Postpartum: What You Should Know

My blogger friend, laughingpromises, is 10 weeks postpartum and just wrote a post about the stuff that happens after you have a baby.  I empathized with her post so much that it made me want to write a postpartum post of my own.  I’d been meaning to write about this stuff for awhile, anyway.

Postpartum is TOUGH TOUGH TOUGH!  Maybe it’s just because I had a complicated delivery and maybe it’s just because it was my first baby, but I’ll bet there are plenty of women out there with easy deliveries of their second or third babies who will have had similar experiences postpartum. I can honestly say that the postpartum weeks were the most difficult part of my entire baby-having experience.  And because I didn’t anticipate how difficult it would be, I was kind of caught off guard.  I mean, I knew that adjusting to life with a new baby would be a big thing and I knew that my body was going to have to recover from a pretty serious feat, but I just didn’t know.  I just didn’t know.

First of all, you have to understand that what makes the postpartum time so challenging is that it is extremely intense in a physical, emotional, psychological, and spiritual way.  All at once.

Physical

Our birth class instructor told us that within a week of having a natural birth, we’d feel like we hadn’t had a baby  I was planning a natural birth; therefore, I expected to feel pretty much 100% in seven days’ time…. HA!  I still don’t know just how off-base my instructor was since my birth turned out to be quite complicated, but I can’t imagine that even a very straightforward birth would leave me feeling tip-top after a week.

Episiotomy/Tearing

What I do know is this: If you end up with a complicated birth (like forceps and a 4th degree episiotomy, for example), it will take weeks- no, months- for you body to feel mostly normal again (I say mostly because I still have tenderness going on).  I was absolutely thrilled to have sex mostly without pain for the first time the other day (and it’s been 4 months).  The first two weeks were. so. horrible.  I couldn’t make a single move without pain and I had to think through what I was going to do before I did it.  Nursing sitting up was awful because I was sitting right on my undercarriage sutures, but nursing lying down wasn’t an option because that also hurt + my baby couldn’t latch that way for some reason.  The simple act of going to the bathroom was something I dreaded because when I sat on the toilet it felt as if my insides were going to fall out if I relaxed at all.  The only way I could pee at all for 2 days after giving birth was to kneel on a stool in the shower, and I was terrified the first time I had to poop.  You don’t realize how much you use your pelvic floor muscles until they’ve been cut in two.  I had to sit down to sneeze, cough, or even blow my nose because I simply didn’t have the support to do it standing.  It was embarrassing to have guests over for the first couple of weeks because I really needed to actually hold my hand underneath myself for support whenever I walked, and I just wanted to sit on ice all the time.  I remember the very disconcerting feeling of passing a little gas about 2 days postpartum and literally having no muscle strength to control it.  It felt like a liquid just flowing merrily out of my behind, and for a bit I thought I’d had diarrhea or something.  I ended up taking a few Tylenol every day for awhile.  When you give birth without drugs and then take them post-partum, you know it’s bad.  I did it just so I could even lift and carry my baby across the room or position myself in bed to nurse him.

Blood Loss

I never realized this before, but significant blood loss is a big deal, and it isn’t something you recover from quickly, especially when your body is already taxed beyond measure trying to make milk to feed your baby.  I was so weak and faint that I could barely walk across the house.  For a week or two, I literally only went downstairs once a day and even that was rough.  I almost passed out after the delivery twice, and each time my hearing faded.  My nail beds were white for at least 6 weeks.

Breastfeeding

Ok, yes breastfeeding is wonderful and extremely important for your baby and a wonderful bonding experience, but folks, it ain’t easy!  It’s so easy and convenient now, four months later, but for the first 2 and a half to 3 months it was NOT.  I am a huge advocate for breastfeeding, but I do think that women should go into it expecting it to be one of the most challenging things they have ever done in their lives.  I know that some babies and mamas pick it up so easily, but more often there are significant challenges.  By day 3, when I’d spent 3 hours in the middle of the night trying unsuccessfully to help my desperately hungry and frustrated baby to latch and nurse, I understood completely why so many women give up.  There were many tears (and my baby cried too).  Breastfeeding can seem awkward at first.  It can really really hurt at first.  It’s messy.  It’s time-consuming.  It’s confusing.  It will make you wish you were a camel and could drink gallons and gallons of water at a time (seriously, don’t EVER try to nurse the first couple of weeks without a huge glass of water within reach)! But, it’s worth it.  I was so determined not to give up and I am now being rewarded with a wonderful nursing relationship with my son.  I wish, though, that I’d known how tough it could be at first.

Emotional/Psychological/Spiritual

I really looked forward to that hormone surge and the wonderful feelings that I’d have after finally birthing my beautiful baby, but I didn’t realize how much of a mixed bag it might be…

Postpartum High

Giving birth is so emotional that you will probably feel like you’re another planet for a few days weeks months.  I loved loved loved the emotional high that I experienced the first couple of days postpartum.  It was like nothing else.  I really did feel like I could conquer the world.  My husband experienced an emotional high as well, probably because he had been so involved and present during the entire experience.  He couldn’t speak of our son or our new family without crying with overwhelming happiness.  I had really never seen him cry before, so to see him cry multiple times a day at the drop of a hat was really new for me.  I felt so so close to him and really felt that we connected emotionally in a way that I’d never imagined was possible.  He took to fatherhood so naturally and assumed care of our son and of me like he was always made to do it (he was,really).  He told me so many times how amazing I’d been and he looked at me in awe like I’d performed a miracle right before his eyes.  I think he saw me in a completely new way, like I was some kind of goddess.  Not gonna lie, I really enjoyed that part.  🙂  Every time I looked at my little baby boy, I felt like it was some kind of dream.  We’d sit in bed at night and just watch him sleep, marveling at every feature of his perfect face and delighting in every little sigh, every sleepy expression.  We were smitten together over a tiny little boy.

Postpartum Blues

At the same time I felt such love and joy, I also felt the most horrible sense of defeat and disappointment over the way the birth hadn’t gone the way I’d hoped.  It was a dizzing mix of elation and depression that had me cycling between high and low.  Completely exhausting.  On our second night in the hospital and I cried and cried and googled “home birth transfer” while my husband and baby slept.  Birth is such a rite of passage and such an important event in a woman’s life.  They tell you to have an open mind regarding how it will go, but it’s impossible not to have hopes and dreams.  It took me a long time to begin to really come to terms with reality vs. my own wishes.  Emotional healing can take even longer than physical recovery, and you really need to allow yourself the time you need.  Writing out my birth story helped tremendously.

