Born in the kitchen...the birth of Reier Gavin

In order to really understand how amazing Reier's birth was, I need to (hopefully very briefly) tell the story of Dahlia's birth, over 2.5 years late.  You may remember that when we announced Dahlia's birth there were no details about how she arrived and relatively few of you were given the whole story.  That is because I wasn't ready to share her birth story when it was still so new and so raw for me.  Her birth was (at the time) both the best and the worst thing that had happened to me.  We were thrilled to finally have her, but her birth was so devastating for me personally that it hung over me like a dark cloud until she was about 2 years old and I became pregnant with Reier.  What follows will be an extreme summary of what was a very long and challenging journey.  A lot of details are not included to keep it short so I can move on to telling the story of Reier's birth.

For Dahlia's arrival, we had planned a natural, unmedicated birth with midwives in our local hospital.  I went into labor with Dahlia 8 days before her due date and had very intense and painful back labor from the start.  I labored both at home and in the hospital with the help of Nathan and our amazing doula, Dianne, for about 26 hours before the pain in my back and exhaustion became too much to bear and I consented to a dose of morphine to help me sleep.  When the morphine wore off and the back labor returned worse than before, I was examined by the midwife and found to be only 3 cm dilated after over 32 hours of laboring.  I was given an epidural that failed (only numbed one side of me), followed by another epidural that worked a bit better along with Pitocin to increase the strength of the contractions and help me to dilate.  I was examined again and again and never dilated past 4.5 cm.  As the second epidural began to wear off and no progress had been made, I was put on oxygen because I was beginning to fade in and out of consciousness from the exhaustion, pain, and lack of food over the past 46 hours.  I was offered food but couldn't eat because of the pain and frequency of contractions.  The contractions were so intense and were coming on so fast that they were stacked on top of each other and I never had a break in between them to recover.  About 47 hours after my labor had started, a c-section was recommended.  I was on oxygen, Nathan and I were both feeling scared and very done with this whole thing and no more progress had been made, even after trying all of the interventions the hospital had to offer (none of which we had wanted in the first place).  We consented to the surgery and met Dahlia very soon after.  The surgeon told us that she was stuck in my pelvis in a posterior position, meaning facing the front of me instead of the back, and that her head was tipped back, making her forehead the presenting part instead of the back of her head as she should have been.  This meant that every contraction tipped her head back further instead of allowing the round part of the head to dilate the cervix and move downward.

This is one of my least favorite pictures since it shows the very worst of the whole process.  We have just decided to have the c-section and were about to be taken down to the surgical suite.

I get to meet Dahlia for the first time after she has been weighed, cleaned up, and wrapped in a swaddle blanket.  I didn't see her without her hat and blanket until hours later when I had come up out of the fog of the drugs enough to unwrap and hold her without assistance.

After she was born and we were sent home, I spent a lot of time going over and over her birth in my head and trying to process it with Nathan and Dianne (the doula).  I had overwhelming feelings of guilt and failure that I wasn't able to birth my baby and that I wasn't a good enough mother for Dahlia because I had (in my opinion) failed so massively at something that mother's are supposed to be able to do.  Dahlia was also gaining weight slowly which made me doubt my ability to breastfeed her successfully, further compounding the feelings of failure and guilt.

As time went by I was able to think back on her birth without automatically crying about it and could just file it away in my head as something that happened that hopefully wouldn't occur again.  It wasn't until two years later, when I got pregnant with Reier and was planning for his birth that I read a book by Ina May Gaskin, the nation's leading advocate of natural birth (she is a home birth midwife and has lead the charge to reduce unnecessary interventions and keep birth as natural as possible).  In the chapter that lists the birth statistics from her practice she says that posterior babies are very challenging, though not impossible to deliver vaginally, but babies with brow presentation nearly always need to be delivered surgically.  We had both of those unfortunate circumstances stacked on top of one another with Dahlia. I was finally able to really see that I had done nothing wrong and had tried absolutely everything I could have tried to get Dahlia out, but she was just plain stuck.  It wasn't my fault.  I was relieved and finally felt like I could try it again without fear.

Since Reier's birth was going to be a VBAC (vaginal birth after c-section), we had a lot of details, rules, and regulations to contend with when deciding where and how to have his birth.  The hospitals that allow a VBAC in Seattle require that you are monitored constantly during labor and birth (to detect uterine rupture, of which there is a very low risk), that you have an IV or heparin lock placed (to be ready in case you need another surgery), you cannot deliver in water (which I wanted to), and a list of other requirements that all seemed to imply "we'll let you try to deliver vaginally, but we're very ready for when it fails."  I appreciate that hospitals need to reduce their risk in situations like this, but I didn't like the vibe I was getting and didn't feel like they really believed in natural birth and what a woman's body can do if the circumstances are in her favor, which they nearly always are.  The long and short of it is that we decided on a midwife who would attend our birth in our home.  She was genuinely on my side and really believed that I could have the birth I wanted since I was low risk and the reason for my previous c-section was because of Dahlia's strange position, something that was very unlikely to happen again.  Throughout the pregnancy our midwife almost seemed to forget that Reier's birth was a VBAC and treated me like any other pregnant woman.  That was so nice and so affirming that I wasn't broken and that the process of birth would be respected.

