HBAC Homebirth Story: A Cervical Lip, a Cesarean, and the Birth That Followed

Yes, you can have a homebirth after a cesarean. Marley Collins did — in a birth tub in her own house, after a first birth that ended in a hospital transfer and surgery. What makes her story worth an hour of your time isn't that it worked out. It's how clearly she can tell you what her first birth cost her, and what it didn't.

Two births, side by side

What is a cervical lip, and why did it end her first homebirth?

A cervical lip is a small remaining section of cervix — usually at the front — that hasn't fully drawn back over the baby's head, so the head can't descend past it. It isn't rare and it usually resolves. Marley's didn't. Hers swelled, and by then she had already been pushing on a strong fetal ejection reflex for the better part of a day.

Her midwife worked the problem for hours. Position changes. Getting her out of the tub. Manual reduction attempts. Ice. Diphenhydramine, orally and vaginally, to bring the swelling down — which worked on the swelling and not on the lip. She told Marley to stop pushing, which Marley describes with real comedy: if you've ever tried not to push through a fetal ejection reflex, good luck.

When the swelling came down and the lip stayed, the midwife called other midwives to ask what else there was. Then she saw meconium. And then she said the thing out loud.

A transfer is a decision, not a collapse

This is the section I'd most want a first-time mother to read.

Marley's transfer was not an emergency. Nobody ran. Her midwife saw early signs, laid out what she'd tried and what was left, and asked Marley how she felt — could she keep going, not knowing how much longer this would be? Marley asked for one more hour on a yoga ball in the shower. She took it. Then she got in the car.

Her midwife stayed with her at the hospital. Slept on the couch in her room alongside her mom and husband. Went home to shower and barely made it back in time to be in the operating room, where she talked Marley through the surgery and held peppermint oil under her nose.

That is what a well-handled transfer looks like: unhurried, informed, and with your person still beside you.

The specific grief inside a cesarean

Marley heard her daughter cry. Maren was laid on her chest. And then the baby had to go to the nursery — and Marley's mother went with her, and Clayton went with her, and Marley stayed on the table.

She missed Clayton becoming a father. He had already missed her giving birth. That's the loss she still names four years later, and it's a much smaller and much more exact thing than "my birth went wrong."

She felt shame at first, because she'd told her coworkers and her friends about the homebirth, and it felt like failing publicly. That passed. What didn't pass was the specific thing. And what she did with it is the whole lesson: she grieved the one piece and refused to write off the rest.

How she prepared for an HBAC

The second time around, Marley's preparation was less about information and more about who was in the room.

She found her midwife through the coordinator of the Amish co-op where her family buys raw milk. This midwife has been practicing for over 35 years, works alongside her husband as her assistant, is breech- and twin-trained, is deeply pro–water birth, and does every prenatal appointment in the family's home. At the consult, when Marley described the cervical lip, the midwife told her she'd developed her own maneuver for reducing one and had never transferred a mother for it.

She also declined a doula — and this is the most instructive moment in the episode. Her midwife recommends one for every VBAC client, and Marley took that seriously enough to hire one. Two small yellow flags and one no-show later, she asked her midwife to explain precisely what a doula would give her that she didn't already have. Then she gave her own view: she had already done the labor, the transition, and the pushing. There was one part of birth she hadn't done. Her midwife agreed with her, and that was that.

At 37 weeks the midwife came to the house for a birth class over dinner, with everyone who'd be at the birth required to attend. The class centered on the pushing stage, on water birth, and on how to catch your own baby — which is what 99% of this midwife's clients do.

The birth that gave it back

Contractions started at midnight on a Monday. Marley labored alone through the night, called her mom and midwives around five, and got in the tub.

When the midwife arrived at six-thirty she said, honestly, that she had another mother in labor twenty minutes away, and offered to check Marley to decide where she was needed. Marley was hoping for an eight. The midwife held up her finger to show a dime. Marley laughed, told her to go, and settled in.

She labored all day with Clayton beside her — he sat through every single contraction — with Maren wandering in to kiss her and rub her back, and with a strict rule the two of them had made to get out of the tub every hour or so and change position. Around noon her body pushed on its own. She locked eyes with Clayton and told him. The midwives came back.

She could feel her baby's head — which turned out to be the amniotic sac, still intact, and she remembers thinking that's squishy, that doesn't feel like a skull. She felt enormous pressure and knew, from what she hadn't felt the first time, that there was no lip in the way. Her water broke as the head was crowning. She squatted, one hand in Clayton's and one in her mother's, felt her daughter's nose with her fingers before anyone could see her, checked for the cord, and lifted Lenora Grace onto her own chest.

