Saturday, February 18, 2012

Logan's Birth at Home

When I became pregnant with my sixth child it was my eighth pregnancy. I'd had two consecutive miscarriages close together, and the last one had happened just five months earlier. I'd gone through a lot of emotional strife and healing in a short time, and I had a new outlook on pregnancy. I wasn't afraid anymore, and I accepted that whatever happened would happen. I knew I could carry a pregnancy to term, as I had five times before, and I also knew the pregnancy could potentially end in loss as I'd experienced twice. I accepted either outcome and moved forward with hope.


I had done some research and personal reflection on unassisted birth, and I was ready to plan an unassisted pregnancy and birth, without any medical or midwifery assistance. My husband, however, wasn't prepared to support me in such plans and asked me to reconsider and rehire the wonderful midwife we'd had with our fifth child's birth at home. I was upset at first, but as I thought about it and considered my husband's feelings and perspective I realized I wouldn't be sacrificing anything by hiring Sherri again. My husband's support was the most important thing to me moving forward, and I would have that along with the midwife's support.


I chose not to schedule any prenatal visits in the first trimester, and my midwife was supportive of that. When I did have my first visit with her I was open about my desire for unassisted birth and explained my feelings to her. She listened to me and promised me that she would not do anything to me that I didn't want her to. I could tell she had really considered my feelings when she called me a few days later with a proposition. She suggested that she team up with one of her fellow midwives (she works with several) and provide limited prenatal care for a lower cost. She would expect me to be responsible for my own prenatal care between the 5 visits with the midwives, and they would provide as much  phone support as I wanted and attend the birth and do postpartum visits. She gave me my prenatal file and asked me to get certain supplies so I could keep track of fetal heart rate, blood pressure, and other things throughout the pregnancy. I was very happy with this arrangement, and we moved forward with it.


I saw the midwives for five or six prenatal visits through the pregnancy, and did my own prenatal care between visits, as I felt I needed. This turned out to be very little, especially when in the second trimester my baby started moving a lot and just kept moving. I seldom checked for fetal heart rate because I could feel him moving and I knew all was well.


I had an ultrasound around 20 weeks, at which point I was informed I had a low anterior placenta. The technician told me that the placenta grows upward and would likely move up and out of the way, but suggested I have a follow-up ultrasound later in the pregnancy, around 34-36 weeks, to double check the placenta's placement. The ultrasound report was sent to my midwife, who gave it to me to keep in my file. When my midwife, Sherri, asked me how I felt about the placenta, I told her I wasn't worried, and she said she wasn't either. The other midwife, Roxanna, was supportive of having a follow-up ultrasound, but she hadn't seen the report and told me to do what I felt was best. I felt peace about it and didn't feel the follow-up would be needed. I never went to an obstetrician during the pregnancy and didn't have any blood work, screenings, or tests done other than the one ultrasound.


The pregnancy was different from my others. The first trimester was really hard. I was an emotional, hormonal wreck, and I felt like a crazy lady. I was exhausted every moment of every day, and I struggled to deal with the constant fatigue. My poor family had to put up with a very difficult mama for a few months.


In the second trimester I found some relief when the fatigue eased up and I wasn't lashing out anymore. I also discovered some helpful supplements that made me feel even better. I followed my intuition on what I felt my body needed, along with advice from friends and my midwives. I changed my prenatal vitamins and added more individual supplements, and I felt better and better. I had the best second AND third trimester than I'd ever had before. The usual muscle and joint pain wasn't nearly as bad as it had been with my past pregnancies, and I had more energy and felt like myself again. In the beginning of the third trimester my iron levels dropped, which is normal, but given my history of pregnancy anemia I started taking additional iron and other supplements to help bring it back up, and it worked well. I started nesting (cleaning like crazy) sometime around 37 weeks along, and then I just got tired around 38 weeks, and at that point I was just too pregnant to get comfortable or sleep anymore.


One of the things I'd told myself constantly throughout my pregnancy was to let go of my expectations. I didn't want to let past pregnancies and births impact this one. I wanted to honor myself and my baby and let it be what it needed to be. I secretly hoped this meant I could let go of the expectation of having another long labor, and potentially have a fast, easy labor. In trying to let go of my expectations I was unintentionally creating new expectations, and I had to constantly check in with myself and remind myself to just let things be and accept them as they happened.


