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Bringing MTMT into the World

I know it’s more conventional for the mom to share her birth story, after all, she’s the one who had to actually push a tiny person out from inside her. But maybe I’m just not conventional because I feel the urge to share our story, from my perspective. I have relived our story so many times in so many ways, through telling it to family and friends, in private moments with rIAm, through stories I’ve told my son and in my own mind.

I should mention right now, this isn’t a short post. Digest it at once or in chunks. But I want it to stand on its own, not in separate posts.

Pregnancy, labor and birth are not things I had spent much time thinking about. When I found out I was going to be a dad I was thrilled, excited and every other adjective you could think of. I just assumed we’d be under the care of an OB, give birth in a hospital and I guess the one thing I knew for sure was that I wanted to cut the umbilical cord. After all, that’s what you’re supposed to do, that’s how it works, right?

rIAm had been given the advice of friends she trusts to take the drugs, get the epidural, don’t try to be a hero: the pain is that intense. She was all for it. Then she started reading. And kept reading. And questioned why she was with an OB. Why she had to give birth in a hospital. Why pregnancy and childbirth were treated the same way as injury, disease and medical maladies.

I should clarify, it’s not that pregnancy and childbirth are something that doctors try to “cure,” but the approach to the care is as if something were wrong, a condition. But pregnancy and childbirth are about as natural as it gets. Yes, things can go wrong or be dangerous, and in those situations the medical establishment is enormously useful; many moms and babies would not be alive today without modern medicine. But if all is going well, why does childbirth have to be in a hospital?

Well it took me a while to come around to it, but I realized that childbirth doesn’t have to be in a hospital. It can be in your home and be perfectly safe. I cannot recommend enough reading The Birth Partner and also The Labor Story, Part One, by Heather Armstrong (aka dooce). There are many resources out there explaining why homebirth is a very safe option, and there is extensive research supporting this, including showing that the negative outcomes would have been the same whether the birth was at home or in hospital.

But this isn’t about explaining why homebirth is a safe option; please trust me that it is, or read for yourself why and then come back, because I want to talk about why homebirth was the right option for us.

Like I say, rIAm was set on a homebirth long before I was, not because I questioned the safety but because I thought it would be more headache and hassle to prepare and clean up before and after our labor/birth team came in and left. I was assured that it wasn’t that much work. Then I started thinking about the benefits.

No trip to the hospital with rIAm in the throes of labor. No crappy hospital food. No exposure to superbugs. No easy access to medical interventions we didn’t want. No cramped, sterile, uncomfortable hospital surroundings.

At home we have our own food. Our own drinks. Our own bed, chairs, sheets, pillows, music, internet, phones, etc. How nice would it be to immediately be able to be in one bed together with our newly expanded family? How great to have as many visitors as we wanted, whenever we wanted them? The list of benefits went on.

It’s also important to note that in Ontario homebirth is fully accepted as a viable option, with midwives, and OHIP fully covers both midwives and homebirths. So yes, we were with midwives, which I highly recommend. Even if you want a hospital birth, the more extensive care midwives provide – longer appointments, care for mind, body and spirit, etc – is worth at the very least serious consideration. If you need one, you’ll have an OB available to you anyway.

We have many wonderful things to say about Seventh Genreation Midwives Toronto and especially about our midwives, Nadia and Alanna. The other essential piece of our team was our doula Kristina, of A Hand to Hold.

I strongly believe now that with knowledge, confidence and a good team, a natural birth, at home or in hospital, is an unbelievable way to go. It seems like the way childbirth has been set up, people immediately assume hospital and then think their only decision is epidural or not. But that totally misses the point that labor and birth are extraordinary moments in life that should run the way the laboring woman wants them to run. If that eventually means epidural, fine, but it doesn’t need to start there as a form of pain management. Unfortunately the whole toolkit of natural forms of pain management are rarely revealed to women and the medicalization of labor I believe often causes stress that leads to complications. Medical interventions are valuable tools and there are certainly high risk labors that should be in hospital, but we don’t need to start there. Through more education and changing the mindset of pain management to include a broader toolkit that doesn’t necessarily start with an epidural, I am confident, would lead to fewer c-sections, complications and perhaps shorter labors.

I don’t want to come across as if I’m on too high a horse here; I certainly want each family to decide for themselves what is best for them. I don’t expect anybody else to want exactly the same things we wanted; no two labor stories are the same, anyway. But that’s just it, I want it to be each family’s choice, and not up to the doctors or medical community.

