I attended my 16th birth yesterday, and it was a sweet sixteen. It was the 2nd homebirth I have attended, with 14 hospital births in between the homebirth bookends. Although I have witnessed 15 births prior to Peggy's, hers will remain with me for a very long time. It was her first baby, and that alone made it extra special. When I arrived at Peggy and Blake's house on Monday night, Peggy was a young married woman. She is just a few years older than me and I felt like she was a peer, that we were at somewhat similar stations in life and that I could identify with her. I shared hot chocolate and a bowl of ice cream with Peggy, Blake, and Peggy's mom Nancy, as we sat around and talked about our families, our faith, and how Blake and Peggy met. I was incredibly impressed with Blake's affection and attention to Peggy from the moment I walked in the door -- I hope I have a husband like that someday. I admired their humble and precious home, filled up with lots of love. Peggy's labor was just starting to become active, with increasingly intense contractions coming about every 5-7 minutes. Peggy was chatty and excited, and just as adorable as she could be too. She called her midwife to come over, and we continued getting to know one another.
The midwife and her apprentice arrived about 10PM, followed shortly by Peggy's friend Susan. The birth team was assembled. I didn't know it at the time, but it was the beginning of a long, challenging, and deeply rewarding experience. The midwife checked Peggy and found her to be 4cm, 90% effaced, and at -1 station. Peggy soon decided that she wanted to get into her birth tub in the kitchen. This was the first birth I have attended in which the mother used a pool for labor (and potentially birth). She labored like a warrior from the very beginning. She labored like a lady too -- even when labor was at its hardest, she still smiled between contractions and was so positive and sweet. The beginning of Peggy's active labor started with a concern: her baby's heart rate was in the 160's and 170's several times. The midwife explained to Peggy and Blake why these high heart tones were concerning, saying that over an hour of a rapid HR would cause fetal distress and require intervention. We were all scared. There were tears. Despite everyone's natural fear over this news, I now believe the Lord was preparing all of us, especially Peggy, for what was to come. He was building our trust in His sovereignty over the birth journey. The midwife administered a homeopathic, and we gathered around Peggy as Blake prayed for the baby's heart rate to stabilize. Jesus answered our prayers -- her heart rate was great from then on.
Peggy continued to labor. She took breaks from the pool and then would get back in. Nancy, the soon-to-be grandma, prepared snacks for everyone and was just the sweetest hostess the whole time. She was also a great support for Peggy, and mother and daughter seemed in tune throughout. Susan and I looked through the midwife's herbs and homeopathics and ooed and awed. I helped document on the labor flow sheet. I listened to heart tones. I smiled at Peggy and told her how marvelous she was doing and tried my best to exude love in every way. This was my first hands-on doula experience, and I was really shooting from the hip and praying God would make me as helpful as I hoped to be. I quickly picked up on the fact that Peggy did not need six people around her all the time. We took turns, with Blake and Nancy doing the majority of the direct labor support. I washed dishes. I boiled water and poured it into the birth pool (I snickered to myself every time I boiled water, it seemed so stereotypically homebirth). Susan, the apprentice, and I watched "The Bucket List" in Peggy's living room. We dozed off to sleep here and there, and Susan said she thought the baby would come by 3AM. Peggy got out of the pool around 2:30 and went into her bedroom. I fell asleep somewhere around that time and woke up at 4-something with my contacts glued to my eyeballs. During the interim, the midwife checked Peggy again and she was 6cm.
By 7AM Peggy was 8cm. She was doing it! She walked around some, but spent most of the time in her bedroom with Blake. We watched the end of the movie and Nancy made scrambled eggs. I started to get anxious that the baby wouldn't be born by 10AM, when I needed to leave to make it to Jeff City on time for an afternoon at the health dept for my community health class. When 9:30 arrived with no baby, I called my preceptor and told her my friend was having a baby and that I needed to come on Friday instead. At 10 the midwife checked Peggy again and reported disappointing news -- she had gone back to 7cm. Obviously this was discouraging news for Peggy. She was working SO hard. It didn't seem fair. A little while later, we invited Peggy to read some Bible verses with us to encourage her...Genesis 25:24, Luke 1:57, Isaiah 66:9 and others. We suggested a change of scenery and offered that it might help for Blake and Peggy to take a walk outside. Instead it turned out that everyone else went on the walk instead of Blake and Peggy, but that was fine too. We walked up and down the road, chasing their dog, while Peggy and Blake labored on the porch. Eventually the midwife got a text from Peggy saying she was getting back into the pool.
