Dear Charon,
In my last entry, I was telling you about the birth of your little
cousin Louis. Here is the continuation of that story..
Katy was in the tub, dealing with contractions that looked as
painful as any she'd had, as far as I could see. I was getting
a bit worried for her. But I was hopeful, too, because she was
starting to show signs of wanting to push, and Kaisa, her midwife,
had said that she could be near the birthing stage now. If we
could get Katy through transition, the part of labor that is often
described as the most painful and that occurs just before the
birthing stage, I knew she would be able to avoid meds like she
had hoped.
Katy didn't seem too comfortable in the tub; it was just a regular,
small bathroom tub, so she sat leaning forward, and Dave and I
took turns squishing into the little place on the floor beside
her to put our palms on her back. A few days after the birth,
I asked Katy if the bath helped her to deal with the contractions.
She said being in the water felt good because it was familiar.
During her pregnancy, she swam 2-3 times a week, and took many
baths. I think a birthing tub would have been wonderful; I wished
Katy had been able to submerge herself more, and relax a bit into
that weightless feeling water can give you.
I remember one of the things Kaisa said to Katy at this time
that really touched me. "We use the word 'contraction,' but that
makes it sound like a tightening, and tensing up during labor
can be painful. It might be better to think of them as surges.
Your uterus is using each surge to ease your baby down and out
of you. It's the most powerful muscle in your body, and it's doing
its most intense and important work right now. Let yourself open
up and let your uterus ease that baby out of you. Can you believe
you're going to meet your baby soon? Isn't that wonderful?"
After some time in the tub, Katy decided she wanted to get out
again. It took some time, with Katy moving very slowly and carefully,
and stopping for each contraction - or surge - to let it do its
work. Her huge tummy dripped with water. It was at the biggest
it would be with this pregnancy, and looked very awkward but so
beautiful. She carried little Louis in those last hours of labor
with such grace and care.
We were finally at the bed. Katy would have to lie down so that
Kaisa could check her cervix. She explained exactly how she would
check it, and how it would feel to Katy, before she started. We
all hoped for good news.
Kaisa's face lit up as she felt Katy's cervix. When she was done,
she smiled at Katy. "I think you're fully dilated, Katy. I need
to check one more time; sometimes there can be a lip around the
bottom, but if there's not, you'll be ready to push!" The second
check confirmed that Katy was now ready for the birthing stage.
Kaisa explained to Katy that pushing the baby out is a gradual
process. "It's like getting a car's tires out of the snow. You
make some progress and then you slip back. But all of it is paving
the way." I remember reading in The Birth Partner that the baby
moves down during the pushes and then slips back again, easing
out of the mother slowly so that her vagina and perineum have
time to stretch.
We all got ready for this exciting stage of the birth. Kaisa
wanted Katy to first try pushing while lying on her side, so Katy
slowly worked her way into that position on the bed. Lorinda asked
if Katy wanted a mirror, and got a strong, "Yes!" My sister likes
knowledge, and is not afraid to see what is going on with her
body.
Katy was told to push three times during each contraction, but
also to listen to her body and follow what felt right to her.
I remember Katy telling us that with the first push, she was often
a bit hesitant to start, wondering if she had the timing right,
so she was more timid about pushing. By the second push, she'd
realize that pushing hard felt better than the timid kind of pushing,
so that second push was usually the most productive. On the third
push, she did her best, but was often tired out and couldn't quite
get the momentum she'd had with that second push.
After the first few pushes, Kaisa said, "Don't be scared, Katy."
She tucked the paper sheet over Katy's bottom a bit. Katy said,
"Thanks for covering those up! I think not seeing them will help."
Katy had gotten terrible hemorrhoids during her pregnancy, and
they looked quite painful.
The side-lying pushes were a bit awkward for Katy. We encouraged
her to try another position. She moved to try pushing on all fours,
but was pretty uncomfortable that way, too. Kaisa suggested she
try the squatting bar at the end of the bed. We could tell Katy
liked that idea; she moved as quickly as I'd seen her during her
labor, from laying to standing, then squatting to push. Even though
Kaisa hadn't given her any specific directions, Katy appeared
to know what she was doing.
After a few pushes, Kaisa asked her to move back and try her
side again. She needed the baby to be presented in a position
that would help her to suction him and move him quickly to be
checked for meconium inhalation. I was disappointed; I think Katy
would have liked to try a more upright position, but I trusted
Kaisa, and I could tell Katy did, too.
The second time Katy tried the side-lying position, we got to
see the baby's little head for the first time. A wrinkled shape
with black hair peeked out at us, letting us all know progress
was being made. Katy was thrilled about being able to see her
baby already, after only a half-hour or so of pushing. The amazing
sight encouraged her to work harder, but after a few more pushes,
Katy said she felt like the position wasn't working very well
for her.
