He came not quite how I expected. I’d spent weeks getting everything ready for my homebirth. Italia was born at home and we planned the same for this little one. I’d primped and prepped my bathroom, typed up birth prompts for Brenan, had my birth kit, extra towels, specials snacks, and so much more all organised and waiting. I was not afraid to give birth again. Giving birth at home again was the one thing I had been consistently excited about and looking forward to the entire pregnancy, no matter what my feelings at the moment were on having another kid. However, I WAS terrified of ending up at the hospital with a male doctor who was a stranger to me amidst a room full of other strangers in the event of a transfer during the birth. I wrote up a concise preference list for just such an occasion, as well as a list of things that would need to be packed in a hospital bag. I fully understood that you couldn’t plan a birth and so a hard fast birth plan was absurd, and instead opted for countless contingency “preferences.”
40 weeks
Forty weeks came and went. I wasn’t slightly surprised or put out. I had fully expected to watch my guess date come and go and would have been quite shocked and annoyed if my baby dared to make an appearance before my 39th week. I was 41 weeks and 6 days when I went for my prenatal on Friday March 18th. My baby had been unusually active that morning and early afternoon so both Nancy (my midwife) and I were not expecting to find his heartbeat to be dangerously low. It returned to a healthy range eventually, but it was slow to come back up despite the fact he was moving lots. An active baby with a dangerously low heartbeat was a big red flag for a baby in distress and my midwife Nancy even offered to call an ambulance to take me to the hospital. Since his heartbeat was back to normal we opted to drive ourselves (my mom, dad and Tali were there) because then we could choose the hospital we wanted instead of going to the closest one. I remained under the impression that we were simply going for a non-stress test and that if everything checked out I would be on my way home afterwards. I had zero intentions of staying at the hospital for an induction if I didn’t have to.
Brenan made it to the hospital before us, as we had been waiting for Nancy to call the hospital midwives and give them a heads up we were on our way. He got us checked in, and because of my belief that we were simply there for a non-stress test, we kept trying to tell them we didn’t need to be fully checked in yet, that we weren’t staying if everything checked out fine. We’d just had an NST two days before and everything was perfect and I fully expected to find the same again.
We left my parents and Tali in the waiting room and were taken to our room. We sat there waiting for Nancy to arrive. Brenan looked around and said what I was thinking “I don’t want to give birth here.” The room was cold and uncomfortable: sterile. With Tali it was when I waited for my rhogam shot in a room very similar that I decided I couldn’t give birth in a hospital. “I know he’s fine,” I told Brenan, “I’m just scared that out of precaution I’ll lose the birth I want and it will be for no reason at all.”
A nurse came in and asked me to change into the hospital gown. “I’d rather leave my clothes on,” I told her. “Um, ok, I guess that’s fine,” she responded. “I’m not staying here,” I said back, “We’re just here for the NST.” Why did everyone think we were staying?!
I was hooked up to the continuous fetal monitoring and once again we were left alone. Where was Nancy? The heartbeat, as far as I could tell, continued to look fine. I could feel him move every now and then. My baby was healthy, he was fine, I was fine. What were we doing here? I desperately wanted them to bring in the ultrasound machine, tell me he looked good, and rush home. I longed to go home. Why did we leave my parents and Tali in the waiting room? I wished they were there in the room with us. Brenan went out into the hall to see if he could find anyone to give us a heads up on how much longer we would be there. When he came back he said the on call midwife, our nurse, the on call OB and Nancy were all talking out there. Shortly after they all came in and proceeded to tell us why they were so concerned. It wasn’t only the extremely low heartbeat, but that while I had been there on the monitor, the heartbeat often went through periods of little variation, which was also bad. Nancy made it sound as though she would respect my wish to still have a homebirth, and would happily be there as my care provider, but that what she’d witnessed today was likely to happen more often during labor and if it happened during the birth it would mean a hospital transfer. She told me how wonderful the oncall CNM and OB were, that this was her dream transfer scenario and we likely would not be so lucky in the event of an emergency transfer.
