If you are pregnant in Virginia or plan on using a Virginia care provider during your pregnancy, you might want to spend some time on the Virginia Health Information Site. This fabulous (and rather eye-opening) site has cesarean section and episiotomy rates by providers (note, not all providers are listed). The next time your Virginia provider states that he doesn't know what his/her cesarean/episiotomy rate is, you can just look him up! I am looking forward to the day when full disclosure will mean that doctors must choose between lowering their cesarean and episiotomy rates or loosing patients.
When Gavin's mom first emailed me her birth story, she felt it was too long to post on the blog. I thought it was such a beautiful story that my readers wouldn't mind the length. Thanks so much for sharing!
During my first birth I learned to trust my body. This birth taught me to trust my baby.
If every child is different, then every birth must be that way, too. I really didn’t want to enter into Gavin’s birth with a feeling of needing to settle the score with nature. Really, there weren’t many things about Nate’s arrival that I would have changed – it was a wonderful experience (not that there weren’t a few things about AFTER that I would have changed)! But when you’re that close to wonderful, it’s not hard to think, “if I could just do X next time, then it would be perfect!!” Being human, that’s exactly how I felt about Gavin’s birth -- I wanted it to be just like Nate’s, only even more perfect! Since I had mastered the hypnobirthing techniques, and could still achieve the deep relaxation I had with Nate’s birth, I was looking forward to another pain-free labor. The part I wanted to change? Pushing. With Nate, I had to actively push but I really wanted to see what would happen if I just “breathed the baby down” this time. AND, I had read a few articles on orgasmic birth, and thought it sounded pretty great, too – maybe I’d just go ahead and make that my goal, you know?
But life likes to throw you curve-balls sometimes. Just before we decided that we were ready to start trying to get pregnant again, we found out that the Maternity Center in Bethesda had closed its birth center. I was so upset – I really didn’t want to give birth in a hospital, but our only remaining birth-center options were all 45 minutes or more away. However, this turned out to be a blessing in disguise. We would have certainly returned to the Maternity Center for any subsequent births because we DID have such a great experience there with Nate. If they had not closed, we would have never had any reason to even contemplate a home birth.
My husband, Bill reluctantly accompanied me to an orientation at BirthCare in Alexandria. He seemed a bit more open to the idea after the orientation. We found out a few weeks later that we were expecting, and after much conversation, decided to go ahead and move my records and start my prenatal care with BirthCare. While we were accustomed to the attentive care that midwives provide during pregnancy, we were blown away by the kindness and thoroughness of the midwives at BirthCare. They spent so much time going over our medical history – and Nate’s birth – at that first visit – that we immediately felt at ease with them. We were able to spend the whole nine months looking forward to this birth!!! Best for us, the practice was exactly what we needed at the time – we could use the birth center if we wanted, but they also attend homebirths, so I would have a little extra time to get Bill to “come around” to homebirth.
One thing that differed with their practice was the birth assistant. At the Maternity Center, they had an on-call staff of nurses that assisted the midwives during births, so you just got whoever was on-call (and just like a hospital, they change shifts at 7 am – the nurse who came on shift after Nate was born was not my favorite person there. But I digress . . . ) But at BirthCare, they have a list of approved “birth assistants” who work with the midwives. You interview and hire them on your own – and then they assist the midwife during your birth. The people on their list include everyone from L&D nurses that enjoy attending out-of-hospital births to certified doulas. Since you interview and hire them yourself, they actually end up functioning as part midwife assistant, part doula. Since one of our friends at church is a midwife in training (Virginia recently changed its laws to allow direct-entry midwives, so she was in the process of finishing her training to become licensed), we decided to interview her first! Since she only attended homebirths (not birth-center births), we also had to decide for certain if homebirth was how we were going to go. I had e-mailed her a couple of times and explained how Bill was a “reluctant Dad” about homebirth, and she said that she’d be glad to talk to us.
We met Aimee for lunch one Sunday after church, and I feel like she and Bill hit it off immediately (I think her being an attorney had something to do with it!). I knew that I sensed something special about Aimee from the other times I had spent time with her, and Bill felt it, too. We got to hear her story – quite an interesting journey from being an attorney to becoming a midwife – and she helped Bill understand the pros / cons of a homebirth. She pointed out that once you’ve decided that you’re more comfortable with an out-of-hospital birth, the “jump” to home birth is much smaller! We were just as close to a hospital as we would be at the birth center, the midwives bring everything to your house that they would have at the birth center, and we would be closer to home if anything did go wrong (so we’d be with our pediatricians, not some random on-call person in Alexandria). Before we left lunch that day, Bill had decided that we could go ahead and plan a home birth and we officially became one of Aimee’s March clients! I was so excited – we were planning a home birth and we had a wonderful Christian birth assistant/doula/lactation consultant/midwife- in-training to help us!