We returned from our walk as Peggy continued to labor like a warrior woman. We spent the afternoon somewhat in the background, as Blake stayed by his wife's side. The midwife spent some time talking to Peggy about her fears, as we wondered if unrealized or unspoken emotions were holding things back. Around 2PM, when it was very clear that the baby was not coming any time soon, I had to make a difficult decision. I needed to leave immediately if I wanted to make it to the Columbia party for Kurt Schaefer in time. One of the purposes of the party was for Schaefer to associate my name and face with the midwifery cause! I was supposed to be co-hosting the event, for goodness sakes! We had been planning it for weeks. But here I was, at Peggy's birth. Not yet a midwife by profession -- and thus not yet living on call -- I didn't know what to do. The midwife in attendence, as well as Mary, Elizabeth, and Susan, were just as kind as they could be. They told me they could not make the decision for me. I felt obligated to attend the party, no I WANTED to attend the party, the prospect of a senator who would listen to us was and is so exciting! But it made me ache to consider leaving Peggy. I didn't feel like an irreplaceable part of her support team. I know the midwife certainly didn't need me around. Part of me felt selfish for wanting to stay when I rationalized I was more directly needed in Columbia. But in the end, I didn't care about any of that. I was midwifing Peggy the best I knew how at the time, and every moment passed and every moment to come was so precious. I listened to my tears. I told Mary my heart needed to stay with this brave new mother in Springfield. I know it was the right decision...because as much as I care about "the cause," it means nothing to me compared to individual women and babies.
Around dinnertime, when Nancy had amazing lasagna baking in the oven, Peggy was becoming discouraged again. She was STILL 8 1/2cm. We decided to try some black and blue cohosh to make her contractions more effectual. One of the coolest parts of being at Peggy's labor and birth was how much the midwife counted me as a partner and asked for my opinion in all proposed changes to the plan. It was incredible and so affirming! I don't know the first thing about black and blue cohosh, but the midwife still cared what I thought! She is a very gentle and considerate woman, and treated her apprentice, Susan, and me with the greatest respect the whole time. Peggy and Blake consented to the black and blue. It worked quickly! Peggy's contractions soon become nearly overwhelming and brought her to tears. At this time, we took a more active role in labor support. We took turns holding her hand, resting our hands on her knees and rocking with her, offering her drinks of water and Emergen-C, and telling her how amazing she was doing. She labored sitting on the living room couch, standing or leaning on a chair occasionally, for the majority of the evening.
By 8 or 9PMish, she had no cervix left except for an anterior lip. At one point, we gave her some Pulsatile(?) to help dilate away the rest of the lip. Peggy labored much of the night on her bed, sitting or on hands and knees. It was a very, very difficult time for her. She was obviously exhausted, having been awake for over 36 hours and laboring actively for over 24. At one point she said in desperation, "I just want to go to the hospital and have a c-section!" My heart just broke for her. My goodness, it was sooo hard and soooo long. The midwife lovingly explained that first they would want to try Pitocin and attempt a vaginal delivery at the hospital too. Peggy continued to labor. Blake went into the other room to take a nap around 11ish, and we had a session of being solely "with woman." It was beautiful to watch Nancy labor with Peggy. It was beautiful to watch Blake with Peggy as well, very much so, but the mother-daughter beauty was special in a different way. We prayed. We waited. We slept.
