The story of Hazel’s birth

On July 30, 2015, probably the hottest day of the year and 3 days past my due date, I was 60lb over my pre-pregnancy weight and desperate for my second baby to be born. Planning a homebirth with Sandra Londino, I asked my midwife to come to my house in the afternoon and strip my membranes, a simple procedure to get your body to produce prostaglandins and encourage labor. This worked to induce labor for my first pregnancy so I was very hopeful that it would work again. I went to bed around 10pm that night and woke up just after 1am starving. Josh helped me downstairs and made me a baked potato, then went back up to bed. I ate, watched some TV and enjoyed some quiet time, but was too restless to go back to bed. By 3am, I started having recognizable contractions, that were a bit uncomfortable but certainly not painful. I woke my husband again to tell him that it was go time!

Born on Harry Potter’s birthday

Josh bustled around the house rounding up the truckload of supplies that we had gathered in anticipation of a homebirth. Then he started to inflate the kiddy pool we bought to serve as a labor tub. I walked around the house very slowly and deliberately, pausing to lean over any high surface (cat tree, countertop, dresser or windowsill) depending on what room I was in. Contractions immediately started coming every 3-4 minutes, just as they did when I was in labor with my firstborn, Evee. The contractions were powerful and required all of my concentration, but I still really didn’t find them very painful. I gave my midwife a quick call just so she knew what was going on, but I asked her to stay at home, knowing that she lived just 2 blocks away and could get here in a flash. With 2-year-old Evee and Janet (Josh’s mom) sleeping, the house was so peaceful that I felt like a confident, competent little elf, working secretly and silently in the middle of the night to make something wonderful.

 

The intensity of my contractions ramped up steadily, and just before 5am I felt like they had turned a corner. They were incredibly powerful, and that power started to feel like pain, although it was definitely bearable. I asked Josh to call the midwife and tell her to come over. I slipped into the tub set up in my living room, and filled with 100*F water. Ahhhh. The tightness and tension that had been creeping up on me melted away and I felt peaceful again. A few minutes later, Sandra quietly entered my house and Janet woke up and creeped down the stairs to find me laboring in the tub. Although the almost magic quality of the night was interrupted by the arrival of people, everyone whispered and moved slowly, so the calm, secretive peace was preserved.

Janet provided quiet, background support while Josh and I became parents for a second time

I asked Sandra to do a quick cervical check to get a baseline for where I was in labor, so she leaned over the tub and slipped her fingers inside me. “Do you feel like pushing at all?” she asked. Definitely not. “Well you’re about 9cm dilated”. Holy cow! I’d made it through almost all of the labor in just over 2 hours, and with surprisingly little pain! By the time I was at this stage with Evee, it had been almost 11 hours, 9 of which were spent gradually (and sometimes not gradually) changing my personal definition of “unbearable pain”.

 

So I waited quietly in the tub, where my contractions were painful but manageable and my muscles felt deliciously loose in the hot water. I waited for a sign from my body that it was time to meet my precious baby. At the end of my labor with Evee, I felt an incredibly powerful, impossible to ignore desire to push, and the result was an 8lb 5oz little girl after only 20 minutes of pushing. So with Hazel, I knew just what to look for. By 7am, 2 hours of laboring in the tub and wondering when I was going to get that feeling, I was pretty burnt out. The contractions were coming fast and incredibly painful, I was exhausted, and another exam proved that I hadn’t made any progress. What was going on? Why wasn’t Hazel coming?

“I prefer pleasantly plump”

I decided to get out of the tub, despite my exhaustion, and try to shake her into action. I explored my living room, restlessly looking for a place to stand, or kneel, or move in a way that would get this baby to move down into my birth canal. I spoke with Sandra about breaking my amniotic sac, but she preferred not to disturb the natural process and wanted to wait it out. But I had been in the transition phase for 2 hours, battling ever increasing levels of pain, and there was no change in the baby’s station (how far down she was into the birth canal) or my dilation. I decided to try to take matters into my own hands and see if I could push her down, even though I didn’t feel the urge. I slowly and deliberately climbed my stairs with Josh’s attentive assistance, and decided to sit in the bathroom to try to use the familiar space to try and stimulate a pushing urge.

