June 28, 2008

Blogs to Link to?

I am trying to update my type lists.  Since we entered the fix up our house to put on the market and have our third baby at the same time and then move with a newborn phase I have had a hard time reading more then a couple of blogs but I would like to link to more blogs so I am hoping my readers can help me out.  I would love to know of a great L&D Nurse blog to link to and any other blogs that I should definitely be linking to that support empowered birth.  Many thanks for your help!  Once  we sell our house and move (hopefully by August!) I should be back to weekly blogging and once again reading my favorite blogs.

Unfortunately our doctors don't always tell us the truth...

I just wrote the below post on the moms listserv to which I belong.  It was prompted by a discussion on induction...

I wanted to respond to a recent message in which a mom mentioned that her doctor said induction did not increase the risk of cesarean.  Unfortunately doctors often say things that are not evidence-based.  I suggest reading the book Pushed, the Painful Truth about Childbirth and Modern Maternity Care by Jennifer Block, www.pushedbirth.com, for countless stories of caregivers practicing non-evidenced based care.  On that note, let me quote the below paragraph from Pushed on induction.

"Gary Hankins, MD, professor and vice chair of obstetrics and gynecology at the University of Texas Medical Branch at Galveston and chair of the obstetric practice committee of the American College of Obstetricians and Gynecologists (ACOG), says nobody should be doing inductions without a good reason. 'That's not good medicine.'... Hankins says he personally never induces for convenience. 'An induction absent a solid indication absolutely increases all risk to mom and baby,' he says.  Laura Riley, MD, medical director of labor and delivery at Massachusetts General Hospital and Hankins's predecessor as chair of the ACOG practice committee, which releases guidelines on such practices, agrees. 'Ideally you wait for natural labor,' she told me. 'Just by the mere fact of induction, you've now intervened in a pregnancy that otherwise would have continued, and you've already increased the risk of a c-section.'" (pg. 8, Pushed, the Painful Truth about Childbirth and Modern Maternity Care, by Jennifer Block).


The book makes a great case for doing your own research rather then blindly following your doctor's suggestions during pregnancy.  I HIGHLY (can't say it enough) recommend that you read Jennifer Block's book whether you are pregnant or not.  It is very easy to digest and full of loads of well-cited information about birth in the U.S.  If you are happy with your induction, that is fine, but the hard-core fact is that many many women are being encouraged to be induced for "controversial reasons" that are not supported by research and the results can be harmful to mom and baby.  And I am absolutely not saying that induction or a bit of pitocin to speed things along is never warranted.  But induction for a "suspected big baby," for example, is not supported by either ACOG OR the literature (see Pushed page 8).

