repay sins. Pain management was frowned upon

and herbal teas were the only options for these women.

Laura Alcaunter

Having her last pregnancy at a hospital gave Mrs. Alcaunter more options as far as pain

management. She had the option of getting an epidural, getting a caesarian section to avoid pain,

or getting opioid analgesics. The epidural was not an option she was willing to consider so she

decided to get a short acting opioid analgesic. She does not have a recollection of the name of

the medication. Mrs. Alcaunter received the medication intravenously which made her feel

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better for a short amount of time. She also remembers getting normal saline to help with

dehydration. The pain medications received were not as effective as the teas that she was used to

taking at home. The effects lasted very little and she was afraid of asking for more medicine

because of potential harm to the fetus. Pain management was never discussed prior to giving

birth. She never went to prenatal consultations. Prenatal consultation was not a common

practice in her home town. At the time of her last pregnancy, pain management was still

frowned upon so getting an epidural was not an option for her. She admits guilt after getting the

pain management medications at the hospital. If she had to do it again, herbal teas would be the

only pain management she would consider.

Current Practice

Pain management in current practice ranges from nonpharmacologic techniques such as

breathing exercises to pharmacologic options such as general anesthesia. Nowadays women

have a wide variety of choices when it comes to pain management. Pain management options

are discussed during prenatal care or sometimes the day of delivery. Some of the most common

nonpharmacologic techniques used are: relaxations exercises, effleurage, counterpressure,

application of heat and cold, acupuncture, water therapy, music, and biofeedback (Lowdermilk,

et al., 2016). Some of the pharmacologic options for pain management includes: systemic

analgesics, nerve block analgesia and anesthesia, general anesthesia, local anesthetic injection,

pudendal block, tranquilizers, narcotics, and nitrous oxide for analgesia (Lowdermilk et al.,

2016). It was evidenced by the student nurse that some of the most common narcotics used at

the hospital where: Demerol, Stadol, Nubain, fentanyl, and morphine.

Paternal Involvement

Rafael Alcaunter

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At the time of her first delivery only the father and the lay midwife where allowed in the

room. Having other people, such as siblings, would be a disgrace to the birthing mother. Her

mother, the lay midwife, cut the umbilical cord because the father was afraid to do it. The father

did not help during post-partum. His job was to be the bread winner and no help of any sort was

offered to the mother. The mother was the only caregiver and there was no way around this as it

was part of their culture. During the times of her first pregnancy no parental classes were

offered.

Laura Alcaunter

During her last birth the father was also present. Even though the father refused to cut

the umbilical cord he was more involved with this birth. This time around, the father assisted in

carrying the newborn to give Mrs. Alcaunter a break. He also assisted in taking care of the older

children. At the time of the last birth, no prenatal classes were available. They come from a

very small town in Mexico and that was never an option. The biggest contribution the father did

was paying for all medical expenses. In Mrs. Alcaunter’s culture parental involvement is not

expected. If the father was too involved the women would be accused of being lazy and the

father would be seen as a wimp.

Current Practice

It was observed by the student nurse that parental involvement is different for each child.

In one situation the father was camera ready and eager to meet his newborn. Pictures were taken

of each movement the newborn was making after birth. He was constantly asking about the

mother’s status and stayed by her side the whole time. In a different situation the father of the

newborn was not as involved, despite the fact that his newborn was in the intermediate care

nursery. He came to visit his son for about 10 minutes but seemed distant during the interaction.

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Unfortunately, in this case the pregnancy was not planned and it was evident with the lack of

bonding from both the mother and the father towards the newborn. Other factors that could

affect parental involvement are age of father, relationship with mother, social support, culture,

socioeconomic conditions, health of father, and personal aspirations (Lowdermilk et al., 2016).

Role of the Nurse

Rafael Alcaunter

No nurse was present during the first delivery. Mrs. Alcaunter had her mother as the lay

midwife deliver the newborn. A lay midwife is someone with no formal education who does

similar things as a midwife (Lowdermilk et al., 2016). The lay midwife was not wearing scrubs.

She did not wear gloves before, during, or after the delivery. The house did not have flooring so

the midwife recommended watering down the dust. To sanitize her hands, the lay midwife

washed her hands with hot water and alcohol. The expectations were met by the lay midwife

because there were no complications during labor. The role of the lay midwife before labor is to

come every four months to visit Mrs. Alcaunter to massage her abdomen and reposition the

newborn. The first bath, which is given eight days after delivery, was given by the lay midwife.

Some common herbal plants were used during this initial bath. Additionally, the lay midwife

provided some basic teachings for her. She mentioned no having sex for 40 days, taking one

shower every eight days, and absolute bed rest for 40 days. No family members where involved

during the teaching.

Laura Alcaunter

The nurse during her last pregnancy had similar job duties when compared to nurses in

current practice. The nurse during her delivery was in charge of cleaning, weighting, dressing

up, and showering the newborn. The nurse was very friendly and attentive to her needs. She

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looked clean and her long dress attire made her look professional. The care provided was

different when compared to her first birth. However, even after all of her expectations were met,

Mrs. Alcaunter would have rather given birth at home. The environment was very different and

that made her anxiety level rise. She was discharged the same day that she delivered. In this last

pregnancy the nurse did provide more teaching. Some of the teaching included the importance

of resting when the newborn is sleeping, immunizations, hygiene, breastfeeding, and postpartum

depression. The father was encouraged to be part of the teaching and the nurse even mentioned a

few ways he could help the mother at home.

