Julie's miscarriage story, from Christian perspective

This is Julie's story of her miscarriage. She asked that only her first name be published, so if you know this family personally, please do not include identifying details in the comments. Thank you!

October 15th

October 15^th, 2012 will mark a very sad but monumental day in my life. That was the day my little baby was born, never to live here with me but to be safe in the Father’s arms.  Sharing my story comes from wanting to have some sort of closure but also stems from the desire to help those who are looking for some information during this difficult season of their life. Perhaps someone needs these exact details that will ease the pain or help with the process of losing a very precious part of a mommy’s life. 

When I found out that I was pregnant with my 6^th child, I was tickled and nervous. Five living children, homeschooling, and very active in my community, I could barely wrap my brain around adding another baby to my already busy schedule. On top of that, I would be 41 years old and my husband nearing 50 when our baby would be born. It was hard not to feel nervous about it, however, every child has been an incredible blessing to our family and I had absolutely no regrets. I felt like an old pro so I wasn’t in a rush to go to the OB/Gyn and get an ultrasound. I felt fertile and experienced so I got my vitamins, ordered my iron pills and watched my sugar (I often get an early onset of gestational diabetes). My husband and I started planning which large van to get come Spring as we would no longer be able to transport our growing family in our current one. I was excited as we anticipated this new baby! My children were also happily involved in dreaming about the baby. My 12-year-old daughter was especially excited as her little maternal instincts kicked in. We were thinking up names, imagining what the baby looked like, and overall enjoying the pregnancy. 

I finally got in to see the doctor at 12 weeks. Prior to the appointment, I had my first ultrasound. That morning, I woke up early to this dreadful feeling that the baby was not alive. I was cramping for 3 hours and if I had actively checked for discharge I believe I would’ve noticed something. However, I passed the cramping off to being backed up due to the extra iron pills I was taking. However, I couldn’t shake this foreboding that I wouldn’t see my baby alive. I think every pregnant mom has that fear in the back of her mind but usually it’s dismissed with a blinking heartbeat on the monitor. My fears would be confirmed, however, as the wand panned around my belly. I saw a gaping black hole and no heartbeat. I knew within 3 seconds that the baby was not alive. The technician was very quiet and didn’t say much but she was able to tell me that she didn’t see any activity. She checked and checked and we saw that the baby only measured 6 weeks, the gestational sac only 10 weeks and looked very irregular. She went to get a room for me to await the doctor so I wouldn’t have to go back into the waiting room. At that time, the tears rushed in and I sat crying while my husband held my hand. I couldn’t believe the baby was dead. 

My OB is a kind and experienced doctor. While not a believer, he is respectful of his patients’ beliefs and desires to make me comfortable. He gently explained what would happen while miscarrying, the option of the D&C now or later, as well as affirmed that there was nothing I could have done to prevent all this. I think one of the most helpful things he said was that it wasn’t my fault at all. I can’t blame it on age, that glass of wine during my anniversary dinner, that I didn’t take my vitamins early enough, or whatever it was. I know that many women carry guilt about what they did or could’ve done differently to prevent a miscarriage. I still wonder about my age, however, I will never know what happened exactly and feel that he eased my concerns early on. Whatever you did or didn’t do, you have to understand that it wasn’t your fault and be at peace knowing that every baby is a miracle. 

That day, I spent time at home crying and praying. I told the children and while the boys didn’t seem terribly affected, my girls were very sad, especially my 12-year-old. I could see that she was grieving as she stayed very close to me. She drew pictures expressing her grief that I’ve captured on camera and will hold dear to my heart. She stayed with me at night and we talked about things. I was very open with her as to what was happening and why. My dear husband was such a support at this time. He took her to a craft store to get a tiny wooden box that she could decorate in case we saw the baby. She painted it and waited for the baby to come. 

The hardest part was waiting. Every day, I spotted more and more. It was Tuesday when I started spotting. My husband took time off on Friday and Monday so he could help with the kids and the homeschool group I am in charge of. I prayed that the baby would come by the weekend. I started taking black and blue cohosh in order to speed the miscarriage along. 20 drops of each in a tiny bit of water, held under my tongue for about a minute five times a day was what I was told. The cohosh tasted nasty but I chased it with OJ and it was palatable. Sure enough, within a few days, the bleeding started and I felt confident that it was to happen on the weekend. 

The spotting turned to intermittent bleeding by Friday. Whenever I went to the bathroom and wiped, I turned up some brown blood as well as some blackened tissue. The lining was shedding slowly but surely. I also started cramping more and had a loss of appetite. I took this time to distract myself with cleaning and doing some other quiet projects I wanted to get done. I also prepared myself with what I was going to do to ‘catch’ the baby. You see, I suddenly had an incredible desire to see the baby. I felt so sad when I thought about my baby being flushed down the toilet. Please, if this happened to you, don’t feel badly. I know that if I didn’t see the baby, that was God’s sovereign plan, for whatever reason, but I really wanted to see it if I could. I was able to secure one of those ‘hats’ that you can put under the lid of the toilet that you go into to measure the volume of output. This assured that I would be able to see everything that came out before I flushed it. It definitely helped me feel less anxious about going to the bathroom.

I also had a few other supplies ready: a small, clear container of water that I could put the baby in, craft sticks in case I had to sort through, disposable gloves, and paper plates. I also had some extra trash bags. I know these are a lot of details and I think at one point I would’ve thought this a bit macabre but I feel strongly about sharing details in case you are clueless what to do. This worked for me and I needed everything I had prepared. It was truly a blessing to be ready rather than panicked. 

I also checked out some websites that a friend sent to me. Several of these prepared me for what to expect. The one I found very useful was Still Birthday: Pregnancy Loss is Still a Birthday. This had links to different developmental stages of your baby. It really helped me to visualize what size the baby might be as well as what it might look like. There are stories and actual pictures tastefully done. 