I had a lot of vivid dreams during my pregnancy, and most of them were of myself giving birth. In all of them I was upright, pushing my baby out into my own hands. I never saw anyone near me in my dreams, but I knew there were people in the house, whether they were in another room or just not right next to me. I talked with both midwives about my dreams and we talked extensively about my wishes for them to be hands off during my labor and birth. They were both very supportive of my wishes. I wanted no vaginal exams unless I did them on myself or requested them, and I wanted the midwives to stay outside my room unless I asked for them. I wanted to have them at my disposal, but not in my space, and they were very respectful of that.


For the first time ever I wanted more people to be at my baby's birth. In the past I'd always kept the number of people to a minimum. This time I wanted my sister and my mom there specifically, which was something I'd never wanted before. I also wanted to make sure we had arrangements made for the kids to have someone watching them in our home during labor, and I wanted all five of our children to witness the birth itself. I wanted pictures and video of the labor and birth, because I regretted not having more documentation of past births, especially Liam's surprise breech birth which had been such an amazing experience. I asked specific people to fill specific roles for me during labor and birth, and communicated with those people beforehand to ensure I had their support. I also requested postpartum help from the Relief Society at church, with meals, school carpool, and help with my younger children during the days in the first week postpartum. I was overwhelmed by the love and support people gave in response to my requests. I had more support than I thought I had, and I felt very blessed.


Around 38 weeks I found out my mom would be traveling out of state for three weeks and would be gone a week before my due date and two weeks past it. I was devastated. She was always my main postpartum support, and I had really been looking forward to having her there to witness the baby's birth. When the full impact of her absence hit me, I sobbed and cried and threw an incredible pity party until I thought I was done. Then the next day I couldn't stop crying anytime I thought about it. It took me about two days to work through, and I eventually made peace with the situation. I felt that everything happens for a reason, and that whatever happened we would be fine. My husband told me he would step up and do more to compensate for my mom being gone, and I decided that if my baby wasn't born early enough for her to be there then maybe she just wasn't meant to be at the birth. I also felt that her trip was important and possibly more important for her than being there for my baby's birth. I made peace with it and was no longer worried about planning every last detail.


I debated about using the birth tub since in all of my dreams I pushed my baby out “dry” while being upright. I didn't see myself birthing in water this time. The water had been a huge help to me while in labor with Liam, and I believe it was instrumental in allowing him to move and float as his body came out bottom first and he was able to help push his own head out. I wasn't sure if I needed the tub again, but I still wanted the option. I made arrangements with the midwives to use their tub, which was actually a large plastic trough that we lined with blankets and plastic and filled with water. The tub was placed in our bedroom with the hoses and other accessories and birth supplies, and sat there empty for a while as we waited for the baby to make his debut.


One week before my due date, on a Friday, I started having contractions, but they were spread out and inconsistent. I called Sherri and let her know what was happening, and she relayed everything to Roxanna. I also kept the rest of my support team updated as I could, so they were prepared for the possibilities. I was glad it was the weekend, and a long one. Monday was a holiday and the kids would be home from school. The kids were so excited, and it was hard for them to wait for the baby. They knew things were happening, that I was contracting, and they kept asking when Logan would be born. I kept reminding them that we couldn't predict these things and we knew he would be born soon, but not exactly when. 


I puttered around the house when I had energy, but most of the time I was tired and just wanted to sleep. I felt guilty for going to bed so much during the day, but I hadn't been sleeping well at night and needed to rest whenever I could. The whole family stayed in that weekend and we relaxed, watched movies, and just kept everything low key. The contractions would pick up at times and be regular for a while, and then just slow down and stop for a while. I knew from past experience that this was normal, and I'd been through it before. I had said I wouldn't post labor updates on facebook, but things were going slowly and I needed the distraction, so I was posting occasional updates and trying to keep my mind on other things as much as possible.


