Monday, July 20, 2009

Max's Homebirth Story



Max is eight months old and change, so I figure it took almost as long to write this as it did to gestate him!

I am a pregnancy and birth fanatic. I have attended many homebirths as a doula, and firmly believe that homebirth is as safe or safer as hospital birth for healthy low-risk women. I started working as a doula a year or so before Max was conceived and was lucky to be able to work with a homebirth midwife, Jules Johnstun, who attended my birth and is one of my very closest friends.
This story is very long. I can't be held responsible for any house-destroying that your children may embark upon while you're reading this. And be aware that I'm including pictures. Because Max was born at home, there are quite a few pics that involve some degree of nudity. I'm trying to be tasteful and PG rated, but consider yourself warned.
Max’s birth story begins with big sister Ashlynn’s birth. After about an hour of active labor, Ashlynn was born on the side of the freeway, in the front seat of the minivan, caught by her daddy with the assistance of the 911 dispatcher. There are so many ways that Ashlynn’s birth affected me, and I didn’t realize how profoundly until I was pregnant again. Prenatal visits were filled with talk about what to do if the baby came too fast, or how to slow down labor to make it manageable. I became extra worried when my family moved in the middle of the pregnancy- my midwife, Jules, was now around an hour from me. I visualized a longer labor; four, maybe six hours would be perfect. It would allow my team time to get to me, it would allow for more time to integrate my experience and stay on top of the contractions. After a lot of soul searching, I realized that I was scared of birthing alone, scared of the out of control feeling that was so prevalent during Ashlynn’s birth. I spent a lot of time meditating on a peaceful, calm birth, and worked to believe that just because a previous birth had been chaotic didn’t mean that this one was going to be.

When I started having regular contractions on the night of November 6th, I thought nothing of it. Regular, timeable contractions were an almost nightly event, but when I would change positions or activities, they would peter out. But that night, I noticed a few contractions that were continuing despite my activities. I didn’t want to say anything to Tom for fear of jinxing it, so we sat down to watch tv, fully expecting everything to stop. Instead, contractions started lengthening, getting stronger and closer together until they were about 3 minutes apart. When I realized that these contractions weren’t going away, I decided to call Jules to give her a heads up. She told me later that I called just a few seconds after she put the finishing touches on the booties she was knitting for Max. I wasn’t ready for her to come, but wanted her to be prepared. I was grateful that things were starting out slowly and gently.

I was restless, pacing, walking up and down the stairs, and rolling my hips with contractions. Tom was anxious to do something, so he started getting the birth tub set up, checking the hoses, and asking if it was time to fill it up yet. I was amazed to see the birth tub in my own bedroom; the crinkle of the tarp and the vinyl smell of the tub were so familiar to me from births I had attended as a doula. Having it in my room made it real- I was actually going to have a baby!

The birth team showed up around midnight. I was having consistent contractions by this point, but when Jules checked me, I hadn’t progressed much further than I had been at my previous prenatal visit, and Max’s head was still stuck on my pubic bone. We decided to try lifting my belly during contractions to help Max’s tuck his head and put more pressure on my cervix. After a few minutes with the belly lift, the contractions noticeably intensified, and I had to work a lot harder to stay on top of the sensations. An hour went by, and I needed more and more support physically and emotionally. I couldn’t keep tears from flowing- they weren’t from pain or frustration, they just came from the intensity of the emotions I was feeling. What I needed most at this point was lots of counterpressure and lots of Kleenex!

We didn’t know how dilated I was, but the frequency and the intensity of the contractions changed so much so quickly that we knew I was making progress. One of the things I really wanted during labor was to keep things light-hearted so that I didn’t start taking things too seriously, and I was really enjoying having my good friends with me laughing and joking. There were moments of true silliness that I really needed, because things were getting really intense very quickly. I moved to the tub before too long, needing the comfort of the water during the intense surges.

