Saturday, April 12, 2014

Planning For a Preciptious Home Birth

Precipitous labor is defined as a labor that is accomplished within three hours of onset. According to my history, every labor except my first fit this description. In my midwifery studies, the chapter I could find on precipitous birth was a short and simple paragraph, outlining that in these cases, the woman and her family needs to be prepared for taking responsibility for the birth and considering that they may in deed be the only available providers of care. (Well, that's helpful!) So though I didn't have too many concerns about having a completely unassisted birth, my husband and children did not like the thought of that being plan A, so we set in place a birth team plan that included a birth photographer, a very experienced doula who also had midwifery experience, and a licensed midwife, in addition to my husband, and two older daughters age 16 and 14 who would function as midwife assistants. Plan A was then to get my whole birth team present at the birth, and plan B was to be in contact by phone, as we had at my last birth.
I wanted to make sure that each member of my family was prepared for the sights and sounds of labor. I took my two oldest daughters to Valerie's Midwife Assistant Class that was one night per week for 2 hours, lasting 12 weeks, and ending just the week before I was due. I spent a lot of time with my 4 year old discussing sounds I might make while pushing out a baby, and we even filled the tub and 'practiced' having a baby so that she would know how she would need to act if she was in the tub with me (which was her adamant desire). My husband and I attended a summed up Bradley Method birth class - we could have used a few more of those - but he did a wonderful job giving me just the support I wanted from him. Perhaps my 9 year old was the least prepared, but also she didn't want to talk or think about 'gross' things. So overall, I felt my family was as prepared as they could possibly be for a birth that I well knew may once again end up as an 'unassisted' delivery.
What causes precipitous labor? This is something I would really like to study and figure out. But the best I can come up with is this: precipitous labor probably only proceeds in women who no longer have any personal fears about birth. The women know for a fact that they can have a baby, and have no great traumas attached to that fact. They are certain that their bodies are strong and capable of childbirth, and they are not afraid of it. This is the highest peak of childbirth without underlying fears. I have often heard it taught that fear increases pain and pain perception. That fits my definition here. I also presume that the woman with precipitous labors has an adequate and generous pelvis, with a baby in a favorable position (although my last birth did not include a very favorable position). But this time, I also recognize that I had every person that I needed and wanted present (okay, one of them was via plan B); I was where I wanted to be, feeling comfortable in my surroundings and safe to proceed with birthing in the way that I desired without being criticized or directed in anyway.
So my theory is 1) no fear of my body's performance and abilities, 2) being in the safe environment of my choosing, and 3) having my chosen birth team present, and perhaps 4) having a generous pelvis and experienced uterus.
* * * * * * *
Pregnant women are good at two things; being emotional and worrying about details. I was no exception. 
My greatest concern for this birth was being able to recognize that I was actually in labor, have my family all present, and be able to get my birth team to my home in time for the labor (hopefully) but especially for the birth.
Because of the point I was at in my midwifery training, I wanted to catch my baby, experience a water birth (75% of the births I had been present at were in the water), and have very little intervention or even monitoring, (after all, I realized there probably wouldn't be time for it anyway), unless my daughters wanted to perform it.
That being said, every braxton hicks contraction from March on I felt concerned; I wondered - is this it? Is this how labor starts? How will I know? I remember several different nights mid-March when I would awake about once an hour due to a contraction that woke me up, use the restroom and then be able to go back to sleep until the next one hit… how many days would these continue before I would awake and truly be in labor? I was hypersensitive to every little movement of my uterus and trying to figure out what would happen next. Hypersensitivity is not a fun way to live for a day, let alone a month. On March 18th I even thought labor was beginning enough to use the ipod to time four contractions that were all closer than ten minutes apart; and that, too, was just more nothing but nothing. On March 22nd, I tried to stimulate labor with clary sage, and a few other things, which got contractions going every 10 minutes for about 2 hours; and then it all died away...

Well, I am sure you are ready for the real story; it will probably take you nearly as long to read it as it did for me to experience it.