We asked questions concerning our preferences if we choose to stay at the hospital. Could I forgo the IV? Yes, but since I had opted out of GBS testing the pediatrician wouldn’t sign out our baby for at least 48 hours after the birth if I didn’t get antibiotics (we considered just leaving right after the birth anyways, as we could do that, but then our insurance wouldn’t cover things in the event of leaving against a doctor’s recommendation). How long would this particular midwife and OB be on call? Until monday? Great. This was a relief as the OB was female and so far I felt comfortable with her. How would we go about doing the induction? I liked their responses to this as they seemed to want to avoid pitocin at all costs and were really hoping that just sweeping my membranes would get things going. In the event of pitocin, they said they would prefer to just give me a small dose and turn it off. They wanted to induce me as “natural” and intervention free as an induction could possibly be. Could Tali be in the room the whole time? Yes? Awesome. Tali had been beyond excited to watch the birth and made sure Nancy knew in advance that she wanted to “cut the placenta.” We wanted delayed cord clamping, would they be respectful of that? “Yes, it was their standard practice.”
Our many questions asked and answered, everyone left the room to give Brenan and I time to talk. Brenan sat on the bed and put his arms around me and we clung to one another and cried, grieving for the birth we so desperately wanted but knew was no longer our best option.
Our tears shed, we both agreed that if we left the hospital we would spend the remainder of the pregnancy in fear and that fear was not something we wanted in our birth. This was not going to be our ideal birth, but it seemed that everything was in place for us to have the best hospital birth we could have hoped for and that we would make the most of it.
We called everyone back in and let them know our decision. We swept my membranes and in doing so, found that I was already nicely primed for induction at three centimeters dilated, 60% effaced with a nice low baby. They put in my IV for the antibiotics, and once I had my first dose they unhooked me and left it as a saline lock. I asked if they had something I could wrap around the tube in my arm so I wouldn’t feel like it was going to snag on things, but more importantly, so I didn’t have to look at it. I was informed that they didn’t even have an ace bandage for me, thankfully, Nancy had one in her car. My parents and Tali came in and we chatted while I bounced on an exercise ball and felt some consistent early surges, though they were just what I had been experiencing every night for several weeks. My parents left to pack our hospital bag and to get us all food. Food which I’d been informed by the nurse relaying the midwife’s orders that I shouldn’t eat. I rebelliously enjoyed the food anyways. The continuous fetal monitoring was touchy, not only did it restrict my movements because I felt tied down but they also kept getting jostled out of place, or even when I’d been sitting perfectly still, they still lost the heartbeat. I wanted them gone, and yet the whole reason we stayed in the hospital was so we could keep a close eye on his heartbeat and so I put up with them.
It was nearly nine O’clock PM and Tali needed to get to bed. She clung to me and cried, “I want to stay with you mom!” I wanted her to stay too, but she needed sleep. “I promise you can come back first thing in the morning” I said. She still whimpered and clung desperately to my body. “Are you scared to leave me here in this strange place?” I asked her. She nodded her head yes. “I know it seems scary,” I told her, “but this is a nice place where they are going to take good care of me and Bertie.” (Bertie was what she had been calling the baby for most the pregnancy). This finally calmed her down a bit, and brenan walked her and my parents out to the car.
When he returned we decided to release my water and insert an internal fetal monitor, hoping that would track the heart better and therefor help me to have more movement. Very soon after his heart plummeted again. They had me on hands and knees, put oxygen to my face, the room began to fill with people as we waited several long minutes for his heart to return to a healthy range. This, despite being a little scary, made me feel a bit happier about our choice to stay at the hospital. I was pleased to see there really was a REAL reason for us to be there and that what we had seen at my prenatal appointment hadn’t been a fluke. Part of me blamed breaking my water “early” as the source of the distress, but I also rationed that if that alone, without any surges was stressing my baby out, then it was a really good thing we would be in the hospital during the intense surges of active birth.
Within a couple hours I was surging great on my own and it was clear pitocin would not be necessary. However, we continued to see the really low heartbeat that was slow to recover. They hooked me back up to the IV in order to give me more fluids to replace what had been lost by breaking my water. This seemed to help and the heart dipped less often, though each time the nurses would come in and have me change position, usualy right when I’d finally found some comfort. A new position always made his heart return to a healthy range. I had great care providers who were genuinely trying to do everything in their power to give me a vaginal birth, as intervention free as possible, they were patient and so long as his heartbeat came back up within a minute (still rather slow) and wasn't going down after every surge they didn't have any problem with my continuing to labor and try for a vaginal birth. This continued to be a comfort and relief after each “episode” as I kept expecting the OB to come in with the CNM and tell me they thought a speedy delivery via c-section was the best way to go. That never happened though. It was somewhere between midnight and one am that I gave up on the idea of getting any sleep and climbed out of bed to manage my ever strengthening surges. I kept thinking of them as “expansions” and breathed into my belly, making space for my uterus to grow.
