Noam's Birth Story

Let me set the scene:

I’m very hugely pregnant (measuring 44 cm a week before the birth). I had about 8 hours of “practice” labor at 39 weeks. My mom came to stay with us 3 days prior to this. We had asked her to be at the birth to help take care of the kids. At the point this story begins, I have been in early labor for a day or so, with contractions about 10 minutes apart…. 

Monday, May 4, 2015 (41w2d)

I woke up a little after 2 AM for yet another trip to the bathroom, then again just after 5 AM. The second trip I found more bloody show. Yay! I went back to bed, but couldn’t sleep. Around 6 AM, I noticed my doula (Kim W.) was online and messaged her, “This is gonna be a long one, but at least it’s easy. The contractions aren’t really worse. A little longer this morning though, but also a little more spread out. Last night they were more like 10min/30sec, now they are more like 15min/over a min. I consider that the same.” An hour later, I was back to the bathroom again - more bloody show (and lots of it!). Yay!

My mom and I got the kids up for the day, and we decided to take the kids to the park. While we were getting ready, I sent a message to my chiropractor (Kat Wilson) to let her know that I had been having contractions consistently for a couple days and wanted some extra help to encourage progress, but I didn’t want my mom to know what was going on because I felt like a watched pot. I also texted Debbie (my midwife), to let her know that I had been having contractions and what they were doing. We dropped my oldest off at preschool and headed over to the chiropractor’s office around 9:30 AM. Dr. Jake (Kat’s husband) adjusted the kids and me, they wished us luck, and told me to call them if I needed them again (or to adjust the baby ;) ). 
After we were all lined up, we headed over to Morgan Falls park to enjoy the relatively nice, sunny morning. We were only there about 30 minutes when Reuben (my 2-½ year old) decided to climb to the top of a play structure and refuse to come down. No amount of bribery, coercion, or pleading would get him to come down. Under normal circumstances, I would climb right up there and grab him, but I just couldn’t. I was still having light contractions, I was terribly uncomfortable, and the only way up was either a slide or a tunnel that I didn’t fit in. This lovely woman watching this whole disaster offered to go fetch him for me. I was never so grateful to another mother! As soon as he was down, I packed us up and we left. We still had to go to Costco for groceries, and the kids needed lunch.

We arrived at Costco at 11 AM. We had lunch (they have yummy pizza) and then did some shopping. I had been mostly distracted from the contractions at the park, but they were definitely picking up a little while we browsed the store. Just as we passed the avocados, Debbie called me. I didn’t answer because I didn’t want my mom to know that anything was going on. I was still feeling like a watched pot and just really wanted to be alone. I moved as quickly as possible to finish our shopping and leave. 

We arrived home around 12:40 PM. I managed to haul all the cold items up the stairs and put them away (I left the rest for my husband to get later), and then I took Reuben into my bed to try to get him to nap. While he was sleeping, I was chatting with Kim W. via Facebook.
Me: Things have mostly stopped no surprise

KW: When it's time...nothing will stop them. I know that sucks to hear, but you know that nothing will slow you down once it gets to rolling. Your body is just giving you a break for now.

Me: I'm lying down with Reuben now and they are starting back up. It's just annoying, Ya know?
Just before 2 PM, I called Debbie back. We had a very reassuring conversation about how everything was going. This labor pattern was notably different from anything I had experienced before, but also the same. I expected a long, slow early labor, but this was the first time I had consistently timeable contractions the whole time. With Reuben (my 3rd), the contractions stopped during the day, and would only pick up at night. I felt like the way things were going I was walking around about 5 cm dilated, just teetering on the edge of active labor. 

After I talked to Debbie, I returned to chatting with Kim.

Me: I love my Mw. That was a very calming phone call. She's happy with the way things are going and she thinks the contractions are just trying to keep him low since he seemed to want to be floaty, helping put pressure on my cervix. She said that's probably why all the discharge. Because it's really a lot more than I remember ever having. And she said just let her know if they change at all because she really wants to be here and not miss his birth. 

15 minutes later….

Me: They're getting longer... So that's good. I think I need to change positions though because they are mostly in my back. (I was laying on my left side.)

