Tuesday, June 22, 2010

When Home Birth Becomes Hospital Birth

I started blogging a few months ago about the process of choosing and preparing for home birth. I had spent over half of my pregnancy overly concerned about preterm labor, having giving birth to my son ten years ago at 27 weeks gestation. When I finally reached the 32 week mark (the point at which *early* preterm labor is no longer the issue), I pretty much stopped worrying and began planning for birth to happen the way I'd hoped it would happen the first time, only this time at home instead of at a birthing center.

Well, my daughter had other plans. Six days before the 36 week cut off (the midwife would not deliver at home before 36 weeks), my water broke as we were heading out the door to church. I had my frustrated, angry, upset cry before we left for the hospital as I was trying to find just one of our birth attendants who wasn't on vacation. My doula was available, and she met us at the hospital. I'm awfully glad she was there, though she told us more than once that she felt her presence was a bit redundant. We asked all the important questions ourselves, and the few times when it was necessary we advocated for ourselves and stated our own desires.

One such time, or rather one such issue (it came up several times) was the doctor's desire to get labor moving with pitocin. They're rather rabid about getting the baby out within 24 of a woman's water breaking, and that was the first thing that happened for me. My water broke at 9:45 AM Sunday morning, and labor hadn't really started in earnest by 9 PM. The nurse came and found us in the hallway where we were walking and reading, trying to encourage contractions by staying on the move. She said the doctor was ready to start pitocin. I said I didn't want to, and that if there was any leeway at all, I intended to take it. If they started pitocin, I was fairly certain I wouldn't make it through the process of labor and delivery without an epidural. She said she could give me an hour before she'd have to insist that we start it. That's a funny way of saying it--if a person refuses a treatment, there's not really much the physician or attending nurses can do about it. However, when a woman is in labor, or at least when *this* woman is in labor, and when she is laboring in a hospital, she automatically feels a bit as if she has to play by their rules. We did our best not to.

The nurse agreed to an hour, and we continued walking. There are, for those who are interested in knowing, a great many things you can do to stimulate labor. There's no need for me to go into detail here, but if you're planning a home birth, or even if you're just desiring to give birth naturally (without pain medications or unnecessary interventions that lead to those medications) do your research and know about those things in advance, so that you can ward off pushy doctors and nurses and get things moving in a natural way.

By 10:30 PM, contractions where coming regularly and intensely. I know I was in the birthing pool not long after that. And yes, they *did* allow me to use the pool, even though my water had broken more than 12 hours previously. Don't let anyone push the assumption upon you that they won't let you, because the pool was my best friend.

I'm fairly certain that transition started while I was in the pool. For me, it lasted a long time (at least an hour), which was discouraging in the midst of the process. But we did it, and the moment she was out, the labor and delivery pain ended and the wonder began.

So we planned a home birth. We *paid* for a home birth. What does one do when home birth is thwarted by pre-term labor? Luckily, our midwife has a method of prorating her services for situations like this, but we never talked about it beforehand. This made for a bit of an awkward situation once we got home from the hospital and knew that the bills were just around the corner. It took a couple of days for me to get around to calling the midwife, and once I did I realized I had nothing to worry about. However, this is a subject that I realized is best handled *before* the situation arises, and it would have been good to include questions about prorating of services in the interview process. Since we have no plans of doing this again, and this information does not serve us, I want to make sure that anyone who ends up using these blog posts as a home birth resource realizes what we didn't.

No one who is planning a home birth wants to assume that it will end up in a hospital--but it may. First of all, talk with your midwife about that possibility, and along with discussing what role she would play in that event, discuss also how she would charge you for her services, since those services will surely change rather drastically.

