Because you wanted a minute by minute account of the labor…

Actually, I know you didn’t, but some people have asked, so I wanted to explain the whole process of our home birth.  If you’ve never had a baby, or never had one out of the hospital, this might be interesting to you.

Day of labor
Yesterday Sarah and I did some house maintenance.  It was our first day after Sarah officially went on maternity leave on Friday.  We installed a
new screen on the back door, and Sarah gardened, trimming the roses and
weeding the vegetable garden while squatting on a stool or on all
fours.  Many labor stories start like this (including Sarah’s mom’s
activity of squatting and painting baby furniture on the day of her
delivery) so it should be no surprise that this ended up being Sarah’s story as well.

At 5:30pm Sarah, our house guest Cheryl, and I, got cleaned up to go
out to have dinner with my sister Sam and her husband Tom. As we were
leaving Sarah had a small amount of blood discharge.  She called the
midwife at Birthcare who seemed nonplussed but said to keep her phone number handy.

We went to Full Kee for dinner in Chinatown where Sarah had
non-spicy vegetables with noodles. Dinner was almost aborted when we saw a rat on the lower level of the restaurant, but we moved to a different section and ate in pure denial.

On our way into the restaurant a
cute African-American lesbian couple stopped her to talk to her.  "You
look like you’re about to have that baby!  Are you 8 months pregnant?"
"No, I’m nine months", Sarah said.  In an enthusiastic tone, she said,
"You’re going to have that baby real soon!"  The woman’s partner was
punching her to stop her from shouting at Sarah, though it was all in
good fun.
Early Labor

After dinner we went to the new Chinatown movie theater to see
Batman Begins with Bj, a friend we had coincidentally recruited to be at the house for
labor support as well.  Sarah needed a little help walking in because
of a contraction, but nothing notable.  She’d been having them for
weeks at odd intervals.  The movie started at 7:45pm and Sarah started
having contractions at 8pm as soon as the previews were over.  By the time we started timing them regularly they
were 7 minutes apart.  Sarah got up to leave to turn off the beeper on
her watch, because using it to time them was annoying her neighbor.
When she came back I noticed them coming 5 minutes apart.

I said, "Come on honey, let’s go home."

Sarah, having been through a firedrill the week before, said, "No, it’s probably nothing."

"No, let’s go home" I insisted, and off we went.  We all headed
downstairs, while Bj and Cheryl took care of Sarah I got the car.  On
the way home I started noticing the contractions 3 minutes apart, and
flagrantly violated DC’s cellphone law and spoke to Alice, the midwife
at Birthcare while we drove home without speeding.

Once home at 9pm Sarah’s water broke and the midwife and birthing assistant said they were heading over.  The birthing assistant Aimee came over first
from another birth she had just helped with.  Alice from Birthcare was
on her way.  Sarah was unable to do anything else during the
contractions at this point which were happening 3 minutes apart, and
headed for the hot tub around 9:30 or 9:45pm.

Active labor

Img_4021We then spent about two hours in the hot tub, completing the early
and active phases of labor.  During active labor, some of the hardest
effort, she got on all fours in the hot tub, with her head and
shoulders over the edge.  In order to distract her from the pain during
contractions, she had me draw light circles on her lower back with my
finger.  This wasn’t a pressure point, or some foofy New Age treatment,
this was to help her concentrate.

As long as she was able to focus on
the consistent feeling of my finger on her back, she was able to keep
the pain from getting to her.   Quiet was also really important.  As long as she could focus on relaxing, she was a labor machine.

Once or twice I stopped, or broke rhythm for a moment to lean over
her to kiss her, and she commanded at the top of her voice, "CIRCLES!
DON’T STOP CIRCLES!  IT HURTS WHEN YOU STOP!"  In fact Sarah said later
that anything that anyone did or said to distract her would cause her
to lose her concentration, and that’s when it hurt.  If you know Sarah
well, you know that she can concentrate to the point of blocking out
all other senses, and in fact this is exactly what she was doing.  Only
the circles I traced on her back, or the sound of the birth assistant’s
voice Aimee, helped her to keep her concentration.    Any time anyone else spoke, she had a painful contraction because she would lose her focus.

