THE BIRTH OF ELLIOT

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Thursday, April 17, 2008 at 5:35 a.m. at 41 weeks and 6 days of pregnancy

My first pregnancy was a stressful affair, plagued by blood pressure issues, too early contractions, and pre-natal testing fiascos. Many of the problems that I experienced were directly related to the clinical and non-nurturing nature of the prenatal care that I received through my obstetrician. While Audrey's birth was a very positive experience, I knew that I wanted an entirely different pregnancy experience my second time around. So before conceiving, I researched the options that were available outside of the standard obstetrical model of care, and came to the conclusion that I needed to receive prenatal care and have a home birth under the care of a home birth midwife.

Aside from the horrible morning sickness that I experienced during the first four months or so of my second pregnancy, and a serious bout of eczema on my hands, I'd have to say that the pregnancy was all that I could have hoped for. My appointments with my midwife, Yelena Kolodji CNM, were relaxed and enjoyable. My blood pressures were stellar. From my experience the first time around, I knew not to worry too much about my early Braxton Hicks contractions. And when I did have a few troublesome bouts, Yelena relieved my stress by recommending calcium-magnesium supplements to keep my uterus calm, and by speculating that the uterine activity might have been related to storm activity that we were experiencing. Rather than spending the last months of the pregnancy worried and on the couch, I spent it running off to yoga class, taking walks, helping out in Audrey's nursery school classroom and cleaning the bathroom, big belly notwithstanding. I never even got to the point of asking James to tie my shoes.

Other than some hip and bladder issues, I was reasonably comfortable even at the very end of the pregnancy. I was sleeping well and never experienced the overwhelming desire to be done with pregnancy that most women seem to experience in the final weeks. Elliot, similarly, was in no rush to exit his comfy womb. Despite the fact that Audrey arrived a week ahead of her due date, Elliot stayed put through his due date. And then a week past his due date. And then he kept right on staying put as the days ticked down towards two weeks past his due date. James and I weren't particularly concerned, but our midwife Yelena started to get anxious about his reluctance to enter the world. She urged us to start taking action (breast pumping, walking, acupuncture, sex, etc.) to try to get my labor going. We also had an ultrasound and non-stress testing done as a precaution, to make sure that the placenta looked healthy, there was enough amniotic fluid, and the baby's measurements and movements looked good and he didn't appear to be in distress. He passed with flying colors, as I expected. That was reassuring. But the downside to the ultrasound was that the technician predicted that baby would be a nine pounder. I was expecting Elliot to be bigger than my seven pound, five ounce Audrey. After all, he was a second baby and a boy, and I'd gained more weight and gestated him significantly longer. Still, the technician's estimate was a little bit disheartening to a woman on the verge of labor, and I wished I'd thought to ask him not to give me his estimate. I tried not to dwell on the baby's size while taking comfort in the fact that both my grandmother and aunt had successfully pushed out nine-pounders.

I should probably speculate about how different my end-of-pregnancy experience would likely have been if I had been receiving care through an OB. In all likelihood, I would have been under intense pressure to get labor going with an IV of pitocin rather than with a few acupuncture needles and a breast pump. Thankfully, my chosen practitioner shared my bias for basically leaving nature in charge of the situation. Midwife delivery chosen=bullet dodged.

I spent the last few weeks of my pregnancy looking for signs that my body might be ramping up to go into labor. And my body basically indicated that it was maintaining the status quo. I had many days of regular, mildly painful contractions, and other days with fewer or less noticeable contractions. The Monday before Elliot was born my contractions were quite regular and more painful than usual, so I thought maybe things were going to get going. But on Tuesday and Wednesday my uterus was very quiet. It was a busy week. Ultrasound Monday, appointment with Yelena on Tuesday (with non-stress test and vaginal exam), acupuncture appointment on Wednesday. Suffice it to say, James didn't put in many hours at work with all of our running around. During the vag exam, Yelena found my cervix to be very soft and open to three or four centimeters-very similar to what it was before I went into labor with Audrey. She gently swept my membranes to try to stimulate prostaglandin action. (It was a far more pleasant experience than when an OB swept my membranes during my pregnancy with Audrey. For one thing, Yelena actually explained what she was doing and asked my permission.)

