IUI, Fresh Inseminations, and a Home Birth Story

I was excited to come across this queer family’s conception and birth story on The Birth Hour podcast, and wanted to share their experience.

From the Birth Hour: “Caitlin and her wife had a difficult time navigating the barriers faced by queer couples trying to conceive. After two years and many failed IUIs, they decided to take a different route and try at home inseminations with a known donor. She hoped that removing the stress of the fertility clinic would help her body welcome pregnancy. She was right! And shortly thereafter Caitlin finally got the positive pregnancy test she had been longing for.”

Listen to their story here.

Baby Ruth

When we decided to have a baby, we were in agreement to use a known donor. For Hunter, this was driven by a desire for as little medical intervention in the conception process as possible. Basha is a second-generation queer who was conceived with an anonymous sperm donor, and found that anonymity very disempowering; for her, it was important to give our child the knowledge about their donor that she didn’t have.

We came up with a list of criteria for known donors. We wanted our donor to be Jewish, live locally, and be interested in having a non-parental relationship with our child. Though we considered this to be minimal criteria, we couldn’t think of anyone to ask.

We drafted an email to send our to our community asking for donor recommendations, and worked on getting up the nerve to ask distant acquaintances. Meanwhile, we enrolled in an 8-week class called “Maybe Baby” at the local feminist therapy center. We already knew almost everything there was to know about getting pregnant thanks to our bible, “The New Essential Guide to Lesbian Conception, Pregnancy, and Birth,” but we took the class hoping to meet other queer prospective parents. When we mentioned to a friend from class that we were having trouble finding a Jewish donor, she immediately thought of her good friend S, who might be interested in helping us. She asked S that night, and they said they would consider it, so the next week we were set up on a blind date of sorts.

We liked S right away, but the process of courting a previously-unknown-to-us known donor was awkward at times, and we all took it slow. S told us that they had two goals: one, to enact the world they desire to live in, where queer people share sperm in order to help each other create families; and two, to have more children in their life that they could have a loving, non-parent relationship with. This was exactly what we were looking for, but it still took time to build a relationship that we could envision continuing for the rest of our lives, and to develop the trust needed to make a baby with someone who would legally have parental rights over our child for a few months. We got to know each other, ate pizza, and felt it out in a non-committal way. In the meantime, S got some basic labs done to make sure their sperm was viable, we read “Taking Charge of Your Fertility” cover to cover, and we both tracked our cycles. We spent many hours in conversation with each other about who would get pregnant first, and came to a tentative decision that it would be Hunter.

After months of process, S came to us and told us that they had decided to start HRT in about 3 months. Once on HRT, S would stop producing sperm; if we wanted to make a baby with their sperm, we had to do it now. They agreed to bank sperm so that we could have a genetically related sibling down the road. We realized that we could maximize our chances of conceiving by taking turns inseminating, since we were ovulating about two weeks apart. We got a bag of leftover insemination supplies from friends who had just had twins, bought a bunch of pregnancy tests, and were ready to start trying.

S lives just two blocks away, so the technicalities of inseminating were easy. Hunter met S on their porch, picked up the small plastic cup full of what we hoped would become our baby, and rushed home. The first time that Hunter emptied the syringe up by Basha’s cervix, all the semen spilled right back out, and had to be drawn back up and inserted again. We tried again the next day, but two weeks later, Basha got her period. Luckily, that the same day Hunter became fertile. This time it was Basha meeting S on their porch, trading semen for banana bread, and carrying it the two blocks home between her boobs to keep it warm.

Between insemination attempts, S went to the clinic every few days to freeze sperm for baby #2. This was a huge undertaking for them, and to their credit, they never complained. We had talked to a local fertility clinic and learned that for us to have a known donor freeze sperm, it would cost a minimum of $2500, and would involve a lot of red tape. But, if S was the client instead of us, and froze sperm as a part of their gender transition, it was a quick and affordable process. This workaround saved us thousands of dollars.

Impatient for a positive, we started testing only a week after inseminating Hunter, and Hunter was pregnant. Hunter’s first try, and our second ever attempt – we couldn’t believe it. Ten months later, right on her due date, Ruth was born.

There are a few other interesting components to our conception and birth story. One is that we planned a homebirth with a queer midwife (Ray). We share so much queer community with her, that on the day Hunter went into labor, she had to cancel her plans to attend a potluck… that happened to be at our donor’s house! S texted us that night to say they hoped we were the labor she was called to, and wished us good luck. We also had an incredible queer doula working with us, with whom we have stayed in touch. Although Hunter’s rising blood pressure necessitated a hospital birth, we were luckily greeted by a hospital staff that let our our midwife and doula facilitate almost the entire birth, and Hunter managed an unmedicated labor much like the one we had planned at home.

