Sunday, July 26, 2009

Eliana's birth

Eliana's Birth Story- a Christian Perspective

Some women know exactly what time their labor began. At the beginning of Dustri’s labor, I knew: 11:30 a.m. This one was different. I had been having uncomfortable contractions for weeks and other pre-labor signs, but nothing that said labor was really imminent. On Thursday, May 7, two days before our sweet Eliana breathed her first breath, my contraction patterns shifted. It is hard to explain because it was so gradual and so subtle. I found myself at the park with Dustri and my mom, climbing downright awkwardly up and down slides with Dustri and doing side lunges with the help of the picnic tables. I had a sense as if this baby was trying to work its head into my pelvis, much like a key fits a lock. Later that day, the low aching that I had felt in my back for the last few months ebbed away and I wondered if my baby had finally turned to the preferred anterior position. Contractions continued slowly and irregularly throughout the evening and woke me a few times on Thursday night.

On Friday, I had an appointment with my midwife, Candie, and debated whether I should finally get checked for dilation. Besides, I thought my fore waters may have ruptured so I decided it was worth the quick procedure. No PROM, but I was 3 cm. dilated and 50% effaced with the baby at -1 station. What did this tell us? Not much, except that my body had done a fair amount of work and I could get into active labor at any time…or I could wait a little while too. I was satisfied to hear that the images of the lock-in-key imagery I had been having all of yesterday were true. I was informed the baby was “lined up and ready for take off.” Thank goodness, I had prayed that I would not have to labor with a posterior baby. Candie reminded me again that she had family affairs to attend throughout the day and throughout Saturday afternoon. “If you have the baby from about midnight to noon or so, I can be there, but if not, the doctor on-call will be there,” she said. Well, I wasn’t sure whether this baby would born that soon, but I decided to keep it in mind and said a prayer since I really wanted Candie at the birth.

On the way home from the appointment, I had several more contractions and I continued to have contractions somewhat regularly throughout the rest of the day. I don’t really remember the day all that well. My mom and I took Dustri and drove around Paducah. I also remember that prime rib sounded absolutely delicious, but by the time we got to Outback it was seven in the evening with an hour and a half wait time (that’s what you get on a Friday night), so we went home and ate pizza instead. At some point my contractions picked up in intensity and I began to question if tonight might be the night. I lay down in bed to rest and my mom came in to massage my back and to keep me company. This set the mood of active labor off to such a wonderful beginning. My mother, knowing me so well, knew exactly how to massage me, which I find to be an immense comfort anytime, but especially during labor. I was also able to discuss more fully my desires to have a God-centered birth along with numerous fears and thoughts. We began praying and speaking to each other through Bible verses and through prayer to God, which I found to be so relaxing. I was able to be vulnerable with the one being who knew me best and had the most power over this labor: God. And my mother, who was my physical support, was able to hear my vulnerability and thereby know better how to help me during labor. This served us very well throughout labor and allowed me to cast aside tension and fear and to relax into the arms of my Maker while mom became a companion of spiritual, emotional, and physical encouragement.

After a while, mom went off to bed and I kneeled rocking on my birth ball. Between eleven p.m. and midnight active labor was really kicking in, although I was having a hard time accepting it. I called Kirstin at around 12:30, since mom had gone to sleep (she knew better than I that it would be a long night). Since Kirstin is my sister and a fellow birth doula, I figured she might be able to help me make some decisions: “Do I call Carrie to come watch Dustri?” “Am I really in labor?” After all, the last thing I seem to like to do is jump the gun and get too excited too quickly. Kirstin assured me that from the sounds of my voice, my breathing patterns and my pauses for contractions that I should probably stop denying the fact that labor had begun, accept it, and get Carrie to watch Dustri so I would stop worrying about childcare. Well, it took me another hour or so to decide she was right, but I finally called Carrie and she came over to watch Dustri.

