Sleeping beauty

Cara Nicole Frantz

Cara's due date was June 27th. It came and went with no Cara. We had planned a midwife attended homebirth and our midwife, Audrey Treppiccione, performed an internal exam a few days later and found that the baby--named "Muffin" while still in utero--was at +1 station and that Missy's cervix was 25% effaced and 2 centimeters dilated. She seemed on the cusp of going into labor.

Missy's mother, Joyce Leslie, made the 13 hour drive from her home in Michigan to ours in North Carolina to be with us shortly after the birth but now she would be here for the birth...or so we thought. She stayed with us for ten days taking care of us and our house (laying mulch, gardening, mowing the lawn, vacuuming the house three times, cleaning toilets, scrubbing floors, doing laundry, sewing quilts, cooking meals, cleaning the kitchen, doing some plumbing, running errands, etc.). We took gentle measures to invite labor to start; drinking raspberry tea, taking the herbs blue and black cohosh, nipple stimulation, sexual intimacy, walking, soaking, massages, then finally and most dramatically stripping the membranes between the uterus and the amniotic sac. An internal exam at this point indicated Muffin had backed up to -1 station while Missy's cervix was 75% effaced and 2 cm dilated stretchable to 4 cm.

For days Missy was having contractions while walking (some as close as five minutes apart) but generally they were not strong or regular and they stopped when she was sitting or lying down. We were reluctant to take the next labor inducing step and do an amniotomy (rupturing the amniotic sac or breaking Missy's waters). That was a large gamble since if labor did not start within 48 hours, we would give up our hopes for a homebirth. On Friday, July 11th, 14 days beyond Muffin's due date, we asked Audrey to perform another internal exam. Muffin was back to +1 station and Missy's cervix was 95% effaced and 4 cm dilated stretchable to 5 cm. It looked as if when labor started, it could go very quickly since so much progress had already been made.

On Saturday, July 12th, it seemed that Missy would go into labor. In the morning, her system purged itself as if preparing for birthing. During the day Missy slept and rested, garnering her strength in anticipation. When it looked as if labor was not imminent, Curt stepped out for a little over an hour to officiate at the wedding of two friends, Tuan Nguyen and Phuong Nguyen. He returned immediately following the ceremony, just after Missy's mom left. Joyce stayed with us as long as she could--she returned home to prepare for another trip, to celebrate her 50th high school class reunion in Iowa. Seven hours after she left our home to return to Michigan, 16 days after Muffin's due date, the first phase of birthing would start.

At 1:00AM on Sunday July 13th, Missy thought there might be a pattern to her contractions (which she was having while lying down and which were strong enough to awaken her) and decided to wake Curt and asked him to time the contractions. They were 10 minutes apart. A few hours later, they had closed to 5 minutes. Curt was sleeping through many of them.
      Missy: "How long since the last contraction?"
      Curt (groggily): "15 minutes."
      Missy: "Did you get the two others."
      Curt: "Oh, 5 minutes."
At 4:00AM we called our doula Sonya Pailes. [The word, "doula," comes from the Greek word for the most important female slave or servant in an ancient Greek household, the woman who probably helped the lady of the house through her childbearing. The word has come to refer to "a woman experienced in childbirth who provides continuous physical, emotional, and informational support to the mother before, during and just after childbirth." (Klaus, Kennell and Klaus, Mothering the Mother)]

Sonya suggested we call our midwife Audrey and let her know what was happening. Based on Missy's contractions, Audrey indicated she and Sonya would be leaving for our house shortly.

By 5:00AM Missy's contractions were collapsing on each other. She was standing during them, leaning on a dresser, Curt stroking her back and legs. We woke our 10 year old son Eric from a deep sleep and his excitement brought him quickly to full consciousness. Eric had attended Bradley birthing classes with us and now he was putting some of what he learned into practice, helping Missy relax through contractions by stroking, massaging, and encouraging her.

Having contractions on top of each other was difficult for Missy; she decided to enter the birthing tub which we had emptied then filled with fresh water after labor started. The birthing tub is 5 feet in diameter and some 30 inches deep enabling a laboring woman to fully immerse her body in water. The water helps relax a woman through contractions allowing them to be more effective. It also makes her skin more pliable for birthing and its buoyancy lightens her load.

At 5:20AM, Curt called a family friend, Cindi Freeman--who had homebirthed her second daughter and who would be Eric's advocate and caregiver (as needed) during the birthing--to tell her Missy was in heavy labor. Cindi arrived 20 minutes after the call along with Audrey and Sonya. Between them these women have attended hundreds of births and have personally birthed fifteen babies--most of them homebirths. The full birth party was in place.

The Beaming Birth Team After The Fact Sonya Pailes, Eric, Missy holding Cara, Audrey Treppiccione holding her youngest daughter Judea, and Cindi Freeman posing by the plum tree planted for Cara. Curt took the photo two hours after Cara was born.

