by Amber Kirkley
I always knew I wanted a natural birth. My mother, my mother-in-law, and my sister-in-law had a total of 8 children naturally. My brother had been delivered 27 years ago by Maureen Darcey and her partners at the birth center in Siler City, Chatham County. Although I only remember pieces of it, I was present at his delivery. Hence, I had met Maureen when I was just 5 years old. The day I found out I was pregnant, I called the birth center to schedule a tour. I was excited about the prospect of continuing the tradition of natural birth in my family.
In the months leading up to my daughter’s birth, I talked to many people about my plans for a natural birth. I was always interested to see people’s reactions. It seems that natural birth causes a polarity of responses. People often are either really into it or simply think you are crazy. People asked if I was scared about the pain of natural birth. Since this was my first child, I could not say that I was scared. In fact, I had no idea what to expect. I had read every book I could get my hands on, spent countless hours on the internet, and taken a wonderful natural childbirth class taught by a close friend’s mother, but I still had no idea what labor was going to be like. What I did have was the confidence that many women had gone before me in giving birth naturally, and I felt strongly that I, too, would be able to have a natural labor and birth. I also felt increasingly confident in the midwives I would be working with during this experience.
I was nervous throughout my pregnancy that it would not work out for me to have the baby at the birth center. I had borderline high blood pressure, and I was always concerned I would develop pre-eclampsia. As my due date approached, I was so thrilled to not be pre-eclamptic, I gained mental energy and strength. I am a nurse, so I worked 12 hours on December 30th, my last scheduled shift. I was hoping that my baby would be born very soon. My due date was New Year’s Day and honestly, I did not want to be sitting around without a baby in my arms for 2 weeks at the start of my maternity leave.
As if my daughter heard my request, the following morning at 5:30 A.M., I woke up with some cramping and thought I might be having contractions. I tried timing a few and it seemed like they were coming every 15 or 20 minutes. I went back to sleep until around 9:30. When I got up, I still felt like I was having contractions. I timed them again, and they were about 10 minutes apart. Even though I felt like this might be “true” labor, I still had this feeling like, “Am I making this up? Is this really happening?” Around 12:30, my husband, Luke, convinced me to call the birth center and give them the heads up. I got on the phone and talked with Emily, the midwife. The plan was to call her back in a couple of hours and give her the update as to how I was progressing.
Throughout the day I had contractions that slowly got closer together and slowly got more powerful. I rocked on the birthing ball, my husband applied counter pressure on my back, we went for walks, and we relaxed at the house on the beautiful last day of 2011. Since our farm is 45 minutes from the birth center, around 5:30 P.M., we made the decision to go to my parents' home, which is 15 minutes from the birth center. I called Emily and let her know that the contractions were still about 7 minutes apart. Again, we made the plan for me to call Emily back in a couple of hours with progress. Over the next 5 hours, things continued to slowly progress.
With the next check up around 10:30 P.M., Emily suggested that I take a hot bath and some Benadryl to slow my contractions and try to get a couple of hours of sleep. I got into a hot bath and relaxed. My contractions spaced out to more than 15 minutes apart and were barely painful. I took some Benadryl. My best friend, my brother, his girlfriend, my father, and my husband were all there, and at 12:00 midnight everyone toasted an exciting new year ahead. I laid down to try to get some sleep. I was thrilled to think that when I woke up, likely we would head to the birth center and my daughter would join us in this world.
I consider my labor to have 2 parts: the calm and peaceful first half, and the crazy second half. As I laid down on the bed, thus ended the first half of my labor. Not 15 minutes after getting into bed, I was rocked by a strong contraction. I got up to go to the bathroom and my water broke. Almost instantly, I transitioned from contractions 15 minutes apart to contractions that were coming every minute and a half, and hurt with a 10 out of 10 pain. Luke called the birth center, and even before they called us back, we were all on the way. No matter how much I had read or learned about, I still was not prepared for the intensity of the contractions. Each one felt like it hurt everywhere. I felt like I was having both regular front labor and back labor. I was extremely thankful to be taking a 15-minute ride instead of a 45-minute ride to the birth center. I was happy when I finally got there and saw Emily’s and Missy’s faces. I was praying that I was in transition and this was not simply what active labor felt like. I was always nervous I might come in too early and be disappointed at how far I had dilated. When Emily told me I was 7 cm and fully effaced, I was thrilled and proud of myself. In my head I could see the words in What to Expect, “Transition should last 15 minutes to 2 hours.” By my calculation, I was already about 30-45 minutes in, so I was in the home stretch. I got some antibiotics, due to being Group B strep positive, and got into the bathtub.
