I had a baby! HBAC story

I’m thrilled to share that my daughter was born in a successful water birth at home on Monday, August 2, a vaginal birth after cesarean (VBAC) assisted by a licensed professional midwife (LPM) and support from her assistant, a licensed nurse midwife (LNM).

I first want to thank all my friends and family for their support through my pregnancy and birth and to thank the many groups that have supported me personally and work for birth rights and VBACtivism in general including the International Cesarean Awareness Network (especially Northern Virginia and DC chapters), Holistic Moms Network (especially my Arlington/Alexandria chapter as well as the NoVa, DC and Annapolis chapters), Birth Options Alliance, NoVa Homebirth, blogs like The Feminist Breeder, Momotics, The Empowered Birth Blog, and others I’m too groggy to name.

Thanks also to my midwives and doula and to all the childbirth educators who moderated discussions or held solo sessions with me from Bradley, Hypnobirthing and Birthing from Within traditions, to my yoga instructors, and to so many healing professionals who assisted me on this journey from conception to homebirth. It really was a collective effort! Thanks to the NIH for holding that panel on VBAC in March and to Mothering for giving me the chance to report on it and also to MJ Hanafin and the National Center for Homeopathy for allowing me to attend the powerful “Midwifery and Homeopathy” seminar in April. I have learned so much on this journey!

Below is the story of the birth of my daughter told in the way I feel comfortable sharing with the public. I want friends and family who are interested in the full story to have access to it, and I’d also like to have this out there as one more success story about HBAC for anyone who is interested.

A note on names: I might have once been in the habit of referring to my son as EJ on this blog, but he’s just going to be E from now on, and his new baby sister will just be A. She doesn’t have her own friends & family blog yet but I’m okay with a few public newborn photos, though I typically don’t do face shots of E on this blog. “LJ” is my husband.

Please consider that this whole entry might be one big TMI if you’re not into birth stories. I’ve tried to be tasteful, but not all details may be appropriate for all types of readers. Skim wisely if you’re squeamish. Otherwise, enjoy!

Pre-Birth Story

I went to bed Sunday night after 11 (post-“Mad Men”) upstairs alone while the boys camped out downstairs in the guest bedroom as has been the norm during the super hot days of July. (We are getting estimates on insulation for the upstairs!) But I had less numbing wrist pain in the upstairs bed, so I’d been sleeping up there since the heat wave calmed down. It was actually a nice night to sleep with the windows open!

I’d gotten a massage and some craniosacral work that afternoon, and when I asked “any recommendations?” the therapist said to talk to the little girl and see if we were on the same page about what kind of birth we wanted to have. So I did, for the first time in a while. I told her I hoped it would not be too long but didn’t want it so fast that I couldn’t really inhabit it. I didn’t hear any disagreement, but I also didn’t get a clue it was going to happen the next morning. Maybe all she was waiting for was for me to acknowledge what was actually going to happen.

I fell asleep listening to my hypnobirthing CD and woke early making a mental list of all the things I wanted to do. One was to find Creative Memories software to re-load on the computer that got cleared off a while back so that we could make our own birth announcement (and a very belated “We’ve Moved! announcement and an apologies-for-no-holiday-card card). Another was to make phone & email contact lists. And a whole bunch of other stuff. The list was stronger than my fatigue, so I threw in the towel on sleep.

I looked at my watch at 5:21 and decided to get up and do some yoga and try to get back to sleep for at least an hour 6-7ish. I was planning that day (after dropping E off at camp) to drive to Maryland to observe and take photos of Monica Corrado’s food camp so I could try to write and pitch an article to the Post by Tuesday evening. (I might still try a less timely piece for a magazine at some point since I have plenty of interview notes, but it’s a bummer that I can’t see it with my own eyes!) I expected a busy day and had even arranged to have a friend pick up E from music camp at 1:00 and take him to her house for a while so that I could spend more time on the job and not worry about making it back on time. But I knew I’d be tired once I got to pick him up, especially if my day started before 5:30.

I got out my mat and did some pelvic rocks and side stretches. Then I thought that since I hadn’t been sleeping soundly in the mornings, maybe my adrenals could benefit from a bridge pose. I lifted my hips up and felt a funny pop and then a small gush of liquid. “Oh, no,” I thought. “Do not tell me that my water just broke.” I envisioned that I’d be walking around for hours or a day or more with broken water and no signs of progress. Wrong!

I sat down to pee and felt a bit of a contraction of a different sort than regular Braxton-Hicks but nothing walloping. I called my midwife, Marilee of TLC birth (hereafter referred to as M), who was already at the home of my neighbor and new friend who was also going for a home VBAC (but was at that point two weeks late). Her son and mine had played together at the park with their dads just 12 hours earlier, and now she and I were in labor at the same time, something we’d joked about when we first met.