Also, consider how you would handle advocating for yourself in the event that you give birth in hospital and not at home. Our nurses were wonderfully supportive. Our doctor was amazingly tolerant, and even supportive, of our desires. I didn't push on my back, which I thought for sure would be an issue. I pushed on my side, and in the end, I think that's how I would've chosen to do it at home. My contractions were far too intense for me to want to be upright at all, let alone while pushing. Yet even with how supportive they were, there were still an abundance of opportunities for our desires to be pushed aside. If we had not actively put forward the fact that 1) we did not want an epidural or drugs, 2) I did not want an epidural or drugs offered to me at any point (I would ask if I wanted it), and 3) we did not want any unnecessary interventions, including pitocin-- we would have ended up with induction by pitocin and stripping of membranes (the doc was hot to trot on both of those as soon as she got there), probably an epidural to help me cope with the intensity of induced contractions, and whatever other unnecessary and unpleasant interventions which might have become necessary because of the epidural.

We planned a home birth for lots of reasons, not the least of which was to avoid medical interventions in a non-medical, non-emergency situation. In preparing for home birth, I did a lot of thinking about what I didn't want to have happen to me while I was laboring, and I read a lot about women who advocated for themselves in hospital and achieved the births they desired. I was not completely unprepared, and neither was my husband. But I had the experience of a previous, very early birth under my belt, and that gave me much food for thought as we prepared to give birth. If you are preparing for a home birth, prepare also for what probably won't, but possibly could, come.

Wednesday, June 16, 2010

New Memory

16 June 2010

I emptied the sugar bowl this morning,
the Tour d'Eiffel disappearing through the hole in the lid.
That spoon hung useless on the wall, sat neglected
in the bottom of a box since a dark childhood
visit to the City of Lights.

Suddenly comes purpose, though
I keep running out of sugar. So much
coffee to drink, so many bottles of under-valued
wine to enjoy, so many sweetnesses to spoon out
that sometimes I forget the grief altogether
in the midst of forcing words, struggling to write
anything anywhere--keep poetry flowing
through the books that will someday fill
the shelves we have not built.

Those pages once were bound to be topped off
with bitter melancholy--so many caged and angry
women and their box of useless spoons.
I cannot possibly grieve again as I did back then,
and I wonder if there is less meaning now,
with joy and grief so unevenly matched--
one grown, contented woman stirring her coffee
with a new memory of Paris.

Tuesday, June 15, 2010

My Husband's Job

Eight days ago, I gave birth to Elise Marguerite. She was 6 lbs 3 oz and about 20 inches long. She's lovely and healthy and content, and we are enjoying her in the extreme.

To say that I gave birth to her feels a bit like short-changing my husband. He left only once early in the process, before it became unbearable, to get himself and our older daughter something to eat, but he was present and working hard with me for every moment of active labor. Several people offered him breaks, including myself. I think I was the only one in the room who realized, after having offered the break, that he really, truly didn't want one. He was tired, but so was I, and I didn't have the option of a break. He stayed right beside me as I labored in the pool, let me squeeze the hell out of his hand while reading Dandelion Wine to me between, and sometimes during, contractions. When I had to get out of the pool for them to monitor the baby again, he lifted me out of the tub as I cried that I was afraid to stand up. He applied counter-pressure to my back for what seemed like hours (probably was minutes) while I endured transition. He never allowed the doula even to take *that* job so that he could sit down and just hold my hand for a while.

When it came down to pushing, he sat beside me, held both my hands, [turned off his hearing aid, I'm sure], and let me moan and scream in his face. There's no more intense moment with him in my memory than staring into his face, aware only of the pain and the color of his eyes, between the last few contractions. How frightening that must have been for him. I think it's probably normal for a woman to have thoughts of death in those moments, wondering if she can live through that pain. I know I said to him once that I felt as if the contractions would kill me. Did he believe me? Did he fear the same? If he did, he only let it come through in his voice once or twice. The rest of the time he was calm, reassuring, adoring, gentle. I have no idea how he maintained such a demeanor in the midst of so much of my emotional chaos, but I think that, in light of the experience, he will always be my hero.

So now we have this amazing little girl at home with us, often lying between us on the bed because at 3 AM, I really don't have the energy to get up off the floor (we don't have a bed frame) and put her back in her bassinet. I feared during the pregnancy that her presence might cause tension or resentment for one or both of us. We both liked our life very much the way it was. Contrarily, I think we're both experiencing that she belongs here, and her existence is just a natural extension of our love for each other.

