Tuesday, February 5, 2013

The Home Birth Cesarean of Canon Patrick



Note: After Canon's birth, a friend linked me to the Homebirth Cesarean* (HBC) site. Because the rate of planned home births resulting in cesarean birth is so low, those of us who have had these experiences fall between a crack of sorts. We aren't exactly homebirthers, but we aren't exactly typical cesarean birthers, either. The months we spent planning and preparing to birth our babies gently at home, and the time we spent at home laboring in the care of our midwives bind us to the home birth community we hold so dear, while our surgical deliveries simultaneously alienate us from it. I have embraced this term, Homebirth Cesarean, to describe my birth experience, and I hope that sharing my experience will help my HBC sisters to process, embrace, and celebrate their own beautiful birth stories.

The timing and order of events is hazy, so all times are approximate and to the best of my memory. :)



Tuesday, January 22, 2013

We drove out to our midwives' birth center for our 39 week prenatal appointment in the morning. Everything went as usual. Canon's position was good, our vitals were good, Delilah had fun helping the midwife check the baby. We scheduled a 40 week appointment and joked that we hoped that we wouldn't need to keep it. Ty went back to work and Delilah and I went home to have lunch and get her down for her nap. When Ty arrived home, I left for work to do my women's group along with my substitute. I got home around 6:30 and did some documentation for work, then did some tidying up around the kitchen.

Around 7:30, Ty started getting Delilah ready for bed, and I joined in for bedtime songs, ending, as always with "You are My Sunshine," which Delilah always insists that I sing by myself with no help from Daddy. I kissed her goodnight and left her and Daddy to lay together for a while. A friend of mine who was due around the same time as me and who was under the care of the same midwives in preparation for her own home birth shared a link to a beautiful HBAC story. While I was reading it, Ty came downstairs with tears in his eyes and said how nice it was to just lay with his little girl while she drifted to sleep. He headed to the basement to watch some TV while I finished reading the birth story, and commented to the friend who had shared it: I can't wait!

I can't wait.

The moment I finished typing those words, I felt a bit of warm fluid gush out of me. In disbelief, I stood up, and sure enough, another gush. I yelled down the stairs to Ty that my water had broken, and he came racing up to find me standing in the kitchen, dripping water, and laughing hysterically. He hugged and kissed me and asked what I wanted him to do, and I asked him to please take my pants off me and get some towels.

2 hours after my water broke
We were both giddy with excitement. This was it! We were having a baby! Ty called Denise, the midwife on call, to let her know my waters had broken, but that contractions had not started yet. He turned the phone over to me and she reminded me of the protocol for Hibiclens rinses and tracking my temperature, as I was GBS positive and preferred to avoid the use of antibiotics unless I started having signs of infection. She urged me to eat something and get some sleep and give her a call when I started having contractions I could time.

I called my mom to have her come in the morning and pick up Delilah when she woke up. After hanging up with her, I got emotional about my last moments as a mother of one and went up to climb in bed with Delilah and snuggle with her for a little while. After a snack, a Hibiclens rinse, and some random tidying up around the house, Ty and I went to bed around 10:30. He quickly fell asleep, and of course, shortly after laying down, the contractions started. They were sporadic and the pain was manageable, so I did my best to just rest through them, though I was too excited to surrender myself to sleep.

Wednesday, January 23, 2013

I eventually drifted off and woke up around 1:30 am with contractions that were a bit more intense and closer together. I got up to time them and sat and wrote a letter to Canon and just enjoy the peace and quiet of the middle of the night. I called Denise close to 3:00 am to let her know my contractions were 5-6 minutes apart and lasting about a minute. She again urged me to get some sleep and to call her back when I woke up in the morning, or if they started getting more intense or closer together. I laid back down and the contractions gradually slowed down, allowing me to get a few hours of sleep, waking up here and there to breathe through a particularly intense wave.

Ty woke up around 5:00 am to shower and start getting birth supplies organized and ready. I was still in bed when my mom arrived around 7:00 am to wake Delilah up and take her and our dog until it was time for them to come and meet Canon. Delilah was so excited to be going with Grandma that she couldn't get out of the house fast enough and barely kissed me goodbye. Ty made us breakfast and we were both excited to get the show on the road. I was certain that with Delilah safely in the care of my mother, things would pick up quickly and I'd be in active labor in no time.