I also experienced a very dark period during the couple of weeks after giving birth.  I wanted to just feel happy, but after you give birth all of the hormones that you had during pregnancy begin to shift and it takes its toll on you.  I felt that I was in a deep pit.  I felt angry.  I felt hopeless.  I felt terrified and trapped.  I wondered what I had gotten myself into and wondered if I’d ruined my life.  And I didn’t want to admit that I was feeling that way because it seemed so wrong.  I was ashamed of myself, but I know now that those feelings were normal.  Postpartum depression lasts longer and affects fewer women, but postpartum blues are very common.  I was so relieved when those feelings began to subside.  Getting out of the house a little bit helped, going places with my baby helped, and becoming more confident as a mother helped.

Mothering Instinct

I was shocked at how visceral my reactions to my baby’s cries were.  They could make me frantic, even angry.  I had such a strong strong drive to take care of him that when he cried I felt that I must find the reason and stop it as quickly as possible.  In the beginning, it’s tough because you don’t have the experience yet to always know what’s wrong or how to fix it. You have to get to know your baby.  If he was hungry, I could not allow myself to do ANYTHING else before feeding him.  It was such a strong compulsion, and my body would react by letting my milk down right away and I’d leak all over the place.  I could not rest knowing that he needed me.  Sometimes it seemed that he was crying because he was angry at me, and in my hormonally-charged, sleep-deprived state, that made me feel angry too.  At him, even though I knew that he was an innocent.  Feeling such strong feelings really scared me, especially the angry part.  I remember at times just laying him down for a few moments in order to collect myself because I was in no state to handle him.  I guess I just want other moms to know that it’s probably normal to feel this way and that you won’t feel that way forever.  Maybe I just have a low tolerance level for unexplained baby cries, but this was one of the toughest things for me, emotionally.  I would often just cry along with him because I felt it was a safe way to let go of my frustration and stress.  I often felt so upset at myself for not having more patience.  That has definitely improved with time, thank goodness.  🙂  Sometimes, though, I still have to pray for patience on really tough days.  Prayer- don’t forget it!

Body Image

I felt simultaneously so proud of my body for performing such a wonderful and difficult feat and so sorrowful over the beating it took.  I looked with a mirror at the damage about 3 days afterward, and it wasn’t a pretty site.  I will say that it was not as bad as I had expected it to look.  Maybe it’s a good thing I didn’t look earlier because my husband was already telling me I was healing up so quickly and so well.  The hospital doctors said the same thing.  Still, I dissolved into tears one evening over the fact that I’d never have the same body I had before.  My perineum, though it’s healed up so much better than I ever thought possible, will never be the same.  My tummy, though I am blessed to not have any lingering fat, is still soft and weird and weak and bulges after a big meal.  I have an awkward skin tag that somehow got created when they sewed me up.  My boobs are bigger (ok, that’s actually great) and my nipples are forever changed (They may point down or sideways and be two miles long by the time Alex is done with them).  Yes, our bodies were made and specially designed by God to give birth, but birth also forever changes our bodies.  I had to mourn that.  We may have stretch marks, scars, dark lines, and tenderness that will never fade and we have to accept this about ourselves.  We have to let ourselves love our new bodies for the miraculous vessels that they are.  I will never again look at a pregnant woman without feeling a huge sense of pride and joy over the sacrifice her body is about to make to create life.

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I wrote this post just to share my experience and to talk about the stuff that women don’t always talk about, either because we feel we should be focusing on the joyful parts or because we don’t want to scare other future moms.  I also wrote it as part of my own healing.  I don’t want to scare those of you who haven’t had babies yet, though, because the truth is: IT’S WORTH IT!  Yep, it absolutely is!  The joy I receive from the special smile my baby reserves only for me is like a huge thank you card that gets better and better each time I read it.  I fell in love with my son the day he was born, but I also fall deeper and deeper in love with him every day.  As he grows and reveals more and more of his special personality, my bond with him grows and just affirms that, yes, postpartum struggles are nothing compared to years of joy.  🙂  

When you hit the bottom of the well after your postpartum high runs out, just remember that women everywhere know exactly what you’re going through.  They made it, and so will you.

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Alex’s Birth Story

I’m so excited to finally be sharing Alex’s birth story!  He’s already nine weeks old, and I both can’t believe it’s been that long and can’t believe it’s only been that long.  Time definitely takes on another quality when you go into labor, and I’m convinced it doesn’t really return to normal afterward (probably because days and nights kind of merge together when you’re up every couple hours to nurse a newborn!).  I wanted to write and post this much sooner than now, but writing it felt overwhelming, probably because I was compelled to write down every detail.  It was also difficult to write because of my conflicting feelings in regards to the birth.

It’s super long (seriously long), but I’m not going to apologize.  I only mention it to warn you.  I wanted to write absolutely everything because this story is to make sure I don’t lose these memories.  I feel like they are seared into my brain, but I know my brain will eventually age (probably while I’m trying to keep up with a smart, energetic little boy) and they might grow hazy.

My birth experience with Alex was crazier than I ever could have imagined!  It was simultaneously everything I’d dreamed of and everything I’d feared.  Nothing, NOTHING could have prepared me for how it all turned out!

Note: Some of the pictures might be a little graphic, though I actually tried to use the least graphic ones.  Just a warning in case you’re squeamish or easily offended.  🙂

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On Tuesday December 11 I decided to do some Christmas shopping.  Nothing crazy- just one store for a couple of hours.  We’d had our 39 week midwife visit the night before and discussed how we hoped our baby would be born when my family was here (they were supposed to all be here by the 19th, which was also the due date).  My midwife, Stacia, had joked that I probably shouldn’t go Christmas shopping for 10 hours or anything if I didn’t want to go into labor, but I thought only 2 hours should be safe.  The baby was very low and in a great position for birth, and our midwives both kept saying that they didn’t expect me to go much past my due date.  I had had a feeling for several months that the baby would be early, but thought it was probably just a paranoid reaction after being afraid of preterm labor when we thought my uterus might be bicornuate.

While in the store trying to find a sweater for my mom, I began to have some cramping that felt like menstrual cramps.  This had been happening on and off for a few weeks, but it seemed a little more intense this time.  I got a strong feeling that the baby was coming soon.  When I got into my car, the cramping stopped, but I still texted my mom that I felt like I was going to have a baby very soon and I got a little emotional on the drive home thinking about it.  We went to sushi with friends that night, per usual.  They asked me how I felt and I said I felt like I was about to have a baby. 🙂

Back at home that night, we decided to have sex.  We weren’t sure if we should since the last time we did (the previous Saturday morning), I’d had cramps all during church.  We knew that semen would soften my cervix and wanted to wait until our due date to have a lot of sex, but we figured a little beforehand would be fine…. Well, shortly after we’d done the deed, I began to have cramps again.  The baby was also kicking the crap out of my insides as the little dear liked to do each evening, so I got out of bed and came downstairs and made paper snowflakes (yes, that was the last “project” I did before giving birth, ha!).  After that, I read a birth blog where a woman had blogged several times during her labor, which was really cool and gave me the idea to blog while I was in labor too.  I finally crawled into bed around 1:30am, feeling really tired.

