Tuesday, September 2, 2014

Mel's Birth

July 13, 2014

Baby Mel arrived very slowly and all at once. I spent the pregnancy feeling that he would be born between 38 and 39 weeks. This was my third pregnancy, and my first and second sons came at 40 and 38 weeks, respectively. It seemed natural to me that the third baby would follow suit. I stopped working at 36 weeks, and started diligently preparing for our 38+ week birth. In the middle of gathering supplies, my husband, Ben looked at the “birth sheets” and said, “maybe the baby is coming late.” Very briefly, I considered this thought, and then dismissed it. Late? Was he kidding?

For the first few weeks of maternity leave, I was very happy. I worked really hard during the pregnancy, and I was so glad to have a chance to catch my breathe. In addition to my biological sons, I have two stepsons; our household already hums with activity.  Maternity leave gave me more time for everyone, including myself. I cooked, picked up the kids from school, exercised every day, and had an extra date-night with Ben. Through week 38, I secretly felt twinges of sadness about the baby arriving, knowing that my “extra” time would evaporate.

Week 39 arrived, and  I started to get really uncomfortable.  Ben liked saying that I was graceful while pregnant, but grace departed at 39 weeks. To distract myself, I baked bread, sewed a blanket, and watched a long, BBC mini-series. I theorized that I could “trick” myself into having the baby: “If I’m really into my projects, I won’t think about when the baby is coming, and therefore, the baby will come.”  

Week 40 arrived, and I moved from uncomfortable to irritable. I picked fights with everyone in the family, went to acupuncture a lot, walked up steep hills, slept poorly and generally felt miserable. Throughout the week, I was slowly dilating. For a few hours every day, I had regular, painful contractions that never crossed the threshold into active labor. I was 4 cm dilated, and I was still baking bread and sewing.  Every night, one of our sons went to bed saying, “I wonder if tonight is the night.” Our whole family was waiting.

Week 41 began, and Mel officially took the award for longest gestation in the family.  I started to consider that our home-birth plan was not to be; I worried about all the ways and days we could induce.  I’m a ob-gyn nurse-practitioner. Standard hospital practice is to induce at 41+ weeks -- I can quote the studies that serve as the rationalization for this practice -- and I knew that my friends and colleagues at work would want me to come in for an induction, once I hit the 41 week mark.   It was hard for me to have this information, and to stay confident about the low overall rate of complications, up to 42 weeks.  I started to have little self talks with scripts like, “everything is okay; the baby is healthy and strong. You’re healthy and strong. You have a good plan. You can trust it.”  I’d like to say that these mantras were very reassuring, but I think they just kept me from teetering over the hospital edge.

Mel is the baby that we didn’t think we were having; he wasn’t just late to arrive, he arrived late in our lives.  Our kids were 18, 15, 10 and 7 when the little pink cross showed up on the pregnancy test strip, last October.  In my previous pregnancies, I briefly considered home-birth, but I didn’t let myself pursue it because I was scared that my colleagues would say I was crazy, and my family would be doubtful and worried.   This pregnancy felt like a mysterious gift -- like running to catch the train as it’s pulling out of the station, and somehow managing to jump aboard, just as the doors swing shut.  The mystery of this unexpected pregnancy gave me the chance to dream.  I finally let myself imagine the birth that I had always wanted. In my dream birth, Maria was there! The sheets smelled like me. The room was quiet.  In the dream birth, there was no drive home, after the baby was born because we were already home. In the dream birth, I didn’t want to act from fear. Ben was 100% on board, and that helped me tremendously.

As 41 weeks was coming to a close, Maria helped Ben and me make our pre-induction plan. We decided to try doubling the dose of castor oil (I had already tried a 2 oz dose earlier in the week), and to add herbal tinctures. Maria brought over the herbs at dinner time and gave us big hugs before heading out to some square dancing.  

I took the castor oil at about 8 pm. An hour later,  I was sitting on the couch, and I realized that Ben was going to have to put the kids to bed without my help; I was so nauseous and disgusted from the taste of the castor oil, and my full attention was needed to cope with the sensation.  As I sat on the couch, I blessed the baby with the same blessing that I give the kids on Friday evenings for Shabbat: “may you be who you are, and may you be all that you are.”  This was different from wishing the baby would come, or trying to trick the baby into coming, or worrying that the baby wasn’t coming. I was burping castor oil and my intestines were beginning to storm, but I was at peace.

I think I sat on the couch for about an hour:  it took quite a bit of concentration to cope with the sensation of the castor oil in my throat and stomach.  At 11 pm or so, I decided to go to bed. By the time I moved from the couch to the bedroom, sleeping seemed unlikely.  Instead, I started contracting and pooping, at the same time. I was moving from the toilet to hands and knees, then back to the toilet.  I called Ben to say that I thought he should blow up this exercise ball that I was planning to use during early-mid labor. Suddenly, the idea of  bouncing on a ball seemed very funny, possibly because I knew it was never going to happen -- I was laughing, crying, pooping, burping, and contracting all at once.

At around 1 am, everything quieted down, and I got into bed.  I was a little confused.  What was happening? Was I in labor, or had I just been contracting so strongly while I was emptying my bowels?  Ben asked if we should start the herbs, and I told him I couldn’t. I was still so nauseous from the castor oil, and I couldn’t imagine putting anything in my mouth.  Ben got in the shower, and I took the chance to rest, wondering whether or not I’d wake in the morning, still pregnant.

Sometime between the start and finish of Ben’s shower, my questions were answered: this was labor. The sensation was familiar from my past births. I was entering the waves. I moved out of bed and went to the other bathroom, which has a bathtub. When Ben found me, I was moaning on the toilet, unable to complete full sentences. I think he said, “what’s happening?” And I think I said, “call Maria.”

I got in the tub on hands and knees and turned on the water. I needed to lean against Ben during the contractions, and so he sat on the toilet, while I gave him my full weight and made low pitched animal noises. Between contractions, I moaned while the water hit my back. The contractions were incredible, and I remember thinking, “I must have missed the beginning and middle of this labor;  I’m already in transition.”  My whole body was inside the wave. When I felt that the pain was intolerable, I visualized the baby descending, and I told myself, “you have to feel this way to birth the baby. You are birthing the baby.”

Maria and Kristen arrived at 2:15 am. I could hear them setting up supplies, and I felt relief. Ben did, too. I could feel his body relax, once they arrived. At  2:45 am, Maria asked me if I was having any low pressure. I said, “yes” and she suggested that I get out of the tub and go back to the bedroom. She wanted to do a cervical check.  I knew that I was completely dilated because I was already starting to push, but I was so inwardly focused that it felt impossible to explain.  

It still seems like a minor miracle to me that I was able to move from the bathtub to the bed, but I guess we did it between contractions.  As we arrived in the bedroom, I realized that there hadn’t been time to put the “birth sheets” on the bed, and Kristen was quickly doing the job.  I think Maria or she suggested that Ben help, when suddenly another wave hit, and I called out for him. I remember kneeling on the floor, supported by Ben, and Maria saying to him, “you just stay there.” She knew he couldn’t assist with the sheets because he was being my rock.

Once on the bed, Maria checked me and said, “there’s no more cervix. You can push, whenever you want.”  I remember saying, “I don’t know how to push,” which is interesting because I think I’d already been pushing for several contractions.  I think maybe I had pushing performance anxiety -- I had to tell everyone that I wasn’t sure I would push well.  Suddenly, I was sort of squatting with Maria and Kristen behind me and Ben holding my weight in front. I pushed through two or three contractions, and I could feel the baby’s head crowning. I let out a very loud, high sound which woke the older boys. The next moment, I could feel the head was out. I gave another slow, long push and felt the rest of his body slide out.

At 3:04 am, Maria said, “your baby is here!” I held him, and couldn’t believe that he was our baby. My first thought was, “this is our baby?!”  The older boys came bursting into the bedroom to see if it was true, and somehow they made it real to me -- yes, this is our baby. Mel was born with dry, peeling skin, weighing 7 lb, 7 oz. He looked like a baby who waited 2 weeks after his due date to arrive. Maybe he needed the extra time inside to gain weight. Maybe not. Who knows?  The wait was a lesson in patience, faith, and the power of the unknown.

