Ezra's Birth

Two weeks ago, I gave birth to my son, Ezra.  When I worked as a doula, I would write a letter to my clients' babies, detailing their birth story.  Below is Ezra's birth story.

Our baby Ezra,

You were born two weeks ago and you are strong and magical.

While you lived inside me, you loved to stretch your bum and your legs from one side of me to the other, and seemed to arch your back at the same time. We called you the Lumpy Baby because your bum and feet made lumps across my belly. We think this position led to into the unusual position in which you were born.

Your birth began at 4am on Saturday, February 9^th, 2013.  I remember being in a dream, and feeling something entirely new deep in my belly. I woke up and felt it again. It was a warmth and gentle tightness that radiated across my lower stomach. I thought, “That’s exactly what I thought it would feel like,” and excitement took over. But I had been told not to get too excited, as birth can last a long time, so I willed myself not to tell Daddy and tried to go back asleep.

Daddy found out something was going on at around 7am, when I started to moan and wiggle during contractions.  His face lit up with excitement, but I told him the same thing I told myself: we needed to go back to sleep in case this labor would be long.  We slept until 11:30am.

We woke up, ate breakfast, took our showers, took Lareau for a walk. We cleaned the house, prepared the bed with sheets for the birth, placed all the supplies in the bedroom. We took a nap, and then another walk. We cleaned the snow off the car, in case we needed to use the car later to go to the hospital.  All this time, contractions continued, uncomfortable and about 5-7 minutes apart.  We walked to get some pizza, but I was eager to get back home and labor in private once again.

Granddaddy called, Nanny called, we called them back and told them I was in very early labor, and not to worry.  I got off the phone with Nanny at around 5:30pm and that’s when my active labor began.

Contractions came every three minutes and lasted a minute or more. I had one contraction that lasted three minutes. I started pacing, squatting, rocking on my hands and knees, and moaning louder. Daddy wanted our doula, Gabriela, to come over. I didn’t want her to come too early, so I said no.  Daddy wanted our midwife, Kristen, to come over, but again, I said no.  A half hour later, I felt that this labor was established enough and agreed that we could invite Gabriela to come.  Daddy was relieved.

Contractions became even harder. I told Daddy, “I need to get in the tub NOW.”  He rushed to blow up the tub and fill it up.  Gabriela arrived and I told her, “This is really hard. This is so hard.” She said, “I know, I know it is.” 

The tub was ready, I climbed in.  I thought it would feel so good. It did not. It was too cold and I did not feel that relief that I had seen other mothers feel.  Daddy put more hot water in, but during contractions, it was too hot.  I leaned over the side of the tub and breathed in the plastic smell. I didn’t care.  I yelled, “Owwww!” I said, “I don’t like this!” I said, “I’m so mad.”  I said, “I am DONE with this.” 

Daddy and Gabriela wanted to help so badly. They tried to rub my back, but I did not like being touched. I squeezed and squeezed their hands, their forearms, their shoulders.  My arms were tired, but I couldn’t stop squeezing.  Everything was tight in my belly, pelvis, and back. It felt like a force that would not let go.

Daddy called Kristen and I spoke with her on the phone between contractions, and she listened to me yell during contractions. She said, “She needs a midwife there.” But Kristen said she could not be the midwife; she was helping another laboring mother.  She was going to send another midwife, Karen. I was angry and scared. But I was also relieved. I wanted to push, but I didn’t want to push without a midwife by my side.  So I was looking forward to having any midwife by my side, even if it wasn’t Kristen.

Karen arrived with Kristen’s student shadow, Lillian.  I wanted Karen to check my dilation to tell me if it was ok to push or not. She said if I felt like pushing, I was probably ready to push and should trust that. I wasn’t ready to trust that, so I didn’t push.

Karen took out her fetal heart rate monitor and put it on my belly under the water. Your heart rate sounded very strong. 

I got out of the tub and laid on my side on the bed.  This was the most miserable position ever, but Karen encouraged me to stay for a little while, so I could rest between contractions.  After a few contractions on my side, I thought to myself, “I just have to push. I don’t care if I don’t know if it is right yet or not, I am going to push.” So with the next contraction, I started pushing. I felt my water break.

Karen saw meconium in the water. Meconium means you have pooped, which means labor may be too stressful for you. Karen authoritatively told me to turn onto my hands and knees. I knew that this position helps stressed babies in labor, so I flipped over pretty fast, wanting to help you handle the labor better.  Karen listened to your heart rate during a contraction.  It accelerated a little bit (it got faster), which is a good sign. Karen wanted to check my dilation, so I laid back down on my side.  She felt inside for a long time. I was confused: why couldn’t she just measure and get out of there? When she finished, she crouched down beside me and said, “So Leda, I think that the baby might have its hand coming with its head, or maybe the baby’s face is coming first.”  I looked at her with wide eyes and I said, “That’s not good!” She replied calmly, “No, not necessarily! Let’s see what happens!”

