Wednesday, July 2, 2008

Sam's Homebirth

Sam's Birth Story, Part V -- Birth

When Pam told me she was concerned about the blood she was seeing and that she wanted me to get serious about pushing, I wasn't concerned. I was so inside of myself, overwhelmed with the intensity of what I was feeling, that what she said didn't worry me. I knew that everything was going to be okay.

As the next contraction started to build, I started to push. Hard. It was the strangest feeling -- almost like I was pushing against a brick wall. It felt like this baby wasn't budging a bit, and remembering that no one had checked my cervix to tell me that I was fully dilated (I was operating on instinct), I wondered if my sense was correct. Maybe my body wasn't ready yet. No sooner had that thought crossed my mind, then I felt an explosion. I had pushed the baby's head out without even realizing that I was crowning. I wouldn't have even known that the head was out if somebody (I don't know who) hadn't said something. Being in the water took away all of those "ring of fire" sensations that I was expecting. It was amazing.

Pamela and Lennon reached across to unloop the cord from around the baby's neck. This is the part that I wasn't aware of until I saw pictures. My back was to everyone and I had no idea anyone even came near me (shows how good they are at their job). With another small push, the baby shot out towards the other end of the pool, totally under the water, and Lennon reached in and "swooshed" the baby back through my legs so I could pick him up.I reached down and pulled him up by the armpits, and held him to my chest. I was in awe. I was finally able to open my eyes to look up and see my family gathered on my bed. Mike and John were smiling; my mom was crying; Stacey, Lennon and Pamela looked so supportive. I was filled with love. Love for this new little boy I was holding against me, and love for my family and friends that were able to share the experience with me. I don't really think I can find the right words to describe that moment with any accuracy. Just filled with joy.

Cradling him in my hands, I held him out so I could have a look at him. He wasn't moving at all or making any noises. For a moment I was worried something was wrong, but right then he brought his arm to his face and let out a little coo. He never cried. He kept his eyes closed, and to me it seemed like he must have slept through most of labor because he really acted like he was asleep. I studied his faced wondering who he looked like, and noticing his nose first, I announced that he looked like Charlie. He was perfect.

Pretty quickly Lennon had me get out of the pool to sit on the birth stool to await the delivery of my placenta. She wanted to better be able to monitor my blood loss. Even though labor was over, I was continuing to have contractions and cramping, as my uterus was clamping down, trying to do the last of its work. This was not fun. I wanted to just hop in bed and cuddle with my baby, but instead I was squatting on a very low stool that resembled a toilet seat while holding my baby. Someone helped me take of my swimsuit top and wrapped me in a towel so I could keep Sam warm. After a half-hour of waiting, I got impatient, and Lennon did a little cord traction to see if the placenta was sitting right there, but it stayed put for the time being. Finally, after another fifteen minutes (45 minutes total), the placenta plopped out into a metal bowl after a little push from me. My pesky placenta and I were finally face to face, and I could care less. I was ready to get cleaned up and get into bed.

Stacey and Lennon washed me from the waist down and checked for tears, all while little Sam was in bed with me. After pushing so hard, and not very carefully, I fully expected to need some stitches. Amazingly, I only had a very superficial first-degree tear that did not require stitching. As they were working on me, I was able to put Sam to my breast and he latched right on. His eyes were open wide and he just stared at me while he nursed. It is my favorite memory of the birth. I felt so bonded to him. While he was nursing I could hear that Charlie was up too, and I could hear him laughing and playing with Mike and John.

Lennon weighed Sam right next to me on the bed. He was seven pounds, two ounces -- my smallest baby by nearly a pound. After he was weighed Lennon asked me if I would like to dress Sam, but I was too tired so I asked her if she would do it. She dressed him in a little nightgown that I had picked out and set aside several weeks before he was born. Pamela came in and washed my face with a cool washcloth, and it felt like heaven. I was so hot. I got up and put on a clean t-shirt and climbed back into bed.

Soon, Stacey, Lennon and Pamela made their way home. They would be back the next day to check on me. My mom and Mike settled down the kids and got them ready for bed. Slowly, the house became quiet and dark and Sam and I snuggled into my bed together, mother and baby son. It took me a long time to fall asleep. My mind was full of memories of the last 48 hours, amazed at how perfectly things had turned out despite my worries and fears. Looking down at this new little boy, I felt a strong sense of completion. We had our three boys: John, Charlie, and Sam, the children I felt that we were meant to have.

