The Birth of Linden Miles

December 22, 2008, 10:12 am, 7 lbs, 5 oz., 19.5 in.
Sage Femme Midwifery birth center

With a Christmas Day due date we expected Linden to be our Christmas present. Instead he was our wedding present.

Linden, our first baby, was born after 10-12 hours of active labor, including 22 minutes of pushing. He was welcomed in the Pink Room by his mama and papa, our midwife and SFM founder, Judi (RN, CNM), and our two student midwives, Bianca and Jessica.

Our story begins on the morning of the Winter Solstice, the "day of new beginnings." I'd planned to wake early that morning, and the first contractions awoke me 20 minutes sooner than planned. It was just before 7am. The contractions were 10 minutes apart. I felt them low in my back, and then a little in the front. These were the first contractions I'd ever noticed during the whole pregnancy. This morning was already something special as it was also to be our wedding day. Yep, we tied the knot 24 hours before Linden joined our family!

I was especially tired out that morning. The previous day was filled with nonstop wedding preparations. A late night of making chocolate red wine wedding cupcakes left me that morning with only 6 hours of sleep. I so didn't want to wake up, but my bladder couldn't wait. After three contractions I went to the bathroom, and saw my mucus plug in the toilet. "Hey! This means something!" I thought. I next googled "mucus plug" and decided it might not be anything to get excited about.

I went through the day convinced this was going to be a day of practice contractions that would just go away. Two full term students in my prenatal yoga class described that experience, so I figured it must be my turn now too. Another good reason not to get excited too soon came from our childbirth class instructor, Melissa. She cautioned us about that so that we'd save the energy for when it was really needed. And besides that, we had big plans for the day!: a little ceremony to perform, photos to take, an out-of-town holiday lunch with immediate and extended family that afternoon, and surprised wedding news to share to everyone. (It was all hush hush since it was uncertain we'd be able to pull it off so close to the due date.) So, we calmly carried on as planned.

Our ceremony was performed in the chilly, drizzling rain on our favorite neighborhood hill. Under my dress I wore a heating pack very thankfully sent to me by my father-in-law. Despite the weather, this turned out to be a most delightful and distracting activity for early labor! People tell us that the steps we climbed to the top of the hill probably contributed to the quick progress that followed.

Mild, irregular contractions continued through the late morning. We cancelled plans to meet my family for an out-of-town holiday lunch. On the phone, my mom and aunt seemed confident that this was "it."

We ordered take out from a favorite Vietnamese restaurant. Lunch at home was a fun and relaxing time with our friends, Kristine and Roeben. They had performed, witnessed and photographed our wedding ceremony. At the end of lunch I felt my body weaken suddenly during a couple contractions. Such an odd sensation. There was no increase in pain level; just all of a sudden I felt all my weight give in to the table. I remained certain that active labor was still a long way off, and we continued our nice visiting. However, I did decide it was time to start practicing with Contraction Master (the free online tool for timing contractions). We never ended up using it much; it turned out I needed Rick more for pressing on my pressure points than pressing on the keyboard.

After a round of champaign tea and the chocolate red wine cupcakes, our friends headed home. I was starting to think I should take the possibility of real labor more seriously. Time to get some rest!

I napped on and off into the early evening. The first call to our midwife, Judi, was just before 5 pm. My descriptions suggested to her that it could be tomorrow or three days. Around 6 pm I posted my status on Facebook to let family know I was resting and turning off my phone (since they kept calling to check on me). I was feeling good about everything.

I sensed things picking up more around late dinner time. I directed Rick to prepare our vegetarian "turkey" roast, which we brought to the birth center for our post-birth celebration meal. It was time also to begin using pain relief techniques from childbirth class. I arranged pillows and blankets as props like in my prenatal yoga class.

The lower back discomfort was there since the morning. I was slow to accept that the dreaded thing called 'back labor' was happening to me. Back aches lingered between contractions. Once labor picked up it was difficult to tell when a contraction was over. Sometimes I experienced a series of short, intense contractions one on top of the other. We timed a couple contractions at 3-4 minutes in length (because I couldn't tell when they really ended.) Now was the time to regret not following advice against slouching in the preceding weeks. It was explained to me which reclining positions could lead to back labor, but those were always my favorite.

