Indie Birth podcast on my breech research and my birth stories

I recently did a podcast with Maryn Green of Indie Birth: Restoring women's choice for vaginal breech birth: My chat with researcher Dr. Rixa Freeze.

In the first half, I talk about all of the breech-related research projects I'm working on. And then I tell my four birth stories. Come listen!

Read more ...

Julia & Harry: Having our breech babies in Sheffield

Julia & Harry

A parent's view: Having our breech babies in Sheffield

North of England Breech Conference, Sheffield

Day 2

We had a lovely family talk about their two breech births: Julia & Harry. Julia first talked about the birth of Frank, her oldest, who is now 2 1/2. They had been trying to get pregnant for around 4 years and finally succeeded with AIUI. The whole process was very involved medically, with lots of scans and visits, and emotionally stressful.

They found out Frank was breech around 28 weeks, but initially Julia's providers told her not to worry, he might turn. Julia tried all sorts of natural techniques to encourage him to turn: moxabustion, acupuncture, inversions, swimming upside down, etc. Her providers booked her in for a cesarean, and at that point Julia's whole world crumbled. She hadn't realized how much emotional stress she was carrying. That last straw—to say we’re going to just come in and take your baby out—made her feel powerless, like there wasn’t anything she could do. Her whole life she had looked forward to giving birth. It was a very primal thing. And being told that she was going to have a cesarean really upset her.

Harry: If someone tells you you can’t do something, you generally want to do it.

Julia: Julia told her midwife  that she wasn’t happy about the cesarean. She had wanted a home birth. Her midwife said, you know, there’s a team who can do breeches! She got referred to Helen Dresner Barnes and felt so relieved that she’d have a chance to try. She did lots of reading and research and read other birth stories. Julia had a cesarean booked in, so she had a bit of deadline, but at least she had a deadline and some options. Julia went into labor naturally and was in a good head space: if I needed a cesarean, it would be fine. In the end, she had her baby vaginally in the hospital. Although the whole process of pregnancy was quite hands-on, the actual delivery day was very hands-off, with no intervention by the midwives. All three of them just let her do her thing to get him out.

Two years later, they weren’t actively trying to get pregnant, and Julia wasn’t having any periods. The doctor said she’d need to go through AIUI again to get pregnant. Julia went in a week later for a bloated belly and discovered that she was 4 moths pregnant! With the second pregnancy, the midwives were more hands-off. Julia had just one scan at 16-17 weeks.

Harry: Such an opposite experience form the first pregnancy.

Julia: Julia went into labor planning a home birth and thinking her baby was head-down. Florence came within 2 hours of labors tarting. Julia had the same team of midwives, who liked to care for “repeat offenders.” She had Florence on her own. Sally, one of the midwives, arrived 10 minutes later.

Her two pregnancies were very very different experiences, from high intervention the first time and pretty much nothing the second time. Julia doesn't think the second time would have gone the way it did—the trust in herself, in her own instincts—without the first experience and having had the team there the first time.

The main thing Julia learned from her two breech experiences: "I wanted the power myself to be able to make an informed decision on what I was to do, whether it was to have a cesarean or not. You can only trust yourself if you have the support in order to feel you can trust yourself."

Harry: In hindsight with Frank, we were engaged with medical science and technology at every point. I was amazed at how instinct kicked in when labor started. And the breech team gave that space, that light touch, to let it kick in. That was the most surprising and, in hindsight, the most obvious thing I realized after Frank.

Julia: If we had known Florence was breech before she was born, there might have been more intervention.

Helen Dresner Barnes: I learned that Julia had a breech birth when I came into her home. Julia told me, “It was okay; I recognized what was happening. I don’t know what I would have done if the baby was head first!”

Read more ...

Ivy Claire's birth story

Part I: Musings

I’m sitting in a still house on a Sunday morning, my newborn curled up in a sling. As Ivy sleeps and dreams, her face flickers with smiles and frowns. She’s practicing a repertoire of expressions that she will later learn to put on purposefully. She breathes irregularly, her body not yet fully attuned to the steady rhythm of earth life.

This will be a different kind of birth story. I’ve always written detailed play-by-play versions: this happened, and then this, and then this. It was my strategy for capturing as much as possible before the smallest things sifted away through the cracks in my memory.

But the problem with writing a story down is that what gets left out no longer can exist. It disappears from the page and eventually from memory. If I write that labor was calm and empowering, or difficult and fierce, or any other combination of words, then it becomes hemmed in by what it was not. By what I did not say or remember.

I could choose a list of words to describe the day I gave birth. All are true, yet they contradict each other and still do not approach the essence of that day. If I swim in a river for a few hours, I cannot return the next day and recapture the water I swam in. It is gone forever. Even if I document the moment in a photograph or video, those images cannot reproduce the pressure of the water or the pull of the currents or the way the thousands of tiny hairs on my body swirled in response.

And yet, I must try: I remember calm and peace. Quiet accentuated by the muffled thumps of my children playing in the attic. The clatter of pans and dishes in the kitchen, cupboard doors closing. Ferocity and fear and uncertainty. The peculiar stillness that follows a snowstorm. Wildness and chaos contained by the pattern of my body’s labor. Hope for a living, healthy child and the audacity of that desire. Disbelief that it would actually happen. Uncertainty about the process gripping my body, alongside an uncanny awareness--sometimes demonstrated only in hindsight--of what was happening.

During this pregnancy I swam in (against?) an undercurrent of fear. It didn’t dominate my pregnancy, but it was always there pressing against my body, reminding me that I could not blissfully talk about the baby inside me as if it were already safely born. It was a hint of bitterness in everything I touched, if only the smallest aftertaste. With each pregnancy, I become more acutely aware of how much I stand to lose. Amidst all the other reasons for being done having children, the biggest is this feeling of tempting--and cheating--fate. I have four beautiful, healthy children and for that I feel incredibly blessed. Lucky, even. Isn’t it best to stop while I am ahead? I often think.

I could not let myself fully believe or imagine this new child until it was safely here earthside. No matter that suspended belief would not alter the outcome in any way. Until I saw and heard the baby, nothing was fixed or certain. That is why I exclaimed, as soon as Ivy emerged, “I can’t believe I have a baby!”

Part II: A series of vignettes

The night before the birth. We eat dinner at a friend’s house, and I hide the strong but intermittent contractions. This is not labor yet: no pattern, no rush of hormones. But I know it was the beginning. It is my secret. Later that evening I feel shaky, anxious. I am brought back to my university days--those hours before you take a big exam, when you’ve prepared as much as you can and all you can do is worry and wait until the work begins. Multiply that anticipation and tension a hundredfold, and that is what I am feeling. I know that labor will begin at night with strong but irregular contractions. That I will sleep in between them for at least part of the night. That I will stay in bed until morning, listening to my hypnosis tracks if I am unable to sleep. That I will finally get up, knowing active labor will begin but ready to work with contractions after a night of lying through them.

Morning, 6:30 am. In bed, contractions are increasingly strong but still widely spaced. I do not watch the clock until right before I get out of bed. They are 10-12 minutes apart.

I get up and feel palpable anxiety within my body. I know what is coming. I know what I have to go through to get the baby out...and it weighs on me. I feel shaky, uneasy, and unsure.

I ask Eric for a blessing. Some things are too personal to share, but I feel the power of the message moving through Eric. At this moment he is just a voice for something more vast and wise than himself. He assures me that I will birth smoothly and without complications, that this birth will bring the same joy that my other children’s births did. I finally feel able to move forward toward the task at hand.

As soon as I am up, contractions come quickly. They also seem a bit shorter, but it might be because I’m moving rather than lying still. The few times I glance at the clock, they are around 4 minutes apart.

We had a massive blizzard the night before, and the roads are terrible. I tell the midwife and the photographer to come right away based on the following calculation:

Time from getting up to move with the contractions until birth:
Zari: 10 hours
Dio: 7 ½ hours
Inga: 2 ½ hours
This baby: ??? but I know it will not be long

Around 8:30 am. The household is awake. Children are eating breakfast. Eric is fulfilling a list of tasks (fill the pool, dress the children, call the babysitter, gather some final supplies). I’m leaning over the radiator next to the bedroom window, feeling the heat shimmer up my arms and chest. Outside is deep in untracked snow. Our babysitter pulls into the driveway and her car gets stuck. The midwife’s car has just turned onto the street. A man arrives with a snowblower, clears out the pile of plowed snow blocking our driveway and our entire front sidewalk. A small serendipity. I speak on the phone to the photographer, who arrives soon after and tries to enter the wrong house at first, 3 doors down. The snow has altered the landscape. It makes the day seem separate from reality, a small window away from the mundane.

