Monday, February 20, 2012

Our Fourth Birth Story!!!!

It's that most wonderful time of the year - birth story time!!! Oh, boy!

And boy did I get a bit lengthy with this one.... the births keep getting shorter, but the telling gets longer. Pretty soon I'll be writing short novels for each birth.

Just a note on our first week - we are doing well! Our little guy is sweet, gentle, and absolutely adorable. He is letting me sleep almost perfectly through the night (just eats about three times while we sleep), and he's a darling. My recovery is going swimmingly as well! Right now DH is at home - such a blessing! - and we're having a good time, despite the fact that the other two kids are sick (praying that we and the baby don't get it).

Here it is!!

*****

First, housekeeping notes:

(1) When it comes to birth stories.... I'm very longwinded. My apologies in advance. This is my own record as well as a public one, so I want to remember every detail.

(2) As this is a birth story, it will contain plenty of TMI. Be prepared. If you don't like TMI, definitely dive for the little "X" at the top of the screen.

(3) I tend to be rather plain-spoken about birth terms - again, apologies in advance.

(4) Longterm readers may notice a slight change in personnel in our birth team. I want to state clearly and publicly that the changes were in no way occasioned by any dissatisfaction with past birth teams - all changes were situational in nature only. We love each member of past and present birth teams and would gladly and enthusiastically recommend each one.

(5) I'm afraid I am NOT birth-photogenic, unlike some women I could name but won't. My look tends more toward the "blotchy and bedraggled" look. So don't expect birth-goddess type photos!

(6) Birth team:

Stephanie - midwife
Krystel - apprentice midwife
Rose - doula (also an apprentice midwife, though at this birth she acted as doula)
The family - DH, our 5yo, and our 2yo

(7) If anyone's counting, yes, this is our fourth birth story but only our third living child - our first child was lost in a first-trimester miscarriage.

*****

Let's get started!

This Pregnancy

These past nine months have been a very challenging experience. Though this has not - thanks to medication and God's mercy - been an HG pregnancy, it has been physically challenging and even more so spiritually and emotionally challenging. It started out with the most frightening night of my life, followed by the most confusing two weeks of my life, and went from there. Though NVP-wise it has been my easiest pregnancy, it has been an extremely challenging time. It's been a valuable experience, but I can't say I'd care to repeat the first part of it again.


Preparing for This Birth

I have always had a hard time preparing for childbirth. Most women seem to eagerly await the first signs of labor, but I've always been reluctant. Why? Firstly because I love pregnancy - I'm always sorry to see it end. Secondly, though I absolutely adore newborns, I don't particularly adore the newborn stage in our household. It has a way of messing with one's mind and one's sanity. Secondly, birth hurts - a lot. 'Nough said.

This time was no different. However, a couple of things happened. Firstly, for the first time ever I experienced false labor. Not seriously, but repeatedly. It's emotionally and physically exhausting (especially as it always seemed to start as soon as I went to bed!), and it got me to the "Okay, enough already!" stage.

Secondly, we went far longer into this pregnancy than we'd ever gone before - both of our other babes had arrived at about 39+3, and this baby did not choose to make an appearance until 40+5. The anxiety of constantly wondering "Is today the day? Is tonight the night?" and trying to keep the house perfectly in order all the time finally got me to the place where I was feeling more along the lines of "Alright, let's get things going! Enough is enough!!" Frankly, that was a very positive thing to have happen in my mind. Good stuff.

Our first and only belly pic, taken the week before our birth:







Operation Afterpain Take-Down

With each of my two first pregnancies, I had problems with overwhelming and excruciating afterpains that have prevented both breastfeeding and holding the baby during the first hour post-birth. This time, I worked with my birth team to develop a protocol to fight back against the onslaught. Here it is: (1) calcium-magnesium liquid supplement, taken during the last trimester and kicked into high gear in the postpartum, (2) homeopathic arnica, (3) Advil - lots of it, (4) "Ease" afterpains tincture from Worts & Cunning Apothecary, and (5) placenta medicine in the form of raw smoothies.

If anyone is interested (or curious, or absolutely repulsed) about the thought of placenta medicine, here is a list of links to the evidence supporting this awesome practice. Placenta medicine is specific to helping with postpartum recovery, specifically with milk supply, afterpain relief, bleeding minimization, prevention of baby blues and postpartum depression, and emotional stabilization. I am a huge fan!