June 25, 2008

Adrian's Birth

A big thank you to Adrian's mom for sharing their story!**

Adrian’s Birth Story
What I will remember most vividly is the sight of your small body floating up to me through the water, the intensity of your dark alert eyes.  I lifted you out and held you to me, enjoying the sensation of your soft skin against my chest for the first time.  I remember thinking that you were strong, already moving your head willfully to inspect your surroundings.  At first you were not breathing, and Kate gave you mouth-to-mouth twice before you uttered your first cry.  Adrian, our little boy, it was then that your voice filled our home for the first time.  Mark and I had talked about it so often, the miracle of your new voice.  And there it was.  Unceremonious, natural, clear.
Mark joined me in the tub and we took turns holding you, inspecting your face, your full head of wet black hair, your valiant little chest.  Before long, I moved to the bed, which we had to do very carefully since I was lightheaded and your umbilical cord was so short.  Then I lay on my back and held you to my chest.  When your umbilical cord stopped pulsing, Kelsey clamped it in two places.  Then she tugged on it gently and the placenta slipped out of me painlessly.  I cut the cord, which was surprisingly thick and rubbery.
Our journey had started at about 3:30 a.m. the previous morning.  I was awoken from sleep by what felt like very painful menstrual cramps.  At about 3:45, I started writing down the time that each one started.  They were coming at six or seven minute intervals.  I could not fall asleep again until about 7:00 a.m., when the cramps mercifully stopped for about one hour.  I am convinced that this was divine intervention.  Without that small bit of additional sleep, the challenge ahead would have seemed so much greater.
I spent the day walking laps around the first floor of our home, writing down the start and duration of each contraction.  As the contractions got stronger and longer, I asked my mother to take over recording.  Around mid-day, we called Kate.  She confirmed that I was in labor and asked me to call her after lunch.  I called her at around 2:00 p.m. and she said that she would come by soon.  She arrived around 5:00 p.m. when it was starting to get dark.  By then, I had moved to our bed upstairs.  The contractions had grown so strong that I really needed to concentrate on my breathing to make them tolerable.  Mark was laying behind me holding me, kissing me, and encouraging me.  He kept saying I could do it, that I was strong and that he loved me.  Without his support, I don’t know how the rest of my labor could have been tolerable.
During this phase, I had a powerful feeling of divine protection.  I felt the presence of many loving entities in the room and I was moved to tears at the thought that there were perhaps angels watching over us.  I felt deeply blessed by the honor of giving birth to you, of becoming an instrument in the emergence of a new life into the world.  I felt immense peace and gratitude.
I remember everything from this point forward like a dream or the delirium of a fever.  I have no concept of time and no clear recollection of the sequence of events.  I know that my contractions were coming very quickly by the time Kate arrived because she asked me whether I was feeling the urge to push.  I think that she thought there was a chance I might be going through transition.  Unfortunately, that was not the case.  When she checked me, I was only one centimeter dilated.  She dilated me to about four centimeters with her fingers, which was intensely painful.  I kept asking whether I could go into the tub, which Mark, Kate, and my mother were filling with water.  They kept telling me that it was not yet warm enough.  I was starting to despair because the contractions were growing increasingly strong and I was sure that the tub would offer me relief.
I am guessing it was 6:00 or 7:00 p.m. when I was able to get into the tub.  At first, I was leaning over the edge, but then I found that reclining on my back was actually more comfortable.  I kept my sports bra on at first, but then I had to take it off because it felt like it was restricting my breathing.  In the weeks leading up to your birth, I had been so concerned about modesty during labor.  Now, in the middle of everything, this wasn’t even an afterthought.
