Thursday, February 28, 2013

Baby boy #5's birth


This is the story of the birth of my fifth son. I’ve had births of different experiences, including some traumatic ones, but they were all hospital births, and I was determined to have a home water birth this time, and I was wishing for the baby to be born in the caul. I had mentioned it to my husband the two previous pregnancies, but he wasn’t game for that. When we conceived baby #5, I told him we were having a home birth. Luckily, through Facebook, I had reconnected with an old high school friend, who had a friend who was apprenticing with a midwife. That’s how I met Vanessa, and through her Debbie and Jessica, who became my birth team.
My estimated due date was more like a range – my last menstrual period and early ultrasounds gave us a range of due dates from January 24th – February 2nd. We knew he’d come when he was ready, and I was prepared to wait until mid February before I’d start getting worried. My only complaint was the teasing contractions. I’ve always dealt with prodromal labor – regular contractions that for me would last WEEKS before actual birth would kick in. Exhausting! With my previous history of fast labors, I usually am not sure it’s real labor until transition, and then it would only be an hour or so until birth.

With the “it could be any time” mentality in hand, I was keeping up with chores around the house and I was trying very hard to stay prepared. But… then the pre-birth despair set in around 39 weeks (according to first due date) or 40.5 weeks by the latest. The “This baby is never coming! I’m going to be pregnant forever!” lament that always happens. And I said, “Screw it!” and let the house go to crap, because I was certainly going to have another weekend to worry about it.
On the evening of January 30th around 7pm, I messaged Vanessa on Facebook that I was having regular contractions every 10 minutes or so. I had done this twice before already, so I was sure that when I said that this could be it, the contractions would peter out and I could get some sleep. They were still consistently 7 minutes apart or so when I crawled into bed at midnight, determined to sleep. The contractions slowed down to every 20-30 minutes, so I blissfully got some rest, but they were strong enough they were waking me up.

At 5am, I looked at the clock and thought I should take a bath, just in case this was the real deal. I was planning on a water birth and I wanted to make sure that I would have enough warm water after getting cleaned up for my big birth pool. I climbed into the warm tub and read on my Kindle, monitoring the contractions that had now picked up to every 5 minutes or so. I was getting excited to think this might really be it – baby day, birth day! They stayed at 5 minutes for the whole hour until I reluctantly climbed out of the tub and awoke my husband, Tom, for him to check my cervix for change.
With this pregnancy, we had already done this routine before, and I think he didn’t really think we’d see any change. We would have another weekend at least, right? Nope, the contractions were FINALLY being productive! Tom agreed we should alert the birth team and call in the troops.

We debated about whether to send our oldest sons, Dominic (11 years) and Xander (8 years) to school as we wanted our whole family there for the birth but ultimately decided they should go to school and someone would go pick them up early if needed, as we live only 5 minutes from their schools. We sent the boys off to school and I feverishly went into clean-up mode, scrubbing counters and running loads of laundry, trying to make up for slacking off for the past few days before we added our littlest son to the family.
Around 9am, our team started arriving:  Jessica, our birth photographer, and the midwives Vanessa and Debbie, my mother Maureen, and my best friend Allison.
Debbie on the left, Vanessa on the right
 


By then I had moved to my birthing ball to bounce through the contractions. They were pretty mild still – I could definitely talk through them and was generally pretty happy. He was finally coming! I wasn’t going to be pregnant forever! I was calm and peaceful, ready to breathe the baby out and let him come on his own time.
 

We did a quick heart tones assessment. Everything sounded good! Contractions were coming around every 4 minutes, but it was hardly a bother to me. I was happy to be laboring in my home. I definitely think it helped with pain management to be in a familiar place. I returned to my ball to bounce, and while making circles with my hips, I slid off the back and fell on my bum on the floor. I was embarrassed but laughed it off; apparently my circles were too big.



Around 11am, contractions were still around every 4minutes and I was still coping easily. We decided to do a cervical check to figure out when we should start filling the birth pool.  5cm, halfway there! We thought it was probably time to start filling it up. We used up all the hot water in our tank and then started boiling pots of water, my lovely birth team and husband taking turns running pots of boiling water up and down the stairs to our bedroom.
 

