Empowering Birth Blog

Study On Breech Pregnancy and Birth

Heads Up! Study on Breech Pregnancy and Birth

 

If you gave birth to a breech baby, or if your baby was breech at some point during pregnancy, we would like to invite you to participate in a research study. Please share this announcement with others who might be interested in participating.

 

Research goals:

Breech research is often aimed towards health care providers and tends to focus on maternal and fetal health outcomes. Our research explores women’s experiences and feelings about carrying a breech baby; their decision-making process when discovering that their baby was breech; their care providers' recommendations and protocols for breech birth; and the birth options available to them, from vaginal breech birth to elective cesarean section. We will present the results at theInternational Breech Conference in Ottawa. We also hope to submit an article to a peer-reviewed journal. Participation is confidential.

 

Who can participate:

All North American women who have had breech pregnancies or births are invited participate in an essay-response survey, which takes approximately 15-30 minutes to complete. We are interested in participants who had breech pregnancies (breech babies who turned head-down before birth). We would also like to hear from women who have given birth to breech babies, whether vaginally or by cesarean section; with midwives, physicians, or unassisted; at home, in a birth center or in a hospital. We welcome input from both singleton and multiple (twin, triplet, etc) breech pregnancies and births.

 

How to Participate:

To take the survey, please visit the Breech Pregnancy and Birth Survey (http://tinyurl.com/mco7kp).

 

About the researchers:

Dr. Rixa Freeze has a PhD in American Studies and focuses on childbirth and maternity care. She blogs at Stand and Deliver. Julie Searcy is a PhD candidate at Indiana University with interest in the cultural discourse around birth.

 

Questions?

Please contact us at breechbirth.study@gmail.com.

Homebirth Continues to Move into the Mainstream!

Go Ricki and Abby!  Ricki Lake launches a new celebrity webisode series.  

When Birth Doesn't Go As Planned

I asked Arielle's mom if I could share her story since it is a beautiful story of a mom who had an enjoyable birth, despite very unexpected complications.  This strong mom had her second child at a birth center and her third at home.

Arielle June Chasse

In September of 2001, right after the 9/11 disaster, I found out I was pregnant with my daughter Arielle.  It seemed so symbolically fitting, life after loss.  I glowed with joy, excitement and anticipation. Although she was not planned, I knew I wanted her more than anything. Being a mommy was my ultimate dream and hearing her little heartbeat in my womb brought a smile to my face and my heart like I had never known before. 

The pregnancy was amazing, finally using for myself and my baby the relaxations and visualizations that I had been teaching to others; finally feeling inside my own body the little kicks I described to women in my classes; finally knowing the joy of prebirth bonding and finally using what I’ve learned and taught and practiced so many times in preparation for my own birth.

Six weeks before I was due, I developed pre-eclampsia, after having experienced a perfectly smooth pregnancy. My little ankles turned into coconuts and I was lucky if I could see my way to the bathroom past the black dots and not fall over into the toilet. After almost fainting at my mothers day lunch, I ended up in the emergency room, fighting HELLP syndrome and hoping to stay alive long enough to deliver my daughter. 

Since delivery was in fact the only cure,  I was induced that evening. I was a certified advanced clinical hypnotherapist. I had spent my life focusing on natural childbirth, relaxations and visualizations for birth. I had practiced and fantasized about this birth all my life. But that moment, the moment that was supposed to be the most magical of a woman’s existence, I was wired up to a cold bed and two IVs. 

But then my daughter punched me a few times and reminded me that it’s okay! We are still in this together. She can still benefit from my relaxations, as could I.  Suddenly the sterile room and tray full of needles didn’t matter.  I began a self guided relaxation and pictured each contraction as a wave, rising and falling. I focused on the waves crashing against the shore and dissipate into bubbles, allowing my pain to dissipate and dissolve into the sand.  Amid doctors and nurses all clambering about,  I felt my body, felt my baby, focused and relaxed. 

Being a teaching hospital, the room was full of students, interns and residents, all checking out the mama with HELLP syndrome. I floated into another world, knowing that the best thing for my baby at that point was to keep both of us calm. As they decided an epidural was necessary due to the induction, I pictured the ocean again as I leaned over to share my spine with the steel piercing my skin. Images of jelly fish floated in then faded away. The epidural took off the edge, but still, each wave came, feeling like a menstrual cramp, squeezing my baby down the canal to me.

 

When the time came to push, I sat up in my hospital bed and reached down to help out my daughter. I felt her tiny head, all covered in fuzzy, wet hair. So entranced by the energy, power, relaxations and love I didn’t realize until later that the poor medical students were aghast that my ungloved hand dare touch the antiseptic swabbed birth area. 