I am not sure how long I was in the tub that first time.  I remember being on the bed later on around the time that Kelsey arrived, which I am told was around 11:00 p.m.  By then the contractions had reached yet another level of intensity and I was starting to seriously wonder whether I could go through with the labor.  I remember opening my eyes a bit and seeing Kelsey standing over me looking concerned.  She and Kate started stroking my legs and thighs and telling me that I needed to relax my bottom.  Kelsey coached me on how to breathe into the contractions rather that fighting against them.  She told me to take a deep breath in when the contraction started and then exhale loudly through my mouth as the contraction was reaching its peak.  This was very hard for me to do, but it felt more comfortable than struggling against the pain.  I kept following Kelsey’s advice for the rest of my labor.
Kate checked me again and opened my cervix a bit more – this time to six centimeters.  As before, this was excruciatingly painful.  I remember hearing Mark saying, “Honey, you are more than half way there.”  I asked Kate how much longer she thought that it would be, and she replied, “As long as it takes.”
I got into the tub again.  I could tell that it was very late because everyone had grown tired and quiet.  I could tell that my mother was distressed by seeing me in pain, and she had left the room, I assumed, to collect herself.  Kelsey and Kate had gone away to rest, leaving me and Mark to ourselves.  Mark was very tired, but he never left my side.  He was lying on the bed dozing in and out of sleep.  When he would hear me struggling, he would encourage me, telling me over and over again how strong and brave I was.  I was fairly certain that I was in transition because I felt so hopeless.  I actually fantasized about what it would have been like to get pain medication during the birth, and my rational mind reminded me that, not only was I far beyond the point at which that was feasible, but that having a natural birth at home was a precious gift that I had been dreaming of giving to you.  Then I started thinking that my body could not handle the pain.  I became convinced that I would pass out soon and possibly (although it seems ridiculous now) die.  I actually made peace with the idea of death and regretted only that Mark and I had not had the opportunity yet to draft a will.
I experienced so many contractions that night, but there was one in particular that brought me to my knees.  It ballooned in my uterus and then spread quickly like vines wrapping around my back and thighs.  I looked down and noticed that my body was convulsing.  I kept praying to God for strength and for the experience to be over soon.  Shortly after that, Kelsey came back into the room to check my dilation.  Mark helped me out of the tub, which took several minutes because every move I made would trigger another contraction.  Kelsey said that I was fully dilated except for a small lip of cervix that she thought I could push through.  Mark told me later on that my response was, “Thank you, God.”
Kelsey asked me to start pushing on the birthing stool.  She instructed me to take a deep breath, hold it in, and bear down during a contraction.  I tried this several times and found it very uncomfortable.  She then asked me to try peeing because she suspected that my bladder was full and a full bladder can impede pushing.  I tried peeing and nothing came out.  Mark helped me up from the toilet and allowed me to lean on him to walk back to the bedroom.  I felt like I had very little control over my legs and it was very hard to take those few steps.  I asked if I could try pushing in the tub and Kelsey said to go ahead.  In my memory, the pushing took about twenty minutes, but Kelsey told me that it was over two hours.
Back in the tub, I got on my knees and held on to the edge with my hands.  I became very determined.  I could feel your head descending through my pelvis and I wanted you to be born as soon as possible.  Every time I felt a contraction coming, I would breathe in and push with all of my strength.  This seemed to trigger follow-on contractions, and I tried to push through as many of them as possible.  I heard Kate telling Kelsey to invite my mother back into the room so that she would “not miss the main event.”  I heard Kate telling me that I was doing great.  Then I heard her telling someone that she could see the head.  I felt only a slight burning sensation, not the “ring of fire” that women talk about experiencing as their baby’s head emerges.  But I could tell that you were coming out.  I felt like my pelvic floor was bulging.  I felt your head emerge and then retract at least a couple of times.  I noticed that my face was wet, and I realized then that I had been submerging it with every push.  Then I gave one mighty push and I heard Kate announce that your head was out.  One push later, and the rest of your beautiful body was born.
Born January 15, 2008 at 4:22 a.m.
9 pounds, 12 ounces, 21 inches long

