A Birth Story

There is a poem about birth that I had never heard, until Leslie read it to me at our blessing way.

Being born is important

You who have stood at the bedposts
and seen a mother on her high harvest day,
the day of the most golden of harvest moons for her...

You who have seen the new wet child
dried behind the ears,
swaddled in soft fresh garments...

You who have seen this love’s payday of wild toiling and sweet agonizing.                                                You know being born is important. You know that nothing else was ever so important to you.

You understand that the payday of love is so old,
So involved, so traced with circles of the moon,
So cunning with the secrets of the salts of the blood.
It must be older than the moon, older than salt.

While she read it to me, I contemplated your coming arrival. I thought about all the labors I have been a part of, all the births I have seen, all the beautiful souls I've been blessed enough to welcome into the world... and, I cried. 

Tears of joy, trepidation, anticipation, and surrender.

Because, that's what labor is. It is joy, angst, anticipation, and in the end, complete and utter surrender to something so much greater than ourselves. It brings with it the greatest power a woman can experience, along with the greatest joy.

As we prepared for your birth, we knew that it would never go as we thought, planned, or anticipated. I tell patients every day, "You cannot plan this. You cannot control this. It is completely out of your hands. You prepare, and you accept and surrender to the labor and birth as it comes."

We had no idea what your labor and birth would bring. 

We thought it may be quicker than your sisters, we thought we had prepared for that. We knew we needed support from a loving and experienced birth team. We had prepared for that... we had Leslie, Stephanie, Emily, and the fantastic team at VCU where I worked. 

The truth is, we had not prepared for how your birth came to us. 

On February 16th, as Natalie and I got ready for bed, your sister said to me, "Is baby coming today?"

"Not today love, maybe tomorrow." Natalie smiled, she had been so excited the last few weeks guessing when you would come.

On February 17th, your due date, I woke up at 3:01 am with cramping, and a Braxton Hicks. Normal for me. This had been happening almost every night for at least two weeks. I'd wake up, feel a cramp, and know it was nothing.

This was different. A few minutes later, it happened again. Something told me you were coming.

I called Aunt Amanda at 3:08.

"Is it time?"

"I think so. She's coming today."

"Do I have an hour you think?"

"Yeah, I think so. I don't know how long it will take. An hour should be fine. I'll call you if things progress sooner."

I went downstairs to your Daddy and woke him up. He immediately jumped up. I told him to relax, I had called Aunt Amanda, I was not hurting at all. It may be a while.

3:17 Still cramping, nothing special. I was washing my face and while your father loaded the car.

3:27 I looked at the phone to see what time it was. These "cramps" were so random and unorganized.  Well great, I'm going to have a long dysfunctional OP labor. Here we go.

I threw some sweatpants on and went to kiss your sister goodbye while she slept. 

A real contraction came. It was just how I remembered with Natalie. It wasn't so painful that I couldn't think or move, but I wanted to be still... I felt my labor bubble getting smaller. 

Thank goodness I called Amanda when I did.

I texted Emily Bruno. I didn't want to completely wake her by calling. I thought I'd call her after I called Leslie, and we were heading to VCU. That was around 3:30. I went downstairs. 

The living room was glowing, your father had lit all of the candles I had received at our Blessing Way, from my loving, supportive, and amazing friends. It was comforting. I felt my heart swell, knowing I'd meet you sometime soon.

Another contraction. A real one. I just wanted to sit on the toilet, it just felt more comfortable than standing. 

Hmm...that's interesting... I should probably page Leslie when this one is over. 

3:49 I paged Leslie. I knew she was on (and, was inducing one of my favorite patients), I felt like it was truly divine planning that I actually went into labor while she was on. 

Your father came up behind me to rub my back. "Your back is contracting, it's shaking. Are you ok?" 

Oh, crap... I'm clearly must be laboring a little harder than I thought... I've placed my hands on laboring women many times. I know what it feels like when their bodies are vibrating with so much effort, with so much force... with labor.

3:53 I was sitting on the toilet again when Leslie called.

"You sound like you're working."

"I don't know. It's not terrible. I think we should come as soon as Amanda gets here though. I think it's going to speed up." 

We chatted briefly... I had one contraction while talking to Leslie. I don't think I spoke really, or even breathed. I heard her say,"You are strong..." 

* It's important to note here who Leslie is. She is not just a Midwife, a coworker, or friend. She is my mentor, my role model.

