The Birth Story of Joshua David Willms
waterborn at home Monday August 31, 2009
4:35pm
Joshua’s birth story begins five years ago with one word: “Great!” This was the response of a new mom to my query about how her recent birth had gone. While I was hoping that my upcoming birth with my first child would go well, I had never imagined that I could possibly go on to describe it in such enthusiastic and positive terms.
I went on to have two “Great!” midwife-assisted, unmedicated hospital births. Then a couple of years ago a friend told me she was pursuing certification as a Childbirth Educator. A light bulb went on for me. I had never before considered that my growing passion for childbirth could be a career choice. Following some thought and prayer, I enrolled in a program and ordered my reading materials. They fed my passion and blew my mind. I also began following birth related blogs. I learned about what was normal and what was possible. As I learned about birth and, in particular through the lens of my faith, I saw it as something beautifully designed. A process that- given a supportive environment- in the overwhelming number of cases and could be trusted to go right.
When I got pregnant with Joshua, I had the opportunity to put everything I had learned and that I believed into practice.
I had already met Lucia Sanchez, nurse and doula. Instructor of the only independent childbirth education class in the city. A leader in the local drive for the humanization of birth. I asked her to recommend an OB/Gyn. I found Dr. Antonio Lopez to be supportive and open. My appointments with him were very much like the appointments I had had with my midwives during previous pregnancies. We spent lots of time talking. I never felt rushed. We discussed my preferences for my prenatal care and for the birth. Any points on which we disagreed were talked through respectfully until we were both comfortable with the decision. He took the time to read and consider literature that I passed on.
I was very pleased with how comfortable he was with me declining ultrasound and how skilled he was at palpation. He even had a pinard horn for listening to the baby’s heartbeat!
When I first brought up the idea of home birth, neither Andrew nor Lucia nor Dr. Lopez was terribly enthusiastic. I didn’t want to have a reluctant support team so I turned my focus to planning for a hospital water birth. But I couldn’t get home birth out of my thoughts. I found myself shopping for kiddie pools and fantasizing about where I would set it up to give birth at home. A few months later I sheepishly brought it up with Andrew again. His reaction shocked me. “Sure! I support you 100%.” Wow! The next time I saw Dr. Lopez I brought it up with him. Again I was shocked and thrilled. His response was, “Why not?”
We were going to have a home birth!
My pregnancy went extremely well. I was very careful about my diet- whole foods as much as possible, very little sugar and lots of water. I attended yoga classes. I walked. I had lots of energy all the way through. I wasn’t uncomfortable. I slept well.
In the weeks leading up to Joshua’s birth day, I had occasional series of strongish contractions. These often happened in the evenings but never developed into anything more. On one hand I was glad for them because to me they indicated that my body was preparing. On the other hand I found myself feeling some trepidation as I thought ahead to labour. I knew the contractions would only get more intense and the ones I was feeling were already fairly uncomfortable.
Two days before Joshua was born, in the middle of the night I had 3 or 4 hours of strong but irregular contractions. I did my best to relax and sleep through them, trying in fact to deny it might be “time” because I didn’t feel mentally prepared for The Big Event. When they stopped, I was glad but knew that I needed to do some work because like it or not, this baby was going to come! The very next day I received a word from the Lord through bedtime reading with Micah:
Then Jesus turned to his wind-torn friends. "Why were you scared?" he asked. "Did you forget who I Am? Did you believe your fears, instead of me?"
[...]
Jesus' friends had been so afraid, they had only seen the big waves. They had forgotten that, if Jesus was with them, then they had nothing to be afraid of.
No matter how small their boat- or how big the storm.
-The Jesus Storybook Bible, Mark 4 & Matthew 8
I felt at once admonished and encouraged. I gave over my labour and birth to Jesus and was at peace with what would come.
The next morning began uneventfully, though I felt a bit out of sorts and quiet. We drove Eva to school, and then Mom and I played some cribbage. While we were playing cards I began having some light, irregular contractions like I’d often had. At about 10am I decided to have a nap. But as I rested the contractions got stronger. Strong enough that I thought it worthwhile to time them. I used Contraction Master on my iPod Touch and it was so cool, generating a nice little chart which gave me a very good idea of how things were going:
They were fairly irregular, but the range of frequency was tight enough that I thought it worthwhile to give my team a heads up. About a half hour after the initial call, I decided it was time to ask my team to come to me. As I was making the calls it became difficult to walk and talk through the contractions so I felt confident I’d made the right decision. I asked Andrew to go to the store for Joshua’s birthday cake and then to go pick up Eva from school a little early. They got home by about 1:30pm. In the meantime Lucia had arrived and started setting up the pool. I had been listening to my birth tunes and laboring in that area, but it felt too busy there so I began pacing in and out of my Mom’s room instead. Now that I knew this was it, the real thing, I felt calm and ready and peaceful.
