How lucky we are today!  Another local mama has kindly agreed to share her story in our series of Local Birth Stories – and, oh, what a wonderful story it is!

Here, new mama Sarah tells the story of the birth of her son, Niels, with midwives at a local hospital.

Her story is a lovely illustration of how empowering birth can be when a mother is able to surrender to the process in a safe, supportive, environment with caregivers she trusts and is very comfortable with.

Thank you, Sarah, for sharing with us, and congratulations on the birth of your beautiful baby boy!

THE BIRTH OF NIELS

During the 36th week of my pregnancy, I underwent a procedure called an External Cephalic Version. The procedure is intended to turn a baby who is in a breech or transverse position. I had been encouraging my baby to turn from the breech position for over a week using a combination of acupuncture, hypnosis, chiropractic care and inverted positions (including one that required that I lay on a flat hard surface, propped up on the couch, inverted, for 15 minutes). None of these methods were successful, so one month before my due date I found myself in the labor and delivery unit at the Medical College of Virginia (MCV) in Richmond facing two obstetricians, an attending physician and a resident. At MCV, my prenatal care had been with the midwives exclusively. They had recommended the procedure, and one of them was present. My husband and my doula were also there for support. After a great deal of preparation, the procedure probably took about three minutes. It was very uncomfortable, and very effective. My baby was turned 270 degrees and the fetal monitor reassured us that he had barely noticed. The experience was surprisingly positive: the nurse on-hand was kind, expressive and supportive, the physicians were compassionate and they explained the procedure very thoroughly before beginning. The midwife encouraged me afterward by saying that I had tolerated the pain well, and that I would almost definitely do just as well during labor and birth.

There is some disagreement now, even among my team of midwives at MCV, as to whether the External Cephalic Version brought on the labor that started five days later. The midwives do agree that the procedure was a good idea because the baby stayed in the head-down position afterward so I was not required to use an obstetrician or to have a cesarean section when I went into labor.

. . .

 At 1am on March 4th I was startled awake by the awareness of an oncoming gush of water. I hopped out of bed just as a steady stream of clear fluid started down my leg. I hurried to the shower and stood there until it abated and then phoned the midwife on call. I explained that I hadn’t had any contractions but that my water had broken. She reassured me that this does happen in less than 10 percent of women, and that I should call her in the morning to update her on my progress. After we hung up, I arranged a few towels on my bed and tried to go back to sleep. As I was drifting off, the first contraction began. It was mild. The second was less mild. These were irregular and they continued until 4am when I decided that I should eat while I still could. Having eaten, I went back to bed. When I woke up at 6:30am, I was surprised and puzzled. The contractions were no longer occurring. My husband and I ran an errand and enjoyed a Sunday brunch and then called the midwife around 10:30am. “Here’s what I think,” she said. “I think we should get this show on the road.” She recommended mixing an ounce of caster oil with a nut butter and taking a brisk walk afterward. I did exactly as she said (the caster oil/nut butter was disgusting). Two hours later, I spoke with my doula using a video chat. She thought that although the caster oil and brisk walk had not yet had any effect, my labor would soon resume. As we said goodbye, I had a significant contraction. Another soon followed. These quickly became strong and regular – about 5 minutes apart. By 2pm they were 3 minutes apart and their intensity was making it difficult to remain on the exercise ball I had been sitting on. I threw up around this time because the pain was significant. When my husband checked on me soon after I told him that the contractions were not going to stop as they had earlier that morning. I asked him to make sure we had everything we needed for the hospital. I was ready to leave. In the next hour, a friend came to pick up the dog, our bags were completely packed, and the backseat was prepped as an area that I could labor in.

