Tuesday, June 25, 2013

A Double Birthday Blessing by Kalle Sousana

            We went out for dinner on Mother’s Day with a bunch of my husband, Jesse’s, relatives - a party of 13 at an Italian restaurant in North Beach.  On the way home in the car, around 8 pm, I had a few long cramps.  I knew things were starting.  The next day I felt like I was going to have a big period - just crampy.  I had an appointment to see Maria so we trekked over there on Muni from our house in Central Sunset.  She and I both felt there was no way I’d be in to see her the following Monday - the baby would come before that!  After the appointment we came straight home. 
            That night I had a few more cramps but I was able to sleep the whole night.  On Tuesday Jesse had the day off.  I slept in and then he and I went down to Ocean Beach and took a walk.  I really felt like I was about to pop.  We didn’t walk very long, just along the sand for about 20 minutes up and back.  I insisted that we lean over and at least touch the ocean with our hands for the cosmic energy.  It was romantic.  Then we went to Trouble Coffee and got coconuts and ran into one of Jesse’s friends.  It was the nicest day, because usually on Tuesdays we are with Miles, our three-year-old, but we actually got to spend a good portion of the day alone since Jesse’s mother was staying with us and caring for Miles.  When we got home I took a nap.  Jesse went off to get a shave.  That night I called the doula, Lauren, because I was experiencing contractions, but they weren’t very strong.  She came over at 7 PM and walked with us on a good 45 minute walk in the woods (Golden Gate Park), then back at the house led us in some stretching. 
            During the stretching I started to cry - it was an emotional release due to some sadness that suddenly bubbled up in me from a family problem, and I felt so open and vulnerable, and yet I know I had to get through that sorrow as part of the process of labor starting.  At 9:30 I went to bed and slept the whole night, although I was experiencing mild contractions throughout.   On Wednesday, Jesse went in to work and with Beth (Jesse’s mom), Miles and Bubby (Jesse’s grandmother) I went to the mall.  As we walked around the mall I was feeling fairly nauseated and tired and having, yes, mild contractions.  I tried to act like nothing was really going on but I felt crummy and just wanted to be at home.  Because this was my second birth, I thought things might never get more intense and painful than these type of easy contractions.  My body can just open right up easily, right?  Haha!
            We had dinner and then as we were watching TV things started to ramp up.  Around 9 PM we started timing the contractions, writing them down, as they were finally, steadily coming every ten or fifteen minutes, sometimes every 7 minutes.  I tried to go to bed, but they were getting stronger so I realized this was probably it, and that the baby would have the same birthday as Jesse (Thursday May 16)!  At 11:30 PM I called Lauren (doula) to say they were about seven minutes apart.  Then we stopped timing for awhile, on her advice, since this was still early labor.  The birth tub was assembled in the living room, so around 1:45 AM when Lauren came over, Jesse and Beth got the tarp spread out under the tub and then started filling it.  Bubby woke up and came upstairs to help out. 
            Miles woke up with all the commotion and came to see me in the bedroom where I was laying on the bed with Lauren nearby, timing and keeping me company.  The contractions were going short, short, long.  Kind of a pattern.  I was handling it okay.  There was a lot of excited energy in the house, and Miles sensed this.  He got into the bed next to me and snuggled, but soon we encouraged him to go back to his room.  Then Jesse told him, “Your baby brother will be born today,” and he looked at me with the widest eyes and asked, “My baby brother will be here today?” and I nodded, and he seemed to get it, and then he turned completely zany for a few hours, and started chatting rapidly.  Beth and Bubby took him downstairs and he finally settled down.  Beth took some hot chocolate down and I’ll never forget hearing him shrieking, “I like hot chocolate!” in his most exhausted, shrill little voice.  He passed out eventually.    Meanwhile I was still contracting while laying on my side on the bed, and Jesse was laying next to me rubbing my back and applying pressure to my earlobes, and Lauren kept bringing me water and gave me some homeopathic remedies for calm (pulsatilla was one).  They seemed to work.  We laid there in the dark and I just tried to breathe through the contractions.  I got into the shower by myself for maybe 20 minutes and was singing “Wagon Wheel” to myself with the contractions, then when I got out Lauren had me get into an upside-down position with my knees on the sofa and my arms on the floor to see if we could get the baby to turn, since he had been posterior, although I did not experience back labor so maybe he (the baby) had already turned.  I stayed that way for two contractions. 
