Saturday, January 02, 2016

Heidi Annaliese's Birth

Short G-rated version:

Our fourth-born child and second daughter, Heidi Annaliese, was born on December 30th at 12:16am weighing 8 lbs even. We are grateful to God for a swift and uncomplicated labor and birth, and a healthy baby and mommy.


The longer version, for the dedicated among you who can outlast my ramblings:

My due date for this baby came and went. I was due Christmas Eve, though this was a "best guess" by an early ultrasound, as I could not remember my LMP for the life of me. Finalizing repairs on our house in Texas, a whirlwind of house showings, and a gradual return of health from our mold exposure can do that to a person ;-). Keeping track of dates was just not super-important to me ;-). I was vaguely aware of when I was pretty sure I'd ovulated and remember thinking "I should probably record my estimated ovulation, just in case I need it," but I never acted on that. The Christmas Eve due date did line up perfectly with my first positive test (and my negative test a few days earlier), so I'd say it was a reasonably accurate date.

I had really hoped to have this baby by Christmas, for no good reason except it fit my timeline. ;-) Up to that point, the baby had been in perfect LOA position for a few weeks, very low in the pelvis, and I felt pretty well physically, and aligned and ready for labor. My chiropractor had really helped with my tailbone alignment and core strength exercises the previous few months, and I'd had zero pubic bone pain or tenderness for the first pregnancy in my experience. Usually I spend the last month of pregnancy in pain when walking, because of the tenderness of the pressure of the baby on the pubic bone - even in Martin's pregnancy that overall had so much less chiropractic discomfort. So I was really feeling optimistic about my alignment and baby's chance of exiting without a huge deal.

Then I fell on our basement stairs and whacked my tailbone on Sunday, 5 days before Christmas, which set me back some in physical preparation for labor. My midwife's main concern (since the baby seemed fine and still plenty active, and I hadn't fallen on my front side) at this point was that my tailbone get a chance to heal some before going into labor, as laboring with an injured tailbone could be excruciatingly painful, particularly the pushing phase. So I went from poised-and-eager-to-go-into-labor to kind of in limbo, while waiting and wanting to have this baby, but really wanting to let my tailbone recover in the meantime.

In the 3 days after falling, I visited the chiropractor every day, which really helped. The baby had shifted its head sideways a bit after the fall and the head was no longer firmly engaged in the pelvis, but by Wednesday the 23rd, my tailbone and the rest of my skeletal system was holding alignment well, my tailbone tenderness was almost non-existent, and the baby's head was back in a nice location and sloped correctly. *phew* So we were back to the waiting game and thankful that I'd had the time I needed to get my rear back in gear, quite literally.

I was starting to get pretty discouraged a few days after Christmas, though, watching Adrian's school vacation tick slowly by and knowing when my dad and sister and brother-in-law were slated to leave (my mom had bought a one-way ticket and was able to be more flexible), and wondering if we'd spend all of Christmas break waiting and waiting. . . and I kept hoping I wouldn't have another super-late arrival like Martin.

I woke up Tuesday the 29th feeling like all the hypothetical ills of pregnancy, both physical and emotional, had descended on me. I knew this wasn't true, but it was really hard to fight off the discouragement and the intense grogginess (even after a good night's sleep) that about bowled me over and persisted throughout the day. I kept repeating to myself everything I KNEW, which is so much more true than what I FELT. I reminded myself how blessed I have been this pregnancy physically, how normal and totally within range it was to only be 5 days "late," etc., but I felt like I was fighting off demons of doubt all day. I hated it! I'd been hot-natured a lot the last month in pregnancy, but I was getting flushed and hot especially easily that day, and my fingers also were suddenly barely swollen enough to make my rings hard to get on and off. I was dragging physically and my brain was fogged, I kept messing up my words when talking. I was kind of a wreck.

It was so weird and sudden, and I had just been re-reading Baby Catcher, in which the author had the same thing happen with her pregnancies, where she would sail along just fine, loving being pregnant, and then BAM, the day before she went into labor, something happened and she felt physically and emotionally horrible, as if the weight of the world was on her, and then she woke up the next morning in labor. Anyway, I struggled through Tuesday, doing a lot of resting, and finally felt much more normal after a long late nap that afternoon.

