Thursday, January 29, 2009

The Birth of Makenna Ruby

With my due date still two weeks away, after a full day’s work and a good amount of walking (Judy’s orders), I went to bed at 7pm. At 10pm I awoke to use the restroom and was startled to find some pink on the toilet paper. I wondered if this was “bloody show” and I was excited to think that this could be the start of my journey to meet my baby. After calling my mom and husband to report what I’d seen, I stopped to notice that the menstrual cramp feeling I’d had on and off over the past few days seemed to be starting and stopping at regular intervals. I decided to start timing the onset, wondering if they could in fact be contractions. They were coming 4 minutes apart but were not yet painful.

My husband arrived home at 11pm and by then the contractions were becoming a bit stronger. I decided to call Judy to let her know that I thought I might be beginning labor. Judy instructed me to get a good night’s sleep and call her in the morning. She also suggested taking a bath to see if the contractions stopped. Once in the tub, the contractions slowed slightly but kept on coming.

After the bath, I tried to lie down but at this point the contractions had become strong enough that I could not get comfortable while lying down. I decided I’d have to stay up and move around. I moved to the living room and spent most of the next few hours kneeling on my knees against furniture or the birthing ball or sitting on the birthing ball, while listening to the beginning of the music playlist I had put together. While I labored my husband showered and shaved off the goatee he had been growing. I had told him there was no way I was birthing our baby with him looking like that.

Around 2am we called Judy for clarification on when we should make our way to the birth center. She said the contractions should be 2 minutes apart and lasting for a minute for an hour. My contractions weren’t quite there but they were coming 2 minutes apart and lasting about 45 seconds. The hardest part about laboring at home was not knowing how far I had progressed. The level of pain was becoming quite intense and it was becoming difficult to breathe through the contractions. I was afraid that I might only be 2 centimeters dilated and that the pain would become much more intense. At one point it crossed my mind that perhaps my husband should just take me to a hospital so I could get an epidural. Though I did not mention this to my husband. I had learned in birth class that moaning deeply would help my body open. It was the only thing I found myself able to do to ease the pain and get through the contractions.

Around 3:30 I could not get comfortable in any position and I had a bit of a panicky feeling. I was beginning to feel a lot of pressure and only wanted to sit on the toilet. Despite his arguments that my contractions hadn’t met the pattern Judy described for an hour, I made my husband call Judy back and describe what I was feeling. She told him that we should come in.

Up to this point, my husband still expected labor to take quite a long time and didn’t believe that I was very far along. I had to tell him to hurry up so we could get going. We arrived at the birth center at 4am. Judy brought me into the exam room and did an internal exam. I was dilated to 8 centimeters. Judy helped me down the hall to the red birth room. Because I was already feeling a lot of pressure she had my get on my hand and knees with my rear in the air to relieve some pressure.

My husband hooked up the iPod and resumed playing my playlist while Judy, Jessica and Laura readied the birth tub. Judy checked me again and I was nearly complete. My water broke right after the exam. I then moved back to the toilet and labored there until the tub was ready. By the time the tub was filled at 5am, I was fully dilated. With my husband sitting on the ledge behind me, I got into the birth tub.

As soon as I lowered my body into the water I could feel my entire body relax. Even though it was time to begin pushing, the warm water slowed my contractions to 5 minutes apart. Pushing was the most intense feeling I have experienced. Every fiber of my being and every muscle in my body contracted while I let out involuntary groans. Unbelievably, I actually started to doze off in between contractions. The warmth really helped me relax while I was not pushing.

When the baby’s head began to crown, Judy had me reach down and feel the hair. The baby certainly had a lot! As the head came out Judy had me push down on it to help direct it. At this point, having the baby sitting in the birth canal between contractions was incredibly intense and felt like a strong burning sensation. Once the head was out it was time for the shoulders to pass through. This was the most painful part and caused me to yell out! But it was over quickly and the next thing I knew, Judy had caught our baby girl and handed her to me. I held her, still floating in the water, while my husband and I caught our first glimpse. She had her little lower lip sticking out with an expression on her face that said she wasn’t pleased; however, she did not cry right away. The cord was short so Judy clamped the cord and my husband cut it. They wrapped the baby in a blanket and handed her back to me for us to admire a bit longer. When it was time for me to deliver the placenta I passed the baby to my husband. It only took a couple more contractions and it was out. I was then helped out of the water and into bed where I began breastfeeding my little girl.

