Saturday, July 31, 2010

Sadie's Birth - Part III of Sara's Birth Stories

After experiencing the birth center and hospital venues with midwives, I was ready for the full blown home birth experience. I liked Maria's no-nonsense approach to her practice and I felt like with working full time and with two little ones at home, I didn't have the time for or interest in group prenatal visits with other expectant moms. On my first visit, when Maria asked me what I wanted out of my home birth, I told her that I just wanted to be left alone to have my baby. I didn't feel like I had the freedom to just have my baby in the regular hospital setting, but that I would be subject to all the protocols such as their IVs and time lines. She said that it sounded like I was a confident mom and just wanted someone there to provide a safe environment for me to give birth, which was exactly what I wanted.

My early labor was different that the first two. Instead of having regular contractions at regular intervals that felt like period cramps, I had these waves of sensations where my back hurt, my sacrum felt like it was being pulled apart, and I felt like I had to poop. It was the day before my due date and I had no idea if this was early labor or not, but I wasn't about to hang out at work to find out. I would much rather figure it out while walking on the beach with my Mom. (My husband was working as a nurse and was waiting to be relieved before he could head home.)

My Mom met me at my place and we got our flat tidied up for the birth, just in case this was it. My older kids were in school and so after my already scheduled prenatal visit with Maria (where she assured me I wasn't in labor), we headed out for a walk. We only walked a couple of miles, but by then, I was pretty sure that I was in labor as I seemed to be experiencing more intense and more regular contractions. (I hate that word, "contraction," but use it for a lack of a better one. Really, shouldn't we be calling them "expansions" or something less clinical?)

When I went to pick up my daughter from school, I had a pretty intense contraction so I called Maria from the playground to let her know that this was it and I would be having a baby that night. She said it was a great night to have a baby. My daughter was watching her after school film festival and wanted to stay until it was over. I told her that we were going to have a baby soon, which got her immediate attention. She asked me if I was having contractions and when I told her I was she got her stuff together and was happy to come home with me, skipping the end of the film festival.

My Mom, sister, husband, and kids met up at my house and my step-father brought over take-out Chinese food for everyone. I wasn't hungry and was worried I might get sick later if I ate much so I sat down with everyone and just had some chicken broth. I had to stand up and sway back and forth periodically as I could not stay still during contractions any longer. My sister was timing my contractions and they were all over the map from one minute apart to seven minutes apart, but averaging about every three minutes.

I called Maria and she said that she was available to come whenever I needed her. I told her that if I waited until I needed her, she would miss the birth. She suggested that she come over in about 45 minutes and that if I needed her sooner, to just page her and she would come over immediately without calling. I said that sounded good.

Maria arrived around 9:00 p.m. and suggested that I put the kids to bed to decrease the energy level in the house. She said she didn't think I would progress in the current chaotic environment. I was finding it hard to give up my roll managing the household and so I put the kids to bed, periodically having to interrupt our bedtime ritual to stand up and rock back and forth and breath through a contraction. It was about 10 p.m. by the time the kids were asleep and the house was cleaned up and calm.

Maria checked me and said I was 5 cm, but a very soft, stretchy 5 cm so she thought I'd progress quickly. I wanted to get into the tub, but she didn't want things to slow down and asked me to wait so I settled down in my bedroom for active labor with my husband and sister joining me. They were lying on the bed and we talked and laughed interspersed with my breathing and swaying through contractions. We remarked on how my sister had had two kids since she was at my last birth. When Maria came in to check on me next, I remember telling her, "Now I'm having fun," and marveling that I would use the word, "fun" to describe active labor. I also remember Maria asking me if I needed anything to help me through the contractions. I told her no, that I was fine. She then encouraged me by telling me I was doing a good job and my sister piped in with a similar sentiment. Even though I remember doing the same for her when she was in labor, I honestly felt awkward about the compliments. I felt like they were encouraging me for a natural bodily function that I didn't have much control over, like going to the bathroom or something.

