Ramona Cole was born at home on the bed where we made her at 5:27pm February 26th.  By the time labor got going enough for us to call the labor tub delivery service, it was too late to get the tub set up in time for the birth.  Although I remain roughly the same person I always was, her birth and the sheer fact of her existence as a wholly unique individual in the world who is my daughter have changed me irrevocably.  The unbelievably short time it took to go from being a pregnant version of myself to being somebody’s mother has only added to the surreal nature of the whole thing.  In the birth story that follows, I want to record every detail of Ramona’s birth.  But at a certain point, it all becomes a bit of a blur, as these things are supposed to do.  And honestly, the story really begins once she arrived.  The heights of love and fear and pride that being a parent has taken me to in these last days are truly MORE than anything I experienced as I birthed my daughter. 

 

My water broke at 8:30 that morning, after 2 days of loose bowels and painless contractions.  Still, it was a total surprise.  At first, of course, I thought I had peed on myself somehow, but discovered in the bathroom a clear pink-tinged fluid with a few tiny specs of meconium, baby’s first poo.  This was the only time we ever saw the mec, which can be a problem in large quantities.  I’m convinced it was only there so that I would truly believe what was happening – there’s no meconium in urine!  “Want to know something crazy?” I called to Jamie from the bathroom, “It’s not outside the realm of possibility that my water just broke.”  Feeling somewhere between giddiness and denial, I paged our midwives.

 

We were working with a midwifery partnership, Erin and Melissa, who shared call between them, but (at the time we worked with them) were attending births together.  Melissa answered my page, and it was she who we talked to throughout the day.  We were on our way out to our favorite breakfast spot, and after talking to Melissa, we decided to continue on with that plan.  By the time breakfast was done (eggs, sausage & pancakes), I was having mild but somewhat regular contractions.  We stocked up at the grocery store, spoke with a friend driving in from out of town to photograph the birth ("No hurry, take your time"), and made a stop at the post office to pick up a New York Mets baby set -- blanket, onesie, booties, hat -- about which Jamie was very excited.  We also stopped by Jamie's Starbucks to let them know what was up.  Most everyone greeted the announcement that we were in labor, right there in the Starbucks, with enthusiasm, though one nervous-looking young man asked me if I didn't want to go lie down somewhere.  I laughed and told him I was doing just fine.  Across the country, all Starbucks were closing that night for a training event.  Jamie told them he'd be in for the training if things hadn't changed by then.  He thought he’d return the next day to buy the New York Times from the day of her birth, but less than seven hours later, half an hour before the training started, our baby was born. 

At the time my water broke, Jamie and I both had flashes of all the things that could have ended up turning out differently than what we had hoped for.  Although I declined IV antibiotics in labor in spite of testing positive for a bacteria (Group B Strep) that leads to serious illness in a very small percentage of babies, I knew that having the waters broken for over 18 hours was a true risk-factor for the baby developing the disease, and so began resigning myself to IV antibiotics sometime that night.  Much more distressing was the possibility that, should labor fail to progress by the next day, we would likely end up at the hospital, induced with pitocin, hooked up to a monitor -- everything we had hoped our birth would not be.  We didn't dwell on these thoughts, but they were there all the same, so every contraction was a small victory, a step closer to the birth we wanted.  As we headed to our car through the Starbucks parking lot, I mentioned to Jamie that there is a certain “high” feeling about labor, a disconnect from the world that everyone else is moving in, so that it seems surreal.  The true reality is happening within.  I was ready to be home and focus inward. 

 

When we got home, Jamie drafted his fantasy baseball team while I cleaned out the fridge and put away the groceries, listening to Johnny Cash’s American III:  Solitary Man and sipping on Odwalla C Monster – Melissa had recommended good hydration and lots of vitamin C to help keep infection at bay.  When that was gone, I moved on to water and red raspberry leaf tea.  Contractions intensified somewhat, and I spoke with the Melissa -- we would check in again at 3 if nothing had changed before then. 