I was feeling a lot of pressure with the contractions, and started grunting, coughing and pushing with each one. Because I had torn so badly with Ashlynn’s birth, one of my primary goals was to have a gentle and calm second stage, and allow my body to do most of the work to avoid the chance of another large tear. Jules and Heidi, my doula, kept reminding me to be gentle, and I had to fight against my body which was screaming at me to “push!” During one contraction, I felt a “pop” and we saw some vernix in the tub. It seemed like my water had broken. Just after that, the contractions stopped for a minute, and I took the chance to float in the water, release the tension, and let everything go. The room was dark except for candlelight and a flashlight floating in the birthing, and I grinned seeing little white flecks of vernix in the tub. It was such a peaceful moment- it was the hope for moments like this that fueled my desire for a homebirth. In the back of my mind, I thought I had done it- that this marked the end of transition, and I was in the “rest and be thankful” stage that often happens right before the baby is born.

Contractions started again in earnest a few moments later, and I checked myself, expecting to feel the baby’s head close. Nothing. I was surprised- it felt like I had been pushing for a while, and I expected that I was close. A few more pushy contractions went by, and still nothing changed. I asked Jules to check me again to see what was going on. As she did, she got a serious look on her face, and I could immediately tell that something wasn’t right. I asked her what was going on, and she said “Well, you still have some dilating left to do, but the baby’s nice and low- his head’s right here.” I figured I had a little bit of a lip, and it would just take a few more contractions. Having her hold my cervix was horribly painful, all I wanted was to tell her to stop, but I just kept thinking that if the lip would just go away, he could be born.

After a few minutes, Jules said she was done. I asked her if it was just a lip, and she said “Well, no, you still have some work to do.” I’d done enough births with her to know that that was code for “You’re not complete yet, and I’m not going to tell you a number so that you don’t get discouraged.” She suggested changing positions, and breathing through the contractions rather than pushing. It was so frustrating not to push- my body was doing the pushing and I was along for the ride. Fighting against it was incredibly difficult. She had me switch to saying “aaaah” during the contractions and I alternated between the bed, the birth ball, and other positions. Soon, the contractions started easing on both frequency and intensity, and Jules suggested that I might just need a little bit of a rest to get things going again. I was frustrated that things weren’t moving along as I expected, but it was four in the morning, I was exhausted, and figured a little sleep could do me good.

I slept fitfully for about an hour. I was still contracting, but it was only enough to make me uncomfortable. I had a surge of energy; I was ready to have the baby! I started pacing up and down the stairs, and Jules started dosing me with blue and black cohosh. After a half hour of stairs, herbs and no serious contractions, we had the “you’re not progressing, things have stopped, I think its time for you to go back to bed and for us to go home” talk. I hated giving that talk as a doula, but I hated hearing it even more. So frustrating to have done all that work for nothing! I had Jules check me one more time, and once again, she didn’t tell me a number. She did tell me that he was asynclitic, (his head wasn’t positioned the right way against the cervix,) his head was deflexed (making it nearly impossible for him to enter the birth canal,) and he was back to being very high. They tucked me back into bed, with hugs of encouragement, telling me that I would most likely be calling them back later that day or the following evening.

I was incredibly discouraged. It felt like I had been right on the edge of having my baby and had it all taken away. Tom stayed home that say from work, and we spent the day sleeping, moping, crying and walking around the house like zombies. I was contracting on and off, and although they were regular, they were only short and light. About five or so that night, things started picking up again. I retreated to my room, turned out the lights, and turned on some soft music. I put on the necklace of beads that I had been given at my blessingway, read a list of affirmations that H had given me, and tried to stay relaxed, peaceful and focused. The contractions strengthened, and were back to 2-3 minutes apart. I called Jules and said it was time for everyone to come back, but within 45 minutes, knew that I had made a mistake, because contractions were slowing down again. By the time everyone arrived I was sobbing. My body had betrayed me. I was worried that I wasn’t going to be able to have my baby at home. I was incredibly embarrassed that I had had two “false alarms” and brought the entire birth team out to my house, an hour away, twice in one day. I felt very broken.