On Sunday evening, the bleeding started much more heavily. I started having to rush to the bathroom as the discharge gushed out in chunks. I felt stronger contractions – they were much stronger than menstrual cramps and were in intervals just like contractions. I was surprised by how strong some of them were. With each contraction, there was more bleeding and blood clots. I knew it had started. 

That night, I bled for hours and I stayed on the toilet for the majority of the night. I was surprised by how heavily I bled. I was able to see exactly how much volume of blood I was losing as I was going into the ‘hat’. Every 10-15 minutes, I had 300-500cc of discharge. Much of it was clotting and sometimes the clots were larger than the palm of my hand. I literally peed blood. Everything I had read said go to the doctor if you soak more than one pad an hour or if you bleed much more than a heavy period. That’s laughable as it was SO much more. (I found out later that earlier miscarriages (under 6 weeks) would bleed less but over 12 weeks this much blood was more normal.) I called my husband who stayed up with me. I think most husbands - and I sure don’t blame them! - would faint at the sight of so much blood. It truly looked like a murder scene. Terrible! My resolve to see the baby outweighed the grossness of the grim scene. My husband took over examining the discharge for any fetal parts. Thank God for a doctor husband! At one point we wondered, ‘How much bleeding during a miscarriage is too much?’ Neither one of us had seen so much blood. Yet, I wasn’t willing to go to the hospital until I knew I had passed the baby. 

After a few hours, I cramped terribly and when I looked, there was a tiny yolk sac and something fleshy near it. I knew in my heart that this was the baby. I put it in the container with some water to wash it off. After a while, it was obvious that it was different than the other mess that was coming out. It was irregular and very deformed and it had the color of flesh. The size indicated that it was definitely around 8-10 weeks rather than 6. It had degraded some and the parts were barely recognizable. However, I felt relieved. After bleeding heavily for about 2 hours more, I decided to go in to the hospital in case I had lost too much. I wasn’t scared or panicked. I did feel lightheaded and shaky though – most likely because of lack of sleep, no food, and an intense night on top of the loss of blood. Incredibly, I found a sitter at 5am and by 7am I was in the hospital. 

Yolk sac

(I’ve decided not to post pics of the baby)

I’m sharing what happened at the hospital in case you need to go. I didn’t know what to expect. First of all, I was surprised to see only one other person waiting (when I was discharged the waiting room was completely packed). I was taken back immediately and had a very kind doctor. She ordered some IV fluids, blood work, and an ultrasound first to determine whether I needed the more invasive step of a blood transfusion and a D & C. I prayed that I would need neither. The nurse was considerate about putting in the catheter when she heard that the ultrasound was ready for me, otherwise, I would be bed-ridden and uncomfortable for hours. Indeed it took 2 hours for the u/s to be ready for me. 

My husband was asked to stay in the waiting room during the u/s. I knew that this would happen and wasn’t too miffed about it. It was very different than the happy exciting ultrasound of my OB as the situation was more serious. She didn’t show me the screen, which I expected and she was very quiet while performing the procedure. I didn’t ask questions at this point because I know that techs are not supposed to say anything even though it is very hard for a person like me who wants to know everything and see it all not to say anything. I did answer her questions and tried to let her know that I knew what to expect and that I was not afraid of what she found out. I was sad but at peace. Near the end, I did ask her if the doctor would be able to tell me whether they saw the baby or not as this was very important to me. I wanted to be 100% sure that the ‘specimen’ I had at home was indeed my baby. She quietly confirmed that the baby was not there and that she only told me because I seemed ready to hear it. I was. 

Everything else was routine. My blood work came back within safe limits. I was anemic but not terribly so. I had taken some iron pills that night and morning and I’m sure that helped my levels some. I was sent back home with the assurance that we had done everything we could. 

I slept the whole day and night. The next morning, I woke up with an urge to run to the bathroom. There was a huge ‘whomp’ and I delivered the placenta. I didn’t expect that exactly as I thought I had passed bits of it earlier. It was a bit smaller than the size of my fist and one giant ball. After that, the cramps disappeared and the bleeding substantially subsided. I felt peace and closure (but a terrible migraine!).

Was it a coincidence that October 15^th marked my baby’s birthday as well as The Pregnancy and Infant Loss Remembrance Day? Was it by chance that dozens of my friends were remembering and lighting candles for their own children who they’ve not been able to hold or see and that they added one for me? Was it pure luck that one of my favorite bloggers, Tim Challies, had a podcast on Early Infant Loss that very day? No. None of that is chance, my friends. It is pure grace. My heavenly Father showed such care and tenderness to me in so many ways during this time. I know that not everything goes according to our plans and they really don’t have to. However, at times, His sweetness overwhelms me as I find myself being supported, cared for, loved and cuddled by friends, family and especially, by my dear husband. 

I had so many sympathetic notes and remarks via texts and Facebook. I received kind and encouraging words and friends shared stories of their own miscarriages. I had the occasional person say, “Well, at least you have 5 kids.” or “Well, guess this is a sign that you’re getting old.” but I expected these remarks as not everyone has the education on what not to say during a miscarriage but most people have good, albeit awkward intentions. It really doesn’t matter how many children you have, what the chances are on having more, if you already have one boy and one girl, if you are getting along in your age, if you weren’t ecstatic upon the news that you were having another one, if you couldn’t afford to raise another baby. The pain is really there. Your baby has died. You’ve suffered a great loss and the grief can be as deep and as intense as if you’ve given birth to, raised, and bonded with your child. However, I want to extend the same grace to others as the Lord has to me as they help me cope with my loss. I don’t expect them to understand the deep sense of grief I feel as I never could truly sympathize when my friends miscarried. I could only imagine the pain.

