Saturday, February 2, 2013

Olive's Birth




The homebirth of our little Olive girl
liz schau


I’d call this the “nine-lives birth” because I only narrowly escaped a medicalized birth and got to have the homebirth that I wanted. This was the pregnancy that seemed to go on forever and the labor that seemed to last just as long.

My pregnancy was healthy with no complications. We don’t know exactly when baby was conceived, but around the 11 week mark, we had an ultrasound in a hospital OB/GYN office to confirm the pregnancy. I decided I did not want to have any others because of the risks I had read about. Our little baby hopped up and down on the ultrasound screen and the first words out of my mouth were that he/she looked like “a little frog! Long legs”, that’s for sure. Because we chose not to have further sonograms, we wouldn’t know the sex of the baby until birth.

My partner Chuck and I never even needed to talk about what kind of birth we would have or where we would have it -- we already both understood it would be a homebirth with a midwife and no medication. We simply intuited that we wanted to give our child this kind of natural start in life, make bonding and breastfeeding easier, and give baby the healthiest entrance into the world (without meds in her system or mine). Even if I couldn’t be in control of my body, I wanted to be in total control of my environment. So a few weeks later we interviewed and hired a midwife, Salli.

The healthy pregnancy continued and at the 36 week mark I started getting antsy, expecting to meet my little, early baby boy. I had felt all along the baby was probably a boy and that it would be small in size and come somewhere between 36 and 38 weeks -- that it certainly would not gestate the full 40. Both my mother and Chuck’s mother delivered between 38 and 40 weeks so I “knew” I would follow suit. Or so I wished. I was sick of being heavy and uncomfortably pregnant by the 32 week mark so imagining making it to 40 weeks made me feel even more claustrophobic in my body.

From week 37 or so on, every time I’d call my mother, she’d ask if I were in labor -- if this were “the” call. I’d tell her no, and get frustrated because she was just reminding me that I was still pregnant, and I felt rushed. I did not want to be rushed. My midwife had said all along that she thought I’d deliver “late” considering this was our first baby, but I didn’t want to believe her.

Despair set in as my due date came and passed. Our friends had already had their babies. Week 41 also came and passed. I was in disbelief and discomfort. Still, there was no way we would induce unless it became an emergency situation. We had done our research and knew that babies come when they are ready and when their lungs are fully developed.

I started having irregular contractions at 41 weeks and counted them all day long but they were still way too far apart to be active labor. At 42 weeks on the dot, our midwife came by for a home visit and dropped off the birth pool. I asked what we could do to “speed this up” and she did a sweeping of my membranes to get things going. If nothing started happening, we would have had to get an ultrasound to make sure the baby and placenta were fine -- something we didn’t want to do. We spoke about breaking my water that day but I decided I didn’t want to because I didn’t want to be in difficult active labor if things weren’t progressing otherwise.

More frequent, but still irregular contractions started that day after her visit (around 4 pm) and I lost my mucus plug. Things get blurry from here. The next three days are a mish mosh of activity and emotion and I don’t remember everything that happened.  But this is what I recall and what my labor and delivery have become to me.

The next day, Tuesday evening, more painful back labor contractions started and I labored in bed, on the birth ball, and in any position that was comfortable. Chuck set up the birth pool in the spare bedroom. We lit the candles our friends and family had given us in support of the natural birth to encourage me. Between the candles and hot water of the birth pool, I ended up getting hot and uncomfortable. The weather had gotten chilly a few weeks beforehand but had since gone back to unseasonably warm -- 80s or 90s during the day. I was hot and uncomfortable.

I labored and labored what seemed like an eternity in the pool, out of the pool, and so on and so on. The excruciating back labor pains radiated down my spine, into my tailbone and finally butt and legs. It is the most difficult physical sensation I have ever felt -- I’d liken it to someone hammering up your tailbone with all their might. I was scared of the pain and would scream every time a contraction came. I needed Chuck with me to grab his hand and scream; somehow that made them manageable but not less painful. We both got such little sleep during this time; we were totally exhausted and spent. There was no way I could sleep through this pain and he stayed by my side supporting and encouraging me.

