Thursday, May 9, 2013

A Nurse and Her Home Birth- A Birth Story

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I got a great e-mail from this mom along with her birth story and I am so excited to share it with you.  There is something special about every birth.  What I love about this story is it shows how wonderful and transformative birth can be even if it isn't roses and soft lighting.  Natural birth- it changes women and it helps them recognize their power.  

Enjoy!

On the first day of December, I woke up on an emotional low.  It was now no longer my “due month” and I was showing no signs of going into labor.  I burst into tears shortly after waking that morning, no longer one hundred percent positive I really could trust in my body’s internal wisdom.  But I managed to pull myself together and enjoy the day.  I did pick up an herbal concoction of black and blue cohosh with pennyroyal at Cheryl’s Herbs at my midwife’s suggestion; we agreed that I would start that evening with very conservative dosing (not to induce labor, just to “encourage” it).  And it was a good thing too – that was my last day as a (non-laboring) pregnant woman.  My husband Simon and I went to dinner, drove around to look at Christmas lights, and settled in with a Red Box movie at home.  While we were watching the movie (Snow White and the Huntsman – wow Charlize Theron is creepy as the Queen), I noticed that I started feeling crampy. 

I didn’t think a whole lot of it, not wanting to “jinx it,” but I did find that it was more comfortable to bounce on the birth ball than to sit on the couch towards the end of the movie.  I took one tiny baby dose of the “labor blend” during the movie, although based on how my labor progressed thereafter, I’d say my body was all primed and ready to go on its own!  (Anyone want to buy the herbs off me? ;) At 10PM I used the bathroom and noticed I was passing some of my mucus plug and having loose stools.  We went to bed that night just like any other night.  Although on some intuitive level I knew labor was fairly imminent, the doula/nurse inside me took over and wrote it off as the “teasing” that happens to most women before “the real thing.” I didn’t even mention it to Simon.

I woke up at 4AM to pee.  When I used the bathroom, I was shocked and delighted to see that I was having bloody show!  I went back to bed right away, knowing that sleep before labor (and parenting!) is crucial, but I was so giddy and anxious I did not sleep.

At 5AM I started having contractions.  They were mild but regular.  The furthest spaced they ever were was eight minutes apart, but only a few were like that; they were pretty much 5-6 minutes apart from the beginning.  Furthermore, they were pretty much lengthy from the beginning as well.  I had a few that lasted 30-45 seconds in that first hour or two of labor, but they quickly established a pattern of lasting 60-75 seconds.  Again, I tried to sleep through these early contractions, but it was uncomfortable to stay in bed, and my mind was reeling.  Labor!  I think I’m really in labor!  So I got out of bed and started pacing around our condo.  I went to the bathroom frequently and had more show and mucus plug every time. 

I had been texting with my primary midwife, Mary, since the initial bloody show at 4AM, so she was up to date on the situation (I hadn’t expected her to text back so early in the morning; I figured she’d get the message when she awoke at a more decent hour – and I also didn’t think there was any need to wake her at this point – it was early in the game and this was my first baby after all!  But she had been up since 3AM as it turned out – she was on her way to someone else’s birth in Springfield!  And this is why I hired more than one (remotely located) midwife!).

After half an hour or so of pacing around, smiling to myself with each contraction, the next big event happened on the hour: my water broke at 6AM.  It was a gush, but not a huge one (I didn’t leak on the floor ;) .  Bloody show at 4, contractions at 5, rupture of membranes at 6.  Wow this baby could be coming quickly after all!  I went to the bedroom to wake up Simon and tell him the good news.  After his initial groggy surprise, he sprung into action.  I told him I had been texting with Mary, but that I thought we should call Jessica, one of our local midwives, since it seemed like active labor was coming on fast.  He agreed, and prepared to go to the grocery store as we had planned (we wanted to have “labor food” at home for us and for our birth team). 