From the moment I started following her as a student, I wished I could be a fraction of the Midwife she is someday. A large part of our decision to move to Richmond, for me to work at VCU, was because of Leslie. Because, I wanted to learn from her. 

 She is kind, honest, genuine. She has the uncanny ability to see into people, their lives, their feelings, their thoughts, in a way that is sometimes eerie.... She speaks to women who are anxious or scared, with words that come so easily to her, and soothe just as easily. When she is at a birth, the women feel safe, sure, empowered. 

She knows things that just come from years of experience, and deep wisdom. "Leslie-isms" I always called them. I wished I could write them all down. Catalog all her knowledge...

She is magic. In so many ways. 

My very last birth at VCU as a Midwife, was a patient I had been waiting for... who, delivered her last baby with Leslie. 

It just so happens... we were both there the day she delivered. We supported her together. I felt like a student again. I was in awe of her presence, her words, the words she didn't say, her touch. I was in awe of her all over again. I was sad, sad to be leaving VCU soon.

I left that day, feeling totally ready for you, Norah. Knowing I could do anything, I could get through any labor, any way it came with Leslie there. I felt, this was the best way to leave VCU... delivering a beautiful baby with a woman I admired so much, and then having that woman deliver you. 

I was ready. I was excited. I wasn't fearful. I was totally at peace... and, excited about labor...

I walked to the very bottom floor shortly after speaking to Leslie on the phone. I passed your father, and asked him if the car was running, I told him he needed to get Natalie's car seat out, and start the car. He looked at me a bit puzzled... I hadn't been in labor long.

I had literally been cleaning my sinuses out with the Netti pot about 20 minutes before...and, Aunt Amanda wasn't there yet.

The next contraction was intense. The only position I could assume was lying on my side on the bed downstairs. Shaking my leg through the contraction I thought to you, and myself... 

Holy moly, if I don't get off this bed as soon as this contraction is over, we are having a home birth and your father may have a stroke. I have got to get up.

I walked to the car. The next contraction came. 

Crap. I'm in transition. Wait a minute, what is that moaning? Oh gosh... It's me. This baby is coming.... very very soon....

Your father found me in the back seat. Every single nerve in my body was on edge, I felt like a caged animal, I needed to go somewhere, to move, something...but, I couldn't we needed to leave, or call 911. We were not making it to VCU. Aunt Amanda was a few minutes away...

4:11 I unlocked my phone, dialed Leslie, and handed the phone to your father. 

"You've got to tell Leslie we can't make it." He backed the car out of the driveway...

4:14 I heard your father say, "I don't know. No, her water hasn't broken, she just told me to call you..." we were parked in the street, ready to take off when Aunt Amanda pulled up.

A contraction. I felt you move down. I heard myself moan again. That sound that laboring women make when they are close. When their baby is coming and their bodies are surrendering... the sound that's uncontrollable, the sound that is universal...

This is insane. I'm completely dilated. This baby is going to come in this car if we don't leave now. I am probably +1 station with this pressure... Stay in. Stay in stay in...

Your father was on the phone with Leslie during that previous contraction. She heard me. She told him to go straight to St. Francis and call 911. I saw Amanda walking up to the car...

"WE have to go now. We have to go go go. Go to St. Francis..."  Amanda backed away from the car, I think she was scared... Your father took off...and, I laid down.

I remember watching the trees fly by the window. I remember feeling you move down even further, closer to birth. I had my hand between my legs, willing you to not come in the car. Willing your father to continue driving what I assumed was 90 mph, and also praying we didn't crash, or have to pull over. 

We don't have any blankets, or towels in this car. And, what if there's a nuchal cord? I don't think I could reduce it myself, you have to stay in... stay in....

Another contraction. Your father was on the phone with the 911 operator. (Apparently, they kept him on the phone, and were updating law enforcement and St. Francis so we wouldn't get pulled over... and, so the ER would be ready...)

"Yes, ma'am. We are crossing 288 on Charter Colony....She knows not to push, she's a Midwife."

Suddenly, I saw the red light through the trees. The red light we drove by daily on the trip to pick up your sister from school...The red light on Charter Colony Parkway next to St. Francis.... 

Hallelujah!! Maybe you  won't be born in the car!

I heard your father on the phone, "I turned left, it says emergency vehicles only..." I could clearly hear the 911 operator laugh and say,"I think this constitutes as an emergency sir..."

The car stopped. I could see the doors of the emergency room. The car door opened, there was a nurse there. Another contraction... I could clearly feel your head move down out of my pelvis, into the birth canal. 