**Names have been changed


June 22, 2008

Why We Must Stand Together

In my former life, I was a Ph.D. student (I left indefinitely during my first pregnancy) and an organizer for social justice at the Jewish Council of Urban Affairs in Chicago.  Much of my work centered around housing issues, specifically housing for the poorest of the poor, or public housing.  Few were interested in becoming intimately involved with the dwellers of Chicago's severely neglected, rat and crime infested high-rises where families struggled to survive.  I shared the poem below with those hesitant to get involved. I think it is an important one to read whenever we think that an issue is not MY issue.  Whether we decide to birth at home or in a hospital, with or without an epidural, assisted or unassisted, birth choice is an issue that touches us all, women and men.

First They Came for the Jews

First they came for the Jews
and I did not speak out
because I was not a Jew.
Then they came for the Communists
and I did not speak out
because I was not a Communist.
Then they came for the trade unionists
and I did not speak out
because I was not a trade unionist.
Then they came for me
and there was no one left
to speak out for me.

Pastor Martin Niemöller

If I rewrote the poem, it would go something like this:
First they came for the unassisted birthers, but I did not speak out, because I do not free-birth.  Then they came for those who birth at home with lay midwives, but I would would not speak out, because I would not have a home-birth with a lay midwife.  Then they came for those who birthed with Certified Professional Midwives, and I would not speak out, because I would not have a home-birth with a CPM.  And then they came for those who birthed in birth centers and with Certified Nurse Midwives, but I would not speak out because I would not have a birth in a birth center or with a CNM.  And then they came for me, and there was no one left to speak for me.

June 20, 2008

Women and Midwives Need to Work Together for Birth Choice

I haven't blogged about the recent AMA Resolution (scroll down to read Resolution 205 Home Deliveries and Resolution 239 Midwifery Scope of Practice and Licensure) and I was certainly not surprised by it.  (If you haven't heard about the resolution, here is a short article on it). 
But it is not just the American Medical Association who thinks they are the ones who should decide who can (or cannot) have a home birth.  We have our own news-breaking story in the DC area (though it isn't getting nearly as much press as the AMA resolution.)  A few certified nurse midwives (or CNM) in our neck of the woods seem to feel that nurse midwives, not certified professional midwives (CPM) or moms, should decide who is a good candidate for home-birth.   You can find the story here. Click on on CNM_letters.pdf.    In short, these midwives believe that women expecting twins or breech babies or women who would like a VBAC (vaginal birth after cesarean) should NOT be in the care of CPMs and are therefore not candidates for home-birth.  The four midwives sent a letter to the Virginia Board of Medicine urging the development of guidelines that would restrict home-birth.  The current VA legislation allows women carrying twins, breech, or attempting a VBAC to deliver at home with a licensed CPM.  If you live in Virginia, or know someone who lives in Virginia, please tell them to visit the Virginia Birth PAC site and click on their action alert.  If we are going to have true birth choice, ALL midwives and women will need to work together.

June 13, 2008

Birth is Empowering!

As I look through the pictures from my birth again I can't help but wonder why they have to be so different from the pictures so many people hold in their mind of birth.  Where has the ecstasy, the passion, the power of birth gone?  Below are a few of the pictures from my second VBAC (vaginal birth after cesarean).  You can read the story here

Birthphoto2Birthphoto4Birthphoto3 Birthphoto5 Birthphoto1
AntoinettenurseAntoinette

June 08, 2008

Bella's Birth

A big thanks to Emily for sharing her story!


Bella’s Birth

Pregnant for the first time at 32, I knew I wanted a natural birth, out of the hospital and without drugs. 

As a feminist, I believe in the power and capabilities of women’s bodies, of my body, and the wisdom of trained women helping other women birth. 

As a public health professional, I knew that the U.S. has poor birth outcomes compared with other industrialized countries, that most women around the world give birth outside the hospital, and that women have birthed without medical intervention for thousands of years. 

And as an activist, I was vaguely aware of the history of our male-dominated medical establishment systematically working to discredit midwifery starting in the early 1900s in order to make pregnancy and birth into a lucrative business. 

Most of all, I wanted what would be best for my baby.

I had a healthy and easy pregnancy.  I ate well, exercised almost every day, read probably 15 books on pregnancy, childbirth, breastfeeding, and parenting, and took Bradley childbirth classes.  I felt prepared for labor and delivery and confident in the decisions I had made, though I had to defend them often with my family and friends.

Bella was “due” on a Thursday in early November.  Thursday arrived but with no signs of labor.  I worked from home on Thursday and Friday.  I felt good and was not in a rush for labor to start.  I figured my body and/or the baby needed a little more time.

On Saturday, Steven, my husband, and I went to Great Falls park for a hike.  By that time, I really was only comfortable when walking, and it was a beautiful fall day.  The leaves were all shades of red and yellow and orange.  We hiked on the rocks for about an hour and then sat on the rocks and ate and read for a long time before hiking back.

When we got home in the late afternoon, I took a nap.  I knew labor could start anytime and that I needed to be well rested.  When I woke up, there was a very small wet spot on the bed.  I thought my water may have broken and so called BirthCare.  Marsha wanted me to come into the office, and we agreed to meet there.