On Wednesday evening, I headed off to my regular prenatal yoga class. Physically, I was still feeling fine, so there didn't seem to be any reason not to. The class regulars had asked the instructor (who was also my doula) whether or not I'd had my baby yet. Learning that I hadn't, there was great curiosity as to whether or not I'd be dragging my bowling ball belly in for one last class. So when I finally walked in a few minutes late, there were a lot of oohs and aahs. At the end of class, for the second week in a row, the lovely group of pregnant mamas circled around me and sent me off with warm wishes for a good birth. "Second time's the charm," I predicted.

See you soon," said my doula as I packed up to leave. And instead of being noncommittal (as I had been the previous week), I agreed. "Yes." Baby had to come out soon.

I went home, ate dinner and, at long last, noticed a potential "impending labor" signal. All evening I had quite a bit of soft, almost liquidy earwax. I doubt that I would have noticed the significance of my earwax texture, except that a day or two before Audrey was born, I started producing amazing amounts of wet earwax. So I'd been monitoring my earwax very carefully for any sign of changes. The earwax changes weren't nearly as dramatic the second time around as they had been the first time. But they were enough to get me thinking, "Maybe!"

James and I were up late Wednesday night. We had to get our little night owl Audrey to bed, and then James helped massage and support me through fifteen minutes of pumping, 15 minutes of walking, and another 15 minutes of pumping. So it was nearly one on Thursday morning by the time I lay down in bed with a magazine to get ready to relax and sleep. I'd been lying down for just a few minutes when I felt and heard a distinct "kerthunk" in my belly. It was moderately painful for a few moments. I knew immediately that my water must have broken, so I quickly climbed out of bed before I could start gushing onto the sheets, and headed to the bathroom. Sure enough, I was soon spurting amniotic fluid. I called James in, and anxiously examined the color of the fluid. With an overdue baby, I was particularly vigilant to check for signs of meconium. (That's poop staining in the amniotic fluid, which can indicate that baby is in distress.) But the fluid seemed pretty straw colored and didn't have an unpleasant odor, which was reassuring.

I sat on the toilet for a while, and then put on a pad and wandered around the house dripping a bit as James started to pull together our birthing supplies (a pack of disposable medical supplies, towels and washcloths, a crock pot to keep water warm, etc.) and put them on the kitchen table. I checked to see whether or not Yelena wanted to be called about water breaking, but she wasn't interested in hearing about that in the middle of the night unless there were problems with the color of the fluid. On the other hand, my doula, Journey Revington, had instructed us to call immediately if my water broke. So, I gave her a ring. She asked about the color and smell of the fluid, and whether or not I had felt baby move since my water broke. When I reported that I had, she urged me to go back bed and try to rest, if possible, since I was going to need as much energy as possible.

I was skeptical that I'd be able to rest with the distractions that my body was providing. (I don't fall asleep easily under the best of circumstances, after all!) And I figured that I'd be in active labor soon. But I did try lying back down. At 1:45 am, my first contraction kicked in, and it was pretty strong. (My contractions with Audrey had started at 2:24 am, so I'm one of several women I've talked to who started their different labors at the same time of day.) Also as I expected from my first experience with labor, my next contraction was at 1:50. I lay in bed timing for a while, and the contractions came every five minutes like clockwork. To distract myself from the pain, I waved my hands around, concentrating on the movement and on the fact that my hands did not hurt at all. Focusing on a part of my body that didn't hurt helped me to partially ignore the part that did.

I could handle the contractions on my own at that point, so I lay in bed and handled them. But if I were going to the bathroom, as I did several times, I needed to lean against James to manage them. Interestingly, when I wandered around, such as from the bed to the bathroom, my contractions were more frequent but less powerful. (Women are often encouraged to walk around to get labor going, so I thought it was odd that walking made my contractions less powerful.) James started to fill up the labor tub using a hose that he ran from our hall bathroom to the living room, so I was on my own with more contractions for a while. I was still fine with that. I tried more hand waving, and getting down on my knees and leaning against the bed. Both techniques worked pretty well for me.

As James continued to fill the tub, the noise of the running water awakened Audrey a couple times, so James had to rush in and settle her back to sleep. That was stressful as the last thing that we wanted was for her to be awake for the festivities! (We had friends lined up to watch Audrey, but we didn't want to wake them up in the middle of the night if we didn't have to.) Luckily, Audrey went back to sleep easily, and once the filling was complete, she stayed asleep.

