Tethered

I was in Wisconsin this past weekend participating in a writing retreat centered on telling our stories as mothers. One of my goals of the last two years has been to make sense of Merritt’s preterm birth, and the NICU stay that followed.

_____________________________

Last week, in response to a post about Merritt’s second birthday, in which I expanded on some of the feelings I still carried for Merritt’s birth and early days, a reader commented:

“I have been following your posts for quite some time now. I guess I don't quite understand why the premature birth and NICU stay are so traumatic for you still. The important thing is that he's healthy, I'm sure you agree . . . but I also feel like you think that statement is trivializing your feelings. Many, many (did I say many?) women don't experience the birth that they dreamed of, for different reasons. I feel like in the long run, it doesn't matter. My relationship with my oldest child isn't changed by the fact that I broke down and got an epidural. Your relationship with Merritt is not changed by the fact that he was in the NICU for a short time.”

I replied directly to her comment and have thought quite a bit about what she said, and what she didn’t say, which has since made me wonder if the bigger question isn't:  Don't we as mothers/women deserve space to feel our experiences for what they are and are we free to be impacted by them in whatever ways that we are affected (whether those feelings are positive or negative); or do we treat birth and the events that may precede or follow as different in our culture in that we use shame to manipulate women into believing that our Truth has no place at the table in the face of a thriving (or even living) child?

The grief I feel for Merritt’s birth affects me when I think about it, and I don’t think about it that often. I think about it most when something in the present recalls me back to his beginning as a measure of his growth or development. Just as Roscoe was born under ideal circumstances, when his birthday comes around I am drawn to recall the memories that I have of his beginning. Both are equally important chapters of our story.

As part of one of my writing exercises at the retreat, I revisited the reflection post I wrote soon after Merritt’s first birthday and tried to identify the under-developed theme, finally settling on the word “tethered.”

Tethered:
1. A rope or chain, or the like, by which an animal is fastened to a fixed object so as to limit its range of movement.
2. The utmost length to which one can go in action; the utmost extent or limit of ability or resources.

I know only one way to mother, and I wanted to mother Merritt in that way despite his prematurity. He was not a baby too sick to be mothered, who needed to rely more on technology for his survival. No. He was a small and hearty baby born early, who deserved to be cared for in all the ways that I was willing and able to meet his need. I was disempowered by the NICU's protocols and routines, an environment in which it was normal and common to assume that I would relinquish his care to staff nurses who did not, from my perspective, understand my needs as his mother, nor our family’s philosophy and parenting priorities.

Trying to be my momma-self in a discordant environment was incredibly unpleasant. My attempts to foster attachment were met with doubt, uncertainty, dismissal, and rejection. I felt alone and vulnerable. It was exhausting to be on guard, vigilant, never taking a mental break, and rarely stepping away from his isolette for fear of Merritt losing his voice. I now know that not all mothers face these issues in the NICU, but we did.

It was a painful struggle to toe that line between accepting the circumstances, working within the spoken and unspoken boundaries, and being true to myself as his mother to advocate for Merritt's right to receive the safest and healthiest birth and newborn care based on the best evidence. In the NICU these issues largely revolved around when I could pick him up and for how long, pain management, and breastfeeding. I suffered from palpable anxiety and stress in those weeks we lived in the NICU. It was traumatic for me as his mother to go through something like that when my frame of reference for what it is to be a mother came from a perspective of having had an easy and ideal birth and postpartum with my first baby. Knowing what could be made it more difficult to accept the inherent limitations of the NICU, a microcosm of separation and detachment. 

I also hold a space for Merritt, and a sense of unfairness that my ability to protect and comfort him within the scope of my role was limited by the outdated routines of the hospital in which he was kept. When choosing between following the rules and betraying my child, I picked my battles carefully, and made decisions in spite of what I believed to be right, in order to conserve my limited resources. 

*

I arrive at the nurse’s station disheveled and in a hurry, excited to see Merritt. It’s 7:20 in the morning, ten minutes before his first feed of the day. I spent the night at home, slept four or five hours and now I’ve returned with another full day ahead.

“Hi.” I smile wearily. “I’m here to see my baby in the NICU. Meritt?” I’m loaded down with a back pack and tote bag. I am very aware of my own appearance in contrast to the nurse's shiny hair, pulled back in a low ponytail, her full face of makeup, and rested eyes. I think they feel sorry for me, trekking back and forth.

“What’s the last name?” she asks, picking up the phone to dial the extension.

“Sears.” I reply.

“Oh sure,” she smiles, seeming to remember me, “Let me just call back and see if it’s a good time.” She pauses, waiting for someone to pick up, “Mrs. Sears is here to see her baby, can Merritt have a visitor?” She looks up at me with raised brows, expectant. Her mouth turned up at the corners.

Of course he can have a visitor, I think. The formality of this is so stupid.

“Oh.” Her voice falls. I study her face, annoyed that we have to go through this ritual every day, now trying to guess as to what the nurse on the other line is still talking about.

“Ok,” her brow furrows, forging a line between them, “how long will it be?” She pulls the phone from her ear and places it to her chest as if to protect the nurses from my response. Her mouth scrunches up to warn me, “They’re getting ready to replace Merritt’s line so it will be about a half hour.” She moves her mouth to reveal only her bottom teeth and sucks in a breath of air. She knows.

I lock eyes with her, my face is stern, “Oh." I swallow hard. "Well...yeah, I want to be there while they place the line. I want to be back there, will you ask them if I can?” Panic rises in my body, I begin to feel hot.