 

Meanwhile, I continued laboring in our living room. I had given up on the birthing ball and was spending a lot of time on my hands and knees and other positions that let my belly hang. This was the first labor where I felt most of the contractions in the front – I normally struggle with back labor. My husband Tom was incredible support. As I had previously been a surrogate in 2007, this was the 7th labor he’s supported me through. He knows me better than anyone and knew exactly what to do.


At one point, he was across the room when I started to have a contraction – one that was significantly more intense than the ones preceding it. He spied it beginning and sprinted over to me to provide support. I joked to him, “Run, Tom, run!” and he replied, “I got you, Jenn-ay,” in his best Forrest Gump impersonation. I love that the atmosphere of our birth was so light and happy that we could joke – that I could joke – even in the throes of a contraction.
By 1pm, I decided it was time to move into the tub as we had just done a cervical check where I was between 7-8cm. In my previous labors, it was at most an hour from beginning transition to birth so I anticipated that I was near the end. We finished filling it up the tub so I could finally soak in the water. Even at 8cm, I felt good and really just uncomfortable but definitely manageably so.   At 1:30pm I was finally in the water. It was so blissfully warm and comfortable! This was my second water birth and I insisted that my husband Tom join me in the water this time.

Before getting in the tub, mimicking another birth photo I had seen:


Once our youngest Milo (just turned 2 years) saw we were swimming in our bedroom, he insisted on joining us. He said he was “swimming like Nemo.” He didn’t really understand he was going to become a big brother soon, but he knew something was going on.
Milo, left, and Felix seeing mommy in the pool:
 
 
 
 

We decided it was time for someone to go pick up the big boys from school, as it felt birth would be soon. It didn’t take long for them to arrive. They were so excited to be meeting their littlest brother soon! Not too long after Milo joined us in the water, I had to have him get out as I was feeling pretty nauseated and threw up. It wasn’t unexpected – I always throw up during transition.
Our last photo as a family of 6:
Around 2:00pm, contractions started to feel more intense but definitely not unbearable. I had made a birth play list – 2 CDs with 3 hours of music. I sang through my contractions to peaceful music. I wanted my littlest boy to have birth song, like Milo had, and I was excited to hear which song it would be. I was determined to bring our son into the world joyfully.

When we had begun that morning, I thought we’d have a baby by noon, going off my previous labors. I was definitely working more for this baby than I had my others. The only good thing about this labor taking longer is that my younger brother Mike was trying to make it in time for the birth. He lives two hours away and had to work until 11am so we thought he wouldn’t make it in time. Luckily he arrived and helped keep the older boys entertained.
My mother and the Hulk (aka my brother Mike):

By this time, I was feeling a lot of pressure but no urge to push, and I felt like I needed to be pushing. We discovered that I had just a lip left of the cervix. I continued laboring through it but it was getting harder emotionally. I was wearing down. I hadn’t slept well the night before and this was my longest labor. I’m grateful my friend Allison was there for additional support; she was so wonderful to me.

I always crave ice during pregnancy, and this was no exception. I had specifically bought the birth tub with the cupholder so I could enjoy ice during labor. My son Felix (4 years) enjoys stealing my ice from me, and the little fact of me being in labor didn’t change that. He swiped pieces of ice from me.
Felix encouraging me:

And then around 2:45pm, while I was coping with a particularly hard contraction, Felix stood behind me and choked on a piece of ice. It pulled me out of my body emotionally and I turned to help him clear his airway. He coughed up the ice, but by then my entire feeling of zen, breathing through, “I can do this,” attitude broke. All I could think is that as I was working at hard at bringing our baby into the world, I could have lost another one of my sons. I sobbed hysterically as I contracted, unable to find again the peaceful mindspace I had before.


Up until this point, I would have described my contractions as pretty mild. I would have told you that I could manage this labor without any worry. But after my middle son choked behind me while I was contracting, everything seemed intensified and amplified. I started cursing during every contraction, dropping an obscene amount of f-bombs and crying and whining through every one. I was embarrassed for my behavior and apologized over and over again, but I couldn’t help myself. I couldn’t control it.
By 3pm, I was done and telling my midwives that I would avoid a c-section at all costs, but I was wishing for one right now. He wasn’t coming; the baby was never going to come. I was in hysterics, sobbing, unable to catch my breath. I needed help and direction, praying to G-d to help me through this. With my cervical check, I still had a lip – he literally couldn’t make his way through.