Honestly, as I reflect on the last week, I have gratefulness in my heart. Grateful that I have six children and one is completely loved and perfect in heaven. I have Biblical reassurance that this is the case (see the books: Little One Lost: Living With Early Infant Loss by Glenda Mathes and Safe in the Arms of God: Truth from Heaven About the Death of a Child by John Macarthur). I’m also grateful for the opportunity for this life experience for my daughter; for her to see the folly of evolution (one kink in the DNA and it cannot survive) versus the miracle of a beautiful baby created by a living and loving Maker. 

And he said, “Naked I came from my mother’s womb, and naked shall I return. The LORD gave, and the LORD has taken away; blessed be the name of the LORD.” Job 1:21

Drawn by 12-year-old sister

Weighing VBAC vs. repeat c-section

I frequently get emails from mommas who are considering VBAC (Vaginal Birth After Cesarean) vs. ERCS (Elective Repeat Cesarean Section). Are you interested in the possibility of VBAC and wondering what your options are? Here are a few places to start your research.

This post is not intended to try to talk moms who want a repeat cesarean birth, into having a VBAC, or vice versa. There isn't one right answer for everyone. For some, repeat cesarean is best. For others, VBAC is best. It depends on your situation. My goal is to give a springboard for research for those who might want VBAC, but aren't sure where to start with looking into it.

Even if you are still just in the planning stages of your next pregnancy, talk to your care provider about your options now. If you are interested in the possibility of VBAC but your OB doesn't attend VBACs, your best option for having a VBAC will be switching to a care provider who DOES attend VBAC. (You can always change your mind later, if you decide you do want ERCS.) Current research supports the safety of VBAC for the majority of VBAC candidates and some VBAMC (Vaginal Birth After Multiple Cesarean) candidates. Some of the factors to consider are personal health history, reason for prior cesarean(s), how many prior cesareans, type of incision (low transverse incision is lowest risk, but other incisions don't necessarily mean that VBAC isn't a possibility), length of time between pregnancies, whether there were any post-op infections, how recovery/healing went, and more.

Another good step is to request your full medical records of your cesarean(s), including notes from anyone who attended the birth (doctors, nurses, etc.) so you can get the fullest picture possible of what led to the cesarean and all the circumstances surrounding it. You can also ask to have your medical records forwarded to another care provider (OB or midwife) who does attend VBAC and can give you a second opinion about your options.

Some OBs will not attend VBACs regardless of evidence of the safety of VBAC, simply because of their liability. Depending on their malpractice insurance, some OBs are forbidden to attend VBACs or their insurance company will drop their coverage. Some OBs aren't aware of the research and evidence supporting the safety of VBAC and VBAMC. For some, it's a matter of their personal perception of risk (regardless of the research) or anecdotal experience. For others, it's just their personal preference because cesareans are quicker and easier for OBs. Some hospitals have policies outright forbidding (intentional) VBACs, regardless of physician preference. Regardless of your OB's reason, he or she is highly unlikely to change his/her policy and begin attending VBACs or VBAMCs if he or she doesn't do so already. If you want to plan for a VBAC (or even just leave your options open to the possibility of VBAC), your best odds may be to change providers and/or birth location to a VBAC-friendly one.

The number one factor that with whether or not a mother will have a vaginal birth (whether VBAC, VBAMC, or even a mom's first birth) is choice of hospital and choice of care provider. Know your hospital's cesarean rate, and make sure that both your hospital's policies and your OB's or midwife's standards of practice are evidence based and support normal, physiologic birth.

Here is a link with WV hospital cesarean rates:

http://www.cesareanrates.com/west-virginia-cesarean-rates/

In our region, the 4 major hospitals are Thomas (54.5% cesareans), CAMC (43.0%), Cabell (40.6%), and St. Mary's (24.3%), as of 2009 stats (the latest statistics available as of Sept. 2012).

You can find cesarean rates for other states and regions here:

CesareanRates.com

About 50% of US hospitals either have an outright or de facto ban on VBACs. De facto ban means there is no outright ban on VBAC at that hospital, but there are no care providers who attend births there who are willing and able to attend VBAC, for whatever reason (personal or legal). Some moms find that they have to travel a little or a lot to find a hospital that will support their desire to VBAC. The hospital closest to your house might not necessarily be the best hospital for your needs. Check out Joy Szabo's story. She traveled 6 hours away to a hospital that would support her wish to VBAC her 4th child when she discovered that her prior hospital had banned VBACs after her previous successful VBAC with her 3rd child. 

This article helps moms make sense of the National Institutes of Health recommendations for VBAC and VBAMC (most current research & recommendations). It looks at various factors and helps you know what questions to ask when you talk to your care provider.

http://givingbirthwithconfidence.org/2-2/a-womans-guide-to-vbac/

Additionally, we are blessed to have the first ICAN in WV here in Charleston. ICAN is International Cesarean Awareness Network, the world's premiere organization for cesarean recovery, healing, support, prevention, and VBAC info.

Their website has a lot of great info for research on VBAC vs. ERCS.

http://ican-online.org/

Our local ICAN's website:

http://icangreatercharlestonwv.weebly.com/

and their Facebook page where you can get local meeting info:

https://www.facebook.com/ICANGreaterCharlestonWV

An excellent free podcast on preparing for VBAC by Desirre Andrews, the former president of ICAN:

http://motherloveblog.com/2012/04/02/podcast-preparing-for-a-vaginal-birth-after-cesarean-vbac-with-the-president-of-ican/

ChildbirthConnection.org is one of my favorite sites for evidence-based birth info. Here are a few of their resources.

VBAC or Repeat C-Section?

