Friday, November 30, 2012

Birth Story Friday: We Like Ours Well Done

My mother had me 3 weeks early, and I naively expected to follow her lead. When I first started getting contractions at 36 weeks I was so excited. Soon! Soon I was going to meet my baby. My first round of regular contractions failed to organize and dissipated after a few frustrating hours. A few days later, the same thing. Contraction after contraction, getting stronger, and then nothing. I called my midwife and learned a lot of techniques to deal with prodromal labor.

38 weeks came and every few days I'd have another bout of fake labor.

39 weeks, more of the same. I was getting discouraged and gave up the hope that I'd have my baby early.

40 weeks and I was taking cohoshes, walking for miles every day, using my breast pump all in a vain attempt to get labor going. Every few days I'd have hours of regular contractions, then nothing. 8 hours, 15 hours, at one point I went a whole 23 hours with regular contractions and no baby.

By this point we figured out my daughter was posterior, and I spent a good deal of time trying to turn her. When it didn't work I kept telling myself she would turn in labor.

41 weeks rolls by and we go see a movie. I spend a lot of time walking around the nearby park. I stop answering my phone and I glare at people who ask me if I've had the baby yet.

42 weeks, the date no pregnant woman ever wants to see. I gave up all induction attempts and told myself I'd allow 2 more days to get into labor naturally before I attempt castor oil. At 43 I'd walk in and ask for a c-section.

I woke up the morning of 42+1 still pregnant. I was frustrated but resigned. I got sick of whining about being pregnant and just went about my day, trying to ignore the large belly and the constant kicks. I took a nap. I ate food. Then at noon BAM! contraction. Those 6 weeks of contractions? Nothing compared to this. 2 minutes later BAM! another one. And another. And another. Apparently I don't do early labor. I start making calls and getting into my groove. I want some time alone so people take their time showing up. Husband comes home from work early and starts setting up the pool, during which I start hanging out in the bath. I need water by this point as labor is pretty intense. My midwife has to leave to go to the hardware store because my faucet is weird and the hose adapter doesn't fit. I labor, whine, and labor some more. We fill the pool and I get in, but quickly it's apparent that there's a leak. We drain the pool, midwife's husband brings over another one, and we keep on going.

Suddenly the pain shifts. I've been in labor for about 6 hours by this point. There's a burning pain in my pelvis that's truly terrifying. I'm trying not to panic from the pain and telling myself it's transition. It hits again and again. There's no way I could walk after this pain, something is WRONG. I beg my midwife to check me, hoping it's just transition, but nope. I'm at 2-3cms and barely effaced. She checks the heartbeat and baby is fine, but asynclitic. In a stroke of brilliance my midwife grabs the pool pump and runs it on my pelvis next to the baby's head, making a loud noise that startles her back center, and in an instant the pain is gone.

This is the point when I learned just how important fetal positioning is. I went from the worst pain imaginable to "eh, labor hurts" in less than 15 seconds. With no drugs. I believe she was pushing on my pelvis in a bad way and my pelvis let me know in no uncertain terms that it was bad.

The next 24 hours are a blur of exhaustion and labor land. Water gets emptied as boiling water is poured into the pool. I walk up and down the stairs, take cohosh, drink some wine to slow labor down and try to rest. My midwife, her assistant, and my husband alternate putting counterpressure on my back. I never eat, but everyone tries to.

24 hours is a long time, but there's something amazing about labor; time doesn't matter. I didn't notice the hours passing, my world was just what was going on inside my body. Occasionally I'd look up and note that the sun had set, or it was coming up again. Contractions would vary in intensity, but never lighten up enough where I got much sleep. Water was added ot the pool and taken away. I walked, I cried, I was on all fours. I lunged, I rested, I even called my chiropractor to come over. A lot happened in those 24 hours but it was all just a blur. I progressed, but slowly. Somewhere in there my water broke; I never felt it. The pool now had flecks of meconium in it, which I knew was a concern, but at that point I couldn't care. Everything was labor.

Then suddenly the pain changed. That burning searing pain in my pelvis came back. I got checked and was 7-8cms. Finally, transition! It hurt like hell, but I could do this. My midwife checked me and said "she's pretty close, you can reach in and feel her." So I did, and low enough that I could easily reach around my giant belly I felt the squishy flesh of my daughter. It was almost over! "It feels squishy" I said. "That's not supposed to be squishy." But the pain soon became more than I could bear and I was convinced I'd never be able to walk again. My pelvis was breaking apart, it as on fire. It was bad.

I told myself that I could endure an hour of that, and if I made good progress it was fine. Unfortunately an hour of the most mind-numbing panic-inducing pain I've ever felt bought me no progress. 34 hours into labor and I was only at 8cms. Something snapped in my head and I was done. "We're transferring. I need an epidural." I hopped out of the pool (with assistance), dried off, and got dressed. I packed my bag in between contractions and with my husband's help. A few months before a good friend of mine transferred during a homebirth and had an awful experience, so we were nervous, but it was clear that a homebirth just wasn't happening.

The 10 minute car ride was the longest of my life. Bumps in the road during advanced labor SUCKS. We pulled up by the emergency room, I waddled in and said "I'm in labor and I want an epidural." I filled out the forms between contractions and waved my GBS- sheet at everyone, as I'm deathly allergic to penicillin and was doing everything I could to avoid it. Every nurse I spoke with heard how I wanted an epidural, and they strapped me onto the monitors, gave me an IV and told me I should get it soon.

The monitors hurt so much. The pain that sent me to the hospital was bad, but let me tell you if you spend 34 hours doing ab work and then strap thick elastic around it tightly it's going to hurt. The monitor belts hurt more than labor itself and I begged to take them off, begged for the epidural. It never came. Apparently there was no anesthesiologist on staff overnight and he wouldn't come in for a homebirth transfer.

The next few hours were some of the worst of my life. The nurse was mean, they wouldn't take off the belts, I got no pain relief, and the nurse gave me instructions that caused me even more pain. At one point she offered IV drugs, I believe nubain and phenergan, and although I knew phenergan and I don't get along I consented. Bad idea. I have no memory of this, but apparently I lost all sense of awareness, almost pulled my IV out, and wandered around the room constantly. I was also obviously in pain.

