Sunday, January 8, 2012

Let's start from the very beginning. A very good place to start!

Mary Helen’s Birth Story (born February 8, 2011)
I love reading birth stories.  As a mother, there is something so unspeakably powerful about bringing a new life into the world.  I get to meet this beautiful boy or girl whom God has purposed from before time began.  I get to look into the sweet, squishy face of my newborn and hold her wobbly head against my warm breast and get acquainted with this amazing human that God has been so intricately forming in my womb.  This mysterious being that has been wrecking my ribs and heaving up heartburn suddenly appears as my daughter.  Man and woman become Father and Mother; a title bestowed on we who are ill-prepared and under-informed but starry-eyed and filled with love and ambition.  


It's difficult not to pause here and say a word about adoptive parents.  I also love reading their 'birth stories.'  What an incredible sacrifice and true example of love for a family to think about the needs of others and extend the comfort and support of their family to a child who has been abandoned.  What a powerful moment to meet this child you have waited and prayed for, who you know has had too few hugs and too many lonely nights.  How right and holy and deeply good it must feel to give another child the life they deserve, to redeem what was broken and lost and give purpose, hope, friendship and love.  The story of a family is powerful in whatever way it comes to be!


This is our story.  The story of Mary’s birth.  (With a few other details thrown in.)
For my sake, for her sake and for all those who believe in the power of birth.  
(Note: I thought about re-writing the full story and offering a more condensed version, but I just don’t have the time for it; I’ve never been one to know how to tell a short version of a story; and usually those who are interested in a birth story are interested in all the tiny details and I-wonder-if-this-is-it contractions.  So, here it is, in all of it’s 4,700-word glory!)
Starting with this very moment...
January 8, 2012
Today I packed away our Christmas decorations.  I unhooked ornaments, unplugged the tree, removed our pre-lit garland above the fireplace, packed it all in oversized, green and red Rubbermaid bins to be hauled to the basement until next year.  Christmas is over, the new year has begun and I feel giddy about the prospect of another year with my two kids.  
Tonight I fed my almost-3-year-old Elijah and 11-month-old Mary dinner, gave them baths, stacked two loads of tidy, tiny clothes into their dressers, tickled tummies, fit their little limbs into plush pajamas, read a night-night book, nursed a baby, turned on humidifers, sound machines, fans, night lights, and music players, gave kisses and hugs, filled a sippy cup and tip-toed back downstairs to get started digging into my new year’s goals, which would start with prioritizing my kids and cherishing their memories. 
It is hard to believe my little Mary will be a year old in just one month.  A year ago this time, I was 8 months pregnant, house-hunting, planning my little guy Elijah’s 2nd birthday party and, most fervently, scouring books and blogs to learn as much as I could about natural, unmedicated birth.
Remembering Elijah’s birth...
It’s hard to tell Mary’s story without remembering Elijah’s.  I had also hoped then, like more and more moms out there, for a natural, unmedicated birth.  I read a few birth stories here and there, took a birth class at the hospital and read, rather haphazardly, articles and tips and friend’s suggestions about how to avoid unnecessary interventions.  I had heard of epidurals that didn’t work, or that went awry and caused painful, lifelong side effects for the mother.  I had heard of forceps and vacuum extractions that caused short- and/or long-term damage to the mother and the baby. I had heard of c-sections ordered simply for the convenience or legal protection of the doctor and hospital.  Of course, I also knew of many successful epidurals, forceps and vacuum extracted babies and mamas that are healthy and injury-free, and c-sections that were necessary and literally life-saving for mother and child.  It was difficult to decipher the vastly differing messages coming from the voice of doctors, authors, natural birth advocates and friends.  
