Thoughts on Natural Childbirth and Ephrem's Birth Story

"Some women choose to give birth naturally because they love the challenge. Others find great satisfaction in working hard and "getting the job done." Many women are eager to avoid anything that might harm their babies or themselves. But the most compelling reason to choose natural childbirth is a universal one. Women know how to give birth without machines, epidurals, and fear. Why natural childbirth? The more important question might be "Why not?" -Judith A. Loathin.

I received many mixed reactions when I told people I wanted to have a natural birth with only my husband, our midwife and nurses present and free of drugs and other interventions. Most gave their most genuine good luck. Some genuinely asked why. And I would rattle off a few reasons including saying I thought it was best for the baby and I want to see if I can do it. Which are true factors that impacted my decision, however, I didn't truly answer the question for myself at least not in words until this week, the week after the birth. I chose to try to have a natural childbirth because I wanted to be able to trust my inner wisdom and strength. I wanted to connect to the intuition and instinct that I I thought all women have. I feel like in our society we've been taught not to trust ourselves--our intuition, our instincts--especially for women, not just in childbirth but in many areas of our lives.

Note, I said I chose to try to have a natural childbirth, not I chose to have a natural childbirth. As you read Ephrem's story you'll find I did have a natural childbirth but that was due to support of Andy and three wonderful women. They trusted in the labor process and my strength and wisdom to complete it even when I gave up. My natural birth was without an epidural and other interventions but it was not without fear. In the quote above Judith says women know how to give birth without epidurals, machines, and fear. I think many women in United States no longer know this or are not connected to the knowledge. We need to be taught not just the mechanics of anatomy and physiology and ways to deal with the pain but really talk about the mental and psychological barriers and fears. Judith described it as telling and retelling the simple story of birth and the way it's meant to be. Most of us are not surrounded by women telling these stories. These stories have to be stronger than all the medical advice and medical view of birth.

Ephrem's Birth Story:

Around 4:00am Monday, May 26^th contractions start and occur 4 to 5 times per hour and last 30 to 50 seconds. I'm able to go about my daily routine just needing to stop during the contractions. It was Memorial Day and a warm day, so we took a walk to a fountain in the neighborhood so that Terran could play in the water. We also met Andy's sister for lunch at a neighborhood restaurant. The contractions' intensity ebbed and flowed but I could tell they were slowly getting stronger. Around 4:00pm I decided to try to nap. By 5:00pm I knew we would be going to the hospital that night, so we finished packing our bags and prepared Terran to go to his nai nai's house.

At 8:30pm when the contractions were coming every 6 to 7 minutes and lasting about one minute, I called the midwife. At 9:30pm, we walked up to the Triage Room of the Birthing Center at West Suburban Hospital in Oak Park, IL. The baby's heart rate and my blood pressure was checked—everything was fine. We met the three women that would be with us through the labor and birth, our midwife Cynthia, a midwife student, Megan, and a nurse, Brenda. We were excited that the midwife on call was the same midwife that delivered Terran (there are four midwives in the practice I attend—all are wonderful so I would have been pleased to see any of them but it felt special to have Cynthia again). Megan did a cervix exam and found I was 4cm dilated and 90% effaced, so I could be admitted to the birthing center.

At 11:00pm we moved from Triage to regular hospital room. (Unfortunately, all the Alternative Birthing Center (ABC) rooms were occupied at the time. It was a busy night for births!) I paced the room and “slow danced” leaning on Andy through the contractions that continued to increase with intensity. The midwives gave a lot of encouragement and support. Andy kept me me focused on breathing, a routine and trying different comfort measures. (We used methods suggested in the book, The Birth Partner by Penny Simkin).

However, I started growing tired and anxious while waiting get my first dose of antibiotics and to move to an ABC room. Finally, at midnight I get the antibiotics. I had an IV in my arm but I could move about with the pole—it took about 20 minutes to finish the antibiotics then I was disconnected. (I tested Group Strep B positive a few weeks prior, so it is recommended to get two doses of antibiotics before delivering the baby to prevent him from possibly being infected).