            All night long I was waiting for the right time to get in the tub!  Lauren said I was not in active labor yet, and if I got in the tub too soon it could slow things down.  The tub was the promise, the reward, and it became my point of focus.  I also kept waiting for a bloody show and/or for my waters to break, and these things didn’t happen, so it made me question if I were actually progressing.  Lauren also added that I could not get in the tub until Maria arrived.  It was seeming to take so long.  Things were getting stronger and I was whining and flipping out a bit.  Finally it got to be near dawn, and Lauren made me some scrambled eggs and toast.  She acted like this was normal, like we were going to sit at the table and just eat breakfast, no big deal.  I did like her calm manner and she was so crucial throughout, but at the time I was thinking, What’s the matter, she’s acting like nothing is happening, hello!!  The contractions seemed to be much closer now.  I got in the shower again and sat on the toilet a bit, too, holding Lauren’s hands. 
            When I got out it must have been about 6:30 AM and Lauren said she was going to page Maria.  Then I knew we were getting closer.  I felt so much immense pressure down low, like I was going to split open.  It was massive and a different feeling from my first labor, more intense.  I’d already thrown up twice.  I sat on the toilet during a few contractions and peed.  Finally Maria arrived, possibly around 7:15 AM.  I was sitting on the couch and she checked me and said I was dilated to 7 or 8 cm.  Actually, I frowned and felt dismal right then because I was hoping I was already fully dilated.  But, she said I could get in the tub then, so I did that immediately.  Woohoo! Oh, it was so warm and felt great.  It did alleviate the pain at first, since it was hotter than it was supposed to be - 102 degrees.  Maria had Jesse dump a few pots of cold water in it to get it back down to 100, a safer temperature for the baby.  When it was cooled down just a touch, it was no longer as comforting, and I felt the same amount of pain as before.  So then I thought, well there’s no point in being in here!  I began to feel rectal pressure and the urge to bear down during contractions.   I was sitting on my knees and supporting my weight on my arms, and resting my head on the side of the tub in between.  I was nearly fully asleep in between, and the water was making me hot and sweaty.  I felt like I had no energy. 
            Maria came over and gave me homeopathic black cohosh to give me “some extra oomph” she said.  I said I don’t think I need these to be any stronger, you know!  It’s because I’d used cohosh during my first labor and it had helped the labor get going that she thought cohosh would give me some strength through the final part.  So, I took those under my tongue and pretty soon after that I decided to get out of the water and hop onto the birth stool.  I sat on it and Jesse sat behind me and supported me.  Maria checked me and said I was fully dilated.  I began to push and he was born in about five contractions, it seemed.  My sac came out intact - Maria said for me to reach down and I could feel the bulging bag of waters coming out of me.  The pushing was intense and I really felt like I was going to split in half or break apart, the sensation was so powerful.  I even may have said so out loud, because Lauren reminded me, “You are safe, and you are not going to split in two.”  With two good pushes, his head was born, and with the next push, I think his body was born, and he came out so smoothly I could feel it.  It was about 15 minutes in all.
            It was such a different experience from my first labor when I was not even aware of when the contractions were during the pushing, and pushing was much longer, and the midwife was commanding me when and how hard to push.   I only tore a tiny bit this time, too, which I’m glad about - the recovery has been easier.  Anyway, he came out “in the caul” and was born on his father’s birthday.  We saved and dried the sac, and some day I can tell him the story.  He weighed 9 pounds 3 oz.  He began crying immediately and cried for about 10 minutes straight.   The name “Arieh” means lion in Hebrew and Jesse has taken to calling him “that booby lion.”  Beth stood by during the birth and took video and a few pictures. 
            Despite Miles’s enthusiasm for watching birth videos and discussing the placenta (“a placenta is like a robot!”), Miles was not present for the birth, and came upstairs afterwards right when it was over and the cord was still pulsing.  We asked him if he wanted to help cut the cord and he groggily said no and backed away.  Well, I had expected a faster, shorter, easier labor and though this was marginally shorter than my first time (9 hours versus 15 hours), it was not any easier except for the pushing, and the pain was in fact possibly worse.  (Probably because this baby was substantially larger - Miles was 7 lbs 10 oz, so Arieh had a good pound and a half on him.)  I did not cope with hypnosis or any relaxation techniques - I definitely spent contractions fixated on the level of pain I was feeling, but with each contraction I reminded myself I had one less to go.  However, it was a glorious experience nonetheless and went just about perfectly.  I would not change a thing about it!  Being able to climb in my own bed soon afterward, and have a celebratory birthday dinner that very same night in our own home, was priceless.  

