Wednesday, July 7, 2010

Birth Stories

Ezra's Homebirth

I haven’t felt rushed to write a narrative of Ezra’s birth. In the weeks after his birth, I initially wondered if I didn’t care how I gave birth. In giving it more thought, I’ve realized it matters to me a great deal that I had a natural birth and a homebirth. Maybe how didn’t seem immediately important because it happened mostly as I had planned. Ezra has now been with Garry and me for 38 weeks and 5 days - the length of my pregnancy with him. So, I thought this was an appropriate time to think back and to share my perspective of his birth before my recollections and impressions of it begin to fade. Here goes …

Ezra Oak Milius-Posto was born at 7:54 PM on Friday, October 9th, in our home. His birth was a planned homebirth attended by Garry, our doula Amy, our midwife J who delivered Ezra and (joining us afterward) our midwife MH, who did all our prenatal care. Also present were J’s apprentice Connie, Garry’s sister Stefanie, his brother-in-law Joshua, and Connie’s two-year old daughter Teya. Ezra was born a week and a half before his due date. It was entirely unexpected, as I had always thought Ezra would be born right around the due date, October 18. I had even seen MH two days before he was born and there was little evidence to indicate labor was imminent. My cervix was 80% effaced and still primarily posterior, and I hadn’t had any Braxton-Hicks contractions (or “false” labor). It would seem Stefanie has strong powers of suggestion. In the days preceding Ezra’s birth, she told us that Friday, October 9th would be a good day for the birth as rain was expected and she and Joshua wouldn’t be able to work if it did. I felt dismissive at the time, but indeed, it did rain that day, and my labor began at that afternoon.

I had a short labor and, despite the pain (yes, it was painful), a relatively easy labor without any complications. It wasn’t, however, uneventful. My water broke at 2:30 in the afternoon the day Ezra was born while I was at work. This was the last thing I had expected to be the first sign of labor. When my water broke, I felt a distinct pop. For about 30 seconds I didn’t recognize this as my water breaking – I thought it was a weird kick from the baby. I told my female coworkers, one of whom remarked that I would have a baby within the weekend. “Wow,” I remember thinking. I hadn’t thought that far ahead! I called Garry and then called MH and Amy. MH said labor would likely start within 24 hours and instructed me to call her again when contractions started. Garry met me in my lab, and I had my first contraction as we were leaving my building at 3:15.

Rather than making a mad dash home, which in retrospect is what we should have done, we decided to stop by the grocery store. We thought we had plenty of time to pick up a few groceries (we had a list with us!) that we would need for the birth support team and in the week after the birth – the only remaining item on our to-do-list to be fully prepared for the birth at home. We really expected my labor to be slow so we ignored the fact that I had a contraction on the way to the car, and another (maybe two) during the few minutes it took us to drive to the grocery store. We were in the store 20 minutes and during that time I had several contractions, each more intense than the one preceding it. As we were checking out, I was laughing aloud, a sort of incredulous laugh, in response to the pain and to the situation – why had we stopped and why was the cashier so slow?!

We sat in the car a few minutes and timed the contractions. They were coming every 2-3 minutes and lasting 30-45 seconds. Even faced with these facts, we couldn’t actually digest the fact that labor had started. We just kept thinking it would slow down. We called MH and she asked us to call her once we were home and agreed the contractions might slow down or cease once we were in the peace and quiet of our house. We started home about 4:00 and the half-hour ride home was less than easy. At this point, my contractions were very intense and continued coming every 2-3 minutes the entire trip home.

As soon as we were home, I got in the shower thinking the hot water might help ease the pain of the contractions. However, I found it impossible to stand up without support. The contractions were too painful and I felt a lot of pressure low in my pelvis from the baby’s head. I tried kneeling in the shower, but I was unable to manage the pain of the contractions while kneeling on a hard surface. I stood back up and there was blood in the shower. That confirmed in my mind both that labor was real and it wasn’t slowing down. I remember calling for Garry [Garry reminds me he was in the bathroom with me] telling him to call MH and let her know there was bloody show and that “I really, really need[ed] Amy” and I wanted her with us immediately. Garry helped me out of the shower and helped me get on my robe. I was hot, so I opened two windows, got on the futon and just started moaning, yelling and screaming out in pain. I knew from class that rhythm helps, so I was making my best attempt to yell rhythmically.

