Wednesday, January 4, 2012

Birthing In The Woods- Why One EMT Chose Home Birth

This is a perfect birth story.  Well written, fantastic pictures, and an amazing birth team.  I love how this mother introduces her story and tells why she decided to share it:
"I think what finally decided me is just being able to show people -women and men- that birth can be a good experience, a highlight rather than a future horror story, and that men are a vital part of birth. I could not have made it through labor without my partner."  
As you will see, her partner was wonderful, as was everybody else.  Enjoy this story- because it is the whole enchilada- from pre-birth preparations that made her decide on home birth, down to the ending moments.  
Enjoy!
 ~~

It was a Thursday, because all of my later prenatal appointments had been on a Thursday, fitting them in around work schedules. I had  been scouring the web, mostly my favorite site, Babble.com, for the "signs of early labor". 

I thought that the occasional ab pressures I'd been having were just Braxton-Hicks, in fact I had convinced myself of this, so much I didn't time them. They weren't enough to bother me, but I did mention it to one of my wonderful (you'll hear me talk about my midwives with that adjective a lot) midwives at my week 40 prenatal appointment, in Burlington Vermont. 

She agreed with me that the pressure was probably BH, & reminded me that tomorrow, Friday, my midwives, Chenoa & Katina, & their two apprentices, Julianna & Annie, would be up in Montpelier at the State House, testifying on behalf of a bill making it's way through the state legislature, which would require all insurances in Vermont to pay for midwife care & home births (this law did pass, shortly after The Squidgelet was born: http://vtdigger.org/2011/05/17/vermont-bill-will-mandate-insurance-pay-for-home-births/). I wished them luck with it, chatted about Portland, Oregon (my hometown & where my midwives had spent some of their training time) with Chenoa, then I went to watch my partner work with after school kids in the Y's program at a local school. 

The Squidgelet's due "day" was February 9th, but everything I'd read & what Chenoa told me was that first babies are unpredictable, & usually on the later side, so we weren't really expecting the Squidgelet anytime soon. We went home that night, I helped feed our Big Blonde Boys, Bobby & Tucker (against my midwives stern instructions not to haul around 50 pound bales of hay in the winter snows; to my credit, I just slid it across the snow) & went to try to go to bed. I got all settled into bed, resting next to the empty co-sleeper already attached to our bed, laughing a little at all the stuffed animals friends & family had already sent the Squidgelet (why send him something he can't play with for almost a year?) & promptly didn't sleep a wink. 

The pressures kept coming, so often that I had to get up & pace up & down the hall, or stand next to the downstairs wood stove, staring out the window at the half full moon, looking at the snow covered garden & Green Mountains. I tried to sleep in a position I'd found most comfortable these past few weeks, on my hands & knees in the bed with a pillow under my belly, but I was too restless & I had to keep getting up & moving, so I gave up, not wanting to wake up my partner (I learned later that he didn't really sleep either). 

If it hadn't been deepest winter, with up to 5 feet of snow in places, & the temperature well below zero, I would have been marching up & down the dirt road beside the house. As it was, I imagined myself astride one of the Big Blonde Boys, cantering through the snow as we'd done just two weeks ago when the pressures hit me. 

That was the memory that got me through that long night, because I refused to wake up Tristan, as I still thought all these pressures were just Braxton-Hicks, as there were no other signs; no bloody show, I never really knew when my plug came out, & my water remained firmly unbroken.  

Later in the night, I would feel them & I would just have to stand, not breathing, for a few moments until it had passed. 
Most of the night I spent either curled up in the glider chair my father in law had found for free, under my Oregon blanket, or up & pacing up & down the hall. 

I will say this now: Only once was I ever afraid, & it was not during that long, lonely night. I am & ever will be an independent girl, so stubborn every step of the way. Asking for help isn't really in my vocabulary, & I will take this to extremes. That night was probably one time when I could have used the help, maybe, but I was never afraid. 

