Thursday, August 28, 2014

Tessa Ember's Birth Story

"Are you sure you're not pregnant?"

This is how it all started. S was 15 months old. My cycle had just returned the previous month, and we had decided to start trying for another baby - on the assumption that it would take a while since my body is pretty defective. I had really confusing and irregular signs, thought I had ovulated later than I should have, and then on the morning that D asked me this question, had realized (or so I thought) that I hadn't ovulated at all.

"Of course I'm not pregnant!" I told him.

And then I went home and took a pregnancy test. It was late September, and two little blue lines showed up. Clearly, a mistake. I had shown no classic signs of fertility - at least not in the order they're supposed to be.

So I took another pregnancy test. And, of course, there was no mistake.

By the time I got around to seeing a doctor, I thought I was about 11 weeks along. The ultrasound showed me to be at 13 weeks. Goodbye, first trimester! My EDD was set for May 19th.

We then began the search for a home birth midwife, since we no longer live near the awesome birth center where Samantha was born. We found a great midwife named Sarah who was about an hour away - she was really the closest one. So at 20 weeks, I began driving down the Millheim for my appointments. Samantha loved going to the midwife. Sarah would let her "help" take my blood pressure, and push the button for the doppler to hear the baby's heartbeat. (Samantha enjoyed these tasks so much that she started playing "midwife" at home, rubbing her hands together, rolling up her sleeves, and then palpating my belly to feel the baby's position.)

After a completely normal and healthy pregnancy, May finally arrived. The countdown began, with May 19th as the baby's estimated birthday. At 37 weeks, everything was perfect, and baby was head down. At 38 weeks, something changed. I went to my appointment knowing that the baby had shifted positions, and was most likely now lying transverse. Sarah confirmed my suspicions, but wanted to be positive. She knew that if she sent me to the hospital for an ultrasound, and they found out the baby was transverse so close to my due date, they would want to schedule a C-section. So she called another home birth midwife in the area who owns a small ultrasound machine, and sent me over there. Twenty minutes later, I was back in Sarah's office with the confirmation - my baby was suddenly sideways.

Here's the thing about transverse babies - they can't come out that way. There is a possibility that they will turn head down during labor, but there is also the possibility that they won't. So D and I began doing the research on planned C-sections, trying to mentally wrap our minds around the idea that we might have to have a surgical birth instead of the natural at-home birth we were hoping for. It was a stressful week leading up to my next appointment. I knew that if the baby wasn't head down by 39 weeks, Sarah would recommend transferring to her back-up doctor and scheduling a C-section. I did all sorts of exercises that are supposed to help turn the baby into the correct position. Samantha caught on and her new manrta became "head down, baby, head down!" D and I talked endlessly about how we could have a "gentle cesarean" to make the experience as stress-free as possible. (Side note: it is now possible to have a C-section and get to hold your baby immediately afterwards, as well as to delay cord-clamping, and some other neat improvements!) I won't go into all of the anxiety that swallowed our household during this week, but I was a nervous wreck by my next prenatal appointment. Even though I had finally let go of the need to control everything and turned the rest of my pregnancy and the birth over to God, I still wanted to be able to follow through on our planned birth experience.

Fortunately, my baby turned into the right position just in time for my 39 week appointment. I remember asking Sarah, "So, what can I do to prevent the baby from turning again?" Her response was a not-very reassuring, "She shouldn't have turned this late in the first place!" I tried to feel peace by reminding myself that the baby was in God's hands, and that any changes in positioning were for a reason (for example, if the cord was getting wrapped and being sideways was preventing some type of problem). And now it was time to wait. And wait... And wait...

The 19th was a Tuesday. I had planned out activities for the entire week, hoping to have to cancel them. But alas, even though I had been having Braxton Hicks contractions for several weeks, there was no sign of impending labor until that Friday, the 23rd. I started having contractions in the morning, but they were all in my back. D went into work for a few hours to finalize things, and we thought we'd have baby sometime in the next day or two. My contractions were irregularly spaced and on-and-off all day, so we went out to the mall and walked around for a while. After we ate dinner, the contractions stopped altogether. 

Saturday morning I went to a prayer brunch with a bunch of wonderful ladies. That morning, I had a bit of bloody show. I told everyone that I was pretty sure the baby would be here by the end of the weekend, even though my contractions were still so intermittent. They continued to be on and off all day, but never got any stronger. My sister suggested that perhaps the reason they were all in my back, and were starting and stopping, was because the baby was posterior ("sunny side up" - basically facing towards my belly instead of my back.) I started doing exercises to try to get the baby to turn around, since babies don't fit quite as well through the pelvis when they face this way.

Sunday morning, D had to go to the ER for chest pain. My contractions completely stopped. D ended up being fine, but I no longer had any signs of labor.

Monday was Memorial Day. We decided to test Murphy's Law and go hiking with friends. We went an hour away from home, out in the middle of the woods. We forgot to charge our cell phones. And our car started having problems. I hiked part of the Falls Trail - with lots and lots of steps. And yet, no contractions, no baby.

Hiking at Rickett's Glen State Park
Tuesday I went to yet another prenatal appointment, where Sarah confirmed that my baby was posterior.

My contractions didn't start up again until Wednesday morning around 7:30 - eight days past my estimated due date. They were stronger this time, but still in my lower back. They came intermittently. D went to work in the morning, and my good friend Becky and her son Ben came over to hang out. The kids played, and my contractions came more frequently. I kept waiting for them to stop again, but when Becky finally asked me, "Do you want me to be timing these?" I realized that they probably weren't going away. We went for a very slow walk around the block, and then Becky & Ben went home for lunch. I got Samantha down for a nap and called Sarah to give her a head's up that I might actually be in labor. I then tried to relax & lay down, but my contractions suddenly became very intense. During one, I felt a small "pop" and leaked a small amount of water. D came home from work, and our friend Beth came over to get Samantha. 