I called up Jessica and let her know what was going on; I told her we were alright by ourselves for the time being, but that I wanted her to be ready to come over in a few hours, or faster if things picked up rapidly.  Mary and I continued texting, and once I’d informed her of my regular contraction pattern and that I was fairly confident my water had broken, she made plans to have another Springfield midwife take over for her at her birth center so that she could drive to St. Louis ASAP.  While Simon was at the grocery store, I made oatmeal for breakfast (“midwife’s pitocin”) and blasted my “upbeat” labor playlist while I danced around the kitchen in my nightgown.  When Simon got home he thought I seemed to be having a little too much fun for a woman in labor! :)

We texted a few dear friends around 9AM to request they pray for a smooth labor and delivery for mama and baby.  Simon called my mom and his mom to let them know that I was in labor and that we’d keep them updated.  Jessica came over at my request around 10AM.  (By the way, all of the times I quote during the telling of this birth story should be understood to be my best guess.  Any of these times could be significantly off, and the closer we get to the time of the birth, all the more so!). Upon arriving, she assessed my vital signs and Doppled baby’s heart tones, which sounded perfect (120’s-140’s beats per minute my entire labor with great variability and not a single deceleration ever as far as I’m aware!). 

My contractions at this point had picked up to about every 3-4 minutes and were reliably at least a minute long.  They were increasing in intensity, but still felt very manageable.  I felt them pretty much only in my lower back – a pattern that continued my entire labor.  (I’d say I only had 5 contractions my whole labor in which I felt anything in my belly!).  Simon did counter pressure with every contraction, which at this point took the discomfort away (nearly) completely. 

I was still having some bloody show, plus mucus leakage, PLUS amniotic fluid leakage, so I was wearing what was essentially a diaper at this point.  (I’m still baffled at just how much STUFF leaked/gushed out of me!).  Despite the symphony of bodily fluids pouring out of me, I wanted to get out of the condo and enjoy the beautiful weather.  (Although it was December 2nd, it was 70 degrees and sunny outside!).  So after being assessed and getting the green light from Jessica, I threw on my maternity jeans for what would be the last time, and Simon and I set out on our walk in the park around 11AM.

The walk was delightful.  There were people all over the place, so my labor pattern did slow down a tad (labor tends to be “shy,” and is sometimes slowed or stalled by the presence of strangers and/or crowds, a phenomenon which proved to be true in my case).  But thankfully it had already been moving at a pretty decent clip, so the slowing wasn’t a big deal (actually it was nice!).  We strolled through Tillis Park and had a really wonderful time – I will always remember this walk we took together in labor.  The last walk we took as a family of 2.  We decided during our walk that if we had a son, his middle name would be James, to honor both Simon’s brother and my father.  (We had previously decided on a first name for a boy, but had not settled on a middle yet).  Well, we walked through the whole park, and then decided to hit the streets of Brentwood too. 

We ran into one of my best friend’s fathers on our walk and stopped briefly to chat with him, although we didn’t tell him I was in labor…”When’s that baby coming?”  “Oh, you know, any day now…!” We continued merrily along, me stopping to lean on random trees, cars, street signs, etc when I would have a contraction.  I was still gushing fluid randomly, and my diaper held up well…until it didn’t.  By the time we got back home, an hour later, there was fluid leaking not only through the diaper, but through my pants, down my legs, and pooling around my feet!  Certainly not my finest moment, but it makes for a funny story, right?

We got back home around noon.  In our absence, Jessica had been busy setting up various supplies that would/might be needed during my labor and birth.  We filled up the tub, as I was starting to feel like I would enjoy the relief from the warm water.  Mary was on her way, coming as quickly as she could. 

I moved around our condo a lot, meaning that I changed my immediate location as well as my position frequently.  I couldn’t NOT move!  Moving helped.  Staying still?  Umm, no thank you.  I sat on the birth ball.  I got on my hands and knees.  I walked from room to room.  I leaned on the counter, on the coffee table, on Simon.  I got in and out of the tub (whilst in the tub, I switched frequently from hands and knees, to sitting and leaning back on the side of the tub, to side-lying and letting my legs float in the water).

Regardless of my location and position, I wanted Simon to apply counter pressure on my sacrum with each and every contraction.  Of the many, many comfort techniques and coping mechanisms I utilized while in labor, counter pressure remained throughout my absolute must-have!  At some point, I felt a contraction coming on, and I said to Simon, “Go, go!  Do it!”  “Do what?” he asked, exhausted.  I answered, “The same damn thing you’ve done with every other contraction!”  Needless to say, I was feeling feisty – and working hard – at this juncture.

