Wednesday, April 9, 2014

Our Homebirth Story

      I thought I'd start this post by first explaining why we chose a homebirth, then explaining why I would want to tell you all about it, but honestly that would be a monstrous post, because the birth story itself is gigantic. Perhaps another day, but for now I will say that it was a well-researched decision, and a natural one considering that hospitals give me terrible anxiety. I'm writing the story down for me and for Beatrice, and just for anyone that enjoys sharing in this part of motherhood. (in other words, it's not to impress you. I wasn't that impressive. I yelled a lot and stuff.) Quick recap: Bella (4) was an traumatic, unnecessary C-section. Sophie (2) was a medicated vaginal delivery that was not traumatic but the hospital stay was hellish, and Beatrice (5 days) was born at our home in Germany.

     Here's the story I thought I'd be telling: "I had easy contractions all morning, Eleni came over and we had tea with the midwife while the kids played in the yard, I got in the tub and serenely breathed my baby down and she was born peacefully in to my hands." Buuuut that wasn't how it went ;)

     By the time I became pregnant with Beatrice I already knew of a great local homebirth midwife who had assisted in the births of a few friends. I had a low risk pregnancy and knew that German midwives are extremely qualified. I had all the usual prenatal care, bloodwork, ultrasounds etc. Her name is Alexa and I knew from the moment I met her she was right for us. She's uh, eccentric. She's also extremely experienced, knowledgeable, kind, gentle, and intuitive. She is very hands-off. I was in charge of my pregnancy and birth every step of the way.  She knew my history inside and out. Every bit of my care was tailored personally to me and she came to my home for appointments. My husband and children were at ease in her presence. She even had a calming effect on our crazy hyper dog. Basically she was perfect.
     My due date came and went, just as it had in my previous pregnancies. For weeks prior I'd have regular semi-uncomfortable contractions that would fizzle out. Every week I'd go through my nesting ritual where I would tidy up the house, tidy up the family, plan "one last" family day, plan "one last" date night, eat a bunch of super foods, go for a walk, etc. I was sure she'd come several times, but by April 2 I was just at peace with the fact that I'd be pregnant forever. A friend served us spicy Mexican food that night and informed me that she had a history of inducing labor. We went home and for the first time in months I slept hard, for 8 solid hours. I was awakened at 7:20am by a phone call from Daniel saying he was coming home between PT and work and wanted to know if I wanted breakfast from the coffee shop.  Since by now I was SO over high protein breakfasts and healthy crap, I said heck yes. Between the words "muffin" and "macchiato" I had a seriously intense (but not painful) contraction that I couldn't talk through. I knew this was it. After we hung up, I hopped (read: hoisted) my giant belly out of bed, stood there through another contraction, (wow do these seem close together??) and got dressed for the day. I started tidying up the house until Daniel arrived.  We ate breakfast together while Bell and Sophie slept and I told him today was definitely the day. I noticed the absence of nauseating nervousness that had accompanied the start of my other labors. It was the hospital I had feared. While my contractions were close together, they were totally manageable. I would just stop and relax and breathe through them. Knowing this could take hours, I reluctantly told  Daniel he could go into work to tie up a few things, but to make it quick. After he left I woke the girls with news that we would finally meet our baby today. I dressed them and fed them breakfast  then they played in the yard with the dog while I fidgeted with the birth supplies and continued to walk, breathe, and relax during contractions. I called Alexa at 10:30 to give her a heads up and she said she'd come over around noon. Daniel came home at 11 which was good because I was starting to get uncomfortable and wanted to be alone. He played with the girls and did house work downstairs while I labored upstairs. Anytime he came up to check on me I'd have a more painful contraction, so when Alexa arrived at 12 and they were both with me I was getting uncomfortable. As soon as she came I got in the bath filled with hot water which immediately lessened the frequency and intensity of the contractions. Alexa stayed only ten minutes before asking if she should go. I told her to go run errands or eat lunch so I could labor alone in the tub. Daniel was awesome. He quickly and quietly set up a little table next to the tub and brought water, my phone, a rosary, and a bucket to puke in. He lit candles and turned off the lights and adjusted the heater before hurrying back downstairs to be with the kids. I actually sort of enjoyed this part of labor. My husband and kids were comfortable and happy.  