Of course, Elijah’s birth began with the one scenario I least expected and about which had done nil research.  Without any contractions happening (that I could feel), my water broke at 4:30am on February 19, 2009 -- 10 days before my due date. That only happens in about 10% of first-baby pregnancies.  I knew my OB had told me to get to the hospital when my water broke even if labor hadn’t begun, due to the risk of infection.  I was hoping to labor at home as long as possible to minimize my time at the hospital and the availability of an epidural.  After a hasty Google search on whether or not I should go to the hospital, I could find nothing that seemed reliable about laboring at home with broken waters, and so we headed in.  Once we arrived, we were told the risk of infection significantly increased if the baby wasn’t born within 18 hours. (Interesting how that timeline would get the doctor home before midnight!!)  Looking back, I’ve researched more about the risk of infection that we were so fearfully threatened about then.  I was strep B negative, so the risk of infection was extremely minimal, and even if I was positive, a simple IV of antibiotics would have eliminated that factor and I could have labored naturally.  I asked if I could walk the halls, if that would help my contractions to start.  My OB offered little encouragement, saying that rarely helps labor; nothing you can do really does much to bring on labor and encouraged me to start pitocin.  I really wanted my body to begin labor naturally and finally we agreed to let me walk and we would re-assess the situation in a few hours.  By 10am, contractions were still weak and irregular and the OB was sticking to her 18 hour timeline.  Pitocin was started and I was still hopeful to manage contractions without pain relief.  Boy, I had no idea what I was in for!  Sometime in early afternoon the contractions were getting so strong with no breaks in between.  I asked the nurse if she could remove the pitocin then, and see if my body would continue in labor.  That request was turned down flat.  Once the drip is started, it must be continually increased through delivery.  By 4pm I had an epidural and was thankfully, blissfully free of the nightmarish contractions.  Elijah was born just after 10pm.  I pushed for less than 20 minutes and felt none of it.  I was completely numb from mid-back down.  
Perhaps some of my post-birth emotions would have been the same even without pitocin and an epidural; I’ll never know.  But I can’t help but believe that some of my hesitancies, my doubts, my fears, my lack of blissful, newborn ecstasy was due to the missing oxytocin and adrenaline that my body didn’t produce when the synthetic pitocin drip was administered and the epidural blocked all sensation of pain and energy that was pulsing through my belly.  I also had an episiotomy, which I believe could have been avoided if I could have felt and controlled pushing and also if my OB had been educated about and supportive of natural ways to soften and stretch me (and maybe just have a little patience) instead of just cutting me so that we could "go ahead and have this baby in just a couple more pushes!"  In the end I was grateful for a vaginal delivery and so happy to have a healthy baby. But when my second pregnancy came, I knew I wanted something different and that I would have to be incredibly intentional about pursuing and fighting for a natural, unmedicated birth.  I needed to do more research to really know why I wanted that and when it may no longer be an option; this time based on the true health of the baby or myself; not because of a doctor’s timeline or hospital liability.
We were in Michigan now (Elijah’s birth was in Texas) so I needed to find a new doctor, and I had just picked a random OB that a friend recommended.  After my initial 12-week visit and a brief inquiry from myself about their views on natural labor and when to use induction, I came home with the same feelings I had when talking with my OB during Elijah’s birth.  My husband was truly instrumental in encouraging me to find a midwife, or at least an OB that was supportive of using a variety of natural methods to begin and manage labor and delivery.  I called the health center to cancel my next appointment and tell them I was going to using a midwife.  Their unfortunately characteristic response was a sarcastic, “Good luck with that.”
I found a local office that was perfect for us.  The medical staff consisted of several OB’s and midwives.  Patients could choose either route.  There were three midwives and I rotated between all of them, since you never know who will be on call when you go into labor.  In case a pregnancy ever indicated risk, patients were simply transferred over to the midwives’ supervising OB.  And the midwives met regularly anyway with their supervising OB to review all of their patients and their progress.  The midwives delivered at the hospital just like the OB’s, in this case they did not offer a birth center.  So, the primary difference was that the midwife was trained in natural childbirth techniques and was there with you for the duration of your labor and delivery.  (An OB is typically trained primarily in medical events, or birth interventions, and usually comes in when you arrive at the hospital, maybe once or twice to check in on your progress, and then just moments before you push.)
I also hired a doula.  And she was invaluable.  A doula is simply a personal coach for the mother.  Although mine also happened to be a nurse at my OB’s office, as my doula, she was not there as medical personnel.  She was there to support my goals and help provide the birth experience that was important to me.  At our first meeting, she suggested the book “Ina May’s Guide to Childbirth,” which I read and re-read from cover to cover.  Never before had I read so many positive stories about natural childbirth.  In America, birth is typically discussed as a medical event, as a painful, horrific experience.  Mothers who want a natural and unmedicated birth are often met with scoffing, discouragement and fear-inducing stories of the many ways natural childbirth is dangerous. (I am careful to acknowledge the need for safe practices in natural birth and to gladly take intervention when it is needed. However, there is simply an unacceptable lack of knowledge about natural birth techniques with the majority of OB’s today, which leads to unfounded fears in mothers and the highest rate of c-sections in the world.)