For us, home emerged as the place where we’d be most comfortable and rIAm, with my full support, wanted to give the natural way a real shot. In other words, if she ended up needing medical interventions, by all means use them, but if she doesn’t, don’t mention them. Our team was in place, our minds were made up, we told our families… now it was time for the Big Event.

Labor came on fast and furious. We had gone to rIAm’s family’s for a big lunch with some relatives from Italy and after getting home rIAm made it clear in no uncertain terms she was DONE being pregnant. I negotiated as best I could that it wouldn’t be too much longer. We settled into bed and rIAm was asleep and I was nodding off and waking up when rIAm woke up in searing pain below her belly. She didn’t like it. She was concerned. Neither of us thought it was labor; we were expecting to start with more mild contractions space much further apart. I also realized I needed to pee, but my wife crying out in pain commanded most of my foggy attention.

We decided she should try to use the toilet… maybe that would relieve some pressure and the pain would subside. I went along for moral support and over the course of probably more time than I care to think about realized that the pains were coming every 2-3 minutes and lasting about a minute.

Umm, rIAm, I think we need to call the midwife now. And by now I mean NOW.

That was an interesting call. rIAm was in so much pain she wanted nothing to do with the phone. I knew Nadia needed to talk to rIAm. We finally got the speaker phone working. Nadia patiently listened to rIAm explain what she was worried about and then said “basically, I think you’re in labor.” But she humored us and suggested a lengthy, hot shower. This “little experiment” as she put it might clear it all up, at which point we should go back to bed and call Nadia in the morning. But if after 15-30 minutes nothing changed, call her back and she’d come over.

An interesting side note here is that rIAm had also been VERY keen on a water birth, or at least using a lot of hydrotherapy in labor. Me not so much (about the water birth… dealing with setting up a tub didn’t sound like good times and I didn’t want to be climbing in a pool). So I figured that even if the pain didn’t subside, rIAm would love the shower. I couldn’t have been more wrong. She stuck it out for 15-20 minutes but she wanted NOTHING to do with that water. We called Nadia back, who, unbeknownst to us, knew full well we’d be calling back and had packed up and gotten herself ready to come over and deliver a baby. She said she’d be at our place within 20 minutes, but it was more like 10.

We also called our doula, which we weren’t even sure we were supposed to do yet (we still didn’t comprehend that this was labor and it wasn’t going away), but Nadia made it clear that we should call. Kristina immediately recognized over the phone that rIAm was not coping well, gave some tips, and rIAm and I went to work on that while we waited for our team to arrive.

Nadia arrived first and helped rIAm try to focus, but she also had a lot of equipment to get in. Kristina arrived shortly thereafter and immediately got to work helping rIAm work with the contractions, not against them. Three of us – Nadia, Kristina and myself – each set to work on what we had to do to help rIAm, who was clearly in enormous discomfort and pain.

One of the things you do with a homebirth is prepare the house for the birth. We had our bag of supplies, but hadn’t yet fixed up the bed. That involves putting down nice sheets and on top of that putting a fitted plastic cover and then on top of that putting sheets we don’t care about. It also meant clearing a few areas to make way for equipment. Basically, things we thought we’d do in early labor when contractions were 30 minutes apart and we needed to do things to distract us.

Nothing was set up when everybody arrived. rIAm’s contractions were every 2 minutes, lasting a minute. In other words, there was ONE WHOLE MINUTE of time to get stuff done. Fun doesn’t really describe it.

Nadia did a lot of negotiating with rIAm, but finally was able to a vaginal check. rIAm laid back on the bed, in my lap, and Nadia determined how far along rIAm was and what was going on. She looked up and proclaimed, “renée, you’re 7-8cm dilated.” She may as well have dropped a hand grenade in the room. Not skipping a beat, though, rIAm replied “What!??! Are you fucking with me!???” Truly not skipping a beat, Nadia’s response was quite simply, “No renée, I’m not fucking with you.”

That’s when it really hit us, we were going to have a baby, and we were going to have that baby very soon. The next order of business, though, had to be practical. rIAm’s bag of waters was bulging and we were not ready for it to burst. Kristina took rIAm to the bathroom to empty her bladder while Nadia and I set up the bedroom. I fixed up the bed, Nadia worked her equipment. We got everything ready.

rIAm at this point had found some sort of magical place to cope with her contractions. When they say to work with the contractions, to let them wash through you, to not fight them… rIAm found that place. It was unbelievable, one of the most amazing things I’ve ever witnessed. It became clear to me in that moment that women in labor can do anything. But I couldn’t dwell on that thought; rIAm’s waters just splashed all over my feet. That and I needed to keep my hands on rIAm’s back and Kristina needed to keep eye contact.

