Is there more to the Christmas “miracle” mom & baby “mystery?”

In what’s being called a Christmas “miracle,” a mother suffered cardiac arrest and died while in labor on Christmas eve 2009, her lifeless baby was born after an emergency cesarean section, and then “inexplicably, astonishingly” both suddenly came back to life. At least, that is the picture that was first painted by ABC News.

Photo credit: ABC News

Tracy Hermanstorfer of Colorado was without a heartbeat for four to five minutes while her husband Mike undoubtedly stood by in shock. “‘Half of my family was lying there right in front of me — there’s no other way to say it — dead,’ Mike Hermanstorfer told ABC News’ Colorado affiliate KRDO. ‘I lost all feeling. Once her heartbeat stopped, I felt like mine did too.'”

First I must say that I’m so very thankful that Tracy and her son Coltyn were revived and both are doing very well. I can’t imagine what her husband Mike must have gone through in those moments. I wish the Hermanstorfer family a happy, healthy and uneventful new year.

While the story of a Christmas miracle such as this warms one’s heart, many people, myself included, thought there must be more to the story than the media was reporting. Dr. Stephanie Martin, the doctor who responded to the Code Blue and performed the emergency c-section, said she cannot explain the mother’s cardiac arrest or the recovery. “We did a thorough evaluation and can’t find anything that explains why this happened,” she said. In the video linked above Diane Sawyer says, “To Tracy’s doctors, the events are still a complete mystery.” A complete mystery? Really?

If you watch the ABC News interview (below) with Tracy and Mike Hermanstorfer and Dr. Stephanie Martin it looks like the “mystery” may have been solved after all and there could be a very valid explanation for why Tracy went into cardiac arrest – the epidural. Cardiac arrest is a very rare, but very real possible complication of epidurals.

Tracy was pregnant with her third child and had given birth to the previous two without an epidural. However, after her membranes ruptured (water broke), she went to Memorial Hospital in Colorado Springs and was given pitocin to speed up her labor. She found the contractions were “a lot harder” than she remembered so she opted for the epidural. It was not long after she received the epidural that Mike noticed Tracy’s hand was cold, her fingertips were blue and a nurse noticed the color in Tracy’s face was completely gone.

Henci Goer, “an acknowledged expert on evidence-based maternity care” and blogger at Science and Sensibility, transcribed the relevant parts of the ABC interview.

ABC: Code Blue was declared, a scary thing in any hospital. [Dr. Martin arrives in response.]

Dr. Martin: . . . When I ran into the room, the anesthesiologist had already started breathing for Tracy. There were preparations already being made to start a resuscitation should her heart stop. About 35 to 40 seconds after I got in the room, her heart did stop and we started making preparations to do an emergency cesarean delivery right there in the room in the event that we were not successful in bringing Tracy back. Unfortunately, in most of these situations, despite the best efforts of the team, Mom is often not able to be revived, so we anticipated that possibility and when it became clear that Tracy was not responding to all the work that the team was doing on her, we had to make that difficult decision to do the cesarean section, primarily in an effort to give Coltyn the best chance at a normal survival and also hoping that it would allow us to do a more effective resuscitation on Tracy, and fortunately, she cooperated and we got a heartbeat back immediately after delivering Coltyn.

Henci explains her assessment of the situation:

So, according to Dr. Martin, Tracy is an example of how things can go suddenly and horribly wrong for no discernible reason in a healthy woman having a normal labor. All I can say is that Dr. Martin must have slept through the class on epidural complications. Tracy’s story is the classic sequence that follows what anesthesiologists term an “unexpectedly high blockade,” meaning the anesthesiologist injected the epidural anesthetic into the wrong space and it migrated upward, paralyzing breathing muscles and in some cases, stopping the heart. High blockade happens rarely… It does happen, though, and I am willing to bet that high blockade and its sequelae happened to Tracy.

The moral of the print version would be: have your baby in a hospital where you can be saved should this happen to you. The video interview, however, reveals a different picture. The real moral of the tale is that the safest and healthiest births will be achieved by avoiding medical intervention whenever possible.

