Beer and Emergency Birth

Those two things do not fit together.  I can see it, too.  I'm southern.  I chit chat.  People tell me things.  Odd topics get related.  We talk about who our people are.  We make connections.  It's like a game.

Abita Mardi Gras beer--does it get much better?  Well, if you get to talk to an EMT about catching babies because of it, yes.

Here's how it happened--I'm at the grocery store checking out.  The cashier is ringing up my beer, so we naturally start talking about beer.  We both agree that we really enjoy a nice flavor.  She likes an apple beer and Southern Pecan, so I tell her that Lazy Magnolia Brewery's other good one is Indian Summer.

We both agree that plain old beer now tastes like pee.

"Oh," I say, "Excuse me, that was vulgar." 

"I'm an EMT.  That's nothing," she says with a smile.

I tell her I'm a doula so pee and bodily functions in general don't phase me.  I've blotted bubbles of meconium (this is normal with breech babies as they get squeezed down like a tube to toothpaste) off a breech baby's bum as she was being born and wiped a pushing mama before.  It's just not a big deal.

"That's one thing I haven't had to do yet--deliver a baby."

Hmmm, me either, but opportunity is calling my name.  I tell her that precipitous births are usually pretty safe and healthy.  All you really need to do is catch.  She says that's what she's been told.

The one thing in EMT births that always bothers me is how the cord is handled.  I've heard 2nd hand and from EMTs that telling parents to tie off the cord with a shoelace is still in the script.  Yikes!  Why not whip off that shoelace and flush it in a dirty toilet a few times.  It might clean it up a bit.  I cannot think of many things that get nastier than and old shoelace.

So, I smile and say that other than catching, put baby right onto mom's bare chest and leave that cord alone (that might have come out more as a threat).  It's still giving baby oxygen as long as it's pulsing.  She is interested.  She didn't know that.

The main myth I aim to dispell about cord clamping is backflow--the blood being transferred from placenta to baby will not backflow!  It is being pumped, so it is pressurized.  Now, gravity can affect how much is pumped in or out, but immediately clamping for fear of the blood draining out of baby is absurd.  The actual reason we clamp immediately comes from the days of twilight sleep and general anesthesia--the drugs used to knock mom out were so dangerous to baby that getting baby away from the influence asap was critical.  What else does that tell us?  That pain medications given to mom quickly cross the placenta and affect baby?  Yes indeed.  This same reason is why narotics like stadol, nubain, and fentanyl are not used near the time of birth.  They are known to negatively affect baby's breathing.

I quickly tell her that blood backflowing is a complete myth and that there is a substance called Wharton's jelly that beings to naturally stop the flow within the cord usually about five minutes after birth.  I reminded her that unless you have a NICU handy, it's not a good plan to cut off baby's source of oxygen.  It creates a problem where there was none and buys you time to get to safety.

All of this transpired in about 3 minutes.  It was kind of neat.  I might find a baby-friendly set of emergency birth instructions to pass her the next time I'm shopping.  I should probably keep a set* in my doula bag.  The workbook we use in class has a page for emergency birth.  It doesn't happen all that often, and I would never ever use them to replace an actual birth attendant (midwife or doctor).  I am in no way, shape, or form qualified to catch a baby.  I would in an emergency if I had to, but I would not encourage an intentional "oops-we-didn't-make-it-to-the-hospital."  It's all about using evidence-based practices.  They improve safety and outcomes no matter where you are.


The first of 3 grand rounds videos:
http://www.youtube.com/watch?v=W3RywNup2CM
http://summaries.cochrane.org/CD004074/effect-of-timing-of-umbilical-cord-clamping-of-term-infants-on-mother-and-baby-outcomeshttp://www.midwiferytoday.com/articles/neonatalresus.asp
https://www.youtube.com/watch?v=W3RywNup2CM&feature=kp
http://www.mothersofchange.com/2012/01/whartons-jelly-miracle-tissue.html

*It was frustrating to see this ACNM PDF referenced all over the place and not easy to access in full form.  Do not use in place of a care provider, but in the event of a precipitous birth or other emergency, it's a good one.

EDD: Egg Deposit Deadline

First egg ever

6 egg day

 23 September 2013

One of our six chickens has just begun laying.  Her first egg appeared two weeks ago today.  The first few were small, the last few have been about the size of a store bought large egg.  They are all delicious.

She's been giving us one a day, usually mid-morning, so I've gotten in the habit of expecting one in the morning.  I walk to the coop confident that I'll find another pretty, blue egg waiting in the egg box.  I sweet talk her, pet her, and tell her what a good chickie she is.  If the box is empty, I just come back later.