Another unique aspect of our story is that Basha decided to induce lactation so that we could no-nurse. For Basha, it felt like a way to be connected to our baby without having been the biological or gestational parent. She used the Newman Goldfarb protocol, which involved taking medications that were hard on her body and mental health, and pumping 7x/day for the month leading up to our baby’s birth. Once Ruth was born, she had a tongue tie, so nursing was much more complicated than we imagined. However, almost 7 months later, we are still co-nursing our baby. And Basha will be adopting Ruth next week, where we will be celebrating with our local family, including Basha’s non-gestational mom who adopted her almost 20 years ago.

Beatrice Ursula’s Story

The Decision:

I never thought I would have a child.  When Daniel and I talked about it, I was very clear and he was accepting of it.  We never talked about it again, it was a non-issue. Then something switched around spring of 2017.  I am still not sure what changed my mind. Looking back, I think it was a combination of things. First, seeing how good Daniel was with our niece and knowing how good he would be as a father.  Also, seeing friends and family have kids and thinking, “I could do that and probably pretty well.” Also, weirdly enough, seeing the political direction the country was going in. This sounds so cliche, but I really did think about the necessity of more good people in our country and that in some way, we as queer people had a responsibility to help with that.  It sounds very self-righteous writing that, but with the election of Trump and racism and hatred on the rise, Daniel and I had jumpstarted our political activism and for me, this was a part of that.

We were laying on a big lounge chair in Napa Valley at a spa we were not fancy enough for on a vacation celebrating our five year anniversary in July 2017.  We were both quietly looking out over the beautiful landscape when I finally found the moment to tell Daniel when I had been thinking about for a few months.  I said, “I think I want to have a baby.” He was surprised. After asking a few questions about how I thought we would do that – which I had already thought through, it was pretty clear he agreed.  


It seemed pretty obvious to me that I would carry this baby.  I don’t know why that was such an easy decision for me, but it was.  I felt like I was strong enough in my identity and my personal and professional life to make it through without incident.  I knew it would mean stopping hormone therapy, but it would be temporary and I could do it. I stopped taking hormones pretty soon after getting back from vacation.  That fall we attended the Trans Health Conference specifically to go to workshops of conception for transmen. The first workshop left us feeling like it was impossible and would take a ton of money and medical intervention.  Feeling somewhat defeated, we attended the second workshop, which was led by the person whom we would later hire as our midwife. Ray presented a hopeful and straightforward workshop that made us feel like this was not only going to be pretty painless, but it was going to work.  A few weeks later, she was sitting in our house consulting on how to conceive at home – DIY style.

Daniel and I had discussed how we were going to conceive a baby.  I don’t remember ever considering using an anonymous donor considering all of our queer cismale friends.  We ran through the list of possible folks pretty quickly and knew we would ask Steve first. It just seemed practical.  He was a close friend for a decade, we knew him well. Him and Anthony lived in the area. They were great friends and would be people we would want in our child’s life long term.  Yes, we discussed qualities in Steve that we considered hereditary and liked, but that was not a large part of the decision. Most importantly, Steve was a very practical person and I trusted that he would agree based on logic, more than emotion.  The next time we hung out, we asked him and Anthony. Their agreeance was quick and as soon as my body was ready, we would begin to try.

By January of 2018, everything was ready to go.  Ray had helped coach us on the right supplements to take to get everything working again and it had.  We were eager to get things going quickly. Not only was being off hormones already proving to be more difficult for me than expected, but Steve and Anthony had decided to move to Seattle, giving us only a few months of attempts.  Each time we tried to conceive at home, things got easier and easier. However, the rollercoaster of emotions waiting 2 weeks to test, being hopeful and then let down was not easy at all. Luckily, the third time was the charm. I had gotten the pregnancy tests that said the words “pregnant” or “not pregnant” so there would be no mistaken.  When the word “pregnant” came on the screen that morning before work, I couldn’t believe it. It didn’t feel real yet and I was nervous to get too excited too quickly.


Pregnancy was hard and I wondered if it was hard for everyone, or just me. It was a challenge for the regular reasons of aches and pains, heartburn, and nausea, but the emotional toll was also very difficult.  I saw being a pregnant transman as important. Being a teacher, being out and open about my pregnancy was a way to make a statement about gender. I tried to educate about my identity and political views on gender, pregnancy, and birth as much as I could.