Around 9:30 am. The birth pool is filled, yet I resist entering. For so many laboring women, the water promises instant relief. But for me, water can feel like a prison as much as an escape. I have to be upright moving my hips during contractions. I labored in and out of the tub when I had Zari, but never wanted to stay in for more than 30 minutes at a time. For my next two, I didn’t get in until pushing was imminent. So here I am, eying the tub, wanting the warmth and buoyancy of the water but dreading the restriction it might bring.

I’m also feeling tired and extremely dizzy. I never experience the pleasant, heady rush of endorphins I’d had during my three other labors. Instead, it manifests only as dizziness.

Around 10 am. I want to know what’s going on with my cervix. I’d reached in multiple times over the past several hours, but labor has turned all the familiar landmarks into mush. All I know for sure is that the head is fairly low. I catch myself thinking, “Does asking for an exam mean I don’t trust the process? Will it mess me up mentally by having a number associated with my sensations?” And then I realize: Who cares. I want to know, and that’s reason enough.

So I tell the midwife laughingly: “I’m asking you for the first vaginal exam ever in four pregnancies and labors!” She looks surprised and wants to know if I am sure. “Yes, and I know it has absolutely no significance on how long it will take from here on. But I really want to compare it against what I am feeling going on in my body.”

I am a very stretchy 5 cms and the head is quite low, past the ischial spines. This confirms all that I had been feeling and seeing so far. I am not delusional. The bloody show is telling the truth, that persistent rectal pressure wasn’t a figment of my imagination, and labor is well on its way.

I get in the tub and find that I can still move my hips the right way if I kneel and lean over the edge. Only my legs and lower belly are immersed, so I add lots of hot water. It feels delicious. I keep trying to sleep but I can’t rest my head properly.

A few minutes later. In between my efforts to sleep, I pop my head up and say to the midwife, “I really need to work on the CEU & CME applications for the breech workshop in June.”

Around 10:20 am. I know I’m going to start pushing. Not right away, but in 4-5 more contractions. It’s the subtlest catch in my throat, so quiet no one else can hear. It’s the slightest downward heaving during a contraction. I keep this knowledge a secret for a few more contractions. One nice thing about being a seasoned multip is that you can read your body’s cues with extreme accuracy.

Part III: Pushing

I really dislike pushing. I fear it, I dread it, and when it actually begins I endure it only because I have to. I try to convince myself that I should be excited because pushing means the baby will be born soon. But no, it still is just as unpleasant each time. I don’t doubt those women who look forward to pushing and find that it takes the pain of transition away--it’s just never happened that way to me.

There was something “off” about this pushing stage. It took too long at first and then went too quickly at the end. Once you’ve pushed several babies out of your vagina, you know when something is abnormal. When I first checked, the baby’s head was just two knuckles deep. But after several really strong contractions--violently strong--I reached inside and the baby’s head was significantly higher up. I felt a stretchy band of something, probably a lip of anterior cervix, about 1 cm at the widest point and as thick as my eyelid. It stayed through several more contractions. We guessed it was a cervical lip acting, in my midwife’s words, like a “slingshot” and pulling the baby back in. Between contractions I’d stretch it and try to slip it under the pubic bone, but there wasn’t quite enough space for my fingers to push it back.

My body was pushing ferociously, made so much worse by the unexplained resistance keeping the baby’s head from descending. You won’t see any gentle “breathing the baby down” in the birth video. I had absolutely no control over what was happening during contractions.

During one of the pauses, I reached inside and felt a small bubble of water bag. It burst with a small pinch. “I just broke the water bag,” I announced. Maybe this would help bring the baby down?

Nothing happened after the next two contractions, but the earth shifted during the following one. In what I call The Mother Of All Contractions, my body gave a tremendous, 5-minute-long push that brought the baby all the way down, to crowning, and out with only the tiniest pauses.

This was just as un-fun as pushing with no progress. I was sure I’d tear. (I didn't. My body rocks.) Nothing had time to stretch or mold. I barely had time to apply counter-pressure and to cup the baby’s head in my hand before it slid out. The shoulders came just a second or two later. I didn’t even have time to look down before she was all the way out.

The first thing I remember seeing was Ivy’s hand reaching up. I lifted her out of the water, unwound a nuchal cord, and put her to my chest in one fluid motion. When I watch the birth video, I am amazed at the complex series of movements that I performed without conscious effort. I don’t remember thinking about having to shift her to the other hand and unwrap the cord; I just did it.

Part IV: Feel the Fear

Two days after I gave birth, I read these words from a British midwife currently practicing in Australia:

In a backlash against the medicalisation of birth women are beginning to reclaim birth (yay!). Partly thanks to the availability of information via the internet, a counter culture has emerged. Movies, images and stories of empowered birthing mothers circulate through social media – women birthing in beautiful calm environments (usually in water, surrounded by candles), looking like Goddesses whilst gently and quietly ‘breathing’ their baby out. Women are able to see how birth can be, and many are inspired and driven to create a birth experience like those they watch.

Whilst these images can assist in building self-trust for mothers as they approach birth, they do not tell the whole story....

Regardless of attempts to ensure safety, deep down, like our ancestors we know we step into the unknown during birth. Fear is a normal part of birth....

Women who manage to remain calm and serene whilst birthing are admired for maintaining control. In contrast, those who are loud, and appear to ‘lose it’ are considered to be out of control....We have created a culture (and birth culture) that seeks to avoid and minimise extreme emotion and pain, and encourages being in control.... I think it is a shame that this powerful aspect of the birth experience remains hidden and suppressed.

I am telling my story first, before sharing the video or the pictures, so you know my internal experience before viewing it from an observer’s perspective. This birth was really hard. When I edited the video, I purposefully kept the most intense parts. Most of what I removed were the long periods of silence and rest--not because they don’t have value, but because if the video is too long, people won’t end up watching it!

I’m going to share the pictures last because I know they will be transcendent and amazing. If I have any complaint about birth photography, it’s that it can capture beauty in the most desperate, difficult moments. I don’t want my birth story to only show a calm, beautiful “birthing Goddess” or a triumphant superheroine or a rockstar or a woman silently relaxing through her “pressure waves.” I want it to also show the agony and the difficulty that make those previous images possible. Birth isn’t about avoiding one set of realities in favor of another. It’s about embracing all facets of birth--contradictory, messy, or unpleasant as some might be--as vital to the whole.

Ivy's birth video here.

Ivy's birth photos here. 

. 

Read more ...

Birth at 90 mph

A new birth story just showed up in my Google reader, even though it was posted back in February when I was waiting...and waiting...for Inga to be born. It's an amazing story of a baby born on the freeway on the way to the birth center. But unlike most car birth stories, the parents weren't freaking out. Instead, here's what happened:

Davey got me in the car and thank God he had the brains to grab a blanket as we ran out the door. He threw it in the back and we raced towards the freeway. As we flew down the street I started to feel a serious adrenaline rush. And as we merged onto the freeway, I started to feel something even more serious.....the urge to push. We made it about 4 exits until I knew that we weren't going to make it. [The birth center was an hour drive away.] The urge to push turned into the necessity to push and I told Davey, "I have to push!! I'm taking my boots and pants off! Seriously! I need to push now!! Pull over! Pull over!" He started to pull off the freeway and called Lori [the midwife] and told her what was going on. She said not to pull over until we had a head out. So he turned right back around and we were back on the freeway.

Four minutes down the road, on a dark, quiet stretch of freeway, on a rainy night, in the middle of the hills of Lake Elsinore, our baby was born. I reached down and with one, big push felt the babies head moving down towards my hands. And with the next push his head was in my hands and I cupped my hands softly around his neck to make sure there was no cord and also to steady his body as I pushed the rest of him out. He slid out like silk and I turned him toward me and lay him on my belly. He was perfection. Davey was hollering, "YAH!!! WHOOHOO!! You did it baby! You did it!" And the loud, strong cry of our newborn filled the car. He was instantly pink, instantly breathing, and instantly loved and adored. I raised his little leg and exclaimed, "It's a BOY!!!" And Davey and I just smiled and laughed and it was an awesome moment.

Davey pulled over and ran to the back of the car to grab the blanket. He wrapped our son in it and got back in and we quickly proceeded to the birth center. The whole car ride there was like we both were on an emotional high. There was SO much happiness and excitement in that car. I held him tightly in my arms and just gazed at him in amazement and Davey and I couldn't stop rejoicing.