This would be the point my husband called his mother at 4am.

By 6am the phenergan wore off and my contractions were petering out. I was once again coherent and in the dawn light I knew I needed a c-section. I was fine with this. A while later the on-call OB walked in (the first time I saw a doctor in the hospital) and said "I think you need a c-section." I heartily agreed.

I signed the papers and proceeded through the leisurely surgery prep. I'm talking sauntering down the hall, nurses chatting about their weekend plans, me trying to relax through my weakening contractions. Spinal anesthesia worked perfectly and I had to focus to stay awake for my daughter's birth. They held her up for me and I fell asleep for the first time in almost 3 days.

Evelyn Rose Leslie
Born at 42 weeks 3 days by cesarean after 40 hours of labor
9lbs 12oz 21 3/4" long

My husband stayed with the baby while they were stitching me up and overheard the doctor tell the nurse "occiput posterior face presentation." It turns out that that squishy bit I felt was her forehead. According to Spiritual Midwifery a brow presentation has a 40% larger circumference and is nearly impossible to deliver vaginally. There was almost nothing we could have done to get her out at home.

Evie's apgars were 9 and 9, and she was a robust baby. I woke up from my post-surgery nap and felt great. Despite all we went through we were doing wonderfully. We were home in our own bed the next day.

It was hard, but I wouldn't have changed a thing about it. Through Evie's labor I learned that I can handle just about anything, I learned how to work with my body, I even learned to enjoy the intensity of labor. Her birth transformed me and is why I got into birth activism. It was easily the most important experience of my life, and overall a positive one.

Of course I swore to do anything I could to have an easier birth next time.

Tuesday, November 27, 2012

Homebirth Support Group in Urbana

This Sunday from 3-5pm there'll be an informal support group for homebirthers in Urbana. If you're interested in attending contact Ashley at ashrprice AT gmail DOT com

The Wax Study and Dealing with Criticism of Homebirth

In July 2010 the homebirth community was rocked by a study, known informally as the Wax Study, that suggested babies born at home die 2 to 3 times more often than those born in the hospital. Opponents of homebirth (and yes, they do exist) were gleeful and stepped up their campaign to stamp out legal homebirth. Homebirth advocates immediately began trying to refute this study, which contradicts all the others that are supportive of homebirth with licensed midwives.

Luckily the science is on our side for this one. The Wax Study was so controversial and so badly done that Nature printed a refutation of it. I highly recommend you read it.

Homebirth Study Investigated

One of the many reasons women choose homebirth is to avoid the abuse that many feel is endemic. The growing trend of homebirth and lots of people complaining publicly about their treatment during labor has started to get attention. This editorial in the Journal of Perinatal Education is excellent.

Abuse in Hospital-Based Birth?

There's a lot of evidence out there suggesting that in a low-risk pregnancy homebirth with a trained and license midwife is as safe or safer than hospital birth. I won't go into that here, as that's it's own post (or 7). Regardless of the evidence, homebirthers are often berated by well-meaning people for their choice to have their baby at home. If you spend enough time in homebirth circles you'll hear stories of keeping birth plans secret, arrested midwives, DCFS being called on homebirthers simply for homebirthing, harassment by medical professionals for birthing choices, and more. In states where homebirth is integrated into the maternity care system this harassment is less of a problem. Among my Canadian friends homebirth is seen as not a huge deal. Here I've been personally told that I want my babies dead. I was investigated by DCFS (much to their annoyance) after my hospital transfer (birth story coming on Friday). Like I said, it's bad.

There are a host of ways to deal with this, all of which depend on your situation and personality.

1) Don't talk about homebirth plans. Birth plans are no one's business except that of the parents and their chosen birth attendants.
2) Emphasize the safety of homebirth and discuss how homebirth midwives deal with an emergency.
3) Talk about homebirth as a civil liberties and women's rights issues.
4) Talk about why you chose homebirth and what about hospital birth is unacceptable to you.
5) If necessary, get a lawyer. Official harassment tends to stop quickly once a lawyer is involved.

I'd be happy to hear how you dealt with harassment for your birth choices. It's a problem almost every Illinois homebirther faces.

Friday, November 23, 2012

Birth Story Friday: A Long, Slow VBAC

Our Homebirth VBAC Story

I’d been having “prodromal” labor for a couple weeks. I hate to call it that, but they were stronger than my normal braxton-hicks that I’d been having for months and they were consistently 1 – 1.5 minutes in length and 5-minutes apart for hours at a time. There were three specific times that I surely thought I was in labor! But every time, the contractions died down and stopped… usually after a sleepless night. I was frustrated, discouraged, and exhausted. Contractions are hard work! And I wasn’t used to daily workouts, haha.

I remember waking up Thursday morning (Feb. 23rd) and feeling normal for the first time in at least a week. I was happy, I was motivated, and most of all – my mind was NOT on labor. I was cleaning, I shaved my legs, I did laundry… I know you’re all thinking “nesting!” but it wasn’t anything crazy – I mean, I wasn’t on my hands and knees scrubbing the bathroom floor, haha. I just felt good. I guess I had finally given up on the hopes of labor coming soon!

I think it was about 3pm that I had the first contraction. It was definitely strong enough to make me immediately say “hmmm, well this is different.” I’m going to go a head and say they were painful. (Looking back and seeing how painful it really got later on, those early ones were nothing, haha — but at the time, I knew it was real.) I called my mom in excitement and just continued playing with Ryan and doing stuff around the house.

Steve got home from work around 4:30pm and I looked at him and got all teary. A contraction came and I held the kitchen table. I told him it was real this time (FOR REAL this time!), that it hurt, and that I was nervous. He gave me a hug and then I think *he* started nesting, haha, as he worked on cleaning the whole house.

I called my midwife around 5:30pm – not thinking she needed to come yet, but to give her a heads up. She told me to call back in an hour. In the meantime, I started baking a birthday cake for Rebecca! My contractions were, right off the bat, a minute long and every 5 minutes.

