Isis's Birth

Welcoming Baby Isis

 

My Darling Isis,

 

We have amazing bodies, you and I—strong and wise and capable of profound acts of transformation.

 

Your Story, My Story, Our Story

 

On October 21, 2013, you left the only world you had ever known (the dark and watery world inside my belly), and joined your Papa and me on the outside.

 

Before you were born, I had spent a lot of time contemplating how incredible and bewildering that transition must be—to emerge from the womb into a world of air and light and loud sounds and other entirely new sensations. I wondered what you would be thinking and feeling when they first put you in my arms, but of course I knew you would never be able to describe those things to me, because none of us has any memories of our own entry into this world. That part of our personal narrative must remain a mystery forever. All we can know from our own birth are the memories and impressions of those who were there to witness this important rite of passage.

 

So this is the story of your birth, my love, told from a new mother’s perspective. I’ve written it down for you, so that one day when you’re older you can understand how your body and mine worked together to bring a new and delightful little soul into the world. In order to get here, you and I had to take a journey together through pregnancy and labor. It was a journey that required patience and faith, as well as a great deal of effort and determination.

 

There were some unexpected twists and turns along the way. The story in this book is not exactly the one I imagined I would be telling, but therein lies my first important lesson in motherhood. Your birth—your marvelous, challenging, miraculous birth—required me to let go of expectations, and embrace the beauty of the journey we had been given. What a powerful lesson to teach your Mama on your first day on earth!

 

Preparing for your Arrival

 

The day after I found out I was pregnant with you, I hired a team of wonderful home birth midwives at Rites of Passage Midwifery. Nancy and Ami had delivered the babies of several friends of mine, and I was thrilled to have these kind and extraordinarily skilled women caring for me throughout my pregnancy. You and I were both healthy, and everything about my pregnancy was low risk. Assuming things stayed that way, the plan was to give birth at home when the time came.

 

We prepared for your arrival with a great deal of excitement. Your Papa and I watched videos of natural childbirth on YouTube, and we took a class with a bunch of other first time parents planning home births. We knew that first time labor could be a long, challenging endeavor, and it would be a lot of work for your Papa to comfort and support me all by himself, so we asked your Nana and your Tía Rosana to join our home birth team as well. They were happy to be a part of the experience, and we were so grateful to have their support.

 

Your estimated due date was October 24th, but for some reason I had a feeling in my gut that you were going to come a little early. When I went to my 39 week prenatal appointment, I was not showing many signs of being close to labor, but still I thought you might make your appearance pretty soon. At that appointment, we listened to your heartbeat through the fetoscope, and the midwives felt how you were positioned in my belly. Everything was healthy and great. You were in an excellent position for childbirth. Back at home, we had organized all the supplies we needed for your birth. We had also rented a birthing tub, and I had written a dozen birth affirmation cards, to help keep me in a positive headspace throughout labor. I strung these up alongside the blessing beads that we had collected from friends and family at your baby showers. Everything was in place, and we felt ready to welcome you into our family. It turned out to be a good thing we were all prepared, because there would not be any 40 week prenatal appointment. You were ready to be born that week!

 

The day before I went into labor, your Tía Rissy and your cousin Jayden came up to San Francisco to visit. We went to a pumpkin patch out on Sloat Boulevard. It was almost dusk on a clear day, so after we had selected our pumpkins we decided to drive out to Ocean Beach to see the sunset. It was chilly, but I was drawn down to the water anyway. I took off my shoes, put my hands to my belly, and dipped my toes in the cold Pacific Ocean. As I stood there at the water’s edge, I told you that we loved you and we were ready for you to come whenever you wanted. You must have gotten my message, because my first very early contractions started just twelve hours later.

 

The Labyrinth

 

I think of labor as a special journey that mom and baby travel together. When I was pregnant, I took a prenatal yoga class from a wonderful midwife named Jane Austin. She and another midwife, Sue, hosted a monthly labyrinth walk for expectant moms at Grace Cathedral. Jane and Sue talked about the labyrinth as a metaphor for childbirth; when you’re in the middle of it, you do not have the perspective to see the exact path ahead of you. But walking the labyrinth is an exercise in patience and trust. Unlike a maze, a labyrinth has no dead ends; you cannot actually get lost, although sometimes you may feel that way as you traverse the path.

