Baby 3 is here. It’s a boy, and he is now eight weeks old!
Baby T was born on Father’s Day and is a dream come true in every way. To be a mother to three (three!) children is such a mind-blowing thing after a road to parenthood that involved loss and infertility. We are so grateful for our sons. They teach us and grow us every day. Baby T’s birth was also a dream come true in another way: he was born at home. This had been a dream of mine since I was a teenager when I babysat for a mom of three who was a lawyer, Bradley Birth instructor, homebirther, and later went on to be a midwife. When the kids were asleep, I would peruse her educational bookshelf. These readings left a deep impression on me. I learned that birth need not be a unbearably painful, drama-filled thing like in movies. I learned that birth is a process that harnesses the amazing design of the female body and our incredible hormones (the classic Childbirth Without Fear is a good read on this).
Fast-forward many years: for V’s birth, we finally settled on a hospital birth versus home birth in the 3rd trimester for financial reasons.* The hospital, even with a doula, ample preparation, and self-advocacy, was not a fit for me. For E’s birth, we knew we’d find a way to make the money work, as certified professional midwife (CPM) care was a vastly better fit for processing birth trauma as well as pregnancy with pelvic instability. But, with pending construction at our house, we opted to deliver at a freestanding birth center rather than home. It was an amazing home-away-from-home birth, with all the same (lack of) equipment as home, but we still had to load up, drive to get there, drive home, etc. So, for the third time around, we knew we wanted to be at home for the whole thing. Provided baby and I were healthy, it was time for the dream to come true! Now, here’s the story.
*Check out this irony: a hospital birth cost $11K-$30k+ but our part is $0 with insurance. In contrast, non-hospital pre-natal care and the birth is about $4k, but our insurance covers none of it.
The Birth of Baby T
Disclaimer: this is a birth story. It involves bodily functions. I have not shared anything here that I am not comfortable saying aloud to you face-to-face. But, if you aren’t interested in such details, stop reading now.
Late pregnancy is hard. Not only is it uncomfortable and exhausting but there is this big question of “When?” hanging over every day. For me, it was also stressful because baby June Bug would not stay head down and engaged in the pelvis. Baby would stay down for a few days, then come up and go fully or partially transverse. Then baby would go down again, sometimes occiput posterior (“sunny side up” and harder for labor—just like my other two kids), sometimes occiput anterior (optimal). Swimming encouraged baby to do these big movements, so I stopped swimming (a key form of pain relief from pelvic instability). The other trigger for these big position changes was unavoidable: lying down. For months, I had been in bed for 14-16 hours each day to cope with pain so that also was not something I could avoid. I just had to accept that each night June Bug would be engaged and by morning baby’s head would be out of my pelvis. It was stressful, kept me up at night, and made the weeks tick by slowly. As my 40th week came and went, I decided to tell myself that baby was never coming out and I would forever feel this way. Of course baby was going to come, but I decided that if I resigned myself to just accepting my discomfort and enduring pregnancy forever then it would be a nice surprise when labor actually started. Additionally, this helped me shelf the stress of wondering if baby could actually be born at home since a baby who stays transverse in labor needs a c-section delivery.
At 41 weeks pregnant, I was having dinner at my in-laws’ house and telling my brother-in-law my new approach when I recognized that I just could not get comfortable, even more so than normal. Standing led to intense downward pressure; sitting led to pressure and pain. The best thing for me was to have my knees on the ground with torso bent over the couch. I read to my kids and their cousins this way until dinner was ready. This was a clue that things were moving, even if I didn’t believe it yet.
During dinner, I noticed contractions, but I thought it could be another bout of prodromal contractions as they were not consistent or progressing. I had half a glass of red wine to see if this would relax my body out of the contractions. When they kept pressing on, and sitting at the table became more and more uncomfortable, I realized that this might really be it and we needed to get out of there as quickly as possible so I could get home and into relaxation. At that same time, a tornado warning started blaring from various cell phones around the table. We decided to leave anyway, knowing we’d need time to call the midwife, get the last things set up for the birth, and get the kids to bed. The drive home was stressful with intense rain and wind and my body railing with every pothole and road crack we encountered, but we made it, and it was the right call.
Once home, I requested a hot pad for my tense shoulders and the exercise ball for my tense everything else. Before kiddo tuck-in, I read bedtime books to the boys, pausing to relax as contractions flowed. The boys were sure to do the chant from the book we had been reading daily for weeks: Waiting for Baby. “Rum, tum, tum, baby come!”
