Birth of Melissa
MELISSA ANN WIENER
Birth date: December 18, 1989
Place of Birth: Anchorage, Alaska,
born at home, underwater
Parents: Rosemary (Romberg) and Steve Wiener
Mother’s age: 42
Weight: 7 lb. 10 oz., Length: 20 inches
6th baby, 9th pregnancy (3 previous miscarriages)
Siblings: Eric – 17 ½, Jason – 15, Ryan – 12 ½,
Lisa – almost 9, Kevin – 4 (ages at the time of Melissa’s birth)
I could write volumes chronicling the details of all of my previous pregnancies, births and miscarriages. Those stories have been told elsewhere, but I wish to give a brief recap of my pregnancy/birth history as much of it is pertinent to the events and decisions surrounding my most recent baby’s birth.
Our first baby was born in 1972. We were young, naive, and excited new parents, eagerly taking Lamaze classes and learning all we could about natural birth and baby care. How sad that our great enthusiasm and love for our baby could not have been properly fulfilled in our birth setting. After hours of horrendous back labor and strenuous pushing, our long awaited son, Eric, was finally held up in front of me, wailing and screaming. As I tried to reach for him, my hands were pushed back under the drapes as the doctor said “No, no!” and Eric was handed to the nurse who quickly whisked him down to the central nursery. Shortly thereafter Steve went home and I was wheeled on a gurney past the nursery window to watch another nurse hold my baby up for me to see. Baby Eric was first brought to me for feedings the following morning, 12 hours after his birth. He was all bundled up in blankets with only his head visible. He did not nurse until the 9 p.m. feeding when he was 24 hours old. Eric did not become “our baby” until we went home two days later.
I had an IUD put in at my 6 week check up. Not knowing one from another, I trusted my doctor’s judgment about the type of IUD. About a year later I became pregnant with it in and subsequently miscarried at 12 weeks. The miscarriage was almost certainly caused by the IUD. It was a Dalkon Shield. At around that same time, 17 women died, and countless other were left infertile or with other lifelong health problems caused by septic mid-trimester miscarriages caused by that same device.
The following year, in 1974, our second son, Jason, was born. Yearning for the immediate bonding which had been so ridiculously denied to us by inane hospital rituals following Eric’s birth, we seriously considered a home birth for our second baby’s arrival. Unable to find a qualified birth attendant, and too afraid to try it on our own, Jason’s birth took place in an immensely superior hospital (in terms of being family centered and flexible towards people’s needs during birth.) I was given Jason to hold immediately after his birth, while still on the delivery table (although he was wrapped up in blankets – much is still lost in the bonding process this way), and had total rooming in during our hospital stay.
2 ½ years later, in 1977, our third son Ryan’s birth took place at home with a lay midwife in attendance. At the time this was a daring, “radical”, thing to be doing, going outside of the established medical system to give birth. But by the time our fourth child and first daughter, Lisa, was born in January of 1981, giving birth at home was simply natural, right, and taken for granted – the way I have my babies now.
My pregnancy with Lisa was significantly different from my previous pregnancies. While pregnant with my sons I had experienced moderate nausea during the first trimester. Certain odors and foods did not appeal to me for a few weeks, but this soon passed. It was certainly nothing I would ever consider cause to dread the entire prospect of pregnancy. Overall, I had found pregnancy to be a vibrant, positive, glowing experience. But in 1980 while carrying Lisa I was absolutely wiped out with dreadful, bitter, totally vile nausea and severe depression. I thought I was losing my mind! Also, early in that pregnancy my uterus was unusually large for the stage of gestation. The doctor said that it “felt like I had fibroids.” At the time I scarcely knew what fibroids were. He gave the matter little concern. I carried the baby to term with no problems and gave birth at home to our healthy, full term baby girl. I was almost 34 when she was born and considered our family complete with four children.
Two years later, in 1983, much to my surprise, I discovered that I was pregnant again. I was soon overwhelmed with the same vile, horrid, debilitating nausea and depression that I had experienced three years earlier with Lisa. I was due in November and was soon making plans for another home birth. I went to a highly knowledgeable, respected midwife in the local community. She was concerned because she could easily palpate a large fibroid tumor in my uterus. Her worry was over postpartum hemorrhage. She had me visit a doctor (the same one who had examined me while pregnant with Lisa) for a back-up opinion. There was talk of ruling out home birth or giving me an I.V. at home. But since my condition seemed to be identical to the diagnosis I had been given while carrying Lisa, I refused to get as worried about it as she was. But I was 36 years old at that time – now encroaching into that “elderly gravida” area for childbearing which is one of statistically greater risk.
That June, when I was 17-18 weeks along we moved to a larger house. I sensed that things did not seem “right” about the pregnancy, but chalked it up to exhaustion from moving. At my 19th week my water broke. After about 6 hours of sheer emotional terror I passed a small, limp, partially macerated fetus about 8 inches long. I then began to hemorrhage and had to be rushed to the hospital for a D&C. A subsequent ultrasound five weeks later confirmed a lemon-sized fibroid tumor in the upper portion of my uterus. The doctor advised me that the baby had probably been implanted where the fibroid was and had been unable to get nutrients through the placenta as the pregnancy had progressed. He also advised me that the prospects of a future miscarriage (or more accurately – fetal death) for the same reason were about 50-50, depending entirely on where the fertilized egg would happen to implant. I also learned that the baby was a girl. It then occurred to me that the characteristic severe nausea that I had experienced with that baby and with Lisa was, for me, associated with carrying a girl.