Curve ball number 2 arrived during December. When I was pregnant with Nate, I had quite a bit of hip pain the last 6 weeks or so – doing anything that required standing on one foot (putting on socks or pants, etc.) was really painful. For some reason I thought that was normal. But, when I started experiencing that kind of pain again with over three months to go, I got a little concerned. Then I started noticing the pain when I was lying on my side in bed at night, when I first stood up, anytime I climbed stairs or especially when I stood up to get out of the car. I talked to the midwives about it and they encouraged me to swim as much as possible. That helped immensely, but it was still bothering me. Although I had noticeable relief after swimming, standing up out of bed in the mornings kept getting more and more difficult. My most dreaded time of day became nap time – if I took a nap while Nate was sleeping and he woke up first, he would call for me to come get him out of his crib but I would have to roll over onto my back and lie there for five minutes or so before I could even move my legs!! After consulting with the midwives again, it was decided that I had symphysis-pubis dysfunction. In a nutshell, the ligament that holds my hips / pelvis together had relaxed so much (it IS supposed to relax when you’re pregnant – but my body was over-achieving on this one) that my pelvic bones were not lined up correctly. They were grinding against each other in the front and torquing my spine / back muscles. Then, at my 34 week appointment, I was measuring small, and we realized that Gavin was still hanging out in there sideways! (He had been breech at 19 weeks for his sonogram, and I knew he was still moving positions a lot, but he seemed to hang out that way for a long time). That was enough to convince me that we needed to do something. If my mis-aligned hips were making his living quarters un-conducive to being head-down, something had to be done! So, I reluctantly and nervously went to see a chiropractor.
My chiropractor became an angel - I suddenly found myself able to move and walk again without pain, and not long after the first series of adjustments, Gavin settled into a head-down position! I saw her once or twice a week (depending on how much pain I was in) and she was able to keep things pretty well aligned.
Preparing for a home-birth was a little different than just showing up at the birth center – we had to get our “homebirth kit” and other supplies gathered, and once we had our oxygen tank at home, Aimee visited us to make sure that everything was ready (and to test our directions – they don’t want to have problems finding your house when you’re in labor!). I remember having a conversation with Aimee at our 36-week home visit about my experience with Nate’s birth. After hearing about how far along I was when I realized that I was really in labor (I arrived at the Maternity Center not sure if “this was it” – but I was already 8 cm!! Nate was born about two hours later), she made us PROMISE that we would call her as soon as we had an “inkling” that I might be in labor. She was afraid that if we waited until we were certain, that they might not make it here in time for the birth. She also went over the “what Dad has to do if the baby is coming and the midwife hasn’t arrived yet” instructions. You should have seen the expression on Bill’s face. When we had gone for our Birth-day planning meeting at BirthCare in February, (they have a meeting for all the families due each month), they told us the same thing, “don’t try and be polite by waiting to call us – we’d rather come to your house and have to go home several times than have you call us saying, ‘um . . .I feel like I need to push . . .”
Being duly convinced that early warning was the way to go, my only fear about this birth was that I wouldn’t realize that I was in labor in time for the midwives to get here. I started praying that I would figure out what was going on, and that it wouldn’t be during rush hour! (Fortunately, one of the midwives lives about 30 minutes from us and at one of our last visits she assured us that if we thought we needed someone there quickly, we could request that they page her, even if she wasn’t on call!).
My mom agreed to stay with us for Gavin’s arrival – partially because I really wanted her to be here for it, and also so she could help out with Nate. We had a really hard time trying to figure out when to fly her up (my Dad would drive up after Gavin was born to take her home). Since Nate was a little early, we wanted to make sure we got her here in time, but we didn’t want to impose on her for too long! We finally decided to get tickets for her to arrive about two weeks before Gavin’s due date (Easter weekend). Hopefully, he would cooperate and not come before that! She arrived on March 11th, and I remember thinking that night, “okay Gavin, you can come anytime you want now!”
