Tuesday, December 11, 2007

Abraham at Home

Abraham at Home
Essay & Photo by Andria Brown

It was ten days after my estimated due date, almost a month past my personally expected due date, and I’d been in “pre-labor” for over a week.

I went to bed around 11pm, feeling nothing physically stronger than my usual fatigue. But then I woke up about an hour later. And then ten minutes after that. And ten minutes after that. Still not convinced I was breaking out of the pre-labor pattern, I fought to go back to sleep, but then at 1a.m. I got the, "No, seriously" call from my uterus. Contractions were five minutes apart and after another half-hour, I couldn't lie down and be still during them. I got up and watched the clock for another twenty minutes or so and then woke up Jeff at 2a.m.

Next I alerted the midwives. Since she had the furthest distance to drive, I called Andrea first. She answered the phone excitedly and asked, "Is it time?" It was thrilling to be able to finally say yes. She said she'd call Amy and head right over.

Jeff was off to a slightly groggier start than I was. Maybe it was all the false alarms, or perhaps just the 97 minutes of sleep he was running on, but it took several reminders to get a pot of coffee made for the midwives (and him). He was in gear after about ten minutes, though, and we both spent the next hour puttering around, picking up the house, lighting candles, picking out music and contracting every 3-5 minutes (well, that was just me).

When Andrea arrived around 3:15, we were in a very peaceful yet productive mode. I was resting between contractions, rocking back and forth to Julie London, and then up and circling the dining room table when they hit. The repetitive movement was my primary motivation, but it was also an instinctive desire to get away from everyone and into a dark, quiet room. Andrea checked my blood pressure and the baby's heart rate and position and said we looked to be in good shape all around.

Amy rolled up about 4a.m., and she and Andrea set about getting things prepared. It didn't occur to me how much stuff they'd show up with, and it was pretty cool to see how they'd organized a mobile birthing center into a couple of carry-on bags. They both quickly adapted to the mood of the house and, although they did their work and carried on conversations, they moved and spoke smoothly and quietly, never interfering with my own rhythm.

As the morning rolled on, Jeff asked if we should wake my mom (aka Cha Cha) up. I said no, since I didn't see much need for her to sit around and watch me hurt. I also figured it would be better for her to get as much rest as possible before Miss M arose and she had to entertain her for an indefinite period of time, even though I was thinking we wouldn't have all that much longer to go.

Turns out, this was a good call.

Not long after the sun came up, Miss M came stumbling into the living room. At this point, I was making noise during contractions, going from audible exhales to quiet groans. We'd prepared M as best we could for what she might see or hear during labor, and she didn't seem bothered by what was going on. She was very clingy to Jeff, though, so we decided to wake Cha Cha up and turn over child-wrangling duties.

Contractions had been getting more and more intense during this interlude, and I finally hit the point where I could no longer complete my dining room table laps and had to just stand in one place, grab the back of a chair, and moan out my exhales.

When I started doing this, Amy and Andrea started bustling around, clearing space around me and laying out all the waterproof materials. They'd been assessing my dilation to that point based on my circulation and the location of my uterus, so I figured they had a good idea that I was getting close. Looking back, though, I think they just wanted to protect the rug in case my water broke.

I wasn't so much feeling pushy as just ready to be done with those really fierce contractions, and based on my sudden hot flashes and shakiness, I was pretty sure I was in transition. Glad that I'd thought ahead and closed the dining room blinds, I followed my urge to take off all restrictive clothing (i.e, all of it). This cued Miss M to take on one of her pre-assigned tasks, and she ran into her room and got a tiny little fan that she proceeded to use to cool me off. It was pretty damn adorable. For about 15 seconds, anyway. Then she got bored or freaked out or otherwise occupied and quietly went off with Cha Cha.

Saying things are a blur from this point on isn't entirely accurate. They're more dark than blurry, owing to the fact that my eyes were closed 90% of the time. I stayed in the dining room for a short while longer, but I suddenly remembered how soft and comfortable the bed had looked when I passed it on the way to my 319th pee, and I spontaneously decided on a change of venue. The bedroom was clean and light and airy and seemed like the perfect place to be.

I waddled into the bedroom and hoped that I could find a way to rest in between contractions. Problem with that plan, however, was that I couldn't get myself into any position other than standing or kneeling with my body straight up. Lying down just wasn't an option. Neither was being on my hands and knees, which I thought would help with the baby's position. I also became aware that, well beyond the intensity of the contractions, the pain in my back was getting stronger and stronger. Jeff resumed his post from Miss M's delivery, with his fists firmly pressed against the upper points of my pelvis.