 

Preparing for your arrival, I had walked the labyrinths at Land’s End and Grace Cathedral a number of times. I found a lot of peace and comfort in this meditative practice, but I don’t think I fully understood the power of the labyrinth metaphor until I was actually in labor with you, facing some very real, unexpected turns along the way.

 

LABOR BEGINS

 

The very first twinges of early contractions started at 7:00am on October 20th. I had woken up at 5:30am, and couldn’t get back to sleep, so I was lying in bed quietly when the mild cramping set in. I noticed it was happening about three or four times per hour through the morning. I got up and made breakfast, and after a few hours of these contractions, I texted my midwives to let them know what was happening.

 

This was a Sunday morning, and your Tía Rosana came upstairs from her apartment to see if anything was going on. She was very excited to hear we might be headed into labor, but we all knew that it could still be a false alarm, or at least it could be a while before anything really started happening. With the contractions still so mild and so far apart, we decided we needed some distraction, so your Papa, Rosana and I took off on a long walk. If this was false labor, we understood that walking would probably put things to a stop, but if it was real labor, the walking might help move things along.

 

We walked from home to Union Square, and had lunch around there. Contractions continued throughout the morning and afternoon, but didn’t seem to be getting any closer together or any more intense. I remember it was a clear, sunny day, but there was a crisp wind blowing. I felt pretty tired of walking after lunch, so we rode the F-Market streetcar home. When we got back to the apartment, I decided to take a shower, in case it was my last opportunity for a little while.

 

In the shower, the contractions started to seem a bit closer together. They were still mild, but I thought I should try timing them for a little while. Laying down in bed, I discovered that I was contracting closer to 8 minutes apart, and the sensations, while not painful, were becoming more distinctive. I called your Nana, who was waiting down in Palo Alto for word from us. We decided it would be best if she came one up to the city to spend the night, just in case you were ready for your debut.

 

By now it was about 4:00pm. I asked your dad to set up the birthing pool, but leave out the water for now. I also texted Rosana to tell her that Nana was on her way to the city. Rosana headed out to the grocery store to stock our fridge and cupboards with loads of good food for labor and postpartum. Nana arrived in San Francisco a little after 6:00pm, and we all settled in to see how things would develop. I didn’t want to get my hopes up, but I was starting to feel like this was the real thing!

 

At 6:30 I felt something leak out of me during a contraction. I wasn’t sure, but I thought maybe my water bag had just broken a little bit. The fluid seemed clear, which was good. A little while later, more fluid leaked, but this time it was tinged slightly brownish. I texted a picture to Nancy. The coloring could be from meconium, but it was so light that she wasn’t concerned. Contractions continued to be steady and spaced pretty far apart all evening. As darkness fell, we all carved pumpkins together. I wanted jack-o-lanterns to keep me company if I ended up laboring through the night. The warm orange glow set just the right mood to welcome our little October baby.

 

Because I was fairly confident that labor was officially underway, I got out a measuring tape to take one last belly measurement… Forty nine inches around! How incredible that our bodies can just stretch and grow like that to make room for a whole new life inside! At thirty nine weeks pregnant, I had been feeling pretty uncomfortable with the weight of that belly down very low on my pelvis, but as I measured my final circumference, I knew that a part of me was going to miss that marvelous belly that held you and nurtured you for all those months. Being pregnant was an extraordinary experience—one that I will always remember fondly.

 

EARLY LABOR AT HOME

 

My midwives said I should be sure to eat and drink through early labor to keep up my energy for the hours of hard work we knew were ahead, so after we had carved pumpkins, I ate butternut squash soup while your Papa played you some beautiful and calming Bill Frisell songs on his resophonic guitar. Things felt cozy and calm, but also exciting. We were going to meet you very soon!

