Liam's birth day

***Warning:  Get a cup of coffee and sit back, this is going to be a long one. Also, there may be too much information for some of you. :) ***

Where do I begin? Liam's birth day, all started a little before 5 am last Sunday morning. I was dreaming I was having contractions. I fell asleep listening to my hypnobabies tracks on my iPod so I thought it was just me "visualizing" the actual birth day. In the dream I even questioned whether these were real contractions and I told myself if they were real then I wouldn't be able to sleep through them. But a little before 5am I was woken up by a contraction. I just laid in bed and told myself if I got 4 in a row I would get up and make breakfast since so far all my Braxton hicks have been in a pair and then nothing. By 5am, I was buying an app for the iPad to track the contractions. I made breakfast (2 eggs, ham, and toast), then contractions were less than 10 minutes apart so I went upstairs to wake Nick up.  He reminded me that Kaleen lives an hour away so she would need a bit more notice.  I think he was scared when I told him contractions were now 6 minutes apart and had been less than 10 minutes for an hour now.  So, I called Kaleen and she said she'd be right over.
I was in good spirits.  I didn't feel like listening to the relaxation music, I wanted regular music so Nick played whatever song I told him I wanted to listen.  I swayed to the music in between contractions.  Nick and I are staying in my old sister's room and there's a 4 post bed, I just held on to one of the posts through contractions and I used it as support to squat through contractions.  I tried to use the birthing ball but it only felt good when I was not having contractions because the pressure was too strong through contractions.  So, I remembered the birthing positions from the hypnobirthing book and I recalled the squatting position.  I tried it and it made contractions more bearable.  I did a lot of "body work" (walked, squatted, and breathed) through each contraction.  At this point, I felt great because even though they were strong, they lasted anywhere from 1 minute to 1:40 but I was getting 5 minute breaks in between.  So, for my runner friends-- it was no different than sprinting your heart out for a minute and then walking for 5 minutes, it was enough of a break to feel good about doing it again.
Kaleen and Rhonda (assistant/doula) got to the house around 7:30am and they went straight to my parents' bedroom where I was to give birth.  My mom and dad had already cleared the room but they had to set up.  A few minutes later, Nick came into the room and said "whenever you feel up to walking over, they're ready for you".  I walked into the room and saw it transformed.  I wasn't expecting it to look the way it did-- they had their stations set up.  My supplies, the baby station, the afterbirth section, etc.  I will say that when I saw the "Emergency Oxygen tank" on the floor, I got a little anxious but I quickly went back into my zone and ignored that part! :)
By this point the contractions were stronger and I was not getting much of a break in between.  Kaleen never checked me to see how far I was dilated.  In my mind, I didn't want her to or at least I didnt' want to know how far I was because I thought if she says "5 cm" and I was feeling the contractions so close in between then I would probably go into a negative zone.  So, I was happy she never did.  I really thought I had hours to go.  She would just ask "do you feel nauseous?" and she made sure I drank in between contractions and would talk me through in the most relaxing voice (she was calmer than the CD's I had listened to).  At one point I told her I felt really weak.  I remembered having this feeling with Gavin's labor---except I interpreted it as a drop in sugar and that's when I asked for an IV because I thought I was going to pass out.  Well, when I told Kaleen I felt weak and shaky, her and Rhonda both said "that's good".  They both laughed and said they knew what I was feeling and it just excited them.  Kaleen explained this was my body releasing all the relaxing hormones to get ready for delivery.  She knew I had a full breakfast and had been snacking/drinking so she knew I was ok.  I then said "ok, now I'm nauseous" and again they both said "that's a good sign".  Well, it turns out it's not uncommon for women to feel nauseous when they reach 8cm or so.  This was also the point when I got a contraction that was SO intense, I bent over the end of the bed and was tapping out--it was all on my back and so tight.  I remembered this contraction.  It was the same as the one I felt at the hospital with Gavin.  It was the one that broke me down and led me to the epidural.  What I did not know or realize at the time is that my body would give me a break afterwards.  It was so intense but the next two contractions were not as bad.  My body knew I needed a break to go on.  Kaleen asked if I was ready for the tub.  Without hesitation I said YES!.  With Gavin's labor, being in the tub took away all the back pressure so I was looking forward to this part when I would get my "aquadural" (the natural "epidural").  The tub turns out was not as good as I had hoped.  I laid back and felt the pressure even more on my back so Kaleen said to try leaning forward.  The tub shape just did not work too well and that didn't work either so I tried laying on my side and that worked ok.  The problem was that I was feeling pressure out the other end---I was afraid I would relax too much.  I kind of had the urge to push but I didn't think it was because of the baby so I told Kaleen I wanted to go to the toilet.  Rhonda said the toilet was a great place to labor because psychologically we are already trained to relax those muscles down there when we're sitting on a toilet.  So, they had me sit on the toilet backwards so I could lean on the back.  As I walked over to the toilet, Kaleen told Nick "get ready Nick because if she starts pushing we're going to have to pick her up and take her to the bed."  I laughed and she said she wasn't joking she's had to pick up women herself.  I didn't think I was ready to push a baby.
As I sat down on the toilet, Kaleen said "are you pushing?"....I honestly don't think I answered--I think I was trying to process what was happening.  All of a sudden I hear her say "NICK!" and that was that----trip to the bed.  When I stood up, she could feel the head.  From that point, it's a bit of a blur to me since it happened so fast.  I do recall Nick's face as he said "OH MY GOD, he's there!" as I laid on the bed.  I had crowned and my only words were "Get him OUT!" and Kaleen replied something like "just wait 'til the next contraction and push him out".  I was quiet through the laboring process but at this stage I did let out a couple of loud grunts.  I did cover my mouth at one point and Nick said "Oh, Steph please"....but it wasn't out of consideration for everyone else.  I just knew that it would just waste energy so I was trying to physically remind myself to not loose it.  There was no time for the ginger compresses--two pushes later Liam was born.  Even though I felt pain/pressure, my mind kept reminding me to take in this moment.  I remembered thinking "so, this is what it feels like".
I can't even describe the feeling after it's all done.  As soon as Liam came out, the relief and the rush of all the hormones made me feel amazing.  After the afterbirth, when I walked to the bathroom I could not believe how great I felt.  I did not feel like I had just pushed out a baby.  For anyone who has the opportunity to and is able to do a natural birth, this is definitely the way to do it.  I realize that's not possible for everyone but it really was as empowering as I thought it would be.  I think the fact that I was home contributed to the quick labor.  I was relaxed and familiar with the setting and I never worried about anything else other than myself and Liam.  Plus, the timing was perfect.  I had about 5 hours of sleep and had a good breakfast so I was rested and fueled which makes a huge difference.  Who can run a marathon on no sleep and no food?  Labor is no different.  