We had our plan in place for a home birth,  a water birth, with my two midwives & their apprentices, all EMT's, everyone living in the house with me was either a Wilderness First Responder, such as myself & my partner, or EMT trained. If something happened, the town's first responders were notified of the upcoming birth-in a town of less than 2000 people, home births were not unheard of, & the ambulance driver was the next door neighbor (next door being a relative term in our town).  

Yes, other people quietly worried about my decision to bring The Squidgelet into the world in the isolated house above town, in the middle of a long, always unpredictable Vermont winter. Questions abounded when I first brought up the idea; What if my midwives couldn't get through a storm? What if something went wrong & the ambulance couldn't make it? What if the power went out? Y

es I did realize the potential for disaster; avid reader that I am, I read every book, every blog, every website I could find (even the sometimes infamous Dr. Amy's website & comments all over the Web). But the first book on birth I read, while still in college & the thought of a baby was many years away,  was Jennifer Block's book, "Pushed". 

I was terrified by what it represented, the implications that modern medicine was telling me that my body was defective, & couldn't do alone what evolution had programmed it to do, that I, infamously independent, couldn't do without drugs & monitoring. I knew then, months before I figured out I was pregnant, that I wouldn't be giving birth in a hospital. 

I did consider a birth center, but my midwives weren't affiliated with any & I refused to give them up. Plus, the idea of being at home, where I was comfortable, where I knew where everything was, where I wouldn't have a time limit on recovery, where I wouldn't have to leave, and where the possibility of an invasive procedure was very low, was extremely appealing to me. The house just happened to be on a dirt road, up in the Green Mountains, in the middle of a Vermont winter. 

The winter part should have bothered me more, but I considered myself a veteran after 5 previous winters spent in Vermont. I knew the reality of the weather, I also had faith in the local's ability to deal with it, & there were few & far between storms so fierce-some that the first responders refused to move.

But the morning, when it did eventually show up, dawned as one of the clearest, brightest, but coldest day that winter, with the temperature in the afternoon hovering around -10. 

That was the first morning that I physically could not get down to the barn to help feed the horses with my partner, & deep in my stubborn brain an inkling began that these ongoing pressures might be something more. After he returned from the barn, to find me kneeling on the futon upstairs, my partner timed the pressures for the first time & found them about 5-10 minutes apart, & regular. 

Still, I insisted that these were just practice labor, despite the fact that during those pressures I couldn't breath, or talk, or stand upright. When I tried to get to the fridge for some milk, I was like a drunk, unable to find a straight line to walk. 

It was my mother in law  who finally got through to me, getting me to admit that it might be time to call in the cavalry. She actually made the call, for at that time I was again in my hands & knees position on the bed in the beautiful sunlit room next to the kitchen, gripping a pillow & not breathing through contractions (yes, I had finally admitted what they were) every 3 minutes or so.    

Chenoa was up with her apprentices, Julianna & Annie, in Montpelier, a 45 minute drive on a good day, & her partner & friend, Katina, was 45 minutes in the other direction, south, at another woman's regular appointment. Chenoa made the plan with my mother in law & my partner (I was pretty much totally into my own body by now) that she & her apprentices would leave the State House right then, at 9am or so, & head straight to town to check on me, then call Katina with the birth tub if this proved to be show time. 

All I remember from this point is looking out the window, at the Green Mountains tinged pink with sunrise, & my partner telling me about the rooster stew he was cooking up for everyone, made in part with one of the roosters I'd helped him process earlier that winter. 

Such a short time later, I felt Chenoa's cool hand on face, & I hadn't realized I'd needed it until right then. She convinced me to lay propped up on my back for a few minutes, so she could check my progress. That was the first time I was truly uncomfortable, as everything my body was telling me was to get out of that position. I was grateful when she let me move back to my hands & knees, & she stayed with me through the next few contractions, coaching me, telling me how to breathe.