Finally, as the night sky started to glow with the sun's first light, I fell into an exhausted (and sweaty) sleep, holding the sweetest smelling baby in my arms.

Tuesday, July 1, 2008

Sam's Birth Story, Part IV -- This is It!

I've read several birth stories lately where the author has used their midwife's notes to write everything out. This makes sense, because when in the throes of labor, it can be very difficult to be aware of everything that is going on. Everyone at a birth has their own experiences and perceptions, and I've done the best I can to be as accurate as possible, while sharing my own perspective of the birth. Interestingly, I got some pictures back from my doula the other day of the birth. She had captured a picture of something that I had absolutely no idea had occurred (I'll share more about this later). I don't know where I'm going with this, other than to say that the facts presented are my own thoughts of how everything occurred, and maybe I'm not totally accurate, but I think I'm pretty close.Back to the story...

Stacey, my doula, was first to arrive. It was about one o'clock in the morning. I had been in the water for less than five minutes, and I really had a hard time finding a comfortable position. I tried sitting cross-legged, leaning back against the walls of the tub, floating on my stomach, and kneeling, but as soon as a contraction hit my whole bottom would hurt so bad that I just didn't know where to situate myself. I started yelling, "No, no, no, no, no" over and over during contractions. Stacey encouraged me to relax my face and that I could definitely do this.

Lennon came in soon after to listen to the baby's heart rate during a contraction. She didn't make me move at all, and just stuck the doppler into the water and listened. The baby had gotten a lot lower so it was difficult to find his heartbeat, but she did after several tries, and it was a wonderful sound.

Within minutes, the contractions were right on top of each other. I was yelling my way through them. I was yelling so loud that I was sure I would wake up the kids and my neighbors. Later, my midwives told me that I wasn't yelling all that loud, but, in the moment, I felt like I was loud enough to bring down the roof. It was the only way I could manage the pain. I never would have felt comfortable yelling like that in the hospital, but it really helped me to feel better.

Stacey mentioned that she would like to try and take off my swimsuit bottoms in between a contraction (unlike me, she actually thought I might have a baby sometime soon). I agreed with her, but the contractions weren't really having a breaking point, and the baby was just pushing down so hard. Every time he moved it was excruciating and the most difficult part of labor. I had never experienced that sensation before. It was almost more than I could handle. I kept saying, "don't move baby, please don't move". At some point, Stacey came over and yanked off my underwear. It was quite an ordeal, and one of my funniest memories of the birth. Me squirming around, trying to lift my hips and her pulling off my very wet, and difficult to maneuver, bottoms off.

I wish I could share some amazing technique that I used to get through those contractions, but I don't. This was such a different labor for me, and it was all I could do to get through it. I was yelling, saying I couldn't do it, crying. I didn't visualize a bud opening up to the flower. I didn't have a mantra. I felt like I was on a runaway train, and was just hanging on for dear life.

A little before 2:00 AM I switched positions to lean over the side of the pool. My back was towards everyone. Lennon came over to listen to the baby again. I had another contraction, but it felt different this time. It felt good. It wasn't painful. I was able to just breathe through it and didn't feel the need to yell. At the peak of it I wondered if my body was starting to push. I told Mike that I thought it was time to go and wake up John. I waited for the next contraction to actually try pushing. The contraction came and as it peaked I pushed a little bit. I could feel my water breaking and said so out loud.

From behind me I heard Pamela's voice. I hadn't even realized she was in the room. Quietly she told me that she was seeing a little more blood than she likes to see (I hadn't noticed that the clear water of the birth pool was slowly turning red) and that she would like me to push really hard during the next contraction and get my baby out.

I grumbled something about already pushing hard, and started to bear down.

Monday, June 23, 2008

Sam's Birth Story, Part III

Since completing my doula training, and immersing myself in birth culture, one of the things that really interested me was fetal positioning. Although I had never experienced it myself, I had heard many stories of friends who had had excruciating back labor, indicating that the baby was posterior (facing forward). I also had read about ascynclitic (baby's head cocked or angled to the side) births, where labor and delivery lasted forever because baby was not in an optimal position. Probably due to all of this exposure to alternative positioning, I had a lot of concerns about how I might handle this if it happened to me. My midwives can attest to me bringing it up often during our visits, asking them what we would do if I experienced back labor or a different "malpresentation". I read books about optimal fetal positioning, slept on my side, didn't recline backwards, sat forward on my birth ball, spent a lot of time on my hands and knees, and even visited a doula friend in another town so she could rebozo me, encouraging baby into a good position.