Finally, when my sister told me my contractions were about two minutes apart and lasting about a minute long, I told her to ask Maria if I could get into the tub now. "I want to get into the f#*$%&$ tub," I think were my exact words. Maria gave her blessing and I remember being in the tub telling them that I didn't remember birth being quite so exhausting and that maybe it was because I was getting older. After just a few contractions in the tub, my water broke during a contraction and I immediately started pushing. I knew this was it and told Maria that I was going to have her right then. My Mom went to wake up the kids (at that point, I really didn't care whether they were present for the birth, as I was preoccupied, but they had asked to be woken up to see it). Zoe (8 yrs) woke up and came in, but Theo (4yrs) couldn't be roused from sleep.

Maria was instructing me to get into a birthing position and Sadie was born with the next push. I held her in the water as we all welcomed her into the world. She was just perfect and covered with vernix. After a few minutes, Maria suggested we cut the chord and then Maria got excited when she discovered a full knot in the umbilical chord. Somehow Sadie, when in utero had maneuvered herself around and through her umbilical chord and tied a knot in it. Apparently, if the knot gets pulled too tight, the fetus can strangulate so we were lucky. Maria said the knot was extremely rare and was an auspicious sign. She told me that Sadie was a little dare devil and would give us a run for our money. Maria got her camera and took pictures of the knot so we followed suit.

After getting out of the tub and birthing the placenta, my Mom put Zoe back to bed and she and my went home as we settled down for the night. I had such a wonderful birth experience that I was sad that this was my last baby and that I wouldn't be able to experience birth again. Although I had said all throughout my pregnancy that I was getting too old for this and that this was definitely my last time, once Sadie was born, I realized that I could definitely go another round if I had a husband who wanted to (which I don't).

So after experiencing three different natural birth venues, what were the highlights of each?
Birth Center - No clean up required. Good compromise for those who want to stay out of a hospital, but aren't ready to do it at home.
Hospital - No unsupportive comments from concerned relatives. Immediate medical backup ready and waiting if needed.
Home - Can sleep that first night in your own comfortable bed and stay barefoot and in your PJs for the first few days after birth. Don't have to strap your day old baby into a car seat.

Which would I do again? Definitely, the home birth.

Wednesday, July 28, 2010

Theo's Birth -- Part II of Sara's Birth Stories

For Theo's birth, I had an in-hospital birth with a midwifery practice at St. Luke's. Again, I loved the prenatal care and enjoyed the group of parents I met through the practice. We rotated through each other's homes for the prenatal visits and they provided a different focus for each visit. The experience that stayed with me as the most transformative was an exercise where we had to write out nine hopes that we had for our birth, each on a three by five card. On the back side of the card, we were then instructed to write what the flip side of that wish would be. For instance, a natural birth on one side might include a cesarean on the other. As we sat with our cards out in front of us, we were asked to flip three over. We all agonized over which of our prized outcomes we could possibly give up. When we were done with that painful task, we were asked to flip over three more. I can't even explain how difficult this exercise was, to face, even on paper, the thought of giving up our hopes for our births. There were tears for some and it was agonizing for everyone. Finally, we had to flip over two more so we only ended up with a single positive outcome. Looking down at my last precious three by five card on which was written, "Healthy baby/Healthy mommy," suddenly all was put into perspective for me. I realized that whatever dreams I may have to give up for my birth, as long as I reached this final outcome, that was really what mattered in the end. Although not an enjoyable exercise, it was freeing to loosen my grip on the attachment I had to a perfect birth experience.

The debrief from the exercise was very emotional and some people were so upset about the thought that a cesarean could be an option they might have to face, the midwives offered to have someone from their practice who had recently been through a cesarean come talk to us about the experience at the next prenatal visit. The mom came to our next meeting with her beautiful newborn who slept peacefully throughout her story. Her baby was breach and she told us of her numerous failed attempts to turn her baby from acupuncture to homeopathy to hanging upside down and the list went on. She told us of her emotional journey from fear to acceptance to anticipation and finally of her detailed experience of the cesarean. Somehow, her story reduced the anxiety level for the rest of us in the group about the possibility of this outcome for ourselves.

