Fourth Baby, Second Homebirth
Tuesday the eleventh of January was a normal day for me. I went into the Maternity office: Did a few prenatal, helped with a postpartum of a mom with twins, and compared bellies with a lady that was due a few days before my due date, February 19. By the end of the office day, I was beginning to feel some strong Braxton Hicks contractions, and went home to rest and re-hydrate. The contractions kept going that afternoon in spite of lots of water, a warm bath, and chamomile tea. After dinner the contractions started to feel “laborish” and I called Judi to let her know. She came over and checked me and my cervix was 2cm, not at all effaced with a high baby. We both assumed it was nothing and I just needed more rest. I drank some warm milk and went to bed.
I woke Wednesday morning, January the 12th, got out of bed and waddled down the hall, only to find, Colin my almost 5 year old had beat me to the bathroom. I felt some trickles of liquid run down my legs and assumed the baby had kicked my bladder and caused some pee to leak out. When I sat down on the toilet I had a lot of fluid gush out and thought “Oh my, is that my bag of waters breaking?” In disbelief I got up and started to walk around with lots more fluid coming out. Reality sunk in and I went and grabbed a baby diaper and a clean pair of undies. My water had broken prematurely at 34 weeks and 4 days.
I called Scott at work and said, “My waters broke, REALLY broken and I don’t have any laundry detergent to wash baby clothes.” I was caught totally unprepared and getting ready was my number one concern. I then called Judi and Beth to let them know that the baby was coming sooner rather than later. They said they would be by my house later in the afternoon. Roberta, my friend and birth photographer got the next call and hearing me panic about not being ready, she came over with her 3 girls to help my clean and get organized. I then called Marge, another friend who was to watch the children and let her know it would be soon.
Scott came home at lunch because I wanted him nearby and was already beginning to feel crampy. All the midwives, Judi, Beth and Barb came a few hours later and discussed risks and whether or not to continue to plan on having this baby at home. We decided to birth at home and be ready to maintain and transport the baby if need be. I also received an IM penicillin injection propholacticaly since PROM is a high risk factor for Group B Strep. The waiting game was on to see when labor would begin.
We had the children leave in the afternoon and spend to night with Marge. I began contracting moderately after supper and promptly vomited all of the food I had eaten. I was not able to sleep well with the contractions coming even though the were irregular, anywhere from 6 minutes to 20 minutes apart. At 11 PM I had a good bit of bloody show and the contractions were making me work a bit so I considered this the beginning of labor. By 5AM on the 13th, contractions sped up coming 3-5 minutes apart for about 30 minutes, they were strong enough that I needed to move and breathe through them, they reminded me of what I had felt at 5-6 cms with my last labors. Since my last 2 labors were very quick I called Beth to come out. When she arrived the contractions had spaced back out. I had my first exam since the waters broke and I was still 2cms, not effaced with a high baby just as I had been Tuesday night. I was SO frustrated. Beth advised to have the children come home and go about a normal day.
I laid back down and was able to get a couple hours of sleep. Scott brought the kids home and about 8AM. I woke up and began contracting again, still with nice strong, yet irregular contractions. I was not able to have a normal day because of the strength of the contractions, so I puttered around and rested as much as possible. Judi came by at about 2PM and wanted to heck me and see if she thought my bag of waters had truly broken (Ha, Ha) At this point we were thinking to transport in the morning and wanted to have everything official. She checked and I was still 2cm and not effaced! She couldn’t feel a bag of water during a contraction, yet got no fluid. She wanted Beth to meet me at the maternity office later and to a sterile speculum exam to officially confirm PROM.