I called my midwife about 6:30pm. We decided she should come over around 8 – 8:30pm… I was stopping between contractions, but I guess I could still kind of talk through them. (If I had any idea how intense labor would get later on, I never would have called them this early). I sent a text to my doula and she came over at the same time, around 8 – 8:30pm. It was the night of a snow storm so everyone wanted to get here earlier rather than later. My mom came, too, because she was going to watch Ryan.

About 9:30pm, I went to the bathroom and lost some mucous plug – whoooo! I was so excited. BABY TIME!

this would be me at the computer – doing my early updates to facebook/twitter — that’s my mom on the couch

My cake was done and we decided to play the board game Buzzerwizzer (it’s a trivia game, so fun!) because we were all just sitting around. We kind of had a house full and I felt like everyone was watching me, waiting for me, and I didn’t know how to (re)act. Well, turns out that’s because it was really early labor, I wasn’t in full-on focused mode yet, and… had a long way to go, haha.

We never finished the game because I got up to use the bathroom and felt the contractions were more intense. It was late – maybe around 11pm? We decided to rest, take naps… I tried, but I was in and out of the shower. My doula really helped me get through the night. At 4am, I had bloody show – whooo! More excitement. I got in the tub for about an hour then, while Steve slept. I got out for a bit and then took a shower at 6:45am. Everyone was up and at ‘em in the morning, with Ryan getting up around 7am?

He made me smile, but it was hard to have him there during contractions. I ate some peanut butter toast (or tried to). At 8:30am, my contractions slowed to about 7 minutes apart. I was checked for progress and my cervix was very posterior and the opening couldn’t even really be reached. The edge felt thick and closed. Meaning… no progress. I think the disappointment was visible across my face so I was told that “mayyyybe I was 2 – 3 cm dilated,” but I don’t think I was at all. But that’s what I posted on facebook, 2-3cm dilated, because I was too embarrassed and disappointed to post otherwise.

What did this mean? I had been in labor for 12+ hours with no progress. I was not in active labor, maybe not in “real” labor? We all decided that it would be best if the birth team left. I felt watched and we all know a watched pot never boils. I think I had performance anxiety… I didn’t feel comfortable and that can definitely slow progression of labor.

I sobbed. Of course! I was in pain and had been for 12+ hours. I had weeks of prodromal labor that apparently did nothing. I was tired. I felt defeated, I felt disappointed, I felt discouraged. It was the only time through this whole thing that I thought… I can’t do this. I’m not going to be able to make it. I have sooo much farther to go. How can I do it?

Steve tried to get me to go out for breakfast with him. He thought it would take my mind off things… I was told that this labor could even possibly stop and not start again for hours or even days. AH! I considered going out for breakfast, but then another contraction came and I was like — there’s no way.

So Steve left to get breakfast and bring it home to me. I took two benadryl, got in bed, and fell asleep – hoping the labor would stop if that was the plan or that the rest would help and things would pick up again. Steve woke me up with breakfast when he got home shortly after, but I shooed him away so I could sleep. In hindsight, I’m glad I got some sleep, but that benadryl wiped me out so when I woke up only 2 hours later because the contractions were too much, I was a little slow moving.

Throughout the labor, there were definitive periods when my contractions stepped it up a notch. I mean, I could look at Steve and say, “okay, we’re at the next level.” Then my body would get used to that level of pain and it would be bearable again, until of course the contractions stepped it up again… it’s fascinating the way your body adjusts and copes. I eventually reached a point where I was just in a trance… in another world… completely focused and breathing through each contraction. One at a time. I knew that if I let myself slip up – FEEL the pain and think even for a second that “I can’t do this” – then I’d never come back. It’s so hard to relax a person that is tensing up and freaking out about pain… so I just never let myself do that. My chants through contractions were “doooooown and out” and “IIIIII can do it,” over and over. The word “can’t” was not allowed to escape my mouth or enter my thoughts.

Steve and my birth team stayed in touch all day. I think I stayed in the shower for like 4 hours – until the hot water was gone. I had Steve call the birth team that night, around 7pm. I felt my contractions were stronger, they were clearly not stopping, and were now 3 minutes apart.

I didn’t even notice when they arrived – I was in bed, moaning through contractions. I was focused. This was real.

Steve was amazing and stayed by my side the entire time, encouraging me and helping me relax. But my doula… she was something special… she had a magic touch and voice, I tell ya. Those painful contractions would come, she’d remind me to relax those muscles, tell me how strong I was for my baby girl, tell me I could do it… and the unbearable pain was suddenly bearable. I loved her.

My mom came back, too, but Ryan stayed at her house with my dad. We had wanted him there, but at this point knew it’d be better if he wasn’t.

At 8:30pm I got in our jacuzzi. I remember telling Steve, “I hope I’m not getting in too early.” Meaning, I thought I was nearly done and I’d be giving birth in the tub.… hahahaha. Ohhh if I only knew!

At 10:30pm, I was checked. I was scared. I did not want more bad news. My cervix was still a bit posterior, but I was 5-6cm and 50% effaced. Oh THANK the heavens, I was making progress!!! I was half-way!!! Okay, okay, we’re half-way there, we can do this! I CAN DO THIS!

So about 11pm, we tried new positions. I hung from the door during contractions with a rebozo and rested on Steve in between. I labored on hands and knees, then tried going up and down the stairs. Around 1:15am, I was so tired – I went to bed to try to rest. Every time I laid in bed to take a rest, my labor would slow down and contractions would space out… but I sooo needed the rest!

I didn’t rest in bed too long – I needed a change (to help with the pain) and I got in the tub from 2:30 to 4:30am. My contractions were 5 minutes apart and I was “sleeping” between contractions. If you’ve been through this before, you know what I mean by “sleeping” between contractions. It’s not exactly sleep, it’s… some form of total la-la land. Steve slept.