I noticed a steady increase in 'bloody show' each time I used the bathroom. I took this to mean that dilation was going well. I credit Ina May's book for the idea of using visualization techniques to help with the progress. I remember at one point wondering if it might be working too well, and whether I ought to stop using it. My visual came from our favorite Japanese cartoon, My Neighbor Totoro. I imagined the magic cat bus and it's magic door, opening for passengers with sci-fi sound effects. Each time I went to the bathroom this door and sound were in my mind. I trained Rick to make this sound for me often so I would not forget.

I grew concerned when the bloody show increased and started clotting. I read this could indicate a problem with the placenta. A quick call to Judy relieved my worries. That was around 11:15 pm. At her direction Rick and I had a glass of wine, so we could try to get some sleep. We'd bought a bottle of red wine precisely for this moment. I was excited about getting to use it, but it was surprisingly difficult to get that glass down. I was feeling dehydrated, thirsty for just water, and too tired to drink. It seemed like it took 15 minutes for Rick to get me through it, then we hit the sack. It was midnight. Three hours of the best solid, deep sleep followed.

Around 3 am I woke up sweating and in a panic. The panic was because I suddenly became aware that I'd fallen asleep still wearing the heating pack, which the warning label says never to do since it could lead to skin burns. In my sleepy state I imagined Linden burning, and I instinctively torn off the pad. Then, immediately, I felt a wave of super intense contractions very close together. I felt like I was in a free fall. I pushed my legs against Rick to brace myself.

I don't know how he was able to sleep through that. I sensed I needed help, but didn't know what to say or ask for. I woke him and commanded him to time the contractions. We moved to the living room, where the laptop and pillows were set up. We found some good positions, massages and pressure points. The best spots were the knees and around the sitz bones. When pressure was just right, I felt deep relaxation. It was like throwing a mechanical switch that lessened and/or ended the discomfort quickly.

Labor was like an Olympic event for both of us. Rick did an amazing job. The pressing was hard work. I often felt his arms struggling to hold a position for the length of a long contraction. I wished so much that there was some relief for him. I'm so proud of him for following the advice never to admit feeling tired.

If there's ever a next time we've decided we'll have a doula to help. An extra person would have helped for those many times when Rick's hands missed the mark or when his strength gave out. I was frequently making demands for him to press harder. Dare I ask him to move his hands and risk loosing the tiniest bit of relief while he searched for the right spot? All pressure helped at least some, and it's very difficult to direct someone to the right spot when you are focused on getting through a strong contraction, and can't speak. Sometimes his hands felt like they were just gently resting on me, and I'd hear him say he couldn't press any harder. Then, a rush of emotions would come over me--frustration, helplessness, abandonment, etc.

Humming was an amazing source of comfort. In the childbirth class we experimented with various pain relief tricks while keeping a hand submerging in ice water. We discovered that humming together was the most effective of the distraction techniques. But we never practiced this outside of class before active labor began. We had to trouble shoot our methods now. I had Rick hum in a low pitch similar to the 'om' used to open and close my prenatal yoga classes. Once he figured out what I wanted, I found it extremely soothing. It had to be the right low pitch and last for the entire length of a contraction. If not, I felt the heights of agitation.

In our early tinkering with Contraction Master, we decided I would say, "spacebar" to signal when contractions started and stopped. However, the intensity and frequency of the real thing took me by surprise. I had trouble speaking coherently. Often when a contraction started I was only able to repeat, "okay, okay, okay, okay." Rick would ask for confirmation, and I would just nod and repeat, "okay."

The surges became closer together and our techniques required increasing effort to bring relief. I had Rick consult our birth center-issued handbook for additional back labor tips. He didn't have to read much in the handbook before he became convinced that I was well into real, active labor. He later told me this was when he first started feeling nervous. He called Judi.

Judi directed me to get into the tub to see if the hot water would slow things down. Around this time I started sometimes feeling a mild urge to push. I was in denial about what that could mean. I didn't want anyone thinking we should stay home and call the paramedics.

