Maisie (Margaret Mae Fiedler)
An unplanned home birth at 10:20 PM on Wednesday, August 22, 2001
Assistants: Judith Halek & Kate Corona Weight:
6 Pounds 9 Ounces Length: 20 Inches
Time of Birth: 10:20 PM on Wednesday, August 22, 2001
I would like to begin by saying we never planned for Maisie to be born at home. It was all her idea. The birth plan was for Rebekah to go into a slow labor near September 5th and we would have a leisurely dinner at an Italian restaurant with a nice bottle of red wine during the first stage. We were told it would be our last dinner out for a while and Rebekah could safely have wine now after 9 months of abstinence. We would then meet Deirdre McLary, our doula, at our apartment and she would help Rebekah in the early stages of the labor. Our photographer, Judith Halek would then come by for a few photos of labor at home before we all hailed a New York taxi to take us from our apartment on East 46th Street to the Elizabeth Seton Birthing Center on West 14th Street. We would meet the midwife and nurse there, light some candles, add some lavender incense, enjoy the Jacuzzi “spa” at the luxurious and spacious birthing room and call our friends Mary Haskins and Mary Chung who were coming over for the birth.
The best laid schemes o’ mice an’ men gang aft agley! Like I said Maisie had other ideas. Labor at 7, water breaking at 8:40, birth at 10:20 in one of the smallest bathrooms in a city known for small bathrooms. Judith arrived at 10:23 and the EMS/Firemen/Police came 10 minutes later. But I am getting ahead of myself. Here is the whole story.
It really was the perfect pregnancy. Rebekah conceived in December which was the first month after “The Conception Cruise” in the BVI’s even though our friends had teased it would take months at my age then of 56. We made an excellent choice for a natural childbirth at Elizabeth Seton based on our common philosophies that childbirth is a natural and joyous occasion and not a medical procedure. We skipped the amnio synthesis since Rebekah was only 32 but the triple screen and our genetic testing all came back perfect except we found out Jim has a recessive gene for cystic fibrosis which is common in descendents of Northern Europeans. Since Rebekah did not have that gene, the odds were still miniscule of a problem for the baby. Modern technology is amazing and the benefits should be known by everyone. Rebekah did not have a moment of morning sickness and did not have to get out of bed in the middle of the night to pee more than a couple of times in the last trimester.
We were excellently trained and obviously well prepared. Ilana Stein taught us Hypno Birthing with four sessions at our apartment and Rebekah trained daily with the tapes for the last three months. Our six 3 ½ hour birthing classes were taught weekly by Erica Lyon at the Center. Barbara Schoefield taught an infant care class and Jan Wink taught the breastfeeding class both at the center. Deirdre McLary and Judith Halek had both been helpful in our meeting with each of them. We had met at least once with each of the 5 (or 6) midwives at Elizabeth Seton and learned something new or a little different from each. We had seen dozens of births in the training films, on videos and on the birthing channel. Everyone had been supportive and positive. Surrounding ourselves with a support group with similar prospectives made all the difference in the end.
The due date was September 5th but we knew she could come two weeks either side of then. She was considered a full term delivery anytime after August 16th. Rebekah had spotted when I was in Indiana for Mom’s funeral August 5th but was told that was normal and did not mean a thing other than a baby was actually coming in the next 6 weeks. We were now meeting with the midwives every week as the visits are scheduled more frequently the last month. Rebekah had resigned herself to Maisie coming late in mid September.
Rebekah had been having Braxton Hicks contractions for at least three months but on Monday night, August 20th, they were so strong that they kept up most of the night and she had trouble sleeping. Keeping Rebekah up is an almost impossible task. She did not know that her mucus plug had passed that Monday morning in the shower until I found it the next morning when I cleaned out the drain. But that is the most unreliable of signals and labor may not start for another 3 weeks. Thursday was supposed to be her last day at work but she stayed home both Tuesday and Wednesday. The day of rest seemed to help and the Braxton Hicks contractions subsided and she had a peaceful nights sleep. The regularly scheduled visit with the midwife at the center was at 6 PM on Wednesday with Esme.
