Her man snores softly
on the other side
of her cozy bed,
smooth sheets twisting around his legs,
the toddler a bridge
between their shoulder blades.
Blue light from the bathroom
illuminates the numbers of the clock
when the phone jangles.
She answers cheerily.
They think she was awake anyway.
She wasn’t.
She rises quickly,
splashes the sleep from her eyes,
brushes peppermint into her teeth, and
dresses in carefully folded clothes
that have been waiting patiently
on her rocking chair
for a week or so.
She loads boxes and bags
in her car
and drives into the silent night
sighing a prayer of supplication
for all to go well.
She tiptoes
into another’s home,
another’s space
whispering a hello
to the family dog,
who greets her with a wagging tail.
She hears the moans
and sighs
of the work of bringing forth --
the effort of releasing.
She holds space
and peace
and bears witness
while time warps
like melting glass
She counts galloping beats
inside a gravid womb
brushes damp hair from a sweaty brow
offers a drink of juice
and a word of encouragement
a rush of water
pain
joy
urgency
love
LIFE
As the family rejoices
tears track down her cheeks.
The miracle never wanes.
She cleans the sheets,
the floor,
the bathroom.
She reassures the new mama,
assists the babe
in his quest
for his mother’s warm milk.
She feeds the family
a celebratory feast
of crackers,
and fruit,
and the soup that grandma made,
which smells like comfort and love.
She smiles broadly
as the older children
stumble in the room
like sleepy puppies,
wonder highlighting their faces.
She explores a fresh newborn
head to toe
and with a kiss
on the baby’s head,
inhales his scent
like sweet hay.
She tucks the new family in
And murmurs goodnight
She loads boxes and bags
in her car
and drives into the silent night
sighing a prayer of thanks
that all went well.
She tiptoes
into her home,
into her space
whispering a hello
to the family dog
who greets her with a wagging tail.
She treads silently up the stairs
where the cool side of the bed
waits
She lays down.
Her man snores softly
on the other side of
her cozy bed,
smooth sheets twisting around his legs,
the toddler a bridge
between their shoulder blades.
Wednesday, August 03, 2011
Wednesday, March 09, 2011
Trust Birth?
I've been cogitating on this post for a while now. I have had a couple of experiences lately with women wanting an unassisted birth (UC). I bet this will create a firestorm, so I'm getting out my asbestos panties.
There is this thought among some circles that UC is the ultimate birth experience possible. That it is more "pure", "better" or even "holy/sacred". I don't buy it. Some even call it Purebirthing or Freebirthing. If a woman is having to think and be aware of what's happening is she really free to go to that primal place? What happens if her baby needs resuscitating and she has to do it herself? Certainly that's possible. Some women may prefer that. For myself, I did not want to have to, even though I know HOW.
I understand that this is largely a backlash against the overuse of technology in birth. For some women it's a reaction to a horrible previous experience, either with a midwife or a hospital birth. Here in America, where we have access daily to clean water, plenty of food, adequate shelter, and indoor plumbing (with it's resultant sanitation perk), women are most often healthy enough to give birth to healthy babies with not a lot of issues.
However, birth is not always perfect. Even when the woman is educated and unafraid. Shoulder dystocia is a thing. It happens. And it's not always as simple as "flip the mom over and the baby pops out. Easy peasy". If only that were so! It's not always as simple as "if the mom bleeds, pop a piece of placenta in her mouth or a dropper of Shepherd's Purse and her bleeding will stop before it's dangerous". If only that were so! It's not always so simple as "If mom eats good food when she's hungry, and listens to her body, she'll grow a healthy baby." If only that were so!
The catchphrase is "Trust Birth". Well, I don't trust birth. Birth can be a fickle and capricious mistress. We live in a sinful, fallen world. Our bodies are no longer in the perfected state in which they were created. I trust God, not my body. My body gets sick. My bones can break. My body is not perfect. I trust God, but I still buckle my seatbelt. I trust God, but I still have life insurance. I trust God, but I still bring in an income to help feed my family. I trust God, but I still carry equipment and supplies for resuscitation and to treat hemorrhage.
Some UC birthers end up going to the hospital when it's not necessary simply due to a lack of knowledge or support. Some end up staying home when they should go in because of a lack of knowledge or support.
I've heard several stories lately about UC birth. In one a woman who showed up three times to two different local emergency rooms with questions about her health postpartum. The third time was a day and a half after the birth and she had a perineal tear she wanted evaluated. If she'd had a midwife, she would not have needed to make any of those visits to the ER, using taxpayer resources at the most expensive level possible.
Another situation was a first time mom who had developed every classic sign of pre-eclampsia and was still debating if she should have to go to the hospital. (She did, thank God)
The office of midwife is one ordained by God. It is talked about in Scripture. Midwives are even named in scripture and we are told that God blessed them and their families. Women from the beginning of time have had midwives by their side giving birth, and there's a reason for that.
Even I had the idea that women give birth unassisted "all over the world" with no problem. Until I talked to several midwife friends who had been to third world countries on mission trips and saw the problems that can occur. Until I dealt with my first shoulder dystocia that was NOT because of a big baby, but because of the position of the baby's arms. Changing the mother's position did nothing. Until I dealt with the woman who had a partially separated placenta and had dumped a huge amount of blood and was losing consciousness.
I have seen enough in my short little career as a midwife to convince me that most of the time I am "expensive cleanup", but there have been a few times I have been there that I (and the parents) have been very, very grateful for.
Some women say they are taking the responsibility on themselves, but if they are not conscious, or their baby is stuck, they will not be the ones dealing with it. Their partner or husband will be. Is HE ready to deal with those emergencies?
I am sure this will not be an entirely popular opinion, but there it is. Midwife Judy Mentzer has said, "All the midwives need each other and the women need all the midwives."
There is this thought among some circles that UC is the ultimate birth experience possible. That it is more "pure", "better" or even "holy/sacred". I don't buy it. Some even call it Purebirthing or Freebirthing. If a woman is having to think and be aware of what's happening is she really free to go to that primal place? What happens if her baby needs resuscitating and she has to do it herself? Certainly that's possible. Some women may prefer that. For myself, I did not want to have to, even though I know HOW.
