Mikal's 5th baby  

This was to be Mikal's 5^th baby, 3^rd VBAC (Vaginal Birth After Cesarian). Labor began for Mikal at 4:30 AM, Friday morning. She called me at 6:30 AM with good, established early labor. Her contractions were about 8 minutes apart, and she was handling them fine. She spent a lot of time in her bath tub. I got there at 7AM, knowing that her last labor went very fast, and never got hard for her, so I wanted to evaluate the situation with her. It seemed clear to me that she was definitely in the latent phase, and there was time to stay at home. She was able to talk & walk through contractions, and I was rubbing her lower back with each one. She had back labor, and I gave her suggestions to labor in so the baby might turn. I suggested all fours with elbows bent & head on pillow. She said it was too uncomfortable. I then suggested a few lunges, and she did them, but she found that squatting was best for her. I squatted with her, rubbing her back with each contraction. I tried a massaging tool, and a cutting board on her back for counterpressure, but she preferred my hands. At around 9:30 AM, she got very tired, and the contractions got more spaced apart (20 mins apart), and she was resting/sleeping between them. She suggested I that I go, and check in on her in a while, so that she could get some rest. (Her husband was home, so I wasn't worried about being in contact if they needed me).

I called a few hours later, and she was still in labor, and it had picked up some, back to 8 or so minutes apart, and harder. She said she didn't feel I needed to be there yet. Then, later in the afternoon, just before Shabbat, we agreed that she'd call me when it was time to go to the hospital, and they'd pick me up in a cab on the way. 

They called at 6:00PM, and we were at the hospital at 6:15. She was clearly in the beginning stages of active labor. She could no longer talk through contractions, and they were 3-4 minutes apart. She was hooked up to an external fetal monitor (EFM), and remained so throughout the entire duration of the labor & delivery. She was also given a heparin lock, and fluids were administered. This was because of a few things in her history. One was that she was diagnosed with CMV in her first trimester, and the other is because it is hospital policy to have IV & constant EFM for any VBAC.

Her first examination showed that she was 4cm dilated, and with the head low. Fifteen minutes later, she was 7-8 cm dilated, and head at station 0. At 7:30 PM, the head was at -1, and 9cm dilation, and full dilation was at 7:35 PM. She maintained her fantastic sense of humor throughout the entire labor. Counting backwards until the contraction was finished was a technique that she asked me to do, and it worked really well for her. I started at 20, and counted either slowly or faster, depending on what I saw on the monitor recording the peak & end of the contractions. This, along with hand squeezing, were her "rituals" for when a contraction started. Between contractions, I dabbed her face with a cool washcloth, and also rubbed her feet. Mikal decided to have her water broken artificially, although initially she was quite against it. There was pressure from the Dr.'s to do a cesarean again, even though she was doing beautifully, and the baby was doing beautifully in labor. They wanted to do it because of the size of the baby, and because of the possible complications from the CMV. The midwife told her that if she broke her waters, she'd give birth immediately. She decided to do that for two reasons: one because she was feeling the desire to hasten the birth, and two because she was worried about the Dr.'s suggestion for a repeat Cesarean.  After the water was broken, she reached full dilation. She pushed very efficiently, and the head came out with one push. The midwife suctioned the airways because of the presence of light meconium, then instructed Mikal to give another push for the shoulders. It was a big baby, and Mikal really had to push to get her shoulders through. The body was born at 7:41 PM. Placenta out 7 minutes later. Baby was put onto Mikal's chest & she nursed immediately.

Alta's 1st baby

Labor began roughly at 3:30 in the morning, when her husband, Itzik, called me at home. He said that contractions had been steadily coming, and Alta was not able to rest because of them. I recommended a warm bath and a relaxing glass of wine, and to get back to me afterward. I decided to go to them because I felt I needed to assess the situation, this being a first birth, and the fact that she was now starting labor 2 weeks & 2 days early.