At BirthCare, we met Juno, a midwife in training, and she and Marsha preformed two tests, showed us the slide under the microscope of what turned out to be my amniotic fluid, and confirmed that my water had broken.  I was not at all dilated.  Labor would have to start soon, or we’d have to get it started early the next morning with castor oil.

On our way home, we picked up Ethiopian food – one of the only cravings I had throughout my whole pregnancy.  I ate a huge meal, took a warm bath, and got in bed; it was about 10pm.  Almost immediately, I felt my first contraction, and it was strong!

Steven called BirthCare, and Alice was now on call.  She said to call again when the contractions were closer.

I thought I’d be really active during the first stage of labor, when the uterus is dilating, but I quickly found that I could focus on relaxing best when lying on my side in bed.  I let Steven know when each contraction started, and he rubbed my lower back and talked me through each one.  I focused on relaxing and breathing deeply through the contraction. 

In between contractions, I kept running to the bathroom.  My body seemed to be getting rid of all of the food I had eaten, and I vomited many times.

The contractions started to come every 4-5 minutes by about 3am.  Steven had had a pot of coffee by then and was reading his book in between contractions.

Not a lot changed when Alice, Juno, and Claudia, our birth assistant, got to our house at about 345am.  I was so focused on relaxing and breathing through each contraction that their presence was almost a blur.  But I heard their very positive feedback and encouragement.  All was going well!

The hard part came during the transition to the second, pushing stage.  I felt confident that I knew how to handle first stage contractions and could get through the longest, toughest one.  But then my body started wanting to push out the baby, and I couldn’t figure out whether to relax and breathe through the contractions or push.  For the first time, I screamed through the toughest part of the contractions and was scared and panicked.  It was now about 9am.

After a few more panicked contractions, Juno for the first time checked to see how far I had dilated.  I was almost there and so she and Alice told me to push.

At some point while I was pushing, Claudia said she was going downstairs.  I blurted out that she should put the lasagna in the oven.  Everyone laughed that I would think about food in the middle of pushing, but I was so grateful to my birth team and wanted them to be well fed!

After about an hour, during which Juno patiently put warm compresses on my perineum, Steven helped support me in a squat, and I pushed, Juno said she saw the baby’s head.  I pushed and pushed again and then my baby was suddenly on my stomach!  Holding her for the first time, still attached to me through the umbilical cord, I was in awe, proud, and so happy.

Isabella Emma Biel Figdor weighed 8 pounds, 6 ounces and was healthy and strong.  She latched on almost right away.  Then, Steven and I held her, ate a big plate of lasagna, and relaxed together in our bed.

June 03, 2008

Nettie's Cord Fell off!

You have been with us almost two weeks and today your cord fell off.  How have the days passed so swiftly... We are at the end of the last big push to put our house on the market, Thursday is the big day!  Nettie is sleeping five our stretches, almost as if she knows that life is a bit intense at the moment and she wants to do her part to help out.  I am very grateful for the sleep.  When things slow down a tad I promise to write more about Nettie's birth and other things.  I just renewed my Neonatal resuscitation certification with Karen Strange.  Now what was I doing at a workshop nine days after giving birth?  Well, Karen's approach to neonatal resuscitation is unique and I really enjoy her class.  In addition, it was held at my midwife's house so I was very comfortable (and friends were present to help out). And the reality is that I didn't want my certification to expire, it is a very important one. The other place I would like to take the class is The Farm but that is not going to happen until the next time my certification expires (it is good for two years). 

