Home sweet home … insemination: A midwife’s journey
by Michelle Borok, LM, LMP
In this special guest post, Midwife Michelle Borok recounts her experience with home intrauterine insemination (IUI).
When I was in midwifery school in the Southwestern United States, I forged a friendship with one of my favorite midwifery teachers in the sweetest way. She was trying to conceive, and I had the honor of becoming her main support person in that process. We earnestly studied her cervix together every day, gauging and documenting its location, texture and dilation. She talked and I listened about what it was like to try, wait, get hopeful, and surrender each month. I attended an appointment with her and her partner at the local infertility clinic.
They struggled to get into that clinic. Not because they actually weren’t struggling with infertility, but because they were queer. My friend and her wife had previously been driving 8 hours each way to the closest clinic that would perform an insemination for an “unmarried” (gay) couple. The clinic in town eventually acquiesced. Thus my friend got to have her transvaginal ultrasounds with these reluctant providers. The last appointment she sought at that clinic was the one I attended. The timing was off that day. Because she had already ovulated, the insemination couldn’t be performed. It was a hard day.
Three midwives and a midwife’s wife
The clinic’s misstep around the timing of the insemination, and a bedside manner that paled in comparison to what we offered as midwives, ultimately inspired us. We realized that we could do an intrauterine insemination ourselves. An intrauterine insemination, or “IUI,” means the sperm is placed directly in the uterus, bypassing the vaginal canal.
Lots of folks do their own intravaginal insemination (IVI) or intracervical insemination (ICI), which can both be accomplished with a needle-less syringe at home. An IUI calls for a few extra steps — it requires a midwife or other provider to locate the cervix with a speculum, and place a thin, flexible, sterile catheter through the opening of the cervix and inside the uterus. We knew sterile technique, we knew the speculum, we knew the cervix. My friend knew her timing better than anyone. All we needed was a little know-how and the equipment. Quickly, we acquired both, and with help of a second midwife, we performed the next insemination at home on her couch. We blessed the vial. We did a gratitude meditation. My friend receiving the insemination set the pace. We all did it together, three midwives and a midwife’s wife.
A paradigm shift
It was incredibly empowering for all of us to demystify the process and realize how simple and easy it actually is. No fancy equipment, no rocket science. No cold room, no heteropatriachy. It was sweet. She didn’t get pregnant that cycle, she did soon afterwards.
Once I’d completed midwifery school, I returned to the Bay Area to start my practice. I’ve been offering home IUIs and home births as a Licensed Midwife there ever since. I’ve also had the joy of training and mentoring more than a dozen homebirth midwives from all over the country to perform IUIs in their communities.
Homebirth midwives and home IUIs
A homebirth midwife is in many ways the ideal provider to offer IUIs to those on a conception journey. We are on-call providers, accustomed to living our lives around the signals and timing of our clients’ bodies. Access to a provider that can show up at your home, day or night, weekend or holiday, is critical to getting the timing just right. And with IUIs, timing is vital.
There is little doubt that clients’ emotional states during and around the time of inseminations have an effect on how quickly they become pregnant. Of course, feeling safe and feeling stressed are inversely related. Many clients report that the experience of receiving an IUI in the comfort of their own home – warm, cocooned in the arms of their partner or with their best friend by their side, with a provider who is attuned to their individual needs – is a healing one.
“Guardians of safety”
As midwives we hold space, listen, offer guidance as needed, and interact with our clients and their bodies with utmost respect. Being a homebirth midwife teaches the midwife about being a guardian of safety, while simultaneously not being in charge. In our work, we abide by the body’s natural rhythms, bowing to the ultimate mystery of conception and birth and surrendering to the client’s wisdom about their own experience. We collaborate with our clients, determining the ideal timing of an insemination together. Most of all, we provide a service, an option, a choice. Some of us offer massage, moxa treatments, guided meditations, fertility rituals, and other additions to the home IUI experience. Ultimately our goal is to put ourselves out of a job as soon as possible.
About Michelle Borok
Michelle Borok, LM, CPM is a Licensed Midwife offering home births and home inseminations to her adored clients in and around Oakland and Berkeley, California. She is happy to receive requests from midwives looking to learn more about offering IUIs, especially those in areas where queer, single, Native, POC, and otherwise marginalized folks are denied or begrudgingly provided with (in)fertility services.