The past couple of days, though, I've really been almost peeved that she's not laying on a schedule.  I've been giving her an EDD, a deadline based on my convenience

About when it all started

Bitsey, the boss, mean muggin'

I've also been anxiously watching the others to see when they'll "go."  My two red stars or red sex-links were supposed to be the first ones to mature and lay eggs.  Neither is yet, despite one being the quickest to physically mature. I have been going out more and more to check the egg box as they seem closer and closer to laying.  Still, it's just been the one blue egg daily.

She isn't on my clock.  Gosh, somebody slap me.  Hi, my name is Kate.  You know, the birth activist who really thinks due dates are a complete myth?  What is the deal here.  I've gotta back off and let these feathered ladies do their thing.  They really do remind me of ladies of decades past with ruffled petticoats peeking out from under long skirts.

So anyway, due dates...estimated dates of confinement, expiration dates.  Yeah, they are all crap if you are healthy and your baby is, too.  I just read the most amazing birth story of a first time mother who gestated happily for 43 weeks and birthed a 10 pound baby boy with her patient, supportive doctor cheering her on.  Wow.  Where is he?  Can he teach seminars around the country?

Many of us, myself included, do have a last minute panic and feel like yes, I am going down in history as the first woman who was pregnant for forever.  We put so much pressure on ourselves sometimes, and so do the people around us.  It bubbles over as a meltdown most often or the kind of grumpiness that puts you in a funk.  I don't want anybody to spend those last days of pregnancy down and/or anxious.

It's just so hard for me to hear about an intelligent, informed mother going back and forth with her provider about an arbitrary date and being pressured, scared, or convinced to accept intervention when both she and baby are still thriving.  Even worse is hearing the woman who says things like, "I never could go into labor on my own."  Your dates were wrong, my dear, not your body's clock or hormones.

Yes, there are women who carry babies ten full months, over 42 weeks no matter how you add up the dates, but I honestly think that is rare.  Far more commonly do we miscalculate whether from lack of knowledge of how it actually all works, business, or just forgetting to track a month or two.  It's easy to do.  "Wait, did I ovulate last week or the one before?"  That one week makes a huge difference depending on your provider who will likely rely on a date from an early ultrasound (which you do NOT have to have).  Even fundal height can easily be off depending on who measures and how they do it.

We didn't all start menstruating on our 12th or 13th birthdays did we?  Do we all ovulate on day 14 and have 28 day cycles.  Do we all experience labor the exact same way?  Do we all have our morning (or afternoon or evening) constitution at the same time?  Do we all like to be intimate at the same time of day?  Nope.  Why on earth would we all fit into the very narrow window of acceptable dates for giving birth?  Great apes have something like a 60 day window.  Why is ours 28 days at best in most situations, since 37-40 is what's okay for women by the standards of many care providers?  Bravo for the evidence-based practitioner who understands that 41 and even 42 weeks are nothing to fear.  Sure, it's a period of watching and waiting, but not one inherently fraught with danger and fetal demises.

There are multiple ways of calculating your dates, at least 5.  Mine with Isabelle were spot on, just a few days apart.  With Will, they were all over the calendar, some falling in July, most early to mid August.  He was born August 22nd.  I was 41+4 calculating the most generous way, which I hear most midwives find to be the closest date to go by.  On "The Wheel" I would have been 45 weeks pregnant with him.  I very much was NOT 45 weeks pregnant.  He had vernix still, languno, and was quite plump.  That should give you pause and consider how many "full term" babies you've had or met who really were 36, 37, 38 weeks instead of 40, 41, or 42.  Contrary to popular belief, overdue babies do not get too big to be born vaginally.  They do the opposite.  A clinically post-term baby is shrunken since he or she has used up the mother's body's resources and is no longer thriving.  In fact, the only way to know if you were "overdue" is a thorough newborn exam and examining the placenta. 

So, as a chicken owner, I've decided to give them the same respect that I do to the human mothers around me.  Back the f&*# off.  Leave them alone.  The more I go out, the more the neighbor's dogs bark, and the longer it takes her to lay that one egg.  A watched pot, even feathered, does not boil.  If chickens didn't know when, where, and how to lay eggs, the culinary arts would be far different.  I've only had chickens since April.  People have been cultivating these charming, comical, and practically brainless birds for a looooooong time.  I bet mine will know what to do when the time comes, whenever that may be, and I bet each will do it on her own terms.

2 February 2014

That was written in a hurry a few months ago.  I literally started laughing at myself as I shut the laying box.  After Bitsey "went" (just as we birthy peeps say of "our" mamas), the other 5 followed spaced out by about a week.  There were some pheromones flying--the week before somebody else "went," the other who were already laying bullied her.  The laying ones got all exclusive.  It became a layer's only club.  Coco, the last one to "go" is still the odd man, well hen, out.  They just do not like her.

For the time being, we get 4-6 eggs a day rain, shine, or ice here lately.  All of my ridiculous frustration was forgotten until today when I realized that I've sworn to publish something daily and saw this 85% complete.  That's another bad habit of mine--jumping into a project and almost finishing, like so close it's absolutely ridiculous.  Out with the old, in with the new.

