Maryland Area Homebirth Options

Information, Resources, Midwives for Maryland and surrounding states.

Birth Stories

The Homebirth of Kai

Posted on July 15, 2011 at 9:28 PM

From the moment I felt the first contraction, I knew Kai's birth would be different.

~ * ~

Thirteen months before, his brother was born in a 27 hour labor that nearly defeated us both. But this felt different. Smoother. Less torturous.

~ * ~  

"I think I'll come over now. Just in case," one of my midwives, said to me when I called to tell her my contractions were three and a half minutes apart. She sounded nervous: She lived 40 minutes away and it was a rainy Thursday evening rush hour. I didn't blame her.

~ * ~

Most women just hire one midwife, but we were planning a homebirth with one of the busiest solo midwives in central Maryland. Because I'm a worrier--and because I believe three minds are better than one when the unexpected happens--I hired a second nurse midwife to be her back-up and assistant. It was a bit excessive but I needed it. Emotionally, I mean.

~ * ~

It was 6 pm and my husband was still battling traffic on his way home. My contractions had gained momentum but something made me hold my assistant midwife off. Even though she insisted second labors are much quicker, I still didn't feel like it was time. "You could be like this right now and a few hours from now you could be holding your baby," she warned before I hung up the phone.

~ * ~

Unconcerned, I sat down at my laptop with Facebook and a toasted bagel, reveling in the fact that it was finally time for our baby boy to arrive. Like many overdue women, I was convinced I would never go into labor: I would continue to toddle around as an off-balance, unwieldy pregnant lady forever, the baby continuing to gain an ounce every day until we both exploded. But that morning, eight days past my due date, I'd woken up and spent half the morning vomiting in the bathroom. The other half I'd spent rearranging the kitchen cabinets, which my husband had explicitly warned me not to do. He had claimed the kitchen in our new house as HIS domain. (Nonetheless, the thought of organized cabinets pleased me so much that I devoted at least two hours to relocating breakfast bowls and stacking dinnerware.) After setting the last teacup in place, I called my craniosacral therapist who is also an acupuncturist, a midwife and an all-around birth guru, and scheduled an appointment for the following Monday so that if I were still pregnant, she could work her magic and possibly send me down the path toward labor. She assured me that the morning-in-the-bathroom bit was a good sign and I seemed to be headed in the right direction. We'll see, I thought.

~ * ~

It was a gray drizzly day, the kind that always threatens to drive me insane. My son was "on vacation" at my husband's aunt's house and I missed his company but was grateful for the break. Around noon I decided the best way to battle the dreariness was to go take part in it. I grabbed my umbrella, shopping bag and jacket, and headed out on a long walk through our hilly neighborhood. Destination: the seedy Giant. After nodding politely to at least 10 well wishers and one elderly man who suggested I was having twins, I carted myself and the groceries home, unpacked the animal crackers and 64 ounce orange Gatorade and got ready to leave for yet another non-stress test to see how the baby was coping with his extended stay in my uterus.

~ * ~

That's really when it all started. My midwife and I decided to do an internal exam – the first one I'd had all pregnancy – to see if my cervix was softening and amenable to something like castor oil or cohosh to get my laber started. Just before the exam, she said that if I was dilated at all she could try to strip my membranes, or sweep her gloved finger along the tissues that attach the bag of amniotic fluid to the inside of the uterus. The process sometimes releases hormones called prostaglandins that bring on contractions. I said sure, hoping for at least 1 cm so we could finally get things moving. Turns out I was 4 cm. "No, wait," she said, feeling around. "Four to five." Five! Laa!

~ * ~

Now, several hours later, I finished the last of my bagel and typed my excitement on Facebook. Soon afterward, my husband came through the door with raindrops beading on his hair and jacket. "I'm in labor!" I announced. "Oh no," he groaned, then smiled. Our life was about to change forever. Again.

