The Birth Story!

“There is a secret in our culture, and it’s not that birth is painful. It’s that women are strong.”

– Laura Stavoe Harm
 

So I found it really interesting that I procrastinated on posting the 'Preparation' blog-- since our son arrived the next day!!! I think it's a pretty good birth story (definitely not how I expected things unfolding but perfect in how it did!) and I'm still a bit in shock at the whole experience :)!

On Saturday night, Kelvin and I attended Open Door's Holiday party at the Arcata Community Center. We got to catch up with many friends from work (nice since I've been off and out of the loop for a week) and enjoyed dinner which included lasagna and salad. Molly and Nina, two of my prenatal colleagues also term, were both there and "undelivered" too.  There were no signs from my body that anything was brewing. In any case, we headed home between 10 and 1030 pm and tried to go to sleep.

Around 1130 pm, I started having what I'd describe as cramps. They were anywhere from 5-10 min apart and I kept going back and forth to the bathroom, at first thinking I had some GI upset (that lasagna!) but then realizing that I was probably going into labor!

I turned on my hypnobirthing tracks and listened to the sections getting you through 30, then 60 and 90-second contractions.

Around 130 or 2 am, I told Kelvin that I think things were getting more intense. I was still spending a lot of time in the bathroom, kneeling over the birthing peanut ball I got and the cool tub, or lying on the floor. Kelvin joined me and started using the contraction app tracker to check the contraction frequency.  We filled and I got in our bathtub (pics omitted for decency!) with warm water and some lavender essential oil which really helped me cope with the pain (hydrotherapy is great for labor!). Pepper joined us and made herself cozy on the bathroom floor, too! :)

 

By close to 4 am (I found that time did really fly when I was trying to breathe through contractions!), I was trying to examine myself to see if I thought I was really in "active" labor (6 cm+) and ready to go to the hospital.  With everything I've read about natural childbirth during this pregnancy, I was hoping to try to do a birth without meds if I could tolerate the pain, recognizing that there was no way to know how it would affect me (and yes, there was pain, not just an "intense sensation or surge" like Ina May Gaskin, a renowned midwife, likes to say), so my goal was to be strong yet open and flexible! I didn't want to go to the hospital too early in labor. However, on my self-exam, I could feel the baby's head and a bulging bag of water and so thought it was time to head the 5 min over to Mad River. I called the birth center before heading in as a heads up, letting them know I "thought" I was in active labor and needed an objective person other than myself to check my cervix :)

Boy, I'm glad we didn't wait longer at home. I had about 3 contractions between our door and the hospital door a mere mile or so and 5 min from our house, and barely made it into the triage bed before my water broke all over the place (with clear fluid, thankfully). It seemed like it took forever for me to get my weight and vitals taken, put on the monitor, and examined, but the nurse told me at 0445 that I was 10 cm, fully dilated, and definitely a "keeper"! I was relieved yet anxious at the same time as I knew pushing was ahead.

They luckily wheeled my bed into rather than having me walk to one of the true labor rooms, and I was not very aware of much of anything as I think I had my eyes closed and was death-gripping the bedrails. However, we got settled, and although I didn't get a saline lock IV or any time for meds, epidurals, or the like, Kelvin did have time to get out and put up the decor we had packed for the "event," including white Christmas lights, the dreamcatcher and birth affirmation flags from my Blessingway the previous weekend, and the essential oil diffuser.  He turned on my "labor playlist" on iTunes which included some mellow chorales as well as Christmas music and some peppy pop, all of which set a nice mood.

K insisted on this "labor selfie" (in between contractions, I was actually able to smile!)

Eloi, my colleague on call and neighbor, arrived soon after to coach me through pushing, which was definitely hard work! I felt like I was being a bit wimpy, not wanting to "push into the pain" as I often tell my patients.  It was definitely intense. But I could definitely feel his head descending, and even reach down to feel my progress.  I pushed for about an hour or so, with questionable effort but at least I buckled down, cooperated, and did it :)

At 615 am, about an hour and a half after reaching the hospital and 7 hours after the first contractions started, our son "Iver" was born! I think he came out to a Christian worship song "Trading My Sorrows" (we didn't time things quite right as Handel's "Hallelujah chorus" from The Messiah played a few minutes before Iver came out!). We had not picked the name beforehand but rather had a short list to narrow down when we met him. His name is a Scottish and /or Scandinavian name which means "archer" or "bowhunter," and we used my maiden (and current middle) name as his, too.   He came out screaming with Apgars of 9 and 10 and was the most beautiful sight I'd ever seen! He was born on the Winter Solstice which perhaps is lucky in some way? :)

first cry

I was incredibly emotional when I first held him to my chest!

Eloi was amazing! I couldn't have asked for a better cheerleader in the second stage and she also took great care to repair my tear!

Family of three!

Iver was incredibly alert at birth!

giving us the bird :)

Getting weighed! He was 7#2 oz, 3238g, and 19 1/4 inches.

First baby exam

Proud papa

 

Feeling more human, a few hours later

I had an absolutely miraculous and perfect birth experience!  I am so thankful for a mercifully fast labor (don't think I could have done it "naturally" if I was in active labor for more hours or days!), uncomplicated delivery, and healthy baby boy!  

“Birth is not only about making babies. Birth is about making mothers. Strong, competent, capable mothers who trust themselves and know their inner strength.”
- Barbara Katz Rothman

Happy birthday to Iver, happy Winter Solstice, and Merry early Christmas to us!