I only had about three (maybe four) hours of intense laboring where most everything blurred together with a few vivid memories that stand out. For the first hour or so, Brenan obediently squeezed pressure points in my hands and feet during each surge. “Does that help with the contraction” the nurse asked curiously after one surge. “Oh yes,” I said “some people think the pressure points hurt, but it distracts them from the discomfort of the surge, but I think it feels really good and it calms me.” I was surprised she hadn’t seen anyone using pressure points before.
I kept wishing I was at home and didn't have the fetal monitors on my belly and the IV in my arm and desperately longed for my circle of friends back in Utah. I had missed my sisterhood so much over the past couple months and there were points during my birth where that became a desperate longing. Whenever things got really hard it was because my head would go to that place of wishing for a different room in a different state with different people. Then I'd hear Brenan's voice. He was my VIP, the most important person that mattered to me and he was all I truly needed in that birth room with me. He was always there telling me how awesome I was doing and I would latch on to it and vocally say out loud "I can do this" "I'm doing awesome!" "I'm opening!" And Brenan would repeat everything I said and I clung to his body and his voice like my life depended on it. There were times that I’d ask for something and he’d start to go get it and I’d cry out in panic “but don’t leave me!” and Nancy would come to the rescue, bringing me whatever it was I needed while allowing Brenan to remain plastered to me.
Despite it being hard, the few times people mentioned pain I would think "pain isn't right. What I'm feeling isn't pain. What I'm feeling is my body getting really really big and my muscles working really hard and I'm desperately tired and wanting a break from this marathon." Pain didn't ever feel like the right word because to me pain is my brain getting the signal "something is wrong," but I never felt like something was "wrong." In the face of the dips, I was never worried about Bertie and I was never worried about my body, I was just worried about having to throw all my birth preferences out the window and finding myself recovering from a c-section. I told Brenan and Nancy several times “I’m just so tired. I’m really tired and all I want is a few minutes to sleep.” My body was working so hard and it made every part of my body fiercely, hysterically tired.
As things got harder I also understood what all the signs meant. I realised the pooping and the puking and the chills meant I was nearing the end, and the one time I vocalized the desire "I don't want to do this anymore" I instantly felt better because I knew that meant things were almost over. Soon after saying that, I found myself on the exercise ball leaning on Brenan's knees getting a nice little break from my surges. I was ready and just waiting for the waves to begin again and my body would begin pushing this baby out all on its own. Relief settled over me and excitement danced along the edges of my consciousness. Soon enough I was raising my butt off the ball and grunting and moaning down my little boy. It really does feel so good to push with the surges. My uterus was this rubber band I was stretching and expanding to capacity and pushing was me finally letting go and allowing the built up momentum and energy to do its thing.
I felt his head descending into the birth path and took the next break between surges to quickly move to a quasi squat/hands-and-knees position on the bed and for the first time in a couple hours I felt truly comfortable and excited. My birth hormone cocktail flooded me and even with only having pushed through one or two surges I knew I only had a couple more to go and he would pop out. Someone held a warm compress to my perineum. “What are they doing?” I thought, and then remembered I’d failed to go over with them my preference that no one touch my perineum whether it be to help me stretch, or because they were helping maneuver the baby out. I wanted me and my baby to do it completely alone. However, the compress and having that warmth to push towards felt very grounding and I found myself grateful to whoever was holding it there. Baby flew under my tailbone and I swear I heard a “pop” from it. After that he came pretty fast. How many surges and pushes, I'm not sure but it all happened in a matter of minutes. When I knew he was crowning I adjusted my position so I could see between my legs and watch everything. I couldn’t see what everyone else was doing, but felt someone was tugging on my baby. “Please don’t pull on him” I called out. I pushed again, and still, I felt as though he was being tugged on. “NOOOOOOOO” I grunted out with one last push, and by “NOOOOOOOO” I really meant “please get your hands the hell away from my baby” (I think they unwrapped his Cord while he was still half in me and that was the “tugging” I felt, not them actually pulling on the baby). I hadn’t wanted them touching me or him while I was pushing, but that annoyance all went away for the moment as I began to roll into a seated upright position as quickly as possible so I could receive the new baby being held out to me. My little boy was placed right on my chest. He gasped a little and soon a cry filled the room. What was happening around me didn't matter after that. I had my baby in my arms and my husband's arms around me as we cooed and talked to our gooey baby.