I actually had a pretty long list of things I wanted to do before he arrived and my Mom was helping me cross things off that list pretty quickly. Then, Nate and my mom both came down with a stomach bug at the end of that week, and I started telling Gavin to stay put! Once they were both feeling better and we had the house clean again, I started entertaining the notion of having a St. Patrick’s day baby, but the 17th came and went.
As I promised myself last time, I got another pregnancy massage! I had an adjustment at the chiropractor on Wednesday the 19th, and got a massage right after the adjustment. I had several “flurries” of contractions that evening – but they were just little clusters – nothing with any notable pattern. And again I found myself asking Bill to put his hand on my belly asking, “is that a contraction? Do you think it feels like a contraction?” My boys have an uncanny ability to stretch in utero in such a way that it makes it difficult to distinguish the stretches from contractions! My mom just laughed at me when I would ask Bill to help me figure out if I was really having contractions or not.
The next day I had my 39-week appointment with the midwives. I had been having contractions (now that I had finally realized which were stretches and which were contractions) on and off all day, and actually contemplated whether we should drive to Alexandria or just stay put. But, chasing a toddler and getting showered and dressed isn’t really conducive to resting – so I decided that we would get in the car and start driving that way – I told myself that if the contractions didn’t space out once I was sitting that I would just call Aimee and turn around!
Once I was in the car, the contractions spaced back out, and were only coming about once every 20 minutes or so – so we went ahead to our appointment (everything was great), ate dinner with some friends (Mexican!), and came home thinking that Friday would just be another day of waiting. In fact, Mom and I had planned to do some shopping that day!!
I woke up to go to the bathroom sometime around 4 am on Friday morning, March 21 and couldn’t go back to sleep. I lay in bed and watched the clock for a while – and realized that I was having contractions about every six minutes. Having had the FEAR OF GOD (or rather the FEAR OF BILL HAVING TO CATCH THE BABY) put into us by the midwives, I woke Bill up and told him that we needed to call Aimee. She had said that if it was time to be asleep, and I couldn’t sleep, that she wanted to be awake too! Looking back, I realize that my inability to sleep was probably more because of excitement than contractions, but those things are really hard to differentiate when you’re in the middle of them!
I called Aimee (5:20 am) and she decided to go ahead and come over right away. We were all worried that if we waited, she might get stuck in rush-hour traffic. It didn’t occur to any of us until later that day that it was Good Friday – and Spring Break to boot – so there wasn’t really any traffic.
She suggested I take a shower and see how things went before I called the midwife on call. I had Bill put the clock in the shower so that I could time contractions while I was in there – and they were hanging out right at 6 minutes apart. I wasn’t having any problems breathing – or even talking – through them. But, I was thinking that things could progress really quickly, so I went ahead and called BirthCare (5:50 a.m.). Being the intuitive Mom that she is (or it could have been that it was hard to sleep with someone in the shower and all that talking on the phone!), my Mom woke up during this time and decided to get up herself.
At 6:10 a.m., when Aimee arrived, I was sitting at the computer looking up name meanings for middle names, and my Mom was in the kitchen fixing a breakfast casserole (we hadn’t quite finished our to-do list!!). We went upstairs for Aimee to make sure that all the supplies were still ready, and she helped Bill re-make the bed. (you make a sheet sandwich – comfy sheets on the bed, then a plastic liner, then old sheets on top – that way when it’s time to clean up you just strip the top layers and you have your comfy bed waiting for you!)
Aimee did her preliminary checks – blood pressure, temp, and the baby’s heart rate. She quizzed me about whether we were certain about the sex. Apparently Gavin’s heart rate was on the high end of normal (boys supposedly have slower heart rates in utero). Bill and I both told her that we had seen evidence to prove he was a boy on the sonogram, so she declared him a happy “chirpy baby” and said she couldn’t wait to tell one of her colleagues about this baby boy with a high-end of normal heart rate.
Regina arrived shortly after we went back downstairs (6:40 a.m.), and got all her supplies in the house and ready.
My friend, Leann (who was also there for Nate’s birth) arrived not long after Nate woke up. When the breakfast casserole was ready everyone had breakfast – I think Nate thought it was really neat to have so many people eating breakfast together.
