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I found Jacob’s birth to be an empowering experience. In large part, this is because we were able to plan and have the birth that we desired. Initially, we weren’t sure what this would be, but as we researched, and spoke with our midwives, we developed stronger ideas about the safest, most relaxing, and most loving way for us to bring our baby into the world.
Along the way we made choices that were available to us because we chose registered midwifery care, and because we live in the province of BC. These choices were not undertaken lightly - we did a lot of reading, and talking, and thinking. Our first priority was always Jacob’s (then known only as Baby S-R) and my health and safety.
As we found out more about birth and the various options available to us, we started thinking more and more into home birth. Our midwives were good about providing plenty of information, and dialoguing with us during the months before the birth. Ultimately, after months of discussion, we were swayed by the evidence that shows women who have low risk pregnancies and birth experiences actually have better outcomes (i.e. less interventions, less infections, etc.) than similarly low risk women who give birth at a hospital. We were also comfortable with our midwives homebirth transfer policy, and were confident that they would advise on an appropriate time to transfer if it should arise.
We also chose to hire a doula. We did this largely because of the evidence that shows that women who hire doulas have better birth outcomes. We also did this because, frankly, neither Andrew nor I had any experience with birth before, and we wanted an additional support person. We met with a couple doulas, and ultimately selected Chloe Dierkes. We knew Chloe was a match for us when Andrew asked during our initial meeting whether Chloe could make Andrew a “birth ninja”. Chloe indicated she could, and suggested that her and Andrew design and wear costumes during the birth.
For our prenatal education, we chose Hypnobabies. Hypnobabies is a childbirth education and preparation course that focuses on teaching self-hypnosis to mamas-to-be, and guided hypnosis to papas-to-be. Hyponbabies provided both Andrew and me with a real tool to use during birthing -- something that we were both grateful for in the lead up and during birth. As part of the Hypnobabies curriculum, we were taught a different language to speak about birth. This is because the common words to speak about birth often have associations with fear and pain. To facilitate hypnosis, avoiding these fear and pain associations is essential. Some of the most common language we use is as follows:
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In the last weeks of my pregnancy I became a little apprehensive of the possibility of my waters breaking when I was out of the house. At our 37 week appointment, I asked one of our midwives, Laurie, for some reassurance that my waters would not break on public transit. Laurie confirmed that was incredibly unlikely, given that in 90% of cases, women experience sensations of cramping for several hours before their birthing time starts, and that in plenty of cases, the waters don’t break until pressure waves are well-established. As a result of this, we largely didn’t pay attention to the details on “what to do if your waters break and you don’t have pressure waves.” And as a result of that, we were a little clueless when my waters broke in the early morning (around 2:00am) on Thursday, February 7, 2013.
I had just returned from (one of a thousand) trips to the bathroom, refilled my glass of water, and settled myself onto the couch for another attempt at sleep. As I settled in, I knocked my water off of the table and, as I sat up to clean up the water, I had a sudden sensation that I was peeing. Or...no, not peeing exactly, because I certainly couldn’t stop it. But there was definitely water. A lot of water. I grabbed the nearest blanket, shoved it between my legs, and quickly waddled to the bathroom. On the toilet, I checked: the fluid was clear, and kegels could not stop the flow. Gently and calmly (I think), I called to Andrew, “Honey, I think my waters have just broken.”
We discussed what to do. Since neither of us could remember precisely what the next steps were, we decided to call the midwives. After a few questions, the midwives determined that all was well, and advised that my birthing time would likely begin within the next 24 hours. They suggested I take some gravol to help me sleep, and that I go back to bed and call them in the morning.
I was happy to take their advice, however a steady stream of water was still flowing, so I sent Andrew to purchase Depends from the 24-hour pharmacy down the street. Funnily, our prenatal instructor had suggested that a box of Depends might come in handy for the early first stage of birthing. At the time, I had laughed, rolled my eyes and pretty much declared, “over my dead body.” (Note - I wore Depends for the first 8 days after Jacob’s birth, and can with confidence state that they are so much more comfortable than underwear and a pad. If you’re expecting, buy some Depends!!) At this time, we also texted Chloe, our doula, to let her know what had happened, and what we were doing. We didn’t need her to come yet, but we knew that time was not far off.