Danielle from Momotics asks, “Why was there a need for pitocin? Because no one wants to be sitting around waiting to deliver a baby on Christmas eve?” She also wants to know why the possible correlation between the epidural and the cardiac arrest isn’t being talked about in the media. “Why is the mainstream media not reporting these things? Mass hysteria? Loss of money for the pharmaceutical companies that make pitocin and these anesthesia drugs?”

Jasmine who writes for The Examiner offered up her own take on the situation:

Knowing the side effects of both pitocin and the epidural, Hermanstorfer’s history of having unmedicated births, she probably experienced a dropped heartrate from the pitocin which may have caused her cardiac arrest upon administering the epidural. We all like the story of hearing “miracles” and they do happen, however, we have to know a little more about modern medicine and the side effects and dangers of modern drugs.

Nicole from It’s Your Birth Right speculates a few possibilities of what may have gone wrong. She admits that there is no way for her to say for sure what happened in Tracy’s case, but she wants people to know that having an epidural does carry risks.:

I just want it to be clear that Epidurals can indeed cause cardiac problems and can also stop a woman’s breathing immediately after administration. Does it always happen? NO. Does it usually happen? NO. Can it happen? YES. And did the media completely ignore the possibility of the epidural having anything to do with the cardiac arrest? YES.

Nicole adds:

Often when I tell people I don’t want an epidural they don’t understand why. THIS is why. The risks in my humble opinion are high for a procedure that is considered elective.

Often when I tell people epidurals carry risks that are not discussed with women resulting in misinformed consent for a procedure they know little about, I am considered an extremist. PLEASE if you want an epidural, that’s your choice but get INFORMED!!!

Here are the reported side effects of epidurals on both mother and baby.

Conspiracy theories aside, I think one of the reasons the possible cause of Tracy’s cardiac arrest wasn’t reported by the media is because it diminishes the feel-good Christmas miracle aspect of it. I think the media sensationalized the story to draw as much attention to it as possible. They succeeded.

The truth is we may never know what caused Tracy Hermanstorfer’s heart to stop beating, but it seems likely that the sequence of events – pitocin, epidural, lying on her back (which can cause “problems with backaches, breathing, digestive system, hemorrhoids, low blood pressure and decrease in circulation to your heart and your baby. This is a result of your abdomen resting on your intestines and major blood vessels (the aorta and vena cava).”) may have had something to do with it. While this story had a very happy ending, most like it do not. What can we learn from this? Educate yourself, learn about the risks of common interventions, and hire a doula.

Once again, I wish Tracy and Mike Hermanstorfer and their family all the best. :)

Cross-posted on BlogHer

Joy Szabo Travels 350 Miles for Vaginal Birth

Joy Szabo recently drew nationwide attention when she refused to have a repeat cesarean section at her local Page, Arizona, hospital. Instead, Joy and her husband Jeff decided that Joy (alone) would move 350 miles from home to Phoenix where they could, according to CNN, get “the birth they wanted” – a vaginal birth after cesarean (VBAC). Many are calling Joy’s vaginal birth a victory, but Jenn at Knitted in the Womb acknowledges that while on one level getting the VBAC is a victory, on a larger scale she wonders was it really a victory?

Photo courtesy CNN
Photo courtesy CNN

Here’s a little history. While seven months pregnant with her fourth child, Joy Szabo was told by her local hospital that she would be required to have a repeat cesarean section rather than allow her to have the birth she wanted, a VBAC. It didn’t matter that she had already had one VBAC at this hospital, the policy had changed and VBACs were no longer permitted there.

VBACs carry a less-than-1-percent increased risk of a uterine rupture, which could cause brain damage in the baby or even death, according to the American College of Obstetrics and Gynecologists.”

According to CNN:

After their discussion with their doctor, the Szabos made an appointment to speak with Page Hospital’s CEO, Sandy Haryasz. When the couple told her about their desire for a vaginal birth, they say Haryasz would not budge, even telling them she would get a court order if necessary to ensure Joy delivered via C-section.

The Szabos thought that seemed extreme and rather than succumb to the hospital’s new policy, a few weeks before her due date Joy moved into a Phoenix apartment 350 miles away from her husband and three children while she waited to go into labor. At the Phoenix hospital Joy gave birth to her fourth son Marcus Anthony in an “uncomplicated vaginal delivery.”