The contractions became more regular and Salli and her midwife-in-training, Shara, came over Wednesday. We thought we’d have a baby some time on Thursday (10-11-12-- a cool birth date). I labored for a very long time in the birth pool, then tried to get out and get into bed to rest. It was impossible. Salli and Shara monitored my contractions and the baby’s heartbeat. Sometime in the early morning, Salli came up to me and said “okay, we need to get these contractions closer together!” with a clap of her hands, as if I had some magic power to speed them back up. Apparently my contractions had slowed and I was no longer in active labor.

One reason why labor wasn’t progressing was the baby’s head positioning -- he/she was occiput posterior and didn’t have his/her head turned the right way. It was frustrating because just one or two weeks beforehand, the baby had moved into the perfect position in the center of my stomach but had since moved back to my left side. Salli said that normally she has women push through this problem but since my labor hadn’t progressed, I wasn’t able to do that and it was getting down to crunch time. Meanwhile, my water still had not broken and my vitals and baby’s were good, aside from my dehydration (which was easily remedied).

Thursday morning, Shara had to leave so a nurse who had taken my blood once at Salli’s office arrived to take her place. The labor still wasn’t progressing and Chuck and Salli went into our bedroom to speak about the next steps to take, away from my earshot. Apparently Salli had told Chuck that since I wasn’t progressing, we might have to transfer to the hospital. He didn’t tell me this until later.

But Salli and her nurse were still trying to be hopeful and figure out why my contractions had slowed. They massaged my lower back where the intense contractions were taking place and I told them I have a left hip that is overextended backwards and a right hip that is overextended forwards, making them uneven. The baby was staying put on my left side so they used the rebozo and made some hard rolling movements to get baby to move to my center stomach and correct her head positioning. They also had me in a hands and knees position for an hour at at time. Nothing helped baby’s positioning or restarted active labor.

So that Thursday, Chuck suggested going to the Chiropractor to get adjusted to see if that would change the position of the baby’s head. So, while still having regular contractions, we got in the car and drove to the Chiropractor’s office. I was scared that the drive and being in a bumpy car would make the contractions feel even more painful, but it actually muted them. For some reason, while we were in public, the contractions were painful but not nearly as intense. Still, I cried the entire way to the chiropractor, feeling defeated and coming to accept that I would probably end up at the hospital. I told Chuck that I would and could accept it even though it was devastating to me, because we had tried our hardest to have a homebirth and I knew we had done everything in our power to do what we thought was right. He told me we were going to have this baby at home and I needed to stop fixating on the baby’s position -- if I could get my contractions closer together, I could simply push her out despite her positioning.

I got adjusted and nothing seemed to change. We stopped and got Thai food (I had barely been eating the whole week due to the labor and nausea), and also stopped by a drugstore to get some kind of medicine to numb the pain. I needed to sleep, I thought, so that I would gain some strength and sanity and not end up in the hospital. I played with the idea of taking Nyquil and aspirin. I couldn’t bring myself to take either, so I bought some icy-hot roll-on stick and slathered it all up and down my spine and butt. Even buying that was a big decision considering I hadn’t taken any medications -- even over-the-counter meds -- for about three years and didn’t want any chemicals to affect the baby. The roll-on stick did give some immediate numbing from the contractions but it eventually wore off. At the Thai restaurant, it was obvious I was in labor and braced myself and held Chuck’s hand, and a few women smiled and wished me luck.

When we got home from the errands, my contractions picked right back up again. I stepped in the door and said to Chuck, “why do they get so much worse at home?” He said something about a woman being safe and relaxed in her own home. I was moaning in pain. Chuck looked at me and said he was calling Salli because the contractions were very close together again. I said no, I didn’t want to disappoint her -- have her come all the way down if nothing was going to happen. He told me, “we paid for her services and we are going to use her.”

When Salli and Shara came back over, Chuck and I were in the birth pool trying to get some sleep. I was able to calm my senses and “ignore” the intense contractions for a while. So when Salli came in, I explained this to her -- that I was trying to be calm. I labored like this for some time. At one point, Shara came in to give me a pep talk and told me something about my joy would come in the morning (metaphorically) after I endure this part. I told her “this is so hard! Why do people make it look so easy?!”

