The Andreyevskiy home in Lakeville is bustling place with four children – three sons, ages 10, 7 and 4 and a 10-month-old daughter. Mom Elizabeth has had a variety of birth experiences, all special for various reasons, but the way her daughter arrived was a first for her and her birth team at The Mother Baby Center.
Elizabeth’s first son was delivered via cesarean section in a hospital after a long labor and a failure to progress. The experience made her eager to try something different the next time, so she planned a home birth for her second son.
“I came across some documentaries that talked about what a home birth is like, and oh my gosh, this is what I wanted! So I had midwives that I hired and it was wonderful,” said Elizabeth.
She was hoping for a calmer and gentler birth experience than her first, but during the delivery her son got stuck and needed to be lifted out by the midwife overseeing the birth. A similar thing happened during the home birth of her third son. Then an internal pelvic exam revealed Elizabeth has an abnormally shaped pelvis, so vaginal births will likely always present problems during delivery.
When Elizabeth became pregnant again, she had a miscarriage. She was referred to The Mother Baby Center, a partnership between Allina Health and Children’s Minnesota, for the delivery and aftercare. “I had a really good experience there with the team and how kind everyone was, very understanding and empathetic,” said Elizabeth.
Elizabeth knew she wouldn’t be able to have another home birth, but she was hopeful to find some options to achieve the calm, gentle delivery she was seeking when she became pregnant again. Remembering the positive experience she previously had at The Mother Baby Center, she chose to work with a midwife and doctor that will deliver her baby there.
A new birth option
During her pregnancy, her sister-in-law told her about a cesarean delivery performed in another country where the mother lifted her baby out of her belly during the surgery. Elizabeth was fascinated by this option, but her next thought was – “what doctor here will do this for me?”
She approached Dr. Kim Fischer, an obstetrician-gynecologist who delivers at The Mother Baby Center, with the idea and some videos of this procedure. She was expecting any doctor to dismiss the idea, but she got a different response from Dr. Fischer.
“I had never heard of this method, but I thought it sounded like something we could do,” said Dr. Kim Fischer. “If we can do it safely for the baby and the mother, I’m open to helping a woman have the birth experience she wants.”
During the weeks leading up to the delivery date, which was scheduled for July 8, Dr. Fischer, Dr. Suresh Ahanya, Dr. Deniz Perese and patient care manager Lori Luther made the plans for this maternal assisted c-section. The team carefully considered the risks and response plans. The main concern was safety, such as preventing infection and maintaining sterility during the delivery while allowing Elizabeth to lift her baby.
What is a maternal assisted C-section?
During a cesarean delivery, the obstetrician begins the surgical procedure as usual. Once the baby’s head is out, the mother can reach down, grab their baby under the armpits and pull them up onto their chest. This is not an option for every mother-to-be and never for an emergency C-section. But it can give some women the option of being more personally involved in their cesarean birth.
Change of plans
About a week before the scheduled delivery date, Elizabeth started to experience labor symptoms. She told Dr. Fischer what was happening and asked if the delivery date could be moved up. She worried another doctor would not do this special delivery, and even if Dr. Fischer could come in, she likely couldn’t get the entire team that planned to assist her to also do that.
“I went into labor at 38 weeks and I was like mentally trying to stall the labor by holding my baby belly and saying no, it’s not time yet,” said Elizabeth. “I don’t do well when things don’t go to plan, but the labor kept progressing and I was super discouraged.”
On July 3, Elizabeth woke up at 3am and her contractions were strong. She knew it was time to go to the hospital. Dr. Fischer was away for the holiday weekend, so Elizabeth met the doctor who was there and started trying to explain her special birth plan.
“First of all, I’m in labor and not on any meds at this point, and now I’m super emotional,” said Elizabeth. “I broke down and started crying because this is my last baby and I really wanted the birth to go a certain way.”
The team caring for Elizabeth called Dr. Fischer. When they reached her, they relayed the message to Elizabeth: “Dr. Fischer is an hour away. Can you wait one hour for her to come in?” Elizabeth said, “Yes I’ll wait one hour!”
Dr. Fischer arrived, as well as several other people on the special delivery team that were also supposed to be off that day. The room was set up as planned and Dr. Fischer explained how everything was going to work to Elizabeth and the others.
“No one in the room questioned why because we knew it was all for Elizabeth and what she needed,” said Dr. Fischer. “We all commented how fun it was to be doing something not just different, but something so meaningful to a patient.”
The big moment arrived
The procedure began and when it was time to lower the drape, Dr. Fischer guided the baby’s head out and Elizabeth reached her hands under the baby’s armpits and pulled her onto her chest, just as planned.
“I was holding my baby and I got the birth that I wanted, and it went so well,” said Elizabeth. “I’m so grateful for Dr. Fischer. She was willing to put herself out of her comfort zone and do something new – and come in on her day off. She didn’t have to do that. She knew how super important this was for me and she went out of her way to come in and make it happen. I’m so so grateful to her.”
“The fact that we could actually go ‘outside of the box,’ still provide excellent care and allow Elizabeth to have the delivery she needed, gave us that sense of being part of something bigger,” said Dr. Fischer. “We weren’t just doing our job. It was more than that. We were helping to make this much more meaningful. I still cannot believe it really happened.”
Today, baby Nellie is a healthy and active 10-month-old. Elizabeth has had a successful recovery and is eager to encourage moms-to-be to consider this birth option.
“I think it’s an ideal experience for a mom who really doesn’t want to have a C-section and wishes she could have a more natural birth,” said Elizabeth. “It’s a little bit of a compromise.”
Whole person care
Dr. Lisa Saul, president of The Mother Baby Center, notes the exceptional team of care providers who considered Elizabeth’s well-being as a whole person:
“This is a prime example of what you conceive of, delivered,” said Dr. Saul. “People who deliver by cesarean sometimes feel disconnected from the birth experience. Our entire care team worked together to ensure we could honor this special request in a way that was safe for Elizabeth and her baby. Dr. Fischer and the care team provided Whole Person Care by listening to Elizabeth’s preferences and improved this family’s experience beyond measure. We hope to be able to offer his procedure to well-selected patients in the future.”
At The Mother Baby Center, we’re committed to partnering with families to make sure they are heard during their birth journey. We believe every mother deserves to be heard, every baby deserves the best care and every family deserves support. Learn more at themotherbabycenter.org.