Friday, June 22, 2012

The Birth of Evan

  At 40 weeks, Maria said that the baby was still pretty high and recommended to walk. I started to climb Bernal Hill every day and it felt really good! She also recommended to go back to my Zumba classes, which I have been taking until 37 weeks... and she even came with me! :)

I was a bit surprised to reach 41 weeks, on March 22nd. My daughter was born on her exact due date, 3.5 years ago, and I guess I was expecting this baby boy to come out close to the guess time as well. My french due date was actually passed only 2 days ago, so I was then relying on this one. I went for a non-stress at the hospital (Kaiser) on that day and it went very well. An induction was scheduled for the following week.

I was having some mild cramping and had two false start at night during the last few days, so I was optimistic and staying confident that this "false" or "pre" labor was leading somewhere sometime soon - at least before the induction. I was tired though, as it was difficult to sleep through it. That evening, I asked Maria what I could do and she suggested to take a bath and have a glass of wine. That's what I did and the glass of wine was amazing! It took me some time to drink it but I was definitely feeling more relaxed and sleepy. I went to sleep around 11pm.

I woke up at 2:30am and I was having my first 'real' contractions. I felt some leaking so I had to wake up my husband to protect the mattress and the floor so I can stand up and go the bathroom without making a mess (in case my waters would break). I was not able to go back to sleep in between the contractions, and may have been afraid that they could go away if I was falling asleep! I was happy and hopeful to be in labor as I deeply wanted this homebirth. I knew it was real labor because they were not going away even though I was changing positions, eating, etc. I started to time them. At some point I went into the baby's room and labored in there, sending my husband back to sleep. I wanted everyone in the house (including my daughter and in laws) to sleep so I was very quiet.

Everybody started to wake up in the morning and I went back to bed around 8am. I was tired. I was waiting for the contractions to get into a regular and active pattern but this was not really happening. They were sometimes close together but short, some other time further apart but more intense, but I was not getting a 4-1-1 pattern yet. I first called my dear friend and birth doula, Ti, so she knows I was in labor and probably needing her on that day. She told me to call her back when I needed her to come. Then I called Maria, she asked me if I wanted her to come and I wanted to say YES but I knew it was still early and we agreed to stay in touch in the morning.

My daughter left with her grand parents to go to preschool. Maria said to start filling up the birth tub by the phone and Yann did that, but it was a bit more complicated than when we did it before labor started, 'to try it out'. I was getting tired to be on my own as my husband was busy with the tub so I called Ti and asked her to come. When she arrived she helped me to realize that I was still in early labor and that it could be long... which was so difficult to hear! She suggested to stop timing the contractions and focus so much on them, and to go for a walk. I'm glad she suggested that and I wanted to do it, but I was a bit scared to deal with the contractions in the outside world. We went out thinking we'd go one block away from the house. I had a few contractions and was able to manage them. So we decided to go on Cortland Street a few blocks away to the coffee shop. We stopped at the pizzeria because it was smelling good and I had a few bites of a slice, in between two contractions. Then we decided to go up the hill... which I have been doing every day for a week. I was hanging from houses' fences and my husband when I had contractions. I didn't really mind what people could think. I climbed some stairs at the top of the hill and we came back. It took us a long time! The weather was really nice.

When we were almost back home, I know I needed to go to the bathroom. Ti told me that a change could occur after I went to pee. I had a strong contraction on my outside stairs. And indeed, everything changed as soon as I went to the bathroom. Contractions began to be every 3 minutes and at least 1 minute long, there was a clear pattern change as they were stronger and closer apart. Everybody was trying to have a few bites of food in between contractions in the kitchen. We called Maria and asked her to come, she arrived less than 30 minutes later.

Maria checked me and I was 5 centimeters, exactly what I was thinking and hoping for! But she also said that my cervix was thin and soft and that I could dilate easily the next centimeters... I think this few words set up a new tone and direction in my labor. It took me 12 hours to dilate until 5cm, and only 4 hours more after that until the baby was born.