I understand that this is largely a backlash against the overuse of technology in birth. For some women it's a reaction to a horrible previous experience, either with a midwife or a hospital birth. Here in America, where we have access daily to clean water, plenty of food, adequate shelter, and indoor plumbing (with it's resultant sanitation perk), women are most often healthy enough to give birth to healthy babies with not a lot of issues.
However, birth is not always perfect. Even when the woman is educated and unafraid. Shoulder dystocia is a thing. It happens. And it's not always as simple as "flip the mom over and the baby pops out. Easy peasy". If only that were so! It's not always as simple as "if the mom bleeds, pop a piece of placenta in her mouth or a dropper of Shepherd's Purse and her bleeding will stop before it's dangerous". If only that were so! It's not always so simple as "If mom eats good food when she's hungry, and listens to her body, she'll grow a healthy baby." If only that were so!
The catchphrase is "Trust Birth". Well, I don't trust birth. Birth can be a fickle and capricious mistress. We live in a sinful, fallen world. Our bodies are no longer in the perfected state in which they were created. I trust God, not my body. My body gets sick. My bones can break. My body is not perfect. I trust God, but I still buckle my seatbelt. I trust God, but I still have life insurance. I trust God, but I still bring in an income to help feed my family. I trust God, but I still carry equipment and supplies for resuscitation and to treat hemorrhage.
Some UC birthers end up going to the hospital when it's not necessary simply due to a lack of knowledge or support. Some end up staying home when they should go in because of a lack of knowledge or support.
I've heard several stories lately about UC birth. In one a woman who showed up three times to two different local emergency rooms with questions about her health postpartum. The third time was a day and a half after the birth and she had a perineal tear she wanted evaluated. If she'd had a midwife, she would not have needed to make any of those visits to the ER, using taxpayer resources at the most expensive level possible.
Another situation was a first time mom who had developed every classic sign of pre-eclampsia and was still debating if she should have to go to the hospital. (She did, thank God)
The office of midwife is one ordained by God. It is talked about in Scripture. Midwives are even named in scripture and we are told that God blessed them and their families. Women from the beginning of time have had midwives by their side giving birth, and there's a reason for that.
Even I had the idea that women give birth unassisted "all over the world" with no problem. Until I talked to several midwife friends who had been to third world countries on mission trips and saw the problems that can occur. Until I dealt with my first shoulder dystocia that was NOT because of a big baby, but because of the position of the baby's arms. Changing the mother's position did nothing. Until I dealt with the woman who had a partially separated placenta and had dumped a huge amount of blood and was losing consciousness.
I have seen enough in my short little career as a midwife to convince me that most of the time I am "expensive cleanup", but there have been a few times I have been there that I (and the parents) have been very, very grateful for.
Some women say they are taking the responsibility on themselves, but if they are not conscious, or their baby is stuck, they will not be the ones dealing with it. Their partner or husband will be. Is HE ready to deal with those emergencies?
I am sure this will not be an entirely popular opinion, but there it is. Midwife Judy Mentzer has said, "All the midwives need each other and the women need all the midwives."
Saturday, August 07, 2010
The Sound of Silence
I listen
The silence thunders in my ears
Missing the swishes, thumps, and rhythm
There is no ocean here
Only the salty streams
On my cheeks
The gravid mound
Yields to my fingers
But does not press back
My heart beats
Icy in the hollow of my stomach
I taste bile
I must be wrong
I’ve made a mistake
Black and white
Blurred images
Still
No rhythm there
I was not wrong
Tears gather
Refusing to rush forth
Barely filling the cup
Of my lower lids
Reality blurs
Time stands still
And speeds by
What do you do when
There is nothing to do?
When there is nothing to say?
My eyes burn
Full of grit
And grief
I want to embrace
And offer distance
Solace will not come
Night passes
Day passes
We wait
Minutes stretch into weeks
Years pass in a day
Letting go is the impossible thing
The silence thunders in my ears
Missing the swishes, thumps, and rhythm
There is no ocean here
Only the salty streams
On my cheeks
The gravid mound
Yields to my fingers
But does not press back
My heart beats
Icy in the hollow of my stomach
I taste bile
I must be wrong
I’ve made a mistake
Black and white
Blurred images
Still
No rhythm there
I was not wrong
Tears gather
Refusing to rush forth
Barely filling the cup
Of my lower lids
Reality blurs
Time stands still
And speeds by
What do you do when
There is nothing to do?
When there is nothing to say?
My eyes burn
Full of grit
And grief
I want to embrace
And offer distance
Solace will not come
Night passes
Day passes
We wait
Minutes stretch into weeks
Years pass in a day
Letting go is the impossible thing
Sunday, August 01, 2010
I've been to three lovely waterbirths since my own baby was born. He came with me, Violet came to watch the baby. Each time, the mama had her baby within two hours of me arriving. Simply gorgeous births.
Then on Wednesday, July 28th, I heard from a client what no midwife ever, ever wants to hear. She texted me: "Can I come over and hear the baby's heartbeat? I haven't felt any movement today." She was 33 weeks and 1 day. I told her of course, to come right over. She replied she was waiting for her husband to come home because she wanted him with her. That's when I knew it was more serious than just a simple worry.
I had just seen her eight days before for a completely normal prenatal. Baby was active, heartbeat was 156.
Her other three children came and played with my kids. We went into my office and I went straight for the doppler. Filling the room with the sound of a galloping heart would be reassuring for everyone.
I placed the doppler where I felt the baby's back. Nothing. I tried the other side, thinking, maybe, just maybe I heard something in the middle. I listened for a long, long time. In the upper right quadrant I heard a beat, but it didn't sound like the clapping of fetal heart valves, and it was too slow for this baby. Feeling the mom's wrist I realized it was her heart I was hearing. I listened all over the fundus. No placenta sounds either. No "windy hilltop" sound. No thumps. No bumps. No swishes. I got out my fetoscope and listened with that all over her uterus. No sounds. I now know what the term "silent womb" means.
I asked her when she was positive she felt the baby move last. She said that she thought she felt the baby move on Tuesday, and she had for sure felt hiccups, but the last voluntary movement she remembered for certain was Monday night after her prenatal yoga class.
