Long version: Sophia's birth

Warning: this will contain potentially graphic details, so if you're not interested in that sort of thing, just read the short version.

I had a pretty good pregnancy with Sophia. Sure, there was the near-constant pubic symphysis pain, starting much earlier in the pregnancy than when I had it with Stephen, and after 30 weeks or so, I couldn't bend over as such, and we had that scare at 28 weeks... but it was, on the whole, a much healthier pregnancy. My blood pressure never went over 118/76, I never spilled sugars (a potential sign of gestational diabetes), and I had very little swelling this time. I was also determined to enjoy it as much as I could, because it will in all likelihood be my last.

By the end of September, I had been having Braxton-Hicks (or "false") contractions for a few weeks, with some of them being quite strong. I was hoping that these would add up to not-insignificant cervical changes, and lead to a shorter labor, but alas. I had also been reading a lot of other birth stories, especially the short and relatively pain-free ones (i.e. mom goes into labor at 7 am, has baby by noon!), in foolish hopes that I could influence my labor through visualizations (a.k.a. wishful thinking). I had in mind going into labor at around 4pm on Friday (October 2nd) and having the baby at around 8 that evening, so that David wouldn't have to miss any work and we could all get a good night's sleep. I knew it wouldn't really be like that, but hey, it doesn't hurt to dream.

I had been thinking for the whole pregnancy that I would probably just want to be relatively alone and in the dark with this labor. Stephen's labor felt really busy in retrospect, with lots of light and people milling around -- it was fine then, but it wasn't the way I pictured this one.

I felt the first "real" contractions at 11 pm on September 30th, the day after Sophie's official due date. Just like my early labor with Stephen, they were quite irregular, coming anywhere between 4 and 10 minutes apart. During Stephen's labor, I tried to keep things going by walking around, climbing stairs, and generally exhausting myself; this time, knowing those probably wouldn't make a difference in the length of my labor, I just took it easy. I called Mom, and talked briefly to Cilia, our midwife, to let her know that things were underway, but it would probably still be a while before the baby was born. I tried to get some sleep, and lo and behold, was able to get some, unlike the last time. I did wake up rather a lot with some long contractions, though, some lasting up to 120 seconds.

I was supposed to have an appointment with Cilia on the morning of October 1st, so I called her at around 8 am and told her I didn't really want to drive over while I was in labor. I took it easy that whole day, spending some time in front of the computer posting to the forum, talking to people on the phone, and generally being lazy. I was kind of hoping things would pick up, as 10-01 would be a neat birthday, but the whole day, contractions were pretty irregular, again 4-10 minutes apart and between 45 and 120 seconds long. (Those 2-minute ones felt like an eternity!) David stayed home with me, and fetched water and food for me at intervals.

All through that day's contractions, I'd been coping pretty well by trying to relax my muscles and breathing deeply. This was working for the most part, although some of the contractions were a lot more painful than I remembered from the last time, and occasionally I'd just tense up into a fetal position (as much as I could, what with the 40-weeks-pregnant belly!) and whimper until the contraction was over. I don't really remember what David and Stephen were doing that day; my mom arrived at around 2 pm (I think) so I guess she must have taken care of Stephen most of the day, allowing David to concentrate on me. I know Mom and Stephen went to the park for a while, and she made his lunch and dinner, but it's all pretty blurry.

Labor didn't really pick up until the night of October 1st. Then the contractions started to get closer together and much more painful. We called Cilia again at around 11 pm (24 hours after my first real contraction) because I was shivering uncontrollably during and between the contractions, even though I was pretty well bundled up, and thought I might be in transition. It certainly felt painful enough! So Cilia arrived at out house at around 11:30, checked my blood pressure (132/78), the baby's heart rate (148), and timed some contractions with me -- 4-5 minutes apart (all this is written in the notes she kept during my labor). At 12:10 am (October 2nd), she did an internal and found that though the baby's head was at 0 station ( at the pubic bone, I think), she couldn't reach my cervix to find out how dialated/effaced I was. Robyn also arrived at some point that night, though I don't remember when.

I got into the bath, hoping that would help some. I had assembled some essential oil mixes for labor, but we hadn't used them yet, so David sprinkled one of them -- for 2nd stage -- into the bathwater. I don't know if it actually helped, but it did smell nice. I found myself wishing yet again that we had a bigger bathtub -- there really wasn't enough room for me to stretch out, or even to get my belly under the water, which was what I really wanted. The towel helped some, just to keep the heat on me. I would have given a lot for a spa-type bathtub, or even a birth pool, but there was no place to put one in our apartment (except the basement, and I don't think even the pool would have made up for that ambience!).

I don't know how long I stayed in the bath -- until the water got too cold, I suppose. Cilia's next note is that I tried out her birth stool. I had spent a good portion of labor with Stephen on it, and remembered that it was fine for a few minutes at a time, but I didn't want to spend the whole pushing phase on it. Cilia did another internal, and found to my dismay that I was about 7 cms dialated (out of 10) and the baby was at +2 station (+4 means you can see the head).

The contractions were coming hard and fast, and I just couldn't get comfortable. I tried all kinds of positions, from lying on my back on the bed, to lying on my side, pulling my legs up, straightening them out, standing up, sitting on the birth ball (which felt like it was pushing the baby back up into me, so I gave that up in a hurry!), and kneeling on a pillow with my upper body resting on the edge of the bed. The last seemed to be the most comfortable, as it allowed me to rock back and forth and also stretch out my arms, but I was tensing up a lot during each contraction no matter how hard I tried not to. This was definitely more painful than Stephen's labor. Still, Cilia respected my essentially unspoken wish to be alone, and I labored at the side of the bed with the lights off, David sometimes rubbing my back. My mom and sister were there, too, but went to sleep upstairs until the action picked up.