Within 15 minutes, I was settled back on the couch. Instead of simply letting myself fall asleep, I put in my headphones and listened to the “Deepening Hypnosis” Hypnobabies track. I fell into a deep state of relaxation, and didn’t wake until about 5:00am. Then, I took another dose of gravol, and tuned in to Hypnobabies again. When I awoke, it was almost 8:00am. Strong pressure waves were coming irregularly, and lasting for 10-30 seconds. I wasn’t experiencing pain, but was experiencing a sense of discomfort with each wave. I started to use the Hypnobabies tools we had learned, but because I found walking and swaying my hips most comforting both during and between pressure waves, I was unable to get my lightswitch into the off position during pressure waves.
Around 8:30am, we called Chloe to discuss the status, and to make a plan for the day. On the phone with Chloe, I had several pressure waves, which gave her a sense of how I was coping. Because I was feeling the pressure mostly in my lower back, she thought her TENS machine might provide some additional assistance coping with discomfort. We agreed she would come over in an hour to drop off the TENS machine, the birth pool and her other doula supplies. At the time, we thought she would check on us in person, help Andrew and I to make some preparations at our house, and then, if all seemed well, leave and return sometime later in the day. By the time she arrived at our house, however, my pressure waves had picked up and intensified. When she arrived, I recall feeling a renewed sense of safety and relief - funny what having an additional support person around will do.
Within minutes of arriving, Chloe helped me to visualize my hypno-anesthesia and to release muscles I had been clenching. She hooked me up to the TENS machine, and then helped Andrew and I brainstorm some positions that were most comfortable during pressure waves. Chloe also encouraged me to eat, and to drink liquids -- most particularly a birthing aid liquid with some juice for energy and crushed calcium magnesium to help the smooth muscles of my uterus to do their job. In the first half hour Chloe was at our house, my pressure waves became longer, stronger and closer together. It quickly became evident that my birthing time was progressing quickly and that Chloe would be staying with us until our baby arrived.
Sometime in the morning, Chloe began to prepare our house for the birth. She put down protective floor coverings on our (white!) carpet, changed the sheets on our bed to include a shower curtain between two old sets of sheets, and began preparing the birth pool. Having Chloe do this work freed Andrew to fully support me. It felt good to have both of them there; there was a sense of calm, forward motion.
As my pressure waves intensified, I moved deeper into the birth experience. As this happened, I lost any sense of time, aware only of my body’s needs, desires, and aversions. I recall having strong needs and desires -- for heat, dim lights, certain types of movement or support, specific foods, etc. -- and equally strong aversions. Sometimes a food or drink was exactly what I wanted one minute, and then completely unappealing the next. (How frustrating that must have been for Andrew and Chloe.) During pressure waves, the most comfortable position for me was to be in a relaxed standing position with my arms around Andrew’s neck. In this position, he was able to stroke my hair, put his hands on my shoulders, or rub my back -- all things that felt really good.
I continued to let my body work through the pressure waves, and Andrew began to assist with some of the Hypnobabies cues. When I was having a pressure wave, Andrew would push down on my shoulders, or stroke my hair and say, “Relax,” in a calm, soothing voice; or, he would whisper in my ear, “Peace.” From time to time, he would describe my hypno-anesthesia to help me visualize it and breathe it into my birthing muscles. Andrew also described the place that had come to me during a hypnosis session focused on creating a special place in my mind where I could go and be with our baby. All of these cues were ones we had practiced together over two months, so my body and my mind had internalized relaxation responses to each.
With the assistance of the TENS machine, Andrew’s touch, and the Hypnobabies cues, I was feeling much more calm and relaxed, and therefore more able to let my body do the work it wanted to do. Chloe and Andrew both reminded me several times that my body and my baby knew exactly what to do, and my job was to relax and let that happen. Andrew and Chloe encouraged me to eat and drink, and did an excellent job at keeping up with my food whims. They also timed the pressure waves and kept the midwives apprised of progress so they would know when to come.
Our midwives had asked us to call when pressure waves were four minutes apart, 1 minute long, and had been that way for an hour (4-1-1). As my pressure waves got closer to the 4-1-1 mark, they moved quickly past that and approached more of a 3-1-1 pattern. This happened quickly, and I remember feeling suddenly overwhelmed by the intensity and pace. All morning, as I worked to relax through the pressure waves, I had enjoyed the rest between them as a respite -- a time to share little moments with Andrew, talk to Chloe, and eat or drink. The sudden change of pace initially startled and unsettled me. Chloe began reminding me after particularly strong pressure waves that once a pressure wave was done, I never had to experience that one again, and that each pressure wave was bringing us closer to meeting our baby. With these and other affirmations, I began to feel more excited.