At 8:45am (Saturday), I ate a little breakfast, changed my clothes and brushed my teeth. It was a new day! I tried more positions, some swaying and “dancing” with Steve, more hanging from the door. At 11:30am, I was going up and down the stairs sideways with the rebozo on and Steve helping me. I didn’t have a clear transition phase, but this is when I kind of showed some signs of it… I was shaky and my contractions seemed to have no end. I’d feel the wave lessen, like the end of a contraction, but it’d pick right back up again before stopping completely. It wasn’t terrible though, and I never broke down and said “I can’t do this!” which is a typical sign of the transition phase.

Alright… we’re nearing a full two days of labor now. Around noon, my mom left to go to the grocery store. While she was gone, I was checked and found to be 90% effaced, at +2 station, 8-9cm dilated and very stretchy. AHH!! I can’t even describe the amount of happiness I felt at that moment. With Ryan, I got to 8cm, 80% effaced, and +1station before the c-section. I knew that sometimes in VBACs, moms stall at the dilation point they reached during the previous labor. Maybe I did, maybe I was at 8cm for awhile? I wasn’t checked often enough to know, but… at this point… I had passed it.

I pushed twice, just to see. I couldn’t feel anything, but my midwife felt the head moving down with each push – it was on the pubic bone. My bag of water was still intact, but bulging.

I changed my clothes (“Proud VBAC Mama!”), had a snack, and suddenly felt like my contractions barely hurt at all – I think I was so excited to be “almost done” and past the point I got to with Ryan. I couldn’t stop smiling! And maybe the pain really did lessen – maybe this was my body’s resting point before the big finish?

Since Rebecca was on the pubic bone, I laid like this for awhile – head down, butt in the air. They used the rebozo a bit too, around my belly, holding it up. The idea was to get the baby to move slightly up and then, when I changed positions, she’d move back down, off the pubic bone.

This was the next position – to move the baby back down. Yea, that’s Ryan’s potty stool, haha. And the rebozo around my belly.

About 4:30pm, I was doing some more light pushes in my bed. My contractions hurt so much, pushing was a relief – I don’t know if it really took pain away or if it gave me something else to focus on. Either way, it helped, but I didn’t really have an urge to push. I had a slight cervical lip so my midwife helped hold it back while I was pushing to help it disappear.

About 6pm, I was in the tub again and doing some more pushing. I was having some urges to push and those were my most successful pushes – it takes over your body and there’s nothing you can do but PUSH! It was an overwhelming feeling and I made some sort of moan/yelling noise with each one. I tried on my back, on each side, on my hands and knees… At 7:30pm, there’s a note that I’m pushing harder and the cervical lip was still there, but it would disappear on its own with each push.

The birth team was discussing a transfer at this point, but I had no idea. They asked Steve if *I* had said anything about it – if I wanted to transfer. Steve said no. (I didn’t know about any of this until after Rebecca was born and I’m thankful). The thought of transferring never entered my mind, not once. Of course if something was wrong or if someone had told me we needed to transfer, I would have in a second. But just because the labor was long and I was tired? No. I wasn’t giving up, baby girl was doing GREAT, she was checked (and I was checked) all the time.

I was pushing on the bed. Some sort of liquid came out with a push and I was like “did my water just break?!” Um, no, I peed. Awesome.

At 10:10pm, my membranes spontaneously ruptured. I was in bed and it was a gush. The fluid was clear.

I remember asking what time it was (I had no concept of time) and was told 11:45pm. They said my baby might have a Feb 25th birthday! That meant I had 15 more minutes to push her out… I was excited!

That didn’t happen, haha.

At 2:05am I was in the shower… for the last time. It was nearly impossible to walk – with that head between my legs – and I was exhausted. My contractions were weakening. I mean, if you lifted a weight over and over for 2 days, your bicep would give up, too. My uterus was tired. I sat on a birthing ball in the shower and although I was in complete la-la land, I gave myself a mental pep-talk. It’s now or never. There is no option, this has to happen NOW. Let’s do this.

I shot out of that shower, into the family room where I ate some fruit and peanut butter, drank some chicken broth, and was ready to go. I think everyone in the room was holding their breath. It was 3am. I thought I’d give birth in our bedroom (or maybe in the tub), but I think everyone agreed I needed a change of scenery. I needed out of that dark bedroom.

I pushed on my hands and knees on the birth ball. Then in the running start position (leaning on the ball with one leg propped up) – hated that one. I could feel the discouragement in the room. With each push, there was silence – there was no more news of progress. I finally asked, “Am I doing nothing?! What’s going on down there?” I was feeling discouraged, too. But not giving up.

Finally, a squat position. It did the trick.

Steve sat on the couch behind me and during contractions, I squatted, feet flat on the floor, with his support under my arms. Between contractions, he pulled me up to his lap. At first I tried to sit on him, but there was a head in between my legs and I could not sit! So I kind of… laid on him, haha. Oh and my VBAC t-shirt? Gone. Everything, gone.

At one point, I was told to reach down and feel my baby’s head… they thought it would motivate me. It didn’t. I felt a tiny area of her head and all I could think about was how big her head would actually be and how far I had to go, haha.

A little bit later, they got out a mirror. This time, much more of her head was showing and that really motivated me. I could see progress while pushing and I could see how close I was. ALMOST!

Then I mumbled a comment to Steve between contractions about how I was scared – of the upcoming pain – I used the word “uncomfortable,” which was probably an understatement, lol. Not to say I wasn’t already in pain, haha, but you know. My birth team replied that I couldn’t be afraid of that ring of fire! It’s coming no matter what, there’s no choice.

I realized I was somewhat holding back. Maybe not pushing as hard as I could – because I was afraid of that pain to come. But good point, it’s coming no matter what… time to push this baby out.

At 4:09am, Rebecca was born.

She came flying into this world in one push. It turns out her left hand was up by her face, which might help explain the long labor. I got teary, Steve cried. She was absolutely beautiful and perfect. I sang her happy birthday and held her tight, skin to skin.

We did it. It was over, Rebecca was here, everything was amazing. The experience was incredible – I’d do it all again in a second! The feeling is indescribable. Like…the last 3 days of my life were working toward this moment. Toward this beautiful baby girl. And she’s finally here, safe and sound and perfect in our arms. We did it!

