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Katie's Birth

by Donna Sarapata

I had an unassisted birth for my second child. At the time, I thought it was unplanned, but now I'm not so sure.

My first daughter, Betsy, now 4, was born at home in Miami, Florida, where midwives are legal and readily available. I had a wonderful birth. Well, OK, they did have me pushing while they counted to 10, and I had a small tear. It certainly wasn't the sort of disaster that you write Nancy Wainer Cohen about. I just didn't plan to push like that again.

Then I moved to New Jersey. The midwife closest to my house, just across the New York State line, has been barred from practicing in New Jersey. Another midwife moved right after I became pregnant. I found myself asking two midwives who had originally told me I was too far north for their practice to reconsider - even though the drive would be 75 minutes. My mother's second labor was only 2 hours.

That was in 1968. They had to push on the baby's head and give her general anesthesia to keep her from giving birth before the doctor arrived. My sister was pulled out with forceps. She was grateful that they had been able to stop her from giving birth without her doctor. You would think that this barbaric behavior would have stopped by now, but a dear friend just let her doctor induce labor 3 days after the estimated due date so that he could attend her birth. He rotates, 2 weeks on call and 2 weeks off. The baby was 6 pounds, covered with lanugo, and spent a week on a respirator due to "immaturity of her respiratory system." The pediatricians have carefully avoided using the word "premature" in the parents' presence. But I digress.

The midwives agreed to take me, and to let my aspiring midwife friend Tracy serve as apprentice for my birth. It was going to be her second "catch," and her first official supervised birth - she needs to attend 25 to meet MANA guidelines. I also invited three other friends who want to start attending births. I figured that it would be nice to have someone to take pictures, and someone to entertain 3-year-old Betsy if she got bored.

I also asked for extra exam gloves in my birth kit, in case anyone wanted to practice internal exams. Of course, I know they're not usually needed, but it's a necessary skill that a midwife can only learn through hands-on experience. I was certainly willing to put up with a little discomfort in the interest of midwifery education!

At around 3am, Monday, October 3, Betsy climbed into my bed. I had trouble getting back to sleep. I realized at around 3:30 that I was having contractions. This was not particularly unusual - for at least the last month, every night after eating dinner and doing the dishes, I would sit down, put my feet up, and have contractions every 5-10 minutes until I went to bed. However, they had never kept me up at night. Timing them with the digital alarm clock, they were 2-4 minutes apart.

I decided to walk around. If they didn't stop, I would call the midwives. I sneaked out of the bed and went downstairs. On the steps, I had a contraction strong enough that I couldn't stand up straight until it was over. Not painful, just intense. That certainly meets the threshold for waking someone up at 4:15am.

I cheerfully related the above details to one of my midwives. She said she would call the other, and they would come right over. I then called Tracy, my friend who was going to catch my baby. I wasn't as peppy for this conversation. My husband came downstairs while I was talking to her, and I let him call the rest of the guests as I was now having a hard time talking through the contractions. Only one of the husbands seemed concerned about a strange man calling his wife at 4:30am!

I decided to go to the bathroom. I laid on the couch for several contractions after making this decision. I finally realized that I was going to have to do it in stages - go into the bathroom, lay on the floor during a contraction, then sit on the toilet. This necessitated a trip back upstairs as the downstairs bathroom had no rugs on the cold, hard tile.

When I made it to the bedroom, I decided to rest on the feather-filled futon we had placed on the floor in our bedroom for the new baby. Fortunately, K-Mart had been out of nice, thick mattress pads and I had had no choice but to get a crummy waterproof pad with a noisy plastic backing. I should have known I'd end up having the baby there. I never got around to going to the bathroom.

After helping me upstairs, my husband was doing stuff like unlocking the door and turning on lights. He returned during each contraction to press on my tailbone, which equalized the pressure and virtually eliminated the closest thing to pain I had experienced. It didn't really hurt, it was just a lot of pressure. I kept wondering what he was going away to do that was so all-fired important that it couldn't wait!

