Friday, April 11, 2008

Simon's Birth Story

Laura and I had been convinced that our Little Man would arrive early, as all the babies in Laura's family and our donor's 2 kids came early (1-3 weeks). With an April 1st due date, we figured sometime early to mid-March. Boy, were we wrong!

March came and went. April 1st came and went. The entire first week of April came and went! On Tuesday April 7th, one of our homebirth midwives, Amrit Khalsa, sat us down to talk about next steps since he was going to have to come out eventually. We decided that to start down the road with a series of less invasive interventions. We already had an appointment with our backup Ob on Wed just to check in and Amrit thought it would be a great idea to have him strip Laura's membranes (basically wiggle a finger around in her cervix to separate her amniotic sac from the cervix, which often is enough to stimulate labor. If that wasn't enough, we'd do some testing on the baby on Friday and if he looked strong, do castor oil on Saturday (very not fun, so we hoped to not get to that).

Wednesday April 9th, at 3:30pm we met with our Ob who said Laura was 1 cm dilated and 70% effaced. He stripped her membranes (uncomfortable but not horrible, Laura said) and strongly encouraged us to make an appointment for an induction at Alta Bates hospital for the next Tuesday night in case he didn't come by then. We resisted, because it meant we wouldn't be able to have a homebirth, but we were most interested in having a healthy baby so we made the appt.

Laura :
Within five minutes, I began feeling that different kind of contraction (lower and more menstrual like) that I had felt before but not consistently. These continued and started picking up in intensity on our drive home and through our 20 minute dog walk. From the very beginning, we were timing them at 5 minutes apart and 45-60 seconds long!

When we got home from the walk at about 4:30ish, I just needed to lie down and rest through these new contractions.

Jaime: Laura began vocalizing to cope almost immediately because they were pretty intense so I called Lior, our other midwife. Lior encouraged us to keep watching them but mentioned that they could just be a reaction to the stripping and might not be real labor.
At this point the contractions seemed to follow a bell shaped curve with a clear start, peak and then mellowing out. The vocalizing that I was doing was about matching the curve and felt really good.

I was pretty convinced it was the real thing but we waited for about 2 hours at which point I started making phone calls (we had a phone tree and we needed to get Laura's sister, Jen, to fly up from L.A. to be our other support person). Jen asked to talk to Laura during our call to her and when Laura not only refused but started to vocalize during the phone call, Jen decided to get herself on an earlier plane.

Amrit was due to stop by after an 8:30 appointment so we labored together alone for about 4 hours. It was a little scary at times but also so empowering to see that we could do this together.

In the middle of the bed labor, Laura threw up and then shortly after lost her mucus plug while on the toilet, so I was pretty darn sure this was the real deal. It was amazing to have something so definite happen. It was clear that it was a mucus plug and not much else too. Holy big loogie looking blob!

After about 3 and a half hours on the bed, with the intensity of the contractions incrementally increasing , I suddenly started getting cold and shivering the same way that I did during my days immediately following my head injury. It was weird to feel that energy coursing through my body to the point that I just needed to flex my arms and legs during the breaks in between contractions.

Jaime suggested that I get in the hot tub we had rented for labor. I immediately relaxed, although my contractions continued to increase in strength and were getting slightly closer together. The contractions continued to follow the bell curve rhythm but being able to completely float in the water meant that I was able to ride them in a much more present way. Oh yeah, then I threw up again.

At about 8:30, Amrit came through the door and I felt an immediate sense of relief. I knew labor was moving fast and I wasn't sure if she was going through transition with the puking. I'd already caught one baby at home by accident (my friend Jessica who had a 90 minute labor with her 4th child) and I was hoping not to have to do that again!