I was surprised to have no comfort in the bath. My dreams of a water birth vanished. This was my second time in the bath during labor. Both times I was left alone and laid my back on foot massage balls. I got no relief near as nice as with Rick's hands on the living room floor.

Getting out of the bath felt impossible. It seemed like my movements were triggering the contractions. The surges were so close together. I became afraid to move, and felt trapped in the bath.

Judi called to check on me and told us to head over to the center (a 15 min drive away). I needed Rick's help to dress between contractions. I thought we'd never leave. Rick was running back and forth between putting things in the car and helping me in the bathroom. As soon as a surge ended, he'd run to the car. Barely out the doorway, he'd hear me yell out for him to come back for another contraction. I posted in advance by the front door our checklist of things to bring. Don't ask me why those things weren't already in the car.

After 30 minutes Judi called to see what'd happened to us. I was stuck on the toilet, half dressed and afraid to move. She stressed that we needed to leave asap.

We finally arrived at the center at 6:40 am. In the car I was anxious about having contractions alone. I took the back seat so I could lay down, still buckled of course. I forced myself to relax by focusing all my will and energy. I would count, one, two three, and then release my muscles. Whenever I succeeded in this the pain seemed to stop suddenly. I reminded myself that by doing this I was also making things easier for my baby. Rick thought I had fallen asleep, because I was so quiet. Nonetheless he let me know where we were along the whole drive there, and I really, really, really appreciated that.

When we got to the center we were both so happy (relieved to finally be there!) that the birth team thought we couldn't possibly be as far along as we soon learned we were. The contractions were still very close together, so I had to lean on Rick to get through the surges every few steps. I smiled at our ridiculously slow progress through the building.

First, they wanted to start with a urine sample. This didn't happen. We later learned that Linden's head was compressing my urinary track, preventing me from being able to pee. At the time I thought it was some strange, sudden mental inhibition. I tried to visualize the cat bus door again and we ran the faucet to help encourage me. One of our student midwives, Jessica, kept suggesting I try again after the exam, but I hated any extra movement, and every time I started to stand, I felt the urge to pee, so I kept on trying. After the delivery, I heard I'd been on the toilet for 40 minutes. Rick stayed with me most of that time to press on my knees during the contractions. Finally, they got me and my full bladder into the adjoining exam room.

At the exam Judi said, "well, guess what my dear, (little pause) you're ten centimeters." Ah, what relief to hear those words! I was way too tired to show much reaction. During her little pause Rick admitted later that he was afraid she was going to tell us to go back home.

We had another 2 and a half hours to go before getting the green light to push. Three things had to be taken care of: (1) I needed antibiotics because I was positive for GBS; (2) Linden needed to be repositioned from face up to a face down position (this was the cause of the back labor), so that he would not get stuck on the way out; and (3) my bladder had to be emptied with a catheter to avoid my bladder becoming distended and taking up space. The catheter and turning Linden ended up seeming like the least pleasant parts of the whole experience. I'd gladly trade extra contractions for those moments.

Speaking of tougher moments, there were two times when I wondered if I was in the transition phase: during the second bath and during the ride to the center. The sensations were very odd--as if my body was trying to do something impossible, like it was trying to turn itself inside out. As tough as things got, I always expected it to become even harder than it actually was. I don't remember ever thinking I cannot do this--except perhaps when we tried to turn Linden's body around.

Judi tried a couple times to turn Linden's head with her hand, but his head kept flipping back to the same position. This was pretty painful and I was afraid that my cervix might shrink as a result. We moved to the delivery room to try another technique--lunges.

The Pink Room was made up for us. The lights were kept dim according to the specifications in my birth plan. Judi gave me a choice of a pad on the floor or the bed, which looked pretty high off the ground. My body went instinctively for the closest, easiest option--the pad on the floor. For these lunges I needed to be on all fours with one leg bent to the side. I was too weak and in too much discomfort to hold this position correctly, so Rick had to hold my leg in position. My arms rested on a small birth ball, because I had sore wrists. I had to do lunges continuously through three contractions on each side until I felt the baby move.