I think the placenta cord was cut before I pushed it out, but we did wait until it stopped pulsating. I think it was about 15 – 20 minutes? And then I felt a little crampy, gave a little push, and the placenta slid out easily (4:30am). It was inspected and looked great – we saved it in our fridge for encapsulation. (More on that later.)

They offered to help me to the bed, maybe to the shower if I wanted, and I said nu-uh, no way, I’m way too tired to move – I am laying RIGHT HERE. They put a sheet down for me, but otherwise I laid right there, on the plastic and towels where I gave birth, haha.

We iced my bottom (frozen water-filled condom – best ice pack ever!) so the swelling would go down a bit. Rebecca was latched and nursing by 4:55am. She was a pro – it was really easy right from the start and we’ve never had any issues with that! I immediately asked for one of the chocolate chip cookies my mom had made and that I hadn’t been able to eat during labor, haha.

Everyone left around 7:30-8am and the three of us were alone. Steve did help me get up and get to bed. I can’t remember how long we slept, but my BIL and his girlfriend brought Ryan home around 5:30pm, I think, and he met his little sister for the first time “She came out!”

Other randomness:

~I hiccuped twice after every contraction. Every.single.contraction. It became a joke throughout my labor… and while I had no clear cut transition period, there was a time when my contractions – although they lessened in pain – never seemed to actually end. That was “proven” by the fact that I wasn’t hiccuping, haha. And the best part? The two hiccups I gave right after she was born = The. End.

~Total = 58.5 hours

~She was 7 lb 6oz, 21 inches long, 13.5″ head

~I had a second degree tear and I chose not to have it stitched. Everything healed great.

~The question everyone wants to know: did I poop during pushing? You bet I did. I even peed on the bed, guys. No shame.

~I ate a few times – or tried to eat (fruit, cheese, peanut butter, crackers, broth…) – but really survived on vitamin water and water. There were 2 cups with straws filled at all times and people were always sticking them in my face. I think we went through 2 cases of Vitamin Water. And lots of spoonfuls of honey.

~Steve was incredible. He was sweating right there with me. He walked the stairs with me, he supported me through contractions, I hung around his neck. He massaged me and talked to me and encouraged me. He even got in the shower once with me. He never had any doubt that I could do it and he never once wavered in his support. I couldn’t have done it without him and WE couldn’t have done it without our doula.

~During contractions some women moan, some might yell, some may be silent. I chanted. I guess through all my reading and hypnobabies, the ONE “affirmation” that really stuck in my head was “down and out.” I think it gave me something to focus on and it was a positive thought – let’s get this baby down and OUT! So with each contraction, I’d moan “down and out, down and out, dowwwwwwwn and ouuuuuut, dowwwwwwwnnnnnnnnnn and ouuuuuttt” and when they were really bad, I’d start turning my head from side to side, too. My other chant later on was “IIIII can do it, IIIIIIIIIIII can do it.” The muscles I liked to tense up were my shoulders, so Steve and my doula did a great job at reminding me to relax those. The relaxation and letting go is really what got me through it.

~I really did want to keep everyone updated the whole time, but there are a couple of reasons I stopped posting on facebook/twitter. Mainly because everything got so intense and I was way too focused to be off typing on a computer. I was in another place… I was in la-la land… the last thing on my mind was facebook. However, all you lovely people did pop into my head a couple of times. I thought about updating a few times, but never got to it. Once, I said to Steve “wow, everyone online is probably freaking out right now! I need to update them!” and Steve replied that HE was updating for me. So at that point, it pretty much went out of my mind. I felt at ease that Steve was telling you guys what was going on throughout the labor. Of course I found out afterwards that he only posted ONCE. So… I am sorry for that, I know many of you were following and were truly concerned! <3 This post is long enough so more to come in future posts: dealing with pain/using hypnobabies, placental encapsulation, and hiring a doula for a homebirth… <"img src="" width="448" height="674">

“Born at Home” — fist bump!

Friday, November 16, 2012

Birth Story Friday: A Magical Birth

Birth of Luca Qrzwin

I enjoyed the prenatal care I received from a group of midwives at a local hospital. When I reached my due date, I realized that receiving care from a midwife did not protect me from hospital rules that sought to take away my autonomy and prevent me from making intelligent decisions about what would be best for my body and my unborn baby. I was told I would be induced. I heard about how Pitocin gets a bad rap, and how I should just have my water broken when I got induced, because one way or another—via vagina or c-section—I was going to have a baby. I regretted not searching further for a home birth midwife, which is illegal in our area, though available on the black market.

I spent week 41 doing everything I could to coax a baby out of me. I used a breast pump to simulate contractions, took castor oil, used cohosh tincture and tea, walked, bounced on a birth ball, and had sex. I cried a lot, because I felt like I was heading into a c-section, not because I needed one, but because I was not going to be allowed to encounter birth on my own terms. I would be induced, denied food and water, and unable to labor or give birth in water. I’m naturally an optimist, and tried my hardest to be okay with what seemed inevitable, but I couldn’t.

Fortunately, I complained to the right person, because my friend had a friend who is a midwife. She would be happy to take me at 41.5 weeks, and was confident the baby would come out when he was ready. We met with her the day before I was scheduled to be induced, and asked our bazillion questions. My main concerns were with making sure my baby was healthy past his due date and also with my positive GBS status. After talking about methods and philosophies, we felt we had a viable option to what felt like an inevitable c-section: an illegal home birth.

I didn’t go in for my induction. I didn’t answer the phone when the hospital called.

My home birth midwife felt the baby and told me he was off-kilter, and perhaps that was the reason I had yet to go into labor. She prescribed walking a lot, taking stairs two at a time, and doing lunges to try to align him. I did, and it worked. He popped fairly straight and in the right place. He had been bouncing around, sometimes anterior, sometimes posterior, and always off to one side or the other. The midwife stripped my membranes, though she couldn’t get in far enough to do much. Still, I bled a bit, and went to bed feeling hopeful.