Current Practice

The nurse’s role has evolved into becoming one of the most important roles during a

patient’s hospital stay, especially during pregnancy. The student nurse observed that nurses are

highly knowledgeable and they are held accountable for most of the mother and newborn’s care.

Some of the nurse’s role include: monitoring vital signs, doing head to toe assessment, creating

nursing diagnosis and interventions specific to each patient, evaluating lab values, passing

medications, assessing for overall newborn developmental status, offering perinatal services,

client referral, teaching, and most importantly giving recommendations of treatment to

physicians.

Use of Technology

Rafael Alcaunter

Mrs. Alcaunter is from a small town with a population of no more than 200 people. In

the early 1960’s technology was very limited. If a person owned a television or a radio they

were probably middle class families. As far as medical equipment and technology, there was

none. In her home town, not even a stethoscope was available. Every assessment performed

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was done by palpation with ungloved hands. For them to travel to the nearby city was a long

walk and no cars were able to be driven through the rough roads. Horses, donkeys, and mules

where the mode of transportation. During her delivery, there was a bucket of water, towels, a

rope to hold her legs, and a lay midwife. There was no such thing as technology.

Laura Alcaunter

The hospital where she delivered her last newborn was in a nearby city. Technology was

at its rise and she was able to benefit from it. During her stay, the nurse was assessing the

newborn with a fetal monitor. There was no such thing as an autonomic blood pressure so it was

done manually. Ultrasound machines were also available but were not used during her stay. She

was given IV but it was just a direct drip with no machinery involved. She also had a television

in her room and a telephone to receive and place phone calls.

Current Practice

The use of technology has revolutionized the health care system. It was observed by the

student nurse that multiple forms of technology are used before, during, and after pregnancy.

Some of the technology observed in the labor and delivery rooms included: a television, a

telephone, smart phones, an automatic blood pressure machine, pulse oximeter device, a digital

thermometer, an otoscope, glucose analyzer, external fetal monitoring, electronic health care

record defibrillator, electrocardiograph, infant incubator, and warming unit for the infant. Other

devices include ultranonography, fetoscope, doppler ultrasound stethoscope, electrical

breasfeeding pump, bilirubinometer, medication scanning system, magnetic resonance imaging,

ventilator, and weighing scale (Lowdermilk et al., 2016).

Care Routine

Rafael Alcaunter

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In Mrs. Alcaunter home town there were no such things as prenatal visits. Instead they

had the lay midwife do routine checks during the whole pregnancy. The lay midwife would

come and visit her every four months to give her a massage and reposition the newborn. If the

newborn was in a transverse position prior to delivery, the lay midwife would massage the

abdomen until the newborn was head down. During labor the lay midwife was the only other

women there. During postpartum the lay midwife gave Mrs. Alcaunter a bath and then follow up

with her every eight days. Mrs. Alcaunter was only allowed to take a bath once every eight days.

She was not allowed to leave her house for 40 days following delivery. At home, the husband

would assist her if needed but the whole town would come together and provide the meals of the

day. Every day for the next 40 days a town citizen would come and drop off food for the day.

Bathing privileges were granted but she had to be well covered from head to toe. In her culture,

it was believed that lactation will stop if the mother was exposed to cold weather.

Laura Alcaunter

Twenty years later the care routine for Mrs. Alcaunter changed in a negative way. No

longer did people come to feed her like in her first pregnancy. She was to take care of herself at

home without the assistance of a lay midwife before and after pregnancy. There were no follow

up appointments or prenatal visits to the healthcare provider. The whole 40 day rest period came

down to 15 days. The biggest help she received during the care routine was by her oldest

daughters. This was a big change for Mrs. Alcaunter. She was discharged from the hospital the

same day so the care routine was very brief. After she was discharged she went home rested for

a 15 day rest period and then she went back to work.

Current Practice

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The current care routine for pregnant women starts since the day she is thinking about

becoming a mother. Once she is pregnant there is prenatal care, labor and delivery care,

postpartum care, and newborn care. During the prenatal care the patient visits her regular doctor

and the healthy development of the fetus is monitored. As evidenced by the student nurse,

during labor and delivery the nurse becomes the eyes and ears of the patient. The nurse’s goal is

to provide optimum care and a care plan specific to each birthing mother. The nurse assesses,

provides a nursing diagnose, plans outcomes and interventions, implements interventions, and

evaluates the patient. During the postpartum stage a lot of teaching is involved. The postpartum

teaching depends on the type of delivery that took place and if there were any complications

(Lowedermilk, et al., 2016). After the postpartum stage the nurse will encourage a follow up

appointment that ranges from two to six weeks depending on whether it was a cesarean section

or a vaginal delivery.

