Monday, March 4, 2013

Attention: New Mama Blog!

So I'm just stopping in to share that I've started a new blog, The Tired Hamster, to share my parenting journey.  For a while I wanted to blog here at Journey of the Bump, but this was originally created for my work as a doula and massage therapist... and so it felt "wrong" in some way to stray from all things pregnancy and birth with my personal anecdotes (or novels) of being a mama.  So I've created The Tired Hamster if anyone would like to join me over there :)  As I continue to work (eventually), which will be sparse for a while, I'll still add to this lovely little space as well.  Thanks for reading and I hope you'll join me on the other side!

Sunday, January 13, 2013

The birth of Beau David Brocato, Part 3: Our Hospital Birth

If you missed Part I: The Plan, read it here
If you missed Part II: Our Home Birth, read it here

It was approximately 7pm when the security guard rolled me up to the nurse's station to check in.  Right away quite a few nurses recognized me... "It's Juli the Doula!"  Somehow in my complete hazy world I made the joke, "Juli-a the Doul-ia"  (ya know, from The Wedding Singer's Julia Gulia)... they at least gave me the courtesy laugh, but I have no idea if they got it and honestly I was so out if it I didn't really care.  They wheeled me into L&D room #1 and had me change into the usual hospital robe from my cute binsi birth skirt that I was wearing.  They probably wouldn't have minded if I stayed in my own clothes, but at this point I was just ready to follow the typical protocol and have a baby already.

The smell of the hospital was quite familiar to me as I had helped many mamas in this very room, so I was actually comforted a little by being there.  It wasn't long before my Dr. arrived to begin talking about options.  First he checked my cervix and of course it was still only 3cm dilated and baby was still at a -2 station.  So I sat on my birth ball while he sat beside me going over everything that I had prepped myself for him to say.

  • Option #1:  Start IV antibiotics for the prolonged ruptured membranes, and get some Pitocin going to see if we could get even stronger (really?!) contractions to get more progress.  (As if the knife-like back labor wasn't already enough).  
  • Option #2:  Leave me alone to keep doing what I was doing but at the first sign of infection he would likely take me back for a cesarean.  
The Dr. told me to trust him and that if I would just let him do his job that he wouldn't abuse the interventions but would likely be able to help me have a vaginal birth.  I also remember him saying he wouldn't let anything happen to me, especially if we did have to go back for surgery.  This was actually really comforting to hear.  I do trust him, very much, which was why I had chosen him to be my backup in the first place.  I'd always seen him make really good decisions in the delivery room, and only used interventions when necessary.  He always gave mamas and babies ample time before making any big decisions, so I trusted that I was in good hands.  I warned him that I'm incredibly sensitive to medications so to PLEASE go lightly on the Pitocin.  He promised to use it very minimally and told me he wouldn't tell anyone if I had to get an epidural to relax.  This made me chuckle (in my head anyway)... my not wanting an epidural had nothing to do with not telling anyone or trying to be superwoman.  I told him that I was petrified of an epidural (for myself, for my baby, and for my birth outcome), but worried that with the stronger pitocin contractions on top of my already pretty excruciating back labor, that I wouldn't be able to handle much more.  They asked why I was afraid of an epidural... "where do I start?", I replied.  I had SO many reasons that I didn't want one. 

So I agreed to Option #1. After all... if I was going to just keep doing what I was doing we may as well have stayed home, so they started getting me all set up with my IV.  I sat on my ball and poor Marilyn and Andy were squeezing the hell outta my hips nonstop and pressing on my sacrum to help relieve my back labor.  Then they began the Pitocin.  I swear it had only been about 10 minutes (or less?) on the Pitocin when suddenly my pain was through the roof.  The contractions became so unbearably sharp (that's the best way for me to describe them... much sharper than before like bone grinding on bone) that I begged (aka yelled) for the nurse to turn it off.  I had to gather my thoughts.  I turned to Andy, and Marilyn, and my mama as I didn't know what to do.  My mom encouraged me that if I needed that epidural then to get it. I know Andy and Marilyn did too, but it was the conversation with my mom that stuck out the most for me. I felt so defeated.  She had both her children without epidurals, my sister had her baby without one, and here I was "unable" in my mind to keep going.  I remember feeling like if only I were at 8 or 9cm then maybe I could hold on and push through the stabbing pain in my back.  Knowing, however, that I was only 3cm and had only slept 1 hour out of the last 33 (and not even knowing that I would still have another 12 or 13 to go)... I just couldn't go on. I told the nurse that I would agree to an epidural if they would just shut off the Pitocin and then start it again after the epidural was administered.  I was shocked that the nurse actually agreed right away.  (I've often seen nurses who refuse to pull back or shut off Pitocin once it has begun, or at least put up a stink in doing so).  At this point I'm sure I probably became quite the drama queen with each grinding contraction, but again I just didn't care.