After Carrie came over, I became calmer, as if my mind said, “Ok, your daughter will be fine; you can focus on the labor now.” I felt so blessed to have Carrie watching Dustri at our house, especially considering how short noticed our childcare arrangements were. Her presence was so calm and enlivening; I found myself wishing that she could be at the birth too. I had begun referring back to the prayer and bible verse portions of Christ Centered Childbirth, a book I had not read since pregnant with Dustri, but has now become my favorite book on the subject of childbirth. Carrie was interested in it as she was pregnant with her third and we began to discuss spiritual issues. I told her my frustration at “losing” my Clarksville home church and not feeling very comfortable in a large institutionalized church setting. She then went on to inform me that she went to a small church that had, at its heart a family-center and house church history. At that moment, I knew that if for no other reason God had allowed Carrie to come over to our house and watch Dustri so that we would have that discussion. One of many answers to prayers.

As I transitioned closer to going to the hospital, I found myself in some ways mourning the loss of a homebirth. What an annoying decision to make! “When should I leave; when do I upset my patterns of labor (mentally and probably physically), leave my comfy nest, get into the car, and drive to another location where I am not nearly as familiar and probably not as comfortable?” I found myself wishing I didn’t have to make that decision, but thanks be to God, bitterness did not enter my heart at my homebirth loss—just a little frustration. I was able to maintain a good mood, even a chatty happy mood while I rocked on the birth ball and mom prayed over me and rubbed my back during contractions and I talked with her and Carrie between contractions. It was so cozy: It was night, there were people close by who supported me and cared for me—I thank God for those moments.

I was surprised to find that my contractions were coming every three to four minutes lasting for at least 60 seconds. What! It can’t be time to leave yet, can it? Knowing my previous labor history, I couldn’t depend upon all the emotional signposts like the phrase “Don’t leave for the hospital unless you cannot smile for a camera” to help guide my departure for the birthplace. Historically, I had been a very polite birther. But, with the hospital a half hour from our house, I figured I did not want to wait until it looked like transition was upon us, or like I had (quite by accident) done for Dustri: waited for the slight urge to push. Besides, unlike Dustri’s birth, I trusted this birth place. I trusted the providers and the nurses to respect my wishes and did not fear the unnecessary use of intervention because of such subjective things as a hurried provider or a lack of trust in the birth process. So, although I would rather have stayed home, I decided the anxieties caused by waiting to go the birth place outweighed the benefits of staying home and I woke Richie to tell him it was time to go. By the time the bags and pillows were in the car and we were ready to go, I was mentally ready too and was eager to move on to the next phase.

The drive to the hospital was uneventful and I found that my contractions lessened and were fairly easy to cope with. When we arrived at the entrance, I hesitated. I prayed out loud expressing my fears of hospital policy, my mistrust of the iatrogenic-based birthing system, and asked God to make my way smooth. I prayed out loud much as I had earlier in labor with mom: to express my vulnerability to the one I could trust most, to verbalize my fears as they seem easier to let go of if you speak them away, and also to let those who would be integral in giving me support know what my fears were so that we would all be on the same page.

I entered the hospital tentatively yet excitedly. It was quiet as it was around 3:45in the morning. I was glad to go in my bathrobe without having to think about other people like I would have if it was during business hours. I liked the calm of walking in and, of course, they obviously knew I was in labor because who else walks into a birthing unit in their bathrobe? From the beginning, the nurses were gentle and unassuming and I found myself knowing that God had answered another prayer. I would feel uninhibited and would be able to labor and birth as my body dictated without worrying about people’s stares or opinions.

The nurses did a wonderful job of respecting my birth plan and keeping me informed about procedures. I felt like a birthing woman not a patient, which is something I had greatly desired. Like during the car ride, my contractions had lessened in intensity, and it was not uncomfortable to get my blood drawn and not that uncomfortable to be semi-reclined in bed while we did an initial monitoring of the baby’s heart rate and my contractions. I was glad when they told me that everything looked fine and that I could move around again. I was checked and found to be a soft 6 cm. 90% effaced. This was another answer to prayer because I had had it my mind that I really may not be inclined to stay if I was less than 6 cm. I am glad God made it apparent that I was making progress so I was content to settle in at the hospital.

I was informed that Candie would be unable to make it until around 6 or 7 in the morning since she had slipped and severely hurt her foot a few hours previously and was on some strong pain medications. At this point, I almost laughed because I thought “Well, God, you are definitely making me lean on you. My initial homebirth midwife died, I got sick and couldn’t do a homebirth, I’m giving birth on the four days that Jenna is not able to be here, you know I would rather not have a back-up doc catching my baby or making decisions about my care and here I show up during the 10-12 hour window that Candie is available to be my midwife and now she is not available for another 3 hours. Your will be done because it doesn’t matter; you are in charge, God.”