Just a side note-neither my partner nor I attended any birthing classes. I looked, but none in the area were affordable for us, geared toward our experience, or worked for our schedules. I hadn't done any breathing or pelvic exercises. I had read a thousand birth stories, both real & fictional, & I read & watched amazing water births. 

I had an idea fixed in my mind that water would be my pain control, my haven,  as I had decided against any drugs after reading about the negative effects on the baby, on bonding & breast feeding. I was already terrified on reading accounts of mother's with severe depression that took months to love their babies, or never had the chance to breastfeed because of the drugs making them so drowsy & out of it during those crucial few hours.

Genetics were not on my side with the breastfeeding; my own mother's milk never made it to her station, & I was formula fed the whole way, so I was determined to do my best, for as long as I could. Plus, remember the independence? I didn't need no stinking drugs.

Shortly Chenoa returned from conferring with her apprentices, & told me that not only was I in active labor, I was nearly fully dilated & heading to transition. The show was moving too fast, & Katina with the birth tub was too far away, since she would have to return to their office to grab it & then up to town, so the possibility of a water birth was pretty much out. 

That was the first time I...I hesitated. The pains weren't horrible, I have had worse in my memory, but I prided myself on my high pain tolerance. But I also remembered all the warning's I'd read: Birth pain is like no other. 

That moment, when Chenoa told me there would be no large, comfortable, warm tub, no partner behind me holding me upright, was the crucial moment for me, the moment I wanted to throw in the towel. But to what? Our emergency plan was transfer to the hospital in Middlebury, 20 minutes away, & they had no tubs either, just the scenes I'd read about in "Pushed" & feared. 

It was my partner, my beloved, my hand fasted man, who got me past that moment. He reminded me that I could still have water; there was a tub in the bathroom, small & uncomfortable as it was, who talked me through that moment, spilling all those worlds I needed to hear: That I was strong, amazing, beautiful,  tough, an Amazon bringing our son into the world. 

It was Julianna who helped me to the shower, who watched me stand while the tub filled up. It was relief, of a sort, for now the pain was coming, that I'd feared would come, but I was still handling it, with Chenoa's voice in my head telling me how to breathe. 

Eventually the tub filled up, & I sat down, shifting & rolling every few minutes, trying to soak all parts of me, restless again as I'd been through the night. I was dimly aware of the full house; my mother & father in law, welcoming the midwives & showing them where everything was; all my midwives, my cavalry, moving in & setting everything up with super efficiency; my partner in & out, telling me everything that was going into the stew, telling me how amazing & goddess like & strong & wonderful I was; an apprentice, either Julianna or Annie, always with me, holding my hand, coaching my breathing, talking to me, always there. 

I knew all this was going on, but my brain wasn't really holding on to the information, I was so deep in myself. I remember talking to the Squidgelet silently, telling him the world was ready for him, on this brightest winter day, everyone was ready for him, the room was warm & bright, his father was here, his midwives were here, it was time.

Not long was I in the tub, for the water was getting cold fast, but it had done the trick of relaxing me just enough. I was in the doorway, halfway between the bathroom & the connected room, when I truly learned what pain was, when I realized all those women whose birth stories I'd read were utterly, completely right: Birth pain is like no other. Worse than having an ATV drive over me; worse than falling into a bunch of cacti; worse than getting kicked in the leg by an irate horse; worse than being crushed against the barn wall by a frightened, one ton Tucker; worse than my altitude sickness in New Mexico. 

Words cannot really describe the pain of my water breaking in that doorway, & the Squidgelet's face dropping so fast, too fast, into my pelvic bones. They just can't. A too oft used cliche, but a true one. Like my mother's old 14 pound pink bowling ball being dropped on my pelvis? 

Suffice to say, my partner bore the bruises on his arms for weeks, since he was the unfortunate one who was helping me from the tub to bed, the one whose arm's I gripped as my water broke, the one whose strong arms held me up when I would have fallen senseless to the floor, the one whose surprise at the fluid drenching his bare feet made me laugh instead of scream for pain drugs (instead of just scream, which I did for many minutes) got me through that, the worst moment, in that doorway. 