The next day, I woke up to what felt like my period coming on. I wasn’t having contractions, but my body felt strange and full of anticipation. I felt nothing indicating impending labor the following day, so I again went through the litany of baby coming forth good juju exercises (minus castor oil—just couldn’t stomach that again), even attempting to sing him out, but nothing doing.

About an hour after I woke up the following day, Tuesday the 15th of November, I had a contraction. A few minutes later, I had another one, and then another one a few minutes after that. Although I’d had six weeks of sporadic “false” labor, it didn’t take me long to realize this was the real thing. I woke my partner Andrew: “I’m in labor!” We were both calm, as was my 11 year-old daughter, but excited. I had been pregnant for 42 weeks and four days, and finally—FINALLY!—the big day had come.

I thought I’d have time and energy to do things around the house before serious labor started, but I found I couldn’t really do much besides concentrate on the contractions, and answer questions between them. My daughter packed clothes for an overnight at a friend’s house, while my partner made arrangements to take the dog elsewhere. While my partner was gone and I was alone, the contractions slowed down and were not so intense. When he returned, however, so did the intensity and the frequency.

I took a shower, figuring it might be my last for a time. The hot water felt fantastic. When I got out, I laid down on the bed, and soon after the midwife came. She checked me and told me I was dilated to 2-3 cm. I was disappointed, as it had felt pretty intense. She told me I was having active labor during the latent phase, and that I should call her back when the contractions were longer, or if I felt I needed her. I got out of bed, because the contractions felt more intense when I was lying down.

After the midwife left, I settled onto the couch, sitting and leaning over a birth ball, with a quilt and a pillow piled on top. My partner was behind me, putting his hands on my back when I felt a contraction. After a few hours, I felt it was time to call the midwife. She came over promptly and checked me again. I was dilated to 3-4 cm. It was a bit discouraging, as I’d been having contractions every three minutes for five hours or so by then. But I was still very happy to be in labor at last, and I knew the pain was going to be more intense later, so I did my best to integrate each contraction, focusing on opening up and relaxing.

The midwife began to set up the birthing pool, as my partner had been providing me continuous support, and I did not want him to leave me. We did not have the connector piece that attached the showerhead to the hose to fill the pool, so the midwife left to find a hardware store. Soon after, my friend Maggie, who was acting as my doula, arrived. I was surprised at how different my preferences to cope with labor were than I had anticipated them to be. I had several cds of relaxing music, but I wanted—needed—complete silence. I had a bottle of massage oil, but any kind of movement on my skin distracted me from concentrating on the sensation of the contraction and relaxing into it. All I wanted to feel was a constant pressure. I did not want my hands held; in fact, I used them as a sort of magick wand to wave away and scatter the pain the contractions brought.

Maggie took Andrew’s place behind me so he could eat some food and get some air outside. I felt incredibly sleepy through most of this, and I do not know how long I was slouched over the birth ball, dozing between contractions, then moaning during them. I was incredibly thankful when the midwife said the birthing pool was ready for me. I stripped off my clothes—no modesty left whatsoever—and climbed in. My partner changed into his swimming trunks and climbed in as well. It took a bit to find a comfortable position. I sat on the pillow inside the pool. It was painful, as was lying down. I remembered reading of the thought that pain was a way my body was telling me that this was not a good position for me. Finally, I took to standing on my knees, facing outside the pool, while Andrew was behind me with his hands providing a firm touch on my lower back. Later, he said he felt like he was giving me reiki, and that was what it felt like to me as well—why I found it very necessary that he be with me.

The afternoon went by with three minute contractions. The midwife had to leave to pick up her child, and checked me before she left. I was dilated to a very stretchy 6. After she left, the contractions picked up in intensity. At some point, my friend Eva arrived, as did extra towels. I was fairly out of it at this point, just concentrating on the contractions—waving my hands around to scatter pain, moaning low to open myself up, and soon it was dark outside. I lost all sense of time. It felt like labor had just begun, but I knew an entire day had passed.

The midwife returned, and said I was dilated to 7 cm. After a while, I was having a hard time with the pain of the contractions. I could hear my voice rising and I felt my own fear. If I was in a hospital and had been offered pain relief, it would have been very hard for me to say no. As it was, this was not an option, for which I am thankful. But I felt I could no longer keep on top of the contractions. I didn’t know what to do. “I just need a five-minute break,” I said. I laid down in the pool, as did my partner, and he put his arms around me.

I thought about what was happening, about all the thousands of women around the world who were also giving birth at that moment. I felt a contraction coming on, and I acknowledged it, but thought, “I’m not ready.” It evaporated. I thought about creation in general, and how it doesn’t seem like birth should hurt. I felt at some primal level that we humans had lost the way to give birth without pain. Another contraction crept up, and I again said “I’m not ready,” and it melted away. I thought about how humans have been giving birth for millions of years, and how this was a completely normal process. The less fear, the less pain, I knew. Another contraction began that dissipated when I again stated I was not ready. I steadied myself. Finally, I was ready. I stood up on my knees and waited for the next contraction.

I found myself staring at a bottle of coconut water, of all things. It had some sideways writing on it that I could not—did not want to—decipher. The contraction came on, but instead of feeling it in pain and fear, I surrendered and let it wash over me. My hands began to conduct the contractions. I put my hands together in a circle and spread them apart, and I could feel myself opening up inside. I pushed one hand down, and could feel the baby moving down. If the pain got intense, I scattered it away by moving my hand back and forth. I breathed through the contraction instead of moaning and yelling through it. It was far more intense, but I felt again like I could handle it. I could see/feel my birth attendants looking at each other, but I did not feel like I could explain what was happening.

After a while of doing this, I asked the midwife if she would recheck me. She asked me what was going on with my contractions. Had they stopped? I told her they were more intense, but I was better able to handle them. She told me I had dilated to 9 cm. I was in transition, I knew. All this time, I felt I was experiencing this birth in two places at once. I was here in this physical world of Earth, feeling the sensations of labor pains and warm water and loving touch from my partner. But I also felt I was in some strange world where energy swirled; I thought this must be the primal state that so many women feel during labor. I felt I was equally in both. I was wondering if the primal part would take over at some point, but it did not. I was fully present in the world of sensation and also in the world of primal energy. And I was still staring at the bottle of coconut water!

