Vaginal breech homebirth

And then people send me beautiful, delicious birth stories like the following, which was written by my friend Miriam, and I am so grateful that births like this exist! Congratulations on your lovely birth, which would have most likely become an emergency c-section if it had occurred in the hospital (since very few doctors know how to deliver breech presentations, and it’s no longer even taught in med school). Three cheers for homebirth! Enjoy:

Nadia Tell was born on Friday, May 19. She was 37 weeks and 2 days gestation, and is healthy and wonderful and loved.

Thursday, May 18, was a gorgeous perfect May day. I walked down to the Chocolate Gecko and spent a good two hours chatting with Lissa, the owner, while she dipped an order of chocolate-covered fruit (and fed me the ones that got marred by being dropped on the counter). She was talking about other young families in the neighborhood and wanting to put us in touch, and generally thrilled to hear all about our plans.

On the way back I stopped in the dollar store and CVS for some final birthing pool-related supplies—sponges, a hand mirror, an inflatable ring. It felt, like much of the rest of our prep, like I was ticking off the ends of a list by a deadline so we could be well-prepared well ahead of time. I wrote a piece for Metroland’s summer guide that wasn’t due until June 1, and sent it in, cleaned the microwave, and sat on the porch enjoying the weather with Mary, knowing from her that the weather report was predicting big storms coming in and rain for days. It felt like it was likely to be one of many similar days to come. I had lots of things to do, but nothing felt urgent, and I was enjoying the calm.

I made dinner since Robin and Rebecca had somewhere to be early evening. We put off our usual Thursday grocery run until Friday. Over dinner we discussed the far-fetched proposition of buying the Chocolate Gecko (Lissa’s selling and was pushing it). It was a fun and fanciful conversation. I was writing something about it in my journal before bed, and sat down on a stool in my bedroom to note down a few last thoughts.

As I leaned forward I felt a tiny movement down low near my cervix, and sudden there was a flood of warm liquid all over the floor. It was hard to believe and yet unmistakable. I stood up, still gushing, and called “Hey guys?” A face popped out of the bathroom and another from their bedroom. “My water just broke.”

There was a flurry of brains adjusting themselves. It was thrilling, but it involved jumping a few pages ahead to a carefully laid out “ready” place we’d mostly been looking at, not dwelling in. I called Midwife A’s pager, and stood there in just my T-shirt in the middle of the kitchen, with amniotic fluid still dribbling, and occasionally pouring, down the inside of my legs. It was surreal—I felt nothing else at all unusual, but it was sort of my first sign of accepting the weird physicalness of labor that I couldn’t bring myself to do anything particularly practical about the fact that everywhere I went I left puddles on the floor. I had no idea how long that would last, and hadn’t really expected it. It wasn’t unpleasant though, and I just let it happen. Robin periodically mopped up behind me, and sometimes I stood over a towel.

Midwife A was a little surprised, but pleased and calm, as is her job. She said to expect labor within 12 hours, and to sleep. In fact every other thing she said was get sleep. Because of course she knows that it’s hard to imagine doing, and yet we’d all need it. This had been a mantra given to us from early on, but she knew it needed repeated. She sounded a little worried that we hadn’t yet gotten to experimenting with filling the pool, but recovered quickly and said it wouldn’t be the first time. She gave general instructions to eat, drink, made sure I’d been eating well all day, and let us go.

As R&R rushed about attaching the hose to the washer-dryer hook up and making sure all was ready to fill the pool, clear away some last bits of in-the-way stuff, put the plastic shower curtain and sheet down on the futon etc., I made myself some chamomile tea, got out my bag of labor snacks, and soaked two pairs of underwear before giving up on the idea. Oh, and Robin took final pregnant-belly pictures.

Mary came up in the middle of the pool prep, and we were all a little flummoxed, not wanting to hide anything, but not yet having processed enough to want to deal with anyone else’s excitement. I stood and dribbled in my room out of sight and they chatted for a bit and she went back downstairs.

Rebecca did some brief mourning for not getting to hold the “big belly bash” event we’d scheduled for Saturday. I called Potiks to let them know to expect Mary with in 12 hours.

And I did sleep. By midnight or so, astoundingly. They stayed up a little longer making preparations, and I kept my organizer self in check. I had to start going into not-in-control mode. I had already figured out that it was probably the low pressure system that had brought on the water breaking, and I was trying not to spend much time on wondering if it could have been just that and my body wasn’t ready for labor and it wouldn’t come, or we’d spent a long time waiting and getting antsy. (Hah.) I’m so glad I managed not to fret too much.

