BIRTH STORY: A Rewarding Experience

(by Kristen Coblentz, about the birth of Shane Michael Dillon, born 3.24.09)
On March 23rd I woke up because Noelle was saying her window was loud. She got up about 3 times and I kept putting her back in bed. She finally fell back asleep and so I got back into bed. As I got in bed I realized I was having contractions. They weren’t too painful and there was no pattern to them so I just went to sleep.

I got up to get ready for work at about 7:00am, and the contractions were still coming. They were about 19 minutes apart. Derek said that I should call Tami just to let her know and to see what she thought. I dropped Noelle off at day care and then called Tami. I told her what was going on and she said it could be early labor or just Braxton Hicks but to keep an eye on the contractions.

I had kept in touch with Derek and Tami all day through email, letting them know how far apart the contractions were. Tami was with the midwife (Alina) all day so they both knew what was going on. At 4:30pm we were leaving work and a co-worker asked me if I would be in the next day. I said of course I would be. He asked if I was sure and I told him that I would let him know otherwise, but I planned on coming in.

On my way home, the contractions were getting a little stronger but they were still all over the place. I started to think, "If I am in labor I need to do laundry, the baby’s clothes and blankets need washed and we need clean towels!" So I got home and started to do the laundry. By the time Derek got home with Noelle I was just finishing folding it. It was about 7:00pm and the Bright House guy was there to hook up our home phone, and when he was looking at my face he looked a bit nervous. Derek started cooking dinner for us and I was sitting on my birthing ball. The contractions were getting stronger but there was no pattern yet.

We ate dinner, and while Derek was getting Noelle ready for bed I took a shower. The shower didn’t really help. It was about 9:40pm and Derek said, "Maybe we should just go to bed in case you are in labor, that way you get some rest." I agreed. I called Tami and told her I was still having the contractions and they were somewhat stronger but we were going to bed to try to get some rest. She said that was a good idea (she told me later, when she got off the phone she thought I would be having a baby that night).

We laid in bed for about 15 minutes and it was like a bomb went off. All of a sudden the contractions were incredibly strong and they were about 5 to 6 minutes apart. We stayed in bed about an hour to see if they stayed in a pattern, and they did. At 11:00pm I called Tami and she said she was on her way over and I needed to call Alina. I called Alina and she said I was in labor, and it would take her about an hour to get to our house. I then called my grandma and my friend Darlin (my grandma was a support person and Darlin was taking pictures).

Tami arrived first. She watched me for a little bit to time the contractions and then she started to get the birth kit together. My grandma got there second and immediately started to help Derek support me. Darlin came next and started taking pictures right away. Alina came last. She started to help Tami and then monitored the baby’s heartbeat to make sure he was doing okay. All was good.

I was okay in between contractions, but I wasn’t so quiet while having them. I don’t know how Noelle slept through it all, but she didn’t wake up the whole time. Derek went and filled our tub up and Tami made sure the temperature was okay. I am not too sure of the time I actually got in the tub, but after a while of having contractions I just wanted to be in there.

I got in the tub and after a few contractions I was able to just breathe through them. Alina then checked to see how far I was, 7 cm. I felt so relaxed and comfortable in the tub I ended up falling asleep with my head on the side of the tub in between them.After a little while I wasn’t able to just breathe through the contractions; they were to the peak and I knew I had to push. I was so much more aware of what was happening with my body, I knew I had to take my time pushing because I didn’t want to tear. I pushed for a little while, trying not to push too hard (I was screaming at this point). I finally felt his head come out. I could hear my grandma saying “Kristen his head is out!” (she was so excited). I pushed a little bit more and his shoulders and body came out. Tami caught him and broke the bag of water off of him--my water had never broken--and put him right on my chest.
He never cried, he just looked up at me with his tongue out. He was so beautiful. Tami got a baby hat and put it on his head to keep his head warm (that’s when he started crying) and then a receiving blanket on his body with the warm water from the tub. After a little while I gave him to Derek because I had to deliver the placenta. I then got cleaned up and got into bed next to Derek and Shane. Alina checked Shane out and then me to make sure we were both okay, and then we went to sleep.

