Birth Story: Liam James

This is the story of my second birth experience, a home waterbirth in Colorado.

Liam was due on January 7th, 2004 but, just like his sister, Madigan, he was born 6 days late and on a Tuesday. That is pretty much where the similarities end, apart from the fact that both pregnancies went very smoothly, he too was born naturally at home and it was an amazing and beautiful birth experience.

I had been feeling Braxton-Hicks contractions for weeks before my due date. In fact, on December 29, 2003, I had had them all day and they were regularly 3-5 minutes apart. Andrew felt I should call our midwife, Tracy, to let her know, which I did. Although I was not totally convinced I was in labor, Tracy had suggested that I might not necessarily recognize labor right away given that I had had back labor with Madigan and an anterior baby would seem relatively easy in comparison, so I was unsure. Tracy, Kris and another assistant arrived at around 8pm. I was still only 2 cm dilated and my contractions were “moderate” and fairly regular. They slept in the basement until 2 am when Tracy checked me, then decided to go home as I had not progressed. Instead of going into labor, I developed a fever and a cold. Andrew had been fighting the bug for weeks and had repeatedly resisted my suggestions to take vitamins and get more sleep so I blamed him for my misery entirely! After all, who wants to be 9 months pregnant and sick? Not to mention that our families were all at our place for the holidays: we had 7 guests at the time!

We had a couple more appointments with Tracy, who stripped my membranes on January 6th. This had worked to start labor last time, but didn’t work this time. I was getting eager to have this baby as my belly was huge, Tracy estimated the baby weighed 9½ pounds and I was afraid that at our next appointment scheduled for the 13th, she would finally recommend the dreaded castor-oil-in-milkshake remedy to induce labor. So on the 12th, I tried a number of labor-inducing activities, including having 3 strong cups of red raspberry leaf tea and painting a blue background and white clouds on the ceiling of Madigan’s big girl room. We went out to dinner and I asked the waitress if anything on the menu induced labor. I ordered the spinach and artichoke pasta and had a glass of wine….

At 12:22 am on the morning of January 13th, I woke up with contractions. I waited an hour before waking Andrew, telling him I thought perhaps he should fill the birthing tub. I’d had so many contractions in the previous few weeks, he said he wanted to hear one first. Soon enough, he did and decided this was indeed it. A little later I got up from the bed and felt a small gush of water – my water had broken! I called Tracy, who lived about 60 miles away, at about 2:30 am. I remember feeling silly and apologizing for being in tears with emotion and anticipation but Tracy remained very calm and supportive. Tracy, Kris and an assistant arrived at about 4:20 am. By this time, the aquadoula had been filled and I was eager to get in. The contractions were pretty intense. Andrew had to apply counter pressure to my lower back during each one. Although we didn’t say it aloud at the time, it had occurred to us both that this was very similar to last time… when I delivered a posterior baby!

Tracy checked me and I was 5cm dilated. I was a little disappointed, I had hoped to hear a higher number. I got into the aquadoula and settled into my new watery environment. I remember saying I would have liked the water to be warmer (it was around 98 degrees) but that changed and soon enough I was dipping a flannel in a bowl of cold water to splash on my face and to bite down on. The contractions were hard and intense and came close together. Around 5:30, I asked Tracy when she thought this baby would arrive. Given my last labor, I expected this to be a long one too and didn’t think we would meet this baby until after noon, but she said we’d have the baby by sunrise. I don’t think Andrew or I believed her. She said “Trust what your midwife tells you!” and I said “My midwife told me I’d have a 2003 baby!”. Fortunately, she had a sense of humor!