Doesn't that make you want to have a baby all over again?

Read the rest of the story here. 
.

Read more ...

What if something goes right?

I love reading birth stories where everything goes right. Where mothers plan and prepare and get what they want. Where their wishes are respected and they feel elated at what they accomplished. Where things work out perfectly in the end, even if labor throws them a curveball or some initial plans have to be abandoned.

Here are a few such stories I'd like to share:

First off, my youngest sister whose son was born two days before Inga. She had care with a hospital-based midwifery practice and also hired a doula. She hoped for a spontaneous, unmedicated vaginal birth--and that's what she got! Read all about it here at Grayden's birth story. Way to go little sis!

baby Grayden, from low-maintenance.blogspot.com

Next is the story of Busca's fourth child and second home birth. Busca blogs at Birth Faith. This was her longest pregnancy, going to 41.1 weeks. Her other three children were all 5-10 days early. She also had a much different labor pattern this time, hardly feeling any pain or intensity until the last few minutes. Read her story of Surrender in four parts: part 1, part 2, part 3, and part 4.

Busca with her newborn baby, from birthfaith.org

And you've probably heard that Gina, aka The Feminist Breeder, just had her third baby! It was her second VBAC and first home birth. Gina also had a different labor pattern than her first two. After lots of prodromal labor, Gina finally got labor to kick in using a combination of sex, breast pumping, and AROM. She even took a nap at around 9 cm dilated (and still wasn't feeling much pain at that point). Gina, you rock! Read the story of Jolene's birth here. She also had a friend who live-blogged the birth, where you can watch video clips of labor and pushing.

Gina & Jolene, from TheFeministBreeder.com

And finally, Desiree of Hitting My Stride had her baby Sofia! We started corresponding during our pregnancies and have become friends along the way (and she's letting me stay with her during the Lamaze conference this September!). She has two serious clotting factors, which meant heparin injections twice a day throughout her pregnancy. It also meant induction if she didn't go into labor by 38-39 weeks. She was induced at 39.2 weeks with a very favorable Bishop score and had a fantastic birth. Her birth story comes in four parts--Suck Ball City, Labor Faces, The Mirror, and After Birth.

All I can say is: a Pitocin induction with no pain meds? Amazing! She also sent me her birth video, and I was amazed at how non-medical it felt. The atmosphere in the room was calm and quiet. No shouting or coaching or anything, just her pushing and vocalizing when the urge hit.

Desiree, Drew, & Sofia from desireesdaydreams.com

A big congratulations all around. And here's hoping for many more birth stories where everything goes right.

Read more ...

Inga's birth story, part 2

Reflections on Inga's birth

Additional commentary on resuscitating the baby:
The midwives Penny and Holly watched the birth video while I was resting after the birth. I asked Penny if I reacted appropriately to Inga’s condition—was I too quick to do mouth-to-mouth? Should I have done anything else first? Should I have waited longer? She said I absolutely acted appropriately and that, frankly, Inga looked pretty darn scary for a while. Based on Inga's rapid loss of tone and color, the midwife suspects there was some kind of cord compression/restriction during the birth. Between my giving her mouth-to-mouth and the blood resuming circulation after the birth, Inga recovered quickly.

The other nurse-midwife Holly (who arrived after I was settled in bed) added that it was probably best that they weren’t there for the birth. I knew what to do and was able act quickly and calmly. She guessed it would have been more stressful for me had they been there and stepped in to intervene.

Was I scared? Not really--more focused on the situation at hand. I do remember thinking, as Inga was losing color and muscle tone, "I have NOT done all this work for nothing--come on, baby!" I knew it was serious, but I also knew that I had the appropriate knowledge and skills. I feel strongly that every pregnant woman should prepare herself for how to handle situations such as this, no matter where she is planning to give birth. Had I been planning a hospital birth, I seriously doubt I would have made it on time. And obviously, the midwife won't always make it on time either!

And as scary as the resuscitating part might seem, I'm glad to to be able to share it. It shows how to handle an emergency situation without losing calm.

I was very glad to be in a home setting in this situation. It's very unlikely that Inga's cord would have remained intact during a hospital resuscitation, which would have further compromised an already struggling baby. As it was, Inga was able to receive her full placental transfusion and make a quick recovery. 

Regarding the midwife not making it to the birth on time:
Not surprisingly, this didn't concern me at all. In fact, it hardly even registered that she wasn't going to make it. Now I didn't intentionally call Penny too late. In fact, when I called her the second time, I still wondered if it was way too early! She probably would have made it on time, had she not taken a shower after my second phone call. She told me, "I should have known not to get in the shower! After all, it was Rixa calling me!"

As you know from reading my blog, I planned an unassisted birth with Zari, so doing it on my own wasn't at all scary. Plus there's nothing that would have happened much differently had Penny been there. She would have checked heart tones, but otherwise everything else would have been the same. I know this, because Dio's birth that she attended was nearly identical to Inga's. With him, I pushed in the same position for about the same amount of time; I supported and caught the baby myself. Penny was just there to keep an eye on things.

Other thoughts:
I'd love to dispense with the practice of labeling our births. In my experience the line between a midwife-attended and an unassisted birth was so fluid as to be nearly irrelevant. Now that I've had a planned unassisted birth, a midwife-attended home birth, and an "accidental" or "surprise" unassisted birth, I can say that the labels don't really mean much at all.

There was an OB who was hoping to observe the birth, but he wasn't able to make it out. I know he had a busy call schedule on top of regular office hours. Too bad, though. Maybe next time?

The timing of this birth worked really well in the end. I was well-rested and fully recovered from the stomach bug. The day before I went into labor was incredibly relaxing, even languorous. As with my other two children, labor began at night and the birth happened during the day. And even the time of day of Inga's birth was perfect. It was a sunny morning and we were in an east-facing bedroom, so the light was beautiful. We got everything in order--barely--before I started pushing: house tidied, kids sent off, birth pool filled, etc. And my mother-in-law arrived the day after Inga was born. Couldn't have been better!

Someone asked why I chose not to have the kids present for the birth. It would have been way too distracting to have them underfoot, especially Dio. There was no question once labor started about wanting them around. I really liked the quiet time both before and after Inga was born, without the distraction of happy, noisy, energetic siblings. 

By the next day, the events of the labor and birth were already feeling surreal and dreamlike. Did I really go into labor and have a baby? Obviously yes, since I'm holding her right now! But it seems hard to believe that it really happened and that it's already over.


And finally, I am SO happy that we filmed this birth!

Read more ...

Inga's birth story, part 1

I woke up to strong contractions around 1 am. From their length and intensity, I knew this was the real deal. I had to breathe slowly to work through them. Counting breaths became my early labor mantra. By the fifth breath, the peak would begin to subside. By the ninth or tenth breath, the contraction was gone. I got out of bed several times to use the bathroom and turn the water heater to the hottest setting, but otherwise made myself stay under the covers and rest. As much as I wanted to be up and moving with the contractions, I was too warm and cozy and tired.

I purposely didn't watch the clock, so I don't know how frequent the contractions were. But they were really intense. I listened to the Hypnobabies track "Easy First Stage" once. It was really relaxing and gave me welcome distraction from labor. I also composed a mental list of tasks for Eric to do in the morning: feed & dress the kids, drop them off at a friend's house, fill the birth pool, pick up toys, start a load of laundry, etc. Toward the end of the morning, I drifted in and out of sleep between contractions.

At 6:48 am, I got up to use the bathroom and decided that I had had enough. Time to get up and work with, rather than try to ignore, the contractions. I noticed the familiar pink-tinged mucous or "bloody show" that has heralded labor with all of my children. Soon we were all awake and getting ready. I called the midwife first thing to give her a heads-up, letting her know I'd call again when I was ready for her to come. I kept hurrying Eric and the kids on. Somehow I just knew that we didn't have the time for a leisurely morning. As soon as I got out of bed, the contractions starting coming much more frequently. I showered and dressed (bikini top & bottom, compression hose, yoga pants, & shirt) and started filling the birth pool as soon as the hot water tank had recharged. My logical brain was wondering if I was jumping the gun, but the instinctual part of me compelled me to act quickly.

By 8:15 am, Eric had returned from dropping the kids off. The pool was filling. From when I woke up until I got in the birth pool, I did "Rixa's labor hula" during contractions, as my sister-in-law calls it. This was right before I got in the pool and about 10 minutes before my body began pushing. You see me hit the button on the laptop when the contraction ends.



