Wednesday, July 13, 2005


Amie Nguyen

With this being my fourth birth and my second unassisted birth you'd think I would have known what to expect, but lets just say—always expect the unexpected!

With my last baby, I had had very traditional OB prenatal care until we moved to a new state when I was 7.5 months along. (You can read the birth story in Fertile Ground #2.) This time around I felt the need to have prenatal care but didn't want to use an OB. There are only a handful of midwives near me and only one that accepted my healthcare. Visits with her were what I called “drive-byes.” I waited to see her for 30 minutes to an hour and then went back into the office, peed in a cup, got weighed, went in the exam room and waited another 15 minutes, got asked a series of silly questions, listened to the heartbeat, and went on my way. That amounted to an hour or so of waiting for a five minute visit with the underpaid OB (i.e. the hospital midwife).

I’m not sure why I continued to see her throughout the pregnancy despite the fact that she spewed ridiculous information and advice at me at many visits. (For example, she said I needed to stop nursing my toddler by 18 weeks or I was risking my unborn baby’s life.) My instincts told me I should go.

The only tests we consented to were the six-week and twenty-week ultrasounds, the latter of which was done by a perinatologist because of my younger daughter’s conditions (ACC, blind, micocephaly). Throughout the pregnancy I felt like the baby was healthy and the outcome of the birth would be good. However, I had a nagging feeling that this baby would be BIG and that I may have some complication, but it would resolve itself. The midwife scoffed at my suggestion that I was bigger than with my last three or that the baby was unusually big. She thought that my instincts were whiny complaints.

The midwife estimated the baby’s due date to be December 9th at the six-week ultrasound and the perinatologist estimated it to be December 2nd at the twenty-week ultrasound. I gained a total of fifty-five pounds from my six-week appointment to my forty-week appointment. I didn't have any real discomfort or “problems” except that the baby felt huge and there was a very sore spot under my rib cage. Although I know that a estimated due date is just that—an estimate—it left me with the uncertainty of whether it would be closer to the 2nd or the 9th.

I had a couple of days of thinking this is it! I wasn't sure if I should expect the same type of labor as my last (menstrual-like cramps with a quick transition) or something different. All the false alarms felt very different from Lucy's birth—they were actually painful contractions and were regular at short intervals, but they stopped after a few hours each time.

My December 2nd due date came and went without any sign of baby. I got paranoid that maybe he wouldn't come on his own. The midwife even tried to convince me that this being my fourth birth, my uterus was worn out and wouldn't be able to maintain productive contractions. She said that I “needed” her to break my water and have a pitocin drip to get things moving along. Of course I laughed and refused to even considering that as an option. I did however try every trick in the book to get labor started. Nothing worked. I had OMT (Osteopathic Manipulation Therapy), chiro adjustment, spicy Thai food, spicy Mexican food, fresh pineapple, sex, nipple stimulation, walking, jumping on the trampoline, blue/black cohosh, and I rubbed castor oil on my stomach. (I couldn't make myself drink it.) Not to mention, I had been taking Red Raspberry Leaf & Evening Primrose Oil for days.

On December 9th (my original due date) just like with Lucy, I started to feel the menstrual-like cramps, followed by a feeling of urgency. This was around 7pm just after dinner. My husband, Dien, lit candles, ran a bath, turned on Sade, and got all giddy with excitement. We didn't tell the kids anything, since I didn't know if I'd be in labor for minutes, hours, or days. By 8pm the cramps required a bit of focus and were coming at exactly eight minutes apart. I was amazed that my body was so punctual.

I decided to get in the tub about 8:30pm when the cramps moved to six minutes apart. I was very talkative and was thrilled that things were going so well. Dien was a sweetheart and listened to me talk like an auctioneer about everything under the sun. By 9:30pm the cramps were full on contractions every three minutes. I got out of the tub and went to the toilet and then back to the tub. I began my primal roars when I re-entered the tub and Dien began asking what I wanted him to do. I kept saying, “I don't know—nothing.” Then the question changed to, “What do you need?” My reply every time was, "Sleep. I just want to sleep. Make this stop so I can sleep.”

I could see that Dien was feeling a little helpless so the next time he asked I said, “Don't ask anymore—just do what you want.” Well he did. He saw that I was hot (the heater was on but I didn't want it off despite how hot I was) and he got a cold wet towel to wipe my face. The first time he did it I hated it and was mad, but a few seconds later I motioned for him to do it again. I went back and forth between loving it and hating it four or five times. (I feel really grateful to have such a loving and patient partner.)

Around 10pm I could feel the head ready to come out. I told Dien and he again asked what I wanted him to do. “Nothing,” I said. I was on my hands and knees and Dien was trying to help support my body by putting his arms under my arm pits and pulling my body up. The head didn't just pop out like it had with Lucy, it took three pushes and the entire time felt like it wasn't ever going to come out. It finally came out and I was shocked at the size and weight.

