He's here! Our son, Miles Benjamin, was born to us Tuesday morning, November 16th, at 2:04am. 8lbs 11oz, and 21 inches long. He is beautiful as can be. We, his entire family, are so in love.
Miles Benjamin is a special name to us. One hand picked for him by his daddy and mom, and one that fits our son well. "Miles", his first name, means "Mercy" in old German. The Mercy of God to give us a son at such a time that we would turn our faces toward our Father and seek Him deeper and truer than we had. And of course "Miles" makes a person think of a journey--the miles we must cover, the adventure to be had... the adventure we have had. Benjamin is a Hebrew name that means "son of my right hand". And, I think, in modern English "son of my right hand" could simply mean "my boy". Miles Benjamin is "our boy". His spirit is so sweet, and we love him very dearly.
The birth of Miles Benjamin.
It was an adventure, and did not go as "planned". I do want to share it, and really, as wild a ride as it was (and as much as I would not care to have a birth like that again...), Miles' birth was something I will forever treasure. It is good to remember and be thankful.
We had been planning a home birth with the same beautiful midwives who attended Calvin's birth at home. Both of our older boys arrived before their due date, and we had casually assumed Miles would arrive on the early side as well. Well, we waited and waited and (impatiently) waited, and finally, quite surprisingly to me (as I think I had simply come to assume he would never leave the womb) I easily slipped into labor Monday afternoon around 2pm, the 15th of November.
The labor progressed very quickly and easily to about 8cm (around 7pm), and again very easily to 10cm after my water was broken, but with a cervical lip in the way. Baby was doing well, and I was feeling well. It was odd to me how easy things really went. I felt calm and present with all that was going on. I enjoyed laboring in the boys quiet bedroom the best, and also enjoyed the birth tub set up in our kitchen. By 9pm, or was it earlier, everything was laid out and ready for us to birth our baby. Except that pesky cervical lip.
For some reason the lip would not let me labor it away. In fact, it seems my dilation was regressing a bit, and during the contractions, no less. I began to feel more and more intense, and a fear grew over me about the labor and about my ability to do what I was going to need to do to get our baby out. I felt unsafe and unsure, for no apparent reason other than fear of a repeat of my last labor that was long and painful and felt overwhelming to me at the time. I think around 9pm I began to apologetically insist that we go to the hospital. I was very scared, and my feeling at the time was that I was going to need some medication to help me deal with the labor if I was going to be able to relax enough to labor away that stubborn cervical lip and push our baby out. We briefly talked about what was and was not possible as far as pain meds at this point in labor, and what transfer might entail (i.e. relief would be limited and not immediate), and I was asked if I felt I may later regret the decision as there was really no medical need to go in. All things considered, I felt very in control of my decision and able to express that I felt I needed to go, and I would not regret it.
Next was a bustle of finding clothes for me, throwing a couple essentials into a bag, and shuffling out to the car in the dark in the throws of transition to get to the hospital. Thankfully by car the hospital is a mere 2 minutes away.
We were ushered into the birth center, and offered our choice of rooms (no other patients that night). I chose the room to which I was bracing myself in the door jam during a contraction. "Good enough," I said, and we waddled over to the bed.
Somehow I was changed from my sweats to a gown, strapped to the monitors for a brief strip, and an IV with antibiotics (due to Group B Strep status) was started. I was also given a dose of Fentanyl at my request for pain management. Fentanyl does not actually dull the pain, and I've heard makes people feel really dopey and euphoric. I did not notice that at all, what I did notice was that it helped relieve some of my intense anxiety and fear that I had been feeling--an effective strategy for me at the time, and I am thankful for having that choice available for this birth.
Soon the midwife from the clinic was there, and I began to feel like I needed to push. She found that I was again 10cm dilated with a cervical lip. She had me begin to push when needed and tried to hold back the lip so the baby could slide past. We tried this at home previously as well. It was not working.
Gosh, everything is so hazy, but what ended up happening is it soon became clear that our baby was becoming very stressed by the contractions. I was feeling an intense urge to push, but when I pushed (which was not doing much to bring him down) his heart rate would plummet. The midwife called in a local OB doctor to come help. Internal monitors for the baby and for contraction strength were placed. The baby was bobbing up and down and moving all around trying to find a way through (it is a miracle to me that babies have the wherewithal to do this), and handling contractions very poorly when I pushed--his heart rate plummeting into the 50's or 60's... even the 40's at times--so I had to pant instead, which was overwhelming and painful and felt very frantic. I was very afraid for our baby, and afraid I was not going to be able to pull off what was being asked of me in order to birth him safely. I just remember saying over and over again, please help me and I want our baby to be okay and I'm really scared. I am so thankful for my husband who sat beside me and held my hands and let me stare into his face when trying to keep myself from pushing. I am so thankful for all the good support and instruction I received during this time. There was a lot going on.
