The Birth: Uncut

My mom is seriously outdoing me in the blog posting since Michael's birth. This has to stop.

Ok, I don't really mind if she outdoes me. She's an excellent blogstress. Plus, you'd all be wondering if I was even still alive at this point if it weren't for her. Frankly, I wonder if I'd be alive (or sane) right now if it weren't for her help these past several days.

So here I sit, boobs on fire, ready to tell my birth story. (Can you say enGORGEment? I can. And I can be the picture in the encyclopedia. I keep trying to remind myself, "this too shall pass"...)

Let's start with Friday, Feb 19th. I went to Montrose to visit my midwife Bill for a prenatal appointment. 40 weeks and 1 day pregnant, having had only a few days worth of regular Braxton Hicks (painless early labor contractions). I asked Bill to check my cervix because I was curious if the BH had been effacing my cervix at all. He checked. He told me I was zero cm dilated and about 50% effaced. When he told my mom the news, she said something like, "So her cervix is tight? Tight like a drum?" And I later coined the phrase, "My cervix is tight like unto a dish." Bill sent me home with some evening primrose oil in gel capsules. I resolved to use one of the capsules that night since I pretty much thought my cervix was going to take another week or more to soften up and prepare for labor.

Friday evening around 11 PM:

Kevin helped me insert my EPO capsule just before we retired for a restful night's sleep...

NOT.

Saturday, February 20th, 1 AM:

I awoke with stronger contractions (about 5 times the strength of any of the Braxton Hicks I had previously felt) and couldn't sleep through them. Being the experienced midwife I am, I realized this was either very early labor or just a temporary effect from the EPO that could very well wear off in a few hours. I tried all my little tricks, drinking lots and lots of water and lying on my side to see if that would settle my uterus, taking a warm, candlelit bath and listening to my HypnoBirthing relaxation CD, making sure to keep my bladder empty, etc. Nothing was working to slow them down. They were coming about every 2-5 minutes.

4 AM:

I called Bill to tell him what was happening, and he agreed that it might be the effects of the EPO and that it could go away within a few more hours. We made a plan that I would try a few other things, and try to get some rest, and call him at 8 AM whether the contractions had gone or not and we could re-evaluate. I ended the phone call and crawled back into bed with Kevin, lying on my side and asked him to hold me. Somehow it made me more comfortable with the contractions and I felt myself starting to doze off...

5:38 AM:

I was awakened by a slight "pop" and then a small gush of fluid between my legs. Pretty unmistakably, my water had just broken. I told Kevin. He said, "Really? Do you need me to get a towel?" Luckily, my baby's head was low enough that I didn't lose more than maybe 1/2 cup of fluid initially, and I had a pad on anyway, so my amniotic fluid didn't even get on the bed. I called Bill to inform him of the news. My fluid had a light greenish hue, which comes from meconium or baby poop in the womb. It wasn't really a concern since it was light and there was no particulate matter in there. Kevin asked me how I was feeling, and I said, "Ready or not, here he comes!" My contractions were still the same as they were before I felt the water break, they felt strong enough to be doing something, but very bearable. I breathed through them and kept my body relaxed to allow my uterus to do its job. Bill offered to come up right away and stay til the birth, but I told him he could take his time coming over, since it was so early and I knew it would be a long day ahead. Kevin sent my mom a text saying my water had just broken. (My mom was asleep in the guest room down the hall.) She replied, "You better not be joking." Kevin had cried wolf a few times to play tricks on his family, so my mom wasn't sure she should trust him. A little while went by and I had Kevin run another bath for me and we hopped in our swimsuits and got in together. It was nice to have him supporting my back, and the water was soothing. We were still in the bath when Bill arrived, and I was still doing very well.

8:56 AM

Bill checked my cervix for the first time since the day before, when I was tight like unto a dish. I was so happy and proud to learn that I had made a lot of progress in a matter of less than 24 hours. Some of that, I'm sure, is credit to the evening primrose oil. The rest, to my champion of a uterus... jk :) Anyway, my cervix was now 3-4 cm dilated and 70% effaced, the baby was at a -1 station. I took a lot of encouragement from this since I knew I was starting active labor now. Kevin was by my side through the rest of my labor, pretty much my right hand man. I moved around a lot, walking through the house and pausing to do hanging squats from Kevin's neck whenever my contractions came. Laboring on the toilet, the bed, in the tub, etc. I kind of got into a groove and started moaning with each exhale when my contractions would come. Long, slow, deep inhales followed by a low-pitched "Ooooooooohhhhhhhhh...." as I exhaled. I knew active labor is slower with a first baby than it can be with subsequent ones, so I geared up mentally for a long day, but the time was honestly passing more quickly than normal. I remember looking at the clock once when I went out into the living room and it was after 10 AM and I thought to myself, "Hmm, it's mid-morning, not the middle of the night anymore. That's nice."