I was plunged into deep grief following that experience as I attempted a number of purported “wholistic” healing treatments and special diets to eliminate the tumor from my body. The following spring I was examined by the doctor who pronounced my uterus apparently normal and tumor-free, with the prospects of a subsequent full term pregnancy considerably more optimistic. I became pregnant again in May of 1984, 11 months after losing the last one. I was soon experiencing the same intense, vile, horrible nausea that I had undergone with the last one and with Lisa. I was also overwhelmed with immense anxiety about the outcome of this pregnancy.
This time my uterus seemed normal sized for the stage of pregnancy. During my previous pregnancy that I had lost in 1983 my uterus had always been quite large for dates. This gave us some hope. But in September I began recognizing the now familiar symptoms of intrauterine death. “Pregnant feelings” such as nipple sensitivity and general “aliveness” disappeared. I was passing bits of brown mucus. I felt overwhelmingly depressed. I soon lost that baby in a manner almost identical to the last one. The doctor told me that he had felt fibroids inside of my uterus when he did the D&C to remove the placenta. There had been a lot of amniotic fluid with my 1983 pregnancy, but very little with this one, which must have explained the smaller uterine size. That baby was also a girl.
Filled with deep discouragement and depression following the second of those two miscarriages, I made an appointment for a tubal ligation. Then something compelled me to cancel the appointment at the last minute. Three months later, in January of 1985, I became pregnant again. I was in the midst of an overwhelming spiritual upheaval in my life, triggered by my catastrophic losses. I was terrified by the prospect of yet another pregnancy. But I did recognize that I was not experiencing the bitter, horrid, vile nausea that I had undergone with Lisa and the two girls that I lost. This was the much milder, not too troublesome nausea that I had experienced with my sons. By that spring and summer, much to my immense joy and relief, I found that I was, indeed, carrying this baby past the point where I had lost the last two. An ultrasound at 22 weeks revealed a “myomatous thickening” at the top of my uterus, with the placenta safely implanted at the back of my uterus where no tumorous growth would get in the way. Also, this baby was a boy. Although I was unbelievably delighted and relieved to be carrying this baby to term – something I had desperately craved and had believed I would never be able to experience again, there were still some feelings of loss that I was not having another girl.
Much to my deep disappointment, my previous midwife, who had given me much attention and emotional support through my last two pregnancies and losses, now refused to share my joy and optimism about this baby’s birth. There was no fibroid threatening this baby’s life. All I wanted now was to again be a healthy, normal mother having a healthy normal baby – something which I knew I was, but desperately needed that verification from my health care providers. Her rejection of me at that time was quite painful. “You’re not a midwife’s patient!” she insisted.
I then turned to another midwife who did only hospital and birth center births. At least if I had to have a hospital birth, I wanted a midwife’s care. (I liked my doctor very much, but still felt there would be a big difference in the type of treatment I would receive.) This midwife was a lovely person, but turned out to be much more interventive and “doctor-like” than I had anticipated. I put a great deal of energy into clarifying and arranging matters with her towards making my upcoming hospital birth as “home-like” and uninterfered with as possible – especially emphasizing my desire for no routine monitoring or I.V. during labor. I still desperately wanted another home birth, and considered doing it on my own, unattended, or with a less “official” midwife. A second ultrasound done in my 8th month revealed “no abnormal uterine tissue” – visual proof on film of the documented absence of any fibroid tumor in my uterus. But even this was insufficient to convince any of the people involved that I was indeed not a high risk case. I never could understand why my previous midwife thought that Kevin was in any greater danger than either of the two previous babies would have been had they been implanted differently. (She had accepted me as a home birth client with both of those pregnancies.) The whole situation seemed to be based on fear and politics. I did not accept the hospital as a safer place to give birth, but I simply did not have it together enough to do it at home on my own after all the emotional trauma I had been through with losing my previous two babies. The hospital was the only place I could give birth with the professional and emotional support that I needed at that time.
Many aspects of the hospital birth were good. My four older children, husband, and two other friends were all present as I gave birth in an attractively decorated birthing room. The scene was worlds different from my first two “labor room – delivery room” hospital experiences. Perhaps had this option been available back in the 70’s I would never have taken an interest in home birth.
However, my midwife was insistent upon giving me an I.V. and continual external fetal heart monitoring – interventions which I had believed myself strong enough to refuse in the hospital setting. Interwoven with all of my residual fears over my previous losses, the fetal heart monitor, while a fascinating tool, lent an air of anxiety and medical emergency to the impending birth. My own inexperience with the device probably caused me to project unnecessary fears onto the monitor bleeps and readings. The baby’s heart rate fluctuated considerably throughout labor. My midwife and the nurses were concerned that the baby’s heart tones were not recuperating quite as fast as they should after each contraction. I now know that this is within the realm of normal and that many medical practitioners are overly cautious and mesmerized by the workings of the monitor.
As birth approached the heart tones were lost on the monitor screen. My midwife was attempting to insert an internal electrode into the baby’s head as it was crowning. I pushed Kevin out as rapidly as possible to save him from “failing heart tones” and from being jabbed with the monitor electrode. It was an episode of great panic and anxiety rather than peace and joyousness that birth should be. At the sight of my vigorously healthy, screaming baby I instantly realized what I had known in my heart all along – everyone’s fears were irrational and uncalled for. There was also no excessive bleeding after birth – everyone’s big fear with fibroids and “advanced maternal age” (38).
