Jonah’s Birth

Abstract

Rachel Goldstein shares her experience of exploring options related to care provider and place of birth early in her pregnancy. Goldstein and her husband, Marc, after reading and research, chose midwifery care and a home birth. She shares the story of a long labor at home supported by her husband, her doula, and her midwife. Her positive attitude, her ability to use various comfort strategies, and the support she received throughout labor contributed to being able to give birth naturally and ecstatically to her son Jonah.

PROLOGUE

When I found out I was pregnant in December 2006, I was excited and scared like most women pregnant for the first time. I wanted everything to go well and for the baby to be okay. I see a gynecologist for my annual checkups, but she doesn’t do obstetrics so she referred me to a colleague. My husband Marc and I went in for the appointment around the 9th week mark. I’d already been doing a little reading about birth and was interested in the birth center that was part of the hospital. I knew I wanted to do a natural birth. I don’t know why, aside from the fact that my mom had done it for her four kids and I guess I figured if she could do it, so could I. At the time, I had no idea that this was such a challenging deal in our culture.

Do you have a birth story that illustrates the power of childbirth and encourages women to give birth with confidence? We invite you to submit your story for possible publication in The Journal of Perinatal Education (JPE). Please send your story or query to Judith Lothian, Associate Editor (Jalothian@aol.com).

We had an ultrasound at that first appointment to confirm a healthy fetus and narrow in on an estimated due date. The obstetrician gave us a due date of August 15, a few days later than my estimate, so I took the later date. She seemed okay, but she did not seem positive about natural birth or using the birth center. She was also a bit condescending. I didn’t have a great feeling. I also didn’t love that it could be either her or one of her six colleagues when I finally did go into labor. I wanted to be with someone I knew and felt really good about. She also discussed some prenatal testing, which I know is pretty routine, but I got a sick feeling in my stomach just thinking about it. Marc and I knew we couldn’t abort an imperfect baby, so it didn’t really make sense for us to do the testing.

Because I had a bad feeling about this particular obstetrician and was reading so much and figuring out what I wanted for my prenatal care and birth, I knew I had to keep looking. We signed up for a tour of the birth center at one of New York City’s large hospitals, which also included a tour of the hospital’s regular labor and delivery unit. The tour participants included Marc, me, and about 50 other couples, most of whom were due any day and clearly just checking out where they’d be having their babies. Marc wondered, “Uh, should we be here?” The birth center was lovely and the rooms looked more like a bed and breakfast and had huge Jacuzzis for laboring in. The rooms were all empty. The labor and delivery floor looked more like a regular hospital. Some of the rooms had small showers. They were very small rooms and felt very medical. I still didn’t have a great feeling.

I decided to call a midwife who my friend, Teresa, had recommended. The midwife seemed fine too, if slightly distracted. I also toured the labor and delivery unit of another New York City hospital where I’d have the baby if I worked with the midwife. The rooms were bigger than the previous hospital Marc and I visited, and the midwife said they were trying to get some tubs put in. I still didn’t have a great feeling about the hospital. My gut was telling me, “This doesn’t feel right. This is not a nurturing place. I don’t want to have to follow someone’s institutional rules while I’m trying to have my baby. I don’t want to have someone I don’t know caring for me in labor.” I knew I had to keep looking.

While I was searching for a doctor or midwife, I was madly reading The Official Lamaze Guide: Giving Birth with Confidence. The information in the book helped me sort out my questions and the pros and cons of where one gives birth. It was blowing my mind that our nation’s standard birth care practices are in direct opposition to what is truly best for moms and babies. I couldn’t believe that pretty much everything we think about birth in our culture is wrong. It was really hard to process.

I also had a deep fear about having unnecessary cesarean surgery. I knew that New York City hospitals had cesarean rates of 30% and higher. I wanted to do everything I could to minimize the risk of an unnecessary surgery. Although the birth center seemed like a perfect compromise, I had some uneasiness about it. I knew they “risked out” women fairly easily; for example, if you went over 41 weeks. I knew that going “overdue” was very common for first pregnancies. I didn’t like to think that I’d be excited about my birth center birth for 9 months only to find myself, over some technicality, back in the labor and delivery unit that I wanted to avoid. I also was thinking, “Why travel all that way in labor?”