At three in the morning, having officially confirmed that my contractions were strong and long and frequent and showed no signs of going away, I called my midwife to report what was going on. She said that she was going to call her assistant, midwife-in-training Hope Willems, and start getting ready to come. She requested that I call her back at 3:30 to give her an update. I also called my doula back. Journey asked what Yelena's plan was, and I said I was to call her back at 3:30. (I neglected to mention the whole, "I'm going to get ready to come" part of my conversation with Yelena, because I hadn't really fully registered it.) Journey also asked if my contractions were still manageable. I said they were-after all, I was still handling them on my own as James ran around getting equipment ready. She asked how I was managing through the contractions. I said I'd been trying different positions such leaning on my knees and vocalizing. She also asked where I was. I told her that I was on the couch. She asked if that was working for me. I said I was only on the couch because I was making phone calls, and I should probably get into a better position to be ready for the next contraction! Journey told me to give her another call when I called Yelena back.

But actually, Yelena didn't even wait for me to call her. She called me back at 3:15ish to ask how everything was going and to say that she was on her way. She advised me to call Journey back and tell her to come, too. So I did.

I didn't fully realize it at the time, but I think that my contractions must have started getting quite a bit stronger right around then. James was finished pulling equipment together, and I started relying heavily on him during the contractions rather than being able to handle them on my own. We stood in the living room, and when my contractions came, I leaned on him and pushed down as hard as I could onto his shoulders.

I had a better attitude about my contractions during my second labor than during my first. One thing that really helped me before my labor with Elliot was a friend's reminder that the pain of contractions is your body's way of telling you what you need to do to get your baby out. Your body's way of telling you to move, find a better position or a better mental space that will help you efficiently get your baby out. That really helped me approach the pain with a positive attitude my second time around. During my labor with Audrey, I never felt quite ready when I felt a contraction coming on. I always wished for a longer break between the pains. But with my second labor, when I felt a contraction coming on my attitude was more positive. Instead of wasting a little energy by momentarily regretting the arrival of the contraction, my attitude was, "OK. Here it is. Time to get to work." I knew that the sooner the contractions opened my cervix, the sooner I'd be done with the pain, so I concentrated on doing everything in my power to move labor along as quickly as I could.

During my labor with Audrey, I was not successful in my brief attempts to visualize the contractions opening my cervix. So for the first 14 hours of my labor with her, I endured the contractions, waiting for them to work rather than trying to work with them. But during my labor with Elliot, having read and thought a lot more about natural labor techniques, I really tried to throw myself into every contraction. I tried to climb on top of my contractions. To ride them like a rider astride a bull, to master them, to bear down during them and use them to force my cervix open. As each contraction started, there were a few seconds of struggle, when the contraction and its accompanying pain, was mastering me. Then I would gain control of the contraction, and the pain would diminish, and I would power through it and use it for my own purposes. So my experience of the "opening of the cervix" contractions was much, much, much better during my second labor than my first.

Which is not to say that the contractions were a walk in the park or anything. (In the words of a friend, I won't be throwing a contraction party any time soon.) Shortly before Yelena arrived, I experienced a "double-peaker"-a contraction that diminished but then turned into another full contraction instead of fading away. I was annoyed not to get my usual break! At that point, I remember feeling a little bit anxious for my birthing team. I felt like I couldn't quite relax until they arrived. I suggested to James that maybe I needed to try another labor position, but wanted guidance from one of my experts. So I was relieved when I heard the noisy rumble of Yelena's BMW sports car pulling up in front of our house at 3:30 a.m.

We greeted each other, and Yelena made a few trips to the car to tote her various bags of equipment into our house (a birthing stool, oxygen tanks, etc) . I had contractions. Soon Hope arrived. I had contractions. And by 3:45, Journey pulled up. The team was in place.

My memory of what exactly happened at that time is somewhat vague. (I guess I was pretty busy with contractions or something.) I know the baby's heart rate was measured and declared excellent. Hope waited for a break between contractions and took my blood pressure. James joked to Journey that he was getting excellent shoulder massages during all of my contractions. He mentioned to her that I'd wanted to try another position, but I said I was OK. (Now that my team had arrived, the leaning against James method of powering through contractions seemed to be working fine.) Journey suggested that I try hanging off of James more. I tried that. It also worked well (and it gave his shoulders a break from my, um, massages). Journey suggested some music, and plugged in a stereo. But I was concerned that the music might be too loud and might wake up Audrey. And instead of getting turned down, it got turned off. And I didn't really notice.

