And so began our pregnancy.
Pregnancy and birth involve many choices, so Karin and I started doing our research.
We read a good number of pregnancy books. The ones we recommend the most highly are The Pregnancy Book, The Birth Book and The Baby Book. These books were written by a doctor and a nurse who are married to each other and have 8 kids together. They tell you all the medical stuff you need to know, and they tell you how to avoid the many aspects of hospital births that are unhealthy for the mother or the baby.
We also really liked The Thinking Woman's Guide to a Better Birth, Birthing from Within, The Continuum Concept, and Baby Catcher.
One of the useful things we learned from these books was about the risks of unnecessary medical procedures. For example, many doctors will always give a birthing woman an epidural, a drug treatment that numbs the woman from the waste down. Women who receive epidurals are 2 to 3 times more likely to need a Cesarian than women who do not use an epidural. Many hospitals have a 40% Cesarian rate! We decided that we would intend for the pregnancy to be drug-free, but that we would use pain-relief drugs if they seemed to be necessary.
We also decided to go with a midwife instead of a doctor, since midwife-attended births are statistically safer than doctor-attended births. They have fewer Cesarians, fewer episiotomies and fewer forceps interventions.
Another choice to make was whether to have the birth in a hospital or at home. We considered a home birth, but at the time we knew 3 women who had had home births, and 2 of the 3 had complications that caused them to be rushed to a hospital at the last minute. Although we knew that on average home births are much safer than that, the idea left both of us somewhat uneasy, so we decided to have a hospital birth. With a hospital birth, the birth can be a completely natural childbirth, but if the mother decides that she needs pain relief, drugs are available. And doctors and medical facilities are available in case a complication arises.
We explored the options that were covered by our insurance, and discovered Jeri, a midwife who is also a nurse practitioner. She delivers babies at Alta Bates in Berkeley. Alta Bates is a five-minute drive from our house, and it has the reputation of being the best hospital in the area for birthing.
Jeri performed all of Karin's prenatal care during the pregnancy, so Karin had no need to see an ob-gyn at all. Being a nurse practitioner, Jeri could do all the things a doctor would do, such as prescribing medications, ordering lab tests, etc.
Jeri told Karin that it is recommended that women who are giving birth at the age of 35 or over have an ultrasound exam during the fourth month. So we did that and found out that we were having a girl.
Since Jeri was 100% covered by our insurance, we were able to also afford a doula. We found a really great doula named Lisa.
Also, Karin has a good friend Jill who is a massage therapist who wanted to be a nurse. Jill had attended several births and agreed to take on a supporting role at Karin's birth.
Karin explained the birth plan to her mom. Midwife childbirths are a fairly foreign concept to most Americans of our parents' generation. Karin's mom, for example, had been completely put under for Karin's birth. Karin asked her mom if she wanted to attend the birth. Her mom decided that she would be more comfortable coming to visit us after the birth. Karin's due date was December 12th, and it is typical for a first baby to be born about a week after the due date, so Karin's mom got a plane ticket to Oakland on December 18th.
Jeri asked Karin if I wanted to catch the baby. I would kneel in front of Karin as the baby came out, and Jeri would guide my hands to ensure that the baby was properly supported. Karin asked me if I wanted to do that. When I thought about it, the idea of doing it made me happy, so I said yes.
Pregnancy was generally agreeable to Karin. She had her fair share of vomiting and tiredness, but she was always in good spirits. She was in an exceptionally great mood throughout most of the pregnancy.
Karin and I spent a lot of time talking about baby names. I told Karin that ultimately the decision was hers, but that I would give her my opinions on the names she was considering. It turns out that I'm pretty opinionated about names, since I disliked her suggestions more often than I liked them. The names that were our favorites were Helena (Lena), Serena, Kira, Elinor (Ellie), Rachel and Sarah. The baby's middle name was definitely going to be Roberta, which is Karin's mom's name.
We found a childbirth class that we liked. One of the things that we spent a lot of time on in the class was learning various pain-relief techniques. We learned that labor contractions last about a minute, and after each contraction is a rest period of least 3 minutes, during which the body produces endorphins, morphine-like chemicals that reduce pain and cause some euphoria. So we learned how to handle a minute of pain. We practiced this by submerging one or both hands in a bowl of icewater. (If you have never done this, try it some time.)