After less than 8 hours of labor, at 5:40 am, Makenna Ruby was born into the water while the song “One”, sung by Warren Haynes (a cover of the U2 song) played. There was very little blood and I was lucky not to tear. The entire birth couldn’t have gone more perfectly. I am still in awe of the experience we had at Sage Femme. After so many appointments and classes at the birth center, my husband and I truly felt at home there and had the utmost confidence in Judy and her team. I hope to have the opportunity to deliver future babies at Sage Femme and can only hope for another birth as magical as Makenna’s.

Friday, January 9, 2009

The Story of James West Black Brenneman

On April 30th, 2008, the sign was positive. I stood in the bathroom staring down at the two pink lines on the pregnancy test, shocked. I couldn’t breath, I couldn’t think. I stared at Jason, jaw dropped - our baby had come! I immediately called mom and nana and in as casual a voice as I could muster, asked if they wanted to meet for dinner. I chose a restaurant with a gorgeous flower-filled garden; it was the perfect place to tell them the first grandchild was on the way. When we finally met, the sun was low in the golden sky, the air laden with Jasmine and sea. I immediately blurted out, “I’m pregnant!” My mother froze and then started laughing and crying as my grandmother ran in elated circles waving her arms about like a bird. Jason took pictures as we held each other - crying, laughing, breathing hard, deeply excited by the future of our growing family.


Jason and I began prenatal care at the University of California Medical Center in San Francisco. We chose this hospital because it boasted an alternative birth center with midwives and had a low cesarean rate. It seemed like the best of all worlds: natural backed up by medical, “just in case.” However, as I progressed with my midwife in 15-minute appointment intervals, I began to realize that UCSF wasn’t as “natural” a place as I had originally thought. This was especially apparent when I toured the hospital. The white board over the nurses’ station listed all the women in labor and the drugs they were taking. Almost all of them read “PIT” which is short for pitocin, a drug used to induce labor. The nurse leading our tour kept joking about how much pain we were going to be in, but lucky for us there were plenty of anesthesiologists ready to administer epidurals. The women around me looked apprehensive yet resigned because what other choice did we have? This was the best hospital in the city. But somewhere deep inside I knew I could do better.

About 26 weeks into my pregnancy, Jason and I started classes at Natural Resources, a childbirth education center. There we read Ina May Gaskin’s Guide to Childbirth, which blew my mind. In particular it was her Sphincter Law that really moved me. Sphincters are the circular muscle groups responsible for the opening and closing of certain organs, such as the cervix and vagina. When a woman is upset, uncomfortable, frightened, or self-conscious her sphincters unconsciously contract. So if a woman is in an uncomfortable birthing place or situation she will literally have difficulty birthing the baby. I suddenly realized that my discomfort with my midwife and fear of the UCSF paradigm of interventions could seriously hinder my delivery. Plus the more I read about how the common labor drugs can negatively affect the baby, the more obsessed I became with having a drug-free birth. My first priority became to protect my son and to ensure that nothing during the birth could hurt him. I also watched Ricki Lake’s The Business of Being Born and became utterly disgusted with the way hospitals handle birth. The “snow-ball affect” of interventions left my head spinning. I viewed birth as a beautiful and natural process in which all I needed was a healthy body and a strong birth team. I hated the idea of treating labor like a broken leg - a painful problem that needed to be dealt with in a medical manner.


That was when Certified Nurse Midwife, Judi Tinkelenberg, the owner of the Sage Femme Birth Center in San Francisco, came into my life. We attended her monthly orientation and the first thing I noticed was her unconventional appearance. She had ultra short bleached blonde hair, fake nails and bright make-up, which said anything but medical practitioner to me. But as I sat in the living room like setting, I found myself in reverence of her forthright natural and her enthusiasm and passion for birth. She was obviously very educated and highly skilled - I immediately trusted her. The orientation was four hours long, but I was won over well before it was finished. By the time we left I had made my first appointment - I knew I would give birth there.