At some point, in response to something that James said, I remember Hope telling him that we would have a baby soon. But that wasn't news to me. I knew things were moving quickly along. Someone asked if I was intending to birth in the tub. I said it was James who really thought that would be cool. I said I was planning to do whatever felt right in the moment. Yelena said she liked that attitude.

I remember James wanting to leave a few times to show people where things were. And I remember having to command him sharply back so that he would be in position for my next contraction. I began to vocalize during contractions. (Some? All? I don't remember. But the vocalization helped.)

I remember someone asking me if I were feeling a lot of pressure. I had to think about it. Then I realized, "Now that you mention it, I am feeling a lot of pressure." And there was general laughter. Hope tried putting pressure on my lower back during a contraction, but I told her to stop. After the contraction was over I explained that pressure felt good between contractions, but not during. Journey put a cool washcloth along my back and upper shoulders. It felt refreshing. Some time later I made a brief report: "Just constant pressure now. No breaks."

There's a lot of pressure as the baby moves down," someone informed me. The pressure continued. Journey asked me to nod my head when I was ready for her to help remove my sweatpants. After gathering willpower for a few moments, I lifted up one leg and then the other, so that she could take them off for me.

Then the constant pressure stage must have passed, because I remember feeling more contractions. It occurred to me that I might be able to push during the contractions. And it didn't occur to me to inform anyone of my intentions. My goal was to really work with my instincts during this labor, since instinct had been given so little regard during my hospital labor. So I started pushing a bit to see how that felt, grunting along to the sensation. Probably a few minutes later Yelena asked, "Are you pushing?"

I giggled as I answered, "Yes." It suddenly seemed funny that it hadn't occurred to me to mention what I was doing.

I thought I recognized those sounds," the midwife assessed. I continued pushing with contractions.

Someone suggested I should have a drink. Journey checked the fridge and asked if I wanted cranberry or apple juice. I requested cranberry. She suggested a mixture of the two since cranberry alone might be too acidic for a laboring woman. I said that sounded fine. Soon I was sucking down quite a bit of juice or water after every contraction. And soon, I needed to pee. But I was in the living room. And the bathroom was so far down the hall. I stared at it longingly. "Good luck," Hope joked.

Then, inspiration. I turned to Journey. "In the shower in our master bathroom, there's a potty. I want that." I think James asked if I was serious, and I assured him I was completely serious. Journey hurried down the hall in search of the potty. When she returned with it, I tried to squat down, but it was too low to the ground. Someone suggested that I sit on Yelena's birthing stool, and they could lift the potty up under it. So that's what I did. Peeing accomplished.

Now I was on the birthing stool. I continued to push, leaning forward on James for contractions. A mirror was placed under me, and Journey had me direct where to place it so that I could see baby's exit route. Journey also periodically checked with a flashlight to see if baby's head was visible. I pushed with contractions for a while. No head. Someone urged me to keep my feet flat on the floor instead of resting my toes on the floor. She was afraid I'd get foot cramps. I tried changing the position of my feet, but I couldn't comfortably rest them flat on the floor. "I'm too short." So, someone found some towels and rolled them up to create foot rests for me. One of the towels kept slipping, so Journey had to hold it in place. During a break between contractions I explained that, "For the record, sitting with my toes curled on the floor is a very natural, comfortable position for me." It only looks uncomfortable to people with less flexible toes!

Yelena suggested that since I was carrying baby very low and in front, it might help to bring him down if I leaned back a bit rather than leaning forward. So I leaned back during contractions, pushing while pulling up on James' pajama pants with all my might. It occurred to me that a new pair of pajamas for James might become an unexpected cost associated with the birth. But I think they ended up making it through unscathed.

Journey kept peering for signs of head, but still nothing. So after about 20 minutes of pushing, Yelena decided that she wanted to check my cervix, and she directed me to lie on the couch, which the team had covered in absorbent materials (towels, waterproof pads, etc.). Her examination confirmed what she had begun to suspect; a lip of cervix remained and was impeding baby's progress. (A similar lip of cervix had stubbornly persisted during my labor with Audrey as well.) So, she explained what was going to happen next. "I'm going to hold down the lip while you push until baby's head gets past it."