Alice, the midwife stayed at the side of the hot tub trying to get a
fix on the location of the baby.  Was it head down?  Yes.  At least we
wouldn’t have a breach birth.  Sarah’s refusal to get out of the tub
for any length of time made it hard to get a fix on the facing of the
baby.  She tried to get out and lay on her back so Alice could feel the
baby’s direction, facing back or front, but enduring a contraction
while lying on her back was more unbearable than anything else during labor to that point.

While concentrating, Sarah was nearly motionless, sometimes
weathering contractions so perfectly she had to tell the midwives they
were happening.  Every few minutes Aimee would use her waterproof
Doppler device to listen to the baby’s heartbeat while placing it under
the water, and then take Sarah’s blood pressure and heart rate at
tubside.  Alice at one point held her through a contraction and
identified "double peaking" contractions, happening one right on top of
each other.  She also used the flashlight to identify an appropriate
amount of discharge in the water.

As I stood in the hot tub soaking in my shorts and tshirt, drawing
my circles, we talked Sarah into letting us take her clothes off.  The
baby was pushing on her colon and bladder and she’d be more comfortable
if all the various things wanting to come out of her body could do so.
Knowing I was going to have to completely drain the tub after this
anyway, we got her clothes off.  She couldn’t, really, though.  We
ended up dealing with her full bladder on the other end of this process with a catheter.

Transition

Sometime after 11pm Sarah grew talkative and self-doubt crept into
her voice.  She started talking about staying in the tub, worried of
what would happen if she left.  She had entered transition phase and
Alice explained to her that she really didn’t want to deliver the baby
out here in the cold, wet, and dark.  Suddenly, Sarah started talking
about the urge to push during the peak of each contraction.
Transition phase was over, and we were now into pushing phase, where
the baby is born.

Aimee and Sarah had an agreement that Sarah would state when she had
the feeling of a watermelon in her butt because that meant it was time
to go.  Sarah quietly lifted her head to Aimee and said, "There’s a
watermelon in my butt."  Without debate we helped her up, on with a
towel, which she didn’t seem to concerned about wearing, and she headed up to the bathroom by our bedroom.

Pushing

While I changed into dry clothes, Sarah weathered two contractions
squatting on the toilet with Alice and Aimee.  We could feel the head
poke out and return into her birth canal, but man was it happening
fast.  Sarah screamed on each on one, and tried standing up to see if
that would feel better.  Aimee explained that would bring the baby out
faster, which didn’t sound like a good idea at all.  Aimee and Alice
suggested Sarah lay on her side to slow down the arrival a bit, and we
all moved to the bedroom.

Once on her side in our bed around midnight, Sarah lay down while I
held her.  We had thought about me catching the baby if there wasn’t a
health risk, but frankly my place was with Sarah.  About a week ago a
close friend had come by my office to drop by a baby gift.  We chatted
and she said, "You know, don’t you, that there’s nothing you can really
do during the birth, right?"

I realized that opinion was never so wrong as it was at that
moment.  Sarah sat on her side with her right leg in the air, sole of
her foot pressed against Aimee.  Pressed hard.  I held Sarah and talked
her through it.  She couldn’t really see what was going on, and needed
me to talk her down when she got worried. 

What seemed like three contractions was probably a few more.  I
counted three because Sarah gave three full throated yells on the last
three contractions.  When the baby’s head poked out and stayed there
she screamed once moderately.  I coached her through yoga breathing
which distracted her from the pain.  It’s totally silly, but we had worn out an old joke when talking about how to breathe through labor.  When I wanted her to breathe in, I’d say, "Up your nose, with a rubber nose", the old Welcome Back Kotter insult.  Breathing out was "Out your mouth, on the couch", which sadly never got funny no matter how many times I said it.

Suddenly, Sarah heard Aimee the birth assistant say to Alice that she couldn’t find the
baby’s heartbeat.  This wasn’t a crisis as the baby was almost out, but
it started to panic Sarah.  I didn’t hear it, but it didn’t matter as I
was telling her to focus on her breathing.  She did and the crisis
passed on the next contraction.

When the baby’s nose and cheeks came out, she screamed really
loudly, thinking the midwife might have cut her without asking first.
I’m pretty sure this is what the neighbors heard too, when they told me the next day they heard Sarah the night before crying out.

Of course the midwife would never cut without asking (that’s why we used her, and not our OB/GYN), and Sarah kept asking "What
are you doing to me?"  Everyone said, "Nothing, nobody is doing
anything."  I kept whispering in Sarah’s ear to make her focus on me
and her breathing.  We found out later that she’d had two small tears
inside her vagina at this moment.  No other tissue damage happened.  Given the speed of the birth, this was minimal damage.  No other damage occurred, and of course, an episiotomy wasn’t necessary.

