Homebirth After a Hospital Transfer: Gracie's Four Birth Stories

Can you plan a homebirth after your first one ended in a hospital transfer? Yes. Gracie Gould did it three more times, and her four births share almost nothing except the woman in the middle of them.

Gracie lives in Greenville, South Carolina with her husband Jesse and their four children. She came to homebirth through her own mother, who had seven babies, the last several at home — and in a lovely bit of continuity, one of Gracie's midwives turned out to be the daughter of her mother's midwife.

What her four births actually looked like: a planned homebirth that transferred, a homebirth in a fifth wheel camper trailer with a shoulder dystocia, a hospital birth with midwives, and a water birth at home at 42 weeks and 3 days.

What happens when a planned homebirth becomes a transfer?

A transfer usually happens because labor has stalled or a mother's stamina is running out, not because something has gone catastrophically wrong. Gracie transferred with her first daughter after being stuck at nine and a half centimeters for hours, unable to keep down water or food, growing dehydrated. Her midwife raised the transfer, and Gracie agreed.

At the hospital, the peanut ball opened her a little. Her cervix was manually opened the rest of the way. Then she pushed for three hours, and her daughter turned out to have been asynclitic the whole time — her head tilted in the pelvis, which is exactly why she hadn't descended.

What Gracie wants people to hear about that hospital: they were kind. They explained everything, they gave her room to decide, and she carries no trauma from any of it. She calls that birth team angels. She was leaning back at the end of those three hours, having declined a position change, and she tore significantly. Her daughter was born with low oxygen and spent a few days in the NICU before coming home healthy.

Can you have a homebirth after a hospital transfer?

Yes. A prior transfer is not a disqualifier for a future homebirth, and many mothers who transfer with a first baby go on to birth subsequent babies at home. Gracie planned a homebirth for her second and had him at home — living, at that point, in a fifth wheel camper trailer.

Her line on that, for anyone whose objection is their house: you can absolutely do this.

That birth moved fast. Her water broke with a pop while she was on the phone with her midwife, and within a short stretch she was pushing. His head came, and then he was stuck. Double shoulder dystocia. Her midwife moved her through position after position, and when he still wouldn't come, she scooped his shoulders free with both hands.

He was born behind Gracie, on hands and knees, purple and unresponsive. She thought she'd lost him. He came to, cried, and latched right away. Nine pounds, six ounces — from a mother who is about five feet tall and weighed 98 pounds before her first baby.

And the tear from that birth? First degree. Tiny. Her midwife told her she likely wouldn't have torn at all if she hadn't needed to intervene to get him out.

Does birth position affect tearing?

Position matters because it changes the angle and pressure on the perineum, and because a mother who can feel what's happening can slow herself down. Gracie's clearest evidence is her own body: a serious tear leaning back after three exhausted hours of pushing, a first degree tear with a nine-pound baby on hands and knees, and no tear at all with her third.

Her conclusion: "I'm a firm believer in letting a woman go in whatever position she wants."

That isn't a guarantee, and Gracie's own experience shows why — the maneuvers her son needed were the reason she tore at all that time. But the ability to move, feel, and choose is real, and it showed up in her body three times over.

What is it like to give birth in a hospital after two homebirths?

Gracie's third baby, Paisley, was born in a hospital with midwives, chosen because insurance was supposed to cover it. She liked her midwives. But she couldn't use water because of her prior shoulder dystocia, she wasn't supposed to eat or drink, and the room was cold and bright and interrupted.

Her body wouldn't relax. She took a shower and labor slowed. Nurses came in to check. She was starving.

Offered either artificial rupture of membranes or low-dose Pitocin, she chose the Pitocin, reasoning she could stop it if she hated it. It steadied her contractions, her water broke on its own, and she pushed Paisley out on hands and knees. Seven pounds one, screaming immediately, no tears. She calls it redemptive — her first birth with a robustly healthy baby right from the first second.

The insurance, in the end, covered less than promised. She paid nearly what a homebirth would have cost. That did most of the deciding for baby four.

Why did her fourth pregnancy test her so much?