 

We didn’t want to stay up too late, because we knew that labor could get more intense at any point, and we wanted to have some rest before that happened. At 9:00 that night, Nana and Rosana went downstairs to sleep, and your Papa and I climbed into bed as well. Before I brushed my teeth, I remember standing in the doorway to the bedroom, hugging your dad tight, and saying to him, “This is it! We’re really doing this…” I got a lump in my throat, and tears sprang to my eyes. I didn’t feel scared or sad. I was just overwhelmed with emotion that this event I had dreamed about and hoped for and planned for was finally upon us. I felt very ready to meet you, but I also wanted to just stop and take a breath and acknowledge those final moments of our life as a family of two.

 

I crawled into bed and closed my eyes. Your Papa wasn’t sleepy yet, so he tried to watch a movie on his laptop with headphones. I dozed lightly, but never quite fell asleep completely, because as soon as I lay down, my contractions had become a little more uncomfortable. I started breathing through each one, but remained totally relaxed, lying on my side in the bed. Every time your dad heard my breathing change, he paused his movie, timed the contraction, and rubbed my lower back in time with my breathing. The contractions were about 8-10 minutes apart at that point, and still not very painful. That all changed at 11:20pm, when a much bigger contraction hit, I felt a gush of water, and I suddenly just had to get up. The last place I wanted to be was lying down!

 

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THE MIDWIVES ARRIVE

 

We moved out to the living room, and I got comfortable leaning over the ball in hands and knees position. Contractions had suddenly leapt to three minutes apart, and they were obviously much stronger than before. I asked your Papa to start filling up the tub that we had rented for the birth, and I called Nana and Rosana to ask them to come upstairs and keep me company while your dad hooked up the hose to our shower and got warm water flowing into the pool. I knew it was not ideal that I hadn’t managed to sleep at all before labor picked up, but I wasn’t too worried about it at that point. I felt alert and full of energy, and excited about laboring through the dark, quiet, peaceful night.

 

We texted the midwives with updates about my leaking water bag and the spacing of my contractions. Ami was in Hawaii at a memorial service for a midwife colleague, so Nancy was the one on call this weekend. When contractions had been three minutes apart for an hour, we spoke with her on the phone, and she listened to me vocalize through a few contractions. She asked us to see how things continued for another hour, and to call back sooner if anything changed. At 1:20am, contractions were still steady and strong at three to four minutes apart, so Nancy and our apprentice midwife, Carlee Ann, woke up and headed over.

 

I liked laboring bent over the ball, but it was hard to sustain for too long, because of the pressure on my knees. I started trying standing positions, and much to my surprise, I really liked that coping technique. When contractions would come, I would sway and move my hips and vocalize through the wave. Sometimes I liked to pace around the living room, and other times I just leaned against the back of the yellow vinyl chair. That became my favorite spot to labor for most of the night. That is where Nancy and Carlee Ann found me when they arrived.

 

They got all their supplies set up quickly, and started some initial monitoring of your vital signs and mine. Everything looked good for both of us, so Nancy went to nap in the bedroom while Carlee Ann kept watch. By this point I was in well-established labor, so Carlee Ann said I could get in the tub. I was worried it might slow down the progress of my contractions, but Carlee Ann assured me it was unlikely. I needn’t have been worried. Contractions didn’t slow down at all in the tub. My amazing uterus kept going strong! The warm water did give me some relief from the intensity, and I loved being able to totally submerge my heavy belly.

 

I was in the water for about two hours. Rosana and your Papa kept me fed and hydrated, while Carlee Ann periodically checked your heart rate with the Doppler. Rosana made the world’s most delicious buttered toast. I was very content. This whole time, I could feel you moving around inside of me. You were kicking and stretching your legs inside my belly, and I wondered about what you were thinking and feeling as my body squeezed you every few minutes.

 

Over the course of my time in the tub, Carlee Ann noticed your heart rate had been slowly climbing up above your normal baseline. She woke up Nancy to consult. It was still dark out, but morning was creeping closer. Nancy wanted to see your heart rate come back down, so she asked me to try laboring in some different positions outside the tub. We tried side lying on the couch for a while, but I was pretty unhappy in that position, so after a bit we moved back to hands and knees on the living room rug. I was drinking loads of coconut water and trying to channel calming energy to you, but your heart rate kept creeping up, and you continued to be super active inside my belly.