I was partially awake at 5:55am for some reason, enough to feel a “pop” from inside.  My first thought was: “I wonder if that was my water?  No, surely not!”  I thought about walking to the bathroom, but hesitated a few seconds, and that’s when I felt a gush of amniotic fluid.  And then another.  Good thing I’d put that shower curtain under my sheets!  I grabbed the towel I had stashed by the bed, shoved it between my legs, and waddled to the bathroom.  Water soaked the towel and went into the toilet.  There were flecks of pinkish white in it, but otherwise it was clear- good!  No meconium!  (I actually have a picture of what I saw in the toilet, but I decided to refrain from sharing, haha! You’re welcome.) I sat there for a moment, absorbing this turn of events.  I had never expected my water to break before contractions started, so I was surprised!  I also now knew that my family wouldn’t be present for the birth.  They were going to be so disappointed!  After giving myself a minute to adjust to what was happening, I crept back to our bed, still using the towel to absorb the periodic gushes of fluid.  I whispered “Dennis, my water broke.”  He struggled to escape a deep sleep, “Really??  Should I still go to work?”  he babbled.  “Uh… NO!”  Silly Dennis.  😛

I got back into bed and Dennis and I lay there holding each other for awhile, excited that this was finally happening but trying to remain calm.  For some reason I began to shake violently even though I didn’t feel cold or stressed.  I’m still not sure why it happened- maybe because of something in my amniotic fluid?  Contractions began almost right away as I lay there.  They felt a lot like the cramps I’d been having but had a definite beginning and end.  They were very mild, but I didn’t want Dennis to talk or move during them.  They started out 4 or 5 minutes apart and about 1 minute long and pretty much stayed that way all through early and active labor.  After about an hour, Dennis got up and called Stacia and Erin, our doula, to let them know what was going on.  I called my parents and sister and texted 3 of my friends to tell them it was go time!

We got out of bed and Dennis began to run around getting stuff ready.  The hose for the pool was still outside and frozen, so he had to thaw it out.  He also vacuumed (bless him!), something that always makes me feel better (clean floors- ah!).  I don’t remember exactly what I did- just some puttering around in my bathrobe and putting away clutter.  I found the pile of freshly-cut snowflakes from the night before and cleared them from the kitchen table.  I probably brushed my teeth.  I was so happy that we’d mostly gotten everything important done early.  I put on a big pad to catch the fluid that was still periodically gushing out.  I tried eating a little bit- some trail mix type stuff- but threw it up.  This was disappointing because I’d always planned to eat in early labor to keep my strength up.  😦  Stacia had told Dennis that since my water was broken I shouldn’t take any baths or get into the pool until active labor, but that I could take a shower.  I wanted to take one, but decided to wait until a little later (time morphed from there and I never took one).

From here on out I get a little fuzzy about times, but I do know that I wrote a blog around 9am, and I said that I was beginning to feel different even between contractions, kind of in a daze, and everything felt hazy.  Around 10am I was no longer able to text people.  I kept trying to figure out where in labor I might be based on how I was feeling and acting, though I didn’t want to assume I was farther along than I was.  When contractions first began, I felt completely normal unless I was actually having one, so I knew I was progressing past early labor when I began to feel so out of it all the time.  I was in the “labor land” that women always talk about!  Your body really does take you to another place when you’re in labor- a merciful place where time loses its meaning and pain is relative.  I made sure I let myself stay there and remain detached from everything else happening around me.

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The entire time I was in labor, I felt the contractions mostly in my lower back/pelvis area.   The baby was not posterior, so I wasn’t having the dreaded “back labor”.  In retrospect, I think I was feeling my pelvic bones moving apart.  The contractions were definitely happening in front as well, but I really don’t remember feeling them there because the sensations in my back were way more intense.  It felt right to lean forward during each one, which is what I did for the whole labor.  I spent some time in the kitchen where a heating vent blew air onto my feet and felt really good.  I could lean forward there and rest my forearms on the counter and move my hips.  About this time I started having Dennis put some counter pressure on my lower back/pelvis- it felt so good!  For the rest of labor, I always wanted someone to give me counter pressure during contractions.

Sometime around noon I got incredibly sleepy.  I was glad I’d had a few hours of sleep the night before, but really really wished I’d gone to bed a little earlier!  I moved to the living room where I tried leaning on my birth ball covered in a towel.  After that I leaned on a big cushy chair and pretty much slept between contractions, which was totally crazy!  Dennis was in the kitchen making himself some lunch- something with leeks in it.  The smell of those cooking leeks filled the house.  It seemed like it was taking forever and I just kept thinking: when is he going to be done cooking those leeks so he can come push on my back?!  That seemed like the longest part of labor for me.

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We weren’t sure when to call Stacia, Cynthia, and Erin to come over.  I wanted to labor alone with Dennis as long as possible.  Finally he called Stacia and she said she could come over just to check on the baby, and we said ok.  She arrived around 2:30 and ended up staying.  She sat with me during a few contractions and then told Dennis he might want to start filling up the pool.  I felt really excited when she said that because I figured it meant that I was in active labor or at least close.  I didn’t know for sure because I hadn’t had any internal checks yet, and I was ok with that.  Erin came around 3PM, I got into the pool around 3:30, and Cynthia, the assistant midwife, arrived shortly after.  The water felt so good!  I labored leaning on the side with my arms out of the water between contractions.  I think I was on my hands and knees a lot during contractions as well.   The temperature was sometimes perfect, sometimes too hot, and a couple times too chilly, but my birth team was great about adjusting the temperature when I asked them to.  We had a hose coming into the pool from the utility sink in our laundry room.

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Whenever I had a contraction, my birth team would take turns providing counter pressure on my lower back/upper pelvis.  Between contractions, Erin got a bowl of cold water and put cool washcloths on my forehead, back, and neck.  That felt really good!  I was so warm and so absorbed in what I was doing that for the most part I didn’t want anyone to touch me.  That surprised me a little bit.  I just felt like I wanted to put absolutely all of my attention on what was happening inside my body.