I began to think about having a home birth. I tried to figure out how I could find out about home birth in New York City. I remembered seeing an e-mail and website included on our neighborhood electronic mailing list for a woman who was a doula. I remembered looking at her website and noticing she had had a home birth. Somehow, I found her website again and called her. She gave me the name of her midwife after cautiously asking me why I was interested in home birth. I called her midwife, who was already booked up for August, and she gave me some other names to call. Everyone was booked up! Except Kristen. She was just starting a new home birth practice. I called her to set up a time to meet.

At some point here, Marc and I had a huge argument about this. Even though we hadn’t met Kristen yet, I knew I was heavily leaning toward home birth. Like most people, I was a bit afraid of it. I wanted to do the “normal” thing and have a baby in the hospital where it was “safe.” But everything in my being was saying, “No!” Marc’s resistance was also based on the fear of something going wrong. Ultimately, Marc recognized that this was happening to my body and the decision was mine. He made it clear that he was completely against the idea, though.

We both met with Kristen, who gave us a warm hug and hello in our apartment. We asked a million questions. I was ready to go for it right there. Marc felt more confident after meeting and talking with Kristen. He could see that she was professional and experienced. At about the 16th week mark, we agreed that we would have a home birth with Kristen as our midwife.

The Official Lamaze Guide: Giving Birth with Confidence (2nd ed.) by Judith Lothian and Charlotte DeVries is available from http://www.amazon.com

Although we still both felt nervous and unsure, home birth met so many of the criteria that had become important to me as I educated myself about birth and what I wanted:

• •I could choose exactly who would be with me in labor. No managing of rude staff or staff changes.
• •I would know my midwife and have a relationship with her.
• •I would labor in the comfort of my own home, feeling safe in my own space.
• •Marc could spend the night with me! I wouldn’t have to share a room with anyone or pay $400 for a private room.
• •My body and my baby would get treated exactly as I wanted.
• •I would not have to travel anywhere. No laboring in a taxi stuck in New York City traffic!
• •I would not have to put my new baby in a car seat and endure another crazy taxi ride home. I could labor however I wanted—eat and drink my own food, move around however I liked, have whomever I wanted with me in labor.
• •I knew that if Kristen suggested we move to the hospital or if I ended up needing a cesarean, it would be because it was truly necessary.

My prenatal visits with Kristen took place in the comfort of my own home. We could talk about anything, and we did. Most visits were nearly an hour. Kristen would write down my weight, but it was no big deal if I had forgotten to weigh myself. She listened to the baby with the Doppler fetal monitor (asking my permission) and measured the outside of my belly. Marc attended some visits with me. I think the most important part of the prenatal visits was building the relationship with someone who was going to play such a key role in an important day in our lives. We did do some of the standard tests (20-week ultrasound, group B strep, glucose) and omitted others.

I wanted to do the “normal” thing and have a baby in the hospital where it was “safe.” But everything in my being was saying, “No!”

To prepare for the birth, I read everything I could that was positive about home birth and natural birth. I had some affirmations that I read to myself and also listened to a hypnosis CD. I ate healthy but did indulge, and I went on walks and did prenatal yoga when I could.

Ironically, as the birth day approached, I was the one getting nervous. I kept asking Marc, “What if I can’t do it? What if something goes wrong?” Now Marc was the one who was completely confident, “I’m not worried. You are going to be amazing. Kristen is great. It will all be fine.”

And he was right.

THE BIRTH

Contractions started Monday, August 13, at night. The previous Thursday, I felt the baby drop, and it felt like I was holding in a big weight. I also had occasional cramping, but I didn’t think too much of it because I knew so many women have cramps for weeks and it doesn’t go anywhere. I was also still hoping that the baby would come a week or so late so I would have some downtime to nest after my last day of work on August 15.