 

After 20 minutes of wearing myself out pushing against nothing and making no progress, I felt like I could here my mother’s voice in my head: “The Dr. had to break my sac for both you and Pat; I think we may just have strong sacs.” Broken sac or no, I didn’t feel like I could wait patiently for this baby to descend any longer. I asked Sandra to break my sac, and she told me to lie down on my bed so she could perform the Artificial Rupture Of Membranes. Well, the act of lieing on my back in bed was so incredibly painful, I couldn’t bring myself to stay in that position for more than 1-2 seconds. Every time Sandra came near me with the little crochet-hook-device, I squirmed up in agony onto my knees and said “Just wait for this one to pass”. But it felt like a wall of contractions with no beginning and no end, and I felt terrible for the women compelled to lie on their backs during labor. It was unimaginable torture.

“That was hard”

Eventually I managed to lie on my side and lift a leg up for 15-20 seconds so she could break the bag of waters. When it broke, only a little fluid came out, unlike the gush of water that drenched everything when the midwife broke my bag when I was around 7cm dilated with Evee. I imagine this is because I was farther in labor and Hazel’s head was blocking the canal, so most of the water was stuck behind her. However, when the sac ruptured, I felt immediate relief and the contractions slowed down dramatically and were much less painful. Also, right after the rupture, my urge to push finally showed up!! Sandra said I had immediately dilated to 10cm and it was time to have this baby.

Sisters for life

I was already in my bed, which had been appropriately covered with protective sheets etc. to make for a clean, contained birth. But after only a moment of trying to push in bed, I felt like I couldn’t get the leverage or the position I needed to be in on the fluffy surface. I climbed out of bed, and poor Sandra, and the nurse Erianna Flores, who were trying to follow me around and predict where I would actually stop and have this baby, went back to moving the chucks pads and supply trays. I squatted on the floor, resting my arms and head on the foot of my bed, and finally felt like I could really push. The floor was so firm, and the bed provided a great spot to grip so I could curl around my huge belly and start pushing this baby down.

 

Evee had apparently woken about 30 minutes earlier and was happily playing with her grandmother in her room while all this happened. At this point, Janet came into my bedroom with Evee on her hip and I asked Evee if she wanted to stay and watch Hazel’s birth. She said she did and then I beared down to push again. This felt much different than pushing Evee out, Hazel felt like she was much bigger and more stubborn to move, and the feeling of trying to inch her down was incredible. Being in the squatting position and gripping with all of my strength on to the bed for leverage felt like the only way I could possibly make progress. But when I pushed, I sent the bed flying, so Josh asked Janet (still holding Evee on one hip) to stand on the far side of the bed and help hold it in place. Although Hazel’s descent felt incredibly obstructed, I could feel that she was moments (minutes?) away from being born and I felt very lucid. Sandra was positioned behind me, attentive to the birth, and I reminded her that Josh wanted to catch the baby.

Evee fell in love with Hazel instantly

Then I pushed with extreme intensity a few more times, making loud grunts and groans. Later I was told that Evee listened to these grunts, wide-eyed, and announced that “Mama is working hard!” I felt the “ring of fire” when it seemed like my birth canal was stretched impossibly wide as Hazel was crowning. This was so intense, that I had assumed I had just pushed Hazel’s head out of my body, and to my shock I heard Josh say that he could see some hair. Why was he just now announcing hair when that whole head had to be hanging out of my body? Although I was confused, I doubled down for some more intense pushing, and after what felt like, to me, the whole body had slipped out, Josh and Sandra announced that the head was out. Although it was painful to be squatting on the floor with a baby only half born, I took a break because I truly felt like my work was over. The urge to push had disappeared instantly and completely, and I couldn’t believe that Hazel wasn’t in my arms yet. But after a few moments, Sandra urged me to keep pushing; Hazel’s head was out but the rest of her body was stuck. In my head, I wondered “really? Shouldn’t she be born now?”, but I listened and tried to push anyways. Unlike the minutes before where pushing felt necessary and instinctive, I couldn’t feel anything, and I didn’t feel like I could get a grip on the baby to actually push. It felt like such a strange situation. As I tried to talk my body into working past quitting time, the atmosphere of the room changed. Because I was so internally focused, I didn’t realize it at first, but everyone was starting to get pretty nervous, and trying to instruct me.