Wednesday April 2, 2014

4:30 a.m. Roused by a good contraction I awoke and used the restroom and retired to my bed again, then realized I was having another contraction.  I took out my phone in order to time duration and length of the next contraction and fell asleep with it in my hand only to awaken to another contraction after 5:30 a.m. (so I didn’t bother-just more of the usual).
7:40 a.m. Got up for the day and said “I should eat a really good breakfast today.” My attentive husband kindly made me breakfast. I was feeling a bit happy and excited, due to the fact that I had not had any contractions of any sort for the previous two days.
8:00 a.m. Before the girls left for school just after 8 am, I asked my 9 year old “If I have the baby while you are at school today, would you like me to call you home?" 
“No, I really like school - I’d rather stay at school,” she responded.
I told my 14 year old to feel my tight stomach, and she sensed that I seemed excited about it.  She asked if I was having real contractions and I told her I didn’t know.
I drove my 16 year old to school and told her to text me at lunch and stay in touch-it might be the day.
9:36 a.m. I texted Valerie Hall, CPM, to let her know that I seemed to be having contractions about every 20 minutes but I hadn't timed them yet. She called me and reminded me that this pattern is how most labors begin and I should really pay attention to any and every little change, and let her know. I told her I would time them and promised to send her any info about changes of any sort. My hand written note of when contractions occurred (9:42, 10:05, 10:29, 11:20, 11:38-all hand recorded contractions were under 20 - 30 seconds long, and it was impossible for me to tell whether they were just braxton hicks).
10:35 a.m. I texted Tina Chavez, my Doula, and mentioned I was having discernible contractions every 20 minutes.
11:05 a.m. I texted Valerie to let her know that contractions had spaced apart, the last ones were 40 minutes apart and then one hour; but just then I had used the restroom and noticed bloody show, I also texted Tina that info. 
At this point I decided to get my hair and makeup done (this was one of my top priorities if there was any chance I was in labor - I wanted to look good in my birth photos!) and texted with my photographer Allie White to let her know that something might be going on.  I set up a play date for my four year old daughter to go up the street and play for a few hours.
12:13 p.m. I walked my four year old up the street, visited with my neighbor and timed three contractions while I was gone, all under 30 seconds.
12:44 p.m. I returned back home,  had some more bloody show and my Mom called on the phone. While I spoke with her I had three contractions during our 20 minute phone call and prepared the bassinet.  She pointed out that I ought to call my midwife as contractions seemed much closer than 20 minutes apart.  We got off the phone and I insisted Jason get off his phone and call to check my 14 year old out of school, and I called Valerie to report.  Valerie told me that another of her clients was in labor and filling their birth tub and sounded concerned about being able to come. I told her that I was going with Jason to Franklin Middle School to pick up my daughter.  My mom called back to see if she should get my 16 year old to come home and I said ‘yes.’
12:49 p.m. First timed a contraction with the iphone at 1:01 minutes long.
12:58 p.m. Second timed contraction lasting 48 seconds.
1:03 p.m. Third timed contraction lasting 58 seconds.
*** At this point I seemed to have stimulated some serious adrenaline and fear that I would not be able to get my older daughters home in time - that it was not a safe or good time to be in heavy labor - in hindsight I think this is what caused a large pause in the labor pattern during the car ride. ***
1:11 p.m. Jason and I left the house to pick up our daughters from school.
1:15 p.m. Picked up my 16 year old daughter from school - worried that I had jumped the gun in getting her - maybe, after all this was just more braxton hicks contractions again...
1:20 p.m. Texted Tina I was picking up my 14 year old and contractions were more frequent.
1:23 p.m. Fourth timed contraction lasting 1:11. This occurred in the car on the way to the middle school.
1:28 p.m. Picked up my daughter from Franklin.
1:33 p.m. Fifth timed contraction lasting 26 seconds, second contraction in the car. I was now concerned that I had really jumped the gun getting the girls out of school. A 26 second contraction? Sigh...
We were nearly home now and I talked with the girls a little bit about the stages of labor and where I possibly might be.  The only sign that I might be in active labor was that I was starting to be annoyed with Jason’s jokes and felt a little ‘labor land like,’ however from our discussion we determined that the contraction pattern looked more like early labor.
Jason then told the girls “Well, this is your mom we’re talking about, so if she’s in early labor now, by the time we get her into the house she’ll be in pushing stage.” (We were less than two minutes from the house).
1:42 p.m. Sixth timed contraction-now at the house- lasting 1:52 minutes.
1:44 p.m. My 16 year old started filling the birth tub.