I was working through things on my own with breathing, relaxation, and prayer. I felt safe and peaceful. But eventually the warm water lost its magic touch and no longer seemed to be helping. After being in the tub for an hour, at 1pm, my water broke. I got a little nervous here. This was when I decided I didn't want to be alone anymore. Daniel called Alexa and then left to meet her at the gate (we live on an Army base) As Daniel was getting in the car to meet her I heard him talking so I went to the window and saw him standing there with two of our friends/neighbors, Eleni and Katie, taking their kids to the park near our house. Though the original plan had been for my kids and Eleni to all be with me during labor, it was obvious by now that I wanted a quiet, empty house, so I was so very relieved when Katie and Eleni took the girls with them. They were close enough that I could hear the kids laughter through the bathroom window from the tub. I was comforted knowing the girls were having fun with their friends and nobody was terribly inconvenienced as it was the middle of the day, so I could focus on the task at hand. Alexa arrived it was around 1:30pm and I was having a hard time finding a good position to deal with the contractions. Each one made me feel so warm that I became nauseated during them, even with Daniel holding a cool rag on my face. (he is a gem, people)  I had to get out if the tub. This was not going to be a water birth! At this point we moved into the guestroom because our bed was too high for me to get in and out of easily. Daniel got to work making the room ready by stripping the sheets to put down the plastic mattress cover and some old sheets. He brought all my stuff from my table by the tub and lit all the candles again. Alexa set up the birth stool and got all her supplies ready. The contractions were coming hard and fast and for several of them I just sat on the edge of the bed with my hands on my knees moaning/humming. Then for a few I had to be holding Daniel's hands while Alexa pushed on my lower back (or vice versa) Then I had to stand and sway my hips for several. Still while crushing the hands of whichever unfortunate person had my hands at the time. I never knew what my body would force me to do next. It completely took over the decision making of trying to find the best position to bring baby down. I whimpered that I was tired and that there was no position that wasn't completely sucky. Despair is a classic sign you've reached transition (7-10 cm dilation, the transition between laboring and time to push) but it never crossed my mind that I could be that far in, as I had only been hurting for one hour. Alexa suggested getting back in the tub and I agreed, hanging on to the slim chance it would provide the same relief as it had that morning. Once she filled the tub I got in and laid my head on the bath pillow and my whole body relaxed. It felt amazing. Until the next contraction. Oh my goodness. This is the part where I started cussing between prayers. I'm pretty sure I yelled that I could not do any more contractions lying down and I had to get out right now. Alexa asked permission to check me for dilation, which I had not wanted done at any point during my pregnancy or labor thus far, but I knew that if Alexa was asking it was because she had a good reason. In my head I was saying "please don't say less than four" so when she announced I was 8cm I was thrilled, because when Sophie was born, dilation from 8 to 10 was very quick then I immediately started pushing. Pushing had provided complete relief from contractions. (the epidural with Sophie didn't really numb everything) So basically I was really excited that pushing was not far! A few more contractions! I could do that! I got out of the tub and went back to the guest room. I think it was somewhere around 2:15 pm. Instead of a couple of contractions to complete dilation, I had several excruciating ones over the next hour. I clawed Daniel's arm bloody. I tried to rip the sheets. I took a bite out of the solid wood birth stool I'd been trying to break as I knelt over it. I broke Daniel's stainless steel rosary. I was standing.  Then sitting.  Kneeling. One leg on the bed. Hugging the birth stool. Sitting on the birth stool. When I did that, my body started to push involuntarily with each contraction. I had no control over it. But that's good, right? Pushing relieves the pain from contractions, right? Well, not this time. The pushing hurt worse, but I couldn't stop. (fun fact: I have scar tissue adhesions from my c-section and I'm pretty sure I tore every one of them free during this pushing.) Every muscle in my body wanted her out, but she wasn't coming down at all. . I pushed like that for a while til I started to feel faint. Alexa asked Daniel to spoon feed me some raw honey and water. She checked me again and told me I was complete except for a small bit of cervix. This "lip" was holding baby back but my body was pushing anyway, so Alexa asked how I felt about her manually stretching the last of it out of the way, or we could give baby more time. She was content not to rush baby but told me later that she did have some concern that my cervix could tear, which would cause a lot of bleeding. I agreed to the stretching, because I was worn out and reeling from the intensity, but I knew I'd have to endure a contraction lying down (on my side on the floor) and that the stretching would be excruciating. It was, and after it was over Alexa told me she thought I was being too quiet, too gentle, too polite. She wanted me to yell and roar and see if that helped the baby come down, now that dilation was complete. It didn't seem natural to me at first, I had been so focused on being relaxed and loose and trying to make low sounds, but I was desperate. With the next three contractions or so I made the most ridiculously loud noises that I can't believe I am capable of making. And it was working! I could feel her moving down. After a few of these Alexa wondered aloud if it would be possible for me to rest a moment on the bed. I had no interest in the idea because I knew there was no rest til it was done, but I crawled up onto the bed anyway and propped myself up on my side leaning on Daniel. Lying that way was not fun but before I could protest Alexa could see baby coming. I pushed, this time voluntarily, and she was coming. I pushed again, roaring like before to help her come down. That stings! (understatement alert!) Her head was out! I'm done! Right? No, she wasn't coming.  