Friday, April 15, 2016

Miri's Birth Story

[OK so this isn't really about triathlon, but our birth photographer shared her experience of Miri's birth, so I figured I might as well share my version as well]

As with my first born babe, this was a very planned pregnancy.  We felt like we were getting a handle on our 2 yr old (we knew nothing).  Mama was in great shape.  And our guess date would be well after football season was over (Dad is a coach).  It was time.  And so it was, I became pregnant with a guess date of 18 Dec (Babe#1 birthday is 22 Dec – foreshadowing).  Babe #1 was a surprise breech water birth.  And when I say ‘surprise’, I mean, the midwife realized when my son’s testicles were in her hand, and I realized a few moments later when his entire body was out and his head remained to be seen.  A few days before he was born our midwife had a hunch that he ‘might’ be breech, but probably not…..And so we welcomed our breech babe, in the water, at home, healthy and safe.

But this isn’t about my first breech vaginal birth at home…..this is about my second.

As it became time in my pregnancy for my midwife to check position, we were in constant awareness of baby’s position.  Confirming, visit after visit, that babe was head down.  I attended a Breech Balancing class with both my midwife and doula, just in case we would need to try to turn babe, but it was mainly ‘maintenance’ for me as an added precaution.  As my belly grew, so did my midwife’s ‘hunch’ that this baby was not head down – not necessarily bum first – but perhaps not head down as we had thought.  I mean really….two breech babes???  We sought other midwives opinions and confirmed, basically, that we couldn’t confirm what position the baby was in, so, my midwife and I decided an ultrasound would be the prudent thing to do.  I wasn’t very happy about making this decision, but I trusted my midwife and followed her lead.  What I was most worried about was confirming a breech position and then, being 39 weeks pregnant, having no options but a cesarean.  I had no doubt I could deliver a breech babe again, so if we didn’t do the ultrasound and it was a surprise, then no worries – been there done that.

And here in lies the rub.  Knowledge is power….right?  The more we know about the babes position, the better we are able to prepare for the birth right?….but not in the case of breech position.  In a clinical setting, Mom’s have no choice when breech position presents – the only decision is to go into labor naturally before the Cesarean or simply schedule the Cesarean.

After just moments into the ultrasound, it was confirmed that Babe#2 was in a breech position.  Everything about baby looked great, size, organs, blood flow, placenta, fluid – all looked as it should.  As the tech is apologizing to me for the ‘bad’ news, I tried to explain to her, that breech doesn’t have to mean cesarean, and I kept on telling myself that until I called the midwife. Honestly, I didn’t really know what my options were.  Babe#1 was breech, but there was no turning back when we realized it.  I resolved to be stubborn to have this babe at home, until I spoke with my midwife.

Thankfully for me and my family, we had Aly.  A midwife who was ready and willing to go on this wild ride with us.  I called her on the way home from the ultrasound and we decided she would come to the house for a visit and we would discuss options.  I was so thankful that she was willing to spend the extra time with me, as it really helped me map out what our choices and ultimately what our decision would be.  Although I was determined to have this babe at home, it was important for me to be smart and not put anyone’s health at risk.  So we came up with four options:
1.     Scheduled Cesarean – Just get the babe out
2.     Planned Cesarean where mama goes into labor in the hospital (some labor can help mom with hormones even when Cesarean is planned) to follow with a Cesarean section.
3.     ECV to try to manually move babe into a head down position
4.     Begin bodywork with a Breech Balancing massage therapist to try to turn babe, and get body nice and ready to birth baby breech if baby didn’t turn and have babe at home.  Come up with an altered birth team to allow for additional support and possibly a breech birth expert – Gail Tully

All options had their own considerations and their own risks.

I was not comfortable with doing the ECV this late in pregnancy because of the risks of going into labor in the hospital where my only path would be a cesarean.  I was not comfortable with the Cesarean options as there were risks with those as well, but we also had to have a very real conversation about the risks of having a breech baby at home.  Also, I was not the only decider in this equation.  Dad had some say as well, and after discussing the 4 options when he got home, we planned for him to have a private discussion with the midwife so he could speak with her freely about his thoughts and concerns.  It was pretty obvious what I wanted, and I was just trying to convince him to come on my side of the fence.

After lots of discussion between the midwife and Dad, we decided to take it one day at a time and access our options.  One thing to consider was Gail would be out of town until Tuesday 15 December, just 4 days before my due date.  We all really felt more comfortable with her being at the birth, so ….. if I could just hold out until then.  We also decided to schedule as many appointments with the massage therapist for body work to get my body in the best shape possible to have this baby breech at home.  Our midwife would start assembling different options of the birth team as it would include midwives that also have their own practices and could be at other births, so lots of alternatives had to be planned out.  We would check in every day to see how everyone was doing and if anything had changed.  At this moment, we were a go for having a home birth with the knowledge that the midwife would have much tighter bounds on when we would go to the hospital, and if, at any time, any one of us started to think we might want to go to the hospital – we go and do a cesarean. 

So, I did my inversions, laid upside down on the ironing board, did my stretches….but I really didn’t think the baby was going to flip, I was just using it as time to talk with babe and start visualizing her birth. 

Tuesday came and went, So we had another meeting at our house with the midwives we hoped would be at the birth, including Gail and her pelvis and baby, to show me how baby would be born and the complications that could occur.  This was such a fun time for me as I felt so supported by three midwives who weren’t trying to scare me out of birthing my babe at home.  They were simply stepping through what her birth might look like, what my preferred birth position was (hands and knees), and allowed a space for me to ask any questions, and voice any concerns.