Labor Begins

On Friday night, I had three hours of false-alarm labor, starting at 10 p.m., that nearly had me hopping in the tub and calling the birth team before everything quit abruptly at 1:00 a.m. After that, not only did the labor-type contractions stop, but so did most of the uncomfortable Braxton-Hicks - from then on through the entire day on Saturday. It was nice to have a break!

Saturday night, we went to bed tentatively planning to go to church in the morning, but we knew that our chances of making it there would be slim. Besides waiting for any-minute labor to start, we got to bed super-late, and DH ended up sleeping on the couch due to insomnia (which turned out to be a blessing for all of us).

At 2:48 a.m., I awoke to a strong early-labor type contraction. Was this it? I waited for a while in bed, and the contractions kept coming. I decided that this was probably it, and eventually got out of bed.

(Incidentally, DH had come through the room at 2:30, shortly before falling asleep himself, and he said later that I was curled up in an odd position with a grimace on my face. Kind of sounds like contractions were already happening, just not enough to wake me up yet!)

Before getting out of bed, I had a brief emotional tussle. Was I ready to deal with this? But the "let's get on with this thing!" spirit prevailed, and I felt ready to get this party started.

I should also note that I practiced Hypnobabies with this birth. I did not take the class (unfortunately) and have not read the Hypnobabies texts, but I did have a set of CDs given to me by a friend that I listened to every night (two tracks per night, mostly while asleep) from January 1st through the night of the birth, February 12th. I do not think I ever got real hypnosis to work, but when I went into labor various quotes from the "Easy First Stage" CD immediately started coming into my head, and they were very comforting to repeat during early labor. I also found the CD very comforting, even though I couldn't pay attention to it once active labor kicked in. I kept it on all the way through the first 15 minutes postpartum. I would definitely recommend Hypnobabies!

Once up, I started getting things ready. I got the birth ball and the CD player out, took out the trash, ate a snack (banana & cheese), got an empty trash can, made sure things were set out - though, as predicted, I did forget to get baby's birthday cake out of the freezer. (I have always wanted to make a "labor cake" for baby's birthday, but each time - including this time - labor has immediately claimed my attention. This time I stole a march on the whole bit by making the cake a month in advance! And then forgetting it, of course.)

At 4:30 a.m., I went to the computer to time my contractions using contractionmaster.com. I felt like I was in labor, but I was worried because my contractions seemed too short - they felt to be 20-30 seconds each, rather than the gold-standard one minute, and I wanted to find out what was going on.

And as soon as I sat down to time my contractions, the contractions stopped. Completely. Not another one for almost a full half hour.

At this point, I started feeling pretty silly - I had spent two hours out of bed getting ready for a birth, when this was obviously false labor. Again. Time to go back to bed and forget the whole thing.

But as soon as I walked back in the bedroom door, BAM! Contractions started right back up again. So much for timing contractions the sophisticated way. Instead, I sat on the birth ball in the bedroom and started writing down start times on a piece of scrap paper. I never did get around to timing contraction length, but start-to-start time was every three to seven minutes.

I had two goals - to let DH sleep as long as possible, and to avoid waking my birth team up in the middle of the night. So I was determined to go as long as I could without notifying anyone.

Additionally, I should say that I have always had a passing fancy for unassisted birth. This always fades in the light of day, as (1) I would be an awful midwife to myself during birth, and (2) when the rubber meets the road and labor gets tough, I always have an overwhelming desire to be surrounded by other women. So it's not something I truly desire or would ever plan. But having three hours of "unassisted labor" was something really special, and I enjoyed it tremendously (in a nervous sort of way!). I had never had that privilege before.

Something that always cracks me up is how one's body turns into an absolute dictator during labor and/or birth. The body really lets one know what it likes and doesn't like!! During this labor, I tried a position I'd always thought about trying - kneeling while leaning over a birth ball. It sounded like fun.... but when I tried it - yeeouch!!! Nope, not happening! That didn't even last for half of a contraction.

At some point, I realized that I should get dressed for the occasion, so I went and dug out the (ugly) bikini top that I had bought from Goodwill for our last birth. And... it was a wee bit too small. (You know, of course, how these things tend to shrink over time in storage! Ahem.) Thankfully I remembered that I had bought an oversize swim top for earlier in the pregnancy, and that thankfully worked just fine.