I felt another contraction grip my body and I couldn’t help but forget what Karen had just told me.  Kristen texted Karen and said that her other mother had had her baby and she was rushing over to us with her assistant, Piper. I was so happy that she was coming. I wasn’t sure what was going on, and I wasn’t sure if everything was ok.  I knew there was meconium, and I knew you were coming down in a funny way. Karen was holding back from making any clinical decisions until Kristen arrived, and I wanted Kristen to tell me what I needed to do and if we were safe.

I continued to need to push, but I had to get off the bed; lying on my side was just too uncomfortable. I walked over to the bathroom and sat on the toilet.  I felt something come down, and it was the rest of the bag of water, intact (what had broken earlier was something called the “fore bag”).

Kristen arrived. I looked at her and couldn’t say anything, but I was trying to tell her, “This is really hard, and I’m mad, and I’m worried something is wrong.”  She gazed back at me with a concerned face and she said, “I’m going to check you now.”  She felt the bag of water and it broke.  She felt my cervix and she felt your face. Lillian placed the heart monitor on my belly and kept it there throughout a contraction. Your heart rate slowed way down, and did not come back up to its normal rate until the contraction had long passed. I knew that was bad. I said to Kristen, “I don’t like that heart rate,” and she shook her head and said, “I don’t either.” 

Even though my labor was overpowering, I still understood the severity of what was happening clinically. It seemed as if you were in trouble.  You passed meconium, you were being deprived of oxygen during contractions, and you were coming down in an abnormal way. It crossed my mind that transferring to the hospital and giving birth to you by c-section were real possibilities.  And I was ok with that.  Not only was the thought of pain relief and being done with labor very attractive, but delivering you as fast as possible and making sure you were safe were paramount.

Kristen led me back to the bed where she could check me again and get a better sense of my cervical dilation.  Later, she told me that when she entered the bedroom, she shook her head mouthed to Karen, “We are out of here,” meaning we needed to go to the hospital.

I laid down on the bed, and let Kristen check my dilation.  She confirmed the position of your face and body (face presentation, occiput posterior).  This is what you looked like in the face presentation position (which only occurs in about 0.2% of deliveries):

Kristen felt my cervix, which was fully dilated with a little lip of cervix left.  As another contraction told hold, Kristen held and stretched the lip of cervix back.  When the contraction passed, the lip had softened, and I was completely fully dilated.  During this contraction, Karen held the heart monitor on my belly.  This time, your heart rate stayed steady throughout the contraction and didn’t slow down.  Kristen now began to consider the possibility of not transferring.  But she wanted to see if I could push you out quickly enough, and make sure you remained stable throughout.

Kristen said to me, “Ok Leda, we are going to see if you can have this baby right here.”  A new energy came over me. If Kristen thought I could give birth to you at home, you and I might actually be able to do it.  Kristen told me to push with the next contraction, push as hard as I could.  With full permission to push, knowing that the faster I pushed, the safer you’d be, I resolved to be the best pusher in the whole world.  The next contraction washed over me.  I bore down and pushed hard. Hard, hard, hard.

When the contraction passed, I opened my eyes and asked Kristen, “Progress?”  She nodded with a smile, “Yes.”

I continued pushing. Karen continued to monitor your heart rate during each contraction, which stayed steady. Kristen told me that you would need some resuscitation once you were born, that you would need it whether we were here or in the hospital.  I trusted Kristen, and I accepted this without fear. I trusted you and believed in your resilience. 

Kristen said, “Leda, you are amazing.”  Gabriela said, “You can do this! You are pushing your baby out!”  Daddy said, “That’s it, sweetie, you have this, keep pushing, baby, that’s so good.”

I kept pushing and I felt you coming down with each push.  I began to feel you on my perineum.  Everyone (except me!) could see your beautiful face.  Your lips appeared first, then your chin, then your nose, then your eyes and forehead.  

This is a face presentation crowning (not me)

I began to feel you crowning.  Everything burned; my whole body was burning as you stretched me.  I felt I could not stretch more, yet everyone told me to push through the burning.  I said, “I can’t! It’s too much!” Gabriela and Daddy and Kristen all said at the same time, “Yes, you can! You already are!” I realized the only way to stop the burning was to keep pushing, so again I pushed.  And then, I felt relief.

Your head had delivered, and Kristen unwrapped your umbilical cord from around your neck.  I gave another push, and the rest of you slipped out.  Kristen unwrapped the rest of the cord from around your torso (your double-wrapped cord explained why your heart rate kept decelerating). Daddy screamed, “It’s a boy!”