Chickens no likey ice

Sweet Coco with a pecked up comb

The two reds as days old chicks

Add caption

Girlie Day

Today has been a day full of errands.  Odd runs here and there disjointed like the movements of a piano concerto.  Somehow the closing of the piece ties together all of the loose ends.  It all fits and makes sense.  There is no more dissonance, only resolution.

The random running began with a well-earned trip to the Disney store with Isabelle.  She'd never been before.  It was awesome.  She was more than a little awestruck.  Not wild (honestly, apeshit) as I anticipated, but cool and a little blissed out.  We counted out the saved Christmas money, and she picked out just what she wanted.  The first favorite was a purse filled with pink jewel dress-up accessories, "Because I don't have things to go with my PINK dress, Mama."  At our house, one must match in costume.  No wild, disorganized get-ups.  Outfits per the princess's orders.  She is never Cinderella when in a blue Cinderella dress.  "It's just Isabelle IN a Cinderella costume," she is quick to say.  Funny kid and neat to see the complexities of preference and personality are very present even at four.  In close second was a zipper pouch filled with colored pencils, markers, a ruler--school stuff.  My mother described it perfectly when she said, "Oh for making trash.  Yeah, she does that at my house, too."  Sorry, dear daughter, fine arts abilities don't run on my side.  I'm thrilled for her to play in it and enjoy it all, but I won't be saving any of it for an exhibit at the Met in decades to come.

Quick ride on Pumba

So, home again, home again, jiggety jig after stopping to have froyo for lunch.  Mama was SO much cooler than usual today.  As soon as Will went down for a nap, I ran to a local junktique store looking for a birth stool rumored to be in some store past Walmart.  Score!  It was there.  I didn't get it.  What on earth will I do with that?  It won't be seeing any action in the near future if ever at my house.  Maybe for an office later, but our house is bursting at the seams already.

The birthing chair

On to the health foods store--how I love Five Seasons in downtown Ocean Springs.  Jan and Paul are incredubly knowledgeable and helpful.  I'm hunting for a home remedy for my sweet kitty who has feline herpes virus.  No laughing, it's very common in feral cat colonies or unhygienic places where cats are overcrowded.  Both of those describe her humble beginnings from what I can gather.  It's pitiful.  She pukes all the time, has rotten teeth, and has upper respiratory symptoms periodically with outbreaks.  We are currently having an outbreak.  So far, probiotics, grain-free crunchies, grain-free canned food just for her, plus olive leaf extract (gag, it's vile) are really helping.  She is still snot rocket sneezing, albeit less often, so I picked up some colloidal silver to treat the infection.  The outbreaks always come with a wicked upper respiratory infection.  I'm trying to avoid the vet, because the only way of treating there is with anitbiotics which kill ALL of her gut flora.  With an autoimmune issue at the root, I hate to level her defenses and kill all the beneficial cooties.

From the heath food store to the grocery store for a beer run, quite a bit in fact.  The weather is pretty.  We love sitting outside.  Beer is practically required to rock on the back porch on nice, warm evenings.  By this time, I've decided that the birthing stool is the perfect early Mother's Day gift for myself.  I mean, really, if this simple, hand hewn piece of history was picked up by someone not in the know because it was a cute little chair for wherever, what a loss!  I have imagined it's tragic end by this point--getting broken and tossed out with the trash.  Think of all the stories lost if it sits unappreciated in some corner.  That seems worse than being broken and discarded. 

The lady at the store grins when I come in the store again.  She knew I'd be back.  The first time, she told me about all three of her births.  Her kids are grown, my age-ish.  This stuff sticks, folks.  Anecdotal experiences like this morning, the random stories of ladies I've met, the research I love--it's sure nice when science backs up what I've suspected as elderly ladies tell me what they remember vividly of their experiences.

I now own a birthing chair, or birthing stool.  I'm glad I bought it.  It may be a silly way to spend money, but both of my grandfathers were born at home in rural areas of Mississippi within a couple of hours of here.   Maybe there were seats like this where they were born.  Maybe not.  I think both were caught by their grandmothers.  I can personally attest to the importance of something sturdy to hang on to when giving birth--squatting bar with Isabelle and the handles of the birth tub with  Will.

My dad's father was born in his grandparent's home in Wayne county Mississippi almost a year after his mother's first baby was stillborn.  He and his sisters settled on calling her a "community nurse" when they were telling me about her and how they were all born at her house.  Apparently, she served the area in many capacities, assisting the local doctor on house calls and catching babies when needed.

My mom's father was the youngest of five boys born at home in Covington county Mississippi.  I think he came too quickly for the doctor to make it to the house in time.  His grandmother stepped in to catch there, too, I believe.  Just last summer at the family reunion, one of his cousins got up to talk about Granny.  Feisty, tiny, red-headed lady who was hailed a healer and had well-remembered medicinal and flower gardens.  She had the ability to walk in to the sickroom, take a whiff, and discern the fever or illness from the smell.  She taught her daughters how to do this as well and what plants to use.  One of those girls lived well into her hundreds, and I knew her.

