Friday, November 29, 2013

Leah's Birth

The story of Leah's birth begins the morning I was 40 weeks and 1 day pregnant. Ben (my husband), Ella (my 4.5 year-old daughter), Brenna (my 2.5 year-old daughter), and I dog-piled on the couch for a snuggle, and when I stood up to go make breakfast, I felt a warm gush. "Ooh! I think my water broke!" I walked upstairs to my bathroom and stood there a second, thinking, "Maybe I just peed myself..." but then woosh! My waters released with a cartoon splash on the floor. Still disbelieving, I touched my amniotic fluid indicator to the puddle, and yes! It was bright blue!

This would be my shortest pregnancy yet. My other two were 42w2d and 41w5d. I was still scheduled to work through that weekend (I'm a night nurse on a mother/baby unit) so I called in to say I wouldn't be there for my shifts.

I contacted my midwife and doula, and had Ben take the kids to my mom's house so we could nestle down for labor. We headed to the chiropractor to get adjusted, then to the midwife's office for an assessment. All was well, and ultrasound showed us that baby was in great position and very active. We went home for lunch and a cuddly afternoon nap. We woke up ready for a walk around our neighborhood, and I went to prenatal yoga that evening, feeling just crampy.

Once we got home, Ben and I finished cozying up our birth space. I spent time dancing, rocking on the birth ball, and doing lunges on the stairs. Our midwife came over to evaluate and listen to baby some more. Time was dragging on. Here I was, feeling like all my ducks were in a row, birth supplies set up, kids taken care of, and I was left twiddling my thumbs. It was clear I was still in early labor, so my midwife left in the very early morning, and I went to sleep.

I slept well for several hours into the late morning. Contractions were virtually gone, and now that it was 24 hours since my water broke, I knew Ben and I had better have a good talk-through of the possibility of transferring to the hospital. Transferring would put us on a particular trajectory, one that had caused much trauma in our past. Our first planned homebirth ended up as a hospital transfer, 30-hour induction with no pain meds, tough labor up to 9 cm with a malpositioned baby, and Cesarean birth. We hadn't prepared for the possibility of transfer. Our second birth was a healing VBAC at home. With the experiences we'd had and now being so much more equipped with knowledge and confidence, we could heart-to-heart and hand-in-hand face and discuss those hard questions.

We thought a change of scenery might shift things, so we headed to the grocery store, visited my mom at our family restaurant, and caught up with Ben's mom and sister who had Ella and Brenna for the day. We stopped at our midwife's office for another assessment. Contractions were very spaced out, but baby and I were still doing well. Ben and I headed home for another solid rest, then later, my dear friend stopped by with snacks, a massage, and words of encouragement.

At this point, I had been ruptured for 36 hours without sustaining a labor pattern. I had tried different labor-encouraging techniques. I tried being up and active and I had tried sleeping and resting. I was hydrated, had eaten, prayed, done all the tricks and hadn't turned the corner into active labor. My midwife called to check in, and we all felt like it was a good idea to go to the hospital. Despite being sure that was the right decision, I had to let go of my hopes for this to be a homebirth. I allowed myself to grieve and cry and shift gears. I called in to see who was working and would be my nurses that night.

My doula and midwife arrived at my house. I dallied my way through packing my bags for the hospital. I was very distracted and couldn't quite focus, and I was still holding onto a shred of hope that simply making the decision to transfer would ironically put me in labor. My kids arrived at my house with my sister-in-law to stay with them overnight. It was time for them to get ready for bed. I hugged them tight, telling them that I needed to go to the hospital for baby sister to be born. Ella said, "You're going to the hospital? But Leah's supposed to be born here!" My sensitive, sweet Ella shed tears right along with me, feeling my heart's sadness. Brenna snuggled up and nursed for her last time. As their bodies quieted into sleep, I gathered my resolve for the next chapter of this birth.

We left my house close to midnight. In the car, I was feeling contractions pull from my back, the kind of labor that I'd experienced when my other two girls were malpositioned. Crap. I don't want an asynclitic baby.

