Into Mama’s Hands: An Unassisted Birth

If you missed yesterday’s post where I explained how I came to UC, look here.

On Tuesday, November 9th, 2010, I had my 39 week prenatal appointment.  I had reluctantly agreed to have my prenatal care transferred to the hospital midwife who worked under the back-up OB.  She checked my cervix and found me to be 3-4cm dilated and 50% effaced, but baby was still high.  I went home and continued my day as usual.  Around 4pm, as I sat on the porch talking to my husband, I coughed (I was getting over a long episode of asthmatic bronchitis triggered by a very dusty, pollen-y cleaning marathon several weeks prior), and felt a trickle.  I looked at him with a sheepish smile and said “I think my water just broke.”  I stuck my hand down my pants and felt the distinct wetness, and said, “Yup.”  Hooray!  Birthing day had finally arrived!  Contractions had not begun yet, however.  I figured they would soon, though, like they did with my last labor.

After the initial excitement, I started to get nervous.  Was I really going to do this?  Did I really have the mental capacity to have a UC?  Was I endangering myself and my baby?  I found a bottle of Riesling in the fridge that had been there for 9 months (haha), opened it, and poured myself a small glass.  It was delicious, surprisingly enough considering how old it was!  It was about all I could do for the anxiety, and it did help.

We called a few friends over, those who knew our plans (and there were VERY few of those), to help with the last minute preparations.  One friend came and cleaned the kitchen and tidied the rec-room (for my TV-viewing pleasure, haha).  Another friend got our children ready for bed.  During this, my husband moved all the laundry baskets and boxes out of our bedroom so there would be room for the birth pool.  It was set up, and starting to fill.  We turned the water off when it was half full so that it could be filled the rest of the way with fresh hot water when it became needed.

setting up the pool

my birthing cocoon, tucked into a corner of the bedroom

Then the three of us ladies went on several walks to try and stimulate labor, which was still nowhere in sight.  After several hours of waiting (my bedtime having passed), I became increasingly tired and discouraged.  I decided to go to bed, hoping to be woken up by labor.  No such luck.  I slept horribly and morning came with still no labor.  I had been having periodic gushes ever since my water broke, and every time, I would wait for a hard contraction to begin afterward.  Never happened.

It was then Wednesday, November 10th, the United States Marine Corps’ 235th birthday.  All through the pregnancy I had jokingly said I was aiming for 11/10 to give birth in honor of my husband’s 10 years in the Marine Corps. It was so awesome that it looked like that was going to actually be true!

I was starting to get a little nervous, because of the 24 hour “time limit” OBs tend to stick you with when the membranes rupture before labor has begun.  The risk is of infection.  I, however, was not being exposed to the main risk factors, which are being in a hospital full of foreign germs, and having multiple cervical exams to check progress (I had not done any on myself since my water broke).  The fluid was gushing regularly so the area was constantly being flushed out.  I was monitoring my temperature and the baby’s heart rate regularly, and both continued to be fine.

Around 8am I sent my husband to Mother Earth Market to buy a new bottle of blue cohosh tincture (an herb that is used to induce/augment labor contractions).  He got there only to find that they didn’t open until 9am.  I was frustrated, but knew I could do nothing else but wait.  At 9am, he called to say that the store was sold out of both brands of blue cohosh tincture.  Ack!  He then had to drive across town to the other Mother Earth store, where they did have some.

When he finally got home around 10am, McDonald’s breakfast in hand, I reached out and said “Gimme, gimme!”  He started to hand me a mocha frappe, and I said “No!  Give me the tincture!”  I went straight to the kitchen and took a dose.   I had decided to take the doses more frequently than usual, because I knew from past experiences that it took over an hour for any contractions to start (after 2 doses).  I was going to take it every half hour until contractions began, then decrease to every hour until they were strong and regular.

I had loaned my double electric breast pump to a friend, so I called her to see if she could bring it back that morning so I could use it to try and induce labor with some pumping sessions (which release oxitocin, the hormone that causes contractions).

I finally decided to call my homebirth midwife to consult with her.  I had been trying to avoid involving her, because I had no intentions of going to the hospital as long as things seemed to be going okay.  I’m pretty sure she knew that, but I didn’t want to put her in any kind of awkward situation (ethically).  But, the clock was ticking and I had been ruptured for over 18 hours by then.  I needed to make sure I wasn’t making a dangerous mistake by continuing to stay home, and to hash out what to do if/when it became truly necessary to go to the hospital.