~ * ~

But not as soon as we thought. By 9 pm, my contractions had slowed to every 20 minutes. Over the phone, my doula encouraged me to get moving – try going up and down the stairs, try sitting on the exercise ball, try walking around, she said. "You've come so far! You don't want to lose this momentum, right?" But less than 10 minutes later, my midwife assistant called to say I should throw in the towel and go to bed. "Just let it go," she urged. "Otherwise it will be like trying to roll a boulder uphill. If it's not the right time, don't force it. Get some rest."

~ * ~

In the end, I did both. I went downstairs to get a snack, stopping for a few lunges and hulas on the ball, then came back upstairs and got ready for bed. I laid on my side while my husband placed gentle pressure on my hip and inner thigh, performing the muscle and ligament releases my acupuncturist had recommended to help Kai descend in the best possible position. Afterward, we started to watch an episode of The Office but I drifted off halfway through. Briefly, I wondered if it would be possible to oversleep and wake up so far into labor that it would be too late for the birth team to arrive. Nah, I decided. If it were that easy, all women would take a nap and wake up holding their babies. So much for sweeping my membranes, I thought, melting into sleep.

~ * ~

I dreamed about dark dungeon corridors and hot iron swords being thrust into my back. When I finally woke and felt through the darkness for my cell phone, it was 2:32 am. I realized the swords were contractions, and they were coming hard. I crept downstairs to start making calls, then went back up to let my husband know he didn't have to wake up right away but people were going to start arriving soon. Of course he leapt out of bed. Coffee was brewing in no time.

~ * ~

My doula arrived first. After a quick hug, she went to work setting up the birth pool in our living room, in front of the bookshelf where my husband's butterfly collection was displayed. I stayed on the glass porch, rocking back and forth on the exercise ball and staring through the misty windows at the yellow auras of the streetlamps.

We had moved into the house three weeks earlier and, just as my husband had claimed the kitchen for himself, I had designated the glass porch my happy room. Icicle lights were strung in the windows and Ben Harper was singing with the Blind Boys of Alabama. Rain beat against the windows, surrounding me on three sides. My contractions were frequent and intense, but between them I laughed with my husband and enjoyed the warm, bright haven we had created. I felt relaxed. Confident. In charge.

~ * ~

Less than five minutes after my doula arrived, I saw more headlights in front of our house and my assistant midwife came to the door. I escorted her to the porch and we sat on the chaise while she took my blood pressure and temperature, and listened to the baby's heartbeat through a few contractions. My midwife arrived about an hour later, fresh from another birth. I watched as she rolled her supplies up the sidewalk and onto the porch. Homebirth midwives carry nearly everything necessary to cope with an emergency situation long enough to make it to the hospital, including neonatal resuscitation equipment and medications like pitocin to control hemorrhaging. It took a few trips to get it all in the house. The home-to-hospital transfer rate for second-time moms is low, hovering somewhere less than 2 percent, but just in case the need arose, we had a bag packed and three sets of directions to our local hospital, five minutes away.

~ * ~

The next hour or so kept my husband busy, fetching various supplies for my midwife and helping everyone set up for the birth.

~ * ~

To my husband, my midwife said, "I'm going to need a wire coat hanger," I heard her say while I was in the bathroom. A wire coat hanger? Hello?! What was this?! "Dude, what the...?" I called to my doula, who was standing just outside the open door. We laughed. Turns out, she needed the hanger to suspend the bag of IV antibiotics. I had tested positive for group B streptococcus, a bacteria that resides without incident in the vaginal flora of up to 40 percent of women. But there's a 0.5 percent chance that the bacteria could infect the baby during delivery and cause meningitis or pneumonia, so most providers like to administer a single dose of ampicillin a few hours before the birth. The jury is still out on how effective or necessary the treatment really is, but I opted for it anyway. We had enough complications after my first son's birth to last a lifetime.

