Sawyer's Birth- The most profound surrender I have ever done

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Birth is the most profound letting go and surrender we can ever do…I said those words to thousands of students over the years, usually I meant a tongue in cheek reference to the fabled pooping in labor fear, but it wasn’t until my son was born that I realized just how true those words could be.

I have been a prenatal yoga teacher and a birth doula for the past 15 years, so I was eagerly looking forward to actually experiencing labor myself. I planned a home birth, using my professional connections to select the exact midwife team and the best support I could have. I even had a nominal statement from one of the few OB’s I trusted for hospital birth that if anything happened I could call her if we transferred…Not that I expected to need it, but just to have all the bases covered.

Labor started at around 3am on November 19th, my birthday and also my due date ironically. Warm-up surges (we were using HypnoBirthing-which I also teach) felt like mild menstrual cramps or possibly gas pains. Worried I was disturbing Ryan’s sleep with my shifting I let him know I was having a lot of practice surges, but to just ignore them. Morning came without much change and we headed out for a birthday brunch with the family. We’d lied about the due date, so no one else knew baby was even expected at this time. They thought I still had 2 weeks. The surges gradually became stronger, so that by the time we finished brunch I had started pretending Baby was hitting my cervix (something which had been happening for months) as a cover for having to stop and breathe for a moment.

Back home we napped and tried watching a movie (Princess Bride of course!) and after a few hours (around 5pm) called our midwife. I think she came over expecting to find only early labor, but instead she suggested we call in our doula since this was definitely the real thing.

I’ll admit as a HypnoBirthing instructor I had hoped that the surges wouldn’t hurt. The course doesn’t actually promise this, but the thought was still there. Maybe I’d feel sensation, pressure, tightening sure, but surely not pain. This began to feel like pain. A sharp, ache in my lower abdomen which never subsided even between surges, and tension which radiated down my hip flexors. All sensation was localized in the front of my abdomen and quads; no sensation in my back. We did all the things I thought one was supposed to do. Leaning over a birth ball. Lunging (I kept trying to stretch out the quads so they’d release- to no avail), swaying, slow dancing, spinning babies positions as best I could, deep breathing and staying calm, visualizing each surge opening a path through my body and fluttering my lips to help release my pelvic floor. The surges definitely kept increasing, and the pain began to fluctuate from a “6” between surges up to a “10” during them. A few hours into this I began throwing up from the intensity of the sensation (this would prove to be a key hurdle, though I didn’t know it at the time). My water released at 10:30pm and sensation definitely intensified as I hoped that this was the transition point in labor and I’d be meeting my baby soon.

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I knew there was a point in Labor when moms turn inward, when they shut out the world and just focus on what is going on in their bodies. I found myself starting to drift in and out of that state, and I honestly did lose track of time. Birth tub, side-lying on the bed (more throwing up). I became aware only of Ryan’s body near mine, and holding his hand. Our doula admitted later that he was so focused on being by my side that he refused to leave to get dressed, so we have some great pictures of him in his underwear as I’m leaning against him, slow dancing through a surge. Sometime in the middle of the night (probably around 12 hrs into active labor) I was aware of my midwife talking me through the surges, impressing on me the importance of staying calm, keeping my breathing steady, and my body as relaxed as much as possible. What I didn’t know at the time was my blood pressure was reading high. I was starting to get dehydrated from the throwing up and not being able to keep down water. Fortunately my blood pressure was very responsive and with deep concentration I was able to bring it back down. I drank more fluids.

At some point we checked and it seemed my cervix was able to slide out of the way, so given my dehydration level and the blood pressure we started pushing to see if we could finish this. While I had intended to do the HypnoBirthing gentle breathing down, in this case the urge to push didn’t feel overwhelming, so I actually started going for the holding breath pushing. Side-lying, back and even on the birth stool by the bed. At one point between surges I reached in and could actually feel something round and smooth about 1 ½ inches inside. The sensation blew my mind, realizing both how close he was, and at the same time how much further he needed to move. Even with the squat position and gravity he didn’t seem to want to drop. A quick exam discovered the cervix was back (or maybe it had never been fully gone?) So back to deep breathing and relaxation. At this point I remember saying to Ryan, when it was just us two in the room that I thought I was done. Really done. He came back with exactly what we’d agreed he’d say, which was that I could do this and was doing it, and that I was so strong. The thought going through my head was that I knew I was strong and could do this, but I didn’t want to anymore. That “wall” they talk about for the marathon runners? Yeah this was it- I had decided I was done and if I couldn’t push then I wanted to be finished.

There is a point in Labor when moms turn inward. I found myself starting to drift in and out of that state, and I honestly did lose track of time.