They kept checking the baby's heart tones as often as they could manage, and as time went on, just about the only thing encouraging me was hearing that strong, consistent beat. After wandering around the bedroom and trying several positions suggested by the midwives, including sitting backwards on the toilet, I found my most comfortable spot. This involved standing in our teeny bathroom, hands pressed into the wall and arms straight ahead of me, trying to create a straight line of energy between the pushing in my arms and pushing out the baby. The crucial part of this set-up was Jeff, who was stationed behind me with his hands pressing into my back. Because the bathroom is so small, he was up against the opposite wall (or so I thought; he later showed me that he was actually jammed up against the closet doorknob) so there was a lot more counter-pressure.

Amy and Andrea were paying close attention to my energy level, and when I seemed to be wearing out, they were right there to encourage and coach me. When I thought I was about to tip over from hunger, Amy appeared with a spoonful of honey. When my legs started shaking from standing too long, Andrea suggested I try moving back to bed and trying to push from my side or back for awhile. Even though being in bed wasn't as comfortable for me, I actually found myself relaxing (or, more accurately, collapsing) and nearly asleep in between contractions. I also tried to keep focused by talking to myself, muttering words like "open," "release" and "strong."

But my back. Holy hell, my back. There was nothing else going on in my body that rivaled the pain in my back. It was searing, like flaming knives stabbing outward. When I wasn't bellowing incomprehensibly, the only words out of my mouth were, "MY BACK MY BACK OH PLEASE MY BACK!" Jeff did his very best to accommodate my hollered requests, but I felt like I was taking up valuable energy and breath trying to detail where I needed counter-pressure when I should have been spending it on pushing. Andrea did suggest that I try holding in my urge to groan and focusing that effort on pushing instead, which did seem to help make the pushing more effective.

Or so I thought, anyway. After all that work, I couldn't imagine that the baby was very far away. I kept waiting to hear, "He's close! I can feel the head!" but I never did. Every time they checked my dilation, I could tell that the baby was still very high up. Sometimes there was still a lip of cervix, sometimes not. I deliberately didn't look at the clock, but I overheard the midwives discussing the heart checks and Andrea said something about 10:25. When I heard that, I wanted to cry. Three hours. I'd been at this three hours and I wasn't even close. Andrea asked me to lie down so she could get a good check, but it hurt so badly that I flipped over and scurried over the edge of the bed like a startled spider. (You have to clearly envision my giant contracting belly for that to seem as impressive as it was.) I believe it was Amy who then said, "Well she's still got spirit."

At this point, the baby was doing just fine, but I was feeling in distress. I fell to my knees at the side of the bed, in exhaustion and fear and supplication. I prayed. I choked back the urge to sob. The idea of a hospital transport flitted into my head, but I knew I could never make it sitting in a car for 20 minutes. I also knew that I'd be a very likely c-section candidate, especially after I gleefully accepted an epidural and all its back-numbing deliciousness. So some stubborn voice, way way back in my head, told me to just keep going. To trust that we were doing fine and that everything would be okay.

I got back up and into the bathroom, mentally if not physically stronger. I felt a small increase in the effectiveness of my pushing, and with one particularly strong push, I felt the massive sploosh of my water breaking. As did Jeff, who was still stationed right behind me. I was somewhat encouraged by this change, mostly because it meant that something was happening. The midwives also noted that I'd feel a lot less pressure now that the bag of water wasn't trying to get out ahead of the baby. And they were right.

But oh my fothermucking back. Andrea offered to try saline injections to relieve the pain, but having heard nothing but failing reports from other mamas who'd tried the same thing, I decided against it.

I think it was about this time that Jeff pulled out the big guns. A few nights before, we'd watched Borat and, as much as I enjoyed the movie as a whole, there was one part that made me laugh out loud both when I watched it and any time afterwards that I thought about it. It was just one second of the movie, but it cracked me up. And I told Jeff that, when labor got unbearable and I seemed like I wasn't going to make it, that I needed him to duplicate that scene for me. So there in our bathroom, after 11 hours of watching me trying to squeeze out a baby, Jeff took it upon himself to cluck like a surprised chicken in a dropped suitcase. And in the middle of all that pain and frustration, I laughed.

The laughing stopped shortly afterward, though, when Amy came in to check the baby and we all heard something we hadn't heard before. No one said the word "deceleration," but after all those previous checks, it was easy to tell that the baby wasn't doing as well as he had been. His heart rate was noticeably slower. This time, Andrea's recommendation that I lie on my side wasn't a suggestion. And this time, I didn't resist it. I knew my comfort wasn't the most important thing anymore.

