Tuesday, September 29, 2009

The birth of Isla Elizabeth, our second daughter

November 13th 2008 at 11:40 PM I gave birth to our second daughter, Isla Elizabeth. She was born at home in our family room. Once labor actually started it was only about 4 hours start to finish ! She weighed 7lb 4oz and was 21 inches long. For those unfamiliar with her name, it is pronounced EYE-la, (like Island, the S is silent) and is of Scottish origin. Her middle name is after my auntie. Here is her story.

Things started off slowly this time. I was 40weeks and3 days pregnant and was ready to be done. After spending the evening walking with my daughter Addison on my mom's treadmill, I had about 24 hours of pre-labor contractions... not super painful or anything but not effective and never closer than about 6 minutes apart. They produced some bloody show, and I was very excited! I thought that I would have a baby for sure by morning.

They were bad enough that I couldnt sleep through them and they came every 6-8 minutes all night long! I spent the night in and out of bed, bouncing on my birthing ball and talking on the phone with my midwife. But they never got any closer together. Talk about discouraged! I was tired, and I couldn't sleep. By morning I was discouraged and exhausted from lack of sleep, and they had kind of petered out and were coming more like every 10-15 minutes. They were still pretty pinchy and painful. I could not help but feel like her head was not in the right position, and was just jamming ineffectively into my pelvic bones. By this time I was praying they would stop so I could just have some rest.
I finallydrifted off to sleep and had a two hour nap with no contractions to speak of. The sleep was nice, but I was still dissapointed.

I had a midwife appointment at 1:00 PM and was encouraged to find that all those obnoxious contractions were actually doing something after all, I was 3cm dilated and 90% effaced! (the day before I was only 2cm and 40%) They stripped my membranes again and sent me on my way, reassuring me that when things did finally decide to kick into gear it would most likely go very quickly. I left the midwife in much better spirits.

On the way home we went to Fred Meyer for some groceries, and on the way out the door I had a really nice strong contraction that I had to breathe through. We grabbed our last minute provisions and headed home for our home birth!

Once we got home we put in a movie and I laid on the couch and we waited for things to pick up. Once again, the contractions were a stinging, sharp pain in my pubic bone and I just wanted to cry. This was not how labor should be. I could not relax through this kind of pain! I couldn't work with it! I just wanted it to be over already.

Jay tried to cheer me up, and he told me he was betting we'd have a baby before midnight. I thought to myself, "yeah... right." I wasn't even in labor yet, and midnight was only 7 hours away!

It has been my experience that just when you resign yourself to the fact that your baby is NOT on it's way, it mysteriously decides to come out! I think I will try to be determined of this fact much earlier with the next baby. *giggle*

I was in the bathtub when my mom arrived, and Jay was sitting next to me writing down my contractions on a peice of paper. They were still pretty irregular, but were coming between 5 and 7 minutes apart. They were still rather pinchy and just did not feel effective to me. They had a strange quality to them, and I still wondered if Isla's head was in the proper position. We discussed it and decided that I should get out of the tub, that maybe the warm water was slowing things down. My mom suggested that we go find something to distract ourselves, so we sent Jay to Walmart to buy a game of Scrabble to keep our mind off of things and wait for the hard contractions!

I was still downstairs in our family room, and my mom had gone upstairs when my cellphone rang in the pocket of my bathrobe. It was Jay, and he wanted to talk to my mom. Unbeknownst to me, he was going to tell her to call the midwife and see if they would come check on me. He thought I would be encouraged if they were there. I didnt want to call yet, because I was still thinking this just might be another false alarm.
I jogged up the stairs to give the phone to my mom, and I felt the baby shift in my pelvis. The next contraction when I got to the top of the stairs immediately felt different. Like labor. No longer pinchy, and I recognized the feeling from Addison's birth. YAY! She had finally tucked her chin, and we were ready to rock and roll! I was much encouraged at that point, and we called the midwife to come check on me in a little while.

Months later, I happened upon an article on fetal positioning, discussing techniques to get a baby to tuck it's head for a better delivery position. One of the suggestions was walking up the stairs! I am so glad Jay called when he did.