We shifted to sitting in the bath and I made my attention turn inward. In retrospect I’m so glad I was at home and the transfer hospital was 45 minutes away- with a closer one for actual emergencies- because there is no way I would have tried the tub again and found that I could re-center had I had the option of an epidural readily available. To me it seemed like 20 minutes but apparently I sat in there for 2 ½ hrs. I think I may have actually slept for moments between the surges. I was hoping that when I got out it would be time to push (in fact I told my midwife I didn’t want to get out if I couldn’t push yet) Unfortunately when we checked it still wasn’t time (8cm) and my blood pressure was now reading into dangerously high levels.

There are times you birth at home so you have full control over your environment, and there are times you transfer to take advantage of the interventions available at Hospitals. With my blood pressure running high, and my dehydration getting worse we decided to transfer for IV fluids. That was the real problem for home, I couldn’t keep water down with the nausea. I decided I wanted an epidural, figuring that if this front belly/pubic bone pain disappeared I might just relax and would open the last little bit. To my relief and joy, the doctor who’d graciously agreed I could call her if something actually happened, was actually on and willing to take me, so off we went.

The whole transfer took about an hour mostly because walking was challenging at all, and then sitting down in the car was even more so. Once we arrived, we started IV fluids and within 10 minutes both Ryan and our Midwife (she came with us as our doula) commented that my color and complexion dramatically changed. We checked and my cervix was 8 cm, but baby was facing forward not back (Occiput Posterior). I think my exact response when the doctor said this was “Fuck!” I got the epidural so I could rest while they ran in 2 more bags of fluid, and drew admitting labs. It was these labs coming back which gave us the full picture of what was going on, and began the full process of surrendering to the turns this birth was taking. My kidney function was completely off (levels were 3 times higher than the highest normal). We agreed to start some Pitocin (Ok we did our own stimulation for an hour, and then agreed we’d take a little through the IV as well )

I will say that given where my kidney function was, or rather wasn’t, I credit my OB with giving us as much time as she did using the Pitocin. This was one of the reasons I had been glad to have her as a possible back-up because I knew she didn’t and wouldn’t rush me into a surgical birth without good reason; that I wouldn’t be pressured or forced into something that wasn’t actually necessary. And she gave us several hours, but eventually she did check and I still wasn’t fully opened. After a lot of discussion she recommended a Cesarean Birth.

I went numb for a moment. Thoughts running through my head of how we’d made a mistake coming in, and we should have stayed at home, but as the doctor talked I began to realize that this was an actual special case. His head, facing backwards, had most likely bruised my kidneys early in Labor, and was now blocking the ureters running from the kidneys to my bladder. Thus the entire system was backing up. (As a side note, neither myself, nor my midwives had ever seen this occur-and between the three of us we had over 1000 births to go on) I looked at the doctor’s face and saw the same expression I’d seen her give my clients when something was truly wrong. The face I knew too well meant we had to release and meet this moment as it was. Reluctantly I realized the final letting go would be the vaginal birth I had been dreaming of for years.

But even as I surrendered to this turn, I kept advocating for myself and my baby. I started asking about how to make the birth still be meaningful. I knew my baby boy was completely healthy (thankfully his heartbeat never waivered). I asked about doing gentle cesarean, being able to see him as he came out, having a clear drape rather than opaque, and doing skin to skin in the operating room, and the answer came back Yes to all of them. She would do her best to make this as close to the birth experience I had wanted as far as bonding and connection would be, even delayed cord clamping was an option (no more than a minute though). We talked through all options, and then we had some time to talk with each other. I cried a lot, mourning the loss of the birth I had been planning and expecting, and at the same time doing my best to be fully present. I was about to give birth no matter what, and I wanted to remember every moment.

For those who aren’t familiar with the term, a gentle or “natural” cesarean is one where the pace moves a bit more slowly, and there are certain options available - such as being able to hold the baby post surgery - which otherwise are not offered to Mom. Most C-sections require an opaque drape placed across Moms chest so she can’t see anything going on below, no description of what is being done until the moment she feels the pressure of the baby being removed, the cord is cut immediately and the baby whisked off to the nursery without Mom being able to hold him/her. Even if the Baby isn’t taken away immediately, it is usually only Dad who is able to hold the baby by Mom’s face. No immediate skin to skin or extended time for bonding, and the baby still leaves Mom for nearly an hour to do a trip to the nursery for an examination.