As the day wore on, contractions varied in intensity and remained sporadic, ranging from 10-30 minutes apart. It was a day full of emotion and impatience. I listened to my birthing affirmations. I regretted having been so hasty to send Delilah off, now wishing that I'd spent the day with her rather than waiting idly for labor to ramp up. Ty and I watched a movie together, we ate and drank, we went for a walk, and he comforted and supported me through both the physical and emotional discomforts of a long early labor. I checked in with Denise throughout the day, and around 4:00 pm, we agreed that she should come over to check on me and listen to the baby.

When Denise arrived, we all sat down together and she discussed the standard of care, given that we were coming up on 24 hours since my waters had broken. She gave me the option of using antibiotics, and after discussing the risks and benefits, and the research on outcomes of antibiotics versus Hibiclens rinses and monitoring for signs of infection, I declined them. She checked my vitals (all normal) and listened to Canon through a contraction, which he handled beautifully. She was extremely encouraging and reassuring that everything would happen as it should in due time, and urged us again to stay well fed, well hydrated, and well rested. Denise suggested that if I wanted to, I could try pumping one breast at a time for 5 minutes, then wait 5 minutes, then the other breast for 5 minutes, for an hour, to see if that would kick start things.

After Denise left, our spirits were lifted, though I still had some tearful moments of uncertainty that active labor would ever start. Pumping brought on a few contractions, but nothing regular. Ty and I ate dinner, watched some TV, and then went to bed a little after 9 pm.

Thursday, January 24, 2013

I had woken up a few times to contractions, but around 1am, I could no longer tolerate them laying down. I came downstairs, gathered my birth art and my ipod, and sat on my birth ball, gently bouncing, focusing on my birth art, and listening to Hypnobabies birthing day affirmations. When a contraction came on, I breathed through it and switched to moving my hips in circles on the ball. When the affirmation track was finished, I started timing my contractions, and was excited to find that they were about 5 minutes apart and lasting a minute each. I was tempted to try to get some more sleep, but I was worried that laying down again would slow everything down, and I was determined to keep things moving.

I woke Ty up around 3:30 am to let him know that I was going to call Denise. He came downstairs and I called her to update her. Remember that friend I mentioned who was due around the same time as me? Denise was on her way to her house as she had gone into labor too! I assured her I was managing fine on my own and that birth was not imminent. Ty and I were both nervous and amused that our friend was in labor at the same time. I'd had a feeling that we might have our babies very close together, and reminded Ty that this is why there are two midwives and backups!

Denise called me when she arrived at my friends house to tell me that the baby was coming quickly and that they would send the apprentice midwife, Alison, over to my house as soon as possible. Alison arrived around 6:00 am; she checked my vitals and listened to Canon with the doppler. She let me know that they would monitor him every 30 minutes.

At this point, Ty was supporting me through contractions; I'd put my arms around his neck and he would firmly massage my lower back, as each contraction started low in my abdomen and then radiated around to my lower back. (Everything they say about back labor? True.) I was vocalizing through contractions with low, open "aaaaaaah" and "oooooooh" sounds, sometimes "oooooh" to "ooooooopen" and "aaaaaaah" to "aaaaaaa-out". Alison told me I was doing great and that the type of vocalizing I was doing was perfect, keeping my throat open and relaxed. Between contractions, I swayed, bounced on the birth ball, and walked around the house. At this point, I was just happy that I was finally in active labor and was feeling optimistic and confident that I would meet my baby that day. I stayed hydrated with water, Gatorade, and tea, and did my best to keep eating bits of yogurt, fruit, and cereal here and there throughout the morning.

Denise arrived mid-morning and Alison updated her on how things were going. I had a contraction as she was arriving, and I heard her to say to Alison "Wow, she sounds great!" Hearing that boosted my confidence and I was grateful for Denise's calming and positive presence. I asked about my friend's baby and she told me that mom and baby were doing great, and that mom was worried I'd be mad that she had her baby first! I laughed and said I wasn't mad, just jealous of her quick labor!

The rest of the morning passed by in a blur of much of the same. Denise helped relieve my back labor through contractions by applying pressure to my lower back. Denise and Alison took turns resting and did their best to be quiet and unobtrusive, saying that Ty and were working beautifully together and they didn't want to disrupt our rhythm. At one point, I asked Denise about getting in the tub, and she said she would prefer I wait until it felt like I absolutely needed to get in the water.