It turned out that he was trying to gather birthing supplies. I had put everything in a cabinet in the bedroom, and showed it to the midwives so that poor John wouldn't have to run around the house fetching stuff like last time. I hadn't bothered to show him. He must have ransacked the entire kitchen to find a bowl just in case I threw up - the bowls were in the bedroom cabinet. He triumphantly brought a Tupperware container, but since I wasn't nauseated, I wasn't particularly impressed. I told him not to leave.

At this time, I became aware of a sensation that I was holding back. I made a conscious decision to try to relax and open during the next contraction to see what would happen. I felt a popping sensation - not my water breaking, but reminiscent of what my mother said she felt when she decided to quit writing thank-you notes in the fathers' waiting room and go lie down. I also felt a lot of movement. Not wiggling - the whole baby just slid down all at once.

I told John where the chux pads were. He got one. I was in the process of telling him to get a dozen out and spread them around when I had another contraction. At this point, Betsy, who was asleep in our bed, woke up. He wanted to go get her, but I told him not to leave and called her to come over to us. I was lying on my side, facing away from her. She just stood there beside the futon, quietly watching.

My water broke during the next contraction. During each contraction, I was quietly breathing, "oh . . . oh . . . oh." John later said I sounded like I was having sex. But once or twice, my abdominal muscles seemed to tighten for a few seconds and I would grunt. Immediately following these brief, involuntary pushes, when the muscles relaxed, I felt the baby move down.

I asked John if he had seen the head. I believe this was his first indication that I wasn't planning to wait for the troops to arrive. I described to him the location of the bulb syringe and gave him instructions on how to use it if the baby seemed stuffed up - squeeze first, then put it in the nose and slowly let air in. Take it away and squeeze again, then put it in the baby's mouth and gently let air in. During the next contraction, he saw the head.

I tried to explain to him how to support my perineum so that my skin wouldn't tear. I was surprised when he placed his hands so far apart that they touched my legs. I felt my baby's head gently ease out of my body. I asked him to look for the cord and loosen it if it was around the neck. He said it was over the shoulder and looked OK. I then explained that the shoulders would come out one at a time, and told him to support the skin as the first shoulder came out so that I wouldn't tear.

During the next contraction, my baby was born. I could feel that there was still something inside me, but I thought it was just little feet. John asked if it was OK to pick the baby up, and I said yes. The baby was actually still inside from the waist down. He placed the baby on my chest and covered it up with a towel. I asked him if he could hear any breathing and whether the baby looked pink. He said he couldn't hear anything with me talking and couldn't see the baby under the towel. Of course, I could feel the baby breathing and see two little eyes looking directly at me, so I wasn't really worried.

We invited Betsy into the bed, and she sat next to John, looking at the baby but not touching. She later said that she didn't want to touch the baby because it was sticky. When I started to tell her that this was her new little brother Bobby, John suggested that we check under the towel. I thought that he had gotten a good look at the baby when he picked it up, and had assumed that he would have told me if it wasn't the boy we had decided it would he. He still proudly boasts that both the midwives and the doctor eventually confirmed his "diagnosis" - she's a girl, Katherine Ann!

Finally, we heard a car pull up in the driveway. Tracy bounced in, casually looked at Katie, said something reassuring, and started looking for the placenta. She told me that it had already separated, and that if I sat up and pushed, it would fall out. Sure enough, it did.

About this time, the two midwives arrived. Beth followed soon after with her two kids and the video camera. At least she got the birth story on tape! My favorite part is seeing Betsy in the background, wiggling her fingers in a tiny wave and saying, "Hi, Bobby - I mean Katie," while watching Kate nurse. I didn't notice that at the time.

I was surprised at how enjoyable the exquisite sensations of giving birth were with no one distracting me by telling me what to do. After all, I had a nice homebirth with my first child; I didn't think it could get any better. Also, I had no tearing, no swelling, and no hemorrhoids. I now feel that they were a result of prolonged (and unnecessary) straining.

Still, it would have been nice to have pictures. It would have been nice to have Tracy there so that she could "count" it for her certification. I guess Katie was just more concerned about our enjoyment of the process, and she knew she had to hurry to avoid the circus.

I realize now that although I didn't get the birth I planned, I got the birth I wanted. We'll probably get a midwife for our next baby - it was nice to have someone there to examine both of us after the birth. We'll just ask her to sit in the living room until we call her.


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