I never remember hearing that the cervical lip was gone, I just got to a point where I could not hold back any longer. The doctor wanted to start pitocin to help make contractions stronger. I refused and cried and asked that they simply take him out via c-section. I was given another dose of Fentanyl, which helped enough with the fear and hesitation that I simply began to push. I could not help it anymore. I could hear and see on the monitor how dangerously low our baby's heart rate was plummeting, but it seemed this time that he was actually moving down. Pitocin was started, and to my surprise it was a total relief to be able to have my uterus pushing as hard as I was wanting to will it to push. I pushed so incredibly hard for our baby. Finally I could feel him crowning. The midwife was pulling and I was pushing and a small staff waited for him to come out. Finally he was out! I caught just a glimpse of him before the his cord was cut and he was whisked over to the warmer where the nurse began to work on him. He was pretty blue, and they were needing to help him begin to breath, and suction him out. He was born with lots of meconium.
Well, it turned out our Miles was in respiratory distress--he just couldn't get going breathing well. The pediatrician was called in (he was born at 2 in the morning, so we ended up waking a lot of people that night). She ordered chest x-rays and blood work. The staff continued to work with him. He could breath, but not well at all. He was grunting, and not keeping his oxygen levels up when not being helped along. He was pretty frantic. But there were good signs, too, like his color was improving, and he was fighting all the commotion.
These women are our incredible home birth midwives who encouraged and supported us during our birth, and afterward as we recover.
I was so relieved that my baby was okay--not well enough to be with me, but he would be okay. So relieved to be done. My fear began to lift, though I wanted to hold my boy. The experience was so intense. The midwife stayed with me to help the placenta be born (is a placenta born, or does it just 'come out'?), and to help patch mommy back together. I was shaking fiercely from all the adrenaline, and I just lay on the bed and watched as all the different people came in to check on our boy, to draw blood, to attach electrodes, to take turns pumping the ambu bag... I could only get glimpses of him through the bodies and machinery in the room. I excused Raymond from my side, instructing him to remain with our son. What a faithful and wonderful Father, you have Miles. Raymond would speak to Miles, and Miles would look directly at him, fixing his deep blue eyes on that daddy of his. I credit Raymond with so much of how our scary start turned into something so reasonable for us all.
Finally, I needed to get up to use the restroom, and the team of folks helping our boy decided to take him for x-rays and other stuff in the nursery. When I came out of the restroom, the delivery room was empty but for the nurse in charge of caring for me. It was a mess, and seemed very lonely and sad. She helped to situate me in a wheel chair, and took me over to the nursery to see my boy.
The staff had a Cpap started on Miles, which he just fought and fought. The x-ray had been taken, and was thankfully found to have no indication of pneumonia or meconium aspiration. Soon the blood work came back, and was also normal. Other blood work was sent out to be cultured for GBS disease, but would not be back for 48 hours. Miles was fighting all that was happening to him, which was not helping his oxygen or heart rate to be normal despite the cpap. I was able to be close enough to hold his little hand and pat his chest. He was just beautiful, and reminded me so much of Calvin.
During this time in the nursery during regular vitals checks it was found that I had spiked a fever of about 103 degrees. Not a good sign with the entire situation considered. I was started on another antibiotic as I sat in my wheelchair nest to my boy. I think another hour passed as Miles was fussed with and attached to this and that, looked over with a fine tooth comb, and his daddy soothed him as best he could with his pinky finger to suck on and his strong voice speaking peaceful words. It was beginning to look like Miles would be headed to the NICU at St Joe's hospital, and I was urged to go rest so I would be able to be well enough to care for Miles at the earliest possible. I agreed. I took Raymond's phone with me to the room so I could text people for prayers. And then, our night began to turn around.
I was just out of the chair, making my way to the bed when I was told our pediatrician wanted to try one last thing. It seems Raymond was so convincing about how much Miles was being calmed by being able to suckle on his finger a bit, that the doctor decided to try to let Miles nurse to see if he would calm down enough to allow them to monitor his breathing and pulse without his being too frantic.