 

Nancy was concerned. She explained that we would need to move to the hospital if we couldn’t get your heart rate down pretty soon. She suggested we try giving me IV fluids to see if further boosting my hydration might help. It must have been between 5:00 and 6:00 am when Nancy placed the IV, because I remember the sun was coming up, and I could hear the garbage trucks outside doing their morning pick up. We hung the fluid bag from the ceiling fan and I went back to laboring standing up behind my favorite chair. Nancy checked your heart rate after a few minutes and found that the fluids had worked! You were back to a calm, steady beat in the 120s/130s. I was so pleased we would be able to continue laboring at home.

 

THE INTENSITY MOUNTS

 

I don’t know if it was because of the IV fluids or the change in position, or simply a coincidence of timing, but as soon as I started laboring standing up again, my contractions reached a new level of intensity. It was a lot of physical work to cope with each wave of pressure and pain, but I felt really energized and powerful during this part of the journey. I was completely present in my body and letting my uterus do the work it needed to do to move you down and out.

 

Contractions were still coming about three minutes apart, and I felt compelled to vocalize loudly through each one. Different sounds came from my mouth during this time, without me making a conscious decision what to say. Sometimes they were just sounds, like “Ah-eee-ahhhh.” Other times words would form. I remember saying, “Wowwww” through a bunch of contractions, drawing out the vowel sound and the last w. I also found myself saying, “Dowwwwnnnn” and “Oooopennnn!”

 

Between contractions I would sometimes talk to you and encourage you, saying, “Come on, baby.”

 

Each contraction felt like progress at this point in labor. I remember feeling your head descending lower in my pelvis. The pressure was astounding, but I wasn’t scared. I felt safe and loved and supported by everyone around me on my birth team, so it wasn’t too difficult for me to cope mentally with each wave. I didn’t fight the feelings that came with each contraction, because I knew that all that pressure was helping my body stretch and open and make way for you to move yourself out into the world. I focused on giving into the sensation as best I could, so that I wouldn’t create any more tension or extra pain that might get in the way of our progress.

 

The contractions were relentless, but I felt like I was on top of each one, riding it forward to get to the place where I could start pushing. This was my favorite part of labor. I felt so strong and connected to you. We were doing it together, my love. After the IV fluids had drained, I moved back to the ball. Rosana hung my affirmations in the window for me. In the morning light, I labored alongside the beautiful images of childbirth on the Women’s Building mural across the street.

 

OUR SUPPORT TEAM

 

Your Nana, your Tía Rosana and your Papa were all such wonderful companions through the night and into the morning, despite how tired they must have felt! When we had previously discussed what my expectations were for my birth partners, I had told them I didn’t know how I would feel in labor, so I just wanted everyone to be ready to go with the flow. I didn’t know if I would prefer it dark or light, silent or with music, serious or light mood, strong touch or light touch or no touch at all. The only thing I was certain about was that I didn’t want to feel lonely during the journey. I couldn’t imagine that I would be one of the women I had heard about who prefers to lock herself in a room and labor alone for a while. Not me. I wanted the comfort and consistency of close companionship through the labyrinth.

 

As it happened, I didn’t mind lights at all, and I enjoyed having music from the many playlists your Papa had put together in the last days of my pregnancy. I was surprised to discover that I only wanted light touches on my back and head. In theory, a firm lower back massage sounded great, but once I was actually in labor, my body was creating enough pressure on its own. I didn’t want more coming from the outside! Your Tía Rosana had agreed to take pictures, but she was worried that I might feel annoyed by the sound of the clicking shutter. In the end, I didn’t even notice it at all… and I’m so grateful for the amazing images she captured of your birth. What a treasure!

 

Of course, Papa and Nana and Rosana were not the only ones keeping vigil with me. Nancy and Carlee Ann provided an ever calm and reassuring presence as I labored under their watchful eyes. Carlee Ann swapped out seamlessly with Nana and Papa when they needed food or bathroom breaks. Nancy kept a detailed log of progress notes, paying attention to how I looked and sounded as I coped with each contraction.

 

The whole time, I felt surrounded by people who believed in me, and I took so much strength and energy from their words of encouragement. I can remember Nancy cheering me as I vocalized through the mounting intensity and peak of each contraction. I could hear her voice over mine from the couch exclaiming, “Yes!! Good, Penelope. Good!” I heard people reading my affirmation cards aloud to me periodically, and in the quiet space between contractions, I remember soft murmurs of encouragement from Nana, telling me how well I was doing while she stroked my back.