I was desperately trying to keep a good attitude at this point and spent some of the afternoon walking around the yard laboring. We had such a beautiful day, temps were in the mid to upper 60’s and it felt so good to be outside. Beth called at a quarter to five and said she would be by to get me at about 5:30. Scott went to the store with the kids and I had some time with myself. I sat on the porch swing and flipped through my scrapbook of women I have been a doula for. I thought about how strong the women I have attended were in their labors and affirmed to myself that I would do well with this labor too, no matter what was to come. During this time my contractions had continued to increase in intensity and became regular at every 5-6 minutes. I would get up and lean on the porch rail to sway and lunge through the contractions. Beth arrived and we went over to the office getting there at about 5:45. Contractions strengthened the entice time we were together, through the speculum exam and blood work (to monitor for infection). Beth commented that she didn’t think she would be going home since I was in active labor, yet my cervix was still barely 3 cms and 20% effaced.
When I got back home, I was met by Marge coming to pick up the children. Roberta came over soon after. I labored walking around, swaying with Scott trying to stay up and on my feet. At some point early in the evening, I had Scott draw a big smiley face on my tummy to remind me to stay positive. It was a reminder well needed, since after several hours of transition like contractions I asked Beth to check me again and was 4cms and 70% effaced at 8:30 PM. My body was not ready for labor and was working this hard just to efface my cervix!
At around 9PM, I began laboring on my hands and knees. I would walk around the house and then drop to the ground as a contraction began. For a while I labored in front of the open back door and let the fresh air blow over me. It felt so good I really wanted to be outside. At this point I also began dealing with nausea and vomiting between contractions. This is my usually sure sign I am in transition and the birth is near. I was also feeling a lot of pressure and wanting to bear down a little at the peak of contractions. However, at 9:45 I asked Beth to check me again and I was 6cms and 90% effaced.
I continued to labor feeling somewhat out of control and unable to deal well with the pain. Judi arrived at about 10PM. I continued to grunt and bear down a little through the contractions because it seemed to take the edge off. I asked to be checked again at 10:45 and wanted to see if the cervix could be stretched out of the way. I didn’t know it but I was still 6 cms. Beth tried to massage the edge of the cervix, which was excruciating but it dilated me to 7cms. Beth (who is a ND from Bastyr) decided to try a remedy and gave me Gelsemium 200C. I worked through contractions for another 10 minutes or so and she checked again. I was still 7cms but much stretchier. She gave another dose of the Gelsemium. Five minutes later Judi checked and I was 9cms and she was able to hold up my cervix while I pushed past it. After that it was only a couple more contractions until I was guiding baby Emmanuel’s head out. I was not in a good position to truly catch the baby myself so Judi finished delivering him and he was up to my arms at 11:09 PM.
Emmanuel breathed right away though was pretty grunty, heartbeat was good and he had a 1 minute APGAR of 6. At 3 minutes he totally crashed and Judi gave him a couple puffs of air via mouth to mouth, lots of stimulation and blow by O2. He perked right back up and his 5 minute APGAR was back to a 7. While they were working with Emmanuel I cramped and felt several large gushes of blood, much more so than with my other births. I could see a bit of blood pooling under me and Judi and Beth were eyeing me but too busy with Emmanuel to deliver the placenta. I thought not to wait for them and said “do you mind if I just do it?” Judi said go right ahead and so I delivered my own placenta.
Emmanuel only continued to improve from then on out. He was smaller than we expected being 5 lbs even and 18 ¼” long, with a head size of 12 ½”. We never let him out of someone’s arms for the first 48 hours. The first 24 hours he was a bit grunty but it never worsened and his respirations never became to rapid. If he was left in one position too long the grunts would become louder, so we changed his position frequently. After the first 48 hours the concern became jaundice and weight gain. The jaundice was moderate and he never needed the bili lights. We sunned him often, being very thankfully for some sunny days. He dropped down to 4 lb. 14 oz. On day 1 and gained from there, attaining his birth weight by 5 days. We supplemented the first 5 days as he was often to sleepy to nurse. We would try to feed every 2 hours and then supplement with a Preemie size Haberman feeder. AS he gained strngth and began acting like a normal newborn, nursing vigorously and letting us know he was hungry, we dropped the supplements. He has been a excellent nurser since! He has just thrived now at 2 weeks old is 6 lbs even.
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