Facing the Dragon
My first child, Anton, was born after a “failed” homebirth, when our midwife diagnosed me with preeclampsia at 36.5 weeks. I was hospitalized, induced with pitocin and prostaglandin gel, and was on magnesium sulfate for three days, and I was nearly on the operating table when labor finally kicked in. My actual labor with him was quick and painless, but both he and I were pretty traumatized by the experience. After much research on the subject of preeclampsia, which included speaking to my birth mother (I’m adopted), I came to the conclusion that preeclampsia is more of a clinical disease, and that I hadn’t really been ill, until after I went to the hospital.
Three months into the pregnancy with our second child, my partner Max was transferred to The Netherlands by his company. We were planning to do a homebirth with Dutch midwives, but from the very first appointment with one of them, it became clear that the Dutch midwives and midwifery system were even farther from our idea of an “ideal” midwife than our American midwife had turned out to be. I had met Laura Shanley on-line about a year after Anton was born, then met her in person for tea and read Unassisted Childbirth. I had stuck this idea about unassisted birth in the back of my mind as a back-up plan, in case we couldn’t find a midwife to take our case for a second pregnancy. After just a couple of dreadful appointments with these midwives, I started thinking pretty seriously about it. I planted a little seed in Max’s mind one day over lunch, asking him if he would be frightened to deliver the baby by himself if s/he came too fast for the midwife to get there. He hardly even had to think about it before replying that he would be completely fine with that. Eventually, our conversations got around to discussing how we would handle the situation if the midwives insisted I go to the hospital, but I didn’t think I needed to, a situation that seemed to be fairly likely. Max was totally and completely there: yes, we could and would do this on our own if we needed to. We finally came to the place where we decided we really wanted to do this birth alone, regardless of what transpired with midwives. This was such an amazing decision-making scenario, we really dug deeper and deeper into the soul of our relationship to come to this point, a point of complete trust in each other.
By the third trimester of the pregnancy, we had basically withdrawn from the midwives as much as possible. We went to our appointments, but we never asked questions or volunteered information. We probably would’ve dropped out of prenatal care completely, except that I was worried that if the baby were born without being in some sort of socially-sanctioned prenatal program, we might have a difficult time getting a birth certificate, and then a passport, and I could just imagine the nightmare of trying to get our child out of the country and back to the U.S.. Each appointment was incredibly stressful for me, increasingly so by the seventh and eighth months. The appointment that was scheduled for the exact gestational age when Anton was born was particularly stressful. Sure enough, my blood pressure was up to the exact level as on that fateful day three-and-a-quarter years before. However, from having consistent appointments, there was a pattern of slowly rising blood pressure from the sixth month onward. The interesting thing, too, was that the Dutch midwives and medical system only regard high blood pressure to be a problem when the diastolic is greater than 100. So at the 36.5 week appointment when the diastolic reached 90, they suggested that I needed to start taking two long naps or lying-down rest periods a day. I tried to do this as much as possible with an active three year old, and by the next week it was about the same. But at the next appointment (38.5 weeks) it was up to 98 and 96 on two different readings. Still, I felt fine, except when I had to go to these appointments, and then I would just feel the adrenaline surging through my body, so I was pretty convinced that these high readings were mostly due to acute stress. By this time (which was a Tuesday), though, the midwifery clinic was ready to refer me to the hospital. Although I knew I wasn’t going to the hospital, they called to make the appointment, and couldn’t get one until that Friday, so they decided I should go home, be in bed as much as possible, but they wanted to see me on Thursday.
I felt besieged and somewhat depressed as we were walking home. Max was more cheerful and up-beat, and kept playing an old Bob Marley song, “I’m a Rebel” over and over again when we got home. He said something to the effect of, “Look, you feel fine, you look fine to me, and this is exactly the scene we were expecting, and we’re prepared for it, so don’t worry, we’re going to handle it.” Wow, I don’t know how I could’ve done it without his amazing confidence and courage!
