Baby D's Birth

D was due on December 29.  As due dates often do, this one came and went.  By Monday January 2nd, I was taking some herbal tincture, taking long walks, doing lots of yoga, and generally trying to get things get for labor.  I also made an acupuncture appointment for Monday afternoon.  My acupuncturist just had a baby herself, so I haven't seen her since September or October.

I got to her office at 4 p.m.  At 4:15 p.m., while chatting with her about her baby and my pregnancy status pre-needles, my water spontaneously broke -- in a dramatic gush!   Statistically improbable and just like in the movies.  Very glad this didn't happen on the Bart train on the way over there.  She was cool (and unconcerned about the upholstery I had likely ruined) and gave me a stack of towels to sit on while she started inserting the needles.  She gave me a short 20 minute session, including the Tens machine for a few needles on labor points on my feet. (Tens is a gadget that pulses low levels of electrical current through the needles to make them even more potent.)   As I sat there, gush after gush of fluid poured out, when the baby moved, when I coughed, etc.  Huge mess.  She sent me home with half-soaked flannel sheet around my waist.  G came to collect me in the car (with a beach towel on the front seat).  We drove home wondering when contractions might start and were a bit anxious that we would be facing the 24-hour clock to induce labor after the water breaking.

Around 6 p.m., after we got home, I started to feel a bit crampy and uncomfortable. G made me a piece of peanut butter toast and I decided that being on my hands and knees seemed like a good idea. So I got the yoga mat out and planted myself on the floor.  We called Michelle and my mother to give them updates. (My mom was planning on attending the birth, so she was on call.)  Around 7 p.m. or so, I started to have identifiable low grade contractions.  As suggested in our birth class, I tried "ommming" through them, which really helped.  G ommmed along with me and pressed on my sacrum or hips as counterpressure.  We developed this routine very quickly, after one or two contractions, and stuck with it through the entire labor.  Every contraction - omming and G squeezing the outsides of my hips.

Meanwhile, G was trying to finish up a cooking project (food to freeze for post-partum) and was in the kitchen cleaning up a huge mess and packing the freezer.  The contractions were 12-15 minutes apart, so he would work for about 10 minutes and the run upstairs when I called, squeeze my hips, and then run back downstairs.

Around 8:30 p.m., G decided I should go pee. (Michelle had advised us to make sure we were drinking and peeing frequently during labor.)  We went to the bathroom and I sat on the toilet, had a massive contraction and vomited the entire contents of my stomach all over the place!  So much for the toast and the electrolyte water G was feeding me.  Oy vey!   Poor G was then trying to wipe up vomit while being interrupted to push my hips for a few more contractions. When things were semi-cleaned up, I went back to my post (hands and knees on the yoga mat) and G called my mom and asked her to come over.  Michelle talked to G and asked him to get the birth tub ready.

Unfortunately, my nausea continued throughout the labor and I threw up several more times.  The next time, G gave me a small plastic waste basket we had in the office.  For the duration of the labor, the bucket and I were inseparable.  I kept it right near my face the entire time and used it more often that I would have liked.

G filled the tub with hot water from our nifty new on-demand water heater and turned on the tub's heater to maintain the temperature.  My mom arrived around 9:30 p.m. or so and Michelle arrived shortly thereafter.  She told us she would come when the contractions were about a minute long, 4 minutes apart for an hour.  I was really out of it at that point, so I'm not sure that was the case.  But she had listened to me through a couple of contractions on the phone and based on the speed at which things were progressing, I guess she decided she needed to be there.  I was so out of it that I didn't make eye contact with either my mom or Michelle when they arrived.  My mom's job was to manage the tub, so she checked the temperature and realized it was way too hot -- 120 degrees (not coincidentally the temperature at which our water heater is set).  So she started adding pots of cold water, bucket-brigade style, to bring the temperate down, with little success.  At some point, the assist midwife, Sue, arrived.  At a home birth in San Francisco there are always two midwifes, so that one is available to care for the mom and one for the baby after the delivery, if there are any issues.  They try to time it so the assist midwife is there for the last 4 hours of labor and delivery. I'm not sure when I became aware of Sue's presence, but G knew that her arrival meant that things were happening!  Sue and my mom managed to bail enough hot water out of the tub and then fill it with cold to bring the temperature down to 100.

During this process, Michelle suggested that I move to the bed, because I had been complaining about my knees hurting (our office floor is wood and the yoga mat was not doing much to cushion my knees after a few hours).  They hauled me into the bedroom and I resumed my hands and knees position on the bed.  While I was in there, the contractions got quite a bit more intense.  I was really hanging on to the "ommms" and just trying to survive each one.  Soon, the tub was ready and it was such an unbelievable relief to sink into that hot water.  I couldn't believe the immediate decrease in tension and intensity.  I remember that the thought crossed my mind that I might not be making any progress because it didn't hurt as much anymore.  But that was not the case.   I stayed on my knees, hanging over the side of the tub with my arms and clutching the bucket with one hand.  Poor G was hanging over the side of the tub to squeeze my hips through each contraction.