Options: VBAC or Repeat C-section

Best Evidence: VBAC or Repeat C-Section

Tips and Tools: VBAC or Repeat C-Section

For moms who have a cesarean scar other than the traditional low transverse incision (including other uterine surgeries such as myomectomy), the group Special Scars ~ Special Women provides support and info on options.

Their website: http://www.specialscars.org

Their Facebook page: https://www.facebook.com/specialscars

The medical term for "attempting a VBAC" is TOLAC (Trial of Labor After Cesarean), just so that you're not alarmed by that. That term can sometimes be a little bit unnerving or less-than-confidence-inducing for some moms, but nothing negative is meant or implied. It's just the terminology used.

If you are still in the planning stages of your next pregnancy, now is the time to work toward improving your health and resolving any current health concerns, such as working toward a healthy weight for your build, getting diabetes under control, seeing a specialist if there are any endocrine issues (thyroid, PCOS, etc.) that can be treated now, reducing or eliminating environmental toxins and cleaning chemicals, and researching the pregnancy diet and supplements that are recommended for your needs. An early pregnancy class might benefit you, to let you know what preventative measures can be taken for best health for you and baby prenatally, and another comprehensive birth class later in the pregnancy if you have not already attended one.

VBACfacts.com is a great source for statistics on VBAC vs. ERCS. Its owner periodically offers online classes for parents who are preparing for VBAC.

Moms who choose a repeat cesarean may choose options for a family centered cesarean, but that's another blog post.

I hope this gives you a place to start your research! Please let me know if I can serve you with preparing info for a private (in person or via Skype) or group class for you, whether it's info on TTC, for a healthy low-risk pregnancy to increase your odds of vaginal birth, and/or birth class for later pregnancy. I specialize in informed options.

Pacifier clip = teether tether. You're welcome.

Why did it take me 5 children before I figured this out? Regardless, here's a little lifesaver for you. Use a pacifier clip as a teether tether and never lose another teether (or small toy).

I'm sure some of you figured this out before your 5th child. How many of you have tried this before? What other ridiculously simple, "a-ha!" tricks have made getting out and about with baby a little easier?

2 Mommy Necklaces Giveaway! (Ends 8-21-12)

I'm so excited to offer you not just one, but TWO beautiful, practical Mommy Necklaces up for giveaway! I contacted Raelynn Hughes, to ask her for her business cards for my clients, since I love my Mommy Necklaces so much, and Raelynn generously provided an Ambience Dangling Donut Mommy Necklace and a Nourish Rainbow Necklace with 5 extra rings, to match your outfit! For the record, Mommy Necklaces did not provide me with any of my personal Mommy Necklaces. I paid full retail for some of them, and received others as gifts from my friend. I'm not being compensated in any way for my review. I really believe in Mommy Necklaces (MN)! I own 7 Mommy Necklaces so far, which is a pretty good start to my collection.

Several of my friends had MNs before me, and raved about how sturdy they are, how high quality, how on-trend, and how comfortable they are. They are "Jewelry, Justified." MNs are strong, lightweight, and designed with you in mind: meant to be worn with little sweethearts tugging on them. One of their signature features is their "breakaway clasp" that is designed to come apart if your little one is tugging very hard at the necklace, as an extra insurance that your MN will not break.  Read here to see more benefits of Mommy Necklaces.

Left: Ambience Mommy Necklace Dangling Donut & Strand: Center: Nourish Mommy Necklace & 5 ring set.

Up for giveaway are two beautiful, durable Mommy Necklaces.

Ambience Dangling Donut Strand, 32", which can be worn with the Donut, or without it, as a chic strand necklace. $27.50 retail value.

Nourish Necklace for feeding time fiddlers, a must-have accessory for moms whose babies twiddle, pinch, or are easily distracted. Included is a set of 5 rings to wear on the Nourish Necklace, one at a time or in combination to match your outfit. Retail value $25.

Love these necklaces and want to buy one now, or in a different color? Dangling Donut Mommy Necklace collections are available here, and Nourish Mommy Necklace selections are available here.

Thanks again to Mommy Necklaces for their generosity!

Winners, I'd love to see a pic of you wearing your necklace, if you have a chance to upload a pic to Well Rounded Birth Prep and/or Mommy Necklace Facebook Wall or Tweet it to us!

ENTRY RULES:

• The only way to enter is through the Rafflecopter app below.
• All steps must be completed to qualify for an entry (I will verify each one.)
• This giveaway is open for US and Canada.
• You MUST use a valid, accessible email to enter. If I can’t contact you, you can’t win!
• Giveaway ends at midnight on August 21. Winner will be announced August 22.
• You have 7 days to respond, otherwise another winner will be drawn.
• Contest is void where prohibited.

  a Rafflecopter giveaway

6 y.o. son wants to be a lactation consultant (video)

My 6 year old son informed me that he wants to help mommies nurse their babies when he grows up. He has encouraged me as I nurse his baby brother, and he himself weaned at an age that we'll call "well into his toddler years."  He remembers nursing and I'm thankful that he knows that breastfeeding is the biological norm. I'm pretty sure that he isn't aware that an alternative feeding method exists.

He has heard me on the phone, consulting with moms who need breastfeeding info and support. When he started telling me what he wants to do when he grows up (in addition to the other things he wants to do when he grows up, like being a superhero, owning a bakery like on Cake Boss, and winning bike races), I recorded it and here's the result. It's heartwarming (to me, anyway) and too cute (in my biased, humble opinion.) He'll be a wonderful, supportive husband and daddy someday.

Have your kids ever talked about helping mommies learn to nurse?