This was such a rewarding experience. I would never want to give birth any other way than this.

Heads Up on Infant Mortality

September is Infant Mortality month, and Orlando Midwife Jennie Joseph is leading an international campaign to raise awareness of this important issue. Did you know that 1,687 babies died before age one in 2007 in the state of Florida alone? The 2009 Campaign for Healthier Babies is drawing attention to infant mortality by knitting one baby hat for every baby who didn't reach their first birthday, in what Jennie calls the 'Heads Up on Infant Mortality' program.

"Too many babies are being born too soon, too small, or too sick to survive," said Jennie Joseph, CPM, Executive Director of Commonsense Childbirth. Please join Jennie in her endeavor to promote early prenatal care and save the lives of our children!

How you can help:

- knit or crochet one or more baby hats
- teach someone how to knit or crochet a baby hat
- donate to the campaign
- encourage all pregnant women to start prenatal care right away - we can help, no one is turned away

The hats will be displayed at a rally in September (date & time TBA). You can help by knitting or crocheting one or more infant hats and bringing or mailing your hat(s) to:

The Birth Place
1130 E. Plant Street
Winter Garden, FL 34787
Call: (407) 656-6938
Email: Elena@TheBirthPlace.org

In Sarasota, you can save shipping costs by bringing your hats to Birthways Family Birth Center by September 1st, and midwives Christina Holmes and Sabrina Zehr will mail them for you!

Sarasota Healthy Start Celebrates World Breastfeeding Week 2009

The following is reproduced from the 08.17.09 Healthy Start press release:

Emergencies can happen anywhere. In Southwest Florida, we know all about hurricanes, tornadoes, and fires. Whatever the emergency, breastfeeding is a lifeline and a shield that protects infants.

During emergencies and catastrophes, infants and young children are especially vulnerable to malnutrition, illness, and death. The American Academy of Pediatrics’ breastfeeding recommendation—early initiation and exclusive breastfeeding until six months of age and continued breastfeeding for at least one year—is even more critical in emergencies.

Breastfeeding is the one safe and secure source of food and fluid for infants: it is instantly available, clean and ready, and it protects infants against illness, particularly by eliminating the need to mix formula with water that may be contaminated with fecal bacteria or other hazardous substances. For mothers who deliver their baby during an emergency, immediate breastfeeding can reduce the risk of post-partum hemorrhage after the birth.

As part of this year’s World Breastfeeding Week activities in August, the Healthy Start Coalition of Sarasota County, Inc., conducted its Annual Door Decorating Contest for local health care providers and others to promote and support breastfeeding in a public display. This year’s theme was “Breastfeeding: A Vital Emergency Response.”

The 2009 winners were:

* Sarasota County Health Department, Children’s Health Center – Best Pediatric Display
* Comprehensive Childcare Associates – Most Creative
* First Step of Sarasota, Mothers and Infants Program – Most Beautiful
* Sarasota County Health Department, Women’s Health Services – Best Obstetric Display
* Sarasota Memorial Healthcare System, Lactation Services – Best Educational Display
* Sarasota County Health Department, Women, Infant and Children Nutrition Program (WIC) – Best Use of Theme

If you need more information about breastfeeding, please call the Healthy Start Coalition office at 941-373-7070 to request a list of Breastfeeding Resources in Sarasota County.

About the Healthy Start Coalition of Sarasota County, Inc.: The Healthy Start Coalition of Sarasota County, Inc. is a not-for-profit 501(c)(3) organization whose mission is to improve the health and well-being of pregnant women, infants and young children. For more information, contact Jennifer Highland, Executive Director of the Healthy Start Coalition of Sarasota County, at 941-373-7070.

Reducing C-Sections: Incentives and Precedents

The Washington State Legislature has just passed what I hope will be a landmark measure to reduce their state's cesarean section rate. Beginning this month, Medicaid will reimburse Washington hospitals the same amount for uncomplicated c-sections as for complicated vaginal births. Just as in Florida, about half of all births in Washington are paid by Medicaid. The impetus of this measure is to effectively remove the financial incentive to perform a c-section. The theory is that this will impact the economics of birth so drastically that there will be a directly correlated reduction in c-section rates.