Anyway, the next day, Wednesday, Max went to work, but told them he was starting his paternity leave on a part-time basis that day, so he could come home and take care of Anton in the afternoon so I could rest. He came home in the early afternoon, and took Anton to the park while I showered and napped. When they came home several hours later, we were going to take a batch of pregnant-belly photos, but I felt very dreamy and still sleepy, and I was feeling a lot of Braxton-Hicks. He told me I should just “let it happen” if it was time. A little while later, we were starting dinner, and Max had to go to the store for a few things. We were standing in the kitchen discussing the shopping list, and I noticed that I could see an aura around Max, and at the same time I felt a little “squirt” sensation in my bottom. I didn’t think much about it, and Anton and I continued to make dinner. Anton was washing broccoli, but eating most of the broccoli, so I took a picture of my funny vegetable-eating kid, and as I was walking across the floor to put the camera on the shelf, my water broke! I rushed to the bathroom, and the water just poured out. It was so very exciting. We had purchased a cell phone just so I could reach Max quickly in case the baby came really fast, and although I was pretty sure it wasn’t coming that fast, I thought it would be fun to call Max at the store, so I sent Anton to get the phone. By the time he jumped around, exclaiming “The baby’s comin’ out, the baby’s comin’ out…!” and got the phone to me, Max was already at the door. “Papa, the baby’s comin’, come look!” I don’t know if Max expected to see the baby already half out, but it was quite the scene.
Unfortunately, the amniotic fluid had a fair amount of meconium in it. I had read that this is a pretty serious problem, showing that the baby might be in stress, and that the baby might breathe the meconium into its lungs, causing respiratory distress after birth. I was feeling very ethereal at that point, though, and just couldn’t get very distressed about this turn of events. (In thinking back on the events of the previous day, I could just about pinpoint the moment when I had felt intensely stressed by the seeming repetition of birth history, and I really believe that was probably when the baby became frightened as well and passed meconium.) We decided to try to listen to the heartbeat, just to see if it was good and strong. Max had been able to listen with his bare ear for months, and we had read that an empty toiletpaper roll works about as well as a fetoscope, but with all of Anton’s noisy excitement and the contractions coming, Max wasn’t able to hear it. I just sat down and took some big deep breaths, thinking to the baby, “Tell us if you’re okay, we need to know,” and the baby starting kicking vigorously. This made me feel very reassured, peaceful and happy, to know s/he was doing fine, and that I could just ask, and s/he would “tell” me.
The contractions were not too strong, but they were pretty regular, between five and seven minutes apart. So, we finished making dinner, and ate. During dinner I was starting to need to get up and walk around during each contraction. Since Anton had been outside playing a lot that day, and also jumping from all the excitement earlier in the evening, he thankfully asked to go to bed early, and fell asleep with Max fairly quickly, then Max ran out the door to take the dog for a walk at about 9 o’clock. The contractions were getting pretty strong, and I was a little desperate that he should be fast with walking the dog. I finished clearing the table from dinner, then started trying to select some music for labor. It was next to impossible to concentrate, though, and I only managed to pick out two CD’s, one from a good friend that had arrived only the day before in the mail (!), “The Planet Sleeps,” and one from my favorite jazz vocalist, Tuck and Patty’s “Tears of Joy.” When Max returned from walking the dog, he moved a coffee table upstairs and set up the “nest,” changing the bed into old but sanitized sheets and blankets, and laying out our box of stuff (I had gathered a birth kit, which included no less than about 70 items, of which we used a handful!).
Contractions were getting a lot stronger, in fact much stronger than I remembered them being with Anton’s birth. The position that made them okay was all fours with intense lower back massage, just like with Anton’s birth. Fortunately, this time we were well stocked with Arnica massage oil! Soon after we got going with the right position and massage, I clearly was in transition: the contractions were coming right on top of each other, I was sweating during them but cold and clammy between, I sometimes was feeling unsure, especially wondering why this labor seemed so much more intense than with Anton. Max was terrific – he seemed intuitively to know when to massage harder, when to breath with me, what to say; once when I whined about how much harder this time seemed, he just very calmly told me that I didn’t remember how intense Anton’s birth had been, and that’s all I needed to hear! I remember looking at the clock, noting that it was about 10:45, and thinking, “Wow, this baby’s going to be born at almost the same time of day as Anton” (11:30 at night).