She nods her head then brings the phone back to her ear, “Mom says she wants to be present, is that possible?”

I interrupt, “I want to talk to the charge nurse,” my lips press together in a frown.

I’m gripped with helpless fear. I think back to two days before when I cradled Merritt skin-to-skin after a feeding, only a curtain separating our space from the baby’s next door. Three different nurses tried unsuccessfully to place a line in Merritt’s neighbor. One after the other. That baby’s mother wasn’t around. That baby had no advocate. One after the other, amidst the unbroken and desperate wails of the baby, I could hear the air escaping their lips as they missed. First one, then the next, then the next. It went on for more than 30 minutes before they decided to give that tiny little baby a break.

That will not be Merritt.

The nurse hands me the phone.

“What’s going on?” I demand.

“Jacqueline, this is Helen, how are you?”

“Fine. What’s going on?”

"Merritt’s line needs to be replaced.” She begins. “Remember how we told you last night that we weren’t sure if the line that we put in yesterday was going to hold up?”

“Yeah,” I remember.

“Well, we weren’t sure then, but it definitely needs to be replaced. So we’ll get that line in and then you can come right back,” she states.

“I’m here, I’m standing right here outside the nursery, why can’t I come back? I want to be there to provide him comfort.” I’m grasping for a way to convince her.

“Well,” she concedes, “let me find out who’s going to do it and see what she says. Sometimes the nurses don’t like to have parents present during procedures.”

I ask who’s been assigned to Merritt, and learn it is Beth, known for getting lines in the first time. My heart settles slightly. I wait.

Her voice returns, “I talked to the nurse and she would rather not have you back here. I’m sorry.”

What the fuck. I knew I couldn't trust that woman.

I say it again, “Well, I want to be there.”

“I’m sorry,” she says, “can you come back in about a half hour? It will take less than 30 minutes.”

I know that I've reached the end of the line. My tone changes realizing that I don’t have say in what happens next. “Well, I’m staying right here at the nurses station.” My words are cold and hard, delivered through my teeth. “I’m waiting here.” I hope my physical presence will compel them to be efficient.

I give her my phone number and ask her to call me as soon as it’s over, then hand the phone back to the desk nurse who smiles meekly and says, “I’m sorry,” without consequence.

I want to kick the wall and fly into a rage, but I don’t. These people are the ones who give me access to my baby, I can only push back so much. 

*

Although getting along was a necessary coping mechanism, I am remorseful for passively giving up Merritt’s right to have me with him. Part of the emotional challenge has been to reconcile these moments in our history, because it will always be what it was, even though I know so much more now.

When I first read Anonymous’s comment, I didn't recognize her words as judgement, unintentional or otherwise, but I see it now. To associate a mother’s dissatisfaction with any aspect of her mothering experience and reflect it directly onto her connection or satisfaction with the relationship that she’s building with her child is an unkindness to all involved. I have to believe that because we can’t know the nuance of emotion that other mothers feel in their own lives, more compassion and empathy is needed mother-to-mother. Are we not collectively our own worst critic? To feel judged causes unnecessary suffering too, as it tethers our ability as mothers to be present in our experience, and limits our capacity to accept our Truth and to bypass the shame, so that we can work through it to become the best versions of ourselves as mothers and women.

Merritt is two years old today

Every year I look forward to these three months between February and May. To say that the boys are just a year apart in age offers a simple explanation for how crazy our days can feel.  Ooh, they're two and three. 

Last year we celebrated Merritt's first birthday with a colorful celebration of hearts and lions. This year, we opted again for a small party with even less fanfare. A simple home cooked meal, a few surprises for the kids, and a short guest list of his two primary caretakers and their partners.

On the menu: chicken adobo (a filipino dish that I grew up on as a kid), coconut rice, a green salad with garlic dressing, and roasted root vegetables. For dessert we shared a mountain of doughnuts served with miniature glass bottles filled with milk, and paper straws.

It snowed most of the day, so by dinnertime the long and blue shadows of winter cast over our meal as we sat down at the table. The kids wanted nothing to do with the food so they played while we indulged in the warmth of good company and candlelight.

While it is Merritt's second birthday, today also marks the anniversary of my second birth. Last year I was melancholic as February came around. This year felt a little less so. I'm not sure what that means as far as progress and healing are concerned, but it appears at first as an improvement. In truth, our beginning still pains me. I try to avoid acknowledging the still tender disappointment when it creeps into an otherwise happy moment. I wish I could pinpoint exactly the thing that is so painful about the birth, or the NICU, but I haven't yet been able. I'm afraid it is all the little things that add up. It makes me heartsick knowing that we can't influence the past. The more time that separates then from now, the less clarity I have. The deeper involved I become in my work supporting women through their own family beginnings, the better I understand how complicated this could be, how unhealed I am, that I may always carry with me a sense of loss and grief. Being made aware of that last little piece was a bummer all on its own.

Though I experience this day with all the bitter sweetness that it brings, Merritt shined his light brightly and enjoyed a very deserving birthday party on Saturday and a worthy encore today with ice cream, a park trip, and many, many, renditions of happy birthday. He is the kind and gentle little brother of our family and we love him so much.

a (birth) love poem

The sun is setting.
The curtains glow floor to ceiling
with the last rays of the day
that came before the night
in which I will become a mother.

Out there the light fades,
and the people call it a good day.
In here the work is just beginning to take shape;
we know we will be changed.