May 29, 2008

My Thoughts on Water Birth

I chose not to use an aquadoula with this baby.  My midwife commented, you loved the water last time (I did) and my friend who is a doula and was offering the use of her aquadoula for free queried, "are you sure?"  I did have a beautiful and empowering water VBAC but I decided not to have a water birth this time for several reasons.  I thought I would share them here.
Water Temperature:
The maximum water temperature suggested for waterbirth is usually 37.5 degrees Celsius or 99.5 degrees Fahrenheit.  Some studies recommend 37 degrees Celsius (98.6 degree Fahrenheit).  Now if you are not a hot water fan then water birth might be the choice for you.  As for myself, I am happiest in HOT water, preferably 105 (40.6 C) but I could make do with 102 (38.9).  Yet 102 degrees is too hot for a water birth.
Second Stage (pushing):
I am the the overly exuberant type.  As soon as I discovered Fen, my last baby, was crowning, I wanted him out and pushed him out with all the strength my rather muscular body could manage.  You guessed it, I tore.  Recovery was much more difficult then expected and I stayed in bed for a good two weeks instead of a week (today is the end of my week confinement).  In addition to tearing, I had a reaction to the suture material, Vicryl, which left a rather ugly scar.  Now gobs of arnica oil (Weleda makes some great stuff) massaged regularly into the scar on a daily basis a good two weeks or so before the birth did wonders for the scar but I wanted my perineum carefully guarded during second stage so that my midwife could instruct me to put on the brakes at the appropriate time.  I ended up breathing (rather than pushing) Nettie out with only a slight skid marking the passage of her head.  Recovery has been a breeze and as a result I have a lot more pictures of Nettie as a newborn then Fen.  Sadly I was too sore to move much with Fenimore the first week or two and I am the picture taker in the family.  Thankfully I hold his newborn pictures in my heart.
Catching Baby:
Have you ever watched "Birth in the Squatting position?"  That is sort of what I pictured for this birth.  I wanted to be squatting and fully aware as I caught Nettie slowly emerging from my body, then gently pull her to my body.  I had trouble catching Fenimore in the water.  I pushed him out so quickly that he slipped from my hands and I had to fumble a bit before pulling him up.  The water was deep and I am small so I couldn't very well slowly catch him and comfortably bring him up to my chest or he would be under water.  I had to stand up immediately after the birth.  And once I stood up, I was freezing, shaky from the combination of birth hormones and the abrupt change in temperature.  It just seemed that it would be simpler for me to catch a baby and then sit back to relax for a few breaths (as in the afore mentioned film) if I was on land.
The Cons:
Labor pains were ineed more intense out of the water but with the fear of giving birth out of the way I was able to embrace the pain and open without the help of the water.  I found other ways to cope with the pain (stay tuned for my next blog post!) .  In my opinion, I think water birth can be a great choice for VBAC or first-time moms when staying on top of labor pain might be harder but for a second vaginal birth, it can be fun to explore other options.

May 26, 2008

Antoinette's Birth Day!