We were mostly left alone after that. Our birth attendants checked mine and baby's vitals all while we sat and nursed. He latched on nearly immediately and nursed like a champ for about two hours before we ever weighed and measured him. Brenan patiently waited all that time before finally asking “when can I have a turn holding him?” We both lamented that Tali had not been there, and he expressed his desire to be home, cuddling in our own bed instead of being squished together on the hospital bed. Our hospital birth had gone pretty well. I had very few complaints and yet we both still longed for our home and the gentler, more private birth we had experienced with Tali. In truth, Brenan and I rocked our hospital birth, and my “labor” had no moments of “pain” like I remember from my first birth (when I had to lie down and have pressure removed from my cervix to help the swollen lip go away). I was much more mentally “prepared” and yet far more lonely. I missed my mom and Tali who were always meant to have been at the birth and I missed my friends.
He had APGAR scores of eight and nine and is a perfectly healthy baby. We still don’t know for sure what was causing our baby distress in the womb. He was born with the cord wrapped around his neck twice (nuchal cords are quite common and generally not cause for alarm) and around his armpit. Because a change of position always brought his heartbeat back up, we can only guess that the way the cord was wrapped around his arm was causing it to get pinched from time to time, but we really don’t know.
There’s a part of me that wants to rewrite my birth in a more positive light. We had a great hospital experience. I liked our nurse, I liked our midwife, I liked our OB. Brenan was phenomenal and kept me from feeling like I was drowning in my own body, always keeping me anchored to him. Nancy was with us as a counselor we knew and trusted, or an extra set of comforting hands, every minute that she wasn’t putting together make-shift heating pads out of waterlogged absorbent pads, or fetching whatever else it might be I decided I needed. There were so many good things about our birth, and yet it continues to be bogged down in my memory with disappointment.
One moment remains a purely happy one, and that's the moment I held my little guy in my arms for the first time and the two hours that followed. A healthy mom and baby are not all that really matter, the whole birth matters and it’s OK that I’m disappointed, but I’ll concede, those first two are the most important. It’s that first meeting that I play over and over again in my head and the rest of the birth fades in my memory as that moment remains crystal clear.
***The name. We spent 9 months trying to find the right name. Brenan and I could not agree on ANYTHING. Part of the problem was that I had promised Brenan years before that “Robert” could be one of the names for our first born son. Robert is Brenan’s middle name, his Dad’s first name, and goes way back in his family. It’s also a family name on my side of the family, and likely a family name for just about every family as it has held strong in the top 100 babies name list for CENTURIES. If you haven’t guessed, I’m not a big fan of “common” names even if I do like the name itself. Because of various issues I had with the one name I’d already conceded to, I was especially picky about whatever the other name, the name we would actually call our son, would be. Tali, and most all of us, had been calling him “Bertie” for the majority of the pregnancy because “Bertie” was the one nickname that came from “Robert” that I really liked and Tali glommed on to it. We went through countless names. Brenan seemed ever determined to give our child a name like “Guiarto Roberto Luige Volpe” a name which I wholeheartedly agreed to, provided our child was born with a mustache. I, personally was a fan of Celtic and Norse names, my favorite being names such as “Faelen” or “Bjorn.” Around 41 weeks Brenan said “What about Kasen?” I was thrown back to my younger years in which there was a garden bed at the end of our driveway where I had named all the plants (mostly trees and bushes) my favorite names. Most of their names I’ve forgotten but i do remember “Alliddiah” the japanese maple, and “Kasen” who I believe was some sort of small pine tree. I’d named the tree Kasen because I adored my big brother Kasey but didn’t want the tree to have his EXACT same name. That name remained a favorite of mine through most my life and for some reason, it had completely flown my mind for the entire length of my pregnancy. “Actually, I LOVE that name, and always have,” I told Brenan. It was the first name that had felt ‘right’ to both of us and it only took us 41 weeks to agree upon it! The order of the names….that remained up in the air until we actually had family meeting our new baby in the hospital, and we finally decided upon Kasen Robert Volpe. At home, he continues to be Bertie 90% of the time, but that’s OUR special name for him, the rest of you can lovingly call him Kasen.