Kevin was born right before midnight. My family and friends left around 1:30 a.m. The baby and I would go home in the morning. My heart ached as I watched them all leave. I desperately wanted to pack up the baby and the rest of my stuff and go home with Steve and the kids right then. The remaining night in the birth room, even with the baby in bed there with me, was a sad, lonely experience. Following my home births I have always especially treasured the immediate aftermath in my own environment.
During the months following Kevin’s birth, 99% of the time I was simply happy to have a baby in my arms again – a reality seemingly too good to be true after my previous losses. There was a part of me that still wished to get pregnant again and have a little girl – understandable since by this time I had four sons, only one living daughter, and had lost two baby girls. But I put that out of my conscious mind. The idea of yet another baby seemed too greedy. Five kids were plenty. I didn’t want to risk another miscarriage. I was too “old.”
We moved to Anchorage, Alaska in the fall of 1988 shortly after Kevin’s third birthday. Moving to such a cold, dark, strange but exciting land was quite an upheaval. I turned 42 that winter. In March I was in Anaheim, California for the first NOCIRC symposium. I was one of the guest speakers because I have written a book about circumcision. One of the major speakers was Michel Odent, from France (now residing in Great Britain) who has delivered hundreds of babies under water. He showed films of several water births – each with the mother relaxing in a tub of water while the baby emerged quickly and easily. Anyone who has experienced labor and birth can easily imagine how soothing and helpful warm water must be during this process. In Europe non-religious circumcision is an alien concept. Odent was a guest at the symposium because the concept of leaving infant boys intact should go hand in hand with other peaceful, non-violent practices in birthing and infant care, including underwater birth. I also met Jeannine Parvati Baker whose two youngest children were birthed under water. In our new home in Anchorage we have a double Jacuzzi bathtub in our master bathroom. It occurred to me that this would be an ideal setting should I ever have another baby.
Back in 1982 I had seen some films on underwater birth which had left me unimpressed. In those films the babies had been left beneath the surface of the water for several minutes before being brought up to breathe. Even though those babies were alive and healthy, getting all their “breathing” through the umbilical cord, the sight had left me weirded out. Later I learned of a baby in Spokane, WA. that had drowned during an underwater birth. (I later learned that that baby had been left under water for an hour and a half!)
Occasionally we would omit using the diaphragm when it’s near the beginning or end of my cycle. In April, it was just after I had had my last period – nowhere near the supposed time of ovulation according to the charts on natural family planning – that Melissa was conceived. I experienced a spiritual encounter with the soul of this child at that time. I knew she was a girl and she wanted to come into the world through me. I told her I didn’t think it would be a good idea, for a number of personal reasons. But I also told her that “If you do, don’t you dare leave me.”
About a week before my next period was due I had a routine GYN exam which revealed a normal sized, (apparently) non-pregnant uterus, with no palpable evidence of fibroid tumors. A few days later, but still before my period was due, I was at the local library. A woman with a tiny new baby was walking around, and I found myself turning to “goo” inside over the sight and sounds of that little baby. I sensed then that something had to be going on inside of me.
Around the time my period was due my husband spent five agonizing days passing a kidney stone. Trying to help and comfort him was much like working with a woman in hard labor, except nothing would happen. Several times I took him to the hospital where they gave him Demerol and I.V. therapy, only to take him home, stone still unpassed, hours later. Finally, on the fifth morning, he passed the tiny stone. Two days later – six days after my period had been due – that old, familiar nausea set in. Each day the nausea increased in intensity. A couple of days later the pregnancy was confirmed by a lab test – hardly a surprise by now! By that weekend I knew that this was definitely “girl nausea.” I felt identical to the way I had felt while carrying Lisa and the two baby girls I had lost. Compared to the way I have felt while carrying my sons, “girl nausea” for me is somehow much more intense, bitter, – a distinctly different “flavor” although almost impossible to describe.
By the time I was 6 ½ weeks along the nausea had escalated to a point of intensity so severe that I could scarcely function. That Friday night I was so terribly ill with nausea that I could not sleep. I could not swallow anything, not even water, without retching. By morning I was certain that something must be terribly wrong. In panic I asked Steve to take me to the hospital. While I believe that abortion is wrong, I had strong, panicky feelings of “I don’t want to be pregnant!!” Besides the horrible nausea, the terror of yet another possible miscarriage had also resurfaced for me. I had thought I had put all of that to rest after Kevin’s birth.
At the hospital the doctors ran blood tests, gave me an I.V., and injected me with Phenergan, an anti-nausea drug considered safe during early pregnancy. I was so severely dehydrated that I went through five liters of Ringer’s lactate and did not get an urge to urinate until I had completed the third one. My uterus was unusually large for the stage of pregnancy – about the size of a 12-14 week pregnancy. I wondered if I might be carrying twins. The doctors brought up the possibility of a “molar” pregnancy – an abnormal growth more likely to occur in older pregnant women. They checked me with a small ultrasound machine which revealed a large fibroid tumor and a small gestational sac in my uterus. The sight of the fibroid gave me a sense of despair and futility. I had believed that the fibroid problem had been resolved years before. I couldn’t make heads or tails about where the baby was growing in relation to the fibroid. The doctors expressed relief that I had an apparently normal pregnancy – not something grotesque like an ectopic pregnancy or a mole. They were not overly concerned about my previous miscarriages because I had carried my last baby to term and had had so many babies successfully. Even with a visible fibroid, they were not considering me a high risk case. They did not seem to be familiar with the type of fibroid caused miscarriages I had experienced. They were more concerned about fibroids causing premature labor in late second trimester or early third trimester, with a viable baby. They also talked about various diagnostic tests such as alpha-fetal protein tests, amniocentesis, and other things they thought I should have done later in pregnancy. (I never did have those tests run, despite my age. I only had ultrasound and routine bloodwork. The other tests are more invasive and pose the question of elective abortion in the event of abnormalities. I feel more comfortable avoiding such types of testing.)