When I got to L&D triage, I was 6 cm and the nurse could feel one of baby's hands by her head. I spent three contractions in open-knee-chest position, and I could distinctly feel when baby shifted her hand and aligned beautifully for birth. The OB asked if I wanted to be admitted or go home, and I said I wanted to stay, that it felt right to be there.

Later, my midwife and doula would tell me that they both saw a discernable change in me when we arrived at the hospital, that I went from putzing around with my labor to ready for this work. I was committed to the change in plans with the hand I'd been dealt.

I had been sure that going in to the hospital would at the very least mean IV antibiotics, possibly Pitocin, and close monitoring. When I asked about getting my IV started, my nurse said since I wasn't having symptoms of an infection, the OB didn't order antibiotics, and since I was a VBAC, she wasn't comfortable using Pitocin. She chose to monitor me with a Doppler. As we got settled in my labor room, contractions really started to pick up. These were strong, regular contractions! Finally! Active labor! My doula gave Ben a rebozo to do abdominal lifts, making baby's head put good pressure on my cervix. As with my other two labors, I found it helpful to relax my pelvic floor with contractions. The negative to that approach is that I end up peeing, so my birth team just follows me around with chux pads. "Watch your shoes!"

It was wonderful birthy juju with my midwife, my doula, my photographer (who is also a midwife), and Ben (who missed his calling as a doula) there supporting me (a former doula and current maternity nurse). I could feel my team holding my space despite the change in scenery. I was in the zone, doing my work, rocking this labor.

At one point a little while later, another woman arrived at the hospital complete and pushing. We could all hear this woman screaming at the top of her lungs in the hallway as they moved her into a labor room. Our focused, calm, tranquil labor space totally erupted into hysterical laughing at her screaming. Here I was, moaning in low, primal tones, and this lady is hollering like a banshee. It was like a scene from a movie! I got to laughing so crazy hard that I'm sure it opened my cervix right up with all those good giggle hormones. Soon I started throwing up between bouts of laughter, so I was puking and laughing and laughing and puking. When a mama starts throwing up, birthy folks get excited - it's a pretty good bet that mama is entering transition and a baby is coming soon.

I felt surprised that I liked being in a semi-reclined position. I laid back on the bed with my feet propped against the bottom of the squat bar uprights. I was thinking, this is totally the "no-no position" that encourages baby to rotate to OP, but it felt like her head was applying good, even pressure on my cervix. I was reassured that listening to my body was the right thing to do. I felt best in a mostly-lithotomy position with my feet propped up on the squat bar and a slight left-tilt.

Not long after laying in the bed, within the space of two or three contractions, there was a dramatic shift in my body. Oh my goodness, could I be feeling pushy already? Things went from completely able to work with this labor to holy crap, my body has a mind of its own. I hadn't ever experienced involuntary pushing before! I was no longer the engineer on the I-know-I-can birth train. I became a bystander, a passenger with total surrender as my only option. I closed my eyes, then heard a whole lot of movement and shuffling and shouting. Someone told me to stop pushing. Someone called out the time of birth. Multiple hands moved my body to assist baby's rotation for birthing her shoulders. And suddenly there was a baby on my chest! I opened my eyes and saw my beautiful Leah, and I inhaled her intoxicating, fresh new baby smell.

Leah Jo, born October 18, 2013, at 4:22am, 7 lbs 8 oz, 20 in.

She cried right away, then quieted as she nestled against my skin. She nursed well, I got cleaned up, and we headed up to the mother/baby floor (my home-away-from-home... where I often spend more hours than at my house in any given week), where I was cared for by my friends and peers. Several of my co-workers expressed how sorry they were that I had to come in to the hospital, but I had such an overwhelming sense of peace about the transfer. I felt prepared for whatever this birth would bring. I feel like I worked through all of the possible physical and emotional dystocias before we transferred. I don't know why labor didn't start at home. I don't know why labor waited until we got to the hospital. Despite my membranes being ruptured a total of 44 hours, this was my shortest labor at only 3 hours from active labor to birth. It wasn't what I had envisioned, but it was a beautiful, natural birth surrounded by so much love.

Monday, May 7, 2012

Why natural birth? This is why...