 

As contractions continued apace, I mentioned feeling a lot more pressure dropping low in my pelvis. Based on the way I was moving and sounding, Nancy and Carlee Ann thought I might be in transition (almost ready to push). They encouraged me to try some positions that would involve getting my body into more of a squatting position. This would help you continue to descend, and would encourage my muscles to relax and give way to the pressure, rather than tensing up and fighting against it. Your Papa and I were excited to try one of the labor tricks we’d learned about in our home birthing class, so we moved into the hallway to get set up.

 

CHANGED CIRCUMSTANCES

 

We rigged up a sort of a squatting rope on the bedroom door by knotting off the end of a scarf, and closing the door on the knotted end. This left most of the scarf hanging down for me to grip while leaning back into a sitting or squatting position during contractions. Your Papa supported me from behind, in case I lost my grip. I really liked this position. Contractions still hurt, but the scarf helped me harness the power of gravity, and really lean into the pressure. I wish I could have labored like this for longer, but midway through one of the contractions you descended further and—Gush! I suddenly felt a fresh burst of water. Nancy checked the fluid that had leaked onto my pad, and that’s when we discovered the thick green stain of meconium. Oh dear. It looked like you had your first poop just a little earlier than we would have liked.

 

As soon as we saw it, we knew that we were not going to be able to welcome you into the world at home after all. This was a definite reason for a hospital transfer, because meconium aspiration could be very dangerous for a newborn baby. It did not necessarily mean you would be born sick, but in the event that you had contracted an infection of some sort, we needed to be close to the excellent pediatric intensive care that the hospital could immediately offer.

 

It was a disappointing reality to face, and I felt really sad about it, but I was not going to take any chances with your health and safety. The hospital was not the environment I preferred for labor or birth, but it was where you needed us to be, given the circumstances. I had come upon an unanticipated turn in labyrinth, and I had to accept that this was our pathway. Whether I had wanted it or not, the hospital was going to be a part of our story. I told myself that this was simply how you needed to be born, and I did my best to accept the change of plans gracefully.

 

HOSPITAL TRANSFER

 

Before we got in the car to drive the ten minutes to UCSF, Nancy wanted to check my dilation to determine how far along my labor had progressed. She explained that if I was fully dilated, we needed to move extra fast to get to the hospital before you arrived, but if I was less dilated, we could go at our own pace. This would be the first cervical check I had had since labor started.

 

I lay down on the couch between contractions, and Nancy did an internal exam. She found that I was 5 cm dilated and about 80 percent effaced. Nancy explained that the last 5 cm can go much, much faster than the first 5, but in any event we had some time to spare. We agreed that we would drive over in our own cars. Nancy and Carlee Ann would call ahead, so the hospital was ready to admit us directly. When Nancy had finished, I lay on the couch through a few contractions, letting the new reality sink in. Meanwhile, all around me, people started pulling bags together to relocate to UCSF.

 

We hadn’t packed a bag specific for the hospital, so when someone asked me what to bring, I was at a loss for what to tell them. People packed whatever they thought I might want or need for the rest of labor. God bless whoever grabbed my Tums on the way out the door! My affirmations and my blessing beads made it into the bag, as well. With the flurry of packing activity happening all around me, I sat in the bathroom, waiting until the last minute to head down to the car. I found myself thinking about one card in particular that I had borrowed from a classmate of mine in our childbirth class: “I ride the journey I am given.”

 

“Okay,” I told myself, “this is our journey. It just looks different than the one I had imagined. It is going to be okay.” But, for the first time since labor began, I felt scared. I wasn’t afraid for your safety or mine. We were both doing fine, and I knew you would have the best care if you needed extra support after your birth. No, I was afraid of all the unknown aspects that transferring to the hospital introduced to our journey. Who would the doctor or midwife on call be when we arrived? Could I trust them? Would I be able to cope with contractions as well in the hospital as I had been at home? Would my energy last through the end of pushing? If it didn’t, would I have to deliver you by cesarean section?