As she emerged, they let daddy cut her cord and take her over to the neonatologist for her first check up. I floated down from one cloud and gently plopped onto another as she was finally handed to me. I took her into my arms and brought her tiny little body to my chest as I looked into the dreamy deep blue eyes of my little girl for the first time, and smiled. We did it.

Hmm, Induction Isn't So Good After All...

Seems like the evidence is stacking up against inductions.  "Hospital's Oxytocin Protocol Change Sharply Reduces Emergency C-Section Deliveries."  And I quote "As oxytocin utilization declined from 93.3% to 78.9%, emergency cesarean deliveries decreased from 10.9% to 5.7%." (emphasis mine).¹ Hopefully hospitals will soon be changing their induction protocols but in the meantime, if your doctor plans an induction, you might want to share this article with him.

1 Betsy Bates, "Hospital's Oxytocin Protocol Change Sharply Reduces Emergency C-Section Deliveries", Elsevier Global Medical News, June 23, 2009. http://egmn.idsk.com/stories_global/35_ds_7863805.jsp

Staying Home: Why and What if?

My friend who helped me (and my husband!) find the way to home birth has just written a great post, copied below.  It reminds me of a remark recently made by a local midwife.  She noted that many of her clients come to her explaining that they want a home birth for a slew of reasons and that her comment is, "those are wonderful reasons, but I hope you are also choosing home birth because it is the safe choice."  Yes home birth can be ecstatic, yes you can give birth in water, yes you can wake up in your own bed, etc. etc., but given the alarming rates of intervention in the U.S., home birth is often the safest choice.  Ginger is pregnant with her fourth so please visit her blog if you would like to follow along (first hospital born, subsequent babies born at home).

Staying Home" Why and What if?

I’ve been planning a few Q&A posts to answer questions I am frequently asked. This first post will examine two questions that tend to come together. How did you decide to have your babies at home? What if something happens?

The answer to the first is fairly short, but needs some explaining. I decided to have my babies at home because statistically, it is the safest place to give birth. Though I enjoy stories, opinions and philosophies of childbirth, I’m more of a numbers person when it comes to making decisions that impact my health or that of my children. I’ve spent a fair amount of time looking at research on childbirth statistics and outcomes. Interestingly, every study out there shows that midwife-attended homebirths have better outcomes compared to hospital births.

Better outcomes outside of the hospital? How could that be? What if something goes wrong? It is true, there are risks involved with homebirth, but there are also risks involved with hospital birth. The most recent and largest (to date) study examining the two was published by the British Medical Journal (BMJ) in 2005. The conclusion? Planned home birth for low risk women using Certified Professional Midwives was associated with lower rates of medical intervention and no higher likelihood of death than that of low risk hospital births in the United States." This was an important piece of research because it is the largest homebirth study that also matched women for risk (meaning the hospital births were of low-risk women who would have qualified for birth at home).

This may not make sense at first, especially with all of those emergency cesarean stories we've all heard. With so many emergencies, how could it be safer to birth outside of a hospital? Pay attention, the next time you hear one of those stories, chances are, the emergency was preceded by an intervention of some sort. Common examples: Labor wasn't going quickly enough so we started pitocin and then the baby crashed and we needed and emergency cesarean. After they did several internal exams and broke my water (both increase the likelihood of infection), the mother got a fever and the baby's heart rate sky-rocketed so we needed an emergency cesarean. She got an epidural and the baby’s heart rate dropped. They put on an oxygen mask, gave her a shot of something and had her rolling from side to side, but the baby didn't recover and we needed an emergency cesarean. Hearing story after story like that, hospital birth does sound dangerous.

But sudden reactions to medications and invasive procedures don't exist at home because the medication and procedures that cause them are not used in the first place. In the absence of medical intervention, the majority of complications in childbirth arise slowly with plenty of time to notice them and seek medical care, if necessary. Common examples: The baby gradually becomes less tolerant of labor. Labor is prolonged and the mother begins to wear out. When non-emergent complications do arise at a homebirth, a skilled midwife can help resolve them through a variety of non-medical techniques; she can also provide some medical treatments like, oxygen for neo-natal resuscitation or drugs to manage hemorrhage. In the rare event that a complication cannot be handled at home, she has a transport plan and will recommend transfer to a hospital (in the BMJ study 12.1% of the homebirth group transferred to the hospital, but less than half of a percentage of women had urgent transfers).