And then she looked up at her husband.

Afterward there was a placenta that wouldn't come until she moved to the bed, a genuinely complex tear that her midwife — who specializes in complicated repairs — took her time with, and the unwelcome discovery that Marley is resistant to lidocaine. Maren woke from her nap partway through the stitching and met her sister.

The midwife's husband had been charting the whole time, writing down what Marley said through each contraction. She reads the list on air. It's the best two minutes of the episode, and I won't spoil it.

What to take from this one

Marley prepared beautifully for both births and got two completely different stories. That's not a failure of preparation, that's what preparation is for.

What carried over wasn't a technique. It was that she knew where she stood. She could name the one part of birth she hadn't done yet, and she could laugh when a cervical check told her she was further back than she'd hoped. Both of those are the same skill.

And she'd do it again either way. If Lenora's birth had also ended in a transfer and a cesarean, she says, her third attempt would still most likely have been a homebirth.

This article shares one mother's personal experience and is offered as encouragement and education, not medical advice. Anything about your own pregnancy, birth, or postpartum belongs in conversation with your midwife or provider.

FAQ

What is a cervical lip in labor, and how is it treated?

A cervical lip is a remaining segment of cervix — most often anterior — that hasn't retracted over the baby's head, blocking descent. Documented midwifery approaches include position changes and gravity-neutral positions, water immersion, manual reduction during a contraction, ice applied directly to the cervix, diphenhydramine, side-lying release, and epidural analgesia to allow rest. Most resolve. A persistent, swollen lip is more often a sign of something else — position, exhaustion, or pushing that began before the cervix was ready — than the root problem itself. Source: LoGiudice, "Midwifery Management of a Birthing Person with Cervical Edema During Labor," Journal of Midwifery & Women's Health, 2022.

Can you have a homebirth after a cesarean (HBAC)?

Yes, and for many women it goes well. In the largest U.S. dataset on planned midwife-led home birth, 87% of the 1,054 women attempting a vaginal birth after cesarean at home achieved one. Broader clinical guidance puts VBAC success at 60–80% generally, with the strongest odds for women who go into labor spontaneously and have an interbirth interval of 18 months or more. Sources: Cheyney et al., Journal of Midwifery & Women's Health, 2014 (MANA Stats, 16,924 planned home births); FIGO good practice recommendations for VBAC, 2025.

Is an HBAC safe? What's the actual risk of uterine rupture?

Uterine rupture is the primary concern in any trial of labor after cesarean, and it is uncommon: roughly 0.3% to 0.7% for a woman with one prior low-transverse cesarean. That risk rises meaningfully with induction and with oxytocin augmentation, and falls for women who have already had a vaginal birth. Because rupture requires rapid surgical response, distance to a hospital and your midwife's transfer plan are central to this conversation — which is a conversation to have with your own midwife, not a decision to make from an article. Sources: FIGO good practice recommendations for VBAC, 2025; Didier-Mathon et al., Acta Obstetricia et Gynecologica Scandinavica, 2025.

Is homebirth after cesarean legal where I live?

Homebirth itself is legal throughout the United States, but what a licensed or certified midwife is permitted to attend varies significantly by state, and a prior cesarean is one of the most commonly restricted conditions. Some states permit it outright, some require physician consultation or referral first, and some place it outside a licensed midwife's scope entirely. Rules also change. Check your own state's midwifery board or state midwifery association, and ask any midwife you interview directly how a prior cesarean affects her practice.

How often do planned homebirths transfer to the hospital, and does a transfer mean something went wrong?

Transfer rates vary by country and depend heavily on whether it's a first baby. Across studies from high-income countries over the past decade, overall intrapartum transfer rates from planned home birth run roughly 9–21%, with 24–39% for first-time mothers and about 5–12% for women who've given birth before. The most common reason is slow progress in labor, not emergency. Most transfers are non-urgent, and a transfer generally means a birth team recognized a limit early and acted on it. Sources: Scarf et al., BMC Pregnancy and Childbirth, 2019; Birthplace in England cohort, 2014.

How long should you wait after a cesarean before trying to conceive again?

Eighteen months between births is the interval most commonly associated with better VBAC outcomes, and it's the figure clinicians most often give. Marley was told 18 months by both the OBs and the midwives she spoke with, and waited. Shorter intervals don't rule out a VBAC, but they do shift the risk picture, which makes this a question for your own provider. Source: FIGO good practice recommendations for VBAC, 2025.