Sam asked if I should try to breastfeed her, in my excitement I had not given
this any thought. I was wearing a bikini top, and pulled down the strap on one
side to see if she would latch on. She was not yet too interested, so after a
few minutes we gave up and continued to enjoy our time with our daughter. K.
snapped some wonderful pictures during this period, and every time the flash
went off she wrinkled her little forehead and closed her eyes tightly shut,
resenting the intrusion of bright light after spending such a long time in the
dark cocoon of my womb.
After 10 minutes or so I began to feel the onset of another contraction. It took
me by surprise for a moment before I remembered that I still had to deliver the
placenta. I hadn’t expected these contractions to be as painful, but they still
required my attention to breath through them, they felt very similar to the
contractions of early labour. We checked the umbilical cord, which was still
pulsing quite strongly. Unlike in a hospital birth, most midwives do not
immediately cut the cord on delivery, preferring instead to allow the baby to
receive the last of the placental blood. Once the pulsing of the cord has slowed
or stopped, the baby is no longer receiving benefit from the placenta and the
cord it cut. I continued to experience a contraction every few minutes and would
just zone out and breath through them. Twenty minutes after her birth I reached
down and noticed that the placenta was already partially outside of my body. I
told P. what was happening and waited for her instruction. She told me that she
did not want me to deliver the placenta in the pool, because water could rush
back inside me. She instructed to hold the placenta inside of me until I was out
of the pool. The cord was still pulsing slightly, but I at this point I was more
than ready to get out of the pool.
We uncovered Isabella, who screamed aloud with displeasure at this unwelcome
invasion. With instruction from the midwives, Sam cut the cord, severing the
last physical connection between my daughter and myself. I looked at her and
told her that she was now her own little person. She was separated from me
physically but an emotional bond had already formed which could never be broken.
P. took Isabella, who was still making small noises of protest at the
disturbance, and dried her off. She was swaddled tightly in clean, dry towels to
keep her warm, and then handed her to her daddy for the first time. Sam took her
like a pro, handling her gently and with such tenderness it brought new tears to
my eyes. It was such a beautiful sight and I could see that he was already
completely in love with her perfect little girl.
After Isabella was safely nestled in her father’s arms, the ladies came to help
me out of the pool. R. and P. got behind me to help lift me up. I felt very
ungainly and the very antithesis of ladylike as I slowly struggled to an upright
position. As soon as I stood up the placenta fell out of me and landed in the
pool with a big splash. I was pleasantly surprised that the third stage of
labour had been so easy! Even though I had two women supporting me I felt
extremely weak and dizzy, and they quickly brought me over to lie down on the
bed. It was such a wonderful feeling, after so many hours of physical and mental
exertion to sink into my soft, comfortable, familiar bed with my husband and
daughter lying right next to me.
Unfortunately my relief was short lived, just moments after I reached the bed I
realized that something was wrong. I heard P. say “K., get me the pitocin.
Fast!” From my research I knew that pitocin (the synthetic version of the
hormone oxytocin, which stimulates uterine contractions) was administered after
birth in the event of a post partum hemorrhage. The pitocin stimulates the
uterus to contract harder, expelling the placenta and closing off the blood
vessels at the site of placental attachment. Everyone was very calm, but moved
quickly and with a sense of urgency. We normally associate blood with pain, but
I was bleeding profusely, at a rate that required drug intervention to
counteract, and I could not feel a thing. It was a strange, almost surreal
experience. Within moments P. was injecting the pitocin into my thigh, with an
apology for the pain. My leg burned at the injection site at the drug made its
way into my muscles. She had me visualize the capillaries at the site of
attachment closing off and the blood flow stopping. I asked if the blood loss
was serious and P. replied that it was not, but that she was taking action now
in order to prevent a dangerous situation from occurring. She explained further
that sometimes the placenta separates slowly and blood pools within the uterus,
so that it is unable to contract down correctly. Following the injection my
bleeding quickly slowed to normal levels and the room once more regained an aura
of calmness and peace.
P. continued to perform external massage of my abdomen in order to ascertain the
position, size and firmness of my uterus, and to help it continue to contract.
The massage was uncomfortable but not painful. P. then examined me while Sam
held Isabella, comforting her and telling her softly that her Mama was busy, but
would be with her again soon. I looked over at them to see that Bella had found
her thumb and started sucking away, her small fingers splayed across her cheek,
she must have been practicing for several months! Following the exam P. gave me
great news. I had no perineal tears, just two small internal "skid marks". No
stitches were necessary; although she told me I could still expect some
discomfort. Sam and I had faithfully (if without enjoyment) performed perineal
massage during my last trimester. I credit this, as well as the fact that I gave
birth in the water with preventing me from tearing, even though her head was
above average in size. P. also gave me a great complement and told me I stayed
very in tune with my body and listened to my instincts about when and how to
push. I brought my daughter into the world with very slow and controlled pushes;
this helped me to stretch to accommodate her so that I did not tear during
delivery. I was very swollen and sore, and unfortunately had developed one of
the things I had hoped to escape, hemorrhoids! I feared that my body would never
be quite the same again.
For some time the three of us lay on the bed and spent some quiet time together.
I held Isabella and allowed her to lick and suckle at my breast, as P. told me
that this would signal my body to release it’s own oxytocin. She rooted around
but seemed not quite sure what she was supposed to do; it would end up taking
her a few days to figure out nursing. P. and K. took the placenta into the
bathroom to examine it. They explained that it is very important to make sure
the placenta was complete and that no pieces remain inside my uterus.
Fortunately, the placenta was complete, and appeared very healthy. Sam went into
the bathroom and they showed it to him, and explained the different parts and
how it had provided our daughter with blood and nutrients. I very much wanted to
see it, but due to the blood loss I was not permitted to get up from the bed.
