Since I’m taking so darn long writing up the rest of the birth story, you can refresh your memory (or catch up) with:

Birth Story: Prologue

Birth Story: Part I

After the midwives left Paul and I to talk about what we wanted to do, given that labor had stalled after being at nearly ten centimeters all day long, I told Paul I really didn’t want to have my water broken prematurely or go to the hospital for Pitocin, but I knew I couldn’t keep going like this much longer. I was totally exhausted; it was only the irregular contractions keeping me awake. All I wanted was to go to sleep…hey, that sounds like a good idea! How about I just go to sleep? So we called the midwives back in and I said, what if I let labor stall on purpose? Can I just try and sleep for a while? I know that when women transfer to the hospital after not progressing for a long time at a homebirth, they often have an epidural so they can sleep enough to have energy to wake up and push. My contractions were far enough apart that I was hopeful I could rest even without an epidural, especially if I could sleep in the birth pool (which is often called “the midwives’ epidural” anyway.) They thought this was a great idea, but were concerned I wouldn’t be able to sleep in the pool because I couldn’t both sleep and keep my head above water. So Paul said he’d come in with me and I could sleep leaning on him.

So they bailed out some of the cool water and added a lot of boiling water to make it nice and warm, and I climbed in with Paul and fell asleep almost immediately. I think I slept for about two hours. Midwife Janet curled up on the floor by the front door (silly Janet - there was an entire unused bed! She insisted that midwives can sleep anywhere.) Midwife Kathy fell asleep in the easy chair, and Kadie stayed up cleaning up and periodically checking the baby’s heartbeat under the water with the Doppler. I would wake up slightly with each contraction, but they continued to be pretty weak, and I’d fall back asleep. But they got stronger and stronger until the noise I was making woke up the midwives and we were pretty sure we were back in action. Kadie got me big crackers slathered in peanut butter and a large glass of milk, which I wolfed down in the pool. They also continually offered me an electrolyte drink spiked with a lot of honey to get more glucose into me for energy. I got out so they could check me. I had gotten to full dilation while sleeping - no cervical lip left! And apparently my water had broken too, since Kathy could feel the baby’s hair.

At a later appointment, Janet said I may have saved myself a cesarean with my idea of just taking a nap in the pool. We suspect that the baby just wasn’t in a good position and therefore wasn’t putting the correct pressure on my cervix to complete dilation. She thinks that relaxing in the buoyant water for a while gave him time to move a little, along with giving me strength to contract properly. If he would have stayed in an unfavorable position, with me not being able to contract hard enough and eventually becoming totally exhausted, he could have ceased to tolerate labor very well, possibly causing real distress, which would lead to a c-section.

I had started to feel pushy in the pool. They had me try pushing in various positions. I think I may have started pushing a little too early, because although I was fully dilated, I didn’t have a strong urge to push yet and so I didn’t have a lot of strength to make a lot of progress. Or maybe the baby just wasn’t low enough yet, and I needed that early pushing to move him down a little before I got that uncontrolable pushing urge. I don’t know. They had me push sitting on the edge of the toilet. That was totally uncomfortable and hurt like the dickens, so they made a big pile of pillows against our closet door to lean against, and Janet tied two knots into a bedsheet. Kadie sat across from me on the floor and during each contraction we would play “tug of war” while I pulled the sheet for leverage. That was really helpful and I think next time I might just start out with that. During this time, the midwives started getting things ready, rummaging around the house for my supplies of baby blankets, baby hats, other birth supplies, etc. Someone had the brilliant idea of making me a big mug of strong red raspberry leaf tea with a LOT of honey stirred in. They put a straw in it and had me take a drink between each contraction. You’re supposed to drink red raspberry leaf tea during pregnancy to strengthen the uterus, which I did, but I got really sick of it and didn’t drink it as often as I should have. But after drinking it during labor, I’ve been craving it every since! Good thing I bought giant amounts of bulk red raspberry leaf. I think I’ll go make some now…

Now I’m back. When they checked me after I got out of the pool, Kadie had noticed a little bit of light-colored meconium (the link explains what this is and way it may be dangerous in some situations). While meconium-stained fluid can be a sign of fetal distress, Kathy assured me that a little light-colored meconium was ok. The baby’s heartbeat was ticking away just fine, even during contractions, so we weren’t worried. Darker meconium is more likely to be a sign of distress. I did know, however, that dark or particulate meconium was an automatic hospital transfer, no argument, both because it could mean fetal distress, but more importantly because if they baby inhales meconium during birth, he would need to be suctioned by the neonatal pediatric team immediately after birth (see link for info about meconium aspiration syndrome). I was way too far into Laborland to really worry too much about this.

When I was pulling on the sheet with Kadie, Kathy checked the fluid I was passing. The meconium had gotten much darker. “Ok, we have to go,” she said.

Then everything got very busy. I can’t say it was chaotic. I was too busy involuntarily pushing a baby out to even be too concerned about what was happening, but everyone was calm and efficient. The midwives started packing up their huge bags of stuff. Paul gave information as it was requested. And, best of all, Kadie was on the phone with Labor and Delivery at the Hospital of the University of Pennsylvania (HUP) asking for Mamie Guidera. As nurse-midwives, Janet and Kathy both have delivery priviliges at another hospital, Montgomery Hospital. However, Montgomery was an hour away, and they didn’t have priviliges at HUP, which is just minutes away. But another midwife, Mamie, who was one of the faculty I was assigned to as administrative assistant at my job at the School of Nursing, was a midwife on the L & D floor at HUP. I love Mamie and had often asked her questions when I had concerns at work and Janet wasn’t around (like when the baby hadn’t moved for too long for my comfort). Kadie told her I was coming in with Janet, and to be ready for us.

I had been terrified of the prospect of transfer to the hospital, but really, at the time it happened, I was WAY to busy being in second stage labor to be scared or worried. I wasn’t worried about the baby; his heartbeat had been fine and for some reason I really wasn’t worried about the meconium either. The only thing I was worried about was the immediate problem of getting out of the apartment, downstairs, in the car, and to the hospital when I was seriously about to push a baby out at any minute. I could hardly move. I did, however, to Paul’s amusement, notice that the stove was still on, heating stock pots of water to keep the water temperature in the birth pool up, and had Kadie turn them off. I also managed to hold the elevator doors open so Janet could get her suitcases of birth supplies  in to it. I’m pretty sure both Paul and Kadie were off moving cars to the front of the apartment by this point.

I’ll have to write the next part separately, since the little boy is about to wake up. Stay tuned; it’s the good part!