By 2, things had changed.  Jamie had taken out a bunch of garbage and recycling, and been thwarted in an attempt to do laundry (both washers in the laundry room were full).  I had put some essential oils on the burner – chamomile and lavender for relaxation, rose geranium for uplift, and clary sage for intensifying contractions – and laid down to rest for a minute, listening to a hypnobirthing affirmations cd.  Not long in to the second track on the cd, a relaxation exercise, I was rocked by a contraction that demanded that I get up and get moving.  For a while, I stood leaning forward and holding on to Jamie around the neck, rocking my hips left and right.  At some point, I was on my knees, leaning forward on the birth ball, and rocking some more.  Soon, I wanted to be in the bathroom, on the toilet.  At 2, we called the midwife from the bathroom, told her things were picking up, but we still didn't think contractions were any closer than 5 minutes apart (until we got off the phone, when Jamie said it seemed more like 3).  I couldn't talk much during contractions, but I listened to the Melissa say that things were moving along well, we should call to have the labor tub delivered, and she'd arrive at our house by 4.  Jamie took care of paging the tub service while I stayed in the bathroom.  When he was done, he said he was going to go try to put in the laundry again, “…unless you want me to stay here with you?”  “If you want to go do the laundry, that’s fine,” I told him.  “Does it matter to you if the laundry gets done?” he asked, “Because even if you’re neutral on it, I’m going to stay with you.”  “Then stay with me,” I told him, “because I don’t care about the laundry.” 

 

We decided to get into the shower together, as Jamie had been wanting a shower, and at that point, I wanted…something different.  I lit some beeswax candles my mother had given to me, and we got in.  The shower and the closeness with Jamie were lovely, though the both of us barely fit with my big belly.  I stayed in for a while when he got out – in retrospect, not the best plan, as the lack of tub was due in large part to lack of adequate hot water in our water heater.  Then I was back on the toilet, feeling a little shaky and a little nauseated.  I told Jamie about how most first time moms can have a mini-transition into active labor, and that was probably what I was feeling.  In fact, this was likely the real thing – the transition from 8 to 10 cms dilation, from passively opening to actively pushing.  I got to a point where nothing felt right – I left the bathroom and went to the bed for a few minutes, but that didn’t help.  Back in the bathroom, I asked for the heating pad.  Jamie plugged it in, and I folded it into the place where my legs met my torso.  It was amazing how much I was feeling the contractions in my upper legs. I asked Jamie to put on some Celtic music I had discovered on our computer, and I tapped my feet and patted my knees to the rhythm, explaining to Jamie labor support guru Penny Simkin’s theory of ‘relaxation, rhythm and ritual’ for coping with contractions.  Looking back, I’m pretty amazed at how with-it I still was between contractions at this point.  I was remembering to drink, and being on the toilet led to remembering to pee.  Jamie and I have had this joke in our relationship ever since we got together – all the romance is gone once you see your partner using the toilet.  So, we give each other privacy in the bathroom.   But not this day.  It got to the point where I was pooping a little with every contraction.  I really loved that Jamie didn’t care that he was there in the bathroom with me. 

 

As the poop thing continued, I realized that it was happening because I was getting relief from bearing down with the contractions.  Clearly, this was no good.  As mentioned, I thought I was just getting into active labor, which happens at about 4 to 5 cms cervical dilation, out of a total 10 cms necessary to push out the baby.  The contraction pattern and the relative ease of coping up till that point all lead me to this conclusion.  And here I was bearing down.  Being a student midwife, I know that pushing against a cervix that is not fully dilated can lead to cervical swelling which ultimately slows labor down and can even reverse cervical dilation.  I did think to check my own cervix several times during what followed, but I was pretty convinced that I wasn’t completely dilated, and didn’t want anyone, including myself, pushing microbes from the vagina (like, for example, that Group B Strep thing) up into the uterus and causing infection.  (I had been relieved to hear at our last prenatal visit that my midwives were of the same mind and wouldn’t do cervical checks with broken water unless either things weren’t progressing or I was feeling pushy.)  Plus, I don’t trust myself to do an accurate cervical check anyway, and probably wouldn’t have believed what I would have felt, namely a baby head moving through my bones.  But until someone arrived and told me that yes, I was complete, I refused to believe what was happening was right.  If I had surrendered and trusted my body, I know I wouldn’t have pushed for as long. 