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The wee stocking I made 🙂

I hadn’t had any internal checks during my pregnancy or labor.  I hadn’t really wanted checks during labor because, if I wasn’t very dilated yet, I didn’t want to hear a disappointing number and feel discouraged.  I know that dilation doesn’t necessarily happen in a linear fashion, but in the midst of labor I might not remember that very rational thought and just think “Oh no, this is going to take forever- I can’t do it!”.  I could tell, though, that I was progressing just by the sounds I was making.  I’d begun to make sounds pretty early on, and the longer I was in labor the louder my sounds became.  I kept them low in tone, but I increased the volume and duration to match my contractions.  I remember at one point thinking, “Wow, I’m amazed that I’m able to make that loud of a sound for that long!”  I don’t think my contractions ever really got longer, except maybe at transition, but when they got more intense the period of time that I felt I needed to make a sound during one got longer, if that makes sense.  I was relieved that I didn’t feel too self-conscious to be vocal.  That was something I had worried about, along with whether or not I’d feel comfortable being naked in front of several people.  I needn’t have worried!  I had a bikini ready to wear in the pool, but when it came time to get in, I just threw my bathrobe out of the way and jumped right in; I didn’t care!

We videotaped some parts of the labor.  I haven't looked at it yet.

We videotaped some parts of the labor. I haven’t looked at it yet.

Dennis’ parents stopped by in the early evening with some food.  Stacia met them at the door and told them that it would be about an hour until Baby arrived!  I couldn’t believe that it was possible, but I was excited.  About this time as well, Stacia talked to us about whether my husband was going to be in or out of the pool to catch the baby.  She said she anticipated that there was still some time left before the birth, but she wanted to talk to us while I was still lucid.  I really didn’t feel very lucid at that point, but I figured she knew I’d be less lucid later on.  That was around 6:00 or 7:00pm.

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Dennis was feeling really excited and was looking into my eyes and kissing me and telling me how happy he was that we were about to meet our baby and how well I was doing, how proud he was of me.  He was so emotional.  That’s one of my favorite parts of laboring in the pool, though at the time I was just so focused on the work that I still had to do that it was tough for me to join him in his pre-celebration.  Erin was also really happy and told me that this was just how she had imagined that labor would go for me.  I remember feeling really proud of myself for how I’d handled labor so far, but I just wanted to get to the end and THEN be really happy!  I had no idea what was still ahead (and neither did anyone else, apparently).

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In most of the birth stories that I read in preparation for labor, I noticed a common theme in which each woman would reach a point, usually during transition, where she would doubt herself.  Sometimes those “I can’t do it” thoughts would only be in her head, but often she would vocalize them, usually to her husband.  A lot of women beg for the hospital or pain meds at this time.  I had warned my husband and family ahead of time that at some point I would probably say that it was too hard or that I couldn’t do it and that I just needed them to encourage me because I KNEW I COULD do it.  To my surprise, I never really reached the point where I felt that labor was impossible to handle.  I do think I know when I passed through transition, though, because I remember, after one particularly long and intense contraction, thinking “Wow, this is really intense!  I wonder how much more intense it’s going to get??”  There might have been a few contractions that were also closer together.

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That must have been the most difficult part though because then I began to think about pushing.  I decided to try it a little on the next contraction, just to see how it felt.  It felt ok…  At that point, though, it was definitely just a thought, not an urge…. Until it WAS!  After a few contractions of “thinking” about pushing, I was definitely pushing and I Could. Not. Stop.  When they say that your body takes over and pushes and there is nothing you can do about it, they aren’t kidding!  I’ve heard it compared to vomiting and that’s a pretty apt description!  As long as I pushed, I felt ok.

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After a few pushing contractions, Stacia told me that she could tell that the baby wasn’t moving down.  I still am amazed that she could tell so much from the outside.  She asked to check me and I agreed.  She found that I was about 9.5 centimeters dilated, but still had a cervical lip that I’d been pushing against and it was getting swollen.  She asked me to try NOT pushing for 3 contractions to see if it would move…..  WHAT??!!  Not push- are you KIDDING me??  I didn’t see how it was possible.  Erin explained to me, though, a way to breathe to keep myself from pushing.  It was a very very fast “hoo hoo hoo” sort of panting breathing.  So I tried it.  Man, not pushing was really rough, but I did the breathing and didn’t push.  I’d lose control a few times during each contraction and my body would push, but I’d just get things back under control and do the panting again.  Erin told me that’s exactly what I should be doing, so I felt really good about it.  Erin was so encouraging and supportive the entire time.  She was truly an emotional bolster, and I loved loved loved having her there!

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After 3 contractions of the horrible not-pushing, Stacia checked me again.  The lip was still there.  She wanted to keep her hand inside during a contraction and try to push it out of the way, and I said ok.  I kind of floated on my back in the pool with Dennis holding me under the arms and Erin and Cynthia holding my legs.  Stacia kept apologizing for the unpleasantness of her hand inside me during a contraction, but the funny thing was that it really didn’t hurt at all.  If anything it felt better.  I still haven’t figured that one out….  In any case, it worked!  I was fully dilated!  Back to pushing, for real this time.  I think that was around 9:00 or 9:30?

At about 10:30, the baby still unfortunately had not moved down and Stacia suggested getting out of the pool to try other positions.  …….And this was the point at which my lovely straightforward home water birth turned into a very difficult complicated birth……….

I had to go to the bathroom anyway, so I tried pushing on the toilet for awhile.  Dennis sat in there in the dark with me, as did Erin for awhile.  Stacia came in periodically with a flashlight to check the progress.  There wasn’t much.  We didn’t know exactly why the baby wasn’t coming down.  Stacia said that when he did come out we’d probably see what had been the problem, a hand by the face or something like that.  Finally Stacia suggested that we go upstairs and have me try pushing in the McRobert’s position.  This is the only back-lying position she would ever recommend.  We had talked about it during our prenatal visits.  Basically, you lie there like a cockroach with your legs up and knees pulled back toward your head.  This position allows the birth canal to be open, but also lets you get some rest.  Stacia herself had given birth to both of her children in this position.

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So we tried McRobert’s.  And we tried the birth stool.  And we tried the toilet again.  I was in the bathroom alone when I heard Stacia telling Dennis that they would have my try for a few more contractions and then begin talking about hospital transfer…  I felt so mad just hearing those words!!  At that point, I did NOT feel like giving up on my homebirth dream and I was DETERMINED to get that baby out right then and there!  When the next contraction came, I pushed and pushed and pushed for all I was worth and even tried to stretch my perineum with my fingers.  They came away bloody.  I didn’t know where they blood was coming from, and I didn’t care!  I just wanted to get the baby out, and my thoughts were no longer on the preservation of my body.  People, if willpower alone could have brought the baby into the world at that moment, it would have happened!  Unfortunately, it wasn’t enough.

