For those who love a birth story, here you go <3 If you'd like to read his little brother's birth story too, that can be found here
Saturday morning, April 30th – 38 weeks pregnant.
I insist that we have to go out and buy a toilet paper holder, towel ring, and towel rack for the bathroom we’ve been slowly renovating. I drag Nathan around to 3 different stores before we pick out bathroom accessories I’m happy with, and we install everything as soon as we get home. Everything else in the house has been ready since 37 weeks.
Monday May 2, 2011 @ 3pm – 38 +2 weeks pregnant
I meet with Stacey at Quinte Midwives for my 38 week appointment. My blood pressure is 148/88 – not quite so high that we have to consult with an OB, but it’s been getting steadily higher over the last few weeks (even though it registers more in the 120/80 range when I check it daily at home) and Stacey is concerned. I’m one of those people who gets ‘white coat hypertension’, and my BP at my initial appointment with the midwives in early pregnancy was 130/86.
I go sit in an empty office to chill out for 30 minutes, and Stacey takes my BP again – 134/92. So a little bit better AND a little bit worse. Stacey knew I really wasn’t interested in dealing with the hospital unless absolutely necessary, and suggests that the easiest way to avoid a consult is for this baby to be born sooner than later. She suggests doing a stretch & sweep today, then repeating it in a few days/week to hopefully get labour going prior to 40 weeks. Because it’s my first pregnancy & I’m only 38 weeks it is unlikely that she’ll even be able to do a S&S, because my cervix is likely firm and closed. If she can do one, she lets me know that it will probably be pretty uncomfortable and won’t likely cause anything to happen right away. We review the risks (cramping, discomfort, accidental ROM) and I decide that I’m okay with it. Before the appointment I’d thought through whether or not I was okay with having an internal exam at my 38 week appointment, and had decided that while I wouldn’t ask for one, if my midwife had a *good reason* I agreed with, I would be okay with it - - knowing that it only tells me what is happening in that moment, is in no way indicative of what’s to come, and isn’t risk-free.
Stacey starts the exam, and we are both shocked to discover that I am already 3cm dilated & roughly 50% effaced (my cervix was about 2cm long; typically at term the cervix is 4-5cm long – hence the 50% effaced). She suggests that I could possibly be in early labour, and that would explain my high BP. All that being said, neither of us anticipated that labour was imminent. Baby was still a bit high, so she did a good ‘stretch’ but not a lot of ‘sweep’. There was more bloody show than she anticipated as well. We decide that in addition to the stretch & sweep, I’ll start 3000mg of vaginal evening primrose oil that night, and take a dose of Caullophylum 200C. Stacey doesn’t really believe in homeopathics, but is open to me taking them if I want to. I wasn’t interested in doing anything more intense like castor oil. I believe baby’s come when they are ready, and I didn’t want to force anything. Which I had to balance out against how everything would change if I had to go to the hospital for a consult or potential transfer of care. I felt like the S&S, homeopathics, & EPO would only help tip me over the edge if my body & baby were ready. I picked up Nathan from work (his brother Isaac who also worked there, took the car home) and we head to the mall to buy the EPO. I have a bit of spotting from the s&s, and a few ‘twingy cramps’, but nothing happens that makes me think labour is coming. I know that I could walk around at 3cm for another 3 weeks… and that’s really what I expected to happen.
Over the evening I have mild cramps (just felt like BH ctx), that come every 20 minutes for a couple hours, but they are completely ignorable and eventually disappear. There was a heap of dishes we needed to do, but Gloria LeMay’s Birth dvd had arrived in the mail that day and I REALLY want to watch it with Nathan, so we do that instead, then Nathan & I go to bed. As I drift off to sleep, I say to myself “Open for the baby. Be open for the baby. Surrender.”
Tuesday May3, 2011 - 5am
I wake up to a cramp that is slightly more than the Braxton Hicks have been, and wonder if I could be cramping from the s&s the day before. It’s so mild that I decide if it wasn’t for yesterday’s appointment I would ignore it, so I’ll ignore it now! It goes away… but comes back a few minutes later… and a few minutes after that. I don’t want to disturb Nathan’s sleep though, as his alarm will go off for work at 6:15am, so I commit to lying still and quiet in bed until then. I realize that these cramps are coming every 5 minutes (I had 6 of them between when the clock chimed 5am & when it chimed 5:30am), lasting about a minute (each one lasted for 9 deep breaths, which I knew from practicing comfort measures with my clients, equalled about 1 minute for me) and they are starting to require my concentration and movement. Still, I say nothing. I had a couple things I really wanted to finish up at work, and was thinking that I could go to work early then come home once labour picked up, if this was really it. Then I feel a small gush similar to when your period starts, and after a couple gushes decide that I don’t want to make a mess of the bed so I’ll go to the bathroom to see what is happening. As I sat on the toilet I felt a release of fluid, but assumed I had just peed (it didn’t seriously occur to me then, that it could have been my water breaking). There was lots of bloody show, so I went back to bed and woke up Nathan “Hey honey. I don’t think you’re going to work today”. It wasn’t just a little bit of spotting, but the kind of show you see when the cervix is making substantial change – thinking about it now, I estimate that I was maybe 5cm or so at that point??