The drive to MCV from Williamsburg was oddly beautiful. I noticed, between contractions, that spring was beginning. There was a new green haze around the bare branches. It started to rain about 10 minutes after we got in the car and it quickly became a heavy downpour; the windshield wipers were on the highest setting. I remember feeling very calm around this time – the intensity inside my body and outside the car were so well matched that they somehow managed to cancel one another out. When the rain stopped, my husband suggested that I eat a piece of fruit to sustain the effort that I was obviously engaged in. I agreed and he peeled a banana. Before I could reach for it, its smell reached me. It was hideous; the most overpowering and terrible smell I had ever experienced. I yelled (for the first time that day) to him to throw it out the window. This was hard – he doesn’t litter. Ten minutes after the banana incident, we arrived at MCV. The rain had stopped and it was around 4pm. We were stunned by the light; it was orange on the tall buildings in downtown Richmond and the shadows were long. I asked my husband to make sure to tell our little boy, when he gets older, how beautiful the light was on the day he was born.

It took about twenty minutes to get from the car to the labor and delivery unit on the 6th floor of the hospital. I had three contractions on the way. The midwife I spoke with on the phone earlier was waiting for us (she had been communicating with my husband). A minute after I saw her, at the admissions desk, I collapsed on the floor into another contraction. She rubbed my lower back and her hands were so warm and caring. I was handling each contraction silently and when that one was done, we checked in and started down the hall to the room I had been assigned. It was spacious and had a beautiful view. I was introduced to the nurse and my husband went to get our things from the car. Soon after, there was a shift change and the midwife who greeted me left. Before she did, she kissed my forehead and told me that I was a strong woman. Even in that state, I was shocked by the experience of being treated with such intimate kindness by a healthcare provider. Her replacement was the midwife who had trained her. She looked like she was in her late sixties. She had a commanding, reassuring presence. I immediately felt comfortable with her. My doula arrived shortly after and told me later that she was surprised that no one had checked my cervix before she arrived. This did happen soon after and I was dilated to 4cm. The midwife told me this warmly and positively. However, I was slightly surprised because my contractions were strong and close together. I started to get discouraged by this but was distracted by oncoming pain. Between contractions, I was very sleepy. This was one of the most welcome involuntary reactions I encountered during labor because it made me completely relaxed. During each contraction, I breathed deeply and remembered that “this is bigger than you are”. I did not have an adversarial relationship with the contractions that completely overtook my body. I think this is ultimately why the birth went well: I surrendered entirely to the forces at work.

After the midwife checked my cervix, my doula, my husband and the nurse helped me to change positions four times and to go to the bathroom twice. I sat on the exercise ball, moved to all-fours, and eventually came back to a side-lying position on the bed. By this time it was around 8pm. My first contraction back on the bed was the most trying contraction that I had yet experienced. I was screaming; I felt entirely overcome by intense pain. I yelled “I can’t do this!”. In response, the midwife came to the side of the bed and told me sternly and with absolute certainty that my body was made to give birth, and that I was going to be ok. At the end of the contraction that followed, I pushed. I did not mean to do this. I told the midwife and she checked my cervix for the second time. She reported that I was completely dilated and that I could now do whatever my body told me to do. As she said this, she stepped away and I immediately understood that something else had taken over. For the next forty minutes, my body pushed my baby out. My mind and my will were not required for this at all. At 8:38 pm, our son was born. He was placed directly on my chest and he was blue and crying. I asked if he was ok and the nurse and midwife answered quickly that he was perfectly healthy. He latched on to my breast fairly soon after he was put on my chest.

The contractions associated with the birth of the placenta were more painful than I had anticipated. I had also torn during the birth; while my son was on my chest, the midwife stitched the wound. Before she did this she administered a local anesthetic. This shot was incredibly painful. After an hour or so, my son was taken off my chest to be cleaned a bit and examined. My husband went with him to the warmer that was about ten feet away. During the two days that followed in the hospital, we were never apart from him.

The experience of our son’s birth has changed our lives. We were both deeply moved by the complexity and strength of the process that my body engaged in. We would not have been able to focus so completely on this process without such a fantastic team. I am so proud that my son came into the world with the help of such excellent professionals, in such a supportive and welcoming environment.

The Birth Team:

Doula: Peggy Caister, Doula on the Peninsula

Midwives: Kathryn Beaton, CNM and Brenda Brickhouse, CNM, of VCU Medical Center