During those afternoon hours, I believe around 1:30, I told Simon I wanted the rest of our birth team to make their way over.  My sweet friend Allison, who is also my midwifery preceptor with whom I have attended many other women’s births this year, arrived first I think, with her 10-week-old daughter in tow.  Mary arrived around the same time; maybe it was 2:30 by now?  Mary, Jessica, and

Allison collaborated beautifully to provide me with exceptional care over the course of my labor and eventual birth.  (As it turned out, I was in labor for quite a while, so it was good that I was spoiled with 3 midwives, as it allowed them to take turns resting, while still offering me continual support and care.)  My dear friend Corinne, pregnant herself, arrived around 5, in the role of doula and photographer. 

All of these wonderful women cared for me so well during my labor.  Allison held my hands and whispered words of encouragement and affirmation.  Jessica always verbalized that baby sounded strong and healthy when she Doppled heart tones: “Baby doesn’t mind those contractions one bit!” (She also talked me off the ledge when I wanted to go to the hospital later!).  Mary gifted me with her presence, simply sitting nearby, often in silence, but very much WITH me throughout labor.  Corinne?  Well, she stripped off half her clothes and jumped in the birth pool with me!  She did a great deal of hands-on labor support, which allowed Simon some much-needed rest.

It was late afternoon or evening when I discovered that I LOVED the shower.  I liked the birth pool very much; I was in and out of it all day, but I loved the shower.  If we had had an unlimited hot water supply, I would have been in there my entire labor.  And at this point in my labor, it was actually FUN to be in the shower!  Simon came in there with me, and it was like a little vacation from labor.  I was still in labor, obviously, but rather than the focus being on the physical intensity, it was instead about our love story, and the wonder that we had created a new life and were now bringing that life into the world.  It felt like our honeymoon.  I loved it.

All throughout the day, I had not desired to have my cervix “checked” to assess dilation.  I didn’t want to know because I know that that “magic number” can really cause emotional setbacks in labor…it’s great if you’re told 7, 8, 9, or 10, but if you hear 1, 2, 3, or 4, it really sucks!  So I feel it’s often best not to know ;)

However, after laboring all day (and pretty much active labor all day), I eventually started to get pretty curious.  Especially when I started vomiting after the sun went down.  It sounds strange, but I was glad to be throwing up, and I know my birth team took it as an indication of my labor progress (women often vomit during transition, the last part of labor before pushing).  So I threw up once…and then again…and again.  My contractions remained strong and close together, and I think pretty much everyone thought the baby was coming soon.  When the sun had gone down, I moaned, “Please tell me this baby is coming before the sun comes up again!”  Mary smiled and said, “Oh yes!  I think December 2nd will be the birthday for sure” (telling me baby would be born before midnight). 

I know she would have never said this if she didn’t feel quite confident, but as it turned out, my baby fooled us all!  So there I was, vomiting, contracting, vomiting, contracting…after a while Mary asked me if I was feeling any pressure in my bottom.  I said no, none at all.  I have no idea if I finally asked to be checked, or if my birth team requested to check me, but it matters not…around 8pm, I had a cervical exam, and it’s a very good thing the results were kept from me at the time…I was only dilated 3cm.

I know what you’re thinking.  3cm?! Hadn’t she been laboring for like 15 hours?!  Yes, dear reader, you are correct.  That was the situation.  Thankfully, Mary is both very wise and a complete sweetheart, and instead of crushing my morale with “You’re only 3cm!”, she said instead, “Wow, you’re baby is very low in your pelvis, about +2 station!  You’re doing such a good job of brining this baby out into the world!” (and didn’t mention my dilation at all). 

Granted, I’ve been around “the birth world” long enough to know that if you’re not being told how dilated you are, it’s because it’s a number you don’t want to hear.  Still, I assumed the “bad number” was like a 5 or 6 (not a 3!), so I do think it’s good they didn’t tell me (they did pull Simon aside and tell him).  My birth team quickly set to work having me do various things to quicken my progress and ripen/dilate my cervix (apparently the tissue was quite tight, in addition to being largely un-dilated). 

