Wednesday, October 6, 2010

Ella's story. Part 2. So it begins...

Disclaimer: This is LONG. It has to be long because a. I love to talk and b. I really didn't want to leave anything out. I keep trying to edit for length and failing. Oh well, grab some tea and a snack and settle in.

Spoiler alert: I have a baby at the end.

Dear Ella (part 2)...

In the days leading up to your birth I contracted almost constantly. They were almost never more than 15 minutes apart. A week before your due date I woke up at 2 am to a very strong contraction. I was almost certain it was the start of labor. I didn’t know if I would know what labor was, having been induced 3 times, but this hurt. It took my breath away and made me feel like something was happening. Something different. The contractions kept coming. Irregularly but there. 8 minutes. 6 minutes. 4 minutes. 10 minutes. I didn’t wake your dad or call the midwife. I just sat up all night waiting for them to get closer or more painful or regular. They never did. The next day we met with the midwife, Jacque, who gave us some suggestions for dealing with the contractions. Bath. Wine. Chamomile tea. Massage. We tried those things but the next night was more of the same. And the next and the next. Over the course of the next week and a half I would have episodes of contractions every night. I was getting tired and weepy and I was arguing with your dad about anything and nothing (he's a saint by the way). I wasn’t at all proud of how I was handling this part of the pregnancy (being a whiny baby, that is) but he kept telling me he wouldn’t expect me to handle it any other way. I was exhausted and in constant discomfort and honestly felt like I might be losing my mind. Because i had never gone into labor on my own I began to wonder if I even could. Irrational but still. I felt like I might be pregnant forever. I can laugh about it now but I was really frustrated. I was doing lots of research on prodromal labor and trying to figure out what was going on. Your dad kept reassuring me that once you were here it would all make sense. I would swing between feelings of quiet contentment, enjoying my last days with you, and total discomfort and frustration just wanting to meet you. I was so confused as to why I couldn’t just START. I mean I have three other body should KNOW what to do by now. Jacque continued to reassure me that my body DID know and that I wouldn’t be pregnant forever. She continued to make her suggestions as to how to keep myself busy which often fell on deaf ears (except the baths, who wouldn't like a bath?).

The day before I went into labor your dad and I debated what to do. We had been trying hard to keep my mind busy. We had got a dog that week (Lucy) , gone out to lunch twice and shopping at Whole Foods and TJ’s. I was so discouraged and tired. That morning, Saturday, I fell asleep on the couch and slept for almost 2 hours while your dad did some studying/work. It was September 11th, the 9th anniversary of the 9/11 attacks. We weren’t sure if that was a good or bad day for you to be born. Anyway, before I laid down I told him I wanted Chinese food. When I woke up it was after noon. We got up and I wanted to see your brothers and sister (they were with their dad for the weekend). We went to see them and visited for a little while. Then we headed to Chinese food. The US Open was on and your dad was checking the score the entire time on his phone. It looked like Roger Federer was going to lose to Djokovic. While we were eating your dad said, "if Federer loses you’re having the baby tomorrow." Whatever, I thought. He already won the Open 5 times. I figured he was going to win again for sure and I laughed him off (He lost. Duh.). When the US Open started I told your dad I’d make sure you were born before the finals... We had Mongolian Beef and Chicken Chow Mein and I had contractions. I was timing them like I always did but again they were 6 minutes apart. No closer. I was pausing with them and he was watching me watch the clock. Ugh. More contractions.

This continued through the afternoon and evening. Contraction after contraction I counted and timed then tried not to count or time because it was only making me frustrated thinking I was now going to have contractions all day AND all night. We snacked for dinner. I wasn’t hungry. We decided to watch TV and put Arthur on. We had a little wine (it's ok the midwife told me to). I told your dad that maybe something was happening because even the wine didn't help me relax. I laughed at the movie a few times (though i didn't find anything very funny). About 11:30 we decided to go to bed. The movie wasn’t over but I think your dad could tell I needed a change of scenery. We got upstairs and he offered me a backrub but I declined (who declines a backrub? I mean REALLY?). I was tired and ready to try to sleep. Or cry. One of those. Your dad fell asleep quickly but I laid awake timing and trying to sleep in between contractions.