I left the room to take a cat nap around 12:45. When I returned about 1:30, Peggy's water had clearly ruptured (it had been leaking for two days) and she was completed dilated! When the midwife reported the good news following the vaginal exam, I lost my birth composure and reverted back to my cheerleading days: I shouted "Woo hoo!" and pumped my fist in the air! Whoops :) Peggy, very lost in transition at this point but still surprisingly composed, said, shaking, "Praise the Lord!" She had the urge to push almost immediately. With Blake on her right and her mom on her left, she naturally pushed with each contraction for the next two hours. She was exhausted and doubted herself, but she had a renewed sense of purpose now. We reminded her that this too was normal. The midwife reminded her that although pushing was slow, it was steady: the pushing was going much better than the dilation had! We did some minimal breath coaching and suggested position changes and encouraged Peggy to feel the baby's head with her fingers, but for the most part, Peggy just followed her instincts as the midwife applied warm compresses to her perineum. It seemed like a short time (for us) from Push #1 til crowning, around 3:30AM. When Peggy told us she could feel the burn, and reached down to check her progress after a long time since her last check, her eyes opened wide and she said "Oh, wow!" when she felt that her baby's head was exposed nearly to it's widest diameter! It was a transformative moment -- all of a sudden, Peggy knew it was true: she really WAS about to become a mother!
With Blake in awe and Peggy in fierce determination, she pushed her baby's head out at 3:38, and the body at 3:39. As she emerged, we saw what the hold-up had been: she has a posterior nuchal hand, the little stinker! She had her hand on the back of her head, so it took a loooong time to achieve full dilation due to the lack of uniform compression of the head. But no matter -- Peggy did it anyway! Because of the positioning of the baby's hand, and the quick delivery of her body, her elbow shot out to the side as it passed through the birth canal, causing perineal and labial tears :( But I don't think Peggy noticed in the least. As soon as she had that sweet baby girl in her arms, everything else faded away. The look on her face was priceless. She was in complete joy and told us with her eyes that it had all been worth it. She and Blake held their daughter close and inspected her from her head to her cord to her toes. She was pink and screaming from the time she was born; we assigned her Apgars as 8 and 10. She was perfect. Peggy pronounced that her name was Nancy Mae, named after her own mother. Realizing what time (and day) it was, I said "Happy Birthday" to both mother and baby. Peggy was born on December 3rd herself, and now so was her daughter. How cool is that?
Peggy shot out her placenta in the first first contraction she had after delivering. It was so simple, and such a blessing, relieving Blake and Peggy's fears of placental complications. While Mom, Dad, and baby fell in love and figured out breastfeeding, the midwife cleaned up Peggy's perineum and inspected her tears. They appeared jagged and complex, as we realized it wasn't only a perineal tear. We conferred in the kitchen about what to do. The midwife asked me how my suturing skills were(!), to which I replied I had zero experience. (I can take stiches out...) We decided this was beyond everyone's skill level at the birth, and that we needed to call in reinforcements. Blake began trying to get a hold of a church friend of theirs, who happened to be an ER doc. He was unavailable, so as it turned out, Peggy and Blake had to make a trip to the hospital. It was unfortunate, but necessary. I found out later that the trip to the hospital went very well, and that mother and baby were doing fabulous, so I feel great that Peggy got the care she needed without hampering her beautiful birth experience. We loaded her up on Chlorophyl, helped her to the bathroom and into some clothes, and tucked her into the car. Grandma Nancy was more than happy to love on Baby Nancy during this time. I gave Peggy a hug before they set off, and she thanked me for being there. I didn't have any words at the time, but I wanted to tell her thank you for letting me witness her miracle (I thought of the words later, and sent her a Facebook message, silly as that is). I slept on her couch for two hours before driving back to Columbia, back to school, back to the land with decent radio stations. I thought about her miracle the whole time. She pushed a baby out, yes, which is totally and utterly amazing, but she also became a mother. More subtle, often unnoticed or undervalued, but completely spell-binding and transformative. She gave birth to herself as a mother. In an instant, she changed not only her physical form and external circumstances, but also her very soul, perspective, and purpose. She knew she couldn't do it. It was bigger and harder than anything she'd ever done in her life. It was impossible. But she DID do it! SHE DELIVERED her baby. When I arrived at her home on Monday night, she was a young married woman, and a lot like me. Now she knows the secrets of motherhood. Now she is a mother = a woman who can do anything.
Sixteen is sweet indeed.
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