At home in their living room, Marc offers soothing support as Rachel takes a break between contractions.

—Photo by Bonu deCaires

On Monday, I worked from home, met a friend for lunch in the city, and was at home the rest of the day. That evening, I told Marc I had an occasional cramp that felt like a pain just above my pubic bone. He urged me to call our midwife. I was a little embarrassed to call her about something that seemed small, but I went ahead. She said that once labor really started, I would know if this cramp was related or not, and everything sounded fine. I went to bed in the guest room, ready to head into the office the next day for my last day of work. I later learned that Marc had “had a feeling” and he had reread portions of The Birth Partner that night instead of his usual comic book.

I’m not sure what time the contractions woke me, probably around midnight. I really wanted to labor alone through the night so Marc could get a full night’s sleep, but by about 2:30 in the morning, I didn’t want to be alone anymore so I went into our bedroom and woke him up from a deep sleep. He asked if I was scared, and I nodded and felt my eyes well up. I was thinking, “Oh my God, this is it. It is happening!”

Marc came to the guest room with me and spent some time timing the contractions, which were coming every 5–6 min and lasting between 15 and 50 s. He called Kristen, our midwife, to update her and she suggested that he call Bonu, our doula, too. I know we spent time in the bed. I had to rest on a pile of pillows, because I could not lie down when a contraction came, and it was easier to sit up to manage it from a semireclined position. Whenever Marc heard me moaning, he’d sit up and rub my back, and then we’d both conk back out in between contractions. It was a huge help that we were both able to sleep between the contractions.

At some point in the morning, I got in the bathtub; it felt really good to be in the warm water. According to Marc’s notes, later in the morning, my contractions were between 30 s and 2 min long and coming every 5–10 min, still very irregular. We didn’t call our families or anyone to say I was in labor. Right from the beginning, I moaned and rocked to get through the contractions. The funny cramp I had felt earlier was definitely related to labor because my contractions felt like a much more intense version of the cramp. I realized at some point that it felt like severe stabbing in my lower abdomen, then I realized that I should not have such a violent image of contractions.

I tried the birth ball a little bit but didn’t find it helpful. I also thought I’d be famished and happy to be able to eat whatever I wanted at home, but I had no appetite. Bonu and later Kristen kept encouraging me to eat bites of this and that and kept giving me juice and tea between contractions. It helped keep me going.

Bonu, our doula, arrived around 11:00 a.m. on Tuesday. It was great to have her with me! She suggested I try the shower for a bit and it felt great. Marc fed me some hummus and crackers while I was in the shower, which is pretty funny and we have a picture. Bonu also had us take a walk around the garden. I was nervous to go outside, for people to see me in labor, but it was a beautiful day and there weren’t too many people out there. When I’d have a contraction, I’d slow dance with Marc and Bonu would rub my back. She had a great, calming touch. She’d say soothing things like, “When the contraction is over, just let that one go.” Things seemed to speed up with our walking. I remember being annoyed when someone would talk to me during a contraction, so sometimes I’d moan louder to drown them out. I didn’t want to be rude and tell them to be quiet, so I’d just moan louder. I had bought a CD of nature sounds thinking maybe I’d want that. But I didn’t want any music or sounds at all during labor. Only silence.

Marc made some lunch (quesadilla and smoothies), and I ate a few bites. I’d have to stand up and lean on the table, and he or Bonu would rub my back if a contraction hit. Then, for a while, I labored by leaning on the back of the couch or slow dancing with Marc while Bonu rubbed my back, and in between I’d sit on a chair and lean on a pile of pillows on the back of the sofa. I’d hear Marc and Bonu chatting, or notice them reading, or Marc writing in his journal, but I couldn’t engage with them, really. I remember feeling a little jealous that I couldn’t hang with them, or that they weren’t observing some sort of deep, focused silence for the laboring woman. I just had to rest and doze in between, and they’d run to help me for a contraction and then go back to what they were doing in between. Bonu started reading a book from our shelves.