At one point shortly after Amrit arrived I remember feeling the contractions begin to change during the peak time. I started to be very aware of my lower back during the peak time and as soon as Amrit asked me how they were going, I was very clear they were really picking up in sharpness in particular at peak time in my lower back. As soon as I mentioned that to Amrit she said it was time to get out of the tub. I had about a second of thinking "but I like the tub" and then remembered that more important was "giving up" to the process and the incredible wise woman that I knew had so much wisdom.
Amrit checked her at 8:30 and found her 3 Centimeters dilated with a bulging bag of waters. Shehad Laura get out of the tub and onto the floor and showed me how to apply counter pressure. We (mostly Amrit) did this for about 30 -45 minutes and then Laura had to go pee. We sat in the bathroom for a bit and I realized I was STARVING so I went in the kitchen for a minute to get food. Those of you who know me know that little comes between me and food when I'm hungry, but I only managed to get half a cheese stick and a few bites of pasta in my mouth when Amrit called me back. Laura really wanted me there with her which felt very sweet and also a little intense because it meant things were really picking up. She'd been fine when I'd stepped away for a minute or to before but this was different. While we were in the bathroom, she started sounding a little different during the contractions- in the middle it sounded like she was sobbing. I thought it was really starting to hurt and maybe she was touching on some old stuff from her motorcycle accident. Amrit told me that she was going to go to her car to get all her gear, so I figuered were were in a new holding pattern and that things had settled enough for her to take a break and get her stuff.
Laura: When I got to the bathroom it felt so nice to be sitting and holding my tumm up. That lifting really helped with the contractions and having Jaime right there next to me with more physical contact was awesome. I didn't realize until she went to get something to eat that closeness was huge as I headed into the next phase (that I had no idea I was heading into). It was in the bathroom that I first experienced the change in contraction from that consistent curve to something else (now we know it was transition). It was during the peak of the contraction that all of a sudden I lost my focus and felt this "lifting" and not being able to continue my vocalizing. Hence the sobbing that Jaime thought she was hearing.
Before Amrit came back to the house, Laura wanted to move to the floor by our living room where we had pillows covered in a canvas tarp set up. At 9:40, jJust as Amrit walked through the door, Laura started moaning with another contraction, but halfway through made a really gutteral grunting noise. I looked up at Amrit in shock, because I distinctly remember that noise from when I caught my dear friend Jessica's baby. Laura was already starting to push and it was only about 6 hours into labor!!!!! Amrit just smiled and nodded and said, "oh yeah, we're going to have this baby soon". I started giggling in total disbelief that we were already at this stage. It had felt like a fast labor but I didn't have a real schema for how long it could take and also was in a total time warp.
Laura: Once I lay down on the floor I had a few more contractions where I felt that shifting during the peak of it and then all of a sudden there was this one contraction where not only did I catch my breath and feel the "lifting" even beyond the peak of the tightening, but there was an involuntary push!! Dude!! It's so crazy. When I think about "pushing" (anything.. a door open, a baby out..etc) I think of a deliberate action. A decision is made in the brain and then the body follows directions. Not this. This was something that felt just like a wave and it came over me and there was nothing to do but ride it.
Amrit checked Laura and she was at 6-7 cm dilated. Amrit asked her not to push but to try to "blow out a candle" breath during contractions so that she wouldn't push against her cervix before it dilated completely. If she did, it would swell up and stall labor. She did this for about 10 minutes and I was trying to coach her myself but couldn't really help her that much in getting the breath right. Amrit was busy trying to lay out her essentials because she knew this baby was coming FAST. Amrit called Lior, our other midwife, and said the baby was coming and that she needed to get here as fast as she possibly could. At about that point I realized how imminent the birth was- Lior only lived about a 15 minute drive away, so if she needed to book it, it meant this kid was barreling through.
Also, at about this point, I realized Jen still wasn't here. She was going to take an 8:30 flight from L.A. which would have put her here at about 9:30 or so and then her friend Saun-Toy was going to pick her up. I couldn't call her or text her to tell her to hurry up because Amrit had just let me know that I was going to be her lovely assistant for this birth if Lior didn't get here in time. Hey, I'd done it before with my friend Jessica and the last time I'd only had the midwife on the phone coaching me- this time I had a midwife in the flesh!
At about 10:30, Lior walked in the door. Laura was hyperventilating a bit in her rapid breathing, so Amrit had Lior get a paper bag and some oxygen so she could get things settled down. After that, Laura started to be able to push and about then I realized that her water had never broken. We looked and this yellow balloon was starting to appear at the opening (the amniotic sac, completely intact!). She kept pushing and before long there was a 4 inch in diameter bulge of her sac, which I have to say, is one of the most incredible sights. Right about then Jen walked in the door. It took her about 2 seconds to take stock and she got right down on the floor by Laura's head. She kept looking at what was coming out with a look of complete puzzlement and I explained that it was the intact amniotic sac.
Laura: At this point I had the blessing from Amrit to push and get that baby down. It was like something clicked in my head about not only riding the wave of the contraction but in fact joining in. It felt incredible to feel the momentum that my body was producing on it's own and then add in this powerful feeling of intention along with it. With hindsight now it is amazing to me that at this point in the labor, as the little man was really heading into my pelvis and it needing to do it's thing (move and widen) I was feeling nothing but groundedness in this part of my body that had been through so much trauma.