So next thing I know they're ordering me an epidural and I'm feeling completely defeated yet relieved at the same time.  I was exhausted and the contractions were still getting stronger.  I never thought I'd say it, with all my fears around epidurals, but I couldn't wait for that anesthesiologist to get there!  I was so nervous about a needle in my spine, and having to sit still through the procedure was pretty near unbearable since the only way I'd been coping thus far was to move through each contraction.  I sat petrified hugging my nurse and squeezing Andy's hand.  Everyone else had to the leave the room.  The anesthesiologist mentioned that I might feel a "zing" down one leg like hitting my funny bone and BOY did it zing!  Weirdest jolt ever.  As the contractions hit even harder while I was sitting as still as possible,  I grabbed something very tight and squeezed with everything in me so that I wouldn't move.  Then I heard, "that's right, you just squeeze me... just keep squeezing me".  I realized I was squeezing the nurse's love handles!!!  (And I swear she was really quite thin). I hope I didn't give her a complex cause I managed to grab a really big handful of skin!   Next thing I knew they were taping me up and after a few short minutes I was laying down with instructions to rest.
Now I realize that I'm an odd bird when it comes to this next part, but to be quite honest I hated having that epidural.  I know, I know, most people think it's a cakewalk from then on, but not me.  First off, I remember it made me itchy... like claw-my-skin-off itchy and while I knew that was a common side effect for some people, I didn't realize how overwhelmingly itchy it would be.  They offered me a narcotic to help with it, but I wasn't willing to have a baby that was sleepy or unable to breathe from a narcotic so that was easy for me to decline.  I just told myself over and over again "my skin feels fine, I'm not itching, I'm not itching...".  It's odd not being able to feel your lower half, yet you can still feel that it itches.  But the itching was the least of my concerns.  Next, half of my epidural wasn't really taking so I could still feel my left side.  The pain level, however, was much less than without the epidural, so I figured I'd just keep breathing through my contractions.  The nurse noticed and said that I should be able to sleep through them, which clearly wasn't happening, so they called the anesthesiologist back to come and give me another bolus of medicine.  After that, my lower body was SO numb that it didn't feel like my own.  Like at all.  It was dead to the world... I remember laying there and the nurses would move these massive heavy legs in front of me, but they just weren't mine.  They were fat and hot to the touch, but it was literally like touching someone else.  That completely weirded me out and I started having fears of having to get up and leave in an emergency... after all it was almost Sept. 11th and it's hard not to think of random emergencies, right?  Not being able to move my own body was terrifying for me.  Yet even that wasn't the worst of it.  The hardest part for me to deal with was that I began having chest and head tightening with each contraction which to me meant that I was clearly going to die. (Clearly).  I couldn't feel my belly or back anymore, but I knew every time I was having a contraction because my chest would slowly start to tighten which would then squeeze it's way up to my head and it seemed harder for me to breathe.  At this point I was actually glad to be in a hospital... when you can't feel your body and you are laying there in the stillness, all you are left with is your mind. Mine can be awfully good at convincing me of some pretty frightening things, so this little combo wasn't such a good mix for me.  My nurse assured me that she was watching my vitals and that my heart looked just fine.  This did help, but no one could explain why my chest and head would squeeze with each contraction.
I felt bad for my team.  Normally, as a doula, everyone gets a slight rest once a mom gets an epidural.  It's usually a welcome break for all involved when it's been hours upon hours of such hard work.  But I wasn't resting at all, and therefore neither were they (not much anyway).  They all took turns standing by my side.  I remember my mother standing close, rubbing my hair, kissing my forehead and comforting me while I was finally able to articulate what I had been feeling prior to the epidural.  Then she and Andy decided to try and get some sleep since they had both been up with me for so long. In fact, I forgot to mention in the previous post that my mother was the one squeezing my hips in the middle of the night back home while Andy got some rest.  She worked tirelessly for her baby the way I was working so hard for mine.  It's kind of beautiful when I think about it. Needless to say I was incredibly grateful that she was still in town for all of this!
At this point my brain wouldn't stop and I felt so anxious just laying there unable to move.  The tightening in my head and chest was making everything worse and I worried whether my heart would be able to handle pushing when the time came.  Marilyn stood by me and just placed her fingers in the center of my chest and offered me essential oils to smell.  It immediately calmed me.  Then of course the shaking/trembling started.  I remember my teeth were chattering and Andy thought I was cold.  I see this so often with moms and I let them know that it's completely normal. But being on the other side, it didn't feel normal.  I couldn't tell if it was truly from the medicine, or the hormones, or because I was so anxious.  It felt like I was panicking.  Either way, whether it was caused by my worries or caused by my hormones or caused by the medications, it definitely felt awful and therefore it made me worry.  I remember thinking this was NOT what I had in mind when it came to my birth.  I had pictured myself staying nice and relaxed, knowing what to expect at each stage and what to do.  I knew that my baby would feel everything I was feeling and I wanted his entry into this world to be calm and peaceful.  And yet here I was feeling very panicked, and nervous, and jittery, and wide awake. Though to be honest, with my history of anxiety which always crept up during hormonal times, I'm now surprised that it didn't ever enter my mind that the crazy hormones of labor might just snag me again! Thankfully Marilyn stayed by my side for many hours to help keep me calm while the others slept.

At around 1am or so (I think) Ali, my photographer/one of my closest friends, walked in.  I was SO excited to see her sweet face as she walked up to my bed and hugged me saying, "ohhhh friend...". For some reason it felt like such a relief to have her there by my side and I just broke out in tears.  She was so sweet to come.  This was the weekend that she was unavailable and yet she still made it in the middle of the night, exhausted from all of her other goings on, AND to top it all off she too was pregnant in her first trimester!  (I can say that now that it's public news!)  Marilyn was then able to join the others for a nap and Ali stayed by my side, holding my hand, and chatting with me. I told her about everything... from my water breaking to how we'd ended up here.  She was so amazing and calming and encouraging that you'd think she was a doula too!  Ali and I tend to think similarly so she knew just how to talk me down from all of my "what if's" that I was constantly throwing out left and right.  After quite some time, and I don't remember what time it was, I was calm enough that Ali was also able to go lay down for a little nap.  During that time my sister, back in Richmond, was also my rock.  She would text me funny, completely random tidbits to sidetrack me and make me laugh.  I knew she was thinking of me constantly and praying from afar.
In the middle of the night at some point, my OB came into the room to check me.  He walked in and there were bodies all over the place sleeping in the dark.  "WOAH.. " he said, "it looks like a refugee camp in here", which made everyone laugh.  I was nervous for him to check me... I kept thinking, what if there hasn't been any change?  Thankfully, there had actually been some progress... I was now 6cm dilated but the baby was still at a -2 station.  This worried me.  I feared that he was too big, since everyone loved predicting that I had a massive baby, and that perhaps he wouldn't be able to descend into my pelvis. {note to readers:  don't ever tell someone who has to pass a whole person through a small opening in their body that said whole person looks like he's going to be huge! Even if you think it, just shut the heck up and move on!} I also worried because he was still OP and now I wasn't able to get into all the positions I could have had I been mobile in order to get him to rotate.  Ugh.. I'd seen it plenty of times before with other mamas, and now it looked as though it may just be my fate too.  At this point Marilyn suggest we use her peanut ball.  Thankfully our nurse knew exactly what the peanut was from working at another hospital where it was a standard tool (I feel like she was from Minnesota or something), and so Marilyn ran out to her car to grab it.  {In case you have no idea what I'm talking about, or are a doula and would like to order a peanut: click here}.  So together, the group moved my heavy ass legs to get my body on its side to place the peanut between my legs.  The key is to have your upper hip pointing forward towards the mattress instead of stacked above your lower hip.  This rotation towards the bed, coupled with the widened hips propped by the peanut, allows for the pelvis to open and gravity to help rotate the baby around to a more ideal position.  The nurse was so sweet, I remember she couldn't get a good heart rate on the monitor for the baby in this position so instead of making things convenient for her and making me move, she stood for what seemed like many hours holding the monitor to my belly and moving it every time he would shift.  I felt so blessed to have such a great team even if this wasn't the picture perfect scenario for my birth.

