Peace and Quiet - And something that resembles a birth story.

Sometimes anyway.

Life with three boys is interesting. Babe continues to grow apace. 8#13 at birth, probably around 11# now. Can't be bothered to weigh him, he's in 6 month clothes already. He sleeps a helluva lot and is content to be put down, schlepped all over, and is mauled countless times by his labrador-puppy-like brother who squeaks "Hi! Hi! Hi!" right in his face. Once again I've done the precipitous postpartum weightloss returning to my pre-pregnancy weight (if not my pre-pregnancy shape) in a little less than a month. Don't understand why this happens but this is the third time so I'm calling it my 'normal'.

H (now bedeviled middle child) is regressing right on cue and, without his preschool schedule is driving me spare. I'm tired of saying/yelling "No" a million times a day. Try hard to remain positive but have officially become of one mind with my Mother - School holidays are absolutely the WORST thing about being a parent. That summer holidays here are almost 3 months long amounts to cruel and unusual. Contemplate homeschooling (even though I'd suck at it) so they could be learning and occupied year round.

Have finished several knitting projects and read a couple of 800pg novels. Have luxuriated in not being on call, but consented to a brief weekend back on a week or so again when my MW got caught short with 4 mama's all stacking up. Didn't end up going even though I was excited by the thought. Many people called me mental. Realized that I will be back on call as of Aug 1 - less than a month away, and will attempt to get to somewhere around 8 births in that first month in order to complete this last irritating school requirement. 4 of those births I will serve simply as a birth assistant as new green student acclimates. I'm excited to watch her learning curve too! Alec will become the midwife's baby and accompany me to those births.

I think I mentioned that I watched my birth video the other week. It's since been shown to a group of trainee Somali and Latina community outreach doulas as part of their training and I'll share it with my small group of birth professionals tomorrow. I have been asked several times to tell the story more fully, and I'm trying to, it's just that the whole process was so simple and dramatic only in it's quiet perfection. My boy and my body decided it was time, I went with it and I suppose was supported in that lovingly by a group of women who I trusted with everything that went along with the birth. I had stumbled about before hand trying to figure out how one 'plans' for a homebirth but discovered that what we as midwives strive for over the course of care is this perfect trust and understanding that we will hold for you a safe space and do what is necessary to let you find your own best birth. My midwife and my friends did that for me. They let me build my space inside that pool, reaching into it only as they needed to (and over an hour-long active stage and an 8 minute second stage that aint a lot). They followed my cues, respected my wishes and let my birth just be what I wanted. But here's my best effort.

***

"This had better fucking be transition." (Me, charted by Julie, 28 minutes before birth)

Interestingly as I've pondered those events I have realized that being a midwife was only troublesome before the labor when I really needed to stop trying to midwife myself, and then at one point during the labor when I decided to check my cervix. I felt what I was quite certain (in the moment) was an anterior lip. It was at the most difficult part of my labor, the contraction before had been my 'wall' the point at which I clearly said in my head "I can't do this anymore". I told my midwife and she quietly replied "Well then, you know what to do." What to do in this situation (usually) equals don't push for a bit till that bit of cervix melts away. All I wanted to do in the world was push. There was no way on God's green earth that I was going to not push. After having a (completely silent mental) freakout I stubbornly pushed anyway, and maybe it was a lip and maybe it was simply a fold of vaginal wall I felt but in two or three more contractions his silky head was in my hands. No ring of fire, just the power of contractions (fetal ejection reflex, anyone?) and focus on counterpressure and supporting my own (!!) tissues and then the most exquisite relief as his face cleared my perineum.

"That feels AMAZING!" (Me, charted by Niki after birth of head, 2 mins before birth)

Husband was asked at this point if he wanted to catch, so he sidled sideways and touched baby's head as it sat there in the water. I had another student midwife moment as it registered silently that his head hadn't restituted (turned, in preparation for the shoulders to deliver). As we waited for the next contraction (about 2 minutes) I found myself checking gently for a cord and found nothing. As I touched his neck though I felt his shoulders rotate into the appropriate plane, and some movement of his hips, legs and head into the bargain. My third baby and for the first time I could feel his participation in his birth as he navigated the very odd angles which babies must to exit a pelvis. At about that time I felt another contraction build and then found myself pushing gently downwards on his head to help his shoulder slide under my pubic bone. At that point I told my husband "I've got him" and he took his hands off. His shoulders slid into my hands, my thumbs into his armpits and up he came slowly, out of the water, into my lap.

"He's a BOY!" said Hugo. "Can we get the Star Wars stuff out now?"

The other thing that I got to really understand was how important it is to leave the mother undisturbed for the period immediately following the birth. I know, I know I should have really understood this by now... but for whatever reason I hadn't really soaked that into my bones. We could all see how well flexed he was when he came out of the water. Even though his eyes were closed I knew he was 'there'. I could feel his heart beating through his chest, didn't even think to touch his cord. No one put their hands on him except me and then his brothers and his dad for the longest time. I was quietly, jokingly asked to give him an APGAR at 5 mins - it was 9, but who really cares? After loosely planning active management of third stage I instead quietly became aware of the separation gush as it blossomed at the bottom of the pool, recognized it as a normal, physiological amount of bleeding and simply stated "The bleeding's fine". A few minutes later my uterus began it's work again to birth the placenta. I asked my midwife to do some cord traction to deliver the placenta but it felt odd and awkward (like I was sitting on it) so instead I decided to hand off baby to his dad, my eldest son cut his brother's cord and I stepped out of the pool, squatted beside it on a chux pad and caught my own placenta 17 minutes after baby was born. It felt very primal and earthy and easy.

And then it was done. Some 6 or so hours of gentle (and I mean, hardly noticeable) early stuff, and then about an hour and a half of active labor. It was everything I could have asked for. Everything.

Other interesting things:

• He was born at 8.27pm. Oliver was born at 8.22pm and Hugo at 8.12pm. What is it about being born after 8 but before 8.30?
  
• 41 and 3 days gestation (rock solid dates). Longest pregnancy to date. No vernix, quite tired looking placenta. But let's be real - I was not the best nourished, well rested midwifery client ever. I may have challenged that lovely organ a bit with 5 weeks of subsistence of peanut butter sandwiches (on white bread thanksverymuch) in Vanuatu followed by a bout of pneumonia and then influenza a few days prior to the birth. Oh yeah and attending 70ish births during my pregnancy.
  
• Huge (and I mean almost 3ft) cord. No loops of cord (a first, both other boys had nuchal cords), no knots, only a few variable decels during the NST a few days earlier (probably that cord getting squished somewhere).
• Nuchal hand responsible for small perineal laceration which didn't require sutures. Healed beautifully.
  
• No perceptable rupture of membranes though there was something which may have (and might not have) been light mec observed with the birth of the head. I have a feeling there wasn't a huge amount of fluid left, no evidence for this, just a feeling.
• TEBL (Total estimated blood loss) = 350cc. Normal, reasonable, didn't even notice it.