M said she would send her birth assistant, S (luckily a midwife herself, but a certified nurse midwife, or CNM), up the hill to check in on me. By the time S arrived, I was contracting every 4 minutes (starting with the first one I wrote down at 5:47). They each lasted close to 2 minutes, which is why I was thinking (and told some people) that they were 2 minutes apart (because I only had 2 minutes of respite). As much as I’d have liked to imagine them to be “surges” in the hypnobirthing lingo, they came on too fast for that to fit.

S then became our primary midwife for most of the labor. My husband, LJ, furiously ran around cleaning some things up and getting the hose connected to the birth tub. Thankfully, our son slept through all that prep. I had no time to putter or arrange anything. As soon as possible I was on my knees on the floor bent over a birth ball (which turned out to be just the right size – thanks for the bday gift, LJ! Sorry I complained that it was too small!). I was moaning my head off. It was nice for us that it was a cool morning so we didn’t have to have the A/C on, but I also wonder if our neighbors thought there was a gang of raccoons getting into some s—t with the mangy fox couple that likes to hang in the same forest ‘hood. Oh well! At least I didn’t wake up E.

I was still on the floor when he did get up though, and I remember LJ asking, “Is it okay for you to hear this?” of my intense sounds. We never did get around to watching YouTube birth videos, but I had shown the boy all the birth scenes in The Business of Being Born, and we’d read “We’re Having a Homebirth” and “Welcome with Love” and some other kids’ books about having a baby, so he had a clue. But I will never forget hearing his voice upon just getting up for the day and walking into lights and commotion, curiously inquiring, “What’s goin’ on out here?!”

So labor started at 5:47 a.m., and at 7:15 a.m. I asked, “When can I start pushing?” I was just not in a place to let the contractions just travel through me and really wanted to lean into them. Still, I also didn’t want to develop a cervical lip by starting too soon.

S checked me and said it was okay if I felt like bearing down. “Am I complete then?” I asked. “Yep!” Wow, 3 cm (as I was a few weeks ago at an prenatal appointment where I requested an internal exam) to 10 cm in about 90 minutes of labor. Who knew? Well, my midwife had pointed out that four years ago I’d dilated to 4 cm with my breech son without the help of head pressure on my cervix (maybe even to 6 cm on the Pitocin, if you believe one set of reports over the other that says I remained at 4 cm as I’d been for a few weeks). Ever since she remarked on that and indicated I’d better call her early, I had the idea that maybe my labor would be on the faster side. It was!

Birth Story

S was talking to LJ about what to do if I had the baby in the position I was in on the floor, which was a little freaky to hear that she thought it might go that fast. I started to wish I’d woken him up earlier, but I wanted him to get as much rest as he could, and I thought we’d have more time. Fortunately, we did get the birth pool filled up, and the difference was amazing.

On the floor, I’d felt like there was hardly any time between contractions and like there was no choice but to moan and groan through them. (When our doula walked in, she quickly commented on the “great sounds.” Bless her heart for being such a pro-birth nut! And she was fabulous with E who was super comfortable with her. I’m so glad we had her on board).

Once I got into the water, the experience changed dramatically. I had a little more time between contractions, and they just felt so much more manageable. “That’s more what I thought late labor would look like,” LJ said later. Still, neither of us thought the whole thing would take only 4.5 hours!

It got very quiet as I labored in the tub, bearing down with each contraction because that’s what I wanted to do. All in all, you could say I pushed for close to 3 hours, but I was not thinking I was really moving toward birthing the baby until I felt the head with my hands. I spent some time on my back in the pool, but most of it I was on hands & knees. LJ made breakfast for E, they ate, I tried to tune out the smells, and then it was just quiet while I did my thing and S and LJ watched and waited, bringing me electrolyte water and coconut water and cool washcloths. At some point we added more warm water to the tub.

Although S had been great, I still longed for my midwife who had been so encouraging (“I’m so excited for your birth!”). But at the same time, I felt bad that my overdue neighbor had lost her birth assistant and I certainly didn’t want to leave her without her midwife. I kept wanting to say “I’m sorry!” for having such bad timing and for things going so quickly.

Since my neighbor’s birth was not imminent, M came to the house when S said our baby’s head was visible, and S returned to my neighbor’s place. It was great to hear M’s familiar, soothing voice and positive words about my position (left knee down, right knee up, leaning against the side of the Gentle Birth tub.) I felt like now, even though this was faster and a week earlier than I expected, now I could feel like this was the experience I had been planning. The baby was born just about 15 minutes after M arrived.