They arranged for me to have a professional ultrasound done during the following week. I was sent home with some Phenergan suppositories. The nausea was still overwhelming, but I was able to eat small amounts of things like soup or toast.
I was 7 weeks along when I had the professional ultrasound reading. The technician was very understanding and reassuring about my concern over fibroid tumors. I told her about my two previous miscarriages and my worry about where this one was implanted. She said, “I don’t think you’re going to have that problem this time.” She pointed out the fibroid that was attached to the upper front half of my uterus, and the beginning baby that was safely implanted on the back half of my uterus where the uterine tissue was good. She showed me the smooth, normal area of my uterus and said, “This is where your placenta is going to be.” The baby was just a tiny speck, but she was able to find the heartbeat as well.
I left the ultrasound office feeling immensely relieved. I was practically in tears over the knowledge that this baby would indeed make it to term normally, unthreatened by the fibroid. It then occurred to me – what if the baby had been implanted on the fibroid instead of safely on a good part of my uterus? I do not believe that abortion is right, but if the beginning baby is doomed to certain death anyway, why should I endure weeks and weeks of horrible nausea? What would the moral implications be over having an early abortion in a situation like this? I was very much thankful not to be facing such a horrible dilemma.
I was perplexed that the fibroid had mysteriously reappeared after not being detectable with ultrasound while pregnant with Kevin, and never being detectable by manual examination since then. My hypothesis now is that for me carrying a girl, severe nausea and fibroids are somehow interlinked. It is known that fibroids are caused by female hormones, particularly estrogen. It is also a fact that the nausea of early pregnancy is caused by the hormones of pregnancy. I have apparently never had a problem with fibroids while carrying a boy, and I have experienced only mild nausea while pregnant with my sons. Somehow, for me, carrying a boy baby agrees with my system, making for a positive, vibrant, easy pregnancy. But for me, carrying a girl does not agree with my system, making for an emotionally difficult, generally yucky experience. It appears that when I am pregnant with a girl my system becomes flooded with abnormally high amounts of hormones which cause both severe, debilitating nausea, and the development of fibroid tumors. Also, apparently when I am not pregnant, or pregnant with a boy, the fibroid tumors go away. For lack of any other term I have labeled this “girl pregnancy syndrome.” I would be interested in knowing if anyone has more information or answers for this problem.
The nausea was at its worst at the time of my 6 ½ week visit to the hospital. As the weeks went by it continued to be horrible, but gradually diminished in intensity, although it was not completely gone until my 20th week. Those early weeks involved literal survival from day to day – sometimes even from minute to minute. May is now a blur to me. June was better as I spent much time outside gardening during the long, Alaskan, summer days. July brought the welcome arrival of our oldest son, Eric, who had remained in Bellingham, WA to complete his junior year of high school after the rest of our family had moved to Anchorage. In July I also reached the crucial “milestones” of staying pregnant past the 16-17 week stage at which my last two miscarried babies had apparently died.
During all of this I had to make a decision about prenatal care. The doctor who had treated my nausea at the hospital and had ordered the ultrasound had also told me that he would get back in touch with me about the ultrasound results. He never called me back. I then spent several days trying to reach him by phone and he still never contacted me. This infuriated me as I have always received conscienscious personal attention from all of my health care providers during my pregnancies. I would definitely look elsewhere for prenatal care and birth plans.
I decided to start out by contacting one or more midwives. I didn’t know my way around the birthing scene in Anchorage, but did know that there were several midwives here – both those that did home births and those who practiced in hospitals. I was still haunted by my feeling of heartache inside over watching my family go home after Kevin’s birth. The feelings of fear and later anger over Kevin’s head nearly being jabbed by the heart monitor electrode were still fresh for me. Much of my being still gravitated towards home birth. But by now I was 42, having my 6th baby, with three previous miscarriages on my record, and with a verified fibroid tumor again. Dare I even think about home birth?
I could at least start by contacting local home birth people. At worst I could just be given the same song and dance that I had gotten from the midwives in Bellingham four years ago while carrying Kevin. If so, I would then ask them to direct me to other resources in town.
During the previous winter I had contacted everyone on Peaceful Beginnings’ mailing list for Alaska. One local home birth midwife, “Z” had responded and had ordered several of my information sheets. I decided to begin by contacting her. She was on vacation at that time, however, and did not get back in touch with me until my 12th week. I described my entire situation to her. (I had considered omitting the miscarriages and taking a few years off my age, but decided I had better be totally honest.) “Z” expressed no alarm over my age or past history. She was entirely positive and encouraging towards me and my desire for a home birth. But she decided that she was overbooked and gave me the names and phone numbers for three other local home birth midwives. I attempted to contact all three. The first one that I got in touch with, “M”, scheduled me for an appointment. She too was refreshingly positive and unfearful over my desire for a home birth and my need to be treated like the healthy normal mother carrying a healthy normal baby that I indeed was.