First, I consented to and was given a vaginal dose of evening primrose oil, or EPO as it is sometimes called.  EPO is a fairly gentle cervical ripening agent; you can buy it at health food stores and take it orally and vaginally in the final weeks of pregnancy to encourage the cervix to soften and open.  I had been taking it myself for a week leading up to labor.  However, as a maintenance dose, I was inserting 4 capsules nightly.  My labor dose was much different: Mary drew up the contents of 10-15 capsules in syringe and administered it right on my cervix (for those of you who are imagining a needle because I said syringe, there was no needle…it was like a squirt gun, not a shot :)

Next, my birth team told me that I really needed to get some rest.  I’m sure it was clear to everyone that I was very tired, and since I had a ways to go, it was crucial that I not become completely exhausted.  I drank a small amount of red wine, and also an herbal tea of sorts (I know it had chamomile in it), both of which were intended to help me relax and hopefully catch a few zzz’s between contractions. 

Although it sounded absolutely horrid to me, I laid down on my bed as I was asked to and attempted to “rest” between my contractions.  I know from assisting other women in labor that any rest is good rest, even if it is between contractions.  While that may be true, I must say, when you’re the laboring woman yourself, and you manage to fall asleep (sweet relief!), only to be awoken every 3 minutes by a monster contraction, it feels like a cruel joke to call that rest!  Even so, it probably helped me get through.  I put up with this sleep-contract-sleep pattern for only a short while, before I flipped out and jumped out of bed – the pain of my labor was much more intense while lying down!

I believe it was around midnight that I began my 4th episode of vomiting.  I started to get a little worried about dehydration, knowing my body was more and more spent every time I emptied my stomach contents.  I had been eating and drinking freely during labor, in order to keep up my strength and hydration, but at this point everything that I took in just came right back out.  I requested IV fluids from my birth team.  I stood up in the bathroom and leaned over the counter when I would have a contraction; the overhead light was flipped on to visualize my veins. 

To my birth team’s chagrin, it proved quite difficult to start an IV on me.  Although my veins were easy enough to find and stick (there was flashback every unsuccessful attempt actually), they kept rolling or disappearing when the fluids were started.  Jessica tried twice, and then Corinne (who is a nurse) tried once too.  They kept apologizing that they were having to re-stick me, although I honestly didn’t care a bit. 

The discomfort of the needle stick was nothing compared to the intensity of my back labor; I actually found the entire IV ordeal a welcome distraction!  After Corinne’s unsuccessful attempt, Jessica said that it didn’t seem to be “in the stars” for me to have an IV at home.  I said something along the lines of “No!  I have to have it!  Keep trying!  Put it in my foot if you have to!  And I need someone to pray for my cervix right now!  Out loud!”  At my insisting, Corinne promptly started to pray aloud for my cervix to dilate and open and let my baby out – it really did make me feel better. 

Simultaneously, also at my insisting, Jessica attempted a 4th IV start.  Praise the Lord; that one worked!   I soon had a 1,000cc bag of fluids running into my left forearm, replenishing my electrolytes and reviving my energy level.
Now that I had ceased resting, and I had my very-much-desired IV in place, my birth team put me to work!  Mary had checked my cervix again and found it to be 4 ½ centimeters dilated (she didn’t tell me that one either, ha!).  The cervical exam also revealed baby’s head to be asynclitic, meaning it was cocked in a funny way, making baby’s descent more difficult. 

Due to the asynclitism, Mary wanted me to assume some inverted positions that would encourage baby to slip back out of my pelvis (“un-engage,” if you will), and allow him to “fall back in” in what would hopefully be a more favorable position.  Picture this: I’m kneeling at the top of my stairs, and I have my hands on the floor about 3 steps down.  So essentially upside down, yes.  (This is formally called the forward-leaning inversion, coined by Gail Tully, a midwife who is known for her techniques in “spinning (malpositioned) babies”).  So I did my inversion on the stairs for several contractions, with Simon and Corinne supporting me in that awkward position. 

After I had labored like that for a little while (I’m sure it felt longer than it actually was), I also “did the stairs” for a while: I took them two at a time and walked sideways (facing the banister).  Up.  Down.  Up.  Down.
I went back to leaning on everything.  I went back to the pool.  I went back to the shower.  My time in the shower, now in the wee hours of Monday morning, was no longer the sensual, beautiful experience with my husband it had been hours before.  It still hurt. 