My contractions grew in intensity, but they weren't getting any closer together. They picked up at night, and it made sleeping even more difficult. I called Sherri, one of the midwives, at 1 am Sunday morning, in frustration. I couldn't sleep through the contractions, and they were coming every 10 to 20 minutes. Not active labor by any means, but I was having a really hard time coping. Lying in bed only made them hurt worse, but I needed the sleep, and nothing seemed to be working. I would fall asleep, only to wake up every 10 minutes wanting to crawl out of my own skin and hop into the tub. I lost count of the number of baths I'd taken in the past two days. I couldn't remember early labor ever being this difficult, and I felt embarrassed just admitting that to myself. I felt like I was somehow a failure for struggling with something I'd done so many times before. I felt like I should have things under control, but I didn't. I was praying almost constantly.


Sherri said the baby might be in a bad position, and said I could try some different positions to resolve it, but suggested that I not do anything to try to get labor going in the middle of the night. She agreed that I needed to rest as much as possible, and suggested trying some different positions to sleep. I wanted to sit in the recliner, which I knew wouldn't necessarily be best for the baby's position, but Sherri said it might give me enough of a break that I could rest a bit. The recliner helped for a little while, but then I felt like I needed to get out of it. I went to bed in an open knees-chest position with my bottom up in the air, and I was able to sleep for a few hours.


Things were the same on Sunday morning and I had already decided the night before that it would be best to keep the family home from church. I called Sherri again late in the morning, and she reminded me of the positions I could try to get the baby in a better position. She suggested I use the open knees-chest position, crawl around on the floor, and do some lunges on the stairs. She also reminded me to rest as much as possible, and eat and drink like crazy to prepare myself for the marathon ahead. I almost laughed out loud because that was exactly what I'd been doing for the past few days.


My family thought it was funny when I stuck my bottom up in the air and crawled around on the floor, but I explained to them what the purpose was even though I felt pretty silly myself. I just hoped it would help get my labor into a good pattern and be more manageable, and I tried the various positions a few times during the day. By Sunday night it didn't seem like anything had changed, and I did my best to sleep again.


Monday morning came, and I did the knees-chest, crawling, and lunges again, and things finally shifted. My contractions started coming closer together, and they felt different. They were no longer crawl-out-of-my-skin intense, and they felt like how I remembered “normal” labor feeling, and were coming closer together. I had been trying to do my own vaginal checks all weekend, but until this point my cervix had been too high to reach. At this point I could finally feel my cervix and it was definitely open, maybe 5 cm or more. I wasn't sure of the measurement because it was hard to reach across it, and I didn't have experience with vaginal exams. I called Sherri and gave her the update, and she said she was on her way. My husband and older two sons filled the birth tub, and I got in it as soon as the water was high enough to cover my belly. We called my sister to come watch the kids and my sister in-law to take photos.


Roxanna was the first midwife to show up, and she started setting up. I had decided I wanted her to check my cervix to verify what I was feeling, and when she checked me she said “How does 8 sound?” I said “8 sounds great!” and she went on to continue setting up in the other room.
During a contraction


When my sister came the kids were being really good and we decided they didn't really need someone to watch them. She came into the room and helped my husband hold pressure points on me during contractions. Both she and my husband are massage therapists, and they were my constant support through active labor. They took turns holding the pressure points between my thumbs and forefingers, and my sacrum. I was once again having a lot of back labor, and the pressure on my sacrum felt really good and helped lessen the intensity of the pressure of the contractions. Between contractions we chatted with each other, and during contractions I dropped my head and shoulders and focused on relaxing my muscles and breathing, and my sister and husband held my pressure points. My sister in-law was in the room with us, taking pictures, visiting with us, and simply observing.


Sherri showed up, along with one of her midwifery apprentices. The midwives and apprentice stayed in the kitchen and front room while I labored in the tub in my bedroom with the family members who were with me. My children came in and out of the room, and at some point we decided the younger three kids needed a distraction, and they went to the neighbor's house next door to play. I was hesitant about sending them all, but I realized the younger two would be a distraction to me if they stayed, and the six year-old wanted to go with the younger two and I wanted to honor his feelings. The older two boys definitely wanted to stay, and they helped add hot water to the tub and they put their hands on me for comfort during contractions. They sat at the side of the tub a lot, and their presence was comforting. They also helped the midwives find things and did whatever else they could to help.
Between contractions


I changed positions a lot in the tub. One position worked for a while and then I felt uncomfortable and needed to move, and I kept shifting as I needed to. I continued checking my own cervix and I could tell it was opening up more and more. I asked the midwives to check me a second time, and Roxanna said I was complete with a very soft anterior lip, which she said would easily move out of the way as the baby came down. It was cool that I had felt what she described to me, and her explanation helped verify what I'd noticed myself but wasn't sure of.