Now, on to the good part (thanks for hanging in there with my super long story):

7/17/12 - 10 days before Reier's due date.  The big day!

1:30pm - Dahlia and I had been playing at the Greenlake wading pool with some friends which required a mile walk to the pool and a mile walk back to the car, pushing her in the stroller.  I started to feel some mild contractions while walking, but could easily ignore them as I strolled chatted with my friends.  We head home from the park to have lunch.

2:30pm - Nathan has taken the day off because he has an architecture licensing exam scheduled for 5pm today.  It is a 4 hour test where they take your phone away and you are totally out of communication.  He gets a call that he can come in to test early if he wants to.  I tell him that I am having very mild contractions and think I might be in labor but it will likely be a while because labor takes 12-18 hours, right?  I tell him to go ahead to his test and will see him later.  Off he goes.

4:00pm - My parents arrive because they are dog-sitting for my sister who is on vacation in Japan for 10 days (and thank goodness they came because, as it turned out, their presence was absolutely essential to the whole process!).  They play with Dahlia, my Dad fixes Dahlia's broken window (she had managed to dismantle the latch during her quiet time and her room is on the third floor, yikes!), we have snacks, all the while I am still having contractions, but nothing more than the Braxton-Hicks I had already been having for the past few weeks.

4:30pm - I decide to take a shower while Nana and Papa are here and my mucous plug comes out (sorry for the gooey details, but birth is messy).  Hmmm, I think I might actually be in labor.  My mucous plug came out nearly two days before labor actually started with Dahlia, so I wasn't too excited yet.  I call the midwife after the shower to give her a head's up and she suggests I lie down and time the contractions for an hour and call back with a report.

5:00pm - I send my Dad out to get take-out dinner and lie down to time contractions.  They are still so mild that I can't even time them.  20 minutes into it I get bored and start to clean up the kitchen to get ready for dinner.  At this point I tell my Mom that I might be in labor, but it will be a while since it is so mild, so don't worry about anything.

5:30pm - We are having dinner and the contractions are beginning to get a bit more noticeable.  I can't finish eating because pacing the house seems like a better idea.  Nothing hurts yet, but sitting down a bit uncomfortable and walking seemed to feel better.  My Mom starts to wonder why the midwives and doula aren't here and when Nathan would get home.  I am still thinking I had hours and hours of this ahead of me and not to worry.  We finish dinner and start to get Dahlia ready for bed.

6:30pm - Things have started to pick up now and the contractions are becoming more intense.  Not painful, but I couldn't ignore them anymore.  I am now really believing that I am in labor and call the midwives and doula and suggest that they come over with the birth tub.  Nathan calls and says his test is done and he is on his way home.

7:00pm - My Mom is putting Dahlia to sleep, I send my Dad out to the grocery store to get labor food (fruit, gatorade, granola bars, etc., thinking I was in for a long haul again).  I am still able to talk through the contractions and I am getting nice peaceful, painless breaks between contractions.  Nathan gets home and finds me pacing in the upstairs hallway saying something like "Welcome home, I'm definitely in labor, how was your test?"

7:15pm - The doula and midwives arrive and start setting up the tub with my Dad's assistance.  Dahlia is now asleep (thank God!) and my Mom gets to work remaking the bed with a shower curtain under the sheets in case the tub isn't ready in time.  The midwife takes one look at me and says "you are definitely getting the fast version, we won't be here long."  I don't really believe her and beg someone to press on my hips to help with the pressure I am feeling.  Nathan and the doula take turns helping me with hip pressure and helping to get the tub and other gear set up.

7:30pm - My water breaks during a contraction while I am on my hands and knees on the living room rug.  Thanks to a well placed towel, there was no mess.  I am shocked that I immediately feel an overwhelming urge to push and the midwives suggest that I go upstairs and lie on the bed for a few contractions so I will have an easier time breathing through it instead of pushing when I am not fully dilated.  I alternate between lying on my side and being on hands and knees upstairs in our room.  The contractions that came after my water broke were definitely painful and much more intense than what I had been feeling before then.