Emily from Laundry and Lullabies said, “Joy, you’re an inspiration. Thank you for standing up for yourself, for bringing attention to the state of maternity care in America, and for making it just a bit easier for other women to follow your example.”

Danielle who blogs at Birth, Babies & Everything In Between believes VBAC is much safer for healthy, low risk women than elective repeat cesareans. She likes to use the example of Michelle Duggar to demonstrate the safety of VBAC. Michelle has had four c-sections and 13 VBACs and recommends the organization International Cesarean Awareness Network (ICAN) for those wishing to gain information about VBAC.

On the Duggar’s website, Michelle describes how things have changed from her first pregnancy to her 18th.

I would say the greatest change that I have seen in the field of obstetrics, and I might add that it is very troubling to me, is the idea that once you’ve had a C-section you must have a C-section for any other pregnancy. It is much healthier for mom and baby to avoid major surgery and all the complications that go along with a C-section if possible. Granted, there are health situations that would warrant such, but for years obstetrics encouraged TOL (Trial Of Labor after previous C-section) with many successful healthy vaginal births. It was quite alarming to be told that I could no longer have a vaginal birth due to hospital or insurance companies regulations. It appears that what is best for the patient is not the priority with this decision. I feel our health care is being jeopardized by this unhealthy approach. Doctors are having to tell their patients that they no longer offer VBAC assistance due to hospital regulations and some might even state to the patient that they are not safe so as to avoid confrontation. Statistics prove much differently. For the many women that find themselves in this situation, ICAN is an organization that is very helpful in gaining more information on this topic.

Jenn at Knitted in the Womb, who I mentioned above and questions the “victory” aspect, says:

I am glad that Joy got a vaginal birth, and on that level the birth was a victory. But on the larger scale level…the extreme hoops she had to go through make it less than that. The “victory” that I see missing is an acknowledgment by the Page Hospital administration that A) VBAC is safe and B) even if they disagree with “A,” they have no right to force a person to have surgery. For a woman who does not have the financial means to do what Joy did – move away from her home for over a month – surgery is still a forced situation.

…this could easily be used by hospital administrators as “precedent.” “You want a VBAC? So sorry, we don’t offer that here. Do what Ms. Szabo did, go move to be near ‘hospital X.’”

I agree with Jenn in that the CNN article headline, “Mom fights, gets the delivery she wants” is misleading. When I first read it, I expected that Joy Szabo had fought the Page hospital and had her VBAC there. I wasn’t expecting that she had to move six hours from her home, leaving her children and husband, to get a VBAC at another hospital.

Yes, the fact that she got a vaginal birth is a victory, but this story also shows that birth advocates still have a lot of work ahead of them. As more hospitals ban VBACs, there will be more and more cases of women who are forced to make difficult choices.

The fact that this situation got the national attention that it did, that CNN covered it and posted “some tips for what to ask your doctor (or midwife) in the delivery room if the suggestion is made that it’s time to give up on a vaginal birth and head to the operating room” is a step in the right direction. It might not be the big victory that many of us are hoping for, but it’s a small victory and that counts too.

Related posts:

Cross-posted on BlogHer.

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Birth plan? Doula? Natural birth? Not here you don’t.

A sign posted at the Aspen OB/GYN Women’s Center in Provo, Utah has many women up in arms. What’s so offensive? Read for yourself.

The sign reads as follows:

Because the Physicians at Aspen Women’s Center care about the quality of their patient’s deliveries and are very concerned about the welfare and health of your unborn child, we will not participate in a “Birth Contract”, a Doulah Assisted, or a Bradley Method delivery. For those patients who are interested in such methods, please notify the nurse so we may arrange transfer of your care.

I first learned of this sign from Naomi, the Denver Doula, who posted it on Facebook. Being a doula (which is misspelled on the sign) herself, she took a particular interest in it. When she called the Center and inquired with the receptionist as to why the sign was posted she was told, “in case there is an emergency we don’t want anyone to get in the way of the doctor doing what he has to do.”

Annie from PhD in Parenting was inspired by the sign to write How Not To Have a Natural Birth and believes the center might as well have said:

Because Physicians at Aspen Women’s Center care only about doing things their own way and making as much money as possible from unnecessary birth interventions, even if it poses greater risks to the welfare and health your baby, we will not participate in a “Birth Contract”, a doula-assisted, or a Bradley Method delivery. For all patients who have done any research into having the safest birth possible, please notify the nurse so that we can transfer you to a facility that cares less about control and money.