At some point while I was in the tub, after the last vomiting episode which apparently accompanied transition, I started feeling a little "grunty."  Michelle asked me if I felt like pushing, but I didn't really, not at that moment.  She told me that I could go ahead and push whenever I felt like it.  However, I had not yet had an internal exam (in fact, I had not had an internal exam at any point during the pregnancy).  Instead, Michelle used a neat little midwifery trick to verify that I was fully dialated.  During labor, I developed a red line between my butt cheeks that grew longer and longer in coordination with my cervical dialation (evidently everyone gets this).  In my case, since I was on hands and knees with my butt in plain view the entire time, this was a particularly handy way to see how things were going.  Based on the fact that the line had reached 10 centimeters and also based on the quality of the contractions as demonstrated by my grunting, Michelle gave me the green light to push.

After a very short time, I did feel a strong urge to push and started on the most difficult part of the labor.  The "ommming" went out the window I started yelling with this throaty sound, throughout each contraction.  Even though it only lastedan hour and fifteen minutes, the pushing phase seemed like an eternity.  I pushed and pushed and felt like I wasn't making any headway. I felt like the baby should be out each time, and each time she wasn't.  At one point I said something expressing my frustration and Michelle suggested that it might go faster if I got out of the tub.  She said I might be able to take advantage of gravity outside the tub.  Someone had set up the air mattress with a stack of pillows and towels so that I could be in a supported hands and knees position, with my butt facing the middle of the room.  I kept pushing there, getting more and more discouraged that it wasn't over yet.  Finally, Michelle laid out a plan for me.  I don't remember what it was, but something along the lines of:  you're going to push through a couple more contractions, it will start to burn, you should stop pushing and hold the baby in place when I tell you, and then it'll be out.  I'm not sure how many more contractions it took, but having a roadmap was extremely helpful.  And she was right -- it did start to burn, and she asked me to hold the baby in place a few times to stretch the skin and tissues.  (During each contraction, the baby descends through the birth canal and then retracts after the contraction.  It's sort of like two steps forward, one step back.)  I think I managed to hold the baby's head in place, but it was extremely difficult.  Then -- finally! -- her head was born.

Michelle checked her neck for the cord and, feeling it there, asked me to not push.  She was planning to pull the cord up over the baby's head.  But I did not follow this instruction and instead pushed her body out with the tail end of that contraction.  Michelle held her head in place so that her body came out in a somersault, unwrapping the cord in the process.

She started breathing right away and it seemed to me that I heard her cry immediately after I realized that she was out.  Michelle handed her to me through my legs and I rolled over onto my side to snuggle her against my chest.  I could not believe that it was finally over!  I just couldn't believe she was actually out.  I thought it would never happen.  G was right there with us and we just ooed and ahhed for a few minutes.

My mother finally piped up and asked if anyone was going to check the gender.  We had completely forgotten!  G looked between her legs and we realized that it was a girl.  Since we had been completely convinced that it was a boy during the entire pregnancy, it was amazing to us that she was a girl.  G checked a second time to be sure.  Then we told everyone her name -- D Morgan.  She was born at 1:54 am, about 8 hours after labor started.

After I delivered the placenta, we made our way to the bedroom to be a bit more comfortable.  D stayed on my chest and we spent a really sweet hour together.  The cord had stopped pulsing, Michelle clamped it off and tied it with a bit of string, and G cut it!  Then Michelle did the newborn exam and verified that D was healthy.  At some point, D had latched on and started nursing.  Michelle verified that she had a good latch and things seemed to be working.

I don't remember exactly what happened after that. My mom helped me shower and clean up (I was so happy to brush my teeth after all that vomit).  Someone made me a snack of peanut butter toast, at my request.  Then everyone slowly cleaned up and left over the course of the next couple of hours.  Michelle let us know that she would be back for a check up at 9 a.m. the next day (about 24 hours later).   There we were, tucked in to a clean bed with our precious new daughter!

Update post-birth: One of the great things about midwifery care is that there is a huge amount of postpartum follow up.  Michelle came to the house for visits 24 hours after the birth, on Wednesday, and again on Friday, and again on Monday.  She stayed with us for over an hour and a half at each appointment.  She weighed D and checked her temperature and breathing each time.  She checked my blood pressure and felt my uterus to make sure it was invaluding properly.  She taught us how to get into the Moby wrap.  And, most importantly, she provided amazing lactation support.  I developed extremely sore and damaged nipples in the first couple of days because D's latch wasn't quite right.  Michelle suggested that I use a nipple shield, which was absolutely invaluable, to let my nipples heal and to help D learn to latch on correctly.  Michelle also set us up in a couple of differently holds to try to get the best latch.  It was really incredible, I have no idea how I would have managed without that guidance.

When my milk was coming in, on Thursday evening, I texted with Michelle and she suggested I put cabbage leaves on the boobs to ease the engorgement.  It was totally crazy-looking, but it felt amazing and it worked!  Since the milk came in, breast feeding has been going quite well.  I'm still using the nipple shield, but I think the tissue is almost fully healed, so I'm going to ease off of it soon.  Luckily, we have three more appointments with Michelle over the next couple of weeks.

D is doing great, and at the weigh-in yesterday, she exceeded her birth weight by an ounce!  We were very happy.  She went to the pediatrician last Thursday and he gave her the all-clear as well.  Today, we met Michelle to register D's birth at San Francisco vital records and got her birth certificate.  She is now on the grid!