A bit later, I decided to try laboring on the toilet, another popular position. It took some definite cramming to fit myself, a birth ball, a pillow, and a huge blanket (it was cold!) into our tiny toilet room, and it wasn't that comfortable. That, however, is where DH found me shortly after 6:00 a.m., when he came into the bedroom to find all of the lights on, the CD player playing Hypnobabies, and me laboring in the bathroom, covered by a huge blanket. "Er, is something going on here?"

I should also say that some of my nighttime essays from the bedroom had awakened our 5yo, who asked what was going on. I sent him back to bed as quickly as possible, but unfortunately he never went back to sleep, so he was up with DH from 6:00 a.m. onwards as well.

I told DH that I was pretty sure that I was in labor, but I wasn't sure if we should call the birth team yet (I was still wary due to those short contractions). I told him, though, that I was definitely ready to jump in the tub, so I abandoned the birth ball and headed for the bath tub.

While in the tub, I tried another laboring position - leaning back while pouring water over my tummy. It was okay, but I found that the sensation of water pouring on a contracting tummy was painful - so I returned to my usual (sitting up while leaning over on my hands). Looks like that's just the way I labor!

At 6:30 a.m., we went ahead and called our midwife and our doula. We didn't feel the true need for anyone yet, so DH just asked our doula if she could come over perhaps by 8:00 a.m., and told our midwife that we'd check in in a couple of hours to let her know when we needed her.

By doing so, of course, I joined (or re-joined, as I did it last time too) the club of women who vastly underestimate the speed at which their labors are going to progress. (This should have been a no-brainer.) By the time that DH had gotten off the phone, I was starting to vocalize through contractions and realize that we needed people much sooner than "in a couple of hours," so DH ended up calling our doula right back and asking her if she could come as soon as she was ready. She came at 7:30 a.m. or so, and I was so glad to have her there. She immediately suggested calling our midwife and asking her to come sooner, so we did that as well.

Our eldest (5yo) surprised me by sticking around for nearly the entire birth. He had spent this pregnancy telling me that I was entirely too loud last time (true!) and that he didn't want to be around this time, but he really changed his tune as soon as labor started, and stayed close the whole time. I also had no idea how much he remembered from his brother's birth, or everything that he has apparently picked up from living in the house of an avid birth junkie!

Lecturing me on pushing technique, sometime around 6:30 a.m.:


Dealing with contractions, sometime around the same time or a bit later:


With our doula, Rose:


Time passed, and contractions got meaner. Our lovely midwife Stephanie and her apprentice Krystel arrived sometime around 8:30 a.m., which was when things were getting really tough. They immediately moved into high gear, getting their gear inside (oxygen, supply packs, etc.) and setting up the room (double making the bed, etc.).

Something I love about non-first-births for myself is how much consciousness I retain compared to the first birth. With our first birth, I was so completely out of it that I was not even able to communicate verbally, let alone have conversations or notice what on earth was going on around me. This time and last, I was able to hold mini conversations in between contractions, notice everything that was going on, etc. - and this time was even better than last time. Much preferred!

Here's an interesting tidbit I learned from our doula, Rose, during one of our mini conversations: Contractions after longer breaks tend to be the super-big ones (hormone build-up), while those following close on other contractions tend to be minor "after-shock" types. Interesting, no?

The bed, ready for birth or post-birth (the bed is made, covered with plastic, and remade again with new sheets that can be easily removed and washed). Notice the brilliance of brown sheets for a birth (thank you, Freecycle!):



Supplies for the birth at the ready (bowls, chux pads, supplies, etc.):



Stephanie checking our supplies that we had gathered (sheets, towels, olive oil, bowls, trash bags & cans, baby clothes, etc.):



Apprentice midwife Krystel sitting on the bed, while Stephanie knits our baby's newborn hat:


Then, of course, things got truly nasty (about 9:00 or so a.m.). I call these "wall-climbing contractions" - the nasty kind that are extremely difficult to deal with, and which come so fast that there is just not enough recovery time in between them. In a word, transition (also known in the literature as the "why did I choose unmedicated childbirth??" moment). Drumroll, please!