At some point towards morning the doctor came back in to check me again.  At this point I had been mentally prepping myself for the last few hours for him to potentially see no change and to suggest that we do a cesarean.  I was so afraid, but kept telling myself that it was going to be ok, no matter what he had to report.  So he gloved up, squirted some lube on this glove, and asked me to butterfly my legs in the usual cervix-check-fashion.  I took a deep breath as he began his exam.... hoping, praying.  Suddenly he was offering me a fist... as in to give him a fist pump (with his clean hand)... and he said, "I don't feel any cervix!  You're complete... and the baby is.... (digging for another minute).. at a +2 station"! (or was it +3? I've forgotten). He said that he could feel that I had plenty of room in my pelvis for him to rotate and that he was now making his way down!  I was shocked!  I cried out, "REALLY??!?"!!!  Those who were sleeping woke to all the commotion and we started picking up the 'refugee camp' to make room for delivery!  He actually had to run into a scheduled cesarean at 8am so he told me to hang tight, labor down for a bit (this is when your body brings the baby down with more contractions rather than having to push for hours), and that we could start pushing around 8:30am or so while he was in the OR.  He was sure that "unless she's a crazy pusher" he would be back in time for delivery.  My legs were so numb from that second bolus that I asked them to pull back on the epidural so that I could feel to push.  They called the anesthesiologist in and it wasn't that much longer before I started feeling the typical "butt pressure" (or more appropriately termed "rectal pressure") from the baby's head moving down so low.  I also started feeling a bit nauseous which I knew was completely typical of this stage of labor.  Just then my mother and Marilyn walked in with coffee and gave one to Andy.  I think he gave me a kiss and I smelled it on his breath, and right then I knew that I was going to puke.  (I normally love the smell of coffee!).  The nurse got me a plastic container to hold just in case, and I asked for a piece of gum or something to take the icky taste and smell away.  Andy gave me a piece and I remember the nurse warning me that sometimes producing saliva makes the puke come faster.  I put the gum in my mouth anyway, chewed about 2 times, and literally threw up in the bucket right then.  As I was vomiting I could feel my stomach pushing down on the baby.  I asked the nurse if it was possible to "puke out the baby's head" from all the puke-pushing.  She thought I was fine, but it felt awfully close to me.
Many mamas have fearfully asked me if they were going to poop when pushing.  I always explain to them that they might, but it's always just a little and everyone is so used to it that it's really a non-issue.  But as I was sitting there and starting to feel more and more pressure it felt like I was pooping just sitting there!  I remember asking the nurse to check under the covers because I was "sure I just shat the bed."  She peeked and assured me that I hadn't... but man was that pressure intense!

At around 8:35/8:40am everyone got into place- both Marilyn and Andy grabbed a massive leg and I started pushing.  I remember I could still feel my chest tightening with each contraction and so I didn't want to hold my breath to the count of 10.  I still pushed with all my might which made me incredibly hot and thirsty. Marilyn was giving me water to drink and putting cold compresses on my forehead between pushes which felt amazing!!
It wasn't long before they told me to reach down and feel the top of my baby's head.  It was incredible!!!  He was so close! I asked everyone if they could see any hair and they all nodded with big eyes, "oh yes! lots of hair!" I started gently stretching my vagina around his head with my fingers... amazed at what was happening. Ali was clicking away with her camera and I kept hearing "oohs and ah's", and "yes Juli, push like that!" when I was making more and more progress.  Andy was adorable.  He kept kissing me and telling me how amazing I was doing.  His eyes would get big watching (yep, he looked!) and he would turn and encourage me more and more.  
I don't know how many more pushes there were, but it wasn't long before the nurse asked me to stop.  Normally at this point they bring the Dr. in but for some reason he wasn't coming.  I asked through sweaty panting where he was, and she was reluctant to admit that the dr. was still in the OR!!  WHAT?!  At this point (and yes I could feel everything) I was gritting my teeth saying "I can't stop though.. I can't wait!", so she quickly called in another OB to catch my baby.  Within a minute or so this woman came in and sat on the bed.  Part of me was disappointed as I really wanted my own backup to be there... he had been with me through so much of this journey and we already weren't having the birth we had hoped for, so I wanted HIM damn it!  But another part of me just HAD to push RIGHT NOW.  "F**k it", I thought... and started bearing down. {Please excuse my language... but L&D isn't for the mild mannered. When the going gets tough, the sailor mouth gets going!} Right then my OB burst through the door and suited up as quick as he could.  YAY!  

I remember he sat down and as I was pushing he said something about thinking this was going to be a pretty big baby... I grunted out, "NOT. HELPING." He laughed and said, "why?  He's coming out this way now!" (Clearly spoken like a man!) :) I remember saying at one point, "I can't... I can't anymore, I just can't"... I was so tired and it was so hard, but he was so close.  Then I thought "damn it Juli, you have to, otherwise it's surgery", so I gave it one last MASSIVE push through that terrible burn (and to be honest it felt like I was tearing straight up through my clitoris.  Sorry for the TMI).  I felt a sort of pop, and then the dr. was telling me to hold off a second because the baby's head was out!  He unlooped the umbilical cord from around his neck and then asked for another easy push.  Or maybe it was another big one....  I can't remember.  I just know that baby was so tight and I needed to get him out NOW!!  Next thing I knew there was this huge release as our sweet baby boy came slipping out of me and was gently placed onto my chest.  He cried immediately and I was SO relieved to be done!
I could hear all the cheers in the room and the sound of Ali's camera click-click-clicking away, capturing every single precious moment.  I looked over and saw my mom and Ali holding each other crying.  I looked up at Andy, he was crying.  And most importantly our little son was perfect, I couldn't even see him very well from my angle, but I just knew that he was. I gave him immediate kisses and began singing to him... the same song that I'd been singing to him for many months.  "Sleepy Man".   Not a lullaby per se but a song that meant a lot to me and felt appropriate.  I remember towards the end of the song, my Dr said, "I don't want to interrupt your singing, but I need you to give me another little push..." I did and out slithered my placenta.  It felt SO amazing to get it out... like a huge weight just plopped out of me.  (Well, Juli, I guess that's because a huge weight had just plopped out of you!) Of course I pretty much immediately asked the Dr. if everything was ok. "Am I bleeding too much?", nope.. very normal. "No amniotic emoblism?", with this one the dr. chuckled and assured me that I was fine.  Sigh of relief... I'd lived!