I was excited to be completely dilated, but I didn't feel an urge to push. I had discussed pushing with both midwives at my last prenatal visit with each of them, and we had agreed I would follow my body's cues and wait for the urge to push rather than arbitrarily start pushing with a complete cervix. I also liked the idea of “breathing the baby down” and allowing a slower descent rather than using the forceful pushing I'd been taught to do in the hospital in the past. The midwives were supportive of this, and Sherri had only asked that if she were to tell me to push I would do it. She told me she wouldn't tell me to push unless there were an important reason for it, and I trusted her judgment. At this point I continued to labor as I had been, expecting that at some point I would feel an urge to push or my body would start doing it of its own volition.


I continued to check my cervix in anticipation. The amniotic sac was still intact, and I could feel it like a little protective bubble over the baby's head. I felt the head descend, sometimes coming down a significant amount, and other times seeming to sink back upward. I mentioned this to Roxanna, and she told me that this was part of breathing the baby down, and that it's like a dance, back and forth, two steps forward and one step back. I understood this concept already, but it was nice to be reminded of it in the moment. 


At some point I noticed my skin started to itch, and I thought I was probably having a reaction to some of the essential oils that had been added to the water. Roxanna had put some oils in when she arrived, and my husband and sister added more a bit later. They must have added too much, because it was making me uncomfortable. I didn't think much of it at first, and continued laboring in the tub for some time, but the itching seemed to spread and increase the longer I was in the water. I mentioned to the midwives about my itching, and they suggested adding some olive oil to dilute the essential oils. Someone grabbed my monstrous bottle of olive oil and soon several people were adding it to the water and rubbing it on my skin.
Checking my cervix


I felt greasy and uncomfortable, and I couldn't seem to find a good position anymore in the tub. I was frustrated and voiced my feelings to everyone in the room. I felt like what I was doing wasn't working anymore, and I needed to change something. I wanted to get out of the tub, and I stripped off my wet shirt and the midwives gave me a towel and helped me out of the tub and onto the bed. Someone brought me a shirt and I put it on.


I wanted to be upright and I knew it would probably help the baby come down. The problem was that I was tired and my limbs felt weak. I tried kneeling on the bed and it just didn't feel right. Someone gave me the birth ball to lean on, so I tried that and I just got frustrated even more. I said “I know how to push a baby out! Why isn't this working?!”


I said that maybe if we broke my water it would help things along. Roxanna reminded me that I didn't want any interventions, and she was right. She said “She just wants the baby out” and I quipped back “Yes I do!” I heard someone say “Get the birth stool” and I said “Did someone say birth stool? Yes, that's what I want!”


Very soon the birth stool had been set up near my bed, and I got down from the bed and sat on it. Almost immediately there was a gush as my water broke. Everything suddenly opened up and my body pushed, so I pushed with it. I reached down and held my baby's head as it was coming out. I said “I've got a head!” Then I felt an undeniable stinging and I yelled out “Ooh, ring of fire!” I had never felt it with any of my other kids' births, and it didn't feel hot like fire at all, but it mainly stung. I pushed through the ring of fire and it was gone as quickly as it had come because the head was out!


I was leaning forward to catch my baby, and Roxanna had knelt in front of me as I was pushing. She said “You're going to have to lean back because there's not enough room for him to come out”, and as I leaned back the baby's body literally shot out of my body into Roxanna's waiting hands. I leaned forward and immediately picked him up from her and brought him to my body.