Labor was hard no matter what I did.  Even so, the shower continued to provide me the best relief of everything I tried.  (The 3rd time I hopped in there, I neglected to consider my IV, now in a saline lock, and I managed to infiltrate it before I had realized and asked for it to be wrapped up to keep the water out.  I had a pretty good bruise on my forearm for a week or so after the birth, where my vein infiltrated).  I would stay in there until the hot water ran out (always a sad moment!), and then I would resume utilizing counter pressure with each contraction.  The tub and shower let me know I loved heat as a coping mechanism, so I also came to rely on a rice sock for relief, heated in the microwave and then placed directly over my sacrum, with firm counter pressure applied on top.

Pretty much everything from 1AM(?) to 6AM is a blur.  This makes sense to me, because this is when I was doing the hardest work: very active labor and transition.  I was finally getting into my “primal brain” (meaning I was letting my hindbrain, my animal-like instincts take over, and my neo-cortex was no longer “getting in my way”).  Some people refer to this as “Labor Land.”  I like that description because of the reference to being in another place…that’s exactly how it was.  I was not there, in my body…and yet that’s the ONLY place I was.  I can’t explain it.  It was ethereal, other-worldly.  I only remember bits and pieces of my trip to Labor Land…

When I was checked and found to be 6cm and Mary was excited that my cervix finally felt “like butter.” “The rest of your cervix is just going to melt away now!”
When I really started to crash emotionally and doubted my ability to birth naturally: I started fantasizing about getting an epidural.  It sounded so absolutely tantalizing…I just wanted the pain to stop!  “I keep thinking about the E word! (Epidural).  Just take me to the hospital!”  I remember Jessica’s gentle but honest reply: “Well, we can do that, Halley, but even if we left right now, it’d still be about 2 hours before you’d get the epidural, since you’d have to be admitted and have labs drawn and all that.”  %$*&!#@, she’s right, I thought to myself.  Maybe I can have this baby OUT in 2 hours.  

I managed to put “the E word” out of my mind (mostly) and sort of get over it.  How?  I don’t know.  Women do amazing things.  (I think it was mostly because the epidural was not easily accessible.  If I’d been at the hospital already, I really think I would have “caved.” To all the moms who have done natural birth at the hospital, anesthesiologist down the hall – MAD RESPECT).

More stairs…Simon falling asleep on the floor for a few minutes (well deserved!)…Mary telling me how sweet I was being to everyone even in the midst of hard labor (apparently I was pretty nice to everyone the whole time?  I didn’t feel particularly nice, but I’m glad I was!)…Allison nursing her baby on the couch…my stupid sweatband that kept slipping off and letting my hair fall into my sticky face…more trips to the shower – my oasis, as long as the hot water held out…being told I was 9cm with a “lip” of cervix left: “A lip!  I have a lip! I’m a 9!”, I cried out with joy to Simon.  Generally thought of as a bad thing (a stubborn cervical lip, a barrier from being complete and subsequently pushing), I was thrilled to be 9 with a lip!  Because it was ONLY a lip!  I had been going for about 24 hours – I could do a lip!

At 6AM I started pushing.  I still had my lip of cervix, but Mary said I could try some grunty pushes if I wanted, and she said she could manually “reduce” the lip while I pushed if I wanted. Umm, yes please!!!  So Mary gently pushed the remainder of my cervix away while I offered some pushes.  Now, I had genuinely been looking forward to the pushing stage.  First of all, pushing means you’re almost done.  Second of all, I just wanted to feel a DIFFERENT sensation.  (And I’ve actually heard of and talked to women who LIKED pushing!).  But boy, let me tell you, I did NOT like pushing!  It hurt SO bad!  It really surprised me how much it hurt.  Give me back labor any day over pushing! 

Granted, I never experienced that “uncontrollable urge to push” that people talk about.  For me, pushing (all 2 ½ hours of it) was a very conscious choice.  I had to make myself do it.  And for the first leg of it, I resisted because of the pain.  To push with much gusto was to bring pain upon myself – and my instincts said NO!  If you touch a hot stove, you pull away!  It wasn’t like labor; my contractions were largely outside of my control; I couldn’t tell them when to start or stop or how strong to be.  But with pushing, I did start it, and stop it, and decide how strong it was going to be.  I had to voluntarily cause myself pain.  At least that’s how I thought about it until I decided I needed to think about it in a new way.