WV DHHR wants to know what I think about WV births

I was "randomly selected" to receive a questionnaire on the health of mothers and babies in WV. "PRAMS: Pregnancy Risk Assessment Monitoring System. You can help improve the health of West Virginia babies," the cover states. WV Department of Health & Human Resources sponsors the questionnaire.

An aside. I do find it a bit odd that 1 out of 14 WV new mothers receive the questionnaire, yet I received one following my 2008 homebirth as well. Coincidence?

Most of the questions were multiple choice or yes/no demographic questions or asking about health during the pregnancy, whether I had insurance, whether I smoked or drank or took vitamins, whether my baby was in NICU, etc.

At the end was this gem. "Please use this space for any additional comments you would like to make about the health of mothers and babies in West Virginia." Why, I don't mind if I do.

Here's what I wrote. I could have done better with time to prepare, but I wanted to get it finished and in the mail.

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WV has the 5th highest cesarean rate in the US, 36.3%. (cesareanrates.com) The World Health Organization has stated that the cesarean rate should never exceed 15% or else more harm is being done than good. Clearly, WV's cesarean rate is adversely affecting the health of mothers and babies through both preventable mortality and morbidity.

"According to the World Health Organization, midwives should be the preferred medical caregiver for low-risk pregnant women, reserving OB-GYN's for high-risk pregnancies for emergency birth complications only." (http://www.choicesinchildbirth.com/Choose_Your_Medical_Caregiver.html)

World Health Organization "Definition of the Midwife," 1992:

"The most appropriate person to care for pregnant women is someone with midwifery skills who lives close to the community. People trained in midwifery are qualified to provide preventive care to pregnant women, detect abnormal conditions in mothers and infants, assist women through labor and delivery and prescribe essential drugs. When delivery complications arise, those providing midwifery care especially at the community level- need to be able to carry out emergency measures if medical help is absent and get medical assistance or refer women to an appropriate health facility."

The answer to safer, healthier pregnancies in WV and around the world, is MORE MIDWIVES, both in and out of hospitals. More midwives means huge savings in healthcare dollars, too.

Following the 6 recommendations for the safest birth possible (as recommended by the World Health Organization) would dramatically improve outcomes:

1. Let labor begin on its own.

2. Walk, move around, and change positions throughout labor.

3. Bring a loved one, friend, or doula for continuous support.

4. Avoid interventions that are not medically necessary.

5. Avoid giving birth on your back, and follow your body's urges to push.

6. Keep your baby with you--it's best for you, your baby, and breastfeeding.

Details, free videos and print materials at mothersadvocate.org.

* WV MOMS DESERVE EVIDENCE-BASED CARE. * Their babies--our babies--depend on it.

*******************************************************************************

This is what I wrote on the back of the return envelope.

I don't know how to rotate that, so here's what it says.

"WV cesarean rate: 36.3%
World Health Organization max recommended cesarean rate: 15%"

"Treating normal labors as though they were complicated can become a self-fulfilling prophecy. --Rooks"

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What would YOU say in the write-in section about the health of mothers and babies and birth in your state/region?

Our Christmas Eve home waterbirth story

I've really wanted to write up this birth story, but it seems so big, too daunting to even begin. I've felt that way with each of my births. I'll give it a shot anyway.

Quick backstory:

• 2002 Hospital birth of our 1st baby. Unmedicated birth as was my goal, but hospital routines that were not appropriate for my situation led to very difficult and painful recovery. 
• 2004 Our 1st home waterbirth with midwives. I had sought a different model of care with this pregnancy to prevent the problems and pain that happened with my first birth. Healing birth.
• 2006 Our 2nd home waterbirth with midwives. 
• 2007 Missed miscarriage followed by D&C at 14 weeks 5 days. Devastating.
• 2008 Our 3rd home waterbirth. Accidental unassisted birth. Long story.
• 2011 Here we go again... You can see my posts from this pregnancy here.

*****DISCLAIMER: THIS IS A BIRTH STORY. PLEASE CLOSE THIS TAB IF YOU ARE NOT PREPARED TO READ ABOUT DETAILS OF PREGNANCY AND BIRTH.**********

I will also upload (modest) photos from my labor and birth, but these are still labor and birth photos. If you are uncomfortable discussing cervical dilation and how to keep a perineum intact during pushing, please don't read further instead of leaving bizarre comments or telling me that I overshared. Mkay?

**************************************************************

Who's who:
me: Sarah DeGroff
hubby: Rick DeGroff
doula: Tara Gilkey, DONA
midwives: Angy Nixon, CNM, and Dorothy Kaeck, CPM
apprentice midwife: Pia Long, DONA 

I was at a prenatal checkup at my midwife's house on Wed. Dec. 21 when I had a bit of bloody show. How exciting! I was 39.5 weeks along, and hoped that would mean onset of labor within the next few days, although I have a friend who had steady bloody show for two full weeks before labor began at 41 weeks along. I really hoped I wouldn't have to wait two weeks, but I was prepared to wait until baby was ready on his own time.

The next few days were spent nesting with joyful anticipation. I had set a salon nail appointments for myself, my mom, and my 7 year old daughter for that evening, and I hoped that getting a pedicure would be all my body needed to let little man arrive. 

My 7 y.o. daughter's and my pedicures. We have sparkly snowflakes painted on our big toes.

My hubby took me out to eat after that (while my mom watched our kids), our last date without kids for a lonnnngggg time.

The next day, I got my hair cut, since that hadn't been done since mid-September. A girl can only go so long without having her bangs trimmed.

The next day was my mom's last day with us. (She had come to stay Monday through Friday to help cook and fill my freezer with postpartum meals. A wonderful gift!) I had kind of thought that I would go into labor as soon as I got my mom out of the house because I am rather private about who is around me during my labors and births. I would have felt self-conscious with mom there. 

