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.

The Sweet Reward by Joy (Part Two)

When we returned to our building for the second time that day, I felt a contraction coming on at the base of the stairs.  While draped over Jamie, I let the energy out with my deep birth cry.  The increased pressure down there along with my scream resulted in a pop and release of warm fluid rushing down my legs filling my boots and creating a puddle by my feet.  I pointed down to the ground during my contraction, which puzzled Jamie.  When the surge passed, I asked, “Is this what you mean?!?”  Everyone laughed.  Lu kindly hosed off the amniotic fluid for the sake of our neighbors.  With Jamie’s help, I went upstairs and stepped into the shower.

I was on all fours in the shower; the warm water provided a massage as it pelted onto my back.  I had several contractions in the shower and wailed away during them.  There’s no doubt that my neighbors can hear me, I hope they don’t mind!  It was a quarter to 5pm and I was feeling a strong urge to push accompanying my contractions.  I told Maria about this and wondered if this meant I was fully dilated.  After the shower, Maria had me lay on our bed for the second time that day and checked my cervix...I was 6 cm dilated, which meant I couldn’t push yet!  Hmmmm, but my body is telling me to push during the contractions!  How do I work with this?

Maria instructed me to blow through the urge to push, she also told me that my cervix was mostly in the front and that I should avoid being on all fours.  This would assist opening of the cervix by not adding unnecessary pressure to that area.  She also mentioned that if I did push during the contractions, while not fully dilated, my cervix may get swollen and this would make it more difficult to become fully dilated.  Whoa, so I need to tell my body NOT to push even though that’s what my body is signaling to my brain?!?!  Imagine having diarrhea and not being able to push it out because you aren’t at the toilet yet.  Like you have been holding it for HOURS but you just can’t shit your pants, - that’s how much pressure I felt down there with each contraction.  There’s no release, you CAN’T release ‘cause your cervix isn’t fully open yet, (and if you do push, well, there may be a trip to the hospital and I definitely did not want that) so you have to release the energy somewhere, and that’s what I did...

Here is what I remember about the next several hours:

• The quality of the contractions to follow and how I dealt with them was much different than the contractions before our second walk that day.  
• I was breathing differently during the contractions, as if blowing out a candle a foot away from my face with strong hard breaths and pursed lips.  
• Every other contraction I was able to overcome the urge to push and “blow it away” (I was pretty quiet and Maria had to ask me when my contraction had stopped...some of them felt like I was blowing away the urge to push for a loooong time!)
• I thought about how my breathing was similar to how you breathe when you’re on the bike climbing and going anaerobic.  You get into a rhythm.  
• Every other contraction the urge to push was just TOO strong.  Even though I had to tell my body NOT to push, my body surrendered to the urge and I felt like a bucking bronco as my brain and body conflicted with this.  (Think about how a fish flops around when they are out of the water, that’s how I looked during these surges.)
• I was LOUD!
• I visualized my breaths blowing open my cervix!
• I was in the tub and Jamie had a compress on my butt to prevent my hemorrhoids from getting worse.  Lu was stroking my hair.
• Jamie whispering encouraging words in my ear about riding bikes in the Alps.
• Toasted crumpets from Trader Joe’s with butter, honey, and sea salt cut into bite sized pieces.
• Hypnobabies playing in the background.  Today is your birthing day...
• Forcing my chin up during the contractions, even though I wanted to bear down.
• Relaxing my face and shoulders, and being VERY conscious of the effort to do so.
• Thanking everyone after a set of contractions.  Subconsciously thanking the contractions for bringing Baby G closer to me.

Almost 2 hours into the VERY-strong-urge-to-push-but-cannot-part of my labor, I got out of the tub.  My bladder felt engorged, I attempted to pee but nothing came out!  I stood in the shower, bent over with my hands resting on the hot and cold faucet knobs (remember, I could not be on all fours!) and tried to relax and pee, but even my urethra couldn’t release!  I think I was in there for what seemed to be at least 10 minutes.  Maria said she could catheterize me to release the pee.  I freaked out.  I didn’t want MORE discomfort!  I listened to the water, I thought about waterfalls, I recalled how this sensation was exactly like the one when you have to pee SO BAD, and you’ve been holding it for SO LONG that it takes like 30 seconds before you start to pee, and when you do it burns a little at the beginning.  I had that burning sensation a few times and thought Oooh, this is it, my pee is going to come out!  But it didn’t, so I agreed to have a catheter put in me for the first time in my life.

I resumed the exam position on our bed; on my back with my legs spread.  My bladder was so full that I had a separate pooch from my baby pooch.  Lu even said that my bladder was so large that she thought that the baby may have turned and her mind started to stir.  After 750cc’s of urine drained out of me, I felt MUCH better.  We used the old Brita pitcher to contain the pee.  Ha, I will always think of being cathed when I see a Brita pitcher now!  There may be nothing worse than the feeling of being cathed, but there is: having a contraction with the urge to push-but-you-can’t while being cathed!  I was 7 cm dilated.  

I got back into the tub and breathed, bucked like a rodeo bull, listened to Hypnobabies, drank more (but not as much, cause I feared that I would fill my bladder again and have to get cathed sooner than later), kept my chin up, visualized blowing my cervix open.  I even divulged to Maria some childhood stuff that I had intended to tell her prior to the birth during one of our visits, but always forgot to.  I thought that perhaps this information might be blocking my cervix from dilating quicker.  I read about a birth in one of Ina May’s books where after many hours of labor, the birthing mama’s cervix progressed and dilated quickly after she admitted some of her fears to the midwives.  So while we were in the tub and Maria was sitting on the sofa, in between my bucking bull contractions I told her some stuff that I only share with close friends.  And just like a best friend, Maria listened intently and asked genuine thought provoking questions.  