This may sound strange, but one of the most meaningful parts of our birth is what happened right after Maria placed him in my arms: I started to have a pretty good hemorrhage. Maria once told me that going to Haiti always reminds her that midwifery is first and foremost about saving women’s lives. My hemorrhage showed me a window into this truth.  It gave me a chance to be the recipient of the most professional, competent, and personalized care.  I knew I was bleeding quite a bit, and I wasn’t scared:  I was in good hands, and I felt safe.  Maria and Kristen -- two incredible midwives  -- circled around us, as we held our baby, and they kept us safe by knowing just what to do, and by doing it with love.

Once my bleeding was under good control, and we’d done a newborn exam, Maria and Kristen tucked us in for a nap.   It was about 5:00 am.  A few hours later, the day would begin, but for a little while, everyone in the house went back to bed, and it felt like the whole world was at peace.

Sunday, August 3, 2014

Pasquale Daniel Iorillo, Sr. 1937-2014

24 hours into my summer vacation in New York, my father died.

For the last week, my life has been steeped in old photographs, Italian food and the rituals of death. My father’s health had been on the decline for nearly a decade. We always joked that he seemed to have 9 lives, as modern medicine would continually prop him up, seemingly against all odds. But, on July 23rd, he closed his eyes for the last time. We are so grateful that it was a peaceful passing. During that day, my mom and dad where up in the country where we have a country house. Upstate for New Yorkers usually means anything north of the Bronx, but our country house is really upstate – the Catskills: rural, quiet, green. My mother and father went to an art show of my sister’s, went out to lunch, had ice cream. Back at the house, they entertained the neighbors around 7:30pm. Around 8, my father got up to go to the bathroom. When he didn’t return, my mother got up and went looking for him. She found him in a comfortable chair, looking like he was sleeping. When he wouldn’t rouse, deep in her heart of hearts, my mother knew he was gone. She called the EMT neighbor back to the house, she called 911, but she knew he was already gone.
He really did just look like he was sleeping. My mom thinks that he just sat down for the last time and his heart stopped. I believe it. My Dad was so strong-willed that, I think, he powered through his last day even though he was having trouble breathing. He felt comfortable and safe with only my mom there. I know that if any of his kids (or forget his grandkids) were there, he would have put up a fight, such was his love and dedication to us. But, it was his time and he was ready. So, with just my mom, he went peacefully, without fear or a struggle. He simply sat down and ended his day for the last time. At his wake, I kept telling people that he got his money’s worth out of Wednesday.
My Dad was a character— an old, Italian man who was born in the house that he lived in all his life. His family settled a small corner of Rye, NY, as immigrant laborers in the early 1900s.  I grew up knowing the stories of my grandmother’s tomato gardens, and how they used to make tomato paste by drying tomato halves in the sun on a piece of plywood. My father would come along as a kid and run his finger through the sun-dried paste. Whenever my Dad would tell me that story, he would lift his finger up and I could tell that he could almost taste the fresh tomatoes on his tongue.
My Dad was a musician. His brother, Sonny, played the accordion and his mother would sing old, Italian songs when they had backyard barbecues for the whole neighborhood. My father learned to play the bass when he was around 14 so that he could go out with his brother on gigs to the Rye country clubs and make extra money. He loved the bass his whole life and played in a performance 2 weeks before he died.
My Dad was an amazing father. I was his favorite of the 4 siblings. But, the funny thing is, we each were his favorite— my brother because he is the firstborn and his namesake; my sister, LuAnn, because she is creative and sensitive, always trying to get out from her older sister’s shadow (that’s me, of course); my youngest sister, Laura, had to do double duty to compete with me for the coveted position of “My Father’s Favorite.” She trumped me when she moved 2 houses down and gave him 4 beautiful grandsons. Each pregnancy kept my father alive for 9 more months. He had the capacity to make us all feel special, as if we were the only one, as if we were the favorite (but really — I am!)
I know I am the favorite because when I was born, I weighed only 4 pounds 10 ounces. In those days, if you were under 5 and a half pounds, you needed to stay in an incubator. Thus, I was in the hospital for 2 weeks, behind the glass of  the 1963 nursery. Like clockwork, my father came to visit me every day. And when I finally was allowed to leave, my father gave all the babies in the nursery with me a pair of knitted booties that his mother had made while I was there.
My father loved that I am a midwife, such an old-school profession that he could really relate to. He would always ask me how many births I had attended. I would try to keep track of the numbers so that I could answer him accurately. I can still hear his voice bragging to his friends (or anyone he would meet, for that matter) that I had been to over a 1000 births. I became the daughter from California who has been to 1000 births. At his wake, countless people, as they would make their way to me on the receiving line, would brighten with recognition when I would introduce myself as his eldest daughter. “Oh! You’re the one from California! You’re the midwife!”
My father’s wake (Monday the 28th) was attended by hundreds of neighbors, friends and musicians. It was a ritual that blanketed my loss in the richness of community, tradition and culture. I, having only attended one other open casket event when I was 11, was impressed with how everyone knew the drill. The community that my father created arrived in droves. The line wrapped around the funeral home and out the door for hours. Paying respects is a well-worn groove in the Italian pattern of life. People waited patiently to speak with my mother and each one of my siblings and myself. We laughed and told stories about my father; I introduced myself a million times. You see, my father was also a jokester. He always made people laugh and I heard this over and over again as his friends introduced themselves to me. My father had shtick — slapstick, embarrass-your-children shtick. Like his oversized, circus clown sunglasses or his sunglasses that had just one lens — that was for days that were partly sunny. Over and over again. And people loved him for it. His children would just cringe. But on Monday, it was a way to remember him, to celebrate his life with laughter instead of tears. Even the Mayor of Rye (if you’ve never heard of Rye, think Pawnee) stood on line for an hour to pay his last respects. My father would have LOVED that!
The pomp and circumstance around his funeral included a Catholic mass, his 5 oldest grandchildren were his pall bearers (this included Tyler and Viola), a 9-motorcycle, police escort from the church to the cemetery, a local fire truck parked in front of the church while a kilted cop played the bag pipes, and a Navy color guard at the grave site. My father-in-law, Walter, says that all of this is highly unusual. Knowing my father, he would have loved it all. We loved it because it reminded us of him. Through it all, trays of meatballs and pasta would arrive at the door just when we were getting hungry.
Through this rich and powerful sorrow, I have mostly felt gratitude. Of course, I was shocked in the beginning, but as the story of his death developed into a story to share, it all made sense. My father and mother had a good day, all his children were “home,” even his credit cards were paid off. He had completed a wonderful life.
On the day that my father died, my mother and father saw more animals up in the country than they had seen in years. Two wild turkeys with 12 chicks wandered around the backyard, a deer with her twin fawns nursed about 20 yards off our back porch. While they were driving home, a black bear crossed the road.
I believe that these animals carried the spirits of my father’s ancestors on their backs. They appeared to him to comfort him, to let him know that the time was near, to be ready. I believe that, at the end of July 23rd, they returned to him in his eternal sleep and escorted him to a better place. A place where he inhabits his younger body. A place where he can visit his parents and siblings. If there is a heaven, my father is there, having a ball, telling everyone there how proud he is of me.
Gratitude for a life well lived, gratitude for a perfect ending. Gratitude for a community guiding us through this time, and for my father’s wisdom to show me how to build community for myself. But most of all, gratitude for the gift of knowing that I. Was. His. Favorite.

Thursday, July 3, 2014

Baby E arrives!