Annie added, “I guess we can at least credit them with warning women in advance. Many hospitals with the same attitude don’t have a sign hanging out front.”

Amber responded, “I always thought the big ‘trust birth’ poster in my midwives office was a little cheesy. Now that I’ve seen the alternative, I think it’s truly marvelous. Really.”

Miriam Zoila Pérez of Radical Doula wrote a post called Signs You Don’t Want to See at Your OB-GYN’s Office. She believes the sign could be translated to say:

We don’t care at all what you want as a parent, or a person in labor. We want a patient who will sit quiet and do what we say–no matter what. Oh and if you have a partner you want involved, tough. Your desires don’t matter.

Miriam adds, “They should change the name of the center to the ‘Unborn Children Center’ since they don’t seem to care too much about the women involved.”

A commenter named Janna responded saying, “That’s what bothered me most about this hateful little sign–not once is the “welfare and health” of the MOTHER mentioned, just the “welfare and health” of the “unborn child” and the “quality” of the “deliveries.” Who would want to give birth in a place where they’re the lowest priority on their caregiver’s list? I hope women in this area have other options and the opportunity to have safe, healthy, supportive births.”

Does no doula, Bradley Method birth or birth “contract” equal no women’s rights?

Summer who writes at Wired for Noise says signs like this one and stories like the lack of choice with regard to our reproductive health and doctors’ personal “birth plans” make her sometimes think Doctors Hate Women.

What does it say when women have to escape, have to run away in order to do something as normal as give birth? What does it say when women are treated like children, talked down to, insulted, lied to, and handed letters telling them what the god-head doctor will allow or not allow. When all you want to do is give birth and you’re doctor is more concerned with telling you to sit down and shut up, what is that if not hatred?

I have to agree with Annie that at least some doctors are upfront with what they will and won’t “allow” as part of their practice. Kudos to them for being honest. Hopefully that will allow women to look for another care provider while she’s still early in her pregnancy.

Rest assured if the OB/GYN I had at my daughter’s birth would have given me a piece of paper with her “rules” or had a sign posted like that at the Aspen Women’s Clinic, I would have found another care provider pronto. Instead, however, she paid me lip service and acted like she cared about my birth plan (though she didn’t act very well and that should have been a big clue for me) and said we could “try” Hypnobirthing, etc. However, when push came to shove (no pun intended), it was her way or the highway. I had my healthy baby girl at the end of it and for that I am truly thankful, but I also got a lot more than I bargained for (and not in a good way). Then again it was that experience lead me to pursue a home birth for my second child and become a home birth advocate.

Although I admire the Aspen Women’s Center’s honesty, I find it truly offensive that they imply that if a woman wants a doula, natural birth, or has a birth plan, she is not concerned with the welfare and health of her baby (so much more personal than “unborn child” don’t you think?) or is even putting her baby’s life at risk. Studies have shown that when doulas attend birth, labors are shorter with fewer complications, babies are healthier and they breastfeed more easily. And how exactly is choosing a Bradley birth not good for the health or welfare of the baby? “Bradley® classes teach families how to have natural births. The techniques are simple and effective. They are based on information about how the human body works during labor. Couples are taught how they can work with their bodies to reduce pain and make their labors more efficient.” What about a birth plan or “contract?” Is that harmful to the “unborn child?” The American Pregnancy Association suggests, “Creating a birth plan can help you have a more positive birth experience.”

There are other things I find offensive as well, like Janna mentioned above, the mother does not seem to be included in the equation at all. Is there any concern for her “welfare and health?”

Who’s time money welfare are they really concerned with? I’ll let you draw your own conclusions. I’ve obviously already drawn mine.

Cross-posted on BlogHer.

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Babies come out of where?! Explaining childbirth to kids

I was due to give birth to my son when my daughter Ava was 2 1/2 years old. Since my husband and I were planning a home birth, we felt it was important to discuss with Ava how the baby would be born. Because she would be within earshot if not in the room when Julian was born, I wanted her to know what she may see as well as hear.