I was pleasantly surprised to find that my midwife was calmer about the situation than I was.  She assured me that labor would start, and that things would probably go quickly when it did.  She had to consult the hospital midwife and inform her of what was going on, and I reluctantly agreed.  I was told that, because of the hospital-based nature of the practice, it was recommended that I come into the hospital to be evaluated.  I declined, and my choice was documented.  I knew if I went in they would pressure me to start pitocin, and that would completely kill the experience I was aiming for.  Not to mention that there was no medical indication that I needed it at that point.  So my midwife instructed me to monitor myself for fever, keep checking the baby’s heart rate to make sure it remained strong and steady, and adhere to the “nothing in the vagina” rule.  No problem!  I told her I had just started taking blue cohosh and was going to be using the pump as well.  Big thumbs up.  I felt much better then!

So, around noon, after 5 doses of cohosh, 3 pumping sessions, and still no labor, I decided that I wanted the kids to leave the house.  I couldn’t concentrate or relax; their presence was keeping me tense and nervous as they went about their day as usual (which consists of running around, making lots of noise, demanding attention, and occasionally fighting with each other).  So my husband called his mom and she agreed to come pick up the 3 younger children (my oldest was visiting his dad).  She arrived around 12:30pm, and my 2-year-old son started to freak out.  Poor thing knew something was going on, and did not like the idea of being shuttled away – it was a new experience for him.  We finally got him in the car and he was weeping…but apparently the smiles returned a few minutes down the road and my mother-in-law called to tell us that.  Good.  I could finally relax.

Enter mind-body connection.  Within 15 minutes of the children departing, I had a contraction.  A real one!  I was excited and relieved.  My husband had just made me a turkey-provolone sandwich and I was slowly eating it; I was not very hungry, but I knew my body needed more than the Gatorade I’d been drinking.  About a minute or two after that first good contraction ended, another one began.  Wow!  I was sure it was a fluke.  I continued to eat a bite of sandwich, breathe through a contraction, repeat.  After about 5 contractions in a row like this, I finally realized that I was actually in labor!  The contractions were 2-3 minutes apart, which signifies active labor, and the intensity of the contractions were consistent with that stage of labor as well; strong, but doable.  I posted on MDC (MotheringDotCommunity, an online mamas’ forum) that I was finally in labor shortly before 1pm.  My sandwich sat, half-eaten, on the porch table.

After about 45 minutes of these contractions, still coming quickly and strongly, the intensity suddenly increased dramatically.  I knew my husband needed to get the birth pool filled and warm, because it was time for that “aquadural” relief.  I had been holding out as long as possible so as not to waste the warm water or cause labor to stall.  So, between contractions, I breathlessly instructed him to get the pool ready.  There were 4 big pots of water being heated on the stove, and he emptied our hot water tank into the already half-full (but room temperature, by then) pool.

“Go boil some water!” (this was taken 39 minutes before she was born!)

At this point I got down on my knees and leaned over the birth ball during contractions.  I had to focus on relaxing my abdominal muscles, because I had been inadvertently tensing them.  The contractions were slightly less uncomfortable this way.  I breathed slowly and deeply, and rode each wave as it came.  After several contractions like this, I seized the opportunity during the (short!) break between them to pick up the ball and go to the bedroom (I’d been on the back porch this whole time).  I made it back there just in time for another contraction to start, so I threw the ball down on the floor and got on my knees, leaning over it again.  I was waiting for my husband to finish warming the pool water.

Shortly before 2pm, the phone rang.  It was my midwife calling to check on me (we hadn’t spoken in a few hours), and to tell me that she had a class from 2-3:15pm, so to text her instead of calling if I needed her during that time frame.  She asked if things were picking up and I replied “Oh yeah…”, still breathing heavily, as I had just finished a contraction.