In my final days of pregnancy, I read numerous birth stories on the Internet. Since I had a pretty manageable first birth experience, I was feeling pretty confident and excited and looking forward to having a calmer experience during active labor this time. Although I would characterize my first birth as the most intense experience I my life, I really wouldn't call it painful. Pain just doesn't seem like the right word to me. In fact, after my first birth, I wondered why everyone seemed to make such a big deal about labor. After hearing about and reading numerous birth stories, I realized that my very manageable experience of labor was probably due, at least in part, to the fact that my active labor was relatively short so I never had the experience of birthing through exhaustion. It seems to me that managing contractions while physically and emotionally exhausted must be infinitely more challenging than my own birth experience.

Getting to the actual birth, with Theo, my water broke at about midnight three days before my due date. I started having contractions pretty soon thereafter but couldn't reach my mid-wife. We called St. Luke's Hospital and decided to go in right away so as to avoid any possibilities of the mad dash we experienced with Zoe. The hospital tried to reach my midwife also, without success, so I spent the night in a tiny room hooked up to a monitor with no signs of my mid-wife or birth tub. Needless to say, this wasn't my vision for the birth so I was feeling rather depressed and sorry for myself. I tried to sleep (unsuccessfully) and tried not to let my labor progress until my midwife arrived the next morning. Apparently the storm the night before had knocked out a cell phone tower which rendered her pager and cell phone useless. By this time, we had moved into a birthing room so she set up the birthing tub and now we were in business.

I spent an enjoyable morning in early labor with my sister, mother, daughter and husband dancing around the room to music and the sound of Theo's heart beat. When the nurse came in and asked me what my three-year-old's name was, I told her Zoe and she said that she had a niece named Zoe. Later, when she returned she asked what we were thinking of naming this one and I said, Theo. She looked shocked and said that Theo was the name of her nephew, the younger brother of her niece, Zoe, by three years. We took this as a cosmic sign that we had picked out the right name.

When my labor started to pick up, I sent my daughter home with my mother and got into the birth tub. I spent an hour or two in active labor hanging out with my sister and husband nearby. My sister, three months pregnant with her first, was video taping me. I remember breathing through an intense contraction and her, having not gone through the birth experience before, teasing me through the camera and saying "Oh, Sara's getting serious now, she's won't look at the camera any more." I realized, watching the tape later, that she had gotten a smile out of me during active labor and only about half an hour before Theo was born. Needless to say, she was able to keep the mood light and kept me from taking myself too seriously even during such an intense experience as active labor.

I had to get out of the tub for the birth due to the hospital rules and Theo was born after about three pushes. I was kind of sad that I really didn't have much of a pushing phase and wasn't able to recreate the incredible experience of power and exhilaration I felt during the pushing phase with Zoe. Since I didn't have the adrenaline rush I did with Zoe, nearly having her in the car on the freeway, I avoided the violent shaking of my first birth and was able to hold Theo and enjoy him right away. I'd say, except for the rather sterile environment of the hospital setting, the birth was everything I could have hoped for. However, the postpartum care was a drag, being woken up all night for vital sign checks and shift changes. I was glad to leave for my own home the next day.

Tuesday, July 27, 2010

Zoe's Birth-- Part I of Sara's Birth Stories

Coming from a long line of women who believed in and practiced natural childbirth, I had that vision for myself and was wary of how that would play out in the Western Medicine context. At my first prenatal appointment, I told the OBGYN as she was hurrying out the door after about a five minute appointment, that I had some questions for her. Since she looked rather annoyed and in a rush, I told her that I could wait until the next visit if she was in a hurry. She said to ask now, so I told her my questions were about the birth. She relaxed, smiled, and waived her arm at me as she walked out the door saying, "Don't worry about the birth, you'll be fine. I delivered eight babies just yesterday." Clearly this was her show and not mine.

On my next visit to another OBGYN practice, which was also highly recommended, I had a better visit with a woman who spent about ten minutes with me and answered all my questions. Among other concerns, it seemed that I would see a different person each prenatal visit and who was there at the birth just depended on the luck of the draw. This was still not working for me. I wasn't quite ready for a home birth and couldn't seem to find a hospital birth experience that I felt comfortable with so when I discovered that there was a birth center in SF, I signed right up for the experience.