But, s/he wasn’t born by then. In fact, Anton awoke at around midnight, and I was still having contractions which were pretty intense, although the sweating and cold shakes had subsided. When Anton came into our room, I felt a moment of panic, because I didn’t know how I would manage if Max had to go put Anton back to bed. This was quickly resolved, though, because Anton hardly noticed that anything was happening, and he just planted himself in bed right next to me and fell back asleep. Although at first I found his presence a little disconcerting, soon I actually found it comforting, because it seemed like if Anton could sleep through this whole process just a foot or so away, then all must be well. Another aspect that was really wonderful, was that the baby was very active, kicking often between contractions, so I felt very certain that s/he was doing great.
Shortly after Anton came into our room, the contractions backed off significantly, both in duration and in intensity. I took this as a sign that the pushing stage was certain to begin soon, that this was the resting period many women get between transition and the pushing stage. Well, 1 o’clock came and went, and no pushing urge; 2 o’clock, and still contractions were steady and strong, but no urge to push; 3 o’clock…. We tried other positions, like squatting, standing up and leaning, sitting on a short stool, and sitting on the toilet, but everything felt unbelievably uncomfortable, and just simply wrong. So we just kept going with the all fours position, with pillows strategically placed so that we could fall over between contractions and rest. I actually was able to fall asleep between contractions! A couple of times I felt something move down, then pop back up across a bone or something. It was quite puzzling why the pushing stage didn’t resume. Still the baby was kicking, especially in response to my mental queries, so I felt all was fine.
Finally, at 4 o’clock, Anton awakened, and after taking in all the chaos around him, demanded, “Hey, where’s the baby, why hasn’t the baby come out?” It was quite humorous, and somehow changed the entire energy of the room. Although we had decided beforehand not to try any cervical checking, I now thought it might be a good idea. Max washed his hands thoroughly, and tried to feel if dilation was complete. He said he could feel a lip of cervix, but he couldn’t feel far enough to the other side to estimate if dilation was 10 or any other number for that matter. I asked if he could feel the head, “Oh, yeah, I can feel the head, with lots of hair.” This just sent a bolt of happy excitement through me – a head with hair, a real baby with hair!! I was suddenly so inspired to get this little person into the world!
The previous morning (before labor had started), I had felt the cervix, and it had been very soft and thin, but now I felt a fairly stiff lip of cervix (maybe this was what I felt popping back and forth earlier). I had read that it was a good idea to take a dose of homeopathic arnica just when the pushing stage was commencing to minimize the swelling of the perineum, so I had arnica on hand. I thought this might help with a swollen lip of cervix, so I took a dose of it then (actually, a “dose” is hardly what I took, I was supposed to take 10 drops under the tongue, but a contraction started right then, and I just took a swig of it!). I had planned to check the cervix again after a few more contractions.
After a couple of contractions, I had this thought that I wanted to go to the bathroom. It wasn’t that I really needed to go, and the toilets were unbelievably uncomfortable in Holland (designed for people who are all six feet plus, leaving short me with feet dangling), but I just wanted to go there. So Max and Anton helped me there, and sat on the floor having a conversation while I sat on the toilet. Suddenly, I had this contraction that came on without any forewarning, and I found myself uttering an unbelievable and uncontrollable sound – deep, growling, loud – Max looked at me with complete shock. Without feeling like I was pushing, I felt the head move down and almost out, I was sure! Breathless with amazement, I told Max, “I think the baby’s head is almost out, could you check?” He looked and felt, and sure enough, the head had just crowned. Somehow, we decided to move quickly back to the bedroom, so Max pretty much carried me back there, holding the baby’s head so s/he wouldn’t be born.