2:10 PM

Bill checked me again since I had seen quite a bit more bloody show and mucous the last few times I had gotten on the toilet. I was prepared to hear that I might be about 6 cm because I tried to check my own cervix twice when I was on the toilet, but could only reach the anterior side of it. (TMI?) There was still enough cervix in front that I could feel, I was sure I couldn't be much more than 6 cm. To my surprise and delight, I was 8-9 cm! I had only an anterior lip left on my cervix -- that means the back half of the cervix had already softened, opened, and slipped behind the baby's head. I was 95% effaced now and the baby was at a zero station, meaning he had come lower into my pelvis. The bones of his skull had started to mold to help him fit through the small space. I just have to say, there are few things in the world that compare to the joy of thinking you've only dilated to about 6 and finding out you're almost done with the first stage of labor. Wow. Pure joy. I tried to remain relaxed as the contractions continued, but the pressure from Mikey's head was making it harder to keep my breathing pattern and my muscles relaxed. Unfortunately, I would soon find out that Mikey's head was entering the birth canal at an angle. This would probably explain the difference I was feeling in my contractions. Instead of feeling them all over the lower segment of my uterus and abdomen, I started to get stronger sensations on the inside of my pelvis, specifically where Mikey's head was being pushed into my pubic bone, and making it difficult for the last bit of my cervix to open. The medical term for Michael's presentation is asynclitism. Instead of the "crown" or occiput of Michael's head being the first thing leading into the birth canal, it was a spot of the back of his skull just behind his left ear.

4:18 PM

I still had an anterior lip, which was now getting a little swollen from being wedged between my pubic bone and Michael's head. His head continued to mold, though, as all babies' heads do. I was feeling more pressure now with each contraction and started to have involuntary pushing urges at the end of my exhalations. Bill, Kevin, and my mom were all reminding me to try to stay relaxed and to let my body open and let the baby through. The four of us were in my bedroom now, and we got the plastic drop cloths laid out everywhere. I stayed in my room until the birth, changing positions as the labor progressed. It was so crazy to me to be the person in labor and not the labor supporter. As a midwife, I had helped so many women through the exact same intense part of labor, using many of the same words of encouragement that I was hearing now. I can honestly say that no matter what you yourself know is right to do in a situation, it still sounds good to be reminded. My mind would have a tendency to wander or I would let doubts creep in at times, and hearing the same encouraging words over and over is not only helpful, but necessary. At least, I found that to be the case. "Open for your baby" or "Slow, deep breaths" or "Breathe in, and then breathe your baby down" seemed to be things I heard a lot that kept me focused. I was definitely in another state of mind by this point. Labor and delivery people often call it "Labor Land" when a woman goes to another place mentally during labor and lets her instincts take over. There also happens to be a level of amnesia that accompanies this, which is a phenomenon I can't explain, even after having gone through it just a few days ago.

5:00 PM

I had started bearing down in earnest by now, with each contraction. The baby's head was at a zero station the last time Bill checked, and for those of you unfamiliar with station, the baby needs to get to a +3 station in order to be crowning. A -3 station is when the baby's head is still floating around in the amniotic fluid and not really engaged in the pelvis yet. So I was essentially half way through the progress I needed with the baby's descent. I was happy to be in the pushing stage since I had pretty much had enough of the breathing and relaxing and waiting for my cervix to open. I spent a lot of time in this hour pushing while in a kneeling position at the foot of my bed. I would lean my upper body over the edge of the bed to rest between contractions, and when I felt one coming on, I would lean back onto my haunches (I can't think of a better word) and sometimes swivel my hips. My mom and Bill were taking turn rubbing the lower part of my back and sacrum and Kevin was beside me supporting me. I spent the next two hours bearing down with most of my contractions (the ones that felt strong enough) and changing positions to try to facilitate the baby's descent. One of the funniest positions I tried is the one my mom posted on her blog. I was standing at the edge of my bed with my legs straight, bent forward at the waist and resting my arms below my shoulders on the bed. My arms were taking most of the weight of my upper body, so Kevin volunteered to help support my upper body by lying on his back on the bed underneath me and holding me under the armpits. It looked like he was doing a pushup with my upper body. Standing during the contractions and pushing was pretty good, I thought, since I was able to really swivel and sway at the hips. I had been pushing for two hours when I got the bad news from Bill that the baby's head still had not really descended more than a zero station. Remember how I said that finding out I was 8-9 cm was some of the best news ever? Well, finding out all my pushing and laboring for the past two hours had done essentially nothing was some of the worst news ever. I was starting to feel like I wouldn't be able to finish this. I was sad that Mikey's head was wedged crooked in my pelvis and all my movements weren't helping him turn his head. Mostly, I was exhausted.