Looking at the BMJ study, the effectiveness of this gentle approach to complications was clear:
Induction or Augmentation of labor (with pitocin or prostaglandins) 4.8% vs. 39.9%
Episiotomy 2.1% vs. 33.0%
Cesarean Section 3.7% vs. 19.0% (it is worth mentioning that the national cesarean rate is now over 30%)

With so many risky interventions at hospitals and no improvement in outcomes, many women planning hospital births also like to "stay home as long as possible" to reduce the likelihood of unnecessary intervention. I guess my preference is to stay home as long as possible too. I just prefer to do it with a skilled attendant present to catch any signs of trouble. If my midwife recommends transferring or I just feel I would rather be at a hospital, I can always go. But if not, staying home as long as possible turns into just staying home.

As I ponder homebirth, privacy, comfort, support, convenience and a positive birth experience have been nice perks, but they are not the reason I stay home. I stay home because I know the risk of death is the same in or out of the hospital, but the risk of injury, infection and intervention are significantly lower at home. I prefer my body and my baby to be uninjured, uninfected and left alone and that is why Johannes and Willem were born at home.

You can learn more about midwives and homebirth here.

Full results of the BMJ study.

Cesarean Hemorrhage

When life slows down I have some serious blogging to do about cesareans in Maryland.  In the meantime, here is a post on a cesarean that could have had a graver turn.  

Mother Nature

I have been communicating with another strong mama.  A mama, Mariahadessa Ekere Tallie, who skillfully (and what skill indeed is required) carved out time, while nourishing and nurturing two beautiful daughters, to share her thoughts, kernels of wisdom, with fellow moms.  This booklet, Mother Nature, is about the journey, about one mom's journey towards natural birth and conscious mothering.  It is a bold booklet because instead of waiting for perfection, Ekere put it out there, put it out there because her words needed to be shared NOW.  When I first read this, I thought, I wonder if Ekere wanted to write a book, but how to find the time to do that with little ones!  Her booklet reminds me (I need to be reminded) that sometimes we have to take baby steps along the road to fulfilling our dreams (or towards having an empowering birth!). Ekere is a poet and her booklet reads like a poem.  Mother Nature offers some excellent tips for using herbs, green cleaning, healing after birth, yoga during pregnancy and more. Mother Nature is listening to another mama who has been there, it is a guidebook that flows.

Because it can be very stressful for moms awaiting its arrival, in the breast-feeding section I might add that it can take two or three days (or more) for your milk to change from colostrum to mature breast milk (longer after cesarean birth).  And I would LOVE for Ekere to include her birth stories.  I guess that means Ekere will have to put out another booklet in the future (and a book of poetry too).

It was the poem on the first page that drew me into this book. Because it is so beautiful, I would like to share it with you:

Mother Nature

(For Millie)

She comes to me

daughter of dandelion

and redwood tree

prayer christening her womb with kicks

worry flits across her smile

she explains the tug of war

between kale and quarter water

asphalt and oat straw

women tell her horror stories

but she hears whispers

a woman of cotton fields

and white sage guiding her to red

raspberry leaf and the power of her own scent

this full moon

will birth a new moon

open radiant like night sky

eclipse boundaries

speak in her foremother’s voice

this full moon will walk across burning stars

in a ritual as ancient as constellations

courageous

knowing her strength pulls

the Earth closer to herself.

--Mariahadessa Ekere Tallie

Book Review: Your Best Birth

Book Review of Your Best Birth By Ricki Lake and Abby Epstein (New York: Wellness Central) 2009 

In a stroke of good luck, the publishers of Your Best Birth sent me an extra copy. I could pass it along to my sister who has not yet caught my passion for home birth and is not fully sold on midwives as it thoroughly explains the differences between home, hospital and birth center birth as well as the differences between midwives and OBs.  I could mail it to my sister-in-law whose friends rave about the epidural; this book is written for the hip American birthing woman and emphasizes informed birth without being pushy about natural birth.  I could share it with a doula friend to lend to clients, and I bet at least one would find the road to birthing with midwives (maybe even at home or in a birth center).  Perhaps I will just keep it for myself, my lending library could use two copies of this book.

There are some excellent childbirth books out there, but I think this is the first childbirth book I've read that speaks to all pregnant women.  It encourages the reader to seek a birth that is truly best for mom and baby while acknowledging that mom must be empowered by the process as well. Your Best Birth embraces both the potential homebirther as well as the mom strongly leaning towards an epidural. It is also probably the first birth book I've read that simply and clearly addresses the disconnection between the birth you want and the birth you will actually have unless you choose your provider very carefully. 

This book is an easy read!  I have very little time when I don't have at least one child clamoring "Mommy, mommy" and yet I finished this book in a week and a half!  There is something to be said, in today's busy world, for a book that can be read while eating breakfast with your three kids and whose information can be retained even when half asleep from a night up with a teething baby. 

Your Best Birth has easy to read, useful lists that will help you navigate the path towards an informed birth. 

• The Birth Inventory (to will help you find and remove birthing fears)
• A list of things to ask on the hospital tour  
• Questions for your doula 
• Questions to ask before being induced  
• And More! 