I finally came out of the bathroom, feeling slightly defeated but still not ready to give up.  I was willing to do anything and everything that Stacia suggested.  I tried the McRobert’s position again, my birth team falling asleep between my contractions and then waking up to hold my legs while I pushed and pushed and pushed.  I remember kind of feeling badly for them.  It had been many hours at that point, and I knew they must be exhausted.  It’s odd that I was worried about them being exhausted, right?!  I remember Dennis on my left and Erin on my right, with Stacia and Cynthia down near the end of the bed.  Erin kept telling me how amazing I was, how strong I was.  She was really such a wonderful emotional support the entire time.  Dennis was trying to make sure I got some liquids in me between contractions.  I really had to pee, but hadn’t been able to for hours.  Finally Stacia put in a catheter just to drain my bladder.  I was pretty dehydrated at that point even though I was trying to take sips of water, tea, and an electrolyte drink whenever they were offered to me.

I pushed on hands and knees, I pushed leaning on the birthing ball, I pushed leaning on Dennis, I pushed in a full supported squat.  So many times everyone seemed really excited and told me they could see more of the baby’s head during a contraction- “We could see a lemon-sized portion of the head that time!  You are SO close! Push your baby out, Lydia!” –and I would keep trying to move the baby down.  I think they were really just trying to encourage me because Dennis told me later that it always looked about the same to him during those hours of pushing.

Yes, it had been hours and hours by now.  I remember looking at the clock and realizing that it was no longer December 12, but December 13.  My baby wouldn’t be born on 12-12-12.  Funny that this should be something to greatly disappoint me at that point, but somehow it made it all so much worse.

Finally Stacia began to talk to me about hospital transfer.  My birth plan had stated that I didn’t want any talk of transfer unless it was under the strong advisement of Stacia.  I knew that she had been thinking about it for awhile. I also knew that we had tried just about everything we could and that I was really exhausted and weak from not having eaten anything for almost 24 hours.  I had been keeping fluids down, but then I vomited during a contraction and lost what must have been everything in my stomach at that point.  It was time to get some help.  Stacia talked to us about what they would probably do at the hospital.  She said they would probably want to do an episiotomy and then assist the delivery with either vacuum or forceps.  She said she would do an episiotomy there in our home except she wasn’t sure that that was the only issue.  If the baby was stuck on bone and not just tissue (if he had an elbow up, for example, that was keeping him from coming through my pelvis), an episiotomy alone would not do the job.  The irony of actually asking my midwife for an episiotomy was not lost on me.  I remember her response to the episiotomy question when we first interviewed her: “Eckh!”

Once a transfer was decided on, everyone began to scurry around getting ready.  Stacia called ahead to the hospital to let them know we were coming, and Dennis began to gather the things we needed.  Of course I hadn’t packed a hospital bag, so they were asking me what I wanted to take.  It was difficult to think clearly about packing when I was still having regular pushing contractions.  I requested my bathrobe, the boy and girl blankets I’d made for the baby, and my chapstick (I believe I requested this several times to make sure I got it, haha!).  Cynthia was to stay behind and clean up while Stacia and Erin went to the hospital with us.  Erin sat by me on the bed with kindness in her eyes, and I remember just looking up at her and saying “I’m so disappointed.”  She said, “I know, this is hard.  But remember that it’s not over yet.”

I felt a little stunned that this was the thing that was making us transfer.  I had anticipated pain upon pushing, I had accepted the fact that I might tear upon crowning, and I had even come to terms with facing the famous “ring of fire”.  What I had never never imagined is that I would not even be able to move the baby far enough down to feel perineal pain or burning or to fully crown.  It was incredibly frustrating.  I’d been pushing all night and I just wanted to have my baby at home, but as we made transfer preparations that dream slipped away.  I’d been in labor for 24 hours.

I was a little concerned about the car ride- HOW was I supposed to sit in a car for 20 minutes with a baby’s head trying to come out of my vagina?!?  I mean, his head was right there, my perineum was bulging and swollen, and I could NOT sit without sitting on his head.  I walked out of our house wearing some mesh panties and a giant pad, my bathrobe, and snow boots.  It occurred to me that I must look ridiculous.  Oh, and I couldn’t really stand up and walk straight, thanks to aforementioned baby head.  Half walking, half leaning on Dennis, I made it to the car.  We had talked about me kneeling on the floor in front of the seat, but with the carseat in the back, there was no room to move my seat back (my car is kinda small), so I knelt backwards on the front seat leaning my torso on Dennis as he drove.  When a contraction started (I had 3 during the ride), I would grip the bars on the headrest of my seat and, bearing down with all my might, push and push and push.  I hated that I was still pushing!  If I couldn’t push the baby out without help I wanted to rest until we got the hospital, but I literally was powerless to stop.  The incredible birthing force would not relent in spite of my exhausted and spent body.  Each contraction, I could feel the baby’s head move down, and I actually reached down a few times to make sure it wasn’t all the way out!  I wondered how it would be to have the baby right there in the car!

Finally we pulled up in front of the hospital at about 6:30am.  Dennis told me he would let me out and then go park the car.  “HOW am I supposed to walk into that hospital??” I wondered, when out of the blue a man in scrubs appeared with a wheelchair.  I climbed onto it backwards just like I had been in the car, gripping the IV pole as he quickly wheeled me in the doors and into an elevator, where I had another massive contraction.  The unearthly roaring sound I made while I pushed echoed through the elevator and was released into the lobby when the doors opened.

The wheelchair-pusher stopped me in front of a desk, where they asked me to, yes, fill out some paperwork- ARE YOU KIDDING ME?!?  I’m busy pushing out a baby here!  Right on cue, I had another contraction and my roars filled the waiting room.  The phrase “pushing in public” popped into my head, and I remember thinking that this was probably one of the things I’d laugh about later. J I almost laughed about it right then with Dennis and Erin when they appeared and, I think, took over the paperwork for me because I don’t remember doing much more than sign my name in the messiest way possible.

I guess they could tell that I was definitely having a baby because we got into a room very quickly.  The doctors and nurses began to poke and prod me, trying to figure out what the situation was, and they were not as gentle as Stacia had been.  They found out I hadn’t peed since Stacia catheterized me, so they catheterized me a second time to drain my bladder.  My pee was really concentrated.  I was really dehydrated, and so was the baby based on the way his heartbeat pattern looked on the monitor (his heartbeat was always good and strong during the entire labor, thankfully), so they gave me an IV.  They actually hoped that hydrating me would give my uterus some extra ooph to produce more powerful contractions and get the baby out.  I guess it didn’t work that way.

Shortly after we arrived, there was a shift change.  The new shift did everything the first shift had done all over again.  Poked and prodded.