 

I felt my thoughts spiraling a bit. I had lost my center of focus for laboring, and this made me experience contractions differently than I had been. I don’t think they had gotten any more intense, but they suddenly seemed more painful and less productive. I was thoroughly in my head at this point, and no longer just laboring with my body. I heard Nancy in the hall, and I called out to her from the bathroom. As I told Nancy my fears, I started to choke up. I remember she came down to my level, put her hands on my knees, looked me straight in the eyes, and gave me the reassurance I needed right then. She told me that things were going to be a little chaotic at first, but that going to the hospital did not mean things were inevitably going to cascade out of control. We would take everything one step at a time, she said. Stay in the moment, and try to refocus on the task of laboring. Nancy’s words and presence gave me comfort, and I managed to find the courage I needed right then.

 

 

DECIDING TO GET SOME REST

 

Nancy was correct about the transfer feeling chaotic. The short drive felt like an eternity because laboring in the car was so unpleasant. Checking into the hospital was easy, but then I had to deal with meeting a parade of new nurses and doctors, and try to find new coping positions and methods in a tiny hospital room while tethered to a continuous fetal monitoring machine. The labor ward was unfortunately overly full that day, so there were no birthing suites available. The room we were put in felt so tiny. I found myself wishing that it had been possible to bring my yellow chair, so I could have kept laboring in a familiar spot.

 

Nancy had been hopeful before we left home that I might dilate another centimeter or two while we transferred, but when the midwife at the hospital gave me an internal exam, she found that I was still at 5 cm and 80 percent effaced; I had made no progress in the two hours since we left home. That was hard to hear, but not necessarily unexpected, since I knew I had been coping with contractions so differently during that time. Instead of visualizing the progress you and I were making with each wave, I had just been gritting my teeth and tensing my body until the contraction passed.

 

By this point, I had been awake for nearly thirty hours. I did not feel totally exhausted yet, but I was starting to worry about eventually running out of steam. With the initial settling in process at the hospital now over, I knew I could probably refocus, and return to productive contractions if I really set my mind to it, but I was feeling discouraged by the news of no progress, and worried about too many “what ifs.” What if I was labeled with “failure to progress?” What if I used every physical reserve I had left to cope with the next several hours of contractions, but then found I had nothing left at the end to give to pushing? I knew if that happened, I would wish I had saved my energy.

 

It felt a little like I was doing triage in my head. What did I most want out of this labor, given the circumstances, and what could I do without? I wanted you to be born healthy, of course, but besides that, I just really, really wanted to be able to birth you vaginally. Since we left home, I had let go of so many of my expectations about what your birth would look like, but I was not ready to let go of this one. I still wanted to be able to be the one to push you out myself at the end of labor. To ensure that I had the energy to do that, I decided I needed some rest, so I asked for an epidural—a local form of anesthesia that would take away the pain and allow me to have a nap before we got to the pushing stage of labor.

 

The epidural worked very well. It was perfectly balanced to take away the pain, but leave me with enough sensation to feel the pressure of contractions. One of the concerns with getting an epidural is that it can slow down the progress of labor. If that happened, I knew they might end up administering more drugs, like pitocin, to augment my own natural contractions. I hoped this wouldn’t be necessary, because I knew that pitocin contractions can be much more intense than natural contractions. While I wouldn’t be feeling them, I knew that you would, and I hoped to spare you that experience. Nancy was watching the monitor as my epidural went in, and I was thrilled when she reported back to me that my uterus had not slowed down one bit! My natural contractions continued to be as strong and as frequent as they had been before the epidural, so my body was still moving things forward. Your heart rate was great, which told us you were still coping with the labor just fine. With the epidural in place and our bodies continuing to perform exactly as needed, it was time for everyone to get some rest!