Our second midwife, Tavniah, who had stayed at my friends house to get some rest and be there in case she was needed, arrived at our home around lunch time. Denise filled her in on my labor pattern (contractions were consistently 4-5 minutes apart) and how I was handling it. The midwives agreed it was time to decide whether I wanted to try to get some rest or try to put some more effort into getting things moving along. I insisted I didn't want to rest and wanted to keep things moving. Denise left to get some food and Tavniah worked with me after sending Ty to rest for a while. We did some Rebozo work, I worked through some contractions down on all fours, and did stair lunges through some contractions. After working through these various techniques, Tavniah had me eat some soup and suggested I try to get some rest by laying face down on a pile of pillows. I was able to rest briefly, but contractions were more painful in that position and I was soon up and moving through them again. Ty got up from his brief nap to continue supporting me through contractions.

When Denise returned, I asked again about getting in the pool. She gave Ty the go ahead to start filling it. Shortly after he turned the water on, the adapter for the hose malfunctioned somehow and Ty was trying to hold the hose to the faucet to keep the water flowing. Denise suggested we see if the hose was long enough to reach the pool from the hot water line in the basement, and thankfully, that worked! We were able to get the pool a little more than half-way full before the hot water heater ran out, so we started boiling pots of water and had to wait about 45 minutes for the tank to refill.

When the pool was finally filled, I couldn't wait to get into it. I slipped into the water just as a contraction came on, and was immediately relieved at how soothing the water was. In the water, I was able to drift off to sleep for a few minutes between contractions. My contractions slowed down a bit, but I was thankful for the rest. After a while, Denise suggested I get out of the water to get things to pick up again; I reluctantly agreed.

Contractions picked up again shortly after I got out of the pool, and seemed more intense than they had been before. I did more stair lunges through a few contractions and kept moving. Canon's and my vitals and monitoring continued to be normal. My midwives kept encouraging me to eat, but my appetite had all but disappeared. As the afternoon turned to the evening, Denise asked if she could check me for dilation and I agreed to a check. She announced I was dilated to 6 cm and that my cervix was "nice and stretchy." I was disappointed and said that I was hoping I'd be further than that, but Denise was reassuring and said that it was great progress and it's not unusual to go from 6-7 cm to fully dilated quickly. While I was still laying on my back, a contraction came on, and it was the most excruciating pain I'd ever felt. I remember saying "Women are crazy for laboring on their backs!" and "No wonder so many women in hospitals get epidurals!"

Shortly after my check, I asked to get back in the pool, as my contractions were growing more and more intense, especially in my lower back. Ty and Alison worked on removing some of the water to add more hot water to bring the temperature back up. I got back in the water and again was able to rest peacefully between contractions, though this time, they didn't slow down. Based on the number of times Alison listened to Canon, and the number of times Ty added hot water, I think I was in there for close to two hours, at which point Denise took my vitals. She was concerned that my pulse was high and that I was getting overheated, so she asked me to get out of the tub and work on re-hydrating myself. She had me lay on my left side, but laying down through contractions was unbearable so I ended up moving to the toilet and sitting through a few contractions there. I had been through a few "I don't know how much longer I can do this" moments throughout the day, but I was starting to feel very frustrated with how long labor was lasting and like I really wasn't sure how much more I could take. Denise reassured me that I could do it, that I was doing it, and that I could keep going. She encouraged me to eat, but the thought of food made me nauseous. I finally agreed to eat a popsicle and continued drinking lots of water. Contractions remained consistent at about 4 minutes apart.

Friday, January 25, 2013

Around midnight, still sitting on the toilet, I told Ty I thought I was going to be sick. Tavniah ran for an ice cream pail and handed it to Ty just in time. I vomited 5 times (all water). I had never been more thrilled in my life to throw up, as I hoped this was a sign that I was nearing transition and getting closer to meeting my baby!

I got back in the pool one more time. The first time Alison monitored Canon, she accidentally dropped the doppler into the water. The other doppler had gotten wet at my friend's birth, which left them with only the fetoscope to listen to Canon with. Alison left to drive back to the birth center (a 40 minute drive) for another doppler while Denise and Tavniah worked to figure out a way to monitor me with the fetoscope while in the water. I had to raise my belly out of the water, Ty held on to Denise so she wouldn't fall into the water, and Tavniah counted and timed Denise's finger taps as she listened to Canon. It was quite a spectacle, but since the alternative was having me get out of the pool until Alison returned, I was grateful they were able to improvise.