I spent some time on the computer, sat in our recliner eating granola and yogurt, walked around, generally putzed, sometimes stopping to sway with a contraction, but mostly just hung out until around 9 am or so. I wasn’t feeling any pain (yay for hypnobirthing!), and since the midwives were having a hard time telling how far along I was (Aimee commented that it was really hard to tell when I was even having contractions!), Regina asked if she could check and see how much I was dilated. I really didn’t mind – in fact, since everything had stayed basically the same (none of that “more frequent” and “more intense” business that we were supposed to be having), I was curious, too. We discovered that I was 4 cm dilated, so I was definitely in labor! I guess I was secretly hoping that I was further along than that – I had built myself up to thinking that a ridiculously fast labor would be possible, so now that I was just over 5 hours in, I started to wonder just when things WOULD pick up. (but then again, the contractions weren’t all that intense, so why was I complaining????)
I got all of Nate’s things ready for him to go to my sister’s house – I packed for the day and for overnight just in case. My sister showed up with her camera ready – joking about why Gavin wasn’t here yet! She said she just wanted to be prepared because she thought it might go really fast this time.
I was a little worried that Nate wouldn’t want to leave, but he was so excited to be going to my sister’s house and getting to spend the day with his cousin that he literally never looked back (10:00 am). He did get to help Aimee listen to Gavin’s heartbeat before he left, though.
I really wanted to get in the tub, but kept thinking that I would wait until walking around on dry land wasn’t cutting it.
Aimee kept checking my blood pressure and Gavin’s heart rate intermittently, and handing me my glass of water (or juice – whichever I was drinking at the time). She was my hydration dictator – she wanted to make sure I didn’t get dehydrated. She also kept asking if I had been to the bathroom, too. But, since a full bladder can interfere with your uterus doing its job, it WAS important for me to keep going to the bathroom.
On one of my trips to the bathroom, my GI tract decided to empty itself of its contents. This is one of the “warning signs” of labor, so I guess I was glad to have a little more confirmation from my body that it really was planning on having a baby soon. But, I was wishing that I hadn’t eaten Mexican the night before . . .
Since it was the first Friday of March Madness, there was plenty of basketball on television to keep us distracted, and some of the pre-game hype was coming on TV. I remember about this time feeling rather silly that I had called the midwives so early . . .
I was sitting in the recliner at one point, and everyone was laughing at how much Gavin was moving – and how much you could see it on my tummy. Aimee asked if she could palpate my tummy and figure out which direction he was facing (we knew he was head-down). She thought she was seeing knees and feet – which isn’t good. The baby really needs to be facing your back (they just come out more easily that way), and she confirmed that he was definitely facing front!
Aimee got the birth ball out of her car and inflated it so I could lean over it and do some pelvic rocks to see if we could encourage Gavin to rotate. Then, we decided I should get in bed for a little while and lie on my left side to see if that would help Gavin move around. She sat on the bed and we just chatted for a while. Gavin rotated a bit, but the contractions really slowed down at this point – they were about 15 minutes apart.
Since it seemed like Gavin was on the move and happy with me lying down for a while, they suggested that Bill and I have some “quiet time” together. (that’s midwife-ease for “go make out with your wife while she’s in labor!” ). A little skin-to-skin contact and nipple stimulation can be helpful for increasing your hormone levels, so it was a pretty non-invasive way to see if we could get the contractions going more frequently again. I’m sure Bill felt a little awkward about it – other than Gavin, he was the only guy in a very small house that was very full of women at this point. It was a little weird being upstairs together, knowing there was a living room full of family, friends, and midwives that KNEW what we were upstairs doing. But, I have to say – it was SOOO nice to be able to just cuddle with Bill and relax for a while. I’m sure if we’d been laboring in a hospital, some nurse would have been waving an IV bag of pitocin in my face right about this time.
I have to confess, though, I was a bit confused (not really frustrated, though) about why it was taking so long. I was completely comfortable even during the contractions, but wasn’t labor supposed to pick up eventually? My body had done this before – and I totally trusted my body. But wasn’t it supposed to be faster the second time? Why was Gavin taking so long?
After our cuddle time, I realized that it was way past lunch time (2:15 pm according to our birth flow chart), and Bill hadn’t had lunch yet, so I sent him downstairs to eat and I got in the shower. The contractions definitely picked up once I was in the shower. They were between 4 and 6 minutes apart now. I was REALLY cold when I got out of the shower, though, so I stood in the bathroom running the hairdryer for several minutes to help me warm up. Leann came in to check on me and just laughed at the sight of me standing there in my robe with the hairdryer under it! She left to go run some errands, and I asked for someone to make me a peanut butter and banana sandwich.