The walking felt good, but I also felt like my pelvic muscles were perhaps not relaxed enough because they were being used. I thought I’d try something different. I rolled the birth ball over to the bed and sat on it, leaning forward over a stack of pillows. That felt pretty good. I did some pelvic rotation and rocking as well and that felt pretty good too.
Dr. Lopez found me like that when he arrived around 2pm. He observed a little and suggested I eat something. I wasn’t sure I wanted to but tried having one of my hearty homemade cookies and it really hit the spot! He then wanted to assess the baby’s heart rate. He tried for a while with me on the birth ball then asked me to move to the bed. Once I was on the bed he still couldn’t find it and I had to will myself to be calm. And I prayed. Finally he found it- phew!- nice and strong, just lower and more to the side than he expected. He mentioned later that he thought Joshua was posterior at that point.
I moved back to the birth ball and Andrew sat down to give me a back rub which felt great. The room felt a little louder and busier at that point than I would have liked but I didn’t have the energy or heart to say anything. I ended up deciding to do some more walking in and out of Mom’s room- in front of her fan, because by that point I was working pretty hard. It was good to be away from the hustle and bustle.
In the meantime the atmosphere became much quieter. As I paced I was grateful that the contractions varied in intensity, giving me a bit of a break periodically. I found the ‘belly lift’ technique quite effective in reducing intensity as well. Through some of the contractions I tried quietly chanting “peace in” while I inhaled and “tension out” while I exhaled. That worked alright.
After a while I noticed that I was feeling a bit chilled. I recognized that this might be a sign of transition. I turned off the fan and walked a little more, assessing how I felt and what I might want. At about 3pm I decided to use the toilet and then try the tub.
The warm water felt wooonnnderful!!! Delicious. Marvellous. I
highly recommend it.
I experimented a little with positions and quickly found that when a contraction came I wanted to be hands-and-knees. Another reason for labouring in water: I was able to go from reclining to hands-and-knees in a flash, with no help.
I lolled in the tub, leaning forward through contractions and often sitting up and drinking water in between. Occasionally the kids would come in for a visit, which I enjoyed. I remember Micah’s excitement, standing before me, practically trembling, but not knowing quite what to do.
After a while, I could feel that my pelvis was opening through the contractions, and I noticed that some of them fit the description of the ‘throwdown’ sensation some women had written about in their birth stories. This told me that his head was moving into the birth canal. Around that time (3:30ish, I think) Dr. Flores the pediatrician called. He wanted to know if he should cancel his 5pm appointment. Definitely! I knew it wouldn’t be long before I felt the urge to push. I didn’t push long with either Eva or Micah so chances are I wouldn’t with this one either.
Lucia suggested that I could check myself to see if baby’s head was near. I felt the bag of waters bulging at the first bend of my finger, and baby’s head behind it at the second bend. After I had some strong contractions that felt like they had moved him down, I checked again and the bag of waters was at my perineum with the head a few centimeters behind. It was cool to confirm that progress all by myself. I think Lucia and Dr. Lopez appreciated having some additional information.
Sure enough, right around the time that Dr. Flores arrived I started having urges to push. I did my best to let my body do the work, though it did feel great if I added my own efforts. Soon enough I was feeling the
ring of fire. Yikes. I don’t remember having the anesthesia the books talk about. Apparently the head presses on a nerve which is supposed to offer the effect of anesthesia after the initial ring of fire feeling. No relief on that front until his head was out. Around this time I said to get the kids so they could witness the birth. I had my hand on top of Joshua’s head and I managed to grunt out, “Crowning,” as I fought to relax and slowly ease his head out. This was the hardest part of the birth.
Once Joshua’s head was out I practically shouted with joy! I was so happy and relieved! I said something to that effect. I panted and smiled and expressed gratitude. I was also kind of excited that the membranes were still intact. I had read somewhere that a good diet rich in protein made for strong membranes so I had wondered whether the membranes would stay intact until late in the labour if not right to the end.