Most of the time, everyone was quiet and I just did my thing, splashing my face with cold water and saying “OK” rather abruptly whenever a contraction came on. Andrew was supposed to interpret this as “Please apply strong counter pressure to my lower back RIGHT NOW” and, being an experienced birth coach, he did. Tracy would reach into the water every now and then to listen to the heartbeat and tell me the baby was doing fine. I remember one particular contraction when I really felt the baby moving down, it was a very distinct and productive move, unlike any I’d ever felt before. At least I knew we were making progress! At one point, feeling tremendous pressure in my nether regions, I briefly wondered if somehow this baby would be born from my anus. I tried to think of how to delicately express this to the birth team and several verbs crossed my mind. Finally, I just said “I think my ass is going to explode.” Kris dutifully jotted this phrase into the birth notes…

I was afraid of tearing, but I needn’t have been – I was able to move positions in the water and with Andrew’s support as well as the skillful guidance and gentle encouragement of my midwife, our baby was born at 7:22 am, exactly 7 hours to the minute after I’d woken up. And sure enough, this baby too was posterior! I felt a brief burning sensation as his head was born, but Tracy later said I only had a dozen or so “skid marks”, none that really required stitches, and it was better if they healed naturally. Our baby was immediately brought to my chest and Andrew and I peered between those chunky legs to discover our beautiful baby was a boy.

Just a few minutes after Liam was born, I was helped out of the birthing tub and to the bed, holding our new son. As I gazed at my newborn in adoring amazement, he pooped meconium onto my somewhat deflated belly. About 20 minutes after his birth, the placenta was born. It was whole and looked healthy. After the cord stopped pulsating, Tracy tied it and Andrew cut the umbilical cord. I received a shot of pitocin in the left thigh to help stop my bleeding.

Liam weighed an astonishing 11 lbs 6 oz. We knew he’d be big, bigger than Madigan, maybe 10 pounds, but we never guessed nearly 11 and a half pounds. Even Tracy seemed a little surprised. She later confessed that she never tells a pregnant woman if she estimates their baby weighs more than 9½ lbs so as not to frighten the mother-to-be. I remember asking her at one of our appointments around my due date how much she thought the baby weighed and her telling me 9½ lbs and then asking me if that made me nervous. I had replied no, the weight wasn’t so much a factor for me as much as whether the baby was posterior again or not. It seems something about my anatomy makes babies turn posterior during the journey down the birth canal! Tracy checked my uterus at 6 weeks postpartum to see if it tips backward, but it doesn’t. (Note: babies #3 & 4 were born anterior! And it makes a huge difference!)

Liam was 23” long… approximately. He had pooped (yet again!) on Tracy’s flexible measuring tape and we didn’t have a soft cloth tape, so the only thing we could find was a metal measuring tape from Andrew’s tool box. We didn’t want to get it too close to Liam’s delicate newborn skin, of course, so we eyeballed it at around 23”.

I had a shower and was helped back to bed, where I was reunited with my baby. His apgar scores were 9 and 9 and he looked healthy and well. He certainly had a set of lungs! He knew what to do when he sensed my nipple was near… after all, he was a big baby and had a big appetite! Andrew diapered and clothed him like a pro! Things were a little different in a boy’s diaper than a girl’s and we would soon experience the classic arc of pee that infant boys are known for. The birth team showed Andrew how to use the goldenseal powder on his umbilical cord so it would dry and fall off. As it happened, Liam hung on to that cord stump for nearly a month!

It was a truly wonderful birth experience. Andrew was once again a fantastic birthing coach and our birth team was excellent. I am again so happy and so proud that we chose to do this our way, in the comfort of our own home, and that we were able to experience a water birth. I am grateful that our son was born healthy and that this labor, although very intense, was only 7 hours long. I truly believe the labor process affects the family bond and that you must trust your body to do what it was made to do. We are so glad to welcome Liam to our family!

A Postpartum Complication… Endometritis

On Thursday night at about 10pm, I started getting severe abdominal pains. We were already in bed and Andrew was irritated that I was breathing hard and talking softly to myself, telling myself over and over again to just relax, I was fine. At first I thought it was bad contractions, but eventually it felt more like my intestines were knotting up and I had uncontrollable diarrhea. I didn’t want to disturb Tracy, who I would see the next day anyway for our 3-day checkup. I’m not sure how we got through the night, but the next day Andrew went with Madigan to take his mom to Denver airport and pick up my mom who was flying in from California to help out for two weeks. I spent the afternoon in bed with Liam, feeling pretty tired. Andrew, Madigan and my mom arrived home in the early evening, and then Tracy arrived for our appointment about 5 minutes later. She checked me and told us right away we should go to the emergency room as I had a high fever.