Sunday, June 16, 2013

I Never Said... by Holly Pepper

   "I never said it would be easy, I only said it would be worth it."  -- Mae West 

   I became interested in natural birthing after my sisters' births but I didn't know if it would be an option for me.  I am a type 1 diabetic so my pregnancy is considered "high risk."  I use that term in quotations because I have tightly controlled my diabetes since I was diagnosed at age 8 and never let diabetes stop me from doing something.  Exercise, eating healthy, and frequent blood sugar checks are my daily routine.  
   However, the next question is: will anyone consider me low risk enough for a natural childbirth, let alone a homebirth.  My doctors lumped me in the category of all other diabetics: type 1 and 2, poorly or tightly controlled, complications or not.  I felt labeled.  I found Maria, someone who finally listened to my story and believed the same thing---As long as my blood sugars are in control, my insulin dosing is sufficient, I'm just like any low risk woman.  With the artificial insulin in my body, I am a normal functioning body....a little more complicated to achieve, but still normal.  She agreed with this after meeting me and so the journey began.

   I was 39.5 weeks and having mild contractions throughout the day starting on Friday. Nothing strong, nothing noting birth was imminent. When I had my last non-stress test, the RN noticed contractions on the strip and I also felt them. In the 20 minute strip, I had 3. Later I asked my doctor what this meant and she said, no it could still be weeks off.  Hearing this, I didn't get excited and just went on with the day. I was getting a bit anxious because the doctors were recommending induction at 37 weeks due to it being the standard with diabetics (every single diabetic regardless of control throughout pregnancy).  Beckett was kicking a lot less in the last week and I was worried about going longer and each day I questioned if I was doing the right thing by letting my body do the work. Also he hadn't dropped as of my last appointment, so this was another reason why I didn't think it was close. We had an appointment with Maria on Monday and were planning on talking about natural induction methods. 4 days leading up to the delivery day, I took long walks (3 miles was all I could do comfortably), had sex, and did lunges and stretches trying to get my body warmed up. Anticipation was building but still needed to keep in mind it could be some time away.
   Sunday night, November 4th, I was sitting on the couch reading a book after talking with a friend about very mild contractions I'd been having since Friday. Nothing to note though, I told her, it still would be a while away. After hanging up, at 8 o'clock my first real contraction hit me. Hit me it did. Out of the blue per-say, it was pretty painful. "Wow was that a contraction?" Then 4 minutes later, another one came, same intensity. I told Mark and really didn't think this was labor, cause labor should start gradually and not be so intense. 
   After about 20 minutes of regular contractions, I started thinking maybe this is the real deal. I started making popcorn on the stove top to snack on and Mark wanted to run to Whole Foods to pick up stuff for the labor.  I was expecting a 24 hour birth so we had time, right?  While Mark was away, I was still having very regular contractions. I called Maria to say I was having contractions 4 minutes apart, lasting 30 seconds, and had been going on for 1 hour and they were very strong. She said something like, "in my experience, if all three components are not in place, this is still early labor. It sounds like you're definitely in the early stages and should prepare for delivering soon. Go to bed, get some rest and call me back when all three are in place. I'm going to go to bed now and I will expect a call when you're there, probably in the morning." I hung up and was excited yet scared cause the contractions were already so heavy. 
   Here we go, this is it. There was no way I was falling asleep tonight either, the contractions were coming regularly and had a strong urge to pace. So no laying down. I started to pop the second batch of popcorn and by the time it was done popping, my pacing became very necessary to deal with the pain and couldn't finish. Mark was back from Whole Foods and started setting up the birthing tub. The birthing tub itself was easy for Mark to set up but the issue came when it needed to be filled with water. Our sink and the hose were not compatible even with the adapter that came with the tub. Mark tried to rig it with a funnel and that didn't work and leaked all over the floor. Water was not even covering the bottom of the tub an hour after starting to fill it. Mark told me "you might not have the tub for the birth." This was not okay, I was having so much pain already.  I told that I absolutely needed it and to start filling up buckets if he needed to.
   An hour and a half after the first call to Maria, Mark called her back saying I was at 4-1-1 legitimately. They were about 3-4 minutes apart, intense and some came back to back without any rest period which made counting difficult and managing the pain. I felt like I'd prepared myself for a birth of increasing intensity starting out slowly and mildly and working my way up to the final show.  This I felt was not right.  I needed more rest periods.  In my birth prep, I planned to have my confidence and energy restored in the breaks between contractions.  With this type of labor, I felt lost and had a hard time coping.  I was scared about it getting even more painful. In other related news, Mark was still filling up the tub and it was slow going. I looked over and the bottom was still not even covered.