At my 13th week “M” came to my home for my first prenatal visit with her. I showed her our large bathtub and told her I was attracted to the idea of an underwater birth. She had no experience with that type of birth, but was open to the idea. She was worried about a “water embolism” though, and said that she would want me to get out of the tub immediately after the baby was born. She and I left the idea of under water birth as “maybe yes, maybe no.” She scheduled my next appointment for my 18th week. She would investigate whether or not our insurance would cover her. I would have my routine blood work done at the local hospital lab. I felt elated that I had so easily found a midwife who was so positive and understanding of me and my situation.
A few times during early pregnancy I took baths in our large tub and tried to visualize giving birth there. It was hard for me, at that point, to even visualize being big and pregnant again, much less giving birth to a full term baby. Even with the factual proof from the early ultrasound that this baby would make it safely to term, I still experienced an emotional detachment towards this pregnancy. I needed to get past the points where I had lost the other two before I could feel totally safe and positive about the outcome of my pregnancy.
I felt attracted to underwater birth, in part, for my own comfort. Although my labors have gone fairly quickly, I have always found the last hour or so extremely painful and difficult to get through. Also, that stinging, burning, stretching sensation of the baby’s head crowning at birth has always been extremely unpleasant for me. I could easily imagine how the warmth and soothingness of bath water would make birth so much easier.
However, because of the two babies I had lost, I also had an irrational fear of the baby drowning if born under water. The idea of underwater birth did not feel totally safe to me. It felt like another “lunatic fringe” thing to do. In 1977 when I gave birth at home for the first time, going outside of the hospital system had felt like a “wild”, maverick, daring step. Following that, during the late 70’s and early 80’s, my research on infant circumcision took shape. For several years I was virtually the only available resource on the subject. (Today, much to my relief, many other groups have taken over.) I put an incredible amount of personal energy into both the home birth and anti circumcision efforts. But at this point in my life I simply did not feel up to launching out on yet another defiant, “world changing” endeavor. I just wanted to be a normal mother giving birth in whatever way was most comfortable for me.
I felt no similar reservations about home birth itself. Because I had given birth at home twice in the past, the option of staying home for this baby’s birth felt perfectly safe.
My next prenatal appointment with “M” was at my 18th week. Home birth midwifery is legal in Alaska and “M” was an R.N. so I had assumed that our insurance would cover her. But now we had learned that they would only compensate if she was a CNM. or an R.N. working directly under a doctor. Since “M” worked independently they would not pay for her.
At my 22nd week I visited a back up doctor recommended by “M”. She had wanted his opinion of my prospects for safe delivery at home. I have never before met a doctor who was as understanding and empathetic of the home birth choice as this man was. He too gave me the green light on home birth, free from negative pronouncements over fibroids, age, or previous pregnancies.
I had another ultrasound at my 22nd week also. This time Steve accompanied me during the exam. Tears formed in my eyes as we watched the image of our perfectly healthy little baby kicking and moving around on the screen. The fact that this was indeed our second daughter – Melissa Ann – was confirmed. (We never even picked out a boy’s name during this pregnancy.) Elated, I drove straight from the ultrasound office to a baby clothing store and bought several little dresses and girl items.
I visited “M” once more at my 26th week, but by this time we knew that our insurance would not cover her. She charged $800 for attending the birth, in addition to $25 per prenatal visit. So now what should we do about our baby’s birth? Scrape together $800 out of our own pockets? Do it on our own, unattended? Go to the hospital where our insurance would cover the costs without question? “M” mentioned the name of another midwife in town, “G”, a CNM., who was about to open a free standing birth center. (To my knowledge, this was the first birth center in Alaska.) Our insurance does pay for birth centers and for CNM.’s. So my next step was to make an appointment with her.
“G” was a friendly, relaxed, personable and highly experienced midwife. She attended births at one of the local hospitals. Many births soon would be taking place at her birth center. She had attended many home births as well. The birth center had two attractive birthing rooms – with beds that were low, normal beds – not the high, narrow, hard contraption of a bed on which I had birthed Kevin in the hospital birth room. There was also a large bathtub. At least the choice of a water birth wouldn’t be out if I were to have the baby here. I was certain that I could have a positive birth experience here. One drawback – it was located on the second floor of the building and there was no elevator, only stairs. Climbing a flight of stairs during late pregnancy is challenging enough, much less during labor. But I told “G”, “I’ll drive across town and climb your stairs if I have to to save $800!”
By this time my prenatal visits were closer together. I became well acquainted with “G” and we were able to further discuss my concerns. I could certainly have a positive birthing experience in her birthing center. But dragging our other five kids across town, along with food and entertainment for them, plus possibly sleeping bags, just so they could be there for the birth, would be a horrendous hassle. Also the baby was due in December – when the world is cold, snowy and dark in Alaska. Roads can be treacherous. I would rather not have to expose a freshly born baby to all that cold upon going home. Home birth would be infinitely easier for us for so many practical reasons. I asked “G” if she would be willing to deliver me at home. She agreed, but I was not to talk about her being my home birth attendant. Legally she could do home births. But politically, because she attended births at the local hospital, she did not wish to stir up trouble.
By this time I was trudging through third trimester, feeling heavier and achier every day. This stage was not as easy for me as it was when I was younger. The baby kicked and moved constantly and I was so glad that she was healthy and normal. (At age 42 I faced a one in seventy chance of having a Down’s syndrome baby, but that was something I never worried about.)
The first of December arrived. From then on I experienced continual, intense Braxton-Hicks contractions every day. “G” and I both felt that I could have the baby at any time, even though my official due date was Dec. 30. Throughout this pregnancy I had always felt further along than I was supposed to by the date of gestation. Nausea had begun less than a week after my period had been due. The first fluttering movements had been felt at 16 ½ weeks. Both of those events had always occurred later during my other pregnancies. Therefore I had a strong intuition that this baby would be born a little early as well.