Around 1:00am we moved to an ABC room. I was getting more exhausted—I found sitting or lying down made the contractions unbearable so I continued standing and walking which was tiring me out. We decided to try a hot shower, which did helped for a short time.

Around 2:00am, I started doubting I could continue at my current pace. The contractions were very intense but steady—I didn't feel any closer to delivery. I thought back to my long labor with Terran and the point when I choose to get an epidural. I told Andy and the midwives I didn't want to go on and wanted the epidural. Cynthia suggested we check my progress and see if I was far enough along to use the birthing tub. I was 7cm dilated and 100% effaced. (Need to be at least 7cm dilated to use the tub—before that time there is a chance the warm water can slow down labor). I decided to try to the tub, and being immersed in the warm water helped significantly. Even though the contractions became more painful and longer I was able to find a rhythm and go through them then rest in between. At times my “rhythm” included a lot of screaming. Some were easier than others—at times I lost focus and Andy would help me get refocused. I was even able to fall asleep for about 3 minutes at a time in between some of the contractions. I labored this way for over two hours. I received my second dose of antibiotics while in the tub.

Little after 4:00am, I stared losing focus more and not being able to regain it. The fear of not being able to continue returned. I expressed my fear and the midwife said we could try breaking the water bag to see if that will increase the progress. I decided to try this so had to get out of the tub—it took me a long time just to get to my knees in the tub. When I got to my knees my water bag burst naturally. I lay back in the tub trying to continue, but it didn't seem like anything had changed and I was not coping well through the contractions. I again said I couldn't continue like this so the midwife checked my progress. I was 8cm dilated. Hearing that I lost hope—over two hours of the most intense pain I've ever experienced and I only dilated 1 cm. I couldn't fathom going on like that for another 4 hours for the other 2 cm then starting the pushing stage. I said I didn’t want to go on any more and I wanted the epidural. The midwives asked if they should step out so I could talk with Andy. I firmly said no, I want the epidural and asked if it was too late. They said it was not too late and arrangements could be made. The nurse automatically started making the call and giving me orders on how to prep. I had to get out of the tub, move to a hospital room, be hooked up to a fetal heart monitor, and get a full bag of some type of IV fluid in me before the epidural could be administered. I couldn’t imagine moving but I knew I had to if I wanted any relief.

I don't know what time it was by the time I got myself out of the tub and walked to another room (Ironically, I went back to the same hospital room where I was first admitted after Triage). I got on the hospital bed then fetal heart monitor was put around my belly, my IV was attached, and a blood pressure cuff was put on. Contractions intensified—I screamed through most of them but Andy was able to get me to shift to the light breathing technique for some. I started to feel a slight urge to push and I told the midwives so they checked me. I was a 9cm and they tried to push or massage the last bit of cervix open. They said the baby was very close. I think I had another urge to push and they told me to go with it this time. The anesthesiologist came in around this time but I was not going to be able to sit up and sit still for him to insert the epidural. Cynthia announced that it was her professional opinion that I should continue on naturally and it was too late for the epidural to even take effect before the baby came. I said okay and started to prepare myself to get through it.

I started the pushing phase. At times I started panicking and Nurse Brenda looked in my face and firmly said, “Stop panicking and breath”. She guided me through the pushing with firm but positive commands. The other women helped me lie on my side and hold one of my legs up. I gained a rhythm back and felt myself go more inward just focusing on the pushing the baby down the birth canal. Although I know the contractions did not decrease in intensity I found I was feeling less of the pain. As the head crowned I felt the burning of the my skin stretching (one of the parts that scared me the most thinking about pre-labor) but I no longer had fear. I knew I would get through it.

At 6:17am Ephrem was born and was immediately laid on my chest. I can't say I felt euphoria immediately afterwards, but felt relief, satisfaction, contentment but mostly gratefulness. The delivery of the placenta and continuing contractions were more uncomfortable than I expected. I split my focus on finishing the delivery process and the beautiful baby boy laying on my chest, who already found my breast to nurse.

Every one' birth story is unique and I believe the stories need to be told.