   Maria came at 11:40. She came in, gave me a big hug and asked how I was doing. "This is exactly what we wanted, you to go into labor naturally." (We were going to talk about inducing labor naturally the next morning at our appointment) She asked me to get into the shower and that was the best thing cause it separated me from the commotion, allowed me to focus deeply, and was very calming to my contractions. I stayed in there for over 30 minutes and honestly didn't want to get out but I started to get hot and felt a bit glutinous using all that water. After I got out, I sat in the rocking chair and closed my eyes and rested my head against the back of the chair. I was getting waves of nausea and then did actually throw up and felt better. Then sitting on the glider, Maria got me to focus on each contraction, not think about the next one, but just get deeper with my energy. The pain was mounting and the contractions were unrelenting going to a peak then 1/2 way back down and then back up again for 3-4 times. Then after this cycle, I'd get a break. My contractions were 2-3 minutes apart and 1 minute long at 1:20am. Scared again of this pain mounting throughout the night. I didn't dose off but I was able to manage the pain slightly. I kept having to run to the bathroom with feelings of pressure and urge to poop often and would just end up sitting on the toilet, doing nothing productive.
   About 2am, I got into the tub finally since it was partially full. As I did, I immediately started squatting and very mild relief came. The buoyancy of the water was the best thing and I felt I could really open up my pelvis. The water temp was warm though it read at 99. Just after getting in, my water broke spontaneously with a literal 'popping' sound underneath the water and then a gush into the water. There was no meconium and only vernix and blood. Good signs. Feeling like I was making some headway and things were really happening. Though I was still for sure in the Fight or flight adrenaline mode of "running away from the bear."
   Progress was made by my water breaking, but hearing that I was only two centimeters dilated, I literally, literally couldn't believe it.  WHAT?! This is where I started to flip out. I started talking about going to the hospital and needing pain medication---this was out of control. If I was at 2 cm, what would 10 feel like?! I cannot deal with a more intense pain than this. I understand mental focus and how important it is but I couldn't focus enough to think this way.  Maria started to say that another woman who birthed recently told her that the intensity didn't really get much worse and she was so scared of the pain of 10cm but that the pain plateaued and just continued until full dilation.  Those words were very important for me to hear, even though in the back of my head, I felt like it was just a story to help calm me down. However, I trusted that it could possibly be true. 
   Eating ice chips and drinking lots of water, I was not hungry. My blood sugar was trending up at this point so I didn't feel hungry. Before my blood sugars had been 70-100 and now they were 120-130 from all the adrenaline and labor hormones. Mark was giving me boluses of insulin through my insulin pump to aggressively manage it now before it got out of control. The pain was unbearable and I was constantly fidgeting and saying I couldn't do it. I started to say I needed to go to the hospital that I was in too much pain. Maria told me to focus on each contraction, not think about the next. At one point when I said I wanted to go to the hospital, Maria said lets give it 30 minutes and we'll re-evaluate. I never asked again, this was very clever! Mark was great this whole time and was saying you can do it, which I remembering repeating back, I CAN'T do it. Finally got into a rhythm and said I can do it. Holding his hands for each contraction was just what I needed and felt he could do nothing else to help me.
    At 3:35, one hour and 20 minutes after being checked at 2 cm, I felt the urge to push. It was like a powerful reflex that my abdomen just clenched with a tremendous force. I pushed, I shouted. Maria needed to check me again b/c pushing without being fully dilated could cause swelling and potentially very bad. So she checked me again and I was now 9.5 cm! Whoa! Less than 1.5 hours and had gone from 2 cm to 9.5, this was the most glorious, relieving news I could have ever heard. I had made great progress and also this race was nearing the finish.  Mile 22 of the marathon and I could see the finish line. I was finally going to get to meet my baby and realized it was only a bit away. What a relief. 
Maria needed to call the other midwife, Sue Balen. I kept pushing with the urges. Sue arrived shortly after being called at 4am, my eyes were closed and I welcomed her without looking at her.  Little progress was being made so I needed other pushing positions. After 20 minutes of various positions on the birthing stool, there was little progress so we then moved to the bed.
   The bed was not much better but did allow for another set of positions. It felt like I was doing something wrong or for some reason he was stuck. With each contraction, I pushed as hard as I could and then he'd slip back in. I asked if there was something else I could do. At some point, Mark said he could see the head which was a great sign of progress and I just kept trekking to the end. 
    Getting close was so exciting. I never did feel the 'ring of fire' and pushed out his head with a big push. The cord was wrapped around his head twice and Maria told me not to push until she got it off.  I then pushed his body out and he was placed on my abdomen. He felt like a warm fish and started crying right away and I took him up on my chest. I started to cry out, "my baby, we did it!!!" again and again.  We waited for the cord to stop pulsating and then Mark cut the cord. My placenta came out quickly afterwards and bleeding was controlled with quick massage.

