The next stretch of labor was -- there's no other word for it -- fun.
My friend Jenny knew the midwife's assistant Janice, and they were chatting. I started to need to rock on my hands and knees with contractions, but it wasn't a big deal -- I was still laughing and telling stories in between. Fernando Ortega was playing and I was singing snippets of praise songs through parts of my contractions, finally feeling the calm that had eluded me earlier. Janice tried rubbing my back during contractions but I found I was doing better on my own. I was watching for the clock, eager for the midwife to arrive. She made it at around 11:20 and I heaved a big sigh of relief. "Now," I thought, "we can get down to business."
I made everyone guess what time the baby would arrive. Elwood called it, predicting a 1:00 arrival (she was born at 1:05). He nailed it with Joe, too -- I guess he can read me pretty well.
When the midwife checked me, I was between 6 and 7 centimeters. "Perfect," I thought. I hadn't wanted to cut it as fine as I did last time, when she walked in to find me almost 9cm (this was largely because of my birth anxiety -- I wanted to know how baby was tolerating labor before I was that far into it). But I had guessed earlier that I was around 5cm, and I would have been discouraged if I'd misjudged my progress. I was still feeling cheery -- "Almost 7," I chirped to my friend as I waltzed past her on my way to the bathroom.
I labored on the birth ball for a while, with
Elwood stroking my hair. I spent some time alone in the bathroom,
breathing through contractions there. I remember standing up after one
contraction and saying, "That one hurt." "Well," said my
midwife mildly, "hurting is a good thing at this point." Not long
after, I stood up again and said, "I'm starting to feel pushy. Can you
check me to make sure I'm not pushing against a lip of cervix?"
That was the beginning of the hard part.
I was between 8 and 9 cm, and that last stretch before pushing was very quick in my two previous homebirths. I thought that with a couple of gentle pushes the last bit of cervix would ease back over baby's head. No dice. The midwife tried to help slip it back, but it wasn't going anywhere. And once I opened the door to that urge to push, it was inexorable. (I think that the urge to push needs a different name. I have urges to eat brownies, or urges to be short with annoying post office clerks. I can choose whether to satisfy those urges. I cannot choose whether to push or not, any more than I can choose whether to breathe after someone's been holding my head underwater.)
"I'm worried that I've shot myself in the foot here, that my cervix is going to swell now," I not-quite-wailed. I could hear the tiredness in my midwife's voice, but she was so patient with me. We were doing fine, she said, and her calmness was catching. Or at least sort of catching. My water broke while I was pushing and it was lightly stained with meconium. This evoked more not-quite-wailing from me, but we'd talked about her protocols before and she reminded me now: when meconium is light and birth is close, she monitors heart tones more frequently and only heads to the hospital if there's an indication that baby is stressed. Baby was tolerating pushing just fine.
She suggested that I try a couple of contractions in knee-chest, and I headed back into the living room where there was more space.
This next bit is hard for me to write -- I am a little teary after asking my husband about some of my recollections. I can only just remember how painful it was, because birth amnesia kicks in quickly. But I remember a long dark tunnel of uncertainty in which I am rocking on my hands and knees, and squatting, and praying praying praying. Keep my baby safe, God. Help me. Help me now. I want so much to see this little face -- help me. Over and over I am asking for the intercession of Our Lady of La Leche y Buen Parto: Pray for me. Pray. Pray. I am thinking about the contrast between that particular image of Our Lady, in which she is enthroned, regal and ladylike with her baby in her arms, and me in this moment -- wearing only a sweaty purple pajama top, alternately groaning and gasping. I am pushing with everything I have, and I am afraid it is not enough. There comes a moment when I pray, "I can't do this much longer." I do not say it aloud, because I know it is pointless. The way out is through. But that resolution costs me: I don't have much more left in me.
On Monday morning I had re-read some of the papers on homebirth safety, looking again at the causes of the few deaths that occurred. One of them is troubling me here in my tunnel of uncertainty -- a baby whose heart tones were reportedly fine but who had brain hemorrhages in multiple sites. I am rocking on hands and knees again, remembering those terrible trochees: SUBgaLEal SUBaRACHnoid. The pressure of these contractions is enormous and I am worried about my baby's small skull. Heart tones are beautiful, though, and the midwife is monitoring them with every contraction now.
I have a dear friend who is hip-deep in something ugly right now, and I am offering up contractions for her. It is a very narrow world here in my tunnel -- I am pretty much stripped down to pain and to willingness. That's all I have to give and so I give it for her: I keep praying, keep offering.
