Trying to Stay on Top of The Photos

Someone found his thumb!

Waiting patiently for cookies...

Sharing love with their baby brother

More Photos of Our New Family of Five!

Photos From the Past 24 Hours

He's Here!

I'm only on the computer this early because I had to do some online HR stuff for work since I won't be going back for a few weeks, but it's just my luck that the site is down or something.

The birth story is pretty simple - a LONG labor phase and a VERY SHORT pushing phase. In comparison to my previous labors, I was somewhat dissappointed in how his birth unfolded, and I have a good instinct to know it was at the hands of my doctor - appropriately, she is the one I have ALWAYS disliked, and now I have even more reason to dislike her. :(

So, the contractions really started around 11:30, after she did the internal exam. For the next 4 hours, I was in the car with my mom running errands to make sure we were all set to give birth to this child that night. At times I wondered if it really was the real thing, like when I went 30 minutes without a single contraction, but that was the one and only time it happened... the rest of the contractions came fairly consistently.

I do not have my contraction timing list handy at the moment, but I believe it was around 6:00 that I noticed I had likely hit the active phase of labor. So, I decided to get the tub ready, since in my past experience, active phase and transition phase weren't too far away from each other! For the next hour, I just sat and enjoyed the water, but the contractions stayed right around 6-10 minutes apart, even seemed to slow, compared to the 3-5 minute contractions I was having previously. So, I decided to get out of the tub and walk around.

The moment my foot hit the floor, the contractions went back to 3-5 minutes. I labored with the family for the next hour or so. Once they started to get closer and a lot stronger, I moved to the bedroom to be alone (with Shane) and switched back and forth from lying on the bed to kneeling on the edge of the bed, working through the contractions.

Then I decided it was tub time again, and that's where I stayed for the next 2 1/2 hours, until he was born. I spent most of my time either squatting, or in some form of all fours, but I'd say I did spend about 15 minutes just sitting, reclined against the tub. The all fours position was the most 'comfortable' and was how he was born.

OMG the contractions hurt SO BAD! I reached up a few times to see if I could feel anything - granted, I'd never done a cervical exam, so I had NO CLUE what I was feeling for - but I knew my finger went pretty far up before it found anything and I started to get discouraged. The moment I got in the tub, I pretty much began pushing with each contraction. Not the 'Oh I've got to get this baby out NOW' kind of pushing, but just trying to work him down, down, down.

That bearing down lasted for a good 2 hours. I was starting to get SO exhausted, but the contractions were SO PAINFUL, I felt I HAD to keep up with the light pushing. Shane was asking if maybe I should get out and walk around, but that was the last thing I wanted to do. I was honestly beginning to question whether I had the strength to do it, and maybe I would need to go to the hospital. I never verbalized it, but I sure thought it. Then, around 11:00 we got some bloody show. YAY! And it was quite a bit, so I was absolutely relieved to know we were making progress. I did more bearing down, and finally at about 11:20, my water broke! Even more progress!

I had about two more contractions, then I felt his head was ready to come out and the full-on urge to push hit me immediately. If I remember correctly, he was born in two contractions. The second to last contraction I yelled to Shane that the head was coming out and I pushed and pushed and pushed. The last contraction came almost right on top of that one, and out came the head... in this same contraction, with Shane's urging, I continued to push, and with a burst of about 3-4 more pushes, he came out the rest of the way.

I did A LOT of moaning and groaning, and with the delivery of his head and body, I did A LOT of screaming. LOL. I had hoped that being on my hands and knees would make for an easier (and by that, I mean more 'pain-free') birth, but it wasn't so. :) This was, by far, the most painful birth I've experienced yet, and I do attribute that to the actions of my doctor.