I went to the kitchen and got some new batteries for the doppler and listened again. I was sure I had to be wrong. It had to be an equipment malfunction, or maybe I just was listening in the wrong place. I sat down next to L (the mom) and put my arm around her. I told her we needed to go to the hospital for an ultrasound and I asked if they wanted me to go with them. They did. They left their other three children at my house to play and off we went.
At the hospital, we had several nurses over the next few days that I knew from my doula days at this hospital. The first nurse tried getting the monitor on the baby, cautioning the parents that she might not be able to find it right away. She was not able to find it at all. They brought in the ultrasound machine.
I've seen many ultrasounds, but never one like this. So still. No flapping heart valves. No four chambers seen moving and clapping. No movement from the baby. They called in a doctor who ordered a level II ultrasound done by a technician.
We had to wait many hours for the second ultrasound. It showed the same thing. The blood flow studies showed no blood flow in the baby or placenta. The doctor on call was recommending they begin an induction that night. L didn't want to. Her parents are 15 hours away and she wanted to go home, tell their other children, put away some of the baby things, and have a bit of time to process everything.
I didn't sleep much on Wednesday night. And when I did, I dreamt of her.
They returned to the hospital around noon on Thursday to begin the induction. I told them I would do as much or as little as they wanted from me. That I would support them 100% in any choice they made. If they wanted me to watch their other children, I would do that. I desperately wanted to be with them, and to midwife them through this. And I desperately wanted to stay home with tissues and chocolate, crying into a glass of wine. They wanted me to come. They told me, "You are our midwife. We wanted you at our birth, and we still do." So I waited.
And waited.
The wait was agony for me, I can't even fathom what the wait was like for them.
It wasn't until Friday at noon that she texted me that the contractions were starting to feel "real" and she was ready for me to come. The next 24 hours was filled with more interventions and drugs than this mother ever imagined would be used in a birth of hers. Each step was her call, her terms, her time. Each step we talked about, discussed, went over pros and cons.
We talked for hours. We laughed. We cried. We walked the hospital halls at 3 AM together.
How strange to be at a birth without the usual galloping rhythm of the monitor overlaying the ebb and flow of the labor. Just an eerie silence. How strange that all the doctors and nurses who were so sweetly respectful and extremely gentle don't realize that every mom should be treated with such love and care and respect.
The photographer for Now I Lay Me Down To Sleep was not available on the weekend (out of town) so I had agreed to take any pictures they wanted.
When the time came for her to push her baby out, she was so gentle. She looked just like any birthing woman -- strong, beautiful, glowing, joyful. Yes, there was joy here, holding hands with the sorrow. As they laid him on her skin (as she requested) and eventually up into her arms, she smiled down at him with a peace I could not imagine.
Her sweet boy, about 5 days gone in the womb, didn't look as bad as we had feared. I took 134 pictures for them, of the birth, and the baby. Closeup shots, macros of baby lips, fingers, and toes.
After all the family had a turn rotating through the room, holding the baby and mourning, I got to hold him too.
I have no clue how I did this thing. After returning home and looking at the pictures I had taken, I realized with a kind of strange awe that this was not something everyone could do. How did I? How did I do this thing? This impossible thing?
One week after hearing the silent womb, I had to leave for a family vacation. I can't fathom how horrible I would have felt if I had been gone when all this happened. I had time to spend three days seeing them through the birth of their baby's body, bring them their pictures and a meal, and attend the memorial service.
I love my ladies and their babies so deeply. Truly this is a loss for me too, but having been through it, I still can not imagine their pain.
Then on Wednesday, July 28th, I heard from a client what no midwife ever, ever wants to hear. She texted me: "Can I come over and hear the baby's heartbeat? I haven't felt any movement today." She was 33 weeks and 1 day. I told her of course, to come right over. She replied she was waiting for her husband to come home because she wanted him with her. That's when I knew it was more serious than just a simple worry.
I had just seen her eight days before for a completely normal prenatal. Baby was active, heartbeat was 156.
Her other three children came and played with my kids. We went into my office and I went straight for the doppler. Filling the room with the sound of a galloping heart would be reassuring for everyone.
I placed the doppler where I felt the baby's back. Nothing. I tried the other side, thinking, maybe, just maybe I heard something in the middle. I listened for a long, long time. In the upper right quadrant I heard a beat, but it didn't sound like the clapping of fetal heart valves, and it was too slow for this baby. Feeling the mom's wrist I realized it was her heart I was hearing. I listened all over the fundus. No placenta sounds either. No "windy hilltop" sound. No thumps. No bumps. No swishes. I got out my fetoscope and listened with that all over her uterus. No sounds. I now know what the term "silent womb" means.
I asked her when she was positive she felt the baby move last. She said that she thought she felt the baby move on Tuesday, and she had for sure felt hiccups, but the last voluntary movement she remembered for certain was Monday night after her prenatal yoga class.
I went to the kitchen and got some new batteries for the doppler and listened again. I was sure I had to be wrong. It had to be an equipment malfunction, or maybe I just was listening in the wrong place. I sat down next to L (the mom) and put my arm around her. I told her we needed to go to the hospital for an ultrasound and I asked if they wanted me to go with them. They did. They left their other three children at my house to play and off we went.
At the hospital, we had several nurses over the next few days that I knew from my doula days at this hospital. The first nurse tried getting the monitor on the baby, cautioning the parents that she might not be able to find it right away. She was not able to find it at all. They brought in the ultrasound machine.
I've seen many ultrasounds, but never one like this. So still. No flapping heart valves. No four chambers seen moving and clapping. No movement from the baby. They called in a doctor who ordered a level II ultrasound done by a technician.
We had to wait many hours for the second ultrasound. It showed the same thing. The blood flow studies showed no blood flow in the baby or placenta. The doctor on call was recommending they begin an induction that night. L didn't want to. Her parents are 15 hours away and she wanted to go home, tell their other children, put away some of the baby things, and have a bit of time to process everything.
I didn't sleep much on Wednesday night. And when I did, I dreamt of her.
They returned to the hospital around noon on Thursday to begin the induction. I told them I would do as much or as little as they wanted from me. That I would support them 100% in any choice they made. If they wanted me to watch their other children, I would do that. I desperately wanted to be with them, and to midwife them through this. And I desperately wanted to stay home with tissues and chocolate, crying into a glass of wine. They wanted me to come. They told me, "You are our midwife. We wanted you at our birth, and we still do." So I waited.