It was an extremely uncomfortable exercise and felt like it took forever. I remember reflecting on how the prenatal yoga experience gave me the confidence to endure this. Finally, I felt baby movements. Judi confirmed that he was turned. By this time the antibiotics had had enough time to be effective. Next, my full bladder was emptied with a catheter--very uncomfortable. Then, Rick and I were left alone for 15 minutes to confirm whether my urge to push was consistent with each contraction. After that Judi determined that my still-intact bag of waters was the only thing holding things up. She broke it and we were good to go.

Judi provided clear instructions on how to push--when to push and when not to push. I remember feeling like I had to focus hard to follow what she was telling me to do, because I was so tired. I also remember feeling very cold and kept asking if they could turn up the heat. My body shivered a lot; this really surprised me. The team assured me that the room was quite warm already and that the shivering was hormonal. At this mention of hormones I wondered whether I'd feel that rush of adrenaline they described in class. If that came, I don't remember noticing.

With each round of pushing, I heard the team exclaim, "wow, wow, you're doing really good." Hearing that felt like the best thing in the world. Rick remembered to aid my visualization of the cat bus door opening by imitating the sound effect, and I tried following Ina May's advice to smile while pushing. The smiling amused the team.

I heard Judy tell me the baby would be out in a few minutes. I didn't believe her until the next contraction, when she told me to feel the top of my son's hairy head. I remember thinking that his head felt much squishier than expected. One or two more contractions later his head was out, and then with the next round of pushing, I felt the rest of his body flop out. It took only 22 minutes of pushing. Jessica photographed the delivery for us.

He looked bright red, screaming and struggling like he wanted to crawl away as I held him on my chest. I was so exhausted and relieved that his delivery was over, that I didn't think to wonder about his sex. I heard Judi refer to him with 'she' and after a slight pause I asked, "it's a girl?" She actually didn't know. She helped me turn him over so I could be the first to learn that I had a little boy.

My bleeding was a little heavy so they gave me an injection of Pitocin in my leg, after that the placenta was delivered quickly. The contraction that bore it was surprisingly uncomfortable. The team wrapped it up for a later tree planting; Jessica wisely suggested that we get a linden tree (the inspiration for his name).

The team helped me slowly up onto the bed so I could try to nurse and get checked for repair needs. Apparently, Linden's little head passed through easily, but with his arms crossed over his chest, I got nicked by the extra wide load. A few stitches later, Judi said it was an easy repair and that I would heal well.

The first attempts at nursing were difficult. A recurring dream during the pregnancy was of failed first nursing attempts. We tried the side position lying down, but he couldn't keep the latch. Judy described him as fighting us as she was straining her back to lean over the bed to support us. She saw that I would need a nipple shield. One was sent home with us, and it worked like a charm; it helped him sustain his latch and I felt none of the soreness.

When Linden was ready to be weighed, measured and receive his vitamin K, Jessica went to find Rick, so he could be with Linden for that. She found him fast asleep on a couch in another room. I could hear some of their talking through those steps. Then, I heard them laughing at my snoring.

Our remaining few hours at the center were spent resting, eating, and, of course, making phone calls to our families. Around 2:30 or 3 PM we gathering up our things. It was time to go home, where we could rest in our own bed, and enjoy postpartum checkups, lactation support, and pediatrician home visits over the next few days and weeks.

When I thanked the team for everything, they replied that it was all me and that it had been very easy for them. Jessica and Bianca helped us reattach our car seat, which was removed for my ride to the center. I rode in the back seat again now, this time to support Linden's little head. I watching him sleep all the way home.

I'm sometimes told by other mothers how fortunately we were to have had the opportunity to have (or be "allowed" to have) a natural childbirth. One friend told us of a mom friend in Germany who was directed to have a c-sec due to her baby being in the same "star-gazer position" (translated from German) as Linden was in. We feel extremely grateful. With our midwives at the birth center everything about our experience seemed calm, relaxed, safe, and even (I dare say) fun.

I sometimes amuse myself with the idea that if we were living in Ghana then Linden's name might instead be Monday Awesome--based on a tradition of naming a baby after the day of the week of the birth and a characteristic of the birth experience. Thank you, Sage Femme!