One night about two weeks before the birth I was awake almost all night with intense, regular Braxton-Hicks contractions. I knew it was not the downward, achy sensation that true labor would bring, but I became filled with feelings of panic and dread. I was praying that I would not go into labor. I simply did not feel emotionally ready to face labor and birth at that time. Over the next two weeks I continued experiencing similar periods of panic attacks.
With Christmas approaching I kept busy shopping for gifts, decorating the tree, and otherwise preparing for the holiday season. In Alaska the winter solstice brings extremely short days. The lack of daylight causes depression for many people. This probably contributed to my emotional state. Also I had spent much of this pregnancy procrastinating the fact of the impending birth. The losses of my other babies, the unwanted medical interventions for Kevin’s birth, the difficulties with establishing prenatal care and definite plans for this baby’s birth, the state of unsettlement following our recent move to Alaska, the lack of long established friendships in this area, and the perceived pressure on me to be “super-woman” since birth and babies is supposed to be my area of greatest expertise all had contributed to a state of evasiveness and detachment about this baby’s birth. But now that inevitability was becoming too close to avoid.
During my prenatal visit one week prior to Melissa’s birth I shared my feelings of panic and dread with “G”. She greatly helped ease my mind. She urged me to concentrate on visualizing the baby coming out of me. We also discussed water birth – another decision I was still evading. “G” loaned me some recent copies of “Midwifery Today” and “Journal of Nurse Midwifery” both of which had extensive articles about underwater birth. I read them thoroughly over the next few days. Seeing the practice of underwater birth written up in official publications gave the concept a certain validity. The articles repeatedly emphasized the ease and comfort afforded to the mother by being in water during labor and birth. They also reassuredly emphasized the safety as well as the peacefulness afforded to the baby by this practice. Like being born in the caul (with the membranes unruptured), the baby simply does not get the reflex to breathe until its face reaches the air. There was no reason to worry about the baby drowning. Of course I still would want my baby lifted out of the water as quickly as possible.
A couple of times that week I filled our bathtub, sat in it, imagined myself laboring there, and pictured the baby coming out. In my fully pregnant state, this was no longer difficult to visualize. I also noticed that the immense pressure of Braxton-Hicks contractions was scarcely noticeable under water. If it eases real labor contractions as effectively, water birth ought to be wonderful.
On Monday, December 18th, I woke up around 6:30 a.m. While still lying in bed I had several contractions about 10-12 minutes apart. These contractions had a definite, downwards, aching sensation to them. I got up and ate breakfast. As Steve left for work I told him not to go too far from the phone that day. At 8 a.m. I had an attack of diarrhea – another sign of impending labor. I got dressed, puttered around, and took another bath in our large tub, again working on visualizing real labor and birth there. When I got out I piled up several clean bath towels on the counter next to the tub and got out some clean sheets for the bed. Then I put a casserole together for dinner. I kept debating whether or not to call “G”. Sometimes the contraction were barely noticeable. Other times there was great pressure and mild achiness. I went to the bathroom continually, but so far there was no bloody show or rupture of my membranes. This could go on for days. I fixed myself a bean and cheese burrito for lunch but could only eat about a third of it. It made me feel sick to my stomach.
My prenatal appointment with “G” was scheduled for that afternoon. I decided to go ahead and go to my appointment. She could then examine me and help me decide whether or not I really was in labor. The kids were all out of school for Christmas vacation. I left all five of them at home and did not tell any of them that I might be having the baby that day. Steve would be meeting me there for my appointment. A couple of strong contractions came on while I was driving, but I had no trouble concentrating on driving.
I arrived at the birth center as “G” and her office help were returning from their lunch. I had thought that my appointment was at 2 p.m. but I had been mistaken. It wasn’t until 3 p.m. Another pregnant lady, due in January and a lady with a 6 week old baby both had appointments ahead of me. I decided I felt most comfortable lying down on the couch in her waiting area. I mentioned to “G” that I thought I was having symptoms of early labor. She didn’t act like the situation was urgent. She went about her business attending to her other two patients.
By now I was having contractions about 5 minutes apart. They were still fairly mild, but I needed slow deep chest breathing and a focal point to get through them. Finally at around 3:15 p.m. “G” was ready to see me. She decided it would be easier to check me in one of her birthing rooms rather than have me climb onto an examining table. I undressed from the waist down, covered myself with a towel, and put a Chux pad under me on the bed. “G” checked the heart tones with her Doppler and they were 140. She examined me internally and my cervix was dilated to 2 cm., but still long and uneffaced. The baby’s head was still high. She told me “Go home and call me if your water breaks, or when you decide that this is real labor.” Neither of us were sure if I really was in labor. We both figured it would still be at least several hours before things got under way. Then suddenly my water broke right there as I was still lying on the bed!! “G” then suggested that I lie there for a little while to see if the contractions would start getting stronger. The next couple of contractions were decidedly stronger.
I suggested to Steve that perhaps I should just stay there to give birth. But then he reminded me that he would have to drive home, get all five kids, and come back. That would be too much hassle. I really did want to get home and get back into the tub to give birth.