Jules checked me one more time at my request, and nothing had changed since they left early that morning. She finally told me I was dilated to a 6. I couldn’t believe that I had labored for an entire day, felt like I was going to push out a baby, and was only at a miserable 6. We discussed options. We talked about “making things go” via stairs, breast pump, even castor oil. Ultimately, Tom and I talked and decided it was best to leave it alone. I was exhausted physically and emotionally, and I didn’t want to take the chance of trying to force labor and have it fail, necessitating medical interventions. So once again, they tucked me into bed, this time with a healthy dose of advil and a couple of sleeping pills, and the reassurance that it wouldn’t be long before I had a baby, a few hours or a few days at the most.

The next week was a long and miserable one. I tried going to church on Sunday, and left in tears when someone said “I thought you had your baby.” I explained to hom that I had labored for an entire night before things stopped, and he responded, “Why didn’t they just give you pitocin?” I cried every day. I made a list of the reasons why I wanted a homebirth. I read the scriptures, had multiple priesthood blessings, and talked to Max, telling him that it was time for him to be born. Jules called everyday to check on me, to help me laugh and to listen to me rant and rave. I tried to maintain belief in my body and in the process of pregnancy and birth.

I was at a friend’s house the next Tuesday afternoon when I felt a wet spot in my underwear. I didn’t think much of it, just figured it was one more of those lovely pregnancy things. I continued to leak fluid throughout the day. I was texting with Jules from time to time, and mentioned it to her offhand, and we both decided it was probably nothing. (Ruptured membranes put you on the clock- traditionally, you are required to transfer to a hospital 24 hours after your water breaks.) Wednesday I was supposed to attend an all-day training with Jules, so I dropped Ashlynn off at the baby sitter’s, and headed to her house. We were going to do a quick prenatal check, then head off to the training.

When I got there, she handed me a strip of paper to test if it was amniotic fluid leaking. As soon as I tested it, the immediately turned blue. When I asked Jules what color the strip wasn’t supposed to turn, and she said blue, I knew that things were finally going to start happening. Since I had been leaking fluid for a full day without contractions, I knew it was time to do something. As much as I didn’t want the castor oil cocktail, we both knew it was effective and that it was probably the best option. Jules checked me (yes, still at a six!), stripped my membranes, and sent me home with a purse full of castor oil, herbs, instructions to stop at the chiropractor for a quick adjustment and then head home to get things started. I wasn't thrilled with the idea of a castor oil induction, but was excited that it was finally going to happen.
My instructions were to take 2 oz of castor oil and take a long hot shower. Blending the castor oil into a smoothie made it palatable, and by the time I got out of the shower, my tummy was making some terrible noises! The next few hours were a blur of trips to the bathroom, and more doses of castor oil and herbs. It took 3 full doses of castor oil, trips up and down the stairs and lots of quality time with the breast pump before my contractions decided to settle into a pattern.
As the waves strengthened and started to take more focus, I was reluctant to let Tom set up the tub, (we had filled and drained it way too many times!) or to call in my team. Jules and Heidi called frequently, and I gave updates, but felt very gun shy about calling them up to my house again. The contractions varied, but were the strongest on the birth ball, so I camped out in my darkened room, bouncing on the ball. Any time I changed positions or did anything different, the contractions would slow down, so the birth ball is was. Soon, we called everyone again, knowing that one way or another, I was going to have a baby that night!

Being in the water in the birth tub was amazing. I still felt every contraction, but it was much easier to relax and let my body do the work. I loved the peace that came in between contractions. My room was quiet, dark and peaceful- I was aware that people were coming in and out, but I was able to stay relaxed and focused. Someone was behind me stroking my hair and rubbing my shoulders, and I felt very surrounded, supported, encourages and loved. The contractions were difficult, painful, and took all of my concentration to stay focused, but manageable, because this was how I had always pictured labor.