One of the ways I prepared Ava for what would happen was by reading “Welcome With Love,” a beautiful children’s book about natural childbirth. We also watched some childbirth videos (natural and water births) together, including “Giving Birth: Challenges and Choices” by Suzanne Arms. I made sure to explain what was going on and reassure her that although the mommy might make some loud or funny noises, even yell, she was OK. In “Welcome With Love,” the older brother speaks of his mother’s noises during labor but he’s not afraid because she had told him beforehand that although she “might make a lot of noise,” he mustn’t worry because “that’s what it’s like when babies are being born” and that she’ll feel better if she yells and screams.

I kept things fairly simple, but because she was likely going to be present, told her what I felt she needed to know to feel safe and secure during Julian’s birth. It worked well for us. Ava was never scared even though mommy made some very loud noises while giving birth to her brother.

I realized the other day that Julian is now older than Ava was at the time he was born, but because I am not pregnant (and have no plans to become so) and the subject hasn’t come up, he has no idea how babies are born. I will probably remedy that soon by reading Welcome With Love to him and another book I recently received to review called We’re Having a Homebirth!

A friend (who is expecting) recently pondered on Facebook how she will explain childbirth to her 5- and 3-year-old daughters, and I began to wonder how others handle the subject.

I came across a discussion on a BabyCenter message board where the original poster posed the question How do you explain childbirth to a child? Here are some of the responses:

  • One person admitted that she has been “skirting around this issue” even with her 9-year-old. She said she has told her most of the details, but doesn’t “want to freak her out too much or gross her out for that matter.”
  • Another said, “I tried to skirt the question by answering…that the doctor takes the baby out.”
  • Another said, “I have a child psychology book called The Magic Years. They say to be truthful, but give as few details as necessary.”
  • Yet another said, “I found it was quite easy to explain things using the correct words at a young age. And I’d rather explain it while my kids aren’t embarrassed by it and will ask questions instead of having a 10-year-old blush or roll her eyes and not wanting to ask questions about things she doesn’t understand.”
  • From another, “better he hears it from me than his peers at school.”

After I browsed the ‘net, I asked my favorite audience (Twitter) and got some more answers.

Many feel that honesty is the best policy.

@OneFallDay said: If my 7-year-old asks, I answer. I’ve always felt if they are old enough to ask they deserve an honest answer.

Jackie from Belen Echandia said, “[I] don’t have personal experience. But would like to think I’d tell the truth in a beautiful, non-frightening way.”

Penny from Walking Upside Down said, “[I] told mine they came out of a hole between my legs. :) Honesty is the best policy. Did not show them said hole tho’. ;)”

Jessica from Peek a blog said, “I spoke to the doctor about what to say. We told my 3-year-old that mommies have a special place where babies come out when ready. Just enough info with more details on an as-needed basis, but totally truth.”

Cate Nelson said, “I told my then-2.5-year-old that baby was going to come out of Mama’s yoni. (our term for it) I also told him his own birth story, bit of the pain, but how it helped Mama push him out. He loved his (natural) birth story!”

Others think along with being honest, it’s important to use proper terminology with children.

@ColletteAM said, “I always tell the truth about bodily functions and use proper terms. I don’t want my kids to feel ashamed of their bodies.”

Mandie from McMama’s Musings said, “My 4-year-old can tell you about ovaries, eggs, sperm, uteri, birth canals, and c-sections. He calls egg+sperm a ‘seed.’ LOL”

@JenniferCanada said, “I got great advice from @babyREADY to prepare son [for] our home birth. We watched a lot of birthing shows. We talked about what would happen. He can tell you babies come from vaginas and you push them out. He has actions. He is 3 years old.”

Others prefer a more vague approach:

Lee from CoupleDumb said her son was 3 and “I told him that his brother would come out of me when I went to the hospital. That’s it.”

Kristie from Tilvee said she was asked how babies come out last night by her 6- and 3.5-year-old daughters. She “didn’t lie, just told them we would talk about it in 5 yrs?!”

One person thinks explaining a c-section is easier than explaining vaginal birth:

Beth from I Should Be Folding Laundry said, “I’m up for a c-section, so that makes the explanation very easy.”