At one point in the pregnancy, Karin told me that it has been shown that a newborn baby immediately recognizes the voice of its mother and the voices of the people that the mother interacted with frequently during her pregnancy. She asked me if I would like to say something to the baby. So I put my face right near Karin's belly and said to the baby: "Clean your womb."
Karin was 7 months pregnant when Halloween arrived. We want out to a Halloween party, with Karin's tummy painted like this.
December 12th arrived. When Karin woke up, I sang "Happy due date to you" to her (to the tune of "Happy Birthday").
The days passed, and we waited for labor to start.
On December 16th, Karin came down with the flu. We called Jeri, and she told us we should notify her if Karin's temperature ever got above 101 degrees. (Fortunately it never did.)
On December 18th, Karin's mom arrived. Karin was in bed with the flu, so I drove to the airport to pick up her mom. As I was driving, I noticed that my throat was starting to feel swollen. By the time night fell, I had the flu too.
December 19th was a Friday. I stayed home from work that day because of the flu. Fortunately Karin's mom was there to take care of us.
Friday afternoon I awoke from a long nap. I laid there in bed, feeling weak, having a 102-degree fever, not able to think clearly, and looked over at Karin who was sleeping next to me. I couldn't believe that we were going to be having a baby in this condition. At one point I said to Karin, "The next time we have a baby, let's not get the flu."
At 9pm on Friday night we had a housecall from Dr. Lise, who helped us get our immune systems in better shape. Then we went right to bed.
At 1:45 in the morning Karin's water broke and her contractions started.
We called Lisa (our doula), who we knew was spending the night in Sacramento, which is a 90-minute drive from us. Lisa said that she would be back in town by about 10 in the morning. We called Jill (Karin's friend who wants to be a nurse). She had been out late at a party, and she agreed to come over despite having had very little sleep.
Then the power went out for a minute. It had been raining on and off for the past few days, and occasionally the power would go out. It never went out for more than a few minutes, and we were really hoping that this would not be the first time that it stayed off for longer.
Karin's contractions started getting longer and more intense. Her contractions were 4 minutes long. This seemed strange to us, since we had learned that the contractions were supposed to start out short and gradually get longer until they were a minute-and-a-half long. We called Jeri. She told us that long contractions might be a sign that this was a "false labor."
The advice other fathers had given me was to get as much rest as possible at the beginning of labor, since I would need my energy for the long haul at the end. So I went back to bed, leaving Karin in the hands of her mother and Jill.
I woke up at 7:30 Saturday morning to find Karin in agony. Her contractions were now 8 minutes long, with only 1-minute breaks in-between. We figured the irregularities might have been because Karin had been weakened and dehydrated from flu.
Karin had been prepared to handle minute-long bouts of pain. She tried every pain-relief technique she knew, but nothing was helping. These 8-minute contractions were too much for her. Karin said that she wanted to go to the hospital now. We called Jeri, and Jeri told us that she would call the hospital to let them know we were coming.
We had been told many times that birth never goes as you planned, but this was going way beyond that. We had expected that we would both be healthy for the birth. We had expected that our power would be working. We had expected that our doula would be in town. We had expected that the contractions would only be a minute long. This was much more difficult than we were prepared for, but fortunately we were still able to roll with the punches.
We packed up our hospital bags and drove over to Alta Bates. Jill drove Karin's mom, and I drove Karin. When we arrived at Alta Bates, Karin was too weak to walk, so I got her a wheelchair and wheeled her in.
By 8:30 we were in Labor and Delivery Triage. They gave Karin an IV to keep her hydrated. Then they checked her cervix, and it was 1 cm dilated. Birth happens when the cervix is 10 cm dilated. (For the metric-impaired, 10 cm is about 4 inches.)
Lisa arrived at about 10:00, and Jeri arrived at about 11:00. Jeri explained to us our options. We chose to get Karin a pitocin drip to accelerate the labor and a 1/2-dose epidural. The epidural would allow Karin to get some sleep while she dilated more. And having just the 1/2-dose epidural would still allow her to feel the contractions,
By noon we were admitted to a birthing suite. A birthing suite is a cross between the traditional hospital delivery room and a hotel room. Ours had a hospital bed and the usual medical equipment, plus a couch, a cot, and a private bathroom with a shower.
