Wednesday, January 5, 2011

Luka G.

Luka was “due” to get here on Dec. 30th, but our midwife made sure we knew to expect him, as our first baby, to be late. Still, when I had to go in to the hospital for some testing on our due date (I’d been having relatively high blood pressure readings for a month or so, which had my midwife concerned, and then a migraine earlier in the week led her to want to make sure that I wasn’t preeclampsic), I suppose we were hopeful things would quickly and (at least mostly) naturally take their course.

On poor information (a low amniotic fluid reading via ultrasound) and being told that I had protein in my urine (didn’t turn out to be true), I was admitted to the hospital, with the intent to induce labor. I was administered a prostoglandin (basically glorified and expensified sperm) and told that I’d be “checked” in 12 hours to see where things were. Luckily, in that 12 hour interim, we had an amazing night nurse who recognized how far afield from our birth plan desires we were, and who offered some advice and empowerment. She told us that the AFI readings were only one of the latest medical tests that are used to push induction – that they’re not only unreliable, but that little is even known about “ideal” amounts of fluid at 40 weeks. It also turns out that my labs were completely normal – so while the blood pressure wasn’t a great thing, no damage seemed to have been done to me, and monitoring showed that the kid was also likely just fine. The other nurses, while nice, weren’t nearly so empowering – in fact, the experience as a whole felt totally alienating, as we were continually put in a position to argue for the decisions we’d informedly made (some of these were reasons that led us to a midwife in the first place). The comments (from at least three different people) of “Oh, right, that doesn’t work, because we’re at Children’s!” were also less than confidence-building. We decided that, unless my water broke (a sort of point-of-no-return if you’re at the hospital), or I’d dilated like crazy, we would likely leave in the morning. The rates of success for induction on a first-time mother aren’t particularly promising – they often lead to painful Pitocin contractions and THEN a c-section, and the latter was the absolute last thing we wanted.

So, after returning home to pick up any necessary baby things (we hadn’t packed a hospital bag, because we’d never thought we’d need one!) and picking up some snacks for us, Aaron stayed on a pull-out seat and kept me company all night. We watched a marathon of Back to the Future films, listened to the baby’s heartbeat on the monitor, walked around, complained. And in the morning, I wasn’t dilated (only about 50% effaced), no water had broken, and when our midwife came, she also advocated that we leave the hospital since further attempts to induce weren’t likely to go well. So, we returned home, hoping that baby’d be on his way quickly.

Aaron and I spent New Year’s Eve together as a quiet night on the couch, both of us hoping that every contraction would establish a rhythm. But though bloody show finally appeared, a rhythm didn’t come, nor the next day, or the day after that. I started taking blue and black cohosh to promote ripening and coordination of contractions, and we took turns trying to talk the boy into coming out. Yet, over that long weekend, not much seemed to be happening, outside of our anticipation. Then, finally, around 2:30 am on the 4th (late Monday/early Tuesday), the contractions started coming regularly, no more than 8 minutes apart but no less than 5. Later that morning, we texted Eileen (our midwife) to let her know, and she replied that we should call whenever we needed her. That entire day, we kept hoping to be able to make that call – the contractions were increasingly strong, but never got closer than 5 minutes apart, and no water broke. We watched comforting-familiar movies (I think we got through all three original Star Wars, the first Indiana Jones, Labyrinth, Babe, and then also several episodes of Battlestar Galactica) to pass the time, and during the few short breaks that Aaron took to nap, I’d try to focus on bringing this kid around to coming out. Still, no marked change – no “aha, this is it!” I took a bath around midnight, hoping to stall out the contractions (since they weren’t getting more productive, I figured relief enough to be able to sleep some sounded like a good idea).

Rest was not to come – instead, this seemed to spur the contractions on, and as of 4:30 in the morning on the 5th, they were coming every 2 to 3 minutes, really painful, aggravating clockwork. We called Eileen around 8 and she came around 9 am. She checked the baby’s heartbeat (doin’ fine) and found that I was about 5 cm dilated – halfway, which was certainly “progress” but felt somewhat disheartening after more than a day’s worth of contracting and not sleeping. But Eileen has this magical way of saying what we needed to hear and giving us strength to keep going. Aaron especially seemed to take note of her suggestions to keep things as positive as possible, reminding me that a particular contraction wasn’t “bad” but rather “strong” and continually praising as I got through each one of them. She left us with renewed strength – which was certainly necessary over the next 12 hours, which saw me nearly break down and ask to be taken to the hospital. Nothing seemed to be able to help me deal with the rushes better – not thinking about them positively, not practicing the visualization exercises I’d been doing, not the several showers that I took, not trying to focus on other things or even more inwardly. I knew that this was part of the process – that the increasing feelings of losing control were to be expected. But I didn’t know how I was going to deal with it – nothing could have prepared me for what I was experiencing, as each contraction stripped me of my positivity, my sense of self-control, my hope for a happy outcome.

