By Sara Schley
“Birth has a purpose for the mother,” my friend, home-birth midwife, and teacher Terri Nash told me as I sat on her screen porch on a late summer morning, three months pregnant with twins, my feet in her lap. “It initiates her into the next phase of her spiritual development,” Terri continued. “For the deepening of her soul.”
A few weeks ago Terri’s words would have made no sense. After five years of infertility treatments, I was finally pregnant. Forty-one-years-old, I was also more physically ill than I had ever been in my life. In addition to the nausea, vomiting, fatigue, and discomfort that many women also experience, I had just recovered from a rare condition brought on by the infertility treatments called Ovarian Hyperstimulation. In three days I had gained 20 pounds of water, looked like I was seven-months pregnant, and felt like my organs were going to explode. I ended up on the OB unit of the hospital to be monitored for a week. But the twins and I managed to survive this life-threatening condition and as Terri spoke I sensed an awakening of my spirit. Maybe this pregnancy, labor and delivery of twins might hold some promise and power for me. Maybe I would be initiated into a phase of womanhood that had eluded me for the first four decades of my life, maybe I would learn something profound as these babies came through me into the world.
On a routine check-up at 28 weeks, my nurse midwife looked at me with compassionate eyes. “From now on, you’re on your back,” Liza said.
“I don’t understand,” I frowned. I am an athlete, a former Outward Bound instructor, a veteran of basic training in the Israeli Army, and a woman whose friends describe as “physically tough.” Yet this experience of gestating twins, like no other, was bringing me to my knees.
“You’re at 28 weeks but your uterus is the size of a 40-week full-term pregnancy. It ‘thinks’ it’s time to deliver. It’s much too early and too dangerous for these babies to be born now. You’re already 80 percent effaced. Your son’s head is right on your cervix. From now until delivery, gravity is your enemy.”
Liza spun her pregnancy due date dial and calculated that the bed rest would last until January 10th, which was the anniversary of my grandmother Freda’s death, a sacred time in the tradition of my people. I would name my daughter after her. “That’s seven weeks and a couple of days from now,” Liza said. “I know this will be difficult for you, but believe me, for the sake of your babies every day counts.”
So I bought a calendar and my husband Joe and I checked off the endless days of December. On New Year’s Eve, lying on my left side eating garlic roasted chicken and playing Rummy Cube with our friends Mishy and Chris, I felt a gush of something cool and wet. My waters broke. The moon was full and glistening off the December snow. I called Terri. She confirmed that I needed to go right to the hospital.
The babies could be born at any minute and they were too premature to be delivered in our small town rural hospital. A shot of steroids (to mature their lungs) and antibiotics (to prevent infection) later and I was in the ambulance heading to the big city hospital at 12:01 AM of Jan 1, 2002. Mercifully, the nurse on call for ambulance rides that night was someone I knew from my hometown. She was warm and reassuring, holding my hand and watching the fetal heartbeat monitors as we headed south at high speed.
Conventional wisdom states that babies are born within 24 hours of their waters breaking so I thought we might get New Year’s twins. But upon arrival at the hospital and meeting the head of Obstetrics, we learned that we had another option. Since I was currently at 33 weeks, these next two weeks of gestation were critical to the babies’ safe development. Lungs, suck, swallow reflex and size of the babies would all develop and were crucial to their safety. The doctors advised, and we strongly agreed, that every day they could stay on “the inside” was a gift. They would monitor me for infection and as long as none developed, we would wait ten more days to induce labor.
Ten days of hospital bed “rest” on the high risk OB floor followed. I was strapped at my girth and monitored, injected and measured, cuffed and fed. Joe was loyal and loving, bringing me mocha frappes from the hospital’s ice cream store to fatten our little girl up, playing endless games of rummy 500, and sleeping by my side on the sleepless hospital cot.
Joe and I also did a lot of negotiating.
High risk OB floor protocols are thick with tradition and fear. We’d been warned by our homebirth midwife friends that the chance of avoiding a Caesarian in this environment was close to zero. “We’re trained to catch and they’re trained to cut,” Terri explained. For fear of malpractice suits, convenience of the doctors, safety of the babies, or whatever, they prefer the predictability of the operation over the mystery of labor.
We had entered the world of high tech medicine, far from my dreams of a non-interventionist, natural birth. We were informed that the delivery would take place in the Operating Room in case of emergency and that OR policy prohibited anyone else but the spouse to be present. I was clear that I wanted my birthing team of three women as well as Joe to be there. Intuitively I knew that each of these people would play essential roles. Since I was pregnant with twins, I’d given up on the dream of a homebirth surrounded by beloveds. But I was not willing to give up on the vision of having at least three people there with me, Joe for me and one trusted woman friend for each baby. It simply did not seem safe for me to let go of this one. So we advocated strongly and finally got the head OB to sign a letter that agreed that, unless an emergency C-section was needed, I could have Joe plus two others in the OR with me at time of delivery. Prior to that, I would labor in my hospital room and could have others present as well.