 

I told Jamie what I was feeling and asked him to call the midwife.  At this point it was 3:30, and she should have been arriving in about half an hour.  All I wanted was the tub – I figured I could get back on top of this sensation in the water.  Jamie spoke with Melissa, who said they’d be there as fast as they could, and told Jamie that if the baby started coming before they got here, he should call and they’d walk him through it.  At this point, everyone but me truly believed that the baby was coming.  Melissa told Jamie to put some baby blankets on the heating pad.  I was sad to surrender it, and had a hard time coping without it.  As the tub service lady arrived, I was once again tapping my feet and patting my thighs – but with a ramped up intensity.  I felt like I had to be DOING something if I couldn’t push, and so I sat on the toilet working my legs like I was running, and slapping my knees so hard I ended up with bruises.  I called out to the tub lady that I was very glad at her arrival.  As Jamie left to get her situated, I realized through the fog that being on the toilet was a bad position to discourage pushing.  I got down on to the floor in the knee-chest position, on a pillow Jamie must have brought for me.  I noticed some bloody show dripping onto the linoleum between my legs, a sign of cervical dilation caused by capillary breakage as the cervix opens -- even more evidence to my mind that I was still dilating and not ready to push.  Still, knee-chest wasn’t helping to make the pushing stop as much as I’d hoped.  During each contraction, there was a point where my body would heave backward with the full strength of my watermelon-sized uterus, and I could do nothing to control it. 

 

With me on our tiny bathroom floor, however, there was no way anyone else was getting in – I was blocking the door.  I guess the tub lady told Jamie that I should move out of the bathroom so I wouldn’t have the baby in there by myself, and he relayed this message to me. I got up, moved a foot out into the hallway, and plopped myself back down in knee-chest in our entry way, still naked from the time in the shower, with my butt in the air facing the front door.  I was not at all concerned about seriously flashing the whole hallway of our building any time anyone came or went.  Jamie was still working things out with the tub set-up, but that was mostly okay with me – I was in my own world of trying not to do something that my body was doing without me.  The birth assistant, Gwen, arrived (to the sight of my naked ass in the air as she walked in) and I asked her if she could check me, knowing that she probably couldn’t.  Indeed, she couldn’t.  She told me to pant, which helped quite a bit, except, again, for that one point in the contraction where my body simply pushed without me.  I remember at some point saying something like, “I can’t make it stop, why can’t I make it stop?”  Through all of his panic that he’d have to catch the baby (which Melissa had said he’d have to do even if Gwen was there because she wasn’t legally able to do so), he just kept telling me that I was doing a great job.  Now that Gwen was there, he was working with her to get the birth supplies ready and get her what she needed.  The tub lady had gotten all the hot water she could out of the hot water heater, and was asking him to boil water.  Gwen wanted hot water too, for perineal compresses.  She also suggested that we move some of the things in the entry way, like the storage bins we were planning on using to organize our closets the following week.  In the process of doing this, Jamie and Gwen ended up dropping one of the storage boxes on me.  They both felt terrible, but I barely noticed.  So, as the midwives arrived, Jamie was still running around trying to get everyone and everything situated, and I was still on the floor in the entry way, with my butt in the air, trying not to push. 

 