And waited.
The wait was agony for me, I can't even fathom what the wait was like for them.
It wasn't until Friday at noon that she texted me that the contractions were starting to feel "real" and she was ready for me to come. The next 24 hours was filled with more interventions and drugs than this mother ever imagined would be used in a birth of hers. Each step was her call, her terms, her time. Each step we talked about, discussed, went over pros and cons.
We talked for hours. We laughed. We cried. We walked the hospital halls at 3 AM together.
How strange to be at a birth without the usual galloping rhythm of the monitor overlaying the ebb and flow of the labor. Just an eerie silence. How strange that all the doctors and nurses who were so sweetly respectful and extremely gentle don't realize that every mom should be treated with such love and care and respect.
The photographer for Now I Lay Me Down To Sleep was not available on the weekend (out of town) so I had agreed to take any pictures they wanted.
When the time came for her to push her baby out, she was so gentle. She looked just like any birthing woman -- strong, beautiful, glowing, joyful. Yes, there was joy here, holding hands with the sorrow. As they laid him on her skin (as she requested) and eventually up into her arms, she smiled down at him with a peace I could not imagine.
Her sweet boy, about 5 days gone in the womb, didn't look as bad as we had feared. I took 134 pictures for them, of the birth, and the baby. Closeup shots, macros of baby lips, fingers, and toes.
After all the family had a turn rotating through the room, holding the baby and mourning, I got to hold him too.
I have no clue how I did this thing. After returning home and looking at the pictures I had taken, I realized with a kind of strange awe that this was not something everyone could do. How did I? How did I do this thing? This impossible thing?
One week after hearing the silent womb, I had to leave for a family vacation. I can't fathom how horrible I would have felt if I had been gone when all this happened. I had time to spend three days seeing them through the birth of their baby's body, bring them their pictures and a meal, and attend the memorial service.
I love my ladies and their babies so deeply. Truly this is a loss for me too, but having been through it, I still can not imagine their pain.
Monday, June 14, 2010
Why So Serious?
I look in the mirror
Lifting a flap of skin, adipose and dimpled
Underneath is a twisted smile of a scar.
It mocks me.
“Why so serious?” it asks
“You have a healthy baby. That’s all that matters”
It doesn’t hurt now. It didn’t hurt then.
When it felt like a pen drawing a line
A line that bled red and exposed my thin, shiny womb beneath
A line that opened to allow hands to roughly grab
Your delicate tiny head
And wrench it free
Pulling this way and that
Squeezing out shoulders and body
Tiny hands flinging out to the sides in distress
In the frigid sterile air
Your first breath a scream
Instead of a sigh
Why so serious?
You were supposed to come
With a rush of pain, pleasure, sweat, work, and ecstasy
Into the water, out of your water
To my waiting hands
To my warm chest
To my ready breasts
Clutched tightly to me
In a moment of sublime – divine -- joy
Not like that
Not in numbness, shock, fear, paralysis, and grief
Into the bright lights
To the gloved hands of strangers
To artificial warmth
To a waiting incubator
Wrapped tightly in a rough blanket
In a moment of intense relief and torrential tears
Your birth
I wanted desperately to give to you
Taken
With scalpels, sponges, clamps, and retractors
Why so serious?
A healthy baby is all that matters.
Lifting a flap of skin, adipose and dimpled
Underneath is a twisted smile of a scar.
It mocks me.
“Why so serious?” it asks
“You have a healthy baby. That’s all that matters”
It doesn’t hurt now. It didn’t hurt then.
When it felt like a pen drawing a line
A line that bled red and exposed my thin, shiny womb beneath
A line that opened to allow hands to roughly grab
Your delicate tiny head
And wrench it free
Pulling this way and that
Squeezing out shoulders and body
Tiny hands flinging out to the sides in distress
In the frigid sterile air
Your first breath a scream
Instead of a sigh
Why so serious?
You were supposed to come
With a rush of pain, pleasure, sweat, work, and ecstasy
Into the water, out of your water
To my waiting hands
To my warm chest
To my ready breasts
Clutched tightly to me
In a moment of sublime – divine -- joy
Not like that
Not in numbness, shock, fear, paralysis, and grief
Into the bright lights
To the gloved hands of strangers
To artificial warmth
To a waiting incubator
Wrapped tightly in a rough blanket
In a moment of intense relief and torrential tears
Your birth
I wanted desperately to give to you
Taken
With scalpels, sponges, clamps, and retractors
Why so serious?
A healthy baby is all that matters.
Monday, April 12, 2010
The Necessarean
My water broke in Payless shoe store at 12:40 PM on Saturday, April 3.
I was standing in line to pay for the girls’ Easter Sunday shoes and I felt a little gush. I went to the bathroom and there was a spot of brown on my pad, about the size of a nickel. I looked in the toilet and there was a big chunk of brown, so I figured it was just plug.
We got home and I went to the bathroom, changed my pad and when I stood up, another little gush. I looked at the pad. Greenish yellow. I had my daughter go and get me my Nitrazine paper. Initially it was negative. Another gush later, I tested again. Positive.
I called my midwife, D. She asked if I wanted to just go the hospital. I said I would rather not and asked what her protocol was. She said as long as the heart tones were good and reactive she was okay for now. She asked me to listen to the baby for reactivity and to take heart tones every hour. She gave me more information about cleanliness, herbs, etc. We discussed that she was not comfortable with me staying home longer than 24 hours considering the meconium and my unknown GBS status. I’ve been positive in the past and I’m pretty sure I would be again. I sent Preacherman out for some Hibiclens to use as a flush. She decided to wait a while to come because I wasn’t really having good frequent contractions yet.
We continued to talk every couple hours for the afternoon. Baby boy sounded very reactive, he was moving lots and I was having some contractions – no more than 15 minutes apart. When Posie would nurse, they would get down to 3-4 minutes apart and lasting about a minute. When she quit nursing, they would space out again. In all the leaking I had, the total amount of liquid lost was less than a cup. Probably 2/3 cup. I was wondering why it was so little amount.