After a while of this, I felt the contractions again getting to be more than I could handle, and I told the midwife this. She asked me if I felt the baby’s head, and when I reached inside, I could feel a bulge. She asked if I felt pushy, but I did not. She said I could try pushing. After a bit, I did find myself pushing down on a contraction without meaning to. Then I pushed with gusto, though I wasn’t sure how well I was pushing. I told this to the midwife, who directed me to push like I was having a bowel movement. That made it easier! I kept asking if I had pooped, figuring if I did, I was pushing correctly. I don’t think I ever did, but that instruction was quite useful in directing my body.

I stretched my legs to the side while in a half squat, which helped with the fatigue, but they were starting to shake and cramp. Eva and Maggie grabbed my hands and elbows, and I got into a full squat and pushed. I could feel a lip of cervix in front of the baby’s head, so I held it aside while I pushed, and it moved past my cervix. I pushed several more times, until the baby’s head was even with the entrance of my vagina. Meanwhile, Andrew was behind me, supporting the massive hemorrhoids I had sprouted. “Now that’s love!” said the midwife.

My legs by this point were really giving out, as I had been standing on my knees for five or six hours, followed with squats. The midwife suggested I try another position, like lying down. I was hesitant to do this, as any other position I tried hurt when contractions came. She noted that was when my cervix was dilating, and now I was pushing, which was different. It was with relief that I laid back into Andrew’s arms. I enjoyed a quick relaxing break, then grabbed a handle of the birth pool in one hand, and Maggie’s hand in the other, and pushed with all my might. It did indeed feel like I was trying to crap out a bowling ball, a comment I had read several times in reading birth stories.

My friend Eva, holding a flashlight in one hand and a camera in the other, told me she could see the head. I reached down and felt, but it didn’t feel like a head to me. It was something very oddly shaped! She showed me the picture on the camera. Again, it didn’t look like a head, but a weird pointy thing. Two more pushes got the head out. It was intense! I remember smiling with relief. I had been afraid to stop pushing, lest his head keep sliding back up inside. I think the bag of waters broke around this time. The midwife said, “Now the shoulders!” I asked if it would take just one push, and she said it would. I gathered my strength and pushed. Before I knew it, a slimy sticky gurgly grayish thing was on my chest. I was still in the act of pushing, and it was very much a surprise: our baby!

The midwife put a towel around him, and I massaged his vernix-coated body. He gurgled quite a bit, and then eventually cried some. He was a bit limp when he came out, but massaging him helped stimulate him and color him up. I looked between his legs to verify that yes indeed, he was the boy the sonograms had promised. I realized why I didn’t think what was coming out of me was a head—he had a massive cone head! He was still ridiculously cute, in that “this is my baby” kind of way. His eyes were alert. He kicked and kicked and kicked his long skinny legs. I remember those feelings on my ribs and side when I slept. It felt so strange to be feeling them on my arms and breast instead. I pushed out the placenta, which floated in the birth pool in our popcorn bowl.

I felt so grateful that our baby had been born without forced (by situation or protocol) medical intervention. He had been born surrounded by love and peace. We felt incredibly blessed.

Luca Qrzwin


7 pounds, 9 ounces

22 inches long

42 weeks, 4 days gestation

born at home, completely natural, in water

13.5 hours of labor

Wednesday, November 14, 2012

Against the "Unconstrained Rights of Pregnant Women"

"Planned Home Birth: The Professional Responsibility Response"

THIS right here is why Illinois Friends of Midwives, the Coalition for Illinois Midwifery, The Big Push for Midwives, etc. etc. exist. To fight against this attitude.

This editorial in the American Journal of Obstetrics and Gynecology argues for "constraining" the rights of pregnant women. It completely glosses over the concept of maternal autonomy and ignores the many criticisms of American obstetrics that is intrinsic in the homebirth movement.

This editorial is so paternalistic, so misogynistic that the most outspoken opponent of homebirth, Amy Tuteur, has written against it. I encourage you to read her post.

As homebirth advocates we affirm the "unconstrained right" of women to choose where to birth and seek to improve access to competent, trained, professional, and licensed midwives to make that birth as safe as possible. Safe birth and respect for women's autonomy are NOT mutually exclusive, and you can not have a safe birth WITHOUT respect for women's autonomy.

The president of CFIM is looking to start a funding campaign to help the Big Push for Midwives fight against this attitude. I plan to post details when I have it.

Friday, November 9, 2012

Birth Story Friday: My Easiest Birth - Chicago homebirth in the 80s

For a long time HomeFirst in Chicago attended births at home, and my mother-in-law had most of her births through them. They stopped their maternity practice in, I believe, 2010, eliminating the most popular legal option for homebirth in the state.

This is the story of my husband's birth

Kevin was born in May of 1982. Prior to his arrival, I had birthed three daughters (two at home) and then, in December of 1980, I miscarried. This induced paranoia to the extent that I ate and drank huge amounts of very healthy food during Kevin's gestation. Naturally, I was late! Although the practice I was with was noted for homebirths, they apparently did not put much stock in a woman's knowledge of her own cycles. I had a non-stress test when I was, by their reckoning, one week overdue. As I approached the two-week mark (and a second test), they began to talk of hospitals and inductions. I was freaked out. One day before the test, I prayed to my deceased grandfather (who had always hated hospitals) and asked him to help me. Early the next morning, I dreamed that my grandfather leaned over and kissed me. I woke up in the early stages of labor.

Early labor continued very peacefully for about four hours. At noon, I called the practice and breathed through a contraction (over the phone!) for the midwife, who said that she and the doctor would be over shortly. When they arrived, we were all prepared, and I was still rocking in a chair in the living room. My mother had come over to be with our three-year-old. A few hours later, the older girls returned from school. I was becoming very uncomfortable by then and moved to the bedroom. As the contractions got more intense, the doctor, upon examining me, said that the water bag had not yet broken; he encouraged me to "give a little push" with the next contraction. The bag then broke and labor sped up!