 There are moments that define us, that are written so vividly in our memories that nothing erases them, or overrides them. That moment, in the doorway, now defines me to myself, for it is always in my mind. In that moment, I knew I could face motherhood, & everything that word encompasses. 

If I could get through that pain, that moment of the most unbridled display of emotion I'd ever had, when I was gripped in my partner's arms, screaming in his ear "I can't do this, what the hell is happening to me, this is too much", if I got through that without crying Uncle, without the thought of drugs or asking for relief crossing my mind, I know I can manage whatever comes. Mayhap not gracefully, or quietly, but manage I will.

 It was my partner who got me the last three steps to the bed, where I immediately resumed my favorite hands & knees position, where I stayed for 45 minutes, breathing, grunting, occasionally screaming, as I pushed when my body told me to, or when Chenoa or Katina asked me to. This, reading the birth stories, was the time I had feared the most; I feared this time, these contractions, going on for hours, or stalling, or the Squidgelet getting stuck, or a gazillion other things going wrong. Slightly ironically, I never feared my water breaking, as most birth stories I'd read never mentioned pain when that happened, only embarrassment.    

After a half hour of pushing, Chenoa announced that for the last few pushes, the Squidgelet's head had started to poke out, then pull back in at the end of the push. That gave me the strength I needed, to keep going; the head! That meant soon, soon, I'd get to hold the Squidgelet, to count his fingers & toes, to see him. My partner was behind me, his large, work roughened hands, the hands that had started this whole thing, the hands I'd first noticed about him, ready to catch our son.


45 minutes after I hit the bed & started pushing, the Squidgelet slid out into his father's waiting hands, with Chenoa & Katina right there helping. Within a minute, I was propped up on my back again, only this time it was a relief, with the Squidgelet in my arms & my partner beside me, the midwives right there exclaiming over the purple & red beauty in my arms. 

For beautiful he was; I was prepared for a yellow, squashed, alien looking baby, from all the reading I'd done. Except for the purple face, the bruising he'd gotten when he slammed, face first, into my pelvic bones, the Squidgelet was a beauty from moment one, even still covered in blood & what else as he was. 


I will not say I loved him as deeply in that moment as I have come to; but from that moment, the first moment, he has been mine, my fiercest love, my brightest heart....& my ultimate boss man!

It took him a few minutes to announce his arrival, which he did in a quieter fashion than I would have imagined,  but I cherish still those first few quiet moments when everyone was catching their breath; our wonderful midwives, grinning at each other & at us; my partner warm & solid & amazing beside me, gingerly touching the Squidgelet's head; & the center of the show, Squidgelet, purple & warm & all mine. 

Eventually, though, there was some business to clear up. My partner cut the cord, & they showed us the placenta, the parts of it, what had nourished & cradled the Squidgelet when I was his personal jungle gym. They eased him out of my arms for a few minutes, so I could be checked on, & the Squidgelet weighed & measured & checked, then cleaned & handed back to me. 


Sadly, in that first hour after the Squidgelet's arrival, it wasn't my partners delicious rooster stew I craved, poor neglected chef as he is; it was Honey Nut Cheerios. I kid you not. I woofed down three bowls of the stuff as fast as I could, being not very steady with a spoon. 

I remember the intense happiness & relief of everyone around me, that another home birth had gone so well, so beautifully. I remember my partner, grinning like a fool & making phone calls; I remember calling my own parents, & the "Well, of course you did it" congratulations (high praise from them, don't worry). 

I remember that night, we all slept for about nine hours, & that was the last uninterrupted sleep we all got for the next two months. Even my partner, notorious insomniac that he is, slept deep & dreamless for 8 hours with us, the Squidgelet nestled on my chest for his first night in the world. 

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