The doctor checked me out and I had a few very small tears that he decided to repair.  As he began to stitch, I hollered out that I could feel EVERYTHING and that it felt like he was putting a fish hook through my vagina.  "That's pretty much what it looks like," he joked. I could feel the thread of the stitches pulling and I decided to focus on my little boy rather than all the action downstairs. We decided to tell everyone his name as I held him to my breast and he began rooting for my nipple.  Beau David Brocato.  He latched on immediately and we sat blissfully nursing, loving, and thanking God that we'd finally done it!  We spent the next few hours bonding with him.  No one was to take him from my chest.  It was beautiful and perfect.  After those first hours had passed they checked his weight, 7 lbs 13.8oz, and his length, 20".  Andy got to hold him for the first time, so he stripped away his shirt and they put Beau skin-to-skin on his chest.  They brought him a warm blanket to wrap around them and I could just see Beau looking up at his daddy while cooing the cutest excited little sounds.  We all laughed at how vocal he already was!  We continued to take pictures and basked in the sweet moments as a family of 3.
While my birth was nothing like I had planned or perhaps I should say, preferred... it really was perfect in it's own way in the end.  I do have a different perspective now, of course, than just being the coach on the sidelines.  But now more than ever, I know that every birth is different, every woman is different, every baby is different and you just never know until you get out there and give it a go.  You make the best decisions that you can as the circumstances arise and you have to be ok with them.  At the end of the day, I didn't give a crap where I was, who I was with (minus Andy of course), or whether or not I had a medicated vs. unmedicated birth... I just wanted my baby to be ok and to live to tell the tale!  Will I try for a natural birth if we have more children?  You betcha!  But the experience was so positive, all in all, that we think we'll just have a hospital birth next time with our doula.  (Who would have ever thought I'd say that!) Do I think that had certain circumstances been different (like his fetal position) that I could have done it without medication?  Indeed I do.  But I also know that I could be wrong and if I were to have the same sort of experience again, that it would be ok and that we'll make the best decisions that we can in that moment because it too will be different from this one.  Do I feel just as passionate about natural birth, our body's ability to do this on its' own, and the need for less intervention surrounding birth?  Yes!  I'll always feel that way, but I'm also grateful (as I always was) for the interventions that we have in place when we need them.  Can I say that had I stayed home and just left well enough alone that we wouldn't have had a successful home birth-- long-- but without complications?  We may very well could have had a beautiful birth at home.  I'm not playing the "had I not gone to the hospital one of us would have died" card.  All I know is that we had to make some tough decisions and didn't personally want to risk it for a specific experience or idea, and in the end we received the best gift in the entire world-- no matter where we chose to birth.

No matter what path a baby takes to enter into this world, he deserves that moment to be a joyous celebration filled with love and wonder and that is exactly what our sweet baby Beau got!

From the many things I already knew surrounding birth, I had no (real) idea that my life would become so amazing and beautiful and sweet and hilarious and blissful and blessed and filled with such joy and love and anxiety and fear and exhaustion, or that we'd be faced with the toughest decisions we'd ever have to make (and those aren't even the ones at the hospital!), or that I wouldn't change any of it for the world. It's amazing to me that in one moment- that first sweet breath of life- I could fall so deeply in love with another human being in a way that has truly changed my life forever.  
Thank you for taking this special journey with me.  It was a long one but proved to be the best journey that I've ever experienced!

*Photo credit to Ali Caudill Photography.  

Wednesday, October 17, 2012

The birth of Beau David Brocato, Part 2: Our Home Birth

It was Saturday Sept. 8th.  My mother had been in town all week visiting one last time before I hit 40 weeks.  She was due to leave the next day but I told her while she was visiting that while we hadn't ever planned on having her here for the birth, I secretly hoped that I would go into labor with her still here.  There was something very comforting and nurturing about her presence and I suddenly hoped that she'd be able to be part of it all.  I noticed that morning that the baby was moving a little less... nothing dangerous or worrisome, just less active than usual, and I took a mental note wondering if that meant he'd be on his way soon.  That afternoon my mom, Andy, and I went out to Reston Town Center for lunch to try and get out of the house for a bit.  While we were out we heard on the radio of a tornado warning for later that day.  I received a text while at lunch from my doula, Marilyn, asking how I was feeling with the drop in barometric pressure and I chuckled telling her that I was fine thus far as it didn't seem to be affecting me at all.  (Many women are sensitive to large drops in barometric pressure resulting in labor).  At the end of our outdoor lunch the rain began to sprinkle, so we headed back to the car to try and head home before things got ugly.  Sure enough on our drive things picked up significantly and boy was I grateful to be in our new safe car!  The wind was strong, rain was pouring, and debris was flying everywhere.  I kept praying aloud that we just make it home safely and that no trees fall on us while we were driving!  As soon as we pulled up to our street we saw that trees were down, some having crushed cars , and there was no way to enter.  Now I was grateful that we had been out instead of sitting home with our brand new car under a tree!  Andy got out in the pouring rain to see if he could pull a fallen tree over enough for us to get passed.  I looked further and saw others ahead so I called for him to come back.  We drove around to the other side of our complex and found a spot clear of any trees that could still timber over.  The three of us ran (ok, I waddled) through the courtyard getting soaked as we tried to make it safely inside.  As soon as we opened the door we saw that the power was out.  We immediately began lighting candles, changing clothes, and couldn't wait for the storm to end so that we could get outside to assess the damage with our neighbors.  As soon as the storm calmed we headed out to try and help each other clear the debris.  (I picked up little sticks to feel like I was taking part while the others helped chop tree trunks and drag branches away).  Once we came inside, the three of us sat and played Wheel of Fortune on my phone to pass the time.  After a few hours we noticed that all of our phone batteries were about to die so we decided to give them a rest in case we needed them later.  I quickly jotted down the phone numbers of Parveen, Marilyn, Ali, and our OB just in case something started and my phone battery was dead...

My face says it all as I take in the mess

That night we all went to dinner with two of our good friends.  While we were out, I couldn't help but notice that Andy was enjoying himself by ordering some drinks.  As the night went on and the drinks kept coming, I said to him.. "um.. honey, remember that thing about me potentially going into labor anytime from 38 weeks onward and that part about you being on-call and maybe not having tooooo much fun with the drinks just in case??"  He quickly informed me that we were totally fine... that I wouldn't be going into labor any time soon.  He was sure of it.  In fact, he was sure that I'd be going into labor after my due date (at this point I was 39.5 weeks).  He quoted the statistic that he'd often heard me say... "the average first time mom delivers at 41 weeks and 1 day".  I chuckled and said, "how do you know??? you have NO idea when I'll go into labor!" and I also added that for some reason, many first time moms begin labor in the middle of the night and that tonight could very well be that night.  He then replied with the ol', "I think I know my wife... I'm going to be able to tell when you're heading in that direction."  Again I had to chuckle... knowing that there aren't always tell tail sings pointing in that direction at all.  I then added, "Ok, whatever you say, but if I DO go into labor and you're too tipsy or tired to support me, I'm going to be awfully disappointed in you!!!"  Everyone at the table laughed at our silly argumentative banter, but none of us were REALLY worried that I'd actually be having my baby just yet.