The labor molds us as we move through it.
The effort to not resist
but to open up,

let go.
To embrace this pain as work
and love.

My being,
the baby inside this body,
this man at my side.
We share the work going down tonight
in this homey space.

We're in motion.
This will forever be our beginning.
It is ours.

Moved by a power
so loud and thunderous,
so proud and real,
it calls me back to myself.

Delineating an even stronger version of who I was
before I was Momma.

Reminding me that courage has lived here all along
and challenging me to engage with such intensity I feel I may break.

But instead I bend.
I make more room.
I call for help.

Buoyed by love from the ones I chose
to journey with me,
I'm surrounded by it.
Filled with it
as this miracle moves through me.

Firm, even, pressure
like cool sheets on warm skin,
his hands conform to these fatty hips and thighs.
Rhythmically he smooths out even the most powerful surges
with confident strokes.

It is dark now.
The contraction peaks
then fades away like a shadow in the night.

We labor on.
One contraction at a time.
We can do anything
he and I.

Reflecting on Merritt's Birth-Day

Merritt turned one year old on Saturday. We celebrated with a sweet and colorful afternoon party that fit perfectly with Merritt's low-key personality and my need for a quiet anniversary.

I recall the ache of my sinking heart when, at 32 weeks 6 days, my water broke and I understood that Merritt was on his way. The juxtaposition of the onset of labor for each of my two boys is stark. What I welcomed with warm confidence and joy with Roscoe, I summoned will to push away with Merritt. Whether or not I was ready to give birth to him, and for reasons that we'll never know, our little Merritt boy needed to be born early and by the time I had realized it, the process was in full motion.

When I first shared Merritt's birth story there was more that I wanted to write.  At the time, I wasn't sure how my sadness and anger, and feelings of powerlessness fit in with the story of how I met my second, and perfect, little boy. There wasn't room for the raw grief that I felt. But, there has always been more to say, and the feelings I felt then have only intensified with time.

Probably because life has been so very full and a little crazy since Merritt arrived, it's been hard to find time to process any of it. I've needed to grieve for what was lost, on both our accounts, and yet I haven't made time for it. And so, as the new year came and then February arrived, a sad disappointment lingered, which speaks nothing of the pride and sweet joy that Merritt brings to our family, or to the growing love that I feel for him.

We were very lucky that after a swift and uncomplicated labor, I gave birth to a small but utterly healthy baby. I know now that if any of the variables of Merritt's birth had been different--if labor hadn't progressed as quickly, if there had been earlier signs of the placental abruption, if Merritt’s heart tones had recovered even just a little bit slower--he would have been sectioned out. We were very close, in fact.

I’m so grateful that Merritt breathed well on his own, that he was a good size for his gestational age, and that his little system had the opportunity to experience the stress of labor and a vaginal birth.

The smug pride that I felt for beating the odds by giving birth to Merritt in a way that was as close to what I had hoped for us as I could have grasped at the time, was overshadowed shortly after by a quiet and serious panic that set in when first I was made to wait over two hours to see my baby and then, later, when I learned what a NICU stay of any length really implies.

That low-level heightened awareness stayed with me for the full 28 days, and I remained very guarded and vigilant. I held close to my determined heart the confidence I knew as a woman who had done most of this before--birth, breastfeeding, mothering. I clung tightly to the good and powerful feelings I kept from Merritt's birthday, and found enough strength to carry both of us in the foreign world of isolettes, feeding schedules, and separation. My role in there, as Merritt's Momma, made me feel for the first time in my life that I was a grown up. Truly. Merritt's tiny person needed me more than any other single thing and knowing that I was wholly responsible to him was humbling and intensely exhausting. (Posts about our adventures in the NICU begin here.)

I feel more deeply now, though I had always believed it to be true, that the way in which our children are born, our experience of birth, and the way that we process and retell our stories, is so vitally important to our health as women and to our role as mothers, with much, much, greater far-reaching importance and consequence than our society gives credit. I find it miserably inadequate when I hear of these powerful experiences of life and birth and loss whittled down to the healthy baby, healthy mother mantra.  Many will find it hard to understand, but while I am thankful that my baby was healthy and I am also thankful that I was left intact, some things (many things) were lost for me in that experience. I grieve for those things.  And I know many mothers who feel this way and who share the same sense of longing for what could have been.

Of course, I feel so sorry that Merritt was born into a circumstance where separation of mothers from their babies is not only normal but expected. Where painful procedures are frequent and, in our case, where I conceded (more than once) to stand at the nurses station while my baby had IV lines placed, a routine for which the nursing staff wouldn't allow me to be present.  I feel a lot of guilt for leaving Merritt so vulnerable and if ever our family has to endure another stay in the NICU, I will fight against any policy that elevates a protection for nursing staff above my right and responsibility to advocate for and emotionally support my own child.

While Merritt won't remember all that he went through before we brought him home from the hospital, he certainly experienced it, and I will never forget it.  I'll always wish that he had a more peaceful and deserving entry into the world.

Merritt's Birth Announcement

Front

Back

I love the mix of textures, and color photos with black and white. It seems that I can never go wrong with Tiny Prints. Do you have a favorite online stationary store?

Merritt's birth story

It's Mother's Day weekend and a good time to finally share the events that led up to meeting my second son.

His birth is emotionally complicated for me since we had planned to give birth at home. When my water broke at 32 weeks 6 days we headed to the nearest hospital for a preterm delivery.

Part 1 of our story can be found here.