After that contraction Alexa told me very calmly and seriously that I needed to get on my hands and knees. I've read enough birth stories to know what that means: shoulder dystocia.  Baby's shoulder was stuck behind my pubic bone. By the time the head is out, there's alot of pressure on the umbilical cord so its necessary to act quickly. Just in case it was only a suggestion, I said "I can't" and I meant it. How could I move during this insane contraction with a baby head between my legs? She said "you have to" and that was enough. The next several events seemed to happen in one fluid motion: While pushing, I flipped onto my hands and knees, Alexa put her hand in next to baby's head (if you think that sounds unpleasant, you'd be correct.) and as she unhooked her shoulder from the bone, we heard (and I felt) a pop...then the rest of the baby was born, pink and crying at 3:30pm. Alexa passed her to me between my legs and I clutched her to my chest and flipped to my back as I looked at Daniel and said "It's broken.." I cried and hugged her and Alexa tells me I kept saying "she hurts" but I don't remember that. Alexa immediately said "I do think her collarbone is broken." Which is somewhat common for shoulder dystocia. My heart was crushed. We decided we would check her after I had comforted her, which took nothing but a towel  from the dryer and some breastmilk. She calmed immediately and I sent Daniel to get the girls (right after he answered the door to a curious neighbor wondering what all the noise was about.  Oops.) They ran in to meet their sister with sweet happy faces. They watched the delivery of the placenta and Alexa showed it to them and explained it all, much to their fascination and my amusement.  Eleni came in to take a few pictures for us and meet Beatrice. She brought us a huge pot of amazing beef stew and rice which was the perfect post-childbirth meal. Alexa checked over Beatrice and couldn't find a break in her collarbones but we all agreed she should see a doctor the next day to be sure. Alexa mentioned that if it was broken, they likely would not do anything for her, because newborn bones are very soft and heal very quickly, and supposedly a break in soft bone is not as painful as it would be for an adult. Her muscle tone was good, she was a healthy 8lb 8oz, 20in long. Alexa swiftly cleaned everything up and changed the sheets. She had a glass of pink champagne with us to celebrate Beatrice, then left after a few hours, promising to return in the morning. Now it was just the family. We ate our stew and cuddled on the couch before settling into our beds. I was so happy to be comfortable in my own home with my family around me, grateful to have made it through childbirth seemingly unscathed (somehow I didn't tear) and completely madly in love with my perfect new baby. But I didn't have that "birth high" I had after Sophie or the euphoria everyone talks about after a home birth. Mostly because I still felt unsure about the collarbone. I also felt a little defeated, but I'm not sure why. I think I was just really tired from the extreme emotional highs and lows along with meeting my match physically. I just didn't expect it to break me like that, I guess. I have always thought of childbirth kind of like climbing a mountain or running a marathon. Something you punch in the face and conquer and come out triumphant. But it wasn't like that at all for me this time. It was a crushing, humbling thing this time. And that's ok. We have a little pieta figurine, a statue of Mary holding the body of crucified Jesus. It's the very picture of maternal suffering. During pregnancy I said that I would look at it during labor and my suffering would seem like nothing. In a way I was right, it certainly removed my pride from the equation, though none of the physical discomfort. This sounds a lot like whining but let me clarify that other than the collarbone thing (we'll get back to that in minute) I consider this an amazing birth experience. Every bit of pain was worth the benefits of being home and not in the hospital.I'm definitely not complaining. I'm simply trying to walk you through what it was like for me to emotionally process the whole thing. The euphoria is coming to me now. Having a birth that wasn't in a stressful fearful environment was just something that was personally important to me, and I got that. I am happy. But there is a little cloud of sadness over it still, and that is that while Beatrice's collarbones are fine, she did break her arm on my pelvis on the way out. The next day she got an x-ray and an orthopedic specialist checked her for nerve damage (she can move her elbow, wrists, and fingers, so all seems to be well.) He confirmed what Alexa had told us..they didn't really do anything for her. He told us that for 2 weeks we needed to trap her broken arm against her body inside a snug onesie. At that point they will x-ray her again and basically tell us we can stop doing that, or to keep doing it for another week. I thought she would cry all the time, but she is truly the sweetest, happiest little baby. She is so alert and content. She sleeps like an angel at night and eats like a piggy all day. We feel very blessed that it was just a broken arm, because sometimes shoulder dystocia has a much grimmer outcome, especially if there is failure to act as quickly as Alexa did. Anything from nerve damage, to brain damage, to death of mother and baby.