Another thinks a c-section makes it more complicated:

@Loudmouthedmom said, “I haven’t been pregnant again but have always been honest with son, either vaginally or c-section. He took c-section much harder. Learned the hard way not to tell a 4-year-old a c-section involves mom being ‘cut open.'”

The reactions kids have about childbirth are often amusing:

Kailani from An Island Life said, “My 3-year-old thinks the baby will come out of my mouth. :-)”

Krista from Typical Ramblings, Atypical Nonsense said, “When I was pregnant with E, my older kids were 11 and 8 when he was born. I told them how the baby came out. My daughter asked if it hurt, I said yes but once it’s over the pain is gone. She says she is adopting kids. ;)”

Ann-Marie from This Mama Cooks said, “[I] told Nathan how babies got out when he was 7. He told me he wasn’t having kids. Truth is good birth control.”

Childbirth education props: Dolls and Children’s Books

If you are looking for some props to help you explain childbirth, you might be interested in these dolls. Thanks to Kellie, I learned about this childbirth education doll that can be custom ordered or the experience crocheter can make it herself. There’s also a Waldorf doll that gives birth and nurses. According to Droolicious, instead of just sitting there looking pretty, this doll “gives birth complete with placenta, and she nurses too. This Waldorfian handmade plush doll comes from Brazil where it is used to teach girls about natural childbirth.”

There are also lots of books that tackle the topic of explaining childbirth to kids. From books about home birth like Welcome With Love and We’re Having a Homebirth! to more mainstream childbirth books like What to Expect When Mommy’s Having a Baby, How You Were Born, and How Was I Born?: A Child’s Journey Through the Miracle of Birth, there is likely a book out there for your family. And for parents who are looking for some age-appropriate information about “the birds and the bees” check out It’s Not the Stork: A Book About Girls, Boys, Babies, Bodies, Families and Friends and a review of it over on Punnybop.

There’s more information on how to prepare siblings for the birth of a new baby over on babyReady where they suggest: make a game out of the kinds of strange noises that you may make when you are in labour, try not to make too many changes to your child’s routine close to the delivery, let your older child open the baby’s gifts, and take your older child to your doctor (or midwife) visits, and more.

Ultimately your childbirth explanation to your child has to be one that you feel comfortable with. I think it is important to answer children’s questions – about childbirth, puberty, dating, sex, etc. – as honestly as possible while making sure it is age-appropriate. Mactavish said to me on Twitter, “I can’t imagine not being old enough to know how babies are born” and I have to agree. Candace concurs, “I generally assume that if she’s too young, she won’t ‘get it’ anyway and if she ‘gets it’ then she’s old enough for truth.” Sounds like a good philosophy to me.

Cross-posted on: BlogHer

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One year later – Julian’s (footling breech) home birth story

NaBloPoMo – Day 28

It’s been just over a year since my baby boy made his amazing entrance into the world, and yet, I never posted his birth story on my blog. So here it is one year later – in it’s full, unedited (LONG) glory (altered only to change the midwives’ names to first initial) – for your reading pleasure. :) I think you birth junkies out there will especially enjoy it. :)

Julian - 1 1/2 hours old - 11/23/06

Julian Emerson’s birth story

Recorded on Nov. 29 and Dec. 11, 2006

My labor began around 1:30 a.m. Thursday, Nov. 23, 2006, (41 weeks to the day) when I woke up to a real contraction, not the typical toning contractions I’d been having for the past several months. This was the night after I went in for some serious acupuncture (with electronic stimulation) at the acupuncture college to bring on labor. I was excited when I had another and yet another contraction and it started to sink in that I was in early labor.

I mentioned that I thought I was in early labor to Jody when he came to bed around 2 a.m. He got me my HypnoBirthing Rainbow Relaxation c.d. sometime during the night and I listened to it with my headphones on to help me stay focused and relaxed. I went through most of the night sleeping in between contractions. When I did have one, I breathed through it and reflected on something I’d read on a message board. One mama said that each time she had a contraction, she thought of her body giving the baby a big hug. That thought made me smile when I read it and so I focused on all the hugs my body was giving my baby for the last time while he was in utero.