After a while of half-hearted, resistant pushing, I flipped the switch.  I can’t explain it, but I decided I was not going to let the pain hold me back anymore.  I decided that I could be stronger than the pain and that I would overcome the pain rather than it overcoming me.  (After the birth, Corinne told me it had looked like I wasn’t even in pain at all at this point!).  I told myself that pushing was the only way that I could get this baby out, and the only way I could make labor END, and pain be damned, I WAS GOING TO DO THIS. 

So I started pushing with all the strength I had.  I rested in between contractions, but when one came, I beared down and pushed hard til I ran out of breath.  Then I grabbed a breath and did it again so long as the contraction was still going. “That’s the way!  Those are the pushes that get a baby out!” I heard voices around me say.  Sometimes I let a contraction go by and I just rested, always a welcome break that I claimed as needed, but by and large I kept after it with impressive stamina, I must say.  I’d been in labor for over a day.  I hadn’t slept hardly a wink.  But I wasn’t crawling to the finish line – I was sprinting. 

The strongest part of me, a part I hadn’t seen before, was shining.

I pushed in the tub, in various positions for a long time.  Mary got rid of the lip while I was in the tub; at 7AM I was truly complete.  My pushing progress in the tub was slow, so eventually it was suggested that I move to the couch and try there.  (But not before I reached down and, to my utter amazement, felt the top of my baby’s head on the inside!  So incredible!). 

I pushed on my living room couch, on my back with my legs pulled back, in traditional “hospital style.”  It was especially intense on my back like that (just lying on my back during pregnancy was awful; during labor it was ridiculous), but it was effective in bringing baby further down the birth canal.  After that I pushing in a sort-of-squatting position: Simon sat on the coffee table and I straddled his lap, with my legs dangling and my arms clutching his neck.  That position worked really well to bring baby closer!  Baby’s head was now staying visible between contractions I think.  It was VERY intense in that squatting position, so after a time it was suggested that I take a bathroom break.  So the action moved to my tiny condo bathroom – and that is where it remained.

While I was on the toilet, I had some massive contractions, and that precious baby that was sitting in my birth canal, so close to the outside world, decided that it was time to be born.  And then I was crowning. 

And WOW is that the MOST intense feeling ever!  It burned, oh it burned!  I screamed out, “It’s the ring of fire!”, because that is how crowning has been described by many, and I was struck in the moment by how absolutely accurate that description is!  But crowning was over about as quickly as it had started, and POP!  Out sprung my baby’s head!  My birth team did not miss a beat.  They were right there, equipment speedily moved with them, all ready before the birth of the head.  I was promptly pulled to my feet, over the toilet, so that my baby’s body did not plop in the toilet with the next contraction!  It was most intense, crazy, painful, amazing feeling to push that baby’s head out; it was really unreal!

I remember Simon next to me saying, “Oh my gosh, oh my gosh, oh my gosh!”  I had strongly desired for Simon to catch the baby, and he had been looking forward to doing it, but that’s just not how it worked out.  As my friend Samanda says, “You can prepare for a birth, but you can’t plan one.”  After the birth, Simon told me that he had thought in the moment that the head was the entire baby, and that that huge blob was going to somehow “unfurl” into our baby! ;)

So there I was, standing (talk about sea legs) over my toilet, with a baby’s head hanging out of me.  I was totally in the zone, but I was aware of my birth team discussing and quickly acting upon my baby’s nuchal cord (meaning the umbilical cord was around the baby’s neck).  Someone said that it was pretty tight, and I think there was mention of cutting it “on the perineum” (before the birth of the body), but then the shoulders started slipping out obediently, and Jessica was able to slip the cord over the baby’s head as he made his entrance into the world.

Mary caught my baby as he slipped out at 8:40AM.  It was the wildest feeling ever to feel his body flapping out of me – it really felt like a large fish swimming out of my body.  As soon as the baby was out, I collapsed/was set back onto the toilet with support on either side of me.  Although I couldn’t really see it due to my posture and my belly being in the way, my birth team was untangling my baby – he not only had the cord around his neck, but it was also crossed over his chest and wrapped up between his legs.  And then, as he was lifted up to me, time stood still and the unbelievable was happening – I had a BABY in my arms and it was MY baby!!!  I remember utter shock first, then relief labor was over, then more shock over how HUGE his head was, then total joy and bewilderment that this wet, warm bundle of love was mine.  Simon and I welcomed him with tears and awe.