Of course the contractions didn't give me a break—they came right away and I sat through two before realizing I had to push the body out. (It had slid out right after the head with Lucy.) With the next contraction I began pushing, but it felt utterly unproductive. I felt like I was getting nowhere. After three more contractions and pushing with all my might, I declared, “I can't do it—he is stuck.”

Dien said, “Well, what are we going to do?” I said, “I don't know—I just want to sleep.” The next contraction came and I again attempted to push out his body. When I was unsuccessful, I put my hand under the water and felt his head again—it was heavy and limp and I wondered in the back of my mind for a split second if he was OK. I said, “Another contraction is coming!” and all of the sudden Dien jumped in the tub, got behind me, flipped me backwards (I was on my hands & knees), and got his legs under me (to lift me off the bottom of the tub). When I began to push he used all of his force to push my shoulders—causing me to push my feet against the end of the tub. This resulted in much more force and after two pushes at 10:15pm his body emerged.

I picked him up and could barely open my eyes. Just like with Lucy, I said “He's not breathing—is he ok?” Dien assured me that he could see him breathing and he was fine. He let out a cry and I was relieved. He was very purple, but pinked up within a minute or so.

I sat in the water despite the fact it was cold and murky, waiting for the urge to push out the placenta, but it never happened. Twenty-five minutes after the birth I'd had enough of the cold, dirty water and the cord had stopped pulsing so I had Dien cut it and I got in the shower. At almost an hour after the birth there was no sign of the placenta and only mild cramping. Damien had nursed twice for just moments so I decided to try again. He nursed for a good fifteen minutes, but still no urge to push, and no placenta.

I felt fine but I knew the placenta was supposed to have been out by now. I started researching and of course all the medical information said I would hemorrhage or get toxic shock syndrome or worse if it wasn’t out within an hour. It had been almost two hours. I was barely bleeding and felt physically and mentally fine—none of the symptoms of a dire situation. I decided that if I saw lots of blood or felt sick I would call the midwife or go to the hospital.

After about three hours and lots of blue/black cohosh (which again did nothing), I decided to IM (instant message) a friend and see if she had any advice. She was shocked that the placenta was still in and decided to IM a friend who'd had an unassisted birth to see if she had any advice. Luckily she did. She said to walk around for five minutes and then go pee. It sounded way too simple. I did it anyway, even though I just wanted to sit. I went to the bathroom, sat on the toilet (nothing), and made myself pee (it didn't feel like I needed to). I decided this was yet another silly idea that wouldn't work. When I stood up, I felt a weird sensation. I took one step and the placenta literally fell out onto the floor.

Since Damien was born on a Thursday and I didn't want to go anywhere Friday - we scheduled a midwife and pediatrician appointment for Monday. By Monday I realized that although I didn’t tear (thanks to the water), I had huge, painful external hemorrhoids. (They were so painful I actually considered going to the ER over the weekend.) I was very glad that I had a care provider to go to. The midwife examined me and said everything looked great, and that she was impressed. She also said that my hemorrhoids weren't that bad (I can not imagine how they could be worse—I would die!) and gave me a hydrocortisone cream prescription for them. (It was like heaven in a tube and made them disappear quick.)

She weighed Damien because she thought he looked big (Duh! I've been trying to tell you all along) and we hadn't weighed him yet. We all guessed around eight pounds which would have been fairly big compared to my other three that were all around seven pounds. The adult scales said almost eleven pounds. The midwife was sure it was wrong and held him in the air and said, “Probably nine pounds, but call me and let me know what the pediatrician gets.”

We left and went straight to the pediatrician’s office. They were shocked at his size and weighed him—10 pounds 13.5 oz. He likely weighed over 11 pounds four days prior when he was born. Despite the fact that he was in the 90% & 95% on the growth chart and showed all signs of good health, the pediatrician tried to tell us that because we left the cord on for more than a few minutes (25) that he had “too much blood” which is what was causing his skin to appear red. After scaring me (though I thought it was a load of crap the minute she said it—the new mommy had to worry a little) she tested his blood and deemed him healthy and free of this horrible blood disease.

Since his birth I have been told by a number of midwives and the pediatrician that I am lucky—that his shoulders were likely stuck and that he could have had broken bones, died, or been brain damaged. I have heard stories of women whose babies were “stuck” and the trauma that they and their babies were put through. Mine was an UN-complicated birth because I did not perceive the birth as complicated while I was in the process. It was a normal natural process that required me and my husband to use our instincts and to follow our path without being hindered by expectations or averages or standards. It may have been hard to deliver him, and the placenta hanging around for so long might have been a bit worrisome, but it was nothing we couldn't handle.

I realized after Lucy's birth that Unassisted Childbirth saved us from a whole lot of unnecessary stress and trauma. I now see that once again with Damien.

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