Wednesday, February 29, 2012

I am Able by Miranda

My orb is gone and the milk is in; I have to start writing this story before it leaves me. My partner Al and I had the blessing of a home VBAC. To tell the tale, I start with my first birth:
Our son, Lev, was born in a hospital by c-section. It was a birth that confused me, one I will never completely understand. I walked towards it with too much Ina May in my heart, too many easy birth stories nearby. More, we were living in Rhode Island where the C- section rate is of the highest in the country. We didn’t have the finances or medical support to consider a home birth.
For prenatal care we had a great but overworked midwife, Mary. Then, during one of our prenatal visits, we saw Mary’s intern, an MD named Rowena. Rowena was squeaky and new. She wore knee-high spike-heeled boots and had long fingernails. During the one visit I had with her she told me I had to take my glucose test though I resisted (I ended up failing the test). During this visit Rowena also explained she was a family practice MD looking to broaden her experience. She said she was focusing on C-sections, which she (and I quote) “loved to do”. I was grossed out.
My water broke on it’s own near the due date. I soon reached strong, steady contractions. We called Mary and didn’t think too much about it when we learned Rowena was the one on call. We were just excited about what was ahead. We raced to the hospital and then, slowly, over the course of the next night and day, moved downhill.
While I labored with Al, a doula and a best friend, Rowena waited outside the door. She was trying to give us space but there was not trust between us. I could feel it. She was waiting to tell me ‘no’ just as she had with the sugar test. I wanted to lock the hospital door. I wanted the midwife Mary to show up.
I reached dilatation after 15 hours but retained a cervix lip. Then my contractions began to die down. Another several hours later, I was put on pitocin. Finally I was asked to push. I don’t remember having a sense that I wanted to push. My head was blurry by this point, now 24 hours of hard labor later. I pushed for hours. I felt lost. I forgot what I was doing. I wanted everything to end, everything to stop.
Then Rowena entered the room and told me my time was up. She reminded me that I ‘failed my glucose test’ and asserted that there was a hospital policy allowing one to labor only up to 24 hours after the breaking of the waters. She doesn’t even say the word “c-section”. It had been hanging in the air for hours now.
I was so fragile at that point I ask to be anesthetized entirely for the operation. Luckily a smart doc talked me out of it and I was steered into the operating room where I was given an epidural and morphine. Things then felt soft, warm and far away. My son was born. Al sobbed because the birth ended so differently from what he knew I had wished for. Admittedly, Lev was big: 9 lbs, 6 oz.
Afterwards, Rowena came to my bedside to tell me she noticed I had really nice stomach muscles. I guess that’s what she was thinking when she stitched my abdomen back together.
Now, move forwards several years and across the country to a place with progressive birthing culture. When we got pregnant, I knew I had to at least try for an experience that was different from my first. No one in my family has had C-sections. I suspected I too could get a baby out the old fashioned way. I just needed to have the space to try. I couldn’t deal with entering a hospital and immediately being categorized as high risk. I knew it would help if there weren’t an anxious doctor watching numbers and waiting to tell me my time was up.
We were pointed to Maria because she is brave enough to do homebirth VBACs. We knew Maria was the right person immediately. She felt grounded, not full of hocus-pocus or anger but full of love and wisdom.  Trust formed between us. Meeting with her for hour-long visits (!!!!) was beautiful. Both Al and I felt listened to and unrushed. I’ve told every doctor friend I have that this kind of relationship gives me hope for medicine. A human connection is so powerful and so undervalued.
Maria felt that trying to lower the birth weight through diet control was one way we could affect things. Though I had passed my sugar tests with Baby #2, we chose to operate as though I had gestational diabetes. I started watching my diet closely and walking for 45 minutes daily.
Cutting back on sugar was not fun. In general, I’m proud of how I eat. And here I was, at the hungriest moment of my life, limiting foods I think of as healthy (organic farmers’ market strawberries, for example). I held back on breads, grains, fats (esp. milk fats), maple syrup, honey, fruit, yogurt, even tried to not eat too much protein. I wasn’t having beer, juice, milk. I basically moved from celery stick to chicken breast to peanut butter and always felt unsatisfied. But it was what I could do every day that made me feel like I was moving towards a beautiful birth.
As our due date neared, the tension of people around me grew. Family, friends, even strangers offered their opinion on the dangers of a homebirth VBAC. In response, I imagined myself as a mean lion. I watched to whom I spoke. I stopped telling people that we were planning a homebirth. I answered the phone only if it was someone who gave me strength, asked Al to screen calls. I made our home, where the birth would be, a protected space.
Interestingly, as my pregnancy progressed, I also realized I was at peace with the possibility of a second C-section. I didn’t hope for it but I didn’t clench against it. I let myself be open in everyway.
I spent time imagining a successful birth. I imagined the baby’s body squeezing through my own body. I imagined the sensation of him coming out of me. I watched videos of water homebirths on Youtube almost every other night during the last few weeks. I put positive imagery throughout the house (fresh flowers that were opening). I wore hoop earrings that symbolize my opening cervix.  I thought about myself “opening” for weeks beforehand.
I knew the burden of making birth work was on my shoulders. I was so lucky to have the support of Al and Maria, of course! But in the end, I had to do the work. I had to be brave and extra strong. It would have been fine if we’d transferred to the hospital but if I wanted my homebirth, I had to make it happen.
Labor started in the darkness of morning. Quietly, I wrapped myself in a soft flannel sheet. I cooked myself some French toast (and ladled on the maple syrup). Lev and Al slept. I breathed and visualized opening. I crawled back into bed and took small naps between contractions. Four hours pass. It was then daylight. I felt calm and brave and knew it was time to call Maria.
When Maria got to the house, I could still focus enough to “think my body open” during contractions, something very different from my first labor with Lev when contractions were a frightening, clenching moment, a moment when I had no control. Maria checked me. I was 7 cm. I didn’t get excited. It would be hours more. Even days. “Open”, I thought to myself. Sue, the second midwife, arrived. I loved both of them and felt so happy they were near.
Then I was in the bath, Al squeezing my hips, when I started to feel rectal pressure. I wanted to throw up. The bag of waters broke. I saw seaweed in the bath water. Maria thought I’d pooped. I knew I hadn’t (it turned out to be muconium). Uncertain, Maria moved me to the bed. I start to push. It was not what I thought pushing would be. It didn’t feel particularly obvious.
I pushed while Al held me. Sue placed a cool cloth against my forehead. Maria said, “One or two more and the head is out”. I didn’t believe it would be that soon. I looked Maria and Sue in the eyes. I felt Al behind me.
I trusted all of them. I knew it could be hours more so I continued then suddenly the incredible pressure released. A buttercream covered baby was in my arms!
In reflection, Abel’s home birth was shockingly different from Lev’s C-section. For Lev’s birth, I was surrounded by charts, monitors, numbers, clocks, strange faces pouring in, calculating, waiting to tell me my time was up.
At Abel’s birth I was surrounded by my life partner, my own soft sheets, my blue bedroom walls and quiet, powerful midwives. I was present when Abel came out of my body. I was wide awake. I saw it happen. I play the whole event over and over in my mind now, almost in disbelief. It gives me a rush of happiness to know I am able.

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