Tuesday, May 14, 2013

Postnatal: The birth of Alphonse

At 2:30am on May 11th 2013, my hubbie and I welcomed our first-born into the world - in the comfort of our own home, and under the care of our attentive midwife, Kelly. And let me just say... I could not have asked for a better birth.

*Click here to skip the tirade*

I knew, even before I got pregnant, that I wanted a home birth. As in, I did NOT want a hospital birth.

Why this strong aversion? Maybe because I inherited my mother's belief that modern medicine is a double-edged sword. Maybe because of all the negative stories I'd heard from friends and strangers alike about their hospital birth experience. But more importantly, I knew I did not want to be splayed out like some guinea pig on a lab table in front of total strangers who simply treat birth as another medical procedure and not the private, natural and life-affirming phenomenon it is.

Whenever I told anyone I was going to do a home birth, the responses were one of the three:

  • shock - "wow, you're so brave"
  • ridicule - "what about the risks?"
  • rudeness/insensitivity - "it's not going to go the way you plan you know, because for my birth [insert unnecessary horrific hospital birth anecdote here]"
(Note that each time, I did not volunteer the information, but was asked for it.)

Of course, I'm not saying that home birth is for everyone. This is no different than any other risk you take in your life. If you have a high-risk birth or a serious medical condition, a hospital birth makes a lot of sense. But if your pregnancy is low-risk, a home birth is more than adequate. 

But the majority has been brainwashed into thinking that pregnancy is an illness, with a full set of "symptoms" that require the attention of Obstetricians, all of whom have received training in surgical births and have rarely witnessed natural births unfold as they normally would without medical intervention. 

Whenever someone says to me "What about the risks associated with birthing at home?, " I have to resist the urge to laugh. Do you know the risks involved with hospital births? Do you think Obstetricians and hospitals are going to explain the risks of each and every drug/procedure involved fairly and thoroughly to their patients? Sadly in most cases, the answer is no. Hospitals are businesses. They operate based largely on minimizing the risk of getting sued. Do you really think the hospital put  their patients' best interest before their liabilities? It is up to you, as the patient, to research the pros and cons of epidurals, pitocin, episiotomies, C-sections, and anything else they may throw at you. Unless you are proactive about your choices, you'll be windmilled into standard procedures that are not even necessary, and sometimes even detrimental to you and your baby. (For more reading, I recommend Birth Matters, Gentle Birth Gentle Mothering, Baby Catcher, Lady's Hands, Lion's Heart, and Orgasmic Birth.)

This is not to say that all hospital births are negative. It is entirely possible to have a pleasant birth at a hospital; it just requires a lot more work on your part as the patient in clarifying and reiterating your birth plan wishes to all staff members involved. Basic requests such as "I'd like to be allowed to have my labor progress free of stringent time limits as long as my baby and I are doing fine" or "I'd like to walk and move around as I choose" must be made clear beforehand since they aren't part of hospital protocol. 

A response that I often got about home births & risks went something like this: "Someone I know had a home birth and the cord was wrapped around the baby's neck. That kid is now mentally retarded." First of all, a third of all births involve a cord wrapped around the baby's neck. As long as there is no kink in the cord, or circulation in the cord isn't cut off (prolapsed cord) this poses no risk to the baby. People think that the baby will suffocate with a cord wrapped around their neck. But think about it - as long as the cord is intact, the baby is still getting oxygen through the cord and doesn't need to rely on air entering his windpipe and lungs yet.

Another thing most mothers say to me is "I have a high tolerance to pain, and I still needed an epidural." I'm sorry, but that means that you don't have a high tolerance to pain. If someone told me "I sustained a gsw to my cranium and didn't take vicodin, but I still needed an epidural," then that would be a much better argument. It's ok to need an epidural; just don't say something that makes you sound unconsciously incompetent.

In contrast, here are some benefits of having a home birth:

  • you're in your own home, so you're at the most relaxed state possible
  • you've built a personal relationship with your midwife (1~2 hr prenatal appointments covering any and all questions/concerns you may have vs 10 minute prenatal appointments with doctors)
  • you'll be less likely to tear, and will rarely need an episiotomy (hospital nurses tend to stick their fingers into the opening when the baby's head is coming out - this leads to higher chances of tearing. a lot of doctors perform episiotomies even when unnecessary to speed up the process or simply out of protocol) note that you'll heal better from a tear than an episiotomy. 
  • there's less likelihood of an infection since your body is already accustomed to microorganisms present in your home 
  • your baby won't have to adjust to two new environments (hospital + home) within days of being born
  • you don't have to worry about a hectic car ride to the hospital, car seats, packing bags, etc
  • only people you want near you will be present (no unnecessary onlookers, no on-call doctors whom you've ever met before, no nurses switching in and out)
  • it's much more cost efficient (usually half or less of what a hospital birth would cost) 

Anyway, enough rambling :) For those of you curious about how home births unfold, below is a detailed account.

Wednesday 05/01/2013 [37 weeks 5 days]: Kelly estimates Alphonse's weight at 6.75lbs per palpations. He's ready to come anytime since his head is posterior and downward.

Wednesday May 8, 2013 [38 weeks 5 days]: Contractions start in the morning, accompanied by bloody show. Walked the dogs to the dog park with hubbie as usual; contractions become more regular - 30 seconds every 5 minutes. We go out for Indian food & last minute shopping at Babys R Us - bloody show continues but contractions subside. Cramp-like contractions throughout the night.