Such an intense feeling... not painful, almost comforting... until I realized I was still in the back seat of our car... "I cannot get my pants off, this baby is coming now," I said. Another contraction, the nurse had my pants off, and I heard her say, "She's not getting on that stretcher, this baby is coming now. We don't have time to wait for Dr. Johnson, we need somebody here, now."

There was quite a lot going on. Lots of people standing by... two nurses in the front seat... Your father behind me rubbing my head, telling me I was doing awesome. 

A doctor walked up. He looked young, he was clearly from the ER... Don't judge Naomi, maybe he's delivered a ton of babies....

"I'm Dr. Hughes, I need to check you." 

I knew a contraction was coming. The last contraction I could feel your head starting to crown in my hand.

"No, you do not need to check me. You will see this baby's head with the next contraction." 

Contraction. I felt someone try to move my hand, and I felt pressure on the outside of my bottom.

"GET YOUR HAND OFF MY PERINEUM, I can flex her head myself and then you can do the rest."

I heard someone say, "This is how we deliver here."  

Apparently, it was young Dr. Hughes who said this... He is very lucky I was in the middle of a contraction, trying not to push with your head crowning into my hands, or else he would have gotten an earful on natural childbirth and respectful maternity care!

I remember thinking,"I highly doubt you do deliveries in the back seats of SUVs on a daily basis enough to have a protocol for deliveries like this..."

I felt your little head crowning. I felt my hands there holding your head there, waiting, not pushing. 

I distinctly remember thinking, "Wow, you have a lot of hair!" At the same time, I heard your father say, "Wow, she has a ton of hair!"

I knew not to push. The last thing I wanted was a big tear for little Dr. Hughes to poke and prod at.

Oddly, in the back seat of the car, with my legs braced on the door, in the middle of the night, 20 degrees outside, with at least twenty people watching (none of which I knew or had planned/invited to be at your birth)... I felt completely in control. 

The next contraction I felt your head move down, both my hands there, slowly helping your head out... I took my hands away... The doctor asked me not to push because there was a nuchal cord... I looked down, it looked pretty loose... he looked like he had no idea what was happening... he asked for scissors...

It is not that hard to reduce a nuchal cord buddy. 

The nurse, who I later learned was Krystal, an L&D nurse, told the doctor to,"just pull it over the baby's head, it's loose enough."

Then I felt your shoulders come, and there you were at 4:27 am, on February 17th.

On my chest, just as stunned as I was. 

There were hands reaching in every where to help hold you, to dry you, stimulate you to breathe. You opened your eyes, looked up at me and cried. 

There are not words to describe that feeling. Seeing your child for the first time. To hold you, to look at you, for the first time. It's an indescribable joy.

Your father and I have reviewed this labor, this night...over and over and over again. Trying to figure out why it came so fast, why we didn't make it to VCU, why would I labor when Leslie was on call and not make it to her?!

No matter how we timed it out... we would never have made it to VCU... Had we left earlier, Natalie would have had to come with us, had we left a little early and had the neighbor watch Natalie, you would've been born on Powhite. 

Of course, we will never know why things happened how they did... Maybe, I became a Midwife because God knew I'd deliver you in a car? Maybe, I was lead to VCU because I needed natural child birth experience so I wouldn't loose it when I delivered you in the car? Maybe, we arrived at St. Francis because we haven't been to church the entire year we've been in Richmond? 

I think this experience was to remind me of these things... 

Together, your father and I can do anything... no matter how intense, scary, unplanned, or out of our comfort zone. We need not be afraid as long as we have each other for support.

Women are stronger than society has lead us to believe they are... I am stronger. 

Maternity care is not the same everywhere else, as it is at VCU. I have been blessed to be a student and practitioner at VCU. Our Midwifery practice is a rare jewel in the world of maternity care. Our hospital is supportive of maternity care, respectful evidence based maternity care; and understands the importance of being baby friendly. 

You have to trust birth. Truly, trust women's bodies, birth, and how a baby desires to be born. I learned early in my career as a nurse not to trust our bodies, or birth. I was taught that child birth pain is unbearable, and unnecessary. I learned the usual American high risk, high intervention maternity care... and, while there is a place for that... there is a greater need, and place for trusting natural, normal, low risk, low intervention birth. 

Being born is important. I know this. I've seen it so many ways... 

I will always respect birth. Trust birth. Support birth. Affirm its importance. Revel in its sanctity. 

There is nothing so important as being born. I will never forget this.