Prodromal labor is sometimes referred to as "false labor". There is nothing "false" about it, however, as it really does serve a purpose. Prodromal labor are contractions that are irregular, that do not get closer together or more intense, leading up to birth. Prodromal labor can dilate and efface. Prodromal labor can be painful and intense. It can last for hours or days. The main purpose of prodromal, or pre-labor, is to get your body and baby ready for delivery. The contractions can help baby move into a better position. Women who experience prodromal labor can also have shorter periods of active labor.

None of these rational thoughts were running through my mind on Friday evening. I had burst into tears off and on all day in frustration and fear. By 7:00 pm I was completing 16 hours of contractions that were hurting and exhausting me. I hadn't slept more than an hour in the past two days and I could sense that I was reaching my limit. In desperation, Mike and I took a walk around our neighborhood. It was the same route that we took the afternoon before Charlie was born, and maybe I was hoping for similar results. On our walk, Mike reassured me that everything was going to be just fine, and that he trusted what our midwives had told us -- that labor would start that night. I tried to share his optimism, but thought to myself that he wasn't the one enduring contractions every five to 15 minutes.

Shortly after getting home, we all decided to go to bed. My mother had decided not to go home that morning and was going to stay the night. I actually encouraged her to go home because I was sure that as long as she was there I wouldn't go into labor (for some reason). My mom slept in with John and Mike slept out on the sofa, knowing that I probably wouldn't be doing much sleeping once I got into bed. I laid on my side in my bed trying to sleep a little in between contractions, but rest wasn't forthcoming. I stared at the birth pool, inflated but empty. We had changed the sheets that morning and all of the birth supplies were out. Everything was ready, but was I ready? Was the baby ready? I just couldn't shake the feeling that something must be wrong for me to be experiencing this type of labor.

A couple of hours passed with me just laying there, still contracting. I watched TV for a while. Eventually, about 11:30 I got up to use the bathroom. After I stood up from the toilet I had a contraction, just slightly stronger than the ones I had had in bed. I had the idea to just stand up for a little bit to see if the next contraction would come a little sooner. Five minutes later I had another one. And then five minutes after that I had a contraction so strong that I started moaning and rocking back and forth. I questioned myself. Could this be it? Was it just another false alarm? Suddenly I decided that I didn't care if it was a false alarm, I was going to get in my birth tub anyway.

I turned on the water to start filling the tub and walked out to let Mike know what was going on. On the way to the living room I was struck with another contraction. I had to stop to moan and sway. In the darkness I watched Mike sleeping on the sofa, debating whether to wake him. My moaning woke him up, though, and he immediately hopped up to assist me. Before I could finish telling him what was going on I had another contraction and the moaning and swaying resumed. Mike put his hands on my shoulders to comfort me, and said, "Oh, Amy!" Believe it or not this was my first experience having my husband be my labor support. In the hospital environment he had always been too intimidated, but at home we were able to be more comfortable and intimate. I finally was able to tell him that I was filling the pool and getting in no matter what. I didn't care anymore if we had the baby at home and we could just go to the hospital for a c-section in a couple of hours if the baby didn't come. I couldn't do it anymore.

I walked back to our bedroom and put on my swimsuit, top and bottom. My mom woke up, and I told her to go back to bed. In all of my craziness, I was worried that if she looked at me that labor wouldn't progress (kind of like the morning), but she told me that there was no way she could go to sleep. Fine, I thought. Whatever. I didn't have the energy to care about anything anymore, and I was very cranky. I called my doula and my midwives. I mentioned to Pamela on the phone that I just wanted to let her know that I was planning on going to the hospital for a c-section in a couple of hours, that I just couldn't do labor anymore. I could hear her smiling through the phone. All the while I was contracting and moaning every three minutes.

With everyone en route back to my house, I settled myself into the very warm water of my birth pool.