They put Karin in the bed. Lisa, Jill, Karin's mom and I stayed in the room with her. Jeri left, telling the nurse to contact her when Karin was 6 cm dilated.
I asked the nurse if I would still be able to catch the baby, since I had the flu. She said it should be ok since the mother had the same flu.
At 1:00 the anesthesiologist came in. We really liked him. He was really down to earth. He asked us if we had any questions, and he explained everything. He wholeheartedly agreed that the 1/2-dose epidural would be appropriate. He asked Karin to choose one person to stay with her and for everyone else to leave the room. Karin chose Lisa to stay with her.
I left to get a sandwich at Whole Foods, which was only a block from the hospital. I returned 30 minutes later to see a very happy Karin. Her agony was finally over. She was feeling no pain but was able to feel the contractions as pressure.
For the next 12 hours we kept Karin company as she rested and dilated. Karin even managed to sleep for a few hours. My throat was really sore and I sucked on lots of echinacea cough drops. I also called my parents on the east coast to let them know that Karin was in labor.
Jill returned in the early evening and brought me some dinner. Jeri returned at around midnight.
When the night-shift nurse went on duty (who referred to our unborn child as "the cutenik"), she noticed me coughing and sneezing and suggested that I take a decongestant, for the sake of everyone in the room who wasn't sick. I asked her if she could get me one, but she told me that Labor and Delivery doesn't stock decongestants. So I drove home at 2 in the morning to get some Sudafed. I fed the cat and drove back to the hospital.
I parked the car in a residential neighborhood about 2 blocks from the hospital. As I walked up the main walkway to the hospital, I heard an older woman crying and talking (apparently to herself). At first I thought she was a homeless person. As I got closer I heard what she was saying - "Oh god, please don't take my husband. It's too early. Please let him live." The irony struck me. I was there to welcome a new loved one into the world, and that woman was there to say farewell to an old loved one.
I re-entered the hospital and went back up to Karin's delivery room. An hour later I was feeling much more clear-headed. My flu was now just a cough with some sniffles. I managed to sleep some between 3 and 5.
It was now Sunday morning. At 6:00 I called my parents on the east coast to give them an update on Karin's progress.
At 6:15 the pushing part of Karin's labor started. Karin was coached by the nurse and Lisa. Because of the IV, the epidural and her connections to the monitoring equipment, Karin labored lying on her back. Each push was like doing a sit-up. The nurse set up a metal bar over the foot of the bed for Karin to push her feet into. Lisa and I were on either side of the bed, each supporting one of Karin's legs with one hand and giving her back support with the other. Despite being sick and having had little sleep, I felt strong and alert.
The nurse set up a mirror so that Karin (and Lisa and I) could see between Karin's legs. Although Karin's cervix was dilated 10 cm, her vagina did not look more open than usual. But the baby's head caused her vaginal area to protrude almost an inch more forward than usual.
Eventually we could see about a square inch of the baby's head. The scalp was light-grey and had some brown hair on it. I was surprised by the color. In the Sears book, we had read that babies are covered with a light-grey layer of silky material called vernix. The vernix protects the baby's skin from the fluids that the baby is floating in. But when I saw the color of the scalp, I had completely forgotten what I had read about vernix.
Our birthing suite had an east-facing window, with a great view of the misty sunrise over the Berkeley Hills. I said to Karin, "It's tomorrow already" (a reference to a CD that she and I like a lot).
Karin pushed and pushed.
At one point, Karin asked me and Lisa to change the ways that we were supporting her legs and back. She did this without being annoyed or blaming. She just gave us feedback on what wasn't working for her and what we could do to improve.
Jeri returned at about 8 am.
By 9 am we could see (in the mirror) all of the baby's head. We could make out the curvature of the scalp.
Jeri encouraged me to describe to Karin everything I could see. We could only see the baby's head when Karin was pushing, and when Karin was pushing she wasn't able to really focus and look. Karin told me (in retrospect) that as I reported what I was seeing, the awe in my voice was something that she had never heard before and inspired her to keep going.
By 10 am, the scalp was actually protruding from the vagina.
