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.