We arrived back home at about 11:45pm hoping that the power would be back on.  Unfortunately it wasn't and we were all exhausted so we headed to bed by 12:30am.  Suddenly at 1:45am I was awakened by a warm gush that just kept flowing into my underwear and out into the bed.  I gasped and sat up yelling, "Andy, ANDY... OH MY GOD, MY WATER JUST BROKE!.  (Along with a few holy shit's I'm sure).  Andy was slow to wake (surprise surprise!!) and when he finally did, he muttered that I must have wet the bed.  "Ummmm no, I did NOT just wet the bed!" I flew out of bed (as fast as a huge, full term pregnant girl can fly) and headed straight to the bathroom quickly lighting a candle to try and see what was in my underwear.  When I sat down, I continued to leak more and more fluid, and I just knew it wasn't urine.  My mom overheard the commotion and quickly came out of the guest bedroom asking what was going on.  I told her my water had broken (Andy was still insisting that it must be urine... I think he WANTED it to be urine because he was still feelin' those drinks!!).  As gross as it is, and yes this is TMI, I asked him to come and smell my underwear.  "Does this smell like semen to you??", I asked. "UGH (incredibly disgusted)...  YES IT DOES!", he replied as I quickly said, "then THAT means it's amniotic fluid and NOT urine!".  

Suddenly I felt nervous.  This was it.  What I'd been waiting for- not only for the last 9 months, but my whole life.  One way or another I was going to have a baby in the near(ish) foreseeable future, and I was slightly concerned since the onset of my labor began with ruptured membranes.  I knew that I was now on a clock to deliver before infection could set in.  Whenever a mom has called me saying her water has just broken at the onset or before labor has begun, my heart always sinks a little for her.  Our work is now cut out for us. We're not going to have a leisurely time just waiting to see when things pick up, but rather we're going to need to be very proactive about getting things going so that we don't run into trouble later on.  Statistically, only 10% of labors actually begin with spontaneous rupture of membranes (despite how hollywood may like to portray birth), yet interestingly enough both my mother and my sister also had ruptured membranes at the onset of their labors.  Knowing this throughout my pregnancy, I supplemented with more vitamin C to try and help strengthen my amniotic sac.  Also knowing that my baby had been OP (posterior) for most of my pregnancy and leading up to labor (see previous posts or spinning babies to learn what on earth I'm talking about), I knew that a common identifying factor of an OP baby is ruptured membranes at the start of labor.  This told me he was likely still in that OP position (despite my many efforts to turn him in pregnancy).  Gulp.  I knew I was probably in for a really long, tough, ride.

Andy kept suggesting that I come back to bed and rest for a while.  He reminded me that I always tell my moms that they'll need their energy later and that they should get some sleep while they can, especially if the onset is at night.  I was wired though... adrenaline was through the roof.  Anxiety was setting in.  I couldn't just lay there and sleep... NOT NOW! Not to mention the fact that I knew I was on that damned clock... I wanted things to pick up so that slow or no progress wouldn't bite me in the butt later.  I got up and it wasn't long before the crampy contractions began.  Within an hour or so they picked up to the point where I had to at least make noise during them... nothing unbearable, but they weren't mild either.  It was on.  I had a sanitary pad in my underwear but during every contraction I would completely soak the pad and my underwear entirely with fluid.  Within what felt like minutes I'd gone through all of my maternity underwear which Andy had to go fish out of my drawer by candlelight (you should have seen some of the tiny thongs he brought me initially that would now probably not make it past my knee!). I was also apparently using way too much toilet paper when using the bathroom (or so I was told). After one of my many trips to the toilet I suddenly heard a pouring sound behind me as I walked down the hall.  I grabbed a flashlight and pointed it toward the toilet just in time to see it completely running over.  Seriously???? NOW??, I thought,  First no power, then my water breaks in the dark, and now the toilet is overflowing ALL when I finally go into labor???? Andy ran with towels as fast as he could to clean up the mess in the dark.  We just had our floors replaced a few months back due to water damage (for the second time in a year)... and honestly, at this point I didn't care what happened to those floors one bit.  But Andy worked diligently in what little light he had and cleaned it all up before it buckled the wood.  So I was now told not to use that toilet and to use much less toilet paper in the other bathroom to which I immediately thought, "um... I'm in LABOR.  I have to use the toilet every few minutes (literally), and YES, I have to use friggin' toilet paper!".  So I decided since we were already doing things like they did hundreds of years ago without power, I may as well keep that theme going.  I had my mom grab a bucket that we had car wash supplies in... and yep, you guessed it.  This became my new toilet.  I didn't have to leave the room... I just shifted from my birth ball to aiming over my bucket and let 'er loose... over and over again.  It was kind of brilliant to be honest :)  A few other times I missed the bucket or splashed amniotic fluid all over the place (we also had chux pads on the floor)...but like the sweet husband that he is, Andy kept cleaning up after me without one complaint.  He was still really tired so I begged Andy to go back to bed as I reminded him that I would be needing his support much more later on.  He kept saying that he wasn't sleeping unless I was sleeping...but  after much head-bobbing on his end, I finally convinced him that I was nowhere near sleep and he agreed to go back to bed for a while.  My mom, being the night owl that she is, stayed by my side.  So grateful that she was there, I began to labor away sitting on my birth ball, rotating my hips, and doing some belly dance techniques.  At this point all of my labor pains were in the front (like very strong period cramps), which made me feel hopeful that maybe our little one had rotated from his OP position into a more ideal spot to descend.  The contractions were definitely coming, 5 minutes apart or less, but at this point they weren't quite a minute in length.  As they started coming more and more, I noticed that the pain was both in the front and also moving around to my lower back (a sign that the baby was likely still OP).  At around 5:45am I contacted Parveen to keep her updated.  I told her that the contractions were definitely painful and definitely coming, but that I thought that it was more because of the baby's position rather than actual progress.  I'd seen this pattern unfold time and time again... ruptured membranes at the onset, contractions coming back to back in an early stage growing progressively stronger into back labor, shaking due to hormones almost like transition and after hours and hours of hard work, often little to no progress because it's actually an OP baby rather than one that is descending properly...  darn it!  I definitely felt anxious knowing this, but kept at it and continued positions that can help turn an OP baby.  Parveen sensed my anxiety and said that she knew I was only in early labor but that she would still head over shortly just to check in on me.

Now during all of this our power was still out.  At first, I thought "eh, no biggie... laboring by candlelight will be lovely and peaceful!" (and in some ways it was)... but then I also realized that this meant no hot water which is a pretty major part of home birth!  Showers and the birth pool are the best way to relieve even the most painful labors and without the best trick in the book, I felt even more anxious.  When I mentioned this to my mom, she said in her usual southern accent, "well then we'll just have to do it the old fashioned way and heat that water up on the stove!"....wishing that was possible I said, "We have an electric range mom.".........she gave a thoughtful pause and said, "oh.... well shoot!".  Suddenly, however, after about 5 or 6 hours of laboring in the dark, the house lit up, the AC revved up, and we squealed, "Thank you God, we have POWER!"!!