With the kids in bed, Dave spent some time assembling the last of our birth supplies while I rested in bed and timed contractions (roughly 7-10 minutes apart) and tried to distract myself with Netflix. As the contractions moved to every 5 minutes, it required a lot of effort to relax through them. I texted some friends to let them know that we would probably meet baby soon. As it got later, Dave made sure I was set for snacks and drinks, came to bed, helped me with counter-pressure on my back, and fell asleep. His sleeping was fine, as I knew from previous labors that I liked to work through the contractions on my own for as long as possible. Plus, Dave was coming off an illness and I knew he needed to get in some sleep to amply support me through the birth. I attempted to sleep through contractions by dozing for a few minutes and then waking for one minute to consciously relax through a contraction. As they became more frequent, sleep was not possible, so I put on some nature visualization videos and Pandora’s Ambient Radio station.
Eventually, I woke Dave up so he could get our last few things ready: filling the tub and preparing warm compresses and blankets. At 2 AM, with strong contractions every 2-5 minutes, I decided that I would soon want support from our midwife, Kim Pekin (CPM). Dave called her and then called my dad and stepmom to come, as they would be in charge of the kids.
Because of baby’s many large, late position changes, the possibility of a cord issue was on our minds so Kim had arranged for my neighbor Brittany, a student midwife, to be with us for the hour until she arrived. Brittany arrived within minutes and checked my vitals to see that all was well. We talked about me going to the basement to get in the water, as the bed was no longer comfortable. I did not want to stall progress by getting in the water too soon, but she assured me that things seemed to be moving well along. (Note the theme of me being in denial about my progress. The same was true in my last labor, as well.)
Our big tub was ready to go, and it was helpful to get in, though we had some issues. The water was too hot and in the process of cooling it down and draining some water out, the plug jammed in the up position. Dave tried to stop the water from flowing out with a washcloth, but we had to keep working to keep the water deep enough and at the right temperature. We forgot the other elements of keeping the room relaxing like candles and essential oils, though we did have my visualization posters up and I had music until the computer battery died. That said, the water was very helpful. I labored in the tub on my back until well after 3 AM. At some point in there, Kim and Megan (RN birth assistant) arrived. In addition to relaxation and deep breathing, low vocalizations were helpful, namely the word open as I meditated on the idea of energy pushing down and flowing outward, similar to flower blooming imagery.
As it got harder, I had Kim do my first and only progress check of the entire pregnancy: seven centimeters—the exact same place I had wanted a progress check in my last labor. I knew that meant things would probably progress quickly. In other words, transition was coming.
Being on my back in the tub was no longer comfortable, so I tried side-lying in the water and later a hands-and-knees position. This was helpful for a while, but my arm and leg started cramping painfully. I knew if I got out of the tub now I probably would not get in again to have a water birth, something I was hopeful about doing. But, in the moment I needed to get out and get more comfortable. I think I was already starting transition, and if I was more aware of that I would have stayed in because nothing is comfortable in transition. But, I didn’t register that or have the ability to process that in the moment, so I heeded what my body was telling me in the moment, which was get out, get in bed, and lay on my side. The desire to lay on my side was strange one because of my pelvic instability, where side-lying is often painful. But, that is what my body was telling me to do so it was the right call for that moment.
Transition was very, very intense physically this time—more so than in my other deliveries. My whole body tremored, and I was incredibly hot and dripping with sweat. Unfortunately, we had not set aside the small fan as requested on the birth supply list, so Kim and Megan fanned and fanned me intently with a piece of paper while Dave applied counter-pressure to my back. At one point Dave asked if he should get the fan—and dared to slightly move his hand away—and I snapped at him to not move. I was very particular about absolutely nothing changing during the peak of a contraction.
The tremors were so extreme that I called out no during each contraction. I begged my team to help me, help me. Internally, I processed through why anyone would ever have a baby at home and not use medication when this was so hard. But, I also reasoned how going to the hospital now would mean I would have to stay there after the labor and the other kids would miss the birth and we would be apart for days. I also remembered how in my labor with E, I had been disturbed by my desire to leave my body during transition, and how this time I had prepared myself to be in a more positive mental place in transition (thank you, Spiritual Midwifery). So, I changed my vocalization to yes. Yes, I would get through this. Yes, I was strong. Yes, I would join with eons of women who have done this amazing thing that God designed our bodies for.
In time, the intensity stopped and transition was over. Time to push! Though my water had not broken nor had I experienced any mucus or bloody show, it really was time. (Kim later said that I did have a scant bit of clear water during pushing.) But, something was strange. My brain told me to push but my body was not putting in any effort. In fact, I wanted to keep my legs closed around my snuggle pillow. I tried to reason through this. It might have been out loud, but maybe not. Either way, Kim encouraged me to push. As my brain had surges of pushing desires, I decided to put effort into pushing but I still did not understand why my uterus was not taking over.