I got to their apartment at 5AM, and was greeted by a lovely smiling lady in clearly early labor. She was very reserved about her contractions, we (her husband & I) didn't always know when they were coming unless she told us. I thought is was because labor was still early, but I'd later learn that that was just how she is- very reserved and stoic. We timed contractions for a while, and they were about 3 minutes apart, lasting about 40 seconds. Her back hurt, and pressure from a back rub made her feel the contraction stronger in her belly, and not in her back. I felt this was a good thing, so I put pressure on her back with hands, and with the cutting board. Later, I suggested the birth ball I had brought, and first she was over it with her knees on the floor, and that produced contractions that were more painful; stronger. We then took a long walk around the neighborhood, and Alta was having steady contractions, but being very brave. She hardly even showed that there were contractions. We walked for about an hour, and when we returned, the couple decided they'd try and rest a bit together. I left her apartment for 4 hours, between 8AM to 12:00 noon (we spoke on the phone twice in that time).

Itzik called me after 12 to tell me that the contractions had picked up quite a bit, and Alta was having a hard time dealing with them. I knew this was a first birth, and I saw the tempo of how it was going before I left, so I wasn't very worried that it was near the end, and I told him I'm on the way.

We then left for the hospital around 2:00PM. The car ride was calm, and her contractions seemed to relax for the ride. At the hospital, we (her husband & I) were told to wait in the reception area until Alta's initial check & monitor are finished. This is standard procedure in this hospital. An hour passed while we waited, then finally we were allowed in to be with her. She was 6cm dilated, and fully effaced at 3:15PM. Alta requested to be allowed to continue to labor naturally, with IFM, and no IV. She was given a heparin lock as hospital policy, but they were very accommodating about the monitor. For the duration of her labor, they just checked fetal heart rate (not contractions) for a few minutes once an hour.

Next internal check was 4:15 PM, and she was 7cm, and Alta continued to bounce on the ball. Another check was performed at 4:45, and she was 7 ½ cm. At 5:30PM, she was 8cm, and at 6:55 9 ½ cm. Some of the labor was very memorable for me, like the time Alta started playing “catch” with her husband & I with the squishy balls she was squeezing. Here she was 8cm dilated, and concentrating on this 3-way game of catch! Amazing. And, her smile stayed with her (& us) the entire time, it was so remarkable. Also, near the end, she was slow-dancing with her husband, and alternating with me as well, and it was so wonderful. It was a real feeling of a home birth in the hospital. She started to transition when she started to tell me “I can't do this anymore!”. I knew then she was ready to push. I gave her encouraging words to stay with it, keep going, the end is close, her baby is coming. It seemed to calm her enough to stay with it. That was the most Alta ever showed distress at her labor.

Her water broke during an internal check at 9 ½ cm and the midwife stretched her to 10 cm. It was 7:00 PM, when Alta started pushing, and she pushed very efficiently. Her baby boy was out at 7:14. It was a beautiful birth. The umbilical cord was left to pulse as per her request, and the placenta was out 12 minutes later.

Ma'ayan's 2nd baby

This was to be Ma'ayan's 2^nd birth. She called me at 6:15AM to tell me her water had broken at 3AM, and she was having light contractions. I asked how she was sure the water had broken, and she described to me a stream sort of feeling, and it was clear & didn't smell at all like urine, and it was continuing. Sounded like it to me, but no “gush”, so I thought perhaps it was a leak rather than total breaking. She had been to the hospital in the middle of the night & they told her it was a high leak, and they aren't going to treat it like waters breaking.

I got to her at 9:30AM. The fluid from the slow leak was clear, and there was a steady mucus discharge streaked with blood. Her contractions were 3-4 minutes apart, 25-30 seconds long, and weak. I told her it is early labor, and a great start.

Ma'ayan had back labor the whole time, so I massaged her a lot. We did a lot of walking around the neighborhood in the early part of the day. Her husband was involved also in Ma'ayan's comfort, as well. The contractions were consistently getting a bit longer in duration, and stronger. She ate a healthy lunch, and around 2PM, the contractions started to get more painful for her. They were longer; about 45 seconds long, 3 minutes apart. She could no longer talk through them, and we used some other techniques for her comfort. I used my cutting board on her lower back for counter pressure, and she liked that. I also had her on the birth ball, with her knees on a pillow on the floor, leaning over the ball & rocking with the contractions. This was a good position for her. Quite consistently, the contractions increased in length and strength, 2-3 minutes apart. She needed it silent in the room at this point, and it was a very serene atmosphere. She was drinking water throughout the labor, and was generally happy.