The placenta took about 90 minutes to come out on its own, so that kind of made things a bit challenging. I think it was probably ready to come quite awhile before that, but I had never delivered a placenta spontaneously before, so I didn't quite know what to do. At least I'll know for next time. :)

All-in-all, it was a WONDERFUL experience, so do not let my full account of events destroy the miracle of the entire event. Shane got to catch his baby boy, cut the umbilical cord, give him his first bath, and cuddle him while I waited for the placenta. I nursed him in the tub a good 10 minutes after birth and he latched on with no problems! After his bath, Shane gave him back to me so I could use the breastfeeding to urge the placenta out and he latched right on to the other boobie. Since he was born, he's fed from both breasts 3 times, for a total of 6 feedings. He's been asleep now for about an hour and will probably be ready to feed again soon. I felt him make his first poopy, so he'll need a new diaper soon also. He's actually stirring as I type.

So, the stats:

Lathel Shane Priest, Jr.
Born on Monday, February 23rd (he shares a birthday with the only other grandson on Shane's side of the family!)
Born at 11:34 pm
Weighing in at 8 lbs, 3 oz
20" long

He was the EARLIEST baby I've given birth to, yet he's the HEAVIEST! Imagine if I'd gone full-term. Yikes. ;)

At this moment, the SD card is in the camera and I really do not feel like getting up. Once everyone else wakes up and starts admiring him, I'll get some free time to do a quick photo post.

p.s. We did record the last hour or so? of the birth. When I find a way to transfer the video, I may show the last snippet of his birth. It won't be graphic, since we had the video camera set up on a tripod across the room, but you'll definitely hear all the commotion I made. :P

38 Weeks

I had my 38 week prenatal appointment today and was very curious to see if there was any further progress since last week, especially since I spent about 3-4 hours at Wal-Mart yesterday and was contracting fairly regularly. But, if 'history repeats itself' with this pregnancy, I was destined to have made no progress since last week.

I was so surprised when she told me I was 3 centimeters dilated and about 80% effaced! And while she was in there, she seemed awfully rough, and if I didn't know better, she did some form of 'sweeping my membranes' WITHOUT MY CONSENT! Of course, I can't say for sure that she did, but it hurt like a son-of-a-bitch whatever she did - she was all pokey and diggy and I have no idea why. She said the bag of waters was right there, ready to go, and I just needed some contractions to go along with it. Ever since that moment, I've been contracting very regularly, anywhere between 3 and 15 minutes, average seems to be about 5-7 minutes. They come fairly consistently no matter if I'm up walking or sitting.

And that's about all I have to say. I don't want to jinx anything or make myself stall. We're nesting, just in case this is it, and I called my boss earlier today to let her know why I might not be back to work tomorrow.

Of course, if this is it, I'll make an update as soon as he is born, complete with pictures. :)

Getting Close!

I had the 37 week prenatal appointment yesterday... and we got some interesting news. Nothing super-exciting, but, allow me to illustrate:

*37 week appointment with Lorelai: 1 cm dilated, 50% effaced
(actual gestation: 37 weeks, 3 days - born 10 days later)

*37 week appointment with Felicity: 1.5 cm dilated, 50% effaced
(actual gestation: 36 weeks, 9 days - born 18 days later)

*37 week appointment with Junior: 1 cm dilated, 50% effaced
(actual gestation: 37 weeks, 3 days - when will he be born?)

How's that for consistency? If everything else stays on course (compared to my previous pregnancies), I predict we'll be having a baby between the 1st and 3rd of March!

What's YOUR prediction? :)

If Only More Women Were on the Same Page...

"Brave" Has Nothing to Do With It
by Morgan A. M. McFarland

When hearing the news that I had my last baby at home and am planning to have this one at home as well, the first response from most people is, "You're so brave."

This has to be one of the most irritating things that people say to homebirthers. The implication is that birth is dangerous and that we are willing to take on a tremendous risk to do it anywhere but a hospital. It negates the research and planning that we've done to come to this decision. It makes the choice about balls, not brains. After all, homebirth is "dangerous." Hospital birth is "safe." Therefore, it must be bravado alone that would lead a woman to choosing such an option. Right?