Part 2:

Earlier that day

By morning, the regularity of the middle of the night contractions had dissipated but because I was uncertain of when true labor might begin, I requested to meet with the Neonatalogist and also the on-call OB/GYN. I had every intention to take a nap that afternoon and catch up from lack of sleep from the previous day and night but, both physicians decided to stop by before I had the chance.

1:10 pm

Mid conversation with the obstetrician, as we discussed my "ideal" birth and reframed some of my expectations to reflect the current circumstances, the contractions returned and this time they were uncomfortable. I had five contractions over 45 minutes, and at the end of our talk I knew that this was the official start of my labor.

Still on the antepartum/postpartum floor, assuming that I wouldn't be allowed any food during labor, I ordered the lunch that I hadn't eaten earlier in the day. Then I called Andy and my doula to let them know that it was a good time for them to make their way to the hospital.

2:10 pm

Nursing staff came in to hook me up to the external fetal monitor (EFM) and within a few minutes I was wheeled off the floor to Labor and Delivery. The power of the contractions was familiar and continued to increase. I was in labor, but the nurses insisted that I remain in bed on my back while they monitored the contractions so that they could confirm it.

One nurse turned on the tv and handed me the remote before she left. (ha!)

2:30 pm

Andy arrived shortly after I was settled in L&D, and because I had left my room before lunch arrived, and because I was so hungry already, we plotted how to get food and water (I had been told not to eat or drink anything). He bought some chapstick, and retrieved some water bottles and GUs from my room on postpartum.

The intensity of the contractions required my total concentration, and because I was confined to the bed, I couldn't rely on position changes. Instead, I dug deep into my arsenal of Bradley techniques--stuff that I had never used or needed for Roscoe's labor.

Centered at my cervix, each contraction radiated tight and hot to my hips and lower back. Andy applied counterpressure on my lower back for a few contractions, but lying on my side required that I "push back" to avoid being pushed over, and it became less helpful and more irritating so we stopped.

What worked best for the duration of my labor was total relaxation--I never really understood how this technique could work during labor, but it is the cornerstone of the Bradley method and given the constraints of the situation, I was willing to give it a try. Nestled in a bed of pillows and fully supported, I invested my energy in relaxing every part of my body, and then used visualizations to help me focus in on the work of my cervix. I visualized my body making way for my baby.

My Ipod was incredibly helpful--while I hadn't had time to load a birthing playlist (or even make one, for that matter!), for the duration of each contraction I turned on my music and went to other places. I think I listened to the same three or four songs on repeat: Roscoe by Midlake, Dog Days Are Over by Florence and the Machine, Clocks by Coldplay, and I Like It by Enrique Iglesias (don't ask! It was on there, and it worked.).

Music always gives me energy to physically push myself, but in this birth, it also served to drown out the myriad distractions in my room: nurses coming in and out to check the monitors, lights flipping on and off, NICU team staff preparing and organizing in their corner for Merritt's arrival.

4:30 pm

My doctor stopped by for an update and after we talked for a few minutes she checked me and confirmed that I was 4 cm dilated, and 100% effaced. Active Labor! Honestly, I would rather have not known of this "progress" because the contractions were already so powerful. I didn't want to be discouraged, but knowing that I had 6 cm to go was discouraging. I gave myself a moment, and with the pain of the next contraction I forgot all about numbers and welcomed a return to work.

I asked for water and freedom to move and labor as I felt most comfortable. One point not up for negotiation was the EFM--because this was a preterm birth I had to have continuous monitoring, which was ok because the leads were plenty long and gave me enough space next to my bed to move around. The nurse gave me a hard time about wanting to labor out of the bed, but conceded "as long as the monitors could be read." I was given permission to eat ice chips, which I was so grateful for.

5:00 pm

I was relieved by the thought alone of maybe finding a more comfortable position. As you might expect, the external monitors were so sensitive that they lost signal anytime I wasn't lying still and, like clockwork, an exasperated nurse would run in to check the leads.

5:30 pm

My doula arrived, which emotionally relieved a lot of my stress. I really wanted her to be there to help us through the later stages of labor, and I felt much safer once she was with us. We tried some new positions (squatting with the head of the bed raised at a 90 angle, squatting on the floor, sitting on a ball, leaning over the side of the raised bed) and with minimal luck Lori manually kept the monitors in place.

My nurse stormed in to announce that I could have ten more minutes, but then it was "back to bed." The different positions were not very helpful at that point anyway, so I took what I could get and we kept at it. Ten minutes later we had found a squatting position that was more helpful than others and when we asked for more time the nurse said, "well I have the solution, I'll just put in an internal fetal monitor!" (The kind that screw into the baby's head). I had heard enough and jumped back into my pillows.

With the monitors registering properly, Merritt's heart rate was decelling with each contraction. Although this is normal, and he was recovering ok as far as we could tell, the nurse continued to come in and out of our room every few contractions, drowning us in fluorescent overhead lights upon her every arrival. Andy and Lori encouraged me with each contraction to take big deep breaths in order to get the most oxygen to the baby. Lori's mantra was "breathe for your baby". I felt lightheaded and the pain was making me feel nauseated. The nurse warned that if I was going to throw up, that I couldn't have any more ice chips. My doula said it was a response to the pain and I confirmed that I wasn't actually going to get sick. Lori gave me some physical support with counterpressure, and both Andy and Lori cheered me on and continued to work with me through each contraction.