The contractions started to strengthen and get closer together, and I was finding it hard to stay on top of them. In my lucid moments, I was trying to gauge where I was in the labor process, and judging by the intensity of the contractions, I thought I must be nearing transition. I was grunting and moaning with the strongest contractions. Jules suggested that I move from sitting to kneeling in the tub, to try and use gravity to bring the baby down. A few more contractions went by, and it became obvious that instead of the contractions intensifying, they were once again spacing out and weakening. I knew what was coming before Jules and Heidi suggested it: I needed to get out of the tub.

We tried the “doula hula” but I was hopelessly and humorously uncoordinated at the hip movements. Heidi took me through a relaxation script, and while it was nice to try to be completely relaxed, I kept thinking about how few contractions I was having, and how it felt like I was back at the beginning of labor. They questioned if there was something emotional holding me back, or if there was something I was afraid of. I wracked my brain for something, anything that could be holding me up emotionally. I knew I wanted a homebirth, I knew I was ready for my baby to come. I tearfully insisted there was nothing holding me back- I just wanted him to be born.

They again dosed me with black and blue cohosh, and we bundled up to head outside for a walk, hoping that the change of scenery and the activity would start labor up again. It was around two in the morning, and the night was cold and clear. We must have made quite a funny sight traipsing around the neighborhood in the middle of the night! We walked past the stream that runs by the park, and Jules was nearly scared to death by a flock of birds that we had startled out of the marshes. We commented on how beautiful the nearly full moon was. And we stopped every time I had a contraction to once again lift my belly to try to encourage Max to find a better position.

I had been on several middle of the night walks as a doula. I never fully appreciated how much better it is to be a doula than a laboring mom on one of those walks until then. Jules had a whole structured routine involving curb walking, (one foot up on the curb and the other foot on the street,) squats, lunges, and speed walking. I was mentally and physically exhausted, but knew that if contractions didn’t start picking up soon, we would be out of options. So I kept walking. Jules kept chanting and singing “Faster, faster, faster,” and I probably would have either laughed or yelled at her had I not been so tired.

We headed home after about an hour of the drill sergeant routine. Although I was having contractions, it felt much like the beginning stages of labor again- short, infrequent, and weak. But Jules promised me that if I was having contractions she would break my water when we got back. While I wanted my water to break on its own, my start and stop pattern was discouraging and exhausting, and we thought that if we could get his head applied to my cervix a little better, it might get the contractions going in a more consistent pattern.

We went back upstairs to my bedroom, and I looked longingly at my bed. My body craved sleep, and for a split second, I almost decided to lay down and finish laboring another day. Luckily, my more rational mind intervened, reminding me that it was time for the baby to be born. When Jules checked me, ready to break my water, she told me I was at a 7. This was the low point for me. By this time, I had been in labor twice, a week apart. Twice I had been pushing, only to find out that I wasn’t even close to being ready. I had hiked countless flights of stairs, drank a bottle of castor oil, and did lunges through the neighborhood at two in the morning. Still I wasn’t progressing. I was so discouraged, and the pain from the exam was sending me over the edge. I let out a few choice words directed at my midwife, and just then, she snagged my bag of water. I couldn’t believe the amount of fluid that came out. They kept replacing chux pad after chux pad as the fluid kept coming. Once we thought it was over, Jules sent me to the shower.

Things were instantly different. The pain from the contractions ripped through me like a freight train. My knees buckled with each contraction, and I had a difficult time remaining standing. My poor husband was trying to support me, and use the hand held sprayer on my back, but there was nothing that could distract me from these contractions. It only took a few contractions before I decided that being upright in the shower was not where I wanted to be.