After 3 days of continual bloody show and Braxton Hicks contractions that got gradually more intense and crampy, I did start having stronger and longer contractions as soon as my mom hit the road at 4 p.m. on Friday Dec. 23. I put together my labor music playlist, made red raspberry leaf iced tea/punch and RRL punch popsicles, readied last minute birth supplies and snacks, and headed to bed at a decent hour. (I loved my labor playlist throughout my labor, but the playlist needed to have been twice as long! It was on repeat for a l.o.n.g. time.)

Prelabor/ super early labor, evening of Dec. 23, about 24 hours before the birth. Putting together my labor song playlist on Rick's iPad, from my notes on that notebook next to it.

All night long, I awoke with contractions that were intense enough to wake me up. I had to get on hands and knees over my wedge pillow that I slept on to prevent reflux. I intensely wanted Rick to provide counterpressure on my sacroiliac joints, pressing straight down. Occasionally, I would time my contractions using my ContractionMaster.com iPhone app, but since they didn't seem to be getting closer together, I mostly just tried to sleep in between contractions. All night long, they were from 6 to 30 minutes in frequency (averaging 10-13 minutes apart), averaging from 50 to 90 seconds each, and varying in intensity. I knew that since they were so sporadic, it likely meant things were still very early, and that it could indicate malpositioning. Baby had been ROT for my entire last trimester and it seemed that he was still ROT, judging by where I felt his movements. (ROT = Right Occiput Transverse, meaning head-down with his spine aligned with my right side, facing my left side.) I wondered if his head was asynclitic (head tilted slightly toward his shoulder), a malpositioning which often is responsible for irregular contractions, abnormally long contractions for the stage of labor, contractions that are more intense and painful than they should be for that stage of labor, and piggybacked contractions, which started late morning.

Even though the contractions were as far apart as they were, they were definitely intense and painful enough to want support through them. I found myself watching the clock to see when it would be "late" enough to reasonably call my doula, Tara. Her family lives not far from us, and she basically had to drive by our house to get to her family's house on Christmas Eve, so she had already planned on stopping by to check on me and visit for a bit on Christmas Eve, even if I hadn't been in labor. I wanted to see if she could come earlier to spell Rick for a bit so he could get something to eat, feed our four kids and spend a little bit of time with them, and help me get my grounding. I called Tara around 6:15 a.m. and filled her in. She said she would come over after getting everything ready for her husband and kids to be able to head to her family's house later in the day.

At that point, I figured I was up for the day and took a long shower in the dark by candlelight, letting the water and my playlist soothe me while I let Rick sleep. The water was very soothing to me. I still needed to be in a forward leaning position during contractions, slowly swaying back and forth, and I found that singing along with my playlist during contractions helped me have a relaxed jaw per Ina May Gaskin's recommendations ("As above, so below. An open, relaxed jaw means an open cervix.")  A friend had mentioned that during her labor, having familiar songs helped her cope with contractions because she knew the lyrics and it gave her a known in a time of unknown. Maybe it was because I read that, or maybe it would have happened anyway, but I, too, found comfort in my early labor in the familiar lyrics. It gave me something to do, something to focus on other than the contractions.

My plan had been to do a #twitterbirth and post my updates as things progressed (with my doula tweeting for me after I could no longer do so myself), but I was afraid to post that my contractions were more intense or that I had called my doula in, because my contractions were still so erratic. I knew that this was either very early labor or possibly prelabor, but that didn't change the fact that I needed support through these contractions. I didn't want to feel like a watched pot then be embarrassed later if I had to admit publicly that I had called in labor support all for nothing, so I just waited to see what would happen. It was low key and no pressure, since Tara had to drive that direction for her family gathering anyway, so she told me she would hang out with me for a few hours and help me get comfortable, then we would play it by ear. If I needed her to stay, she would. If my contractions slowed down or still weren't in any discernible pattern, she would go on to her family gathering and come back whenever I called her.

Tara got to our house around 10:30 a.m. and took over labor support so Rick could tend to our kids. They both made sure I had enough to eat and drink. By this time, I wanted my electric heating pad on my lower back along with SI countersupport with each contraction. Throughout my labor, I needed to be forward leaning during contractions, either on hands and knees, sitting on the birth ball and leaning forward onto my bed, or standing and leaning onto my bed or onto the bathroom counter. It makes sense that those were the positions that felt right to me, because those positions help babies rotate, especially if they're posterior or transverse (but head-down).

Early labor, maybe 11 a.m. Forward leaning, sitting on the birth ball. Heating pad on my back. Eating Greek yogurt, enjoying distraction from my 3 y.o., and writing my blog on RRL tea labor punch.

Tara suggested wrapping my belly with her rebozo, a thin scarf-like fabric which has many uses in helping get babies better positioned in labor. I wish I had a photo, just for reference, but basically she spread the fabric across my midsection from hips to ribs and tied it tightly behind my back to help lift and bind my belly, to help baby get repositioned. We left this on for an hour or two, then I decided to get in my tub for a bit to try to get my uterus to relax from these long-lasting contractions. My uterus felt tight and painful even after contractions ended, sort of like a charley horse, and a bath can help with that.

11:30 or noon? Trying to relax between contractions.

During contractions. Sacral counterpressure helped so much.

Candy cane scented candles to set a relaxing spa mood.

I continued to eat and drink all day, everything from peanut butter crackers to apples with peanut butter, colby jack cheese cubes, toaster waffles, and chicken noodle soup (which I ate an entire bowl of about 30 minutes before I had my baby). I drank red raspberry leaf tea/punch (and RRL popsicles--yum!). I needed the calories to keep my energy up.