Eric hurried to finish last-minute tasks, then gave me a blessing. I've asked for one during each of my labors, and they have always been incredibly reassuring. By this point labor was really, really intense. I sensed the dizzy, spinny, buzzing feeling heralding the endorphins of advanced labor. But was I really that far along? I called the midwife a second time and told her to head over. I didn’t want her to arrive too early, but if my instincts were correct, things were really cooking.

I timed several contractions with Contraction Master. If this labor was anything like Dio's, I was getting close to the end based on how intense and how close together they were. These are the last contractions I had before I got into the birth pool (and in retrospect, about 30 minutes before the baby was born):

Somehow, I just knew that I would be pushing soon. There was no physical indicator, just an interior knowledge that the baby was on its way.

About 8:45 am, I got in the pool as it was finishing its final top-off. It was the perfect depth and temperature.

I was keen to film this birth, so Eric set up the video camera. I had a few contractions in the tub and started feeling a little bit pushy. Already? After another few contractions, in which you hear increasingly grunty vocalizations, there was no question. I knelt and reached inside. Sure enough, there was a hard round head about two knuckles deep. I felt around for a while, trying to figure out what was what. With all of the folded tissues and wrinkly baby’s head, it’s sometimes hard to tell where you end and baby begins!

Although the birth videos show only the physical side of giving birth to a baby, I was also going through an intense mental struggle. I knew that the sensations of pushing would only become more intense and more uncomfortable. Okay, let’s be honest: I knew it would hurt so much more than it already was. I dreaded it, yet I knew there was no escape. I’m not exactly fond of feeling a baby come out of my vagina, you know? It doesn’t feel good. First your butt feels like it’s going to split in half, then your vagina does. My vocalizations manifested this inner struggle, as well as the physical sensations going on in my body.

Like during Dio’s labor, I needed something to grab onto, so Eric and I “arm wrestled” during contractions. Once the baby’s head began to crown, I put my right hand down to support my tissues. I provided support against the perineum at first. Then, as the baby’s head emerged more and more, the burning and pressure moved towards the front. For the third time, I experienced the impossible-yet-inevitable sensation of a baby’s head emerging out of my body. My palm was cupped over the head. The baby was facing anterior, the smooth back of the head against my palm and my fingertips touching its face. There was a slight pause after the head was born. Then the shoulders emerged. I provided more counter-pressure in the front as the shoulders squeezed out. Another brief pause at the torso, one last little push, and the baby was born. I lifted it out of the water. We discovered we had a girl! We didn’t look at the clock until a few minutes after, so we’re guessing the baby was born at 9:12 am.

Soon after the birth, Inga lost muscle tone and color. I quickly realized that I needed to perform mouth-to-mouth. Fortunately, I became certified in neonatal resuscitation several years ago, so I knew what to do. It was tricky getting the angle right, since the cord was short. I gave her five breaths. After each breath, she coughed and perked up a bit more.

Within seconds of Inga being fully recovered, the midwife’s assistant arrived. I guess she hadn’t been debriefed about me wanting to be left undisturbed. She started bustling around and talking and asking questions and I got really annoyed. So I kicked her out of the room, saying, “I just need peace and quiet. I'm okay.” She beat a hasty retreat. This cracks me up.

One of my other favorite parts is in the middle of pushing when the phone rings and goes to the answering machine. It was an automated appointment reminder for my prenatal visit the next day!

I sat back in the tub for a few minutes to relax. It felt so good to be done!

Okay, now that you’ve read about the birth up to this point, go watch the videos. They're about 30 minutes total, from when I got into the tub until about 5 minutes after Inga was born. There’s some nudity since I don’t have a swimming suit bottom on, but it’s quite tame. Between the labor hula video and the birth video, you’ll get a really good idea of how I labor and birth. You’ll see me give birth in an upright kneeling position, provide my own perineal support and counter-pressure, catch my own baby, and narrate what’s going on. And you’ll get an earful of funky pushing noises!





Pretty intense, eh?

I rested for a few minutes, enjoying the warm water and weightlessness. The midwife arrived and helped me get settled into bed. Did I mention how good I felt? Ahhhh…I had a silky soft baby on my chest, I could finally lie on my back, and the hard work of labor was over. It felt glorious.

Inga started rooting around and pushing herself up with her feet. I wanted to let her do the breast crawl and self-attach. She started going through the breast crawl stages. But she got fussy and I was too impatient! So maybe 30 minutes after she was born, I gave her a little help and she latched on perfectly. The midwives and assistant stayed in the kitchen, entering the room only when I asked for something. It was a beautiful, quiet time spent snuggling and talking and resting.

I started feeling a bit grunty/pushy and figured it was time to get the placenta out. I called the midwife in. She held a bowl, caught the placenta, and then raved about how little blood I had lost—an estimated 10 cc (2 tsp) total! She took pictures of the birth pool and placenta bowl so that her colleagues would believe her.

About 2 hours after the birth, we did the newborn exam.

Then I showered and got my bottom half dressed. The midwife checked me for tears--just two periurethral skidmarks, so minor that they didn't even sting! Eric snuggled Inga skin-to-skin for a long time. It was fun to rest in bed together as a couple with our new baby.

After lunch, Eric brought the kids home to meet their new baby sister.



You might also want to read:
Inga's birth story, part 2
Part 3: Neonatal resuscitation
Part 4: Final reflections
.

Read more ...

Birth Around the World: My Alien Baby

Inspired by Brieanne's story of giving birth at night to the sound of coyotes, Anna wrote a generational saga of two births – her own arrival in Azerbaijan, and her daughter's birth in the USA. Anna has been a blog reader for several years. She wrote to me:

Your blog was my gateway to the birthing blog world. Ten months ago, I gave birth to a baby girl in a homebirth-turned-unplanned c-section. I was so excited about birthing my baby at home. The c-section was incredibly traumatic. I have been working on recovery since the birth. As my daughter's first birthday approached, I felt a more urgent need to heal spiritually from her birth.

Writing the story has helped enormously – writing down my anger at God for letting this happen to me has allowing me to slowly let go and grow in my compassion.

Besides writing the story, I have been working on several writing projects, including my blog. In one way or another the majority of my writing is prayer for my daughter. Her soul was unable to enter this world peacefully, writing for her, addressing my writing to her in the final sentence is my way of sending her divine peace.

Writing is my prayer.

Anna blogs about faith, feminism, and spirituality at Sotah.

*****

My Alien Baby

I believe that is possible to birth yourself.

That I can get down on all fours, open my womb, and emerge from within – whole.

My mother birthed me in a small hospital in Baku, Azerbaijan, a hospital that by all accounts (and by all accounts I mean my mother’s account) was a third world shithole. She was there for three weeks before my birth in a high risk ward, because I was Rh+ and she was Rh-, a potentially fatal mix without a RhoGAM injection. Though it had been available in the west as a routine matter for women at risk since 1968, it was not available in the Soviet Union, even in 1984. Ten thousand babies a year are saved by a RhoGAM injection to the mother. This terrible combination of lacking the real cure, RhoGAM, and still attempting to be helpful overtook the medical establishment. And so, listening to the advice of her doctors, my mom checked herself into a hospital a week before she was due and spent the next three weeks living in a room with a dozen high risk women, whose babies, generally, did not make it. Three weeks of the dead baby parade – followed by labor, alone. Visitors wore not allowed in soviet maternity wards. My mother is laboring alone with her first (and only) baby, knowing little about birth. She has never been to a birth or seen a video of a birthing woman. There were no birthing classes for her to attend.

On the shores of the Black Sea, in the small town of Sudak, Ukraine, a radical apprentice trained midwife, Elena Tonetti-Vladimirova, is running birthing camps where hundreds of women are coming to birth in the sea’s shallow lagoons with the dolphins. There is available footage of eleven of these births in a documentary called Birth as We Know It. These images are alive. I am wet with the ocean water. Elena talks about the spiraling motion of galaxies and of our hips: they are the same.

I am born in the hospital, finally. We are drugged and I am sluggish in the birth canal. The doctors cut an episiotomy. It will be stitched up without drugs – female genital mutilation. I was born after six hours of labor, a short labor for a first birth. No one ever asked my mother to draw her birth energy with washable crayons on white poster-paper, such things did not exist for her in Azerbaijan, and yet there was Sudak and the dolphins.