I was in that place between awake and asleep when I felt a strange sensation and I knew my water was going to break. I was aware, even in my sleep, that it was happening. I sat up almost at the same time I felt a huge gush of water and told your dad to grab a towel. I don’t think he was quite awake but he jumped up and asked me what kind of towel. Hand towel? BIG TOWEL. I got up to head to the bathroom and lost a bunch more fluid into the toilet. I noted it was very lightly tinged with meconium. I came back to bed at 12:48 and had your dad give me a glove so I could examine myself and make sure your umbilical cord was still where it was supposed to be. It was and I grabbed my phone to call our midwife Jacque. I reported to her the happenings of the day and the water breaking and then I had your dad hold the phone while I examined myself again to let her know I was 3-4 cm dilated (yay for being a L&D RN, boo trying to reach my cervix around my huge belly was harder than it sounds). Jacque suggested I shower and then call her back in an hour. You weren’t moving much and I really wanted to feel some good kicks so I had your dad talk to you and you responded with some wiggles. I called your brothers and sister and let their dad know he could expect a call from us soon. During that time I sent your dad off to fill the tub. Not knowing how long I’d be in labor, I wanted to be ready, and I got in the shower. I was pretty hopeful that labor would be quick. The fluid kept coming and my heart was pumping away after being woken so abruptly. I had a few contractions but nothing too painful. I know now that I must have been feeling pretty darn good relatively because I took the time to partially blow dry my hair after the shower. Your dad called Staci and Jacque again. They both were on their way. I remember thinking we’d probably meet you sometime around breakfast. This was the first moment I’d had to really process that you were coming. It was 2 am.

I came downstairs and set about baking your “birth”day cake. By the time it was in the oven Staci and Peyton had arrived. The pool was full. The cake was baking. The team was arriving. Staci took a last belly shot and I paused with contractions to breathe. By 3 am I was leaning on your dad a bit. I didn’t really need to as they were quite bearable but I enjoyed being close to him and didn’t feel like I needed to be independent. He was around busying himself with picking up and such and eating leftover (cold. yuck) chinese food. Jacque arrived and I remarked at how quickly she came. I suspect that she thought the labor would be quick too given this was my 4th time . I was in a strange place of being the laboring mother and a nurse at the same time. I wasn’t sure what to expect not knowing how different an unaugmented labor would be. I was watching the clock and noting that the contractions were still about 3-4 and sometimes even 5 minutes apart. I wished they’d get closer so I’d know I was more active and then I was also a little worried that I’d called the birth team too early and we’d all just be sitting around all day.

Now, as I recall your birth, there are large gaps of time I can’t fill with anything specific. Lots of walking and singing and swaying and laughing (and I'm not gonna lie, there was some pain). Jenny came at about 4. That was good timing because counter pressure on my back was welcome and almost required at that point. I know Jacque checked me at 5:40 and I was a “good 5 cm”. I did the math.... 5 hours of labor and only 1-2 cm dilation. Ugh again. I tried not to be discouraged thinking that at some point things would probably move very quickly as they had in my other deliveries. We putzed around some more. We walked outside. It was almost cold. I had contractions outside and leaned on your dad. We did that for a few laps and then I was cold enough to want to come back in. We enjoyed that time being alone and smooched and enjoyed one another. Jacque suggested we shower and we did. We took our time. He rubbed my back and we continued with our swaying and breathing. He washed me and let me stand in front on the nozzle so the water could hit my back and then my belly. That felt fantastic. It was an intimate time (I realize this might be TMI but your dad is a great kisser).

