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.'