Labor

Almost immediately, about 7:30 PM my contractions started to come closer together. I think Peggy and Jackie (my midwives) showed up sometime around 8:30 and we started getting stuff set up for the birth. Peggy checked me once things were set up and found I was 5cm dilated! I was surprised because my contractions were not nearly as intense as my labor with Addison, and they didnt last very long... only about a minute each. I just did my best to relax through them and allow them to do their job. They were still mild enough I never needed to make any noise through them, just breathing was enough. I was totally alert, and still my normal self between contractions.

They felt much better when I walked through them, so I stayed upright through the whole thing, just pacing and walking and taking breaks between them to play my Scrabble turn! Which I won, by the way!

My sister Rosanna, Jay's mom Christy and our two year old daughter Addison (She was at Grandma's for the afternoon so I could try to get some rest) showed up around 9:00 PM and we all got to talking and laughing. I was surprised that I was still up and around and talking during contractions even during active labor! I got kind of tired of walking around 10:00 and got into the shower. I spent each contractions rotating my hips in circles to help the baby move down better.

While I was in the shower, Jay came into the bathroom and peeked around the shower curtain at me. "We're going to have a baby!" he said, huge grin on his face. He was so darn cute, I couldn't resist. So I kissed him. And I kissed him. And kissed him some more. Just the two of us, laboring for our baby in our own bathroom, all alone. It was very intimate, and arousing, and passionate and dare I say it, sexy! The slow warmth spreading through my belly helped SO much to relieve the intensity of my contractions. This is my favorite memory from Isla's labor, and a pain releif technique I intend to try again!

I stayed there for maybe 20 minutes and then I didnt want to waste any more hot water so I got out and walked around some more while they got the birthing tub filled the rest of the way up and at a good temperature. I grabbed my makeup bag, and went into the bathroom and applied some concealer, and bronzer, and brushed my hair. My mom laughed at me! She said she'd never seen anybody worried about their looks at that point of labor. When the tub was ready I climbed in and felt SO much releif as I could totally float in any position I wanted to without putting pressure on anything. It made relaxing during contractions so much easier and I really felt like we were making progress.
But the warm water slowed my contractions way down again to about five minutes apart. At this point, my grandma showed up so she could see the birth and she joined the family upstairs waiting.

I got a good case of the giggles then, and for some reason had the song from Mulan stuck in my head,
"Let's get down to business, to defeat the Huns. Dare they send me daughters when I asked for sons?" I'm not sure why it struck me so funny, maybe because I was having my second girl? I was in the middle of a contraction, chuckling away in the tub. Although I was reluctant to laugh at first, thinking the pressure of the laughter would make the contraction hurt worse, I found that every time I giggled it reduced the pain by at least half!
I guess it's true what Ina May says, you can't have a tight cervix and a laughing mouth at the same time. I was amazed to find that the more humor I felt, the less pain was involved, even during hard labor. So I enjoyed my time in the tub, talking with my sister about her pooping in the tub when we were kids, and I ate some chicken noodle soup in between contractions.

I did not want to be checked again for a while, because my contractions were still relatively mild, and now spaced far enough apart I was worried that I would still be at 5cm, and I didnt want to be discouraged. But after another few contractions my curiosity got the better of me and I asked for a cervical check. I thought it would be good to know, so I could change activities if I wasn't progressing.

Jackie checked me and determined I was 6 cm, stretchable to 7 and there was a protruding bag of water that was keeping Isla's head from really applying as well as it could have been. So we discussed it and decided to break my water. That immediately made my next contraction much stronger, and I remembered that "birth is imminent" feeling from last time, the one that you cant help but moan... ok moo like a cow through!
I found that again, as in my labor with Addison, keeping mind over matter and willing myself to relax through the contraction, welcome the sensation, allow it to be there and do it's work was the hardest part of labor.
I remember at one point at the peak of a contraction saying "Open open open open open"... over and over again. It was important somehow to tell my body I WANTED to open.