She decided she wanted to go to the hospital around 6:30PM, and we arrived by 7. Ma'ayan was 4cm dilated, active labor, and 70% effacement. The ultrasound showed the baby in anterior position, and it was unclear weather the water had broken or not, so they treated it as if not.

She was then hooked up to external fetal monitoring (efm), and it remained constant throughout the duration of the labor. Around 8PM she was hooked up to hydration IV and antibiotics, because they decided to treat her as if the water had broken. After about an hour on the monitor, pitocin was started because her contractions became inconsistent, after they had been very well established & consistent while we were at home. So, she agreed to a pitocin drip, and was still very much against an epidural. Ma'ayan was still strong and enthusiastic, even after almost 18 hours of labor. I continued to help her with her back labor. We got a ball onto her bed, and she got onto her hands & knees leaning forward on the ball, like she had done at home. She had good contractions that way, even with the monitor & iv hooked up.

At 8:30PM, she was 6cm, 90% effaced. At 9:25PM, 7cm, 100% effaced. Then, 9:50PM, 9cm, involuntary pushing, then the waters really broke. 10:00PM, 10cm, baby born 10:12PM, anterior, no complications. I used my almond oil for the birth of the head, no tearing at all. The baby's shoulders were broad, and took a lot of effort to get out, but no dystocia. Baby was born, and placed on mommy's chest. At 10:18, the placenta was born.

In the recovery room, many family members came to visit, and I encouraged Ma'ayan to breastfeed her new baby. She did, and baby latched on beautifully. I left at 11PM, baby nursing well and Ma'ayan on a high, surrounded by her close family and her husband.

Sarah's (me, written in 1st person) 3rd baby, a home birth

I woke up my husband, Robert, at about 5:45 to tell him my contractions were 7-10 mins apart, and we should go to the midwife. We'd have an hour drive, so I wanted to start out while it was still early. At about 6AM, I had a pressure to go to the bathroom. When that was over, the contractions started coming faster and stronger. We were out of the house by 6:30am with my labor bag and the carseat, praying that later that day the carsaeat would hold our baby girl coming home.

The car ride was very smooth- hardly any traffic lights, and 120 km. the whole way. It was hard, though, as I was having contractions every 3-5 minutes. Robert was timing them, and driving. I spoke with the midwife, Ilana, while we were not quite out of the city limits yet, with second thoughts to go to the hospital 10 minutes away instead of do the hour drive with labor coming so quickly. She was reassuring that I sounded good, and that she thought we'd make it OK. So, we went!

We got there after exactly an hour at 7:30am, and my first meeting with her was while I was squatting through a contraction at the walkway to her house. She walked us to her birthing house, and we entered and I felt *soooo* good. Good that we were finally there, and good about how it felt in there. It is a comfortable big room with flowered sheets on a big Queen size bed, a large corner Jaccuzzi, and homey furnishings and labor aids. It was heated very comfortably, too, and I felt such relief. I took off my head scarf, sweater, shoes, etc and got comfortable and had a few more contractions. I concentrated now on opening up, as opposed to in the car when I concentrated on staying closed for a little while longer. Ilana checked me, took my blood pressure and baby's heart rate. I was 4 cm. dialated, baby's head very low. I had a few more contractions as we got to know eachother, talking about my previous births, and having Robert take vidoes.