 

Eventually I made eye contact with Janet, and she was talking to me, trying to help relay the instructions of my midwife. I heard Sandra ask me to stand up and lift my feet up. It was clear that she had already been asking me to do that, but in my haze I hadn’t heard her earlier instructions. I stood up, but my upper body was still curled around my belly because it felt crazy to stand up straight at that point. I think the midwife and nurse were frustrated because it was like trying to communicate to someone who was both blind and deaf, but eventually they made me realize that, although I didn’t want to, yes, indeed, I needed to stand up straight. Erianna got around to my front and started lifting one of my legs up, urging me to lift my knee up to my chest to help the baby come out. Finally I realized what was being asked of me, so I lifted first one knee to my chest, and then the other, in an exaggerated marching move. Once my second knee came up to my chest, Hazel slid right out of my body and into Josh’s arms. Thank God. Born at 7:52 am.

“Good job, honey.”

Although I was later told that the environment was noisy and anxious during the 3 minutes that Hazel’s head was out but her shoulders were caught behind my pubic bone (called shoulder dystocia), very little of the loud instruction and emotion had pierced the thick bubble surrounding me, and I would only learn later that we had just pulled through a very serious medical emergency. Josh, who had caught the baby while standing behind me, passed Hazel through my legs and into my waiting arms. I held her tight against my abdomen and carefully sat down on the floor, leaning against the side of the bed. I am told that she was pale and limp and not crying at this point, but I was in a state of shock and honestly didn’t notice. Sandra used a nasal aspirator to clear out Hazel’s nose and mouth while I clutched her to my body, and she immediately started crying, her skin pinked up and all of her muscles firmed. By one minute after birth, Hazel had an Apgar score of 9 out of 10. Everybody seemed to breathe a huge sigh of relief. I wanted to bring Hazel up to my chest, but like Evee, her umbilical cord was quite short and I had to keep her right on my lap. After a few minutes of catching our breath, Sandra noticed that the cord had stopped pulsing and offered to have Josh cut the cord so I could get Hazel into a more comfortable position. My first word after Hazel was born was a quiet but firm “No.” which actually surprised me as much as Sandra. Literally one second later, my body instinctively gave a little push and the placenta flopped out and right onto the floor. It was exactly 8am, meaning that the third stage of my labor was only 8 minutes long.

A much deserved rest

Josh cut the cord and I was carefully helped into bed to snuggle and nurse my beautiful, perfect little Hazel. About 15 minutes later, Ash and Tommy would show up after driving through the night. A short while after that, our friend Sarah would arrive to take photos of our brand new baby. Poor Janet would spend an eternity scrubbing a placenta-shaped blood stain out of the white rug on our bedroom floor. But for now, I just cuddled my gorgeous girl and thanked God that it was over. She was a 9lb, 1oz, 21 inch long bundle of joy.

Sandra performs a newborn exam

 

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Some facts about shoulder dystocia:

Effecting 1 in 200 births, when shoulder dystocia occurs in the hospitals, some obstetricians choose to immediately perform a “generous” episiotomy, cutting through layers of the mother’s tissue not to dislodge the baby, who is actually caught behind bone, but to allow space for the birth attendant to insert his/her hands inside the mother and attempt to twist the baby out. This can result in 4^th degree tearing in the mother, potentially leading to a lifetime of incontinence, and 15% of babies will suffer nerve damage in the shoulder, and 10% of babies will suffer a broken collarbone. By “dancing the baby out” instead, I escaped without any tearing whatsoever and Hazel suffered only a bit of bruising from the pressure of her exit. Although I had a bruised tailbone, Hazel and I were spared a hellish recovery.

 

Homebirth critics will say, sure, a homebirth may be fine until anything goes wrong; but the truth is, homebirth midwives are trained to handle emergency situations, and although in some cases this may require transfer to a hospital, the overall statistics of home vs hospital births shows that mother and baby actually have a slightly better outcome at home deliveries following healthy pregnancies (reference: Janssen et al. 2009). And the story of Hazel’s birth is one of those cases that contributes to that statistic.