Since I didn't know whether this was "really it" and whether I'd have the baby today, we didn't want to call and bother anyone on Christmas Eve to have them come help us with the kids, so they mostly fended for themselves, playing Wii and watching cartoons on Netflix. We let them open craft and game gifts every few hours to keep them occupied. Here they're opening a Wii Babysitting Mama game from uncles.

My contractions were still averaging 10 minutes apart, but they were painful enough and intense enough that I wanted labor support. Tara asked if I would be OK if she went to her family's Christmas Eve gathering with family 35 minutes away from my house, if my second midwife Dorothy came to be my labor support. Tara left around 12:30, and Dorothy got here around 4 p.m.

I'm not an advocate of routine vaginal exams in labor, but since my contractions were still in that same pattern, I asked Dorothy to check me around 4:30 p.m. Mid-morning, Tara and I had discussed how far along we thought I might be, and based on how intense and painful they were, we guessed 4-5 cm, and that had been hours before. At this point I was hoping Dorothy would tell me I was around 6 cm. Nope. 3 cm. You have GOT to be kidding me. Baby was -1 station and I was 80% effaced. I know that numbers don't technically mean anything, but this was discouraging. That's part of why routine vaginal exams in labor are such a bad idea. This wasn't what I would call routine, though, because we were trying to get info on what was going on with his position and what to do next, if anything.

I spent the afternoon in and out of the tub, in for a while to try to relax and take the edge off, then out for a while to encourage baby to rotate and descend, but all the while, on hands and knees or forward-leaning, with Rick or Dorothy pushing hard straight down on my SI joints. I felt a little self-conscious that I was having such a hard time coping with the pain of these contractions because neither Tara nor Dorothy had attended any of my previous births, so they had to take my word for it when I told them, "I really have done this 4 times before without an epidural, and this doesn't feel like it did before. I promise I'm not being a wuss. I really do know how to handle contractions." They laughed because they believed me and I didn't have to explain myself, but that's just me.

Since my contractions were far apart and in an ineffective pattern, the endorphins that usually bring a mom into LaborLand in a dreamlike state and help mom manage the pain, weren't there. I was in a conscious, alert state throughout the labor. I'm guessing that the endorphins weren't sustained enough from one contraction to the next to be able to produce the LaborLand effect.It sounds like a treat, on paper, when I tell people that my contractions averaged 10 minutes apart for my entire labor, but there's a reason it's not "supposed" to be that way typically.  I've had it both ways, and LaborLand is FAR more manageable. 

I don't know how many hours it went like this, but for maybe 4 hours, my contractions were painful enough that they felt like transition. I kept telling Dorothy, "I don't know what's going on with this, but I cannot get on top of the pain." One birth affirmation I tell my childbirth class students is "I can do anything for a minute and a half," which is the average amount of time of contractions during transition, the hardest and most intense part of labor. Since my contractions were piggybacking, they totaled 3-4 minutes (combined) and that mantra wasn't cutting it. Dorothy told me, "Just keep breathing. All you have to do is breathe." That made sense to me and was exactly what I needed to hear. I couldn't get on top of the pain, but I didn't have to. All I had to do was keep breathing. I was vocalizing loudly through these contractions, moaning out the pain. Dorothy matched me through the toughest ones, and it helped a lot. I found I felt most right on hands and knees in my tub, with my feet braced against the wall of the tub during my contractions, rocking forward and backward a bit with my contractions.

More challenging to me than the physical pain and demands of my labor was the mental game, knowing that I was "only" 3 cm and "only" in "early" labor. If I had thought it was almost over, I'd have been fine, but I started getting discouraged and crying because I didn't know how I'd make it through if I had 12 hours more of this. Rick had been texting my other (former) midwife, Jennifer Stewart, who had worked with my primary midwife Angy at all my other births. Jennifer moved to California to work at a birth center in November and I was so sad that she couldn't be at this birth. She was not only the midwife who caught my 2nd and 3rd babies, but she is also one of my closest friends. Rick filled Jennifer in on what had been going on, so she called when I was between contractions to try to encourage and buoy me. I don't even remember what she told me. I was a little preoccupied. I had to hang up on her when another one came.

As it approached 8 p.m., Dorothy told me I needed to decide what I wanted to do. I had been up a lot the night before and hadn't gotten much sleep, and I was getting tired and discouraged from all day of labor like this. I could A) try to speed the contractions up and get into a better pattern, B) try to slow the contractions down with either 2 Benadryl or half a glass of wine and catch a nap so we could start fresh and maybe things would be more effective after that, or C) do nothing to change it, and just take it as it comes. My hips hurt too bad from SPD to go up and down the stairs to try to speed labor up. I had been upright a lot and changing positions. I lean toward wanting to let labor chart its own course and take option C) and just see what happens, but I asked her to check me again to gather what info we could for decision-making. I had told her that I really didn't want her to go because I felt like once my contractions firmed up and once my little man got into position, it would all be over, and she wouldn't make it back in time. (Like I said, I had an accidental unassisted birth with my last baby due to the fact that I had a long prelabor and early labor, didn't recognize it once contractions did get more intense and was in denial of transition, and I did not want another unassisted birth.) Dorothy said that if I hadn't made progress, she wouldn't leave me. She would sleep on the couch all night if she had to.

I got out of the tub so I could waddle to my bed to allow Dorothy to check me. The bath water was getting too cool for comfort at that point anyway, so it was time to drain the tub. Then I did something really smart. I asked Rick to go ahead and fill the tub again. He was skeptical because we had been talking about trying to back off on focus on labor since I "wasn't making much progress" and we were going to watch A Christmas Story since it's on TV on some channel for 24 hours straight on Christmas Eve every year. Here's what I told him, verbatim: "Water is cheap." I was afraid that once the urge to push came upon me, whenever that was, if the tub wasn't full already, we wouldn't have time for the tub to fill. I told him that if we need to drain it and fill it again, we could, but I would feel safer knowing it was ready. This turned out to be very important.