After a while, Salli checked my cervix on the bed in the spare bedroom and decided we should break my water. I was 8 centimeters dilated but had a cervical lip (which was probably contributing to the baby’s head position). Salli tried for quite a while to move my cervix and break my water but couldn’t. She said my cervix was so soft, it was almost “watery” but that it was making breaking my water difficult because everything was so slippery. She said she would have to call another midwife who had a tool to break my water. So we waited what seemed like an eternity for this other midwife to come over so we could get things rolling and get to the pushing stage. I had to stand up the whole time because any kind of sitting or “tailor position” would intensify the contractions. Even the toilet was a major contraction inducer.

After the other midwife, Joi, came over, they laid me down on the guest bed on my right side and told me to start pushing. But then they regrouped and moved me to my bed (in our room) on my back and this was where Joi said she would measure the baby to make sure I had room in my pelvis to push him/her through, then she broke my water. I immediately felt a gush of warm relief and let out a big moan. Suddenly the contractions started coming very close together. I was still leaning a bit to my left side where the baby was, so they made me lie flat on my back to start pushing. I said, “but isn’t this the most difficult position?!”, incredulous that midwives would make me lie on my back to push. No one answered me.

I never had any urge to push throughout this entire labor experience. So when the contractions started coming closer together (what felt like seconds apart), Joi would assertively tell me to wait for the contraction to build up and then to push into it. Pushing into the most excruciating pain of my life was no easy task. Everything in me wanted to run from this pain, not accentuate it. I pushed hard, but at first didn’t know where I was directing the pushing. Salli put her finger at the tip of my birth canal and I told her to leave it there because it was helping me direct my energy. Joi told me to take deep breaths, but I could only manage shallow ones (like the kind you see in movies). At one point, Joi said, “we need to get your baby out, we need you to get mad” which implied that I was not pushing hard enough, so I reached inside of myself and found all of my might and said to my baby (in my head), “get the f**k out of there baby!” (I didn’t want to say it aloud because it sounded so ridiculous to me and I was afraid they’d all think I was crazy). I looked down and saw Salli smiling, saying, “this is awesome!” because the baby’s head started to become visible.

Joi took my hand and said, “feel your baby” and I felt the hard head very close to crowning. I remember the sensation of my pelvic bones expanding and while it was uncomfortable for a second, it didn’t hurt and didn’t make me feel claustrophobic like I thought it would. The pushing and the baby moving through the birth canal actually never hurt; only the contractions did.

Joi kept directing me and being assertive, saying things like, “you need to push hard” and when I would say, “I AM!!!” she would say, “you can’t push while you’re talking!”. Chuck tried to offer me pointers, to which I said, “you wouldn’t know, you don’t have a vagina!” (which makes me laugh, in retrospect). I also remember saying, “I feel like no one is listening to me!”. They were listening, but they also knew they needed to direct me after being in labor for so long, so that I could have this baby at home and not get transferred to the hospital for exhaustion. Alot of women talk about instinctively knowing how to birth. I don’t think I was one of those people. I had no clue what I was doing and without the help of this birth team, would have been in labor forever with no direction.

As the baby’s head approached the end of the canal, I head Joi murmur something about my perineum being extremely tight, and Salli said she’d need to make a few snips and give me an episiotomy to get the head out. I knew this was rare in the world of home births, but considering the rest of the physical pain I was in, those teeny cuts were nothing. Finally the baby’s head began to crown and I screamed the loudest scream I’ve ever made, so loud a sound I wondered if the neighbors would think someone was being killed. It burned and made my bone shift. I don’t actually remember the pain now, but I remember I screamed bloody murder and worried about the neighbors.