We got to the bed, and I was sort of sitting up, leaning back. I had this desperate desire to see the baby being born, and had bought a special mirror for the occasion, but realized that setting up the mirror was probably out of the question, so I asked Max to take a photograph. He looked at me and said, “Now?!!” “Yes, with the point-and-shoot!” So, we have one photograph of the baby being born. Although I had thought I would give birth in that semi-sitting position, so I could see the baby being born, again, the position that felt right was the all fours position, so I flipped over. Max was using arnica massage oil on the perineum (doing a great job!). He told me when the head was completely out, and I asked him to watch for the head to turn to one side or the other (restitution). Then I asked if he had checked for the cord around the neck, “Oh yeah, no cord!” I still didn’t have an urge to push, but the next contraction brought the upper shoulder out, so Max told me. Then very easily out slipped the rest of the body!
I had had this notion that I wanted to lay the baby on my lower belly and let him/her crawl up to find the breast. The moment after s/he was born, s/he let out a lusty holler. I looked back sort of over my shoulder, and saw this little face just puckered up like s/he knew exactly what s/he wanted right then, no crawling up a belly or anything of the sort, “Give it to me now!” It was a very compelling look for me, and I flipped over to a sitting position, hurdling the umbilical cord that was still attached to both of us. I took the baby in my arms and put that little puckered mouth to the place it was seeking, and s/he began to nurse immediately, like s/he had been doing it for months already! Max wrapped the baby in a receiving blanket, put a baby hat on, then covered both of us with a big blanket, and took a photograph.
While I was sitting there nursing the baby, I overheard a little conversation taking place between Max and Anton. Anton was asking what that thing was that was attached to the baby, was it a tail?! “No, that’s the umbilical cord,” said Max. Oh, yeah, I thought, better check whether we have a boy or a girl. I was so certain throughout the pregnancy that we were having another boy, I was not a little blasé about checking, I just knew it was a boy, in fact I could feel the penis, since the little guy was straddling my arm. Or was that a penis? But it was kinda long for a penis. What is that thing, anyway? Oh, no, it was the umbilical cord I was feeling (oops…)! I dug through the layers of blankets on the baby to reveal that we had a girl! I was so shocked, I let out a whoop and exclaimed, “It’s a girl, how could it be a girl?!!” I think I looked again and again, because it was such a surprising turn of events. So, here was little DariyaClaire, lovely and chubby and pink and slurping her milk like she’d been in the world for a long long time, not just a couple of minutes!
Soon after I felt a contraction where I had a slight urge to push, the first time in the entire labor that I felt like pushing! It quickly passed, but came again a couple of minutes later, and much too quickly for us to get a bowl under me, what with Dariya in my hands and me still being pretty huge and cumbersome, so the placenta plunked itself out on the bed. Max picked it up, plopped it into a bowl, clamped Dariya’s side of the umbilical cord and cut it. (I had sterilized two pairs of scissors, my very sharp sewing scissors and Anton’s blunt-ended craft scissors [in case the cord was wrapped too tightly around the neck], because I hadn’t been able to find blunt-ended surgical scissors at any of the medical supply stores in the city. Now, every time I use my scissors for their everyday purpose, I feel a certain energy exuding from them – they’ve almost become a talisman!) Max took the placenta to the bathroom to look at it, and it looked very complete, so nothing to worry about. This birthing thing was pretty easy!
In retrospect, I was astonished at how smoothly things had gone. Max knew exactly what to do and when, but also that I was thinking clearly enough to know myself all the things that needed to be checked for. Certainly, I didn’t feel like I was “out of it” and needed someone to tell me what to do, we were working well together as a team! Anton was truly heroic during this birth, too, handled it with great aplomb. He wasn’t frightened at all, just wanted to know what was happening. When Dariya was born rather suddenly, Max asked him to get things like towels and blankets for us, and he was as efficient as any adult would have been, maybe more so, because he was completely focused and not worried or freaked out by it all. I hope on some deep level, he understands that this is what we wished for him, and that this birth was in some ways his birth, too.