Should Washington set a precedent for tremendous cost savings through a return to normal birth, I would certainly expect Florida to follow suit, and will be urging our representatives to take a close look at this initiative in the coming months.

Sarasota can reduce our c-section rates effectively, quickly, and without compromising outcomes. It has been done in hospitals elsewhere with dramatic results.

In January 1996, The 'First Births Project' began at the Children's and Women's Health Centre in Vancouver, British Columbia, as part of the hospital's Continuous Quality Improvement Program. The project's objective was to lower the c-section rate by 25% within six months of implementation, without sacrificing outcomes to mother or baby. To begin the project, the staff of the hospital agreed upon four factors that contributed to high c-section rates:

1: Early admittance to hospital (defined as prior to 4 cms dilation);
2: Fetal surveillance by electronic fetal monitoring (continuous electronic fetal monitoring has been proven to increase the cesarean rate with no improvement to the health of the baby);
3: Early use of epidurals (women who get an epidural before 8 cms dilation are at increased risk of surgery);
4: Inappropriate induction (inducing birth before 41 weeks gestational age with no medical indication).

Task forces were created in each area to use the best evidence and existing guidelines, as well as solutions from other hospitals to improve care at the British Columbia hospital. Guidelines and other strategies in all four target areas were implemented in the spring of 1997.

The results, published here, show that the cesarean section rate was reduced by 21%. The number of epidurals initiated before active labor was 64% lower, continuous fetal monitoring was used 14% less, the induction rate had dropped 22%, and admission at 'early' cervical dilation had dropped 21%. 'All changes were statistically significant. Newborn outcomes were unchanged post implementation.'

Other cases which I've sited on this blog show results of emergency c-section rates and NICU admissions being literally cut in half in a matter of months. The common thread in all of these initiatives is will, leadership, and commitment of the entire obstetric community.

Hospital Board Presentation on Access Sarasota

The five minute presentation I shared with the Sarasota Public Hospital Board urging their evaluation of Sarasota Memorial Hospital's cesarean section rates will be aired on Access Sarasota this week. Show times are as follows:

• Tuesday, August 4th: 10:00am - 11:45am
• Wednesday, August 5th: 4:15pm - 6:30pm
• Sunday, August 9th: 3:00pm - 4:45pm

The presentation came during the public commentary section of the meeting and will air approximately an hour and fifteen minutes into the program. If you happen to catch it, please comment on this post with feedback. Improving this health crisis takes the involvement of a community willing to work together on many different levels.

Sarasota to Host Maternal Health Care Panel

Sarasota, FL (July 31, 2009) -- On November 1, 2009, Sarasota will host a discussion entitled 'Maternal Health Care in the 21st Century: Sarasota and Beyond.' The program will feature a distinguished panel of internationally recognized speakers. The Sarasota-Manatee Chapter of the National Organization for Women (NOW) is sponsoring the event, along with co-sponsors Florida Friends of Midwives and the Sarasota Commission on the Status of Women. The discussion will take place at the Hyatt Regency Sarasota. The public is welcome to attend at no cost.

The panelists for this discussion are:
--Dr. Washington Hill, MD, FACOG, Labor and Delivery Medical Director and Maternal-Fetal Medicine Director at Sarasota Memorial Hospital;
--Ina May Gaskin, MA, CPM, Founder and Director of The Farm Midwifery Center;
--Jennifer Highland, MPH, Executive Director of the Healthy Start Coalition of Sarasota County; and
--Rep. Keith Fitzgerald, PhD, Florida House of Representatives, District 69.

The discussion will be moderated by Kelly Kirschner, Sarasota City Commissioner and Vice Mayor, and will last approximately an hour and a half. Time will be allotted for audience questions and answers as well as refreshments following the program.