Ricki and Abby include a lot of things that every pregnant woman should know but often isn't told. For example, they strongly recommend only inviting people you trust completely and who you don't mind seeing you naked, to your birth.  They tell you what to do when your partner is "Freaking out about your birth plan."  They also talk about patient to staff ratios and what that means for your birth (great tip!). Ricki and Abby emphasize that you have a CHOICE when it comes to how/where you will birth and spend a lot of time giving you the information you need to make the best choice.  This book is jam packed with information, from exploring VBACs to healing from sexual abuse.  

There are a lot of random things I love about Your Best Birth.  They mention craniosacral therapy, an excellent way to help babies recover from a traumatic birth. I LOVE Dr. Mortiz's quote on electronic fetal monitors "The EFM has been studied extensively and the results are clear. It does not prevent poor fetal outcomes....What it does is lessen the need for one-on-one nursing and raise the rate of C-sections. If I monitored your heart for twenty-four hours beat for beat, trust me I would find something wrong." (140) The section titles are catchy; "Not your Mamma's Birth Plan," "A Doula for Youla."  And as an organizer, I appreciate Ricki and Abby's strong call to action, their call to take back your birth.  I have the feeling that many women who read this book, will do just that and that makes me hopeful.

Admittedly I wish the book had advocated a little bit more for normal birth.  Over the course of reading the book I had a few moments where I thought, uh oh, they are looking through the medical model lens...  I would have taken VBAC and "older age" off the high risk list on page 13, though to their credit, the authors acknowledge that the term high risk is loaded. The list "Questions for the Hospital Tour" (44), is missing "what will you do if my water breaks before I go into labor?" (an event that happens to about 10% of pregnant women and the truthful answers to that question are often not very pretty).  I sighed again when I read: "If you are high risk, a home birth is not for you." (59) Readers are referred back to the "high risk" list  on page 13 (wait a minute, home birth is definitely for VBACers.) As a VBACer myself, I am sensitive to statements that discourage VBACing and in general, I really think we need to be careful with the term high risk.  There are conditions that are truly high risk (placenta previa for example) and then there are conditions where you might need to do a bit more preparation and choose a provider with experience but are not necessarily high risk. For example,  VBACing with one low-horizontal incision is no higher risk then any other unforseen complication during birth such as cord prolapse or placental rupture. And I recently read that if a VBACer plans on having more children, it is safer for her to attempt a VBAC at home. Birth, as with all activities in life, is never "risk-free."  

As a student midwife who is studying to be a Certified Professional Midwife (CPM), I am required to bring attention to the following sentence: "Requiring CPMs to pass a national license exam, continue their education on an ongoing basis, and be subject to peer review and state regulation would enhance consumer confidence in that profession." (83)  CPMs are already required to pass an extensive exam to receive certification. They must fulfill continuing education requirements to keep their CPM certification AND they are already subject to peer review.  So the suggested system is already in place (The North American Registry of Midwives), we just need states to recognize the existing system.

And I just can't let them off the hook for including low amniotic fluid on the list of "Good Reasons to Induce."  While it is true that some caregivers think this is a valid reason, the EVIDENCE says it is not. It is so important to get evidence-based facts out there.

I will now step down from my soap box.

Your Best Birth ends with some really great birth stories and a section that explains how a gentle birth, where baby goes straight to mom, maximizes bonding.  There is a resource section for further research as well.

There are a lot of things I LOVE LOVE LOVE about this book.  In the books defense, most of us in the U.S. grew up immersed in the medical model of birth and even with a growing awareness of normal birth, we may continue to view birth through the lens of the medical model.  This book is meant to reach mainstream America and if it had completely debunked the medical model, it wouldn't speak to all women.  If you are pregnant, planning, or thinking about planning a pregnancy, I think that watching the Business of Being Born and reading Your Best Birth should be at the top of your to-do list. I am also incredibly grateful for all of the incredible advocacy that Ricki and Abby do for Birth as it should be, EMPOWERING. 

Nettie is One Today!

Nettie turned one this morning, early this morning.  Where does the time go?  Little Antoinette, born ten days after the due date I calculated (I ovulate around day 20), 16 days after a due date calculated by the last menstrual period. She taught me patience from the very beginning.  I am always amazed at how much our kids teach us and shape us into our better selves.  Thank you Nettie for the gift of you!  It has been fun remembering your birth.

The Birth of Mary Katherine

I gave birth to my first two sons in a birth center with a midwife. This is the birth story of my third baby. We planned a quiet birth at home with a midwife (Karen Carr, CPM) and as unassisted as possible. We wanted our baby to be welcomed by friends and family including Baby's two older brothers, Aidan (3) & John Paul (2).On December 14th at 3:30PM Austin and I left to go to Austin's company Christmas party just hours before labor began.