I took a nap in the afternoon. When I woke up, I listened to the baby. When I put the Doppler on, it sounded like his heartrate was very low. I listened for a while finally feeling my own pulse. It felt like it was beating in sync with what I was hearing. As I listened, it gradually went up to normal. (midwife note: this means it WAS the baby, not me. It's a good thing I had a midwife instead of insisting on being my own.) I listened non-stop for a good 15 minutes and didn’t hear anything but a reactive heartbeat with accelerations. I convinced myself I had heart my own heartbeat. (I did tell the midwife about this when she arrived).
We ate dinner and Preacherman put the kids to bed. My midwife, D, arrived around 8 or 9 pm. I showed her my pad and she felt it was pretty dark color, but not particulate. She listened to Baby Boy and he sounded fine. I told her that when the contractions were further apart, they were stronger and longer, and when they were closer together they were weaker. I got Posie to nurse again and they picked up for a while. I alternated resting with trying to get contractions to actually DO something. I could tell from my lack of emotional changes that I wasn’t making any dilation progress. Baby Boy was never in the same position for long. LOA, ROA, OP, sometimes with his head oblique into my hip. I tried some homeopathics. I tried the breastpump. I even tried 1 T of castor oil (diarrhea, not bad, but no contractions).
By now it was about 3 or 3:30 AM. D had said the last thing we were going to try was some cervical stimulation, which we were holding off on because of the broken water. She felt that whatever we did, it needed to be done while it was still dark out because we agreed my labor would not pick up once it got light out. She told Preacherman and I to rest.
We laid down at about 4. At 5:35 AM it had been 21 minutes since the last contraction and we were both dozing. D was laying down in my office downstairs. I had a MONSTER contraction. It probably lasted 1 min 45 seconds or so and felt like that last couple contractions before you push. D came upstairs right away to listen. She put the Doppler to my belly and we heard… thump………… thump………. Thump…….. The heartrate was very, very slow. Like 70 bpm. “Is that him?!??!?!” I said. She told me to roll over to my left side. I did. She listened again. Thump……thump……thump…… She ran out in the hall to get her oxygen and put the nose cannula on me, telling me to breathe deeply. She listened again. Thump…….thump….. thump. As we listened, finally, it slowly came back up. She said, “I have to check you.” She felt waaaaay up inside. 3 cm. Thick cervix. Head nowhere to be found. She asked if we wanted to call 911 or take our own car. Preacherman said we’d take our own car.
We decided that even though my doctor did NOT have privileges at the closest hospital, we would go there anyway because of Baby Boy’s heartrate. We arrived at the ER there and told them what was happening. My water broke, was green, baby’s heart was too low. They put me in a wheelchair and took me up to the L&D floor while they had Preacherman filling out paperwork. We got up there and the L&D nurse came out in the hall and closed the door behind her, telling us that she was so sorry, but there was no doctor there and that they couldn’t call one in or touch me until I had been seen and examined by the ER doctor. They explained to me that my doctor didn’t have privileges there. I KNOW THAT. We came there because it was closest to my house! RIDICULOUS! They wheeled me back downstairs and wanted me to go into a triage room in the ER. I said that I wanted to get the baby on the monitor and listen to his heartrate. The nurse told me they had no way to monitor him in the ER and that they couldn’t touch me until the ER doc had checked me. After she walked out, D and I looked at each other and decided it would actually be quicker to make the 20 minute drive downtown to the other hospital than to deal with their crap there. I walked out and said, “We’re going to the other hospital.” The ER doctor told me I needed to sign an AMA form if I was leaving. I asked him “What for? You didn’t give me any advice or do anything other than jerk me around.” They wanted me to let him examine me and send me up to L&D. Which I pointed out, they had NO DOCTOR THERE anyway. I told the girl at the desk, who was still making copies of my insurance cards, to “Give me my cards.” She was all “It’s not my fault”. No one said it was sweetie, just give me my stuff, we’re leaving. She said she wanted me to sign a consent to treat form. I actually just laughed. We walked out. As we got in the car, I almost told D, but didn’t have time to say it, “I’m not scared. He’s okay.” I felt sure that Baby Boy was going to be okay. I think God gave me that peace.
In the car on the way to the other hospital, I sat in the back with the O2 on, D leaning over from the front seat to listen to the baby. He sounded fine the entire way. We arrived at the next hospital and they took me right into triage (my doctor has privileges at this hospital). They used nitrazine again and confirmed it was amniotic fluid. By this time the fluid was dark green. The triage nurse checked me and said I was 4 cm, 85% effaced and the head was well applied. D assured me that this was NOT her finding at home, and perhaps the baby had moved off his cord or whatever was happening.
As the triage nurse was leaving the area to get the doctor, I told her that if Dr. B was the dr. on call, that I would not allow him to see me. This particular doctor was abusive to a friend of mine and I knew psychologically I couldn’t handle having him attend me. They asked me who I wanted then. I said I would take whoever was accepting the walk-ins. They told me it was Dr. L. I was very surprised to hear this! Dr. L is who did my c-section with my fifth baby. His personality leaves much to be desired, which is why we didn’t go back to him. BUT, I know how to handle him, I know him, I’m comfortable with him.
They got me into a room and on the monitors. My nurse was wonderful! I was so happy to have such great staff. They were so respectful of my wishes, so nice about everything. Very willing to work with me. I was crying about missing my kids – overwhelmed with sadness that they would miss their brother’s birth. D suggested that since they allowed three people as support for me, that she would go home so I could have my two oldest daughters with me.
Even though the nurse suggested position changes, etc., I just didn’t feel comfortable considering the heart rate issues and possibility there was a problem with the cord. We were having a really hard time getting and keeping him on the monitor. We didn’t have a good strip of his heart rate.
Dr. L wanted a maternal fetal medicine consult, even though we had all of my regular doctor’s records right there, he wanted to repeat things like the ultrasound. So an ultrasound was done. Baby boy was posterior. (Quel surprise!) They estimated his weight at 7 lb 14 oz. I couldn’t believe he’d be that small. My other boys were about 8.5 to 9 lb, and I figured the baby would be too. The sonographer also said that there was no fluid left at all.