   The feeling of being done with labor and having a small baby to cuddle with was quite spectacular.  Seeing Mark falling in love with our little one was paramount.  After a couple of phone calls to family, I walked in to seeing my husband sleeping with our baby on his chest---something I'll never forget.  Our homebirth is something I was so fortunate to experience thanks to Maria and Sue!    

Tuesday, June 4, 2013

Turned Tables

This Saturday, June 8th,2013, Holly Pepper and I will participate in the See Jane Run Half Marathon.

I'm a first-timer.

I’m nervous.

So, I’ve been preparing. Perhaps for 9 months. In the first few months, I was fatigued, sore, maybe even a little nauseated if I jogged a long way without any food. The next 3 months were easier. I settled into a routine, using the C25K phone app, then the C210K phone app, then the 13.1 mile prep. I was just jogging along at my own pace, most of the time not really noticing that I was in training. But, these last 3 months have been more difficult. Aches and pains come and go; I need to see Darci for chiropractic care every few weeks. My knee has been aching after about 9 miles of jogging. I rest, put ice on it. My back hurts sometimes. I waddle.

But now, we’re here. In the zone and the big day is coming due on Saturday!

I’m mostly excited. I feel that I have been mentally preparing myself for months. Elizabeth Rutherfurd says that you need to go out on “Confidence Building Runs.” So, I do that. I’ve taken classes, Pilates and yoga. I read books, talked to others who have done it before. I think I can do it.

But there’s self doubt too. My clients who know I’m about to do this admonish me. “But, Maria, of course you can do it. Just do what you tell us to do in birth.” Pace yourself. Don’t go out sprinting. Drink and eat. Pee. Know that there will be moments when you are going to hit the wall and that is when your team will step in to help you. Holly Pepper is my half marathon doula. She’s done so many before! She’s even finished 3 Ironman races (what??). She runs halves and full marathons, even a 34 mile race (what??). She’s done triathlons and climbed Half Done full-on pregnant. And, she’s a Type 1 Diabetic. So, everyone is telling her she can’t or she shouldn’t be doing those things. She had a baby at home. She is my perfect doula. I imagine her by my side the whole time.

Dina will be there too. On the sidelines, cheering me on with hydration, gu shots and encouraging words. Who knows, maybe I’ll even stop for a quick back massage at some point. I know a Half-Marathon is not really a big deal, but for me, I’ll be checking it off my bucket list if I actually finish.

Will I make it? Will it be painful? What will the pain feel like? Will I be able to breathe through it? Will I give up/wimp out? And how will that feel if I do?

Or, will I will myself to the finish line? Will I find the inner strength to keep going? Will I throw up on the side of the road and wipe myself off? What will it feel like to cross the finish line?

I can only hope that in the midst of my travail, I will remember you.

I want to remember Amanda O’Grady: so in the zone and capable of going on for hours.
I want to remember Melanie Holt and how she turned into a mama polar bear, full of power and determination.
I want to remember Adryon Burton Denmark and her patience through the long night (Am I really only 2 miles into this?)
I want to remember Karen Martinez and Grace De La Cruz – both inspirations for speed and joy (but maybe I’ll get to those feelings on my second or third time around.)
I want to remember Gillian Bowley and her trust in the process. AND her openness to becoming a different person. For her, she became groovy. I want to become an athlete.

You all inspire me. I can only hope that I can remember your faces while I’m jogging along. Heck, if you did it for 2 hours, 4 hours, 48 hours, 58 hours, I can at least make it through a 3 hour, self-inflicted, women-centered celebration of life.

I picked up my race packet today. My birth tub is in my garage. I think I’ll set it up for afterwards.