I didn’t have that experience. The anesthesiologist increased my epidural so I truly couldn’t feel anything, and wheeled the bed to the operating room, while Ryan and our Midwife, Kim got dressed in paper coveralls. It wasn’t certain if Kim would be allowed back, but we were hopeful. Ultimately she was allowed in along with Ryan. Under the bright lights of the OR (completely surreal given where my birth had started). I was moved to the operating table, asked to stretch my arms out so they could put on electronic leads to monitor how I was doing. They set up a clear plastic drape so the surgical field was protected, but I could still see where everyone was in the room, and the doctor could see my face. (Note: I couldn’t see anything of the surgery because of the angle. Try lying down flat on your back and try to see your abdomen without lifting your head). The staff brought Ryan and Kim in, and Ryan sat next to my head with Kim behind him. The anesthesiologist was on my left. I was shaking fairly violently from both the labor hormones and the stress hormones coursing through my body. I knew this was normal and would pass, but even still it felt very odd to be chattering as though freezing cold and to not be able to stop it.

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I didn’t know they had started the surgery. I was busy looking at Ryan and coping with the shaking, but at some point the nurse warned me that I would feel lots of pressure (which I knew meant he was about to be born). And yes there was an immense feeling of pressure in my pelvis and then almost just as fast all the weight I had been feeling for the past trimester disappeared. Two seconds later I heard my baby cry and saw the doctor lift him up from my body. She brought him immediately to her side of the clear drape and I saw my baby boy for the first time. One minute later she cut the cord (yes we did delayed cord clamping even in the OR!). After a quick trip to the warmer where Ryan got to cut the cord (or trim it anyway) and they got his weight, my son was placed straight on my chest above the drape. I could barely look at him due the angle, but I could feel his body warm against mine, and hear his cries. “Oh Baby!” I kept repeating over and over. When I began shaking again and couldn't hold him myself for a moment, they helped me hand him to Ryan rather than taking him from the room. Once they had stabilized me, he came back onto my chest. In all we had nearly 45 minutes of skin to skin contact right there in the OR!

I could feel his body warm against mine, and hear his cries. “Oh Baby!” I kept repeating over and over.

And he never left our side after that. Even when he and Ryan went to the recovery room so I could be shifted back to a bed and leave the operating room, I was only 10 minutes behind them, and then we were together again. He never went to the nursery (supposedly required) but they did the newborn check-in right there next to my bed as I cuddled him against me. I got to see his eyes open, and meet my gaze for the first time.

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I was surprised to discover that when done with respect, communication, and love, a cesarean birth can actually be a positive experience even when you didn’t plan for it at all. I still mourn the birth I thought I would have. Having this birth be positive does not remove the pain of losing the other one, but I’m extremely grateful to be able to look at this birth as it did unfold and still be proud of the choices I made and the way I labored. In some ways I feel even more grateful I had planned a home birth, because at least now I can say I did everything I could to give myself the best birth experience possible. And I have no regrets of what I did or how I did it. I have a healthy baby, my body and wishes were respected, and I gave birth in the way I needed to.

5 Benefits of Prenatal Yoga (And Why It’s Not Just for Beginners)

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If you have recently become pregnant or have friends who are expecting, you’ve probably heard a lot of talk about prenatal yoga. Recent studies have pointed to the benefits of practicing gentle yoga before giving birth. And a recent controlled trial showed positive results after only a few sessions.

But if you are a yoga practitioner, you likely already know the benefits yoga offers: reduced stress, increased strength and flexibility, improved mental focus, and an overall sense of well-being (just to name a few). And if you already have an established yoga practice, you might wonder why you should bother with a prenatal class (particularly if you’re used to a more vigorous style of yoga, like power yoga or vinyasa). While many experienced yogini mamas-to-be do continue their regular practices throughout their pregnancies, there are specific benefits to taking a prenatal class—even if you aren’t looking for something more gentle.

1. Prenatal Yoga is Not Necessarily Gentle

Most prenatal classes will be focused toward level one students, including those who have never done yoga before. But this doesn’t mean that a prenatal sequence won’t give your body a workout. Part of the benefit of taking yoga while pregnant is that you get a chance to experience strong physical sensations in a safe place, where you can practice not mentally running from them. While holding a wall squat or a strong hip opener such as ankle-to-knee (agnistambhasana) for the typical length of one contraction, you get the chance to practice being present and to relax through the intensity (rather than tensing). With sufficient time, this can become a different way of looking at sensation so that strong sensations later (like, say, those labor contractions) become less frightening. This will help you minimize tensing against them, allowing your body to relax and open more—and voila, baby! In this way, a prenatal class will work with you, regardless of the level of your practice.