In 2003, over 20% of women had their labors induced, with a rate closer to 40% in many hospitals, while that rate should not exceed 10% (and has remained at 10% in most industrialized nations). Inductions are approximately 5 times more likely among planned hospital births than planned homebirths. An 1999 American Journal of Obstetrics and Gynecology "Green Journal" review of 7000 inductions found that 3 out of 4 of the inductions were not medically necessary. Inductions are performed unnecessarily for estimated size of the baby (too large or too small), going past the estimated due date, amniotic fluid levels that are low but not critically low correctable in nearly all cases by rehydration of the mother), rupture of membranes without immediate start of labor, the mother being dilated/effaced but not in active labor, or scheduling reasons on the part of the mother or care provider. Approximately 40-50% of inductions fail (depending on the induction method used and the mother's Bishop score), and most failed inductions end in cesarean section. Inductions increase labor pain and length, and create, among other problems, an increased risk of fetal distress, uterine rupture, and cesarean section.

But homebirth is "dangerous." Hospital birth is "safe."

Over 30% of women in the US have cesarean sections, while overwhelming research has led the World Health Organization to set an ideal standard rate of cesarean sections at 10-12%, with 15% being the rate where more harm is being done instead of good. Cesareans are performed at a similar rate across all risk groups, low to high. The cesarean rate for planned births at home or in an independent birthing center is approximately 4%. Cesarean sections increase the likelihood of maternal death by as much as 4 times, and have other immediate and long-term heath risks for mothers that include, but are not limited to, infection, bowel or bladder perforation, hysterectomy, future infertility, and increased risk of uterine rupture for future pregnancies. Risks for the baby include respiratory distress, fetal injury, prematurity (if result of schedule section or failed induction), and breastfeeding difficulties. Four of the greatest causes for the increase in cesarean section are overuse of interventions during labor, concern for malpractice/liability on the part of care providers, failed labor inductions, and "failure to progress" (labor not progressing fast enough or regularly enough for care providers).

But homebirth is "dangerous" and hospital birth is "safe."

The ACOG and AMA have both come out against homebirthing, calling it a dangerous trend and referring to it as a "fashionable, trendy, [...] the latest cause célèbre," and they paint a horrible picture of complications arising in low-risk pregnancies with no warning that cannot be handled anywhere but the hospital. Despite that, the most thorough study ever done on homebirth safety, Kenneth C Johnson and Betty-Anne Daviss's Outcomes of planned home births with certified professional midwives: large prospective study in North America, BMJ 2005;330:1416 (18 June), found that the outcomes of planned homebirths for low risk mothers were the same as the outcomes of planned hospital births for low risk mothers, with a significantly lower incident of interventions in the homebirth group. The Lewis Mehl Study of home and hospital births, which matched couples in each group for age, parity, education, race, and pregnancy/birth risk factors, found the hospital group had 9 times the rate of episiotomies and tearing, 3 times the cesarean rate, 6 times the fetal distress, 2 times the use of oxytocin for induction/augmentation, 9 times the use of analgesia/anesthesia, 5 times the rate of maternal blood pressure increase, 3 times the rate of maternal hemorrhage, 4 times the rate of infection, 20 times the rate of forceps use, and 30 times teh rate of birth injuries (including skull fractures and nerve damage). Breastfeeding success rates are higher and postpartum depression rates are lower for planned homebirths.

But homebirth is "dangerous" and hospital birth is "safe."

The United States spends more per pregnancy/birth than any other country, the vast majority of women in the US give birth in hospitals, and yet the US's maternal death rate is the worst among 28 industrialized nations and the neonatal mortality rate is the second worst. The Netherlands, where 36% of babies are born at home, has lower maternal and neonatal mortality rates than the US. Denmark, where all women have access to the option for a safe and legal home birth, has one of the lowest maternal and neonatal mortality rates.

But homebirth is "dangerous," hospital birth is "safe," and Brutus is an honorable man.