I complained a bit as she held down the cervix. "Ow." The pain of the holding down of the cervix was nothing compared to the pain of the contractions. Nevertheless, I wasn't in the mood for any additional unpleasantness. But none of the pain would go away until I'd pushed that baby out. So she held, and I pushed. Big strong pushes. Through one contraction. Through a second. And there. The head was over the cervix, and I was declared "complete." (Dilated to 10 centimeters.) It was 5:10 am.

The team offered to help me move into another position. (Back to the birth stool? Hands and knees?) Oh so many lovely positions that enable you to work with gravity and open your pelvis as wide as possible. And every book I'd read about childbirth agreed that the hospital standard "on your back" position was absolutely not the way to go. Like, one of they great things about having a home birth was that you wouldn't have to give birth in that unnatural, gravity-fighting, pelvis-closing position. But there I was, on my back, on the verge of giving birth. And the last thing I felt like doing was moving somewhere else. So on my back I stayed.

The pushing quickly became very intense. During the contractions, I absolutely had to push, or the pain became unbearable. Even during brief pauses for breath during contractions, the pain spiraled up immediately, forcing me quickly back to pushing. And I had to push hard, hard, hard to bring that baby down. I could feel when my pushes were particularly productive, when he moved down quite a bit. And my team could tell, too, and they never failed to shower praise on my best pushes. I moaned and groaned during all of my pushes, letting instinctual sounds flow out of me. (Unlike during my first labor, when I was informed that a quiet little grunt after my first push was, "wasting energy.") And, astonishingly, delightfully, Audrey slept right through all of the noise I was making.

With my first labor, I preferred the pushing stage to the opening stage. The first time out, I found pushing contractions to be considerably less painful and more active than opening contractions. But the opposite was true with my second labor. Pushing Elliot out was much harder work than pushing Audrey out had been. I can't say exactly why. Was it because he was almost two pounds heavier? Was it because I knew in the back of my mind that he might be two pounds heavier? Maybe. Or perhaps it was because the opening phase of my second labor had been so much faster and better managed, that the pushing phase suffered by comparison.

In any case, pushing Elliot out I just kept thinking. "He's almost out. The pain will be over when I get him out. It won't be over until I get him out. I have to push hard and get him out." So that's what I did. Pushed and pushed and pushed and threw myself into the pushing. To GET HIM OUT. Because that was how I could escape the pain.

Engrossed in my pushing, I was almost completely oblivious to what people around me were doing. I remember someone reminding me with every contraction to tuck my chin in instead of throwing my head back. (Hello, memories of my first labor!) I think I remember someone applying warm wet washcloths to my perineum. I remember Hope asking how often she should be checking baby's heartbeat with the Doppler, and Yelena saying every five minutes. I remember someone telling me to reach down and touch baby's head. But for the most part, I just remember being inside myself, eyes closed, not fully engaged in anything except for my pain. I have no recollection of where people were. Of when Journey was at my head or when James was. (Apparently they switched at some point.) Of people helping me hold my legs up. I just remember being inside my body. Me and the pain and the pushing.

I pushed hard and pushed hard and pushed hard. And finally, I could feel baby crowning. More pain. Not worse, but different. At that point, I didn't notice contractions anymore. The pressure of the baby was enough to keep me pushing. Unlike my labor with Audrey, I didn't feel an instinct to push with little pushes during crowning. My body urged me to keep pushing strong and hard. I vaguely heard a buzz of voices somewhere outside my body. One voice became more distinct. Hope's(?) voice, urging me to blow. "She wants me to blow and slow down. Worried I'll tear," I surmised. So I blew instead of pushing. Briefly, anyway. And then resumed pushing. Hard. If anyone else was telling me to slow down, I didn't hear it or heed it. I pushed. Pushed out the head. (Good!) But wouldn't get any relief until I'd pushed out that body. So I pushed that body until it was...OUT and I....was....DONE. Good. So good. DONE. It was 5:35 am. I'd labored for just three hours and fifty minutes.

I was unaware of who was where. Unaware that Yelena had railroaded a squeamish James into helping her catch.