1:47 p.m. Seventh timed contraction lasting 1:28 minutes.
1:48 p.m. Texted Tina “Come now?”
1:50 p.m. Tried to call Tina, texted that ctrx were q. 4 min around 1 min. long
1:51 p.m. Eighth timed contraction lasting 54 seconds.
1:57 p.m. Ninth and last timed contraction lasting 1:36 minutes.
Noticeable break in contractions, I felt hungry and was debating getting into the tub. Realized that I may be in the pause after transition and before second stage began... but how could that be?
1:59 p.m. Sent my 14 year old to go pick up my 4 year old from the neighbors house.
2:05 p.m. Mom and 4 year old got into the birth tub after using the restroom.
2:08 p.m. Allie arrived, and I had my 14 year old call the elementary to have my 9 year old come home. (I wanted to give her a second chance to make her own choice on being present at the birth - so she could not hold any future grudge against me for not telling her.)
2:11 p.m. Water broke with second contraction in the tub - noticed some meconium in the water. Someone used my phone to text Tina about ROM-she was en route.
In between contractions I gave my daughters preparation instructions including "glove up," "open the ambubag," and "get on the stethascope." I also assessed how each of my daughters and husband were handling the birth - particularly their emotions and perceptions of my behavior.
During contractions I was consumed by the powers of birth; shaking almost violently, breathing, and trying to give up all resistance. I was aware that I was groaning, making deep, throaty, appropriate birthing type noises, which I would have shut off immediately if I perceived that anyone in the room was really bothered by them. It was so freeing to feel that I could express the birth energy however I wanted, and everyone present was comfortable and trusted that all was well.
2:21 p.m. Jason got Valerie on the phone for the duration of the birth. This brought some relief and peace; at least it was plan B. But I also recognized that I was seriously holding back - I did actually want a midwife present for the birth and immediate postpartum assessment.
2:22 p.m. 9 year old arrived and then chose to go back to school.
There was no longer any doubts in my mind, this was pushing stage, and I could feel the baby descending-but I was not ready to really push yet! I remembered that pushing is not necessary and the baby will come with or without my conscious efforts (as I learned from my previous birth) and so determined that I would 'breathe' my baby out.
2:25 p.m. Doula Tina Chavez arrived, and I began to push with contractions. During the next break between contractions I decided to check my baby's station. I was able to put my finger about 1/2 - 1" inside before I encountered the baby's head...
For the next contraction I declared "I'm climbing away from this one." As that is exactly what I was doing, and I wanted my girls to note what that looks like when a mother does that during pushing stage. (Chin up, arched back, rising up and away from the core).
During the next contraction I felt with my hand as crowning and burning occurred, cradling the head every so gently as it began to slowly emerge. I did not push anymore at this point, but let the contractions ease the baby out on their own (they were plenty powerful enough).
For the last contraction I felt with my hand as the crowning grew, widened, filled my palm and then my whole hand. "Head" I said. "Head is out." But the moment I knew it, the moment it filled my whole hand and I felt the soft contours of the baby's face, I had to let go, the sensations I was feeling were plenty without also having the sensation in my hand, but I knew that my baby was beginning to rotate, and I didn't want to stick a finger in its' face, etc.
2:33 p.m. Head out
I immediately began the move I had "practiced" before, moving from forward leaning over the side of the tub, lifting my right leg, and sitting back. This is when the birth occurred, and though I was not touching the baby during it, I easily and smoothly brought the baby up out of the water all in the same movement.
2:34 p.m. Birth. I greeted my baby with "Hello baby, that was a tight squeeze, wasn't it?" And then asked my husband to come around the tub and be next to me, as I had just moved. My baby cried just the right amount to allay any concerns of heart rate or respiration's and I soothed and assessed her all at once. As it neared one minute I asked my daughters, "Well, what is her APGAR's?"
One minute APGAR 9 (1 off for color), baby alert, crying and vigorous.