Andrea, one of our midwives, and the student midwife, Jenny, arrived sometime shortly after noon. By that time, the birth pool was set up, but I had decided to wait to get into it until after the midwife arrived in case they wanted to examine me. They did want to do an exam and I still recall this as one of the worst parts of my birth experience. The exam was performed on our bed, with me lying on my back. Because of the pressure sensations I was feeling in my back, this was very uncomfortable. Chloe reminded me of how to use my Hypnobabies tools in the moment: I turned my light switch to off, took a few breaths, then turned it to centre, breathed hypno-anesthesia into my cervix and birth canal, and indicated to Andrea that I was ready. Before she began, Chloe reminded her that I did not want to be apprised of my progress in dilation. I still don’t know how far I was dilated at that time, just that I was “doing a great job” and that I should continue to listen and respond to my body. These affirming words were so much more powerful to me than a number would have been, and I was glad I didn’t have sufficient information to begin the mental math of “how much longer” my birthing time would be (i.e. it’s taken me X hours to get to Y, so I have another Z hours to go). After the internal exam, Jenny listened to the baby’s heartbeat with a Doppler; it was strong, and I was reassured to hear it.
When the exam was done, I began to feel nauseous. Every movement I made brought another, greater wave of nausea. Someone put a bowl in front of me and I vomited into it and quickly felt better. I then moved into the birth pool. Instantly, I could feel tension fall off my body, and felt freedom of movement that I hadn’t felt in months.
In the birth pool, it was easier to relax through pressure waves. Shortly after I got into the pool, Chloe sent Andrew out to get some fresh air and lunch. I had intended to do groceries on Thursday, and I knew Andrew had been worried that we didn’t have enough food -- in particular easy and snacky foods -- in the house. I’m not sure how long he was gone, but by the time he returned, my body had started to feel a little “pushy” in an uncontrolled way. It was at this time that I felt intense sensations of discomfort in my hip, which then travelled down to my knee and into my ankle. Andrea, Jenny and Chloe, as well as Andrew when he returned, took turns massaging each joint during every pressure wave to permit physical relaxation and allow me to continue to focus on the work my body was doing to open up. I’m not sure how long this lasted, but I was grateful for the support of my birth team for their duration. The sensations were so intense I would have otherwise felt very helpless and soon disheartened without their support. During this phase, I absolutely had to vocalize through each pressure wave, and I became more dependant on eye contact and physical touch with Andrew and with Chloe. Jenny and Andrea checked the baby’s heartbeat regularly, and were good about asking for permission from me first so that they didn’t interrupt my concentration during a pressure wave.
I recall having two internal exams while in the birth pool. I don’t know the results of either of them, but after the second exam, Andrea indicated that whenever my body told me to push, it was ok to add my strength and push with it. I was in a sitting squat position, leaning against the side of the birth pool, and began to actively push with the next pressure wave. As I did this, my need to vocalize quieted, and my concentration increased. Between pressure waves, Andrew and Chloe used Hypnobabies cues to help me to relax, stay calm and focus on allowing my body to do the work of opening up. Meanwhile, Andrea had called the second midwife, Jill, and she was now on her way over. As my body pushed, and as I added my strength to those pushes, I began to feel the baby moving downwards. Moving and swaying my hips and back helped me to feel as though I was sort of able to rock the baby downwards. Soon I was feeling odd sensations of pressure in my bottom as my tailbone moved out of the way to allow the baby to progress downwards. I also heard and felt a slight click at one point, as my pelvis adjusted to accommodate the baby’s head. Throughout it all, baby’s heartbeat continued to be strong and regular -- a good, reassuring sign.
Chloe encouraged me to change positions, but the sitting squat was the most comfortable for me, and I was reluctant to change from something that felt comfortable and that was working. In this position, I was able to push until the top of the baby’s head could be seen. I then had trouble moving him any farther down. Andrea suggested changing to a more aggressive flat-footed squatting position so I could use gravity to make each push a little stronger. Although this position was more effective, it was also more physically taxing. Andrew got into the birth pool and, after each pressure wave, I would relax back onto him from the squat. He and I got into a sort of rhythm: a pressure wave would come and he would help me to get into the squatting position, I would push through the pressure wave, and afterward he would gently help me to lie back onto his chest and relax. Jill, Jenny and Andrea intermittently took my temperature, and listened to the baby’s heart beat. Chloe sat in front of me to hold my hand and make eye contact during each pressure wave; she also continued to encourage me to eat and drink.