I was feeling a lot more like myself at dinner and enjoyed playing Apples to Apples for a while after the kids went to bed. We started playing around 8pm and I had light contractions all through the game. I wasn't timing them and they weren't intense, but they were pretty often and definitely a bit more "real" feeling than all the painless Braxton-Hix contractions I'd had for weeks and weeks. But still extremely light cramping, nothing major.

After finishing our game we sat around and discussed other ideas for the evening, and we settled on watching a Poirot episode. We didn't start watching until about quarter of ten, which is rather late for me, but I said that I'd had a long good nap and knew I'd be wakeful for a while longer even if I tried to sleep, and "besides, I've been having a lot of light contractions the last couple of hours, so I'm wondering if I'm in labor."

That got everyone's attention! Adrian asked what he could do to help, and I told him the best thing he could do was leave me alone. Ha! This is so classically me in labor :-). I'm not mean or rude, but just don't want attention and certainly don't want the stroking and coaching and massaging, etc. I don't even want hand-holding or touching - from anyone. Which is why I've never invited friends or family  (except Adrian, of course!) to my births or had a doula. I want Adrian there, but he knows his main job is just to BE there, or help by getting me a drink or something. And everyone else (midwives, etc.) is there for strictly safety and other physical support reasons.

So we all sat down and got about an hour into a Poirot episode (Death on the Nile - great, calming birth episode, hehe). At some point past 10pm, I let Adrian "do something," meaning, I let him time several contractions, and then he called my midwife Kathy to let her know I was probably in labor. I was having to start concentrating some during contractions (though still wasn't noticeably acting differently and just sitting there calmly watching the movie) and they were about 5 minutes apart or so, and over a minute long. Kathy said they'd start heading our way.

One thing that was very different about how I mentally processed contractions with both this labor and with Martin's (v. Hans and Gretchen's labors) was in visualizing my cervix opening. With Hans and Gretchen, I tried (semi-successfully) to relax during each contraction, but I still had a mindset of that intense cramping being a somehow foreign thing happening to my body. (This was especially true with Hans' labor.) I really tried to recalibrate myself during Martin's pregnancy to think of the contractions as serving a very useful purpose. Not just a random collection of birth pangs that eventually ended in complete dilation, but as individual steps that were actively opening my cervix little by little. With each contraction I visually pictured the baby's head bearing down and slowly opening my cervix, and it really helped me to see each contraction as a means to an end and as a positive thing (although discomfortable and eventually painful, as labor progressed), not just something to endure.

Claire, one of the assistants, arrived maybe 30-45 minutes after Adrian called Kathy, and started getting stuff set up and getting out birth supplies - which was reassuring, as things were starting to pick up and I liked having someone on the premises who could catch a baby, if necessary. I'd offered that job to my brother-in-law, but he wasn't eager, go figure ;-). And actually, with about 30 minutes to go in the Poirot episode, with me getting up more frequently to head to the bathroom or such, Hannah and Justin just turned off the episode (we finished it the next day) and headed down to bed, without even asking us! The nerve ;-).

My parents and the kids were already settled down in the basement to sleep too, so we had the main floor to ourselves. We had vacated Martin's room, which is next to ours and has very little furniture in it, and moved the birth pool (which had been inflated but upright in our room for a few weeks) in there. I was still mainly in our bedroom for contractions, leaning a lot on the birth ball while kneeling, sometimes standing or swaying, and I was having to breathe deeply through each contraction now.

Our midwives, Kathy and Brandi, arrived before too much longer, maybe about 11:30? Not sure. And Adrian filled up the birth pool, but we quickly discovered that even our very HOT hot water heater (which we had turned on very high for the last few weeks to be ready, and had been burning our hands with for this purpose :-P) was just not enough to fill up our pool, so we ended up with a half-filled pool with tepid water at best. Kathy and Adrian started boiling water in our large stockpots to supplement, as my contractions got more intense and closer together.

I got in the water just a bit (to my waist) to get a feel for the temp, but quickly decided that I couldn't possibly relax through contractions in there, and Kathy had just checked me when she arrived, and I was at 8cm, and I didn't want to be in cold water when it came time to push. (With Martin, I went from 7cm to complete in a few minutes, and this birth was feeling like de ja vu in how it was progressing.) So I got out and moved to the bed, using the birth ball to kneel for a few more contractions. At this point they were really intense, I was having to vocalize/moan pretty loudly through them, and then I could feel the baby's head start to descend. Yep, I was definitely going to be having another land birth, not a water birth ;-).