If any of that is incorrect, dear family, please correct me.  It's oral history.  Nobody has written this stuff down that I know of, and I'm a couple of generations late for getting the details spot-on.

I love knowing this kind of family history and now owning a piece of local history that is tied to what I do.  It's fascinating and sad all at once that they knew so many things that I am just beginning to re-learn.  We know a lot more now in ways, but we have also lost a lot of knowledge.  Sure, I'm not opposed to medicine and appreciate having access to medical care when we need it, but I can handle a lot at home.  That said, I'm going to watch my squirrely girl wallow in her new stuff, drink a beer, sit outside at the picnic table and bench my crafty husband just threw together, contemplate repurposing a dog house into a chicken coop, and figure out in which pots to attempt rooting the elderberry that is growing wild in the lot next to our house to wrap up my day of randomness.

Mary's Birth Story: What Matters

So often when we get caught up criticizing each other, bemoaning the typical standard of care in hospitals, and talking to death what evidence-based maternity care looks like, we are overlooking something big. For the eons that humans have walked this earth, women have been having babies. Many women and babies died; many did not as evidenced by the current world population. We are moving backwards in maternal outcomes in the United States, and a disturbing number of people think it's normal if not acceptable.

I love to read birth stories in general, but this year I felt like I had an inside joke with the long-deceased mother of Christ. Mary's story is a birth story. How funny that two thousand years later millions of people recount and ponder the moments in which she experienced what is one of the most profound moments in a mother's life: birth, the process by which our babies move through our bodies and into our arms. I'm not going to delve into the spiritual side, which I do believe exists, but the human side. For those of of faith, one of the biggest mysteries of that faith is the fact that Jesus was fully divine and fully human. Whether you're following that train of thought or believe that the story is a slice of history or a myth, thanks for reading and bear with me. References to follow once I have all of my bookmarks and books at my fingertips.

She was likely lonely and afraid, not as the mother of the Word made Flesh, but as a teenage girl away from home about to give birth in a strange place without her mother, sisters, or aunts to serve as her guides. I bet I was the only one in church last night imagining what laboring on a donkey would have felt like, imagining what might possibly be going through this girl's mind.

Did she pray? Did she cry? Did her fiancée wipe her brow and hold her? Odds are good that she was not lying on her back with her knees pulled into her chest as the shepherds counted to ten. I'd guess she was drawn instinctively to the warmest, darkest corner of the stable or space. She probably lifted her dusty skirts and squatted just like any good ancient would to defecate. Her baby probably gently landed on cloths, straw or Joseph's waiting hands. The sound of his first grunts and cries were likely the sweetest thing she'd ever heard. Nobody rushed to clamp and cut the cord, no overly anxious nurse whisked him to the other side of the room to be weighed and measured. She probably waited, took that moment to exhale, and reached for him. She probably sat back and opened her garment to place him on her chest where he nursed his fill and slept.

In those days, I can only imagine that a woman prayed to survive pregnancy, give birth to a live and full-term child, not to die of infection or blood loss postpartum, and to remain healthy and nourished enough to breastfeed. In Mary's case, I guess I should add in not be stoned for a forbidden pregnancy it of wedlock. That's a pregnancy concern that has never worried me. There were no prenatal tests or checkups. There was no "deadline" after which a greedy, lazy, or overbooked care provider would arbitrarily schedule a birth. Cesareans weren't an option when desperately needed, much less purely elective ones for frivolous social reasons. An obstructed labor meant at least one would not survive. In many cases, there was no one but another woman who'd had a baby to provide support. They just wanted to live and for their babies to live.

Have we forgotten that ultimate goal? It sure seems like care providers who casually intervene in otherwise normal, healthy pregnancies have. They are risking lives inducing, augmenting, and performing more than twice the cesareans WHO has recommended since the 80s.

The birth plan choices we have are privileges as many women in the world still struggle to survive and produce offspring who will survive. Abuse and overuse of tests, procedures, and interventions intended for rare problems disgusts me. It should disgust you too that over 20 countries are ahead of us in terms of maternal and infant outcomes.

There is good evidence to support that more interventions in labor do not produce a healthier baby. Why do it, then, if it is a fact that maternal morbidity and mortality increase as those interventions increase. There is a direct correlation. Have we lost sight completely of the thing the human race has been struggling for thousands of years to do--bring more women healthily to and through labor and enable them to hold and nurture their healthy newborns?