I could only take a couple of steps back into the bedroom before I dropped to my hands and knees. Heidi was there instantly with counterpressure on my sacrum, and I kept asking her to push harder. I was moaning and yelling; the sounds were echoing and vibrating through my whole body. In my lucid moments I kept thinking about how loud I was being and how I needed to tone it down, but once the pain started, the sounds were involuntary. I looked up briefly to realize that Ashlynn had woken up and joined my mom on the bed. She was quiet, wide-eyed, and beaming with excitement.

At this point there was no break between the contractions. Just as one would come to an end, another would start, and I was powerless. Jules came in and rubbed my back, and said, “Stacy, these are the sounds we’ve been waiting for. You’re roaring! You’re going to have a baby!” It was such a good, tender reminder of what I was doing. In the middle of the earth-shaking force rushing through me, I remembered. A baby. My baby. That's why I was doing this.

Except I didn’t think I could do it anymore. I was finished. Not one more contraction. “I can’t do it anymore.” I said, breathlessly. “Yes, you can,” was their answer. “No, you don’t understand,” I insisted, “I can’t.” “You can do it. You are doing it,” was their response. They didn’t get it. I couldn’t go on. I couldn’t possibly have one more contraction and keep going. I was ripping apart. Why weren’t they listening? Why wasn’t someone doing something? And even as I was insisting that I couldn’t do one more, another came. And another. There was nothing I could do but ride it through.

I looked my husband in the eye, and he said “Think of the joy.” We had talked often about how joyful it would be to have our whole family together after the birth, and how much we were looking forward to meeting this new little person. I took both of his hands and squeezed as hard as I could, his voice anchoring me. In a brief moment of peace, I became aware that I could smell the distinct salty-sweet smell of birth. I looked up and said “It smells like birth!” Everyone laughed, and that was the moment I knew I was going to make it- I was actually going to birth this baby here, in my room.

I started hearing Heidi and Jules talking about moving me into the tub. I refused. Up to this point, every time I got in the tub the contractions stalled, and I was worried that if I made the move to the tub, I would once again stall out. As I saw Jules setting up chux pads around me, I had the distinct feeling of needing to go to the bathroom, and when I voiced it, everyone laughed. All doulas and midwives know that when a woman in the end of labor says she needs to poop, it means that there’s a baby's head coming quick. Heidi and Jules insisted that I just needed to have a baby, and I just kept insisting that I needed to go to the bathroom. Tom helped me up and onto the toilet. It only took one contraction there to convince me that, sure enough, I just needed to have a baby.

The contraction on the toilet was agony- the worst one yet. I couldn’t get off the toilet and back on my hands and knees fast enough. I rode through one more on my hands and knees in the tiny bathroom. (I found out later that at this point, Jules was convinced she was going to have to maneuver herself into the bathroom to catch the baby!) After that one was over, Tom looked at me and said, “That’s it. We’re going to the tub now.” He practically picked me up and carried me into the birthing tub.

The second I was in the tub, I felt his head drop into the birth canal, and I knew he was coming. Within a few seconds of voicing that, my body started pushing. One of my biggest goals that we had discussed when I was pregnant was having a calm, controlled pushing phase, so that I could avoid the extensive tearing that I had experienced due to Ashlynn’s lightening-quick entrance, but there are no words to describe the involuntary force that came over me. I was looking right at Heidi who was demonstrating how I needed to breathe. I was trying so hard to keep my breathing light and up in my chest, but as my body started pushing there was nothing I could do but go with it. I felt him move down more with each push. I briefly noticed both my girls next to the tub, bouncing with excitement, and trying to reach into the tub, as if they wanted to hold him before he was born. I started to feel burning, stinging, stretching- they encouraged me to reach down and touch his head, and I was surprised at how much of his head I could feel. The emotions and the sensations were powerful and overwhelming; I was terrified to feel so out of control. “I’m scared, J” was all I could manage to say. “I know,” she replied back. One last giant surge, a giant involuntary push, I felt a pop, and heard “Here’s the head.” One more push and his body came spiraling out at 4:06 am, November 13th.