Andy awoke around the same time that Parveen arrived which was around 7am.  She decided to check my cervix, if I wanted, so that we would at least have a baseline.  I knew the progress wasn't going to be much and didn't want to grow discouraged, but agreed that it would be good to have something to go off of.  Sure enough, I was only 2cm dilated, 80% effaced, and the baby was still at a -2 station.  Parveen suggested at this point that I try and rest.  I knew it would be difficult, but I tried since I'd only had 1 hour of sleep and this was clearly going to be a very long journey.  I laid down in the bed and with contractions coming every 5 or so minutes, I was able to catch little cat naps between and then crawled out of bed (as quickly as I could) during each contraction to move through them.  I think Andy was sitting there with me, but I was groggy so it's hard to remember. This up-and-down-from-bed- pattern went on for about 2 hours where the contractions then became too strong for me to rest and I gained a second wind.  We decided to take advantage of the gorgeous day outside and tried to go for a walk to keep things going.

The walk was tough.  It happened to be a weekend (one of the very weekends that our photographer Ali was unavailable to be with us), so plenty of neighbors were walking around and I was doing my best to mask the pain and/or noises that I was making so as not to scare anyone off (especially the children running around)!  Andy and I took things slowly but I was definitely having to work hard through the contractions.  We also took the stairs which I completely dreaded, and thought of allllll those mamas prior to me that I had taking those stairs to get their labors to progress!  Andy was a great coach... he didn't let me stop or wuss out.  He just kept encouraging me to keep going and going.  Then at one point I turned to Andy, teary, and told him that I thought I knew the baby's name.  His eyes immediately teared up as he asked "Which one?".  I told him- now through full fledged crying- that I really wanted the baby to be named after my grandmother that I'd been so close to.  {Her nickname was "Bo" and she and I were sort of 'kindred spirits'.  She had always recognized this and told me my whole life how alike we were, but I didn't truly see quite how much so until my adult life after she had passed away.} Throughout our whole pregnancy I'd felt Bo's presence surrounding us often, and it just felt right to use her nickname.  So our sentimental choice was Beau (we wanted to give him his own spelling) and David is my father's name.  It was currently the day before my father's 70th birthday and it was looking pretty likely that our baby would be sharing a birthday with his granddaddy, so sharing his name also felt appropriate.  Andy immediately choked up, tears down his cheeks, and said "that's it then!". "Are you sure??", I asked, knowing that he had originally preferred our other name choice... the one that wasn't sentimental but a name that we both really liked.  "Yep... positive", he said.  So it was settled!  Our baby boy finally had a name... Beau David.  We decided not to tell anyone until after he was born.

After what felt like a really long time we returned inside.  Somewhere in there we spent some time alone in our bedroom so that we could use nipple stimulation to get things to pick up (sorry again for the TMI but nipple stimulation is a wonderful way to release oxytocin which thereby increases uterine contractions).  We also took a shower to help me relax.  Also during this time we ate a little, though I wasn't very hungry at all-- more nauseous really, and Marilyn also arrived.  The second I saw her, she hugged me and I started crying.  I just needed to release my emotions-- excitement and fear-- and I felt a sense of calming relief knowing she was joining us. I had worked with Marilyn many times before, and it was really nice to have something familiar to my 'birth world' around me.  I tried to embrace everything I was feeling... the calm moments, the scared moments, the predictable ones and the unknowns.  I tried as best as I could to be present which truly can be difficult when your body is taking over as it does.  Your mind just wants to shut down (and needs to!) so that your body can let go. This was the hardest for me... letting my mind just shut down so that my body could do its job (which I have to say I never completely allowed it to do).

At around 5:00pm- 15 hours into labor- Parveen decided to check me again.  Hoping for some progress after all that work, I was somewhat discouraged to hear that I was now only 3cm dilated and baby was still at a -2 station.  At this point she said that she'd like to chat about my options.  She had spoken to my OB on the phone and he expressed that he wasn't comfortable with me going past 16 hours with ruptured membranes due to the risk of infection.  I was shocked.  Usually we have at least 24 hours with ruptured membranes before really thinking much about infection, so I wasn't expecting this conversation until well into the middle of the night.  Parveen agreed that it felt early to her too and said that from a health perspective she was perfectly comfortable waiting at home until 24 hours as both baby and I were looking great.  However, with that said, she said that the backup OB that we had chosen wasn't comfortable with me waiting, so I had to make a decision knowing that I wanted him to continue to support us on this journey.  I spoke to him briefly on the phone between contractions.  He said that in his experience, for some reason, he often saw a rise in infection rates after 16 hours of ruptured membranes and so he'd feel more comfortable with me coming in to be monitored and to have IV antibiotics.  It'd be one thing if I was close to delivery, but seeing as though I had so much further to go, we had some decisions to make.  I felt frustrated.  I wanted to stay longer... I wanted to get in my birth pool and see if my body would let go and if I would dilate faster. I wondered if the Dr's experience of increased infections was because of all the hospital protocols... increased vaginal exams, bacteria present in the hospital etc. etc., but I also didn't want to chance developing a fever and putting our little guy in danger.  Of course I was disappointed by the idea of not getting our home birth, but what made me more nervous was knowing what my options were going to be upon arrival at the hospital.  I knew they would give me IV antibiotics.  Fine.  I'm not really a fan of antibiotics and have spent years taking probiotics to increase my good intestinal flora, but whatever.. I could handle the antibiotics and deal with that later.  I also knew that he would suggest Pitocin.  Something I have NEVERRRRRR wanted to experience (not that anyone really hopes to experience Pitocin contractions).  Pitocin is a synthetic form of oxytocin that our bodies make but being synthetic it doesn't cross the brain barrier and therefore doesn't give us the sense of wellbeing that natural oxytocin gives.  It increases uterine contractions wellll past what your body would naturally create (despite what they try to tell you), and of course has risks-- including baby's heart rate reacting unfavorably because of less recovery time from intense squeezing between back to back contractions.  On top of all of this, I was already just about at my pain threshold.  I knew that I could keep doing what I was doing at the current level-- tough as it was-- in order to have my natural birth, and I was ok with them coming closer and closer together....but I also felt like I couldn't take but so much stronger-- which Pitocin contractions very much are.  The other option, however, was to be left alone... possibly develop an infection and then have to be ushered back to the operating room for a cesarean much faster.  DAMN IT, DAMN IT, DAMN IT!!  Since danger was in no way imminent, we took the next hour or 2 talking through our options so that our decision was something we would feel sure about.  As soon as we began discussing heading to the hospital, my contractions began to space apart.  The adrenaline response to anxiety tends to halt labor and it was doing just that with mine.  After much back and forth, one lone statement made the decision easy for me.  I mentioned that I just didn't want to feel that we made the call then to end up in surgery and always wonder what would have been had we just stayed home a littler longer.  Parveen responded by saying, "alternatively you also don't want to take too long at home and always wonder what would have been had we gone in sooner."  That was all I needed to hear.  "Let's go", I said immediately.  We began to pack a bag (no I hadn't done this sooner in hopes that I wouldn't need it)... Andy and my mom were trying to grab things and I just didn't care what went in there.  I think the bag ended up with one or two baby outfits and a robe for me.  We did grab my pillow and some of my essential oils and then I think we were on our way.