I sat in the computer chair to eat my lunch, and only ate about half of the sandwich before the contractions were getting quite a bit stronger. So, I announced that I was going upstairs to get in the bath tub, and left everyone else downstairs to watch basketball.
I spent a few minutes sitting on the bed talking to Aimee & Katie (the student midwife who had just arrived). Aimee and Katie were sitting on the floor of our bedroom and we chatted, with me pausing to breathe through the contractions. Before I got in the tub I did a few more pelvic rocks on birth ball.
(3:25 p.m.) Aimee finally suggested that I do a few pelvic rocks and put my shoulders on the floor to see if we could coax Gavin into a better position. She reassured me that babies can (and do) come out just fine if they’re in a less than favorable position (like he was at the time), but that it’s easier on both of us if he turns around. While I was stretching with my shoulders on the floor, Aimee mentioned that this labor reminded her of another labor she had helped with – slow and gentle progression – and that time it was because the baby was tangled in his cord. Maybe he was taking his time because he was just trying to figure out the safest way out. (midwife’s intuition- right there!!)
I realized when I sat upright again that I felt something strange, and when I went to the bathroom, sure enough – I finally had some bloody show. My body just loves waiting until the last minute to do these things. With Nate, this was the point at which I was convinced that I really was in labor! I told Aimee and Katie about the blood, and amidst their excitement that things were progressing (you could feel it in the air – really! ), I announced that I was getting in the tub. (3:35 pm)
I’m sure I had the water way too hot – but I was really cold at this point, and the water felt really good. Our bathtub is nice and big, but not long enough for me to submerge my torso and my legs at the same time (at least not when I’m pregnant!), so I put my feet up on the wall of the tub so I could be underwater. I donned my iPod and listened to my hypnobirthing rainbow relaxation script. Aimee checked on me and Gavin again, and offered to light some candles if I wanted them. The nightlight we keep in the bathroom was actually just the perfect amount of light, so I said no, thanks. She made sure I still had something to drink and said she was going to let me just zone, but that she was right across the hall if I needed anything (3:45 p.m.)! Bill came in to stay with me, and he sat on the counter or by the tub. This part has to be pretty boring for him, though – because he’s just sitting there watching me. Lots of hypnobirthers seem to like having someone talk to them or stroke their arm, but we discovered when Nate was born that I do better if I just have space to zone on my own.
At some point my Mom came in and said that Leann had called on her way back and wanted to know if I wanted Chick-fil-A. Um . . . no. But thanks anyway.
I got reallllly relaxed in the tub – so much more so than I ever did in labor with Nate (floaty feeling achieved! ). I was so glad to finally be in the water – the surges (now that they were coming so strong, I had to start calling them surges so I wouldn’t think they were supposed to hurt!) were so much more tolerable in the water. They were coming really close together, and they were suddenly really intense. I don’t think I got all the way through my relaxation script before I told Bill that I felt “kinda pushy”. Aimee was back in the bathroom before you could blink, and was reminding me to breathe through the surges rather than hold my breath. It was a good thing, because I didn’t even realize that I was holding my breath. But that tells you how intense the surges had become! (4:15 p.m.)
I really wish that I could say that my labor with Gavin was just as pain-free as my labor with Nate was. But at this point, despite feeling pretty relaxed, these surges were incredibly intense, and the peak of each of them was pretty painful. I wasn’t feeling pain during the entire contraction, just the very middle – but the whole contraction was so much more intense than I remember with Nate.
I rolled to my left side in the tub, so I could keep part of my torso under water. Then the strangest thing happened – my hands got very numb! I couldn’t move them very easily, either. They felt kind of like they do after you’ve been playing in the snow too long and you come inside. I know that lots of women have strange things like that happen in transition, but I didn’t realize that at the time! During this time, they turned on the lights in the bathroom, and Katie and Regina (as well as my Mom and Leann, who had returned from her errands) all came into the bathroom.