It was weird how quickly it was normalized at my school amongst staff and students.  I think I was optimistic about their reactions, but also trying to brace myself for the worst.  The hardest part was actually figuring out how to work with that type of non-reaction. I had definitely prepared myself for negativity and backlash, expecting some type of discrimination.  However, it was like nobody even blinked, as if they had encountered pregnant men all their lives. I knew that wasn’t actually the case and struggled with what this meant for me. It could mean that they are too afraid to be honest and real or that they now see me as “really a woman.”  I never did rectify that tension.

Being off hormones was really difficult for me, way more than I thought.  I expected to maybe feel a little dysphoric about my gender presentation. Early on, I worried a lot about what clothes I would wear, preparing myself to not feel attractive or particularly masculine in what I was able to wear. However, clothes almost never became an issue and because of my pregnant body shape, most of my normal clothes fit for a while and then later, I could just wear one size larger of men’s clothing just fine.  What I wasn’t thinking about at all was my mental state pre-transition and the possibility of all of those feelings and emotions coming back, which they did. I struggled with social anxiety again and a lot of insecurity in general. I needed a lot of reassurance from friends and family about everything.

I sought out community online, which was difficult, in order to not feel as isolated.  Talking to ciswomen about the experience of pregnancy was not helpful at all and I didn’t start those conversations.  However, everyone wanted to talk to me about their birth story. It was frustrating being in conversations so often that got very personal very quickly.  Everyone had an opinion about every aspect of pregnancy and birth and again, making my unique experience as a pregnant man invisible. People asked invasive questions about pregnancy and birth and then told me what they thought about my answer.  I think from their perspective, they were treating me “just like everyone else” but that didn’t feel good.

Ultimately, I think I experienced the most annoying parts of pregnancy with none of the perks (like people treating you politely or letting you have a pass because of pregnancy).  

Preparing for the Home Birth:

I always knew a home birth was what I wanted.  Even before I wanted kids, while studying the politics of pregnancy and birth in college, I knew that a home birth would always be the right move for me, if I were to ever have a child.  Adding a trans identity into the circumstances made it an obvious choice as well, clearly the most validating and secure setting for us. The thought of being in a hospital setting made me nervous.  I imagined having to explain myself over and over, advocating for my pronouns and having to de-gender the room we were assigned. I also knew from my own studies that hospitals work on deadlines and get pushy about medical interventions like induction, epidurals, and c-sections – all of which I was looking to avoid unless a true medical emergency arose.  Ultimately, I couldn’t envision myself birthing in a sterilized hospital over the warmth of my own home, surrounded by only the people I invited.

We took the summer to gather everything.  Daniel shopped for all the supplies as I booked the birth tub we rented.  We decided to invite Lauren and Deana to support us when the time came and we even started planning the meals we might have ready to feed ourselves and our birth team.  

In between hoarding baby clothes and washing and organizing them, Daniel and I read books on birthing – I mostly read positive home birth stories while he read articles and books on  being a coach and partner in the labor process.

As the date approached, we picked up the tub and Lauren and Deana came over to help set it up in the bedroom.  We moved the furniture around to maximize space and put a layer of plastic over the mattress. We shopped for provisions to stock our refrigerator and pantry.  We kept up with the chores so we were prepared when the time came. Everything was set and ready to go.

The Labor:

I went home early from work on December 14th, sure I was in early labor.  I was sweaty and getting small contractions, several within an hour. I said goodbye to my class and students wished me luck with cheers and a slow clap as I packed up and left.  It was so embarrassing. I called Daniel and my mom to let them know I was leaving work and drove home. Little did I know, this was the start to a long road of waiting.

Not only did Bea not show up on that day, she decided not to show up for over the next two weeks.  Her expected due date, December 17th, came and went with no sign of actual labor. I was told that it was totally normal, first babies usually arrived a little late.  As the 41 week mark approached, the midwife, Ray, started discussing risks associated with post-date babies with us. We decided that after the 42 week mark, it was too risky and we both agreed that we would have to do an induction at the hospital, something I really didn’t want to do.  

On December 23rd, with our original date long gone, going to acupuncture for a natural induction for a week, and Christmas approaching, we started to bring out the big guns.  Daniel made me multiple castor oil smoothies and I walked around the neighborhood a bit, hoping to bring on labor. That night, I finally got some strong contractions. We were excited and knew we would have a long day ahead of us.  I texted mom and Lauren to let them know it looked like we were going to have a Christmas Eve baby (something I had wanted all along) and laid down for some rest. Daniel asked me before bed if I felt Beatrice moving a lot and I said that I didn’t and couldn’t remember how much she had been moving all day with the contractions settling in.  A few hours later, Daniel woke up in a panic that something was wrong. He called Ray and asked about the lack of movement and she advised us to go to the ER to monitor the baby. In a rush, we hopped in the car and drove to West Philly for monitoring. By 3:30am, we confirmed that everything was fine and Bea seemed like a happy little camper in my body.  Also, the contractions had done a full, hard stop. After a long rest, we updated everyone again…no baby.