A short clip of the moment of Brenna's birth...

Thursday, April 28, 2011

Brenna's Birth

Brenna Lynn, born April 1, 2011, at 7:45 pm into her daddy's hands, via home waterbirth after Cesarean. 8 lbs 10 oz. 21 inches long.

Birth team:
- Jessica, CPM
- Emily and Tara, birth assistants
- Desirre, doula
- Teri, photographer/doula
- Ben, amazing husband

My first daughter, Ella, was born by Cesarean after planning a homebirth, having a 42w2d pregnancy, transferring to the hospital for “low amniotic fluid,” 30 hour induced-but-pain-med-free labor, failure to progress due to posterior position and double nuchal hand. I knew I’d be making some different choices when I became pregnant with my second daughter, Brenna. My choices resulted in a beautiful home waterbirth after Cesarean.

I knew I’d have to be in an entirely different place emotionally and spiritually. My first pregnancy was during my senior year of nursing school, and with that came a huge amount of physical and mental stress. So I spent my second pregnancy not working as an RN, but rather managing a cloth diaper store part-time where I spent my days helping mommies, families, and babies. Very low stress and it is a job that makes me so happy! I only took doula clients through my first trimester, knowing I likely couldn’t (and shouldn’t) put my body through the possibility of attending a long birth. My first pregnancy I spent so much time researching and reading all the “right” books and videos and stories that I didn’t take time to prepare myself inside for the profound transformation that is birth. However, I always skipped the chapters on medical interventions and preparing for possible Cesarean birth because, hello, I was planning a homebirth so why did I need to know that stuff? So my second pregnancy I spent processing what had happened during Ella’s birth, dealt with my fears and doubts, and surrounded myself with positivity, letting no negative comments, stories, or ideas into my “bubble of peace.” Ben and I took Hypnobabies, a childbirth preparation course that teaches self-hypnosis for relaxation during birth. It took effort, but I journeyed inside, nourishing myself and harnessing my energy.

Photobucket (Cuddling with Ella the last morning of my pregnancy)

My birthing time begins on a Thursday evening when I am 41w4d pregnant. I sit down to watch TV and notice that I’m not paying attention anymore. Pressure comes like medium cramps every 6 minutes or so, which isn’t definitively the start of anything – I had lots of prodromal labor in the weeks before – but as the next couple hours go by, it gets stronger and more intense, and I feel like I have to stand and sway my hips through each wave.

My 11-year-old sister, dear heart that she is, makes fun of my birthy swaying. I arrange for my two-year-old, Ella, to spend the night with my mom, and Ben and I settle down at home to prepare for baby to come. Ben fills the birth pool while I cuddle up in bed with my hypnosis tracks.

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At about midnight I feel ready to have more support. My body hardens as I sway and moan. Ben calls our doula, Desirre. She arranges our space, covering the bed with shower curtain liners then soft sheets. Ben is ready for some sleep, so we send him to bed with the assurance that nothing would happen without him. Desirre and I stand in my kitchen, have a snack, and chat between contractions. Leaned over the counter, I feel a pop, and splash! My waters release at 2:30 am.

Our midwife, Jessica, and her two assistants, arrive as we clean the kitchen floor.

We chose our support team very carefully; instead of having our family members there (which made me feel rather like a watched pot during my first birth), we had our midwife, her two assistants, our doula, and our photographer.

Ben wakes up sometime in the very early morning, feeling a bit more rested and ready to rock this VBAC with me. We spend some time in the birth pool together. I love the feeling of buoyancy and the ease with which I can reposition my big ol’ pregnant body. We spend about an hour in the water.

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It wasn’t long before things change rather suddenly. I experience intense pressure in my back and sacrum. Ben’s whole-body counterpressure is barely enough to relieve the crushing sensation in my low back. Ah-ha. I remember this from my first labor. How could I have forgotten what a posterior labor feels like? Baby’s heart tones are heard on my right side instead of my left. I sound “grunty” and feel the urge to push with contractions, even though an exam reveals I am only dilated 5 cm with baby’s head not well applied. Contractions space out and get more variable in intensity. All of these signs tell us that baby rotated from LOA to ROP, which is a much less favorable position for birth. I am not discouraged, though.