Three days after my birth and after bribing a nurse, she was finally able to see me. Another woman was breastfeeding me for those three days. Was I lying there, mostly alone, for my first three days? I feel petty wondering how this birth affected me – how I might have been different if I was born into the sea. If my mother welcomed me on to this good earth and laid me on her chest and snuggled my gooey, vernix covered, unfurled newborn body? Would I then have peace?

My mother told me the story of my birth many times – I have always known this story. It is a sad story of the pathologizing of birth. It is a typical story of modernity gone wrong – characterized by an authoritarian imposition of power acting upon the most vulnerable, a laboring woman and her infant.

I need a radically different story to tell the un-born creature; to tell myself. In the Torah, the Hebrew Bible, characters are constantly rebirthing themselves in new stories. Each new story is a tikkun, a metaphysical and proverbial fixing of the story that came before, a rebirthing of itself. I want a tikkun for myself and for Eve, who was cursed to bear children in pain. In an inflatable kiddy pool, decorated with fish drawings, on the second floor of my DC apartment, I would undo Eve's curse with my very own birth. There would be no dolphins and no black sea, only my inflatable pool where I would know God in the moment of her birth – a creature emerging from between my legs. Z, welcome to the good earth.

*****

At five am, when I get out of bed to pee, my water breaks like it does in the movies. Many women labor the entire time with their amniotic sac intact, only to have it break at the very end. Some women's water never breaks - the baby is born in caul; this is auspicious. Babies born this way are believed to have shamanic powers in some cultures, including in medieval Europe. My water just burst open, gushing down my legs. It bursts clear and beautiful. I cannot feel any contractions. And as the amniotic fluid continued to leak out, the color changes from clear to yellow to green. Meconium

It is a sign of fetal distress – routine in late stages of labor, but abnormal at the start. My midwife arrives and I know what she is going to say – hospital. I did not pack a hospital bag. I bought home birth supplies instead; gloves, gauze, wash clothes, dozens of receiving blankets in a warmer, mesh underwear, chuck pads, plastic sheets and umbilical tape. I spent the previous week trying to make sure I had the right connector from the water hose to the sink, so the inflatable pool could be filled. I did not pack a hospital bag.

I mourn the birth I will not have – the peaceful, undisturbed birth in the dark, on my knees. The earth, the Universe, God, all of you, how can you let this happen to me? I am so sad. I cry for the next four days – I cry till I am finally home, and then I cry some more. I can barely walk around the block. I am scared to shower alone. I cannot lift my baby from her bassinet – it’s too deep. I go to a shrink and she tells me that I am turning birth into a contest, that it is not my fault. I never go to her again. I don’t blame myself – I blame God. Hospital-pitocin-epidural-csection-hospital-potocin-epidural-csection-hospital-pitocin-epidural-csection. I was going to be a mystic, a seer, a conduit for the energy of the earth, spiraling my hips like the galaxies: I wanted to be a birthing woman.

I read a story of a woman giving birth, squatting on the cold hard earth, howling with the coyotes. I wanted to howl with the coyotes and dance with the moon. I wanted Z's birth to be the exact opposite of my own – no fear, no pathology, no suffering. I dreamt of my birth, imagining the opening of my womb – until she and I emerged on the other end. I was thrilled that Z was female, perhaps, one day she might find herself dreaming like this – dreaming of her own birth.

This was not my way – not this time.

Z was born in the hospital operating room. The operating rooms are insanely cold (for the prevention of infection they told me). I was shivering on the operating table, warming blankets all over the body parts I could feel, mostly my arms and neck. There was no way Z could stay in that room for more than a moment, wet and new, simply because it was far too cold for her. She screamed when she was born – the TV scream, loud and distraught. I held her three hours later – after she was cleaned and the IV port was inserted. She was wrapped in the blue and pink stripped blankets – appropriate for both females and males. I saw the babies in the nursery wrapped in the special blankets their parents brought – we did not think of bringing any special blankets. When the nurses brought her, I read the number from my hospital bracelet, and then they give her to me. My baby.

Maybe Z is an alien. C-sections are really an alien invasion, where our human babies are being taken by the aliens, and they are sending instead little aliens, disguised as babies to study us. Z is sending back messages to her home planet, I hope she likes us and we will be spared when the invasion comes.

I am sad because I did not see her emerge from between my legs. It disconnects me from my body, leaving me wanting for prophecy and vernix; for words, for my placenta, which I did not make prints from. The prints I have seen look like trees. I never saw my placenta. Was it more like a maple or a spruce?

My first nurse after surgery was wearing a gorgeous cap – brightly colored, absolutely fantastic. I love nurses who accessorize their uniforms. She had three c-sections. She tried to birth her first two babies; with the third she scheduled the c-section from the start. Michelle Dugger, a mother of 19 children with a show on TLC, had twelve children vaginally after a c-section. Did she howl with the coyotes when she opened again during the birth of her eighteenth baby? Do her hips spiral with the energy of galaxies? Her nineteenth baby was a preemie and a c-section. She was due the same week as Z, but born over two month earlier. Z and Josie Brooklyn are the same real age – both aliens.

The c-section scar is surprisingly small, a thin line only three inches long. The doctors put their hands in this small wound took out my baby, feeling good about themselves. A textbook c-section and healthy baby. The doctors do not know what I am mourning for. I wanted to birth us both, on my knees on the dirt, howling at the moon with the coyotes, and swimming in the sea with the dolphins in my DC apartment. Would the doctors be sad if they knew?

Z, my c-section alien baby, happy birthday – welcome to this good earth.

Read more ...

A butterfly birth

To end off the year, I wanted to share a lovely birth story from one of my blog readers, Brieanne. She lives in rural California, is LDS, and has three children. This was her second unassisted birth and third unassisted pregnancy. 

A few hours after Annelise's birth, once it was light enough to take a picture

I woke up on the morning of August 16 feeling a bit sad, as this was my daughter's fifth birthday. How time flies! This particular day I was also 12 days past my due date. This was not uncommon for me, as my first was 16 days late and my second was 17 days. We started the day by asking the birthday girl what she would like me to cook for her birthday dinner. She said she wanted a roasted chicken and potatoes, with loads of gravy, and an apple crisp.

After I made my shopping list we all packed into the truck and went to the chiropractor for my bi-monthly adjustment. The chiro made a comment that he would "help me get things started." In my head I thought it was cute he could think he would make any of my babies be born if they weren't ready. Not in this family! I thanked him and told him I hoped I would not be back in two weeks. He agreed.

Our next stop was the grocery store. I picked up all the ingredients to make my daughter's dinner, and then we came home. I put groceries away and then Eric and I sat down to place our food co-op order. Eric was annoying me by opening every page of the website to look at every single item. I had a weird sense of urgency, but was having a hard time relaying this to him without thinking I would hurt his feelings. I finally went outside to call our landlord to see if I could borrow her oven to roast a chicken. She said it was fine, although it was over 100 degrees that day and would make her kitchen hot. I told her I would be up in a bit.

Once I gathered up my items we all piled in the truck again and drove the minute to her house. I preheated the oven, and started prepping things. As she and I were discussing the birth, I felt a click in my uterus and felt a trickle down my leg. I looked down at the white floor and noticed whatever came out of me was yellow. I am sure my face flushed red because for a second I thought I peed on myself. I must have gasped because she asked me what was wrong and I told her that I thought my water broke. We both went to the bathroom and I took off my pants and sniffed, but there was no odor. I knew then it must have been amniotic fluid.

Eric was upstairs fixing a toilet for the landlord, and just as I came out of the bathroom he was coming down the stairs. I told him my water broke, and he smiled really big and looked very happy. I told him I needed help because I anticipated a fast birth, and he agreed. Once we started cooking I had an enormous contraction, which was about 45 minutes later. The time was 7:45 at this point. I knew I had better get down to the house and start preparing for a baby, since my last birth was only 3 hours. We got everything in the oven and then Eric took the kids and I back to the house. He told the landlord he would come and get the food when his phone timer went off.

Back at our house I cleaned up the yard, had Eric set up my tent as this was an outside birth, and got blankets and my birth basket in the tent. At one point I looked out and saw my kids helping Eric put up the tent, and realized what a beautiful picture it was of the whole family helping prepare for our new baby. My daughter then came in and asked if I had put on my blessingway beads yet. I thanked her for reminding me, and then went to put them on. While I was placing them around my neck I dropped one side of the string and all the beads slipped off. My 3 year old scrambled around picking up each bead and then carefully placed each one in my hand with his chubby little fingers. I will never forget this little detail in all my life. It was so symbolic! Here is my former baby helping me prepare for the new one. It brings tears to my eyes every time I think of it.