My baby was here! I was overjoyed! And he had LUNGS! My last baby had been very quiet after birth, but this one was screaming. I held him and talked to him and ignored everyone and everything else in the room. I didn't know or care what anyone else was doing at that moment, because all I cared about was that my baby was born and I wasn't pregnant or in labor anymore. I checked to make sure he was a boy, and the next thing I knew, my placenta was out and the midwives were wrapping it up and tucking it up by the baby. I was given a towel to wrap the baby in, and I held him close as I was helped up from the birth stool and onto the bed.


Daddy doing craniosacral while mommy holds baby's hands.
I laid in the bed and held my baby skin to skin while everyone bustled about around me. He was still crying, and the skin to skin and my talking didn't seem to be calming him down. Roxanna had my sister rub some Rescue Remedy on his back and he immediately calmed down. As I held him after that I noticed his breathing sounded a little funny, and just as I was about to mention it to the midwives Roxanna brought the oxygen tank and some supplies over to the bed. She said he needed a little help getting the rest of the fluid out of his lungs, and she very gently took him and laid him on a towel next to me as she gave him a little puff with the ambu-bag. She alternated between the ambu-bag and holding him face-down over the towel to see if he would spit up any fluid. She only gave him two little puffs with the bag, and she was so gentle with him the entire time. He was calm, and then she placed him back on my chest and put the oxygen tube near his nose and mouth and gave him some “blow by” oxygen while he was lying on top of me. She then gave him a homeopathic and a little Breathe essential oil blend to help open up his airways. Sherri suggested that my husband could do some cranio sacral release work to help open up his sinuses, since it sounded like that was where the fluid was stuck. My husband laid the baby on the towel next to me and held his head and did the release work as I held the baby's hands because he was reaching out and wanted to hold onto something. He was calm and quiet the whole time, and afterward I was able to get him latched on and breastfeeding.


While it sounds like a lot of time elapsed, a lot of this really happened very quickly. The midwives estimated that I pushed for a total of about one minute, and this baby was my fastest birth by far. The labor itself was comparable to past labors in terms of time, but the birth itself was incredible in how efficiently my body was able to push him out in such a short amount of time. Roxanna explained to me at one of our postpartum visits that the reason she told me to lean back was because the way I was leaning forward was causing his shoulder to catch on my pelvic bone. I just needed to lean back to open it up enough for his body to pass through, and it was over in a matter of seconds.


Another thing that was amazing to me was when the midwives assisted Logan with his clearing his lungs. I've seen how this type of situation is handled in the hospital, and our experience at home was much different from that. There was never any sense of danger or panic, or any kind of fear. It was incredibly gentle and loving. The baby was directly next to me whenever he wasn't skin to skin on my chest, and the mood in the room was peaceful throughout. The amount of time spent helping him with this was really only a few minutes. The cranio sacral release work itself took longer than all the time the midwife was helping him. 


Roxanna told me that one of three things would happen: He would either spit up the remaining fluid, it would be reabsorbed into his body, or he would poop it out. That first night as my baby slept next to me I was awakened by an enormous belch. Stunned, I wondered if that could have possibly been the baby! I checked him, and sure enough, he had spit up clear fluid onto his sleeves. At the first postpartum visit the next day, the midwife checked his lungs and they were clear.


We relaxed on the bed with the baby for a few hours before he was weighed or really checked over thoroughly. The cord was cut after about an hour, and Sherri made a placenta print before saving the placenta for us. The midwives checked me and found I had a small tear that needed to be repaired, so they stitched me up.


When Logan was eventually weighed and measured he was 8 pounds, 8 ounces and 20 ½ inches long. His head was 14 ½ inches, which was actually a half inch smaller than my previous baby's head (the breech birth). He's my heaviest baby by 2 ounces, but so tiny to us, and oh so perfect.
Logan, one month old.

7 comments:

  1. I've been waiting to read your story! I really enjoyed it- sounds like a wonderful experience for your whole family, and I know you're enjoying Logan! Thanks for sharing :)

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  2. Thank you so much for sharing you wonderful story! Logan is beautiful! I know you are soooo happy!

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  3. I had to start crying when your water broke! A beautiful experience handled with grace even in the difficult moments.

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  4. What a great story, Cherylyn! Congratulations! So glad everything was peaceful and gentle, even when he needed a little help after the birth. That's the way it should be! Hugs!

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