Alison returned with the doppler and I was in the water for another hour or so before I told her that I was starting to feel more pressure and like I wanted to push. She went to get Denise, who was resting, who encouraged me to just listen to my body. I started to consciously "breathe my baby down" during contractions but didn't feel any real urge to push. I got out of the water again and moved to the couch, where I started bearing down through contractions. I moved to the toilet and started inadvertently grunting and lightly pushing with contractions. I got up and was moving around the kitchen, holding on to the countertop and squatting down during contractions. Ty continued to be right by my side through every moment. I mentioned that it seemed the contractions were coming closer together now, and I heard someone say "two minutes." My confidence was renewed at the new intensity and more rapid contractions; I was sure I would be holding Canon in my arms very soon now.

At around 4:30 am, Denise asked if she could check me again. I laid down on the bed and had another excruciating contraction on my back. Denise checked me as I looked at her hopefully. She looked down quickly, then looked at me gently and said quietly "No change."

"What? Still 6?"

"Still 6."

Denise said she would like to call her backup doctor, who she had checked in with a few times throughout my labor. I looked at Ty and said "That's too long to go with no change. I really don't think I can do this anymore." Ty just put his arms around me and held me as I started to cry.

I moved from the bed to the toilet to wait for word from Denise. She somehow managed to wedge herself in the small space between me and the wall and put her hands on my knees. I looked her in the eyes and said "It's time to go, isn't it." She nodded and told me she was so sorry, and that she was sure I was going to be close to complete with how labor seemed to be progressing. She couldn't explain why there hadn't been any change. Ty was sitting on the edge of the bathtub and had started crying. My tears had stopped by then, and I told him that I was okay. He told me that he was so sorry, that he knew how badly I had wanted this, and that he had wanted it for me.

We discussed which hospital we would go to and Denise called ahead to let them know we'd be coming. Alison started to clean up the house while Ty packed a bag and Tavniah helped me get dressed. Everything was very calm, the only sense of urgency was me not wanting to be in pain any more. There was never any emergency; both Canon and I were safe and physically well throughout the entire labor.

Ty and I left for the hospital with Denise following us. When we arrived, they were expecting us, and ready to escort us to Labor and Delivery. I reluctantly agreed to a wheelchair; thankfully my contractions had slowed to nearly 10 minutes apart with the change of events. Nurses quickly got us settled into a room and got monitors on me while Denise filled them in. VBAC, GBS+, PROM. A resident came in and he too was brought up to speed by Denise. He brought in an ultrasound machine to make sure that Canon was head down. Denise commented "Well if he isn't, he's got a hairy butt!" as she had felt his hair when she had checked my cervix.

Shortly after the resident left, the OB-GYN on call came in. She asked if she could check me, and I asked if I could please have an epidural first. She said that she would prefer to check me first. Because I was a VBAC, and because my water had been broken (increasing the risk of infection) and I had been "contracting against that scar tissue" for so long, she was concerned about letting labor continue unless Canon was in an absolutely perfect position. She checked me and said that his head did not seem to be descending properly and that she recommended a cesarean delivery. Ty teared up again; I was just feeling relieved to have a plan and an end in sight.

From there, things moved quickly. The anesthesiologist came in, the pediatrician came in. I suddenly remembered that we would need to make all of our wishes known, in terms of newborn procedures, etc. I was taken to the OR for Anesthesia while the OB-GYN and Pediatrician stayed with Ty. Ty let them know that I wanted to keep my placenta, if possible, and that we did not want Canon circumcised and wanted to delay any non-essential procedures until nursing had been established. The anesthesiologist was incredibly kind and gentle, and as the spinal block started to take effect, the lack of pain in my back and abdomen was a tremendous relief.



Ty came into the OR and the anesthesiologist unstrapped my right arm so I could hold Ty's hand. I was shaking from adrenalin and he freed my other arm, reminding me not to reach past the curtain.  Ty told me how much he loved me and how proud he was of me as the surgery got underway. The anesthesiologist explained every step as it was happening, and Ty looked over to the glass-doored cabinets lining the room and realized that he could watch the surgery in the reflection. He was warned that watching might make him sick and to let them know if he felt light-headed or nauseous, but Ty said that at this point, he could stomach anything. I kept asking Ty if he could see the baby yet, and finally, he announced "He's out!" Tears filled his eyes and my own as we heard Canon's first cry and got a quick look at him. Ty went over to the warmer where they cleaned him off and did Apgar scoring (9 and 9) then Ty brought him over and placed him cheek to cheek with me.