Honestly, I still haven't figured out the best way for me to push in labor when on land. I delivered Hans in a big jacuzzi, and I didn't even have to think about positioning, which was the advantage of being buoyed up by the water. With Gretchen, I moved to the pool at 10cm, and although her birth pool dimensions and height weren't ideal and made for some positioning challenges, it was still easier than pushing out of the water. And for Martin's birth, he came so fast that I had the odd experience of not pushing at all. My body did all the work and he was out in a few pushes, and my job was basically to not add to the already-quick delivery. So I didn't know what to expect this time around.

This labor was definitely a bit different than previous ones, in that I could definitely tell that with the contractions, they stayed more productive and intense (even in transition) while I was upright, whereas with Martin's, for example, I labored on my side for most of the (short) labor, and birthed on my back, because there was no time to think about positioning and he just flew out before I could get up and get to the birth pool. I know some women like delivering in a side-lying position, but I quickly discovered with Heidi's birth that my legs were completely clamped together in that position when a contraction hit, and it would have taken a vise to get them apart during a contraction in that position. At least on my back, I had gravity to help open my pelvis, even if from many perspectives, back-delivery isn't ideal.

So when it became evident that this baby was coming NOW and the pool was not happening, I quickly settled into a back-lying position, for no other reason than the thought of increasing the intensity of pushing by squatting was NOT attractive. I did fine, though, but much like my contractions being stronger while upright, being on my back just wasn't producing very productive pushes. The baby wasn't stuck and was gradually descending, but it just wasn't as fast as it could be. After a few pushes Kathy said the baby would come either way, no worries, but it would be quicker and easier overall for me if we could just get me tilted up a bit. After my previous experience of not having to push with Martin, I had to re-calibrate the expectation that yes, I'd have to put forth some effort to push this baby out ;-).

I said I couldn't lean myself forward to be propped up so Adrian and Claire (I think?) leaned me forward and shoved some pillows behind me. It's amazing what just a little extra angle can do, and the next few pushes were definitely more efficacious, but Kathy suggested that it would be even better if I could grab my knees and lean forward, which I did. The baby's head quickly crowned after a few pushes and at that point the sensation was so intense that I couldn't hold onto my knees and asked the others to keep them in place (the only time I asked anyone to touch me the whole labor, I think!), which definitely helped. There is nothing quite like the relief of feeling a baby's head slip out, followed by the body!

Heidi immediately started wailing on exit, so we knew she had a good set of lungs! She was born at 12:16 am, and my parents and sister and brother-in-law could hear her healthy cries from the basement. They came up after a bit and waited in the living room to hear more news. We hadn't found out the gender beforehand, but as soon as she was lifted to rest on my abdomen, I could tell she was a girl. When she was weighed later, after placenta delivery and nursing and such, she was 8lbs even, which kind of cracked me up since she had measured so low in fundal height the last 6 weeks of pregnancy, for some unknown reason. Apparently she was just really low and really curled up or something! Martin was my next biggest baby at 7lbs 8oz.

The cord was a bit short, so I had to wait for the delivery of the placenta to latch her on, but then she nursed eagerly while we both got examined. I had a few minor skid marks, but didn't need stitching. I basically have had minor tears in the exact same place with all 4 deliveries. I've been stitched the other 3 times, but this time my midwife suggested letting it heal on its own and lessening the scarring as a result. So it was kind of nice not to have to pause for stitching up, and I've had very little tenderness and no swelling this time around.

For the first delivery in my experience, my midwives were also able to offer some easing and support with pushing. That's not as possible in a water birth (but the water can help with that), and Martin flew out too quickly, but this time as I started to push and as the baby's head crowned, our midwife Brandi gently stretched my perineum and massaged it with some arnica oil, which definitely was not a pleasant sensation, but I could definitely tell it helped, along with the hot compresses they used.

We are so grateful to God for an easy birth, and once again, I really enjoyed being able to stay at home and not worry about birthing in a car or anything. It's nice to settle into your own bed to rest after the birth. I've also birthed in a birth center (for Hans) and a hospital (for Gretchen), and they weren't horrid experiences and great options to have. I think a woman should pick a birth option with providers that are skilled and respectful of them, but that doesn't have to exclude non-homebirth options :-). But it's also nice that so many non-American nations ;-) recognize the safety and even benefits of homebirth for low-risk women. I'm grateful for the option for myself!

And for handy reference, my other birth stories:

Hans Friedrich

Gretchen Liesl

Martin Wilhelm