Robyn and Michael

My pregnancy was a lot more challenging than I anticipated.  I was working long hours as a resident, which felt pretty hard on my body.  At 29 weeks I went into preterm labor & ended up on bedrest for the next two months.  Happily, I did not delivery preterm, and I went back to work at 37 weeks, working long & physical hours on Labor & Delivery.  My last few weeks at work were really difficult.  I started having lots of "false labor" where I'd have regular (but short) contractions for half a day at a time before petering out.  During these episodes I slowly dilated, and by 39 weeks I was 5cm but still not in labor!  I couldn't believe it.  THat week, after caring for a sick patient, I myself came down with high fevers and chills and finally went off work to recuperate.

After a few truly miserable days of sickness, I woke up feeling better--no fever!--though completely depleted.  That afternoon contractions started up, but they felt no different than they ever had with any of the previous false labor runs.  I really didn't want them to get stronger--I couldn't imagine I'd have the strength for labor after that week--so I did my best to make them go away.  I think I took 3 baths that day, drank lots of fluids, tried to nap, tried distraction (I imagined a day at the beach in Mexico--it was nice for as long as I could keep my focus).  Nothing seemed to be helping and the aches came back and I started despairing.  

I called my midwife, who was of like mind with me--best to try to stop the contractions and get some sleep.  I think she suggested a half glass of wine, but I ended up taking a tyco & having a half shot of bourbon.  When that didn't work after a few hours, Michael brought me dinner in the bedroom (I was definitely not up for dinner with my inlaws) & more water to drink.  Still no luck, and I felt totally wiped out.  He drew a bath for me (I think that might have been my 3rd that day) and when it was full I got in.  As I laid down in the tub, the baby started kicking and moving around, and I put my hands on my belly and just enjoyed the feeling.  I had a contraction and thought about how much easier they were in the tub, and smiled & closed my eyes.  

A minute or so later, I heard an audible click in my one of my pelvic joints, and I was bowled over by a contraction that felt altogether different.  It wasn't so much that it hurt more as that the intensity grabbed all my attention. I flipped over onto hands and knees until it passed, and then felt I needed to go to the toilet.  I got out and sat down on the toilet and emptied out.  WHen I wiped, I saw bloody show. I started to shake all over and felt like I might throw up.  I called for Michael & told him to call Ami, my midwife who was on call.  He got off the phone with her and said she'd start heading over and be there in less than an hour.  I got back in the tub and had another intense contraction and suddenly felt a lot of pressure on my bottom.  "Call Ami back and tell her to get here now!"  I heard him on the phone, and yelled "tell her I think I'm in transition!"  Ami said she'd hurry, and called Nancy, the other midwife, who lived closer to me to get over.  I called my OB-GYN friend, Deirdre, to see if she could come over for moral support, but she was working a night shift.  I had to put the phone down during a contraction, and when I got back on she said "Sounds like the real deal!."  I saw that Ngoc, my doctor, had sent me a text message a few minutes before, and tried to call her, when another contraction hit & I realized making calls was crazy!

I feel like at this point I became three different people.  There was the person talking to Michael who thankfully had the sense to call urgently for the midwives; there was my OB-GYN self sitting & watching it all thinking "It can't really be going this fast.  It's probably just that these are the first real contractions you've felt & don't know how to handle them."  And then there was my body, which was just moving along regardless of what my mind was doing.

I hopped back & forth from toilet to tub a few times & decided that I needed to slow things down.  Michael helped me to bed & I curled up and asked him to tell me breathe slow.  We breathed through 2 contractions together & suddenly Nancy was there.  She got set up to check me and my doctor self got embarrassed. I said "I'm probably only 5 and half centimeters," and laughed a little at mysejlf.  But when she checked she said I was pretty much fully dilated and had a big bulging bag filling the vagina--hence all the pressure.  Ami showed up around this time & I was impressed by how fast the two of them worked setting everything up to have the baby.  I thought about how if I was in the hospital there might be a half dozen people in the room, and was grateful for the relative peace in my bedroom.

