Birth
Epic.
Cast of characters:
- Brad = husband
- Lori = very good friend and Labor support
- Micky = midwife
- Kerry = sr. apprentice (doula and HBAC mom)
A bit of background: I conceived twins, after over 2
years of infertility and treatments in October of 1997.
They were "delivered" via "elective caesarean" at 39weeks, 4
days -- basically because my doctors were afraid. The
babies weren't in the "optimum" position for a vaginal birth
and so, in spite of my insistence on a number of things, I
eventually ended up on the operating table with nothing left
of any of my plans. A lot of intense psychological
manipulation on the part of my "caregivers" went into
pushing me to make the decision to schedule, I prefer to say
that I had a coerced caesarean, because it sure didn't feel
"elective". This was an incredibly traumatic experience for
me, made even worse by the complete lack of support I had in
my recovery, both physical but mostly emotional. That
started me on my journey to finding a better way to birth,
if we happened to be blessed with more children. By the
time I did conceive again, we were set on a homebirth, with
a midwife.
I'd been struggling with increasingly intense prodromal
Labor for several nights. Plus there were emotional issues
associated with when my mother would be arriving in
Michigan. After a very rough night Tues/Wed, I decided that
I actually did want her to come help, because I wasn't
getting any sleep at night and Brad couldn't keep taking
time off from work to watch the boys while I slept during
the day. Late on Wed. afternoon, Micky called to let me know
that I was totally normal to be struggling with all of this,
that prodromal Labor was very difficult and she validated my
decision to go ahead and have my mom come out, in spite of
the concerns that I had about her being here before the baby
was born. She then suggested that I go ahead and drink a
glass of wine before bed -- if it was prodromal Labor, which
might relax things enough to let me sleep some, if it was
the "real thing", then it wouldn't stop anything.
By bedtime I was contracting the usual 2-3 times an hour.
Decided to go to bed (without the wine) and see what I could
deal with. At about 1 am, I decided to get up and drink that
wine. Thoroughly enjoyed it, I might add, I love a good
glass of red wine and giving it up for pregnancy/lactation
is always a bummer for me. Went back to bed and slept a
little bit more but not much -- and at 3am realised that the
contractions were coming at about every 10 minutes. Laying
in the bed was not a good thing at that point. Decided to
get into the shower and see if that would relax me enough to
sleep (denial is a strong suit for me sometimes). Ended up
spending an hour in the shower (was already losing my sense
of time, I had NO idea I'd been in there that long!) Got out
and hurt more -- I was kneeling by the side of the bed,
kinda breathing through them and Brad woke up. Asked the
classic question "honey? Are you alright?" Of course I
answered that it sorta depended on what he meant by
"alright". I then told him that maybe he ought to try timing
some of them -- well lo and behold, they were about 3
minutes apart! So, I didn't want to call anyone yet at that
point because I was still convinced they'd stop with the
dawn but I did tell him to go back to sleep (which he did!)
and frankly, I don't remember what I did at that point. At
about 5, things were still happening so we decided to call
Micky and tell her that while we weren't willing to commit
yet, things were more intense than they'd ever been before.
We decided to call her back in about an hour.
At about 6, I decided to call Lori and give her the
"maybe this is it" so she could get her husband home to
watch her daughter. And we called Micky back and said,
"well, we're gonna say this is real, so head's up". She
asked if we wanted anyone at the house yet and we said no,
we'll just keep letting you know how things are doing. Then
we called the family that would be watching our boys for the
birth -- they live about an hour away. So, I just kinda hung
out and breathed and it wasn't too bad. Was a little nervous
because I'd had no show or plug or anything but the
contractions were plugging along so it was cool. At about
7:30, our childcare showed up and everything came to a
screeching halt. The sun was also coming up. I can not tell
you how freaked I was about this. But, I did remember that
for some women, especially in early Labor, changes in the
environment can really throw you off, so I hoped that was
what happened. The boys left and I got back into the shower.
By the time I got out, the contractions were back to every 3
minutes -- funny to feel so relieved about being in pain,
but there it was! Somewhere in this, I did lose the plug --
and that really excited me (does it strike anyone else as
odd that we get excited about pain and bloody slimey stuff
coming out of our vaginas? What a trip birth is!).