The morning of January 10 came. This was the day that the doctors had scheduled a fetal amnio and labor induction, both of which I dreaded. I preferred natural labor if at all possible, and at this late date, I didn’t want to mess with the babies’ sacs. I began to feel some contractions in my abdomen. Fetal monitors strapped around my waist were feeding data to the nurses at the center of the floor. Our favorite nurse Tracy, who we’d become intimate with over these last ten days, came flying in the room beaming.
“There is a God,” she cried, “you’re in Labor!”
Labor had begun spontaneously, a miracle in itself. I had contractions every couple of minutes, lasting for a full minute. Now here’s a small digression: Birthing classes and books and midwives all claim that during early labor the mother will experience contractions lasting for 30 seconds or so followed by significant periods of rest between contractions. Forget it. No rest in between for me. Rather steady intense pain followed by more intense pain, followed by excruciatingly intense pain.
My birthing team arrived. Alisa came carrying a gorgeous bouquet of birds of paradise, she was my closest friend and a woman of great spirit, love and presence who had attended many births including two of her own. There was my midwife friend Kristen, who by great good fortune had done her OB nursing training on the very same hospital floor and knew the senior OB physicians and nurses personally. There was Lynnie, my dear friend who played the harp at births and had been to 75 as a labor assistant. And of course there was Joe, who had been through this with his three older kids, loved me beyond life, and proved to be in his finest hour of grounded presence, strength, and wisdom during this labor.
They labored with me for nine hours until the head OB, Dr. Lucy Bayer (pronounced “bear”), arrived to examine me. Bayer, her stature true to her name, towered over the young male resident who shadowed her. I was 100% effaced and one centimeter dilated. “These babies will be here by 3:00 AM,” she said encouragingly. The number seven went through my head. I think they’ll be born at 7, I said silently to myself. The news that I was only one centimeter dilated after nine hours of what felt like pretty intense contractions was disappointing. But we’re on the way home, I thought. The two beating hearts and little bodies that I’d been tracking for close to nine months now and longing for for seven years, would soon, God willing, be on the outside and in my arms.
At 10 PM Bayer returned to find me still at one centimeter and ordered the nurse to start Pitocin to speed the contractions. Bayer had the aura of a woman with no time to waste. In our “birthing plan” we had said no Pitocin. But with Bayer and the whole hospital scene against me, I decided to choose my battles. With the Pit running through on IV my contractions came on faster and with greater intensity. I howled and leaned on Joe, holding on for life. Kristen began running interference with the nurses on the floor to keep them from distracting me. Lynnie played harp to soothe some of the hospital chaos. Alisa helped me give sound to the pain, rubbing my feet and back as I wailed. Joe was my main physical support, holding me through every contraction, breathing with me, blessing me.
After four hours of agony, Dr. Bayer reappeared. She did a manual pelvic exam, and found that I was still only two centimeters open. Sixteen hours of labor, four hours Pitocin and I’d barely progressed.
“You need to prepare yourself now that this birth is not going to go the way you wanted it to go. I know you are someone who likes to get things done, but this is not something you can will to go your way,” Bayer looked down at me strapped to the table. “You are 41, you've been on bed-rest for seven weeks, you have twins. Twins distend the uterus so it does not contract effectively. Your babies are now at risk. I know you want a natural birth, but death is also natural at birth. This is my 1000th labor and your first. I know this is disappointing, but everything in my experience tells me you are going for surgery, it's time for you to accept that and get ready. You’ve got two hours.”
I could barely stay inside my skin. I felt like a caged animal, in agony on the hospital bed, hooked to two fetal monitors, an IV Pitocin drip, a head monitor through my vagina on my son's scalp. Tethered to a three-foot radius. Not allowed to drink or eat, barely allowed to walk. I had screamed with every contraction to give sound to the pain. But now, when Bayer left the room, I let go a wail that came from a different place. A place of longing, heartbreak and utter grief. I sobbed, shook, and literally puked. There had been so much surrender in this pregnancy. To IVF and fertility drugs, to the hospital with Ovarian Hyperstimulation, on my back for seven weeks. I’d had excruciating headaches, heartburn, vomiting. Then during the seven weeks of bed rest I’d let work, play, yoga, sports, socializing go, surrendering them on the alter of this ancient longing of the heart—to birth these babies. I had joked about going for my Ph.D. in Surrender Studies and resigning as CEO of Control Freaks Anonymous. Was it time now in the finale of this opening act to surrender the dream of a healthy birth without surgical intervention as well? I closed my eyes, went inside and asked my guides in that moment, is this what you really want? Surrender again here? And the answer came back clearly, No. Go for your dream. It was time to pray.