By my own admission, this birth hardly seems fair. Not one of the contractions previous to pushing seemed to overwhelm or overpower me. But completely surrendering to birth and your body is the name of the game. My greatest cognizant thought was "there is just no way I am that far into labor yet."
I did make a lot of noise while in the tub, the sensations of a baby moving through ones pelvis is hardly pleasant, nor is that easily definable feeling of crowning the head and the burning stretch of tissue that you just cannot escape. 
Each of my daughters seemed calm and fairly confident. I am excitedly awaiting the professional birth photography pictures which will hopefully be available towards the end of this month.
My husband seemed the most nervous of the bunch, but mostly due to "not knowing exactly what to do." I tried to explain to him that partner labor support is just as much being present and in the moment; staying in close proximity, and in the same frame of mind. His support this birth definitely made it my best birth ever, he gave me that close, intimate support I had always wanted, but had never been able to define for him. For most men I don't think it feels like "doing" anything, and that is kind of accurate - the best labor support a man can give his wife is "being" with her, in proximity, mind, physical support, emotion and in that place of love that creates families.

My older daughters both wrote of their views and experiences during this birth; I am not going to post them on this blog, if you are interested in reading those I will email them to you.

Thursday, April 10, 2014

Midwifery Journey 2012-2014

The pregnancy and birth of my fifth child, and the choice of home birth changed me forever. I thought about midwifery almost daily.  I was well aware of the sacrifice involved in studying, learning and practicing midwifery-never did I consider it a path through a beautiful garden with just sunshine and flowers. I knew if I started midwifery, it would take me years to complete the training and the educational process, that the schedule was demanding and involved almost constant call, and that the financial sacrifice would be great for my family. Could my children thrive if I had such a profession? Would my marriage survive it? Would we be able to afford it? What unseen sacrifices would be involved in the price of becoming and being a midwife?

After much thought and debate on the process of becoming a midwife, what finally helped me make up my mind, was the drive to know.  I wanted to learn all about midwifery, to know what normal birth included, to know how to handle complications, and to be able to help my daughters to give birth one day, especially in an out-of-hospital situation, as I do not believe that hospitals will always be available for birthing children. I knew a desire to learn was a worthy goal and reason and though I still had a lot of self-doubt on my capability of handling both the financial, physical, emotional and family sacrifice's that would be involved, I chose to move forward and begin my education.

Feeling a confirmation to move forward, I felt that part of my purpose was to work with and help Valerie Hall.  She was working at Agape Birth Center at the time, and so I approached them with a proposition to come and help or become a student. The only viable option for them was students, and so I became a student, enrolling with the National College of Midwifery in Taos, New Mexico, and beginning my studies there in February of 2012, and starting an internship with the birth center in March of 2012.

This is where I was, nearly half way through my studies, half way through my birth numbers, and on the verge of becoming primary midwife, when I found out that I was pregnant and expecting our 6th child.

The pregnancy was a very difficult time for me, as I felt that my life, dreams, career, education,  and financial burden, was being put on hold and made to be so difficult and to preclude my abilities to attain them. There were many times I was nearly hopeless that I would ever be able to accomplish my goals in this path that I had chosen. In addition to that, I would be starting my family over once again, at 38 years old. A new baby and a new life is no small commitment either, in years or sacrifices. I was dismayed that my oldest and only son would be leaving on his mission (as it turned out) exactly one week before the babies birth. I tried to remember that I started midwifery in order to learn and to grow and that the process could take as long as it needed to, and try to value and remember what Michelle Bartlett had often told me at Agape: "The best midwives are made slowly with lots of time and experiences."
"Surely then, I'll be good - this is going to take me forever," I would think to myself.

Tuesday, March 9, 2010

My Home Birth

March 13, 2010

Wow. Amazing. I am so grateful. I am overwhelmed with gratitude for God's tender blessings and mercies...
Last night was like any other night. I settled in to read on my bed around 10-11p.m. I read a little longer than normal, noticing the contractions that seemed to come every night as I read. I settled down to sleep at nearly 1a.m., I had a big day Saturday - I was planning on helping at the Highland Stake Preparedness Fair like I usually do - outside, running the payment situation and water barrels and wheat bucket pick up. So, I mentally scolded myself for reading so late into the night and settled down to sleep. Just like most every night for the last month, I was awakened by mild contractions about 3:15 a.m. I used the restroom and settled back down like normal. But, there was no getting back to sleep, I was very uncomfortable and just after 3:35, gave up on the whole bed thing.