By this time, Reuben had woken up and gone downstairs to hang out with my mom. I decided to try to take a nap, so I took up my favorite labor position - kneeling over pillows. I was able to sleep this way for about an hour before the contractions woke me up around 3:30 PM. They were a little more intense now, but still very easy. 

At 3:45, Joel (my husband) got home and I felt relieved to have him around. I gave him an update on the day, and told him that I was pretty sure that things were not going to stop before a baby came, and that I needed him to not go to work the next day. He started making arrangements with his coworker and PRN staff to cover his patients. I still thought it would be at least 12 hrs, if not a couple days, before the contractions produced a baby, but I knew I needed him around.  
Around 4:20 PM, Joel went downstairs to do dishes so I could make dinner in a clean kitchen. I decided to put some gravity into the situation and moved to sitting on my ball next to my bed. I had the laptop in front of me, and was chatting with some friends, checking Facebook, and just playing around. I did some hip circles on the ball which stimulated some stronger contractions, but if I just sat still they weren’t as intense. 

At 5:39 PM I messaged Kim W.:

Me: They're getting more intense. Not sure if it's just because I'm sitting on my ball.

Kim: How are you feeling otherwise?

Me: Pretty good. Getting ready to go make pancakes.

Kim: That sounds good!

Me: I feel like he's lower...my belly looks like it moved

Kim: Has he been very active?

Me: been a little wiggly. more than i remember from the others in labor, ever. especially for being such a quiet guy

Kim: It's getting closer.

Me: yep. we'll see what happens to everything once i go downstairs. hopefully they will back off a little so i can cook and eat

At 5:50 PM I finally got off my ball and attempted to make my way downstairs to make dinner (being a Monday, that meant pancakes). I made it about 5 feet before I had a contraction that I will never forget. It came on very strong, and I rushed back to lean over the bed. When that wasn’t good enough, I dropped to my hands and knees. Still not good enough, I put my forearms on the floor and buried my face in them. I worked through the contraction, and as soon as it was over I thought to myself, “What just happened? I’ve never done that (fallen to the floor) before!” Strange. 

I picked myself up off the floor and went back to the computer to share the moment with my friends and my doula. My favorite response was from my friend Lori, “Yay! Shosh can’t walk!”. I giggled. NIkki, who is an EMT and a doula, stayed true to form and asked me what the contractions were doing. She’s never off-duty. I reported that all the contractions were under 10 min apart, and the last couple were 6-8 minutes. And they were getting longer and stronger (which is the definition of actual labor - longer, stronger, and closer together). 

Kim W. asked if I was going to call my midwife, but I told her I was waiting to see what happened after I got downstairs. I was somewhat confident that being around other people would slow the contractions down. After all, it seemed to work every other time. And the sun was still shining - I have ever only been in active labor at night. All that business about cavewomen hiding from tigers and stuff - seemed about right for me. 

It was now a little after 6 PM, and I was starving! I really wanted my pancakes, and I knew my kids were hungry, too. I made it downstairs and recruited my husband to help fetch ingredients for the pancakes while I read the list off the computer recipe. I did this for two reasons - number one, I couldn’t actually reach some of them because my belly wouldn’t allow me close enough to the counter, and number two, I had a feeling if I moved around too much it would stimulate contractions. Right at that moment I really wanted things to back off. 

I had my phone with the contraction timer app open next to where I was cooking. I didn’t pay attention to the numbers, but I knew things were continuing to happen, and I wanted to be able to track them. After a few easy contractions, I found myself having to leave the kitchen to get on the floor or bend over a couch during them. They just kept bringing me to my knees. After each one ended, I would return like nothing had happened. I also couldn’t really stay still in between. I was swaying and shifting my weight from side to side to try to get the dull ache to go away. It didn’t. I don’t think my mom noticed, but my husband definitely did. 

I was beginning to have a difficult time completing the pancakes because of how often I was having to walk out of the kitchen. It seemed to be really frequently. I decided I should probably look at my app and see what the contractions were doing. I was a little surprised at the jump I saw from the contractions I had timed just 30 minutes prior.

She told me it probably would not, suggested I call Debbie, and asked if I was ready for her to come. Yes, please. 