During the car ride I had four or five hard contractions but I stayed focused and got through them (it was really tough to sit down with excruciating back labor).  My mom and Andy stayed quiet for me and Andy drove very calmly.  I was nervous but I always knew that hospital transfer was a possibility and I felt grateful that our reason for transferring wasn't because of anything "wrong" just yet.  I tried to take in some of the advice I'd often told my clients:  We know that we gave it a great shot at home and now we just have a plan B that we are grateful to have as an option when it's needed.  Of course it was disappointing knowing that I wouldn't be having the beautiful, peaceful home water birth I had so desired,  but at this point I just wanted everyone to be safe and healthy. We arrived at the hospital and Andy dropped us off at the main entrance so that he could go park.  My mother ran ahead to get a wheelchair as I was having a really tough time walking during my contractions.  Parveen and Marilyn were on their way behind us.  Ali (the photographer) had been alerted, but we knew that it was unlikely that she would be able to come.  I slowwwwly put one foot in front of the other as I entered the main lobby all alone.  I stopped immediately as a huge contraction hit and an older couple, on their way out, passed with concerned faces asking if I had anyone with me or if I was coming to have my baby all alone.  I nodded and pointed in the direction of my mother while breathing as deeply as possible.  The security guard came and helped me into a wheelchair.  I think he thought I was about to have that baby right there in the lobby-- which I told him I was nowhere close to delivery-- as he said "just hooooold on" and took off like a bat outta hell racing me upstairs and leaving my mother to run after us.  As we rode the elevator and rolled down those familiar halls that I'd walked so many times before with my own clients, I prepared myself to keep looking forward and not back.  This baby deserved to be welcomed into this world with the same love, joy, and excitement no matter where or how he decided to join us...

Thursday, October 4, 2012

The birth of Beau David Brocato, Part 1: The Plan

So it's been really difficult for me (like any new mom) to find the time to sit with two hands and actually type the birth story of our son, Beau.  From just trying to sleep when our little guy is sleeping to having a baby in my arms and on my breast when I'm actually awake, it's tough to find a moment to run and pee or quickly shove food in my mouth much less type!  So I've decided to put our birth story together in sections... I guess more like chapters (yep, I have that much to say!).  Everything is already a bit hazy in my memory, so I'm doing my best to sit and type out what I can when I can.   It's tough to know where to begin... Beau's journey was a long one but at the end of the day (ok days) it was all so wonderfully worth it!

I'll start off with our "plan" before our birth even began.  I put this in quotes because we all know that plans, especially when it comes to birth, are just preferences that we have so little control over.  We often detour from these plans, but do our best to honor our preferences along the way.  I realize this isn't the juicy "what actually happened" chapter, but many have asked and asked what I would do when it's my turn.  So I'll start from the beginning... get your popcorn and hunker down... as usual anything I have to say is going to take more than a few minutes :)

The most common question that I've heard through my pregnancy was where I planned to give home, birth center, or hospital?  As soon as we learned we were pregnant I knew that I wanted a home birth.  Knowing what I do for a living and all that I've witnessed at both home and hospital, (and after some discussion of course) Andy was on board and supported me 100%.  So right away I started going through our options for home birth, thinking of all the wonderful midwives that I knew and loved and which would be the best fit for us.  We wanted someone who- aside from having reputable credentials, positive energy, and plenty of experience- would come to our home for all of our appointments, who I had worked with before, and who wasn't taking on so many clients that we had to wonder exactly who would be the one showing up on our special day.  Immediately I thought of Parveen Kelly, CPM.  Her calming presence was there to reassure me right off the bat as she completely understood that while I work in this business, all of that knowledge somehow goes right out the window when it's your body and your baby.  Filled with questions (that I often knew the answers to but just had to ask), Parveen would take her time in answering each and every one no matter how irrational many of them were.  Throughout my pregnancy I noticed that my history of anxiety (see previous posts) was definitely bubbling up to the surface, and so I worked long and hard at trying to keep those thoughts in check, not only for myself, but for my baby.  With all of that said, I was hell bent on covering all of our bases to try and ease my anxieties (or maybe just hell bent on control?!) and  one of those bases was insuring backup- knowing that there was a very real possibility, like with any home birth, that I would need to transfer to the care of a Dr. at any point during my pregnancy or labor/delivery. So I decided I wanted to find my own backup OB... someone who I could trust implicitly and that I felt comfortable working with just in case.  Those who work in this business know that not all hospital transfers are positive.  When you get just any doctor who is on-call you really can't be sure of how you'll be received and sometimes it's not exactly kind.  So I immediately knew who I wanted as my backup and called my favorite OB to see if he'd be willing.  Thankfully he was... he said that he trusted me and knew that if I had to transfer that I wouldn't be like some of the other transfer moms out there: angry upon arrival and unwilling to do what it takes to keep mom and baby safe.  This doctor and I had worked together many many times and have a great relationship, so I knew it was a perfect fit.  He kept in touch with me throughout my entire pregnancy, and saw me frequently as we continued to work together... but at the end of the day we both hoped that we wouldn't need to see each other on the big day at all. Either way, my mind was at ease knowing that if I had to go in at any point, that I was covered and my experience would still be positive.

Photo courtesy of Ali Caudill Photography

I'll stop myself right there before continuing and paste some information below for those who are gasping and thinking that home birth is "crazy" or "negligent".  Normally I wouldn't even bother explaining our choices, as they were ours to make and really no one else's business.  But I noticed throughout our pregnancy that a lot of our friends, family, and even acquaintances had big eyes and "you're crazy" comments (or at least looks) when really they knew very little on the subject of home birth.  I've written posts about birth choices in the past, never revealing what ours would personally be as I've always supported everyone's personal choice in where and how to birth their babies... so now I'll just paste something I wrote to a very concerned friend during my pregnancy in response to our choice:

*Please note that the following is in no way meant to try and change the view or opinion of those who don't agree with us nor is it meant to start a debate, but rather is to help others simply understand why we chose as we did.