The flat-footed squatting was working better, but Andrea did a visual exam during a pressure wave and said she thought I could push a little harder and longer with each pressure wave. I wasn’t sure I was able to push any harder or longer, and said as much to Chloe. She reassured me that I could do it, and that my body knew exactly what to do. The next pressure wave was incredibly strong, and I mustered everything that was in me to push as hard as I could. Midway through pushing, I yelled across the room at Andrea, “I think you’re going to be impressed with this one!” The whole birth team broke out into happy laughter while I continued to give two more strong pushes before the pressure wave was over.
Slowly but surely, with the assistance and coaching of Andrew and the rest of birth team, the baby began to move further and further down. With each push, I was able to move his head a little further down than before. Andrea checked me again when the baby was close to crowning, and discovered a little hand right by the baby’s head. She tried to move it and bring it down, but wasn’t able to. The baby had a large head and the hand only added to the circumference. I had been committed to pushing out the baby’s head between pressure waves to avoid tearing, but Andrea coached me to use the pressure waves and controlled pushing to more efficiently and quickly push the baby’s head out. I followed her advice, touching the baby’s head as I pushed so that I was aware of progress. My tissues felt tight and stretched taught, but I ignored all thoughts about tearing, and focused on how good it would be to meet our baby. Within a couple of pressure waves, I was able to push the baby’s head out. It was exhausting. I then fell back onto Andrew’s chest, and Andrea encouraged me to stay there and push the rest of the baby out from there. On the next pressure wave, Andrea coached me to give one big push to allow the shoulders to be born. I did, and they were. With another small push, the rest of the baby’s body was born. Andrew and I saw him emerge into the waters and, with Andrea’s help, brought him out of the water and onto my chest. Immediately, someone placed warmed receiving blankets on his back and Andrew and I were encouraged to rub vigorously. He cried just a little -- enough to to let us know he had arrived, and was healthy -- and then settled onto my chest, looking all around. Chloe encouraged me to smell the top of his head, which smelled like nothing else in the world -- so fresh!
Andrew and I relaxed with our baby for some time in the birth pool, the magnitude of being a family of three (!) settling in, and enjoying looking at every bit of our precious baby. After absorbing his sweet brown hair, clear grey-blue eyes, adorable hairy ears, and other sweet baby details, we looked at each other, and held him up to see whether he was a boy or a girl.
A boy! Our Jacob!
We continued to love on him, and I relished the accomplishment of having birthed him. Meanwhile the midwives and Chloe were preparing for the next phase of labour. Chloe offered me the tea to help my placenta be born, and I drank it down quickly, surprised by how tasty it was. After the baby was born, we had planned to move to our bed so that the midwives could better assess blood loss during the third stage. I was very shaky, and so was helped to my feet by Andrew in the pool, and then helped to step out of the pool by Chloe, Jenny, Jill and Andrea. The squatting position had exhausted my legs, and I had to ask Chloe to brace my knee as I climbed out. As I stepped over the side of the birth pool, there was a rush of blood as the placenta separated.
All plans of moving to the bedroom were quickly abandoned, and Andrea and Jill helped me to sit leaning against the side of the birth pool on the tarp Chloe had put down earlier. In a few short minutes Andrea asked me to give a small push, and the placenta was born. We then moved to our bedroom so Andrea could examine me and Jacob.
I did have a small tear, which Andrea called a “normal, first-time mama tear.” She was able to put in a few stitches as I lay in bed cuddling, and adoring our son. Andrew and I spent the next hour or so in bed with Jacob, while the midwives completed their exam of me and of Jacob. When he was finally weighed, we discovered he was 9 pounds, 4 ounces...with a 38 centimeter head!! If I didn’t feel strong and empowered before, I certainly did after that news! Jenny and Andrea then showed me and Jacob how to breastfeed. Or rather, they showed me -- Jacob was born knowing how to breastfeed. While all this was happening in our bedroom, Chloe was cleaning our house. Finally, when the midwives packed up, Chloe brought us scrambled eggs (made with whipping cream!) and toast slathered with butter. Eggs Chloe-style has been a standard in our house almost every day now since Jacob’s birth.
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Baby Jacob is now almost three weeks old. He’s still nursing like a champ and, as a result, has grown almost a pound heavier and now weighs in at 10lbs, 2oz.
Welcome to the world little baby Jacob. You are loved.