The hospital staff was really nice, though.  They looked at our birth plan and tried to honor our requests as best as they could.  They saw that I wanted a dim environment with music, so they actually played music for me and dimmed the lights.  I count that as a kindness that I’ll never forget.  I guess there was one crabby nurse who seemed kinda mad that we homebirth transfer people had to come ruin her day, but I didn’t notice.  I did notice the one really nice nurse.

I felt so out of it during this time.  I literally was in such a dim hazy place that I felt like I wasn’t really there.  I rolled onto my side on the bed and fell asleep.  When a contraction came, I’d roll over onto my back again, throw off all my blankets, and call for someone to come hold my legs back.  Normally I would have wanted to be anywhere other than on my back, but I was too exhausted at that point not to be lying down.  I tried pushing on my side and they said it seemed to work well for me, but the hip pain after the contraction was excruciating.  I had hip pain in my sides after each pushing contraction, especially if I didn’t push until the contraction was completely passed (in hindsight maybe it was my pelvis expanding?), but while on my side it was much much worse.

During this time I threw up again when I stopped pushing before my contraction completely ended.  It was like if I didn’t direct the energy downward it had to go somewhere.

Finally the doctors on the second shift had examined me and determined that I need an episiotomy and forceps assistance.  I guess the baby’s head was too “stuck” for the vacuum.  I was ok with this.  The doctor mentioned something about the baby’s head being wedged behind my pubic bone, but that there was plenty of room posteriorly if they could just move the head in that direction.  Then they talked to me about pain medication.  At first I said no way, but they let me know that the main reason I needed it would be for the stitches I’d get afterward.  I talked it over with my birth team and the anesthesiologist and decided to get an epidural without the narcotic part.  I think.  That’s the best I understand it, anyway.  They wanted to go ahead and put the spinal in because that way if I needed a C-section they could just top me off instead of having to put me under general anesthesia.  I was so out of it that I had a tough time understanding exactly what I was and was not getting, but I did know that having a C-section while completely out would pretty much be worse worse case scenario.  I really never thought I was headed for a C-section, but if it ever did come to that, I definitely wanted to be awake for it!  I was concerned about the effect of the epidural upon the baby, but was reminded that the baby would hopefully not be in there for more than a few minutes after I got it.  Also, it’s not like an epidural was going to slow down my labor because I was already past that part.  I was taking medicine for what was basically a surgery, not for the natural labor process, and that’s the only thing that makes me feel better about having ANY drugs involved in the birth.

So then it was time to put the epidural in.  HOW in the world was I supposed to sit still while they did it if I had a contraction during the process??  I was really quite worried about this, but I obediently “sat” on the edge of the bed (I think a nurse was pretty much holding me up as I put the barest minimum of my butt on the bed.  Remember, there was still a baby head there.) as the anesthesiologist inserted the numbing stuff and then the needle.  Sure, it stung, but whatever.  I immediately felt a tingling warmth go through my legs.  It was nice to feel warm for the first time since we’d arrived at the hospital.  Right away I had another contraction, but only barely felt it and didn’t have the urge to push during it.  And that’s the last contraction I felt.

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Getting ready to finally push out our baby!

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Giving it everything I had…

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Waiting for the next contraction…

I’m sure it was only a few minutes before everyone was assembled and ready for me to deliver my baby, but it was nice to relax for a few minutes and not push for the first time since the night before!  I was numbed from the waist down, but I could still feel things, if that makes sense.  It definitely took the edge off, but I still felt everything that was going on down below.  They told me that they were going to help with the forceps but that I needed to push as well.  “You’re still going to push your baby out,” the doctor said, and those are the words I remember most.  They made me feel that I still had some control over the delivery and took some of the sting out of needing assistance.  First, the doctor (a woman doctor, which makes me happy somehow) inserted the huge salad-tong-looking forceps (that hurt!) and then we waited for the next contraction, my feet in the dreaded stirrups.  A nurse with her hand on my tummy and an eye on the monitor had to tell me when one was coming (kind of a buzz-kill).  The first contraction came and I pushed and pushed with everyone cheering me on.  I definitely gave it my all, and Dennis later told me that the doctor was putting so much force on the forceps that her arms were shaking.  That kind of freaks me out, so I’m glad I didn’t notice at the time.  The next contraction came and I knew this was it.  I pushed and pushed and I kept pushing, not caring whether I was contracting or not.  This baby had to come out!  I know I had been putting my everything, my 100%, into pushing for the last 12 hours (YES, 12!), but I think I probably reached even deeper and put about 120% into those final pushes.  I heard someone say “The head! …now the shoulders….” And then, accompanied by the most amazing sensation, I pushed/they pulled my baby out… of my butt!   That’s what it felt like, anyway- like that baby had literally been in my butt this whole time!  As the doctor lifted my baby up and out, I  Could. Not. Believe. How big and long that baby was!!  And the head- it was HUGE!  “That was what I was trying to push out??” I thought.

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Here’s where his head is coming out!!

And then I had my baby on my chest.  Well, on my tummy really, because the cord was kinda short.  The baby was screaming from the beginning and had a big beautiful pouting lower lip (that was the second thing I noticed, along with how heavy he felt).  It was a moment of shock and awe.  I heard someone say something about girl or boy and then it occurred to me to check.  I lifted him up to look and Dennis said, “It’s a boy!”  A boy!  We had a son!  And his name was Alexander.  He was bloody and slippery and crying and beautiful!

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I knew he would have the coniest conehead ever, and he certainly didn’t disappoint! Funny how quickly it changes, though. Also, I’m SO glad Erin was snapping these pictures for us or I never would have seen the look on Dennis’ face!

We had asked the doctors to please wait until the cord stopped pulsing to cut it.  It seemed like only a couple of minutes when they told us it had stopped pulsing, but they were really patient and waited a few more minutes still until we gave them to go-ahead.  I know from looking at the time stamp on the pictures that it was cut about 15 minutes after his birth.  Dennis was given the honor of cutting the cord as we had requested in our birth plan.

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They wanted to take Alex to the warming table to doing the Apgar and stuff.  I really kind of wish they had just left him on me, but I didn’t ask at that time.  Dennis was with him the whole time, though, and Alex recognized his voice and looked for him.

They pulled on my cord a bit to speed the delivery of the placenta, something I also didn’t want, but I’m not sure if they could wait because they were eager to get me stitched up.  I know that usually tears, at least minor ones, can wait until all that is finished, but I had a fourth-degree episiotomy.  For those of you fortunate enough to not know what that is, it’s basically the most extensive one they can do.  The cut went all the way from my vagina to my rectum, and extended through several layers of tissue. L  I thought they said that the stitching would take only 10 minutes, but they must have been talking about how long they’d have Alex over at the warming table because the stitching seemed to last FOREVER!  I don’t want to sound like a big baby, but it was really horrible!  I know I was numbed, but I still felt it really well!  It was a stinging/stabbing sensation over and over.  My feet were still in those stupid stirrups, and I was freezing cold.  I could stop shaking, and I couldn’t put a blanket over my legs to warm myself until they were finished.  Erin appeared by my head and reminded me to do my labor breathing- haha!  I thought it was funny that I had a tougher time with this than with labor, and I was glad I’d had the epidural to take the edge off at least.