That was hard work," I sighed. And Yelena swiftly removed the loop of cord that was loosely wrapped around baby's neck, and she and James laid baby on my chest. Calm baby. As calm as my pregnancy had been. It didn't even occur to him to cry about his dramatic change of circumstances until he'd been on my chest for a minute or two. And then he cried only briefly. I offered him my breast, but he wasn't ready. He just needed to lie there, taking measure of the situation for a while. Now I was engrossed in the baby instead of the pain. The team covered Elliot in blankets that had been warming under a heating pad, and put a hat on his head. A pink hat. When we'd placed our order for the disposable birthing supplies with the medical supply company, we'd requested green, but they'd seen fit to supply us with a pink one instead. So some of our earliest photos of our child show him in a gender inappropriate color. A bit later, James went into the nursery and tracked down a blue hat for him to wear.

Just three minutes after the birth, I needed to direct a bit of attention back to my vagina end. "Separation bleeding," I heard Hope(?) report. "The placenta is coming," Yelena announced, tugging gently on the umbilical cord. With my first labor, the arrival of the placenta involved considerably more time, more contractions, more pushing, and more pain. But this time I don't remember doing any work at all. Yelena tugged it out, and it didn't hurt as it exited. (Perhaps because I hadn't torn this time.)

Normally, midwives like to wait for a good long while before cutting the umbilical cord, to let baby get as much blood from it as possible. But since the placenta was already out, Yelena declared it had served its use and it was time to cut the cord. Squeamish James had declined the honor at our hospital birth, but Yelena didn't give him that option. She handed him the scissors and directed him where to cut.

Yelena set about examining the placenta to make sure it was complete. She declared it a lovely specimen, oohing and aahing over the neatness of the hole that was created when my water broke. She urged Journey to take a lot of pictures of the placenta, and to make a placenta print on a piece of paper. (Quite a contrast from my hospital birth, when the doctor was mystified as to why a woman might even want to see her placenta.) Then the organ was placed in our freezer, and we were encouraged to plant a special tree for Elliot using his placenta as fertilizer.

I lay on the couch, periodically spurting a bit of blood. Someone asked if I had to pee. I said I might, and Hope put down a diaper for me to use if I felt like it. But my need to pee was not very intense. People kept asking if I had peed, and I kept saying, "Oh, I forgot I was supposed to be doing that."

I was a little sweaty, and the house was a little chilly, (despite the fact that Hope had turned the thermostat up to 70 during my labor). So I suddenly felt cold and began shivering. I put in an order for a blanket. James hesitated, unsure what covering to use for me in my messy and bloodied state. So I was insistent. "Get me something, hon." He went off to procure a reasonably washable blanket. The team also placed the heating pad on my chest and belly, and someone helped me out of my wet shirt. I soon felt warm and comfy again.

Eventually, Elliot was ready to nurse, and he latched on like a champ. ("Look at those fish lips," admired Journey.) Also, while I was lying there, Hope checked my blood pressure and temperature. My temperature was 99 point something, so she checked with Yelena before recording it. Yelena wasn't concerned. "I don't feel feverish," I assessed. "You don't look feverish," the two of them agreed. My slightly elevated temperature was attributed to the heating pad and the nice warm blanket.

At around 6:20, Audrey woke up and came out to the living room to see what on earth was going on. "Good morning, sweet cheeks," I greeted her. "Your baby brother is here. Do you want to touch him?" She tentatively touched Elliot's arm. Then, she went off to be with her Daddy, overwhelmed by the strange situation.

Someone asked if I was having any afterpains. I reported that I was, and "Afterpain Relief Tincture" was added to my juice. The pain diminished. The afterpains continued for a couple of days, many of them toe curling and eye watering. When they came, I made many desperate requests of James. "I need a hit!" Whether thanks to the placebo effect or actual efficacy, the tincture worked magic.

Yelena weighed and measured Elliot. Nine pounds. 21 inches. Delivered without a tear. I made a victory fist, pleased as punch at my accomplishment. Baby was carefully examined and listened to, and was declared to be in excellent health with Apgar scores of 10 and 10.

Someone asked if I was hungry. I said not very. But Yelena announced that she was starving, and Hope said that she was hungry, too. So James set about making French toast and a fruit plate in the kitchen. Soon, Journey took over the kitchen duties.