My midwife and I discussed, again, the risks associated with having her breech at home, and we decided it would be good for Dad and I to sign a liability statement.  We wrote our own statement, listing out the Risks and benefits of all 4 options as well as our decision to proceed with a vaginal breech birth at home. And although the verbiage in the documents seemed scary, as to what could happen to babe if she got stuck, I felt no hesitation that our decision to have her at home was the right one.  Honestly, I was more scared to go into the hospital for surgery.   I had so many things going for me.  Second time mama CHECK.  Second home birth CHECK.  Second Breech Babe CHECK. Great health markers throughout pregnancy CHECK.  Baby heart rate and movement great CHECK.

Wednesday, Thursday, Friday, Saturday….

Saturday, 20 December,  night I woke up with contractions.  This was it!!  Contractions weren’t very long and were pretty far apart.  I was able to sleep through them, but thought I should call the midwife.  She said call when they start to get stronger, longer or closer together……they stopped by morning. We decided to check in later on Sunday – no change

Sunday night I woke up with more contractions, but after three of them, similar to the ones the night before, I decided I would call the midwife after the next one….which never came…. and I woke up in the morning.  We had an appointment scheduled for lunch that day, so we would chat then.

Monday, at our appointment, we did the normal checks, chatted about how we were feeling about our plans, and both of us said the same thing.  At times when we thought about the plan, we were a bit anxious, but once we got into the same space together, all was calm.  I felt even a little giddy thinking about the new path we were about to blaze for both of us.  That just solidified more that our chosen path was the right one.  Although my midwife had never planned a vaginal breech birth, I trusted her to the moon and back, and had no worries that she would do the perfect job helping me bring my daughter into this world.  Then as she was palpating my belly, baby shifted from her back on my left side to her back on my right side!  All of a sudden!  She was in an even more ‘perfect’ breech position.  So I headed home, knowing that if things started moving before traffic hit – I needed to call the midwife ASAP as it would taker her a while to cross town if it was rush hour.

And so I called her around 2:30pm?  I seemed to be having some contractions and thought it best to call her.  She decided to come to our house after running some errands and just take a quick snooze at our house.  She had a couple of long days recently and knew she wouldn’t get any rest at home, and if this babe was coming, she would already be here.  I wasn’t going to argue with that.  What mama doesn’t want her midwife upstairs taking a snooze when she is in early labor?  So she snoozed form 4ish to 7ish?  I had Dad come get her when I felt like the contractions were getting a bit stronger, and she was already up – apparently my most recent contraction was on her radar and she came down to get some vitals from babe. 

We started to make calls to get the rest of the birth team there and realized something…….exactly 3 years ago (to the day and time) we were gathering together to welcome my son into the World.  This was going to be even more special J

And so birth goes….slow and waiting….contraction after contraction…slow and steady.  Dad and I decided to head upstairs with the doula to avoid feeling watched and slowing labor, had one more contraction and things had seemed to stop.  Was this not it?  Seriously?  We started walking the stairs and Gail suggested for Dad and I to simply lie in bed together and share some space.  Dad had been sick for weeks and I had been avoiding him like the plague, so we hadn’t been close.  We lay down, the contractions started, and after 2 or 3 of them, my water broke.  This party was getting started.

The entourage of 3 midwives, midwife assistant, doula, and photographer all joined us in our bedroom and the business of getting this babe born was about to begin.  I was directed by my midwife to sit on the toilet for some contractions…augh….I knew I was not going to like this….and I didn’t….I can still hear my midwife’s words in my head (ringing from the first birth as well) “Leslie, the pain is what brings the baby”.  I could have punched her in the face- but I didn’t J  On the toilet,  One foot on a toilet paper roll, one foot on a yoga block, I felt like I was starting to push and the contractions seemed to be coming very quickly.  I was directed to the bed to get on my hands and knees, but couldn’t make it there without a contraction in between. 

I got up on the bed, on my hands and knees, and started the hard work of getting my daughter Earth side.  I don’t really remember much of this other than it was painful and I was having contractions.  Baby’s heart rate was great, and I was working like crazy to get her here.  Then I hear “We saw some of your baby this time Leslie” – What???? Already???

Then I have no idea how many minutes, or pushes it took, but it didn’t seem long.  There was her bum, then her legs came out and plopped on the bed, then her arms came out and she was sitting like a little Buddha on the bed.  Then the midwife mentioned for me to shift forward just a bit, and there was her chin, lips, nose and there she was!!!  Bright eyed and beautiful.     53 minutes from water breaking to her Miri’s birth.  1:04 22 December 2016…..on her Big Brother’s 3rd birthday.

It was an amazing gift that these women gave me and my family, to bring my daughter (and son) into this world in our home.  I’m tearing up just thinking about what the alternatives were. The alternatives that were not acceptable to me, and thankfully not to my midwife.  Tearing up thinking about the beautiful calmness in the room as I pushed her out.  Tearing up thinking about all of the wonderful encouragement I was given throughout my pregnancy and her birth.  I owe a lifetime of thanks to those women who gave me a gift I remember every time I look at my childrens’ faces.  A gift of choice.  Our choice.

If I included it all, it would be a novel (it’s already too long), but special thanks of course to my midwives, Aly Folin at Northstar Midwifery, Rebecca Polston at Roots Community Birth Center, Rachel Voigt, Margaret Owens (Mothering by Mom), Alli  Parfenov (Indigo Birth Photography) and Gail Tully (Spinning Babies).  Also a big thanks of course to my Mother in Law who was willing to trust us, while she cared for out toddler while babe was born.  And of course, to my most amazing husband – the man who puts up with my ridiculous stubbornness every day and the man who makes me realize the woman I want to be every day.  I love you all with everything that I am. 

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