Friday, January 15, 2010

An Alaskan Homebirth

Eagle's Birth Story

I have a lot of thoughts and feelings that I want to put with this story, but it's taking me a while to get them all into words, and since the story part is actually fairly short, I decided to go ahead and post the facts and then I'll post the thoughtful part later on.

There is a standard which suggests that if mama has contractions that are one minute long, 5 minutes apart, and continue at that rate for an hour, then she is in active labor and should go to the hospital (or call the midwife). In the two weeks prior to Eagle's birth I achieved that status at least four different times, always in the evening. On each occasion, I thought hey, maybe this is finally it...but since the contractions never got closer together or more intense (and in fact always slowed when I laid down for bed, if not when I was snuggling in the kids) then I knew it was not really labor. After three days in a row of it however I did call my midwife just to let her know what was going on. I told her I felt a bit silly calling, because I knew this was not it, but I thought she should know that I was contracting a lot, and regularly. She said that probably my body was warming up, and that as soon as the baby's head engaged I would have a fairly fast labor. She encouraged me to do things that would help him engage (ie--drop down and put pressure on my cervix).

I spent two days doing belly lifts/hip tucks and hip circles (both on and off the ball) trying to get him to descend, but so far as I know he hadn't engaged when I went to bed on Wednesday (my due date). He may have started to engage though, because over the course of the evening I had a half dozen contractions that seemed different from the many previous ones. I can't explain how, they just seemed different... I had a gut feeling that I'd probably wake up in the middle of the night in labor, but since I'd had that feeling on several nights in the prior two weeks I didn't bother to say anything to Hubby, and just went to bed as normal.

Bear woke up around 3, so I got up to comfort him for a few minutes, and as I got back in my own bed I had a really uncomfortable contraction. Then 10 minutes later another--the kind where you think gosh, laying down is terrible, I have to move. 10 minutes later I had a third so I got out of bed to lean on the bathroom counter and do hip circles, and the contractions promptly switched to being 5 minutes apart. After all the false starts I decided to wait another 40 minutes to make sure they kept on consistently before I woke Hubby, but I knew they were going to.

Shortly after 4am I woke Hubby. I told him I was in labor and that I needed him to put up the pool. He didn't know yet that I'd been up for over an hour, and later admitted that he wondered if it was another false start and was very tempted to roll over and go back to sleep. But he got up and started puttering around. I felt terribly impatient at this point and started working on the pool myself--we had inflated it to about 80% two weeks prior so it was quick and easy to finish the job. I think my impatience in getting the pool out helped Hubby realize that I was not at all iffy on whether this was the real thing, and he quickly stepped in to get it done for me. As he was working on the pool he informed me that he was going to have to run in to his classroom briefly, as he'd been working on some things the afternoon before and would need to put them away if a substitute was coming in that day. (After two weeks of figuring that any day could be the day, I guess he had reached the "she's gonna be pregnant forever" state of mind too!) He said he would probably only be gone about 20 minutes, so as soon as he finished inflating the pool I told him to hurry and go because I knew I'd need him soon. We called the midwife to let her know that this was it, and she said to call her back as soon as anything changed and she would come right over. So Hubby left, and I took a shower, lit some candles, and started filling the pool.

While he was gone my contractions continued to be 5 minutes apart. After a little while, needing to convince myself that I was making progress, I decided to do an internal check on myself. I had tried this several times throughout the pregnancy, and especially during the final weeks. During pregnancy the cervix is very high and also tipped to the back, so I was never able to reach it very well (I was familiar with what it felt like when I'm not pregnant because I check it regularly as part of my fertility awareness, but pregnancy is a whole different ballgame!) I had discussed with my midwife how I couldn't feel it, and she said that the height combined with the softness of it in those late weeks was probably why. This time when I reached in though I could clearly feel it: I guessed I was around 3cm dilated and I could feel the sack of waters bulging. The sack is the coolest thing to feel--sortof slippery and slimy but also obviously very strong. I couldn't feel the baby's head behind it, just the squishy edge of the sack, but I knew he must be right there since I was dilating.

I started really focusing myself into the labor. The body can (and will) do the work of birthing pretty much on its own, if mama will just relax and let it do so; on the other hand, if mama will work with her body (as opposed to merely stepping aside for it) then the whole process can be all the more effective and efficient. Ina May Gaskin talks about "integrating" contractions so that you can move forward and into the next level. Birthing From Within teaches a similar notion when it encourages the mother to go into the center of each contraction. So as I leaned against the counter and circled my hips I repeated words like "down" and "center" and "deeper." In the prior couple of weeks I had mentally stumbled upon the image of a drop or stream of water coming down onto a pool and the waves of ripples radiating out from it--so I took that image (with the downward and outward motion) and replayed it in my head over and over.