I got back to the tub and felt myself starting to bear down a bit with contractions.  I remember wondering if this would be the part that hurt, because so far, while the contractions were very intense, they weren't painful in the way I'd expected.  Nancy assured me it was fine to push, so the next contraction I relaxed and let my body push.  It was completely wild--I didn't realized i was pushing until I was a number of seconds into it & heard myself let out a deep grunt at the end of the push, like someone trying to lift something very heavy. To my amazement, my body kept pushing without any help from me, as far as I could tell.  After that contraction I wanted to sit up so Ami & Michael helped me to the birthing stool.  When I stood up I caught a glimpse of myself in the mirror, and for whatever reason it struck me how crazy this was.  "I can't do this, this is nuts!" I excliamed, and Michael & Ami both laughed a very friendly laugh.  It made me feel better to know that no one else seemed at all worried.

I pushed a few times on the birth stool, but wanted to be able to rest better in between, so I stood up and held onto Michael.  When contractions came I squatted down, but if felt awkward with Michael going up & down with me, and i couldn't quite explain what I wanted.  So I asked Michael to sit in a chair, got on all fours, and buried my head in his lap.  I put my hands up on the back of the chair and held on to push, thinking "My water will break now," and it did!  I felt my hips creak open as the baby dropped way down into my pelvis--an amazingly different sort of pressure than the bag of water had been.   "Light meconium," I heard, and the doptones went back on (they had been on during and after pretty much every contraction and the FHT had sounded very good).  Now, however, I heard the heartrate in the 60s.  They checked me and I was +2 to +3 station, and they asked me to push my baby out.  Which I wasn't sure how to do, since even though my body was clearly pushing quite effectively, I didn't actually feel like I had any volition over the process.  So I paid attention this time and found at the end of a push I could draw it out a bit longer and add a bit of extra oomph.  The midwives told me I was doing great and they could see the baby's scalp, which was nice and pink, but the heart rate was still too low.  I asked if we needed to go to the hospital, and they said they'd decide in the next few minutes.  My doctor self was surprisingly unworried; I remember thinking "This baby has great reserves, and the bradycardia is just because it dropped in station so quickly.  It will come back up."  They had me get into bed and curl up on my side.  The heart rate rose back up to normal over the next few minutes.  

It felt pretty good to push in bed, because I could just rest in between contractions.  Michael says I seemed skeptical about how well I was pushing, and would occasionally remind everyone "this is nuts!" though I don't remember that.  The midwives showed me the baby's head with a mirror, and I couldn't believe how blond  he was!  It felt overwhelming to look at, but I wanted to feel the head, so I pushed the mirror away and put my hands on his head.  That was such a reassuring feeling I kept them there.  It helped me to know where he was when I pushed, and as I got closer and closer to crowning, helped me feel calm.   My internal doctor was getting very excited about how smoothly things were going.  Over the next few pushes I felt more burning, and then I finally felt the ring of fire.  Rather than feeling it as pain, I got excited--my doctor voice told me he'd be out on the next push!  I pushed gently between contractions to try to ease him down, and then felt his head slide easily out.  I felt this full body sense of relief and smiled the biggest smile of my life.  Evidently I said "I feel great!" though I don't remember that; I just remember feeling complete bliss. Michael said I grinned my orgasm grin.  They asked me to push again but I laughed and told them I didn't have a contraction, and just rested there basking in the wonderful feeling.  Nancy had me feel his ears, which was very cool; they felt tiny.  When the next contraction came I felt him turn a bit more, and then the bumpiness of his shoulders and ouch! elbow coming out (nuchal hand).  They put him right up on my belly, and he was pink and wiggly and crying right from the start.

I remember my instinct was to take the towel Nancy had and rub him all over, and I kept trying to bring him up to my chest, but his cord was quite short.  Before the birth I'd planned to request prophylactic pitocin, but my placenta delivered so quicklyI didn't have time to think of it, and I felt my uterus shrink to become a nice hard grapefruit instantly.  It's funny, all the things I'd worried about (long labor?  OP baby? postpartum hemorrhage?) were completely off target; and the problems that did come up (preterm labor, mastitis) completely blindsided me.

After we'd had time to settle in together & cuddle, it was eventually time to go to the bathroom.  THis might have been my other favorite part of the home birth.  I peed in my own toilet, and Ami helped bathe me in my own shower, I put on my new pink bathrobe, and then I snuggled back into my own, freshly made bed with my new little baby.  Michael was in the kitchen making snacks for me and cleaning up, and singing along to the Driver by Truckers song "every body needs love."  It felt so civilized and homey and lovely.