Rebekah begin experiencing strong diarrhea around 3 PM on Wednesday and it continued into the night. She basically felt like crap when I met her at the birthing center at six. She looked like someone who had gone though 24 hours of difficult labor and just given birth. She was not in a very good mood either.
Both Rebekah and Maisie’s vital signs were good. There were no indications of what was soon to occur but Esme asked Rebekah anyway if she would like an internal exam and she agreed. This was Rebekah’s first internal exam since she had become pregnant. Unlike an OB, the midwives at Elizabeth Seton treat the mother as a partner and respect her desires for fewer internal exams.
Esme found the cervix softening as expected and about one centimeter dilated. The next question turned out to be much more significant than imagined. Esme asked, “Would you like me to see if we can speed it up a bit?” and by that, she meant if we wanted here to increase the dilation with her fingers. We called it stimulating the cervix…others may call it a “reamy”. Rebekah immediately jumped at the chance for anything to speed it up and said, “Yes!” I was more deliberate and said, “Wait a minute, I am not too sure”. Guess who won that discussion? I never had a chance against a woman who had been describing her belly as the size of a barn door for the past few weeks.
Esme said she had done it several times but only once had it worked and caused labor to begin. She barely got started when Rebekah asked her to stop because it was uncomfortable. She said it helped some and now the cervix was thinner and had dilated from 1 to 2 centimeters.
By the time we left the birthing center and caught a taxi for the ride home it was nearly 7 PM. That taxi hit every bump and chuckhole on the way home and Rebekah complained each time. In hindsight Rebekah’s labor had obviously begun before we got home and she thought about just asking the cab to turn around and go back to the center. These pains were lower and stronger and nothing like her previous Braxton Hicks contractions but she thought they were the expected cramps from the stimulation of the cervix.
Manuel was the doorman when we returned to our apartment and he told Rebekah she had better do lots of walking the next couple of weeks if she wanted to get that baby to come. I guess he thought she had done a lot of walking in the next 3 hours when we came back down later with Maisie!
I called Esme as soon as we were in the apartment. She said for Rebekah to take a bath, drink a glass of wine and use a hot water bottle for relief. She still believed it was cramps from the manipulation of the cervix and not labor.
So Rebekah ordered a cheese pizza with a pineapple topping. She had prepared all the ingredients for a stir fried curried chicken dinner early in the day but wisely decided to order in instead. I opened a bottle of Chianti wine while Rebekah took a warm bath. One or the other should help her relax and we were going to have our nice 1st Stage Labor dinner even if it was pizza. I paid the pizza guy and over tipped him figuring it was not a good time to stiff anyone.
Fortunately for me Rebekah was pokey drying off and dressing cause I sneaked a piece of pizza and sip of wine before she sat down. She took one bite and threw up. Now she had diarrhea, was vomiting and suffering from cramps/contractions. She was not happy either. So much for the last supper.
I decided I had better let our doula, Deirdre know what was going on just in case. Another turn for the worse. Deirdre’s husband answered and said she was attending a woman in labor. He offered to call one of her backups but Rebekah really wanted Deirdre and we all agree there was no rush. He would contact her and have her call us shortly.
We had better luck when I called Judith Halek who we had hired to photograph the birth. She was with a client but would finish soon and then come over and act as our doula as well as shoot photos until Deirdre arrived. Judith was one of the first doulas in New York City and had attended over 900 births. She had once considered becoming a midwife but decided instead to pursue her photography talents. She is also a major proponent of water birthing.
Things improved marginally on the home front. Rebekah stopped vomiting long enough to lie down in bed and listen to her hypno-birthing tapes to relax while I lightly stroked her arm to trigger a mild natural anesthesia. The diarrhea was no longer a problem-not because it was over but because her system was cleaned out as effectively as if she had had an enema.
