My Best Birth

Earlier this week we celebrated Ruby's 9th birthday. I find, with all my children, that I start calling them by their coming ages a month or two before their birthdays ("almost-9"), so that when they actually reach the milestone day, it hardly feels like a change. Ruby has always had a certain maturity about her, maybe it's her second-child status, that makes her new age(s) seem inevitable, earned, and not too big of a deal.

I'm still in the first year of blogging, and I've committed to telling each of my children's birth stories on or near their birthdays. The second post that I wrote, last January, was about the importance of birth stories, and the unfortunate tendency of society to devalue those stories. I believe that hearing honest stories about birth is the best way to prepare a woman for a positive birth experience. I also think that these stories can serve as reflections on what we humans are doing here in this world: we are physical beings who live to love.

When I found out I was pregnant, I needed a local healthcare team, and I decided to see a midwife, because I wanted someone who shared my personal view of birth as a normal event. I was also excited to give birth at an in-hospital birthing center. My dream for Ruby's birth was to have minimal interventions, no separation from the baby, and be home as soon as possible after to be with Bella, who was only a year old when I became pregnant.

At my first prenatal visit with midwife Sylvie Blaustein, I was relieved when she asked me to tell her the story of my first birth and about my hopes for this birth. I was amazed by how much time she spent with me; throughout the pregnancy, the visits were emotional check-ins, not simply medical ones. I loved going to see the midwife, even though I had to shlep uptown with baby Bella on the subway.

As with my pregnancy with Bella, I went a week past my due date. I was anxious to get the show on the road and have the baby. For the first time in my life, I had acupuncture, and lying on the table in that tranquil East Village basement, tiny needles sticking from my ankles and wrists, I felt the first real contractions. The familiar pain, like menstrual cramps, made me smile. It was like my baby was waking up and getting ready to say hello. The next day, I had a pedicure in the afternoon, and that's when I was able to start timing them: ten minutes apart, then seven. Later that evening, when I started to have to "om" through the contractions, we called our doula and good friend, Allison, who came over to support us. We also called Josh's sister, Nina, who lived downstairs, and who agreed to come and stay with Bella when it was time for us to leave.

There was some concern that I might have a very quick labor, because of how the end of my first birth had gone. Since I was group-B strep positive, I had to make it to the hospital in time to get antibiotics before giving birth. So around midnight, with contractions 3-4 minutes apart, we went to the birthing center. I remember sitting between Allison and Josh in the back of a yellow taxi, "om"'ing like I was in yoga class. No taxi driver ever likes to hear that, let me assure you. He got us there fast.

We were quickly brought to a birthing room. The midwife on call that night was Barbara Sellars, at that time a 25-year-veteran midwife, with a wise and quiet presence. She checked my dilation, and announced that yes, I would have the baby tonight (phew!). A nurse put in an IV (actually, it took two nurses to get this done--I have small veins--I remember this as the hardest part of the whole labor--being stuck repeatedly, and having to hold still), and I sat on a birthing ball while the antibiotics poured through me.

After that, the labor was, as it often is, a blur. I walked, I danced, I rocked in the rocking chair. Allison and Josh rubbed my back and encouraged me. As I was well supported, Barbara got a few hours of sleep. At some point she came back, and asked if she could check me, and offered to break my water to speed things along. I agreed. The contractions picked up pace and intensity almost from that very moment. I got into the bathtub, which I had been looking forward to, as one of the privileges of being in the birthing center. But once in the water, my discomfort seemed to increase. I vomited (sorry, birth ain't pretty), and I felt like I had nothing to lean on. I had to get out.

(This goes to show that you really don't know what you will like and need as comfort measures in labor, until you are in it--which is why it's helpful to have lots of options available).

I went back to the rocking chair, and "om"ed through several very long contractions. Between contractions, I opened my eyes, and discovered that a cadre of beautiful people had gathered at my feet, watching and waiting, quietly: Josh, Allison, Barbara, a nurse, and a nursing student (whom I had given my permission to be present). No one was rushing me. No one was telling me what to do.

After one particularly intense contraction, I said, "I want an epidural." I saw concerned eyes. Then I said: "just kidding," and went right back into the hard work of the next contraction. (You see, it's a truism that all women will ask for an epidural during labor at some point. I knew this, and I didn't want to disappoint.) I made everyone laugh. In the middle of my labor!