It was around this time my contractions were pretty steady, but were not very painful nor did they require my attention. Eric left to get our food, and when he came back I fed everybody. After dinner we all gathered around holding hands while Eric gave me a blessing. I felt the Holy Spirit telling me all would be beautiful, and not to worry one bit. During my pregnancy I had butterflies follow me around whenever I thought about the upcoming birth. It started when there were 3 in my blessingway tent just weeks before, and then almost every day after, up until the birth. My husband's grandma even called one day to tell me a butterfly was following her around, and it made her think of me and the birth. She had known nothing of my similar experience prior to calling me. I could see my Heavenly Father's hand in all of this, and I was so at peace during the Priesthood blessing.

After the blessing I laid in bed with the kids and attempted to read them a book, but the contractions got too strong and I had to let Eric take over. After the kids fell asleep I stood in the front doorway looking out and my contractions got really strong and regular. I decided at this point to go outside in the tent. It was a beautiful summer night. The weather was really warm and the owls were flying around, like grey ghosts in the sky. We live on 22 acres, in a pretty rural part of California. Going outside was making the decision to join nature in something only nature does the best: giving birth. At this point I let go of all tension and entered my tent. This was a kitchen tent, which was just screen on all four corners, that zipped up so that flies and mosquitoes couldn't get in. Eric was in the shower, so I labored all alone for about 20 minutes. I really got into the flow of labor while he was gone, so when he came in the tent to tell me he was coming in and to ask if I wanted a chair, I felt a bit disturbed. I agreed to the chair, but couldn't bear to tell him I didn't want him coming into my space. When he came in he set my chair in front of me with a towel on the seat, to put my head on, I was on my knees so this was perfect for me. He then set his chair in a corner and just sat there, silent as a mouse. I could see him in the moonlight, and he looked so peaceful there, just watching me. I decided then it didn't bother me too much. Every time I focused on breathing through a contraction, I would look up and see exactly half a moon in the sky, and and then feel so centered.

After doing some pretty hefty labor dancing, I got back on my hands and knees and started pushing. I didn't feel "pushy" at all, but something deep inside told me to just push. When I did I felt the baby come down and then felt pushy. I ripped my shirt off and announced I was hot, so Eric grabbed a book out of my birth basket and started fanning me. I heard a pack of coyotes all howl in unison, and I felt so in touch with myself and with my Heavenly Father's creations. Finally I felt her head crowning, and after screaming at the top of my lungs into a towel, I lifted up one leg and our baby slipped out. The time was 12:41 am. Oh how easily I forget how painful the crowning part is!

Since Eric had made the decision to fan me instead of catching the baby, it gently unfolded onto the blanket. We had only the light of the moon by which to see, so when I turned around to pick up the baby, I swept my hand over it's bottom and didn't feel some parts I expected to feel, since I thought for sure it was another boy. I told Eric she was a girl, and he said he had known all along. I held her close expecting to hear her cry, but she just kind of made some little tiny noises. I felt in the dark and realized the cord was wrapped around her neck, so I gently unwrapped it. She then let out a tiny cry, but not much more than before. She was perfect in every way, but just didn't feel like crying I guess. In the moonlight I could see she looked exactly like my daughter! She was also born 41 minutes after her birthday.

About a minute after she came out, I felt what I thought was the placenta come sliding out, so I immediately wondered why the placenta came out so fast. I had Eric get his headlamp and shine it on the mass. It turned out to be a huge bunch of blood clots! I was confused about this part, but obviously we were both fine, so I didn't worry. I am still a bit curious to know exactly what these were and why they were so big. I didn't experience this with my previous births. About 20 minutes later I tried to push out the placenta, but it only partly came out, so I left it alone for a bit longer.

The baby started to vigorously suck her fist, so I nursed her thinking I would take a shower when she was through, but every time I tried to unlatch her to quickly clean myself off, she would start crying. I ended up sitting there cross-legged, nursing her in the dark, for almost three hours straight! Finally she was through, and so I had Eric cut the cord and pushed out the rest of the placenta. I "rushed" to the shower inside to get clean, and then got dressed and took the baby. All this time the kids had been asleep, so it was actually pretty romantic spending time with my husband, and now just the three of us.

After a few days we decided to name her Annelise Farfalla. Farfalla means "butterfly" in Italian. I want her to always remember how much her Heavenly Father watched over the two of us on our journey through the pregnancy, and then the birth, and how spiritual and wonderful her birth was.

Annelise with her two siblings

Read more ...

Birth Around the World: A Tale of Two Births in Canada

Joanne is a software engineer in Ontario, Canada. Her first child was born in 2007 at Kitchener Ontario's Grand River Hospital, which sees about 4,000 births per year. She chose a midwife-attended homebirth in 2010. This post is lengthy, but it’s really two birth stories in one! It shows two contrasting styles of maternity care available in present-day Canada.

When I became pregnant with my first child in 2007, I had no reasons to distrust the latest technology and knowledge of the Western medical establishment. My family doctor referred me to an obstetrician, who are in short supply in my area, so I “got who I got.” My pregnancy was highly normal and my care was fine (sparse but sufficient) up until the time my due date came and passed, and I waited... waited... waited to go into labour. My OB scheduled me for an induction at +10 days (a Friday--coincidence?) without discussion. I was worried about how I’d be able to handle an induced labour and thus mentally felt increasingly desperate as the fateful day approached.

The night before, I awoke with increasingly strong and regular contractions which I was pretty sure was finally it. When I arrived at hospital the next morning on schedule, the nurses confirmed I was 4 cm dilated and cleared me for continuing since I was in labour already. At noon my OB showed up and was quite annoyed with the nurses (and me) for not following his induction orders.

"We've got to get this baby out now."

"Why?"

"Because it's been long enough."

"I'm concerned about the pain with Pitocin contractions."

"It's called LABOUR for a reason; it's going to be painful. Look, you don't have to do it but I highly recommend it."

Seeing as I was contracting strongly, in pain, I wasn't expecting this, and I didn't have experience going against my primary care provider, I reluctantly agreed to let him break my water and start the Pitocin drip. Of course then I required continuous fetal monitoring, which made every little movement quite an event. The contractions quickly grew stronger, stronger, and more painful. I lasted another 4 hours and with such pain, the tension in my body hadn't actually let me progress past 4 cm. Discouraged, I agreed to an epidural. Admittedly it was a tremendous relief and I wanted to hug the anesthesiologist. Now that I could relax some, I actually progressed to 10 cm in a couple of hours. I also found out something I didn't know about epidurals--i.e. they don't provide total pain relief, at least not for me. Much of the time I could feel most of one side of my body, and the nurse would regularly have to call for permission to top it up.

Naturally I was confined to the bed, so I couldn't move around to deal with the pain. So pushing HURT. I was a good pusher and the baby descended steadily. At some point, the head nurse came in to say "she's got to stop pushing." It turns out (since it was now Friday evening) there was only one OB on the floor and she was busy performing an emergency C-section. And of course, my baby couldn't be born without a doc present. So they turned the Pitocin and lights off and rolled me on my side. What utter agony--I thought my body was going to push out the baby whether we were ready or not!!

There was some meconium in the fluid by this point (likely from the stress) although we could "hear" on the fetal monitor that baby's heartbeat was still reacting well. I was whimpering and at this point my partner secretly believed I was headed for a C-section too. He whispered to me "think of the other family" and I tried to. But eventually the OB and staff appeared, and another 2 pushes, and Alice was out. What relief--I simply cried tears of joy and relief.

The pediatrics team pumped the meconium out of baby’s stomach and luckily she was fine to stay in the room with me. So, in the end, despite all the "help" from the medical establishment, my body did what it was supposed to and I pushed my baby out. Looking back now, I realize I was probably lucky: this combination of Pitocin, epidural, and baby-stress can doom many a woman to an unwanted C-section.

I learned a few more things. I bled heavily after this birth and became anemic.... I learned later this can be a side effect of all the interventions. My tear/episiotomy site became infected, and I can’t rule out the possibility that the cause was from being in a hospital. But: my birth went well, didn't it? I had a healthy 8 lb. 10 oz. baby, delivered vaginally, no NICU visit, and all the nurses were really nice and helpful with breastfeeding. So, I should be satisfied, right? Right?? I had myself convinced for a while.