This panel will review current trends in maternity care in Sarasota within the context of the U.S. and the world and target paths to improving maternity care locally and nationwide. Topics for discussion include:

* maternal mortality,
* obstetric intervention rates and risks,
* legislation,
* legal reform and malpractice concerns,
* community education and awareness,
* the midwifery model of care,
* informed consent and refusal,
* the availability of prenatal and postpartum care (including education, counseling, and doulas), and
* the upcoming expansion of Sarasota Memorial Hospital to include new labor and delivery rooms.

Hosting a panel discussion about maternal health care issues was the brainchild of Sonia Pressman Fuentes, co-founder of the National Organization for Women (NOW). “After spending a lifetime improving the legal status of women and fighting gender discrimination in the US and the world, it is exciting for me to be involved in a field new to me, that of improving maternal health care options for women in Sarasota, the US, and the world,” says Fuentes. Joining her in planning the event is Laura Gilkey, local childbirth advocate and board member of Florida Friends of Midwives. "With a panel representative of obstetrics, midwifery, legislature, and public health, perhaps Sarasota can begin a conversation that will pave the way toward becoming a national model of community healthcare reform through improved maternity care," says Gilkey.

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About the National Organization for Women (NOW): The National Organization for Women (NOW) is the largest organization of feminist activists in the United States. NOW has 500,000 contributing members and 550 chapters in all 50 states and the District of Columbia. Since its founding in 1966, NOW's goal has been to take action to bring about equality for all women. NOW works to eliminate discrimination and harassment in the workplace, schools, the justice system, and all other sectors of society; secure reproductive rights for all women; end all forms of violence against women; eradicate racism, sexism and homophobia; and promote equality and justice in our society. The Sarasota-Manatee Chapter of NOW meets on the third Thursday of each month at the Selby Public Library. For more information on the Sarasota-Manatee chapter of NOW, please visit http://www.sarasotamanateenow.org.

About Florida Friends of Midwives (FFOM): Florida Friends of Midwives (FFOM) is a non-profit grassroots organization dedicated to promoting the Midwives Model of Care and supporting the practice of midwifery in Florida. Florida Friends of Midwives was formed to support midwives who offer safe, cost-effective, evidence based care to Florida's Families. FFOM members are consumers and birth advocates with a common goal: to preserve the legal protection afforded to Florida's midwives and birth centers. They are committed to organizing the community to support midwives and to assure the continued availability of midwifery care in the State of Florida. For more information, please visit http://www.flmidwifery.org.

About the Sarasota Commission on the Status of Women (SCSW): The Sarasota Commission on the Status of Women (SCSW) was established in 1987 and became an independent nonprofit organization in 2007 to empower Sarasota County's women through education, research and advocacy. Their overview is Women and Violence and they work through committees on Domestic Violence, Women and Housing, Women and Homelessness, Sexual Content in the Media, Human Trafficking, Women and Politics. Their focus is local and they encourage the enhancement of the status of Sarasota's women through public policy changes by local, state, and national governmental entities by partnering with other organizations with similar goals. For more information, please visit http://cswsarasota.googlepages.com.

ABOUT THE PANELISTS:

Dr. Washington Hill, M.D., FACOG
Labor and Delivery Medical Director / Maternal-Fetal Medicine Director, Sarasota Memorial Hospital
B.A., Rutgers University, College of South Jersey, Camden, New Jersey, 1961
M.D., Temple University School of Medicine, 1965
Obstetrics and Gynecology Residency, William Beaumont General Hospital, 1970
Post Graduate, Maternal-Fetal Medicine Fellowship, University of California, San Francisco, 1984
Board Certification, American Board of Obstetrics and Gynecology with Special Competence in Maternal-Fetal Medicine, 1989 with Recertification 1978, 1993 and 1998