During pushing, I was mentally stuck on the lack of work from my body. I thought through what might be holding me back and decided that it was because the boys were not there and we had told them that, if possible, we would give them the option to come down for the birth. As I was processing this, Kim got more urgent about me pushing, cautioning me not to delay my efforts to wait for the kids. While I was telling my baby to help come out (talking to baby about this made sense at the time), she was telling me—now, in a more directive tone— that it was up to me to do the work. Her approach in this moment reminded me of the tense moment during E’s birth when I needed to get out of the water quickly so I knew that her guidance meant she had a concern since normally she is all about the mother leading the birth. The pressure of baby’s head was great, and I had no intention of holding off, but I did need the mental release of keeping my word to the kids. I yelled up to my parents to wake the boys while I kept on pushing.
When baby still did not emerge, she made the call to shift me from my side into the same position I delivered E which allowed for getting baby’s head out quickly: on my back with legs up and bent against my belly (the McRoberts position, I now know). The last moments of delivery are a bit of a haze, but I remember seeing that both kids had chosen to wake up and come down. V was rapt with attention with my stepmom; E was snuggly and burrowing in to my dad’s chest. I was doing my “lion roars,” asking for my team to give me verbal encouragement, and pushing, pushing. Yes, there was physical pain and the ring of fire, but my emotions were not conflicted like in transition, so it felt very doable. My focus was on urgent pushing and Kim’s focus was on getting baby out, so I did not get to catch baby, like I’d hoped, but the reason for that became clear when I heard what she was seeing that I could not.
Many babies have heart decelerations during labor, and my baby was no different. But, a rate of 60 beats per minute increased the sense of urgency to get baby delivered especially because though baby had crowned, I just was not getting him out while lying on my side. When Kim rolled me on to my back, this helped baby to get out. As June Bug emerged, she somersaulted baby to disentangle a double nuchal cord (twice around the neck) and a loop around the torso. Between these three wrappings, the cord was taught, which may have been why I did not feel the urge to push—baby’s head was not triggering the pelvic floor. This also might explain why baby had been disengaging and leaving my pelvis at night when I lay in bed, the little bungee corder!
Once out (at 4:50 AM), Kim laid baby on my stomach. June Bug was blue-grey, floppy, and quiet, precious, peaceful, and also a little creepy. Kim and Megan dried and stimulated baby and listened to the strong heartbeat indicating ample oxygenation via the umbilical cord. Since baby wasn’t making an effort at respiration yet, Megan asked Kim if she should give baby some help and pulled out a little ambu bag but ended up directly giving a puff or two on the mouth. After that, the mighty newborn baby scream started. I was taken aback by how strong and persistent it was.
As V&E came near, I think that V asked if it was a brother or a sister. Dave told the kids they had a brother and thus I learned that our baby was a boy. I had hoped to look for myself, like I had done with E. But, it was all a furor of excitement. I snuggled with baby and we let the kids come close and chatted with them a bit before sending them upstairs as I felt the placenta coming 30 minutes after the birth. Once the placenta was delivered, Dave cut baby’s umbilical cord and we were ready to try nursing. After an hour for bonding, it was time for the newborn exam so we had the kids come back downstairs. June Bug weighed in at 8 pounds even, 21.5 inches long, with a wee bit of light-colored hair and very dark grey eyes.
After a bit more family time, we sent the kids upstairs with the grandparents to finish preparing the birth day celebration (complete with our traditional decorations, birthday crown, and baked oatmeal) and then go with them for the day. In the quiet, Dave and I enjoyed snuggling with baby and tossing around name ideas while our birth team worked on notes and cleaning up.
By three hours after the birth, I was stitched (one very small tear), showered, nourished, and upstairs in my own bed ready for a day of snuggles and sleep. In the evening, when the other kids returned home, we had a family party in our bed, sang Happy Birthday, dear June Bug (we did not settle on his actual name for another day-and-a-half) and started our journey as a family of five.
Are you curious about nuchal cords, delayed clamping of the umbilical cord, how you somersault a baby, or delayed breathing at birth? This piece gets into all four topics: http://midwifethinking.com/2010/07/29/nuchal-cords/
About our Midwife
We are so grateful to Kim Pekin, Birth Outside the Box, for her loving, respectful care. Not only did she provide excellent home-based care to me during this pregnancy, she cared deeply for my children, involving them at prenatal visits as well as showing concern for their well-being during the birth. (We later discussed that her hesitancy at having them come downstairs for the delivery was in case resuscitation for baby was needed because of my tricky pushing.) Kim’s job is one of the hardest and sacrificial ones that I can imagine: unpredictable hours; driving all over the place; providing emotional, nutritional, and health care at each hour-plus visit; thinking fast on her feet; responding to each mom according to her unique personality and vision; swimming against the flow of a medicalized birth culture but at the same time building bridges to improve both midwifery and OB care; and on and on. Kim does each of these things with incredible grace, wisdom, and empathy. She has been such a blessing to our family for two births.