5:45 pm

I silently talked myself through each contraction. I can do anything for 90 seconds. I focused on each contraction independent from the rest, and took full advantage of those quiet moments in between where comfort still reigned. Labor is such a beautiful and mysterious process, and those breaks are built in for a reason. Releasing long, relaxed, exhalations also helped me to manage my pain.

I remember being so thirsty during this labor, probably because I wasn't allowed to drink anything, and I couldn't get enough of those ice chips. At some point I snuck two GUs, which were just the thing at the time. (I highly recommend them for running, and other marathons, like birth!)

6:00 pm

By the nature of the contractions, I knew I was close to the end and began searching hard for that feeling to bear down and push, because then I knew relief would come. When Lori and Andy pulled the covers back to help reposition my pillows they found blood and Lori said, "uh, I think she's complete" and went to alert the nurses. In no more than a minute or two, my doctor had arrived, along with several nurses, and an entire NICU team. The room was suddenly bright again and filled with people.

I still had no urge to push, although I could feel him moving down. My doctor checked me one last time, noted that I was 10cm dilated and declared it was time to push. I also remember mention of a suspected cord around the neck and placental abruption.

I wanted to push on my own terms, but I still didn't feel the urge and while I had been told that I would be allowed to give birth in whichever position felt most comfortable, my doctor insisted then that she wanted me on my back in the traditional birthing position. She insisted too, on directive pushing which is totally unnecessary in a natural birth especially, and another common practice not at all supported by the literature.

After a few minutes I could feel the transition from labor contractions to pushing contractions, but my urge to push was still ramping up. My doctor relied on the monitor to estimate when a contraction was about to happen and then she would begin to count to ten, but by her third count my urge to push was over, and I wasn't going to push any more. She began talking about the baby's safety, and how I needed to get him out, like, NOW. Pushing was forced and more painful than necessary. I will always remember the sterile drapes and her stern and serious face.

By the third or fourth contraction I finally felt a real urge to push, and when Andy leaned into me to share his concern that we'd be headed for a c-section if the baby wasn't born soon, I followed her instructions to push, with way more force than I would have chosen if left on my own. As Merritt was crowning, I started to resist and told my doctor that I wanted to breathe through a contraction or two to ease him out, but everyone in the room was insisting that he was right there, and so close to being born. My doctor maintained that I should continue to push, push, push.

One of my most vivid memories of this birth is the feeling of shooting a baby out like cannon ball.

6:20 pm

Merritt was born with the cord wrapped around his neck (she just unwrapped it, no biggie) and a robust cry. His cord was cut after 30 seconds, (not the full sixty that is recommended for delayed cord cutting, but we were thankful for any delay). They let me give him a kiss, and then he was handed over to the NICU staff. He weighed 4 pounds 1.6 ounces, and was 17 inches long. His Apgar scores were 7 and 8.

6:30 pm

I delivered the placenta uneventfully and without the use of pitocin. A partial placental abruption was later confirmed.

6:35 pm

Andy was invited to join the NICU staff to observe and take pictures. I remember looking over to the blur of people revolving around Merritt. Andy was tearfully trying to capture the moments that I couldn't be a part of.

6:40 pm

Merritt was shown to me one last time, and then taken to the NICU. Andy followed to know the location, but wasn't allowed to stay.

6:50 pm

The doctor came in with a dinner menu, but we quickly realized that the cafeteria was closed. Andy was instructed by staff to leave the hospital to find food (so horrible!), but a girlfriend of mine arrived shortly after with homemade enchiladas and strawberry shortcake.

We had to spend over an hour on the L&D floor, with promises to see Merritt on the way to Postpartum. Instead, we were taken directly to Postpartum where we were made to wait more.

Around 9:00 pm

Two and a half hours after his birth, we finally got to see Met and hold him for the first time.

Surprise, it's preterm labor

My water broke yesterday around 12:30pm. I wrapped up a conference call, put Roscoe down for his nap and then settled in for a snack and some email catchup. A few small gushes and a double check in the bathroom didn't convince me, but as I walked back to my computer more water trickled out and I was back to the toilet where I sat for 30 minutes with water intermittently dripping and gushing as I called my midwife, Andy, my mom, and my doula, in that order.

36 weeks is the cutoff for home birth. I'm 33 weeks today. After much debate, and because we thought the baby might come quickly, we went to our nearest hospital, instead of my primary choice located in the heart of DC. I wasn't experiencing much in the way of contractions so we took our time at the house--I showered, we packed my bag, and gathered all the necessities including extra pillows. We left around 2:45; Roscoe was sawing logs in his bed, and my mom was elbow deep folding a huge pile of laundry.

When we first arrived I tried my best to resist any internal exams because they significantly increase risk of infection once the amniotic sac has ruptured. When the doctor couldn't visually see my cervix with the speculum she convinced me to do an internal, my first FAIL.

My cervix was soft, thick, and 1 centimeter dilated. We were told the baby might come tonight, or in a week.

The sonographer paid us a visit and Little Sears was well engaged in my pelvis, head down, and butted up snuggly to my cervix. I thought we might get a glimpse of his sweet little face but it was buried. He's measuring right on track (estimated weight: 3 pounds 13 oz. plus or minus 11oz.) and he hasn't shown any signs of distress so far.

We spent over an hour with the neonatal intensive care nurse practitioner to get a better understanding of the NICU's policies and procedures. At this stage in the pregnancy we're guaranteed a minimum two week stay, and of course the realities that go along with that break my heart, but we're trying to stay positive and advocate for the things that are important to us.