Around 7 am I called your brother’s and sister’s dad and told him to bring the kids whenever they woke up. I felt restless and wanted them there. Jacque remarked that with the sun up and a house full of activity I should expect things would slow down but they stayed steady at the same pace. Given my social nature that doesn’t surprise me. Even though I thought you’d be born in the early morning I’m not surprised you weren’t (well, cause you were HUGE). Staci made pancakes and bacon and the kids arrived at 8:45. I was still social and talking in between contractions. I ate a pancake which tasted great. Those pancakes will always remind me of your birth day. We joked. Your dad told me it was the most fun he'd had in a long long time and I agreed. It was the most fun I've ever had. We sang with the birth playlist. I used the ball and found that helpful but I really felt compelled to stand hoping things would move along. Your dad was a wonderful support. I was doing some moaning with the contractions and he matched my tone. He told me I was doing great. Over and over. I said I felt like I looked whimpy. The room commented that I made it look easy. I didn’t say so but I felt like I was handling it better that I thought I would (which I was). Jenny told me she was amazed... She had seen me birth your brother with pitocin. It was nothing like this. Note: An epidural never even crossed my mind. Never. Ever.

At 9:30 we got in the pool. Jacque suggested it and she only had to say it once (it took long enough). I hopped in. Your dad got right in as well and we got into our little groove. I was worried he would be hungry and I needed him to be nourished. Someone handed him a pancake wrapped around a piece of bacon. We dubbed it a “paco” and laughed about it. I tried to eat jello, drink gatorade and water, I had a popsicle. Nothing really tasted good but I didn’t want to be dehydrated. I loved the pool. It really was surprisingly amazing. I told everyone that labor wasn’t that hard and that I could do it 10 more times. I really didn’t understand what all the fuss was about. Again people laughing. I meant it though. I really felt like it was manageable and wondered if it was going to get far worse. I told everyone I didn’t want to go to the hospital. They said I didn’t have to. Things were fine. I had to explain that what I meant was that I was surprised I had no urge or desire to have pain medication or a physician around me nor was I firghtened. I was perfectly delighted to be in our kitchen surrounded by people I loved. Your sister rubbed my head. Your brother Owen was even there and quietly watching and asking questions. They were so sweet and wanted to see you into the world. Even Sean, who was afraid of the blood, came to the house. He stayed in the living room and upstairs (except when he came down for food ;). Staci took photos and helped out immensely. Peyton videotaped. Jenny was tireless pressing on my lower back. Jacque let us do our thing and stayed quiet in the background in the way a midwife does. She took a nap too and left us to do the work. I appreciated her quiet presence. She was just there in the most peaceful and supportive way. I could write an entire story just about her and how she is part of our family now. What a blessing she is in our lives (That’s for another time though...).

I got out of the pool to pee on Jacque’s suggestion (and only because she made me). I didn’t want to and I even told her I had peed in the pool thinking she might not make me get out. I wasn’t argumentative about it I just liked the water. So I obediently got out and went to the bathroom. It might have been about 12:30. She examined me there I wasn’t sure I wanted to know how dilated I was just in case I was still 5 but said I was almost done. 7 or 8 I think. Transition. After I got back in things started to get more intense (read: OUCH). There was a forebag of fluid. It broke at about 1:30 and I called Jacque in. She examined me and said there was no cervix left and that I should just wait for the urge to push. Wait. For. The. Urge. That seemed like a strange thing... to be complete and have no urge. She suggested we get out and go up and down the stairs which we did. By this time the contractions required my VERY full attention and I was making low sounds in my throat (suddenly a baritone?). I don’t know where I got the idea to do that but it seemed to really work. I paced around. It felt really primal and good to be in my own house. I went wherever I desired and your dad followed and kept me focused. Jacque left us alone for a while and we paced and breathed and talked. He hugged me and whispered in my ear. I told him it was taking too long. I didn’t understand what was going on but in my brain between mommy in labor and OB nurse I knew something was different. Of course I know now what the difference was but at the time I couldn’t make heads or tails of what was going on.
I wondered if you were acynclitic or posterior or what you were doing in there. Jacque had me lay in the hall and she checked me there. I could feel that you had moved up and shifted. Jacque didn’t tell me that she felt the same thing. In hindsight that was probably the best choice. If I had known I would have been afraid you weren't coming out at all.