I got back in bed and onto my side. Jeff had my back, Amy helped support my leg and Andrea was applying compresses and trying to guide the baby's head. I'd rest for about 20 seconds and then groan, "Okaayyy," which signaled everyone to get into position while I pushed. I was still yelling instructions on where I needed my back pressed while I heard Andrea and Amy calmly encouraging my pushing. I finally felt like I was getting close, like the baby was really coming. This was the part I'd been anticipating for four hours.

I pushed and pushed and pushed. I could feel the fullness of the baby moving down and without anyone telling me it was happening, I knew his head was nearly out. And then it was. The relief was so tremendous that I wanted to stop right there and rest for awhile, but the midwives kept calmly but firmly guiding me to continue pushing. Which surprised me a little, knowing that there’s often a rest period in between the delivery of the head and body, and that their general policy was against coached pushing. But I listened. Within a few more pushes, and with a feeling I can only describe as "blooooop," he was all the way out.

And so, so quiet.

My eyes were still closed. All I could hear was the midwives telling me to talk to my baby, call him by name, talk to him. Jeff's face was against mine, and I could vaguely hear him whispering that everything was fine, that the baby was fine. And we both called to him, "It's okay, Abraham. We're here. Abraham. Abraham. You're okay." I can't pretend I didn't think the worst. I thought what every parent thinks in that time when you're waiting for the crying to start.

After a very long minute, we heard the cries we'd been waiting for, and the midwives placed his still bluish body on my chest. Andrea explained that his umbilical cord had been wrapped around his neck. Twice. I didn't think there was a drop of fluid left in me after sweating for so long, but one heavy tear of joy and relief slipped from my eye.

Amy stepped outside and told Cha Cha and Miss M, who had been out back playing in the inflatable pool, to come in and meet the baby. Damp from the pool and red from the sun, they both tip-toed into the bedroom. I'm not sure whose face was beaming more brightly, although Cha Cha had the reflective power of tears on her side. I'm pretty sure my mother hugged me, and I'm positive she told me how proud she was of me. I wasn't prepared for how much it would mean to share that moment with my own mother, and I was so fiercely grateful that she had the chance to be there.

I held Abraham while the midwives assessed how I was doing. I coughed out the placenta a few minutes later and was feeling pretty good, all things considered. But they were concerned about my bleeding, which mirrored the situation after the three hours it took to push Miss M out of me. They dosed me with arnica, both to help contractions and to deal with the already gruesome bruise blossoming on my lower back.

Again, the timing here is all a bit fuzzy, but I think this is when they checked the baby. They weighed him with the slingy-looking scale (I won the weight pool - 8lbs. even), measured out his little body (21" long, 14.25" head, 13" chest, 13.5" abdomen) and gave him an oral dose of Vitamin K. Because he'd spent so much time swimming around instead of descending, his head was a perfect little ball of a thing. He had a light dusting of dark hair, already threatening to curl. His eyes were blue, but a deep sapphire that seems likely to darken into brown but will be truly stunning if they stay as they are. He had a hint of his dad's chin cleft, just like his big sister. He was, quite simply, beautiful.

During one of her checks on my bleeding, Andrea detailed the stickiness of Abraham's delivery position. He'd been posterior - face-up - but slightly turned to my left side. All he really needed to do was flip a quarter-turn to the right and he'd have been all set. But instead, he kept turning left. And turning, and turning. In what is called a "long arc rotation," he spun a full 360 degrees and ended up almost exactly where he'd started - still posterior. The only thing that keeps me from holding this against him his entire life is the knowledge that, in that big spin, he may have unwrapped one more loop of cord from around his neck. I don't think she was being at all dramatic or anti-hospital when Andrea said that this type of presentation was the most common reason for c-sections. She didn't suggest it, but I wholly believe that if I hadn't had this baby at home, I would have surely ended up in surgery.

After yet another discouraging check on my bleeding, I reminded Andrea that I'd been catheterized after M's birth because I'd been too swollen to pee on my own. I gave her permission to try again (forgetting that I'd had a local anesthetic last time, due to being stitched up). It was not a pleasant minute, but it did the job. With my bladder empty, my uterus could contract and the bleeding slowed way, way down. I could see the relief on both midwives' faces, both because I was going to be okay and, I dare presume, because this meant they could get some rest.

And, finally, that I could, too. With my baby at my breast, I laid in my own bed, with the sounds of my family around me, and went into a deep, bone-tired, blissful sleep.

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