As soon as Hubby got home (around 5am) my contractions became noticeably more intense. I really think my body was just waiting for him to get home before it allowed labor to progress. I was needing to concentrate enough that I couldn't time them myself anymore, but Hubby said they were still 5 minutes apart. They were stronger though, so we called the midwife. Since my water had not broken, I'd had no bloody show, and they were still 5 minutes apart, she said she'd be over soon but we all understood that she wasn't rushing. Hubby got a quick shower and I got into the pool.


I had planned to labor in the water with Bear (although at the hospital they'd have me get out for the actual delivery), but labor had been so long that by the time we got to the hospital I was too tired to do anything but lay on the bed. This time I had had a nap the prior afternoon, plus gotten half a night's sleep prior to waking up in active labor--I was awake enough that I was far more conscious of everything that was going on (I was falling asleep between contractions at the end of Bear's labor). I also had enough energy this time to be upright and moving around, which I believe helped labor progress rapidly...although I think this would have been a faster and more intense labor regardless. In any case, warm water felt fantastic on my hard-working middle and back. I sat down in the water between contractions, but during them I still needed to be up and moving, so I knelt up and leaned on the edge of the pool and continued my hip circles...the only problem was that this brought my hips out of the water (right when I wanted it most!). So Hubby got a saucepan and poured water over my lower back during contractions. I have to say, now that I have labored with water, I cannot fathom wanting to labor without it! I started vocalizing through the contractions--keeping a loose throat can help keep a loose bottom, so a low "ahhhh" while contracting can be helpful--and it simply came naturally.

Midwife A arrived sometime around 6am I think--I was far enough into laborland that I had no concept of time. I had recently checked myself again and estimated that I was around 5cm dilated--still with the bulging waters. Bear had recently wakened and Hubby put on a movie for him. A had me get out of the pool between a couple of contractions so that she could check my vitals and dilation. I knew I was in serious labor because I didn't feel the need to grab a towel or sarong when I got out (I'm normally a very modest person, and had those things on hand because I'd expected to want them). Modesty is one of those things that just goes out the window in labor, which is good because it would be terribly inconvenient if it didn't! I was pleasantly surprised when she reached in and said "you're about 8cm dilated" (she later told me I'd been "a stretchy 8"). I got back into the water for a contraction while she called her associate midwife K (who had a 90 min drive) and got her doppler ready, and then I sat on the birth ball so that A could listen to the baby's heartrate through a couple of contractions. During the first one his heartrate dropped dramatically, but during the second it stayed steady. Contractions can be stressful for the baby, though not usually dangerously so, but she needed to listen through a couple more to determine which result had been the anomaly. The next three contractions--two with Hubby holding under my arms (suspending me), and especially the one laying on the bed--were awful. Contractions are intense anyway, but without the mediating effect of the warm water they were harder to integrate. (Did I really spend an entire labor on a bed last time? Yikes!) Baby's heartrate was stable through the subsequent contractions, so I got back into the pool.

Getting back in the water felt glorious, and was just in time...the next few contractions were stronger and I was getting louder at the peaks. I wasn't focusing myself into them anymore, just trying to stay on top of them and let my body work. I remember thinking that this was awfully hard and I'd rather just stay pregnant, and even that I totally understood why epidurals are popular...and then it hit me that those kinds of thoughts are a sign of being in transition, and that it meant I was in the home stretch! (I don't recall having any of those sorts of thoughts during Bear's labor--presumably because I was too tired to have thoughts that conscious.) Between contractions I stretched out, laying my head on the side of the pool and letting my body float out behind me. (A commented "now that's a woman in labor!" so we took a picture, but I cropped it for the blog...I'm open but not quite that open!)

I guess I woke Wolf at this point--though 7 would have been his normal wake up time anyway--he joined Bear watching the movie. I started feeling pushy. I wasn't sure if it was my body pushing or my mind wanting to push, but I told A because I figured she'd want to check me again to make sure I was fully dilated. That's what they'd done in the hospital after all. But A just said "do what your body wants to do; don't do anything that hurts." What perfect advice for labor! I don't know if the timing was coincidental or if her "giving permission" freed me, but with the next contraction I was definitely pushing, and I was getting louder too. A asked if my water had broken yet, and it hadn't, but within a couple more contractions it did. If feeling the bulging sack with my finger was weird, feeling the sack break spontaneously was really strange! (Bear's water was broken by the OB.) It was something akin to blowing a bubble gum bubble and having it pop all over your face...except of course it wasn't on my face. I really thought there was an audible pop, but I guess in the midst of labor sensory perception is garbled because Hubby and A both said it didn't make noise.

The older boys' movie got over and they came in. Wolf sat back but Bear came right over, put his hand on mine, and started vocalizing with me.