Ty accompanied Canon back to our room to be looked over by the pediatrician while I remained in the OR to be sewn up. They wanted to monitor Canon closely for infection due to the circumstances of my long labor with ruptured membranes and GBS+ status. It felt like it took forever (it was about 45 minutes) for them to finish up. I kept nodding off and they'd wake me up, concerned I was passing out. I kept explaining that I was just very tired, having been in labor for two and a half days! As the doctor finished, she explained that Canon's head had been slightly cocked to the side and that his chin was not tucked, which was preventing him from moving down through my pelvis. She also explained that due to the circumstances, my placenta would be sent off to a lab for pathology, which meant I wouldn't be able to have it encapsulated as I'd planned, as it would be stored in formalin.

When I was finally returned to my room, I was able to hold Canon and nurse him right away. He latched on eagerly and nursed well. Denise was there with Ty and exclaimed "Wow, what a great nurser!" Denise told me that she was proud of me. She told me and Ty what an honor and joy it was to see how beautifully we worked together throughout labor and that we had done everything right. She told me that she would still do my postpartum follow-ups and Canon's newborn care for the first 6 weeks. I thanked her for everything and she left to let us get acquainted with our beautiful son.


While I did not end up having the home birth I'd planned and hoped for, I would not have done a thing differently. The care I received throughout my pregnancy from my midwives was empowering and healing after the experience I had with Delilah's pregnancy and birth. The days I spent in labor showed me how strong I am and how much I can endure. The support of my beloved husband and the way we worked together from beginning to end was an affirmation of the love and powerful bond between us. There are no "what ifs"; there are no "if onlys". I do not feel as if I gave up, I do not feel as if I failed, and I do not feel as if the surgical delivery was unnecessary.  My birth unfolded as it did, Canon and I were safe and healthy throughout it, and those three days were the most intense and powerful three days of my life. I will always be grateful for my husband and midwives who supported my goal of birthing at home and who believed in me. I will always be in awe of my body for enduring 58 total hours of labor with very little sleep, then a surgery, then a swift and smooth recovery. I have never been more proud of myself, more in love with my husband, or more sure of the beauty and innate wisdom and power of birth.

*Learn more about the Homebirth Cesarean Book Project and how you can support it HERE.

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12 comments:

  1. Beautiful! Thank you so much for sharing!

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  2. What a powerful and beautiful story, Joella! Thank you so much for letting is in on the details of this incredible experience. And I hope you are getting to enjoy your babymoon!

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  3. This was beautiful. I love it! Thank you so much for sharing it!

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  4. beautiful, beautiful, beautiful birth story! I can't wait to meet Canon! =)

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  5. So happy to read the whole story! You are so amazing! I think everything you wrote here is so wise- birth is so powerful and can be unpredictable, but treated with reverence and respect it can be an undeniably rewarding experience, regardless of the details. You brought a whole new life into this world! He chose an amazing family to be a part of. Much love to you. <3

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  6. What a sweet little guy! He has such a strong warrior for a mama! You have an amazing birth story!

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  7. Crying my eyes out over here. An amazing story, and your little guy is stunning. I had the exact experience with my son and it is heartwarming to read another woman's story. Thank you so much for sharing.

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  8. I am bawling....I can't wait to be a mommy some day - I hope I get too. I love reading your writing. This was amazing to read. And your husband sounds remarkable and I am so happy for you guys. How blessed you are
    Carolyn Johnson

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  9. HUGS. So beautiful that ty is so empathetic that he was crying for you. Sometimes its nice to have reminders that there are loving guys out there (not that i ever doubted it in his case, of course!)

    <3 to all of you!

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  10. It's amazing what affirmation of the mother's wishes and needs can do to make a birth story just what it should be. I'm very impressed with the advocacy of yourself and all those involved with your birth story. This is the respect and tender care that every birth mother ought to receive. Beautiful, simply beautiful. I'm so glad you found it was just what you wanted it to be. :D

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  11. Such a beautiful story. I just wrote my vbac story this week and posted to the baby link up too :) he is beautiful!!

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  12. I always love your DITLs and I really loved your birth story. I adore your relationship and this entry was no exception. You two are fabulous and your babies are lucky to have been born into such a sweet family! Bless!

    (Also LOVE that Canon is following his sister with the hat love!)

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