I went to the kitchen for a drink of water, and my husband was awake at the computer. I told him, if he was up, I would sure like it if he would go caulk our master bathtub. Another contraction came, attention getting but rather mild, and I repeated my request. He looked at me and asked "What are you saying?" As he came into the kitchen and held me. My honest response; "I don't know, I just think it would be a good idea."

"Are you in labor?"

"I don't know," I responded, "but maybe my water is leaking."

He took a quick peek and announced "Yep, you're in labor; your water is broken. Are you going to call the midwife now?"

"I don't know what to tell her - I'm not sure how close my contractions are or even if they are real ones yet," I responded.

My husband had crashed on the couch in his work clothes and went to use the restroom and take a shower. I was able to record two contractions and set up my laptop to a website I had heard of that helped time contractions at the push of the 'S' key.

I wanted to be near him. I knocked on the bathroom door. "Did you call the midwives?" he asked.


"Well, are you going to call them or do you want me to just deliver the baby?" he demanded irritably.

"I'll go call them." I certainly wasn't trying to irritate him or cause him to feel vulnerable.

About 4 a.m. I woke up Michelle Bartlett, my midwife and apologized for the middle of the night call. "I think I, well, I think my water broke about 10 minutes ago, and I think I might be having contractions - maybe they are 5 minutes apart, but it's hard for me to tell. It seems that I have stronger contractions every 5 minutes and little baby ones in between. I'm not sure..." she started talking... I started breathing. I just remember that she told me she would call back soon; there was another mother in labor at the birthing center - the midwives would need to coordinate who would do what.

I got myself another drink, took a tablespoon of flax oil and a shot of NingXia Red. Now a good old contraction hit, and I felt I was drowning in it. I couldn't breath. I told myself - "get a hold of yourself, your labor is just barely starting - you can do this!" I took a breath. "JASON!" I called. "I need you."

"Can I get dressed first?" he called. He had just gotten out of the shower.

"Yes, I just want you to be by me." I sighed.

Funny thing about mother nature, when she starts to take over, logic and reasoning use an ever smaller amount of your brain. And though I was talking and reasoning with myself, I began to be caught up in the tidal wave of force that she brings to bear as a life enters into this world.

Jason came and walked me to the bedroom. I could hear his blood pressure rising in every word he said. "This is it. The midwives won't make it. You're going to have this baby. Where are the plastic sheets? Where are the towels? (All the supplies had been gathered and placed all together in an extra room). What do you need? What should I do?" His words and sentenced raced away with his calm in tow.

He found the plastic shower curtains and laid them on the bedroom floor. I headed for the phone. I was surprised the midwife hadn't called back yet. It was now about 4:25 a.m. But I knew I needed to call her... I began "I am involuntarily pushing with the contractions."

"Don't push. PANT. I am on my way already."

"Good, I thought, she knew to come with that first strange call. I can do this. I can breathe thru this. I can wait to push, just like last time. No problem." I rallied and mentally encouraged myself. I got down into the same position as 'last time' when I seemed able to hold off the urge to push. But my logically brain was loosing and almost gone... I struggled to let it remain in control. Pant, pant, oops little push. Pant, pant, pant whoa push, big gush of water... uh oh.

Jason was being instructed on the phone to get me to lay down on my side. I knew if I tried to move, the panting thing would be over and I would loose this mental battle. He hung up the phone to try and help me. "On the bed, on your side - she wants you on your side."

"No, no, can't... Okay. I'll try to lay on my side here on the floor-get me my big pillows." I consented. Jason threw my pillows onto the floor and kneeled down by me to help me onto my side for the purpose of slowing down the labor. As I moved myself a few inches to the side - like the Leaning Tower of Pisa, my mind registered something... I could feel something between my legs. "Wait. You need to cut my pants off, I think there's something there." I instructed Jason.

He quickly removed them. And 'freak out' is the only way I can describe his reaction as he said, "It's her leg - SHE'S BREECH! I've got to call 911! Oh, no, I've got to call 911!!!"