I got dressed again. I was given a sanitary pad to put into my underpants. I went to the bathroom and there was a little bit of bloody show. “G” told me that she had called “M” (my former midwife who sometimes assists “G” with births) and that “M” would be coming over to my house right away. “G” would come on over later. Then as I was in the entryway putting on my coat and boots I heard “G” say to her office help “Never mind, cancel the rest of my appointments for today!” Later “G” told me that she had watched me stop to breathe through a contraction before putting on my boots and she had sensed that my labor was progressing rapidly. She had had an intuitive feeling that she should get to my house as quickly as possible.
We then started the ironically backwards trip from the birth center to our home to give birth. I wasn’t about to drive. Steve drove our van and we left our pick up truck there. I sat up in the front seat. Steve didn’t think I’d be safe lying down. Contractions were coming about every five minutes and were definitely getting stronger. I lifted the seat belt away from my belly during each contraction.
The temperature was about 30 degrees outside with some snow on the streets – definitely slippery driving conditions. We hit nearly every traffic light red. (One of the reasons I had wanted to give birth at home was to avoid any mad-dash drive to my birth place during labor!) Finally we did reach our home. Between contractions I managed to get upstairs and into our room. Steve removed the shower doors from our tub, rinsed it out and began filling it. I put on a nightgown and lay down on our bed thinking I probably shouldn’t get into the tub until “G” arrived and could examine me again. I focused on the tiny dresses hanging in the closet and experienced several more hard contractions. Then I went to the bathroom again. After that I decided to go ahead and get into the tub. It was about ½ full and could fill up the rest of the way with me in it. I definitely needed the comfort and relief of the water and didn’t want to wait any more. I got into the tub at about 4:30 p.m. “G” arrived at around 4:45 p.m. with a whole bunch of equipment – oxygen, I.V. stand, etc. (most of which never got used.) I could hear her in the bedroom chatting with Steve and had still not come in to see me. “M” arrived shortly thereafter.
My contractions were still quite achy in spite of the water. There were little clots of blood floating around in the water. It occurred to me that during my other births I had never passed any significant amount of blood until late transition. “G” came in to check me at around 5 p.m. I complained to her “I thought the warm water would take away the pain and achiness of the contractions, but this isn’t helping.”
She managed to check the heart tones with her Doppler again. They were 120. She noted that the baby was considerably lower than it had been less than 2 hours before. She was ready to examine me internally for dilation. I kept not letting her do it as by now the contractions were simply not letting up at all. Finally I put my own fingers down to my vagina and felt the solid surface of the baby’s head right there at my perineum. I had not even felt any recognizable pushing urge. Somehow I told “G” that I could feel my cervix right there at my vaginal opening. Either I wasn’t able to acknowledge that that was the baby, or my brain wasn’t totally functioning! “G” agreed, “Oh, yes, you’re dilated to 10 cm., station plus 3!”
With the next contraction the baby’s head was bulging and stretching my perineum. I started yelling, “It’s huge!” Actually this stage was considerably easier for me than my previous three non-episiotomied births had been. “G” was saying, “I want you to breathe your baby out.” Then she was telling me that the head was out. I don’t think I made any active pushing effort. Within a minute or so the rest of the baby slipped out. I said, “Oh, Melissa I’m so glad you’re here!” The baby let out one little cry to fill her lungs as she was brought out of the water. Then she just sat there in my arms, smiling and looking around. It was the most peaceful, untraumatic birth I had ever seen, much less experienced.
I spent the next several minutes just taking in the baby. She had a red, ruddy complexion and her Daddy’s black hair. She looked a lot like her older sister Lisa, (just about to turn 9), only not as large as Lisa had been as a baby. Melissa’s face was round and fat. She had a lot of vernix – more than I remember any of my other babies having.
The information I had on water birthing recommended getting out of the tub to birth the placenta. But I decided we should pull the plug and put a bath towel over the baby as the water drained out. There was a lot of blood and gunk in the tub by this time. One big advantage of water birth is that all that stuff can be easily washed down the drain.
“G” checked my uterus and the cord for placental detachment. The cord was limp by now and I agreed that she could clamp and cut it. The placenta had detached and slipped out onto the bottom of the tub. Steve put it in a plastic bag and put it into the freezer. In the spring we would bury it under a tree.
My uterus was rock hard with no excessive bleeding – everyone’s worry with fibroids, multiparity, and “advanced maternal age.”
Meanwhile, both Kevin and Lisa had been brought into the bathroom to see Melissa who was still in the tub with me. Our other three boys were elsewhere in the house. The room was simply too small to bring everyone in there all at once.
I was ready to get out so I handed Melissa, still wrapped in the towel, to Steve. He ran off with her to show her to the other kids while I quickly showered (to get all excess blood off of me) and put on a nightgown.
Our oldest son, Eric, and his girl friend (both high school seniors) had been in the kitchen making candy. She hadn’t realized what was going on until Steve brought the baby out for them to see.
Back in our bedroom “G” checked my perineum and there were no tears. I had had routine episiotomies with my first two babies and had torn at my old episiotomy site with my next three, so not tearing this time was an incredible accomplishment. Warm water surrounding the perineum is advantageous in many ways.
Steve brought Melissa back. I soon got her to nurse a little bit. “M” dressed her in a little shirt and nightgown. “G” only checked her over minimally. I commented that with all of my other births, including my other home births, everyone had been in a big hurry to do a complete newborn exam of the baby. “G” said she could tell that Melissa was a completely healthy baby and wasn’t worried about it. Leaving the baby alone like this after birth also added to making her birth less traumatic. “G” did check her over more thoroughly the following day.