To prepare for this natural birth, I read a lot.  I actually co-authored a book chapter on how women manage pain during childbirth (forthcoming in the new book, "Midwifery: New Research") so I got to read a lot of birth stories from women who were able to have a natural birth and how they managed labor and compare them to those who aimed for a natural birth but ended up with an epidural.  So, what I learned from doing that research and my own experience is that the human body is an amazing machine but the human mind is even more extraordinary.  It is all about how things are perceived.  I did a lot of visualization through this labor.  With every contraction, I didn't think of the pain, I tried to focus on what my body and Liam were doing.  I could feel him coming down.  Every contraction brought him closer to being born and that changed everything.  It made me focus on what position I could take, what I could do to make that easier rather than just think "it hurts" and tense up--which is counterproductive.

My midwife, Kaleen, and her assistant, Rhonda (also a doula), were a great help through the pre-natal care and on the birth day.  Having never met anyone personally who had done a home birth, I really did not know what to expect.  By the way, a lot of people asked me if the midwife was able to administer drugs.  Kaleen is not only a certified nurse midwife but also an ARNP so she is able to prescribe and administer medication as necessary.  So even though the birth was at home, if there would have been an emergency, she comes prepared with medication to hold off labor to give time to get to a hospital and any drugs that could be necessary for the afterbirth and the baby.  So, it's not like midwives are against drugs/medication.  They just only administer drugs when absolutely necessary.  
I was (and everyone in the room) so impressed with how they handled everything.  It's so different from the medical model of care.  I have nothing but great things to say about the midwifery model of care and would not trade it for anything else now.  The main priority is always mom and baby and not whatever protocol they have to follow.  Plus, when they left no one would have known someone birthed in the room.  I never saw any blood or mess in any way.  In fact, when they put Liam on me I thought they had wiped him down because he was born relatively clean.  She said that's not uncommon in full term babies.  This could be gross to some of you but I thought it was pretty cool that she inspected the placenta in front of me and explained what everything was and how it all worked.  In a medical setting, it's like they underestimate the patient and just don't bother to talk things through.        
I am lucky and thrilled that I was able to have such an amazing birthing experience.  I always compared it to running a marathon and in many ways it is, but the reward is so much better.  :)