This is when I started to get into the labor zone. Laborland. Whatever it was, it was a place that needed my full attention. Your dad and I worked like a well tuned machine (in case I haven't mentioned, he's awesome. You'll know soon enough). As the contraction would approach he would start to breathe and mimic my sounds. We would do that for the duration of the contraction. A few times I felt like I was losing focus at the peak but I was able to quickly regain it. He applauded my efforts each time and told me that i was doing great. When we talked about labor later he told me that he knew it was painful because I said it was but that it was hard for him to conceptualize that because I never “looked” like I was in that much pain. I was in that much pain but in hindsight, and even in that moment, I knew I could do it. I’ll never forget how your dad and I worked together to get you here. He was so sweet and loving to me. He never even noticed the presence of the other people in the room (did I mention he's awesome?). His focus and energy was completely on me and on you getting here. It was just like I hoped it would be and created a lasting bond between us, and with you. He whispered to me in my ear and sang Bob Marley. The song we call ours came on and we both sang and cried (OK I'm crying now). Jacque kissed your dad on the head and said “you’re just the man I thought you were.” I thought so too. For all the talking and anticipation leading up to your birth he surpassed any expectation I had of him. I can honestly say I couldn’t have done it without him (and I wouldn't have wanted to even try).

Jacque examined me again on the couch sometime around 2:30 and had me push once (just to see if you'd budge I imagine). I still had no urge and I wondered if I just wasn’t going to have an urge ever or how far up you must have been. -3? -4? Were you even in my pelvis? Were you even in this zip code? We went back to the pool. Once we were there I pushed without the urge (STILL) maybe once and then finally felt like you were moving. It was 2:43 pm. I felt the actual desire and then a sudden and intense need to birth you. I could feel your head pressed so firmly against my rectum I kept remarking on that pressure. The kids thought that was funny. Me talking about my butt. I pushed and felt you quickly move down. The feeling was so intense I could feel every nerve. Then the burning of your head coming down and out. As your head emerged I felt it draw back slightly. This is what midwives and doctors call the “turtle” and it’s a classic sign of a shoulder dystocia. Knowing this fact might have been helpful or hurtful, I’m not sure which. I didn’t say anything about the “turtle” but I did say “she feels big” in between breaths. Your dad was sitting right in front of me encouraging me and telling me I was doing great. He was touching you and me. He had his hands ready to catch you... the first hands you felt. I touched your sweet head and in the days after your birth I touched it again and again reliving that feeling of joy. The softness of your hair and the wrinkled skin. It was a most amazing feeling. I’ll never forget.

After your head was out I took a pause for breath to wait for another contraction to help get you born the rest of the way. I wasn’t worried. I just waited. And waited. One minute. I knew that you were ok because the water kept your drive to take your first breath at bay. When there still was no contraction I told Jacque I’d push anyway and I did. But nothing. You wouldn’t budge. I knew then getting you out wasn't going to be easy. I said to Jacque “hands and knees?” She said “not yet.” Later she’d tell me she was worried you’d be out of the water if I turned. I pushed again and again and nothing. Your dad moved over so Jacque could get in and grab you. Still you wouldn’t budge. I pushed as hard as I could. I wasn’t scared or timid. I gave it everything but you still wouldn’t move. Your dad kept telling me I could do it. It was a strange sensation to push so hard and have nothing happen. By the third minute Jacque and I were both getting nervous and the rest of the room was too. She said “hands and knees” and I flipped over in a flash. When I watched the video later I was amazed at how quickly I moved. Because I’ve been a nurse in cases like these I know how mom’s can react with passivity and defeat and I didn’t. I was determined and I’m proud to acknowledge that. I was getting you born. Period. Once I was over I grabbed the side of the pool and pushed. And pushed. The thought that you weren’t coming out at all briefly crossed my mind. But it was fleeting. I dismissed it as not an option and I pushed again and again. Because the other people there didn’t really know what was going on they were all getting pretty nervous byt his point. Jenny was in front of me talking to me but I couldn’t hear her. At one point she said something like “you have to push Joni” and I said (ok it was more like yelled) “I’m trying.” When I hear myself say that now on the video I can remember the sensation of pushing against nothing and being so determined but frustrated. Just force with no movement. Jacque told me to give you to her. She told me to hold my breath and push again and I did. She said she had it. I knew that meant she had your shoulder and was getting it free. You finally slipped from me and into the water. 5 minutes 10 seconds from when your head came out. 2:49 pm. 14 hours almost to the minutes from when my water broke. Who knows how long I was really in labor. 14 hours? Two weeks? A long time that passed in a flash.