I started feeling a little gooey sitting in the bed with no clothes on, so I handed Dariya to Max and went to the bathroom. I got up by myself, walked there, peed, discovered that I hadn’t torn at all, and in fact the tissues were not even swollen or sore (the arnica and Max’s deft massage and support of the perineum during birth perhaps? maybe also because I never tried to push?), cleaned myself up a bit and put on underwear with a menstrual pad and a t-shirt, came back to the bedroom, noticed how lovely Max and Dariya looked together and took a photograph. Not bad for having just birthed a baby not even a half hour earlier, eh?! We decided to take Dariya to the bathroom and wipe some of the goo from her, too. As we were leaving the bathroom, I picked up Anton and swung him around, gleeful, ecstatic. I laughed when I realized that you’re not “supposed” to be prancing around carrying a three-year-old right after you give birth, but that’s what I felt like doing. It was magical.
About an hour after she was born, after Max had changed the bedding (Mud the dog “helped” clean up some of the afterbirth, too, while we were in the bathroom!), Max called his parents to tell them the good news. He only told them it was a girl, we were all doing great, but that he had to go, because we needed him. He had already put the first load of laundry on to wash. A couple of hours after she was born, Max tried to call the midwife who was on duty for that week. The telephone number we had, though, did not reach her, there was only a message in Dutch, after which Max left his own message. We expected a phone call shortly. They didn’t call and didn’t call. It was rather puzzling. When it got to be office hours, Max called his office to start paternity leave on a full-time basis, then called the Kraam Bureau.
In Holland, the Kraam is a system of postpartum doulas or midwives who come to the new family’s house for a week or so after the birth to help with the baby and check on the mother, all this covered by health insurance. They come for four to five hours per day, clean the house, prepare meals, play with older children, teach new parents how to bathe the baby, measure the baby’s and mother’s temperature, help with breastfeeding, and do whatever is needed. The Kraam nurse is always present at a home birth to assist the midwife, so the Kraam Bureau was very surprised when Max called them to tell them that we had had a home birth, but without either a midwife or a Kraam nurse present! The Kraam nurse was the first to arrive at our house, about six hours after Dariya was born! She rushed in, rushed upstairs to where I and Dariya were resting and looked astonished that everything was in order. She kept thinking that she must not have understood the English, “Really, the midwife wasn’t here at all for the birth, the midwife hasn’t been here yet?!!?” Max had tried several more times to reach the midwife, but with no luck, so he called the midwifery clinic to tell them about the birth, and to cancel our appointment for that day. The receptionist was speechless, but finally managed to stammer out a congratulations. Soon after, the midwife arrived at our door. She, too, had this horrified shocked look on her face until the Kraam nurse told her in Dutch that everything was just fine. “But how did you cut the cord?” “How did you know to clamp the cord?” “What did you do with the placenta?” This may have been the thing that most astonished them, that Max had actually checked that bloody thing and knew how to tell if it was complete or not. They were further astonished when they saw what a big luscious baby Dariya was – four kilos right on the nose (eight and a half pounds), and I didn’t tear at all! We were walking around like cats-who-got-the-cream in a big way!
Getting a birth certificate, the thing that kept me chained to the midwifery clinic for all those stressful months, turned out to be a breeze. Max had to go in person to City Hall, tell them the details about the birth, and they issued a birth certificate in all the official languages of the European Community. This had to be done within three working days of the birth, otherwise it would’ve been the bureaucratic nightmare we half expected. But, we didn’t need any document from the midwives, or sworn statements from witnesses, or anything at all. A couple of weeks later, we already had her passport in hand, faster and easier than getting ours done back in the U.S.!
The day after the birth, I decided to have a look at the placenta myself. The membranes and cord were still attached, and I was just really curious what it was like. So, I picked it up, letting the membranes fall into their more-or-less natural shape. I was certainly amazed to see that the hole in the membranes where Dariya had been born was right next to the placenta itself! As I was looking at this trying to visualize how it was positioned in my body, I slowly realized that I had very close to a placenta previa case! Somehow, that piece of information made the course of labor make sense: those five hours of labor after transition may have been necessary to get the baby out past a very tricky placenta perhaps partially blocking the cervix. I was very thankful not to have had an ultrasound during pregnancy, because this was an interesting piece of information to know after the birth, certainly not before! I also thought we were very lucky not to have someone there pressuring me to push the baby out, because that might have been a big disaster.