I had said all throughout the pregnancy that I was trying to have no expectations of my birth.  As a doula and aspiring midwife, I had seen so many variations of labor, and I knew that you never know what you’re going to get.  But the fact of the matter is that it’s impossible not to have expectations.  I just planned for the worst – I expected labor to be long and difficult, because I knew that most first-time moms don’t get the kind of labor I had as I birthed Ramona.  But because of that, I was totally unprepared for the labor I was dealt.  I had a birth alter set up in the room where the tub sat with three inches of water in it, and I didn’t look at it once while I labored.  On it were the affirmation cards my friends Janna and Melissa and I had made during my birth blessing over the weekend.  I didn’t look at them, either.  I had a recipe and all the ingredients for “groaning cake,” traditionally made to distract one’s self from labor during the early or early active stage.  I had candles I had been saving to burn.  I had the tub service lined up.  I had my friend Janna on-call as a doula if we needed her.  I had a lot of tricks up my sleeve.  When Melissa checked me, there in the entry way, and told me I was in fact fully dilated, I lost the labor I had expected – making a cake in four-minute increments between contractions, soaking in warm water and gazing at candles on my birth alter, remembering the blessings of my friends.  I had planned to have more time to integrate this all, and I’m still in the process of mourning that labor.  Am I grateful that things went so fast?  OF COURSE.  And I’m grateful that I didn’t need to use all the tricks I had up my sleeve to get through it.  But it all happened so fast that I can’t really believe that it happened.  Jamie has suggested that even had it taken days, it still might not have been enough time to truly integrate the transition to parenthood, and he’s probably right. 

 

So, it turns out that I’m completely dilated at 4 in the afternoon.  I’d flipped onto my back to facilitate the cervical check, but we were still there in the hallway, and I really couldn’t believe what was happening.  Jamie let me know that there were only three inches of water in the tub, the tub lady had left, and he could either boil water and try to fill it in time, or just skip it and be with me.  I wanted him with me, and that was the end of the tub.  I asked for and was given some Rescue Remedy, a flower-based remedy for stress and trauma, and then we moved into the bedroom – not at all where I’d envisioned giving birth, so there was a bit of a scramble there to get things set up in a way that allowed the midwives to do their thing.  At least we’d made up the bed as they’d requested early in labor – one set of sheets covered with a plastic sheet, covered with another set of junky sheets.  For some reason, I ended up side-lying.  Jamie says it seems like that was what the Melissa thought would work best for both of us– maybe something about slowing me down a little, and giving her a good view.  But it really didn’t work for me.  I was having crazy pain in my pubic bone, which made them nervous about a small bit of cervix remaining up front, but they checked me again and no, I was still complete.  Later, we figured it was probably Ramona’s elbow pushing on my bone, as she was born with her hand up by her face.  During this chaotic transition to pushing in the bedroom, my friend Rachael arrived to take pictures.  I was so glad she had made it.  From the time I was in the hallway, I only have a few visual memories of what was happening.  I don’t think I truly saw the Melissa’s face until after Ramona was born.  I have one memory in the bedroom of Erin’s face at the side of the bed, and I remember seeing Rachael’s face, and being so happy she was there.  I know I looked at Jamie as I pushed and rested between, but I don’t have any specific memories of his face.  I do remember kissing him at one point, and how nice it was to be so close to him. 

 

I don’t know if it was the constant pubic bone pain, the position, a full bladder (though I felt like I’d been good about peeing often), the new energy of the midwives in the house, the lack of a meal since breakfast, or the fact that I’d been trying to deny my pushing urge for a good 45 minutes, but I stopped really being able to feel the contractions.  I got up onto my knees, with Jamie sitting in front of me, resting my arms around his shoulders or pressing my hands into his legs with my arms straight as he sat cross-legged.  I was able to push more effectively in this position, though I still wasn’t really feeling the contractions.  I think this was a really awkward position for the Melissa, who was catching the baby, but she pretty much just let me do what worked, thought she encouraged me to be more upright, both to facilitate the pushing and to allow her to see what was going on.  The midwives asked Jamie to do some nipple stimulation to get the oxytocin flowing, and they started asking about what I had eaten that day.  Because it had been since breakfast that I had a real meal, they wanted some calories in me, and I sent them to the birth alter to get the Lopez Island honey my midwife friend, also Melissa, had given me at my birth blessing.  They handed it to Jamie and asked him to give me a spoonful.  “Don’t make Jamie deal with the honey,” I said, “He’s horribly allergic.”  Again, can’t believe how with-it I was to process what was going on and speak up in that moment – perhaps being so present in my head has something to do with why I wasn’t feeling my contractions any more.  The primary midwife talked to me about the learning curve with pushing for first-time moms, and it just seemed so funny, having to now learn how to do this thing that I couldn’t stop from happening not that long ago.  They used warm compresses on my bottom, which really felt good and helped me relax my muscles.  Throughout it all, Ramona sounded fabulous – her heart rate never dropped below 110’s, even at the most head-squishing point of the pushing process.  It’s funny to talk about her as Ramona, because we didn’t know her that way yet.  I remember reaching down and feeling her head about an inch or so inside my vagina, and knowing that that was my baby, but the reality of her didn’t hit until she was out.  In fact, I think it’s still in the process of hitting. 