Transition

I started getting emotional at that point and just wanted to cry as I though of transition... remembering back to my first labor, I was assuming it would still be at LEAST an hour or maybe two of the real intense labor before she would be born and I was a little overwhelmed thinking about it. Although I should have guessed by my emotional response, I had no idea how far along I really was!

I flipped over and rested over the edge of the tub on my knees. My mom came to sit with me, and held my hands as I dealt with my emotions.
"You're almost done,you are doing perfectly! You are making this look easy. It will be over in just a few minutes." She whispered as I fought back tears.
The tears were not from the pain, just the emotion of transition. My body was getting ready to birth.

The contractions were still spaced way far apart and I had three of the really intense ones before I started to feel pushy right at the end of the contraction! I only had three hard contractions in between my rupture of membranes and when I started to push. Three hard contractions, my whole entire labor! I could NOT beleive it!

"I'm pushing! WHY?" I breathed, confused, thinking it must be another premature urge like I had with Addison. But my amniotic sac was no longer intact, so it was impossible to have a bulging bag of water... Then I felt her head slide down into my birth canal.

"It burns!" I gasped. Jackie leaned toward the tub, as Peggy walked around back to see if she could spot a head. "Put your hand down there Sharon" Jackie instructed. "No!" I said, in a state of confusion, "She's not crowning yet! I dont think..." I was thinking how impossible it was that I was really pushing out my baby, when only minutes before I had only been 6cm dilated.

"Sharon" Jackie said, looking into my face. "If it burns, you need to put your hand down there" So I did. "Can you feel her head?" I felt with my hand, and sure enough, there was her head, just inside the opening.
"Oh, GOD! Yes!" I sat back so I was on my haunches, my hand still on my perineum, so I could proceed with my birthplan. There was no way I could catch her myself on my hands and knees.

"Where is Addison?" I asked. Calm and collected now. Filled with adrenaline. Ready to birth my baby. She was upstairs playing. Jay asked his mom if she could go get her.

"I was going to in a minute" she said, not realizing I was so close.

"I don't think we have a minute" Jackie warned. So off Grandma scurried to fetch Addison, and let everyone know things were getting close. They came down and stood on the stairs so they could see the birth without being in the way.

The birth

With the next contraction I HAD to push and could feel her little head bulging out of me! It burned a lot and I was worried that I still had a cervical lip, but Jackie felt at my request and told me it was ok to push, I wasn't gonna tear anything. So I did. I was kind of in a squatting /semi sitting position as her head was born with the next contraction. I was guarding my perineum and could tell just how much to push as I birthed her head into my hands! I felt around her neck and could feel a cord so I had Jackie feel again... it was wrapped twice! And it was too tight to slip over her head.
My contractions were still so far apart, as pushing contractions usually are. There was a four minute break between the birth of her head and the birth of her body. So I was just sitting there chatting away with a baby head between my legs! I was feeling her little face with my hands, and stroking her fuzzy head. I could feel her fat little cheeks and her ears. Her eyes were closed. (Or maybe she just closed them because she didnt want to get poked in the eye by her mother's curious fingers?) I was in love, touching my new baby girl for the first time. I wanted to see her face so badly! But I had to wait for the next contraction.

Addison was on the stairs watching her sister be born and she was soooo excited! She was singing songs and talking excitedly "There is her head! She is coming out!! She is big enough, Grandma!" I could hear her singing.
As time kept ticking away, we were starting to look at the clock because it seemed like her shoulders were not going to rotate on their own. But we couldnt be sure until I had a contraction. So we started stimulating my nipples, Jay on one side and Peggy on the other to get the next contraction to hurry up, and Jackie and I helped her shoulders turn.

"Addie just slid out" I mused.

Isla's heart tones were good, and her cord pulsing, but still we couldnt' be sure how tight the cords were wrapped, and we didnt want her to be short of oxygen. Finally after four long minutes the contraction started and I pushed again. Because the cord was too tight to slip over her head, we had to summersault her out of there and unwrap them on the way up. It was interesting for sure! Half her torso came out, then Jackie had to pull her sideways so her bum popped out before swishing her the other direction to get her legs out. Then she flipped her over twice so she could reach the surface!
I was thankful she was in the water, because it was a much more gentle maneuver with the bouyancy of the water to support her weight. She just swished from side to side.
So obviously I didnt really get to catch her all the way myself, but I was not dissapointed. We did what we had to do to get her out safely.