I arranged myself on my wedge-shaped pillow that I slept on every night to prevent reflux, and Dorothy checked me. She said that I was now at 5 cm, my cervix was still pretty thick and not very stretchy, and baby was a bit lower, maybe +1 now. I asked her to do Leopold's maneuvers to determine if he was still ROT position as we had suspected. I had to change positions again to move on the bed to a spot with enough room to lie flat for this. She confirmed that he was still ROT. Since I had made some progress, she called all of our birth team to tell them to go ahead and come. Dorothy would begin charting and auscultation (listening to fetal heart tones with the Doppler). She went to her van to get her birth bag with all her equipment, oxygen tank, etc. I got up and grabbed my laptop so I could tweet this:

I also posted on my Facebook page, "Maybe baby tonight?" with a link to my Twitter. 

Something in all that changing positions that I had just done helped baby get his head right where he needed to be, because as soon as I stood up after that, I told Dorothy something felt different and I thought I'd need to push soon. It was a feeling of impending dread almost, sort of like when you know you're going to have to throw up, it's just a matter of time. I waddled back to the bathroom. The timeline is blurry. Rick asked if he should turn on the video recorder I had set up on a tripod. I said yes but I knew there wouldn't be enough light. Rick tried turning on the light in the adjoining powder room and leaving the door cracked, but the light was unbearably painful for me. I've read about the importance of having dark during labor, pushing, and postpartum, but this was the first time I had felt that on such a primal level. I told him I didn't care that we wouldn't be able to see the video, just TURN THE LIGHT OFF. (We had 5 votive candles from the pic above as our only light, other than a bit of light coming in from the bedroom.)

With my births, I don't have an "active pushing stage" per se so much as Dr. Michel Odent's definition of Fetus Ejection Reflex. My body does it for me, and I have little or no control over pushing. I can try to slow it down so that my tissues have time to gently stretch, but no guarantees. I got in the tub, and with the next contraction, I was pushing. I couldn't find a position that felt right, though. I felt cornered, panicked. I tried squatting, I tried a kneeling lunge, nothing felt right. Eventually I ended up sitting on Rick's hands like a hammock. Dorothy asked Rick if he wanted to catch, but he couldn't because I was sitting on his hands. Baby emerged like a train coming. Thankfully, I didn't tear (well, a tiny surface tear that didn't need a stitch). That goes to show you what your body can do when birth is instinctive. He cried very quickly after the birth, and his APGARs were 9 and 10.

No wonder it felt so intense. I went from 5 cm and a thick cervix, to baby out, in 14 minutes, including only 4 minutes of pushing. Take THAT, Friedman's Curve!

That was crazy intense. I'm so glad he's out!

We heard a knock at the bedroom door, and our kids said, "We heard the baby cry, can we come in now?" We let them in. I pushed the placenta out then it was time for our 5 year old to cut the cord. This was "his" job that he had asked for more than 6 months prior. It was very special. I don't have a great pic of him cutting the cord, just this pic taken from above, but it captured the moment of how many people were next to my tub. It was a little hectic, but I was glad that my kids could be a part of this.

My hubby is holding baby while our 5 y.o. cuts the cord, and the others watch, fascinated.

The other midwives and my doula were en route when I gave birth and arrived just in time to do all the newborn assessments. One of the wonderful benefits of a homebirth is the ability to shower (in my own shower) then cuddle up in my jammies with my baby in my own bed. 

First nursing. It's a team effort.

My 7 y.o.'s job was to help weigh and announce his weight. 8 lb 10 oz! My second-largest baby.

Sweet little (peeling) feet.

My 9 y.o.'s job was to help measure him and announce his length. 21 1/2", so tall! No wonder I was so uncomfortable.

My midwife Dorothy who caught him.

Watching the newborn assessments.

Sign of the times. Daddy doing FaceTime with his brother & parents so they could see the baby.

The rest of my birth team: Doula Tara Gilkey, Midwife Apprentice Pia Long, and Midwife Angy Nixon.

In retrospect, my midwives and I feel that baby's malpositioning was the result of my SPD. His head couldn't easily find the right position and path due to my pelvic instability. It could have been so much worse, though! I understand even more fully now how and why so many malpositioned babies end up to be cesarean deliveries. When a baby is poorly positioned, it makes labor so much more painful, and if I had been in a hospital with an epidural, stuck on my back, I don't know how he would have found the path he needed to rotate and descend. I was so blessed to have him at home.

When I was recounting the events to a relative, and how intense and painful the contractions were, that I just could not get on top of the pain, she asked me if I was scared. I was glad she asked, because I hadn't thought of it in those terms, but I wasn't frightened at any point. I wasn't concerned that either my baby or I were in danger. I knew that we were safe and healthy, and that I had to just keep breathing.

As more time has passed since the birth, I look on it more and more fondly. I fully remember how much it hurt, but the great thing about unmedicated labor is that you feel 100% normal in between contractions. Plus, I felt like a million bucks as soon as he was out. Recovery has been a breeze. I feel strongly that it was necessary to give him the gift of the safest birth possible. It was totally worth it.

I feel that this birth was a perfect example of how pain in labor does not have to equal suffering.

We got to bed around normal time on Christmas Eve (midnight) and the kids let us sleep in until 8 a.m. We came downstairs and watched them open gifts. We were together as a family. I can't imagine what it would be like to be stuck in a hospital over Christmas.

This was a magical Christmas, our best Christmas ever.

Christmas morning

Our other 4 blessings, ages 9, 7, 5, and 3. Christmas morning.

You can see baby's newborn portraits here, including pics of him in a stocking wearing a Santa cap. Too cute.