Everything is changing. Everything is already different. But it's not a change to mourn--not entirely. There's an aspect for each of us of having lost something--I, my independence (I simply cannot do for myself in the aftermath of the delivery), Richard, his freedom, and both of us our spontaneity. But there's something here to replace those things, and eventually to exist right alongside them, that is so very precious and beautiful and sweet that I'm really not sure what we were doing before. I loved my husband. He was already my best friend. But now the ideas of Protector and Provider mean so much more than they did before as I am forced to rely on him for fulfillment of some very basic needs. As difficult as it can be to need him to fill those roles, he does so graciously and without resentment, even lovingly and, dare I say, joyfully. This is his contribution to the process of her birth. Mine was nourishing her for 9 (well, ok, 8) months, and then going through the pain of labor and delivery, and now healing from that process as I continue to make small sacrifices to provide her nourishment.

It seems my husband never forgets those things. I wish very much that I could be as relationally, psychologically, and emotionally constant as he is. Unfortunately, I'm tossed about rather violently by the biological realities of pregnancy and of the post-partum period. Who am I kidding? My emotional stability is questionable on the best of days, pregnant or not. I suppose that's why there are two of us, and why we're wired so differently. I'm certain my mode of existence serves us in some way. Apparent to me, however, is the fact that it does not provide stability. I guess that's my husband's job.

Saturday, June 05, 2010

Recovering Gifts

A Piece of Her
5 June 2010

I bought a chinois just like Grandmother's--
Ebay has its uses. She never called it that--
it was just a colander with a wooden pestle,
and she couldn't have told you where or when she got it.
She was always so elusive about the recipe--some flour,
a bit of baking powder, a pinch of salt (I'm fairly certain
it was Bisquick), and the dewberries, of course,
which I always thought were just blackberries.
Turns out I was wrong--and right.
Dewberries and blackberries are related,
and the name is legitimate. That makes me smile
as I press pestle against colander, juicing the blackberries;
coming one step closer to the mind of Bernice.
She's been gone for years now,
and I thought her cobbler was gone with her,
but I've found a piece of it, by trial and error--
a piece of her.

It wasn't perfect, but it was very close. It's definitely close enough to satisfy my memory. The taste of it brought tears to my eyes. I think I'll try it again this weekend. Although The Boy wants me to make a strawberry one. That feels like blasphemy. :-) But I guess I can alter tradition a bit here and there for the sake of my children's preferences. But the *norm* will be blackberry--and I'll probably call them dewberries. I'm going to try to find someone who sells berry bushes and plant them in the back yard. I'm very excited about the prospect of having the berries in the backyard like grandmother did.

It's always such a joy to find some small gift that has been passed on to me from my family members. Mother's quilting, Grandmother's cobbler, Vovo's chorizo & eggs (eaten in moderation--whew!). None of these gifts was ever handed down directly--I'm learning them now by consulting the poignant memories I have of the smells, the sights and the sounds associated with watching these women create beautiful things. And now I create beautiful things, both theirs and my own. I feel more whole every time I recover one of these treasures in myself.

Today, I should quilt. Of course, when I say that to myself, and especially when I say it out loud to someone else, I always pay for it later. The Boy wants to go to Gamestop, The Gril wants me to fix her hair, or I find housekeeping tasks that need to be done, and I feel badly sitting down to something "non-necessary" until those things are done. The trouble is there will always be a household task to complete. If I don't *make* the time for these small but very important creative tasks, I will always find reasons why it's not a good time to get to them now. I'm learning as I recover well-hidden gifts inside myself, though, that it's important to pull those to the surface, and to give them to my children.

George MacDonald

"Home is ever so far away in the palm of your hand, and how to get there it is of no use to tell you. But you will get there; you must get there; you have to get there. Everybody who is not at home, has to go home."

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