 

Nancy and Carlee Ann and Nana and Rosana went home to nap, while your Papa settled in to sleep beside me on a cot at the hospital. They left us in the care of a wonderful nurse named Heidi. It was a lucky coincidence that we got Heidi as our nurse. She and Nancy knew each other well, because Heidi had delivered both of her own children at home with Nancy as her midwife! Heidi was incredibly kind and compassionate, and I think she understood what I must be feeling as a homebirth transfer patient. Having her as my nurse felt a little bit like having a proxy for Nancy within the hospital. I trusted her immediately, and was so grateful to be under her care. The epidural had made me shiver a lot, but Heidi got me some warming blankets, and helped me get situated on the bed. The shivering subsided, and I fell asleep right away. As I rested, you kept on working inside of me, getting yourself into position for the birth…

 

TIME TO PUSH

 

After the epidural, your Papa and I both slept very deeply for about three hours. When I finally woke up, it was because my right side had fallen completely asleep from having been in the same position for so long. I rolled onto my back and accidentally knocked the fetal heart monitor out of place. Heidi came into the room at that point, and informed me that they had noticed a drop in your heart rate lasting a few minutes. They weren’t sure it was actually your heart, though. It was possible that the monitors were simply picking up my slower adult heart rate, rather than yours.

 

A bunch of doctors came into the room, and when they checked me internally, they made a very exciting discovery. My body had finished dilating, and you had descended fully into the birth canal. Your head was at what they call “plus two station,” and it turned out there was nothing wrong with your heart rate. You were just so far down that the external fetal monitors strapped onto my belly couldn’t easily detect your heartbeat from where they were positioned. The doctors decided that they needed to get a better reading by putting an internal fetal monitor on your scalp directly. Once they had placed the internal monitor, the doctor told me, “Your baby is doing just fine. The heart rate is perfect. You’re all set. You can start pushing anytime.”

 

“Wow!” I thought, “That was the most productive nap of my life.”

 

Heidi had already telephoned Nancy and Rosana to tell everyone we were ready for them to return. It felt like Nancy and Carlee Ann must have magically teleported back to the hospital, because they were by my side again almost as soon as I heard that Heidi had called them. Nana and Rosana were not far behind. The whole team was reassembled!

 

I’m not sure how exactly it happened, but somehow I ended up getting to begin my pushing with only my home birth team in the room, plus Heidi and a medical resident named Andrea. I was grateful for the more intimate environment. Pushing with an epidural felt very strange, so I needed some direction, but Nancy and Carlee Ann assured me that I was off to a great start. I knew they believed I could do this, so I felt calm and confident. Nancy directed my pushing for the first hour and a half. That was such an unexpected gift, since I had thought once we transferred to the hospital that I would no longer get to have my own team leading my care at any point. We used a mirror to help me see the effect my pushing had with each contraction. We tried several different positions. The most effective for me was lying on my back, with Papa and Carlee Ann holding my legs while Nana held the mirror.

 

JUST INCHES AWAY

 

At this point, you were so close to making an appearance, Nancy suggested I reach inside and touch your head as I was bearing down, so that I could feel you moving with my pushes. I did as she suggested, and reached inside. No deeper than two knuckles in, I felt the hardness of your little skull.

I instantly burst into tears.

 

In that moment, you became real to me.

 

Touching you for the first time was one of the most beautiful and profoundly moving experiences of my life. Tears gave way to grinning and delighted laughter, as I felt your head respond to my pushing. But this only made me cry again, because it was all so marvelous and overwhelming to know that I really had a child who was on the verge of coming into the world. I looked at your Papa, and said, “This is so cool! You have got to feel this.” He quickly went to wash his hands, and then he reached in and touched the top of your head too. I will always treasure my memory of these moments—Your Papa and me, surrounded only by our birth team, greeting a little soul just inches away from being born.

 

I pushed for a total of two hours. It was seriously hard work, and it felt uncomfortable even though the epidural had taken away the pain. Nevertheless, I was really surprised by how quickly time seemed to pass during this stage. It was an extraordinary experience. Heidi suggested I try pushing without using the mirror because she noticed I was losing a bit of time on each contraction, trying to get the mirror properly situated. This turned out to be a great idea. I closed my eyes and paid attention to the sensations in my body, and we started making more rapid progress. I remember feeling the pressure of my contractions starting at the top of my belly and radiating downward. I could feel your head emerging bit by bit. I imagined I was stretching to make way for you, and in fact that is exactly what was happening.