So, I labored for another 5 hours. I had asked for the hot tub to be filled, but knew in the back of my mind that I probably wouldn’t get in it since I couldn’t give birth in it. “What’s the point of being nearly fully dilated and getting in only having to get out to push, maybe before I am even really comfortable in the water,” I thought. (I’ve never labored in water before.) Sure enough, I was 8 cm. dilated and fully effaced when the tub was filled and as I was doing well coping with my contractions as a land lubber, I opted to stay out of the tub. Looking back it surprised me about some of the things I was not comfortable with. I had planned on using the tub, yet didn’t feel like it. I had planned on using the video camera, but nah; it was not worth the hassle. Oh well, maybe next time.

It may seem strange to some, but I really enjoyed my labor. My memories are filled with moments of laughter and giggles, of stupid little jokes, and of funny actions. Ina May is right when she says that birthing mothers do best when they allow for some lightness and humor. At least it worked for me. Three occasions rise up distinctly in my mind. One was when mom and I had wandered into the community snack area to find some water. Of course, I had several contractions during the process. Another woman, who was visiting a new mom, came in while I was having a contraction. I was leaning on the counter and mom had me in a full embrace from behind while we swayed back and forth together. Even in a hospital birthing center, this is a strange sight to see, I suppose, and the woman backed out quickly muttering apologies and looking quite embarrassed at walking in on us in such an apparently intimate moment. I didn’t mind as I was the one who chosen to venture into public areas. Somehow it seemed very funny and my mom and I busted up laughing. For me, my stomach was so large that it turned into a true belly laugh which made me laugh harder…which kind of hurt when another contraction came on, but the laughter definitely seemed to take the edge off. Another time, Richie, mom, and I were standing around listening to a cd I had recently picked up called Spirit Flutes. I had never listened to the whole thing before and there were portions in there of wolves howling, which I found very amusing (this after many hours of no sleep, mind you). So, I decided since mooing and low vocals worked to open the cervix maybe howling would too. So I stood there howling through several contractions and between just to help my spirits. Apparently, it lifted everyone’s spirits including the nurses who could hear me at the nurse’s station across the hallway. As birth got closer, the nurses came in. As I finished a contraction, I looked up and sardonically said, “I can’t believe my baby is going to be born to Spirit Flutes,” which apparently was very funny coming from a laboring mom because they both cracked up laughing. It made me feel good to know that I was historically in the most intense parts of labor and was still making people laugh. There again an answer to prayer: God allowed me to “soar on wings like eagles; to run and not grow weary.”

I spent a lot of time on the “birth throne,” the toilet. I would sit backwards and relax into the contractions while my mother or Richie would rub my back or pray and speak to me. I found many sayings like “good job,” “wonderful,” “you’re doing great,” or “relax your shoulders” annoying. I much preferred prayers and Bible verses than such seemingly powerless phrases like “good.” I don’t necessarily find anything wrong with the other phrases and have used them myself, but in my situation God’s presence was so there that it just didn’t feel connected or in tune with the “vibes” in the room to use to such secular or material phrasings.

Well, without much willful effort I hung on and at around 7 a.m., Candie came hobbling into the room and found that I was nearly dilated with only a small anterior lip that I could push through. Then I had the best feeling vomit of my life and new for sure that I just had to be dilated for sure. Ok, I could have my baby now. Or so I thought. It would be another two hours before birth actually occurred. As with Dustri’s labor, my contractions lost a lot of tangible intensity and the urge to push was fleeting (or fleeing). I walked around and semi-squatted during contractions, doing what felt good and might bring baby farther into the pelvis so that I would get an urge to push. I remember Ronii, my old homebirth midwife, telling me that women with ample birthing hips needed a lot of gravity and many did not feel an urge to push until the baby was at a very low station. I guess this may just be the way my body labors—slowly and not too intensely.