The perinatologist came in to talk to me about my history, etc., and while she was there, his heart rate went way down again. They said they wanted to put in an internal monitor. I knew it was the right choice, KNEW we needed to know exactly what was happening, but I also know how they are placed. I consented. As they were placing it, I just sobbed and sobbed. I could feel him moving and squirming inside of me, trying to get away from that sharp little lead. I couldn’t stop crying, knowing it was hurting my baby, but knowing it was what needed to happen. The perinatologist said I was 5 cm and 85% effaced. She didn’t say what station he was at.
I also knew that if I was stuck in the bed, with a posterior baby and unable to move, I was going to have to have an epidural. It seemed dumb to have an epidural for these sporadic contractions, but they continued to be extremely strong now and then, with smaller ones in between. Another decision I cried over. The homebirth midwife getting an epidural. Preacherman was so awesome and supportive. I also figured if I had to be in the hospital, I may as well enjoy having my baby as much as I could, and the amount of pain of being stuck in one spot was not enjoyable.
My two oldest daughters joined us. Violet, my really sensitive child, was crying along with me. I think they were both a little scared, and this was so different than what they’re used to with birth.
The epidural went in flawlessly and was low dose. I could still feel when I was having contractions, but it helped a lot with the pain.
Finally Dr. L came in. He said that our baby was giving us signals that he was in trouble. The meconium, (which had increased to a sludgy thickness), the complete lack of fluid, the lack of reactivity and the decels. Wait, what? Lack of reactivity? He said that he thought my uterus might be rupturing and that we should have a c-section. He checked me also and said I was maybe 3 cm and the baby was sky high. I still was not really having “labor”. Even though I was having contractions that were double peaking sometimes and lasting almost 2 minutes. We asked for a few minutes to discuss it.
After Dr. L left, I looked over the strip. He was right. Aside from the decels, there was a rather flat line. Beat to beat variability, but no accelerations with movement. He WAS still moving, so that was very good. Tearfully, we decided that for baby’s sake, a c-section was the right choice.
They topped up my epidural and gave Preacherman some scrubs. There was discussion about what would happen if Baby boy had breathing difficulties. I was worried about this also, as I know what they do with meconium babies at the hospital. I wondered how he could possibly NOT have aspirated during those deep decels with such thick meconium.
They got me all draped and ready, tested my anesthesia level and two minutes later I heard Baby Boy yell with all his lungs. They sounded clear and good. But wait, where was my husband? They were still getting him. He missed the birth. I can’t believe they couldn’t wait just a few more minutes. Baby Boy continued to cry lustily. I could hear he had no issues at all. The nurse said he peed on her. His APGARS were 9 and 10. The nurses were commenting that he looked like he’d been dipped in pollen. Mixed with the vernix, the poop looked yellow. It was up his nose, in his ears, under his fingernails and in the creases of his eyes. Once he was mostly wiped off and wrapped up, Preacherman brought him over to me to be cheek to cheek. He was so soft and warm and I was struggling not to sob and make my belly jiggle while the surgeon was working. I heard them estimate my blood loss at 500 cc. The average for a c-section is 800 cc, so that’s not bad at all. The nurse came in and announced that Baby Boy’s weight was 7 lb 3 oz and he was 20” long. So small for one of my babies! Why was he so small?
In recovery, even though it was “not allowed”, the nurse had Preacherman bring the baby back to me. I was able to put him skin to skin and he latched on immediately as if he’d been doing it for weeks already. I didn’t get the horrible shakes like I did after my othyer surgery and I declined any IV meds that would make me groggy, so I felt alert and awake and aware. It was a much better immediate postpartum in that regard.
Dr. L came back into recover to talk with me about the surgery. He said that he had been right, in that when he made the skin incision and retracted my bladder, there was “no uterine muscle left in the area of the scar. It was so thin [he] could see the baby’s face through it.” He also said that Baby Boy's cord was very thinly formed, with very little Wharton’s jelly protecting the vessels. This is probably why he was so small, with skinny little legs and not much ability to deal with the stress of the meconium plus lack of fluid.
I am so grateful to God for giving me D as a midwife, who gave me confidence, warmth and love during my pregnancy and helped me to remain calm through everything that happened. I am so grateful to God for Dr. L being the one on call – a familiar face that I trusted when that was a very important thing. I am grateful for my husband, who supported me in every decision, who assured me that it was okay to get the epidural, that he loved me forever no matter what. I’m grateful for the fantastic staff of nurses who were respectful of my wishes, never rude or mean, and willing to work with me on all of my strange requests. I am grateful that Baby Boy is so healthy, nursing well, gaining weight, sleeping well and being adorable and that he didn’t have any breathing difficulties or need to spend any time in the nursery.
I know I will never be able to labor again. I have an extremely strong feeling that I now have answers to why my labors with Blondie and Posie were like they were. I think my uterus was thinning even then and protecting itself as much as possible. I don’t even know that another pregnancy, even with an early planned c-section, would be a safe thing to do. I am mourning the loss of the dream of my peaceful home waterbirth, of grasping my warm, wet baby to my chest in ecstasy at the moment of birth. I am mourning the fact that no matter what, I will never experience that again. I am mourning the loss of my placenta (and its anti-depressive effects) which we decided not to keep as it had been marinating in meconium. I know I should be grateful for my 8 healthy children, and I AM. But still, this is a loss for me, and it is one that I will mourn.
I was standing in line to pay for the girls’ Easter Sunday shoes and I felt a little gush. I went to the bathroom and there was a spot of brown on my pad, about the size of a nickel. I looked in the toilet and there was a big chunk of brown, so I figured it was just plug.
We got home and I went to the bathroom, changed my pad and when I stood up, another little gush. I looked at the pad. Greenish yellow. I had my daughter go and get me my Nitrazine paper. Initially it was negative. Another gush later, I tested again. Positive.
I called my midwife, D. She asked if I wanted to just go the hospital. I said I would rather not and asked what her protocol was. She said as long as the heart tones were good and reactive she was okay for now. She asked me to listen to the baby for reactivity and to take heart tones every hour. She gave me more information about cleanliness, herbs, etc. We discussed that she was not comfortable with me staying home longer than 24 hours considering the meconium and my unknown GBS status. I’ve been positive in the past and I’m pretty sure I would be again. I sent Preacherman out for some Hibiclens to use as a flush. She decided to wait a while to come because I wasn’t really having good frequent contractions yet.