Bonu, Rachel’s doula, provides the perfect calming touch and support that Rachel needed throughout her labor.

—Photo by Marc Sobel

As we moved into evening, I could feel myself getting discouraged. I realized that my labor was going to be longer than the “average” first-time mom. I realized that my mom’s labors were fast, but my labor was clearly not going to be. I was afraid that Kristen would never come and my baby wouldn’t be born. I remembered reading somewhere that every woman has to let go of her expectations of labor and just be with it. I knew I had to just keep taking the contractions one at a time and telling myself positive things. I would tell myself, “Open,” to get my body to open up for the birth. I’d tell myself, “Down,” to get the baby to move down. I’d say, “Come on, baby,” to encourage him or her. I kept telling myself that I could do this, that women have been doing this work forever, to take one contraction at a time, that it was one less contraction I had to do, one closer to meeting my baby. I think I kept myself pretty positive. I know it crossed my mind to ask to go to the hospital, but I knew Marc and Bonu wouldn’t let me. I remember thinking that I can’t believe some people do this more than once and that I understood why some women choose an epidural. I would have these thoughts and let them go and bring myself back to a positive thought.

I remember being worried that I was holding on to some emotional issue and that was why the labor was slow. I even asked Bonu and Marc at some point. Bonu asked if there was anything I wanted to talk about but there really wasn’t. So she reassured me that everything was going fine.

We labored into the night. Marc made Quorn patties for dinner, and I managed to eat about half a sandwich. I wanted to get in the tub, but we feared it would slow things down further. I think at some point Bonu suggested we wait an hour, so for that hour, I obsessively watched the clock with each contraction. I remember saying, “That was the longest hour ever,” when it was done. I think then we called Kristen, and she gave the thumbs up for the tub and said she’d head over soon. I was so relieved.

The tub actually helped intensify things for me. When I had a contraction, I’d get on my knees and lean on the little stool while Marc and Bonu either rubbed my back or poured warm water on it. In between, they’d wipe my face with a cold cloth, which felt heavenly. The tub felt really warm, so I’d rest with my arms out and sit back and Marc would stroke my hair.

Kristen came while I was in the tub. It was around 1:00 a.m. or so. I remember her saying, “Can I listen to your baby?” and she checked the baby’s heartbeat with the Doppler fetal monitor. She smelled freshly showered, and her clean wet hair was clipped back in her usual simple twist style.

I’m not sure where I labored next. It might have been in the dining room. I did a supported squat leaning against Marc who sat in a chair. This might have been when Kristen checked me. That hurt. She said I was 7 cm. It was nice to know that the hard work was paying off. While I was squatting, Kristen also tried some nipple stimulation to move things, and I was aware a few times that Bonu was massaging me, that she was stimulating the acupressure point on my hand that is meant to help labor, too. I think after the tub and before the squat, I labored for a while on the guest room bed. I’d lean on Bonu between contractions and she’d cover me with a sheet. I’d get so cold between contractions and so hot during one. I remember turning to Kristen and asking if I was in transition. She hesitated before saying, “No.” I was bummed, but I knew there was only one way to go and that was forward. I tried not to ask her questions like that a lot, because I knew that I just had to keep going and didn’t want to get discouraged if the reality was something that I didn’t want to hear or could be interpreted as not much progress. I remember at one point after Kristen arrived, after a contraction, I said, “That was really intense.” Bonu turned to Kristen and said, “That is Rachel’s version of a complaint.” Then Kristen would say something like, “That’s okay, it is going to get more intense.” And I’d think, “Ugh,” and then go back to something positive. I think the mental preparations I had to do for the marathon 3 years earlier was really helpful—same idea of just breathing and putting one foot in front of the other until you reach the finish line.

I think the mental preparations I had to do for the marathon 3 years earlier was really helpful—same idea of just breathing and putting one foot in front of the other until you reach the finish line.