By now I was about 34 weeks along. I looked forward to my weekly appointments with Judi and Jessica, our student midwife. We lounged around for hours on over-stuffed couches, drinking tea, snacking and chatting. I absolutely loved the informal nature of Sage Femme; I felt relaxed and at home, like visiting friends.

Slowly the time passed and I reached 40 weeks. My due date was December 28 but Christmas and New Years came and went with no baby. Everyday I woke up and wondered if this would be it. I felt edgy and nervous. The longer we waited the more concerned about the birth I became. Would I be able to do this? What if something happened to the baby? What if I died? What if he died? How would a child affect my marriage? Affect my life? Each night I lay in the dark stressing, silently willing the birth to commence while at the same time dreading it. I loved being pregnant and though I was so excited to meet our child in person, I felt very attached to him in my womb. He was my own secret little guy and I wasn’t ready to share him with the world.

When the baby was 9 days late it was time for more serious action. I was drinking red raspberry leaf tea, having sex, eating spicy foods and going for long walks, but nothing was working. So Judi swept my membranes and that evening the contractions began.

For 16 hours Jason, Nana and I held up at mom’s house as I endured the strengthening contractions. At first when the cramping began seeping into my abdomen, I would curl into a ball, eyes closed shut. My breath came out in sputters as my feet writhed together. Then mom took my hand and told me to look into her eyes. Together we moaned, trying to release the pain. Nana took pictures and Jason massaged me in a heavenly warmth bath. Already my birth team was in full swing, helping and supporting me.

By 8:00 pm, I couldn’t wait any longer- it was time for the birth center. In a whirl the car was packed and we were on the road for what I dubbed the “the ride from hell.” Every little bump felt like a jagged knife tearing through my abdomen. I hit and clawed at the cold fogged-up passenger side window, trying to breath and keep calm. We sang, chanted and cried out in chorus. The contractions were fast and rhythmic - every dark mile felt like an eternity. When we finally arrived, Judi checked my cervix - I was five centimeters dilated.

We all pilled into the Green Room where I would deliver James. The room was beautiful with a cozy queen size bed full of comfy pillows and blankets, soft green walls and a huge whirlpool bathtub. Jason and Jessica immediately got to work setting out our special birthing objects to create a sacred space and relaxing ambiance. In the window Jessica hung white Christmas lights and set up an alter with a beautiful aquamarine painting of a heart that Nana had created for a birthing focal point. She also set out a picture of my great-grandmother, an African fertility doll and white candles from our wedding. In the soft golden light, amid the sent of lavender and the sound of harps, I lay on the bed painfully enduring each contraction.


The minutes crept by, fading into hours. Around 11:00 pm Judi took Jason aside and told him I was in a holding pattern. I needed to start giving into the pain instead of just managing it. This was a huge revelation and the turning point in my labor. “What do I need to do?” I asked, filling with determination. “Let’s walk,” he replied.

So, thus began our journey of laps around the birth center. Like ghosts in the night we roamed up and down the dark corridors, in and out of the vacant rooms. We stopped with each contraction while I wrapped my arms around Jason’s neck, leaning against him, my knees bent into a squat while Jessica pressed my hips together from the back. Together we cried out “Down! Down! Down!” Willing our baby to drop. In between contractions Jason whispered words of loving support into my ear. But I was not doing well. The pain in my lower back had become far more severe than the uterine contractions. It felt like a car was rolling over my hipbones, crushing them to dust. The pain during the double peaked contractions was overwhelming. I attempted to continue the low-pitched toning but often ended in sputters of quivering and crying. I felt exhausted and certain I wasn’t going to make it through this. “I want to die,” I choked.


We dragged back into the labor room and began nipple stimulation, hoping to speed up the labor. My hair hung in my face, my lips were cracked, my eyes lifeless. I felt so deeply miserable and depressed. I looked to Jason full of despair, and I whispered, shaking my head, “I can’t do this.” I felt like I was drowning, being suffocated by my own body. I deeply yearned for the hospital and an epidural.

Jason took out the affirmations I had previously written to remind me in this very moment of our all-natural birthing goals. I looked into his deep brown eyes, letting the words wash over me, giving me hope.