Mind of a Midwife

 

Last weekend, Kelvin and I (along with some of the prenatal clinic staff) attended a showing of "Birth Story: Ina May Gaskin and the Farm Midwives" at the Arcata Playhouse, featuring one of the most important people in the modern field of midwifery, and the The Farm (commune) she helped found in 1971 which was one of the first out-of-hospital birth centers in the U.S. You can read more about Ina May's mission here and here (when we entered the theater full of women, K remarked, "This is just like when we went to see "The Help"(a wonderful book and movie)! But he agreed later that it was an interesting film).

Now, I am a family doctor doing obstetrics who can and will perform cesarean sections; however, I like to believe that I think more like a "midwife." Some days, I actually think that midwifery may be more my calling than is being a "jack-of-all-trades" in medicine with the added stress and patient demands (but I do love the variety of family med:)).

I have pushed with a woman for six hours to get her a vaginal delivery. I have watched labor curves moving slower than molasses in January and not intervened because I felt that the woman could "do it." I have tolerated some ugly, ugly fetal strips because I knew a vaginal delivery was still the safest option for mom and baby. I am a huge proponent of VBACs (vaginal births after cesarean) and recently rewrote our hospital policy to allow our women with prior c-sections (even >1) more choices and say in their delivery plans and their acceptance of levels of risk.  I delivered a vaginal breech baby this year and would probably do it again ([with extensive consent] [Ina May does!] if a patient felt very strongly that they wanted to try it (although a c-section is generally accepted as the safest delivery route of a breech term singleton). I do c-sections very reluctantly and am often times more devastated than the patient that an operative delivery is the outcome of their birth (as it was yesterday with a woman and twins who just wouldn't come out from below) because the bonding and experience of a vaginal birth is so rewarding. In medical school, I used to cry at most deliveries I attended, and while I have been able to put a plug in most of my own tears (except when I am emotionally and physically exhausted), I love, love, love delivering babies.

I am a bit torn about "home births." Many of the audience members of the show last weekend were actual home birth midwives, women who delivered their kids at home, or children born at home.  This area of the country is very big on home births (and even home VBACs). Because I see and have seen lots of obstetric emergencies and do a lot of the care for "home birth transfers" (home births gone bad), I generally feel that a hospital birth is safest, particularly for the "baby resuscitation" aspect of things, but the midwife in me still sees labor as inherently natural and (hopefully) free from interventions.  I would love to have the opportunity to be a part of/witness some home births to see that side of things. I think that if I were in labor, I'd probably try to check my own cervix and stay at home as long as possible before I committed to the hospital for electronic monitoring, an IV, etc. (I'd love to roll in and be 10 cm and have an unmedicated birth) but would still plan a hospital or birth center birth. I would love to have a midwife do my delivery but have nothing against doctors (if they're of a like mind! :)). How many of you had your baby delivered by a midwife?

While Ina May clearly feels that doctors/hospitals "create" problems for births (sometimes making women feel unsafe, nervous, and unempowered) and that insurance companies/malpractice can really make OBs (and FPs doing OB) more likely to intervene prematurely, I didn't feel while watching the movie that she was attacking doctors as a group (sometimes I get sensitive about midwives hating doctors who do deliveries). As a result of my training, I am a doctor and will be throughout my career (unless I undergo formal midwifery training, that is :)). However, what she communicates well is that doctors and midwives can learn a lot from eachother and should really work together. The Gaskin Maneuver (one maneuver to try during a shoulder dystocia, where the baby's shoulder gets stuck behind the maternal pubic bone) is named after this famous midwife (although the idea was taken from a Belizean midwife who learned it from Guatemala) and, while I've not had a dystocia bad enough to need to use it, I will certainly have it in my toolbox.

Gaskin Maneuver

        from: Obstetrics and Gynecology Clinics, Volume 34, Issue 3 (September 2007)

One of the best books I have read is Midwives, by Chris Bohjalian, a fiction thriller about the scope of practice of a midwife. Many people have suggested I check out the PBS show "Call the Midwife," about midwives and nuns in 1950s East London. Have any of you seen this?

I am excited to delve into some of the books that Ina May has written, including:
-  Spiritual Midwifery
-  Birth Matters: A Midwife's Manifesta

(and, if/when the time comes:)
-  Ina May's Guide to Childbirth
-  Ina May's Guide to Breastfeeding

Any other midwife media suggestions for me?

Farewell to pregnancy (late posting of the belly progression)

I know it seems like it (now that Iver's here and almost a week old!) is a strange time to do a post about the progression of my pregnancy, but in some way, now that that gestation is over, I can fully appreciate and see the changes that my body went through. I really had a very easy pregnancy except from some painful peripheral ulnar neuropathy in my right arm in the last few weeks.  I have a pregnancy and baby keepsake book that I may add this (and the Birth Story) blog posts to, to remember this special time.  We plan to, starting tomorrow, take regular photos to "see Iver grow" too, so this reminded me to finally put all these photos in one place!

The first positive pregnancy test, taken alongside an ovulation prediction strip test in Xi'an, China in April (I was probably just about 4 weeks pregnant here!)

Confirmatory test once we were back, stateside!

First (unofficial) ultrasound by Carolyn to see if we could date the pregnancy!

Dating sonogram "selfie" at around 8 weeks

 These are pretty self-explanatory

13 weeks

20 week sonogram photos

I love these portrait blocks from Erin and TJ although I had to revert back to the cards for one of my photos later as they didn't have the full complement of numbers (i.e. either no three or four)! :)

(missed a few weeks in here when we were on the East Coast)

with my post-Blessingway henna-ed belly!

I delivered at 38 weeks and 6 days so this was our last posed belly photo before Iver was born!

You can, of course, see the result of this growth in the Birth Story blog post!