Baby E is fed and sleeping so this is my moment to write his birth story! He’s in his newly-set-up rocker, with a gorgeous hand-knit blanket that just arrived from my sister D, and if he wakes I’m going to try gently rocking him with my toe while I keep writing, as I read that Louis Erdrich does–she says it’s pretty easy to have a newborn as a writer. We shall see…
Eight days have now passed since the birth and I want to get this down asap–we’ll think of it as the stream-of-consciousness Blog Edition, and I will refine and perfect it later for Baby E’s consumption later in life.
So, let’s begin where I left off–last Saturday, when we were preparing to check in to UCSF. All homey methods of labor induction (acupuncture, walking, spicy food, castor oil) seemed to have no effect–I had no signs of labor at all. The delay in our check-in time to the hospital from 8am to noon to 8pm helped me make the transition mentally to preparing for this new scenario in the hospital. I felt oddly calm, and focused on the benefits of being in the hospital–sometimes all that monitoring and state-of-the-art medicine can come in handy.
I had spoken with my midwife the night before and she walked me through what to expect with induced labor. I would go through a first step of medication (Misoprostyl or Cervidyl) to soften and prepare my cervix. This would take 12-24 hours. Once ready, they would start the Pitocin.
So, we were glad to start in the evening because we could knock out those first 12 hours while sleeping. Still, we packed books and Scrabble and all of our electronics thinking we’d get off to a slow start.
We were admitted at 8pm. It was much calmer on a Saturday night than during a weekday when I had been there for non-stress tests. We were shown to our room which had a partial view of the city at dusk.
I filled out a bunch of paperwork, including papers for the baby on which I was the signatory “parent” (gasp!), and decided to start with Cervidyl, which they described as like a tampon they would stick in and then wait. OK. They checked me at this point and I was less than 1 centimeter dilated, just the width of a fingertip. I called Em, my midwife, and she said to get some rest–we had a lot of work to do the next day.
(E’s eyes just opened but he looks pretty happy. Trying the Louise Erdrich toe-rocking method. Easy.)
I felt some cramping as I went to sleep, and proceeded to get up probably once an hour to use the bathroom. My mom slept soundly on the pull-out chair/cot. The clock on the wall proceeded onward. Everything was quiet.
At 5am, (uh oh–red-faced crying baby…one diaper change later and he is now on the boob. This is a little awkward but doable, Louise.) I was uncomfortable enough that I could no longer stay in bed, although I was hesitant to say what was happening since I’d been maybe feeling contraction-ish twinges for like two weeks and nothing ever turned out to be anything. Soon, though, the nurse came back in and said, “It looks like you’re having some contractions.”
In fact, she determined that I was going into labor without Pitocin. Huge victory at this point–of course, my fear was that Pitocin-induced contractions would be way too strong and start the inevitable spiral of hospital interventions…  and I seemingly had kicked off labor without it.
I texted my doula and she said she was on her way. We were moved into Labor Room 5, a huge corner room facing the entire skyline, East Bay, and the trees of Mt. Sutro. One of the last things I did before things really got going was to take this picture of the sunrise and text it to my sister D in Chicago:
labor room 5

We set up the birth shrine, covered the TV with a sheet. My doula arrived at 6:45am with soup to put in the refrigerator, a sitz bath tea, and a necklace for me that she got 15 years ago in Benin. She told me to set my intention on the necklace (“healthy mom and baby”). I feel like I was in ‘serious’ labor pretty quickly, although throughout the day was confused about the definitions of “early” and “active” labor (and active labor turned out to be much later)–very soon I stationed myself on a birth ball and was vocalizing through contractions.
My dad and sister showed up for a bit, which was nice. By the time they left, I was entering the naked phase which lasted the whole rest of the birth process–the only thing I wore was this halter top of rough fabric that held two circular monitors, one for the baby’s heartbeat and one for contractions. It was the nurses’ primary obsession to keep these circles in place, through many baths and position changes and moving around the room, which annoyed me, but also reassured me that we knew all was well with the baby. (Baby is now back in the rocker and I’m rocking it with my toe again. He’s moving his arms around–and his eyes are open. This writing may not last long as my mom is on a walk…)
Those early hours of labor are a blur…I think it was pretty doable, but felt like real work. I was being told all day that I was progressing steadily so I just progressed steadily. We did the birth ball, hands and knees, child’s pose, the bath. (Just did the 5 S’s of the Happiest Baby on the Block and now he’s swaddled and sleeping again. Man, I picked his fussier time of day to write but I’ll keep going.)
It’s hard to say how I “felt” through these hours–I was just “in it.” I was very present and my body felt strong. It felt intense from the beginning, although you never know how much more intense it’s going to get. They asked me if I wanted to be checked but said they didn’t feel it was necessary since my contractions were obviously progressing, and I said no thanks.
Coincidentally, my good friend M had gone into labor at the same time, and because she had also engaged the services of both my midwife AND doula, it was quickly determined that since I was already in the hospital and she’d be starting at home, she’d get the midwife and I’d keep the doula. Since I was already in labor when I heard this, I just accepted it and moved on–I was so happy to have my doula and my mom and the kind nurses. I knew M needed Em.
In other coincidences, my doula had a THIRD client go into labor and check into the room next to mine. Because this client was 22 years old, she was in and out in like 5 hours, so this was hardly a blip on my screen–my doula left for 30 mins for the birth and then she was back. Around 5pm, my doula’s backup came by, and when she came in the room, I noticed that I was able to have a whole cheerful conversation with her. Which I wouldn’t have been able to do in any of the previous hours. Which seemed not good.
I’d been throwing up multiple times and they had finally given me fluids and anti-nausea medication–I kept saying I felt so much better and chalked it up to that. But it wasn’t that.
It was clear things were slowing down as we approached 12 hours. My doula suggested we dance to move around and get things flowing again. I suggested the song “Happy,” knowing that this song should totally piss me off in labor–yet, there I was dancing through the whole song and not having any contractions. And it wasn’t pissing me off.
A doctor came in the room to say that my contractions were slowing down and we should talk about “augmentation.” Oh god, I thought, here we go. I had thought I was out of the woods and nope. I asked to call my midwife and had a whole phone call with her without contractions. She said I could go one of two ways–if I felt my body needed to rest, I could take a break, rest, see if my labor started back up on its own. I’d need strength for the pushing phase. On the other hand, I was already 12 hours in and in the hospital; if I felt strong enough, I could use a tool the hospital offered: Pitocin. They’d start me off super gradually and maybe I could just pick up where I left off and keep going. I wouldn’t lose any of the progress I’d made. They checked me and I told them I didn’t want to know how many centimeters. I now know that I was 4 cm and 70% effaced at 6:35pm. I had asked the doctor to consult with my doula and my doula would ‘translate.’ I didn’t want to feel the discouragement of the number after so many hours of hard work. Ultimately, the doctor wasn’t happy about not consulting directly with the patient, and my doula didn’t like having information that I didn’t have. (After that, I let them tell me the number.)
I told Em on the phone that while I did feel sleepy, my body felt strong. I wanted to keep going. They started the Pitocin. And, sure enough, within an hour, my contractions were back to what they were and the show was back on the road. (Baby E is gumming his swaddle and making complainy noises. He started crying and his Mimi picked him up and took him into the other room.)
Then we started the long night of gradual gradual progress–by 10:40pm I was 5 cm and 80% effaced. I asked to be catheterized because I’d been drinking all day and could never pee–they first said no, you’re just dehydrated. But I insisted and they got 1.5 LITERS of urine! And I had to be catheterized a few more times through the night.
To try to get things going faster, they turned up my Pitocin a bit and broke my bag of waters with what looked like a crochet hook. It made me a little sad that it didn’t break on its own but I quickly moved on–a small sacrifice.
I kept going and kept going, the contractions getting really intense. The best way to get a mini-break was to get in the warm bath, so I did that many times. My doula was so present, her big blue eyes right there when I looked up. She helped me dive under the waves, connect with my baby, told me over and over that I can do this. My mom was a total rock, even as my suffering intensified. (Right now she is dancing the cha-cha with Baby E.)
Nearly 4 hours after that, I was checked again at 2:20am: I was 7cm and 80% effaced. Such slow progress! Ugh ugh ugh! Starting to get really really frustrated! Starting to think I couldn’t do it. Starting to seriously doubt myself and the whole natural childbirth plan. I started to become desperate. I was so tired. My UCSF midwife, the one I saw for maybe two prenatal visits, happened to be working that night and she became another important rock in the room, total strength. I wanted to get back in the bath, my only respite. She mentioned on the way in that the bath won’t slow down “active labor.” Oh, so I’m finally in “active” labor at this point, I thought, as we approach the 24 hour mark.
Sure enough, the bath felt good but did not lessen the contractions. She sat on the bathroom floor beside me as I alternated between comatose sleeping and big, hard, anguished contractions. I started to say I didn’t think I could do this. She said, “You can totally do this. You ARE doing this.”
I got out of the tub and, in my memory, I crawled back into the room. I think in reality I walked in but ended up on my hands and knees somehow, and I felt so desperate. I was saying I can’t do this, that I was frantic, that I just wanted the epidural. My audience wasn’t really going to budge on that one–they looked at me blankly for a moment, then with compassion, then said again, “You can do this.” I was furious. But I kept somehow, somehow, kept going, one contraction at a time.
The midwife said, well we do have this drug called Fentanyl that can take the edge off, it lasts about an hour to an hour and half. And I said YES, bring me that, thinking OK good, maybe this is all I needed. They brought it in, hooked it up to my IV, and I felt lightheaded for a second, then the next contraction hit. It honestly didn’t take the edge off, at all. Still, lightheadedness was something… And I kept going. By 5:20am I had progressed to “almost 8.” (Yes, that’s right–between 2:20 and 5:20am I progressed from 7 to “almost 8.”)
At this point, I just felt beaten. Em says that this is when I surrendered. I told my mom and my doula to go ahead and get some sleep–there was nothing more they could do for me. They were utterly exhausted. I got in a side-lying position on the bed, the only position I could manage, and the Fentanyl allowed me to sleep for two minutes at a time between contractions. For this, I thank that drug, because although it didn’t make it less painful, I think my body could regenerate just enough. There were almost no thoughts. No more visualizations, no more mantras, no more words or ideas. I couldn’t think of myself or the baby. The only thought I remember having was to call the nurse and ask her to bring me the nitrous oxide setup and specifically not to wake my mom or my doula–it would be our secret! But somehow I didn’t hit that call button.
That last hour was the purest, most intense physical experience of my life. Just huge waves that completely obliterated me, punctuated by sleep. And, at around 6:30am, just as the second sunrise broke across the city, I had the blessed urge to push. “Mom! I have the urge to push!” She had the nurse on the line 4 seconds later, the nurse had the doctor in 4 seconds after that, I was checked, and I was 10 cm–complete!!! Oh, hallelujah! Let’s DO THIS!!!
Everything changed–I was giddy. My doula had gone to the cafeteria and I texted her: “Ready to push come back!” I also texted Em and she was able to come. Doctors and nurses and midwives were assembling in the room and I was getting a primer on how to push–my doula said, “It’s going to feel like you’re pushing a giant boulder out of your butt.” (It totally did.) Gather all the energy of the contraction at the beginning, and, when you’re ready, give it everything you’ve got.
I ended up on my back on the bed, holding my knees in the air, and the sun streamed in, and this incredible team of birth goddesses made a U around the end of the bed–my doula, my mom, a medical student named Kacy who held up my iPad like a mirror so I could watch, a new midwife, the OB who would catch the baby, awesome/amazing nurses, and Em walked in just in time! I actually said, “this part is going to be fun.”
The mood was like a party–after the dim and dark hours of labor through the night, it felt like a different room. Sunshine and the talents of modern medicine and midwifery and family and love all gathered close.
When my first big contraction came, I gave it all I had–and the team totally freaked out, telling me I was a champion pusher and they could see the head already! What?!?! Yes! It has dark hair! Incredible! Just keep doing what you’re doing!
So I did–I was yelling in that gutteral way you see in movies and just pushing like gangbusters, harnessing the freight train that was rushing through my body, like no other sensation in the world. And the baby moved down, and down, and down. They were all so encouraging and clearly having a blast. And, honestly, so was I.
This was the high point, the whole pushing phase, I was totally empowered and animal and in my body. The head started to crown–they were pouring mineral oil over the top and holding a warm compress to my perineum and cheering like a crowd in a stadium. I could see his head emerging on my iPad and it was so motivating!
At some point, Em said, “K, REACH DOWN AND PULL OUT YOUR BABY!” and I did, and his whole body slipped out of me and he was on my chest and I was hyperventilating and laughing and saying “oh my god” a million times and he cried right away and looked at me with his EYES and grabbed my finger with his HAND and everyone was crying and he was perfect. They were wiping him roughly with towels to get him to pink up and suctioning his mouth and nose and it was a short umbilical cord so I couldn’t get him very high up but I could kiss his head and say, “I’m your mama! You’re here!” and he cried and was adorable and HUGE. He was born at 8:51am on May 19, 2014.
(He is back in the rocker sleeping peaceful now, thanks Mimi. And I’m sitting here crying, reliving his birth.)
We stayed like that for a long time, I have no idea how long, and eventually I cut the cord myself (!) and they took him across the room to do a few things and my mom went with him. I overheard someone say “10 pounds, 2 ounces,” and was completely blown away–none of us EVER thought I had a 10lb baby. In fact, thank goodness none of us knew, especially me. He came out long and strong. All his checks went perfectly and they brought him back to me. My mom went to my dad and sister in the waiting room that it would just be a little longer and they could come in–fortunately they weren’t in the room for what came next.
The docs were acting a little nervous about my placenta. Because he was so big, his placenta was also big. Then they were reassured, “there it is,” and it was born 14 minutes after the baby. And, when it detached it caused a hemorrhage. My doula got in my face with her big blue eyes as the room filled with twice as many doctors and said, “So, there’s an issue with the placenta, it’s totally going to be fine, we have the best team working on this, and you and I are going to just stay right here and focus on the baby.” I stayed calm as they put all kinds of new meds in my IV to get my uterus to clamp down and stop the bleeding, which they did quickly, but not before I lost a lot of blood.
So that was scary but because they resolved it so quickly, and I was on Cloud 1,000,000, it felt more like an addendum to the whole experience. I’m just so grateful that it was quickly resolved and I made a quick recovery.
They cleaned up the room and brought my family in and there were tears and photos and we called my sister D and welcomed our new family member. We ordered food and marveled over this little (not so little) guy who was just impossibly cute for having been born just hours before.
They moved me to a smaller room and my family left and I spent hours just staring at him, the rest of the day slipped away and I barely even slept. He was and is perfect. A dream come true. I am grateful for every moment with this beautiful human as I complete one epic journey and begin an even bigger one.
Welcome, Baby E. (and, on cue, he just woke up.)