I was wheeled back to the nursery where I promptly opened up the front of my gown and was given my boy to hold in my arms for the first time. I tucked him inside my clothes and began to hum old and comforting hymns to my boy. I latched him on the breast, which he took to very well. Raymond stayed by our side, and began texting dear friends and family asking for middle of the night prayers. And, do you know what happened? Our boy, our Miles Benjamin, melted and calmed himself. He satisfied himself at the breast, and very quietly dozed in my arms. His oxygen levels were not perfect, but were far from needing special assistance. His grunting was not gone, but significantly diminished. And do you know what our pediatrician said? She said, "Call St. Joe's and tell them we will be able to keep this baby here. We can handle this level of care if mommy doesn't mind holding her baby to keep him calm."
I didn't mind at all.
The next couple days Miles improved and improved. He was given antibiotics "just in case", but at this point it appears his rough beginning was mainly due to a traumatic and difficult birth, and not infection. We found out during Miles last exam at the hospital he also has a fractured right clavicle (which was apparent on the chest x-ray, but had not been told to us by the pediatrician at the time--guess we had bigger problems then). Finding that out made a lot of sense to us as he is very fussy when being moved about, and cries in pain when you touch the area or move his right arm. Just one more thing we are now being mindful of as we recover at home.
I have also improved, and have no further signs of infection very thankfully. I am extremely sore, though. My arm muscles, back muscles, stomach muscles are all very stiff and sore. I've also a few stitches, and sore veins from so much IV medication. What a work that was.
Miles is asleep next to me on my bed right now. Such a peaceful and beautiful boy. My heart is just full of compassion for this little fellow who endured such a journey with us. In the end all indications seem to be that he simply had a difficult time finding his way into my pelvis, and out the other side. He is a couple ounces larger than Calvin was, who also had a long difficult labor, but an exceedingly more easy time pushing him out. Miles struggled much. I don't know if the two could be related to my anatomy, or were independently difficult for completely different reasons. Both boys were said to have acynclitism--which means they were crooked during their births.
Edited 1/12/11: After further conversation I found out the OB and hospital midwife feel Miles' struggle during labor (as evidenced by the heart decels) and his respiratory distress, and also my fever, were due to chorioamnionitis, an infection in the uterus. They feel it was most likely caused by GBS bacteria, as I was GBS+. They feel our quick recovery was likely because we had antibiotics during the last part of labor, and for a couple days afterward, and also due to our excellent overall health that allowed us to bounce back quickly. Miles' difficulty finding his way through my pelvis, and his collar bone injury, are another issue separate from the infection. I've talked at length with all my midwives about all of these things, and we suspect my pelvis is oval shaped at the inlet, and perhaps in a way that our babies need to enter the pelvis in a posterior position.
The view from here.
I don't regret my decision to transfer to the hospital... obviously. We would have ended up there one way or another with the danger signs Miles was showing. It was good to have gotten there before he began to struggle, I think, so the OB doctor could be called and things were able to begin to be trouble-shooted and managed from the start. We have come to think of the reason for our transfer as being "Mother's Intuition." I certainly could not have predicted the events of the night, especially after having such an easy time laboring up until that darn cervical lip refused to go away, all I knew at the time was I was too fearful to stay at home.
I am grateful for the tender hand of Jesus that was ever present, to guide mommy to the hospital before anything became emergent, to give our birth team and my husband the right words and touch to support me through to the end. Thankful for our home birth midwives who supported me as we labored at home, and also in my decision to transfer. Who continued to help me through the difficult birth with their assurance and affirming presence, and who help me to feel validated as a mommy who simply acted in what was best for herself and her boy. I am so in love with my husband who endured with me and did his honest best to help me to feel safe and to keep struggling for our boy. Thankful for my sister-in-law, Renee who did so much of the "dirty work" helping us to set up, clean up, get ready, take pictures, offer support, and continues to offer anything she can give. I am thankful for the hospital birth attendants who helped get our baby out safe, and who helped him to get going in life doing all those necessary things people do (like breath). Gosh, it's funny, you wouldn't think an experience like this would have so much redemption, but I feel oddly built up by our journey. I feel assured of my ability to mother, I feel deeply bonded to my new son. I feel grateful on so many levels, and most of all, so deeply in wonder of the Hand of God that keeps us and watches over us. Our Abba Father whose great wisdom it was to give our family this little guy, Miles Benjamin, and who carried us and him as he came into the world.
Well, if you made it through all of that, then congratulations to you. It almost feels like too big of a tale to tell... for me anyways. The experience was so much bigger than I could ever think I could make it through. I thought that of Calvin's birth, and now with this one... gosh. It really is the strength of Jesus that helps us to do anything set before us, and not of our own, so long as we believe.