Sam's Birth Story, Part II

Just a little after midnight, on Friday, May 23rd (39 weeks, 4 days pregnant), I woke up to go to the bathroom. After emptying my bladder, I knew it would be impossible to go back to sleep. I had had pretty bad insomnia for the past several weeks. Moving around in bed was just so painful, and I had to get up to pee every half-hour, so it was hard to see the point of trying to sleep for any length of time. I headed to the living room and watched the season finale of Grey's Anatomy and ate a bowl of cereal. At about 3 AM I went back to bed and as soon as I laid down I had a pretty intense contraction. I laid there to see if another one would follow -- it did, but not for another half-hour. Thirty minutes later, I had another one. Then another twenty minutes later, then ten minutes later, then five minutes later. They were definitely getting closer together.

All this time I just laid on my side watching the clock, until contractions seemed to be about 3-5 minutes apart, when I got up to get on the computer just to distract myself. I announced to my online due date club I was in labor, emailed some friends, and timed my contractions using contraction master. Because my labor with Charlie was about five hours total, I assumed I would be holding my baby before lunch time.After about half-an-hour of contractions that were about three minutes apart, I called my midwife, my doula and my mother at about 5:30 AM and woke Mike up to get the birth pool ready.

My contractions were strong, and I had to focus through them. I moved to the living room and bounced on my exercise ball, listening to Mike fill the birth pool with air (it was annoyingly VERY loud), and John, who had since woken up, trying to help while asking lots of questions. I felt irritable and just not able to focus. The chaos of my house that morning, as the sun was coming up, was not how I envisioned my beautiful homebirth. Soon the midwives arrived, along with my doula, Stacey. Stacey had been at my last birth, and has since become a very good friend and doula mentor. I couldn't imagine giving birth without her. I was happy to have everyone there, but as soon as they arrived it seemed that my contractions slowed and were no longer moving in a regular pattern. They were still painful and intense (I described them as 6 cm contractions, as they felt about as painful as the contractions I experienced when I was 6 cm along before I gave birth to Charlie), but very spaced out. I started to feel like a watched pot, and told everyone that I was going to go lay down in my bedroom and try and rest. I was really tired, as I had really not slept the night before. I laid in bed for more than an hour, listening to my ipod, trying to focus on my body, willing the contractions to come.

At some point my mom came in to let me know she was there. I shared with her that I thought things were slowing down and I was discouraged. I had assumed that the baby would be here before noon, but it seemed like that wasn't going to happen. Around 8:00 AM, Lennon, the midwife's apprentice, came in to let me know that Pamela, my midwife, was going to go back to Salem to go to her other job, but that she would come back as soon as I needed her. Lennon also let me know that it was very common for moms' labors to slow down as the sun comes up, as it is when our house starts getting busy and our other children need our attention. Stacey also came into my room to see how I was doing. I expressed my frustration. Why was I having these painful contractions 10 minutes apart, when in my last labor these types of contractions seemed to get closer and closer together? I worried that something might be wrong. Both she and Lennon assured me that everything was fine. That I would develop a regular labor pattern, but that things probably wouldn't pick up until the nighttime, when the kids were in bed.

I asked Lennon if she thought I should have a vaginal exam to check my dilation (I hadn't had one during all of my pregnancy, and actually had a goal to not have one at all -- I wanted to be able to just trust my own instincts when it came to labor and pushing). Lennon was willing to do one, but she asked me what I hoped to gain by that information. She reminded me that my current dilation was no indication as to how long I would labor. I decided against the exam. I was just frustrated and impatient. At 9:30 AM I sent everyone home with the hopes that I would be calling them shortly when labor picked up. I almost cried as I heard their cars pulling away.

Meanwhile, my contractions, painful, but irregular, continued.

Sam's Birth Story, Part I

Never has a pregnancy seemed to stretch out over eternity. Never has a pregnancy seemed to pass by in the blink of an eye. Looking back over the last 10 months, I am amazed at all that has occurred, and all that I have experienced and learned while pregnant and giving birth to little Sam. I am reminded of how ordinary pregnancy and childbirth are -- thousands and thousands of women experience it every day -- but also how growing a baby inside of you (a soul that started out as two cells), and then laying eyes on your baby for the first time, is the greatest miracle ever to be experienced by a mother. I feel so blessed to have experienced this miracle again in my life.