I can't imagine leaving him in the NICU alone. ever. We've been told that we can stay with him 24 hours a day, practice kangaroo care whenever possible, and I've expressed my very strong preference that he receive only breast milk. I was a horrible pumper last time so the learning curve will be interesting. Once he is born we will initiate the process to request donor milk in case he needs to be supplemented.

I was transferred to the ante/postpartum ward and ordered for strict bed rest with trips to the bathroom as needed. I've been able to change back into my own clothes and I have a "room service" menu to order from at all hours so, for the moment, I'm pretty content. Overall we've been pleasantly surprised, staff have been really wonderful and we're bummed that they'll be switching shifts in four hours. Of course, I couldn't escape confinement to the bed and continuous monitoring, didn't get to eat for almost 12 hours, or use the bathroom for the first 6, but comfort measures are hard to come by here. Even pillows are a hot commodity and I'm glad we brought three. 'Tis the nature of the hospital I suppose.

I finally fell asleep around 1:30am but woke around 2:00am with contractions that are now 5-8 minutes apart--they're not painful, but I would definitely categorize them as contractions vs. the cramping I've been experiencing off and on over the last two weeks. I'm torn between wanting to keep the baby in as long as possible (I received the first of a series of steroid injections around 6 this evening), and wanting to avoid infection and the higher risk for a c-section. When my body goes into labor they will not try to stop it. My doula is on call, and my hope is that I will still have a natural, vaginal birth. The current estimate is that he'll be born within the next three or four days.

For now everyone is exercising the wait and see approach, which is just fine with me. I'm still processing everything and I'm grateful for this little lull in activity which not only bides us time to emotionally and mentally prepare in the context of the current situation, but to gather our thoughts around our priorities and to adequately communicate them to everyone on staff.

Keep Little Sears in your thoughts, outcomes are typically great for babies at 33 weeks.

Homebirth: Supplies

Have you ever wondered what would be needed for a home birth?

Here is the official supply list, given to us by our midwife at our 28 week appointment. It is requested that all supplies be gathered in one place by 36 weeks.

(click the image for a larger version)

Supplies for labor and birth

Basically, Momma needs to be hydrated and nourished during labor--we have stocked coconut water for hydration and runners "GU" for quick energy. Our cupboards were absolutely bare when I went into labor with Roscoe, and my parents saved the day by dropping off a full load of groceries shortly after labor began. I didn't have a desire to eat any food, but I did suck down two gels during the pushing phase, and had maybe a few sips of grape juice at some point or another. For women with longer labors I imagine that a few easy to eat snacks would be lifesavers.

Since we've done this before we have quite a lot of leftover items, so our job of gathering everything on the list was made pretty easy. We will use two of our laundry baskets and line them with trash bags for whatever trash and linens accumulate during the process. I had a really easy recovery after Roscoe's birth, but I do remember a need in the first 36 hours for frozen peas and Ziploc baggies wrapped in paper towels (homemade perineal ice packs!!). Friends of mine swear by the commercial ice pads provided in-hospital, and when I found them on the birth supply website I decided they would be worth the investment at $2.50 a piece. I'm not sure that anyone will be at my beck and call to reload the pea packs every couple hours so I think the convenience will be great.

We're using the same set of receiving blankets that were used at Roscoe's birth, and Susan will bring an electric heating pad to warm them. Baby hats, newborn diapers, and a digital thermometer are all baby basics and easy to come by. Vaseline makes the first meconium poops so easy to clean up--we put a few dabs on Roscoe for the first three diaper changes and saved ourselves the effort of wrestling with the tarry stuff.

A good selection, and large quantity of pads in different absorbencies were essential and it was nice to have bought them ahead of time so that Andy didn't have to later run to the store and guess at what I might need/prefer.

Birth supplies

The supplies designated for the actual birth are a little harder to come by, but my midwife has a relationship with a homebirth supplier and last time we ordered a customized kit for a little over 40 dollars with shipping--it included everything that our midwife requested. Because we had at least a small quantity leftover of most of the necessary items, this time I only had to order a few more packs of chux pads, 7 or 8 gauze pads, and several sets of sterile gloves.

Before we experienced it, one of our biggest superficial concerns was the "mess" involved with birth and how our white carpets would fare. Fear not! Those blue chux pads are perfect for the job, and in the final weeks of pregnancy I highly recommend stashing a few in your bag, desk drawer, and glove box in case your water breaks and you need something to sit on. My water broke as my first sign of labor. I happened to be asleep on the couch, but what if I had been mid-commute!? Those pads would have come in handy!

Ammonia and hydrogen peroxide serve as all purpose cleaners. I can't speak to their effectiveness because we didn't need to use them (hope the expiration date hasn't passed because they're in the box again). When the birth team left our house late Tuesday night, everything was in order and a load of laundry was humming in the wash. You would have never guessed that baby Roscoe was birthed on the floor in the corner of our bedroom.

Preparing the labor and birth space

I plan to labor throughout the house as I feel comfortable, and give birth in our bedroom or bathroom (who knows where, really!). In early March we'll make our bed with clean sheets, put a plastic painter's drop cloth on top, and then stretch a fitted sheet over the whole thing and make the bed as usual. I know one thing, we'll be sure not to wait until week 38 and 2 days (like last time!). I remember stripping our bed and tossing the sheets in the machine while I waited for my contractions to ramp up, but neither of us can recall how the bed actually got made! Either way, I spent only the intense transitional phase of labor under the sheets, nestled between pillows, so we didn't really make use of the whole preparation.