I didn't choose a homebirth because I am brave. Bravery has little to do with it. If anything, I believe women who choose to give birth in US hospitals are the brave ones, because knowing what I know about our technocratic obstetrical system, I can't imagine voluntarily choosing an obstetrician and a hospital for anything but absolute medical necessity. My decision to homebirth wasn't made in a void, but based upon years of research. I wonder how much research the average woman puts into her hospital birth? Considering how many times I've heard someone say "I'm glad I was in the hospital because..." and then given as her reason a non-emergent situation (such as fetal size or nuchal cord), I'd say not that much.

Call me stubborn, because I wasn't willing to accept out of hand the culturally held belief that hospitals are safer. Call me an idealist, because I believe that birth can be a positive, safe, and empowering experience for child and mother. Call me a nonconformist, because I choose to birth at home in defiance of a powerful technocratic system. Call me outspoken, because I can't keep my mouth shut when I hear about yet another iatrogenic birth calamity. Call me a "birth nazi," because I believe it's the right and responsibility of every woman to educate herself about birth and take ownership of her birth experience.

But brave? Don't call me brave. "Brave" has nothing to do with it.

Another Great Point

Birth Safety as a Binary Condition
by Morgan A. M. McFarland

"Your baby is healthy and that's all that really matters."

How many times have you heard it or some variation of it? How many times have you said it or something like it? A new mom is struggling to make sense of a traumatic or confusing birth experience, to come to terms with unplanned interventions, perhaps an instrumental vaginal delivery or cesarean section that she'd never imagined she'd have. When she expresses her sorrow over the loss of the birth she had hoped for, the beautiful event she'd imagined, too often the response is, "At least you have a healthy baby." Christy Fiscer's essay, "A Healthy Baby Isn’t All That Matters", addresses this troubling tendency to trivialize a woman's birth experience by implying she isn't grateful enough that her baby is "healthy" (which really equates to "not dead or noticeably damaged") or that she's selfish for wanting, let alone expecting, more from birth than to be treated like an insignificant baby-bearing vessel. Seeking meaning in birth outside of a "healthy" newborn is viewed as frivolous, and women seeking empowering birth experiences are portrayed as solely being out to prove something or expecting to "get a medal for going without drugs." There's no need for me to rehash in great detail something that Christy has already addressed so passionately and eloquently. The "healthy baby is all that matters" attitude is merely one facet of a larger flaw in how our culture views birth outcomes.

The other day, someone left a comment [which was deleted due to the comment's author, not the comment's content] on my essay about "bravery" not really being a factor in choosing a homebirth to the effect that, if maternal and neonatal mortality outcomes of homebirths and hospital are nearly identical, that neither hospital birth nor home birth was more or less dangerous. I found this to be an interesting interpretation of the Johnson & Daviss study. While it's true that outcomes in terms of mortality rates were nearly identical, what made the study relevant to my essay was NOT that it showed a difference in the number of deaths, but that the low rate of mortality in the homebirth group was achieved with significantly fewer interventions than that of the hospital birthing group. If safety is measured by number of deaths alone, I suppose this would indicate that neither hospital nor home is more "dangerous" than the other, but is "not a lot of people died" really all that we're going for?

When did "didn't die" become our only barometer for success in childbirth? Baby was born/extracted from womb, both mother and child survived, therefor all is well, regardless of whatever other steps may have been involved in that birth/extraction process, regardless of any long-term harm (or increase in risk) to the mother or child, and regardless of the way anyone feels about the experience. Mom and baby lived; most studies would consider that a positive outcome. From a purely statistical standpoint, the birth was a success. This is certainly how birth is judged in this country from an obstetrical standpoint, but are we really satisfied as individuals with this binary notion of birth wherein "bad" is defined only as "dead" and "good" is defined only as "not dead"?

If a living mother and child are all that is required for birth success (or if, indeed, a healthy baby is the only thing that matters) then yes, hospital birth is "just as safe" (or "equally dangerous" or "no more dangerous," choose whichever language you prefer). If you start measuring safety and success by something more than a binary "live or die" condition, however, then you find disparity in outcomes.