The midwife found that the umbilical cord was wrapped around the
neck twice.  If this had been a problem Aimee and Alice would have
noticed it while monitoring the baby’s heartbeat during contractions,
but it wasn’t.  As the baby came out Alice removed each loop of
umbilical cord gently and without drama.  We wouldn’t have even known
had we not seen it in the photos later.

The third contraction was the final one.  Sarah pushed the baby out
and they brought it up to her chest to rest on her skin.  He quickly
turned from a slight blue to an almost burgundy color, which he still
has from time to time.

Img_4069Within the hour he was latched onto Sarah’s nipple and
breastfeeding.  Alice filled out paperwork and then came back upstairs
to do the physical, which included weighing him.  We named him Moishe
Ben Imber Safdar.  Moishe was Sarah’s father, who passed away too young
a few years ago before Sarah and I met.  I have always regretted never
meeting him.  We would have probably gotten along very well.  He, like
me, loved cigars, building his own PCs from off-the-shelf parts, and
Sarah. The "Ben" part means "child of" in Hebrew, and of course, Imber
and Safdar is what Sarah and I use as last names now.

Alice gave Sarah two quick stitches, emptied her bladder with a catheter so her uterus could contract, and headed out.

Around 2 or 3 am Aimee and Alice left.  They had both been beeped for yet another birth this evening.  The stork was really working hard tonight!  I proceeded not to sleep very well, but Sarah caught a little bit of shuteye here and there.  She’s not allowed on stairs except once per day for a couple of weeks, so I’m pretty much taking care of everything here, and people like Bj and my sister Sam have run out of the house for all the key errands (groceries, DVDs, etc) already.  For the next two weeks I have to make all the meals, do all the laundry (you would not believe how much there is), and still keep one eye on my e-mail at work.  It kind of reminds me of when Sarah dislocated her arm and I moved up to Boston to take care of her, only in a much happier time.

Img_4078The dogs seem to love Ish (our fetal nickname for Moishe).  Our basset-mix pound dog (pictured) has kept his distance and been very mellow.  Our terrier-mix pound dog (not pictured) has become very protective of him.  Occasionally when we aren’t paying attention she tries to lick him, and she growls at anyone that comes near the bed where Sarah and Ish are resting.  When Katie came over to say goodbye and held the baby, our terrier sat on the bed, in rapt attention, and stared at Katie.  She’s cute in her protectiveness.

Conclusion
While I think you can get the birth experience you want at a birthing center, I can’t tell you how great it was to do this at home.  In no hurry to leave, with no external people except exactly those we had chosen, we had an awesome, powerful, and private experience with very little risk.

Obviously it’s helpful to have a hot tub, but more importantly we had some good friends to support us.  The midwife, birthing assistant, and I were taking care of Sarah.  Whenever we needed something, (or I needed something) Bj had us covered.  When the dogs needed to be let out, she did it.  When people needed a dinner break, she covered it.  It really let me stay with Sarah the entire time, and though some might say there’s nothing the husband can do during birth, Sarah and I would both disagree strongly.  Cheryl too was crucial in getting pictures when it wasn’t possible for me to take them.

Cheryl is an award winning documentary photographer who has been a friend of ours for years.  She was with us in Cuba for our honeymoon, and among things, she has shot and edited episodes of the TV show Maternity Ward.  We hadn’t planned on her being there for the birth, but her talents were invaluable since she was.

Contrast this with a hospital where we’d be spending half our time worrying about whether or not the staff was undermining our choices (no drugs, natural childbirth, no episiotomy), and you can see why it’s lower stress birthing at home.  When we have our second child, we’ll do it again.

If you’re thinking about having kids, I highly suggest you start by joining a midwife practice instead of a hospital OB/GYN practice.  You’ll get better care.

Let me say that again.  You’ll get better care.  I’ll expound upon this in a future entry.  I also suggest you take a childbirth class.  We took a Bradley Method class, but when I write up my experience in a future entry there you’ll see why I don’t really think it matters that you take it from a Bradley instructor, or that you even take a Bradley Method class.

I think that’s enough for now.  Two dogs, one baby, and one mother are sleeping, and I’ve got laundry for days to do.

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