When we got there, I had a 103° fever and my blood pressure was in the 70s over 30s. This took a while to discover as the nurses were very chatty with each other as they took my blood pressure and completely missed the reading on the machine. I saw it and even I knew that was quite a bit lower than my usual 90s over 60s. They took it again and this time saw the reading and suddenly stopped chatting long enough to get me into a room and seen to. I was given IV fluids to rehydrate me – an IV in each arm – and an ultrasound to see if there was any tissue left in the uterus that could cause infection (there wasn’t). They didn’t know what was wrong initially, but they admitted me and soon determined it was postpartum endometritis. Endometritis is an inflammation or infection of the endometrium, the inner lining of the uterus, and this happens after 1 – 3% of births. While caesarean is the single biggest risk factor, it can (clearly) happen after any type of birth.

I stayed in the hospital for 48 hours, until Sunday night. They pumped me full of IV antibiotics all weekend and I could not breastfeed Liam – they told me the  light-sensitive antibiotics would have caused his permanent teeth to stain, they were so powerful. I had to “pump and dump” so Andrew had to give him formula, which he’d never done before. I hear that kid sucked down bottles like nobody’s business! The emergency room doctor happened to be a friend of Tracy’s and he was great. His wife was about to have a baby too. He said it wouldn’t be irresponsible to bring Liam into the hospital, but that there was a virus going around and if it were him, he would probably keep the baby home. I couldn’t nurse him anyway and I knew it would be very difficult for us both if I held him and couldn’t nurse if he was hungry, so we decided Andrew would take him home and I would see him again when I was well. I was incredibly tearful all of Saturday, missing my new son and Madigan, feeling lonely and frustrated. The labor unit doctor spent only a couple of minutes with me, leaving before I could ask all my questions and I felt very frustrated. I became very swollen from all the IV fluids, hardly recognizing my own hands and feet. I couldn’t move my wedding ring and when I walked, it felt like I was walking on water blisters. Three days after leaving the hospital, I lost 7 pounds in a single day as my body got rid of the fluids, then 4 pounds the day after and 3 more the next day. I lost all 30 pounds or so from my pregnancy within just a few weeks.

I left the hospital on Sunday evening at about 9pm so Madigan was already in bed. I couldn’t wait to hold Liam again.

Breastfeeding challenges…

The next day, my breasts swelled to what I called preposterously pornographic proportions. We joked about taking pictures and making some money on the Internet. It was ridiculous, even my large nursing bras would only come halfway up my breast. Thankfully, this decreased soon enough, but was clearly a physiological response to seeing my baby again.

The electric pumps I had had to use at the hospital were terrible and caused some damage to my nipples, particularly my right nipple, which is flat. One night I decided to use my manual pump on my right breast to relieve some pressure and help extract the nipple before Liam latched on (or “clamped down” as I called it). I was horrified to see after a few pumps that no milk was coming out, only blood. Not bloody milk, just pure blood. I was pretty freaked out and in tears, yet I didn’t want to call Tracy because it was 11pm. So I figured I’d just feed him on the left for the rest of the night. In the morning, I took the pump and sat on the floor of a hot shower, took a few deep breaths, and gently started pumping. I was relieved to see only milk, no blood. Another obstacle overcome!

Then my left nipple became cracked. This was excruciating and I found myself very tense whenever Liam would prepare to latch on, with my shoulders hunched and jaw clenched. It would usually only hurt for the first 30 seconds or so, as he chewed through the scab and reopened the wound. Andrew finally suggested I pump on that side and that worked beautifully – it was completely painless. I used lots of Lansinoh cream and pumped from the left breast for a week. When I was fairly sure I was sufficiently healed, I let Liam latch on again and it was absolutely painless. So, all in all, we had a few unexpected setbacks but within a few weeks we were a successful and established breastfeeding team! I am so glad I had had such a positive breastfeeding relationship with Madigan so I was determined to do the same for Liam, but I must admit that when I actually saw blood being pumped from my nipple, I thought if it had been my first time breastfeeding, I might have considered quitting! Fortunately, I didn’t and together we soon enjoyed a happy breastfeeding bond.

That breastfeeding relationship would last for 27 months!

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