I explained to Nathan what I was feeling, and he immediately suggested we call our doula, who lives an hour away. I said that I didn’t think we needed to call her yet – this could go on for hours. But because it was an hour away he wanted her to have enough time, so we called her from bed to give her the heads up. I had spoken to Kim the night before to let her know about the stretch & sweep. She told me after it was all said & done that she knew I’d be having the baby that day, so her car was loaded & ready to go, and she had been awake since 5am that morning waiting for my call. I tried telling Kim that there was no rush and to take her time, but by the end of the phone call I couldn’t talk through the contraction anymore so passed the phone to Nathan, who said to go ahead and come now! I couldn’t stay in bed anymore; I needed to move, so we got up and started on the “Early Labour To Do List”. We’d hardly get one thing started though, when another contraction would come and Nathan would have to drop everything and run to support me through it.
I didn’t want anyone to know we were in labour (especially our families), and fortunately Isaac had Nathan’s car because Nathan had come home with me after my midwives appointment the day before, so we didn’t have to call his family to say that Isaac would have to find his own way into work. Nathan called him about 6:30am and just said “Take the car. Don’t pick me up. I won’t be in today. And if Mom asks why I called, tell her I forgot something in the car.” It worked out perfectly!
My contractions were now about 3-5 minutes apart, but were sometimes coming back to back, so I decided not to call Stacey yet, as I figured the double contractions indicated that baby wasn’t in an ideal position and I needed to stay upright and keep moving so that the baby could get well lined up. When contractions were more “regular” I planned to page Stacey. I started to feel nauseous and realized I hadn’t eaten so tried a bite of cracker & some ginger ale but they didn’t help. By 7am contractions were intense. I couldn’t walk or talk through them, they were coming every 2-3 minutes, lasting about 90 seconds, and I was moaning my way through each one saying “oh oh oh.”
I had laboured for a while in the living room, leaning over the back of the sofa, sitting on the birth ball, kneeling on the floor… but spent a lot of time in the bathroom, because I didn’t want to make a mess of the carpet in the living room and figured the bathroom would be easier to clean up.
Nathan paged Stacey to tell her it was time to come. She asked to speak to me, and wasn’t really sure that I was in active labour. She thought, because I was a first time birther, that this was probably just cramping & spotting from the night before, but I insisted that this was NOT from the S&S – this was REAL active labour. I had a couple contractions while on the phone with her and Nathan had to take over the conversation for me. Stacey said she’d grab a bite of breakfast then be on her way to assess where I was at. Fortunately for us, as soon as she hung up she decided that maybe she should hurry after all, and grabbed toast to eat in the car. Kim, our doula, arrived at 7:10am – perfect timing for Nathan, who needed to finish getting ready, and who also needed a minute to gather up his own feelings as things were happening so fast! That last contraction before Kim arrived, I think I cried a little through the contraction and said imploringly “Nathan…. It hurts” (or something to that effect!) Kim walked through the door and Nathan immediately said to her “Take over! I have to get stuff done”. I hardly even noticed the change from one person to the next, I was so absorbed in the intensity of my contractions which were unlike anything I had expected. Everyone talks about contractions as a tightening, but I didn’t feel it that way at all – I primarily felt hot sharp pain low in the centre of my pelvis.
About this time I felt my first contraction with some pressure at the peak, and I found myself catching my breath. I thought to myself “Pressure doesn’t always mean pushing. Pressure just means the baby’s head is getting lower. Stacey is on her way anyway.” I didn’t say anything, just kept labouring. I was in the bathroom, standing over the toilet and leaning against the towel rack for most of this time (Good thing we went shopping on Saturday!). I told Kim that these contractions made me want to use four letter words. She said to just go ahead and use them – she’d heard them all before. So my vocalizations became a mixture of “oh oh oh” and “”F***!”
About 7:25am I felt a trickle down my legs and realized my water had definitely broken. I immediately asked Kim what colour it was. She said it was fine. I said “No, what colour is it?” I wanted to make sure it was clear – no meconium - because the midwives policy (as per the hospital they have privileges at) is that you are supposed to transfer to hospital for any trace of meconium and I didn’t want to do that. I had told Stacey that I would assess for myself whether I felt meconium (if present) warranted a transfer, since she wasn’t permitted to make that assessment anymore. I cracked my eyes open enough to check the fluid, just as Kim told me that it was clear. Phew!