The sun comes up Friday morning. I spend some time sitting on the birth ball leaning forward onto the big bean bag we put on the couch. This is one of my favorite spots. I catch a nap in between contractions. To try to get baby to rotate back to LOA, Desirre supports me through several contractions in knee-chest position, as well as some asymmetrical lunges. Ben and I take a short walk during which I “curb-walk” with one foot on the curb and one in the gutter to wiggle baby around in my pelvis. When I have a particularly intense contraction, and Ben sees that my brow furrows or I was tense my shoulders towards my ears, he uses the cues we learned in Hypnobabies class: his hand on my shoulder and the word, “release,” to instantly relax me into hypnosis. Teri, our photographer (and also a doula), pampered me with a foot and calf massage. Time passes, but it seems only moments pass.

Something I don’t expect and could never have prepared for was the method that I use to relax my pelvic floor. It seems I am very good at relaxing my bottom, so I find myself peeing – yes, peeing – during contractions. The large chux underpads we had come in very handy! I have more “costume changes” during labor than my birth team had ever seen.

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Photobucket (Ben giving me the "release" cue)

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Photobucket (This is what support in labor is all about)

Photobucket (Listening to heart tones)

Since my birthing waves were spacing out and things were getting quiet, Jessica and her assistants leave to get coffee, while Desirre stays with Ben and me. I am tired, so I climb in bed and sleep between contractions, getting up on my hands and knees when waves come. I rest for an hour until Jessica returns. The tub sounds good again, so Ben and I get back in. Jessica encourages Ben to do some nipple stimulation on me to try to jump-start my labor. We enjoy some peaceful, quiet time floating and cuddling in the pool until mid-morning.

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After a while, I feel hungry, so we get out and I eat some toast and applesauce. My birth team and I decide it is time to re-evaluate. Baby is still in an unfavorable position, I have been 5 cm for about 12 hours, and my labor is still variable, so we call my chiropractor to ask if he would come give me an adjustment and release my ligaments so baby could turn. Thank goodness, he is available and willing to come over! I lay on my back while he adjusts me during contractions – not fun. I do not like to be on my back. Jessica holds my hand through two hours of the intense sensation of the chiropractor slowly rotating my baby. I feel her body inching across my belly from right to left. It works! With baby now in good alignment, my labor gradually regulates. Soon I am only aware of the ebb and flow of my birthing waves. I think over and over, “This is not bigger than me.”

Photobucket (Chiropractic adjustment)

Photobucket (Holding Jessica's hand)

It is mid-afternoon. Ben and I go for another walk, and I take another fragmented nap. At 5pm, I am really hungry, having only snacked for most of the day, so we call and ask my mom to bring something for dinner. When she stops by, she leaves Ella in the car, not wanting her to want to stay with me or mess up my groove, but I really want to see her. Ella comes in and, oh, it feels so good to hug my baby! We have never been apart for that long ever before. She asks to nurse so we sit in the rocking chair together. She nurses and we cuddle while I whisper in her ear how much I love her. Her breastfeeding brings on some very intense contractions. I am flooded with emotion – I miss my Ella but know I need her to leave, too, because I feel that these contractions are distinctly different. My sweet girl is helping her sister to be born. Ella leaves with my mom, and things start to get very, very intense.

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Photobucket (I don't want Ella to go!)

Photobucket (Ella senses something big is happening in our family)

At 5:30 pm, I need to get in the pool. It isn’t a want, but a need. I strip all my clothes off and Desirre says, “She must be serious. She’s naked.” Surrounded by my amazing team, I enter the heady phase of transition. The waves are intense, but I can stay on top of them and breathe through. The air feels tingly with energy. My mantra is, “Open, open, open,” and I repeat it as my birthing waves get stronger and stronger. “I feel stoned,” I say, as the hormone cocktail of impending birth floods my system.