With the next contraction, I realized that I was definitely pushing (I had been with the previous contractions – guess that’s why I was holding my breath!), but it still felt really strange. Consciously, I was still thinking that I wanted to breathe the baby down (my goal, remember? ), but my body was pushing so strongly that it was very, very hard for me to not push with it. With Nate, I felt a strong urge to push, and it only hurt if I wasn’t pushing. This time, not only did I feel like I needed to push, but my body was making itself push (I couldn’t have not pushed along!) I think I said something about it not feeling right, and about that time, Aimee whispered to me (at least I *think* she was whispering) that if I wasn’t comfortable, I should move around until it felt right. I was so glad she said that! I knew that, but actually needed someone to remind me that it was okay to move!
In a flash, I was on my hands and knees, and my water broke as I was pushing with the next contraction. (4:30 p.m.) It was a really big contraction and suddenly they drained the tub. I could feel lots of pressure and stretching, and realized that he was coming out!! (I didn’t feel any of this with Nate – he came out so slowly that everything was numb. But Gavin was coming out way too fast for that to happen!) I relaxed while I waited for the next contraction, and suddenly all the pressure went away. I commented to Aimee, “something moved!”. She just said, “Um hum,” but didn’t say anything else. (She told me later that you just don’t tell a mom that she has pushed almost all of the baby’s head out but it just went back in – she also said it was quite strange to see!). My body pushed really hard with the next contraction and I was breathing really hard at the same time (so I kind-of breathed him down) . Katie announced that the head was out. I breathed through the end of that contraction, and looked down to see her pulling loop after loop of umbilical cord from around his neck. There was so much cord that it was draping down to the bath tub after she un-looped it!
With the next contraction he was all the way out, I sat down and Katie handed him to me. (4:37) That was the most wonderful moment! He was looking up at me with such a puzzled look on his face – squinting a little from the bright lights. But he was so calm and wasn’t even crying! I just sat there staring into his eyes saying “hello” over and over. They brought some warm baby blankets in to help dry Gavin off, and wrapped them around him as I held him.
I guess they probably would have let me stay in the tub if they weren’t worried about my history of hemorrhaging. I was bleeding more than normal, but not exceedingly so. Nonetheless, they needed to get me to the bed so Regina could get the IV started (I think they had originally planned to do a saline lock once I was in active labor, but once things picked up, it all went too fast for that to happen!). I was dripping getting out of the tub, and Aimee and Katie helped me to the bed. But, I got to hold Gavin the whole time.
I lay on the edge of the bed so we could wait for the cord to stop pulsing. Regina gave me one shot of pitocin in my thigh (I realized this – but according to my birth-flow chart I also got a shot of methagrine in the other thigh!) and Aimee helped Gavin latch on so he could start nursing. Gavin latched on immediately, and THEN we realized that his cord was wrapped around my leg! It just goes to show how long his cord was. We were able to bend my left knee and pull the cord around without disturbing Gavin or putting any traction on the end that was still attached to the placenta. Knowing that we needed to get the placenta out sooner rather than later so the bleeding would stop, Aimee suggested that Bill, um – how do I put this delicately? -- latch on my other breast. Believe me, his qualms about any of this were gone at this point in the day!! The more natural hormones we had going (and nursing definitely stimulates them!) the more quickly my uterus would contract, the faster the placenta would come out, and the faster the bleeding would stop. So . . .I had Katie waiting to catch the placenta, Gavin nursing, Bill on the other breast, Aimee telling me that it was okay to let go of the placenta (telling my cortex, more appropriately – I was done with it! ), and Regina getting an IV started in my arm. What a hilarious sight that must have been!
But it worked! The cord stopped pulsing and they clamped Gavin’s end of the cord just before the placenta came out with another contraction --although I wasn’t really feeling them so much now. After that intense pushing, I hardly noticed these contractions!
The funniest part of all this – we were trying to find somewhere to hang the IV bag, and Leann suggested the blade of the ceiling fan! So, we hung the IV from the ceiling fan.
Once the IV was running and the placenta was out, the frenzy was over. Bill got to cut the cord (and I watched since Gavin was still nursing!). Regina apologized for the IV being cold (they usually try to get them a bit warm so it doesn’t make you cold – but we didn’t really have time for that!), and I was getting a little cold. Katie had checked and said I didn’t have any tears (woohoo!!!!!), and the placenta came out in one piece (yay for that, too!). We realized that the nursing tank I was wearing had gotten pretty wet in the tub, so they helped me take it off (it had to go over the IV line – still hanging from the fan!) Then, they helped me turn around in bed and got me lots of covers and the heating pad that had been warming the baby blankets so I could warm up. Gavin just nursed through all of this!!