I managed to get the first round of pancakes on the griddle, right as another contraction hit. I barely made it out of the kitchen by the time it hit it’s peak, and wasn’t able to get into a comfortable position to manage it. When it was over I was nearly in tears - I couldn’t fake it anymore. I looked over at my husband who was watching me try to tough it out while waiting for further directions from me, and I said, “I think it’s time to tell my mom what’s going on. Ask her to finish making dinner. I’m in labor. I’m going upstairs to call Debbie.”

Sweet sigh of relief. 

I went upstairs and sat on my birth ball while leaning over my bed as the next contraction came. It was much more comfortable to just be in my room, doing what I needed to do without having to pretend nothing was happening. I called Debbie as soon as it was over (Right around 6:30). It went something like this:

Me (in a tired/slurred/labor-y sort of voice): So….the contractions are 3-5 minutes apart now. They just jumped all of a sudden.

Debbie: OK. That’s sounds good. I’m on my way.

Me: Great. See you soon.

We both knew there wasn’t a whole lot of conversation that needed to happen. Another contraction came. When it was over, I checked in with my friends:

Lori: Did you get your pancakes?
Me: Um, no. I’m in labor. I mixed them.
Lori: Alrighty then.
Me: And had to walk away.
Lori: That’s a different way to go.
Me: I just called the MW
Nikki: Good on calling the MW
Me: The contractions jumped really fast. My goal is to not have a UC above all else. My mom is making the kids pancakes.
Lori: You’re right on track!
Jamie: Baby baby baby! (Sorry for the enthusiasm)
Lori: Tone it down ravenscraft.

I giggled at their excitement, and was so happy to have their support. 

Joel came upstairs to check on me, and in between contractions we started to prepare our bedroom to welcome our baby boy. I knew from my previous labor, that I needed to be very specific when telling my husband what needed to be done. One thing at a time, so as not to overwhelm him with deciding what had to happen first (and he would probably choose something different than I would, which would frustrate me anyway). Since things seemed to be picking up fast, and I didn’t know how it would go, I decided we should make the bed first. No matter what, it needed to be ready. 

At this point, I was in a great mood. I was very peppy and cheery in between contractions. I was excited to FINALLY be in labor, excited that everyone was headed to me BEFORE the baby this time, and totally in shock that it was still daylight outside. It was so surreal. I was trying to take in every moment of what was happening, as I knew this story was coming one day. So many mental pictures. I have a goofy smile on my face just thinking about it.

Anyway, back to the story…..

So it’s just after 7, and we’re making the bed. If you’ve never made a bed for a homebirth, it basically involves making your bed twice (with what I refer to as my “body bag sheet” in between. It’s really just a vinyl mattress cover, but it’s the same material - and therefore smell - as a body bag. Hey, I’m a nurse, it’s my kind of humor.)  

Anyway, I had all the linens bagged and tagged in a basket next to our bed, making it very easy. I imagine watching me try to help was quite comical. I would chat with Joel, all cheery and excited as I attempted to put my side of the fitted sheet on the bed. A contraction would come, and I would drop to the floor. I vocalized a little, gently moaning through them. As soon as it was over, I bounced back up (just as quickly as you can at 41w2d) and would finish what I had been doing. I sympathetically apologized to my husband for not being much help in the bed making department. 

Once the bed was made, we taped down a plastic tarp and I had him start inflating the birth pool. I didn’t know when we would need it, but the pump is loud, and I wanted him to get it done before that would annoy me. I climbed on the bed to watch him work, while I easily handled the contractions. When the pool was finished, I had him put plastic bags over a bunch of our pillows and then cover them with pillowcases. As soon as that was done, I made them into a pile and collapsed in relief on top of them. 

Ahhhhhhh. That’s so much better. 

The one thing that has been consistent in my labors is my love of the kneeling position. It’s especially nice to have something to hug onto, since I’m often more horizontal than vertical. 

At 7:15, I heard the door chime, and Joel went to see who it was. He returned with Debbie right behind him. No one was more glad to see her than my husband! I smiled and greeted her from my perch on the bed. She immediately got to work setting things up for the birth, and Joel asked if it was ok if he went downstairs and got something to eat. I happily sent him down, as I knew I was in good hands. 