**Edit**
At 13 days old Beatrice had her follow up xray which revealed that she was as good as new. She had already been using the arm pain-free for a few days at that point but it was nice to hear an orthopedic specialist tell me to go home and pretend it never happened. ***

So will I do it all again? Yes. Shoulder Dystocia is kind of a freak thing. It's unlikely to happen to me again. It didn't happen to me with Sophie. And it would have happened this time even in the hospital, and the outcome of it would have likely been either the same or worse, depending on the timeliness and method used. If the hospital had used vacuum extraction or similar she could have had serious nerve damage. With that in mind, absolutely. This is what is best for our family for future low risk pregnancies. Feeling safe and having my children nearby, having privacy and real nourishing food and my own bed afterwards was really great.
ANYway. That's how it all went down. We are so incredibly blessed and proud to introduce Miss Beatrice Qualk to the world. <3



The Qualks


Invisible microphone




Big cheeks at her x-ray appointment



Daddy cuts the cord! Sophie is confused.

First time in Daddy's arms

Discussing the collarbone :(

Proud sister
Prost!

First pic with mama

Just a few minutes old

Birthday card to Beatrice from Bella

Bella drew, from left, Eleni taking pictures, Alexa weighing baby, Bella, Sophie, Daddy, Mommy, and pictured below are Alexa's bags and stethoscope.

My sunshine

Who you callin' chunky?

Sophie's a big girl now



A thoughtful gift from Erin and Phil




only 8lb 8oz ;)

being weighed by Alexa

Alexa checks her collarbones











 

5 comments:

  1. Love this so much. Every part. I'm sorry you had some disappointments, but know that my home birth was amazing but I was roaring and screaming and yelled some interesting things too. I love the way you write. Thank you for sharing this!

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  2. I cried a little reading this. You are amazing!

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  3. Yes!! Wonderful. You're awesome. I'm so glad you had the experience you wanted. And no tearing! High fives all around! Beatrice is yet another beautiful Qualk woman; we can't wait to meet her. Can not even wait!

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  4. Very eloquently written for such an emotional experience! I cried a little myself imagining how scary that must have been. You are awesome! Congrats to you all!

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  5. I'm so proud of you in every way possible. I just love you so much and hate more than anything that I can't hold that precious baby right! now! That first picture melts my heart completely. Thank you so much for sharing your story. Hugs and kisses from home <3

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