I realize that I have totally neglected this blog (and website!), but it's true what they say...time really does fly! I've still been attending births although you would never know it from my relative internet silence. Today marks the day, three years ago, that my fourth child was born, and his birth taught me that it really is worth it to have a skilled care provider at your side, even when everything seems low-risk and previous birth history is completely unremarkable.
Just to be clear...I support the right of every mother to choose how she gives birth. Every choice comes with risks and benefits. However, I don't agree with the idea that a skilled, respectful care provider is an intervention in and of itself. Women have been choosing to have experienced birth attendants with them since recorded history; it's only in the last couple of hundred years that these attendants most commonly turned into surgeons...with disastrous results. After my first (fast and easy) birth experience in the hospital, I decided that I would rather have more personalized care prenatally and during labor, and that I would prefer to avoid the hospital if possible. I toyed around with the idea of an unassisted birth, mostly because we no longer had good health insurance...but after some careful thought and prayer, decided that we would choose a midwife who respected all of my decisions and would support a hands-off, physiological birth.
I found that in Janna Grapperhaus, CPM. She attended the uneventful birth of our second and third child, at home and then at her beautiful birth center in Charlottesville. Both births were short (2.5 and 1 hour or so, and straight-forward. And then there was Atlan, number 4.
Firstly, much to my embarrassment given my chosen work as a pregnancy/birth professional, I didn't find out I was pregnant until what turned out to be 14 weeks of pregnancy....because my husband made me take a pregnancy test! I have always had easy pregnancies, even in the first trimester, but with Atlan I didn't even have pregnancy cravings or aversions. My husband had been joking (I thought) that I was pregnant, but I was so sure that this wasn't possible that I completely brushed it off. But...there he was! Another boy. Three.....boys.....
The pregnancy continued uneventfully and relatively easily despite my shock and misgivings...FOUR children just seemed like craziness. Some days....it still does. My last two babies had been born at 41 and 41+4, so I knew that I was likely in it for the long haul. My other labors had all been fast, so we knew to prepare for another possible precipitous birth. When I woke up just 5 days past my EDD with a strong contractions, I was pleasantly surprised! Nervous about not making it to the birth center, I called by midwife...who just happened to be driving (home, at 3am!) close to our house. She offered to drive me to the birth center, so my husband got the other kids together and I got in the car with her and went to the birth center.
We got to the birth center, filled up the tub, and started the music. I knew that I wanted to wait for my mom to get there, so I focused on being somewhat still and just laying in the tub. I really didn't want to speed up the process. As my process, I'm not an "active" birther. I like to listen to music, sing, and lay in a tub, and not have anyone bother me. Thankfully, my midwife was willing to be hands-off and support these preferences. She even had the birth assistants hiding in the shadows! Every so often she checked Atlan's heart tones with the doppler.
About 2.5 hours later, my mom arrived (times might not be *perfectly* accurate....labor is a bit of a time warp). I decided that it was time to get the ball rolling and push this baby out, and contractions were definitely intense. I had planned to drain the tub so as NOT to give birth in water this time. Call me crazy, or call it an experiment...but I will say that it wasn't my best plan. I immediately regretted this plan, but it was really too late to get the water back in. This was my LEAST favorite experience with pushing. I have seen quite a few mothers LOVE pushing on hands and knees, or leaning forward, but this definitely did not seem to work for me in this instance. Still...he was roared out at around 6 am on November 12th.
Unlike my other babies, though, he didn't really cry, and his lungs didn't get properly expanded. He was, of course, still attached to the placenta, so he was getting some oxygen, but he needed more help. More help than I would have been able to give him. His breathing was very shallow, and he seemed very anxious and scared. None of that calmness that I had worked to facilitate for him after birth. Even with skin-to-skin and time to adjust, he just was not able to keep his oxygen levels up. His glucose levels were also low. Fortunately, we had oxygen on hand, a newborn pulse-ox to keep an eye on his oxygen levels, and glucose gel since it would be too dangerous to try to breastfeed him in the state he was in, due to the risk of aspiration. After a couple of hours which seemed like minutes, we had a hard decision. Do we call the hospital and transfer for a higher level of care, or continue to wait? But my midwife had one more "trick" up her sleeve.
I love homeopathy, but had never used it on a newborn. Janna suggested that we try a homeopathic remedy that is indicated when the individual is very stressed, hyper, anxious, and overly sensitive- Coffea. Yes, it's the homeopathic proving of coffee! She even had the tiny baby dosages of it, although she had rarely used it in hundreds of births. I looked at my baby, his little clenched fists and shallow breathing, and felt strongly that he didn't need to be in the hospital. He just needed to calm down and get some proper lung expansion and oxygen. So we gave him the coffea remedy, and within MINUTES his breathing slowed, his little body relaxed, and we all knew that he would be okay. I have never been so relieved, especially after having two other friends who had babies with similar issues in the hospital who ended up with babies in the NICU for over a week!
We never really did figure out 1) Why Atlan was so stressed by being born 2) why his blood sugar was so low, or 3) why he didn't get a good breath, although all of those could be interconnected. What I do know is that, without the skills, experience, and tools that my midwife brought to the birth team, Atlan's birth story could have been very different. He needed assistance that I just didn't know how to provide, and without Janna by our side, we likely would have had to transfer to the hospital and undergo antibiotics and a 48 hour stay at BEST. And I wouldn't been able to keep him with me and watch him like a hawk for the next week!
That's a long story to say that...I am so happy that I had a great care provider. I wish that all women had this option, although I know that many just don't. But I also think that it's worth a diligent search to find a care provider who will respect your autonomy and also step in when it's just necessary. Because sometimes, as mothers, we just need help.
And that's okay!
I look at birth from the perspective that our bodies are wonderfully made, and if we really believe that and work with the birth process and nourish our bodies properly, they will function optimally, most of the time!