Then the contractions started to change from the hot low pain in my pelvis, to crazy intense amounts of pressure and for a few contractions, were a combination of both feelings. (In retrospect, I was probably fully dilated/open at that point).
I cried for a moment at the peak of a contraction as I tried to cope “Kim… it hurts…” Kim moved in closer, breathed slowly, and I remembered that I needed to stay calm; to stay “low, soft, and open” and so went back to vocalizing “oh oh oh.” I moved around a little in the bathroom, trying to find a position that was comfortable – no luck with that! I asked for a hot pack which Nathan got for me but I immediately tossed it on the floor as it didn’t help at all. Nathan tried rubbing my back but I needed his hand to just be still. And I asked for some counterpressure on my sacrum, which Nathan gave, but I didn’t like that either. Kim was holding me and supporting me through all this. But nothing was working! I wanted out of the bathroom. The cool kitchen floor looked appealing, and I considered just laying down on the floor, but then the next contraction came and I leaned against the kitchen counter instead – the floor was too far down. The counter was still covered in dishes and I commented on that to Kim. I felt so bad that the house wasn’t “ready” (ie cleaned to my standards and ready for guests). Kim said she’d wash the dishes for me when everything was over, but I didn’t hear her then. Lol.
I knew now the baby was on the way, and told Nathan “Blow up the pool!” He raced off to do that, but by the next contraction I knew we didn’t have time to fill the pool so said “Don’t bother filling the pool Nathan!” The pressure was so intense now, that I said to Kim “I *know* this isn’t the case, but I swear to GOD, it feels like my ass is going to explode!!!” It really did feel like that baby was trying to create an alternate exit! And anyone who knows me knows that just wasn’t how I normally spoke!!!
Kim & Nathan offered to fill the bathtub instead – I declined, not wanting to create a hassle. (Apparently they exchanged a look and began filling the tub anyway.) And within a couple contractions I was asking if the tub was ready yet – I needed a change. I was so desperate for water that I crawled into the tub in the middle of a contraction. My vocalizations of “oh oh oh” had changed to a more desperate “ow ow ow” mixed with crying – it was really hard to stay in control at this point. There were only a couple inches of water, but the relief was instantaneous. I realized that the baby was coming very quickly, and that saying “ow ow ow” through my contractions wasn’t helpful, so I switched to saying “Whoah Whoah Whoah”, to allow myself time to stretch and open. I put my hands down against my perineum through every contraction. It helped me feel more in control of baby’s descent, as this baby was coming like a freight train. I wanted to be sure of what I was feeling, so between contractions reached inside to see what I could feel - - only one knuckle depth in I could feel the baby’s head!! I told Kim & Nathan to page Stacey back and tell her that I could feel the head so we needed Melissa too. Melissa is the second midwife who comes for pushing and to care for the baby at birth. Nathan skipped the paging step and called Stacey back on her cell phone. She was just down the road from our house, so she paged Melissa as soon as she pulled in the driveway.
Then I had a contraction that I KNEW meant the baby was almost here. Without thought or intention, my eyes flew open and I looked wildly at Kim and at Nathan. I recognized that ‘the look’ had just happened, as I had seen so many of my clients with that same ‘look’ in their eyes. I asked where Stacey was, and they said she was here. Stacey didn’t really believe I was that far along yet, in part because we were all so calm, and was working at getting all her equipment inside but was in no great hurry. I was asking where Stacey was, but what I meant was “Is she ready to catch this baby?” When she came into the bathroom (8am) she had the fetoscope to check the fetal heart rate, as I had declined the Doppler throughout pregnancy. When she couldn’t find the heartrate though I told her it was okay to use the Doppler. With the next contraction she could see how low the babies head was and said “Where do you plan on giving birth? Because there isn’t enough water in this bathtub.” I told her I was getting out and going to the bed to give birth. I knew that if I gave birth in water, it would be more difficult to negotiate a physiologically managed third stage as that was outside Stacey’s comfort level, and I had never been set on having a water birth anyway.