He (though we didn’t yet know he was a he) started wailing right away after birth.  There had not been a moment during my long labor and extended pushing phase that his heartbeat had suffered in the slightest, and he transitioned to extra-uterine life immediately and loudly!  So him being all tangled up didn’t bother him whatsoever, although we think it was a big factor in delaying his arrival (kid had no slack to work with!).  Mary said something like, “Don’t you want to see what you have?”  I had thought it would be like a reflex to immediately check to see if we had a boy or girl, but it wasn’t really like that for us. 

I think we were just so stunned, after 9 months of pregnancy and 28 hours of labor, to finally have a BABY, that it didn’t even occur to us to move beyond that basic but profound truth.  But of course at Mary’s asking, we did lift up the warm towel covering our baby and take a peak between those tiny legs.  To our delight and wonder (and not at all to my surprise), we saw that we had a baby boy, a son!!!  I asked Corinne to call my mom right away and to have her rush over to meet her grandchild – gender to be discovered upon arrival.

Within minutes of giving birth, I got off the toilet

Now that labor was over, it felt wonderful to lie down!  I’m sure I did have 3rd stage contractions to birth my placenta, but I really don’t remember them.  I feel like I had to choose to push my placenta out too, similar to how it was with pushing out my baby.  I do remember that Jessica was yapplying some fundal pressure to my belly, and that was not fun (though I felt fine, and my postpartum vitals were perfect, I was having a fair amount of bleeding.  Nothing crazy, but enough that they wanted that placenta out sooner rather than later I gathe

red).  Nineteen minutes after birth, at 8:59AM, I birthed my placenta.  The sac was pretty much shredded (maybe because it had been broken for a while?  The way that it broke?  I don’t know), but my placenta was big and healthy looking.  We all marveled at my placenta, with its veins composing “the tree of life.”  Even Simon appreciated it – he was sure he was going to be totally disgusted by the sight of it.  (I don’t think he’ll ever think placentas are as cool as I do, but he did think it was neat to see where his son had been living for 9 months).
I took some cotton root bark (a nasty tasting herbal tincture that contracts the uterus) and also threw back a small piece of my placenta (yes, really) to stop my bleeding.  Worked beautifully.  My birth team assessed my perineum and found that I had sustained a straightforward but rather severe tear (borderline 3rd degree).  All 3 midwives recommended I go to the hospital to have an OBGYN do the repair due to the severity of the damage (I took their advice and was stitched up at St. Anthony’s a few hours later.  My own OB, who is very midwife-friendly, made time in his day to do my repair himself.  The experience was totally drama-free and pretty darn painless, physically and emotionally). 