“Women have been doing this since the beginning of time… You are participating in an ancient right of passage… Your body is strong and beautiful… Our baby is coming…”

Finally, upon my insistence Judi felt my cervix again. Surprise! I was ten centimeters dilated and a hundred percent effaced. I never had the biological urge to push, but a sudden burst of energy filled my body and I began pushing with all my might. Screams ripped out of my throat, empowering me with new life. The delivery room filled with my birth team, as well as Laura, the other student midwife and Grace, my mother-in-law. The lights were turned on and my 80’s iPod mix was selected. The time had come - my son was on his way!

At first I labored on a birth stool. With all my strength I pulled up with my arms against the metal rim while pushing down. Judi told me to wait for the contractions before pushing, but the pain in my back was so intense I could barley feel them coming. With each push streaks of light shot before my eyes, blood raged through my face and head, wracking my shaking body. Every time I thought I would pass out, but much to my surprise I remained full of power. In between contractions I rested against Jason who was sitting behind me. He wrapped his arms gently around my shoulders continually whispering words of love and encouragement. The energy in the room was full of support, everyone helping me in their own way to be strong.


I continued to push for about an hour when Judi suggested I move back to the bed because I was getting too swollen on the stool. Plus, the baby’s head became stuck under my pelvic bone and I had ceased making progress. Judi reached inside and turned his head and suddenly I felt movement again. Everyone cheered me on, updating me on the progress, affirming how well I was doing. Laura’s voice was particularly powerful and invigorating. Her enthusiasm gave me new strength. I pushed in sets of three while Judi counted to ten. Suddenly I felt his head begin to crown. Judi instructed me to give little pushes as he slowly emerged. I had no idea how far out he was, I only felt him painfully pushing my pelvic bones apart and the simultaneous relief of the “ring of fire.” Then suddenly Judi yelled, “Reach down and grab your baby!” I instantly sat up and grabbed his little wet body between my hands. I pulled him up from under his armpits and quickly clutched him against my bare breast. In utter shock I stared down into his perfect squished purple face. My whole body shook, my heart pounded, tears welled in my eyes - I was completely overwhelmed and elated. I cried out “Jamie! Jamie!” over and over again, so utterly relieved that our son had safely arrived. He was born at 1:56 am, weighing 9 pounds 1 ounce, and measuring 21 inches long, while the song “Head Over Heels” by Tears for Fears played.


For the next five days I rode the crest of a hormone high. I was in heaven. Jason, James and I never left the room. Amid the cozy womb of soft blankets and colorful Christmas lights, we went over every detail of his new little body. We stared into his deep blue eyes and caressed his soft skin and chocolate brown hair. I held him to my breast, relishing his warm little body pressed tightly against mine. He lived between us on the bed, never left untouched. I wanted these days to last forever. My love for our son filled my heart to the brim. Every peep, cry and chirp he made shot my soul soaring. The pain and agony of the delivery night faded from my mind. It seemed an eternity away and a simple price to pay.

When I look back on that night I am amazed at how Judi, Jessica and Laura handled the whole birth. Their energy and dedication to my family and me far exceeded any expectations I had. They stood with me, supporting me both physically and emotionally through the biggest and most difficult experience of my life. Though it was far more intense than I ever could have imagined, in the end it was exactly what I wanted. It was a birth done all on my own, without intervention. James was born free of any drugs, his body pure and clean. I feel deeply proud of myself - amazed at my own strength, stamina and dedication.

Sage Femme Midwifery is a spectacular place. The amount of attention I received pre-, during and post-labor was exceptional. I felt completely taken care of, completely supported and even loved. The intensity of that night lingers in the back of my mind, sometimes shooting forth in bright clarity, other times a haunting memory. Yet this is the life of a midwife - the life of Judi and her students. Day after day and night after night, they relive this experience over and over again, each time a different mother, a different baby, a different family, but always with the same fervor, passion and concentration. My adoration and respect for them and their services is unmatched. I am so deeply grateful that women like them still exist and that I was able to bring forth my son in a natural, beautiful and holistic manner. I will always look back on that experience as the best night of my life, for it was the night James came into the world.