Joi immediately yelled “hands and knees! Get her to hands and knees position!”. So Chuck rolled me over to a hands and knees position and I gave another push or two (I have no memory of the physical sensations at this point, I was so outside of my body then) and our little baby came out. I don’t know who caught her, but someone handed her to me and I held her in my arms, still attached by the umbilical cord, and looked at her. Our baby started making little cooing, whimpering noises and I thought her voice was so cute; I immediately fell in love with it. Chuck looked at her in my arms and then yelled “it’s a girl!” and started crying. I told him to help me take my shirt off so I could be skin to skin with her, so he did. He ran off into the next room to call our families and let everyone know.  Salli said as soon as baby came out, she made a big hacking sound and got the fluid out of her lungs, immediately started making noise and was perfectly pink. Salli said she had never seen a baby cough right as they were born. She got a 9 Apgar score. I had pushed for a total of 1.5 hours.

I put her to my breast immediately and baby latched great but didn’t show much interest in eating right away. They gave me a tiny shot of pitocin to start the placenta contractions. A few minutes later, I was still having mild contractions, so Salli told me to push the placenta out and I said it was too much to have just given birth, be holding my baby, and birth the placenta. I asked to wait until Chuck came back to take the baby. He came back and took her, Salli pushed on my abdomen, and Joi told me to cough and laugh to get the placenta birthed. I did and a gush of fluid and blood came out along with it. The placenta was so small and I said that aloud while Salli examined it. I was just so surprised at how small it was.

Everyone was congratulating me and telling me what a great job I did. Joi said she had to wait and see how big this baby measured because she looked like a good size. Salli measured her at 9 pounds 4 oz and 22 inches long. Joi said, “you did a great job of nourishing your baby”, which meant alot to me considering my profession (nutrition). After the birth, my legs started cramping from loss of minerals and electrolytes so Shara pushed my feet backwards to alleviate the charlie horses. They gave me a cup of coconut milk to help too.

I had torn in several places, inside and out, along with the episiotomy and Salli said she’d have to give me stitches. I tried to bargain with her to wait until her visit tomorrow -- the last thing I wanted to do after a four day labor and 1.5 hours of pushing was to have a needle down there -- but she said I wouldn’t want to wait because it would hurt to pee and whatnot. So over the next hour, I lay on the bed and Salli stitched me up while Chuck held and spoke to our baby and cried. I was on a birth high and was chatting it up with Salli and the nurse.

When I was done being stitched up, I got out of bed and sat in the rocking chair in the baby room. My ears were ringing, I was weak, and on the verge of fainting. I had barely ate or drank anything for days and I just worked harder than I ever had. I was totally spent and exhausted. I could barely make it to the bathroom on my own to wash my hands of the baby poop (she had pooped on her way out!). Salli told Chuck she didn’t want me to be left alone, so he called off work the next day and I had my mom fly in too.

Baby was born at 12:27 am so we had that entire day to be with her alone. After we got a few hours of sleep, we all woke up and Chuck and I started talking about names. Before she was born, we knew we wanted to wait to meet her before naming her. (Then again, before birth, we didn’t even know if it was a boy or girl). We went through our list and agreed on “Olive”.

I feel so lucky that we were able to have the birth we wanted even though it was by such a narrow margin. Things seemed to go “wrong” or progress in a difficult way, but we were able to work through them all. Salli said that in a hospital they would have just rushed me to surgery and not worked with me through the issues (cervical lip, posterior head positioning, long labor, etc.). Throughout the labor, Chuck kept me sane and focused. Without him, I would have spiraled out of control into catastrophic thinking.

Some women leave their birth thinking they can do anything but this has come with time for me. Initially, I left my birth feeling like I got by by the skin of my teeth. I did have the natural birth we wanted but it was so hard and I had to work at it. Alot of women make it look easy. No birth video, birth story I read, book on natural birth, or accounts from other women prepared me for how challenging labor is.

I want other women to know that it isn’t easy. No one told me this but, it can be so hard. There was nothing traumatizing about my birth experience except for the back labor. Despite the difficulty, the narrow margins, the uncertainty and doubt, it was not a sad experience. It was a learning experience and a rite of passage and it was possible. I was brought to my breaking point and broke through it. Birthing at home, I couldn’t avoid the pain. I thought birth would come more naturally or easily to me. It didn’t, but I learned a ton and still met my goal.
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