I love admiring our little stockpile of birth-day supplies. We're one step closer in preparing to meet Little Sears and I can't believe that we get to do this again! And soon!

If you're planning a homebirth do you have a similar list?

Roscoe's birth story (three months late!)

I've finally drafted Roscoe's birth story! It's really long and very detailed because I wrote it for myself and because I want to remember everything! I don't think people get to hear truly positive birth stories very often, so I wanted to share our experience.

Roscoe’s official due date was May 31st. A little back-story includes the fact that our doula had an out of town trip scheduled for the 21st through the 25th, and that my Grandparent's were visiting from Hawaii, but headed back home on the 21st as well. If we gave birth while Lori was away we would have had to use her backup so our fingers were crossed that he would come before or after her trip. As for my grandparent's, Roscoe is their first great grandchild so of course they were hoping he'd arrive while they were in town.

On Monday evening (May 18th) I set out on my usual 3-mile walk. On the way back I was feeling really tired and sorry I hadn't taken a shorter route. Later that night I felt really stiff and sore and figured I might have overdone it. Despite our initial plan to clean the house, go grocery shopping (our cupboards were practically bare), and make our bed per the instructions of our midwife, I was feeling so out of it that we decided to go to bed instead.

The next morning I felt more pressure in my pelvis, and found it increasingly difficult to comfortably walk around the house. In particular, my lower back was getting tighter and tighter. I began telecommuting up in the loft a little before 9:00 am, sat in on a conference call at 12:00 pm, and took my lunch at 1:00. Around the same time I felt a couple painless period-like cramps, not unlike those I'd been experiencing for weeks. I set my alarm for 25 minutes in order to take a quick snooze and fell asleep as soon as my head hit the couch pillow. Not more than ten minutes later I woke to a flow of warm water and quickly realized it was my water breaking. I made it to the bathroom just in time for a big gush of amniotic fluid, and awesomely, my back pain was instantly relieved, my belly seemed smaller, and I felt great! Despite the early signs of progress noted in previous weeks, Andy and I had tried to maintain the realistic expectation that Roscoe might arrive after his due date, so I was actually pretty shocked to be in labor at 38 weeks, 2 days. A rush of adrenaline simultaneously brought on tears and the shakes.

I first called Andy at work. When he answered I blurted out that my water had just broken, and he asked if I was kidding. Tearfully, I said “no”. He responded with a few sweet words and I could tell he was excited. We got off the phone exchanging “I Love Yous” and a joyful “Oh my god, we’re having a baby TODAY!” Andy left work and headed home knowing it would be at least an hour as he needed to stop by CVS to pick up an antibiotic for group beta strep. With rush hour fast approaching I next called Susan (our midwife), then Lori (our Doula). At that point, I had not yet had any contractions so I was told to go about my day, and to give Susan a call in a couple hours to let her know how we were doing. She said that if contractions didn't begin within the next 12 to 18 hours we would discuss how to proceed, but added that she hoped we'd have our baby by then.

So! After signing off at work, and considering my good luck in timing my leave (I had only worked from home for 2.5 days), I raced around to tidy the house (we had company coming!) and started some last minute loads of laundry while I waited for both Andy to get home from work, and for the contractions to begin.

When the first real contraction came I called Susan for a little pep talk (the first and last) and said something along the lines of, "I know we planned this natural birth and all....but....uh...these contractions kinda hurt. I'm worried!" She reminded me that they would continue to get stronger but that I would acclimate to the pain as my labor progressed. While on the phone I had another contraction more painful than the first, and said, "Oooh, that one was worse." In a calm and steady, matter of fact way, she said. "No. That one was BETTER, it was STRONGER!" Which reminded me to reframe the pain, and gave me a smile. Just one of the many reasons why Susan is awesome!

By the time Andy arrived around 3:00 pm I had experienced only three contractions. He had downloaded a contraction timing App a few days earlier (there's one for everything!), and by 3:30 pm Andy's iPhone showed my contractions coming every three to five minutes.

So there we were at the beginning of DC rush hour, with my midwife (in Maryland) and my doula (in Sterling) on the wrong side of traffic. Susan and Lori kept reminding me that first labors average 20 hours. They were very laid-back and in no rush to head out onto I95. My mom was in labor for 8 hours with me, 1.5 hours with my sister, and 1.1 hours with my brother. My labor was progressing as quickly and I was beginning to worry about the timing of the birth team's arrival to our house. I told them I'd call them if anything changed.

Initially, Andy helped me manage my pain with counter pressure moves we had learned in our Bradley class. Eventually, those were not at all helpful, and I did what felt best which at the time was to simply rock and breathe through each contraction. Lori suggested I drink a glass of wine and head upstairs to take a bath. I didn't drink the wine, but I did get in the tub; the heat felt nice, but lying down was uncomfortable. Andy and I then hopped in the shower but didn't stay long because I just didn’t find it very helpful which was disappointing because I had heard such great things about laboring in water. I redressed and we headed back downstairs.

In preparation for labor, Andy and I had created an exhaustive list of activities to keep us busy in the early stages. They ran the gamut from going to the grocery store to buy supplies for Roscoe’s birthday cake, to taking a hike at the local park, or watching video from our wedding. I entered the active stage of labor within an hour or so of my first contraction, to our dismay we never had a chance to implement the list! At one point, Andy suggested that we sit outside in the sun and maybe take a little stroll. That sounded nice. Just as we were headed for the door, the first of my transitional contractions began, and there was no going anywhere but upstairs for the final phase of labor. I called the birth team again and they were on their way!