We have reached a new low in maternity care when maternal mortality has risen for the first time since blood banks and antibiotics became widespread. Yes, the actual number is small, but maternal mortality has doubled in the last 10-15 years. Doctors don't seem worried about that, but they sure are worried about those numbers that say twice as many babies die in utero past 42 weeks. It's a smaller percent increase than our maternal mortality rate. Let's compare it to the number of non-medically indicated inductions that end in cesarean, the number of women whose fertility is affected by a cesarean, or the number of women who suffer from 3rd and 4the degree perineal lacerations. I don't see shifts in practice there regardless of piles of studies.

Chances are nobody will be telling my birth stories or yours in two thousand years, but I'd settle for moving towards a way of mother making that truly values the lives of both mothers and babies, nurtures the unique dayad that is created, and seeks to lessen number of challenges we must face to get our babies here safely.

...And Then He Turned Two

August 22, 2012

August 22, 2012

                                                                
Two years ago right now, I was beginning to think maybe I wouldn’t be pregnant forever.  It somehow feels right to tell the long version of the story now.  That morning I deep cleaned the downstairs of our house—like vacuum hose to the cracks, crevices, blinds, and baseboards kind of cleaning.  Frank and Isabelle took Clarissa to the vet for her itching feet, something that got progressively worse over that summer.  It was Saturday, August 21, 2012.  The best guess dates we had been able to come up with based on conception was August 12-14.  At almost 42 weeks, it was abundantly clear that baby had other plans.

 

My days were paced by meals, walks, playtime, and Isabelle’s sleep.  I let myself notice the tightening after lunch while Isabelle napped.  My first labor was long, so it seemed like a good idea to rest.  Frank and I snuggled up for a nap.  I am a restless sleeper.  He falls asleep a half a second before his head hits the pillow.  I couldn’t sleep, deciding instead that I’d like to start labor being clean if possible.  Frank stirred as I hefted myself plus 50 some-odd pounds out of the bed and reminded me to take it easy.

The shower felt great.  I pulled on these bright green yoga capris and a maternity tank handed down from a dear friend who’d had two inspiring births herself.  I gathered my comforts around me literally, the things that reminded me of relaxing, releasing, hard work, and those around me who believed in me and in birth.

A few days before labor began.

I don’t remember much of the rest of the day.  At some point I called one of my midwives, though my contractions were still 10-12 minutes apart.  I had not had a single contraction in pregnancy, excepting a day of “irritable uterus” around 34 weeks from being dehydrated.  Walking 3 miles in July will do that to a pregnant lady.  I figured at around 42 weeks the contractions meant something was coming.  I also called my parents 3 hours away and suggested they get gas, pack a bag, and start making a plan.

Back to Saturday--it was skin-scalding hot outside.  Isabelle had just really begun to want to watch a kid show here and there, so we all hung out watching Backyardigins downstairs once she woke up.  I wanted her to sit with me so badly.  I made her a mini pizza on flat sandwich bread and grazed on some myself.  The contractions kept coming slowly and pretty gently.  I didn’t have to stop what I was doing, and it was hard to notice the beginning or the end.

I wanted to do the “last” bedtime with Isabelle as our only child.  She was excited about wearing her “Big Sister” shirt, though at 22 months, she had no idea what a baby coming really meant.  We read, rocked, and sang songs.  She fell asleep on me sucking her paci.  We had weaned at 16 months, because it just hurt really badly.  In retrospect, I wish we’d kept going.  I think it would have eased the transition for her.

It was getting a bit harder to sit still through the contractions during her bedtime.  I was able to be “normal” for bedtime before the real restless early labor stuff started.  Again, there is a big gap in my memory from now until several hours later.  I texted back and forth with the on-call midwife, and the contractions got slowly stronger and closer.  I tried again to rest, and Frank rather hurriedly set up the birth tub in front of the fireplace.  He was very worried about having the “nest” ready in plenty of time in case my labor turned into one of the notoriously fast 2^nd babies.  No such luck!

I was upstairs while he did this.  Even in a big pile of pillows on my side, it was hard to be still and lie down during contractions.  I did this for a couple of hours, moving around as I needed to find comfort.  Maybe I even napped a little between rocking into child’s pose with a pillow under my massive belly and relaxing between the contractions.

I got up and went downstairs to check out the setup and eat something—greek yogurt with strawberries, blueberries, and honey.  Weeks earlier, Frank had helped me string long, gauzy white panels embroidered with delicate silver starbursts from wall to wall.  The living room, which really had my sewing table, some toys, and a stray chair in it opened right into the kitchen, and I knew I’d feel weird laboring with people milling around the rest of the house in my sight.  It created such a sense of privacy and closeness to have those simple pieces of material strung on a clothesline from wall to wall.  Contracting still, I tried out the tub, partly curious to see if it changed anything and partly because I just love a big tub of hot water.  It was delicious.  There is no other way to put it.  It also relaxed me so much that my contractions slowed down.  Not time to get in, yet!  

Frank says I look like I'd been hit by a truck.