I woke up a bit before 9 a.m. on Thanksgiving Day (Nov. 23). Jody and Ava were still sleeping. I continued to have contractions though they weren’t really regularly spaced. I decided to go have some breakfast and watch TV. I had some yogurt, peanut butter toast and Pregnancy Tea and watched a bit of the Macy’s Thanksgiving Parade while I breathed through contractions. I found the TV to be a bit distracting so I turned it off and mostly lay on the couch. When I got up and moved around, my contractions picked up, but while I laid on the couch, they slowed down a bit. I was feeling pretty tired so I decided that hanging out on the couch was a good thing for now, to save up my energy for when I really needed it.

I called K, my midwife, around 10 a.m. and told her that I was in labor and what was going on with me. She said to check in every few hours – like around 1 p.m. – and let her know how I was doing. She also said she would probably come by to check on me later in the day and take my blood pressure and draw my blood so she could make sure that all was going well with me and there were no signs of HELLP syndrome (which I developed when in labor with Ava). In the meantime, she said I should go eat a big breakfast.

Jody came downstairs (and Ava soon after) and made eggs, turkey bacon and toast. I didn’t feel much like eating, but it tasted good and I slowly ate it all.

After breakfast and watching some of the parade on TV with Ava, I was still feeling really tired, so I decided to go back up to the bedroom and take a nap. That was around noon.

Before I went to sleep, I briefly talked to my sister Carrie on the phone and told her I was in early labor, but I had no idea if the baby would be born that day or when. I just wanted to give her a heads-up since she was planning on being here during the labor (once we needed her) and birth to watch Ava.

Again, I slept between contractions while I napped, but somewhere in that hour or so that I lay in bed, my contractions shifted significantly. They started to get very intense and I had to start vocalizing (or moaning) to get through them. I called out to Jody and told him that things were getting really intense and right around then the phone rang and Jody answered it. It was K (midwife) saying she was on her way by to see how things were going with me. Jody mentioned that it was good she was coming because I had just said that things were getting intense. (I later figured out that I must have been in “transition” during that time.)

I don’t recall if I asked Jody to apply counter-pressure to my back around that time or if he just instinctively did it, but it helped a lot to relieve the back labor I was experiencing.

K arrived around 1:10 p.m. She took my blood pressure, which was normal. (She never got a chance to draw my blood, but it turned out not to matter.) Then I had another contraction which I vocalized through and told her that it really hurt. She wanted to check me then to see how dilated I was. I was thinking that I hoped I was at least 5 cm dilated so that I could get into the birthing pool (which hadn’t been set up yet) or this was going to be a very, very long labor. I can’t remember if she said I was fully dilated when she checked me (though she later told me that I was complete), but she commented that the head was still really high. She felt around a bit more and then excused herself. (I found out later that that was when she discovered what she was feeling was limbs and that the baby was now breech. She excused herself so she could call A, the assisting midwife, and tell her to get to my house ASAP.)

K came back in the room and whispered to Jody that she had felt feet while she was checking my dilation. He didn’t quite realize what that meant at the time. At some point he said something aloud about the baby’s feet, which I heard and replied “feet??” (although I don’t remember this). And K said yes, the baby is breech, which I remember. I didn’t have any weird reaction to this news. I thought I remembered reading stories of babies being born vaginally in the breech position in “Ina May’s Guide to Childbirth,” so I knew it could be done. I wasn’t fearful at all. It was all just very matter of fact in my mind – the baby is breech and I’m going to have to get him out.

Somewhere in there, Jody called Carrie (three times) to come to the house. The last time he talked to her, she said she would be here in 20 minutes, but Jody said at the rate things were going that might be too late. So in the meantime, Ava hung out with me, K and Jody in the bedroom. She never seemed scared or worried for me and I think it helped a LOT that we had watched birth videos and read the “Welcome With Love” book (about a home birth) many times in preparation for the birth. In the book they mention that sometimes moms have to yell and scream and make a lot of noise when babies are born and I am thankful that it said that since I ended up making a LOT of noise myself – something I didn’t expect because I never got vocal while giving birth to Ava. At one point, K asked Ava if she could go downstairs and get her purse for her. Ava did it without missing a beat. She was a great helper.

Anyway, I think it was after K left the room to call A that I felt the first urge to push. It was a completely involuntary urge and I yelled out, “I need to push!” I remember K yelling back to go with whatever my body was telling me to do. I think it was on the next contraction or the one after that that my water broke, all over the bed. I had not planned on giving birth in bed, and because things had progressed so quickly at the end, we hadn’t even put a waterproof cover down. I remember thinking, “Oh no! I’m soaking our new mattress!” (Our mattress was only six months old. Thankfully, it cleaned up and dried out nicely.)