We continued to talk every couple hours for the afternoon. Baby boy sounded very reactive, he was moving lots and I was having some contractions – no more than 15 minutes apart. When Posie would nurse, they would get down to 3-4 minutes apart and lasting about a minute. When she quit nursing, they would space out again. In all the leaking I had, the total amount of liquid lost was less than a cup. Probably 2/3 cup. I was wondering why it was so little amount.
I took a nap in the afternoon. When I woke up, I listened to the baby. When I put the Doppler on, it sounded like his heartrate was very low. I listened for a while finally feeling my own pulse. It felt like it was beating in sync with what I was hearing. As I listened, it gradually went up to normal. (midwife note: this means it WAS the baby, not me. It's a good thing I had a midwife instead of insisting on being my own.) I listened non-stop for a good 15 minutes and didn’t hear anything but a reactive heartbeat with accelerations. I convinced myself I had heart my own heartbeat. (I did tell the midwife about this when she arrived).
We ate dinner and Preacherman put the kids to bed. My midwife, D, arrived around 8 or 9 pm. I showed her my pad and she felt it was pretty dark color, but not particulate. She listened to Baby Boy and he sounded fine. I told her that when the contractions were further apart, they were stronger and longer, and when they were closer together they were weaker. I got Posie to nurse again and they picked up for a while. I alternated resting with trying to get contractions to actually DO something. I could tell from my lack of emotional changes that I wasn’t making any dilation progress. Baby Boy was never in the same position for long. LOA, ROA, OP, sometimes with his head oblique into my hip. I tried some homeopathics. I tried the breastpump. I even tried 1 T of castor oil (diarrhea, not bad, but no contractions).
By now it was about 3 or 3:30 AM. D had said the last thing we were going to try was some cervical stimulation, which we were holding off on because of the broken water. She felt that whatever we did, it needed to be done while it was still dark out because we agreed my labor would not pick up once it got light out. She told Preacherman and I to rest.
We laid down at about 4. At 5:35 AM it had been 21 minutes since the last contraction and we were both dozing. D was laying down in my office downstairs. I had a MONSTER contraction. It probably lasted 1 min 45 seconds or so and felt like that last couple contractions before you push. D came upstairs right away to listen. She put the Doppler to my belly and we heard… thump………… thump………. Thump…….. The heartrate was very, very slow. Like 70 bpm. “Is that him?!??!?!” I said. She told me to roll over to my left side. I did. She listened again. Thump……thump……thump…… She ran out in the hall to get her oxygen and put the nose cannula on me, telling me to breathe deeply. She listened again. Thump…….thump….. thump. As we listened, finally, it slowly came back up. She said, “I have to check you.” She felt waaaaay up inside. 3 cm. Thick cervix. Head nowhere to be found. She asked if we wanted to call 911 or take our own car. Preacherman said we’d take our own car.
We decided that even though my doctor did NOT have privileges at the closest hospital, we would go there anyway because of Baby Boy’s heartrate. We arrived at the ER there and told them what was happening. My water broke, was green, baby’s heart was too low. They put me in a wheelchair and took me up to the L&D floor while they had Preacherman filling out paperwork. We got up there and the L&D nurse came out in the hall and closed the door behind her, telling us that she was so sorry, but there was no doctor there and that they couldn’t call one in or touch me until I had been seen and examined by the ER doctor. They explained to me that my doctor didn’t have privileges there. I KNOW THAT. We came there because it was closest to my house! RIDICULOUS! They wheeled me back downstairs and wanted me to go into a triage room in the ER. I said that I wanted to get the baby on the monitor and listen to his heartrate. The nurse told me they had no way to monitor him in the ER and that they couldn’t touch me until the ER doc had checked me. After she walked out, D and I looked at each other and decided it would actually be quicker to make the 20 minute drive downtown to the other hospital than to deal with their crap there. I walked out and said, “We’re going to the other hospital.” The ER doctor told me I needed to sign an AMA form if I was leaving. I asked him “What for? You didn’t give me any advice or do anything other than jerk me around.” They wanted me to let him examine me and send me up to L&D. Which I pointed out, they had NO DOCTOR THERE anyway. I told the girl at the desk, who was still making copies of my insurance cards, to “Give me my cards.” She was all “It’s not my fault”. No one said it was sweetie, just give me my stuff, we’re leaving. She said she wanted me to sign a consent to treat form. I actually just laughed. We walked out. As we got in the car, I almost told D, but didn’t have time to say it, “I’m not scared. He’s okay.” I felt sure that Baby Boy was going to be okay. I think God gave me that peace.
In the car on the way to the other hospital, I sat in the back with the O2 on, D leaning over from the front seat to listen to the baby. He sounded fine the entire way. We arrived at the next hospital and they took me right into triage (my doctor has privileges at this hospital). They used nitrazine again and confirmed it was amniotic fluid. By this time the fluid was dark green. The triage nurse checked me and said I was 4 cm, 85% effaced and the head was well applied. D assured me that this was NOT her finding at home, and perhaps the baby had moved off his cord or whatever was happening.
As the triage nurse was leaving the area to get the doctor, I told her that if Dr. B was the dr. on call, that I would not allow him to see me. This particular doctor was abusive to a friend of mine and I knew psychologically I couldn’t handle having him attend me. They asked me who I wanted then. I said I would take whoever was accepting the walk-ins. They told me it was Dr. L. I was very surprised to hear this! Dr. L is who did my c-section with my fifth baby. His personality leaves much to be desired, which is why we didn’t go back to him. BUT, I know how to handle him, I know him, I’m comfortable with him.
They got me into a room and on the monitors. My nurse was wonderful! I was so happy to have such great staff. They were so respectful of my wishes, so nice about everything. Very willing to work with me. I was crying about missing my kids – overwhelmed with sadness that they would miss their brother’s birth. D suggested that since they allowed three people as support for me, that she would go home so I could have my two oldest daughters with me.
Even though the nurse suggested position changes, etc., I just didn’t feel comfortable considering the heart rate issues and possibility there was a problem with the cord. We were having a really hard time getting and keeping him on the monitor. We didn’t have a good strip of his heart rate.