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Notice how pale I am. This is when things got kinda sketchy.

Somewhere around that time I began to feel kind of funny and my hearing suddenly went dim, like my ears had gotten plugged.  I said, “Um, my ears feel plugged up!” to whomever was listening.  The nurses looked at the monitors and went into a small flurry of action because my heart rate had gone up to about 120 and my blood pressure was extremely low- 60/30 or something like that.  I was losing a ton of blood.  They gave me pitocin through my IV and I stabilized.  My husband said it was pretty scary.  I lost about twice the normal amount of blood, which I guess makes sense because I had so many things happen that can contribute to abnormal blood loss: a long labor, forceps delivery, cord traction and episiotomy.  I think that letting the placenta deliver naturally and leaving Alex on my chest and maybe having him nurse right away would have helped.  They had told me to massage my breasts, but when the stitching began to hurt a lot I quit.  I should have kept it up, but oh well.

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Finally, after what seemed like an eternity, Alex was back on my chest.  It bothered me for weeks that I had no idea how long he was away from me or how long it was before he got a chance to nurse, but I finally looked at the timestamps on the pictures and saw that it was only about 30 minutes.  That’s not too bad, I guess, and Dennis was with him that entire time, but it still felt like way too long.

When all the chaos finally subsided- when I was all stitched up, Alex was back with me, and I was finally able to cover up and get warm again- that’s when Dennis and I finally stood  there together looking at the peaceful sleeping face of our son- OUR SON!  And I finally cried, with joy.

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Alexander Josip was born on Thursday, December 13, 2012 at 9:38 am.  He weighed 8 pounds, was 21 inches long, and had a 14 inch head!

What had caused the problems with delivery?  The best Stacia could tell, from watching the delivery and looking at the pattern of swelling on his head after he was out, was that he was asynclitic, meaning that his head, though facing the right direction and tucked well, was tilted a little to the side.  This meant that he was presenting a larger diameter of an already large head and I just couldn’t push it out that way without assistance.

During our two-day hospital stay and the weeks that have followed, I have had a lot of emotions to deal with concerning the way Alex’s birth ended.  I wish I could write that I am completely at peace with having to go to the hospital and that I don’t really care how he was born as long as he was healthy, but I have to be honest and say that I’m not at that place yet.  The birth story does matter, and it’s something that you cannot just forget or push aside.  I was SO confident that I would give birth at home and SO sure that everything would go well, that my disappointment was acute.  I’ll save more discussion of my feelings surrounding his birth for another time, though.

Nevertheless, I AM so happy for a healthy baby!  I always imagined that the only reason for transfer would be in case of an emergency, which to me would mean that something was wrong with my baby.  Praise God, he was fine the entire time, and for that I am so grateful.  It would have been so scary if something had been wrong with him.  As it was, I never felt afraid, it never felt like an emergency, and we were able to take our time and make our decisions thoughtfully.

I am also VERY thankful that Alex and I were able to experience a vaginal birth and reap all the associated benefits.  I really never ever thought that we were in danger of having a cesarean section, but it could have easily happened.  A few weeks later, when Stacia was doing a prenatal visit in our home, she was telling my family that they should have been there to see how amazing I was (that comment alone made me feel pretty good! :)).  She then told them that anyone else would have had a cesarean.  It was only because of all my hours and hours and hours of pushing that I was able to push Alex down far enough to have a vaginal birth.  I was pretty much floored when I heard this, and I had to struggle to keep from crying because hearing that made me feel like I had accomplished something during all of that pushing that I thought was fruitless.  I had fought for a vaginal birth and I had earned it for us!  That made me feel SO good!  🙂  As acute as my disappointment has been over losing the home birth I’d dreamed of, having to give up a vaginal birth as well would have been so much more difficult to come to terms with, so I thank God for that blessing!

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After my first post-labor shower

Giving birth was simultaneously the most difficult thing I’ve done and the most wonderful time of my life!  I was on a birth high for days, and so was Dennis.  I felt like he and I bonded emotionally in a way that I’d never expected or even hoped for.  Sometimes I wish I could go back and experience it again because all the bad was more than worth the good.  We completely fell in love with our son during those first few emotionally charged days the three of us spent alone before family arrived, and we continue to do so now.  He has brought us an incredible amount of joy already, and we are so proud of our strong sweet boy as we see him grow up little by little each day. 🙂

Writing a Birth Plan

This week, in my mostly crippled state, I’ve set out to accomplish sitting-down goals.  Writing our birth plan is one.  I had a few resources from our birth class which were really helpful.  If you’re writing your birth plan, I would suggest finding some sort of template to use as your starting point, such as this one, and then personalizing your plan from there.

I considered reading the book “Creating your birth plan: The Definitive Guide to a Safe and Empowering Birth” by Marsden Wagner M.D, M.S. , but decided to just write it based on what I already know is important to me and my husband.  I’ve done enough research in the past few years and felt like more reading about possible interventions and things would be a little much at this point.  Plus, I had a difficult enough time fitting it all on two pages.  🙂

I tried to include the things that were most important to us for each stage of labor and delivery and also addressed situations such as cesarean section and NICU admission.  Those are my “just in case” sections so that if we find ourselves with a real emergency we can at least have peace of mind that the choices we can still make are written down.  I feel like the whole birth plan is an odd mix of things that apply to a home birth and things that don’t.  We’ll have to explain to our doula and midwife when we show it to them that we understand that most of our wishes are standard practice for a home birth but that we felt we needed to have some written record of what we want in case we should find ourselves in a different environment.

So, without further ado, here it is (names removed for privacy):

Birth Plan for the Family of (Me and My Husband)

Dear Birth Team- we are so thankful that we are able to take advantage of your care and expertise as we welcome our baby into the world.  We’ve put together a short summary of our wishes regarding labor and birth.  Thank you for helping us to have a safe and positive birth experience. 🙂

Basic Information

  • Birth Team
    • Midwife- (name and #)
    • Assistant Midwife- (name)
    • Doula- (name and #)
    • Family Support- (my mother’s name), (my sister’s name)
    • Desired back-up Doctor and Hospital– (name of Dr and hospital)
    • Maternal History– This is my first baby.  After years of personal research and study, I’ve chosen to give birth at home after a healthy pregnancy because I know that I will feel most comfortable in this environment and will be more likely to have a low-intervention labor and delivery. I realize that sometimes complications arise during birth that would necessitate being in a medical environment, but would prefer to remain at home if at all possible.