Garry had been communicating with MH and the rest of our birth team the entire time. He called to let MH know contractions weren’t abating. When I had bloody show, he called her again. Garry says that she had asked him to hold up the phone so that she could listen to me and get her own assessment of how things were progressing. MH realized the labor was not slowing down. She happened to be at another birth, and made arrangements for J (her back-up midwife) to get to our house as quickly as possible.

At this point, I was feeling very panicked. Everyone was taking too long to arrive. I was in a lot of pain. There was a baby’s head the size of a bowling ball in my pelvis. The 45 minutes between when we arrived home and when the first people arrived are very foggy. I think giving birth is like being drunk; recollection of events is hazy, you are brutally honest, and the next morning you can’t believe some of the things you said. I do remember that I couldn’t get comfortable in any position and we tried several. I tried the yoga ball, I tried walking around, and I tried standing using Garry for support. I naively attempted to sit with my legs open as wide as possible to make more room. At some point, we moved to the bathroom because I felt sick, or I felt like I needed to poop. Regardless, I needed to be near a toilet. Throughout all of this Garry and I kept trying to breathe through contractions together. It was difficult because I was  panicked and having trouble remaining calm. It was also difficult because Garry had eaten a falafel sandwich for lunch. So we were trying to breathe through contractions together while holding hands and making eye contact, but his breath was so strong that I kept averting his gaze. Of all the days to eat a super garlicky falafel sandwich! Garry and I were on the floor of the bathroom together when Stefanie and Joshua finally arrived. Finally!

I felt immensely relieved to see them. [Garry was relieved too – he was mentally preparing to deliver the baby himself.] Piper had become increasingly upset by my yelling and was becoming very defensive - avoiding eye contact with us, head low, growling and was progressing towards, but had not yet started, barking. Garry asked Joshua to take Piper to our friends Kristal and Stacy’s. We had made arrangements for them to watch him during the birth, but they were out of town for a Frisbee football tournament. Luckily, their dog Lucy’s sitter had agreed to be Piper’s back-up sitter. So, we were now utilizing our back-up dog sitter and back-up midwife. The birth’s timing was definitely not ideal.

Amy arrived almost immediately after Stefanie and Joshua. When I saw Amy approaching I started crying because I was so happy to see her. The labor was progressing too quickly, and I was in so much pain. I knew she would be able to help me. She quietly joined Garry and I on the bathroom floor, and I told her in a confidential whisper that Garry had eaten a falafel sandwich and his breath smelled terrible (this is one of the things I regret saying). She laughed and said, “that’s okay,” and immediately helped us breathe through the next contraction.

Garry had one of my hands, Amy had the other, and I was able to direct my gaze from one to the other while the three of us breathed through the contraction. That’s how I made it through the remainder of the labor – always two people with me breathing through the pain. I don’t think I would have made it otherwise. The pain was distracting and I needed my complete field of view focused on them. They were calm and loving and fully focused on helping me, and that helped calm me. At some point on the bathroom floor, I was finding the contractions difficult to get through. Amy told me I needed “to get on top of the contraction.” Those were the magic words. Anticipating each contraction made them a little easier to work through. At some point I think I even started saying, “ I need to get on top of this” at the start of a contraction.

Connie, J’s assistant, arrived shortly after Amy. This was the first time we had met Connie. My first impression was relief … she had a hand-held Doppler … she’s a professional! My second impression, kept to myself, was “she’s so beautiful.” The labor was so fast Connie had brought her daughter because she didn’t have time to arrange child care for her. Connie immediately checked the baby’s heartbeat between contractions and said everything sounded fine.

We moved from the bathroom to the living area since there wasn’t really enough room in the bathroom for all of us. While laboring here, I remember distinctly thinking it seemed like I was in the textbook version of transition, but I had only been laboring in total for only a couple hours (or less) so I kept doubting myself. I also remember thinking that if I wasn’t in transition I wasn’t going to make it – a sure sign of transition. I can’t clearly remember the sequence of events between moving from the bathroom and J arriving around 6:00. I know I got sick, we tried several positions, and I decided I was most comfortable on my back.

There was, of course, literally a head in my pelvis. I could feel it. It felt out of place. It hurt, and I wanted it out. Lying on my back seemed to be the only position that relieved the pressure. It was NOT the position I had planned on laboring in! I don’t really remember J arriving, but I was on my back when I first became aware of her. She asked if she could see how far I was dilated. I was reluctant and worried. If I wasn’t even close to being fully dilated, I felt I wasn’t going to make it without transferring to the hospital. J was in contact with MH, who wanted to know if the baby was likely to come in an hour or 10 hours. So J checked, and I was at 10 centimeters. “Ready to push.”