In the end, I was convinced -- deeply convicted -- that I wanted a natural childbirth.  I wanted my body to prepare for and handle birth on its own timeline and with its own hormones.  I wanted my own oxytocin and adrenaline to conjur up the love and confidence and euphoric energy needed to care for and bond with and begin to raise this child.  I wanted to experience the sensation of delivering my baby.  I wanted avoid a shot in my spine with a needle the size of my pinky. I wanted to avoid having a catheter and an IV and fetal monitoring straps pressed on my abdomen and being confined to my bed during labor.  I wanted an easy and happy birth recovery, filled with the natural hormones and energy that would be strong enough to drown out moments of baby blues and daunting doubt that dotted my first post-partum experience. I wanted my baby free of second-hand medicine that might cause her to nurse poorly. I wanted to avoid a c-section and the impending recovery that required.  
And, I have to admit I just kind of wanted to buck the system.  It made me angry that I had more of a say in my cable TV package than I do in the birth of my child.  It infuriated me that there was no support, no belief in the power of our own bodies to do what God created them to do. And the more I researched natural labor and read the stories of those who were able to achieve a safe birth without pain relief, artificial induction or intervention, the more it appealed to me and just seemed to be the only option.
Looking back to the week of birth...
Wednesday, February 2, 2011
West Michigan got hit with one of the biggest blizzards we have had in years.  It snowed and blowed all night on Tuesday, and I woke up Wednesday with pre-labor contractions.  Every pregnant person was hoping labor didn’t start that day and require an emergency trip to the hospital in the middle of a whiteout.  My contractions were not very strong yet, but they were regular -- every ten minutes -- so I was curious.  I hadn’t felt any pre- or early- labor with Elijah.  These lasted all day long but never got more intense or closer together.  I finally went to bed and they faded out.  
Sunday, February 6, 2011
In the afternoon we looked at a house we really liked and fell in love with it!  Then we went to a Superbowl party with our Sunday School class from church and hoped baby might make a dramatic entrance at half-time.  You felt so low, I was sure my water could break at any second. 
Monday, February 7, 2011
Monday morning I woke up and had a bit of bleeding.  I was also having a few contractions that were stronger than the previous week, but not painful at all and not regular or getting stronger.  They stopped within a couple of hours, but I was on high alert all day because of the bleeding I had in the morning.  I had called my doula, Angela, and she was excited.  She said this usually means the baby will be here in a day or two.  Contractions came and went a little throughout the day and I had the car packed and ready to go.  By the evening I was in so much suspense, wondering what my body was doing and when we would get to meet you.
Tuesday, February 8, 2011
On Tuesday, the day before my due date, I woke up again with a bit of bleeding, and more contractions.  These were a bit stronger yet, but not really steady and not growing stronger.  Elijah was going to a babysitter for the day, and I asked Art to work from home in the afternoon in case I needed him.  I took a nap in the morning and finished a few things around the house.  In the afternoon, I made another chiropractic appointment and got a massage.  I was having a few contractions here and there all day, but after my adjustment and massage, I felt like they were starting to get stronger and more steady, but I wasn’t timing them.  I stopped by the fabric store (I wanted something to keep my mind off of labor!), picked up Elijah from the sitter, and we went home to get dinner and meet our realtor -- we were going to make an offer on the house!  Our realtor came over around 5:30pm (I labored on the birth ball at the kitchen table while we filled out our offer), and was out the door a half-hour later with our bid.  After the realtor left, I told Art I needed to lay down and I needed him to get Elijah to bed in case I needed him soon. I went to rest... to see if the contractions got stronger or subsided.  Art played with Elijah and did his dinner and bath-time.  Around 7:15pm, I had a strong contraction while I was laying in bed.  At its peak, I felt a pop and then my water leaking.  I jumped up, got to the bathroom and called my mom -- my contraction was still going when she picked up the phone.  “Hold on,” I said, “I should have waited until the contraction was over to call you.”  I was so excited and nervous and overwhelmed, I started to shake and tear up.  “This is definitely the real thing!” I exclaimed, “My water just broke!”  Mom said she just sent her last e-mail and would be out the door in 15 minutes.  She lived about 2 1/2 hours away and had a drive ahead of her.