At the party everyone asked when we were due and we said "tomorrow" and everyone joked I'd go tonight and Martha, the party hostess, said we could give birth in her jacuzzi tub. It was all fun and cute but I really thought I'd go tonight. I kept feeling Braxton-Hicks contractions that were strong and long and just felt like labor was coming. I told Austin my "feeling". He and I hung out for a few hours watching the Ravens game and he drank Jack & cokes and LB shots with his friends while I sat in a chair feeling like I couldn't move except to get up and go to the bathroom and had him bring me lots of food and refills of my OJ & Cran juice drink. :) I drove and we got home at 10:30PM and I went straight to bed as I was exhausted.

At 2:45AM, I awoke with very painful contractions. I tried to rest through them at first but after 15 minutes or so, I realized these were pretty powerful and frequent so I decided to time them. At first I just timed by lifting my head up to see the clock on the cable box after the contraction was over with and I used Austin's Blackberry to record the time and then would fall to sleep between them. I was laying on my right side. Contractions were 3 to 5 minutes apart. At 3:30AM, I switched to my left side for awhile to see if this changed anything but it didn't. The contractions were still strong and consistent. So, I decided to time the length of a few of them to see how long they were. They were 40, 50 and 77 seconds long by my count. I decided this might be it, so I got up to go to the bathroom to see what would happen. I stopped on the floor and did some pelvic rocks to help with my back/hip discomfort I have every night but to also get baby in a good position if this is really it. I got back into the bed on my left side.

By 4AM, contractions went from around 6 minutes apart to 2 minutes apart all around 30 to 40 seconds long and they increased in intensity. The pain was felt all low and in the front. I knew that today was the day!! :) I started to feel the need for heat to deal with the pain and felt hungry and woke Austin up.

I began timing contractions on my laptop using ContractionMaster.com :) 4:06AM

At 4:14AM, I sent a text message to my doula/colleague about contractions and emailed her the notes of the contractions I had logged so far for her to look at. By 4:25AM, contractions were 3 to 6 minutes apart, 30 to 60 seconds long and getting so intense I wanted heat to soothe the pain. I was starting to vocalize during contractions. I remember feeling my baby move and knew then Baby was OK.

By 4:45AM, I began having longer contractions that reached one minute in duration. They were 3 to 5 minutes apart. I called my doula and asked her to come over. It would take her over an hour to get to my house so I wanted her to come now in case things progressed quickly. I decided to get out of bed and go use the bathroom again. During that time up to 4:53AM, I was having contractions on the toilet that were 1 1/2 to 3 minutes apart and 30 to 50 seconds long. I started to get nervous this was going too fast. Austin called Karen, my midwife, to give her the heads up (at least, that's what I intended) but she asked him if I was ready for her and he said yes so before I knew it she was already on her way to our house. (I found out later, he felt better knowing she was coming now!)

At 5AM, I was back in the bed and Austin was downstairs. I didn't know at the time what he was doing but he later told me he woke up with a hangover and the room was spinning so he went downstairs and drank a ton of water. :) I kept timing and contractions were 3 1/2 to over 5 minutes apart and 30 to 55 seconds long.

I used my laptop’s webcam to video myself during a contraction 5:14AM

My two sons were asleep in my bed beside me as I contracted and timed my contractions. 5:25AM
I took a picture of Austin excited and ready for labor day! 5:26AM
I had my first 1 1/2 minute long contraction. 5:45AM
Doula arrived. 6:04AM
Midwife arrived. 6:30AM

Over the next hour, contractions were really starting to space out to 4 to 6 minutes apart and then to 8 minutes apart but staying over a minute long consistently. 6:45AM Karen was my amazing midwife that I was glad returned from her vacation in time to attend my birth! 

She came in my room to talk to me and used the fetoscope to listen to the baby's heart rate - perfect! 6:51AM

At this point, contractions were really spaced out and I felt like this may just fizzle out. I told my midwife and doula I wanted to just get some rest and that they could lay down too in our guest bedroom or downstairs until things picked up again. Karen had no problem complying with my request and went to lay down in the guest room. I continued to rest and time contractions with the spacebar without even opening my eyes really for the next hour and my contractions spaced out to 6 minutes and to as much as 10 to 12 minutes apart. They were still well over a minute long and quite painful. At some point, my doula also left us to rest.

At 8:25AM, I stopped timing and just fell asleep. I slept deeply in the bed while Austin also fell asleep in the oversized chair in our bedroom. I woke up sometime after 9AM and eventually made my way downstairs for a change of scenery and to see my boys and eat breakfast. I was laboring downstairs watching Mickey Mouse Clubhouse between contractions with Aidan & John Paul.