A few minutes later, the contractions increased in intensity again.  I had to muster more courage to remain calm through each one.  I got up and stuck my hand in the pool.  It seemed only lukewarm, but I figured the buoyancy might at least help things even if the warmth factor wasn’t quite where I needed it.  I changed into a gray sports bra and fresh undies (‘cause I’m so modest, haha) between a few contractions, and stepped into the pool.  My husband came in and I asked him to turn on the CD player, which had a Polynesian women’s choir CD in it, which I had listened to while in labor with the twins 6 years back.  Then I said “More hot water.”  He was off again.  I was leaning over the side of the pool on the end that has a seat.  He arrived back with a pot of hot water and I moved to the other end of the pool and stirred with the “debris net” as he slowly poured it in.  It felt good, but still not warm enough.  “More,” I said.  Off he went.  This repeated until all 4 pots of water had been poured, and he was refilling them all to put them back on the stove.

riding the waves, deep in a trance

During all of his bustling around, I had turned over and was laying face-up with my arms supported over the sides of the pool, stretched out and suspended in the water.  The contractions were incredibly intense by then, and I was deep in a trance.  My legs were trembling and I knew that I was approaching transition.  I stayed unspeakably calm, focusing on making it through one contraction at time.  After a while, and I have no idea how long (I’m guessing about 10 minutes), I felt a very strange sensation after a contraction finished.  It was a distinct shift in the pressure down there.  My eyes flew open wide as I realized what had just happened.  My cervix had finished dilating, and her head had just slid down into the birth canal.  Holy crap.  I wasn’t about to enter transition.  I had just finished it!  Without even noticing!

This is me going through transition! Just as still and quiet as I look in this photograph.

At this point, I was in a state of disbelief that the birth was so imminent.  The last thing on my mind was calling anyone, or even telling my husband what was going on.  I didn’t quite believe it myself, and thought if I came out of my deep meditative trance and tried to talk to anyone, I might not be so calm.  So I just sat there, in my own little world.  The contractions had stalled, which is normal between the first (labor) and second (delivery) stages of birth.  It isn’t called “The Rest and Be Thankful Phase” for nothing!

As soon as the contractions started up again, they were very hard and sharp.  After a few like that, I took off my undies, squeezed the water out, and chucked them toward the bathroom (I missed and hit the dresser).  I moved to the other end of the pool, the end without the seat, and leaned over the side, resting my head on the edge.  I was on my knees, which were far back behind me, with my belly hanging down in the water.  During the next contraction, I figured I’d try pushing a little to see if that helped relieve some of the sharpness.  It did, so I continued to push, breathe, push, breathe…really focusing on catching my breath between pushes.  I may have been in la-la land, but I realized that I hadn’t checked her heart rate since I’d gotten into the pool, and there was not any possibility of doing it at this point (my primal birthing instincts had kicked in and I wasn’t going anywhere!), so I wanted to make sure I was breathing well enough to keep everything as oxygenated as possible.

My husband came back into the room, and as soon as a contraction subsided, I said to him, breathlessly, “Go turn the hose on, hot.”  He complied (there was a garden hose hooked up to our shower head).  By that point, the water heater had rebooted enough to give at least some hot water.  After less than a minute of the hose being in the tub, and feeling the hot water swirl around me, I started to have a hot flash.  “Okay, that’s good, that’s good!”  He ran and turned it off, then finally climbed onto the bed and settled in by my side.

At this point, I was pushing with each contraction.  I would ease into a push, and then my body would take over and hold the push, and I would grunt like I was taking a huge dump.  I was panting between pushes, and would then push again, because it made the sharp pains dull out a bit.  My husband was there, stroking my hair and telling me what a good job I was doing.  At first, I almost told him to stop touching my hair, but then I realized it was giving me something to focus on other than the pain, and I appreciated it, so I kept my mouth shut.  I hadn’t told him that transition was over and that this was real, intentional pushing.  In fact, I hadn’t said a word to him at all since telling him to turn off the hose.  Apparently, he thought transition was just beginning, because with my last birth, I was pushing/grunting involuntarily during that stage.

Gently, instinctively pushing my baby down.

Within a few minutes, I started to feel the burn.  I knew that I needed to stop pushing and let the tissue stretch, but it hurt so much that I chose to continue pushing as gently as possible anyway.  I knew it was almost over.  I reached down to feel for her head, but felt nothing except a slightly opened hole.  I was grunting and sobbing as I pushed.  I reached down again and felt that telltale “fuzzy walnut” that was her scalp, compressed in the birth canal and just starting to crown.  The burning was intense and I was panting quickly between pushes, still groaning and crying.  But strangely, I was not panicking.  I was so focused on what my body was doing, knowing that this was the moment of truth and that it would soon be over; there was no room for panic.  Another few gentle pushes and I reached down again.  This time, her head was completely crowned, and so I reached my other hand down and pressed down on either side to provide counter pressure.