I did have several fears that were not addressed. For starters, I had not really bonded with this baby before birth and until I felt the baby’s head with my hand, I really don’t think I even fully accepted and realized that there was a baby in there to push out. The pushing stage has been unknown to me as I did not get an urge to push with Dustri either and had been given direction in prolonged pushing during 2nd stage. This was in sharp contrast to the enjoyable 1st stage where I felt very confident in relaxing, in having patience and letting my body work. 2nd stage during both labors was much more intense for me and I have preferred the work of 1st stage labor to 2nd stage.

And so we waited. Being my second child, the nurses and Candie stayed right beside me and I felt as if everyone was waiting for me to do something. I felt like an actor on stage that had forgotten his lines. Where was the urge to push? As I rested on Richie, he finally told me that it was time. “Let the baby out,” he said. I think he knew better than anyone that in many ways that’s what I was holding onto the baby because of my uncertainties of second stage and of being a mom for the second time. I still wonder how much of the delays in second stage are physiology and how much are psychology. Whereas after Dustri’s birth, I bitterly attributed much of it to psychology and birth environment, I now feel inclined to think that, yes, my anatomy and physiology is also a significant variable in my second stage behavior.

Candie suggested that Richie support me on the birth ball while I squatted during pushing. There she was with a potentially broken foot tailor sitting on the floor with her gleaming instruments off to her side. I was very glad to have a chance to squat, on the floor no less, but found that it was not very comfortable and chose to move up to the bed where I could try to feel where to push instead of thinking of which position I was pushing in. At this point, the intensity of the baby’s head was mounting, but Candie helped guide my hand so I could feel the baby’s head at a +2 station. It didn’t feel like I thought it would. It felt like a membrane not a head; it felt gelatinous, not like bone (apparently, this was the caput I was feeling). But it did give me some bearing on where to push. Unlike with Dustri, I was not hooked up to the external fetal monitor (EFM) so only I knew when my contractions were coming. They had checked me with doptone intermittently throughout this labor and while they kept a close eye on the baby’s heart rate they did not strap me to EFM. Only then, as Eliana was moving down the birth canal, did I wish to have someone tell me when my contractions were so I could push with my body. I felt so much so intensely, but I did not feel the pressure of contractions, other than a small feeling about every 6 or so minutes that I thought might be telling me to do something different. And so, I would breathe and then push for a few seconds and breathe and push again as I felt comfortable. I was appreciative that everyone was giving me every effort to be autonomous in my birth, but I still felt slightly overwhelmed by the intensity of the sensations as well my lack of instinctively knowing how to deal with them.

And so our baby came closer to the outside world and finally the baby was crowning. My hands were placed firmly at my side for support (too much tension, I know), but Candie insisted I feel my child’s head as it was coming out. I didn’t want to, but looking back it made a huge difference in my perceptions and possibly my actions during this last portion of the birth process. I don’t know how long it took, but I finally knew my child. There she was, her hair was there and she was a real head, not a penny of squishy fluid. The intensity was really beyond words and I kept praying to God in my mind that this baby would keep coming and not stay there for several minutes while another contraction took effect. But God was gracious and gave me what I had missed during the second stage: Instinctual movements that brought my baby into this world. With my hand firmly placed on her head, I grunted gently yet earnestly through the ring of fire as I felt her move closer and closer to her first breath, her first views of this world. Looking back, I chuckle because in my birth plan I had quoted Leboyer about birth as ephemeral event and one that demanded quietness. Well, I birthed that baby with a loud yell, one that dropped Richie’s blood pressure and I’m sure everyone down the hall heard as well. Little did Richie know that that yell was not one of sorrow or even pain, but of triumph and of relief—for our little baby’s head was out. Even as I echoed my inward relief, I heard Candie say that the baby was trying to breathe and that there were two tight loops around her neck so not to push. This wasn’t that hard to do as most all the pressure was off and I just raised my neck and panted until she eventually cut the cord and then her shoulders slipped through. Now she was truly here. It was for her a quiet entrance. Dustri had come in crying and Eliana made nary a peep. She was taken to the warmer a few feet from where I was as she was rather limp but I felt she was fine. In fact, although none of us had seen, I knew “it” was a she. All through labor, this child had been a he, but as I birthed her my language turned from he to she. My connection had been made. I knew this child…and I loved her. Another answer to prayer.

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