At 8:10am I got out of the tub and made my way to the bed before the next contraction. As I was preparing to get out of the tub I could feel that I was having a small bowel movement and said “I just pooped”. (Poop means the baby is almost here – we were nearing the end) I made my way from the bathroom to the bedroom, and asked for towels from the birth pool box to get laid down, as I didn’t want the sheets to get all wet and messy even though the bed had been made up specifically for the birth. I got into bed as another contraction was building, and laid down on my side with Kim at my head and Nathan at my feet. At 8:06 (tub) & 8:11(bed), Stacey checked the heart rate – 120 both times. My body was pushing, and I was still saying “whoa whoa whoa”, but I wasn’t adding any extra effort to it as I really wanted to give myself time to open. When Stacey took the next heartrate at 8:14 it was only 70, and she asked me to push hard with the next contraction. I thought to myself that for this stage of labour a FHR of 70 wasn’t so bad in a single contraction, and I didn’t really want to push aggressively because it might make me tear. But I recognized that Stacey was on her own, and was probably worried about caring for both baby & I if something went wrong, so I decided I would go ahead and push with the next contraction as she had asked. Stacey also asked me to do some scalp stimulation, which I did. My hands were down there anyway, supporting the top of my perineum as the burning was very intense at the top. I kept saying that it hurt so much up top; that it really burned. In that moment I was wishing for a warm compress, but I knew there wasn’t time to get one so I didn’t bother to say anything. At 8:18 Stacey wasn’t able to find the FHR, but I wasn’t concerned as I knew that was relatively common for this point in the birth. When the next contraction came, I took a deep breath and bore down. Because of having played a wind instrument & having vocal training, I knew how to bear down without holding my breath so that’s what I did. (Lol. The vain part of me didn’t want to be an ugly purple pusher with bloodshot eyes & cracked lips later.) I knew I was pushing effectively because I could feel the baby move, and the pain at the top was increasing. I was pretty sure I was tearing, and kept my hands on my perineum for support as I pushed through it. Stacey didn’t think I was pushing though because I was still exhaling, and at 8:19 am as she looked up to tell me to push, his head, then his whole body slithered out onto the bed. Stacey unwrapped the double nuchal cord, then scooped him up onto my belly and I held him while I breathed a big sigh of relief: It was over! Our baby had arrived!
I was confused at first, because I could feel two arms and two legs, but couldn’t figure out what the fifth thing was that I was feeling – then I remembered it was the umbilical cord. Lol. After a minute or two I asked Nathan “Who do we have?” Nathan looked “We have Levi!” Nathan cried with joy…. I closed my eyes and just rested. After about 10 minutes Stacey was concerned that the placenta hadn’t delivered yet (she’s used to doing active management) and wanted to clamp & cut the cord, and have me push. I wasn’t having any contractions, and I really wanted to leave the cord attached until it stopped pulsing, or for 20 minutes, whichever was longer. I had read an article by Robin Lim just a couple days prior about how stem cells are last to transfer; that some transfer occurs even after the pulsing stops, and how most of the beneficial components transfer in the first twenty minutes. Stacey was nervous that blood could be pooling behind the placenta though, and wanted to deliver the placenta. Even though I wasn’t concerned about that, I understood that she was probably anxious about the potential of dealing with a hemorrhage on her own, and so even though it wasn’t quite twenty minutes, and the cord may have been weakly pulsing still, I agreed to let the cord be clamped & cut, and to push out the placenta while she assisted with gentle traction. Because I didn’t have any contractions, (which to me, means my body wasn’t really ready to release the placenta yet) I had to make more of an effort to push. Kim put her arms behind my head to help me curl up a little and push, while Stacey worked the placenta out. I felt it release and said aloud that it had released. The placenta was very small (the smallest I’d seen up till then) but healthy, and it was birthed at 8:37pm – 18 minutes after the birth. Stacey & Kim bagged it up for me and stored it in the fridge so I could encapsulate it later. Melissa arrived at 8:40am, and after getting acquainted with everyone did the newborn exam while Stacey put in 8-10 stitches. My perineum was intact, but my labia had a small tear at the top near the urethra & clitoris. It was close enough that Stacey was concerned my urethra might swell shut so that first pee was a big deal. I asked for a double dose of the numbing gel before they injected freezing, as I knew from my experiences with the dentist that a single dose of freezing gel isn’t sufficient for me. Suturing wasn’t too bad most of the time, but some of the areas were pretty sensitive and it was hard to hold still and stay relaxed. (What I didn’t realize until a week later at a postpartum visit with the second midwife, was that one of my labia had torn horizontally its entire depth, and that was not sutured. They tried showing me with a mirror what needed to be stitched at the birth, but explained it as being “just cosmetic” and that repairing it would probably take close to an hour. Which should have clued me in to how big it was but it didn’t, so I said to leave it. That labial split was extremely painful and made for a difficult recovery in the first week as I wasn’t taking anything for pain relief, or using sitz bath herbs etc because I’d been told I only had a couple stiches and the labia was “just cosmetic” so I thought I was being a wimp. I cried every time I used the bathroom for weeks even with the peri bottle).
Once the third stage was all done we got settled into breastfeeding, snuggling, and meeting baby Levi; Kim went out to clean up the bathroom, do the dishes I’d been worried about, and get our prepared food out of the freezer; the midwives did their paperwork. Melissa left at 10:20am, and Stacey left about 11am. Nathan asked Kim to stay a little longer – she was with us until about 1pm. Nathan, Levi & I cuddled in bed as a new little family for the next hour, before we started making phone calls to family & friends. It was a whirlwind! But all was well.