Gracie went into Eden's pregnancy believing it would be peaceful and intuitive, with spontaneous labor. Instead: her family got seriously ill while she was pregnant, a midwife she loved died in childbirth, her baby went breech at 32 weeks, she tested GBS positive, her prodromal labor ran hard for a month, and two snowstorms hit South Carolina back to back.

She did Spinning Babies and her daughter turned head down. She declined antibiotics for GBS and took garlic instead, in conversation with her midwife. And then castor oil — which had worked for her every previous time — did nothing. Twice.

A biophysical profile showed why she should be glad. Her fluid, placenta, and baby were all perfect, but her daughter had her hand up beside her head. If that hand came through first, the cord could follow.

At her lowest point, Jesse sent her the verse of the day: Psalm 71:6. Gracie's read of it — that it is God who brings a baby out of the womb, whether that happens vaginally, by induction, or by cesarean — is what finally released a lifelong terror of surgery. Not a promise she'd avoid it. Permission for it to be okay if she didn't.

The baby moved her hand. Her midwife let her go past 42 weeks with a good BPP. And a few days later, after an exam that felt suspiciously like a sweep, Gracie's water broke while she was soaking in the tub.

She got out. Made her family dinner in a giant postpartum diaper, pausing for contractions. Sent the kids outside with a friend. Then got in the tub with her midwife, an assistant, and a midwife in training, and pushed her daughter out in one enormous push on hands and knees. Eight pounds six. No tearing. Labor started around four in the afternoon; Eden was born about 7:20.

"my body's not broken," she remembers thinking, crying in the water. "we did it, we did it."

What Gracie would say to a mother preparing now

Her closing thought is that birth takes surrender — and more than surrender. That we do live in a world where hard things happen, and the ground she found wasn't a guaranteed outcome. It was being willing to surrender to the Lord, knowing, as she put it, that he carries us even in our brokenness.

And on the doubt she carried the whole way: "Even in my weakness and even in my doubt and even in when I was faithless, he was faithful."

This article shares one mother's personal experience and is offered as encouragement and education, not medical advice. Always bring questions about your own pregnancy, birth, and postpartum to a trusted care provider.

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FAQ

What is shoulder dystocia, and can it happen at a homebirth? Shoulder dystocia occurs when a baby's head is born but a shoulder becomes lodged behind the mother's pubic bone, requiring specific maneuvers to free it. It complicates roughly 0.5% to 1% of vaginal births and is largely unpredictable. It can occur in any setting, including at home, which is why midwives are trained in the maneuvers used to resolve it. (NCBI/PMC)

Can you have a homebirth if you test positive for group B strep? Many midwives do attend GBS-positive mothers at home, though protocols vary by state and by practice. GBS is a common bacterium, carried by roughly 18% of pregnant women worldwide, and carrying it is not an illness. Options generally include intrapartum antibiotics, declining them with a plan for monitoring the newborn, or other approaches discussed with a provider — a decision that belongs to each mother in conversation with her own midwife. (ScienceDirect)

What does asynclitic mean, and why does it make labor longer? An asynclitic baby has their head tilted to one side in the pelvis rather than descending evenly, which presents a wider diameter and can stall dilation or descent. It often shows up as a labor that stops progressing without any other obvious reason. Position changes, movement, and bodywork are commonly used to help a baby realign.

Can a midwife attend a homebirth past 42 weeks? This varies significantly by state and by individual practice, and some regulations restrict midwives after a certain gestation. Gracie's midwife attended her at 42 weeks and 3 days after a reassuring biophysical profile confirmed healthy fluid levels, a healthy placenta, and a well-positioned baby. If going past your dates matters to you, ask your provider about their limits early in pregnancy rather than at 41 weeks.

Does castor oil always start labor? No. Castor oil is a laxative sometimes used to try to stimulate contractions, and its effectiveness varies widely — it may produce contractions that fizzle, or nothing at all. Gracie used it successfully for two previous births and had it fail completely, twice, in her fourth pregnancy. It carries real downsides, including dehydration and unpleasant GI effects, and should only be considered in conversation with a provider.