In my discouragement I ask Jenny to bring me the outfit I have brought down for the baby. I need to remember that this is about the end, about that little face, and not about the tunnel. There is a cap for the small head boring down through my pelvis, a tiny gown to keep her little wet body warm. It helps to see them, but I only have a moment to think about them and then it's back to work.
Jenny also pulls my hair back from my face into a ponytail, a much-appreciated kindness. I was too far gone to say that it was bothering me, and too far gone to say thank you. (Belatedly, thank you, my friend.) It reminds me of St. Veronica -- nobody else can walk the road for you, but a small kindness can be a great gift on the way.
Finally, blessedly, mercifully, something shifts within me. I can feel a difference now and I am so grateful. I am pushing with renewed energy, with something approaching desperation. I am pushing even after my uterus stops contracting, because pushing is the way to the end and I am so hungry for the end. The midwife and her assistant are telling me to breathe for the baby, but I don't want to breathe because I'd rather push. The assistant asks if she should get the oxygen for me, which worries me, but the midwife says no. They check heart tones again: 110. "Why," I ask sharply, "is her heartrate only 110?" "Head compression," they say calmly, almost in unison. She is back to normal quickly. And I can feel her inching down now.
She is so close. They are telling me to slow down, to breathe her out so I don't tear. I don't care if I tear: I am going to see that face.
I will not post the next picture, but I will tell you about it: I am kneeling and the muscles in my thighs stand out. There is a puddle of green fluid on the chux pad beneath me, not yet absorbed. That face, the face I've been aching to see, has emerged but her little body is still enclosed in mine. The midwife eases a loose loop of cord over her head. Are her shoulders out yet? I cannot tell from my vantage point but I know the finish line is at hand. I say, "God, this is all for my friend in trouble," and give one last push.
Oh,
the relief, the blessed relief. It is the middle of icy night but the
darkness of the tunnel is gone, dispelled by the arrival of my daughter
-- whose name, coincidentally, is thought to mean "shining light." I
exclaim again and again: I'm so glad you're here! I'm so glad that's
over! Oh, I'm so glad!
After the placenta was out
("Hurry up," I said to my uterus, "because if you hemorrhage on me then
Dr. O will say he told me so"), I got the shivers and scooted over to
the couch with piles of warm towels and blankets. Baby nuzzled and
nursed, with intermittent complaints that this was an awfully different
kind of place than the one she was used to. Elwood brought me a grilled
cheese sandwich and peeled me a clementine. It tasted like triumph and
it tasted like home, all rolled into one delicious entity.
When it was clear that baby and I were stable, we went upstairs to sleep in our own welcoming bed. I woke up throughout the night, listening for the miracle of her breathing. In the morning the boys came in one by one, all surprised and delighted to greet their sister for the first time. "She's my favorite girl in the world," said Joe decisively. I think we'd all agree.
When I went to post the
announcement of her arrival, I wasn't quite sure if I could call it a
gentle birth or not. It seemed a lot harder than Pete's birth -- though
maybe I just don't remember the hard parts of Pete's birth. But you
know, I can't complain: I spent four hours in outright denial, two
hours happily dilating, an hour in my tunnel, and then the next three
in the land of triumphal grilled cheese sandwiches. I wanted to write
about the hard part, but what I'll mostly remember is basking on my
couch with my long-awaited daughter, surrounded by love and good wishes
and people I trusted.
I do wonder about that hard stretch. Was there something a little funny about the angle of her head? Is there something a little funny about my pelvic inlet, that it always takes me a long time to push out my babies? Was it just that Pete was my smallest baby, and that's why his birth was the easiest? Was it harder because my water broke earlier this time than ever before?
I think that fear got in my way: I stopped reading Homebirth Debate in the fall but should have quit sooner. And, too, I was worried about mothering a little girl in a world where little girls are vulnerable. I told Elwood weeks and weeks ago, "I am afraid I'm going to have some trouble pushing this baby out because I'm worried about keeping her safe. I might need you to talk me through that in labor." Was that part of it too?
I'll never know, but I'm not complaining. When I think about this birth I will think about my midwife's patience, and my friend's quiet voice praying aloud, and my husband's reassurance, and the cheerful noisy assistant -- and, above all, that precious face. I believe in the redemptive power of suffering and so I hope that the one dark hour will bear fruit in eternity, but I am at peace about the way it went regardless. The very next day, in fact, when I learned that my MIL had taken the four boys to Toys R Us on Christmas Eve, I said earnestly, "I'd rather go through childbirth again than go to Toys R Us with four kids on Christmas Eve." My husband said, "Forgot already, huh?" -- but I meant it. This was the path that brought me my little girl, and I will always be grateful for it. Of course I'd do it again.
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