Dr. Hill is the Past President of the Medical Staff and Chairman of the Department of Obstetrics and Gynecology at Sarasota Memorial Hospital, Sarasota, Florida. He is currently Director of Maternal-Fetal Medicine. He is also Clinical Professor Department of Obstetrics and Gynecology at University South Florida College of Medicine, Tampa, Florida and Clinical Professor Department of Clinical Sciences OB/GYN Clerkship Director-Sarasota Campus Florida State University College of Medicine, Tallahassee, Florida. Following completion of his fellowship in Maternal-Fetal Medicine, he has practiced this subspecialty for over 20 years first at the Sutter Perinatal Center and the University of California-Davis School of Medicine, Sacramento, California; and then at Creighton University, School of Medicine, Omaha, Nebraska; Meharry Medical College; and Vanderbilt University School of Medicine, Nashville, Tennessee. He served as Chairman of the Department of Obstetrics and Gynecology at Meharry Medical College, School of Medicine, until 1992, when he took his current position as Director of Maternal-Fetal Medicine and the Perinatal Center of Sarasota Memorial Hospital in Sarasota, Florida. Dr. Hill is the author of at least 60 articles in refereed journals and the book Ambulatory Obstetrics.

Ina May Gaskin, M.A., C.P.M.
Founder / Director, The Farm Midwifery Center
State University of Iowa, Iowa City, Iowa, B.A., English, Summa cum laude, Highest honors
Northern Illinois University, DeKalb, Illinois, M.A., English
North American Registry of Midwives
Certified Professional Midwife
Tennessee Licensed Certified Professional Midwife

Ina May Gaskin, MA, CPM, is founder and director of the Farm Midwifery Center, located near Summertown, Tennessee. Founded in 1971, by 1996, the Farm Midwifery Center had handled more than 2200 births, with remarkably good outcomes. Ms. Gaskin herself has attended more than 1200 births. She is author of Spiritual Midwifery, now in its fourth edition. For twenty-two years she published Birth Gazette, a quarterly covering health care, childbirth and midwifery issues. Her most recent book, Ina May’s Guide to Childbirth was released in 2003. She was President of Midwives' Alliance of North America from 1996 to 2002. The Gaskin maneuver, a low-interventive effective method for dealing with shoulder dystocia, is the first obstetrical procedure to be named for a midwife. Ms. Gaskin’s center is noted for its low rates of intervention, morbidity and mortality. Ms. Gaskin is the originator and coordinator of The Safe Motherhood Quilt Project, a national effort developed to draw public attention to the current U.S. maternal death rates. Her newest book, Ina May's Guide to Breastfeeding, will be released October 1st, 2009.

Jennifer Highland, M.P.H.
Executive Director, Healthy Start Coalition of Sarasota County
University of South Florida, M.P.H. Public Health, 1995

Jennifer’s passion for helping mothers and infants began with the birth of her children. Jennifer's early career was in Louisiana, Georgia and Texas, where she served as a registered nurse. After she moved to Florida and became a mother, Jennifer volunteered for the Breastfeeding Advocates of Sarasota County and completed her Master of Public Health Degree from USF, graduating in 1995. Jennifer was the Project Coordinator for the first and on-going national breastfeeding promotion campaign, “Loving Support Makes Breastfeeding Work,” through her employment with Best Start, Inc., in Tampa. She then became trained as a Childbirth Educator and taught at Sarasota Memorial Hospital. Her work at The Healthy Start Coalition of Sarasota County began in 2001 as the Contract/Quality Manager. Her role expanded to include professional education. In 2006 she became the Executive Director.

Rep. Keith Fitzgerald, Ph.D.
Florida House of Representatives, District 69
University of Louisville, B.A., 1979
Indiana University, Ph.D., 1987

Representative Keith Fitzgerald was elected to represent State House District 69 in 2006, and re-elected in 2008. His district includes the northern part of Sarasota County and a small portion of Manatee County. Representative Fitzgerald has lived in Sarasota and taught political science at New College of Florida since 1994. He and his wife, Angela Baker, have nine-year-old twins. Representative Fitzgerald serves as the Democratic Ranking Member on the Policy Council and as a member of the Finance and Tax Council, Health and Family Services Policy Council, Select Policy Council on Strategic & Economic Planning and the Military and Local Affairs Policy Committee. Representative Fitzgerald also serves as Policy Chair for the House Democratic Caucus. His prior leadership positions include service on the Advisory Council of Faculty Senates, the Board of Trustees at New College of Florida and the Sarasota City Charter Review Board.