The baby’s feet were born first without too much pushing on my part. Jody left the room during that time and I yelled to K, “Where is he going?!” furious because he was no longer applying counter-pressure to my back. She said, “He’s getting the camera.” And I yelled, “I don’t care about pictures!” He did snap a few of the baby’s feet coming out, but only one turned out because K’s hand was in the way of the others.

Jody called the professional photographer we hired to photograph the birth around the time I started pushing, but got her voicemail. By the time she called back, the baby had been born. (We opted to have her take family pictures a few weeks later instead.)

Carrie arrived after his feet were born and took Ava downstairs since things were very intense in the bedroom.

After his feet and legs came out, K said I needed to move to the end of the bed, so that gravity would be on our side. I said, “No” emphatically, not wanting to move a muscle. K said I *had* to move, so she and Jody picked me up and scooted me to the foot of the bed. She then told Jody that we needed to get into a supported squat position, so he held me under my arms while I began to bear down with everything I had.

I started out pushing with contractions, but it didn’t take long for K to say she wanted me to push whether I was having a contraction or not. I’ve heard enough birth stories to know this meant that I needed to get the baby out ASAP, so I pushed and pushed, taking breaks just long enough to catch my breath.

While his body was being born, A (the assisting midwife) arrived.

I don’t remember birthing him as being painful per se, but it was really, really intense work. I vocalized through every push and couldn’t imagine doing it without making noise. I think I opened my eyes once and then closed them again so I could focus on pushing. I also remember moving my right hand to the top of my belly. It helped me feel more connected with the baby and the job we both were working on.

Once his body was born (but his head still inside me), at K’s urging I pushed with everything I had to get his head to come out. I remember wondering if I was pushing enough or if I would be able to do it, but his head emerged with one really hard push.

Minutes after Julian’s breech home birth - 11/23/06Mommy and daddy look at Julian - 11/23/06Our son, Julian Emerson, fully entered the world at 2:14 p.m. Thursday, Nov. 23, 2006, after about 13 hours of labor, only one of which was really intense, and about 45 minutes of pushing. It was approximately 1 hour after K had arrived to our house.

It turned out that Julian’s umbilical cord was wrapped around his neck three times. It is for that reason, my midwife and I believe, that he ended up turning into a breech position in the days or hours before he was born. It was as if he “knew” he couldn’t safely be born head-down with the cord as it was, so he flipped to a safer position – in an act of self-preservation.

Also, I later learned that his right arm was tucked back behind his head and K had to reach inside me and pull it down so that he could be born without damaging it or getting stuck. She also reached in while his feet were being born to make sure they both came out together and one didn’t get wedged in.

Jody and Ava cut Julian’s umbilical cord - 11/23/06Julian scored a measly 3 on his first Apgar, then an 8 on the second one done 5 minutes later. A gave him a few puffs of air mouth-to-mouth to help get him breathing, while they encouraged us to talk to our baby. It didn’t take long for him to start breathing, and in the meantime, he was still getting oxygen from the umbilical cord that was left attached to the placenta until it stopped pulsing. Jody and Ava cut the umbilical cord together a little over an hour after he was born.

Julian weighed in at 9 lbs., 8 oz., was 22 inches long, and had a 15 inch head. What a big boy!

After the intensity of that birth and such a large baby, I ended up with only a first-degree tear, requiring four stitches. Not bad at all.

Amy and Julian after breech home birth - 11/23/06Giving birth to a baby in the breech position felt so different from birthing a head-down baby (as Ava was). With Ava, once her head was out, it felt like the rest of her just slid right out. With Julian, I felt like I had to work for every ounce of him to be born – saving the hardest part – his head – for last.

It was an amazing, incredible and very intense experience, but, if you ask me, it could not have turned out more perfectly. We have so much to be thankful for. We have a healthy baby boy and I had a great home birth with our amazing midwife. It is a Thanksgiving Day our family will never forget!


Related Post:
How we made the decision to have a home birth in the first place: Planning for a home birth

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