Eclectic Muddlehood

How's this for a perplexing beginning? I am a great many things, but none of them are me. At least not in my entirety. This is the little corner where I attempt to make the whole greater than the sum of its parts as I muddle through being a wife, a mother and a woman... among other things.

Location: Virginia, United States

Here, in no particular order, is a short list of my parts from the mundane to the pretentious, some or all of which may surface in future attempts to work on the whole: wife, mother, doula, childbirth educator, writer, yoga student, homeschooler, amature organic gardner, kitchen witch, all-around foodie, spiritual truth-seeker, daughter, clutter-bug, complusive list maker, bibliophile, homemaker, friend, homebirth/natural birth advocate, impulse shopper, wine snob, knitter, artist, lover, sensuist, and email junkie (There may be more later, but that's it for now.)

Tuesday, September 05, 2006

The Birth Story Part 1: A Retrospective of Pregnancy

I was driving home from an incredibly difficult birth at one of the area's busiest hospitals early on November morning when I felt an overwhelming, swirling sense of energy in my womb, right about at my sacral chakra. I could see the energy dance and spin in my mind's eye, a brilliant orange. My doula client had labored for hours, endured many medical interventions and ended up with a disappointing surgical birth. I was driving home, frustrated by the experience and lost in thought. I was analyzing how I could've supported her better and whether there was anything else I could've done to improve her birth experience when this unbelievable sensation overtook my mind and body. I already knew I was pregnant for a few weeks by this point, but this moment will be with me for my entire life. I was in awe of the raw power and the amount of life force growing within me and I just knew the recurring dreams I was having must be true. I knew deep in my soul that not one, but two little lives were blossoming there in my womb. It would take my mind a few more months to catch up with what my spirit already knew.

My husband and I made the decision to have a homebirth for our second pregnancy while we were driving home from the hospital with our first baby. Even though we had a fairly good birth experience in the hospital, I still experienced medical intervention without my consent and we had several unpleasant run-ins with the nursery staff during our postpartum stay. On that drive home, we decided we would plan for a homebirth and avoid all of that on the next go around. We selected a direct-entry midwife for our second pregnancy who we thought would provide us the model of care we truly wanted this time.

During my fourth and fifth month, my body started to show me physical signs of our twins. At 17 weeks, my fundal height started to increase at an accelerated rate. By 20 week, I was measuring about one month ahead- like I was 6 months pregnant instead of only 5. Two weeks later, at a prenatal visit, our midwife could feel more than one baby when she palpated. And by 26 weeks, I looked like I was almost full-term. Already knowing what we would probably come to discover, I adjusted my diet around 17 weeks to facilitate growing two babies instead of just one. Using guidance from Dr. Tom Brewer and Dr. Barbara Luke's work, I increased my daily caloric intake to 3,500 and increased my protein intake to 175-200g a day. I read and researched the work of other homebirth midwives who all believed high-protein diets were key in preventing preterm labor and preeclampsia in multiple birth mothers. My pregnancy progressed well. The babies grew fabulously and at our one ultrasound at 26 weeks, their estimated weights were above the 50th percentile for single babies. It was a real challenge some days getting enough food in me. I used protein shakes and ate a staggering amount of red meat every day. My blood pressure remained healthy and I showed no signs of any preterm labor issues. So choking down the shakes and other assorted sources of protein was worth it. Every bite or sip was protecting my babies from weeks in the NICU and the possibility of life-long medical issues. Every bite was worth it, but sometimes every bite was loaded with stress and pressure too. As silly as it might sound, had I experienced preterm labor, I know I would have blamed myself for not eating one more bite of that pork chop or drinking one more sip of that protein shake.

Having the ultrasound did wonders for my confidence. When I first became pregnant, I told my primary midwife I had no need for an ultrasound unless she felt it was truly medically indicated. Then my body revealed the twins and I began to think about those words: "medically indicated." Was a twin pregnancy automatically a medical indication for an ultrasound? My secondary midwife said she though it was great when women were so empowered to trust their bodies that they didn't need technology to tell them everything was fine. Listening to her words, I wanted very much to be one of those women. But I am also a researcher by nature and as I learned more and more about the differences in risk between dizygotic (fraternal) and monozygotic (identical) twins primarily based on chorionicity (how many inner and outer sacs of water they are in) and placental characteristics, I decided the type of woman I am is a woman who appreciates information. As much as I believed my recurring dreams were true and we were having boy/girl twins, I still felt that the responsible thing to do was confirm that with an ultrasound. The woman who performed the ultrasound was perfect for us and wonderfully positive. She located each separate placenta and identified two chorions (outer sacs) and two amnions (inner sacs) confirming that our twins were "Di-Di" or dichorionic, diamniotic. She was also able to get a good look at their lower halves and cheerfully inform us I had been correct- one robust little boy and one beautiful little girl. Any and every possible concern or legitimate reason to reconsider homebirthing these twins was assuaged by a blissfully normal ultrasound. I left the appointment in a wonderful emotional and mental place.