 In terms of home birth, our midwife is incredibly skilled (she was trained in the UK where ALL moms visit a midwife as the norm and are only referred to an OB in cases of high risk pregnancies.  She has worked in both hospitals and at home and has seen very high risk situations in her training in the UK.  She is conservative in that she doesn't just wait for things to progress into sticky situations, but rather is incredibly proactive about her decisions to either stay home or head out for help.)  Many good OB's are supportive of home births as long as mom is a good candidate for one.  I often have OB's tell my own clients (who are planning a hospital birth) that if they don't want to be "messed with" and truly want a natural birth, then to stay home until the last minute.  Even they support staying home if mom wants to avoid unnecessary interventions.  In terms of emergencies, what is hardest for most to understand is that the emergencies seen in the hospital are often caused by the procedures performed at the hospital itself. (Of course, not always, just often). We currently have a very high cesarean rate in the US from hospital births. Most "emergency c-sections" are because of either Pitocin which can negatively effect baby's heart rate and send moms quickly into the OR; epidurals which often cause moms blood pressure to crash, thereby causing baby's heart rate to drop incredibly fast, again leading mom straight to the OR; or artificial rupture of membranes which can cause uterine infection, putting baby in distress and again an emergency visit to the OR.  And these are just the 3 most commonly used medications/procedures in hospitals.  So admittedly, some Dr's will agree... stay away if you want a natural birth.  Now I also realize that without enough information, many would ask "then why not just have a natural birth AT a hospital just in case?" And while it IS sometimes possible, there are still some difficulties with that.  First and foremost the staff often doesn't allow moms the same amount of time for their bodies to do what is necessary to get the job done on it's own... so while they often say they are fine with mom having a natural birth, they seem to grow impatient and truly do step in MUCH sooner to "mess with things" (ie. speed them along) which can often have an unfavorable effect on the process.  Even simple protocols like IV fluids and artificial rupturing of membranes can create a cascade of interventions that are unfavorable.  Also many moms have a harder time relaxing in a hospital environment, and the adrenaline response to anxiety, or white coat syndrome, can lead to a major stall in labor.... then guess what happens?  They mess with it! (I've often seen moms having nice strong productive contractions 3 minutes apart at home, only to then stall completely upon arrival to the hospital).  The energy at a home birth is very peaceful and calm, and not treated with constant anticipation of something going wrong.  None of this is to mean that there aren't times where we NEED medical intervention, a little push in the right direction, and for that I am incredibly grateful for what our hospitals have to offer.  I've been a part of home birth transfers for those very reasons and they tend to be very smooth and proactive. Sometimes the at-home methods just aren't enough and we need to go in for a little help. I realize that those in a more medically minded environment argue this because they only see the emergencies that they see... they often haven't witnessed both hospital and home births and don't understand that often those emergencies that they see are caused by their own interventions.  They have no clue what a home birth looks like and imagine it being without proper medical care (i.e. just some lady having her baby without a clue what to do in the middle of her bedroom).   And not all hospitals, or doctors, or nurses are "bad" at all.  I've had incredibly positive experiences in hospitals with wonderful birth teams.  I just prefer to try at home first where I don't have to worry about the unnecessary interventions.  With all of this said, I realize that there is (of course) a possibility that we will need to deliver at the hospital or even have a surgical birth, and so I have enlisted an amazing OB who has been in touch with me this entire pregnancy along with some Dr's visits to him to make sure he remains comfortable with my choice.  He will be alerted as soon as I go into labor and is part of the birth team- just from a distance.  He too will be part of deciding if I should head in should things start to look that way. In terms of post-birth care, my midwife is trained in emergency response as well as neonatal resuscitation. She will be monitoring both my vitals and baby's vitals through the entire labor, delivery, and for approximately 5 hours post-birth. She will also perform the same blood testing etc. on baby after the birth and we will take the baby in to the pediatrician within 24 hours to have him checked (the pediatrician was also incredibly supportive of our choice to stay home, and only said to bring him in within 24 hours which is when they would usually check baby themselves at the hospital). In terms of baby care, so many studies point to immediate mother-baby bonding...unlimited skin-to-skin contact, breastfeeding, and delaying 'convenient' procedures (weighing, measuring, vaccines, baths etc). Studies are also supporting delayed cord clamping and cutting in order to give baby his full blood volume from the placenta which helps in his transition to breathing well and his blood pressure along with other benefits. While many hospitals are coming around as they learn this information, they are still known for often rushing these procedures, and breaking that contact/bond that is so crucial during those first hours after birth.  None of these things are issues at a home birth.  Midwives fully support what all of this research suggests.  And finally, the maternal mortality rate in US hospitals is sadly quite high.  So much research is now pointing to the interventions and hospital procedures themselves being the cause.  Without going into all of that data, we do feel that we are making the safest choice for both myself and our little one to stay at home given my low risk status.  

So that's where we stood in terms of hoping to try at home with a skilled midwife and an OB in the background.  And that just covers the medical side of why home birth is safe.  Overall I trusted this process when all is progressing normally, and wanted to give it a good go without messing with it!

Photo courtesy of Ali Caudill Photography

The second most frequently asked question throughout my pregnancy was whether I planned on having a doula.  It took me forever to decide as I wasn't sure what I would actually need in labor.  I knew that in early labor, I would be fine with Andy by my side as my mind would still be "with it" and I would be well aware of what to do and what to ask of him.  My only concern was for later in labor... when experienced hands and words are very necessary for relieving pain. (I can't exactly reach around and squeeze my own hips nor can I script what to say!). I figured that mentally I would know what I wanted, but did I even want to have to think about the doula role during labor or just be the laboring mom??  I also knew that Parveen was beyond skilled at what she does and that with her by my side we would likely not need the extra help.  With that said, I kept tossing the thought back and forth... did I need a doula too?  Did I just want one?  Then one night my good doula friend Marilyn Alger and I were on the phone and I heard exactly what I needed to hear.  "Juli you just need a standby doula.  No contracts, no expectations, no pre-birth meetings, just someone who will show up IF you need it during labor, and I'd be more than happy to be that person for you."  I immediately started crying... this was exactly what I needed to hear!  (Plus I could pay her back in massages!!)  So grateful for her generous offer, I felt like my team was {almost} complete.  I had a supportive husband, an amazing midwife, an awesome OB, and now an incredible doula waiting in the wings just in case!

The cherry on top to my birth team was the addition of one of my favorite people~ Ali Caudill of Ali Caudill Photography.  I asked if she'd be willing to photograph our special day.... she was ecstatic and said that there were a few dates during our on-call window that she absolutely couldn't be there due to other contractual obligations, but otherwise she wouldn't miss it for the world. I was SO excited at the idea of her capturing our birth journey so that we could forever remember and share those images with our son.  I trusted that if she was meant to be there, then our birth would fall on a day that she could make it.

Photo courtesy of Ali Caudill Photography

So our team was now complete!  Over the next months Andy and I gathered the appropriate supplies for our home birth... our birth kit, receiving blankets, mattress protector, birth pool, hose and sump pump, essential oils, etc etc. Plus I had my own doula bag filled with all things birth, so I knew we were ready.   During the final weeks leading up to our birth I felt calm.  I felt ready.  I was so excited to meet our boy!  We hadn't yet decided on his name but had narrowed it down to 2.  One we just liked and one that was sentimental.  We decided we would likely just meet him and make our decision then.  So now all we had to do was wait...

Photo courtesy of Ali Caudill Photography