Sarah arrived at 3:30 and checked me - I was already at 8 cm and 90% effaced! I was sure the baby was coming soon, but the contractions weren't as intense anymore. Lisa, the back-up midwife, showed up a little while later. Now it was just a waiting game. The contractions were more consistent, but still very manageable. D and I played Uno while I sat on the exercise ball. Sarah & Lisa sat and chatted in my kitchen and gave us plenty of space. I snacked a lot and we just generally passed the time hanging out. It was very relaxing, but it felt like everything was taking a very long time (especially since I was already so dilated, and because my water had already leaked a bit).

At 5:30 I got into the birth pool. It felt so incredible to be in the water. I could easily change positions, and I tried to be on my knees & leaning forward as much as possible during contractions to help the baby get positioned properly. For the most part, my labor was relatively easy, and for the next two hours D and I talked and joked between contractions. It was a really special time for us, and we were both generally relaxed about the whole process.

Then 7:30 hit, and everything changed. The contractions really started to pick up, and I started bracing a bit to get the baby to move down. I stopped being able to talk easily and just focused on breathing and trying to relax. I did a lot of "horse lips" to loosen up, and found they really helped (even though I sounded ridiculous). D spoke words of encouragement the entire time, and this made all the difference. His reassuring voice in my ear, as I leaned my head on his shoulder, gave me strength. I tried to speak words of affirmation as well ("I can do this, I can do this!"), and spoke to the baby. I got to the point where I felt like I couldn't do it anymore, and that's when I remembered what my sister had once told me - when you reach the point where you feel like you can't do it, you're almost done. 

I started pushing at 8:06. Because the baby was sunny-side up, it was extremely difficult and so much more intense than my first birth experience. When S was born, her body came out without much effort, but this baby was very different! Her head emerged at 8:07, but because of positioning and her larger-than-average size, her shoulders took a while to squeeze through. She wasn't necessarily stuck, but it was a very tight fit. Sarah told me to reach down and feel the baby's head, and as soon as I did I felt a surge of power run through my arm and give me the strength to push her body out. Our beautiful girl was born in the water at 8:08 p.m., after two minutes of pushing (definitely the most intense two minutes of my life). She emerged with the bag of waters draped over her head like a veil.

Because her head was out for a full minute before I was able to push her body out, she was a little bit blue. Sarah and Lisa were completely calm, however, so I never sensed anything was really wrong. My sweet baby opened her eyes and looked at me, and I held her to my chest, relieved to be done and overjoyed at her presence. It wasn't until D asked about her coloring that I even noticed. (It wasn't until over a month later, when Sarah shared her notes with me, that I found out that her Apgar at one minute was only a four - low heart rate, no respiratory effort, pale blue... but because my midwives remained calm, her first few minutes of life weren't disrupted by panic.)

After two minutes of sitting against my chest draped in towels, with Sarah and Lisa massaging her limbs, my baby girl began breathing much better and pinked right up. By five minutes, her Apgar was a nine and everyone relaxed. We spent a few minutes cuddled up, with D learning over my shoulder and our baby against my chest, and for that moment, everything was perfect.

The cord was cut at 8:17 after it stopped pulsing. She weighed in at a whopping 8 lbs 14 ounces and  was 22" long. She began nursing without a problem at 8:37, and we settled in for a little while to rest (and eat peanut butter crackers - I was hungry!) At 9:20, Sarah examined her and discovered that her gestational age was exactly 40 weeks, instead of the 41 or 42 weeks that my due date would have suggested. Looking at Sarah's notes, it is pretty cool the way that the gestational age is determined. They examine neuromuscular maturity and physical maturity, and use a scale which shows various possibilities - for example, on posture, wrist flexibility, arm recoil, what their ears/feet/skin/breasts/etc. look like. Then they total up all of the answers to figure out the baby's gestational age, and our baby scored exactly 40 weeks. Incidentally, this is what I had initially expected to be my due date, until the ultrasound told us different. So it appears that she was just big from the very beginning, and that threw off the dates on the ultrasound.

Tessa's first few minutes of life.

The midwives left at 10:00. We all slept well that night, and D went and got Samantha first thing the next morning. We still hadn't decided on a name for the baby, even though we had known for 22 weeks that she would be a girl. We had it narrowed down to three names, and finally we decided to both pick two and see which ones overlapped or if we could at least eliminate one. Tessa/Tess was the name that we both picked. It was originally a nickname for Theresa, but is now a common name by itself. It means "harvester." We had already picked the middle name Ember, so Tessa's name literally means "harvester of fire." Hopefully this won't invoke thoughts of pyromania, but instead of someone who cultivates passion and enthusiasm for life.

All in all, our first home birth experience was amazing. It was incredible to be in my own home, to have the freedom to move around, eat snacks, and spend quiet time with my husband as we waited for Tess to arrive. My midwives were supportive and present as needed, but virtually invisible when they weren't needed. Being in the water made a world of difference, too. Between Tess's size and her stubborn posterior positioning, I am honestly not sure how I would have been able to birth her naturally without the weightlessness that the water provided. I was able to move easily and get into the optimal position (and it also prevented tearing, which is a plus - especially, again, with her size & positioning being a bit unusual!) And it was absolutely heavenly to climb into my own bed to snuggle with my baby minutes after she was born.

Tess at two days old - when we finally figured out her name:-)

I am so thankful to have had this birth experience. My experience with S was also amazing, but in a very different way. Both births are full of special, unique memories - just as both girls are special and unique.