 

When it looked like I was close to delivering you, the obstetric and pediatric teams came into the room. Nancy moved up to my left side, by my head, where she could talk me through the rest of labor. I cannot tell you how grateful I was to have her there, especially at the very end of my pushing, when the doctor in charge wanted to introduce some interventions I didn’t want. Nancy was there whispering in my ear, helping me find the strength to push you out before the doctor could resort to these unnecessary measures.

 

Just after 5:00pm, you started crowning. At 5:11pm I pushed your head and then your body out all the way. And just like that, you were born! Your Mama and Papa’s hands were the first ones to reach for you. Papa announced that you were a little girl. As I touched your tiny body, I began to cry again—totally overwhelmed with joy. I had become a mother. This tiny, magnificent creature was my daughter.

 

You came out pink and healthy, announcing your own arrival into the world with a robust wail! You hollered as they took you across the room to be suctioned, and you did not stop until you were placed back into your Mama’s arms. With our family of three all together for the first time, we greeted each other through our tears. “Hello, little one! We’ve waited so long to meet you.” You gripped your Papa’s finger tightly. We marveled at your tiny hands, and how much they resembled mine. You didn’t seem to like the bright lights of the hospital, but when we shaded your face with the swaddling blankets, you opened your eyes and gazed at us—and we gazed right back at you. It wasn’t long before you and I both felt hungry. Nancy and Nana helped you onto my breast for the very first time. You latched right away and nursed for a very long time. As I fed you, Nancy fed me some delicious green grapes.

 

FAREWELL TO YOUR OLD HOME

 

I had delivered the placenta very quickly after your arrival. Carlee Ann set it aside so she could give us a tour a little later.

 

Once we you were happily nursing on me, Carlee Ann brought it over to my bedside and walked us through all the elements of this amazing organ, which had been your food source, your home, and your constant companion, beating in rhythm with your Mama’s heart rate for nine months as you grew. We saw the two sides that established the boundary between your world and mine. There was the darker, bumpier maternal side of the organ, which had been attached to the wall of my uterus, and then there was the smoother, veiny, shiny side of the organ, which had faced you inside the womb. We could clearly see what they refer to as the “tree of life” pattern on this side. I thought it looked beautiful. Extending from the edges of the placenta were the membranes of the sac that had housed you, suspended in water for all those months. And of course, coming from the middle of the organ was the umbilical cord that had brought you oxygen and nutrients, and had filtered away waste for my body to process on your behalf.

 

I said a quick thank you to this magnificent temporary organ that you and I had grown together and shared throughout pregnancy. Now that you were out in the world as an independent little being, the placenta’s work was done.

 

So you see, my dear? We have amazing bodies, you and I—strong and wise and capable of profound acts of transformation. And we have amazing hearts, as well, with room enough for infinite love.

 

The moment you emerged into the world, my heart swelled and ached with love for you. I had dreamed abstractly about that moment for a long time. I didn’t know exactly what it would look like, but I imagined how it would feel to become a mother. In many ways, it felt just as I had hoped it would. I was overwhelmed with joy, and totally humbled by gratitude. It was an utter delight hearing your tiny wail fill the room, feeling the weight of your warm body against my chest, and caressing your impossibly soft baby skin as you gazed up at me. What I hadn’t anticipated was the flood of love I would feel for so many others in that moment, as well.

 

I didn’t bring you into this world by myself. I was surrounded by my team of profoundly compassionate caregivers—both midwives and family—whose support and guidance and companionship through pregnancy and though each phase of labor made it possible for me to do the physical work I needed to do to nurture your growth and bring you safely from your world into ours.

 

For over 36 hours—from my first twinge of labor on Sunday morning, to that last big push on Monday afternoon—your Papa, your Tía Rosana, your Nana and your midwives had been by my side, feeding me and hydrating me, tracking our progress, guarding our safety, and documenting our journey. They shared my excitement and made me laugh through the early hours. They encouraged me and helped maintain a peaceful atmosphere as labor became more intense. They provided comfort when things hurt, coaching when things were hard, and reassuring advocacy and companionship when we had to move to an unfamiliar environment.

 

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They helped you come into this world by loving us both, and believing in us, and honoring our birthing process exactly as it unfolded.

 

Welcome, baby girl. We’re so glad you’re here.