We decided to try to bring the placenta home with us, but we weren’t sure it was legal. We checked the official U.S. customs regulations, and you can’t bring meat or other farm products, but I’m not a cow, so it seemed like it should be legal, although I wasn’t certain what a customs official would do if they discovered this frozen bloody liver-looking thing in our luggage – how could I prove it was a placenta?! The day before our departure, we slightly defrosted the placenta, enough to stuff it in its plastic bag into a ceramic vase we were bringing back. We froze the vase and placenta together, put them in several plastic bags, then wrapped this in a down baby coat, stuffed that bundle into a large Tupperwear container and duct-taped it all shut. In our last-minute packing frenzy, there was just enough room for a bag of dog food that was left, so Max packed it without thinking about the customs regulations. When he told me on the plane ride he had packed the dog food, I figured our placenta was done-for, because the sniffer dogs would smell the dog food, then we would be searched. However, our plane was an hour late getting to the U.S., and we had a really tight transfer time of about 20 minutes. We had to collect our six huge duffle bags, two car seats, Mud in his cage, and get this menagerie all through customs and onto the next flight, with two sleepy children in tow. We were everyone’s nightmare in the airport right then! Customs was such a joke, they didn’t even look in Mud’s cage to see that it was a dog, much less check his health certificates, much much less search our luggage for the wayward placenta, they only yelled at us to get our s*** out of the way so they could get the next people through!
After Dariya was born, my milk came in quickly, there was hardly a day of colostrum before the immature milk was present. Anton was psyched, and he nursed and nursed and nursed. Since they were both nursing almost non-stop, we started nursing with Dariya laying on top of Anton. He was amused and delighted to be the tummy cradle for his new sister. I found it quite challenging, though, to nurse two “babies” of such different sizes, and it was difficult in the early days to keep newborn Dariya well-positioned with only one hand, while keeping the flighty big brother from knocking her off his tummy. I had even more milk this time than when Anton was born, and Dariya would just get plain mad about how fast the stuff was coming out. I was trying to get Anton to siphon off some in the beginning to make it easier for her, but first he decided he only liked the “later milkies” (i.e. hindmilk), then he decided that on one day the left breast was his, while the right breast was Dariya’s, then they would trade for the next day. Although I never performed a controlled study on the subject, it seemed to me that this was making my milk supply even more erratic and over-abundant, since the day after he nursed the left side, it was making more milk, but by that time, he was taking his turn on the right side. Obviously, I was nursing Dariya on both sides every day, and this frustrated his three year-old’s sense of order in the universe. I have to admit, it was a pretty ingenious plan for sharing “milkies” with the new baby, but I was getting a little frustrated myself. After a couple of weeks of trying to negotiate a better sharing plan, I decided to cut back his nursing to a few times a day, and it was simply physically easier to nurse him separately. Max’s mom came when Dariya was three weeks old, and she slept with Anton and kept him busy during the day, so he dropped back to only one nursing session a day, first thing in the morning.
Incidentally, the music we listened to through the entire labor, from “The Planet Sleeps,” has a Scottish lullaby that just seems amazingly appropriate as a welcoming song for the birth of a baby. The lyrics are translated here: “Oh see, I see the great mountains; Oh see, I see the lofty mountains; Oh see, I see the corries, I see the peaks under mist. I see without delay the place where I was born; A welcome awaits me in the language I understand; I will receive hospitality and love there when I arrive, that I would not sell for tons of gold. I see forests there, I see groves there; I see fair and fertile fields there; I see deer on the floor of the corries, hidden under a mantle of mist. High mountains with beautiful slopes; people dwelling there who practice kindness; Light in my step abounding to visit them; and I will stay a while willingly.” I often wonder if these are the visions DariyaClaire was having as she was being born…