My cell phone rang. I looked at the caller ID and saw that it was my mom calling. Karin said, "You're not getting that, are you?" I handed the phone to Karin's mom, and she spoke to my mom to give her the latest update.
By 10:30, the top 1/3 of the head was out. We were not able to tell which way the baby's face was oriented. The scalp was light grey, and I could tell that it was definitely alive. It looked like Karin was birthing an alien egg.
Jeri poured mineral oil over the scalp as a lubrication, and used one finger to work the oil into the contact area between the vagina and the scalp. Her finger indented into the soft scalp by perhaps a quarter inch or so, similar to how an orange would respond if you pressed firmly on its surface.
Karin's mom (who was doing a great job supporting us) suggested that I wash my hands, and I did.
Jeri put me in position to catch. I knelt in front of Karin, with my hands underneath the baby's scalp.
After I was in this position for a minute or two, Karin pushed, and in an instant the baby's head had a face. The face was grey and mottled with small amounts of pudding-like goop. Although the eyes were closed, the mouth was moving. It looked like something out of a science fiction movie.
A few seconds later Karin pushed again, and most of the rest of the baby's body slid right out.
Instantly, I heard Jeri exclaim, "Mike, step back!" Jeri swept in and took over as I complied.
Later on Jeri explained to Karin and me what had happened. Usually the baby's face comes out facing down, but our baby came out facing up, which can sometimes be a problem because it is possible that the umbilical cord may be around the baby's neck. When the rest of the baby came out, Jeri saw that the cord was around the baby's neck, so she quickly stepped in to fix the problem.
Jeri got the baby out and cut the cord. I looked at the clock and noted that it was 10:38 AM.
A nurse rushed the baby over to a table, and I followed.
The baby was covered in small mounts of play-doh-like goop, especially in the eyes. Her face and torso were light pink, but her lower legs, feet, lower arms and hands were all a pasty grey. They looked like they were made of clay.
I was in awe as I gazed down at her. It took a few seconds for it to land that this tiny helpless being was my child. I cried. Jill and Lisa came over and congratulated me.
The nurse started cleaning the baby off, suctioning goop out of the baby's mouth and nose. The baby started breathing, and her breathing was very fast, as if she had just run a marathon. The nurse put an oxygen mask over the baby's face for about 30 seconds and then took it off.
Eventually the baby cried. Lisa suggested to me that I talk to the baby. The baby would recognize my voice because she had been hearing it for months in utero. So I said soothing things to the baby like "It's gonna be alright. Daddy's here," and the baby calmed down.
The baby's breathing was still fast, and the nurse gave her more oxygen.
The baby opened her eyes, and I was the first person she saw. I was amazed by the striking blue color of her eyes. I exclaimed to Karin "She has blue eyes!"
Jeri then had me cut the rest of the cord. (She had cut it initially to separate the baby from Karin, but there was still lots of cord hanging from the baby's belly.) The nurse weighed the baby (7 lbs, 4 oz) and measured her length (22 inches).
After giving her oxygen for a few minutes, the nurse placed the baby on Karin's belly. I saw the baby look up and make eye contact with Karin, and my heart melted with joy. Karin started crying and told the baby how happy she was to finally meet her. After a few minutes of mother/daughter bonding, the baby was sent to intensive care.
Karin told me that Jeri had told her that babies that are born face up are pretty rare and are called "stargazers." There is a flower called the stargazer lily, so we decided that the baby's name would be Lily.
After the whirlwind birth, Karin was checked into one of the recovery rooms in the maternity ward. Karin and I went to sleep -- Karin in the bed, and me on a chair. I awoke about 8 hours later. Karin was still sleeping, and I wanted to write down the details of the birth story before I forgot them. I went to the nurse's desk, got a pen and some paper, and quickly filled up 2 sheets of notes. When I was done writing, I went back to sleep.
Lily stayed in intensive care for 3 days. She had no infections, but it took that long for her breathing to become normal. During that time Karin was allowed to visit her for breastfeeding, but I was not allowed in because I was too sick. (Their concern was that my germs would be bad for the premature babies who had no immune systems.) So I spent some of that time in the hospital with Karin, and I spent some of that time at home, typing up this birth story on the computer.
We brought Lily home on December 24th.