Woke up around 2:30 AM and felt something I was figuring was probably a contraction. It was mild, and I could feel it moving up from the cervix to the top of the uterus in a wave. After it was done I got another gush of amniotic fluid. I woke up for one of these every half-hour to hour for the rest of the night, most followed by the fluid gush. A new meaning for the phrase “wet spot.” Rebecca slept with me that night—I still felt too big and awkward and odd for three in a bed, but by morning I was feeling more snuggly, and Robin crawled into my bed, and I began the day in the most wonderful, safe, surrounding hug.

Around 7 AM we got up, and I was able to eat a full breakfast and do all of my usual morning routine, pausing to lean on something for little contractions now and again. Mary went off to Potiks. Not too long later they started to ramp up, and I needed to lean on someone. For a while Robin was standing behind me and Rebecca was seated on the end of my bed (there’s only about two feet between the end of my bed and the wall), and I was able to sink down on Robin like a chair while leaning forward onto Becca during a contraction. I also did a few of these alone on the toilet, which was more intense than standing, but were also the only few where I got a good glimpse of the “rush of power instead of pain” thing that some folks talk about. There were also some where I managed to hold both in mind, but it was definitely pain. A weird pain that goes away in between and is unlike anything else, but pain.

I tried squatting once, but it brought on a contraction that was much more intense, and I didn’t feel a need to do it again.

We had made a long list of songs that might be good songs to sing in labor—I was thinking of them mostly as tools to help me get out of my head and into my body if needed. It wasn’t really needed, but at some point in the morning, as I was standing between R&R in the kitchen, we did sing “Welcome Table.” We changed the words to “You’re going to sit at the welcome table” rather than “I’m.” It took me through at least one contraction, and it felt neat, grounding, and muted the contraction somewhat. I’m glad we got one song in, but when the contractions stepped up I wasn’t really up for singing anymore.

Rebecca called Midwife A who said to check in again when contractions were a minute long. That would be active labor, and it would be OK to get in the pool then. For a while R&R were alternating taking care of me and working on filling the pool. It exhausted the hot water heater several times and they were heating kettles and pots on the stove to try to bring it up to safe temperature. I didn’t pay much attention. I was starting to savor my rests between contractions and make more noise than heavy breathing in them.

It’s hard to describe how they felt. I often got a warning move from the baby first, as if it could feel them first. I felt them in back and front and they would well up and take over my brain and fade away. I moved to the birthing ball on my bed with my robe over it for a while. I was never quite sure I was trying to do during the contractions—during the early ones pressure on my sacrum was good, but as they got more intense it seemed mostly to be about not holding up my own weight and acknowledging the pain. I wasn’t trying to feel good.

But in between I was cheerful and snacking and had good energy. I felt like I could keep this up for a long time—and figured I might need to. I didn’t feel particularly distant or touchy or unable to verbalize at all—though I was on purpose not trying to verbalize much. They ramped up quickly though, and when Rebecca timed 1 minute and called Midwife B (circa 10:15 AM) I was starting to think about getting in the pool. After a few 1-minute ones on the ball I went to the water.

It felt so good to get into. I hadn’t felt like I was tense or sore in between contractions at all, but the warm water was just great. I’ll admit to being a little disappointed that the contractions didn’t feel any less intense, but my options for handling them went up. The inflatable ring that I’d bought just the day before and Rebecca had inflated after my water broke was really nice for leaning on.

Robin was still bringing kettles to the pool to try to get it up to safe giving birth temperature, and Rebecca got in with me, partly to bring the water level up, but she was also of course something to hold onto during contractions, and actually even more something to relax against and cuddle up to in between. I was really starting to make it through the contractions on the power of moaning (and eventually louder stuff than that). It really does help.

I spent the contractions on my knees, with the legs spread apart, leaning forward. All the water birth videos we saw had the woman leaning back into her partner’s arms, but leaning back was just not appealing or comfortable, all aside from the forward positions making it go faster. My world was starting to shrink to the pool, and I was starting to be quiet and inward focused in between contractions. Robin was kneeling outside the pool and I was starting to take some turns hanging on his shoulders, or on Rebecca’s knees as she sat on the edge. I vaguely had the sense that there might be more things to do, but that was too intellectual.

When I vomited the first time, I suggested we call Midwife B to come, and she did in about 10 minutes, though without any of her stuff (probably didn’t come from home?). She walked in during a contraction, heard me, and said “Well guys, sounds like you’re having a baby!”

She gently got some information from me about what I was feeling where, wandered into the kitchen to make a few calls to cancel things and try to reach Midwife A, had Robin show her where supplies we had gathered were, and then did a vaginal exam (the first one she’d ever done on me, actually). It was painful—it seemed to stimulate the beginning of another contraction, but the result: the news that I was 8 cm dilated, was great. We had had no way of gauging the process, and to know that I was that far along, and that these contractions were doing anything even though I couldn’t exactly identify feeling “different” in between was empowering. I guess I might have thought I’d feel more pressure or spreading at that point.