Karen sat on my sofa watching me labor while Austin made us all breakfast. 9:47AM 

I remember at some point getting up to go to the bathroom and my cell phone rang and the timing was perfect for a call from another colleague of mine (she attended my first two births) and see how I was doing and we chatted for a little while. She told me a couple of mine that I taught classes to was also in labor. Good thing they didn’t hire me as their doula. :)

After the call and sitting on the toilet for awhile I went back to the family room sofa. The sofa no longer was comfortable so I switched to hands and knees. 9:53AM

We sat down to eat breakfast - eggs, bacon, toast. I sat on the birth ball but had to lift up during contractions and they were very intense! I could feel the contraction in my bottom and did not like sitting on my bottom when the contraction came. 10:02AM

I was ready to go back upstairs after eating and had several contractions on the way. I couldn't make it up the stairs without pausing and contracting. 10:26AM

I decided to take a shower and use the heat from the water to help deal with the pain of the contractions while Aidan & John Paul played with their train bath tub toys beneath me. During contractions, I had to lean on the wall and focus to get through them as they were quite intense. 10:52AM

My birth assistant Maria arrived and she and Karen sat in our bedroom hanging out at a distance while I labored. I wanted my space unless I needed them and they were very respectful of that request. 10:58AM

When I got out, my doula picked out my hair while I contracted in hands and knees on my bed. 11:25AM

I then went into the bathroom to dry my hair and when I came out, I labored in hands and knees on the floor. At one point, my youngest son, John Paul came out of the shower and brought me his trains and told me they were "wet". He was so cute. 11:41AM

When I was still in the nude walking around my bedroom, my doula snapped a shot of my profile and I got one last belly shot at 40 weeks of pregnancy during labor. A few nights ago, I made a wrap to go around my breasts for labor with a piece of material and my sewing machine. I tied it in the back and used it for the rest of my labor to cover up with. It was perfect! 11:43AM

After drying my hair, I really wanted to put on some make-up so I didn't look so ghostly but I never had the energy to do so. I was getting overwhelmed by the intensity of the labor and decided after the shower and drying my hair to lay down for awhile. 11:47AM

At 12:09PM and over the next hour, Austin started calling my friends who were sent invitations to my homebirth that now was the time and we wanted them to come to our labor and birth. We needed help with the kids at this point because I needed more of Austin's sole attention. I later decided I wanted to get into the tub to labor. I asked for the water to be at 98+ degrees so it would be effective in helping with my pain but I remember getting in and it was lukewarm and not comforting at all. :( I kept telling them I had a thermometer somewhere and we turned the hot water on but it was just not what I needed and I got frustrated. This was one of the things I imagined would be the most relaxing for me but it was quite the opposite. It would have been a great time for my relaxing music on the bathroom counter to be played but that was never done either. In my birth plan (which I only gave a detailed version to my husband and doula), I had made a list of all of the things that relaxed me the most on it and what I wanted done. I'll just have to make sure that is followed through better next time around as the little things can be so very important. Especially quiet. I really just wanted quiet and to be left to deal with my labor alone and with my husband and if I needed anyone else's assistance, I'd ask for it. My "unassisted as possible" birth wasn't exactly as I wanted it in part because I got everyone to my labor too soon. Finally, though, I was left alone with my husband and we were able to labor together just the two of us. :) 12:57PM

In the tub, I knew things were changing and not going as they should. My labor was starting to move into my back. I could also tell by the contraction pattern that something was off with Baby's position because the labor shouldn't be dragging on this long and the contraction pattern shouldn't be so inconsistent. I asked Karen to come in who by the way was great at respecting my wish for an unassisted labor. She came in and we talked and I asked her to see where I was. It was some time after 1PM. It was the first cervical exam I had all pregnancy and labor. Surprisingly, I was 8 cms dilated. I was so relieved and so was Austin! I remember telling my birth assistant, Maria, that I thought this was another compound presentation baby (head and hand coming out together) just like Aidan was. The birth was just too similar in the way I was contracting, the back labor and my gut feeling was so strong. As the back labor got more serious, Austin began applying pressure to my hips to help me cope with the pain. As he worked hard, Karen helped him by putting cool compresses on his head and neck. She was great! 1:52PM

We moved from the bathroom to the bedroom. I wanted to stand and did that for awhile with Austin behind me. As contractions got really intense in my back, Austin began applying hip squeezes to help me cope through the unexpected back pain. At one point, my doula and birth assistant tried to take over doing the pressure squeezes during contractions but they were not as effective as Austin was. I wanted to feel his touch. Just like with Aidan's labor, Austin got quite a work out as my pain was severe and my contractions were long. He was a great labor coach to me always listening and never giving up on me even when I yelled at him if he was too high or too low or not pressing hard enough. :) 2:05PM