If you are familiar with the Bradley method of childbirth, I should tell you a couple of things that I missed at this point. Rebekah completely skipped the first emotional signpost of labor which is identified by elation, excitement and nervousness. She went directly to the second emotional sign post which is seriousness and when she snaps at me. That is exactly what she did when I stopped stroking her arm. And better yet when I saw a note to myself reminding me to return a laptop to work that I had borrowed. I mindlessly asked her where it was and she snapped, “Shut the f-k up and stop asking me questions!” I didn’t ask her another question until I asked if she felt a need to push but I am getting ahead of myself. The third emotional signpost of self-doubt was felt be both of us but unfortunately neither of us verbalized it. I was thinking, she is working so hard that she will be completely exhausted before she even gets to the hard part in 10-15 hours. Rebekah was thinking that if it hurts this much now and it is not real contractions, there is no way I can make it for the real thing. We should have been at the birthing center at the third signpost.
Meanwhile Rebekah was still throwing up even though she was in bed. I had earlier been running around trying to finish packing odds and ends for the bag to take to the clinic, making all the fore mentioned calls, finding tapes for her and fifty other things that needed doing. Now I was beginning to realize this might be the real thing and was focusing more on taking care of Rebekah only. She even apologized for yelling at me earlier. Sometime while I was running it back and forth emptying the vomit pail, she changed positions and the next thing I heard was, “I think my water may have broken”. Nothing was ever black and white in this whole birth. We now quickly moved to the bathroom where we stayed for the rest of the birth. It is 8:40 PM.
Indeed her water had broken but first I need to describe our bathroom since it is the scene for the rest of the story until after the birth. New York City is notorious for the small size of the kitchens and the bathrooms in the apartments. Our one bedroom apartment is quite spacious except for the kitchen and bathroom, which were taken to new levels of miniaturization. Our bathroom is 2 ½ feet wide and about 6 feet long. The sink is at one end and the toilet at the over. The tub is built in its own little enclave. You literally must shut the door to use the toilet. The ceiling is high though. This describes our delivery room.
Rebekah’s water continued to trickle out into the toilet bowl. Fortunately it was clear or pale and showed no signs of meconium. I immediately called the birthing center’s answering service who said Kate was on duty and would call me back. More bad news. Kate is at St. Vincent’s Hospital that is the back up for Elizabeth Seton. She is attending a caesarian birth. I bring Kate up to speed on everything. She confirms this is Rebekah’s first birth and says it sounds like she is dehydrated and having ineffective labor, which is why the contractions are so close together. I am to give her lots of Gatorade and water in sips and they should slow down. I am also instructed to have Rebekah take a shower, which also may slow down labor. I am to call her back in two hours or earlier is something changes.
I also call Judith who says she will leave in 10 minutes and be right over. Unfortunately Judith lives at 110th Street the West Side and we live on 46th Street on the East Side. She might as well have been on Mars.
I am now pouring water and Gatorade down Rebekah waiting on the labor to slow down as soon as she rehydrates. We have accepted that her water breaking means labor has started and the baby is definitely coming most likely within the next 24 hours. I turn on the CD’s we had planned for the birthing center. I also start writing down the time and duration of the contractions. They previously were about 5 minutes apart and lasting about 30 seconds but were inconsistent. Now they are 3 minutes apart and 30 or 45 seconds duration but very inconsistent with some 1 minute apart and some 4 minutes apart. To make matters worse, Rebekah had become mute and was using hand signals and I couldn’t tell for sure when a contraction was “over the hump” or when it had ended. I could certainly tell when they began though.
Rebekah now decides she is going to take a shower to see it she can find some relief from the pain. She has a contraction and immediately projectile vomits all the Gatorade, water and even the Edy’s fruit pop she had eaten leaving the tub red and mushy. Rebekah now returns to the toilet rocking back and forth with each contraction. She is focusing on a low moan and really being brave. It seems to help when I hold her massaging her back and moan and sway with her as if we are dancing. What a strange sight it would have been to see. Occasionally she bends over while holding the tub and sways right and left standing up.