When I became pregnant with my second child I knew I wanted to try something different for care, so I called a local office of registered midwives. At first, I assumed I would go to the hospital again for delivery because that was just what people did. After processing some of the materials in the lending library, to our surprise, my partner and I independently came to the conclusion that we wanted to try a homebirth. Some of the stories about actively-managed labour with OBs in a hospital setting were simply eye-opening--this is exactly what had happened to us!! I don't know if we would have believed them had we not gone through the experience, but we had. So all of a sudden we were committed to a different kind of birth.

homebirth by reading what natural childbirth subjectively feels like. All these stories, including Rixa’s own birth stories, helped me overcome the knowledge deficit and gain confidence in my body's own ability to give birth naturally. I drank these up in my quest to "reverse" society's notion that childbirth is necessarily a medical event to be managed medically.

So, my second due date came and went with no baby in sight. Even with a midwife supportive of natural birth at home, her guidelines dictate repeated non-stress tests and ultrasounds to check on an overdue baby, as well as a "plan" for what would happen should two weeks past due date come and go. I was starting to feel increasingly desperate again as I saw my dream for a simple homebirth, at risk.

But, eventually at +10 days (again) those pesky prodromal labour contractions finally (finally!) became strong and regular enough to push out my baby. I laboured quietly at night in my bed from 2:00-6:00 a.m. which was nice actually--I could relax sleepily between contractions, which I knew was important for dilation. It was just so great knowing I didn't have to deal with going anywhere. By 6:00 am contractions were too difficult to lay through so I woke up my partner and told him it was time to call our midwife. She took her time getting ready and arrived at 8:30 am to find me 6-7 cm dilated ("and your body did it all on its own," she encouraged me). I was anxiously awaiting her arrival so I could get in the bath tub, post cervix check, for a change of pace.

I laboured alone as the others got the bed ready and brought in all the midwife's equipment. I got on all fours for each contraction (couldn't have done that in the hospital!) and actually found a semi-sitting position that was comfortable for relaxing in between. (I found that was key for me in both labours--I felt a lot of pain in between contractions if I couldn't find a good resting position, and those were elusive.)

I was off in labourland when Nicole came rushing in with "do you feel like you need to push?" Apparently my vocalizations had changed to what they often sound like when the baby is descending during second stage. It was all involuntary, which was awesome--my body was doing it all and I was just along for the ride!! My water spontaneously broke with thankfully only a bit of vernix to see. After 2-3 pushes on my hands and knees (still in the tub--not my midwife's idea of a convenient position but I wasn't willing to move anywhere!), Claire was born, nuchal hand and all. Finally I understood what I had read about it being a relief to push--on my hands and knees, it did feel better to push, almost like applying counterpressure to the contraction. (This was a definite contrast from being confined on my back in the hospital.) I didn't feel a ring of fire or any tearing, although I did receive a second-degree tear again. In fact, comparing the two births, I would say the pain levels were similar, although the first one was with an epidural and the second was obviously much shorter in duration.

It was 9:30 a.m. by this point--all the birthing and emergency equipment was barely in from the car and the backup midwives hadn't even had time to arrive yet. The tub had had to be drained (since it wasn't deep enough for a water birth, unplanned anyway) so I knelt on the floor of the empty wet tub, clutching my slippery newborn. I couldn't believe it had really happened!! A birth at home, just the way we had planned. I cut the cord myself.

Out of the tub and back to the bed for the delivery of the placenta, stitches, and initiating breastfeeding. Another healthy girl, 8 lbs 11 oz. So THAT is what birth is supposed to be like! What a privilege to have been able to experience a safe, natural childbirth at home. This is an experience I would wish for more women. It was so perfect and meaningful and to this day it’s still hard to believe it actually happened all the way we planned!! It was an empowering achievement in the way that my first birth, amazing in its own way since it was my first, just wasn't.

So yes, I join the ranks of moms who had one undesirable hospital birth experience and, as a result, experienced a beautiful homebirth subsequently. 2-5+ years ago, I would have never believed I’d be one of these women!! I try to not be judgmental of other people's birth choices, but now I encourage others to at least call a midwife early in their pregnancy to give themselves some birth choices. I remember my grad school supervisor telling me that if you knew at the beginning what you had learned by the end, it wouldn’t have been a learning and growing journey.... It’s not an end by any means, but the beginning to parenting my two girls!

Read more ...

Birth Around the World: Birth at 37,000 feet

Earlier this month, a woman gave birth on a Korean Airlines flight headed for the Philippines. Talk about a birth around the world--literally! Fortunately, CPM Vicki Penwell was on the flight and lent her assistance.

I contacted Vicki to see if I could repost her story and feature her non-profit organization Mercy in Action. She graciously agreed. Here is more information about Mercy in Action:

Mercy in Action is a non-profit organization that focuses on the crisis in Maternal/Newborn/Child health care worldwide. We have been establishing and funding free birth centers for poor families in the Philippines since 1992, and to date more than 12,000 babies have been delivered free of charge for the poorest of the poor in Mercy In Action's Birth Centers, and literally tens of thousands of lives have been helped and healed in the medical outreaches.

Mercy in Action also trains midwives, nurses, medics, and support personnel, helping "provide compassionate health care throughout the developing world." As the Christmas season approaches, you might consider donating to Mercy in Action. I feel humbled at the incredible service this and other organizations (such as MamaBaby Haiti) are providing to women and babies around the world.

Here's Vicki's story of the birth at 37,000 feet:

~~~~~

Korean Airlines Flight #12 on November 15, 2010 took off from LAX on time with Scott [Vicki's husband] and I on-board, en route to Manila to start a new charity maternity clinic for the poor. We scored the exit row seats in economy, so had plenty of leg room and slept for a few hours.

When I woke up about 6 hours into the flight, I noticed a flight attendant was bringing a woman to the jump seat in front of us, and she was sitting like she was in pain. My subconscious brain immediately recognized the unique type of squirming and sideways twisting that I had seen thousands of times...but my conscious brain said "no, people don't go into labor on airplanes except in the movies!" and anyway, in the dark I could not even tell if she was pregnant. But being medically trained in emergency and primary care as well as being a midwife, and being a generally helpful person, I got up and approached the scene to see if I could lend assistance.

A short history revealed that the woman (a Korean citizen named Jannie, who lived in Los Angles) had boarded the plane feeling fine but had been having stomach pains the past 4 hours, and had just gone to the bathroom and discovered she was bleeding. This was her third baby, due Jan 1. Her squirming had now turned into low moaning as well, and the steward looked terribly uncomfortable, unsure of what to do. He helpfully approached her with an oxygen mask, which is what you do for heart attacks, but was not much help for this situation. I told the steward we needed to get her to a private place, that she was going to deliver. He looked shocked and in denial and so did the woman. I insisted he think of a plan for a private place...perhaps clear out the back row of seats?

Finally making up his mind, the steward turned and led the way, so we walked forward, me supporting the laboring woman, all the way through the plane to the very front (the part I had never seen) where the first class passengers live in a world apart. It was like a small apartment, with wide seats that made into fully reclining beds, and very wide isles. We got the woman situated on a makeshift bed. By now she was really in hard labor. The steward in charge came up and demanded some medical ID from me, which Scott produced out of my handbag. It was pretty obvious the word "midwife" did not register with them. They were scared, understandably; they called on the intercom for any other medical assistance, and a Korean cardiologist came forward. However, since delivering babies was not in his scope of practice, he deferred to me and seemed very relieved at my answers to all his questions: "Had I done this before, because he had not"..."Yes," I said, "over 2,500 deliveries"..."Did I know how to resuscitate a baby?"..."Yes, I am trained in Neonatal Resuscitation"..."Did I know how to stop bleeding if she hemorrhaged?"..."Yes," ...and on and on.

The woman's water broke with a splash at this point, and discussion ceased. They all agreed I was in charge and they seemed very happy for it. The stewardesses tripped over each other each time I would ask for something, and rounded up every bit of medical supplies they had on the plane, though most were for heart attack emergencies. Since by dates the baby would be 6 weeks premature, I asked for lots of blankets, and told everyone we would be doing kangaroo care, with the baby skin to skin on the mother covered by blankets after birth. Since the doctor was worried that we had no anti-hemorrhage drugs, I told them all we would use breastfeeding and massage to contract the uterus. Since we had no resuscitation equipment or suction, I figured out a plan how to do that if necessary with what we had on hand.

At the time of the birth, there were about 6 stewardesses up there helping, holding the woman's hands, wiping her brow, giving her sips of water through a straw. it was like a homebirth and they were all her sisters! Scott was standing at my shoulder to hand me the improvised items I had found to use for emergencies should I need it. Fortunately I did not.

Ten hours after take-off, and with 4 hours left to go before landing, a nice baby boy was born, and with a little stimulation he cried and pinked right up. The stewardesses clapped and laughed and cried. The Apgar score was 9/9, meaning he transitioned well to extra-uterine life at 37,000 feet! By exam the baby was 38 weeks, meaning her dates had been a month off and he was really full-term. The placenta came after about 45 minutes, and the baby began to nurse like a champ. Airline policy actually forbids cutting the cord after an in-flight birth, so that was great; I just wrapped it up in a first class linen napkin and tucked it in the blankets, preventing any chance of infection.

For the rest of the plane ride into Seoul, Scott and I sat up in first class and I monitored the mother and baby. It was a very joyful atmosphere. The mother was so thankful and happy, and appreciative, and so were all the airline personnel. Scott took a short video using his laptop computer after everything was cleaned up and the mom and baby were relaxing. (Click the link to watch a few seconds of post-birth video.)



An ambulance crew came on and got the mother and baby when we landed, and Korean airlines officials guided Scott and I personally to our next gate on to Manila, and changed our tickets to business class. The pilot himself on the Manila leg came back and said thank you for my help. It was pretty great, even though I landed in Manila exhausted with that unique feeling all midwives know of having been up all night at a birth, with jet-lag on top!

The really interesting thing is, a few days ago I was wondering why we had decided to leave the states a week before Thanksgiving holiday, and was pondering if we had made a mistake...now I see that God had a plan that I was to be on that particular airplane on that night...nothing happens by chance when our lives are totally given over to God to be used for His good purposes in the world. In mysterious ways He leads and directs our every step, and puts us in position to be helpful to those in need.

Read more ...

Birth story: cord prolapse at home

A reader recently sent me an incredible birth story, and I wanted to share it with you. After a few irregular contractons, she had a cord prolapse at home. She wrote to me:

"This was a planned homebirth...we had called the midwife as soon as my water broke to have her come out (my water had never broke previous to the pushing stage before). Then when I stood to get up, I saw the cord. Feel free to post and link back to me, I thought it was a story you might be interested in hearing. Amazingly, when I went in for my postpartum visit with the OB who did the c-section, the first thing he said to me was, 'You know, nothing would have been any different if you had planned a hospital birth. You still would have been at home when your water broke and the cord would still have prolapsed.' I was amazed at how positive he was and how willing he was to admit this was not a 'home birth' issue. I think Apollo's story is important for people to hear...being knowledgeable about that one issue (what to do in case of a cord prolapse) is what saved his life."