I wasn't thinking about the miracles of childbirth, however, when I was puking my guts out for the first six months of this pregnancy. I truly had never felt so miserable. Sudden movements, bright lights, or any smell at all would send me running to the kitchen sink. I honestly wished I could curl up in my bed, in my dark bedroom, for the rest of my life (or at least until the baby was born). Everyone I talked to said they thought I must be pregnant with a girl this time because of how much more sick I was.I also heard from several people that the third pregnancy and birth can really throw you for a loop, so I should prepare for anything. I had felt so awesome after giving birth to Charlie, often referring to it as the perfect labor and birth, and felt daunted by the idea of trying to manage something that might be more difficult. Especially since Mike and I had decided even before I was pregnant that if we had another child we would do it at home, with the assistance of a midwife. While having Charlie in the hospital was just fine, and everything turned out great, my post-partum experience there was pretty horrific, and neither of us felt like it was the right place for us to have another baby. I found an amazing homebirth midwife, who had an equally amazing apprentice, and I started getting really excited about actually experiencing a birth at home.

At 20 weeks I went in for a routine ultrasound and was thrown my first "loop". The technician assured me throughout the screening that the baby looked great and healthy, but I could just tell that something was up. I had a nagging feeling for a day or so, and kept bugging my midwife for the report (for some reason it took several extra days for her to receive it). Three days after my ultrasound she called to tell me that I had a complete placenta previa. I was totally in shock when I heard the news. I couldn't get ahold of Mike, so I called my doula (and friend), Stacey, and just cried and cried to her about the idea of trading in my homebirth for a surgical one.A complete previa means that the baby's placenta was situated directly over my cervix, which, if by 37 weeks the placenta had not moved, the baby would need to be delivered by cesarean section. Also, with a previa, there was a likelihood of pre-term bleeding and premature birth, as any strenuous activity or dilation and effacement could cause severe bleeding. I felt like I had been hit with a ton of bricks. Not only was I looking at the real possibility of having a surgical birth (the Internet didn't offer much hope of a complete previa resolving), but there was a real possibility that I might have to go into the hospital for a long term stay if I did experience any bleeding and that our baby could be born pre-term, possibly needing a NICU stay. Interestingly, about a week before I found out about my diagnosis, a family friend had been hospitalized at 28 weeks for a complete previa. She ended up having to stay in the hospital for about five weeks before they delivered the babies by c-section. Mike and I started trying to make plans for what we would do if we were faced with the worst case scenario.

Around the same time, our youngest, Charlie, started experiencing some very strange health issues. He would wake up shaking uncontrollably, with muscle weakness and balance problems. This went on for several days before I took him to the doctor for testing. It could be anything to a strep infection to the onset of a muscular dystrophy. We had no idea. After a week of sleepless nights and so many tears, all of the test results came back negative. Although most of the issues had resolved, we still weren't sure what the cause was.

With all of this stuff going on, it was really hard to feel excited about my pregnancy. I didn't even want to read any of my birth books or talk about the birth. When people would ask me about my pregnancy, I didn't really know what to say. It seemed like just when I was starting to feel physically better, I was mentally at my worst. The unknown of everything that was going on was more than I thought I could handle. My husband, however, remained optimistic through it all, encouraging me to have faith that things would work out as they were meant to, that all would be well.

Meanwhile, my midwives were also very optimistic that things were going to be just fine. My midwife's apprentice, Lennon, had actually read some research that indicated that my previa was in the perfect position to move. They encouraged me to visualize it moving, and suggested some herbs to take that had been related to successful resolution of the diagnosis. It helped to feel like I could actually do something rather than sit around for eight weeks waiting to learn my fate. Finally, finally, finally, at 28 weeks pregnant, we discovered that the placenta had actually moved (a full 7 cm away from my cervix) making it totally possible to have the baby vaginally and at home. I felt like those ton of bricks that had been weighing me down for the past two months were finally shrugged off my shoulders. I was elated, and actually started thinking about the upcoming birth, trying to connect with this baby inside of me for the first time.

I Had a Baby!

On May 24, we welcomed a new little boy into our home. Now you know why I've been such a slow blogger. I've decided to share Sam's birth story on this site (it is in several parts, and is still on-going) and plan on publishing a slide-show of his birth once the story is complete. I should be back to doula work late Fall, so don't hesitate to contact me if you are due after that time.