Kristen had said earlier that she thought I’d be pushing by 8:00 a.m. She said it would feel strange at first and would take me a while to get the hang of it, but soon it would feel right. She told me to bear down like I was having a bowel movement. I was trying to do it in a squat, but maybe because I didn’t have the urge yet or didn’t know exactly what I was doing, it felt really frustrating and useless. Kristen and Bonu had me do a lap or two of walking around the apartment.

Kristen suggested we move to the bathroom so I could push while sitting on the toilet. I knew that the toilet was a really effective place for most women—the shape is perfect because there is no pressure on the bottom, and we’re used to pushing there. This is where the rest of the labor took place. We brought the little ottoman into the bathroom. Marc sat right in front of me. I would hold his forearms, accidentally digging my nails in, and holler out with every push and contraction. I knew the pushing was really rolling because I pushed as hard as possible, for my life, when each contraction hit. I couldn’t not push. It felt like it would hurt more to not push, so I had to push and push and push through each contraction. Kristen said I’d feel pressure in the butt, and I sure did. A little more each time. The pressure slowly transformed as the baby moved down. I had an image in my head of what was happening. It was basically a grey image of a large boulder slowly working through a narrow canal. I realized later that the mental image I was getting was actually what was happening.

Kristen wanted me to hold my breath and bear down, but I really could not hold my breath. I had to holler. I tried to keep my sounds low. I remember feeling annoyed at being told what to do and how to push. I think I mostly did what felt right. It must have been fine, because Kristen and Bonu would say, “That was great!” or “Another one like that!” and kept cheering me on. I later learned that Kristen was prepared for 4–5 hr of pushing because my contractions had been so spaced out; however, because I was such a pushing champ, I was done in 2 hr. I really pushed for my life. I’d get frustrated sometimes waiting for the next contraction so I could push again. I had definitely reached the point of, “Okay. I don’t care how much it hurts. Let’s get this baby out already!” After pushing forever, I could finally feel the baby’s head moving down, rather than just contractions in my abdomen, and it was like “Whoa!” as everything started to stretch and make way.

Marc tenderly cradles his newborn son Jonah. He and Rachel were “completely high” on their home birth experience for weeks afterward.

—Photo by Rachel Goldstein

Marc and I were very connected in this phase. Even though I was so deeply internal, I liked that he was there and helping me through. He was above and beyond the incredible birth partner I knew he’d be. We were able to have a very intimate labor experience by being at home.

At one point, Kristen told me to reach inside and feel the bulging bag of waters. I did, and at first I could only feel my own tissues, and then I felt that delicate bag. How incredibly amazing! My water never broke during labor. I remember thinking about how my friend Shanna had said that she felt connected to all the women around the world laboring with her, and I tried to access that. I thought about them, but I didn’t feel the connection. All I could feel was me in this moment and moving myself through this experience.

I would look up sometimes and see Kristen looking at me very intensely. I knew she was reading everything about my demeanor to tell her what was happening with my labor. She didn’t need machines and graphs when she had experience, wisdom, and intuition to let her know what was happening to me. She told me, “Rachel, you are going to have your baby today.” And that brought me back to the moment and what we were doing. It was exactly what I needed to hear as I worked through that final phase.

When the baby was really low, Kristen wanted to move us back into the bedroom. I didn’t want to go at first for some reason—maybe I feared it would not be as effective as the toilet or it would slow things. I got in the bed with Marc beside me. I could feel myself stretching as the baby slowly crowned. It felt like he was crowning forever—it was so hard to wait between contractions. Kristen used hot compresses on my perineum and poured warm olive oil over me to help the tissues stretch.