Kristen placed you on my chest and began rubbing you with towels.  Daddy and I spoke our first words to you: “Hello! Hi, baby! Hello!”  Kristen placed her mouth over your mouth and nose, and started breathing for you. Between breaths, she told us you were really ok.  Your skin color was rosy and your heart rate was steady.  Your muscle tone was a little weak, and while you were taking breaths on your own, they weren’t big, deep breathes, so Kristen continued breathing for you.  Kristen told me, “Talk to your baby, Leda.” 

“Hi Ezra, hello!  You are doing such a good job!  You can do it, Ezra!  Why did you come out with your face first? You are so dramatic.  I love you, Ezra.”  Even though I wasn’t too scared for you, I asked Daddy to pray for you as you continued to receive breaths from Kristen.  Daddy prayed to his daddy (your Grandpa) and his grandpa (your Great Pa), asking them to help you.

Meanwhile, Karen took care of me.  One gush of blood, two gushes, three.  This was a little too much blood for Karen to be comfortable with.  Karen began to think that maybe part of my placenta had detached, so began to work on helping me deliver it.  She gently pulled on your umbilical cord, and then, it snapped.

Piper quickly handed Karen two clamps, who even more quickly clamped both ends of the broken cord.  But I kept bleeding.  Karen asked Kristen, “What do you want me to do here now?” and Kristen replied, “You keep doing what you’re doing, and I’ll focus on this baby!”

Karen said to Piper, “Give me the pit!” This is pitocin, which helps stop bleeding after birth.  Piper grabbed the syringe and threw it across the bed at Lillian, who injected it into my thigh.  Moments later, I delivered the placenta and stopped bleeding. 

Satisfied with your muscle tone and deep breaths, Kristen placed you back on my chest. You weren’t crying, but Kristen said this was ok.  Your neck and throat were probably very sore from the way you were born, and this may have prevented you from being able to cry (but don’t worry, you cry a lot these days!). 

Daddy and I got to look at you closely for the first time.  Your body was snuggly and warm, and you had ten fingers and ten toes.  Your head was covered with fine hair, that, as it dried, glowed a beautiful strawberry blond hue.  Your poor little face showed how difficult your presentation was for you:  your cheeks and chin were blue and purple with bruises, and your eyes were swollen shut.  We realized we had no idea what time you were born.  “9:47! Girl, you pushed for only a half hour!” Kristen exclaimed.

After a little more skin-to-skin time, Lillian began your newborn exam.  Your reflexes were fast, your hips had no clicks, your ankles weren’t clubbed. You were perfect.  Lillian scooped you up and placed you in the sling to weigh you: 6 pounds, 9 ounces.  She measured you from head to toe: 20 inches.  A perfect little baby.

Over the next few days, we helped you adjust to the outside world. Because your neck was so sore, it was hard for you to suck, so we fed you with a syringe. Until my milk came in, you ate little drops of my colostrum and some of Jen’s (our neighbor) milk. You would open your mouth for the drops like a little bird.  When you were two and three days old, Jane and Charlotte came to our house and gave you cranial sacral therapy to help relax all the tension in your neck and jaw, and you began to be able to suck.  When you were five days old, Lea, a lactation consultant, came to our house and helped you latch onto my breast with a nipple shield and a feeding tube.  When you were seven days old, you latched directly onto my breast without any help or tools.  I cried with relief and joy.

When you were eight days old, we hosted a party in your honor.  Friends, family, and neighbors came to our house to welcome you to the world. Kristen and Lillian came, and Kristen cried when she saw you, so strong and ready to receive your name. We wrapped you in our wedding chuppah, and Grandma carried you into the living room to see all our family and friends.  She passed you to Granddaddy, who passed you to Nanny, who passed you to me and Daddy.  Rabbi Mark led a short service, during which we named you Ezra Michael Kushner and thanked God for the blessing of you.  Daddy and I reflected on your birth and what it says about you:

Something we thought about a lot during Leda's pregnancy was trusting Ezra. Even though we knew we wanted to deliver at home, Leda had a lot of fears about the birth and how Ezra would fare. She had been at a few deliveries during which the babies needed lots of resuscitation, and Leda carried this trauma with her.  Our midwife helped us understand that babies are actors in their births just as much as their mothers are, they are not passive passengers.  And because our midwife said Ezra will make his way in a way that makes sense for him, we can try to let go of fear by trusting his ability to birth as much as we trusted Leda's.  Since we understand Ezra's way of birth as something he somehow, on some metaphysical or spiritual way, chose, and since it was so incredibly unique, we feel that Ezra has a special story to tell. At the very least, with his lips emerging first, he's got to have something to say.  We'd like to promise to listen to his story as he continues to tell it.   

We love you, Ezra.  We love you, forever.

Love,

Mommy and Daddy