My phone died right when I hung up with my mom, so I walked to the kitchen to plug it in and hollered to Art along the way, “Water just broke!”  He was in Elijah’s room getting him ready for bed and was on the phone with a friend (Michael Brock!).  Surprised, he exclaimed, “Kate’s water broke!  I gotta go!”  I plugged in my phone and called Angela to give her the update.  As soon as I told her my water broke she insisted I get to the hospital right away.  She said that will probably speed up my contractions and things could move quickly.  Angela was awesome.  She called the hospital and told them - not completely truthfully - that I was in labor and they had confirmed with a test that it was actually my water that broke.  This got me right into a room instead of the pre-labor rooms most women have to go to.  At home, we scurried around, trying to re-pack the car and arrange for someone to come over and stay with Elijah.  Erika Sterken came initially, a friend who was due shortly after I was!  And Dan Stauch came later to relieve her and stay the rest of the night so that my mom could come up to the hospital for a bit and meet the baby.  What a blessing those friends were!
We got to the hospital a little after 8pm and Angela met me at my car door when we pulled up to the emergency room.  A contraction kicked in as I moved to get out of the car, and I had to stop to breathe through it. Angela later said when she saw that, she knew we’d be having a baby very soon.  She stayed with me as I got inside and Art parked the car and brought in our bags.  I had to lay in bed initially so they could get a 20-minute strip of the baby’s heartbeat and my contractions.  I didn’t mind it, as that was the position I was handling things in at home.  I was having some back labor though, and laying down made that more painful.  Around 8:30 my midwife arrived and checked me.  I was so nervous about being checked, about hearing I wasn’t very far along and then thinking too much about how long labor might be and wondering if I could handle it or not. I had opted out of being checked at any of my last weekly appointments simply to avoid the mind game and because it doesn’t really mean anything, anyway.  And -- being checked was extremely painful for me, I think because my cervix was tilted back, so she had to pull it forward to check me.  I was sure she would say I was at a 4, maybe 5... but her eyes got wide and she looked right at me and said, “You’re at a 7/8!”  She said the baby was at a 0 station and I was shocked, but so relieved that my body had been working so hard and so effectively already.  I asked if the monitors could be removed and that helped... I did not like having any additional pressure on my stomach.  
I felt like I was handling my contractions well.  I was doing deep breathing, usually two long, slow deep breaths for every contraction.  With one hand, I was squeezing Art’s hand with a death-grip and with the other I was feeling my stomach contract.  For me, it helped to keep my eyes closed.  Angela was on my other side, talking me through each contraction and reminding me I would get a break soon.  And the breaks were wonderful.  Sometimes I would keep my eyes closed and continue to breathe slowly on the breaks, and other times we were all talking or laughing about something.  After each contraction, my legs would shake uncontrollably from all the adrenaline.  My iPod was playing in the background with songs like Helen Reddy’s I Am Woman, and that helped me stay light-hearted and energized.  As the contractions became stronger and more productive, I took one big breath at the beginning and then let it out in one very long, slow, loud moan.  It honestly felt a little awkward, but it helped so much to put my head down and let my breath out like that; if I could do that, I literally did not feel any pain with the contraction.  But it was hard to get my breathing under control every time to do that.  Sometimes I was just breathing hard and fast, panting and saying things like, “I can’t do this!” or, “Please, make it stop!”  Art, Angela and Sandra were quick to counter with encouraging words... “You ARE doing it!” and, “You’ll get a break soon.”  