I held onto her little foot and said "NO. Call the midwife. C a l l t h e m i d w i f e, Jason." He grabbed and fumbled for the phone, misdialing the number two or three times. He finally got the number right. "Calm down, it's okay," I kept telling him. He wasn't listening to me on that one at all. "Please hold up my leg, it's getting tired," I requested. Now that he could do. The midwife was on the phone and I asked him to hand me the phone.

"I am lying on my right side, on the floor, and the baby's leg is out... and my husband is freaking out." I calmly informed her.

"Give him the phone," she said.

"He is really freaking out," I emphasized. (In other words; I need someone to be calm - I hoped I was communicating to her).

"Give him the phone." I handed it over, and clearly heard her demand to Jason. "Okay, I need you to do two things. First; CALM DOWN. You have got to calm down."

"Okay," he responded, and took a deep breath, immediately calmed.

"Now, the second"... her words faded from my hearing, probably with her volume - or it could have been because I was consumed, once again, and logic and reason were no longer at my command.

Jason took the foot from me. I wanted to hold her foot. I felt alone, pouty. I wanted her foot.

But I knew he was doing what the midwife instructed. "It's her left foot," he reported to the phone. I felt her almost twisting inside of me... but then he let me hold her foot again. The next wave came. Pant, pant, oops push, pant, pant, pant, even faster. My mouth was dry, I needed water, but I wouldn't stop panting - I could pant. Another oops. "The other leg is out" Jason reported to the phone. And he began to follow instructions. I felt even greater pressure, as he began to feel for her arms.

I knew this was right. I knew he was doing it right. Mentally I knew it. I had just finished reading Emergency Childbirth: A Manual, by Gregory J. White, M.D. The text was sure, calm; the section on assisting breech deliveries had clear pictures and precise instructions. I remembered reading it - though I never imagined I would be having a breech - my baby had been head down for the last 12 weeks. So mentally I knew. I knew this was right, I knew Jason was following the correct directions exactly. But the force was all consuming. He was getting her out of me. She would come out... I was scared. I voiced a rather incomplete prayer, but all I could verbalize, at the time: "Heavenly Father, help me!" I said it four times. I needed someone. I needed support. My daughter Ysabel held my hand. Jason relayed the instruction for me to push now... but there was no force, no wave, no help.

"I can't push right now."

"You need to push now, you need to get the baby delivered." I gave two weak little pushes. Weak because there was no force; no contraction; weak because my power over this delivery was minute. Mother nature directed; God oversaw. Or rather, God directed, mother nature obeys.

"I can't push right now."

Jason was directed to help me get up. Ysabel and Anna took my hands to help me get up. Jason held the baby - I knew her arms were out and this was the most important part. And as I began to rise up, maybe only 3 - 4 inches, gravity rocked thru me and it was over. Adellaide Patience Geurts was born into this world at 4:51 a.m. The girls continued to help me into a sitting position and Jason handed me the baby as he grabbed a towel and vigorously began to rub her back.

(Michelle told us later, that the length of time from when he called and told her the foot was out, until complete delivery was about 4 minutes, according to her cell phone).

Still vigorously rubbing her back with the towel Jason started trying to answer Michelle's inquiries as he repeated, "Is she breathing? Is she lethargic?" Answering he said, "She's white. She's white. Her head is blue," into the phone.

"No, Jason, she's pink; she's fine. She's pink, she's fine. She's whining. She's whimpering. She's fine Jason." I tried to convince him. {Covered in Vernix and all pink underneath definitely doesn't count as a white lethargic infant with a blue head...}
(I found out later, this was the time Michelle was most concerned about. Of the few surprise breeches she has delivered, 75% have needed some resuscitation. She also told me that Adellaide got a '9' on the Apgar Test.)

Jason was still listening to directions and trying to assess her. Finally I got louder. "Jason, your hurting her - she's screaming, she's crying - she's fine!"

He eventually stopped, but not because of what I said, I think Michelle could finally hear the baby screaming and told him it was enough. Perhaps this is my one little regret. I had wished to welcome her into the world with kind words and soft touches; not in a bubble of agitated exclamation's. I held her to my chest.