I got down by Laura's right leg (she was lying on her left side) and Lior got on the other side and pulled out the doppler to check the baby's heartbeat. Amrit had checked it numerous times throughout the labor and they just wanted to make sure everyting was good as he was going through the most narrow part. Lior kept trying different locations for about 3 minutes but couldn't find what she was looking for. I felt a little nervous but figured that it wasn't a huge deal. Then I heard Amrit's tone. She told Lior to give her the doppler and she tried. They couldn't find it. She told Laura in a very calm, but very firm voice that we couldn't hear the baby and that we needed to change her position. We rotated her, which was uncomfortable for Laura, and they tried again. They got the heartbeat but it was a bit all over the place (dropped from 120's-140's beats per minute to 90's to 100's) which can be a sign of fetal distress. At 10:45 pmAmrit decided to rupture the membranes so she could check the amniotic fluid for meconium (the baby's first poop) which can also indicate if the baby is in distress.
The fluid was clear which was a really good sign but something was not right. Amrit made Laura breathe through *3* contractions and not push. It was one of the hardest things I've ever seen anyone do...but Laura did it beautifully. Jen and I just looked at each other over Laura's body. I mentally tried to prepare myself for the possibility that we could lose the baby. It was horrible. It's amazing how completely you can imagine an entirely different life in 2 or 3 minutes. I felt cold and had the shivers and just tried to stay calm and watch the midwives and soothe Laura. It all felt completely unreal.
Laura: At this point I had no idea that anything serious was going on, only that I was not supposed to push for a little bit. There was no question in my mind about whether or not to listen to the instruction only the question of "how the frick do I do that?!" Jen really helped me breath and not bear down during the next three contractions by speaking right to me about "in through the nose and out through the mouth" over and over again.
I watched Lior as she used the doppler to check the heart tones again and she broke into a small smile and nodded her head. Amrit told Laura that the baby was doing well and that she could push again. (Later she said that if we'd been in the hospital, they would probably have done an emergency C-section at that point instead of waiting a smidge to see if he recovered. She also said that he recovered immediately because he wasn't medicated- if Laura had narcotics on board, he really would have needed a C-section because he wouldn't have had the same reserves.) She said that he was probably a little in shock from coming through so fast and then later, when we saw how the cord was positioned, figured that it was getting a bit compressed at the tightest part of the canal.
Laura: When Amrit said that I could push again on the next contraction I felt a resounding Hosanna in my body and gave it my all for the next few contractions. It felt so amazing to be able to join in with my body again, I felt some stinging and wondered if he was coming through the "ring of fire". After just one more contraction I felt the stinging subside and thought "I guess not" but then Amrit said something about his head being right there.
Laura was pushing like a champ when Amrit said to me, "Are you ready to catch your son"? I started grinning. She and I switched places and she started dumping olive oil on the opening and I placed my hand at the bottom to support her perineum. Black hair started to appear and I began to realize that it was all about to really happen. After about 8 pushes, at 11:15 pm, his head started to emerge.
Laura: I heard Amrit say that if I was ready and if I wanted to work the next push I could get him out on the next contraction. I felt this surge of energy and bore down and felt his head come out. I heard Amrit say "keep going" and there was no way I was NOT going to do that so with one more breath and a huge push I felt the rest of his body slide out from what felt like the very core of me. Totally sureal and amazing.
All of a sudden there was a head out, facing me, with a squished, alien looking face! At 11:16 pm, within the same contraction, he slipped out, slick and wiggling. Amrit said, "catch your baby" and I tried to lift him and then we all realized that he was completely tangled in his cord in what they called a "bolero". The cord was loose but was wrapped around the back of his neck, over his shoulders, behind his back and then his belly. They tried to lift it over his head but it was not long enough so they brought it down over his shoulders.
I believe the first words out of my mouth were, "Dude! He's alive!". Laura said something similar to "It's a baby!" It's a totally surreal experience to have a living creature come out of my wife's body. I think it was a bit surreal for Laura to have a live baby come out of her body too :-)
We moved Laura to the couch where she got started breastfeeding and we began making phone calls. After about an hour, we moved Laura to the bed where they could repair the 2nd degree tear (minor) and check the little guy's weight and length. He weighed 6 pounds 2 ounces, was 19 inches long and his Apgars at 1 minute were 6 out of 10 and at 5 minutes were 8 out of 10. He was a little shocked from the fast birth, the midwives said, so it took him a bit for his lungs to completely clear and his color to really pink up but he was great.
Overall, it was almost exactly the birth experience I'd dreamed of for us (minus the 5 minutes of scary). I'm so beyond thrilled that we chose to have a home birth and that it was the happy, healthy, safe experience I knew it could be.
I am also eternally grateful to our beautiful, strong, brilliant, kind midwives for all the support they gave us before, during and after the baby's arrival. I realized, as we started putting interventions on the table, that the homebirth experience isn't about where you technically have the baby. It's about the wraparound love of the midwives, the knowledge that no matter what happens they would support, protect and guide us and the belief that we are advocates and active participants in the entire process. For this we, all three of us, are eternally grateful to Amrit Khalsa and Lior Mayer.


Siren said...

I was weeping before Laura even started pushing.

Thank you for actually re-telling an accurate, real, detail-oriented birth story (complete with multiple perspectives). It was WAY better than, "oh, labor was hard..."

My favorite parts were the sac coming through the cervix, Laura's description of the bell-shaped labor pain/energy and the "Dude, he's alive!"
That was awesome.

Now, when I can add my own story, I'll have yours as inspiration!

Peggy Anne said...

Wowza! Written with grace, wisdom and love love your birth story, thanks for sharing it!