I knew that this was the most important time to not push.  But I also knew that one more push would bring her head over that hump and the worst part would be over.  Decisions, decisions.  I chose to push (I should have waited).  I don’t even know if I was having a contraction or not at that point; all I could feel was that blasted “ring of fire”.  So I braced my hands on either side of her head, and pushed hard.  Suddenly, there was an entire head in my hands.  I let out a big sigh of relief and stroked her soft head.  I moved my fingers around to her face, brushing over her tiny ears, felt her nose and mouth, and rubbed her squishy, fat cheeks, all while catching my breath.  It was a peaceful, surreal, and completely magical moment; the world had stopped turning, and it was just me and my baby girl.

Then I was eager for the rest of her to come out.  I knew I had to wait for her to rotate her body so her shoulders could be born.  I waited to feel that happening, as I’d heard others do, but I didn’t.  I became impatient and figured I’d try to push again and see what happened.  I figured I’d stick my finger down there and try and hook her armpit to aid the top shoulder’s delivery.  As I was doing that, she started to slide out a little, and I realized I’d forgotten to check to see if the cord was around her neck!  OOPS!  I unhooked my finger from her armpit and there was the cord!!  She was already sliding out, so I quickly tried to loop it over her head.  I couldn’t, and she was coming out anyway.  She sort of somersaulted out into the water, and I tried to maneuver her out of the cord tangle.  The lighting was dim and I couldn’t really see exactly how the cord was wrapped over her (I believe is wasn’t actually around her neck, but over her shoulder and across her chest).  I couldn’t pull her up out of the water because of it, so I slowly spun her around until she was untangled and I could pull her up.  It was 2:58pm.

[This was the moment when my husband finally realized how far things had gone, poor guy!  He had no idea what was happening until he saw her hand in the water as she was born.  Talk about poor communication on my part!  Time to grab the camera!]

Some of these are really grainy because the flash didn’t go off, sorry!

I lifted her up to my chest.  She was purple and not breathing, but her arms and legs were flexed, her face grimacing, and the cord still attached and pulsating, so I knew she would be okay.  But, I wanted her to wake up.  My husband handed me a warm receiving blanket and I rubbed her vernix-covered back and head, and said, “Hi, sweet girl!  Open your eyes, baby!”  I turned her onto her tummy so she could cough up any mucous or water, but there wasn’t any.  She did give a dry cough, though.  I turned her back over and she was opening and closing her eyes, slowly and sporadically.  I kept rubbing her with the blanket and talking to her.  I stuck my finger in her mouth to check for mucous, but it was clear.  My husband handed me the suction bulb and I stuck it in her mouth and nose, if for no other reason than to made her mad so she’d cry (I wish I hadn’t done that, but I had the slightest bit of panic brewing).  She was making angry faces, but still didn’t really cry more than a little mew every now and then.  I tried blowing into her mouth gently, and that made her mad, too.  After a few minutes of stimulation, she was noticeably pinker and more active, but still very mellow.

I felt another contraction, and remembered the placenta.  I gave a little push, and out it slid into the water.  It was still attached inside by the membranes, so I waited a little longer to see if it would eject itself (it didn’t, so I pulled gently and it came out, tearing off a small piece that ended up passing in a clot a few days later with no complications — I should have twisted the placenta to create a “rope” from the membranes that might have detached more easily).

At 3:11pm, I called my midwife, hoping that maybe her class had let out a few minutes early.  She didn’t answer, but called me back within a few minutes.  I told her “Well, that was a fast labor!”  She was surprised, just as everyone else was who heard the news.  I assessed Brigit to make sure she was okay to wait until the next morning to see the pediatrician.  She was.  My, errr…baby exit door, however, was not okay.  I ended up with a second-degree tear (see: “Suddenly, there was an entire head in my hands” above) that required about 12 stitches, and a very long wait at the doctor’s office.

30 minutes old

“I did it!”