At this point I labored standing up and doing squats when I was having contractions, leaning on my husband or Ti. Ti was massaging me in the back and legs and it felt great. Then something strange and very pleasant happened. I felt like a hormone rush and very confident. The beginning of a contraction was painful, then I was working hard on relaxing my pelvis and cervix as much as I could, until reaching a point in physical relaxation that was making the pain disappear, making me feel so powerful and happy! I was laughing, in the middle of the contraction, kind of a laugh and cry at the same time, because it was so good!! I was working with my body, with my baby, and everything was in harmony. I was feeling the pressure and the baby coming down at each contraction.

I started to feel tired on my legs and moved into the bed. One contraction later I was feeling hot and cold, a bit dizzy and nauseous. I almost threw up but didn't (which was one of my fears, with tearing, though at the moment I was okay with it!). I thought I was in transition because it was exactly how I felt when I was in transition during the labor of my first child. Then I decided to lay down in the bed, on my side. I wanted to rest, but it took me a few contractions to feel okay dealing with the contractions in this position. I think Maria checked me again to see if it was a good time to go in the pool. I was 8-9 centimeters.

I went into the pool and it felt AMAZING! I didn't want to work anymore! I just wanted to relax and enjoy the sensations of being in the water... Contractions slowed down. Maria encouraged me to go back into a squat position, in the tub, and I was reluctant because I knew it would bring more pain and stronger contractions. It took me a little while but I did it and it definitely brought back strong contractions. Then Maria checked me again and I was fully dilated. She could feel the bag of waters and I asked to break it to facilitate the pushing phase... she managed doing it in the water with her fingers. I was getting impatient, and scared. It turns out this baby was bigger than my first one (8lb6oz over 7lb10oz) and I could feel stronger sensations/pressure while the baby was descending. I couldn't see the pushing phase coming. I was asking for help and getting a little bit dramatic... In retrospective I think it was my way to stay connected to my birth team, I needed them to know I was struggling and needed their support, and they all responded to it.

I couldn't feel the pressure and the urge to push in the tub as I probably could have felt it outside. Maria offered to go sit on the toilet and I didn't want to, I wanted to give birth to my baby in the water! I started pushing and I was feeling like I didn't know what I was doing. I was feeling unstable in the tub and asked my husband to come in so he can support me, which he did right away. Finally and very suddenly I felt the head coming and decided to get it out through the same contraction no matter what. I was crowning and asking what to do, my husband I think reminded me to do the horse lips like I told him to... I tried to breathe and relax my jaw which was so difficult... but it was fast and the head was out. I put my hands on his head and felt his hair. Another contraction and the rest of the body came out. My baby boy came on my chest and he looked perfect... He was covered of vernix and so soft! I loved his smell. The pushing phase lasted 23 minutes. My husband was crying, telling me that our son was beautiful.

I was loosing some blood so Maria wanted me out of the water pretty quickly, to know how much I was loosing. Maria clamped the cord and Yann cut it. The second midwife Sue took my baby while I was getting out of the tub to sit on a birthing stool, where I delivered the placenta. Sue gave me my baby back very quickly. I was helped to go in my bed after that. The bleeding stopped quickly and everything was okay. Baby was doing very well. I had 2 stitches first degree and Maria did a great job with it. It was the busiest time for the midwives who were making sure both of us were doing okay and very focused on what they had to do.
Before and after that, they were so relaxed and confident in what was happening! That was very reassuring to me and made me feel everything was normal, reminding me this was a joyful event. My boy latched on on both breasts and was sucking very actively for a while. After about one hour, my daughter came to meet the baby and this was a very strong and emotional moment to me.