The baby’s umbilical cord was cut some time around the birth of the placenta (I think it was a few minutes beforehand) and our sweet boy was handed off to proud Papa Simon.  My mom had arrived during the birth of the placenta and was so completely lit up with joy!  It was such a beautiful sight to watch her ooh and ahh over her new grandSON.  (We asked her to see for herself if the baby was a boy or a girl, so she had the experience of lifting up the towel/blanket for the grand surprise, just as we did).  I wanted to wait until my mom arrived before Simon and I announced the name of our beautiful baby, and now that moment was here: Gabriel James Kim.
Gabriel.  We did not start considering this name until I was 39 weeks pregnant.  After disagreeing on boy names throughout my entire pregnancy (and even before), we finally stumbled upon this strong but gentle, classic but fresh name that we both loved.  Bonus, it came with a super cute built-in nickname: Gabe.  Gabe the Babe.  Gabriel means “God is my strength,” which we both thought was awesome.  Additionally, Gabriel is the angel that informed Mary that she would bear the Christ child.  Seeing as our baby was born during Advent, this name choice felt especially fitting.
James.  The name of my father, as well as Simon’s brother.  We loved that with one middle name we could honor both sides of the family.
Kim.  Our family name.  (And the name that telemarketers constantly mistake as my first name!)
Those first couple hours after the birth were so sweet.  Gabe’s first nursing.  His newborn exam, including his measurements (9lbs, 21 ½ inches long, with a 15in head!).  Watching Simon fall in love with his boy.  Watching my mom fall in love with her grandson.  Hearing both of them on the phone sharing the news with our other family members.  Corinne, with her 22-weeks-pregnant belly, telling me that I was awesome and that she felt so inspired for her own labor and birth.  Eating a huge bowl of yogurt with berries and drinking lots of orange juice, and then a sandwich.  (And not throwing up any of it!).  Figuring out just how I was going to word my birth announcement Facebook status.  Feeling my belly and thinking I felt hollow inside!  Rubbing Gabriel’s head over and over again.
I went to the hospital to get my stitches.  Simon took a loooong nap while I was gone.  (I napped a little, but didn’t really sleep until the next day – I was high on oxytocin!).  The midwives cleaned up and left.  My mom cleaned up the tornado that was our condo.  The birth pool was drained and packed up.  My birth was over.  But motherhood (and postpartum adjustment) was just beginning.  In many ways, I found the postpartum period much harder than labor and birth – so many hormones and so little sleep!  And labor was just one day…postpartum is weeks and weeks!  My body hurt so much; it was almost a month before I could sit down without discomfort (darn tear!).  Initially, breastfeeding was very, very hard, physically (hurt a lot!) and emotionally (I was terrified he wasn’t eating enough).  I found out on Gabe’s 3rd day of life that he had a tongue tie, meaning the membrane attaching his tongue to the floor of his mouth was tethering his tongue TOO much and preventing him from sticking his tongue out and nursing properly.  I was so thrilled to finally have an answer, a reason why nursing had been so excruciating!  (I say “finally” as if it was such a long time to figure it out…it was 3 days…but when nursing hurts, and you have to do it every couple hours on demand around the clock…it felt like a long time!).  Mary clipped the excess membrane the very next day, and as Gabe’s tongue stretched out over the next several feedings, my pain completely went away!  Happy mama, happy baby!  Getting a handle on nursing certainly was essential, but for me the postpartum time remained difficult despite overcoming that particular hurdle.  I was overwhelmed by how constantly my baby needed me.  I had bouts of hormonal breakdowns during which I resented my baby and didn’t want to be a mother.  I felt isolated, geographically and relationally.  My frame of mind could deteriorate faster than Gabe could start crying.  Big transition, this baby thing!  Postpartum…another kind of “labor,” I’d say!  (Btw, I’m so glad I encapsulated my placenta.  It was great to be able to “pop a happy pill” when I was/am having an especially stressful day!).  I just kept telling myself (and still do, though I’m not “technically” in the postpartum period anymore), “I gave birth; I can do this too!”

So there you have it.  My birth story, with every detail I can remember.  Postdates. 28 hours of labor. Vomiting resulting in IV fluids. 9lb baby (with a 15 inch head). 2 ½ hours of pushing. 2nd, almost 3rd degree tear necessitating hospital repair. Nursing challenges due to a tongue-tied baby.

These are not traits anyone would choose to characterize their labor and birth experience.  They are not “fun” things (in fact, some of them really stink). No one wants a long labor, or a “big” baby, or a nasty tear.

But you know what else characterizes my birth story?  A baby who had rock-steady perfect heart tones the entire time and was never in any distress whatsoever. A spontaneous vaginal birth, which unfortunately is not at all a guarantee these days.  (I think I would have almost definitely had a c-section if  had been in the hospital – 15ish hours of active labor and 3cm dilated?  They likely would have deemed me a “failure to progress” and wheeled me to the OR).  A husband who was my rock and labored alongside me through it all. A dear friend who jumped right in as my doula.  A team of skilled and compassionate midwives who guided me on my journey (and had great ideas to make my stubborn cervix do its job!).  An environment to labor and birth in where I felt safe and secure: my home. 

Plus – professional benefits – because I had a difficult labor and birth, I can offer great empathy to other mothers who must battle mightily.   Because I know.  Because I did that.  I overcame great adversity, triumphed over considerable obstacles, and delivered my child in a tremendous showing of power.  I gave birth.  I did that!  I am strong!

My baby was born on December 3, 2012, as was a fierce mother: me.

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