I spun around and took you from Jacque’s hands to mine. You had a nice long cord, 4 feet maybe, which gave me plenty of space to get to you. I knew you were going to need to be called in and I said “she’s going to need help.” I set about massaging your back and lungs. Your heart beat strong and steady at your cord. I bent to give you my breath as Jacque did the same. She gave you two breaths and then two more. Your dad rubbed you. I rubbed you. I reassured your brother and sister that you were ok. Mothering. I knew you would be because I knew what to do for you. You dad and I called you to us and you came. Slowly but surely. White. Then blue. Then pink. Squeaks. Then cries. Limp. Then wiggling. Then kicking. I kissed you and loved you.

Then I told you you scared the shit out of me.

What came after that was just normal. Everyone breathed a sigh of relief. I held you and we loved you and your dad and I admired you and looked at one another. Nothing had to be said. Then I handed you off to your big sister while I birthed your placenta which was large and beautiful and the way you came to be so big and healthy. It took a little time and I worried about bleeding (because I’ve seen way too many PP hemorrhages) but I just said to my body “Body, you’re not going to bleed.” And I didn’t. I got out of the tub and dried off and on the sofa. You came right to me and started nursing right away. You knew where to go and what to do. Jacque looked you over and pronounced you 10 pounds and 6 ounces and 21 1/2 inches long. Staci made me a peanut butter sandwich and a banana which I shared with with your dad. We ate the cake I baked for you 12 hours before and we toasted your birth with champagne. To a “healthy baby.” I took a shower with your dad’s help. I felt great. Just fantastic. No repairs necessary and my bleeding was scant. I really can’t quantify how good I felt. I felt like I had conquered my greatest fears and had my greatest desire fulfilled at the same time. I had you, all 10 pounds and 6 ounces of you, in our kitchen. Your dad was right there to support me and help you get here. Your siblings welcomed you with love. Your midwife caught you. Your friends celebrated you and all of us.

Eventually everyone left. Your dad emptied the pool and you and I laid on the sofa. Kelsey, Sean and Owen ate pizza and cake and at some point we all fell into bed, you in between your dad and I. We slept blissfully snuggled in the bed you were made in.

Now you’re 3 weeks old. It’s taken me that long to get this story written. First it was because I was too busy. Then I was overwhelmed by it. Then I was too busy again. I knew that writing it would make me feel it all over again and partly I wanted to, but then partly I didn’t want to close the book on this wonderful chapter of my life. Since you were born we’ve talked and talked about how you got here. We talked with each of the people who were here. We talked with Jacque. We even talked with some people who weren’t here. I went though a period of endorphin haze where I was so glad you were here I didn’t care about anything else. Then I went through a period of feeling like I could have done something different or better to get you out quicker. Your dad and I talked and processed until we couldn’t talk or process any more. Then we talked and processed some more (more me talking, him listening). He gave me the gift of saying he had faith in me.

Having a baby at home isn’t like having a baby in the hospital. Things can go not quite right and even downright wrong no matter where you birth. Home is no exception. Sometimes babies die. Sometimes mommies die. That’s a sad but painful truth wherever you give birth. It’s inherently risky sometimes. The first step in overcoming fear of those things is just accepting that part of living this beautiful life means taking risks. In the end I’m so incredibly glad we had you at home. I can’t imagine it any other way. Every birth helps makes a woman who she is, a mommy a wife, a sister, a daughter. Your birth changed me in the best way possible. It made me a better woman and a better mommy.