Within another contraction or two I knew things were getting close so I turned over and leaned back against the side of the pool rather than staying on my knees leaning forward. I know a lot of women deliver on their knees or hands and knees, but I wanted to be able to look down and see what was happening. In retrospect this was pointless because I couldn't see around my belly, but at the time it seemed terribly important. I reached in and for the first time felt my baby's head: all soft and wrinkly and covered with hair! The mind definitely doesn't function normally in labor, because I had the momentary thought "he doesn't have a skull" (because I could only feel the soft wrinkles of his scalp). Fortunately the work of pushing distracted me before I had a chance to linger on that notion!

Interestingly, once I turned around I no longer felt contractions nor a physical urge to push. I had a huge mental urge to push, but nothing physical. However I could feel the baby's head coming down so I had no hesitation about pushing like crazy. I'd had a feeling for some time that this baby would be bigger than the last one, so I had mentally geared myself up for a 9 pound baby. As I felt his head begin to enter my birth canal I had the thought that it was impossibly big and would never fit, but there's not really any way but down and out at that point, so I pushed anyway and remarkably enough he slid on down without much trouble at all. Of course sliding down the canal is one thing, actually getting out is another. I don't recall the classic "ring of fire" as he crowned, but I was aware of many hands being there--Hubby was in the pool with me catching the baby, the midwife's hands were supporting my perineum, and I realized that I had reached down to support myself in the front as well. Being part of my own 'catching team' was something I don't think I ever would have done in a hospital, but it came instinctively and I think it helped me not tear. His head came out, but then he stopped at the shoulders. I was pushing but he wasn't budging. Hubby moved aside and A started working the baby back and forth to get him out. My mind started racing with thoughts of shoulder dystocia and I just knew that she was about to tell me to turn over (it's easier to get sd babies out if mama is on hands and knees) and I was just sure she was going to have to break his clavicle to get him out (that's the official procedure if the baby won't come unstuck). All within the moment I was already beginning to mourn my baby's broken shoulder...but A never asked me to flip over. I felt pulling and stretching that made delivering the head feel like birthing a pillow (A later told me that she had her hands "in there with him" to get him free), and then suddenly she was done and Hubby was handing me the baby and A was putting a towel around the little one.

The first moments after birth are so precious, just staring into the eyes of my new little one and realizing the blessing of being part of a miracle.

I hadn't been able to see it, but Eagle had a nuchal hand (his hand was by his face as he was born, so although his head measurement was 36cm, the addition of his hand made it 38cm--15 inches). Hubby and A were discussing the nuchal hand when I felt a uterine twinge and knew it was time to deliver the placenta. I started to hand Eagle off to someone when I realized we hadn't cut his cord so he was still attached to me. I pulled back the towel to expose the cord and discovered that it had broken on its own! I had never heard of such a thing (and I have read a lot of birth stories). A said that it happens occasionally, but is very rare. She clamped it to make sure he did not lose any blood through it, and then turned to help me with the placenta. Delivering the placenta is easy--it doesn't have any bones. ☺

An unmedicated birth is followed by a rush of adrenalin, so I climbed out of the pool and took a quick shower. While I was showering midwife K arrived. Both A and K commented that I seemed very lively for someone who had given birth just minutes before...I wasn't trying to be lively or anything else, I just felt fantastic and ecstatic (and very glad to have the baby on the outside!). I climbed into my bed (how wonderful to be able to get right into my own bed!) and tried to get Eagle to nurse. He wasn't interested for a while, in spite of Bear telling him that nurn was good and he should try it. Wolf cut the umbilical cord (closer to his navel, as the break was several inches down). After we'd all had a chance to cuddle the baby a bit A examined me. She said that between the nuchal hand, the big head, and the stuck shoulder she'd expected to have a big sewing job, but somehow I had no tearing at all. I don't know if it was being in water, being well-supported, being relaxed, my prenatal diet, or something else, but A pronounced that I had "a beautiful vagina" and after double-checking that there was not even a skidmark, she tucked me back into bed with my baby.

B C Brighton

Born on November 12, 2009 at 8:03am

8lbs even, 20.75inches long, 36cm (14.5in) head (Bear was 7lb1oz, 19.5in, but his head was the same size!).

This labor was shorter but more intense than my last one. I was more conscious of everything, but also more in control. I do not have regrets over my choices nor the events of my first birth; in fact Bear was not even an hour old when I told Hubby "I could do that again!" (a sentiment I did not feel for a couple of days this time). However if I could choose one labor & birth to repeat in the future, it would definitely be Eagle's.

*Thanks to MommyB for offering to share her sweet homebirth story!

1 comment:

  1. Just thought I'd mention--Bear was almost 3 when Eagle was born. Wolf was 9 1/2 (he had attended Bear's birth also).
    I had spent a lot of time trying to prepare Bear for the birth--we watched some videos of births and I explained that the mommies were making noise because they were working to get their babies out. He had spent most of the pregnancy telling me that he had a baby in his tummy too (which is common at that age) and after watching the movies he had started imitating the birthing noises and told me he was working his baby out. So when he started vocalizing with me in labor it seemed as natural as vocalizing myself. LOL!! ☺


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