The instructions continued. We were cold. We needed to get warm... Adellaide and I began to shiver.
Lydia was ecstatic.
Anna was in awe.
Ysabel was calm and helpful; becoming my little Doula - as in do-everything-mom-says-very-quickly.
Aaron wanted me to get dressed so he could feel comfortable coming into the room.

Much worse than the delivery itself, the pains began again for the delivery of the placenta. I pushed it mostly out and 5 minutes later the midwife in training, Valarie, arrived. Not even 5 minutes more and Michelle arrived as well.

So... from the time I knew I was in labor (water first breaking in the kitchen) at about 3:50 a.m., until Adellaide was born at 4:51 a.m... how does one hour sound? Proper medical terminology: Precipitous, Traumatic Birth.

It's difficult to think of any of this and not see how blessed we were. How blessed that we switched midwifery practices - there is no way we could have made it to the hospital - and this way, Jason was able to be on the phone with a midwife we both knew and trusted, who was able to almost vicariously and very calmly attend a breech birth. Second, as Michelle said, "thank God we didn't know it was a breech - here is another woman I was able to help save from going under the knife." I am so grateful I did not have to schedule a C-section... but if we had known, and I had scheduled one, they wouldn't have scheduled it before the 13th - time would have made that impossible.

I didn't have to have a C-section. I didn't have to go to the hospital. We had the help and support that we needed, as a family, to be a part of this miracle called birth. We had chosen to learn and to trust - and if any credit can be given for 'saving the day' it is found in knowledge of nature and trust in God.

I feel like Jason did all of the work, and I am so grateful to him. Staying calm, following Michelle's directions and supporting me. I know there was a high potential for harm or danger to both myself and Adellaide if there was any wrong manipulating of the two of us. I am so grateful to Jason for being willing to support my desire to have our baby at home, attend the birthing class, and in the end; deliver our baby safely with his own hands.

Praise God from whom all blessings flow; praise Him all creatures here below... His loving watch care and tender mercies are over all - especially those who will seek His will and follow the inspiration He provides. He is aware of the desires of our hearts. He will not lead us down the wrong path.
May God bless your life this year as he has blessed ours.

Tuesday, March 2, 2010

Choosing Home Birth

July 2009

The pregnancy test is positive. Thoroughly surprised, but also ecstatic, I am elated to find out that I am now expecting our 5th child. We have a 14 year old son, 11, 9 & 5 year old daughters. 2009 has been a rough year so far, my husband laid off by two different companies and considered unemployed for three months of the year... we currently have insurance, but are well aware that another layoff is probably imminent.

2009 began with the sale of our home for the purpose of not loosing it and downsizing. We were blessed to sell it for full market value. July finds our family renting a home across town. This is when we find out! The miracle of birth is exciting, and for a while all the other worries fade. Our efforts focus on finding another home before the school year begins.

We find a home that works and move back over near our old neighborhood. Life returns to normal for a few short weeks as school and friends, piano and soccer begin their daily revolutions. This is when the third job layoff comes. Now we know we will have no insurance in just one short month.
The only Certified Nurse Midwives in town practice with the Pocatello Women's Clinic. A midwife has delivered each of my daughters so far, and I would never switch back to a doctor. I love the support the midwives give by staying with me throughout the labor, helping me breath, coaching and supporting the natural childbirth process. But never yet had I entertained or even thought about having a home birth. To be honest, I thought it must be a dangerous thing - not to have all the emergency options available at your fingertips.
After my first appointment I met with the financial secretary and she went over the prices with me for the average delivery at Portneuf Medical Center and Women's Center Pregnancy fees. $10,000??? When did the prices go up so high??? I could swear my last delivery was no more than 1/2 of that. With no insurance, and unable to qualify for medicaid this was certainly a sobering situation.
At this point I started to wonder - what else can I do? What could be cheaper? I had heard of a friend who had just had a home birth a short while before. Of course, she was a certified Doula, and an amazing woman, but I still wanted to talk with her... I wanted to find out how she was so brave as to have her baby at home.