I loved the relaxed, holistic approach to prenatal care, where I felt like an individual rather than someone on an assembly line. I went into labor four days after my due date, early in the morning. After getting up and taking a shower, I was having light contractions every ten minutes and the midwife agreed I was in early labor. My husband was taking nursing school prerequisites and had a big exam that week. After baking a birthday cake in anticipation of my daughter's arrival, I left him at home to study and spent a wonderful day in early labor with my sister and mother. By the afternoon, the contractions were coming every five minutes. We met up with our husbands for dinner and when my step-father asked me if I was going to work the next day, I replied, "No, I think I'm going to have a baby tonight."

After getting home, I took a hot bath and the contractions nearly stopped, but when I went to bed around 10:00 p.m., they became really intense and close together. Knowing what I know now, that was the beginning of active labor and when I should have headed to the birth center. Unfortunately, my midwife had told me on numerous occasions, not to come in until, "I felt like I was dying." Apparently, she had had people coming in too early lately.

Being a swimmer and practicing yoga both before and during pregnancy, I felt comfortable with my body and with working through exertion and discomfort. I'm not sure if this contributed to my perception of labor, but I made it through transition at home without ever feeling like I was dying. I'll never forget breathing and swaying through a particularly intense contraction and feeling overwhelmed, not knowing how much longer I could do this. When the contraction subsided, I looked up at my husband and desperately asked, "Do you think we should call the midwife now?" His response was, "I think you need to calm down. I think this is going to be a long night." When, on my next contraction, I started pushing, we realized that we had waited too long to call the midwife. He called and she told us to come right away.

I was terrified I was going to give birth in the car on our 10 minute, 2:00 a.m. dash to the birth center on the freeway, but we made it with 13 minutes to spare. So much for the water birth or for having my mother and sister arrive before Zoe was born. (The midwife later told me that the person before me made it with three minutes to spare and the person after me had her baby on the front lawn of her apartment complex so she stopped telling people to wait until they were dying to come in.) My water broke on the stairs as I struggled up to the center and the midwife called down to me, "Don't push, I don't want you to tear your cervix." Not the most reassuring message. Unfortunately, I only had in my last ten minutes the benefit of calm, loving midwives advising me that I could lie down and relax between my contractions and slow my breathing. I realized that I didn't have to feel so anxious and could relax. One of the midwives suggested that I hold my breath during contractions and this transformed the pushing experience for me.

When I held my breath, it was like I put a lid on the energy behind the contraction and I felt the most powerful surge of energy shoot downward through my body with the push. It was the most powerful, incredible feeling I have ever had and definitely did not feel of this world or like something that I can fully articulate. I felt like my body was just a conduit and along for the ride, like I was being pulled under water by this rush of energy, but without any fear. As a swimmer, we often practice breath control so I guess I held my breath longer than the midwife felt comfortable with and she told me to take a breath. I remember thinking, "Do you think I have any control over what is going on here?" When, a few seconds later, the surge let up, I was able to take a breath before I was plunged under again.

I had visions of gazing lovingly into my new daughter's eyes after she was born, but it turned out I was shaking so violently that I couldn't even hold her slippery body and almost dropped her when they placed her on my stomach right after the birth. It was probably 20 or 30 minutes or so and after juice and blankets before my body and I were calm enough to hold and focus on my new daughter. She had now been weighed, measured and swaddled and was like a little angelic gift from God being handed over to me all wrapped up.

My husband and I snuggled up in our bed to sleep through the night with our new baby next to us, listening to the rain coming down outside. We went home the next morning and the three of us took a nice nap together before making all of the obligatory phone calls to spread the word of our daughter's arrival.

Sunday, July 18, 2010

Born Today

Welcome to the world, little Alexa. She was born today, July 18, 2010, at 6:24am to happy parents, Anna and Tuyen. It is so amazing to see babies born at home, slipping into the world all new and wonderful. Congratulations to all!

Saturday, July 17, 2010

A Sibling for Elia - Welcome Diane!

Elia was on hand to welcome new baby sister, Diane Ondine on June 11, 2010. It was a wonderful waterbirth, the second homebirth for proud and happy parents, Francine and Bryce. Welcome Diane! You can see the photo essay of her birth here.