Most of the time I was in labor, I was conscious primarily of the contractions, which were all in front. When I became more aware of the sensation of the baby moving through me, I did have moments of being able to appreciate the sensation as connected to the act that got us there. Having watched Orgasmic Birth with its director at last fall’s Perinatal birth symposium, it was important to me to try to find some enjoyment in the intensity, and I’m happy to say that I did.

There was a little stinging but nothing I’d have described as a ring of fire. It was quite something when I was encouraged to reach down again. I balked initially saying “I think I’ll be disappointed” as though I was going to expect to feel more than would be there, but they were right that it was worth checking out to feel the whole head.

And yet, my contractions were not lasting as long as I’d like, being as strong as I wanted, or coming close enough together for me. I felt like I was losing momentum. M was watching the baby’s color with a flashlight and mirror and when her head started to lose its pink, M was insistent with me about taking big breaths. “Really push this baby out,” she demanded. It was a little unnerving for a mama who had wanted to “breathe the baby down,” but necessary.

The baby’s shoulders were what M would call “a little sticky” – not dystocia – and she helped gently get them through, something that might have happened a lot easier if I’d torn, but I didn’t.

I don’t have a clear memory of the physical sensation of the whole body coming out, but I was pleased to hear myself back on the video make a kind of sexy contented sigh. Yes! M told me to pick up my baby but that she had a short cord so I couldn’t raise her all the way to my chest, just enough to get her head out of the water. (The cord wasn’t anywhere near as short as E’s, but my placenta was high so there wasn’t a ton of slack). Of course, having had one child with a short cord (which necessitated a c-section) and having just been urged to push, I was a little freaked already. And then seeing my baby rather blue and not very active, I didn’t exactly know how to react.

M told me to talk to her and rub her, stimulate her. The heart tones were fine, but her lungs were wet, and she wasn’t crying, so she got a few puffs from the oxygen bag. Then she got a few doses of homeopathic Antimonium.

E and the doula had come upstairs at just about the right time, so he saw the whole thing and was quickly saying sweetly and so cheerily, “Hi, baby!” and asking “Where is the cord? I can’t see it. What color is it?” I think we sang to her “This Little Light of Mine” but that might have been after we got out of the tub. There was no serious concern, but the celebrational feel was a little delayed while we waited for her color to improve and for her to wake up. Her head was super cone-shaped, and her eyes were so puffy; she looked a lot different than she does now!

We moved over to the couch and marveled at her super long toes and her long, pointy fingernails. And at her red hair! I was convinced this baby was going to be a raven-haired beauty like her mama, but she’s just about as strawberry as her brother was (is), but with more hair. It’s so soft! But I get ahead of myself. She was not interested in nursing in that first hour, but she did latch within two, I think. However, we still had some business to take care of before we could just settle into our comfy home as a family of four.

The Afterbirth

“Where’s the placenta?” my son asked after a while (and again and again for the next few hours). Good question. “It’s still inside my tummy. We’re hoping it comes out soon.” But it didn’t. I have one friend who hemorrhaged after birth and the midwife had to manually remove the placenta immediately, which M said she would have done if there was any concern. But there wasn’t; I wasn’t bleeding much, my blood pressure and vital signs were all fine; I wasn’t feeling faint or dizzy like another friend who I knew had gone to the hospital to have her placenta removed after her homebirth. Mine was just stubborn.

And it was being held up by several hours worth of pee I was unable to release on my own. Catheter, nice to see you again! (I remember being saddened when the catheter was removed after my c-section because it meant I actually had to get up out of bed. Ouch.) By the time I’d filled half a large bowl with pee and removed one barrier to the placenta’s descent, I just didn’t have any contractions that were strong enough to do me any good. It was still super high up, and no tugging by M was going to do any good.

Besides, she really needed to get back to my neighbor, so she left, and S returned to see if a shot of Pitocin would help. It didn’t. I’d also tried two or three homeopathic remedies – cimicifuga, caullophyllum, and pulsatilla and then a fourth later when I reached my friend (the one who’d had the retained placenta with her first pregnancy) and she looked up the condition in a book I didn’t have and found a remedy for lack of contractions after birth, retained placenta and inability to pass urine. I have to check to see what it was as I’d never heard of it, but it sounded good, so I took a few doses.

One concern was that my cervix had closed enough that it was just going to be too hard to pass the placenta. So it was decided after about four hours that I would need to go to the hospital to have it removed. M called ahead to let them know we were coming and to make sure they knew I wanted this to be an outpatient procedure (that I did not want to be knocked out and have to spend the night). It sounded like I was probably going to need to get an epidural or something after they’d figured out why it wouldn’t come (as in an accreta or some other condition). I wasn’t scared because I knew I wasn’t in danger, but I sure was annoyed that we couldn’t just wrap up this birth experience at home. I tried nursing the baby again and she latched so well, I was really disappointed to have to leave. But at least she didn’t wail when I pulled her off.