I sensed Jules making some elaborate movements and realized she was untangling him from his cord, then I heard her say “I need the bag.” She placed Max on my chest, and I held him tightly as she used the bag and mask to encourage him to breathe. She kept giving him puffs of air, and I could feel his little body wiggle, trying to come around. I was never nervous that he wouldn’t breathe- I could feel his spirit all around me, and I could feel him making the effort. Finally he took a breath, and let out a small cry.




Those first few post-birth moments are indescribable. He was so tiny, covered in vernix. His eyes were open, studying everyone around him intently. Adrenaline surged through me, and I was so thrilled to be at home, in the birth tub, holding my new little boy. I studied every inch of his tiny body, smelled his hair, kissed his head. We all were shocked at how tiny he really was- 6lbs 4 oz and 18 inches long was far smaller than anyone guessed. Abby and Ashylnn were begging to hold him the minute he was out, and Ashlynn was rubbing his head the second she could get close enough to touch him.






We did the newborn exams, and everything checked out. His head shape was a little different, but we chalked that up to his unusual journey through the birth canal. (I'm so glad i didn't know right away what a journey we would be facing!)






Curling up in bed with my family after he was born was one of the most wonderful, peaceful moments of my life. Max was curled up peacefully on my chest, my girls and my husband snuggle around me. I was elated, and turned to my husband and exclaimed “I did it!” I have never felt such a sense of elation, accomplishment, satisfaction and contentment.



As I think about this experience in retrospect, eight months later, I really believe that the difficulty we had during the labor was caused by his fused skull. As babies navigate and descend, their skull bones move and mold to make the passage easier. Because one of his sutures was fused, it probably made it much harder for him to descend and maintain a good position. This combined with Max having his cord wrapped around his neck three times, and having such a large amount of amniotic fluid probably contributed to his start and stop labor pattern. Once my water was broken, I instantly entered transition because his head was finally in a good position.

I am so grateful that I was insistent on a home birth. If I had been in a hospital, they would have forced pitocin on me the first time my labor stalled out, a week before he was born. I don’t know how he would have reacted to the pitocin, and he was so tiny, I can’t imagine what he would have been had he come a week earlier. If I were in a hospital, they would have taken him from me when he wasn’t breathing instantly at birth, robbing us of those precious wonder-filled moments. He almost certainly would have been diagnosed with craniosynostosis at birth, which would have thrust us into the chaos of doctors and specialists before we were able to get to know and bond with our baby boy. I am so grateful, that despite all the difficulties during the labor and birth, that he was able to be born at home. And I am so grateful that I had Jules Johnstun, such an amazing midwife, and a supportive birth team that helped to make Max’s birth such a fulfilling and amazing experience.

8 comments:

  1. Beautiful birth story.

    I can't imagine getting to the pushing stage only to have it be early labor/false labor pains. I had some early labor contractions with my first daughter that lasted about 5 days. I thought I was going crazy. But it child's play compared to my next labor/birth experience (twins).

    Max is a beautiful baby, you have a beautiful family, and your birth story is amazing. Your boot camp night walk with the moon and squatting and curb steps will always stay in my mind. You are a home birthing warrior!

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  2. It's about time--I've been waiting for this story for months! Beautiful story, worth the wait!

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  3. This is such a beautiful birth story! Very inspiring!

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  4. wow, how amazing you are and you didn't have to be in a van to do it :)

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  5. Wow! Congrats! I'm glad you were able to have Max on your own time table and not any one else's.

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  6. Yae! I am glad little Max is here!

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  7. Aww memories... makes me tear up to think about. You really are a warrior Stacy. What an adventure you made it through!

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  8. So if I have another baby you and Tom can talk Jeremiah into letting me do it at home... ;)

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