I also felt great physically until about 34 weeks. Then I really started slowing down. I couldn't pick up my daughter anymore. Stairs were a major challenge. I couldn't bring the groceries in and I couldn't even roll over in bed. By 37 weeks, my belly rested on the floor in between my legs when I sat on the floor. I had to lift it up to turn to the left or right. My belly skin stretched, stung, bruised and finally started to go numb. But the babies kept growing well, so I focused on having healthy, beautiful, full-term twins. I told my midwife I was determined to give birth to twins that were at least 8lbs. each and not until June which was at least 37 weeks. I talked to them all the time. Even our daughter talked to them. "Grow, grow babies!" she and I would chant over and over together an my colossal belly. I would call them my Solstice Babies and encourage them to stay in the womb until then. Of course, at 37 weeks I was so uncomfortable I changed my tune and started telling them they were welcome to come out any time.

The babies were both vertex (head-down) for most of my pregnancy, but the last two months they started shifting around. First, my son flipped breach and moved lower into my pelvis while my daughter was still vertex. I experienced my first struggle with fear when this happened. I had no qualms about birthing a breach baby, but during my childbirth educator training several years ago I came across an illustration of twin birth that would not leave my mind. In the drawing, the first baby had descended breach and was half way out of the birth canal when his chin got caught on and locked with the chin of the vertex baby. In this extremely rare situation, doctors can perform a c-section to save the life of the vertex baby, but the breach baby will most likely die stuck in the birth canal. Needless to say, this completely freaked me out as a third trimester pregnant woman. Even when I took into consideration that for this almost impossible situation to occur, both my bags of water would have to have ruptured and my babies would have to have turned to face each other, I still could not get that drawing out of my head. So I talked with my midwives and with the babies about my concerns. I used chalk pastels to draw gloriously smooth, fuzzy pictures of intact waters and babies slipping peacefully past each other into the world. A couple of weeks later, my baby girl decided she would respect my fears. Sort of. At my next prenatal visit we determined she, also, was now breach. I struggled with the decision to try to change their position or let them be. I faced no pressure from my midwives to have them in a certain position or lose having a vaginal birth as I would have if I was working with an obstetrician. It was my decision and therefore my responsibility. My midwives and I had maintained a trust in my body and in the babies to grow and develop well and to birth when and how they needed to be born and up until this point, my trust in them never wavered. But here I gave pause. I asked myself if I was afraid of birthing breach-breech twins. I asked myself if perhaps the babies knew better than I did what positions they should be in. I asked myself if I thought I could be responsible for the outcome of my birth experience. And in the end I chose to trust my body and my babies and I let them be. My body, I was confident, could birth them in either position.

Around Memorial Day weekend, I started having bouts of contractions in the evenings. They would be very regular and strong enough to catch my attention, but they never developed further into active labor. As the next few weeks went by, these short bouts grew into entire nights of contractions too strong and too close together to sleep through. This started happening every other night. At 38 weeks, I was beyond tired of being pregnant and ready to be on the other side of this birth. Wavering from my "trust my body/babies" philosophy, I asked my acupuncturist if he could stimulate a few points and attempt to help my contractions actually take shape into labor. I did a session with him and for the first time in a month, I had no contractions for about 48 hours. I was frustrated, but at least a little better rested. At 38 weeks 5 days, I experienced an entire night of contractions at five to seven minutes apart, about a minute long and fairly strong. Early the next morning, I called my primary midwife and asked her if I could come in for a cervical check. When she checked me, I was 3-4cm dilated and the presenting baby (my daughter, we think) was footling breach. Desperate to no longer be pregnant, I wearily asked her to strip my membranes. I was again hoping that this would be just enough to tip the scales and send my body into active labor. It wasn't. And my body continued to fill every other night with prodromal contractions instead of sleep. In a sleep deprived, depressed fog I went out and bought black and blue cohosh tinctures and homeopathic tablets. I was ready to chuck it all and do whatever I needed to do to get labor and birth over with. To hell with waiting until my body and the babies determined it was time. I was done: D-O-N-E, done.

Then the afternoon of the Summer Solstice, I took a long hot bath and decided to let go. The babies would be born when they were ready and our birth would be great. My faith restored, I was cheerful and rejuvenated for the rest of the evening. That night, as if a reward for my renewed faith in the natural process, I started having a considerable amount of bloody show. The next morning, I woke after a contraction-free night at about 4am. For an hour I tossed and turned in bed restlessly until I realized that my contractions were back, very mildly and about 10-15 minutes apart. My husband's alarm went off and we briefly discussed whether or not he should head out to work or not. We decided he could at least go in and get a few things done and we'd see where this morning would take me. He brought me up a cup of tea and a warm rice sock before departing with a kiss on my forehead. I rested in bed for about another hour I decided they were strong enough that I had to get up. I remember thinking to myself, so today's the day, huh?


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Blogger Kristen said...

you write so beautifully :) I am eager for the rest of the story, what an amazing experience...


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