By 3:30pm, Debbie suggested that I try a different position to help the baby change position. I told her I didn’t want to; I had never given birth to any of my 6 previous babies in any other position. I was finally coaxed to squat in the tub. It hurt so much, which is why I didn’t want to do it. Debbie and Vanessa held my hands while Tom supported me in the pool, and Debbie said her own prayer for strength. L-rd knows I needed it, because I didn’t have any more of my own. I was too tired.
 
At 3:45pm, Debbie suggested that we either break my water – which I was trying so hard to avoid so I could have a baby in the caul – and I agreed, because I needed this to be over. I needed the end in sight. I still had that cervical lip. Debbie suspected a nuchal hand but luckily it wasn’t the case. For whatever reason, he wouldn’t change position to rotate out.
During one particularly hard contraction, Debbie attempted to hold back the lip. It felt so miserable with her hand in there during a contraction, but as she held her finger in the right place and directed me to push despite having no urge to, I felt his head turn and push through. He was finally past the lip! What an amazing relief it was.
Debbie supporting the lip while I push:

 
From that point on, my whole attitude change. I remember I excitedly told Tom, “He’s coming! He’s finally coming!” We called to the whole family, who had left the room to entertain the children while I was struggling with hard contractions and, and they returned in time for our littlest boy to be born. I pushed with one contraction, and he was born at 4:08pm. I almost had my baby born in the caul – you can see that the water broke when he crowned. He was caught by one hand from me, one hand from Dad.
Water breaking:


 
 
I was so blissful when I finally pulled his little body to my chest, happy to meet my little passenger for the past 10 months. I can’t even begin to adequately describe my elation.
 
 
 
 
He had his umbilical cord wrapped around his neck once, and as he was born he passed some meconium, which he aspirated. He took a couple of minutes before he took a breath, and I don’t think he breathed during that time either. He didn’t breathe, didn’t cry, and wouldn’t pink up. His 1 minute APGAR score was 2. Debbie did some suction on him to clear out the gunk. I’m pretty sure everyone in the room cried when he finally let out a lusty cry. I could finally breathe and could now take in all the tiny details of my beautiful new baby boy.
 
 
 
We waited a good 40min for the cord to stop pulsing before Felix, my middle son, cut the cord. Dominic had cut the cord for Felix and Xander had cut Milo’s cord; it’s like a rite of passage for my boys.



Once the cord was cut, I passed the baby to Allison and the baby made his rounds greeting her, my brother, and my mother while I got out of the pool and made my way to the bed. Standing up for the first time after birth always takes my breath way. As I rested on the bed, so happy to have my son earthside, I got the post birth shakes while I was examined for tears and received some more Shepherd’s Purse to stave off a hemorrhage.

 
Finally, he had his newborn exam. Abraham Quincy Skywalker, 8lbs8oz, 21.5” long with a 14.25” head. After his newborn exam, we settled in for our first nursing. He knew exactly what to do and we both just looked at the other and took each other in. Pure bliss.
Vanessa weighing him:

He had a small bruise on the back of his head where he kept hitting against that cervical lip for so long. My midwives informed me that he couldn’t get past the lip because his head was in the wrong position. Most babies come with the crown of the head presenting, like in picture A. Baby Bram presented like the baby in picture B; his head was just in the wrong position to put pressure on that lip. We think that when I fell off my birth ball, it jostled him so much he was knocked out of the correct position.
 
 
Reflecting on my birth, now four weeks ago: I was ready to give up and go to the hospital, despite how badly I wanted my home birth. After my son choked and I broke down, I lost my spirit to work with my contractions to bring the baby forth. However, I know that had I been in the hospital, they never would have let me labor so long with a lip – I would have had a c-section. I’m so grateful to my husband for his neverending support, to Allison because she was an amazing attendant to me, to Jessica for being there to photograph all the moments I would have missed without her, and to Vanessa and Debbie, my midwives, for lending me their strength when I had none.
One more photo, for good measure... Bram at 11 days. He's 1 month today and I need to take his photo again.