I eventually got into the bed and labored on hands and knees. I was in intense and severe pain in my back with each contraction. It was so overwhelming internally I was thinking how can I keep going but my mind kept reminding me there's no way to stop the pain, there's no way to go backwards, that now, I can only go forward and the only thing that will end this back labor is to push my baby out. So I asked for Karen again and asked her what we could do that I was ready to push. At around 2:25pm she checked me and I was 9cms. She said she could break my bag of waters which had not broken yet, not even a little trickle of water yet, so I said OK, "let's do it". At this point I was on my back which I hate more than anything during labor especially during back labor as it makes the pain much more intense and she went in to break my bag with the amnihook and stayed in there for awhile getting out as much of the forewaters as she could to get baby's head down on my cervix and get this back labor closer to ending! I was relieved because the back pain was so severe and all I wanted to do was push.

Karen finished and I got back up to hands and knees and she encouraged me to bear down with my contractions to try to push baby down more with each contraction even though pushing contractions were not there yet at all. I did and 45 minutes or so later, finally, I felt the pushing contractions. I was really pushing at about 3PM. I could finally feel my baby's head moving down the birth canal. I was so relieved because I knew that meant this back pain would end very soon!! Karen got in position behind me and my husband was near the bed but after the kids were brought in to witness the birth by my request, they wanted their daddy so he couldn't be right beside me in the bed or catch the baby like I wanted. A couple of my friends were in the room but not all of them as some were still downstairs and didn't know I wanted them all in the room to view the birth but they weren't invited to come up. :( I prepared a list of those invited to view the birth but no one asked me for it and I was mostly out of it and unable to remind anyone of what I wanted and had my eyes closed most of the time. I was glad at least a couple of my friends, Mary Jo and Chrissy were able to view the birth. I started to push in hands and knees for the next 40 minutes even though there weren't any pushing contractions yet just to do all I could to help baby move down faster and end this severe pain.

Finally at about 3PM or so, I started feeling pushing contractions and I could feel Baby's head moving down my birth canal. I just screamed begging for Baby to "get out of me". :) I was so ready for this back labor to be over with!! 3:03PM

Austin was now holding Aidan at my head while I was in hands and knees pushing with Karen sitting on the bed behind me. 3:08PM

Mary Jo was holding John Paul who just wanted Daddy.Soon Baby's head came out and I felt some relief but then wondered why so much time was passing and the body wasn't coming out even when I pushed again. I asked if the head was out and they said yes and I wanted to know why the body wasn't coming out yet. 3:10PM

Austin ended up holding both boys and standing by my head. 3:11PM

Because the body wasn't coming out yet, my birth assistant, Maria, asked me to put my leg up. Karen had to go up inside to see why her body wasn't coming out yet and found a bit of a "sticky" shoulder. The shoulder was dislodged and Baby's body started coming out. Baby's body is mostly out and Baby's hands are both down (not by the head), so no compound presentation. Baby's body was finally all of the way out. 3:12PM

Karen passed Baby underneath me to my hands immediately as she was coming out. I picked up my baby!!! I got to stare at Baby’s face for the first time while Austin brought the boys over so they could all see Baby up-close.

And 3 minutes after the birth, we finally thought to check to see the sex.

It's a... GIRL!!!!!!

We were cheering!!! Austin's reaction - "Don't have to worry about circumcision!" :) We were both so excited!!! I was in disbelief so I looked again - yup, a girl! Beautiful Baby Girl!!

Austin brought Aidan around to meet his baby sister! We enjoyed the first few minutes together with her and I needed to just rest and catch my breath as my bottom was still very sore from the painful back labor and pushing adventure.

Just minutes old, my baby girl was a vigorous nurser! 3:31PM

It was time for the birth of the placenta. 3:31PM

Austin cut the cord that was no longer pulsating and very white. 3:33PM

My friends who attended the labor and birth posed for quick pictures with me and our Baby Girl – Alyssa, Mary Jo, Laura, Chrissy, Nicole. My colleague who served as my doula snapped a quick picture with me and then left to go home because she had a client in labor at the same time and she knew she’d need the rest. Marialuz, my wonderful birth assistant, also posed for a quick picture. I'm so glad she could make it!!