Dr. L wanted a maternal fetal medicine consult, even though we had all of my regular doctor’s records right there, he wanted to repeat things like the ultrasound. So an ultrasound was done. Baby boy was posterior. (Quel surprise!) They estimated his weight at 7 lb 14 oz. I couldn’t believe he’d be that small. My other boys were about 8.5 to 9 lb, and I figured the baby would be too. The sonographer also said that there was no fluid left at all.
The perinatologist came in to talk to me about my history, etc., and while she was there, his heart rate went way down again. They said they wanted to put in an internal monitor. I knew it was the right choice, KNEW we needed to know exactly what was happening, but I also know how they are placed. I consented. As they were placing it, I just sobbed and sobbed. I could feel him moving and squirming inside of me, trying to get away from that sharp little lead. I couldn’t stop crying, knowing it was hurting my baby, but knowing it was what needed to happen. The perinatologist said I was 5 cm and 85% effaced. She didn’t say what station he was at.
I also knew that if I was stuck in the bed, with a posterior baby and unable to move, I was going to have to have an epidural. It seemed dumb to have an epidural for these sporadic contractions, but they continued to be extremely strong now and then, with smaller ones in between. Another decision I cried over. The homebirth midwife getting an epidural. Preacherman was so awesome and supportive. I also figured if I had to be in the hospital, I may as well enjoy having my baby as much as I could, and the amount of pain of being stuck in one spot was not enjoyable.
My two oldest daughters joined us. Violet, my really sensitive child, was crying along with me. I think they were both a little scared, and this was so different than what they’re used to with birth.
The epidural went in flawlessly and was low dose. I could still feel when I was having contractions, but it helped a lot with the pain.
Finally Dr. L came in. He said that our baby was giving us signals that he was in trouble. The meconium, (which had increased to a sludgy thickness), the complete lack of fluid, the lack of reactivity and the decels. Wait, what? Lack of reactivity? He said that he thought my uterus might be rupturing and that we should have a c-section. He checked me also and said I was maybe 3 cm and the baby was sky high. I still was not really having “labor”. Even though I was having contractions that were double peaking sometimes and lasting almost 2 minutes. We asked for a few minutes to discuss it.
After Dr. L left, I looked over the strip. He was right. Aside from the decels, there was a rather flat line. Beat to beat variability, but no accelerations with movement. He WAS still moving, so that was very good. Tearfully, we decided that for baby’s sake, a c-section was the right choice.
They topped up my epidural and gave Preacherman some scrubs. There was discussion about what would happen if Baby boy had breathing difficulties. I was worried about this also, as I know what they do with meconium babies at the hospital. I wondered how he could possibly NOT have aspirated during those deep decels with such thick meconium.
They got me all draped and ready, tested my anesthesia level and two minutes later I heard Baby Boy yell with all his lungs. They sounded clear and good. But wait, where was my husband? They were still getting him. He missed the birth. I can’t believe they couldn’t wait just a few more minutes. Baby Boy continued to cry lustily. I could hear he had no issues at all. The nurse said he peed on her. His APGARS were 9 and 10. The nurses were commenting that he looked like he’d been dipped in pollen. Mixed with the vernix, the poop looked yellow. It was up his nose, in his ears, under his fingernails and in the creases of his eyes. Once he was mostly wiped off and wrapped up, Preacherman brought him over to me to be cheek to cheek. He was so soft and warm and I was struggling not to sob and make my belly jiggle while the surgeon was working. I heard them estimate my blood loss at 500 cc. The average for a c-section is 800 cc, so that’s not bad at all. The nurse came in and announced that Baby Boy’s weight was 7 lb 3 oz and he was 20” long. So small for one of my babies! Why was he so small?
In recovery, even though it was “not allowed”, the nurse had Preacherman bring the baby back to me. I was able to put him skin to skin and he latched on immediately as if he’d been doing it for weeks already. I didn’t get the horrible shakes like I did after my othyer surgery and I declined any IV meds that would make me groggy, so I felt alert and awake and aware. It was a much better immediate postpartum in that regard.
Dr. L came back into recover to talk with me about the surgery. He said that he had been right, in that when he made the skin incision and retracted my bladder, there was “no uterine muscle left in the area of the scar. It was so thin [he] could see the baby’s face through it.” He also said that Baby Boy's cord was very thinly formed, with very little Wharton’s jelly protecting the vessels. This is probably why he was so small, with skinny little legs and not much ability to deal with the stress of the meconium plus lack of fluid.
I am so grateful to God for giving me D as a midwife, who gave me confidence, warmth and love during my pregnancy and helped me to remain calm through everything that happened. I am so grateful to God for Dr. L being the one on call – a familiar face that I trusted when that was a very important thing. I am grateful for my husband, who supported me in every decision, who assured me that it was okay to get the epidural, that he loved me forever no matter what. I’m grateful for the fantastic staff of nurses who were respectful of my wishes, never rude or mean, and willing to work with me on all of my strange requests. I am grateful that Baby Boy is so healthy, nursing well, gaining weight, sleeping well and being adorable and that he didn’t have any breathing difficulties or need to spend any time in the nursery.
I know I will never be able to labor again. I have an extremely strong feeling that I now have answers to why my labors with Blondie and Posie were like they were. I think my uterus was thinning even then and protecting itself as much as possible. I don’t even know that another pregnancy, even with an early planned c-section, would be a safe thing to do. I am mourning the loss of the dream of my peaceful home waterbirth, of grasping my warm, wet baby to my chest in ecstasy at the moment of birth. I am mourning the fact that no matter what, I will never experience that again. I am mourning the loss of my placenta (and its anti-depressive effects) which we decided not to keep as it had been marinating in meconium. I know I should be grateful for my 8 healthy children, and I AM. But still, this is a loss for me, and it is one that I will mourn.
Thursday, April 08, 2010
Baby Boy is Here
Baby boy arrived by c-section on Easter Sunday (my prediction!) at 1:50 PM. He weighed in at 7 lb 3 oz and 20" long.
I have quite a story to tell about his birth, and I certainly will tell it. I'm still getting all my thoughts in order to put it all to words.
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