Not long after, Barbara said, quite to my astonishment, "Where do you want to have this baby?"

I was surprised because I didn't know that it was time, and I didn't see how she knew. (Throughout the entire labor, she only checked my dilation twice: the first time when I arrived at the hospital, the second when she broke my water.)

Barbara really exemplified the caregiving philosophy that puts faith in birthing mothers' innate knowledge of what they need to do to give birth. She was so quiet, so patient, and allowed me to lead the way. She knew it was time because of the intensity and length of my contractions, indicating I was going through transition. (Note: she was watching me labor, not watching a print out or a machine.)

I moved to the large queen-sized bed, but once again, like in the tub, I felt uncomfortable. It was my prerogative to move, so move I did. I sat on a birthing chair (like a toilet seat without a toilet), with Josh sitting on the bed behind me, and supporting my back. My attendants, who were all sitting or kneeling in front of me on the floor, told me to push when and if I felt like it. So that is what I did.

Very naturally, and by naturally I mean without any coaching or assistance, and with the normal amount (i.e. quite a lot) of effort, Ruby came into the world. When she was almost out, Barbara directed my hands to her body, and told me to lift her up. I like to say that I delivered Ruby. I picked her up onto my chest, and I cried. Together, we moved to the bed and Josh and I discovered that she was a girl, and stared at her in amazement. It's always amazing to see the face of your child for the first time.

Right there in the room with us, the nurse weighed Ruby and cleaned her up a bit. Soon after, everyone left us alone. We rested, Ruby nursed, and Josh and I each took showers, and about six hours after the birth, we all went home. Ruby was born at 11:11 am, and we were all home for dinner.

Ruby is my middle child, and she came so soon after Bella that she sometimes thinks she gets short-shrift (certainly, she wears her share of hand-me-downs). But she knows, because I've always told her, that her birth was the best one.

Way Back When You Were Born

Tomorrow is Louisa's birthday, which means it's time to tell her birth story (according to the long-standing tradition begun on Bella's birthday all of two months ago, in these pages). But before I do, some thoughts on memories of today.

Today is the tenth anniversary of the start of the war in Iraq. I remember that time, a decade ago, very clearly. With a ten-week-old baby keeping me up and keeping me down (I was in the throes of breastfeeding mayhem right then), I had nary a moment to read the newspaper, electronically or otherwise. When I finally got it together to call a La Leche League leader for help and she told me that the next meeting was in April, I responded with frustration, "but that's months away!" To which she replied: "No, it's just over a week." I literally had no idea what day it was. (That winter was the only time in my life that I watched, baby on boob, an entire season of American Idol: an obvious sign of my compromised mental state. Ruben won, to remind you).

My head was comfortably in the sand, and whenever I heard mention of the war, I would look at my tiny baby's face and just think: peace.

Becoming a parent can unsettle your relationship with world events, with your spouse, with your friends, and with yourself. Forever after, time is measured in the ages of your kids. I've been known to forget how old I am (seriously), but I could never forget how old they are.

Two years ago today, I woke up in the morning, put on a maternity frock and makeup, adjusted my daughters' hair and dresses, and set out for nephew's bar mitzvah across state lines. It was one day before my due date, and for months there had been speculation in my family about whether I would make it to the simcha. I made it, all right, even though I knew even before I left my apartment that morning that I was in early labor. However, I missed the desserts.

To read the rest of the story of how life began for our littlest, who will turn two tomorrow, click here. (The story was originally published in The Journal of Perinatal Education, Fall 2011, Volume 20 Number 4. If you have comments, please put them here, not on Scribd. Thanks.)

Move Over, Birth Trauma. It's Time for Joy

This post is for a friend who is in the final days of pregnancy with her third child. She is tired, 'over it', and ready to meet the kid already, both emotionally and literally, as she is nesting up a storm. She's trying to be patient (compared to how I was at this stage--ready to stand on my head if it would get that baby out). She's worrying about names, about childcare, about having space and time for all of her kids. All of that is to be expected. 

What concerns me is that she's scared about the birth.

Unlike first-time moms, she's not frightened of the unknown. She not worried about her friend's horrible labors, or a birth she saw on TV, or a co-worker's fright-filled tales. She's scared because of her own first two births. She's scared because she doesn't want another broken tailbone and dozens of stitches like she had with her first baby. She's scared because she doesn't want an emergency Caesarian birth with prolonged pain and difficulty breastfeeding, like she had with her second baby.