Time passed in a bit of a haze. I was glad I was at home, because if I had been in the hospital, I think I probably would have asked for something to take the edge off at this point. Definitely not an epidural, but something... and I didn't rationally want to do that, so it was better that I didn't have the option. At 2:30, my water broke. I hadn't felt that with Stephen, so it was a bit of a shock, and I think we ended up tossing the pillow that I was kneeling on, as it got sort of covered with amniotic fluid. The fluid was clear, anyway, so we didn't have to worry about meconium aspiration.

I decided to see where I was myself, so I lay down and checked, and could feel the baby's head! It was pretty bizarre -- the scalp was all wrinkled up, and I could actually feel the overlapping plates of her skull beneath the skin. I think her head was about 3 inches in. Unfortunately, though I really wanted to push, I thought I could also feel a lip of my cervix around her head, so I just breathed through the contractions as best I could.

At 3:12 (according to Cilia's records) I complained of a continuous contraction. That is my most vivid memory of the labor -- this contraction just didn't seem like it would ever end. I couldn't find any position that helped, and even moving around, which had helped somewhat before, didn't mitigate the pain. I would say that was my lowest point -- knowing that the baby had to come soon but not knowing how much more of this I could take. I would guess this was probably the tail end of transition, in retrospect.

At 3:25, Cilia did another internal, and pronounced me fully dialated. I sat down on the birth stool and started to think about pushing. I think the video starts here -- it's really strange to watch. I didn't make a sound the whole time I was pushing, not even a groan. On the video, it looks almost like I'm praying silently, just sitting with my head bowed, though I don't suppose many women pray with a finger up their vagina. I was tracking the baby's progress as she decended -- being able to feel her head as it came down made me feel like I was accomplishing something.

At 3:29, there was a big gush of water and the plug, and her head crowned, and Sophia was fully born at 3:30 am, Thursday, October 2nd. She was much quieter than her big brother, though she did cry after a while. Stephen's bed is in my room (where I was laboring), but he didn't wake up the whole time. When Sophie was about 10 minutes old, her cries did finally wake him up -- you can see that in the birth pictures, which better illustrate Sophie's first hours. She latched on and started breastfeeding like a charm, while I was still on the birth chair. David had cut Stephen's cord, and didn't particularly want to do it again, so I cut it myself, which was an odd sensation. Because I had been pushing so quickly and she was born so fast, I did have a small tear. It started at the edge of the vaginal opening and spread up to the inner labia, which ripped. Neither required stitches, though I now have a little scar and a labia that's in two parts instead of one to remind me of the importance of slow pushing!

After 15 minutes or so of sitting on the birth chair and waiting for the placenta, we transferred over to the bed, umbilical cord trailing after me (ew). Cilia asked me to push, Sophie nursed some more, and still the placenta didn't come. After 30 minutes, during which time David held Sophia and she was shown to Stephen as well, Cilia decided that she'd like to check internally. She was getting worried about the length of time the placenta was taking to detatch -- up to an hour is normal, but there didn't seem to be any reason for mine to be taking so long, since Sophia had nursed right away and I was still having good contractions. She got out a long sterile glove -- it looked to me like something a vetrinarian would use for bovine artificial insemination, frankly. It went all the way up to her elbow. She told me to relax, then reached into my uterus. Owie, owie, owie, ow. I wouldn't say that it hurt more than the birth did, but it certainly was very unpleasant. I could actually feel her hand inside my uterus -- a bit like feeling the baby kicking, but more purposeful, and definitely more disturbing. She couldn't find any reason for the placenta to be still attached. We talked about going to the hospital if it took more than an hour, which seemed really ironic to me -- here I'd had a perfectly healthy baby at home, and might have to go to the hospital for the stupid placenta!

We waited 15 more minutes and through several more contractions. At last, the placenta was "born", and the reason it took so long became clear. There was a succenturiate lobe, a sort of non-functional secondary placenta. This one wasn't attached to the umbilical cord or to the main placenta at all, just to the membranes (and therefore to me). A normal placenta peels away from the uterine wall because its blood supply is cut off, and blood inside it is transferred into the baby (where it belongs -- it's fetal blood) via the umbilical cord [this is why early cord cutting is bad for babies -- blood inside the cord and the placenta is the baby's blood, and the lack thereof can lead to iron deficiencies during infancy]. This placental lobe had no connection to the umbilical cord, so it was still full of blood, and couldn't easily peel away from the uterine wall. That explained both the long third stage (delivery of the placenta) and the bleeding I had at 28 weeks. Apparently a succenturiate lobe occurs in one of every 20 pregnancies, statistically, but neither my midwife nor her apprentice had seen one before (probably because the problems the lobe can cause, like unexplained bleeding, could also risk a woman out of homebirth).

Cilia and Cindy (her assistant/apprentice) oohed and aaahed over the placenta, then cleaned up the birth mess (not too bad -- that's what Chux pads are for!). I had a well-deserved shower and something to eat, C&C made sure we were all okay, and then they left and we all went back to bed!

Overall, I was very pleased with the birth. I was glad to have been at home and unbothered by a stream of nurses and attendants, and able to labor at my own pace, in the dark and quiet. I could have done without the drama of the third stage, and the tear (silly of me to forget everything I've read about pushing in the rush to Get The Baby Out!), but I don't think I would have done it differently besides that. All the pain was so worth it... Sophia is a wonderful baby, and I think it helped Stephen a lot to have been there when she was born, instead of separated from his family just as it was changing. I would definitely recommend home birth (again) to any woman who desires it and for whom it's safe, and if (big if!) we have another, I'll certainly do it again.

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