(If you are interested in more, please check out Katie's blog at www.thesolomamaproject.wordpress.com!)

Monday, June 23, 2014

Jo's Birth by Nikki

 4/9/14, 6:42am
8lbs 11oz, 21in
The Saturday before Jo’s birth, I walked to Jane Austin yoga on Valencia with Katie, had lunch after at Papalote with her, Melissa, Sage, and Sage's cousin. The 5 pregnant bellies got a lot of looks! Katie and I then walked home (about 4 miles total). When I peed that afternoon at home, I noticed a couple small yellow things on the tissue. They looked like lima bean shells. Dan and I went out to Indian and then to the movies that night to see “The Grand Budapest Hotel”. I felt some contractions in the theater that felt like period pains in my back, and I thought maybe labor was starting that night. I went #2 mid-movie and that seemed to stop them. The next couple of days I noticed that I felt slower, but didn’t feel any contractions.

On Tuesday, 4/8/14, I felt very slow. Instead of packing my day of yoga, errands, reading baby books, etc. I watched a couple episodes of "Call the Midwife" (ha!), a Tanya Harding and Nancy Kerrigan Netflix movie (double ha!) and went to acupuncture in between. I also did a YogaGlo prenatal meditation on "a circle of mothers". My mind was a bit racy, as I would notice I didn't catch a line of her meditation instruction here and there. All afternoon/evening I had been losing pink mucus, so I knew it was coming on. I went to book club that evening and started to feel the need to record contractions around 8:30pm. I was surprised to notice that they were about 4.5 – 5 minutes apart. My book club friends were super excited to be witnessing my early labor. We took some pictures of my belly that night. The boyfriend of the book club host, Andrew, came home and asked my reasons for a homebirth. It was great to repeat them to myself. I am not sick. Jo is not sick. Birth is natural. I feel more comfortable at home. I don't want to worry about the lack of control or independence in a hospital. I trust my body to do the work. I trust my baby. Andrew played a sound recording of Patton Oswalt making fun of homebirth, and we all had a good laugh. It was great to feel at ease and laugh about the experience I was about to endure. I started to feel a little more physical discomfort at 9:45pm and got a ride home.

I called Alli, our doula, at about 10:30pm to warn her that I was having fairly consistent contractions. We decided I'd take a bath and then get to bed for the night to prep for a long day or two of birth. She said, "Now your toes and feet and wading into the ocean." (She told me I was just dipping my toes in when I told her about the mucus plug the Saturday before.) Dan was playing games with friends and got home around 11:30pm. I couldn't sleep. Dan started timing the contractions and we did that for a few hours as Dan starting prepping my labor stations downstairs and filling the birth tub. I would yell to him to start the timer and then yell him to stop. It got harder and harder to let him know. I got up from the bed after a rush to go sit on the toilet and my water broke. It was about 2:35am. I remember being a bit in denial about it because I wanted it to break further along so I could wait longer for the penicillin. (I am GBS positive and decided to have Maria administer penicillin at home.) Alli was already on her way, so Dan called to let Maria know about my water. Alli arrived at 3:10am, and I was leaning over the upstairs tub when she got there. Dan had to leave to drive to Kaiser and pick up the penicillin. I remember being ok about him leaving because Alli was there, but I was definitely glad when he came back later. After Alli watched a few contractions she said, "I think this is early labor." I didn't want to hear that because I was noticing that they felt pretty close together and were getting stronger. I expected a 5-10 minute rest instead of 2-4 at that stage. Sometimes I got between 2-4 waves in a row- usually the first was most intense and then it would lead right into another (or 2 or 3!) "half" or "full" waves. I started to want and really need my hot water bottle on my back and pressure on my hips during each wave. I remember Alli telling me I was wading further into the ocean of labor, now up to my thighs. Alli asked me if I wanted to change positions a couple of times and I pretty much ignored her. I couldn’t think about where to go and how to change positions. I was in my zone and I just needed them to witness and apply pressure to my hips. All fours with my hips swaying was my position of choice. I pretty much did that the entire labor- on my bed and on the bathroom floor. Sitting on the toilet wasn’t as comfortable to me.