Debbie pulled out a blood pressure cuff and let it run while she continued to set up supplies and chat with me. Right as it was finishing, I started having another contraction. I still had some adrenaline in me from a new person entering my space, so it wasn’t quite as intense as the others, but still strong. I looked down at the numbers on the cuff as she took it off - 144/97. Ouch. For a second I was worried this would cause a lot of concern, or maybe make me transfer, because it was a lot higher than it had ever been in my prenatal appointments. I did recall it being very similar after Reuben was born, so maybe it’s just normal for me? I dunno. Debbie’s response was, “Well, in a little bit, I’d like to get you into the pool to see if we can relax you and bring that down.” Seemed like a reasonable thing to me, and although I hadn’t liked (ok, I HATED) the birth pool in my 3rd labor, I was willing to try anything as long as I could stay home. Sometime in here, we also listened to Little Foot’s heartbeat. He was happily thumping along in the 140’s. Perfect!

When she finished setting up the supplies, she asked if it was ok to check me. Here’s where the internal dialogues started. These always amuse me. Here’s the conversation I had with myself, as I remember it: 
“Hmmm. She wants to check me. I don’t know if I want that. Do I want that? A baby came out last time without being checked. Then again, I have been wondering what my body has been doing for the last two days. No one is going to take my “crunchy card” for doing this. It’s my birth. It’s not a big deal. Ok, let’s do it.”

I simply replied, “OK.” You’d have never known that entire train of thought went on in my head. Cracks.Me.Up!

I had another contraction, and then moved to my back. It had been 4 years since I had a cervical check in labor (my last baby was an accidental unassisted birth), and this wasn’t nearly as bad as I remember, or that I have witnessed. I mean, it wasn’t my favorite activity, but not terrible. As she was taking off her glove, Debbie said, “Well.” She paused, I could tell she was trying to find the words to tell me something without giving me numbers. “You have a bulging bag, and I’m glad you called when you did. I’m going to go fill the pool.” 

I laughed to myself at “bulging bag”. Of course I had one. Anyone who has been to a birth with Dr. Tate (I’ve done two as a doula), or even read a birth story from one of his patients whose membranes were intact, knows that every one of them has a bulging bag. Amazing, the things that you find humorous in labor…

I didn’t really know what the rest of her statement meant, but I figured my personal assessment of my progress was probably right. I thought I had been about 5 cm before things got active, and I knew that most of the time the general consensus is to not get into the pool before 6 cm, so I knew I was 99.9% likely to be past that point. Awesome!

As Debbie started filling the pool, Joel returned. He had some kind of scrambled or other version of cooked eggs with him. My thoughts on this? “I’m glad he got something to eat. I didn’t think he was going to bring it upstairs. He doesn’t need to be here to eat, I’m ok without him at the moment. Food in labor rooms tends to make them smell. Do I smell anything? Would the scent of eggs bother me right now? Later? Would it linger that long? Probably not, since I can’t smell it now. Hmmmm….Ok, he can stay.” Hilarious.

Debbie thought there might be a problem with the water because it was flowing slowly, but Joel remedied that quickly and the pool began to fill. Ashley, one of the apprentices (the one I was hoping would be there) arrived around this time.

As the pool was filling, Debbie came over to the side of the bed to watch me as I continued to labor. I was doing ok, but she offered to do counter pressure to make me more comfortable. Ahhhhhh! Such a difference! Bless you for reading my mind. In between contractions, this conversation happened:

Joel: Do we know how dilated she is?

Debbie: I do, but she doesn’t. She didn’t ask, so I didn’t share. (I don’t know if we had discussed this, but I have never wanted to know during labor.)

Me: You can tell him. I don’t care, as long as no one is leaving.

Debbie: Oh, no one is going anywhere. (She held up her hands above my head, to indicate I was 7 cm. I later looked in my chart, and found out I was also 90% effaced and at 0 station.)

Me: Good. That’s all I care about.

I labored for a little bit longer as the pool continued to fill. Then Debbie suggested I get in the water. She sent me to pee first, and told me to keep the bathroom door open “just in case.” I was still really happy and enjoying the experience, and pretty talkative between contractions. I knew why someone might suggest leaving the door open, but I made a funny face to myself that that was a premature suggestion, and waddled across the hall. I humored her and left the door about an inch open. 