That felt good. I remember thinking this is where I get a break. I recalled from our childbirth education class that women sometimes get a break between transition and pushing. I really wanted this break. I had been having contractions about every two minutes for two hours and I was tired. Really tired. I didn’t get a break. Almost as soon as J finished announcing I was ready to push, I jumped right into the next contraction.

Pushing a baby out is hard work and pushing wasn’t really intuitive for me. I felt the contractions and knew I needed to push, but I wasn’t sure how to go about it. In the beginning, I was trying to push through an entire contraction, getting really tired and not making much progress. J and Connie provided some additional help. They suggested that I take a deep breath and push three times during a contraction. That helped tremendously. I then could actually begin to feel the baby descending during a contraction. During each contraction, the descent would be barely noticeable with the first push, modest with the second, and with the third push I felt like actual progress was happening.

I pushed for two hours, and Garry and Amy supported me the whole time. Garry helped support my weight while I was squatting. When on my back, they would help hold my legs while pushing during a contraction. Between contractions they would hold my hands, touch my shoulder and offer encouraging words. I remember feeling very grateful for the presence of everyone there helping me bring Ezra into this world.

At one point I was squatting and the head was just beginning to show. J suggested I should feel the head. Rather than feeling motivated by my progress, I remember saying, “that’s it?” I was disappointed that it seemed like the head was barely out, and I could feel it disappear again between contractions. That went on for a while, until eventually the head crowned and continued to crown for several contractions. That’s when it hurt A LOT. I was getting really tired and was just ready for it to be over. J obviously sensed this and said, “let’s get this baby out. ” This is when I felt a sense of renewed energy. Yes, let’s get this baby out now, I thought, and I pushed with a contraction and just continued pushing until the head fully emerged.

Ezra’s body was delivered easily and almost immediately after the head emerged. The umbilical cord was wrapped around his neck and had to be unwrapped before the body was delivered (this is surprisingly common and not the “emergency” situation people are led to believe). With the next contraction, his body was delivered; the cord was also wrapped around a leg. As soon as he was delivered the pain was instantly gone. It’s almost unbelievable how instantaneous the pain relief was and simultaneously accompanied by a feeling of utter euphoria.

Ezra was placed on my chest. I had my baby. My baby. He was gray and wet, and turned pink before I even realized it. The placenta was delivered easily within 5 minutes and we waited a few more minutes for the cord to stop pulsing before Garry cut it. I didn’t want to know the sex at all. [It’s really hard to remember now that he wasn’t Ezra to us yet, nor even a “he.”] I wanted to remain in blissful ignorance for as long as possible, but then at some point it did seem questionably necessary and definitely interesting to find out.

We waited for MH to arrive to do the newborn exam. It was nice to have J, Connie, Amy, Stefanie, Joshua and Teya all there together resting, snacking, cleaning, playing and recording the birth as I rested and snacked in my own bed with my new baby and my husband. Ezra was in my arms immediately after birth and for two hours before he was taken “away” and he wasn’t really taken away in any sense. MH weighed and measured him and did an exam all on the same futon on which he was delivered and I rested and nursed after delivery.

It’s amazing how inward a woman’s focus becomes during labor. Mine certainly was. Stephanie took wonderful photos of the birth and I was completely unaware of her. I was unaware of Joshua and Teya playing games in the background. I was even unaware of Connie monitoring the baby’s heartbeat between contractions.

I feel very lucky to have had the kind of birth I wanted and planned for. It was rushed, painful and, in the beginning, full of anxiety, but it was also beautiful, loving, quiet and peaceful, and Ezra entered the world in what became his home. Our birth team helped clean up and prepare us for the next 24 hours. Amy left first, followed by Stefanie and Joshua, then Connie and J. When MH left, it was Garry and I with our newly born son in our home.

Ezra's birth was, in a word, perfect. And so my life as a mother began. It’s been a whirlwind several months, but I am so happy to be Ezra’s mother.

The following is the final in a series of birth stories told by several of the people present that day.   In addition to this account, told by Amanda, you can read about Ezra's birth according to Garry, Amy, Stefanie, and Postilius.

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