Homebirth Transfer and Recovery from 4th Degree Tear


Carolyn became pregnant with her first child in June 2019. Her pregnancy went well and was considered low-risk, and after learning more about out-of-hospital birth she was inspired to plan a homebirth with a local midwife practice. She enjoyed wonderful prenatal care throughout her pregnancy. She and her partner also opted to hire a doula

Carolyn’s labor began on the evening of 41+6 after taking castor oil and receiving a membrane sweep. She labored at home for 24 hours and attempted a variety of strategies before opting to transfer to the hospital due to exhaustion, slow dilation progress, and an abnormal contraction pattern. Because Carolyn’s midwife was a CNM and also an employee at her chosen hospital, her midwife was able to transfer with her and remain her care provider throughout the duration of her labor.

Upon admission, Carolyn’s midwife recommended an epidural to help her rest overnight, as well as pitocin to help regulate and organize her contraction pattern. Carolyn consented to these interventions and was able to sleep for 5 glorious hours. The next morning, Carolyn woke up fully dilated and proceeded to push for 3+ hours. When her baby was finally born, it was discovered that he had been asynclitic (head tilted to the side), which helped explain her abnormal contraction pattern and extended, 42-hour labor.

Carolyn sustained a 4th degree tear as well as severe postpartum hemorrhage. While she was very happy with how her birth, tear, and bleeding were managed (calmly and without fear), her postpartum healing was extremely challenging. She experienced pain and pelvic heaviness for many months following the birth, and spent a year in pelvic floor physical therapy healing and rebuilding her strength. This was a very difficult and emotional process.

The day after her baby was born, Oregon declared a State of Emergency in response to the incoming coronavirus pandemic, and lockdown orders began a few days later. Carolyn struggled being newly postpartum in this context and experienced a lot of grief about the loss of hands-on support from family and friends. She credits her emotional and physical recovery to her amazing and supportive partner, as well as her therapist and team of encouraging and responsive medical providers.

Carolyn Schulte Bio

Carolyn lives in Portland, OR with her partner and 18-month old son. She is a Marriage and Family Therapist and enjoys running, word games, colorful jewelry, delicious meals, and spending time outside in the beautiful Pacific Northwest. You can connect with her on Instagram at @carolyn__hart.



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