~ * ~

After the last drops of the IV vanished into my forearm, I stripped down and slid into the birth pool. The water was a therapeutic 99 degrees. My husband went to find his swim trunks, then sat in the pool behind me. There's a reason birth pools are called "nature's epidural": The contractions that had grown considerably more intense over the past two hours were suddenly bearable again. For a few precious minutes, I regained the ability to converse and asked my assistant midwife to replace my Ben Harper cd with Ladysmith Black Mambazo. But soon the waves started coming so close together that I only had a few seconds of relief before the next one hit. I felt as if my life depended on my husband placing counterpressure on my sacrum – in just the right place – during each contraction. Eventually not even his help was enough to escape the pain. I felt nauseous. My doula found some dried rosemary in the kitchen and rubbed it beneath my nose. But the effects were short-lived and she soon had to drop the rosemary for an empty pitcher.

~ * ~

"Maybe it's time to try something new?" my doula asked. I nodded and my husband went upstairs to grab my robe so I could get out of the pool.

~ * ~

On my way to the bathroom, I was hit with another intense contraction and I grabbed onto the nearest tall object, which turned out to be both my assistant midwife and doula. The pain was so intense, I wanted to wrap my arms around the whole world and squeeze the globe until it popped. "Just get out of its way," my doula cooed and I tried to dissociate my body, or at least my mind, from the pain.

~ * ~

Transition hit as I was sitting on the toilet. Suddenly I felt out of control. Nothing felt good. Every movement triggered a worse contraction. I was losing it.  I whimpered out the door to my doula, willing her to come make everything go away. "I just don't know. Just can't. Anymore. Please!"

~ * ~

"Do you want your midwife to break your water?" she offered, helping me to my feet.

~ * ~

"Do you think it will make things go?" I felt drunk. My tongue was thick. My mouth was dry. The pain was blinding. I leaned into the sink and clutched her hand.

~ * ~

"I do, I really do," she said.

~ * ~

"Okay."

~ * ~

I heard her sing out to my midwife as she left me there, gripping the doorframe. "I think she wants to ask you about breaking her water."

~ * ~

"You know I don't like to do that," I heard my midwife say. Shit, I thought. How much longer is this going to go on? My doula came back and steered me to the living room.

~ * ~

"Your midwife wants to see how far along you are," she said.

~ * ~

I laid on my side on our cheap brown couch, over a shower curtain and several layers of Chux pads. I remember feeling incredibly relieved that the exam didn't hurt. My midwife was good at what she did and I was so grateful.

~ * ~

"Almost there," she said, feeling my cervix. "Nine... and... here we go, here we go. She's complete."

~ * ~

As she was talking, I felt the gush of warm amniotic fluid as it pooled under my body. Thank God for the shower curtain.

~ * ~

Then, silence. I knew there was a problem.

~ * ~

"Can I get back in the tub now? To push?" I asked.

~ * ~

"There's meconium in the fluid, sweetie," my doula said, so matter-of-factly that I wondered if it was a problem at all. This had been my one fear. Meconium is the baby's first stool; it accumulates in the intestines during the last weeks of pregnancy and normally isn't released until after birth. But stress can cause the baby to defecate in utero, contaminating the otherwise sterile amniotic fluid. In the rare event that the meconium-stained fluid was thick like split-pea soup, we'd have to go to the hospital immediately. There's a very real risk that the baby can inhale the sludge during labor and develop pneumonia or enter respiratory distress. If we transferred, my labor would likely end in cesarean section. Definite NICU stay. Not at all what we had envisioned.

~ * ~

"Do we need to go?" I asked, opening my eyes to look at my midwife. She shook her head. "It's not very thick. I just need to be able to suction Kai's mouth as soon as his head emerges."

~ * ~

I felt the contraction build in my pelvis and said, "It's coming! It's coming! Help me push!" I moaned a deep moan that rose into a near-screech as I stumbled over the pressure. This is where I screwed up last time and ended up pushing for nearly 5 hours with little progress.

~ * ~

"Honey, you can vocalize if you need to, but it's best to keep all that power inside and direct it down, down. Use that power to push your baby out," my doula said, grasping my hand in hers and looping her other arm under my knee so she could hold my leg back during the next contraction.