Alli kept repeating "deep and low" to help me vocalize through my moans. It was extremely helpful because it was repetitive and simple. I also remember her softly saying "open" a few times to help me fixate on that word. At one point she asked what my mental image was, and I told her I was floating in the ocean. I remember mentally fixating on softening, opening, letting go, floating- all things that required a lot of energy since it is the opposite of what the body is telling you to do.
I felt like I couldn't get enough water and my throat was getting raw from the moans. I was also sipping recharge but wished it was more diluted it as it seemed a little intense of a flavor at the time. Dan had asked if I wanted the music of singing bowls and oms that a friend from birth class shared with us. I said no. I didn’t want anything but pressure on my hips and water!

While Dan was at Kaiser, Alli called and put Maria on the phone. We discussed starting the penicillin by about 10:30am the next day and she said to call her whenever I needed to. I’m sure we discussed some other things, but I can’t remember. I remember thinking, “Oh my god. Maria thinks I won’t have the baby until tomorrow evening after I have 8 hours of penicillin! I don’t know if I can do that.” When Dan returned, Alli asked me to tell Dan what Maria told me. I tried to formulate what she said and to remember our conversation, but I could hardly get it out.

It was around 4:30am when Alli suggested that we think about when we wanted to call Maria. I think Dan called her a few contractions later. When Maria arrived around 5:30am I was on the toilet. She took some vitals, watched a couple waves, and set up her equipment. I remember feeling like my contractions changed a bit when she got there. I noticed my vocalizations started to have more of a grunting sound- my ahhhhs skipping. I started to fear that I was feeling the urge to bear down, but that it was too early. Alli let me hang from her shoulders and drop my head on her belly as I went through a wave on the toilet. I did that again with Dan.

Then Maria had me go to the bed so she could check my dilation. I remember that being the most painful part of my labor- laying on my back on the bed. She felt and said, "I only feel head. There's no cervix!" I didn't quite understand what that meant so I remember asking, "Is that 10 cm?" She said yes and "Nikki! You are going to have your baby soon!" That felt AMAZING to hear! It was about 6:20am. Maria checked in with me and asked if I wanted penicillin. At that point we both knew we wouldn't be able to get the recommended 2 bags in over a period of 8 hours. We also knew that my water had only been broken for a little under 4 hours. We decided not to administer the penicillin, and I felt a huge sense of relief. It had been something I was really dreading about my labor. Maria called her back-up midwife, Laura, to get here as soon as she could.

They asked, "Where do you want to have the baby?" I thought to myself, "I haven't used my tub yet or any of my birthing stations Dan spent so much time setting up, but there's no way I'm going downstairs at this point!" Dan then whispered in my ear, “Nikki, Do you want to have it up here?" And I said "Yes, on the floor." Maria set up chucks pads and quickly got all her equipment ready upstairs. I got down onto all fours and had a couple intense rushes with a lot of grunting. I felt like my body was doing exactly what it needed to on its own. I didn't feel like I was making an effort to push at all. My baby and my body were doing the work, and I just got out of their way. I remember my lips feeling extremely chapped all of a sudden. I was using the corner of a chucks pad to wipe them off in between rushes. It was probably a great distraction!

Maria said to Alli that she would need to put on gloves and assist her if Laura didn't get there in time. That didn’t worry me. Dan and Maria were behind me and Alli was in front of me. As a wave came, I'd lean back into my hips and stick my butt out towards Maria and Dan. Maria kept encouraging me to keep it up and push when I felt the urges. Just as the head started to appear, the doorbell rang and Alli ran down to let Laura in. I remember it being a little hectic and Dan yelling, "Just push the 'door' button!" Maria said for me to reach down and feel my baby's head. I tried twice, but couldn't reach and decided to concentrate on the pushing and let Dan enjoy that moment for himself.

Maria said she saw some meconium so she would do some suctioning if that was ok. I said yes. The word 'meconium' made me nervous, but the confidence in Maria's voice made that dissipate quickly. Maria used the Doppler a couple times to check the baby's heartbeat. I found it extremely reassuring, invigorating, and empowering to hear her heartbeat! It was strange that the Doppler was so far down near my pubis when Maria got a nice, loud, fast heartbeat. My baby was so low and almost out!
I only had a couple more contractions before she was fully out! I remember thinking that it wasn't as painful as the waves and didn’t burn as bad as I thought “the ring of fire” would burn. With the next wave, I grunted and her head slowly came out and then quickly followed by her entire body.

Dan caught our little Jo as she came out at 6:42am. I felt my wet, warm baby placed gently next to my foot while Maria suctioned her mouth and nose and looked her over quickly. She then passed little Jo between my legs to me and had me sit back against Dan. I was completely overwhelmed with joy! Laura got there just as Jo was handed to me threw my legs. She said she walked in to hear, “Nikki, reach down and grab your baby.”

Dan and I sat like that for a few minutes while everyone said congratulations and good work and cried and smiled. Alli was taking pictures during the birth and while Dan and I were snuggling our little Jo for the first time. These will be some of the most precious pictures I’ll ever have!

After a few minutes, Maria had me sit on the birth stool to birth the placenta. I asked if I should push and Maria said to push a little. It happened quickly and smoothly. It felt great to release that.
We were then tucked into bed holding Jo. They all started to clean up the space and Laura came over periodically to check Jo's heartbeat and look at her color. We kept JoJo attached to her placenta.
Maria checked me and said I had a secondary tear which is the most common tear. I was surprised I tore because I didn't feel a lot of pain. I laid on the edge of the bed while Maria stitched me up and Dan held Jo. Maria did some local numbing with a spray first and then several tiny injections. I could hardly feel her doing the stitching which was a relief. I remember telling her to make it good because I'm a vagina model. Dan had to let them all know I was joking.

Then Maria took Jo and checked her body thoroughly which we got on video- so nice to have! She weighed and measured her. I asked everyone to make guesses. I knew she'd be at least an 8lb. baby all along. Maria guessed 8lbs. 10oz. We all guessed lower. We all gasped when she said Jo was 8lbs. 11 oz.! 21in.! I remember saying, "This body was made to carry large babies!" It hit me that this was MY baby when Maria was doing the checks. Wow! Dan and I made this being and it belonged to US!

Not too long after this point, Alli and Laura had to leave. Another mother was in labor that Alli and Maria were working with so Alli left to be by her side. Laura went to Maria's office to greet a couple women who had morning prenatal appointments. One was with our friends, Melissa and Paul, so I told Laura to tell them I had my baby. I found out later another appointment was with Ester from my birth class who was due that very day. We laughed about our due dates being so close together and had our babies make a pact that mine would come that week and hers would hold off until Maria was back in town the following week.

Maria told us she would stay for a while longer. She went downstairs to do some charting and phone calls while Dan, JoJo and I cuddled in bed. Jo pooped 3 times in the first few hours all over Dan! So he got into the shower to clean off and we wiped Jo down.  Soon after that I got up to pee and passed a huge blood clot! Dan called Maria up to check it saying it was the size of a hamburger. She examined it and said she wasn’t concerned, but there shouldn’t be another the same size.

Alli had prepared us a bunch of food (eggs, bone broth and root stew) before she left, so we got back in bed with full tummies and cuddled with our new babe. We skyped with both of my East Coast parents that afternoon. Dan made spaghetti and a salad for dinner. I didn’t sleep a wink that night (or the next!)

As she lays on me napping at 2 weeks old, it still baffles me that she is ours, that we made her and get the absolute pleasure of watching her grow up and guiding her through this strange, wonderful world. We love her so, so much.