Some day maybe I’ll really tell you all the ways it might have been different if you’d been born in a hospital. How you would have been born into the hands of a stranger. How you would have been greeted in this life by bright lights and an unfamiliar room. How they would have taken you from me and then taken you to be resuscitated by a team of professionals who resuscitate babies all day long. How you then probably would have gone to a NICU to be observed because of how big you were and how “hard” it was for you to be born. How they would have pricked your heel to check your blood sugar because they would have assumed I might have been diabetic since I opted not to have the glucose test done. How they would have suggested, probably strongly, that I give you a bottle because of the chance of you dropping your blood sugar. Or, how you never would have been born that way at all because I fell waaay off the labor curve and any doctor would have suggested a c-section (and no one would have dared question that decision. Good grief you weighed 10 pounds 6 ounces for heavens sake). How. How. How. How things would have been so very very different.

In the end, none of those things happened. You were born: At home, on purpose, in the kitchen. My water broke. I baked a cake. Your dad and I danced and sang and loved one another. And out you came. We got you going and you came to us beautifully. I nursed you and you stayed with me. Always. Where you should have been. Oh sure it wasn’t quite that simple, but then in a way it was. It wasn’t easy, but it wasn’t that hard either. It was just beautiful and how it was intended to be. I know that many people would say we shouldn’t have had you at home. Those people would also say that the fact that you got a little stuck (ok a lot stuck) on the way out is that much more of a compelling reason to have a baby in the hospital. But I’d disagree. I'd say the knowledge of a skilled midwife made a differnce. I'd say an unmedicated, emotionally present, strong mother made a difference. I'd say having your dad and your family there made a difference. I’d say that the fact that you were born at home and how well you did after your rough start is only proof that home is where you belonged. I can’t quantify that and no one would dare study it but I know. I know the difference. I know that how well you did after you were born and how you grow up began right here. At home. I know that the hormones of labor and birth helped me to be present in that moment, in every moment from the time you were conceived until you were in our arms. To feel every nerve, sensation and emotion with clarity and to know what to do for you without being told. I trusted my body and myself. I trusted birth. And you were born.

And that’s the beginning...


Buscando la Luz said...

Amazing. The part when the tears started coming was where you said:

"It was just like I hoped it would be and created a lasting bond between us. and with you. He whispered to me in my ear and sang Bob Marley and Jason Mraz with me. The song we call ours came on and we both sang and cried. Jacque kissed your dad on the head and said “you’re just the man I thought you were.” I thought so too. For all the talking and anticipation leading up to your birth he surpassed any expectation I had of him. I can honestly say I couldn’t have done it without him."

I'm so incredibly happy for you.

RamosFamilyBlog said...

What an amazing birth story. I just wanted you to know how amazing I think you are! I am an RN too, and used to be an OB/maternity RN, and we had our baby at home as well. (I am no longer an OB nurse bc. I just don't think I could handle it!)
It's so great to hear of other OB nurses who choose to have their babies at home!
Our little man was born in the water, in our livingroom, after 27 hours of labor. He too came out purple, after 3 hours of pushing, but came back to us within minutes. He is now a thriving 17 month old! I wouldn't have done it any other way!

Thanks for sharing your incredible story!

nursemom34 said...

I am in awe Joni. What an incredible tale. And to think we sat and talked about our patients and the need for more natural interventions. And you did it! You are one brave soul, and what an incredible experience to cherish always! Amazing! Rebekah

Anonymous said...

Loved the story, I wish I was there to see it, I love watching the videos online. Even the TV show that used to come on. I want to go natural I knew at one point that I could do it, and was so impressed with myself but when the epidural came and I opted for sleep, but I didn't get any. I'm to chicken to do it outside of the hospital, I really love your bravery in doing so

Marci Barone said...

I am truly at a loss for words Joni. One word came to me right away and that is "Amazing"!! You and Matt are so AMAZING!! I know Ella has been on this good Earth for a short time now, but again, Congratulations!!

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