Been There, Done That? Try This....
By John Racette, Albuquerque, NM
All births are not alike. This is an obvious statement, but when our new baby, Jacob, was born, it was as different from the birth of our first son, John, as night is to day. Johns birth was fearful, frantic, and full of flashing lights and beeping monitors. My wife Kim was scared and out of control. She had to spend three days at the hospital recovering from preeclampsia.
This time we were smart; we didn't go anywhere near the hospital for the entire pregnancy, but rather invited the services of a midwife, and had the child at home in the water. And under hypnosis.
Looking back on that first birth, I am compelled to say we didn't know what we were doing. It was a little more than two years ago, on a Tuesday morning, that my wife went into active labor with John. She got up at 7:00 a.m. after a night of fitful sleep and irregularly spaced contractions. She showered, dressed, and brushed her hair while she timed her contractions. I made some oatmeal for her, and I paced the floor and worried that my heart wasn't going to last another day. The whole pregnancy had been stressful for me. In the first trimester I had developed eczema on my shins, which kept spreading during the next few months until I was using a tube of hydrocortisone a week. Now we were close to the end and I could barely stay focused on making breakfast.
Kim sat down to eat but never got the chance. She had a long, strong contraction the real thing. It. We drove to the hospital in a state of excited anticipation, expecting to bring our baby home the next day. When we stepped out of the elevator into the maternity ward, we had no idea what kind of machine we had just entered or how much the experience would change our lives forever.
Certain conditions or circumstances warrant childbirth in a hospital environment. During labor, Kims usually low blood pressure had climbed dangerously high. The doctor was concerned that she was experiencing preeclampsia, a potentially dangerous condition for both a mother and an unborn baby. Nurses started an IV, hooked up a fetal heart monitor and what appeared to be a seismograph to measure the intensity of Kim's contractions. Kim was told to lay on her side, immobile.
Contractions came and went. Nurses came, tended to Kim's mysterious needs, and went. Ice chips were provided, affording no relief for her thirst. As if trapped in a shared nightmare we were dragged on, oblivious, unable to do anything but comply with every precautionary measure the hospital staff suggested. I held my wife's hand and smiled reassuringly; it was all I could think of doing. I can never forget the helpless fear I saw in her eyes that morning. It was a fear of the unknown that echoed my own.
Two hours later, a doctor, midwife, or nurse (we don't know which, or what her name was to this day) saw my wife through her rapid, frantic delivery. The umbilical cord was clamped and cut and the baby was whisked away for cleaning, measuring and administering eye prophylaxis and vitamin K. Kim's blood pressure remained high the cause unknown. Blood was pooling and clotting in her abdomen. In order to prevent seizures, she was immediately hooked up to an IV drip containing magnesium sulfate. She remained that way for the next two days, the solution slow-dripping into her veins. They gave her painkillers and Tylenol 3, and catheterized her so she didn't have to get up for any reason.
When Kim would wake up from drug-induced sleep she would complain that her skin was crawling or that she was being cooked alive, both side effects of the Epsom salt drip. I stayed with her nearly the whole time, only making periodic trips to the neonatal ward to look at our son through the window. The nurses brought John to Kim every few hours so she could nurse him to provide the colostrum and antibodies he needed. He was doing fine. The staff tested Kim's blood and urine several times each day and night, administered painkillers and replaced her various bags of fluid.
We believed all this was necessary to keep my wife alive, and it may well have been. I dont remember much of it, really. Mostly it was three days filled with nurses shift changes and bed-dressing changes. That, and an ever present feeling of utter helplessness. Finally, Friday morning, the hospitals discharge coordinator told us we could check out and bring our son home. Kim was still faint, weak, and dizzy, but we were thankful to be going home after those three days. Over the next two weeks Kim regained her strength and we began to settle into our new, sleep-deprived life. I returned to work and silently prayed Kim would never want to have another child.
God knows what we want even when we don't know ourselves. A short year later we realized we wanted another baby. Kim went to her OB-GYN and asked her if she could expect preeclampsia again if she got pregnant. The doctor said it was a good possibility. I asked her how serious Kim's condition had really been. I wanted a straight answer: Had her life really been in danger? The doctor said, What Kim had kills mothers.
I immediately made an impulsive decision: Better to have one healthy baby and my living wife than take a wild chance and lose my wife, or a child, or maybe both. I told Kim we couldn't risk having another child. End of discussion. If the doctor had an opinion, she didn't weigh in.
When I put my foot down, there's nothing else to talk about. Yeah, right. Tell that to my wife and you're asking for a fight. Kim began to study pregnancy, women's health and nutrition. She opened up a whole world of information, and learned more about human physiology than either of us knew existed. It opened my eyes too, to see the strength of determination in the woman I married.
There is a midwife in Albuquerque, New Mexico who knows nearly everything about pregnancy there is to know. What she doesn't know she will bend over backward to find out. I remember when we first walked into her office, a large white room just off the main entryway of her Four Hills home, I told her as far as I was concerned she had two strikes against her going into the game: She was not a doctor, and she did not work in a hospital.
"Fair enough," she said. "I'm not sure I like you, either."