Christmas Day came and went.  We looked at the “Baby’s First Christmas” ornament we had purchased, now feeling silly and frustrated.  The daily check-ins from friends and family were endless. “Anything yet?” “Where is that baby?” “Kids will test your patience, might as well get used to it now!”  I stopped responding. I was getting nervous. The deadline was officially set at December 31st, exactly the 42 weeks mark and our deadline for induction. I didn’t want to go to the hospital and lose my planned home birth, but this baby would not get out!  

Each day after Christmas, I did everything I could.  I went to acupuncture daily, ate whatever the old wives’ tales said to eat, and walked for miles trying to bring on labor.  I would get a few contractions, get excited, and then…nothing. Each day, I felt more and more emotionally drained and probably cried more than I have even collectively in my life.  I was so scared of my birth plan changing and having to deliver my baby in the hospital. I felt like I wasn’t doing enough or wasn’t doing the right things. Was I the reason she wouldn’t come? I tried reading positive birth stories about late arrivals, but they only made me more upset.  I no longer felt like I was in control of my body or this journey.

Finally, on the night of December 28th, we decided to try castor oil again, this time more seriously.  We added more oil and some labor inducing herbal supplements. Daniel and I bundled up and walked around the neighborhood for about a hour.  He got tired and gave up at 9pm, but I walked around and around the fenced in cemetary one block away from the house for another hour, determined to get things going.  This was our last lifeline before just waiting out the deadline for induction.

By later that night, I had contractions coming, finally and just in time!  We again, went to bed hopeful and I spent that first night not resting well as contractions came and went like tiny earthquakes that woke me every 30 minutes. Lauren and Deana came over the next day and the four of us hung out and prepared as my contractions grew stronger and closer together.  For the first full day, each person took turns holding me as a moaned through stronger and stronger sensations. I remember crying tears of joy with Daniel, so excited and relieved that this was finally happening and at home, just as planned. Ray was in touch with us and stopped by to check out the timing and my dilation.  . Things were moving along, but not yet consistently enough that the birth was approaching. Some contractions were on top of each other, while others were 12 minutes apart. She prepared us to be laboring tomorrow as well. The day was exhausting and as everyone tucked into bed that night, I was mostly awake with more contractions.

By the morning, things were 5 minutes apart and getting really strong.  We were finally getting there! Then… things slowed way down. Contractions started coming over 10 minutes apart again.  This was so frustrating. Ray stopped in again and we discussed next steps. She said to send Lauren and Deana home, the presence of outsiders and conversations could have slowed things down, and do some more walking.  We did and as the hours went by, my emotional state grew worse and worse.

It was now December 30th, the 42 week mark and the planned induction was tomorrow.  It hung over me like a thousand pound weight. If we can’t get this labor to speed up again, what is going to happen?  Daniel and I sat in the living room as I cried, again. We discussed the reality of the situation. It was the evening, Bea had decided to pause her entrance…again.  We called Ray who suggested we do one last castor oil shake, this time a strongest combination of oil and herbs, hoping to jumpstart the labor that just wouldn’t move forward.  We made the shake, I walked up and down the stairs a million times, and we waited. After about 45 minutes, I suddenly felt very sick. I went to the bathroom and threw up so violently that contractions started again and liquid fell on the floor (we later determined that my water broke but at the time weren’t sure).  It was scary and I was crying. Contractions were starting again but they seemed to be inconsistent again. I felt like getting that violently ill might be putting the baby in jeopardy.

We sat down again in the living room and had the hardest discussion of them all.  We decided that it was time to go to the hospital for induction. It had been two days of labor with no clear end in sight and things were not looking good.  I was so upset mourning the loss of my birth plan. Being at home was so important to me and I was so scared to go to the hospital. However, the baby’s safety was most important and we had already agreed that at 42 weeks, we weren’t going to chance it anyway.  We called Ray again, about 14 hours before the scheduled induction, and let her know we had decided to transfer to the hospital. She would meet us there. We called Lauren for a ride over and she was at the house in 30 minutes. We called my mom and told her we were transfering.