I got into the jaccuzzi a little while after that, and it made the hard contractions so much more bearable. They were coming harder and quicker, and I knew it wouldn't be long. Ilana was very non- invasive, and didn't check me again. She just told me to tell her when I feel like pushing. I also started feeling tingly in my head and arms after each contraction, and realized I was hyperventillating. I started breathing into a bag inbetween contractions, and that helped a bit. It also helped when Robert coached my to hold my breath a bit at the hight of the contraction, and let it out slowly. After about a half hour in the jacuzzi, I told her I feel the pressure to push. She wanted me to get out and birth on the bed because of my history of hemmoraging after birth. That was so hard- I did *not* want to get out of that tub! Nobody wants to move when you are 10 cm's dialated! But she & Robert helped me out, and I managed to get onto the bed- just a few feet away, thankfully. Another big contraction, and I pushed with all I had. I felt the baby move down, and my water was still intact. A little minute or so rest, and another big contraction, and I pushed as if a house were on top of me to be pushed off. I let out a big *ROAR*- there is no other way to describe it- a low, loud *roar*. I felt her go into the birth canal, and *gush* my water broke. It had light meconium, although the baby's heart rate never showed distress at all. When the head was crowning, I felt that sting around the perinium, and was told to stop pushing. You know, that is like putting a red light two feet in front of a semi- trailer going 100 miles an hour. Holy cow- I yelled I can't stop, and both Ilana and Robert said I *have* to stop pushing. Ilana then told my I have to "pant the head out", and to use the syllable "he-he-he". It worked- I was able to put on the brakes and "he-he-he"'d the baby's head out. I had to not push the body out, too, because Ilana had to suction the baby's airways from the meconium. That was like a minute or so in limbo with her head out and her body in. Robert started to cry to see her face, he was so overwhelmed with awe, for the third time. Then Ilana told me to push a little, and I felt the shoulders pop out, and heard Robert telling me the blow-by-blow of what is out now. Then with a whoosh her torso and legs came out, at 9:07 AM, Dec. 5th, 2002. Ilana worked on her a bit to get pink- she didn't cry at first, and was pretty blue. I was so scared, saying "oh my Gd" over and over, with Ilana telling me not to worry- she'll be fine. After about a minute of that, I heard her cry. Oh, I was elated- it is indescribable- that feeling of hearing your baby after a scare. Ilana put her on me, and I saw her face for the first time. I then noticed immediately that she had red hair!! I didn't expect that for some reason, even though Robert has reddish hair. It was nice to be surprised with something although we knew she was a girl. She was with me for about 20 minutes or so, cord attached and pulsing, placenta still inside. I didn't want to push anymore, but I knew I had to get out the placenta. I felt again a big contraction (the baby was nursing at this point, too), and pushed the big gush of a placenta out. What a relief to have all the pressure out of my body. Ilana clamped and cut the cord, and I nursed more. She then held up the placenta for us to see. It was so cool- I never saw it that way- held up by the cord, stretched out at the sack where the baby lived. I saw all the elaborate vessels of that remarkable organ. We got a cool picture of it.

Then, me & Robert and baby hung out on the bed for a while while Ilana cleaned up, and it was bliss. Nobody else around, no pressure to get to a recovery room, or do *anything*. The baby nursed really well right away. After about an hour and a half or so, Ilana asked me if I wanted to shower. I totally did, and was so relieved to get the chance to do it, because in the hospital they don't let you get out of bed for like 7 hours or something. After my shower (she hung close by to help if I needed) I got into my own clothes, and sat outside on her beautiful idyllic lawn in a chair, with purple and yellow flowers and tall palm trees with a hammock between them, in the fresh morning Israeli air, about 75 degrees Fahrenheit. It was pure bliss, sitting there with my peaceful 2 hour old baby girl looking at me, and Robert videoing. It was a far cry from the flourescent lights, steel beds and other laboring mothers of the hospital after birth experience. I told Ilana next time I'll have my baby in her hammock.

We then went left at about 1:15 to go to the nearest hospital to register the baby, get mother and baby check-ups and then head home. Unfortunately, the hospital took a very long time, and we weren't on the road until evening. Then the trip back home took over 2 hours with a radiator overheating, and huge traffic jams. That was so hard- to sit upright for so long when I had just given birth. Finally we got home, and it was the same day I had given birth. The boys were so happy to see us, and see the baby. Next time, I think I will do it at my own home, so I don't have to travel like that, either going or coming back. I just hope nobody would be listening when I roar. :-)