7:00 PM

Bill left the room for a few minutes to call another midwife and consult with her about my situation. While Bill was in the other room, Kevin asked me if I wanted to say a prayer together or if I wanted a blessing. I was lying on my side in bed and he was sitting up, letting me lie in his lap. He prayed aloud for us, asking Heavenly Father to help the baby's head turn, to help me have the strength to push the baby out, and that both he and I would be healthy after the birth. Bill came back in the room and offered me some homeopathic remedies for helping the baby turn and helping with descent. I'm not really into alternative medicine, but I accepted any help I could get at this point. Bill wanted to try to manually rotate the baby's head, so I tried to get into a knee-chest position (F.Y.I. NOT an easy position to be in when you're this far in labor). I knelt on the floor, stuck my rear end straight up in the air, while simultaneously resting my chest and face flat on the floor. Can you picture it? Good thing I did yoga through my first 8 months of pregnancy! Bill tried to help the head rotate, but to no avail. After this, we decided I would get back on the birth stool because that was the position of all the ones I tried that felt like I could get the most power. While I was on the birth stool, with Bill and my mom sitting at my feet, and Kevin behind me letting me rest on his chest, we all had a chat. It was time to start considering the possibility that the head would not descend any further and that I may need to be transported to the hospital for "evaluation" which basically meant a C-section. Bill knew that I knew what my options were, so all he had to say was something along the lines of, "I guess you know that from here we only have two options. The one you and I both want is for you to get this baby out, but it needs to happen soon." I have to give Mikey credit here because he was a champion through my whole labor. His heart rate was always so strong and in the perfect range throughout active labor, and even during pushing, his decelerations would always resolve at the end of a contraction (a reassuring sign that he was getting plenty of oxygen). Kevin, my mom, and Bill all told me that I could do it; that I could push Mikey out and we could have this baby at home like I had planned. My mom gave me a great pep talk. Kevin told me I was his hero for all that I had gone through to this point, and that he knew I could do it.

All the encouragement,
plus the position I had on the birth stool,
plus a miracle from Heavenly Father,
plus a little someone I like to call "the wild woman within"
plus my mom and Kevin cheering me on and unconsciously pushing with me,
plus innumerable prayers being offered up by family and friends present and not,
plus the looming possibility of C-section driving me to find the strength to get my baby out...

equaled PROGRESS!!!

A baseball-sized portion of Mikey's head was now visible, and a few contractions and pushes later, his entire head turned the corner under my pelvic bone and emerged.

7:31 PM

It was intense pressure, but one of the most satisfying feelings I could imagine. As his head emerged, I stopped pushing and let him slowly slide out. Oh, the RELIEF! His shoulders and body followed easily within seconds and my baby boy was placed on my tummy. I cannot express the JOY I felt holding that little body next to mine for the first time. Kevin was bawling, and I'm sure just as relieved as I was that the birth was over. We dried him off and helped stimulate him to cry. We instantly saw how beautiful he was and gushed our love for him. I had the best adrenaline surge right after birth and at the moment we were doing our first bonding as a family, I was all smiles and I honestly didn't think once about the labor or difficulty I had during pushing. Bill checked me and told me that I only had a few small tears from the birth, and that they wouldn't need stitches. I was overjoyed about that. I had been wearing a nasal cannula for oxygen during the last half of my pushing, and I removed it and placed it near Mikey's nose and mouth to help him turn pink. The last 30 minutes of pushing were stressful for him, but he came around quickly like most newborns do. His 1-minute Apgar was 6 and his 5-minute Apgar was 8. He was a trooper through a 3-hour second stage and I was so happy that our prayers were answered and he came through the whole ordeal as healthy as could be.

7:43 PM

My placenta came out, Duncan side first (the side that attaches to the uterus, or "dirty" side). That's a little less common. So is a prolapsed uterus, which I was also blessed to experience. My uterus partially turned inside out and came part way into the birth canal following my placenta. Unfortunately, the solution for this is for the midwife to insert his entire hand and wrist inside me and push the uterus back up to its rightful position. (That wasn't very fun. I get a baby coming out, and then a man's fist going in.) Good news, my uterus stayed where it was put after that and cramped down just like it should. I lost about 500 ml, or half a liter of blood, which is normal. I could have lost a lot more given my prolapsed uterus, but it had a lot of muscle tone even after a long 3 hours of pushing, and my bleeding slowed WAY down rather quickly. I didn't need medications to help get my bleeding under control, and I'm thankful for that.

8:55 PM

I was all cleaned up and changed, comfortable in my bed. Michael had his first breastfeeding. He latched on immediately and fed for fifteen minutes on each side. Good boy! I was eating Honey Nut Chex Mix and drinking Gatorade like it was going out of style.

9:30 PM

Kevin's parents arrived to greet their new grandbaby. Pictures were snapped left and right, hugs and kisses and congratulations were exchanged.

11:00 PM

Exhausted new parents turned in for some well-deserved sleep.

Michael Gannett Lewis
Born Saturday, February 20th, 2010
at the Lewis home
with Kevin Lewis, Shawn Glenn, and Bill Dwelley in attendance
Weighing 8 pounds
22 inches long
PERFECT in every way :)

I am so happy that I was able to give birth at home. I can't say that it was exactly how I imagined it would be, since every birth is unpredictable, but I was so happy with the outcome. It was the hardest and most rewarding thing I've ever accomplished. I'm so thankful for the help and support that my sweet husband and mother gave me through the entire day. I'm thankful for the prayers that were offered in my behalf, and answered. I'm thankful for Bill, and for his support and encouragement. I'm convinced that my choice of provider and my choice to labor and birth at home were pivotal in allowing me a vaginal birth despite the circumstances of Michael's presentation. There are only good feelings for me as I look back on my birthing experience. I wouldn't have changed a thing.