 

Starting Labor

  • We wish to allow labor to begin spontaneously before 42 weeks.  After 42 weeks, we would consider the use of natural home induction.  We do not wish to do a medical induction unless advised by (midwife).
  • If (my) water breaks before labor begins, we wish to allow labor to begin spontaneously unless (midwife) advises otherwise.

 

Environment

  • I highly value my privacy and would like to have only the members of the team listed above present while I labor. I prefer dim lighting, candles, soft music, and subtle pleasant smells.  During early labor I would like friendly conversation to distract me from contractions, but during active labor when concentration becomes more difficult, I would like to hear softer voices and more limited conversation.  I may or may not want music at this point, and I may not be able to tolerate a lot of physical touch stimuli or close physical presence, but I will appreciate knowing that attentive support is close by.  I may want to spend some periods of time alone with (my husband).
  • I wish to be able to freely eat, drink, and move about during labor.

 

Early Labor

  • If labor begins in the evening, I will attempt to sleep or rest.  If labor begins in the morning, I will go about my daily activities and may want to begin a predetermined “labor project”.
  • We would prefer to use natural stimulation for a slow labor: walking, nipple stimulation, etc. 

 

Pain Management

  • We do not plan to use an epidural or IV narcotics.  The only circumstances under which we would consider an epidural would be:
  1. Caesarean section (after all other options were exhausted)
  2. Extreme exhaustion rendering (me) unable to continue to labor and have a vaginal birth without the rest afforded by an epidural (this would need to be under the strong advice of Stacia and all other options would need to have been exhausted).
  • We would like to use natural pain management techniques such as: breathing, relaxation, changing positions, bath or shower, cold wash cloths, massage, counter-pressure, and visualization.  I would like to have access to a birth ball, a birthing tub, and a shower.  If the things I am instinctively doing seem to be working for me, I would like to be given space and verbal and/or physical encouragement to continue using them.  If I seem to be unable to find relief on my own, I am open to suggestions from my support team. 
  • I will very much appreciate and respond well to verbal encouragement and affirmation during labor, and do not want “negatives” such as the mention of drugs, passage of time, or hospital transfer to be a part of the conversation.  I believe in my ability to birth naturally, and knowing that my birth team believes in me as well will be extremely helpful. 

 

Approach to Additional Interventions

  • We would like to avoid interventions such as artificial breaking of waters, continuous monitoring, IV fluids, vacuum or forceps extraction, episiotomy, pain medication, medical labor augmentation, & cesarean section.  If interventions are recommended, we would like to discuss the consequences of choosing or not choosing the intervention.

 

Pushing Stage

  • I would like to push spontaneously and use positions that encourage my body to open.  I do not wish to push in the lithotomy position.  I would like the option for a water birth.
  • I am open to perineal support and/or lubricating oils and warm compresses to lessen the possibility of tearing.  I would like give my perineum time to naturally stretch around my baby. 
  • We would like for (my husband) to catch our baby for (me) or (my husband) to discover the sex of the baby.

 

Third Stage

  • We would like to allow the cord to cease pulsation and/or the placenta to be delivered before cutting the cord ([husband]would like to have the honor of cutting the cord). 
  • We would like to allow natural expulsion of the placenta.  Please do not dispose of our placenta as we wish to save it for encapsulation! 
  • I prefer local anesthesia for the suturing of any tears.

 

After the Baby’s Birth

  • We wish for our baby to be immediately placed on (my) chest for a minimum one hour of uninterrupted skin-to-skin contact, and all assessment and care during that time period to be delayed or done without removing the baby.  We would like for (me) and Baby to take an herbal bath.
  • We prefer natural expulsion of amniotic fluid and suctioning of mouth, nose, and deeper airways to be done only if medically necessary. 
  • I would like to be allowed to immediately begin breastfeeding if Baby is interested and do not consent to the use of formula.

 

Newborn Care Procedures

  • If our baby is a boy, we DO NOT wish to have him circumcised!
  • We do not give permission for antibiotics, vaccines, or a vitamin K injection to be administered to our baby.
  • We wish to use either an oral dose of vitamin K or to forego vitamin K.
  • We wish to decline antibiotic eye treatment for Chlamydia and Gonorrhea (I do not have these infections).
  • We would like to do the PKU test.

 

Rhogam

  • (My) blood type is O- and (my husband’s) is O+
  • We would like to test Baby’s blood type and, if Baby is O+, do a Kleihauer-Betke test.
  • If the Kleihauer-Betke indicates blood mixing, (I) will have the Rhogam injection.  If no blood mixing is indicated, (I) will decline Rhogam.

 

For a Cesarean Birth

  • We wish to reserve cesarean birth as a last possible option and want (my husband) to be present during the operation.
  • We would like minimal drugs (epidural only).
  • Following a cesarean birth, we wish for our baby to be warmed by skin-to-skin contact with (me) or (my husband).  We want (my) arms to be free so she may touch Baby as soon as possible.  (My husband) should stay with Baby while (I) am unable and should be allowed to warm Baby using skin-to-skin contact.
  • We wish for Baby to be allowed to breastfeed in the recovery room and do not give our consent for formula, sugar water, or pacifiers to be given.

 

NICU Admission

  • We want NICU admission to be a last possible option.
  • If (me) and Baby must be separated, we want (my husband) to stay with Baby and to provide skin-to-skin contact.
  • I would like to breastfeed or provide pumped breastmilk.

I tried to use neutral language (i.e. “we don’t wish to” instead of “you’d better not”), imagining how the plan would be viewed by any health professional, especially one who doesn’t know us or is not as familiar with a natural birth.  It’s difficult to be very clear about your wishes but respectful of the medical staff at the same time, and it makes me doubly relieved that we will probably never need to show this to anyone but our home birth midwife and doula.  Whew. 🙂

I realize that everyone’s plan will be different based on individual preferences, viewpoints, and birth setting, but hopefully our plan can give you some idea of the things you can include in yours.  I also realize that it’s impossible to include every scenario or list every preference on a birth plan (without making it into a book), but I hope that ours at least conveys the most important things to us and will give anyone a feeling for the kind of birth we’d like to have.

 

Thoughts on Labor Pain from a Mom Who Birthed Naturally

I found this blog entry today on labor pain and epidurals. It’s well-written and shares this woman’s personal experience giving birth naturally in a free-standing birth center. I think all of us who choose a natural birth hope for an experience as positive as hers, so it’s very encouraging to read!

Thoughts on Labor Pain from a Mom Who Birthed Naturally.

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