8:20pm - The pushing urge is overwhelming me again and I ask for an exam (the first cervical exam of this whole pregnancy).  I am at 7cm and fully effaced, Reier's head is nice and low.  I ask if the tub is ready ... it isn't yet and I am really wanting it.  The assistant midwife offers me a homeopathic remedy to help loosen what she was calling a "tight cervical band" which I apparently had since I felt so pushy while only at 7cm dilated.  I happily agree and she dumps some little dissolvable tablets under my tongue.  I am amazed that I can still talk and can completely relax between contractions.  Breathing through the contractions when I really wanted to push was very hard, but manageable thanks to those blissful breaks, something that never happened with Dahlia's labor and birth.

8:40pm - The tub is finally ready and I practically run downstairs and dive in.  It is nice to feel buoyant and to be able to move around so easily.  Nathan and the doula are sitting on either side of the tub and the assistant midwife occasionally checks Reier's heart rate with the doppler.  I barely notice that anyone in the world even exists anymore since I am so focused on the work of labor.

8:50pm - I am now having a very hard time not pushing and ask the midwife to check me again.  She calmly says that the last check, when I was at 7cm, was less than 30 minutes ago and I should labor for  about another hour before she will check again.  I put my serious face on and, as politely as I can, demand to be checked now.  Much to everyone's surprise but mine (I somehow intuitively knew it was time for Reier to come), I was at 10cm.  "I guess you really mean business" she said, "go ahead and push that baby out!"  I was elated that I could finally join the energy of pushing instead of trying to avoid it.  It felt great to really be doing something and the contractions during which I was pushing didn't hurt very much at all.  At one point during the pushing phase Nathan leaned over towards me and said "are you still doing anything in there?" to which I emphatically responded with something like "yes ...I  am pushing a baby out of my body!"

9:10pm - Nathan is shown how to get into position to "catch" Reier as his head is crowning.

9:13pm - One push later, Reier Gavin slides out into his Daddy's hands and he is immediately handed to me and put on my chest.  I was able to nurse him right away and we stayed in the tub for about 45 minutes while we waited for the cord to stop pulsing and for the placenta to come out on its own.  My parents came running up the stairs (they had been waiting downstairs with Dahlia's monitor so they could tend to her in case she woke up during the process).  They were able to meet him, take pictures, and text everyone they knew.  Nathan called his family and announced the good news.  The were very surprised to get the "she's in labor" call and the "he was born" call all in one evening.

After we were out of the tub, Nathan carried Reier while I was helped upstairs by the birth team.  I took a shower, was quickly examined (only a teeny tiny tear that didn't require stitches), was propped up on pillows in bed and given a snack.  The midwives did Reier's exam, Nathan got to weigh him, and we put a diaper on him.  We hadn't really planned for a super fast labor, so all of his clothes were in Dahlia's room where she was sleeping.  Since we didn't want to wake her we just wrapped him up in a clean towel and kept him close to me all night to keep him warm.  The birth team and my parents all left before midnight and we were left alone with our new little boy.  It all felt so peaceful.

It wasn't until I was actually pushing that I really believed Reier would be born at home.  When he was lifted up out of the water and handed to me I was immediately flooded with relief that it was all over and he was here.  Along with that relief came a swelling of pride that I had birthed my boy in the kitchen with very little assistance.  I had done the work myself ... I was not broken.  I was finally able to really and truly believe what I had been telling myself about why Dahlia's birth had happened the way it did.  I find myself wanting to tell anyone who will listen about how Reier came into the world and I feel completely healed from the emotional trauma of Dahlia's birth.

And, oh by the way, Nathan passed his test!

On to the pictures:

Nathan gives me water while I am pushing.

Nathan and our doula hang out and wait while I am quite busy in the tub.  Since I was so calm and quiet in the tub, this was about the time when Nathan wondered if I was still in labor.

The assistant midwife (center) checks on my progress with a mirror and flashlight.  The midwife is on the right.  No one bothered me or touched me at all while I was pushing, which is exactly what I wanted.

Nathan catches Reier and hands him up to me.

I can't believe I just had a baby in the kitchen!

I got to have him with me continuously from the moment he was born.

My parents come running with iPhones at the ready.

We are wondering if he is a redhead like his sister.  Nope, we still think he is a blonde.

What a perfect boy he is!

Reier gets to nurse right away and latches on like a pro.

After the cord is cut (about 30 minutes after he is born) Nathan wraps him up and carries him upstairs.

Checking his belly and joints as a part of the exam.

He was a very strong little froggy and still covered in his vernix goo.  We didn't give him a bath until he was about two weeks old.

Checking his lungs and heart.  His head only had a tiny bit of molding that went away very quickly.

Nathan gets to weigh him...8 lbs 6 oz!

I am having a snack and enjoying watching the exam and weighing.

He was already so calm and sweet, even at two hours old.

Reier is drifting off to sleep as he nurses again in bed.