When I got back, I stripped down to just my tank top, and climbed into the pool. Ohhhhhhhh, nice. I was pleasantly surprised that I liked it (I actually HATED the pool in my 3rd labor)! I announced to the room, “Ahhhh. I see why people want to get in these so badly. I looove this pool. It’s soooo much better than the La Bassine.” It was probably close to 7:50/8 PM at this point. As the pool continued to fill, Debbie mentioned to me that after the baby was born, she might have to have me stand up if the cord is too short. Hmmm, I thought. Sure, ok, that was a random thing to say. In between contractions, I looked out the window at the colorful sunset as I rested against the side of the pool. I could not believe I was in labor during daylight! I announced this observation to the room, thoroughly in awe. I knew this was a testament to my comfort level, and the work I had done to set this scene.

Shortly after, Kim H. (my friend and photographer - we met AFTER she photographed my daughter’s birth...yes, AFTER) arrived. I waved and greeted her with a smile. Then I had a few more contractions that were much more intense. Debbie continued to give counter pressure. I knew that Kim H.’s arrival had relaxed me a little more, and I could feel things changing rather quickly. I could hear myself begin to grunt with contractions. I knew my doula wouldn’t make it, and I was sad about that, but it was time to meet our baby boy. At 8:18 P.M. (according to the notes in my chart), I began pushing.

Let me be frank, pushing sucked. It was so physically hard. I don’t usually have one part of labor that I dislike, but this time was different. As my body took over into these incredible contractions, I closed my eyes and held on for dear life. The intensity was indescribable. I wish I had the words. It was so incredibly powerful, that I had no choice but to throw every ounce of energy I had behind what my body was already doing on its own. Unlike with Reuben, I couldn’t feel the baby moving down, and had no idea how, or even if, my pushing was effective. No one said anything, so I just did my thing. I roared from deep inside. 

My water broke (at 8:27 PM), and I didn’t even notice. There was meconium in the water, and I felt Debbie swooshing her hand between my legs. At the time, I had another one of those conversations in my head:

“What is she doing? That feels so weird! Is she trying to feel for a head? Just tell me and I’ll check. That’s weird.” 

As the next contraction came, the intensity without the cushion of amniotic fluid was so incredible. I started screaming/roaring, “GET OUT OF ME! GET HIM OUT OF ME! GET OUT! GET OUT! GET OUUUUUT!” I know Joel was surprised to hear this, because he asked me afterward if things were more painful than the others. I’d never screamed like that before. I wouldn’t call it painful, just so very, very intense. 

I could feel him start to crown. That hurt. It wasn’t the “ring of fire” kind of hurt, but more the “I’m going to tear forward and backward. How big IS this kid?” kind. I didn’t have the ability to express to anyone who could help me what I was feeling, so I reached down to support myself as he started to crown. Someone said, “Yes! Reach down and feel your baby!” In my head, I replied, “Screw the baby, I’m tearing in half!” Instead, I remembered how much I loved feeling Reuben’s head be born, so I reached further and quickly cupped and pat his head. I said, “Hi, baby”, and quickly went back to trying to keep myself intact. Looking back, I’m really glad I was the first person to touch him, but at the time I totally didn’t care. I was so focused on getting him out.

With the next contraction, his head was born. Usually, that brings a little relief. The head is typically the biggest, hardest part of a baby. Well, there was no relief. Not an ounce. I still had that sense of fullness. I started feeling him move, and I thought he was trying to finish being born. In actuality, Debbie was trying to help him turn one way or the other so he could come out. He couldn’t turn, and he wouldn’t budge for her either. He was stuck. 

When Debbie told me that I needed to get out of the pool and onto the bed, I knew why. She said it very matter-of-fact. I had suspected from the measurements that we had gotten at the BPP that there was a good chance of shoulder dystocia, so when it happened I wasn’t surprised. I hopped rather quickly out of the pool and onto the bed onto my hands and knees. Sometimes, just moving the mom like that will make the baby fall out, so Debbie had her hand on his head the whole time. That was not super comfortable. In our case, he didn’t budge at all. Debbie continued trying to help him, while encouraging me to push. As the next contraction came, I tried. I don’t know if it did anything, but it sure didn’t feel like it. I told everyone “I’m trying! I can’t!” Now, I’m a nurse, doula, and childbirth educator. I KNOW how important it is to get that baby out, so I took a deep breath, and gave myself an internal pep talk.