I went back to our bedroom and labored for a little while, and around 4:30 I wanted Lori’s ETA—I was more than ready for some additional labor support. Andy called and she was only about 15 minutes away. I crawled into my bed just as she arrived.

Soon after, I started to bear down and Lori mouthed to Andy that we would have a baby SOON! When Susan arrived around 5:20 pm, I remember seeing her walk through our bedroom door, but I barely acknowledged her; laboring between the time that I went upstairs to take a bath, and Roscoe’s actual birth was quite a blur. I was definitely in my birthing zone, and completely giving in to the experience. My body led the way and I intuitively followed.

The transition from labor contractions to pushing contractions was for me the strangest part of Roscoe's birth. At this stage, the contractions began with rhythmic cramping pain but at the height of the contraction started a completely involuntary squeeze that, in the words of my doula, "is like throwing up backward!" It was kind of awkward and I found myself fighting the contractions. Up until that point I had been practically silent, but with direction from Lori I began vocalizing with each exhalation, which really helped me to focus and relax. After several contractions I had it figured out and headed to the bathroom for what would become my first true pushing contraction. I pushed only once with each of the next few contractions, and alternated between the bathroom and our bedroom for routine fetal monitoring.

When my labor had progressed to the point where I was pushing three times with each contraction, I instinctively retreated to our darkened bathroom after declaring “I want to be alone". I pushed over the toilet for the next 40 minutes and every so often someone from the birth team would poke their head in to offer water, or support. They also checked the baby's heart rate periodically. Otherwise, I was left to labor as I pleased. Andy, Susan, and Lori kept each other company in our bedroom. Around this time, Mel, our photographer, showed up. She had driven from Richmond (about an hour and twenty minutes away) and had timed her arrival perfectly.

With each contraction I could feel Roscoe moving down, and I could see my belly changing shape. I felt like I was getting somewhere so I asked Susan to check me for the first (and last) time. She said that I was making good progress. With the very next contraction Lori said she could see Roscoe's head and asked me if I wanted to touch it. I did and it felt wet, and squishy!

I squatted there in the bathroom and was prepared to give birth, but in an effort to avoid tearing, my midwife suggested we move into the bedroom and try a different position. I had several contractions kneeling in a "proposal" position, and then it was time for Roscoe to make his debut!

I laid back with Andy behind me, and pushed several times. At one point, I felt some burning and Susan suggested I breathe through the contractions instead of pushing with them. She also noted that Roscoe’s head was asynclitic, which means that it was tilted to the side. Instead of the back-top of his head coming out first, the side-top was leading the way. Susan helped reposition his head at the end, which alleviated some of the burning. Lori offered a mirror so we could see Roscoe crowning. The next thing I remember, was reaching down to pull baby Roscoe up onto my belly. His umbilical cord was on the shorter side so I could only pull him up to a certain point, but he locked eyes with us and, like a little animatronic baby, his dark gray eyes opened and closed in unison. He was brand new, beautiful, foreign yet familiar at the same time. Andy and I were awestruck. Roscoe’s apgar scores were 8 and 9. We invited my sister and my mom to come upstairs, and everyone chatted while waiting for the placenta to be delivered before Andy cut the cord.

When I attempted to breastfeed he latched immediately.

Roscoe was wrapped in a blanket and handed to Andy while I took a shower and got dressed. We climbed into bed, a new family of three, and waited for our visitors to arrive. First came Roscoe’s Grandpa, then his other set of Grandparents, and two sets of Great Grandparents. When everyone else went downstairs to enjoy the meal my mom and my sister had specially prepared, Andy and I were given time to ourselves to eat and hang out with our son.

Roscoe was born in our bedroom at 7:54 pm after 5 hours and 23 minutes of labor. He weighed 7 pounds 2 ounces, and was 19 inches long. Giving birth at home was calm, intimate, and empowering above all else. I loved everything about it, from beginning to end. Particularly the time Andy and I spent together before the birth team arrived, and the fact that I got to call the shots and labor how and where I wanted. Roscoe's birth was everything we had hoped for and more. I cannot wait to do it again!

A few surprises included the fact that I preferred to labor alone during the pushing phase. I didn’t want an audience, and I couldn’t have predicted that prior to the actual event.

Also, while we did not implement so much of what we learned during our Bradley course, I absolutely believe that it was instrumental in setting the tone for the kind of birth we wanted, preparing us emotionally and mentally for labor, and for working together as a team to bring Roscoe into the world. The confidence and excitement we had going into the experience really made it for us.

Lastly, many people thought we were crazy for hiring a photographer to document our birth experience. In reality it was one of the best decisions we made. Hands down. As the laboring woman, you miss so much because you have only one perspective. Mel captured things that were happening in other rooms of our home; sweet, sentimental moments that I could not have experienced if it weren’t through the photos she took. Furthermore, anyone who’s ever taken a Bradley course knows that you get to see many, many, MANY births on video. To tell you the truth, some of my absolute favorite pictures are of Roscoe literally being born. It is AMAZING to see your own body work in that way. As for my comfort level with being photographed at such an intense time, mothers will tell you that your modesty goes out the window during birth, but what I found was that I hardly noticed Mel was there. If you ask her, she’ll tell you that it was the most intrusive she’s ever felt behind her lens, but from our end we couldn’t have been more at ease, comfortable in our own space.

Roscoe's Birth Announcement

We finally mailed out all of Roscoe's announcements, no matter that he's almost 9 weeks old :)
We really love how they turned out!