MODERATOR: Kelly Kirschner
Sarasota City Commission (District 3 Commissioner / Vice Mayor)
B.S. Foreign Service, Georgetown University
M.A. Latin American Studies, Georgetown University

Kelly is a lifelong Sarasotan. He has served the Sarasota community as President of the Alta Vista Neighborhood Association as well as having been an active member of the Coalition of City Neighborhood Associations. Believing strongly in public service, Kelly has worked for the White House Office of Public Liaison; served as a Peace Corps Volunteer; and led a USAID community conservation project in rural Guatemala. Kelly lives with his wife, Tracy, son, Bodhi, and daughter, Selby, in District 3.

EVENT SPONSOR: Sonia Pressman Fuentes
The Sarasota-Manatee Chapter, National Organization for Women (NOW)
B.A. Cornell University 1950
J.D. University of Miami School of Law 1957

Sonia Pressman Fuentes, who was born in Berlin, Germany, came to the U.S. with her immediate family in 1934 to escape the Holocaust. She was an attorney for the U.S. Department of Justice, the National Labor Relations Board, the Equal Employment Opportunity Commission (EEOC) (where she was the first woman attorney in its Office of the General Counsel), and the U.S. Department of Housing & Urban Development in Washington, D.C. and elsewhere. She was a co-founder of NOW, WEAL (the Women’s Equity Action League), and FEW (Federally Employed Women) and a charter member of VFA (Veteran Feminists of America). She was the longest-serving board member in the history of NWP (National Woman’s Party). In 1993, she retired from the federal government, thereafter wrote her memoir, Eat First—You Don’t Know What They’ll Give You, The Adventures of an Immigrant Family and Their Feminist Daughter, and embarked on new careers as a writer and public speaker. For further information, please visit her website at http://www.erraticimpact.com/fuentes.

EVENT COORDINATOR: Laura H. Gilkey
Florida Friends of Midwives (FFOM)
B.L.A. Landscape Architecture, University of Florida, 2000

Laura Gilkey serves on the Board of Directors for Florida Friends of Midwives, and is the Florida Coordinating Ambassador for The Birth Survey: The Transparency in Maternity Care Project. Laura is an endorser of The Mother-Friendly Childbirth Initiative and a member of the Coalition for Improving Maternity Care Services. She is a project coordinator and quilter for Ina May Gaskin's Safe Motherhood Quilt Project, intended to raise awareness about American maternal mortality. Laura has recently joined the Planning and Evaluation Committee for the Healthy Start Coalition of Sarasota County, whose mission is to improve the health and well-being of Sarasota's pregnant women, infants, and small children. Professionally, she is the marketing manager for Michael A. Gilkey, Inc., landscape architecture studio, and is the owner of Kangaroo Promotions, Inc., a creative marketing firm in Sarasota. For more information, please visit her website at http://borninsarasota.blogspot.com.

BIRTH STORY: Worth Every Second

(by Lizz Pugh, about the birth of Haven Lea, born 12.24.07)

After a scary post-Thanksgiving hospital visit I decided to look into having a homebirth. I was 37 weeks pregnant when I interviewed Christina Holmes, LM. She had such a calming presence and charming personality that I decided to ask her to be my midwife.

My due date fell on a Sunday. Friday night everything happened very quickly. Contractions came very close together. I called both Christina and my best friend Allison. My cervix was dilating, I had "bloody show"; this was it!

Or not.

My labor started petering out and by five in the morning had completely subsided. I was horribly disappointed. We had tried for almost three years before I was able to conceive. I had hated being pregnant. It was time to hold my precious baby girl! Now!

Allison and Christina headed home and I got some much needed sleep. I was very thankful that I had chosen a midwife. It is likely I would have been persuaded to take medicine to progress my labor.

Saturday and then Sunday (my due date) passed slowly.

The clock was just past midnight on Christmas Eve (Monday) when the worst pain of my life started. It was such a contrast to the earlier labor that I couldn't even breath. I screamed. It was so bad that I threw up several times. My husband called Christina and Allison. I was panicking. I head read that women often vomit during transition and I was convinced that the baby would come before my helpers could get here. Turns out that transition would be hours and hours away.