Events Surrounding Birth

Rafael Alcaunter

Physically abusing women was a common practice in Mrs. Alcaunter’s home town.

Besides the events occurring in her hometown, Mrs. Alcaunter knew nothing about the outside

world. In the early 1960’s her family did not own a television or a radio to watch or listen to the

news. She lived in a small town in Mexico and driving to the city was not common. The only

means of transportation was by horse, donkey, or mule. In the town there was a small store that

sold all the groceries necessary for survival. During this time she does remember her mother

constantly getting sick. This event was significant because her mother was the main support she

had during her pregnancy. Mrs. Alcaunter never attended school so reading magazines or the

newspaper was not possible.

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Laura Alcaunter

With the arrival of the last newborn there was some historical changes taking place. For

one, men physically abusing women was not as common as it used to be. The authorities started

taking charge and these actions became a crime. Many men stopped this violent act but others

still continued and never faced the consequences. Hospitals and the city life became part of Mrs.

Alcaunter’s life. With the development of dirt roads, going to the city was much easier. The

primary way of transportation became cars and buses. During this last pregnancy her husband

was becoming very distant from the family. Shortly after the birth of her last child, he left. Mrs.

Alcaunter was left behind with 14 kids to raise and no family support. At this point she decided

to go back to work and with the help of her oldest children she was able to be a successful single

mother.

Cultural Beliefs and Practices

Rafael Alcaunter

Getting pregnant at the age of 14 was not uncommon in Mrs. Alcaunter’s culture. The

role of the women was to clean, have children, and respect their husband. If a woman was

unable to bear children it was frowned upon and seen as a punishment from God. People in her

home town would see these women as sinners and more than likely they will end up being single.

Breastfeeding was very common during her first pregnancy. Food was very scarce and

sometimes breastfeeding was the only way to feed the child. Formula was not available and

cow’s milk was the second option besides breastfeeding. If the women was unable to lactate,

there were other women in town with infants that would offer to breastfeed each other’s

newborn. Getting the epidural during her first born was not an option. Vaginal delivery was the

only option and experiencing the pain was part of being a mother. As part of her culture, Mrs.

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Alcaunter also believed in the bad eye or the evil’s eye. What this meant was that if another

person looked at your newborn with a malicious glare the baby will be cursed. If the baby ended

up being cursed, he will have bad luck for the rest of his life.

Laura Alcaunter

Live and learn is a common saying that Mrs. Alcaunter kept on repeating. She lived to

learn that being home for 40 days after delivery would not impact her health the way she

thought. For her last pregnancy she only took care of herself for 15 days and she felt perfectly

fine. She also lived to learn that enduring pain during labor and not seeking pain medications

was not a sin. On her last child she did get some pain medication and there was guilt felt. If

given the option she would rather have herbal teas since they work better on her. Some of her

cultural beliefs did remain the same. For example, she still believes in the bad eye and in the

importance of breastfeeding for the newborns health.

Current Practice

Back in the 1960’s having children at the age of 15 was a common practice. If a women

was not married with children at the age of 20 it was seen as abnormal and a sign that the woman

will end up single. Nowadays, teenage pregnancy is still seen but to a less degree. It was

evidenced by the student nurse that young moms are still occupying hospital beds but society’s

response is different. At the age of 15, society expects girls to be in school not pregnant. The

role of the women has evolved in various ways. For example, no longer are women seen as the

only ones responsible for raising children. In today’s society, the responsibilities are being

shared between both parents as more women are entering the work force. With women

becoming more independent, the age for having kids has increased and motherhood is getting

prolonged.

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Personal Meaning of Birth

Rafael Alcaunter and Laura Alcaunter

Giving birth at the age of 15 was a great experience that she remembers like if it

happened yesterday. Mrs. Alcaunter claims that she was at her optimum age for childbearing.

She did not feel getting pregnant at the age of 14 was too young at that time but looking back she

would not want her daughters to have kids that young. Her personal meaning of birth had

changed by the time she gave birth to Laura Alcaunter, the last child. No longer did she feel the

fear of the unknown like at the beginning. One thing did remain the same, that is, the feeling of

excitement with the arrival of the new member. Giving birth is one the most important women

obligations and God will decide who he wants to give that blessing to. Mrs. Alcaunter claims

that every child is a blessing from God. In her case she was blessed 14 different times.

Various differences were noted between Mrs. Alacunter’s first and last birth. The setting

went from her home to a hospital. The pain management went from having plain tea to pills for

pain relief. The paternal involvement improved as the years progressed and the use of

technology revolutionized from having no television to having fetal monitoring. Many things

changed; however, one thing did remain constant that is the joy she felt with the arrival of each

of her children. Current practice shows a more technology driven society but the idea behind

pregnancy is similar regardless of the culture of the individual. Having a baby changes people

regardless of the amount of technology or the type of care received during pregnancy.

Ultimately the goal of the mother is to have a perfect Gerber baby.

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Reference

Lowdermilk, D. L., Perry, S. E., Cashion, K., & Alden, K. R. (2016). Maternity and women’s

health care (11th ed.). St. Louis, MO: Elsevier Mosby.