2. Modifications take into account your changing shape and hormones

This may seem obvious, but even a yoga basics class isn’t going to avoid postures that involve lying on your belly or flat on your back, which at some point you can’t do when you’re pregnant. In fact, many beginners’ modifications for more challenging postures involve lying on your back, which doesn’t work if your baby is pressing on the inferior vena cava (the large vein in the back of your pelvis). When this happens, your blood pressure is suddenly lowered—which isn’t good for you or baby, and can make you feel dizzy or nauseous. While not every pregnant woman has difficulty on her back, many do (especially later on). Prenatal yoga classes walk an amazing line in teaching alignment which is appropriate for your body as it changes with your growing baby, so that you can still experience the full range of postures at whatever level you can handle. In a prenatal class you get postures modified specifically for pregnancy—not necessarily to make the poses “easier,” but to make them more safe and accessible for you. It may seem like a small difference, but it’s a significant one. Plus, later in pregnancy your body starts getting ready for birth, and hormones cause your connective tissue to become more lax. This means you’re at a greater risk for overstretching (especially if you’re already flexible to begin with), which can lead to pelvic and joint instability and/or pulled ligaments. Prenatal-specific alignment, then, becomes doubly important!

And no, not every yoga teacher is going to know how to adjust classic poses to protect against too much mobility. Think, for example, of how many times in yoga class you’ve been asked to “square your hips to the side of your mat.” Many teachers simply don’t realize that this is a movement that can cause pubic bone pain if done too much.

3. The Focus is on both of you, not just avoiding injury to the baby

I get it. If you’ve been practicing yoga regularly, you may not want to go to the preggo class while you’re in your first or even second trimester. And to be honest, you may not always need to skip your favorite vinyasa class in favor of a pregnancy-specific practice. But that fast vinyasa class isn’t going to focus on how things inside your body are shifting on a daily basis. This is not to say you shouldn’t practice strong yoga. But you need to do it with an eye to how things feel right now, and adjusting postures almost daily in subtle ways.

And there’s the aspect of prenatal yoga that involves actually talking directly about all those aches and pains that aren’t typically mentioned in regular classes, but are common during pregnancy (like that sciatic pain in the butt, or achy ribs, or the full-on exhaustion we might feel in the first trimester). Prenatal yoga addresses all of that, helping you find ways to work with it in a strengthening and supportive way.

4. Bonus Childbirth Prep

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While it may not be true of every prenatal yoga teacher, if your prenatal teacher is passionate about childbirth prep, it’s a good bet she has received additional training in some aspect of the field. Maybe she’s a birth doula or a childbirth educator, or is acquainted with hypnobirthing. If that’s the case, then your prenatal yoga classes may focus both on yoga (asana, stretching, physical body awareness) and on mental focus and other such techniques for during and after birth. At my studio (Om Births in Watertown, Massachusetts), our teachers discuss how yoga postures can be used during labor, and students take home information from each class to help them work with body and breath for a better birth experience. Those who begin attending class early on are able to gradually reinforce the physical side of their childbirth classes, instead of trying to take in all the information in one eight-hour marathon childbirth class. (I have taught those classes, and my own brain leaks out of my ears by the end, so I can imagine how my students feel.) Prenatal yoga is like getting birth prep in bite-sized portions—if you don’t like one forkful, you don’t have to swallow it. Take what works for you, and begin envisioning your own birth experience on your own terms.

(Please note that prenatal yoga classes are not a substitute for birthing classes!)

5. Lastly, and yes, I’m going to shout this one: YOU GET TO MEET OTHER PREGNANT WOMEN!!!

Wondering how you’re going to find other like-minded mamas with whom to raise your children or discuss things later that are not related to pregnancy and birth? This is your class! Prenatal yoga is a chance to open up and share a common experience with a community of women. My prenatal classes always begin with some time to chat about how we all feel, and to share ideas about what has been working for each of us. It’s a time for developing collective wisdom, but also the start of your mommy network (without all of the judgment that might come from sectors and aspects of the rest of our culture). Looking for doula referrals? Wondering about where the best prenatal massage can be found? Believe me, there is no better resource than the pregnant women in your area. Each year I watch moms form deep, lasting friendships. This is your New Moms group, your kid’s play dates, your mommy sangha (spiritual community). These are the women from whom you’ll get and give hand-me-downs, who will attend your kid’s birthday parties, and who will remind you to get back on your mat and/or meditation cushion when things get tough.

Wondering how you’re going to find other like-minded mamas with whom to raise your children or discuss things later that are not related to pregnancy and birth?

So yes, mamas, you could just take a beginners’ yoga class or stay in your advanced vinyasa class for awhile. But a specifically designed prenatal class has so much more depth and warmth to offer you than just postures that make space for a bigger belly. I personally encourage every expecting mom to find the class that resonates with her. If one doesn’t fit, then look for another one—just as you would with a regular yoga class. When you find the right community, you’ll know it, and you’ll be so happy you did.

Happy Birth Day, and enjoy the journey into motherhood!