“Your baby is stuck. He needs you. He needs to be born RIGHT.NOW. You HAVE to figure out how to push correctly. No one else can do this. YOU have to do it.”

With the next push, I felt something budge and I felt him come out. Unlike the majority of births, he didn’t just slip out. I had to push again for his hips, but he was finally born. At 8:32 PM, Noam Avraham arrived earthside! Sweet relief, but only for a moment. 

I rolled over to lay down on some pillows (thankfully covered in plastic because there was meconium stained fluid all over the bed), and as Debbie handed me my baby, she warned me not to pull on him because he had a very short cord (just as Debbie had predicted in the pool! Later estimated at about 12 inches). I could only get him up to my belly. 

I could see the top of his head, and that was about it. They started wiping him off to dry him and remove some of the meconium, but he still wasn’t breathing (I’m not sure if at all, or just not well). 

I heard Debbie ask Ashley for the DeLee suction (a special kind of suction for getting meconium out of airways), and when that didn’t stimulate him to cry, she asked for the oxygen. (His APGARs were 4, 6, & 7.)

She gave him a few puffs, and he finally took a good, deep breath. She held the blow-by oxygen near his face for a little bit, while observing my bleeding. Apparently, she wasn’t happy with that either. Since we couldn’t get Noam to nurse because of the short cord, she suggested nipple stimulation. I did a little bit, and finally felt the urge to push out the placenta. It was delivered 20 minutes after he was born - I was done. The bleeding slowed, and I could finally pull my baby up to see him!

As things were calming down, I took in everything that had just happened. I had my fourth baby. At home. With my midwife, and my favorite apprentice, and photographer present. I was sad that Kim W. hadn’t made it, but it is what it is. She arrived right around that time, and despite not making it before he was born, she played a key part in every aspect of this pregnancy and birth.

Debbie made a comment about how she was so glad that this was not the birth that I accidentally had without a midwife. Me too, Debbie, me, too. I was SO thankful she and Ashley were there. I was never scared, because I knew they would take good care of us. I had every bit of confidence that things were being handled as they should be. It’s why I hired them!

I laid in the bed, adoring my newest son until he was ready to try to nurse. What a champ! He nursed for quite a while. Joel cut his cord after it had finally emptied, and I unlatched him and handed him to his daddy so I could take a shower. I felt amazing!

When I came back, my mom was there. She held her 8th grandchild for the first time, while Debbie checked me for tears - just a skid mark! I never even noticed it. As I sat on my bed eating the (now infamous) “labor pancakes”, Debbie gave Noam a good once-over. 

We opted to do the vitamin k shot, so I got to give a lesson in carpujects since none of them had used that kind of injection before. Took me right back to paramedic school, and my instructor (Larry) referencing Roy Rogers as he would flip the caps off the injections. Noam was weighed, measured, dressed, and handed back to me. Before he was weighed, everyone took guesses on what he might be - Joel was spot on at 8lb 15 oz. He was 20.5” - same as Talia and Reuben. I had thought he was right around 9 lb, as well. 

Once he was dressed, Joel ran straight to the bathroom to grab Eli’s light saber toothbrush. I had jokingly told him 2 days earlier that if the baby was born on May 4th (Star Wars’ Day) he could take a picture with the light saber. He was making me fulfill my promise!



As my room was cleaned up, we had Joel and my mom bring the kids up to meet their new brother. Talia had begged me several days earlier to let her be the first to hold him, so she was. Then Eli came in, but wasn’t super into the idea of holding him and declined. Reuben came to our doorway, saw a baby, and tried to turn around and leave! My mom brought him back, and after I handed Noam to his daddy, Reuben was willing to come sit with me.

After Debbie, Ashley, and Kim W. left, Kim H. took a few pictures of Joel and I enjoying our new squish. 

I was in awe at what had just taken place. Amazed that things had happened just as I had dreamed in my picture - a beautiful, easy, early labor; questioning if it was time; then a clear change when it was time to call in the troops; a little bit of caution with the BP, the shoulder dystocia, and bleeding, but ending in the warmth and love of everyone in my home. And all at sunset.

(You can view the birth pictures in the Pictures section)