Some things I did to prepare for the birth:
- Community acupuncture throughout my pregnancy- about once/week
- Prenatal yoga about once/week (I’ve been practicing for 13 years!)
- 10,000 steps almost every day during 2nd and 3rd trimester
- Chiropractic care 1-2 times per week starting at week 36.
- Tried to eat very healthy and limit sugar, but indulged during special times.
- Had a mother symbol that I would envision often throughout the day- a blonde mermaid sitting on rocks at the edge of an ocean. She was very beautiful and relaxed and carefree. Her beauty, grace, and ease were very reassuring.

At week 39:
- Acupuncture 4 times that week (plus the day I went into labor)
- Prenatal acupressure massage
- Perineal massage a couple of times
- Yoga 2 times per week
- A couple birth meditations on YogaGlo (and one the day I went into labor)

Monday, May 12, 2014

Gray's Almost Homebirth by Vanessa

It's been almost 3 years since this beautiful and unexpected birth experience. Although I wrote the story one week after he was born, I haven't shared it until now. I felt disappointed and ashamed about transferring to the hospital and not having the homebirth we planned which I think prevented me from sharing for awhile. I also felt grateful and happy we still had a natural birth with no major interventions and many beautiful moments during the birth. I was born at home and so were both my siblings so I assumed my children would be as well, but the universe had different plans. As we prepare for the birth of our second child, due in one week, the story keeps coming back to me and begging to be shared. So here it is...

Gray Roland Oscar arrived Saturday, May 21st 2011, at 7:01am, 1 week before his due date. He was a healthy and beautiful 8lb 1oz, 20.5 inches long. I had been feeling cramping and Braxton Hicks periodically throughout the week. Friday evening I began feeling lower back pain and some contractions after sitting for awhile to Skype and show off the belly to my brother. I thought I'd either sat too long in one position or it might be time for baby to come, but the sensations were very irregular. So when Matt came home from work around 8pm feeling sick with a cold, we ate a good meal of our favorite takeout (Nopalito) and talked with excitement about the baby possibly coming soon. We both felt tired and that we could be in for a long night so around 10pm we decided to sleep and see what happened overnight.

I woke up about midnight and realized I could no longer lay down and these were the steady surges I had read about coming over me like ocean waves. I immediately woke Matt up and told him to get ready. The labor was intense and progressed fast which caught Matt and I both by surprise. As he prepared our bed and tried to get the birth tub setup, I contacted friends who had offered to help but everyone was unavailable. I then called my mom (who was living in the Boston area) for support while Matt did preparation. I was timing the contractions on Matt's phone which he setup as a stopwatch to track them for me. I talked with my mom, who was living in Boston, for support until my phone died. I mainly wanted to stand and lean (on the table, dresser, sink) and remembering "juicy hips" from Jane's class really helped as well as Matt doing massage we practiced in class.
I felt so relieved when Matt looked at the stopwatch and said we should call Maria. She got there quickly at around 3am. I was going into transition and 7cm dilated when she checked me. My memory is a blur from there, but around this time I also had Skyped my mom and was leaning on the couch for a bit. Then we moved to the toilet and I stayed there for awhile as it felt very comfortable and I had to go so frequently anyway. Maria was a constant, reassuring presence, but let us do our thing and just came in periodically to monitor the heartbeat. I was shaky and threw up a couple times while sitting on the toilet, but the position felt relaxing after leaning over for so long. Sue Baelen came as second midwife with a comforting presence and began offering me drinks with a straw which was nice. My water broke at 5am on the toilet and Maria checked the color to make sure there wasn't too much meconium. She said I would probably feel the urge to push like I had to poop soon and I did.

I'm not sure why or how, but we then moved into the bedroom for the birth. My guess is they told me the tub wasn't filling up quick enough and the bed is where I thought it'd be best to have the baby. I was on hands and knees propped up with pillows on our bed and beginning to push when baby's heart rate started decelerating during contractions and not recovering properly. I began to feel scared, doubtful, and anxious at this point about what was happening both with the intensity of feeling in my body and the baby's heartbeat which I could hear dropping. I could also hear the midwives talking about what to do and could tell something was concerning. Maria checked me again and there was a tiny bit of cervix she massaged open. Then I was fully dilated and started to push again, but still the heart rate was decelerating. They had me rest on my side and not push while they put me on oxygen and assessed the situation. Maria and Sue both calmly said we should consider transporting, but it was our choice and we had to move quick as baby was ready to come. I was in no state to decide and just trying my hardest not to push so I turned to Matt. We had talked about this ahead of time as I knew I would not be able to make decisions in the moment.

At 6am we got in Maria's car and zipped over to UCSF. The hardest part of labor was trying not to push during that car ride with the oxygen mask on in the back seat by myself. Before we left, Sue helped me get dressed and told me to go within and talk to my baby and tell him it is safe to come out. So I went within and focused on that mantra to remain calm when surrounded by the chaos of a hospital. This was so helpful as I had been caught up in my own feelings and forgotten to connect with my baby and the deeply internal process. They were ready for us when we got there and quickly hooked me up to monitors and such. I was terrified of the hospital scene and that they would try to put me on drugs or do all types of interventions. All the doctors and people in blue scrubs with bright lights and machines everywhere was completely overwhelming. So I chose to only look at Matt and Maria, who were both to my left side with the sunrise in a big window behind them.

Maria was amazing as an advocate for us and liaison with the hospital staff. She helped explain everything and made sure they did not do anything without our understanding or permission. Our biggest obstacle at first with the doctors was that I was GBS positive and refusing antibiotics. I remember Maria just saying clearly "This baby is coming now. There is not time for that!" and feeling so grateful for her presence as they seemed to respect her opinion. Matt was my rock and looking into his eyes while holding his hand helped me stay calm and focused.

When they finally told me I could start pushing, it felt so good to finally do it! I just couldn't wait for the next contraction and all my fear dissipated as I tapped into my inner strength to push my baby out into the world. I was really thirsty, but no one would tell Matt where to get me water and they just kept saying they'd give me fluid through an IV which did not help the dry feeling in my mouth. The baby's heart rate was still unstable so they were concerned and one doctor said I had to get him out fast and gave me a time limit of 10 minutes before using the vacuum, which looking back seems silly since I had no concept of time. Another more friendly doctor told me I could take the oxygen mask off during contractions if that helped and it did. So I gave it my all and again focused on Matt and Maria who assured me I was doing great and was capable of getting baby out safely. After about a half hour of hardcore pushing and a small episiotomy (which we allowed under Maria's advisement), Gray was born looking very healthy at 7:01am with a 9/9 apgars and no explanation for the decelerations.

I felt immediate relief, pure bliss, and a wonderful sense of the power inside my own body that had taken over. Holding Gray and snuggling him to my chest for the first time was the most amazing feeling I've ever experienced. Matt and I both were crying with joy and the profound sense of love for our new little family.

My biggest complaint with the hospital birth was that they cut the cord quickly and didn't give him to me right away. Instead, they took him over to an area of the room where I couldn't see to check him out (Matt went with him). I remember asking to delay cord clamping and hold him, but Maria said they wouldn't. I think this was because they saw more meconium come out with him and maybe because of the heart decelerations too. They did bring him to me quickly and he clearly recognized his mama. After I was holding him for a bit, Maria noticed he was making sounds that indicate trouble breathing. So they took him to the nursery to suction out some meconium and mucus way down in his lungs and again we were grateful Maria was there.

Matt went with him to hold his hand and say no to all the other "routine" procedures they wanted to do in the nursery. Gray was back to me for skin time in 20 minutes breathing normally and ready to sleep on his mama's chest which he still loves to do. Maria said we could decide whether to checkout AMA (against medical advice) that day or stay the night and have them do the newborn tests. We decided to stay the day and night at the hospital as we were all exhausted. Although it was incredibly uncomfortable and not our cozy home environment, we did have a room with a panoramic view of the golden gate bridge and some very friendly nurses. We had a great nurse who helped us get discharged the next day even though they wanted us to stay 48 hours for monitoring due to my GBS positive status.

The past 3 years has been a rollercoaster of emotions about this birth. Ending up at the hospital was hard, but ultimately it was still an empowering and beautiful experience for me. Working through my feelings around this birth is one of the greatest lessons and healing opportunities in my motherhood journey. Gray loves to hear the story of his birth and see pictures from that day which helps me remember the truly amazing experience. He is such a beautiful being full of love, laughter, and a wonderful imagination that I feel so lucky to have brought into this world.