Birth is many things: emotionally wrenching, painful, joyful, ecstatic. But it shouldn't have to be traumatic. I could sing this from the rooftops. There's too much birth trauma out there, and too much denying of women's emotional and physical pain from their births, as women are told they should be happy they have a baby. Period. Women are constantly told that the experience of birth doesn't or shouldn't matter. 

But the experience does matter. Growing and delivering a baby is an overwhelming, life-altering experience, second only, perhaps, to raising one. 

Here's my message to my friend:

You are a beautiful, wonderful, capable mother to two terrific kids. You will soon be all that and more to your third. You have the power to birth your baby. I believe in you. You are strong, and you are brave. Surround yourself, in these final days of growing your wonder baby, with people who will remind you of all of these things. When you are in labor, remember that you only need to get through one contraction. When that one is over, you'll have a break. Just focus on one at a time. When it's time to deliver, stand or squat or lean. Protect yourself and your tailbone by getting into a good position for that baby to emerge, no matter the size. I pray that you will both be healthy, and safe and happy. I pray that this will be the birth you've been waiting for. 

And as I said to you, on learning that you were expecting this child: the first is a biological necessity, the second is fulfillment of a plan, and the third is pure joy.

Welcome Sunshine, Part Two

Part One recap: 41 weeks pregnant, in hospital. Finally, labor starts picking up. While the details are hazy for me, my lovely doula Jill Fransen wrote an account. Thank you, Jill, both for writing the story and for agreeing to let me share parts of it, here.

When I arrived around 4:00, your dad was there, and your mom arrived in a little while with food for Josh. Your contractions were tolerable as you sat in the rocker. That rocker would be your friend for many hours that night. 

After your folks left we got down to the real business of labor. Your contractions were really quite close and strong. It seems that your labor was a series of rhythms. The rocker was very effective...you would "OM" through the contraction...going inward and being very focused. Then we decided to walk, stopping every few feet as you bent over holding onto the rail. You were determined to just continue to let your body and baby work together. You got in the shower; we listened to Sting, Stevie and some jazz. 

You labored--your contractions were mounting. You were getting very tired...your energy was being drained, and still your dilation was very slow. Things were getting intolerable: from the birth ball, to the shower, back to the chair, slow dancing with Josh, back rubs, foot rubs, hand massages...it all helped, but you were about to hit a wall. What you needed most was rest. Around 10:30 the nurse removed the rest of the Cervidil to give you a break from the piggybacking contractions. Finally around 1:30 in the morning, you got in bed, had a half dose of Demerol, and were able to get some rest. 

Here's what I remember about this part: I remember that the nurse saw me working hard and said something to the effect of, "I don't think you can go on like this much longer." She wanted me to have pain relief, but an epidural was not an option because I wasn't dilated enough (not that I wanted one anyway). I consented to the Demerol because I believed that I was still at the beginning of labor--that it could potentially be another day or two before the baby would be born, and I just didn't see how I could go on for that long. Josh was also exhausted because we'd been up for past several nights with false-alarms.

Josh opened up the couch, I positioned myself by your side, your small hand in mine. We turned off the lights and you got the rest you needed. I have rarely seem Demerol work so perfectly. You were aware of the contraction, only at the peak...you moved around, moaned, then were able to fall back into a restful peace. I did not leave your side as I held your hand and talked you through the peak of each contraction.

What I remember is that the contractions at this point were incredibly strong and hard, and that I couldn't "OM" anymore because I was loopy from the drugs. So I was literally moaning in pain at the peak of the contractions. While the narcotic undoubtedly allowed me to rest in bed (I couldn't have laid down otherwise), it actually took away my ability to concentrate and deal with the pain. I was very, very grateful to have Jill's hand to squeeze during that time.

Then, an amazing thing happened. As you roused during a big contraction, you said something popped--"my water broke." While you weren't particularly happy at that point, it sure put a smile on my face. Within a half hour the nurse checked you and you were 6 cm dilated! Josh woke up; the lights went back up a little...we were on baby alert. You went to the bathroom and sat there for a while. I believe that is where transition took place, because you experienced powerful urges to push. By the time you returned to bed, at about 2:30am,  you were 9 cm. dilated. This now was exactly the opposite of the old axiom: Hurry up and wait! This was, rather: Wait and hurry up! Dr. S. had to be called--you were going to have a baby! 