Once again I was asked if I needed to pee. I reported that I did, and expressed a desire to sit up. Elliot was handed over to James, who sat on the couch holding baby and Audrey. The team helped me very slowly shift to an upright position, and into a robe. I wasn't yet ready to move any further than that. But at that point the fruit plate arrived in the living room, and I discovered that I had a sudden raging hunger. Kiwis, strawberries, oranges, mangoes, melon. They had never tasted so sweet. Everyone oohed and aahed over the fruit plate. I ate and ate. But then my bladder became more insistent about its needs. "My need to pee is outweighing my need to eat!" I reported.

So Journey and Hope helped me hoist myself to a standing position and trudge down the hall to the bathroom. (Yelena was holding Elliot, by that point.) It was a slow and complicated procedure. My sore and tired limbs would move only at a snail's pace. Journey and Hope held pads under me to keep me from bleeding on the floor, and at one point we had to pause so that Journey could wipe blood off of my foot, which was leaving bloody footprints with every step. (Good thing we had hardwood floors.)

But eventually we made it, and I sat down on the toilet. It took a while for me to convince my urine to get moving, but once it did, I was pleasantly surprised. While my toilet at home got just as bloody as the toilet at the hospital had the first time I peed there, this time I didn't experience any pain or stinging at all. So what an improved first peeing experience. Not attached to an IV of pitocin. Helped by Journey and Hope rather than a nurses' aide I'd never seen before. Plus no pain.

I sat on the toilet for quite a while, coaxing more pee out of my reluctant bladder. Journey also helped me clean some blood and meconium off of my thighs and belly. At one point all three of my attendants were gathered at the door of the bathroom chatting. Someone commented on how amazing birth is, and I observed, "All three of you are hooked on it, obviously." Everyone should be so lucky as to have birth attendants as enthusiastic about the awe-inspiring power of the natural birthing process as mine were.

After aiding me in my trip to the bathroom, Hope left for home to get her kids off to a science class. And then I made another report. "My need to eat is outweighing my need to pee!" So I was helped from the toilet to my well padded bed. A baby was placed in my lap. Fruit and French toast were placed on my night stand. And I resumed eating.

Yelena came in to check my uterus. It's position was declared excellent. She asked if we wanted to give the baby eye drops or vitamin K. I said no to the eye drops as I was confident I didn't have any venereal diseases that might cause my child to go blind. But I asked her to check James' wishes on the vitamin K. We'd agreed in advance that we'd do vitamin K, because a deficiency could, under very rare circumstances, cause hemorrhage and death. James initially wanted to do the injection, which gives baby a single megadose of the vitamin, but when Yelena asked, he decided he didn't have the heart to have our new baby poked, so he settled for a more conservative series of oral vitamin K drops. "He's a worrywart, Yelena informed me fondly as she came into the bedroom to administer the first set of drops." Clearly, she was not a big believer in vitamin K supplementation.

Then Yelena declared that it was time for her to go home, too. She gave us directions for umbilical cord care, reminded us what sort of newborn behavior we could expect, and what I should expect of my body. She suggested that I hang out in bed for the day, and she assured us that Hope would be checking in on us the next day, and that she'd be back to check on us in three days. She told us to call with any concerns. And she left after requesting that Journey clean a couple of blood spots off of the couch with hydrogen peroxide.

Journey finished tidying. (Dishes to be washed, bloody clothes and towels to be soaked in cold water. Blood spots to be cleaned off of couches and floors.) She made sure I had a good supply of juice dosed with Afterpain Tincture. She worriedly suggested that we call someone to watch Audrey for a few hours, for while I was reasonably energetic, poor sleep-deprived James looked to be on the verge of collapse. (We ignored her suggestion. Our poor toddler already seemed quite traumatized by her sudden change in circumstances, and we didn't want to traumatize her further by farming her off somewhere. It seemed really important that we stay together as a family. We did pull out our portable DVD player to use as an electronic babysitter, though.)

Then Journey, too, took her leave, and the four members of our family relaxed in our home and got to know one another.

Attendant Assessments: Immediately after the birth, Journey declared me "amazing." When Hope came to check in on us the next day, she commented that her memory of the birth was that I laughed my baby out. And at the three day follow up, Yelena complimented James and me on how beautifully we had worked together.

Mama Assessment: As I pondered the birth afterwards, I had a couple of regrets. I never even tried the tub! I had a home birth, yet pushed baby out on my back! Surely I could have summoned the strength to move into a more sensible birthing position!

But I think those regrets are just about as minor as they come. My prenatal care and birth experience were superior in every way the second time around. I can recommend home birth without reservations.