As we got me dressed in whatever clothes my friends and doula could find in the mess that was (is) my bedroom, I felt some uncomfortable pressure toward my bottom. Then, when S and I started walking out to her car, I commented on it. She said maybe we should try again. “But it doesn’t feel like a contraction in front. It just feels like I have to poop,” I countered. “That’s what we’re looking for,” she said. So we went back inside. I set down my purse, took off my shorts and put the chux pad down on the bathroom floor. S put on her gloves and with a push from me and a little help from her, out it came!

After the Afterbirth

I was so grateful for S making me go back inside! And so darn relieved that I could get on with my homebirth and now babymoon experience instead of making an expensive and intrusive hospital detour. Now I could finally call my family and just hang out, enjoying the luxury of being in my own space and just getting to know my daughter.

There was just enough time to release LJ and E to go to his 3:00 gymnastics class so that the poor kid would have something regular about his day. My doula stayed until a friend came with her kids and some food, and then my other friend who had been training to be a midwife returned from my neighbor’s house where she’d been on hand to help out since S was going with me to the hospital. What a collective effort. It was nice that the kids were here when E got back from gymnastics and they got to run around outside and play with the hose.

It was great to hang out with some of my homebirth mama mentors and feel their support, which had been unfailing despite my having made it pretty hard to want to be my friend through an emotional third trimester (and a detached/disbelieving/not telling first trimester). I felt so grateful to have a community of women to take care of me, including preparing my placenta and making me a smoothie. (I hadn’t ever gotten around to exploring what was required for encapsulation http://www.time.com/time/health/article/0,8599,1908194,00.html or even what all the benefits of placenta ingestion http://placentabenefits.info/articles.asp were, but I trusted them and was grateful for their help!)

Our doula had trouble loading photos on our computer before she left, but I’m thrilled she got the video loaded and can’t wait to get the other images on CD. She also took a bunch of great shots with our SLR camera, which is also having challenges loading images, and we just haven’t had the time to trouble-shoot it all between eating, sleeping, nursing, pediatrician appointment, osteopath appointment for conehead, midwife follow-up appointment and trying to put back together a house that was not exactly ready to be turned upside-down at 6 a.m. Monday morning.

We still have chux pads littered around in places that might surprise visitors and some other clean-up to do, but we’re getting there. The birth pool is back in its container, and our son is back to being four years old, complete with lots of “no”s, “I want it right NOW”s and other challenging behaviors. He wants to kiss his sister near constantly, which is super sweet, but it is also a little much. He was playing so loud with his trains this morning that I suggested I’d need to move her from where she was sleeping in her Moses basket, and his reply was that then he’d move his play to be near her. Thank goodness he’s still in camp this week. I have got to figure out what to do for the next few weeks so that we don’t all lose our minds.

It has been an amazing past few days, and we still can’t believe how quickly things changed from what we expected Monday morning. E kept saying, “I didn’t know the baby was going to come today!” and we kept shaking our heads saying, “Neither did we!” I really expected to go late, and I certainly did not expect to be holding a baby less than five hours after sitting down to do yoga with zero signs of labor and a busy day stretching before me.

Shortly before that bridge pose/water breaking moment, I and tried to shake of the grumpiness that had come on the previous evening after I misjudged the size of my belly and sort of ran into the bedroom door frame because E was behind me. I’d worried about hurting the baby and felt guilty for how annoyed I was at E just for taking up space, even though he quickly offered “Sorry!” when he realized I hurt myself.

And there was the working/thinking/busy mom vs. birthing/about-to-be-new mom conflict: I really wanted to visit the food camp and write an awesome article about it because it’s so exactly what I’m passionate about, but I also knew my brain was no longer screwed on in a writerly/researcher way. I would give the piece a shot, I figured, but I worried I just wouldn’t be able to come up with something good enough for a paper to take on such short notice since part of my brain had already checked out. I wanted not to fall behind on sleep, and I was torn because I knew it would be wise to spend more of my limited free time wrapping my head around the birth in what I figured was my last week. So I was ambivalent and not feeling super centered the night before my daughter arrived.

As I sat on my yoga mat, I looked out the open window into the early morning and reminded myself that soon this hour might look very different once there was a newborn around. There is nothing like being alone at that hour of the day or being just with a completely dependent being, when all else has lost its regular heft of priority and the only thing to do is nurse and love. I tried to embrace the beauty and quiet of that just-before awakening time.

And then it all began.