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During contractions, I hold onto the edge of the pool and let my body float behind me. In between, I get into a deep squat. Ben and Desirre hold my hands. We all chat and laugh and listen to some relaxation music. Teri, our photographer, opens my Facebook page on her iPad and reads to me some of the awesome affirmations and encouraging words written by friends and family. I do some focus meditation on the stones that people had painted at our Family Blessing Party, and the necklace strung with beads from everyone hangs above the pool. An exam reveals me to have a bulging bag (so the water that had released earlier was a forebag and not the main bag of waters) and the amniotic fluid seems to be keeping her head from applying well. I choose to have my waters released. It isn’t long before I feel pressure in my bottom. Only an anterior lip of cervix! Once that lip melts away, I am completely dilated! My relief at hearing that – words can’t begin to say. During Ella’s labor, I had stalled at 9 cm when the Cesarean was called. Getting to 10 cm is a huge deal. I gasp and say, “Wow. I’ve never been here before!”

Photobucket (Family Blessing beads)

Photobucket (Meditation stone)

As if transition weren’t intense enough, my body begins to do its work without me consciously telling it what to do. Intensity defined. My body is just... happening. The sudden loss of control has me fighting the new sensation of spontaneous pushing. Otherworldly, primal groans and grunts are pulled through my body. During contractions I am in the ocean with waves overtaking me near to the point of drowning. In stark contrast, between contractions, I am able to go completely back to my centered, grounded self. I holler through several contractions when Desirre says, “You can certainly yell this baby out if you want, but why don’t you try harnessing some of that energy with the next push?” And it is like, ding! Lightbulb moment. I’ve been with a few handfuls of birthing women, and that statement helps me step back from myself and see that I was resisting pushing.

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Photobucket (Desirre is The Awesome)

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With the next three or so contractions, I hold in all I could, curling my body around my baby. I yell, “I can!” This kind of pushing is awesome. I feel progress. I feel the tell-tale burning in my bottom that lets me know she is close to crowning. I feel her head moving down through my birth canal. I am strong yet surrendering. I stand up during the next huge push, and her head is out. Another huge push and her body is birthed into Ben’s waiting hands. Brenna Lynn is born April 1, 2011, at 7:45 pm. It is the most breathtaking moment of my life.

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I settle down into the water, cradling my sweet newborn baby and gazing into her eyes. I am in love. So perfect, so alert, so peaceful. Jessica discovers that there is a true knot in the umbilical cord. I feel the cord pulsating as we wait for the final contractions that push out my placenta. With the first one, the cord breaks in the middle of its length, but some quick thinking and acting by our midwife and complications are averted. I birth the placenta (which feels even weirder than baby’s body sliding out of me!), then am ready to move out of the water and into my bed.

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Photobucket (I DID IT!)

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Photobucket (True knot in umbilical cord)

Ben and I had just snuggled up with Brenna when Ben’s mom pops into the house asking for the keys to get Ella’s carseat out of our car since Ella was headed over to her house for the night. What timing! We introduce her to her new granddaughter, and before long, the whole family is called and comes to our house to meet Brenna. Minutes old, and already surrounded by her big, loving family! Brenna and Ella come back into bed with Ben and me. Ella immediately wants to hold her sister, saying, “It’s my turn to hold baby sister!” She is so sweet, giving her lots of kisses and “La foo” (I love you). After our experience last time, it is so incredibly nice to be in our own bed, under our own blankets, and cuddling both of our daughters.

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This birth was transformative. I had always imagined the moment of my VBAC to be exuberant and full of happy tears and squeals, but it wasn’t like that at all. I have a powerful sense of I DID IT. I did it when I was told (and sometimes believed) I couldn’t. I did it after feeling crushing failure after Ella’s birth. I did it after I felt scared, defeated, and broken. I still have a scar on my uterus and in my heart, but I am not my scar. It is an important part of me and who I am, but it does not define me. My VBAC affirmed that I can birth. I am not different or special or separate from other women. I did my hard work and pushed a baby out. I tapped into my inner-most self and faced my fears and doubts. In a way, both of my daughters were born during this birth, with Ella helping my birthing time along, and the shift in my perception of Ella’s birth. In another way, this was the re-birth of our family, made new with the addition of sweet Brenna Lynn.

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