 

The midwives assured me that I was moving Ramona down with each push, and soon her head was remaining visible between contractions, and then crowning, where the largest diameter of the head stretches the vagina to its widest.  As I said, she was born with a hand up by her head, making the stretch especially intense.  I felt as though I was going to tear up toward my clitoris, and I reached down to hold the place where it felt like my tissue was going to give.  The midwives kept saying that Melissa was holding my skin so I wouldn’t tear, but I needed the assurance that holding it myself gave me.  And, if I was going to tear, I wanted to tear down rather than up.  Then her head was out.  There was cord around the neck, a common occurrence and not the emergency most people thing it is.  Melissa was able to slip the loop of cord over her head before I pushed her body out.  I grabbed my glasses from where I had set them on the headboard when we came into the bedroom, and then Melissa passed my daughter to me between my knees, and I turned and sat on the bed. Jamie says what a crazy thing it was that his first meeting of his child happened as she slid through a puddle of fluid and blood between my legs – the most striking moment of the whole experience for him.  For me, it was the moment when I looked between her legs and discovered that we had a little girl.  Everyone had expected a boy for some reason, and so the arrival of our daughter was an incredibly sweet surprise.  I was filled with love. 

 

We met our little girl and waited for the placenta.  After a bit, Melissa felt my fundus to see what was going on, and there was a gush of blood, possibly mixed with urine.  Jamie was horrified at the quantity of blood, , but the birth assistant, Gwen, quietly reassured him that this was normal.  Melissa was concerned, though, and started talking pitocin.  I asked to be given the herbs we had discussed prenatally, shepherd’s purse and yarrow tincture, and Erin squirted a dropperful under my tongue, followed by some motherwort tincture mixed in the last sip of water in my cup.  The placenta came, and I hardly lost any more blood.  The cord was still intact at this point – we waited over an hour from Ramona’s birth to cut the cord.  In the meantime, Melissa discussed the posstilibty of having to suture my perineum, which seemed prettly likely considering the hand up by Ramona’s face as her head emerged.  We were all surprised to find that I only had a few skid marks, though there was a bit of a hematoma and swelling.  Ice and the herbal sitz bath in the peribottle were helpful, and I started doing Kegel exercises as soon as I could. 

 

The first few hours of her life are some of the loveliest of my life – and they are a warm glowing blur to me.  She learned to nurse right away, though her busy hands got in the way a little.  Erin said she and Jamie were twins, and we’ve since discovered that Jamie as a baby was nearly identical to Ramona.  She had none of that alien look about her that I had warned Jamie to expect.  Ramona was beautifully herself from moment one.  Rachael went out and got us delicious Indian take-out.  Ramona was born on the same day as our midwife, Melissa, and my cousin Anne.  Anne was the first person I called to announce Ramona’s arrival, and Erin surprised Melissa with a birthday cake Rachael brought back w/ the takeout food.  We had thought if we had a girl we might name her Shea, for the stadium and because it’s a neat name.  But she was clearly not Shea, so we sang, “Happy Birthday, Melissa & baby.”  I got up to pee and showered with ease.  Jamie held his daughter and introduced her to our cat.  Erin did the newborn exam, and the birth team left. Rachael took some family portraits on the bed.  Several hours after the birth, Jamie asked if maybe we had a little baby Ramona, a name we had considered (and Jamie had rejected) in early pregnancy.  Clearly, Ramona was who we had.  And that is the story of how she came in to the world.