I was quite happy to stay like that with just his head out. Apparently so was my body because it was a little while before I had another urge to push. I just kept my hand on his head and felt his little ears through the sac and enjoyed knowing that my baby was moments from being completely born. My mom said she and Andrew looked at each other wondering if it was ok- his head out, body in, underwater and still in the sac. I kind of wondered the same but recognized that since his head was completely out his shoulders were already safely past my pubic bone. I said that I didn’t have another urge to push yet and as long as it was safe I’d like to wait for one. Mom said neither Lucia nor Dr. Lopez looked concerned. From what I understand, Dr. Lopez was kind of itching to break the sac but resisted and just continued watching and waiting.
Soon enough the urge to push came upon me again and the rest of Joshua’s body emerged into the water behind me, membranes breaking as he somersaulted out. Dr. Lopez said something and I reached back under my leg to bring him forward and up out of the water for his first breath. He was a nice colour already and spluttered and started crying pretty much right away. I wanted to try to keep his body under the water so he would stay warm but somebody expressed concern about me keeping his head above water so I brought him up higher. His cord was on the short side so I brought him up as high as I could and tried to decide how to hold him while I greeted him. “Hello baby!” Dr. Lopez and Lucia scooped water over him to keep him warm but were otherwise completely hands off. I looked up at Andrew and asked if it was a boy or a girl. “A boy!” he exclaimed. I confirmed with a look that we would announce the name we had discussed. I introduced Joshua to everyone.
I offered him the breast. He tried a little but wasn’t overly enthusiastic. Sometime around then I noticed that there was some blood in the water. Didn’t look like a scary amount, but it was definitely noticeable. Dr. Lopez expressed that he was a bit concerned about it and that he’d really like to cut the cord and address it. I trusted his judgment and so he clamped and Andrew cut. I noticed that the cord was quite white. In a later discussion, Mom and Andrew estimated that it had been at least 10 minutes since Joshua’s birth, if not more. Andrew went with Joshua and Dr. Flores, and I stood to do some hip rotations to encourage the placenta to separate. I wasn’t bleeding much so that concern had passed. By now I was ready to lie down so I made my way to the bed. Dr. Flores finished tying off Joshua’s cord stump with some cool elastic thingies (so much nicer than that big plastic clamp Eva and Micah had!), and weighed and measured him. I wasn’t surprised to learn that he was 9lbs 10oz! He was the heaviest and also the shortest of our babies at 19.5”.
I really wanted him back to nurse and got all propped up and ready for him. As he suckled a little more strongly now I could feel my uterus contract. Up until then the tone had been good but I hadn’t felt contractions. I think it was a little over 30 minutes after the birth before the placenta was born. Dr. Lopez reported that it looked good and was completely intact. He also mentioned that the cord was relatively thin, which is interesting. I asked him about the size of the placenta. He said that it was quite big, but that big placentas come along with big babies. Generally there is a 1:8 weight relationship between placenta and baby. More interesting information!
It was no trouble getting a good blood sample from Joshua’s cord and later from the placenta. He is A+ so I had the Rhogam shot two days after his birth. I had two first degree tears that didn’t require sutures.
Throughout the labour and birth I felt remarkably
present. I was focused and relaxed during contractions and my thinking brain was still engaged. This had its advantages and disadvantages. While I felt great after the birth I didn’t have quite the same wild high I did with the other two.
The birth couldn’t have gone much better if I had written a script. The whole team was immensely supportive and respectful of my wishes. Joshua got the gentle, undisturbed birth I so wanted for him. What a wonderful start to life! Thanks and praise to God for hearing and answering our prayers and the prayers of so many who love us.
They were fairly irregular, but the range of frequency was tight enough that I thought it worthwhile to give my team a heads up. About a half hour after the initial call, I decided it was time to ask my team to come to me. As I was making the calls it became difficult to walk and talk through the contractions so I felt confident I’d made the right decision. I asked Andrew to go to the store for Joshua’s birthday cake and then to go pick up Eva from school a little early. They got home by about 1:30pm. In the meantime Lucia had arrived and started setting up the pool. I had been listening to my birth tunes and laboring in that area, but it felt too busy there so I began pacing in and out of my Mom’s room instead. Now that I knew this was it, the real thing, I felt calm and ready and peaceful.
Nana with an exhausted Joshua
Joshua coming up up for his first breath
He's here!
The kids so excited to meet their new brother!
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