Soon after the monitors were removed, I wanted to try to labor in the tub before we got too far along.  The tub was so nice, it was helpful and relaxing to have the warm water around me.  It was better for my back labor, but it was difficult for my legs because the tub was pretty narrow and I could feel the baby moving further and further down.  I think I had 3 or 4 contractions in the tub, then got up to move back to the bed. (That was not easy!) I started having some sensations that I needed to push, so the nurse checked me again.  I was still at an 8 and there was some cervix yet in the way, so everyone was insistent that I wait to push.  A couple more contractions came, and I could resist the urge to push.  I had a couple of long breaks in between contractions, and felt slightly nauseous too.  Angela said this meant transition was coming, and my body was giving me these long breaks to get ready to push.  She told me to try to nap in between.  I thought it was humorous to think about a 60-second nap, but I tried and it helped.  I just sunk into the bed and closed my eyes and relaxed as much as I could. Then I got on my hands and knees for a few contractions.  Angela thought that was a good position to get the baby further down, and it did help.  The urge to push was getting stronger and Angela and my nurse were really trying hard to keep me from pushing.  This urge is ridiculously hard to describe.  My midwife Sandra, had left to check on another patient, but she was back now and getting ready to check me again.  I had a very strong contraction and the urge to push was unbearable.  My body started pushing down no matter how hard I tried to resist.  Sandra started to check me again to see if I was ready to push, and found that I was crowning -- the baby was out to her eyebrows!  They quickly changed gears to get me on my back for delivery.  I was sure that was physically impossible, but a break came and I was able to turn over.  Another contraction came and my body pushed like crazy!  I don’t remember there being any breaks between pushes, I was just breathing hard, yelling, pushing, and yelling some more.  I was oblivious to any contractions now, I was just focused on pushing out my baby.  I definitely felt something like the “ring of fire” I had read about in other birth stories.  It felt like my bottom was being torn in two and I was sure I was tearing like crazy. It was such an incredibly fast birth there was just no time to get a grip on it.  There were less than 5 minutes from the first push I couldn't hold back until she was fully delivered.    
At this point, I remember a very specific thought.  Throughout labor, I continually reminded myself that thousands, millions of women have done this before and it is a normal, healthy part of life.  But when the pushing came, that thought seemed utterly ludicrous and totally unbelievable -- I was sure that NO other woman had ever experienced this intense amount of pressure!  It seemed so larger than life, so other-worldly.  But, there was no stopping it!  I was pushing as hard as I could and it was truly amazing to feel myself giving birth to a new life.  
All of a sudden I felt the head push through, then I quickly pushed again and delivered the rest of her body. It was very surreal!  I could not believe she was here.  Sandra waited a few minutes for the cord to stop pulsing, and then helped Art cut it.  They put her right on my chest and she laid there for an hour.  She was very sweet and content.  She was sucking on her fingers, so I let her nurse and she took to it right away and nursed for almost an hour.
It turned out I only had a very small, superficial tear.  I needed five stitches, and that was worse than labor!  I was surprised, because in most stories I had read, women said that being stitched up was nothing compared with the delivery.  But, that was finally over and I was so ready to close my legs, sit in bed and hold my baby.  
My parents arrived at the hospital around 10:30 and waited outside for a little bit while stitches were finished and I got started nursing.  I think they came in around 10:45. I was so happy they were both able to be there right away and meet our little girl. Dad was exhausted because he was in the height of tax season and in the middle of several very busy days.  His girls keep having babies during tax season!  I’m sure mom was tired too, she had just made the 2 1/2 hour drive from her office to our hospital.  Thankfully, roads were good and we weren’t in the middle of a blizzard.  Mom was able to stay for a while before she went to our house so she could take care of Elijah and our dogs. 
I was so elated, I could barely sleep.  My body felt exhausted, but every time I tried to close my eyes I was just thinking through the whole birth and I felt so happy. I journaled to Mary, “You nursed often throughout the night, and I didn’t mind because I couldn’t sleep anyway. It’s 8am now and you’ve been sleeping soundly since 5:30am.  I’m going to order some breakfast and I’m sure you’ll be ready to eat right around the time I set my plate in front of me!  We are so anxious for you to meet your brother Elijah and have our little family together.  I know you two will love each other.” 


A week and a half later, I journaled:

I am still more in love with you than ever.  You are such a sweet, smiley, content little newborn.  That first morning you did let me eat my breakfast - you slept until almost 10am before we could get you to wake up and nurse.  Your big brother loves you so much and I am just enamored with our little family.  You are very expressive and alert, and it seems that your eyes already hold untold amounts of knowledge and wonder.  We are so blessed that God gave you to us and look forward to watching how He orchestrates His plan for your life.  


We love you, Mary Helen.

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