Finally, I had to ask desperately, “How much longer until the head is born?” Kristen said one or two contractions. Then, two contractions later, she apologized and said it’d be one or two more. I didn’t care, I just kept pushing. All of a sudden, I felt the head move out. At this point, the baby was still in the water bag (the caul broke a moment later as the shoulders were born)! I felt relief, and then the turn and stop of the shoulders. I thought it would be a struggle to get the shoulders out, but suddenly there was movement, and I heard Kristen say, “Rachel, reach down and take your baby.” In a daze, I reached down and grabbed him and pulled him the rest of the way out and to my belly. We were stunned! Bonu and Kristen just gave us the moment and sat silently observing, Bonu videotaping. Little dark eyes looked up at us from a frowny face. Marc asked Kristen if it was a boy or a girl. She said she didn’t know (she knew I’d wanted Marc to tell me), so we looked between those little legs and Marc announced that it was a boy! The baby was squawking, and I was talking to him and kissed Marc. I looked up at Kristen. She had tears in her eyes and said, “Congratulations.” I said to her, “That was crazy.”

Marc then surprised us with a beautiful prayer, written by Naomi Levy, that he read aloud (see Box). The prayer made everyone cry more. Bonu recorded all of this on video. She also got a great photo of us right when I put the baby on my tummy.

EPILOGUE

After Jonah was born, I held him while Kristen dried him off and put a blanket around him and a hat on his head. She had us feel how the cord was still pulsing. I handed Jonah over to Marc so he could hold his new son for the first time. I had to push the placenta out, but that felt like nothing after the birth. Kristen checked it and then showed it to us, explaining a little “Placenta 101,” which I’m sure I immediately forgot. She made us breakfast, which I had no appetite for. It was like after the marathon—I’d just burned 9 million calories but had no appetite. I knew I would later. Kristen checked me. It took a while to stop bleeding, but she gave me some herbs for that and it was fine; so I didn’t have to get Pitocin. I only had one tiny tear. Kristen examined and weighed Jonah on the bed right next to us. He was perfect. I noticed right away his funny pinky fingers. They are still a little curved.

With such an erratic labor that stubbornly didn’t follow the “rules,” I would have been a prime candidate for unnecessary medical interventions in a hospital.

A Prayer When a Child is Born.

By Naomi Levy

Welcome, welcome to this breathtaking world. We have been waiting for you. Waiting to see your beautiful face, to hear the sound of your cry, to kiss you, hold you, rock you. You are the fruit of our love, of our hearts, of our souls.

We have prayed for this day, and now it is here. But no amount of anticipation could have prepared us for you. You are a miracle. You are a gift from God. You are ours.

May God watch over you in love and bless you with health. How can we express our gratitude to You, God? You have sent us a perfect blessing.

Thank You, bless You, Source of all life.

Amen.

We made the phone calls. Kristen and Bonu helped us get started with breastfeeding. Bonu helped Marc put on Jonah’s first diaper, complete with some olive oil on Jonah’s bum so the upcoming meconium wouldn’t stick to it too badly.

We were completely high on the home birth from the second it was over and for weeks afterward. We just thought it was the coolest, most amazing experience ever. I still love to talk about it. I never expected to have a home birth when I got pregnant, but it was absolutely the best choice for us. With such an erratic labor that stubbornly didn’t follow the “rules,” I would have been a prime candidate for unnecessary medical interventions in a hospital, and who knows where that could have ended up. I’m so lucky that we had the option for a home birth.

For me, childbirth was incredibly painful; but it is definitely manageable if you have the tools and support. People do the childbirth experience a disservice when they solely focus on the pain. It is so much more than that. You also get a break between every contraction where you feel completely fine. Sort of like life, it is about just working through the rough spots.

I’m completing this article after Jonah’s 18th month birthday. Maybe it has been hard for me to put the childbirth experience to rest. I always felt there was so much I wanted to say. But here is what I have, how I remember it. Giving birth to Jonah was one of the best experiences of my life. Getting to know Jonah and learning to parent with Marc has of course been another amazing experience. What can I say? I’m blessed a thousand times over. I’m grateful.

Biography

RACHEL GOLDSTEIN is a doula and aspiring childbirth educator, thanks to her education about birth while pregnant with her first son, Jonah. She writes a blog at her website, Postmodern Childbirth (http://postmodernchildbirth.com/), when possible while juggling work, family, and the newest love in her life, Jonah’s little brother Leo.