What do many homebirth advocates view hospital birth as dangerous? It's not because more women die in hospitals, or because more babies die in hospitals, but because the interventions performed in ever increasing numbers in hospitals can have a devastating effect on long-term physical and mental health. The increased likelihood of cesarean section for women giving birth in hospitals is a good example of what is perceived by homebirth advocates as a danger of hospital birth. Cesarean section is a major abdominal surgery. While some care providers like to present surgical delivery as "just another way to give birth," the reality is that the procedure introduces a host of new risks to mother, child, and future pregnancies. These risks are worthwhile if the cesarean section is necessary, as the World Health Organization says the procedure is for less than 15% of births, but the procedure is grossly overperformed in the United States. Can a woman who did not need a cesarean, but who was manipulated/pressured, legally forced, misled by care providers about the necessity of the procedure, or who experienced iatrogenic health complications (for herself or her baby) due to mismanagement or over-management of her birth, be said to have had a "safe" or "successful" birth experience, even if the immediate outcome of the surgery is that mother and child live?

Maternal mortality rates do not tell us if the mother who had a unneeded cesarean section went on to have more children (as cesareans can cause fertility problems). Maternal mortality rates do not tell us if she had other cesarean deliveries as a result of her primary c-section (as fewer and fewer doctors/midwives will attend VBACs and many insurance providers will not cover them), or what complications or outcomes came from that birth (as each additional cesarean section has increased risks over the previous cesareans). They do not tell us if she experienced uterine rupture during her VBAC or repeat cesarean as a result of scar tissue from the primary surgery (the risk of rupture for VBAC and repeat cesarean is nearly identical, at slightly less than 1%). They do not tell us if she experienced placental previa or accreta in later pregnancies as a result of her prior c-section (the risk of both is increased in women who had have c-sections). They do not tell us if additional surgeries had to be performed after birth to correct iatrogenic health conditions, such as damage to the bowels or bladder (rare, but possible). They do not tell us if she experienced post-traumatic stress disorder, postpartum depression, or sexual dysfunction (all more common among women who had unplanned c-section than women who had planned vaginal births or planned c-sections) as a result of the unexpected surgery. Maternal mortality rates don't tell us if the mother had difficulty breastfeeding (women who have c-section are less likely to breastfeed). The only thing that maternal mortality rates tell us is whether or not a woman died during or shortly after giving birth as a result of that birth. These rates say nothing about the dangers to a woman's long-term health, either physical or mental, that resulted from the cesarean section. These rates say nothing about the feelings of disappointment, guilt, confusion, anger, or fear experienced during or after the birth.

I could list every intervention more common in hospital births than homebirths and tell you exactly why I, as a homebirth advocate, feel the overuse and misuse of these interventions make hospitals a dangerous place for low risk women to give birth, but why beleaguer that point? The heart of the issue, for me, isn't to examine the individual interventions, or even the cumulative risks of the whole cascade of interventions, but to bring attention to how little a binary notion of birth location safety actually tells us about the safety of giving birth.

When a child is born, a new mother is made. The process of her making, the experience of her birthing, is a meaningful one. Statements like "a healthy baby is all that matters" marginalize the mother by implying that the she doesn't matter, that she is lacking in worth (either by comparison to her child or in general). Though every mother's primary concern is a healthy baby, the mother's own experiences are not suddenly made worthless or unimportant if that goal of a healthy child is attained. Defining birth outcome by whether or not the mother and her child lived is equally marginalizing of the mother, because this narrow definition doesn't allow for variations in personal experience, physical or mental health, non-mortal birth crises. This definition of birth success says that only life or death, not the process, has meaning, and that even if you were poked, prodded, injected, cut, dehumanized -- if you didn't die, well, you were actually "safe" the whole time. You were in no danger, because the end justified all the means.

I don't know about you, but I want more than that particular binary view of safety.