~~~~~

The Birth of Apollo XIV

Friday night after we put the children to bed, Chuck and I sat down to watch a movie. As I sat idly rubbing my belly, I noticed the baby had once again turned transverse. I had a head bulging on one side and bottom bulging on the other. We looked at each other and sighed…

The movie ended and I headed to bed at 11:20. Sometime after midnight I woke up to a strong contraction…I had a few more, very strong but infrequent (12-20 minutes apart). I was uncomfortable so I kept making trips back and forth to the bathroom. At one point I finished up in the bathroom and was about to stand up when my water broke with a pop and a gush. The water just poured out of and wouldn’t stop. I called to Chuck (who had headed to bed only 10 minutes before) but he didn’t hear me. Once the flood slowed a bit I put a towel between my legs and waddled down the hall, gushing fluid the whole way. I flicked on our bedroom light and told Chuck my water broke. I headed back the toilet where the fluid continued to pour out.

We were immediately on high alert. If you read my previous birth stories, you know my water has never broken before I was fully dilated and ready to push…and in every case except Hezekiah, the water broke as the baby was emerging. Was I in for a long, long labor? Or were we going to deliver this baby in the next ten minutes by ourselves???

Chuck got the phone and called the (back-up) midwife and asked he to come out to the house and check me. He turned and headed down the hall and I stood up…I glanced down and saw a good 3 ½ inches of umbilical hanging out of me.

This was the single worst moment of my life. A prolapsed cord = death of the baby…the only way this can be prevented is with an immediate c-section…and I was alone in my bathroom.

Nightmare or not, I didn’t hesitate for one second. I grabbed the cord and stuffed it back when it belonged, then slid to lie down on the bathroom floor. I yelled down the hall to Chuck, “Chuck, the cord’s prolapsed, call 911 NOW.”

He came back in and said he needed to call the midwife. “No, call 911.”

“I need to call the midwife first,” he said. He still had the phone in his hand- he had only made it down the hall a few steps when I realized the cord was prolapsed.

“Call the midwife, then 911.”

The conversation with the midwife was short. “The cord’s prolapsed.” “Call 911 and get to the hospital,” the midwife replied. As he called 911, I crab walked into the playroom, holding the cord in the whole time. I lay on the couch with a couple of pillows under me and soon realized I could not keep holding the cord in. Chuck needed to do it. With out a moment’s hesitation, up went his hand to keep the cord safe in my uterus. Soon I realized I couldn’t keep holding up my pelvic area so I slid down until my bottom was on the couch and my head on the floor. Chuck shoved another pillow under my bum.

It of course seemed to take forever for the ambulance to arrive but Chuck said it only took 10-12 minutes. Once we heard them on the property, we realized we had no way to unlock the door. No one else in the house was awake…after a moment of deliberation, Chuck let go, dashed across the room to unlock the door and ran back to me. Up went his hand again.

The paramedics were a bit shocked by the scene they fell upon…by this time I was hanging halfway off the couch--upside down, jammies around my ankles and Chuck was holding the cord in. “Can you see the head?” they asked. “NO! The baby’s not being born- the cord is prolapsed.” It took several explanations to get them to understand the situation. All the while I was trying to stay relaxed…so I wouldn’t bring on more contractions. Once Chuck could hang up the phone, he called a neighbor to stay with the kids. There we were--headed away in an ambulance in the middle of the night. Chuck had no wallet, no shoes (a paramedic grabbed a pair for him and our neighbor his cell phone). Off we went.

Once in the ambulance, Chuck called my mom to come out to the house with the kids and get everyone she knew to pray--the baby’s very life was on the line. The ride seemed to me to take forever (but by checking his cell phone record, we saw it took only 19 minutes to get from our road into the OR). As soon as we arrived they wheeled us straight through the front doors of the childbirth center at the hospital and through the lobby. I can only imagine what the visitors thought as they saw me rushed in on a gurney, Chuck’s hand inside me, and the paramedics running full speed.

The OB was waiting for us and ushered us into a room with an ultrasound machine. After it warmed up he put it on my stomach and said, “There’s a heartbeat--we’re doing surgery. Code Purple!” They of course had the room all set up and ready to go for us. In we went (I heard them yell, “Entering the room at 2:45!”) They of course had no time for an epidural. It took about five minutes to prep me and put me out. As they were prepping me, they noticed my jammies around my ankles and someone removed them. Meanwhile, Chuck was still holding the cord in place.

The doctor elected to do a “bikini cut.” Despite coming c-section, Apollo still refused to come out! In fact, he came out breech and had his feet caught up under my ribs. Chuck was able to remove his hand just as they maneuvered Apollo out and had a great view of his gender. They warned Chuck ahead that he needed to stay back as they worked on Apollo. He wasn’t crying, was floppy and of course had lungs and a tummy full of fluid. He had to be transported to the nursery because his lungs were “wet.” Chuck spent the first hours with Apollo, holding his hand, rubbing him and talking to him.

Chuck likes to tease me about how after finding out the baby was alive, I came out of the anesthesia hollering for pain medication because my stomach hurt so bad. I’ll admit it--I was yelling and insisting they give me something for the pain, which they did. I was wheeled back to a room and Chuck stayed with Apollo.

There is no doubt that Apollo surviving the prolapsed cord at home is a miracle. Thank God I knew what a prolapsed cord was and thank God Chuck had the courage to do what he did. I only had one contraction after my water broke--another miracle. Contractions would have moved Apollo down and pushed on the cord. It took only nineteen minutes to get from our house the operating room. It took 14 minutes from entering the operating room until Apollo’s birth. The doctors and nurses all told Chuck he saved Apollo’s life by holding his cord in and allowing him to breathe. A maternity nurse on duty said she has never heard of a baby surviving a prolapsed cord that started at home.

I have no regrets. I don’t regret the c-section, not seeing him for his first few hours or anything else about the experience. I am only grateful to have my beautiful baby alive and healthy.

Our son is a miracle, and my husband a hero.

Read more ...