Me: "How are we doing?"
Rose: "You're doing really well!"
Me: "Not that! How are we really doing?"

However, I didn't recognize this as transition, because I had checked my dilation recently and my cervix was still unreachable - not a sign of advanced labor. (Which further confirms my personal policy on cervical checks: Just say no.) However, my advanced vocalization (i.e. hollering) caused my midwife to hurry in from the bedroom, as she knew things were happening quickly.

Stephanie: "You're going to meet your baby very soon!"
Me: "Do you mean that, or are you just saying that to be nice?"
Stephanie: "It's true. I'm not that nice."

However, neither of us knew how close this baby was! Stephanie told me later that she was thinking 30 minutes or so, and I was convinced we were going to be there for a few more hours (Heaven forbid!). But baby was born within 3-5 minutes of that point.

The midwife team, transferred from bedroom to bathroom in anticipation of the birth:


And then....

I noticed that I was starting to feel "pushy" - not seriously pushy, but a wee bit. I didn't say anything, being a bit preoccupied, but I noticed that I felt slightly pushy for about two contractions.

Brief Aside: An Ode to the Power of Spontaneous Pushing

I have to pause briefly to pay homage to the utter amazingness of the spontaneous pushing urge in the female body. When Hypnobabies says "I am safe, and my baby is safe, no matter how much power flows through me," they ain't kidding 'bout that 'power' thing. Pushing is truly the power of the universe flowing through the human body.

There are, of course, two types of pushing contractions. The first are of the "Gosh, I feel like I could push!" ilk - obeying the urge is entirely optional. Personally, I always opt out.

The second kind of pushing is the type where, in a typical birth story, a woman yells "I have to push! NOW!" The nurses then say, "Not yet, sweetie! Your doctor's not here yet!" to which the woman responds, "Are you stinking kidding me?" (usually with a lot more colorful language added in) and proceeds to push anyway because compliance is no longer optional.

(Though I should note that this urge is (I believe) usually absent with an epidural. A friend of mine was told "You can't push yet, because your doctor won't be here for another two hours," and with an epidural she was able to sit there and wait. I don't know if that's always the case or not.)

But the sheer power of spontaneous pushing contractions (the second type) just blows me away. I cannot believe that my body has that much power - it is awe-inspiring. It reminds me of standing right next to a the tracks when a freight train is thundering by - that sort of earth-shaking power. Though the metaphor is flawed, because (1) a woman is not standing next to a freight train; the woman is the freight train, and (2) frankly, a freight train is pathetic and wimpy next to the power of a woman's body during pushing.

Continuing on:

Just as I hadn't recognized transition, though, I didn't realize pushing either. Firstly, I always throw up during transition - so I thought that pushing couldn't arrive until that had happened. Secondly, there is usually a "rest and be thankful" pause between transition and pushing - and that hadn't happened either. So what happened next took me by surprise. One wall-climbing contraction started...

And grew.... and grew...

And BAM! It turned into a pushing contraction, type 2, at full speed ahead, and from then straight to crowning. It was the contraction of a lifetime - and that's putting it mildly.

This led to a rather funny situation.

DH was actually out of the room at the time, getting something for our eldest. From the kitchen, he heard my vocalizations turn from "I'm having a really hard time" vocalizations to full out screaming - something I only vaguely recognized at the time - and immediately he heard the midwives calling out, "Hey! Come in here RIGHT NOW! Hurry!"

What they meant, of course, was "If you want to catch your baby, you need to get in here right now!" But what he thought they meant was, "We're having a medical emergency and we need you to help get her to the hospital!"

So DH rushed into the bathroom in a panic, sure that something terrible was going on, only to find the midwives saying "Your baby's almost here! Get ready to catch!"

In either that same contraction or the next, baby's head was out. "Reach down and touch your baby's head!" As usual, I had little to no interest in this, but did it anyway - always amazing. Though I can't be sure, I believe that the membranes were intact over baby's head at the time - so we almost had our caul baby! Sometime seconds later (though no one noticed it happening, including me) the membranes must have burst, because it immediately became clear that we had old meconium staining in the water, which was immediately fish-netted out.

At that point, I was ready to be DONE, so I continued to push hard, contraction or no. Stephanie suggested pushing with short pushes, so I push-push-pushed and baby was almost out. At that point, I was desperate to be done, so I said "Can someone please just pull him out?" Stephanie replied, "One more push and you're done!" - no more said than done. OUT!