But now that it was probably 4am and I’ve had to pee since midnight, I made my dash to the bathroom, not giving anybody time to object, because my bladder was about to object. Later I found out Kristina was petrified that she was going to have to be me for those precious moments and that she may not do an adequate job. I returned as quick as could be.

After a while rIAm started to cope with contractions differently. Something obviously changed. Nadia recognized that pushing was imminent and encouraged rIAm to push with the contractions if she wanted. After a bit of that we changed positions to try to attempt active pushing. It wasn’t going well. rIAm couldn’t wrap her mind around how she was supposed to change her approach to contractions.

It was at that moment that I most wished I could have done some work for my wife; I understood what needed to be done, but was basically powerless to make it happen. Moral support is great, but it doesn’t get the baby out. After 10 or 15 minutes Nadia suggested we take rIAm to the bathroom to do a final void and practice pushing on the toilet – you push the same way you poop, after all.

We never quite made it to the toilet. rIAm had one or two contractions on the way and then another as we were trying to convince her to sit on the toilet. With the last contraction she was more loud and shaken than most and then started shrieking:

“THERE’S A HEAD BETWEEN MY LEGS! THERE’S A HEAD BETWEEN MY LEGS!”

Apparently, there was a head between her legs. Max’s head. That’s not how it’s supposed to work. I was confused how there had been more waters on my feet. I didn’t think I needed to look down, but didn’t think there was anything left in the bag of waters. But the shrieking made me look and I realized there was blood on my feet (and on the bathroom floor. Not a scary amount, but the reality of the moment set in.

My baby’s head had just popped out of my wife’s body. I was virtually a Dad. We were in the bathroom. We didn’t have anywhere to go.

Nadia came running from the bedroom, where she had been calling the second midwife to come – because she expected another hour or so of pushing. (The second midwife attends to the baby once s/he is born, and in this case was paged when Nadia thought there was a good hour or so of pushing ahead of us). Nadia kept her cool, though (a real testament to the fact that she’s a real pro), and calmly told rIAm that her baby would be born with the next contraction. Kristina and I each took a shoulder. rIAm sort of had some weight on the toilet. We braced.

Max slipped right out as Nadia predicted and quickly started crying. Very good news. rIAm got settled on the toilet, her baby in her arms. She started exclaiming “there’s a baby in my arms! there’s a baby in my arms!” Through the emotion, the whirlwind, everything, I realized we didn’t know if we had a son or a daughter. I was by the legs. I was by the answer.

Even though we had hoped to be the ones to find out if we had a boy or girl, we knew that our midwife might be the one to inform us. But Nadia was busy attending to Max, conscious of the fact that she wanted rIAm back in the bedroom asap. So I checked between the legs and saw boy parts. But then I thought maybe I wasn’t seeing right.

I checked again. We had a baby boy. I shared this news. We were in shock, awe, bliss. Still on the toilet, but we didn’t care.

I got to cut the cord. Then I helped get rIAm back to the bedroom to deliver the placenta. Before I knew it I was holding my son on my chest, keeping him warm.

I was a Dad.

I Finally Understand Dad

To us, our son was (and is) perfect. Our labor and birth story is everything we could have wanted it to be. We never had to consider the hospital or any interventions rIAm didn’t want. Our team was amazing, unbelievable, really. That midwives and doulas can go through that experience 40 times a year is mind-boggling.

What’s been interesting is how many people hear that rIAm’s labor was just shy of 6 hours and exclaim how lucky she was. It’s true that we feel fortunate we did not have a marathon labor and in that way I guess it’s true that we’re lucky. But those 6 hours were the most intense six hours I, and I’m sure rIAm, ever experienced. There was no break from the time rIAm woke up to the time MTMT was born. At one point rIAm even asked for one and Nadia politely explained there wouldn’t be a break until our baby was born.

Part of the challenge was that because labor came on so fast and so strong, rIAm’s ability to cope was very low while the pain was very high. It took a while for her coping ability to catch up, but even once she did, it was exhausting. I also believe firmly that rIAm’s mental attitude toward labor contributed to her having such a fast labor. She didn’t get nervous, scared or anything negative that might have slowed things down. I think MTMT knew he had a supportive mom who firmly believed her body was made for and ready to pop him out. (After all, pop out is exactly what he did!)

Regardless, it’s our birth story, and it’s a darn good one. It was made possible by the tireless dedication of my unbelievable wife, in whom I have an unbelievable amount of pride, and who is an even more unbelievable mother. I’m sure we’ll make some mistakes along the way as parents as we figure out our son and how to best raise him. But I know for certain there were no mistakes in how we brought him into this world.

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