We went up to try and sleep again around 11pm—seriously, after 2 nights of no sleep with Isabelle, I was hoping not to start out that exhausted again.  Frank, again, was asleep in no time.  I showed him where to push on my top hip, and he’d wake up enough to give a good squeeze during a contraction.  They were getting stronger, the beginning and ends were more noticeable.  I had a rice sock heated and propped under my belly or against my low back for the crampy, achy feeling.  

After a while, Frank was snoring, and I was getting really uncomfortable.  A summer thunderstorm had blown up outside, and my labor seemed to match the growing intensity of the storm.  It was taking all of my focus to relax and be open to the changing sensation of the contractions.  With one, I could not stand lying down anymore, so I slid my legs off the bed and sort of slithered onto my hands and knees.  Ah, so much better.  That turned into wandering around our room and bathroom, stopping to lean on the counter or dresser, lean over the side of the bed, or get on hands and knees to sway through.

By 2am, I was not going to rest, and I needed Frank to be awake with me.  The storm had stopped.  We went downstairs.  He checked the water, pumped out some cooled, and refilled some hot.  I really wanted to go outside, so I walked around the driveway for a little while.  It was surprisingly cool after the rain.  We walked around the block (again, on a secure military base) in the dark, stopping to slow dance through contractions.  At some point, Frank told me with more than a little surprise that they were 6 minutes apart like clockwork.  I didn’t care about the time and had not even noticed he was wearing a watch.  It was getting real—I finally had the “maybe this is it” feeling.

We came inside around 3am, and I got in the tub for a little while in the last bikini that fit enough to squeeze into.  Again, the water was delicious, but my contractions stayed strong and steady this time.  Frank asked if I thought it was time to call my midwives to come to the house.  No, I didn’t think so.  I was still trying to think the baby out.  Even though I knew better, I was doing labor math—no mucous plug, no bloody show, not in the “out-of-it” laborland.  It’s going to be a long time.  Maybe I’m being a wimp about these contractions.  Maybe they're going to stop completely.  

I got out of the tub, snacked on something I can't remember, put on a tee shirt, and decided to labor in the bathroom for a while.  Let me tell you about laboring on the toilet.  It’s a good place.  Even in the hospital on pitocin with Isabelle, the only place I wanted to be was in the bathroom by myself in the dark.  Think the basic, mammal part of my brain was looking for a safe, dark cave?  Yep, me, too.  So, the toilet—it’s the only place we “modern” women are conditioned let go of our pelvic floors in the way a baby needs to move down and out.  Immediately, the next contraction was more intense, the pressure increased, and the peak seemed longer. 

  

After a few of those, I wiped and there was a glop of mucous with some blood.  My apologies if this is too much information.  This is a birth story, a real one.  Goo, blood, and bodily fluids are part of birth.  They aren't gross or embarrassing.  They just are. From then on, I had a bit more mucous and consistently saw show.  This is good!  Show means dilation, but again the labor math caught me—so many people pass a mucous plug long before labor.  There’s no way this is active labor.  I can’t be very dilated.  

 The fact was, nobody knew how dilated I was.  My midwives didn’t even ask to do a “check.”  They didn't need to, figuring my first baby came out just fine even with a nuchal arm.  My body knew what to do.  Why make me uncomfortable and increase the risk of infection?  I’ve never understood the point anyway, other than morbid curiosity.  It doesn’t tell you a thing about when the baby will come.  I know two people who’ve been 5+ cm for weeks and not in labor.  Personally, knowing that would have driven me crazy. 

Frank, apparently is better at all math than me, even labor math.  Maybe it's more like calculus than algebra.  He literally slept through AP cal, so that's got to be it.  He saw very clearly the shift in how I seemed, the emotional signposts that say this is active labor, baby is coming.  He did NOT want to have a surprise unassisted birth.  He quietly leaned into the small powder room from the hall and again encouraged me to have the midwives come.  I couldn’t cope with the contractions and argue, so I agreed, even though I really did not think it was time.   My parents were about an hour away and would be to us around 5am, too.

That settled, I waddled back to the tub, and Frank got in with me.  It felt a little silly at first, like toddlers in a giant bathtub together, but the first contraction back in the water was wonderful with his support.  We had a big sponge floating around, and he would squeeze the water slowly across my shoulders and upper back during contractions.  The rhythm the sensation and sound created became something upon which I depended.  He didn’t ask question, he simply followed my lead.   

By this time, I was vocalizing with the peaks of contractions, a low mmmhh on exhales.  My breathing pace comes naturally.  When I run, I count the breaths in my head.  I had no idea how this pre-set rhythm would help me.  I stretched out my same old rhythm as my breath deepened and my exhales grew longer.   

We quickly fell into a pattern together, and  this working together was a whole new kind of intimacy.  It was romantic.  There was nothing gross or scary.  It was simple, powerful, and the oxcytocin was flowing.  In retrospect, the endorphins played a role in this love-buzz feeling, too.