Lori showed up about 9 and I was upstairs rocking in the
rocking chair -- it was this pretty surrealistic experience
-- we'd be talking about something trivial and then I'd stop
and breath and she'd time and then we'd just pick up the
conversation. Micky called and I decided that I'd like to
have someone out at the house, mostly just to check on the
baby every once in a while, I wasn't feeling particularly in
"need" of some help or anything. So she said she'd send
Kerry out -- she got here about 10 and set up some of her
stuff and came up to check on how I was doing. Then I wanted
to be alone, so everyone left and I just kinda chilled out
some more. Through all of this, Brad was pottering about
keeping himself busy -- doing the dishes, cleaning up the
toddler tornado in the livingroom, calling the people we
wanted called, doing the email thing -- and finally! Blowing
up the pool!
I really don't remember exactly when I first got in the
pool but it was heaven. We had the fishy pool that many
homebirths use and it was really great for us -- I was able
to assume any position I wanted. For me, water was HEAVEN --
although I reacted to it differently than some women --
while it definitely helped me cope and relax, it always
kicked my Labor into a higher gear -- that happened in the
shower too. At this point, I'd yet to have a vaginal exam
-- my midwives were SO cool about this -- Kerry asked once
if I wanted to be checked and when I said no that was the
last I heard of it from her. Actually, what she said was
"ok. this baby will be born whether we check or not". I was
really afraid of the VE because I just couldn't deal with
the idea that I might only be 3 cm or something, plus,
laying on my back just for the checks on the baby was bad
enough, even in the tub.
At some point, I'd been in the tub for a while and
everything clicked up a notch -- I was having trouble all of
the sudden -- that's when my support made a difference -- I
was shaking uncontrollably, and started to cry and Lori was
great -- kept reminding me that it was all normal and I was
doing great -- they got a cool cloth with some lavender and
rubbed my face with it. I was a little worried about Brad,
mostly because I knew he was pottering -- which was fine
with me if that was what he wanted but I didn't want him to
feel "closed out" by all the women. Kerry had him come in, I
was glad to see him; he wiped my face for a bit. Then came
the first time I thought about being non-compliant -- Kerry
asked me to get out of the tub -- she said that I was
showing signs that I needed to get out and get upright --
she wanted me to hang onto Brad and walk around, swivel my
hips during a contractions, that sort of stuff. On the one
hand, I knew everything she was suggesting was a good idea
to keep things moving, on the other hand, I knew it was
going to hurt and I really liked the tub! But I did it and I
was right, it hurt like hell.
I think Micky showed up shortly after that -- the first
thing she said to me was "I hear that you officially don't
want to be doing this anymore" (yes, I'd already said
that!). For most of the Labor, I didn't really want people
around me much and I NEVER wanted anyone touching me
anywhere other than to wipe my face -- all the pain was up
front, in my cervix and across my lower belly -- never
anything other than tightness across my back (THANK YOU
GOD!!!). Lori told me later that shortly after Micky got
there, I had a little "rest" sitting on the couch -- and
then I announced "I'm going upstairs, I want to be alone". I
got in the shower, things got hairier pretty fast and I
ended up in my bedroom by myself. By this point, I was
getting loud -- ok, I'll be honest, I was pretty stinkin'
loud the entire Labor -- that really surprised me, btw, not
normally a loud person at all -- I was doing lots of low
moaning and groaning. But this was an entirely different
thing. I was kinda side lying on the bed and the
contractions were coming one after another and they just
would not stop and I was definitely losing any semblance of
control -- I couldn't keep my noises low and frankly, didn't
give a flying flip about control after too long. Lori came
in, and sat down and just was "there" with me -- and then it
happened, the moment that Brad will never let me live down
(because it is just so darn "not me") -- NO NO NO NO OH GOD
MAKE IT STOP!!!! (Remember, I've yet to have a VE, I have no
idea "where" I am in Labor and am afraid to believe it might
be what I suspect and hope). Micky comes flying up the
stairs and sits on the bed. She says something about it
getting pretty intense. Then she says "I'd really like you
to let me check you" and I just start crying and I'm saying
"I can't, I'm so scared because if I'm at 3 cm then I'll
just die because I can't keep doing this" and she says that
she knows, and its scary but then she holds out the carrot
-- if I let her check and I'm at least 5 cm (is this funny
in retrospect or what?) I can get back into the pool. Well,
give me that pool -- so she says, "in between contractions,
roll over and we'll be as quick as we can be" (in between?
that's the problem, Micky, there is NO in between!) Anyway,
I manage to get myself rolled over and she checks and I hear
"oh honey, you are 9 1/2 -- well, no actually there's just a
little anterior lip -- you are just about ready to go".