Christina came and helped me labor. The only thing that got me through each contraction was looking at pictures of babies. As long as I could focus on the fact that I'd be holding a baby in my arms--my baby--by "this time tomorrow" I could breath and get through it. I had a brief period of time when I was convinced that I couldn't do it. I wanted to go to the hospital. Christina and Jay talked me through it and I got through it. Breathing more openly helped and made things tolerable. I didn't use any of the breathing I had learned through the SMH classes. I also didn't want to be touched or held. I had Jay's hand in mind and focused on the baby and my breathing.

My hubby went ahead and filled up the pool in our living room. I wasn't allowed into it for a long time. It felt like forever, but was probably a half hour or so. I didn't want a water birth but purchased the supplies just in case I changed my mind. I am so glad I did! I'm also very glad I decided not to have my hubby in the pool with me. While I prepared for the pool I felt a wonderful pressure and knew that my water was going to break. I didn't expect to feel it before it happened. It gave me strength because I knew that no matter what she was going to be born that day. Labor wasn't going to peter out again.

I laid in the pool and stared at the outfit I knew my daughter would wear the next day. It was a green pj outfit with "Elf In Training" embroidered on the front. It was a gift from Allison when she came over for the first labor session. She hadn't called us back or shown up. We figured they had gone to bed and didn't hear the phone. The outfit was more effective than pictures of other babies.

Allison walked in the door just over seven in the morning, minutes after I started pushing. She was such a life saver. My back hurt after every push and Jay just couldn't find the right place to support. Allison had had back labor and knew exactly where to press. Pushing was horrible. I had to push; there was no choice. But man, it felt awful. I got through it, knowing that each push would bring her closer to coming out. Feeling her head really helped as well. Finally, after what felt like a million pushes, she crowned.

If pushing was horrible then crowning was hell on earth. I tore in three places. Minor tears. I can't imagine what some women go through with major tears. It was the worst pain I've ever experienced in my life. "Ring of fire" is an accurate description of what it felt like. I was terrified that my more sensitive parts were going to be torn apart and I'd never find pleasure in sex again. (Thankfully that was not the case!) Eventually the primal part of me took over and pushed through it. I pushed through the fear. I pushed through the pain. It was time for my baby to come out.

We had discussed my birth quite a few times and had decided that Jay would catch our daughter and welcome her into the world. She was placed almost immediately on my chest and I was lost in love. I know that most books tell mothers not to feel bad if they don't feel love at first sight. I was prepared to take a few days to get to know her. I didn't need it. I was head-over-heels in love with her from the moment I held her in my arms. The picture I'm sending with this shows my husband behind me. I didn't know he was there. I was completely unaware of anything but my amazing little bundle of joy.
I was moved into the bedroom and settled on the bed. I waited as long as I could to cut the cord. I had decided that I liked the symbolism of cutting the cord myself rather than having my husband do it. I wanted to welcome her into the world and acknowledge that she is an individual. Having the father cut the cord made it feel more like he was coming between us. It was so much thicker than I had expected.

I delivered the placenta and tried to breastfeed. At some point Haven was taken out of my arms to be weighed and have her hair washed and I had a chance to rest. One of the birth assistants let me look at my placenta. It was one of my favorite moments. It had a strong tree of life. I thanked it for taking such good care of my daughter and for helping her grow so big and strong.

Christina and her helpers stayed for a long while. I was surprised that they drained and sanitized the birthing pool and then scrubbed my bathtub. They cleaned up any blood spots off the floor. They made sure someone fed me and brought me lots of liquids.

I'm very glad I made the choice to birth at home. I felt empowered and surrounded by love and support. I never had to deal with a stranger coming in or being treated as a number. I didn't have to worry about doing things on anyone else's schedule but my daughter's. And while it was the hardest and most painful thing I've ever experienced, I did get through it. And seeing how active and alert my daughter was made it completely worth it. If I had to do it again I'd choose home birth. No questions.