Then up she came out of the water and on to my chest at 11:40 PM! Jay was right, she was born before midnight. (All in all it was only 35 minutes from the time we broke my water (6-7cm) until she was in my arms!) There she was! My baby girl! She was pink and warm and wiggly. She croaked a little, and grimaced.... and then she WAILED!
Such a high pitched mew of a cry, but filled with so much spunk! Wel aughed and thought she sounded like an angry kitten. I scooped her up in my arms close to my chest and kissed her little head.... another perfect baby girl to call my own. Oh what a precious moment!

Big sister Addison was with her grandma on the stairs watching her sister be born and her little face was priceless as she saw Isla come out! SO adorable! She ran down the stairs once the baby was born, and peered over the edge of the tub to see her. She did great, she wasnt afraid at all.

I am so glad she got to share that experience with us. Also watching the birth was my grandma, my mom, Jay's mom and dad and my sister Rosanna who was taking video. My little brother who is 14 was here too, but he stayed upstairs until everything was cleaned up. (who can blame him?) We spent the next 20 minutes or so floating around in the tub.
Isla was so alert, just looking around her and kicking her feet and waving her arms around. She was listening to everybody's voices and trying to figure out who was who, following people faces. She really was trying to find her sister's voice. She could hear her but not see her over the edge of the tub and it was obvious she was looking around for her. Its amazing how much newborns know when you just sit and watch them! Once my placenta came we cut the cord and let Jay take her so I could get out of the tub.

She got her newborn exam and came back to me to nurse. She latched on immediately like a pro! She nursed and nursed and nursed and nursed which was a good thing because my uterus was having a hard time staying clamped down and I was losing a little more blood than normal. But as soon as we got it to really clamp down it stopped and I was totally fine. The midwives left a few methergine tablets for me to take every four hours, just for preventative measures.

It took about three hours for the midwives and everybody to get the birth area cleaned up and all the checks done. I was happy to report I did not tear at all! I had wondered if maybe I had a few little nicks because it burned a little more than I expected when I pushed her out, and then we had to kind of pull her shoulders out which could have caused a tear, but I was good to go! That definitely makes recovery much easier. I am very thankful for no stitches down there in my lady business!
I got a shower, the tub got emptied by my husband and everything was buttoned down for the night. Jay put Addison to bed, the extended family went home and we got all tucked in for bed. The midwives left us about 3:00 am and we went to sleep, baby Isla curled up on my chest.

It was pretty much perfect! I couldnt have asked for anything better. Isla is a great nurser, she latched on right away with no problem, and is alert and curious. She looks so wise and all knowing, and has wonderful eye contact, like she has something she would like very badly to say. Her features are completely different from Addison's, she is definitely her own little person. It appears she will have blue eyes, they are definitely brighter than your average newborn gray!

Some thoughts
In hindsight, I think it was probably the cords around her neck that kept real labor at bay for so long, she probably had a very hard time tucking her chin enough to get in position. Even as her head came out and I was feeling the little fontanelles, I know she was coming out with her head more straight on, as the fontanelle I was feeling was very large... the major soft spot on the top of her head, not the little triangle of bones on the crown that you usually feel when their chin is tucked properly. Even the midwives commented as her head was born, Jackie thought she might be posterior because of the top of her head presenting. And in the day after her birth, you could see redness on her face, as though she scraped it along on the way out. But it all worked out and she was still born very quickly, regardless! I am very happy with the way things went and I feel very blessed to have had a super easy labor and another beautiful baby girl!

My home birth was amazing in every way, it was easy, gentle, peaceful, intimate, and joyful. Everything I hoped it would be. I am looking forward to doing it again next time!

Her birth video can be found at http://www.vimeo.com/6453093

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