A few reflections

Before wanting a homebirth, I wanted midwife care for this pregnancy. I wanted continuous care, choose/know the person who will be there when I give birth, and get some postpartum care (6 visits instead of 1 through the regular hospital care...). When I realized that midwife care was going along with homebirth, I started to think about it, get more information, go to Meet the Midwives at Natural Resources and watch homebirth videos on YouTube. I was already a few months pregnant. After meeting some midwives with my husband (and getting his support about doing it), it suddenly became obvious that it is what I wanted to do.

During the last 2-3 weeks of my pregnancy, I really needed to be surrounded by other women who had a homebirth or where also planning on having one. I needed to hear about their stories in details or share our plans/excitement/concerns when they were expecting too. I have two friends who had a successful homebirths and I wanted to hear again about their stories. I established quick and strong connections with some other women under the care of Maria as well, met through the group that she is facilitating in her office twice a month. At some point I couldn't hear about other people's questions or fears about our birth plans, even coming from close friends or family, I just needed to protect myself and feel part of a community who was sharing the same goals and birth philosophy.

I think women who plan on a homebirth are even more educated about the birth process. Watching many videos is part of the preparation, and I learned so much through them... Can the baby stay safely in the water when the head is out but not the rest of the body? What does the placenta looks like and what are the ways to birth it? What are the best pushing positions to avoid tearing? Also, a homebirth includes material preparation. My midwife gave me a full list of supplies to get ready and believe me, you learn a lot while figuring out why each item is asked for... You need to think about where and how you want to deliver in your home, find a bowl in your kitchen to receive your placenta, buy some plastic tarp to protect your floors and mattress, and so on! You are in charge of your own birth event.

I had a non-medicated birth at the hospital with my first. Although everything went accordingly to my birth plan without any complications, I needed to tell mybirth story as often as possible and probably provided more details than people wanted to hear :) I think I was a bit in shock, because of the intensity of it. It also lasted 30 hours + and I was exhausted at the end. Whatever is the reason, I do not feel the same about this birth. I feel much more at peace with it. I needed to ask a few questions to Maria and to Ti a few days after the birth, but that's about it. It don't feel able to relate the simplicity of the story. I feel like I'm sharing a secret with the people who were there. They know.

It looks like I was very suggestible during this birth. When Ti told me to expect a possible change when we came back home after the walk and going to pee, my contractions began suddenly much stronger and closer, Ti called Maria within 10 minutes after that. When Maria checked on me the first time, she said I was 5 cm and that my cervix was so thin and ready that I could dilate very fast if I wanted to - and it took me 'only' a few hours to be complete. When Maria told me that the head would be out a 'handful of contractions' later, I almost got angry at her because I didn't want her to give me false expectations or hope... but only one contraction later the head was out! I don't think these are coincidences. I think I had so much faith, love and respect for all the people around me that they were really able to influence me - my labor and my body. Considerably! Trusted people and familiar environment are invaluable.

Midwives are amazing. They know exactly what to do and what to say, at the exact right time, to help you get going, reassure you, or just help you to keep trusting your body. They are not necessarily talking or doing that much... but when you need them they are here! A few times during the pushing phase I screamed "Mariaaaaaaaaa, help me!' and she did. They have a very safe presence and never give you the feeling that they know better than you what is going on. They let you take the lead so you feel powerful and able to push this baby out.

Someone asked me if there were some disadvantages of giving birth at home. I would say:
- there is quite some work to do during the first few days after birth for the dad, in terms of cleaning up (doing laundry to wash the sheets and the towels), especially if it was a water birth, and you can't really wait and let this sit for a while ;)
- it is wise to make plans ahead for the first few days: since you are at home and more likely walking fine, people around (or yourself!) may start doing things on day one that nobody would expect you to do if you were in a hospital... it was almost like nothing happened and I realized it was wrong, I was not ready to go back to 'normal' life especially with a toddler around, so I forced myself to take the time to heal, recover, and enjoy those precious few days (but I wish I had envisioned it ahead of time)
- financially: since we are at Kaiser, we had to pay out of the pocket all costs (somewhere around $5000). We have no regrets at all, of course, but that's an aspect to consider.

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