And this is where I have to explain how wonderful my partner is. I mean, I knew this beforehand - I married Aaron because he’s fantastic and funny and because we fit. But this choice that we made, to have a home birth together, without using a doula, took so much courage, and kindness, and patience, and also a bit of subterfuge, on his part. Even during the earlier parts of labor, there were times when I couldn’t stand to be touched, would refuse to eat (every time I put something in my mouth, it seems like I’d trigger a contraction), or would need, immediately, to lean on him. My sense of humor grew perilously thin. As I neared transition, I literally started to lose myself – lost my sense of why this choice was important in the first place, lost my faith in my ability to handle everything (or anything), lost my determination to make sure that this birth was as close to the gentle experience we wanted as possible. At one point, I broke down and told Aaron that I couldn’t do it. And he held me, and refused to take these comments to heart. Instead, he recognized that it was likely that I was going through transition (this is when everything’s dilated, nearly ready to push, and a lot of women experience a sort of breakdown – we both knew this from our fantastic childbirth education class, but I’d managed to either completely forget it by this point, or more likely, just figured that I was right and that I couldn’t take any more), and called Eileen.

She arrived around 9 pm, checked on the baby (still doing fine), and found that I was 9 cm, maybe 9.5 cm dilated. So there had been progress! As she went back into the living room to start prepping things (she reassured us that we most certainly would be seeing our child soon, and at home), I stood up from the bed, walked into the hallway, and my water broke. This is an exceedingly strange sensation – the best way I can think to describe it is as if someone threw a very warm water balloon from inside you and one at you simultaneously. It was also very good news, as this meant that I could follow any urges I had to push from this point on. My water broke around 9:30 and for the next hour or so, contractions would come and Aaron and I would work through them. These contractions were different than the ones before – not less or more powerful, but they somehow felt… clearer. My sense of purpose had returned, and it also felt like I was somehow coordinating things with the kid, working with him, as opposed to merely having my body worked on by him. Eileen stayed in the front room (I didn’t know what she was doing, but Aaron told me later that she was calmly knitting), and I, instinctively I suppose, picked the bedroom as my laboring place of choice. At some point, her helper, a fantastic woman named Pat who I’d met at a prior appointment arrived (everyone I’ve met from Eileen’s office is wonderful, but I can genuinely say that I was happy that it was Pat who came – she has this incredibly gentle and kind demeanor that was quite welcome at the time), and she and Eileen came into the bedroom. I’d been switching positions, from sort of on hands and knees to sort of squatting low, when Eileen suggested that we try the birthing stool. This was an excellent idea, and I spent the remaining few minutes of laboring on it. It afforded me better balance and allowed me to grip with my shoulders and arms, and at the same time push through with my legs. I found that I could almost bring about contractions by opening my mouth widely, and would then push – probably, in retrospect, too much (two not-insignificant tears to show for this), though it felt powerful and sort of terrifying in the moment. After perhaps thirty minutes of pushing like this, with Aaron behind me, his hand on my back and continually offering sips of water and words of praise, Eileen in front of me and Pat behind her, Luka came through and was caught. I think Eileen caught him, though I’m honestly not sure. I know that he was handed straight to me, and that I commented upon his then-pointy head. I know that I felt overwhelmed, but in a completely different way than I had those prior 45 hours.

I got onto our bed, and held Luka against me as the rest (passing the placenta, a bit of an exam for me and one for him, Eileen examining the placenta [it is, by the way, such a cool organ – I really had no idea how phenomenal a thing it was until she showed it to us], Aaron getting to cut the cord) happened. I think at this point my appreciation for all that Aaron had endured hit, and I was filled with such an admiration for him, and such a sense of connection between the three of us. He was buzzing, alternatively tearing up and talking excitedly to Eileen and Pat, telling me how proud he was of me, and this huge wave of thankfulness and love washed over me. At the same time, I felt so incredibly proud of what we’d done together – labor was longer than I’d thought it could be (even having read the stories of others, I seemed to think beforehand that it would come relatively easily, since so much of the pregnancy did), it took more from me than I knew I had to give, but it also gave Aaron and me such an immense gift. Aaron held on to me – or maybe even a sort of idea of me - when I was in no position to do so for myself, and he made returning to me happy and peaceful. I have never felt luckier, or more in love, or more certain in myself.

I’d really like to honor Eileen Stewart, as well as her wonderful staff members at Buffalo Midwifery Services, our childbirth ed instructor Courtney (at Lifecycles, a sister organization to Buffalo Midwifery), and Dawn and Heather, the two home-birthing mama nurses at Children’s who helped us hold on to our values and hopes. Eileen provides an amazing service, and she does so with incredible grace and such a loving presence. The difficulties we had in the last few weeks of this pregnancy – mostly with potential physical issues and the fear these brought out – were dealt with honestly and compassionately, and she never faltered from her goal to help us have the birth we wanted. Her faith in the birthing process gave us strength when nothing else could have. These other women were also instrumental in helping instill a sense of efficacy, and naturalness, to a process that has largely, it seems, been taken out of women’s hands and put into those of medical professionals. This isn’t to disparage the medical model or those who utilize it, but rather to praise – as highly as I possibly can – the midwifery model, and the faith that it puts in the mother, in the mother’s body, and in the birthing couple. Eileen insisted, from our first visit with her, that a home birth (especially for a first time mom) was not for the faint of heart, and she certainly didn’t exaggerate this. Aaron and I are so lucky to know now exactly what she meant.

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