Katie brought the placenta over to show it to Bill and me (it was actually really cool!), and she and Aimee measured the cord because it was so long. Counting the little bit that was still attached to Gavin, it was just over 32 inches long! No wonder he had it all wrapped around himself. His toes were a bit dusky at first (his Apgars were 8 & 9), but he was nice and pink after about half an hour.
What I love the most was that I was holding Gavin during all this and kept holding him until he un-latched on his own. I moved around a bit for them to change the pads on the bed, and Aimee and Katie checked my tummy to make sure my uterus was still contracting like it was supposed to be doing. About an hour or so later, Gavin decided he was finished nursing, so Bill got to hold him for a while.
Aimee helped me back to the shower to rinse off – I really wanted to stay in there for a while, but didn’t need to stand up that long just yet. It was so strange to see my now deflated belly when I looked down. Aimee helped me back into bed. Gavin was snuggling (skin to skin) with Bill, then they did all of his baby checks right there on the bed with us. It was so fun to see Bill holding up the fish scale when they weighed Gavin! None of us could believe that he was over eight pounds! (The fish scale read 8 lbs. 9 oz., but they subtract the weight of the blanket). He was 8 lbs. 3 oz., 20 ½ inches long, and had a 14” head.
My sister and her husband brought Nate back just after 6:00. My Mom brought him up to meet his brother– so Nate and Gavin met when Gavin was about two hours old! Nate looked at Gavin and exclaimed, “baby Gavin did come out of Mommy’s tummy!”
Bill called our pediatrician to make an appointment for Saturday morning, and Aimee and Regina decided which days our home visits would be (they do postpartum checks as home visits so you don’t have to leave the house). After the midwives finished cleaning up, did their final checks and felt confident that Gavin and I were both stable, they went home. We were all snuggled in our bed, ready for what ended up being a pretty restful night! My Mom fed Nate dinner and bathed him and got him ready for Bed – while Bill and I ate dinner and took turns holding Gavin. It was so wonderful to be together all that time.
Even though I was a bit embarrassed that everyone rushed to our house so early that morning – only to have to wait 10 hours for Gavin to make his arrival – I am so glad that Aimee was with us all day. We knew Gavin was okay because his heart rate stayed strong all day. Aimee helped me move so that we could encourage / help Gavin figure out which way he needed to move. If we’d been laboring by ourselves, we might not have figured that out all on our own.
I wanted to get bumper stickers that said, “ask me about my midwife!” and go around telling everyone how we had avoided an emergency C-section because we had a homebirth with a midwife!”
If we had introduced pitocin into my system, things could have gone horribly wrong. As it was, Gavin was in control of it all. He started labor when my hormones were on their down-swing (hormones have a circadian rhythm – peaking around 3 am and reaching their lowest point at 3 pm) – so that probably lowered the intensity of the contractions. Most babies, even ones who are a bit compromised (as he was – having your cord wrapped three times around your neck and once around your chest isn’t the best way to come out!) can handle normal contractions. But the contractions that happen when they give you pitocin are unnaturally strong, and can last for unnaturally long stretches. If Gavin had been exposed to contractions like that – it is very likely that his heart rate would have bottomed out, and we would have had to do a “crash” section to save him – so I would have been under general anesthesia and Bill wouldn’t have been allowed to be in the room.
So, Gavin taught me to trust my baby in birth! We’ve always known that babies are the ones who choose when they’re ready to come into the world – but now I know they choose HOW and how quickly they come, too. God and Gavin had a plan – and I was just along for the ride! Despite all the potential for problems with his cord, since we followed his lead, he had what was ultimately a very calm, peaceful birth. I am so glad and we were so blessed to be surrounded by competent caregivers who trust normal birth.
Was not so amazing after carrying three babies. After Fenimore I managed to control and then stop occasional loss of urine by doing kegels. When I experienced urine loss after Nettie's birth, I assumed that it was only a matter of time before I was dry again. As the months and then a full year went by, and I continued to change pad after pad after pad, I became concerned. A bottle of tea-tree oil and vinegar by the toilet helped keep the odor away but there is something very discouraging about being incontinent when you are thirty five (thirty six next month!).