Music to my ears, let me tell you.
So, after crushing both their hands through a couple of
contractions on my back because I was sorta stranded that
way by the contractions (and later, Lori said I almost
shoved her through the wall a couple of times) I finally got
up and moving -- women, a word of advice -- don't do
transition on the stairs, it really sucks. But, by the time
I got to the pool, I was pushing. The moment I'd waited for,
because "it feels good after the dilation". Well, guess I
get to join the "pushing hurts like hell and really kinda
sucks" club. No, it wasn't fun. It was more like being
demonically possessed. And it definitely hurt, even though I
was supposedly "doing" something (though not consciously,
really it was being done to me). I found that kneeling, but
with my legs folded and spread really far apart (a very
strange position I made up all by myself) felt the most
effective -- Kerry told me later Micky was really concerned
because it was so weird but Kerry could tell that it opened
me up even better than squatting. I tried leaning back on my
tailbone for a bit but that wasn't going anywhere, so I
stuck with squatting and the kneeling thing. Kerry was
pretty much doing everything -- she was supposed to catch
the baby (and this was totally cool with me) so she was
trying to coach me through the pushing which ended up being
kinda funny in the deep recesses of my brain -- stayed in
there because I really couldn't talk. She'd tell me to push
a little bit more towards my bottom and I'd just laugh
inside because it assumed that I had any control at all --
the only thing I could change was holding my breath a bit
longer when I pushed -- I could tell that made a difference
because I actually would feel Ena move down when I pushed
that way (totally cool feeling, btw).
So I pushed. And I will say that it was a very odd place
I went to. I just lived each contraction, and then caught my
breath in between. I had no sense of time at all; it was
just the contractions and then the next. It started to feel
a bit burny and I gasped something about that and Kerry felt
down and said "bulging bag" (my membranes had not yet
ruptured!) So I kept pushing and she kept saying "even more
bulging bag" and I kept pushing and Ena kept coming down.
(*Aside -- guess Vit C worked for me, I heard Kerry comment
to Micky about how tough the bag felt). At this point I was
leaning over the side of the tub, butt sticking out (but
still under water) and trying my best to break Brad's
fingers (that's what husband's are best for -- physical
abuse during Labor -- I felt bad about Lori but not at all
about Brad!). I felt this "pop" and heard Kerry say "there
go her membranes" so I decided it was time to really get
serious about getting the baby out. On the next contractions
cycle I felt the burn start -- and I pushed as best I could.
Ena crowned on the last push of the contractions. All these
people are yelling "pant pant don't push just let her come
easy" and I'm thinking in my head "shut up! I couldn't push
if I wanted to and if I could I would because this REALLY,
REALLY HURTS" They're going on about what a great job her
head is doing stretching me and I'm thinking "no ****
Sherlock, get that head OUT OF ME". Finally, about a hundred
years later, a contractions starts up and "pop" out her head
comes. They say "pant so we can check for a cord" and there
is no cord so they say "push" so I start pushing and
nothing. Nothing. And the contractions stops, of course. So
there she is, head hanging out, under water and nothing.
They ask me to push but that's pretty useless without the
contractions. I hear someone say "head's been out 2 minutes"
and I hear Micky say "get pads on the floor in case we have
to get her out of the tub" and I'm thinking in that tiny
part of my brain that never stops "oh, shoulder dystocia.
I'd better get this baby out". Contraction starts and I
start shoving and Micky jumps in and fiddles with something
and "whoosh" out she flies! (It wasn't a real shoulder
dystocia, Micky tried to explain it to me later, basically
just had to tip Ena's head up a bit and wiggle her little --
not a big deal but not something Kerry had had to deal with
yet -- so Micky did end up catching in the end). I flipped
over and they passed her up to me and I held her on my chest
and at that moment, none of the past 13 hours mattered in
the slightest. It was 4:32 pm, just about 13 1/2 hours after
I first thought, "something might be happening".