~ * ~

While I pushed, my assistant midwife used the Doppler to listen to the heart tones. I could tell they were on the slow side. "Nineties," I heard her call out, loudly.

~ * ~

"Ok", my midwife responded. "During this next contraction I'm going to need you to take a rest. Don't push."

~ * ~

I opened my eyes. "He ok?"

~ * ~

"The baby is ok," she said. "He just didn't like his head getting squeezed. Let's turn over on your other side."

~ * ~

Ugh, I thought, lifting my back so I could turn. We can't wait five hours this time. Out loud I said, "It's coming! Help!" I grasped around for my doula's hand.

~ * ~

Not pushing is like not throwing up when you have a stomach virus. Once the impulse hits, it's nearly impossible to ignore. My husband sat behind my head and coached me to breathe lightly through the pressure. I tried to match him as closely as possible, giving in once or twice to a pushy groan.

~ * ~

"Sounds good," my assistant midwife said, lifting the Doppler off my abdomen. Heart tones were normal. Thank God. "He was probably going under the pubic bone."

~ * ~

"Can I push this time?" I asked my midwife, whose response I couldn't hear. "What did she say? What did she say? It's coming!"

~ * ~

"You're good to go," my doula answered, squeezing my hand. "Wait for it... let it build... now nail it! Here we go!"

~ * ~

As Kai's head bulged against my perineum, I felt my midwife place a warm compress against my skin. "Nice stretching, good, good, keep going," I heard her say. "Come on, push!"

~ * ~

"Does that mean he's crowning?" I asked, knowing full well he wasn't, but willing us to be farther along than I'd thought.

~ * ~

"Uh, no. Not yet, hon. But you're doing really great. Really great," my husband said. "You're doing this!"

~ * ~

Just a few pushes later, he was crowning. And there was the ring of fire, which stung terribly but meant we were almost done. My midwife told me when to push and when to rest so that I could avoid tearing. She massaged the area with Vitamin E oil. When it was time, I pushed through a contraction and then between one because I wanted it to be over and suddenly it was. Kai was born.

It was 8:35 on a Friday and the sunlight was streaming through our windows. Despite the rainstorm the night before, the sky was clear and blue. It was a perfect autumn morning.

~ * ~

Kai was pink and plump but didn't cry at first. My midwife suctioned his mouth quickly, then placed him on my chest and covered us with a warm blanket. "Talk to your baby," she said, giving him a brisk backrub as someone's hand--my assistant midwife's, probably--came in and released a few drops of herbal Rescue Remedy into Kai's mouth. My midwife didn't need to tell us to talk to Kai; my husband and I were more than happy to exclaim over his little face and rub his tiny hands. So here's who had been kicking around my belly for so long; who had shocked us with his presence one stressful Monday afternoon a few weeks after Valentine's day. We're so glad now; so glad.

~ * ~

"Heart tones sound great," my assistant midwife said, just as Kai gave a sputtering cry that turned into the high-pitched screech that we've since come to love and fear.

~ * ~

The rest of the morning is a blur. My husband cooked blueberry pancakes, eggs, veggie sausages, fakon, and oatmeal. Kai learned to nurse, the midwives weighed him on our old antique baby scale...

 ...and then on my midwife's hanging scale that looked like it should be used for weighing fish. After breakfast, my assistant midwife helped me upstairs and into the shower, while my midwife and husband performed the newborn exam on our bed.

My doula cleaned up so well it was impossible to tell I had just delivered a near-10 pound baby on our living room couch. We took lots of photos. Not like we could ever forget. It was perfect.

~ * ~

My doula was the last to leave, just as we were snuggling into bed together, exhausted and estatic. As she slipped out of our bedroom and closed the door, Kai smiled in his sleep – a huge, contented grin.

~ * ~

Life on Earth was good.

Categories: Homebirth with CNM, Doula assistance