I was soon in a semi-seated position in bed, braced by my husband. A few pushes later, the head was born but suddenly, there was a problem: the shoulders were stuck! The doc immediately said, "Hands and knees" so my support team gave me the old "heave-ho, over you go" and the shoulders came right out. Kevin was born at ten pounds, one ounce, at 4:35 p.m. The doctor later told me that if that had happened in the hospital while I was in stirrups, the delivery team would have dislocated the baby's shoulder to deliver him the rest of the way. Wow! I was so glad to be at home!

I subsequently had two more home deliveries, both big boys, without having to do a last minute position shift. But to this day, Kevin still reminds me, in many ways, of my dear grandfather. Thanks, grampa! And thanks to my knowledgeable delivery team!

Monday, November 5, 2012

The State of Midwifery in Illinois

Hi everyone, and welcome to our little corner of the web. This blog is to be the public face of Illinois Friends of Midwifery, a volunteer-led consumer organization that is trying to license homebirth midwifery in the state of Illinois.

To understand the task ahead of us, I think it's important to review this history. Rachel Dolan Wickersham, president of the Coalition for Illinois Midwifery, has already outlined it for us:

The Illinois General Assembly works in a two year cycle. Most bills are introduced in the first of the two years and, generally speaking, only fiscal bills or emergency bills are introduced in the second. At first we only introduced bills in alternate years. As our bill progressed, however, and we pointed out severe shortages of maternity care providers for home birth families, we were gradually able to get more attention in the second year of each cycle. Here is a rundown of the years:

1979 - 2000 Various groups of midwives including the Illinois Alliance of Midwives presented various licensure and decriminalization bills. Hearings were usually short and bills did not get out of committee.

1997 – 1999 The Illinois Council of Certified Professional Midwives (ICCPM) and the consumer group, Illinois Families for Midwifery (IFFM) were formed. On a national level, there was the National Certified Professional Midwives Guild (NCPMG) - part of the AFL-CIO. Union lobbyists gave CFIM, ICCPM and IFFM access to briefings, introductions to some legislators, and taught our activists the ropes in Springfield.

2000 – Coalition for Illinois Midwifery (CFIM) formed, bringing together midwives and consumers in a coordinated effort to seek out other supportive groups and together, pass CPM legislation.

2001 - First licensure bill submitted specifically referring to CPMs. The bill gets an unusually long hearing due to the committee chair being a strong union supporter. The bill does not pass out of committee.

2003 – NCPMG no longer in existence. Short hearing. The bill does not pass.

2005 - 94th General Assembly. CFIM hires a lobbyist, Dan Johnson, and with little effort, passes a resolution in the Senate. SR189 calls for the Senate to consider midwives as part of the solution to state healthcare shortages

2007 – 95th General Assembly. On lobbyist’s advice we try the Senate first instead of the House as usual. SB385 passes the Senate on a vote of 51 – 7. It picks up 19 sponsors in the House and after long negotiations, gains the support of the Illinois Society of Advance Practice Nurses and a neutral stance from the Illinois Nurses Association. After a spectacular two hour hearing, it does not pass in a House committee and dies in the House.

2009 – 96th General Assembly. Knowing we can pass the Senate, we start in the House again. HB226 gains 18 sponsors including the assistant majority leader of the House (second only to Speaker Michael Madigan) Barbara Flynn Currie. It fails to pass in the spring of 2009 and “remains in committee” (code word for “dead bill).

2010 – Despite the Home Birth Safety Act’s “dead” status, Coalition members start an aggressive campaign to revive the bill. It works and the bill picks up 19 sponsors, however the deadline for a hearing is missed. Leadership indicates a willingess to hear the bill if we can find a vehicle. A shell bill is found – one that has already passed through the Senate and through a first hearing in the House, but is no longer needed. SB3712 – the Veterinary Records Act is gutted and the Home Birth Safety Act is moved into its shell. It picks up 20 sponsors immediately. With the amendment of the new midwifery language the bill goes back to committee, now within deadlines because it is a “second” hearing, and the bill passes out of the Health and Healthcare Disparities committee in early May – the first time ever that a midwifery bill achieves House Committee passage in 30 years of attempts.

2011 - In January, during a lame duck, post election, veto session, just days before the closure of the 96th General Assembly, at a time when the most controversial bills are heard, the bill comes to a floor vote. The Senate prepares to receive it and rush it through, but it fails on the House floor with a vote of 46 – 71.

2011 - 97th General Assembly – Taking the approach that if the legislature refuses to protect home birth families by licensing CPMs, they may at least want to assure that emergency transports go smoothly, the Coalition introduces HB5370 - originally the Home Birth Integration Act, eventually known as the Safe Transport Act. The Illinois Hospital Association assists in drafting this bill and takes a neutral stance – another first for a midwifery bill. However before the House Committee hearing we are told essentially that although this idea is interesting, what we really need to do is seek licensure. The bill dies in committee. A Home Birth Safety Act for CPM licensure is also filed in this session but does not receive a hearing.

2012 – Governor Quinn issues a mandate to cut billions from the Medicaid budget. CFIM prepares a 12 page proposal to save Medicaid $5 million annually by licensing CPMs and allowing them to become Medicaid providers. The figures are verified by an economist. The proposal does not make it into the Medicaid Reform Bill despite the fact that it is the only proposal that adds services for those without private insurance, rather than reduce them, while still saving money.

This project is obviously political, but truly nonpartisan. Midwifery licensure is in line with every political ideology, and the women who make up the board of IFoM represent most of the political spectrum, from very left to very right. We all want women to be able to safely and legally choose the location of their birth.

This blog won't solely be political, I sincerely hope it will also serve as a hub for the Illinois homebirth community. Here you'll find support, encouragement, and information relevant to homebirth. Accordingly, if you've had a homebirth in Illinois, please send us your birth story (hospital transfers are welcome too). Every Friday I'll post one Illinois homebirth story.

Ultimately I want this to be a resource for you. If you have questions, ideas, or just want to talk to us please feel free to comment.

Lastly, don't forget to vote!