Midwife B left an “8 cm, get over here” message for Midwife A, and then hovered at the periphery of the room. She didn’t insert herself physically at all, but during contractions she kept saying “You’re doing great” “Stay open” “Let it come” and other simple things that were incredibly useful. I threw up two more times and the spaces between contractions started to decrease rapidly. That was the only time I got really scared—during the contractions I didn’t exactly know how to handle them, but I just made noise and knew they would end and I would get to recover. But when the recovery started to shrink, and I could feel another one coming on quickly, I felt actual fear. Midwife B kept being reassuring, and said something approving about my sounding pushy.

Looking back that must have been transition, when a little fear is considered good to get the adrenalin going. Somewhere in here my memory gets fuzzy, but Midwife A showed up, and Robin got in the pool in front of me, clothed, and Midwife B asked him if he was going to catch or she was, and he looked bewildered but stayed where he was because a contraction was coming. This was the only time I leaned back, and I ended up with my feet braced on the sides of the pool next to Robin, leaning back into Rebecca’s arms, with her supporting my back underneath, so I was flat and floating, and got to engage my leg muscles when I pushed.

I’m not sure I can tell you whether or not I had an “urge to push,” but I clamped down with those muscles I’d been exercising because I wanted this baby out. I recognized a brief flash of burning sensation that I remembered meant the perineum was stretching. I actually felt something between my legs after about two pushes and Midwife B coached me to hold still between contractions and just sit with the feeling.

I did this, and then there was commotion. “Guys this baby has decided to come butt first,” says Midwife B, “so I’m going to have to ask you to get out of the pool.” It seemed utterly impossible to stand, and it was the only thing I actually protested about, but I knew I had no choice and got out with Robin’s help, though I panicked as I felt the butt slide back in as I moved the couple feet to the futon. But they insisted it had not gone back in, and it was fine. “this baby’s coming.”

This is where the midwives really took over, getting me positioned on the edge of the bed, supported in various quarters by R&R. One push got the butt and body out (relief!) and then they hung it over the edge to help pull the head under the pelvic bone. Midwife A kept telling me “little pushes,” and after I processed that that didn’t mean littler pushes, since I had stopped pushing. I took a deep breath, and pushed, and the head came out with relatively little fuss, and there was a baby on my belly! All covered in vernix and looking like a newborn.

The midwives were rubbing her lungs to get the gunk out, gave her a little oxygen and listened make sure she was breathing OK, but we were all able to be near her and touch her while it was happening. The cord was very short and the placenta followed her out unusually quickly, but I barely noticed other than to give a small push when instructed to. Rebecca cut the cord after it was clamped, and later after it was fully tied off, Robin did the second cut.

Shortly they declared her lungs clear and we got some time to just admire before they did a full checkup of her and me. She had her eyes open and was looking around, calm and interested after the first squalling that got her lungs working was over. She got pink and human looking almost immediately, so much faster than in all the birth videos I’ve seen. (We’d been prepared to have a purplish baby for a while, because if they are born in the water they take longer to get pink.)

At 12:36 PM we realized no one had looked at a clock, but we guessed that 12:30 was pretty darn close.

She was examined there on the futon, with all three of us keeping our hands on her for comfort and talking to her. Aside from a little bruising on her butt and one thigh, she was in perfect health. As for me I got away with little bleeding and no tearing. I have a labial split, which is in the skin, like a split lip. Still something to be reckoned with, but merciful as it goes. I felt great, if dazed. I recognized the feeling of being full of endorphins, for obvious reasons, though I’d never had it so strong yet unaccompanied by exhausted leg muscles. This was a different kind of exercise.

Robin said during labor I only sounded so pitiful he almost cried a few times, and Midwife B said she was very impressed with how I moved back and forth wordlessly between them as I needed.

And there was Nadia, immediately, of course, the center of our attentions and focus and thoughts with practically no exceptions. Not surprising that one of the midwives’ main functions was to tell us (over and over) to be sure to remember to eat. They also talked us through a first feeding, cord stump care, and showed us the placenta as they examined it. There was small spot of calcification on it, which sometimes indicates the placenta is ‘getting ready to be done,’ and may have had something to do with her early arrival.

Because she was so little and had some bruising on her sacrum and one thigh from the birth, we accepted the midwives’ suggestion of a vitamin K shot (would have been standard in the hospital). Midwife B gave it to her while she was in my arms asleep, and she didn’t even wake up. May all her early experiences with shots be like. (Fat chance, I know.)

It was nearing 5 PM before it even occurred to us to start calling grandparents and following up with people who knew about the labor because the belly bash had been canceled. We did very little contacting people though, and let the grapevine do the rest.

There hasn’t really been days beginning and ending so much since then, so it’s a little hard to know where to leave off this particular account. But perhaps this will do.