My notes show that I started recording her contractions at 8:52 and the last entry is at 9:54. That hour literally flew by and neither of us can remember many details. I know at some point I spoke to Judith who told me the reason Rebekah threw up was because she was drinking too fast and to have her strip from a straw. The only straw we have in the house is from Siouxz’s bachelorette party in South Beach, Florida. It is a pinkish straw that glows in the dark in the shape of a man’s genitals…balls and all. So there is Rebekah moaning and swaying sitting on the commode and drinking a Gatorade/water concoction though a penis straw in a 2 ½ by 6 foot bathroom having a baby.
The contractions were about 2 minutes apart from 9:15 to 9:35 but they still lasted only 30 to 45 seconds and were still inconsistent. I somehow lost the next 10 minutes but from 9:45 to 9:54 the intensity of the contraction seemed to pick up but they were still about 2 to 3 minutes apart. But how do you time them? I was timing from the start of one until the start of the next one; otherwise the math was too hard under duress. The last contraction I recorded was at 9:54:30 (I was now obviously getting serious and counting the seconds) and lasted 2 ½ minutes. No more entries. I must have woken up. Panic!
That is probably when I asked Rebekah (first question since the laptop incident) if she had any urge to push and she said YES. I then asked if the had pushed yet. She said, “I think so”. Now that is information I could have used long ago! I immediately called the birthing center and got the answering machine so I left a message something like this, “Tell Kate that we are going to have a home birth and to send a midwife over to our apartment immediately”. Of course this is impossible since they are not sitting around waiting to make house calls and they could not have made it anyway.
I then called Judith and she left immediately and called me back as soon as she got a taxi and stayed on the phone with me. Two memories stand out. She said babies are very slippery when they come out and I need to be very careful to catch it. She told me to get as many towels as I could and to lay them on the floor and that I could use a towel to catch her if I felt more comfortable that way. Now you have to realize we only have 6 towels in our apartment and I am not allowed to use 2 of them because they are pale yellow and would never come clean. The other thing was Judith must have gotten the only taxi driver in New York City who was from the Vatican or some other Holy Land. I could here her urging him to “just go through the red light, there is nothing coming either way” and “if a cop stops us I will tell him I am a midwife on the way to an emergency delivery” and best of all “yes, I will pay the ticket if you get one”!
Sometime between the twenty-five minutes from first finding out Rebekah was pushing and the birth, Rebekah scooted her butt down on the end of toilet seat and laid her head against the wall. All the swaying and moaning stopped. I also saw than her labia were extremely swollen and looked something like the picture of Mount St. Helens shortly before eruption. At this point I decided it was a good time to feel for a head. Timing is everything and I tried to feel as a contraction was beginning. Rebekah slapped my hand away and then felt herself after the contraction was over. She said, “I think I feel a head”. Didn’t matter since I saw the head in the next couple of minutes.
Now Kate had called on call waiting and took over from Judith in guiding me though the birth. I am sure both MCI and ATT must have called sometime during the evening too. Kate asked if I had called 911. I am sure she was in the hospital where getting one phone is difficult and two is impossible. But try to picture this. Here is Rebekah beginning to crown and I have the midwife on my regular phone in one hand and am trying to call 911 on the cell phone with the other hand. Plus I am picturing me doing all the work and some burly fireman coming in at the end and pushing me away and catching Maisie. No way. Fortunately I saw the head and told Kate to call 911 if she wanted.
Try to picture the top of the head with lots of hair showing itself a little with each contraction and then disappearing, as Rebekah would rest. She was making a conscious effort not to push but her body was now on automatic pilot and this baby was coming and coming soon. Out comes this little blue cone head with the next contraction. Hello Maisie all scrunched up and blue with her head facing down in the normal birthing position. Now I know the umbilical cord is still connected and provided her with life so she is in no danger as Rebekah’s body rests for a while until the next contraction. It seemed we were waiting a while and that the body actually slows down here. Kate asks me if the umbilical cord is around her neck. This happens sometimes and is a problem. You have to reach down and unwrap it from the baby’s neck. However babies don’t have necks…at least not the kind you can see. So I guess when you don’t see a neck, it means the umbilical cord is not around it. At least that worked in my experience.