Frank went to get my mom at the gate.  Even he figured we weren’t that close to babytime.  The 3-4 contractions alone were harder, still manageable, but not as good as with the simple presence of the person with whom the baby was made.  It’s true that to facilitate labor, make an environment as similar to the one that got the baby in as possible.  More apologies if that makes you blush.  First mucous and blood, now sex--like I said, this is a real birth.  Stop compartmentalizing--birth, intimacy, sex, love, and trust all go hand in hand on a chemical level. 

It was a relief to have my mom there.  My dad went on to the hotel.  I’m not sure if I would have felt as uninhibited with him there.  My dad and I are close.  He is a loving, gentle kind of guy, but he is pretty squeamish, and I wouldn’t have felt normal walking around partially clothed in front of him with Frank following me around with a chux pad.  Mom was so calm and not worried about me giving birth in my living room.  I needed to have Isabelle taken care of, too, to really let go and get into the groove.  By 5am, my midwives arrived.  They were so quiet and careful not to interrupt me other than the occasional doppler on my belly after a contraction. 

As they arrived, I still wondered if I was even in active labor.  I felt a little silly and figured maybe I’d be holding a baby by lunchtime.  They brought in cases of supplies, laid things out nearby, and sat quietly at our kitchen table just on the other side of the curtains.  I got out of the tub again, making a loop downstairs through contractions.  I ate a piece of peanut butter toast over the sink between a couple, knelt on the floor leaning onto the couch for another, and finally ended back up in the bathroom, door barely cracked, by myself.  I needed to be by myself.  It wasn’t lonely like when Frank had to leave.  I knew everybody was right there.  It got so intense.  I made it through 2 or 3 sitting on the toilet rocking and moaning.  I remember Amy saying, “Is she pushing?” so I must have grunted or something at the peak of one.  She poked her head in and suggested that I get back in the tub for the next one.  This was code for: “If you want a waterbirth, get in the tub.”  Midwives, ah, do I love them.  Mine could tell simply from the way I moved and the sounds that I made that we were getting very close to greeting a baby.

Roger that, after this massive contraction I feel coming, I'll be back in the water.  Forearms crossed on the countertop, I started rocking and moaning as it built.  By the peak, I was practically hopping on my toes trying to counter the intense sensation.  At some point I reached down and felt the baby’s head (still inside, not crowning) pushing against my hand.  It shocked me.  It was my moment of doubt—what on earth was I thinking having a baby at home.  This is big and real.  This kid will be coming out of me soon like it or not.  My head had to catch up with my body.  I don’t think I could even verbalize having felt this physically or emotionally at the time.  It inspired me to hurry back to the tub, though, in hopes of some change.

Oh, sinking into the warm water was indescribably good.  I coasted on the relief it brought for a couple of contractions.  The fireplace was turned on, and my hard worked on Pandora playlist was playing chill yoga tunes and haunting Native American flute songs.  I remember Andrea saying with appreciation, “Is that Nakai?”  Our sweet

Clarissa

dog was on the floor by the fireplace, calmly leaned against the side of my tub.

It was hard to get comfortable.  I tried to squat, and quickly got out of it before the contraction peaked.  All that felt right was leaning over the side of the tub, holding the attached handles, with my face buried into a wet towel.  By this time, Frank was doing the magic hip squeeze for all he was worth—and I kept telling him, “Harder.”  I heard Andrea say, “Her sounds are perfect,” and realized that I was saying, “Open,” over and over.  It was a moan, long and low, but I was saying and imagining my body opening and the baby moving down.

It worked.  Every contraction felt very long, even though they were about a minute and a half with plenty of time between.

Yes, the breaks feel that good.

Time gets funny in labor—the contractions felt interminably long, but after maybe 4 or 5 really, really hard contractions back in the tub, my body (without my conscious permission) pushed.  It was the most physically intense and surprising thing I have ever felt.  It felt like I was rocking the whole tub rocking myself through the contraction on the handles.  Afterwards, I looked up to my midwives, who were both sitting on the chaise longue nearby and said, “I’m not ready to push.”  Andrea sort of smiled with a sigh that might have been a knowing laugh and told me to trust my body—if it was pushing, it was time.

I didn’t so much bear down as relax into my body’s work and stop fighting it.  It felt so much better.  Then, in the middle of that contraction, I felt a pop and a great release of pressure.  All I could say to let everybody else know was, “ Ohhhh, pop.”  They knew what I meant. Things were moving quickly, so I wanted to go as slowly as possible breathing the baby down and letting my body stretch.  A couple of contractions passed, and the midwives asked if I felt the baby’s head if I reached inside—how much, dime or quarter?  I felt; Frank felt and said, “Definitely quarter.” 