This was only the third water birth that “G” had ever attended. “M” had never seen one before. Now “M” was saying she wanted to have her next baby this way. Both were amazed at how fast my labor had proceeded – from barely dilated and not sure if I was in labor at 3:30 p.m. to giving birth at 5:15. “G” later discussed with me the importance of “assimilating” my birth since I had had so little time to put the entire experience together.
That evening I ate dinner at the dining room table with my family. We ate the casserole I had put together that morning. Melissa in her infant seat was our “centerpiece” at the table. That night I sat up in bed and read stories to Kevin and Lisa before they went to bed.
I have never experienced postpartum depression. My tendency is to feel lousy during late pregnancy, with all those negative feelings lifting once the baby is born. Although I had been dreading the prospect of labor before Melissa was born, once labor was actually underway I had honestly welcomed it and was thankful to be bringing my pregnancy to completion. The aftermath of birth has brought the usual discomforts – after-cramps, engorgement, a breast infection at 2 ½ weeks, and general over-all fatigue. Still, I have felt gloriously happy just to have given birth and now to have this beautiful baby.
Melissa was an unusually beautiful and healthy baby who grew and changed fast. At age 42, having lost three babies, and having seen my other five babies transform into big kids before my eyes, I knew to especially treasure those precious days of infancy.
After giving birth to my 6th baby while in my 40’s, any consideration of having any more children could never be considered a rational possibility. (My husband later had a vasectomy. Today, as I am editing this, I am now in my 50’s and past menopause. Melissa is an active, busy 11 year old.) However, in the hypothetical event that I were to have ever give birth again, there is no question, barring extenuating complications of course, that I would again wish to give birth under water. This was by far my fastest, easiest birth. I only wish that I had known about, or been able to achieve such an option for my other five births. “G” acknowledged that I had done a lot of healing with Melissa’s birth – over my previous losses of two baby girls and over the unwanted, unnecessary hospital technology I had had to face during Kevin’s birth.
I sincerely hope that water birthing will catch on as a safe alternative for birth for the general public. The 80’s saw the advent of birthing rooms and midwives as attendants for normal births. It would be wonderful if the the future will see hospitals and birth centers adopting birthing tubs as available options for labor and/or delivery.
Water birth has been called a step beyond Leboyer. Leboyer birthing has been a popular idea over the past decade, but disappointingly has not caught on widely as a true birthing option. I have frequently emphasized that Leboyer birth must be part of an overall philosophy of sensitivity and consideration for the baby’s feelings and needs or it will be reduced to just another fad. But in fact, all too frequently, even with the sincerest of efforts and intentions, attempts at Leboyer techniques simply have not worked. In my own experience, when our first daughter, Lisa was born in 1981, she was placed in a bath of warm water shortly after birth. Instead of relaxing and enjoying the experience, Lisa screamed frantically until she was back in my arms.
When Melissa was born there was a bright light over the tub. (I had thought of having it off for the birth, but during the actual event forgot about it.) We didn’t make any special efforts to be quiet. Yet Melissa had no birth cries save for one little squawk. The naturally soothing medium of water for a baby to emerge into provides a much simpler method of achieving non-violent birth. Regular Leboyer birth is much more contrived and difficult to accomplish.
The pregnant/laboring mother is often unable to think beyond the immensity of her own condition to the reality of her baby – even though she will undoubtedly become as good of a mother as any once the baby arrives. Caught up in her own pregnant condition, as if it were a separate reality from the fact of the baby, attempts to inspire her into embracing nonviolent birthing techniques for her baby’s sake, or to spare her baby from other questionable, traumatic procedures, may fall on deaf ears. But the option of water birthing may still be greatly appealing simply because it offers considerable comfort and pain relief for her. Various resources present water birth as a valid, natural alternative to anesthetics or analgesics for pain relief during labor. The warm water medium is particularly recommended for the mother experiencing a long, difficult labor or for calming the panicked, frantic laboring mother.
My own experience causes me to propose it as a natural, non-interventive alternative to induction of a slow labor. For many women labor proceeds quite rapidly after getting into the tub – obviously due to the immense relaxation afforded by the warm water.
I have long spoken out against subjecting babies to circumcision and other highly questionable, painful, traumatic procedures. It is my hope that if increasing numbers of babies can be birthed in this method, which so readily results in a peaceful, natural birth, increasing numbers of parents, birth attendants, and other medical personnel will automatically witness the beautiful reality of totally untraumatized babies. Peaceful birth such as this should help to make infant circumcision and other questionable medical routines obsolete – such choices becoming logically contradictory to such a beautiful, untraumatized beginning for a baby.
Whether or not this type of peaceful birth makes any long term difference to the ultimate outcome of the individual is a moot question. The long, arduous journey from infancy to adulthood shapes our lives from a composite of life experiences. Long term results of gentle birthing – in contrast to more conventional, typically traumatic birthing, would be virtually impossible to prove scientifically and probably would never be taken seriously by the established medical/scientific community. But, in my opinion, whether or not this type of birthing makes any long term difference to the individual is irrelevant. Treating a baby with love, gentleness and respect, via non-violent birthing techniques, sparing him or her unnecessary, traumatic medical procedures, or practicing any of a number of other positive, beneficial infant care procedures such as breastfeeding and not following a rigid schedule for feeding, all should be considered of value in and of themselves, regardless of any potential difference it may or may not afford for the individual’s future.
by Rosemary Romberg (Wiener)
(Revised – 2013)
13020 Sues Way
Anchorage, AK 99516
Baby Melissa with her Daddy.
Melissa – age 3 with big brother Kevin – age 6.