Kate next tells me to reach down and pull the arm out as the shoulder appears. At this point I suggest I put the phone down and she agrees. For the first time I ask Rebekah if she can push since Maisie’s head is out and her body is in. I am getting a bit nervous even though I know she is perfectly safe in this position. Rebekah tells me she is not having a contraction and must wait for one to push. So we wait and when the contraction comes, Rebekah pushes and the right shoulder begins to emerge. It is slowly coming out and not stopping so I don’t do anything. Then the left shoulder starts to appear and come out. When the arms get about to the elbows, Maisie just sort of squirts out into my arms. Followed of course by a gush of amniotic fluid and blood which was blocked in the uterus behind the baby even though the water had broken. That is the only time I am glad we are in the bathroom rather than the bedroom. Rebekah immediately recovers and says she feels great. She is smiling and even looks like she just put makeup on and came out of a bandbox. This is the same woman who looked like she had just given birth 4 hours earlier and now is glowing when she actually does give birth. She was amazing. I only had to do one thing and that was to catch the baby. She did all the rest.
I now take Maisie and lay her on Rebekah’s belly and she takes hold of her. Maisie’s mouth is open and she begins to cry on her own. Kate later told me that was the best sound she ever heard. Rebekah is now asking me to get a syringe and clean out her nose and throat but I point out since she is already crying, that they are open. Maisie is one of the self-cleaning types. Kate is now back on the phone with me and asks if I have dried her off and covered her to keep her warm. Of course I haven’t but I grab a towel and make a half effort to clean her but make sure she is dry and well covered because I do understand hypothermia. I wish I had spent more time cleaning her two days later when we are still getting dried blood out of her hair.
About on Maisie’s second cry, the doorbell rings and it is Judith. She is concerned about the placenta and asks me to get a plastic container to catch it in. If we don’t catch it, it could fall to the floor and rip the cord out of the baby if the cord is too short. Try to find a plastic container big enough for a placenta when you have never seen one and don’t know its size. I give the phone to Judith and let her talk to Kate. The doorbell rings and it is three EMS guys. I tell them they are too late and the baby is born and well and in the care of a midwife. I thank them for coming but tell them they are no longer needed and shut the door on three confused faces walking away. I finally grabbed a colander from the kitchen and stuck it in the top of the trashcan for the right height. Now Judith is asking me to find plastic bags or a shower curtain and old sheets to put on the bed for under Rebekah for when we move her there to birth the placenta.
As I am about the lose it, the doorbell rings and here are about 5 firemen, a couple of policeman and the EMS guys back. I guess they ran into the others in the lobby and came back up together. So I invite them all in. I just figured the hard part is over and we will just move Rebekah to our bed, deliver the placenta and go to sleep. Kate is meanwhile trying to talk me into letting them bring Rebekah down to St. Vincent’s recovery room where she is in case of hemorrhaging after the placenta is separated from the uterus. So is one of the policeman who never seems to have been told no before. I am trying to get Maisie to latch on and nurse. Judith seems ambivalent to whether we go to the bedroom or to the hospital. All of the task force are trying to squeeze into the bath room. Rebekah is telling them that it is up to me. At some point Rebekah connects and realizes I didn’t intend to go to the hospital. About the same time I talk to Judith and she convinces me the upside of going outweighs the downside and we agree to go. Everyone leaves but two of the fireman, Martin and Glenn, and they are great. Now I have to find Rebekah a robe to wear to the hospital and clothes to wear home the next day. More panic. I forget the Champagne for the celebration afterward.
So Rebekah gets on a stretcher with Maisie on her stomach still connected by her umbilical cord all covered in blankets. The two firemen plus Judith and I join to make a procession together down the elevator and through the lobby passing Manuel who is the first doorman to meet Maisie. Me with two tote bags and Judith with her camera equipment. We take a few photos outside the big EMS type ambulance and then get in with Glenn in the back with us and Martin in the front. And down Second Avenue with sirens blaring and lights flashing as Rebekah and Maisie both go on their first ambulance ride together. Somewhere during that ride Maisie finally latched on and started nursing.
Doctor that put the “love Stitch” in at Saint Vincent’s Hospital was Dr. Gaskin.