The attitude of the medical community at large regarding preeclampsia is one of management rather than prevention. We interviewed the midwife and pumped her for answers about how to deal with the recurrence of the condition during pregnancy. She told us it was entirely preventable, but that a pregnant woman has to start preventing it long before the first symptoms present themselves around week 21. Proper nutrition and exercise were crucial.
She was the third midwife we interviewed. On the drive home I asked Kim what she thought about her. We agreed she seemed to know her stuff, and her candor and optimism were a refreshing change from the doctors guarded admonition. We chose her and felt relieved, as if we had made an important turn on our road to a larger family.
And one day, when the test showed two lines, Kim began a regimen never prescribed by any doctor.
Kim watched her diet carefully, especially keeping track of her protein intake. She exercised and took prenatal vitamins and iron. She went for monthly consultations with our midwife, and reported on her diet and physical activities. She walked, enrolled in a yoga class for pregnant women and regularly received massages from a licensed massage therapist who specializes in pregnancy massage. She practiced deep relaxation and positive visualization. Kim focused on keeping her blood pressure low. We even took a class in HypnoBirthing, offered by our midwife, wherein we conditioned Kim to enter into the state of relaxed birth.
We made the decision to stay home and birth our second baby in our bedroom with a midwife and apprentice. Jenny, the midwife, is seasoned by a thousand births, and Anne is sharp, attentive and observant. Over the course of Kim's pregnancy our midwife swayed me. While essentially resisting every paradigm shift I went through, I came to the conclusion that my wife is having a baby in the natural way.
Watch the Learning Channel for any length of time and unless you are a cynic, you will marvel at the state of prenatal and neonatal medical care available in the world. Science is a miracle. Seven babies can be born of the same mother on the same day and all stand a good chance of leaving the hospital alive. Doctors can take an infant out of its mother just 24 weeks after conception and orchestrate the completion of its development in an incubator. A team of doctors and nurses can perform heart surgery on an infant while it is still in its mothers womb. This is amazing and speaks to the incredible value we place on a single human life.
But be careful that you don't believe everything you see. Birth isn't necessarily a science, or even a medical procedure. Birth is the blossoming of a flower, and no one should dream of rushing it along.
Was I scared of natural childbirth? Yes. I was scared of the thought of my wife screaming in panic and pain while I rushed her to the hospital in our mini-van because something went wrong. I was scared of our baby coming out and not taking its first breath and of being helpless because we had him in our bedroom instead of the maternity ward. I was scared of my wife suffering the seizures that were prevented with the slow IV drip the last time. I was scared of a life of regretting our decision to do this on our own instead of treating it like the white antiseptic medical emergency I thought it was. My wife and I have invested more than forty weeks of emotion in this birth, and I didn't want all our hopes to be meaningless because of the whimsical decision to have this baby at home in a tub of water.
Most of all, I was scared of losing my wife and unborn child.
When the time came for the birth, our bedroom was warm and quiet. Soothing music overlaid with calm affirmations of competence, in our midwifes steady voice played on a small stereo Kim and I had purchased just for the occasion. How wonderfully unlike a hospital it sounded! Kim reclined in a wide, circular pool filled with warm water in the center of the room, arms draped over the side, head back, eyes closed. Her breathing was deep and relaxed. She was aware of everything going on around her; our sisters in attendance, our two-year-old son watching Blues Clues in the other room. She was aware of the warm water I poured steadily over her stomach from a large soda cup.
The midwifes assistant listened to the babies steady heartbeat and checked Kim's blood pressure. Perfect. Kim had been in active labor for nearly an hour, without any stress. Deep in hypnosis, her body did all of the things a woman's body must do. Oxytocin was produced, causing uterine contractions. No synthetic drugs were necessary for this delivery. The baby progressed down the birth canal because that is what Kim's body let it do. My task was simple: Keep pouring water over my wife's belly. The water has a tranquilizing effect on us both. There was such serenity in the atmosphere that I began to think of lunch.
All of the fears I had probably served some purpose in my psyche, but I could not begin to tell you what that purpose was. Did my wife scream in panic or pain? No. I watched her go through active labor with a calm expression of competence on her face. No one yelled, Push, but Kim's body pushed when it was ready. There is no red-faced ten-count with held breath, followed by frantic huffing.
Kim shifted in the water, hardly aware that her body was readying itself to bear down. A powerful surge of purpose washed over her. She groaned sharply, suddenly back inside her body. The midwife smiled and reached into the water, picking up our son and laying him on my wife's chest. He took his first breath and let out a cry, without any problems. No suction or eye prophylaxis was needed. My wife held the baby and the midwife draped them both with a warm towel. The umbilical cord remained intact, the placenta continued to pulse for a few minutes, all of its goodness going to the baby.
I am proud of our decision to have this baby in our own home with our midwifes humble supervision. The success of our home birth experience was the result of months of self-education. We did not need the white walls of the hospital. My wife's body knew how to give birth to a baby. She would not take no for an answer, and now our baby Jacob sleeps in his brothers crib.
(John Racette is a New Mexico writer who lives with his wife, Kimberlie, and four boys, Lewis, John, Jacob, and, most recently, Dallas in Albuquerque.) This article was first printed in "Having a Baby Today," a Midwifery Today publication. Issue #8, Winter 2002. The author and his wife are clients of Jenny West and Albuquerque Homebirth.