It was 11pm, we got out of the tub and moved to the bedroom.  The game plan was to get some rest.  My contractions were even stronger now with the urge to push growing steadily.  It felt like I had a poking coconut-head!  Maria said she would check me again at 3am, but if I felt that the baby was dropping and the pressure was increasing she would check me earlier.  

During the contractions I remember Lu massaging my hips and legs, Jamie lying next to me face to face, my hands squeezing his.  The pattern resumed with my blowing away the urge to push with the contractions, and with the urge to push taking over my body and me bucking hard on my side.   I started to feel my back cramping in between contractions.  It was becoming difficult to relax as my muscles were fatigued and seizing from the bucking.  Later Lu told me that I looked at her and said, “I’m beginning to have doubts.”  I remember weighing the risks and benefits of driving to UCSF.  How long will it take to get to UCSF?  How shitty would it be to have a contraction in the car?!  I don’t know how much longer I can do this!  I think I need an epidural.  What if I’m not fully dilated when Maria checks me again?    

For sustenance, I had a GU and water sometime past midnight.  Lu had cut up a baby watermelon into bite-sized pieces and my spirits lifted.  That was exactly what I needed!  The cool sweetness and juicy bits satiated me.  My confidence was starting to waver and I had to tell myself to stay positive.  I continued to visualize my breaths blowing my cervix open and hearing Maria say I was fully dilated.  At 2:30am I told Lu that I wanted Maria to check me at 2:45am.  That’s a good compromise.  I will give my body a little more time to open up.  Please be a 10, PLEASE!  Just before 3am, Maria checked me.  I remember the look of concentration on her face.  “We’re where we want to be.  You’re fully dilated!”  

Lying on my back, I remember the muscles on my face forming into a smile while slowly raising my hand to give everyone a high five.  “You mean I can push now?!”  I asked.  

I couldn’t have been happier.  I could FINALLY push!  Now this was a challenge for my mind to grasp since I had been forcing my body to overcome the urge to push for the last 10+ hours.  I had to wrap my mind around the fact that I could actually push.  OK!  Change in game plan!  YOU CAN PUSH NOW!  

For the next two and half hours I pushed.  Here is what I remember:

• Getting cathed one more time so that Baby G had as much of an opening as possible.
• I was so exhausted that I was falling asleep in between sets of contractions.
• I pushed in 7 different positions*
• For more than half of the sets of contractions, I had to rely on my mental state and environmental factors to initiate my body to have a contraction and push.
• We listened to my energizing playlist, when a song came on that wasn’t energizing enough I had Lu skip to the next song.
• The quality of my breath and how I dealt with the contractions was much different than before.  Contrary to what we were told in my prenatal yoga class, I had to hold my breath while pushing.  I was releasing too much energy from my throat and out my mouth, when I needed to be releasing energy down my core and out my yoni.  
• In our Bradley class we were told about the “Ring of Fire” which is a burning sensation you feel when the baby’s head is crowning.  I didn’t feel a Ring of Fire, I felt a “Ring of Sting!”
• Everyone offering words of encouragement when I would have a contraction.  It felt as if I had my own cheering section.  This really helped me push and stay focused.  In fact, there was 1 time when it was silent during my contraction and I couldn’t really get into the push.  I communicated to everyone that I really appreciated the cheers and I needed the words of encouragement to get Baby G out!
• Our apple TV scrolling through our photos on the TV and feeling as if our friends and family were in the room with us.
• Lu handing me a teacup full of warm miso soup to keep me going. 
• Talking out loud to Baby G in between contractions and telling him/her how we were ready to meet him/her.

Another amazing midwife named Sue arrived and we moved to the main room.  I was on the birthing stool when I first felt Baby G’s hair.  This is really happening!  We’re about to finally meet Baby G!!!!  We moved to the tub since we intended on having a water birth.  Jamie and I engaged in some nipple stimulation.  This seemed to work, however the warm water was also extremely relaxing.  I encouraged Jamie to do some clitoral stimulation since I had to rely on extrinsic triggers to initiate my contractions.  Believe it or not, I had a short but satisfying orgasm and a contraction followed.  I pushed and pushed and Baby G just wasn’t coming out!  In fact, Baby G’s heart rate had dropped significantly enough such that Maria had us get out of the tub.  I remember hearing the difference in Baby G’s heart rate on the Doppler.  This definitely caught my attention and everyone was calm.  

We resumed on the sofa.  I was lying on my right side and as I was falling asleep I would force myself to bring my left leg up to bring on a contraction.  Stay focused.  We’re soooo close!  I recalled another Ina May birth story where the birthing mama’s cervix closed after being fully dilated!  I can’t let that happen to me!  I found that for over half of the contractions, I had to mentally bring on the first contraction, then my body would take over and the next surge would be more visceral and I could REALLY push.  Baby G’s heart rate returned to normal, but I was so comfortable I was falling asleep.  This position was no longer working for me.  “I think I need gravity’s help.  Let’s move back to the birthing stool.”

---

* Side-lying on our bed, side-lying on the sofa, sitting on the birthing stool, side-lying on the floor, in the tub, back to side-lying on the sofa, and sitting on the birthing stool.