Labor has no clock and it is impossible to know when you are going to have a baby.  Liz had called me earlier in the evening to ask if she should go out dancing or if I was going to have a baby (since I had proclaimed it was coming Wednesday night).   I thought by morning, but....  And later I had no idea when to call Karen.  When Karen asked me to call her back once contractions were under 8 minutes a part, I had no idea if that would be in 10 minutes, an hour, more?  I don't like to call too early because I like to labor by myself as long as possible.  I ended up being surprised by how quickly labor rolled along and pulled me into its vortex. By midnight, less then thirty minutes after calling Karen, contractions were regularly 4-5 minutes apart and sometimes less.  I waited a good 30 minutes to confirm I had reached the point of no return and then called Karen the second time.  I love Karen's voice.  It is calm, and confident and full of trust in birth.  I am on my way!  I called Liz and Corbin to report Karen was on her way and then called my sister who had the shortest distance to travel.  As the phone was ringing, I passed it to Matt.  There would be no more talking on the phone for me, I had a baby that was ready to be born.  I continued to labor standing up, feeling more comfortable upright, even between contractions.
My mom lay on the futon in our office/guest bed room as I labored, not asleep, she labored with my in the middle of the night as well.
Labor land.  The doorbell rang, and rang again, and there were knocks and footsteps.  Someone was in the hall, where was my sister?  Matt said Liz or Luz (I wasn't sure whose name he spoke) was here and wanted to come in, of course.  I was very restless but was in transition and shaky on my feet so decided I should move to a squatting position to conserve energy.
I glimpsed Corbin setting up camera equipment outside and felt Luz and later Liz and Karen enter the room. By 1:30am, everyone who had been called was at the birth.  Karen asked if I wanted to be checked and I said yes though I needed some time to negotiate putting my body in a position that would make a vaginal exam possible.  I decided upon a semi side-lying position and Karen speedily checked me so that I could return to a more comfortable position.  I was nine centimeters at 1:55am with a bulging bag of water.  I wasn't surprised by the bulging bag, I sensed something was in the way and had an overwhelming desire for my water to break.
I labored on, all fours, supporting my upper body by draping it over Matt's shoulder.  Matt reminded me that I had been in a similar position, on our first night out together (the perfect thing to say at the time).  He had given me a piggyback ride home, my head buried in his hair. 
Shortly after 2am I felt pushy but wasn't sure what position I needed to be in to really start pushing.  I had a few contractions where I was just hanging out, hoping my body would be inspired to find a new position sooner rather then later, I felt a lull.
I looked around as if someone in the room might offer a solution and for one brief moment thought "won't someone break my water?," before remembering this was my job.  Maybe it was because there were so many people in the room (while I sensed their loving energy and support, I never fully noticed they were there until the lull before pushing) but all of the sudden I said to myself, I'm going to go to the bathroom, announced that I had to pee and walked out of the room.  Karen later remarked that at births with many attendants, the mom usually heads off to the bathroom to have her baby.
Ah, the bathroom, I couldn't have made a better choice!  When we first bought this house I dreamed of having a baby in the claw foot tub that we would restore.  I was a bit off, I didn't have the baby in the tub, but the tub and sink provided the perfect squatting bar, with the toilet for back-up if my legs gave out.  I dangled my self, supported by tub on the left and sink on the right, and let my pelvis open, making full use of gravity.  In this self-supported upright squat, I found the strength to give a huge push and my waters blissfully released (2:25am).   As soon as my bag broke, I felt Nettie's head move down to my perineum and I eagerly began pushing.  I would have forcefully pushed Nettie out, impatient to have my baby in my arms, but Karen and I had talked about my need to have someone slow me down while pushing and she gently encouraged me to stop pushing and just breath her out.  Since I didn't have to focus on pushing, I had a heightened awareness of Nettie's descent from my body, it was wild!  At some point I stopped dangling, supported my weight with my legs, and reached over to hold onto her as she reaching the end of her journey into this world.  I pulled her up to my body (2:30am) and collapsed exhausted onto the toilet seat, letting the waves of exquisite birthing hormones roll over and through our bodies.
I felt for a moment that I was about to push the placenta out into the toilet and someone asked if I wanted to move back to my bed and slowly we made our way back down the long hallway to our bedroom.  Nettie latched on immediately, a nursing pro minutes after birth, and I caught my breath as I waited to birth the placenta.
So that is our story.  I promise to add pictures soon.  As with all spiritual, awesome events, words try to capture the essence of the story, but slip.  Perhaps when I am better rested and have a thesaurus at hand, I will rewrite.  Many thanks to my amazing midwife and her two beautiful assistants who were at the birth (I feel blessed to have discovered midwifery in this corner of the world, with so many strong and loving women on the journey and with such a dedicated guide), to my mom and sister, the closest women in my life, to Corbin who took beautiful photos and to my strongly loving and supporting other half, Matt.
Oh, I forgot to mention that my "BIG" week and 1/2 "late" baby was a mere 7 pounds and 3 ounces.  Smaller than her brother who was born two days "early."