Then Kaisa said, "I know this sounds strange, but let's give
this a try. Katy, I want you to lie on your back. Dave and Caryl,
you can hold Katy's legs up." Katy was up on the bed at maybe
a 30-degree angle - not quite lying down, but not using gravity
to its greatest advantage, either. I was skeptical.
Dave and I took hold of her legs. "No, both the same!" Katy instructed
us. She bent her knees, and we took hold of her calf just under
her knee with one hand, and put our other hand on the ball of
her foot. I told Katy she could let the weight of her legs rest
on our arms, that we could support them. She let them go and I
felt the difference. "Okay, contraction coming." Katy even had
a signal for this by now: a lifted finger to signal one was probably
coming on, and then a pointing sign and a nod of the head when
she was ready to push. We moved her legs in towards her body as
she worked to push her baby out.
On her first push in this position, we saw more of the baby's
head than we ever had! All of us got excited, including Katy.
On the next push, Katy gave it her all, and we all cheered for
her: "Push up to the lights! That's it, Katy!" Kaisa instructed.
"Yes!! Good job, Katy!" Dave was thrilled with the progress she
was making. "Oh, Katy, you're doing it! You're doing it!" I yelled.
"Go, Katy! Go!" Lorinda shouted with glee. As I watched Katy,
I was so impressed with her strength. She stayed focused with
each push, working to make every one count. Her face turned red
with the effort, and I could tell she was determined to see her
baby as soon as possible!
She pushed through a few more contractions, watching the mirror
for her baby's head, and became a bit frustrated when some of
the pushes didn't look as productive as others. At one point,
I encouraged, "That's good, Katy," in the middle of a push where
we weren't seeing much. "No, it's not! Look!" Katy replied, nodding
at the mirror. After her contraction was over, I reminded her,
"After we see a really good push, I would expect there to be one
or two contractions where we can't see anything happening. But
remember what Kaisa said: Progress is being made. Your body needs
time to gradually and carefully push this baby out, and your body
is taking good care to do that."
Finally, after about an hour and fifteen minutes of pushing,
the baby's head was staying down low enough so that we could see
it even in between pushes. "This is it, Katy!" Kaisa exclaimed.
"We're almost there now! We've called two people from the nursery
staff here. I will be giving them your baby to check over immediately
after he is born, because of the meconium in your water, and then
we'll be able to give him to you. Okay, on this next push, I want
you to hold baby there as much as you can in between contractions."
Katy pushed, and pushed, and even when the contraction was done,
her baby's head was right there where we could see it, and she
told us she wanted to keep pushing. Without waiting for an answer,
she pushed some more, and some more. and out came a beautiful
head. Katy yelled when it emerged, a loud, surprised exclamation
of pain, and I remembered that feeling when you were born, Charon.
I looked at her, and Katy's eyes looked back at me, surprised
and a little scared. "It's okay," I said to her. "There will be
one more really painful feeling when the shoulders come out, but
this one you just experienced was the worst. And it won't hurt
after you're done. You're almost there! You can do this!"
Katy took a deep breath, and with a look of incredible determination,
she vocalized again through her last push. Suddenly, all of the
baby's body was outside of her, and in this great big world where
we could see..
Dave looked. "It's a boy," he told Katy with a knowing grin.
They had expected this, if only because Dave's side of the family
seemed to almost always produce male offspring. Louis Robert was
checked over as his Daddy looked on, talking to him and holding
his little hand, welcoming him into the world. He was pronounced
healthy and beautiful.
When
Katy first held their new little baby, Dave sat at her side, his
arm curled around the two of them. The sun streamed into the room;
it was the first glimpse of it we'd had all day. "Did you bring
the sun, Louis?" Katy asked. Together, the new mama and papa sang
to their baby: "Don't worry. about a thing. 'cause every little
thing. is gonna be alright..." They had started singing this song
to him near the end of Katy's pregnancy. This was the moment they
had been working up to, the moment they'd been waiting for, the
moment they'd dreamed of. Louis knew his parents' voices, was
calmed by them. He peeked out at their faces; his eyes were still
scrunched almost shut, surprised by the brightness of this strange
new place.
Watching him, Katy got tears in her voice, and Dave gently teased
her: "Are you going to cry or are you going to sing?" "I'm going
to cry," she replied, and she laughed as the tears came, and then
continued singing with her husband:
Rise up this morning
Smiled with the rising sun
Three little birds
Pitch on my doorstep
Singing sweet songs
Of melodies pure and true
Saying, this is my message to you - ou - ou..
Love,
Mom
Note:
I strongly recommend the book, The Birth Partner by Penny Simkin,
for anyone who will be a support person for a woman in labor and
birth.
Copyright © 2001 - 2003 Caryl Mousseaux. All rights reserved.