The next day, I took the baby to the pediatrician to be checked out (and weighed and measured!).  Our guess for her birth weight was 7lbs 8oz (and that’s what we put on the birth certificate), since she had already passed meconium 4 times before she was weighed.  She was 20” long with a 35cm head circumference.  Perfectly average in size!

This experience was incredible.  Despite the tear and some difficulties I had with recovery, I could not have asked for a more perfect birth.  It was 23 hours from my water breaking to her birth, with a mere 2 hours of labor in the end.  I was calm, followed my instincts, and have been healed from all the past birth traumas.  I have never felt more empowered; I am forever changed.

baby bliss, 5 hours old

welcome to the world, baby sister!

Into Mama’s Hands: An Unassisted Birth © 2010

Brigit at 15 months (Feb. 2012)

How Did I Get HERE? My Journey to Unassisted Birth

I had my heart set on a homebirth for so many reasons, including previous birth traumas, disdain for intrusive medical interventions, privacy/modesty concerns, and outright spiritual need.  I hired the midwives and began my preparations (mostly mental at that point).  Around 20 weeks I had an ultrasound and a consult scheduled with the back-up OB because I had risk factors (fairly ridiculous ones) that he needed to sign off on so that the midwives could legally attend my homebirth.  He strung me along for over 3 months before deciding that he would not, in fact, be granting me permission to have the midwives attend my birth at home.  His main concern was for my history of birth and neonatal “complications” (every single one of which was relatively common, unpredictable and thus unpreventable, and did not necessitate a hospital to deal with – at least not for the birthing part).

20 weeks

After the initial possibility of this happening was brought to my attention at that 20 week consult, I began researching Unassisted Childbirth (UC).  I remembered seeing the documentary, “Freebirthing”, about this fringe movement.  At the time I thought “these people are nuts!”, like I’m sure many people did, but when I actually started digging into the research, I was awed to discover that people choose UC for the exact reasons I wanted a homebirth in the first place.  The thought of such an empowering, magical experience as UC made complete sense to me, and I needed to do it.  I decided that I didn’t want anyone but my husband and children there; not even friends or other family.  It was to be a private, deeply sacred event.

28 weeks

I did more research about birth than ever before.  I read about 5 books about natural childbirth, some of them midwifery textbooks.  I read them over and over.  I had to focus not only on the emotional aspect of birthing without any professional attendants around for support, but also the functional aspects of safe, responsible birthing.  I read birth stories and watched birth videos on the internet of other successful UCs.  I read stories of unsuccessful UCs that resulted in hospital transfers.  These women were smart; they were prepared enough to recognize when something wasn’t right, and when the point came that they could not handle it alone.  That is what hospitals and OBs are for.  The “real” emergencies.  It blew my mind to learn how very unnecessary so many routine medical interventions are, and how often hospital staff overreact to things that occur during birth that are simply a variation of normal.   It was amazing how much I learned about natural birth, including every single “complication” I had ever had, and how most of it was really no big deal as far as “normal” birthing goes.  It was fascinating and empowering.  I knew I could do it.  It was a long journey that required a lot of deep consideration and bravery, but when the time came that I made up my mind, I knew I could do it.  I trusted my body and my mind to get us through this safely, regardless of whether I actually got to UC or not.  I was certainly not willing to sacrifice health and safety for the UC experience, which is why I had to be so prepared; so I would know how to deal with anything that arose and recognize when to throw in the towel and call in the professionals if things went bad.

30 weeks

I gathered the appropriate supplies.  I purchased a birth pool, a Doppler, a stethoscope, a blood pressure monitor, a pulse-oximeter, chux pads, gauze, gloves, alcohol, umbilical scissors and clamps, hemostats, various herbal tinctures for augmenting contractions and helping stop hemorrhage and shock.  I learned all about how to deal with a surprise breech, shoulder dystocia, hemorrhage, and shock.  I learned neonatal resuscitation and instructed my husband on it.  We talked and talked about things, over and over for a total of 4 months.  I made sure he knew how to support me during transition, when I typically lost emotional control and had panicked in previous births.  I mentally prepared myself for the pain of crowning, because I’d felt it 3 times before, so I knew exactly how much it would hurt.  I was determined to swallow my fear of the pain and be the primitive birthing goddess that Mother Nature intended.

36 weeks

***Tomorrow I will tell you how things turned out, so stay tuned!***

~ Michelle