Sunday, March 9, 2014

The Birth of Beau Austin

Everyone always told me that I would “just know” when labor started. I didn’t quite understand what that meant, but when I awoke at 3:30 am on January 19 to the feeling of slight lower back pain that moved around to the front of my body in a wave-like formation ¾ I just knew. Labor was starting and we would soon meet our baby boy, Beau, whose arrival we had been anticipating for so long.  I was excited and ready to do whatever it took to meet him.

I rolled over in bed, nudged my husband, and told him that I had just felt my first real contraction and that I had a very strong feeling the baby would be born that day. We quickly discussed that it was possible that we had a long road ahead of us; so, we both tried our hardest to fall back asleep and resist the urge to get the day started.  I went to restroom before going back to sleep and noticed a small amount of pink-tinged liquid in the toilet.  All I could think is, “this is really happening!” I never thought I would be so excited to greet the “bloody show” I had heard so much about and that was a sign that “real” labor ¾ not the Braxton Hicks contractions that I had been feeling for weeks ¾ had finally arrived!

About an hour later, I had another surge that woke me from my sleep. When I glanced at the clock I saw that it was 4:44 am.  From that point forward, I felt a great sense of calm and an unwavering confidence that the birth would go smoothly and that I was being watched over and guided by a force greater than me.  The number 4 and the time 4:44 has always been special to me.  Throughout most of my life, my mother and I always wake briefly at 4:44 am for what appears to be no reason at all, and she always told me that when I did so it was a sign that angels were watching over me and guiding me.  I consistently awoke at 4:44 am during most of my pregnancy ¾ just as my mother had done during her pregnancies.  It sounds silly, but waking for that surge at 4:44 am set me on a very positive course and helped me have faith that everything was going to be just fine with the birth.

I was able to go back to sleep until approximately 7:00 am, at which point we woke and made a delicious breakfast of our favorite spicy cheddar muffins.  After we finished breakfast, my husband called our doula, Sandra Lloyd, to let her know that labor had begun.  Sandra suggested that I try to take it easy and rest as much as possible to ensure that I maintained my strength for the rest of the labor.  We also called Maria to let her know that labor had started and promised to keep her updated.  I then called my family to let them know that I was in labor, and as planned, my mother began shopping for an airline ticket so that she could hopefully make it out from Dallas to San Francisco in time for the birth.

Early labor was pretty uneventful.  For most of the morning I did what I would do any normal day ¾ took a shower, did some light housework, read the news, and spent some time in the backyard enjoying the beautiful and unseasonably warm January weather.  I even started questioning whether what I was experiencing was real labor because my surges were only about six minutes apart and were not painful or even that noticeable. 

Things started to pick up mid-day.  I began to experience some pain on and off with the surges that caught me by surprise. Every third to fourth surge would be really strong, and they started coming closer together at about four minutes apart. I was trying my best to eat and stay hydrated, but when the strong surges came, I had a hard time keeping food and drink down.  In the course of a few hours, I vomited with six of the surges.  We were worried that I would become dehydrated; so, we called Maria again and she suggested that I slow my ingestion of food and liquid to see if it would stop the vomiting.  Maria’s suggestion was exactly what I needed because from that point forward, my stomach felt much better and I did not vomit again.

I spent the rest of the afternoon laying on the couch and distracting myself from the pain of the surges by watching the 49ers lose to the Seahawks in the NFL playoffs.  I also dozed off intermittently while my husband prepared what was to be a fantastic post-labor meal of some of my favorites ¾ lentil soup and rice krispie treats.  The afternoon seemed to fly by in a matter of minutes, and my surges sped up very quickly. By this time, I had gotten into the groove of labor. I was no longer feeling pain; rather, I was feeling very excited about meeting our baby and kept replaying affirmations in my head, such as “you’re making progress” and “you’re one step closer to the end.”  By the end of the afternoon, I had sufficiently psyched myself out and was actually looking forward to strong surges because they enabled me to visualize the baby’s head sliding down faster than with the easy surges.  I had no idea how quickly I had progressed, but by 3:30 pm my surges had become only two minutes apart.  At this point, I had the strong urge to labor on the toilet and began to feel a slight sensation to begin pushing.  I also lost my mucus plug while sitting on the toilet.  In the meantime, my husband had begun filling the aqua doula that we assembled several days before. 

My husband quickly called Maria and our doula, Sandra, to report on the progress, and both told us that they were headed our way since things were progressing so quickly.  By the time Maria and her back-up midwife, Laura, arrived early that evening, I was so in the zone that all I remember was being very still and introspective.  I was focused only on making progress and doing whatever it took to meet Beau as soon as I could.  When Maria checked me, she said that I was at 9.5 cm, that I was going to have the baby soon, and that I should let her know as soon as I was ready to start pushing.  At that point, all I felt like doing was sitting on the toilet to labor. I had every intention of using the aqua doula for labor and delivery, if possible, but the tub wasn’t even all the way full and it was too late to jump in.  A few minutes after sitting on the toilet, I heard a very loud pop and a gush of water (I credit the Vitamin C with bioflavonoids I had been taking for several weeks for the strength of the bag). Maria rushed in and checked that the water was free of meconium, which, thankfully, it was.

I immediately felt a very strong urge to push. Maria and Sandra guided me into my bed where I began pushing.  After about 30 minutes, I felt that I would be able to push more effectively if I sat on the birthing stool; so, I transferred to the stool and continued to push.  I made much more progress in that position, and after about an hour, Maria let me know that I was very close to birthing the baby’s head.  My husband later told me that this sight was one of the most surreal that he has ever seen, and I wish that I had not turned down the opportunity to feel the head at that moment. However, I spent most of my time pushing with my eyes closed and my hands on my knees, and all I was thinking was “I’m making progress!”  I didn’t want to change anything at that point ¾ not even the position of my hands.  My mother arrived right around this time, and as Maria mentioned later, Beau was waiting for his grandmother to arrive before making his debut because the delivery kicked into high gear after she arrived and he was born within a matter of minutes.

After a few more pushes, Maria told me that my perineum tissue was pretty strong and was not tearing to accommodate the baby’s head as typically occurs.  She said that with a small incision to the perineum, the baby would probably be born in only a few pushes.  I really wanted to avoid an incision of any sort; so, I told her that I wanted to try giving a few more good pushes and that if he didn’t come, I would consider the incision.  After a few more pushes, I felt like he was so close to arriving that I took Maria’s suggestion that we make a small incision to allow his head to ease through the tissue.  I transferred back to my bed, Maria made a small quarter-inch incision, and our beautiful baby boy was out and on my chest in only two pushes at 10:12 pm. 

Beau was so alert and calm, and we spent several minutes staring into each other’s eyes. It was love at first sight, and was such a surreal feeling that I will always treasure and never forget. My husband cut the cord after it stopped pulsing, and Beau continued to lie on my chest while I admired him and basked in such intense feelings of joy and relief.  I felt so grateful and relieved that the birth had gone smoothly and that my precious son had finally arrived.

After I spent about 20 minutes bonding with Beau, Maria guided me back to the birthing stool and I birthed the placenta in just a few pushes.  Then, Maria gave me a few stitches, and I hopped in the shower to recharge.  I later learned that my husband took this opportunity to take Beau outside in our backyard, show him the full moon, and give him his first breath of fresh California ocean air ¾ an experience that we could only have at home.

I emerged from my shower feeling better than I ever have in my life.  The rush of energy I felt was incredibly intense ¾ I felt so empowered, and I know I will always be able to draw from that energy in the future.  I then returned to my freshly made bed to begin breastfeeding Beau, and we concluded the night with a delicious feast of lentil soup, warm bread and rice krispie treats.

Beau’s birth was the most amazing experience of my life and I feel blessed beyond belief. I am extremely thankful that I had someone as skilled and dedicated as Maria to guide me through the birth I had always wanted and knew was possible. 

Tuesday, February 11, 2014

The Birth of Rowan Violet

My husband Chris and I knew Rowan would be born on Christmas Eve. I’m not sure how we knew, we just knew. We also knew she was a girl, even before the ultrasound. But as Christmas Eve approached, I had to take a few deep breaths and try to release my control over her birth.

Maria said to plan on 36 hours of labor, so at dinner on December 23rd, we thought a Christmas Eve baby was a long shot. But at 11:45pm, I woke up leaking amniotic fluid. I soaked my underwear and a spot on our sheets, but I knew there was nothing to do about it yet. I changed and went back to bed. I slept restlessly for a couple hours, and woke again at 3am to another release of fluids. This time I sat on the toilet to confirm it was amniotic fluid, and sure enough it had little bits of pink and white floating in it. I started to get excited, but knew I needed sleep for what was ahead. Chris was partially awake and asked if I was ok, and I told him my water broke, but to go back to sleep. We would call Maria in the morning.