Now you were experiencing real bearing down urges...almost uncontrollable urges. This was when Josh just shone. He had you concentrate on his face, on his finger, guiding you through those extreme urges to push as we waited for the doctor to arrive.

To explain: the nurse was in a bit of a panic, as the doctor was not there. She told Josh to hold his finger in front of my face and instructed me to blow out the candle...instead of pushing. So, essentially I was holding the baby in due to absence of the doctor. Good times!

You were just amazing as you blew on the birthday candle that was Josh's finger. The urge at that time is greater than any other bodily function; watching you two at that moment I knew you were quite a team. I think the nurse thought she would have to deliver this little bundle...the first time we looked we could see about one eighth of her little head peeking out. So we were very grateful when Dr. S. walked in, sleepy and so beautifully pregnant herself.

Because you had done so much work before; because you had done so much breathing down and letting your baby just descend, you only had to push two or three times, and there she was...in all her glory of girl and red hair.

When Bella was placed on my chest I cried, and Josh cried, and I kept saying, "Beautiful! Beautiful!" because she was.

Isabel Renee

January 30, 2003

3:45 AM

8 pounds, 9 ounces

Bella's Birth Story, Part One

In honor of Bella's birthday: her birth story. It only took me ten years...

About a week before my due date I moved back into my parents' house, where I slept in my childhood bedroom. This was because my Ob-Gyn, Dr. S., was my father's partner, and also the same doctor I'd been seeing since I was eighteen. No one wanted me to have to travel to Long Island from the city whilst in labor. It wasn't half bad having my parents watching over me and feeding me, like I was a child again. But there wasn't much to do other than wait, and being away from home really put a big black exclamation mark over that magical and elusive due date.

When that date came, January 22nd, 2003, I started work on my labor project, an idea I took from the inspirational book, Birthing From Within. I made a birthday cake for my little Sunshine, the name we called her throughout my pregnancy, not knowing that she was a she. If only I had actually been in labor... (We stuck the cake in the freezer and brought it to the hospital after Bella was born, where we shared it with the nursing staff. No awards for me in the cake-decorating dept., I know.)

A few days later, I started having daily non-stress tests (a half hour or so strapped to the fetal monitor) at the doctor's office. At each test, Dr. S. said, "The baby sounds great. We can induce you now, you know." 

Josh and I took a lot of walks, as I was determined to move the baby down and get labor going. It was freezing out, one of those bitter winter weeks, so we found a place to walk inside: up and down every aisle of Target and Best Buy and Home Depot. I thought maybe Sunshine was staying put because it was simply too cold out for babies (or because she was afraid of big box stores).

On day five or six, the doctor's message changed slightly: "Soon it will be time to get that baby out." She stripped my membranes (ow!) and said, "You're really not dilated at all. Maybe a one." What I heard was: Nothing's happening. Your body is not doing what it needs to. That baby is never coming out without our help. 

On day seven, at the prospect of Josh having to leave to go back to work in the city, I gave up. I didn't want to be induced. I knew that inductions with first babies have a higher rate of resulting in Caesarean births. But I was beyond ready to be done with the waiting and to meet my baby. 

When I arrived in the hospital (straight from the doctor's office) for my induction on January 29th, I was already having patterned contractions, which had been happening on and off for days. I hadn't slept well the past two nights, and I was already tired. The doctor inserted a Cervidil suppository, and I had to stay in bed with a large uncomfortable plastic belt around my middle. (Whoosh, whoosh, thump, thump..the sound of that monitor never ending; Josh staring at the printouts because there was little else to do.) "In the morning, we'll start you on pitocin," Dr. S. said. Then, pregnant herself, she went home to sleep.

When the contractions soon became strong, I was very thankful to have my wonderful doula, Jill Fransen, at my side. She encouraged me to ask for permission to walk around, and reminded me to practice techniques to get through each contraction. I had prepared for this. I believed then, as I do now, in the mind-body connection that allows a woman to give birth. I tried to gain strength from my (hokey) piece of birth art (another Birthing From Within inspiration), and reminded myself what I had to do.

I don't have a good sense of the timing or details of what happened next, but lucky for me, Jill wrote a detailed description of the birth. 

Tomorrow: Part Two, Jill's account of Bella's birth.