By the time we got to the hospital, my contractions were pretty regular, about 4 minutes apart and still going strong.  However, I wasn’t very hopeful. After two days of on-and-off labor and giving up on my birth plan, I had nothing left. Luckily, our family doctor, who we had established as our back up in case of a hospital transfer, had just gotten back into town and was able to switch her schedule with.  She, the nurse, and Ray were in the room as the checked my dilation. I joked that after all this, I bet I am going to be something ridiculous like 8 centimeters. Sure enough, Ray said I was 8 centimeters. After throwing up so much, my body had actually gone into full labor – 4 minutes apart and 8 centimeters!  We could have gone back home, but after all of the decision making and back and forth and it being almost 10pm, we decided to stay. I couldn’t do the drama and still didn’t have faith that things were going to keep going.

As contractions came and went, Daniel tried to make the room loosely resemble the home birth I had hoped for.  He turned down the lights, helped me into my own comfy clothes, and turned on my favorite jazz playlist. We passed midnight and went into the early hours of the morning laboring all around the room.  I hung from Daniel’s body, hung over a step stool, hung from a bar over the bed. I spent hours at 8 centimeters. However, things were still inconsistent. Contractions slowed down again. Daniel and I moved from the bed to the stool, to the toilet.  We checked again and finally had gotten to 9.5 centimeters dilated but contractions had slowed down to almost 8 minutes apart. We tried taking contractions at every angle, on the bed and in the tub, hoping to get the last half centimeter. No luck. I hadn’t hit transition yet.  In between contractions, I was my normal self. I was logically analyzing my body. I had read enough to know that when it was time to push, my body would tell me. My body wasn’t telling me anything yet. As much as I wanted this baby out, I couldn’t will it to happen on any of my own terms.

I watched the sun rise from the big window in our room.  It was the morning of December 31st, New Years Eve, and officially 42 weeks.  The hospital shift changed over and our doctor and Ray suggested that we start pitocin to get things going again.  They were concerned that it had been so long and no other strategies were working to get to the pushing. I really didn’t want induction, but after so much, it was the only thing left to do.  I could not hang out at 9.5 centimeters having irregular contractions for another day. We had also discussed inducing at 42 weeks, so it was time. My IV was hooked up and the nurse tried to position the monitor in place to hear Bea’s heartbeat.  I knew it wasn’t long now.

As the pitocin drip began, I talked through what pushing should look like with Ray.  She said long and deep sounds. I tried a few for practice with contractions, but it wasn’t quite right.  As the drip started to kick in, the contractions came on stronger and faster (in the end, they only turned it up to 8 out of a possible 40 dosage level, giving me only the tiniest of medical intervention).  Daniel held me as I hung from his neck and tried to push. Eventually, I found myself on the floor on all fours with Daniel sitting in front of me, my head between his legs. Bea was so low, the nurse and Ray took turns holding the monitor in place in between my legs as I pushed.  With each contraction, I got better and better at low and deep sounds, pushing as hard as I could. The gaps in between contractions felt like forever and then never really got as forceful as they needed to be. I pushed for a little over an hour. With each push, I started on Daniel’s lap and dropped to the floor for the rest of the pushes, coming in waves of 3 and 4.  Eventually, I felt her coming through me. First her head with a handful of pushes and then her body with one more big push. She came out alert and crying loudly immediately. I held her for a minute as Daniel cut her cord. Then she was wrapped up on his chest. Finally, the journey was over.

Afterwards, I was told the labor from start to finish was 58 hours from consistent contractions at home until delivery.  I am still sad about not having the home birth I wanted. It was one of the hardest decisions I have had to make, but ultimately, I think the hospital transfer would have happened anyway, just later than we originally made (especially considering the seriousness of the tear I suffered and necessary stitches afterwards).   In the end, Bea’s birth turned out to be nothing like we planned, but what mattered most happened – we were together, Bea was safe and healthy, and I was able to fully experience having our baby, free of pain medication and on my body’s own terms (mostly).

Paths to parenthood

In my daily life, I get to help queers get pregnant and birth babies. It’s pretty amazing.

From this work, I’ve decided to start this blog to tell the stories of how queers create families.

Queer conception is confusing, there’s no roadmap for us and the health systems that exist aren’t designed for our needs.

But our community is resilient, and through telling our experience are showing others how to make babies and queer the path to parenthood.

This blog are the stories of our community. If you would like to tell yours, email me at midwife@refugemidwifery.com with the story you would like posted and any details, resources, or pictures you would like to share.

If you’re in the Philly area, I host a list serve and potluck for LBGTQ folks who are trying to conceive, pregnant, or have new babies. Email me to join.