We both slept as best we could, waiting for 9am so we could call Maria. When we called, she asked if I’d had any surges, and I didn’t think I had – I assumed I’d know when I had one. I was having sensations super low in my pelvis, but nothing I would consider strong, or what I was expecting a surge to feel like. Maria suggested going on a walk, making an acupuncture appointment, and doing some nipple stimulation to get things moving, as we needed labor to start within 24-48 hours to avoid infection now that my bag was open. So we slowly started getting ready to meet the day. I spent a few minutes meditating, inviting my labor in, inviting it to start. My brother came over and we walked to The Mill, home of the infamous $4 toast, a few blocks from our house. On the way we ran into our friends James and Ally, who were super excited for us. I ordered pumpkin butter on wheat, which was surprisingly difficult to eat – I was feeling pretty out of it, like waiting for a drug to come on. Then we walked to Alamo Square so our dog Calamity could run around. We chatted with some folks at the park, watched her play, and took a super touristy and awesome photo in front of the pink ladies.
When we got home, Chris went to the grocery store to get food for the birth while my brother rearranged some furniture and set up the birth tub. My brother then headed off for his haircut appointment – he didn’t want to leave me, but I was convinced we had lots of time before things really kicked into gear. I started doing what remained of our birth setup, but quickly started feeling strong surges. I texted Chris at around 3:30pm to come home – I was definitely in labor.

By the time Chris got home, my surges were one minute long and ten minutes apart, and I needed him to put counter pressure on my back and hips while I rocked on the ball. He called Maria, and she told us to expect another twelve hours of this type of labor. But very quickly the surges became more intense, about four to five minutes apart. Chris wanted to call Maria again, but I said the surges needed to be consistent for a full hour before we called. Then the surges got stronger again, and I moved downstairs closer to the bed and the tub. Within a few surges, I was having minute long surges every two to three minutes, and I remember asking Chris, “Why is this happening so fast??” One of the affirmations from our birth class was to rest in the pauses, but I wasn't getting any pauses – the surges just kept coming in close waves, and I was having trouble processing each surge before the next one came. I asked Chris to call Maria (I know now he had already called her when I asked), and she said Sue Baelen was on her way, as Christmas Eve is Maria’s night off with her family. I almost cried when I saw Sue, and again when Leah, our doula arrived. Sue told me I was doing a great job, which I definitely needed to hear, and she took my phone away from me – I didn’t need to be timing the surges anymore. Leah dove right in and started putting counter pressure on my back and vocalizing through the surges with me. Leah and Sue then suggested I labor on my side on the bed, so I could rest in between, as up until now I had been on the ball. I had a few surges on the bed, and felt a need to pee, or poop, or something. I had a strong surge on the toilet, and needed Leah to help me through it. We went back to the bed, and I started feeling pressure on my pelvic floor, like I wanted to start pushing. I remember saying out loud that I thought I wanted to push - I was surprised at the sensation. Sue asked if she could check me, and I said yes. She asked what I wanted to be, and I honestly said I didn’t know. When Sue said 8.5cm, Leah cheered, and I felt awesome - I know I smiled, I may have even laughed. Then another surge came, and it was longer and stronger than any other surge so far. Sue asked how it felt, and I said it was “something else," as it took me over completely. I asked if I could get into the tub (which was magically filled up by now), and Sue said yes. I started laboring in the tub, leaning over the side and rocking during the surges. I asked Chris to come in with me to apply pressure on my hips, but a surge came quickly and he put pressure on from outside the tub, and it was way too much – I couldn’t have any pressure on my hips anymore, and I wanted to be in the tub by myself. Leah continued to massage and put pressure on my sacrum, and breathe and vocalize through the surges with me, which were now amazingly intense. I knew I was vocalizing, but I didn’t quite realize how loudly. After one particularly strong surge, I heard Maria come in. She said, “You’re a rock star!” and kissed my forehead. It was so good to hear her voice, and she brought such a strong, solid calm in with her – the whole room lifted, and I laughed and cried. I was and still am so so grateful that she came, even on Christmas Eve.

And then I really started pushing. Maria asked me to flip over onto my back so she could see what was happening a bit better. I did, and started pushing with my legs against the side of the tub. Chris held me from behind outside the tub, and Leah held my right leg so I could more easily push against the sides - I needed them both there to hold me, and I wouldn't let them leave. Maria told me to feel between my legs, and it was both surreal and inspiring to feel our daughter’s head pushing out. I couldn’t stay in the moment long, as another strong surge sent me back to holding hands with Chris and Leah. My eyes were closed through most of the surges, and only opened when someone spoke. During one surge, I arched my back and yelled upward, and my energy went everywhere – I was having trouble grounding until Maria suggested I tuck my chin and vocalize downward. She pressed on my perineum and told me to focus my energy on pushing there. I did as best I could, and I felt her head coming farther and farther out, and slipping back in between – the sensation of her slipping back was super uncomfortable, and I said so out loud. But the surges kept coming, and I was making headway. I had a moment of concern about my legs being strong enough, but the moment didn’t last long - I couldn't dwell. Maria then told me it was time to slow down and breathe her out. I heard the words, but I couldn’t – I kept pushing. Maria helped stretch the area where she was coming, which was uncomfortable but very helpful. With the next surge, I felt so close – if I could just push a little more, she’d be out – so I pushed and pushed and pushed, and pushed one more time, and it felt like she came out all at once.

I opened my eyes as she was put on my chest, and I got to see my beautiful daughter for the first time. Her little head was covered in vernix, and she had a pi sign in the middle of her forehead. 
She cried just a little, and then I held her against my chest and rubbed her little shoulder. My husband cut her cord after it stopped pulsing, and Maria suggested I cradle her in the water – she started looking around, just checking out the world. She was so alert and calm, and absolutely perfect – the rush of emotions in that moment are indescribable. Our little Rowan Violet was born at 7:13pm, about 4 hours after my surges started.

Then it was time to get out of the tub and birth the placenta. Chris and Leah took our daughter and dried her off while I sat on the birth stool. And nothing happened. I didn’t feel like pushing, and I didn't have any more surges. I tried pushing anyway, but nothing. I nursed Rowan, but still nothing. After about 30 minutes on the birth stool, Maria suggested I get on the bed and try a new position. And still nothing.  Maria and Sue offered a shot of Pitocin to help get the placenta out, and I said yes. And still nothing. I was surprised, as I’d heard Pitocin really kicked surges into gear. I tried pushing even though I had no urge, and still nothing. Maria and Sue were both looking a little worried about this point – I knew that the placenta needed to come out, but I didn’t know how to make it happen. On Maria’s suggestion, I thanked the placenta for everything it had done, and told it that it was time to let go – it’s job was done, and now we needed it to be born. I tried pushing again. And nothing. I wasn’t bleeding, so Maria said we had three options – we could continue to wait, she could try going in to get it, or we could go to the OR to get it out. I did not want to go to the OR, but I was ready to be done. Maria said she couldn’t really tug it because the cord was torn, and she was afraid she’d lose it, so she needed go in manually to retrieve it. As a last ditch effort, they tried a catheter to empty my bladder, but my bladder was already empty. We decided to have Maria go in manually, as she felt confident, and we felt confident in her. They set me up with an IV just in case I started bleeding and we needed to transfer, and gave me another shot of Pitocin. Maria went in, and it was unbelievably raw and uncomfortable. I helped push, but the placenta didn’t come out. She went in again, and together we birthed it. Sue immediately checked it over to make sure it was whole, and Maria watched for bleeding. I wasn’t bleeding, the placenta was whole, and a weight lifted - the work of birth truly isn't over until the placenta is born, and now I could relax.

The placenta was small, but it helped sustain my daughter’s life for 10 months, and I am grateful. Maria showed me where she was in the amniotic sac, and showed me the placenta. It was really beautiful. Now that all the work of labor was done, we went upstairs to our bedroom to settle in. Chris put new sheets on the bed, Maria and Sue set us up with what we needed, and went home. I nursed our little girl, and was amazed at our wonderful Christmas present. Our little Rowan Violet is perfect, perfect, perfect, and we’re so in love. I am so incredibly blessed - we had the home birth we wanted, the home birth we envisioned, and I am very, very grateful.