She was a bit floppy -- initial APGAR of 5 -- turns out
that while she didn't have a nuchal cord, she did have an
"occult" cord -- the cord was looped up over her chest and
so was pinched there at the end -- I think it was only a
factor at the very end because her heart tones had been
perfect throughout the Labor -- and Micky wasn't able to
check right at the end (mostly because I couldn't get myself
turned over to be checked) and had given me "2 more
contractions and then I absolutely have to check again" and
I got things out in 2 more contractions. Ena's 5 minute
APGAR was 9, so she did fine. The water in the tub was
getting pretty bloody so they really wanted me out because
they were a bit concerned about haemorrhage (*aside: Micky
told me later she suspected I might bleed a bit more than
"usual" just because with the twin pregnancy, my uterus
really had been stretched out -- so she wasn't surprised
when I did bleed, although Lori tells me the apprentices
were a little freaked). Got out and got sitting on the couch
and the placenta fell out -- a 7 minute third stage! They
asked Brad if he wanted to cut the cord and he said "heck
no, that's what we pay you for" so they cut it and got me
laid down and within 30 minutes Ena was nursing. But, I was
still bleeding so we had to deal with that.
10 minutes after the birth, the phone rings and its my
mother, she's in town, 15 minutes away. The timing could not
have been any more perfect. Guess God does know what He's
doing after all. Brad calls his mom and tells her we aren't
at the hospital, we are at home. Later she tell him that
she's really, really glad we didn't tell her about our
plans, that she would have worried the entire time, so we
played that one just exactly right too.
I ended up losing an estimated 4 cups of blood, quite a
bit for an otherwise uncomplicated birth. They gave me
Shepherd's Purse tincture and I drank a lot and ate a lot
and by the time they left, my uterus was actually involuted
down to the size they'd expect 24 hours later so I think
some of it was just that I lost a lot of blood in a few
hours that "should" have come out over the next day -- I
only passed clots a couple more times and now, 4 days out,
have very little discharge at all. So, while it was a bit
scary (I did get really faint and woozy and had to be
carried up the stairs -- Brad's mom walked in as they were
dragging me up the stairs, leaving a trail of clots -- Micky
was a bit worried about the impression of homebirth we gave
her but I told her not to worry, I'd clear up any
misconceptions!) it ended up not being all that serious.
No tears (at least 2 minutes of the ring of fire did do
something positive!) and just a couple of minor "skid marks"
on my labia. I feel so good "down there" that I forget to
use the peri bottle. But no one told me how much it itches
as those skid marks heal! The herbal bath that I'm using for
perineal healing is wonderful, and it has dried up Ena's
cord like gangbusters too. Ena has no moulding -- probably
because she was almost born in the caul -- and only one
little scrape by her right eye -- she is just as "perfect"
looking as her caesarean brother's were. I feel great,
although I do have to be careful not to overdo things.
Random closing thoughts:
Did I ever think about uterine rupture? 2 times -- when I
first started pushing because it hurt so damn much and all
low and in the front -- but since the pain stopped in
between pushing, I figured it was unlikely. And then when I
was still in the pool but bleeding -- and because it didn't
hurt at all, I figured again, unlikely. Never crossed my
mind at any other point.
What techniques did I use? In early Labor, the more
classic Bradley relaxation stuff was really helpful,
although not in the sidelying position. Later I drew a lot
on the variety of stuff that "Birthing From Within" talks
about -- especially vocalisation and "going into the pain"
-- as funny as it sounds, facing and embracing the pain was
the only thing that made the slightest difference during
what I now know was transition. If you don't have the book,
get it. Period.
Was it my dream birth? Well, actually, I didn't have a
dream birth and I did that on purpose. It was exactly the
birth I needed, and I find it supremely ironic that I
basically had a textbook "Friedman" Labor -- 12 hours of
dilation, 1 1/2 hours of pushing. Whoda thunk me, of all
people, would do it "by the book"?!? Yes, I'd do it again,
but hopefully not for a while. I'm not on a screaming high
but I'm happy. And having fun. That's really all I want --
the first 12 weeks after the boys was such a dismal, grey,
unhappy time, with no positive thoughts to it at all -- just
to be having fun is enough for me.
Could I have "done it" in the hospital? Well, I hope
never to know the answer to that question. I do know I would
not have done it the way I did do it if I were in the
hospital -- I would have taken drugs, if offered, (I would
have taken a bullet if offered there at the end) and I would
not have had the freedom to be loud, to move around, and
most importantly, to be absolutely by myself when I needed
to be. I think that was the single most important thing my
support people did for me -- left me alone. I am so thankful
that I had the support from Brad and the people that
mattered when it came to planning an HBAC -- it was the best
decision I could have made.
Gretchen (Aleksandr and Daniel, coerced c/s, 6/30/98, Ena
Rose, HBAC, 1/18/01)
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