After the cord was cut, I was free to get up and Karen suggested I soak in an herbal bath to help soothe the pain in my bottom which was quite sore. I took Mary Katherine with me and together we got into the warm water (it was the right temperature!) and enjoyed a bath together. I decided to wash her hair with some baby soap to get the gooey out of it. :) It was a nice time of bonding followed by more nursing! 4:02PM

Aidan came in to see us in the bath and he and I had a long conversation talking about his new baby sister. He touched her toes and ear and gave me a big kiss! And then, GG & Boompa arrived and came in to meet their granddaughter. 4:26PM

GG brought her "It's a girl!" sign for our front yard and we decided it was time to announce the name – Mary Katherine (no middle name decided on yet).Austin held his daughter for the first time. 4:44PM 

I got out of the tub and took a quick shower to feel fresh and clean. 4:45PM

Austin enjoyed holding his little girl and wrapped her in a pink blanket. After my herbal bath and shower, I got dressed in my comfy pink PJs and held my baby girl again. 4:54PM

Karen took her so they could do the newborn exam. 4:54PM 

Everyone was standing around watching the exam, talking and taking pictures.Karen bundled her up in a blanket and put her on the cloth scale to weigh her. She weighed 7lbs, 14oz (and that's after a major meconium poopy on her parents bed when she was born!) Next, Maria performed the rest of the newborn exam. Mary Katherine didn't like the cold air and missed her Mommy as she cried loudly for a bit. Maria checked out her body, listened to her heart, lungs and bowel sounds, measured her and she was perfect! Karen posed for a picture with me as we waited for my baby to return to my arms. Maria gave her back a few minutes later and I put on her first diaper. 5:02PM

Then, I gave her to Austin so he could let GG (his mother) hold her granddaughter for the first time. 5:03PM

Austin popped a bottle of bubbly and we all toasted our baby girl. 5:07PM

We then went downstairs to eat a large spread of food everyone brought with them. I started out trying to sit at the table on a cushion but my bottom was so sore, I had to move to the sofa instead to eat. 5:20PM 

For the last hour or two, Aidan & John Paul were napping. John Paul woke up and came down to see us and Austin reminded him about his baby sister being born. 5:30PM

I finally had a break to call my family to tell them the news - Mother, Dad, my sister-in-law Amber and brother Jay, my sister Joni, Grandmother Byars and Grandmoney. 5:59PM to 6:45PM

Then, Boompa held his granddaughter for the first time as did a few of my friends. 6:30PM

At about 7:30PM, everyone started to leave and I was getting tired and ready for a nap. I snapped a picture of her first to text message to my family and friends.

Her name which was fitting as she was born a week before Christmas…

Mary Katherine
Frances
Groves

Mary (after the Mother of Jesus)
Katherine (after my paternal grandmother)
Frances (after Austin's paternal grandmother who passed away - Feb 2008)

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I loved giving birth at home and I loved my midwife and her gentle ways. She was very hands off which is exactly how I like things. I loved not having to drive anywhere and to do whatever I wanted at any moment during my labor and birth without being told what to do or where to do it. I wasn’t planning to have any cervical exams or my water broken but I enjoyed being able to be the one to decide that I did want those done and I requested it only after labor was in an unusual pattern and quite intense. I didn’t expect to have another back labor. I’ve learned I mentally lose it when labor pain goes into my back. I’m not the same logical thinking person any longer and emotionally I got frightened and it led to me feeling very moody. I started to anticipate the pain of each contraction before it began. Severe back labor certainly is not a pleasant and romantic labor but it still was done on my terms and in my home. And my back labors have only made me become a better doula understanding fully what a woman with a back labor needs, what she doesn’t need and how I can best help her to have the birth she wants. I enjoyed the presence and labor assistance of my husband and I hope to work it out so he can be more involved in the birth aspect and closer to me physically at the time of the birth next time around. I loved that my children could witness the birth of their baby sister. I’m so thankful for all of those present who worked so hard to help me have my homebirth and were there to welcome our little girl into the world.

The next three weeks flew by and we spent our babymoon rushing around for the Christmas holiday and getting everything done that we could get done and our sons both had RSV just days before the baby was born and I eventually got it and so did Mary Katherine and some of those who attended the birth. For me it turned into bronchitis and for my baby girl, my breastmilk antibodies rock because she has done well with home treatment and did not have to be hospitalized since she never had difficulty breathing! Whoohooo!!

Mary Katherine has grown a lot. At my second postpartum visit done by Karen in my home on her first week’s birthday, she had gone from 7lbs, 14oz to 8lbs, 9oz - an 11 oz gain! She’s continued to grow and at 3 weeks she was over 9 ½ lbs gaining 1lb, 11oz since her birth. At 5 months, she was 14 ½ pounds and started crawling at 5 ½ months old. 

I found out later that my health insurance actually covered my homebirth, too! Everything simply went perfectly!

Thank you for reading our story! I hope it inspires you and any woman to have the birth you want!

(To read the version with pictures, click here - http://grovestigercubs.blogspot.com/search/label/Mary%20Katherine%20-%20Birth%20Story)