So we prayed quite consciously for a miracle. With my beloved husband Joe and beloved women friends, we prayed. We shifted our focus from the physical immediacy of the contractions and joined our intentions for just one moment, speaking them aloud. “Let the gates be open, let the miracle happen, let these babies come through now.” I realized that I so thoroughly believed Bayer’s pitch that I had given up hope for that moment. But Alisa, Kristen, Lynnie and Joe did not. “It's happening, you are opening, these babies are coming through,” the women promised me. “You can do this,” Joe affirmed. They saw the healthy birth of the babies so clearly and voiced this as prayer with such love and focus and joy that I actually began to believe it myself. And I regained my faith and my will to give it my all.
“Let’s get you off this table,” Joe said. “You’ve got to get vertical and get gravity going for you.” I focused my intention, with an intensity I’d never experienced before, digging deep into the core of my being to find the place of opening, leaning physically on Joe and spiritually on the container of women surrounding me with prayer. I was the daughter of an unbroken chain of mothers beginning at the beginning of time who have birthed this way. I knew in my marrow how to do this. I wanted to pass this legacy on to my own daughter who would be born today.
Ninety minutes later Bayer returned, practically scrubbed and with scalpel. She checked my cervix one last time. “Unbelievable,” she said. “I never would have predicted this. You are seven centimeters, almost ready to push these babies out! We’re back on track. Whatever you’re doing keep it up.” And she left the room. We cheered.
An hour later I was ten centimeters dialated. I was wheeled at high speed to the OR while Joe, Kristen and Alisa scrubbed up and donned their shower caps and gowns. Samuel Aaron was born at 7:04 AM. He did not cry, he was blue and his Apgar was only one. The Pediatric intensive care team immediately went to work on him. After three minutes he was breathing and pink and swaddled in yellow.
I’d been cut open to deliver Sam – Bayer didn’t want to waste any more time pushing fearing for his heart rate – and had lost a lot of blood. I kind of drifted away in exhaustion and ecstasy after he was born, almost passing out. We did it! Then I vaguely remembered I had another baby to deliver. Kristen took a gorgeous picture of Sam crowning, but chose not to photograph this one. “You would not have wanted to see it,” she told me later. “The resident had his arm up to his elbow inside of you, grabbed the baby by the ankles and yanked her out.” Maya Freda was born at 7:12 AM. She weighed only three and three quarters pounds and had an Apgar of two. Another team of Pediatric experts grabbed her, gave her oxygen, and swaddled her. After three minutes she had an almost perfect score of nine out of ten. I was blown open literally and blown away with joy, gratitude and relief. I was allowed to hold both babies ever so briefly, a moment of euphoric delight, before they were whisked away to NICU, neonatal intensive car. The first time I would hold them skin-to-skin, against my chest would be 24 hours later, while they were hooked to monitors and IVs in NICU. I held the tiny Maya between my breasts while Joe cradled Sam. It was a moment of pure, ecstatic, heart opening joy that happens, I think, once in the lifetime of the new mother.
“So what’s the anatomy of a miracle,” Terri asked when she visited me a few months after the birth. This time we were on my bed while I was tandem nursing Sam on the left, Maya on the right. The preemie babies were now thriving 14 pounders, smiling, laughing, engaging with the world. If birth was a microcosm of a miracle what did it teach me?
“When I lost my faith, my community held me. They were right there believing with me, loving me, protecting me, and seeing when I lost sight,” I answered softly, realizing that Terri had been right—that the birth of my twins had brought me to a more spiritual place. “Miracles happen in community, with God’s help, and a blend of will and surrender.” Sam and Maya were both snoozing at the breast now, with that look of milk-drunk bliss on their faces. My heart has replaced my body.
Sara Schley is the co-founder and president of SEED Systems, an internationally known consulting company dedicated to helping businesses become more ecological and socially sustainable. She has lead workshops with dozens of business leaders and thousands of their employees on three continents and has worked with companies as diverse as Ford and Ben & Jerry’s. Schley teaches businesses to apply systems thinking and organizational learning to create sustainable enterprises. In partnership with the Society for Organizational Learning, (SoL: www.solonline.org), Schley and her husband Joe Laur, along with their colleague Peter Senge, established the SoL Sustainability Consortium, an active group of industry leaders in learning and sustainability. This consortium includes members from BP, Ford, Harley, Unilever, UTC and several other companies, universities and NGOs. Schley is also co-founder of the international women’s network, Women in Power a right of passage and empowerment experience for women. Her work includes teaching, writing, coaching, speaking, facilitating groups, designing curriculum and consulting on systems change to large organizations. Her writing has appeared in the New York Times, the Valley Advocate, the Greenfield Recorder, and elsewhere. In addition, she and her husband are co-authors of “The Sustainability Challenge,” and “Creating Sustainable Organizations” published by Pegasus Communications.