Bumping into her and hearing her story was wonderful. Inspiring wonder, awe and even the thoughts of - could I do that? I found out that her midwife at home had everything necessary to monitor mother and baby, that a 'birth kit' was supplied in her home in case things moved faster than the midwife could get there, and that the midwife was trained in Newborn Resuscitation and had oxygen and all the medical necessities that may be needed for everything short of a c-section - for which, course, transport to the hospital would be the course of action. The price tag for such services? Right around $4,000. With no insurance that certainly sounded better than $10,000. But would it, could it really be safe. I knew that the reaction of friends and family - those who would say exactly what they thought, not sparing my feelings - would be shock, concern and disbelief. Afterall, our is a society of advanced allopathic medicine - how could one trust anything different?

Of course, I absolutely trust the labor process as natural and nearly perfect; in my mind and experiences, any intervention carries many more risks than benefits. But... what if... And as I listened to my own thoughts, I realized, the only reasons I can come up with not to have a home birth is fear. A fear cycle. I don't want to be a slave to my fears! So I began to meditate and pray. What would really be best for me? What would really be best for my baby.

At my next midwife appointment at the hospital, I mentioned my concern about the H1N1 virus and how no one was being allowed to attend the birth except for my husband. (I really wanted my other children to be able to be present right after the moment of birth - or before if they desired). My midwife said she also wished that she could eventually work it out with her practice so that she could do home births, but that the Doctors in the practice were currently opposed to the idea. And I realized... why would I wanted to have my new baby in a place where the most concerning illnesses are being treated? Why would I want to expose my baby to that - just so that I could be in a hospital?

Now I found that I had more legitimate concerns and questions that needed to be answered. I called and visited with my friend again, as well as contacting a midwifery practice that ran a birth center as well as did home births. Each of these women had something in common; complete trust in the birth process with no need to interfere or control it. In theory, I could agree, but somewhere deep in my mind I still struggled; maybe I'm different, maybe it won't go smoothly for me, maybe I can only be safe at the hospital. But the more I learned, the more experiences of home midwifery that they related, the smaller and smaller my concerns became.

I made the commitment to home birth and switched midwifery practices mid pregnancy. I knew that these midwives knew what they were doing; and that they would not do anything that would compromise me or my baby in anyway. They would err on the side of caution; they would support us all the way, even as a friend at the hospital if it came to that. But what I loved was their very small rate of hospital transfers - less than 16 out of more than 400 births - averaging a 5% or less need to transfer!

That night I dreamed a very strange dream in deed. Myself and my husband and children were on a cruise (I've always wanted to do that) and having the time of our lives. Everything was just as I had ever hoped for such a grand adventure... And as I woke up from the dream I realized that it represented my choice for home birth and how excited I was for it - and what a grand adventure it would be - and I laughed about that to myself all day long. My subconscious mind was likening a home birth to a family vacation cruise adventure!

Well, at this point, my major concern was would my new midwives be able to make it to my home in time??? Their practice was no less than 1 hour and 15 minutes from my home. Would I know that I was really in labor early enough to give them the time to arrive and help me? So, I called my friend again to see if she could be my doula. She was possibly moving and wanted me to see if I could find someone else - but if she was available she would come. This comforted me as she is only 5 minutes from my house.

Realization slowly dawned on me over time that if my labor was so fast as to be unable to give the midwives enough time to get them here before the birth, then everything would be going very smoothly with no complicatoins. Complications would slow the whole process down and they would be there in plenty of time.

So now we wait. It is March 9th. My 20 week ultrasound put me due on March 15th, my period date says March 17th, and conception date is March 20th. No matter what I am done to the wire. My biggest concern right now is of a very big stomach. At my 38 week appointment I measured 46 cm (usually the cm measurement equals your weeks of pregnancy). I have been measuring about 5cm larger than my weeks since week 28. I had my midwife really feel the baby to see if she could tell how big she is. My midwife feels the baby is currently between 8 - 8 1/2 pounds, and also that I have lots of amniotic fluid, which is why my measurement is so large.

Besides being slightly concerned about my ability to deliver a very large baby, I have few other worries. Of course, I hope all the stars will line up correctly so that my husband and children can be here with me when the time comes... and I'll blog the whole birth story as soon as possible under the title 'My home Birth.'