Baby was scooped out and immediately put on my chest, and I was again the first to find out the gender - a boy!

DH had been really hoping for our first girl, but as always, when it came down to it nothing of that sort mattered. We were so happy to see our baby!

And, I must mention with modest pride, DH tells me that I entirely surpassed my past record in terms of birth vocalization volume (*blush*). I believe my midwife will agree with him, as soon as she recovers from temporary deafness.

This was also the first birth in which I was able to see the birth. For our first birth I was laying down and for our second I was side-lying. This time was reclined seated in the tub, so I actually saw the birth. Not that I noticed much at the time or remember much now, but definitely interesting!

Baby was just fine - awake and alert immediately, and wanting to nurse within 5-10 minutes. We moved onto the bed and spent a happy time postpartum with our birth team while clean-up was done and I rested.

Now for pictures! Note: Though my blood loss was entirely within safe parameters, for some reason I still managed to get blood everywhere this time - as you will see. And no, water births aren't usually this messy. This was a combination of blood and meconium-stained water that makes it so murky. Our last water birth was much neater.

Right after baby was born:



New baby! Notice the green/yellow tinge to the skin, the result of old meconium staining:



Shortly afterwards:



DS comes in to inspect baby - he had run out of the room when I was pushing:



Birth team inspecting baby!



Dealing with an after pain:



DH with baby! Cord was clamped about ten minutes after the birth, when it had basically finished up pulsing:

* Note on the metal clamp: We clamped the cord when it was basically done pulsing, but you could still feel it just a bit up near the baby. Thus, we cut down where it was completely done pulsing first, and then shortened later with the plastic clamp.





Getting a start to breastfeeding. This was the FIRST TIME EVER that I have been able to hold and breastfeed baby immediately without killer afterpains preventing. Operation Afterpain Take-Down - a success!




Nursing, with our 2yo nearby:



After a few minutes, Stephanie suggested biting the bullet and birthing the placenta - always intimidating in thought but easy in fact. And, may I say, one of the loveliest placentas I've ever seen! Third stage (birth to placenta) was 24 minutes.



Birth weight - 9 lbs. 9 ounces! Wow! (First two babes were 7#12 and 7#15)



Newborn exam!

Here's an interesting note: A month or so ago, I had an interesting conversation with my midwife about postpartum transports. She told me that when, after a birth, the mother starts doing badly (bleeding, shock, etc.), the baby can continue to do just fine because - let's face it! - he doesn't know anything about what's going on. But when a baby starts doing badly (breathing problems, etc.), the mother will often start doing badly as well because her anxiety over the baby will disturb the physical and hormonal changes going on with her body and can cause problems. Interesting, no?

But I got to see it for myself, in a very minor way! When I was ready for a break, I handed baby over to the midwife team for weighing and etc., and immediately (within 5 seconds) I began one of those full-body post-birth shaking episodes. I didn't even notice the correlation, but my doula told me that she most often sees reactions like that happen when the baby is taken away from the mother. There you have it! Amazing! I had no idea how much the mother's stability is founded on the ability to have undisturbed time with her baby. Amazing stuff.

Taking baby's temperature:





More various pictures:






And the birthday cake at last! (Which we didn't remember until long after the birth.)



Welcome, Baby Giles! And thank you to our wonderful birth team!


Baby Giles
Born 2/12/12 (our third palindrome birthdate!)
Labor time: 6:45 (2:48 a.m. to 9:33 a.m.)
Apgars: 9 and 10
Third home birth, second water birth 

5 comments:

  1. Lovely story! Thanks for sharing. :-)

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  2. Great story! Lovely, big boy. :) Found you through a link from Kathy's FB page.

    And, wow! You sure do have a lot of AZ resources in your links! I'm in AZ, too, in the far NW valley. I just wanted to add that I'm taking my youngest daughter to Dr. Jesika DiCampli who is a naturopath and a CPM. http://4wecare.com/physician/jesika_dicampli.aspx

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  3. Lovely birth story. You did so well.

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  4. Thanks for sharing! I really enjoyed reading your story.

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  5. Congratulations! I'm so glad that your efforts to reduce the after-pains were successful! Magnesium! Yay!

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