Thursday May 9 [38 weeks 6 days]: No progress except a few minor cramps during the day. Stronger cramp-like contractions throughout the night.

Friday May 10 [39 weeks]:
11:43 Water breaks. Pads aren't enough to contain the spillage so I resort to standing on puppy pads. I text Kelly every now and then with updates.
14:11 Contractions begin. I can feel the peaks, but the beginning and ending aren't clear
15:21 Finished building Ikea sideboard for the kitchen
16:35 Finished baking our favorite banana bread with Matt
17:28 Contractions are stronger, but still irregular. Matt starts keeping track of them for me since I keep on forgetting to stop the timer. Just hanging out, reading some books. Jogging around furniture during contraction peaks
19:16 Contractions average 50 seconds each, 8 minute apart. Still feel fine, but now I need to lie down or sit through the peaks
19:30 Kelly advises me to take some Vitamin C for immune support & to monitor temperature.  Matt starts monitoring my temperature - 98.4F
19:56 Drank some homemade lemonade with 500mg Vitamin C
20:03 Contractions are intense enough to cause nausea. I spend the contraction peaks in the tub, stop by the bathroom, relax on the bed, repeat. I thought I would want candles and incense during my labor, but now I have to remove them all from the area
20:12 Too nauseous to text anymore. Using all my willpower to deal with contractions, running between the bathroom & tub
20:24 Can hardly leave the tub anymore. Contractions are 35~45 seconds each, 3 minutes apart. Matt starts texting Kelly for me.
21:34 Contractions are 45~75 seconds each, 2~4 minutes apart. I can't even talk anymore to tell Matt when they start and end, but he gauges by facial expression.
21:52 Matt guesses that Alphonse will be born at 3am
21:54 Kelly tells Matt I'll want her there soon. I tell him I don't want her to come (too much stimulus)
21:58 Matt figures that once I'm suffering enough to not give a shit about my state, that'll be the signal to have Kelly come over. Temperature is 98.3F
22:10 Matt calls Kelly
22:23 Contractions start getting bad enough where I need to mumble aloud and use visualization techniques. Start squeezing Matt's hand a lot now but find little to no relief no matter what I do
22:50 Kelly arrives. All I can do is give her a weak smile. She asked Matt if I threw up at all, he said "No, is she supposed to?"
23:30 Start having a couple contractions where it feels like my body is involuntarily pushing
Friday May 11 [39 weeks 1 day]
00:00 Kelly check my cervix; I'm shocked that it's fully dilated. He is two inches from the entrance.
00:02 I climb out of the tub. Kelly and her assistant have the bed set up for me.
00:04 I lie on my side and begin pushing with each contraction. The pushing feels good compared to the contractions, but I have to scream really loud to push effectively.

Timeline is fuzzy here, no text messages to track or logs, Kelly has notes maybe I will add them later.

After several pushes, I can feel Alphonse's head begin to emerge. I push, his head emerges a little more; I have to relax my muscles between pushing to get using to the pressure from his head. It's not so difficult. I tell Kelly & Matt  "man, it feels like I'm passing a massive shit" They think it's funny but I'm dead serious.
With each subsequent push his head emerges more, but then goes back in a little. It's frustrating to feel his head backtrack, so I try to keep his head where it is; this takes too much effort in between pushing so instead I try to push more with each contraction.
The thickest part of his head begins to emerge; I get a burning/stinging sensation, but at this point I don't care if I tear - I want him out. I push as hard as I can into the burning. I half-beg Kelly if she can just pull him out.
With a few more pushes, the rest of his head finally pops out - I can literally feel his nose and chin go through, and the little neck just stuck there. Such a great relief - but then it's "oh no..now I have to push his body out."
Luckily he scrunched his shoulders inward so with one push he's out up to his rib cage. One more push and his arms and legs slither through in a single swift movement.
After that, the placenta only took one small push to come out - it was so fast and didn't hurt at all.

We wanted to collect cord blood, but we waited until the cord stopped pulsing to make sure Alphonse got all of the blood he needed first. Matt cut the cord, but there was too little blood left in the cord to collect. But it's probably best (and cheaper) that Alphonse keep the blood now rather than have it sit in a blood bank for 30 years.
Kelly and her assistant Heather cleaned everything up for us while we checked Alphonse out.
I felt awesome right after the birth - probably high from all the oxytocin. Everyone else was so tired, but I wanted to be up and about.
Kelly checked for any lacerations; I hadn't even torn. But I did have trouble emptying my bladder; Kelly was worried so she waited until I could eliminate at least half before leaving me for the night.

My bladder was actually full from way before. Although I didn't feel it during the pushing, I thought all that pressure would make it burst. But it was fine; it was just numb for a while but normal by morning.

Although my contractions got to a point where they were giving me intense nausea, they were never what you'd call "painful." It would actually have been easier to deal with had it been real pain. But I kept on telling myself that things would have to get a lot worse for this to be over - you can't quit here.
Pushing was strenuous work but nowhere near as difficult as the contractions. I could feel the progress with pushing, so it gave me a lot more motivation to keep bulldozing through. Even after Alphonse popped out it just felt slightly stingy, nothing major.

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