At a visit with my local midwives (I see two local nurse midwives for well-woman care) Mairi and Erin asked if I had any other questions. I disclosed my incontinence and they said suggested I see a physical therapist who specializes in pelvic floors. A few weeks later I sat sheepishly in Pat Strott-Wheatley's office, marveling over the fact that I had been so busy taking care of my three little ones, my husband, and the house (not to mention midwifery!) that I had forgotten to take care of myself (sound familiar anyone?).
In the first visit, Pat mentioned that most people were able to stay dry 85% to 90% (or more) of the time upon faithful completion of pelvic floor therapy. The first week began with writing down everything I ate and drank as well as each trip to the toilet. The next assignment was to go to the toilet every hour in an attempt to stay dry. I was shocked to realize that I often couldn't even go one hour without leaking and I found it humorous how hard it was to pee every hour. Days at the pool were the most challenging. Khady swims but not well enough to leave alone in a pool and neither Fen nor Nettie swim. So our daily routine went something like this. "Ok (for the fourth hour in a row) everyone, out of the pool (grumble, grumble, grumble, why mommy), mom has to pee!" Writing down the times I peed was another roadblock. Do you know how hard it is to pack for a family of five at the pool? Adding my "Bladder Diary" to the bag with the suits and swimmies and lotions and shampoos and plates and snacks just did not happen. Somehow I made it through the week.
At my second appointment I was hooked up to a computer that measured how strong my kegels were and determined the extent to which I was relaxing between kegels. I learned that while I kegeled well under the watchful eyes of Pat, at home I was not adequately relaxing between kegels. I was so focused on getting my kegels in that I was contracting beautifully, but not fully relaxing. Remember, biofeedback works! A hand on the belly reminds you to relax.
I also watched a movie on the amazing pelvic floor. Did you know that the urge to pee lasts 14 seconds and instead of rushing to the bathroom when you feel the urge (this makes you leak) you should first take a breath and kegel? Pat sent me home with new homework, pee every hour and a half and add kegels, three sets, contract for 8 seconds, relax for eight seconds.
Visit three, PROGRESS! The kegels were working! I was able to stay dry peeing every hour and a half and during a conference were I just couldn't slip out to pee, I found myself doing extra kegels and staying dry for about two hours! I noticed a few leaks that occurred when I had my morning latte and Pat suggested that I switch to half-caff (a painful switch but I am adjusting and you bet I will NOT be drinking half-caff at a birth.) I was hooked up to the computer again and the program detected that I had greatly increased the strength of my kegels in just one week! More home work. Pee every two hours and kegel four times a day, contract 10 seconds, relax ten seconds.
Week four. I forgot my sensor today and so I am scheduled for a final session in one month (probably a good thing as I will not slack on my kegels). The good news, when I kegel regularly I no longer leak! I will need to kegel for the rest of my life, and regularly (at least one set four times a day) but staying dry is worth the effort. And there are other benefits too! Developing strong pelvic floor muscles helps alleviate constipation and leads to better sex (among other things). If you are kegeling and it isn't working, I HIGHLY recommend visiting a physical therapist who specializes in pelvic floors. She (or he) will make sure you are kegeling properly, offer advice on how to kegel more effectively, and suggest things in your diet (like caffeine) that might be adding to the problem. If you are in the DC area, I highly recommend Pat Strott-Wheatley who has an office in Annapolis. Her email is PBSW@comcast.net.
A disclaimer, I made dramatic improvement in a short amount of time (four visits over the course of less then two months). This is because I had rather strong pelvic floor muscles at the start. It can take several months to see improvement and you have to be very diligent about doing your home work. If I don't kegel regularly, I leak, it is as simple as that.
I would love to see all midwives talk about the correct way to kegel (equal emphasis on relaxing as well as contracting) with their clients prenatally and post-partum. My gut feeling is that there are a lot of women out there who are incontinent and don't realize that a physical therapist can help you learn how to stay dry. I am a convert!
Babies don't wait for you to be there to be born. I called my friend Marcia before I headed out of town to say that I would come by to see the baby as soon as I got back. My stomach tightened as I talked, I really wanted to be there for Marcia's birth but I had made a commitment about six months ago (before Marcia anticipated her VBA2C) to attend a weekend midwifery retreat in West Va. Since I am attending births again I felt the need to get re-certified in Neonatal Resuscitation and I wanted to take the full day course. Attending the retreat was a good way to get re-certified and for Matt to really have fun while hanging out with the kids (I took the whole family with me, cheap lodging, scrumptious food and a breath-taking mountain setting). I took a deep breath and practiced non-attachment.