Through this part of my labor, I am most thankful that I was completely unaware of the clock in the room because it seemed like transition was lasting a lot longer than my expectation of 2 hours. One of the most important coping mechanisms I had at this point was simply to stay in the present moment, not thinking about the past or the future, but simply getting through one contraction at a time. I spent time in the bathtub. I spent time walking around. I made a lot of low guttural animalistic noises. I chanted mantras to help me mentally move the child down and out of my body. I marched rhythmically while leaning on a counter. My husband and best friend applied a remarkable amount of counter-pressure to my back. Although I am not sure I was prepared for the pain, I felt like my body was taking over and telling me what I needed to do to birth this child. It was an extremely awesome and powerful feeling.
Finally, around 4:00 am, Emily checked me and said I was 10 cm dilated, and I could try to start pushing. I had this expectation that as the pushing phase started I would experience some relief from the pain on transition. Unfortunately, this was not the case for me. The pain changed. It did not feel as much like it was all over, but I had an intense, stabbing pain in my lower abdomen every time I pushed. I was also extremely tired, since I had been in labor for almost 24 hours, it was early in the morning, and I had taken Benadryl 4 hours earlier.
It took me a while to get the hang of pushing. After 45 minutes of pushing, I finally asked Emily how far I had progressed. She said that I was progressing, but the progress was slow. I was a little disappointed, but this also gave me the motivation to push even harder to try to speed the process up. Emily suggested I try emptying my bladder, so I went to the bathroom. There in the bathroom, I finally was able to push more effectively. It was not the way I imagined it, and it was not the prettiest sight, but it worked, and that was the most important thing to me.
After pushing in the bathroom for a while, Emily suggested that we check and see how I was progressing. I was thankful when she said we had made significant progress. Another half an hour of pushing and the time came close for my daughter to make her entrance into this world. I was so tired by this point, but completely focused on pushing. After my daughter’s head crowned, it took some quick extra maneuvering into several different pushing positions to help open up my pelvis enough to fit the rest of her body through the birth canal. With the help of Emily and Missy’s skilled hands, Baby Rowan was born at 6:15 am on New Year’s Day. I later learned from Emily that Rowan had a shoulder dystocia, a condition where the shoulder is not easily able to fit through the birth canal.
After Rowan was born, she needed a little extra help to get her breathing well. Emily and Missy had everything they needed in the room to be able to give her the extra support. Luke was rubbing her body, using his touch to encourage her to breathe better. I heard Emily say her heart rate was good. Because of this, I had a lot of faith that everything was going to be fine. A strong sense of calm came over me and I felt extremely connected with my sweet baby girl. Although her first Apgar score was low, after a minute or two, I heard her first precious cry, and started seeing her color change to a rosy pink. By 5 minutes, her Apgar score was an 8. Rowan was breathing on her own and crying heartily. After some time, things calmed down and we weighed and measured baby Rowan. She was a whopping 9 pounds, 12 ounces, and 22 inches long. This was a surprise, but it certainly helped explain the reason for the shoulder dystocia.
People have asked me if there was ever a point when I wished I was in the hospital instead of the birth center. I can honestly say that there was never a point I did not feel completely comfortable in the hands of Emily and Missy at the birth center. I think if I had been at the hospital they would have wanted me to have a C-section because she was so big, and they might have admitted Rowan to the NICU because of the shoulder dystocia. Neither of these interventions were ultimately needed.
Even though there were some tense moments in the end, I was still able to have the natural birth I always wanted. Labor was hard work, there was pain involved, and there were some scary moments. However, labor was also exciting, awe-inspiring, and even peaceful at times. I believe sharing this range of emotion with my family, friends, the midwives, nurses, and my daughter is why it was so valuable to me to carry on the tradition of natural birth at the birth center.
I am thankful for the help, skill, and confidence of Emily and Missy in birthing my daughter. I am also extremely thankful for the tireless work of the midwives and nurses at the Women’s Birth and Wellness Center. They have all helped make these experiences possible for generations of women and their families in North Carolina. With our family, friends, and birthing center community, we are thrilled to celebrate the arrival of our New Year’s gift, Rowan Juedi Kirkley.