With the next contraction, I felt the baby’s head move down a lot.  I reached down, instinctively, and put my hand on the little sliver of wrinkled head.  The force of my body squeezing that little body through me would have taken my breath away were it not for Frank’s whispered, “Breathe,” at just the right moment.  I tried to let him feel the baby against me with a contraction, but I had to push him away and go back to my new-found ritual.  My hand was holding the baby in and my body together all at once.  The baby pressed down, then moved back up a couple of times.  

One of my midwives, I can’t remember which one, came up and said, “Frank, when the baby’s head come out,….”  He had the deer-in-the-headlights look, but said, “Okay.”  He was still squeezing my hips.  I remember wanting one more contraction to ease the baby out, but at the peak of the contraction, I felt him lift his chin and, pop, there was a head.  After the intensity of the “ring of fire” (yes, it is real, and no laughing matter), it felt great to have a break and rest for the next contraction.  It is surreal to wait with a new person partially born, partially inside you, everyone in the room ready but calmly waiting.  

Sunday, August 22, 2010.  7:03 am.  9 pounds, 4 ounces of perfect.

With a grunt, and one more bearing down, the baby was out and floated gently into Daddy’s waiting hands.  Set, hut!  The moment afterward, I think I closed my eyes and was frozen with the instant relief of his little body leaving mine.  Hearing a rather surprised Frank say, “We have a little boy!” is one of my dearest memories.  We both thought he was a girl, of course either would have been wonderful.  We planned for a baby.  I turned around, and Frank passed him to me.  As he was being born, I heard Isabelle begin to stir and talk upstairs with my mom.  Within five minutes of the birth, Mom and Isabelle appeared.  She saw him, grinned, and said, “Baby!”  

Less than 30 minutes after the first picture was taken.

We sat in the tub for a few more minutes.  Frank hoped out just before my placenta came.  After the placenta, they helped me out and settled me onto the chaise just beside the pool with baby on my chest under blankets.  We sat like that for the “golden hour,” and within a few minutes he made his way to my breast and nursed.  Just like with Isabelle, it surprised me how strongly he latched and suckled that first time.  Amy brought me a big glass or apple juice, a grilled cheese sandwich, and some blueberries while he went to town.  For the coming weeks, he nursed constantly day and night.

Frank said I looked like myself, just holding a baby this time.

The next day.

So, that was all two years ago.  I’ve told the short story a lot and shared pictures here and there, but it felt like time to tell the long version.  My body was so extremely different then, it almost doesn't feel like looking at myself.  I hope my memories may inspire you to believe in yourself or encourage the mothers around you.

 It’s been fun, stressful, exhausting, and trying.  Parenting is much harder than giving birth and caring for a baby.  We’re still figuring out a lot as we go along, but the kids seem to be happy.  Sometimes this life makes me feel crazy, but I do love it.  It’s mine.  My daily mantra is: “This is my life, these are my kids.  Let me be the best mother for them.”  I don't always do that as well as I'd like.

Ten years ago, I had no idea I’d be happily married to Frank, my best friend from highschool, and have these two babies.  I’d laugh if you told me I’d let go of the dream of a glamorous career and let my heart lead me into birth advocacy and serving other women in pregnancy and birth.  I certainly wouldn’t believe that the birth of my son in our home would so profoundly change me.  It more steeled my resolve to change the way our culture tears down mothers and plants seeds of fear and doubt.  It’s not a scary medical ordeal for most healthy people, unless we choose to make it one, sometimes unwittingly with the mentality of "what is must be best."

Birth is as old as time.  The story is never new.  It's been part of daily life since before the written word, before the spoken word.  My story is big to me, but it was simple, really.  Life as usual went on in the homes around ours, and we began our new normal.  I went upstairs, got a shower, put on the nightgown my grandmother sent, and got tucked into my own bed to sleep and nurse my baby.  

From the other side of it, I feel part of something bigger, something most mothers are denied unnecessarily.  I was fully present in every moment, even the hard ones.  The pain and discomfort aren’t medals of honor I wear on my chest.  I chose those moments of intermittent, purposeful pain over weeks or months of healing from a medical birth.  Even the pain was normal—it told me how to move, how to breathe, what sounds to make to get my baby into my arms.  I’m not a member of any special club.  My body isn't any more uniquely equipped for this work than yours probably is.   Our bodies are incredibly designed  to grow, birth, and nourish our babies.  

Messing with the foundation of the physiological process without just cause is dangerous.  It changes the chemistry of your brain and denigrates the ancient wisdom of our bodies.  It chips away at our confidence as mothers.

I chose to give birth in my own home with my loving family and skilled, compassionate midwives paying close attention to safeguard my baby's entrance to the outside world.  My health and that of the baby were at the top of everyone’s list.  I would do it again in a heartbeat.  The chill that ripples through me on a good run as the endorphins begin to flow  is pennies on the dollar to the hormonal high after that birth.

I know if I can give birth, I can do anything.  So can you.

August 22, 2010