The midwives then got busy straightening up the room, and would periodically
check to make sure we were both okay, checking my blood pressure and Isabella’s
heart rate and respiration. K. let Sam and I listen to her heart rate through
the stethoscope. As I lay there, her tiny, perfect hand closed tightly around my
finger for the first time, and I felt my heart squeeze and knew she had also
wrapped herself around my heart.
P. was concerned that I still had not emptied my bladder and helped me to sit up
on the bed to undertake a trip to the bathroom. I felt a gush of warmth on my
legs and said, “I think I am bleeding.” They immediately laid me down again and
gave me the pitocin for the second time. Unfortunately this time the pitocin did
not have the intended effect. Methergine tablets were crushed and put under my
tongue, and I was given a combination of herbs called Womb Stringe. While
pitocin strengthens uterine contractions, metherigine creates one long sustained
contraction and is given in serious cases. As we had discussed methergine and
its uses prior to my labour I knew that this was something to be worried about,
yet everything was handled so calmly that I don’t recall being afraid. I
expected the contractions from the drugs to become much more painful, but
fortunately they did not seem to change very much. K. put an oxygen mask on my
face and monitored my blood pressure to be sure it did not fall to dangerous
levels.
P. believed that my full bladder was contributing to the bleeding, as it was
pushing my uterus off to one side and interfering with the contractions. There
was also some question as to whether my septate uterus, which caused us so much
worry early in the pregnancy, could have affected the uterine contractions. The
septate itself would have a low musculature and might not be contracting hard
enough. P. inserted a catheter to empty my bladder, I was nervous about his, but
it only hurt for a moment. Apologizing frequently and profusely, P. then
undertook some very hard and extremely painful external abdominal massage. This
was probably the most painful thing I had endured during my entire labour. P.
was exerting a great deal of pressure and told me that I would be bruised
tomorrow. She later confessed that she had never massaged anyone that hard
before. The massage caused me to pass several very large blood clots that slid
from my body one after another, adding to the list of strange sensations I had
experienced that day.
After the passage of the clots the bleeding slowed again and after careful
monitoring it was clear that the crisis was over. If things had not resolved
themselves at this point P. let us know that we would be heading for the
hospital for further monitoring. I remained on the oxygen and my blood pressure
was monitored periodically over the next few hours to be sure that everything
was all right. Although I was very weak I felt fine, and was enjoying my time
with Sam and Isabella. Throughout this we were informed at every step of the way
what was happening, and the midwives were so calm and efficient that we were
able to remain calm as well. I remember feeling nervous, but perfectly confident
that P. knew exactly what needed to be done, and would care for me with the
highest of standards. Shortly afterwards I asked Sam if he had been afraid, he
replied that although there had been a lot of blood, he could see that everyone
was so professional and prepared that he felt calm and in good hands.
Once we were sure that everything was all right with me, K. and R. preformed
Isabella’s newborn exam. She is weighed 8 lbs, 8 oz and measured 23.25" long,
14.5" head circumference and 14 " chest circumference. They told us the average
length of a newborn was approximately 20 inches and the average head
circumference was approximately 13 inches. What a big girl! They checked her
heart rate and respiration and all her reflexes. She was given the Vitamin K
shot, which fortunately she did not seem to react to. We declined the
erythromycin eye ointment. As we were very sure I did not have any STDs, there
was no reason for her to be given antibiotic eye ointment that could irritate
her eyes and interfere with our first night of bonding.
Isabella was given a clean bill of health and was dressed in a onesie and socks
with a footed sleeper on top, along with a hat and a tightly swaddled blanket to
help her keep her warm during her first night in the big cold world. We all
laughed when Sam first returned from her nursery with clothes for her, he had no
idea what a sleeper was, and had brought back a 6 month size onesie for our tiny
little girl. Evidently Daddy needed just a bit of practice, and he got some very
soon as Bella required her very first diaper change. You would not know he had
never changed a diaper before; he was an expert father right from the start. The
midwives then left us alone for a little bit of private time to bond as a family
while they cleaned up and did the laundry, talk about service! After the
midwives left Sam and I were exhausted but unable to sleep. Isabella had fallen
asleep soundly in her bassinet by our bed, and we just sat and stared at this
beautiful little creature, sent from God to grace our lives. We were amazed and
humbled that we had been so blessed. In less than 24 hours we had experienced an
event so profound that we were forever changed. We found it hard to believe that
we had started the day as a couple and ended the day as a family of three. We
lay in bed together, curled side by side, whispering softly to one another as
Isabella continued to weave her spell around our hearts. We felt completed, more
in love than we ever had been and before we slept we gave thanks for the gift of
our beautiful daughter.
Part VIII: Epilogue
I entered my pregnancy aware that I wanted to seek out an experience that was
different from that which I had seen portrayed in the media. I instinctively
knew that this was not the way birth was meant to be. My labour and the birth of
my baby cemented my beliefs. All of my desires for Isabella’s birth were
fulfilled by the blessed event we experienced. We know that without a doubt that
all our future children will be born at home, in an atmosphere of peaceful,
trusting and joyful anticipation.
Sam and I would like to sincerely thank P., K., and R., for helping us achieve
our dream of a peaceful and beautiful entry into the world for our precious baby
girl. Your wisdom, support, strength and love are visible in everything you do -
thank you so much for being a part of our pregnancy and Isabella's birth. Our
homebirth experience was a dream come true, an empowering experience and a
wonderful way to begin our life together as a family.
Submitted by: Jeannette
February 2002
Heart and Hands : A Midwifes Guide to Pregnancy and Birth
by Elizabeth Davis
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Revised edition (December 1997)
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