Labor's first phase was perfect. Missy was in her bedroom, with low lights and soft music playing, attended by her son and husband and three experienced, loving, supportive, encouraging friends. Cindi would later write of this time, "Missy is GLOWING! A floating Queen who is extremely focussed, peaceful, and ready. I am so proud of her tears come to my eyes." Independent of Cindi's comments, Missy later said she felt like a queen with everyone listening to and helping her meet her wants and needs. She felt her power. What she requested was immediately given her: "Don't touch my stomach," "hold me like that again," "press on my knees," "water please."

Eric was bringing Missy cold water to drink and frozen grapes in case she wanted to snack. Curt was massaging her forehead, shoulders and back. The three wise women waited and watched, honoring the process as it unfolded. They offered inspiring words of encouragement, they gently helped with a touch, or a suggestion for a position, relaxation technique, or way for Curt or Eric to touch or hold Missy. They were in the background flowing support and energy that raised and strengthened Missy. They also took pictures and video, offloading that responsibility from Curt.

The atmosphere was relaxed, calming, loving and empowering. Missy was occasionally moved to laughter in the midst of her laboring. Some insights and comments were humorous, one from Curt went over the line. Complimented by Cindi for the good support he was providing Missy, he cracked, "Yeah, I'm doing all the work here." The room got quiet and the women exchanged sideways looks at each other. Leave it to Curt to create a pregnant moment on a pregnant moment.

Quiet time between contractions...

...and the hard work of birthing.

As the labor progressed, Curt and Eric entered the birthing tub with Missy to give her even more support; Curt holding and caressing her from behind and Eric using massage and acupressure points to help Missy relax through contractions. After two hours in the tub, Audrey suggested Missy step out and see how the contractions were out of the water. The contractions immediately collapsed back on each other. After three contractions, we went back in the tub. The contractions spaced again...but not for long.

The family focussing: Missy assumes a kneeling position.

At about 7:00AM, Curt asked if the first internal check could be done. Midwives in general tend to minimize performing internal exams as they are an invasion of a woman's most private space at a most delicate time. On Missy's request, Audrey measured the opening of her cervix at 8.5 cm. By 7:20AM, the contractions, even in the tub, were back to back. Audrey suggested the urge to push may come soon. Twenty minutes later, Missy left the tub for a bathroom break. When she re-entered the water, she had the urge to push. We followed her lead and supported her in sometimes squatting and sometimes sitting back positions. Eric donned the goggles he had placed nearby and dove underwater to have a closer look at labor's progression. The women in attendance, homeschoolers in heart if not in practice, proclaimed this was the ultimate homeschooling experience.

Though she had not eaten in ten hours, Missy threw up, which Sonya self-protectively caught in a bowl. Audrey indicated that was a sign the baby was passing through the cervix.

The second phase of labor, the pushing phase was barely thirty minutes long but very intense. Early on, Audrey made a comment that Missy found to be a source of strength throughout this phase. She said, "Just think, soon you'll be able to lay around all day and nurse your baby." Missy focussed all her incredible strength and energy into powerful pushes. The atmosphere electrified. Her voice, quiet, confident and determined throughout the first phase of labor, rose in volume and pitch. After several pushes, it began to lose its sense of confidence and became somewhat frantic: "What's happening? What's going on?" Audrey was now in position to help Eric catch Muffin. Her calming voice temporarily quieted Missy, "Everything is fine. Keep doing what you're doing." The confidence in Missy's voice returned for a few pushes, then: "I'm losing it. I'm losing control!" Audrey got Missy's attention then assertively and lovingly told her, "You are not in control. This baby is in control. This baby is being born."

A couple of pushes later, only a dozen or so pushes and thirty minutes into labor's second stage--Cara's head began to emerge. Eric, giddy and positioned for the catch squealed, "Everything's going perfect. I see her head! She's almost here! She's almost here!" He asked Audrey where the baby's face was and Audrey calmly stated that she was facing down but her face was not yet out. Missy was still struggling and somewhat frantic. Sonya leaned in and stroked Missy's arm, "Let your baby move down. You can feel her." Missy placed her hands on Cara's head, then slid them to her perineum. Audrey encouraged her, "I like what you're doing with your hands."

"Aaarrrrggghh!" Missy groaned, "Is she moving? I think she's stuck! She's not going anywhere!" Audrey went on heightened alert, looking for signs of distress in the baby while keeping her voice calm and encouraging: "Her head is almost out." Then it was. Sonya noticed the liquid expelled from Muffin's mouth was clear, no meconium (the tarlike substance unborn babies have in their lower intestinal track). Audrey saw the tub water was turning dark, indicating the amniotic sac had ruptured and that it contained meconium. Its presence was a sign of baby distress. Cara might have been stuck and the pushes to get her out had been stressing her. Between pushes Missy cried out, "Who's moving her?" Audrey replied, "No one is touching her, she's moving herself."

As the next urge to push rose, Audrey commanded in a firm voice, "Push Missy!" Again Missy bore down, groaned, then cried, "What's going on?" Audrey calmly replied, "Her shoulders."

Missy pushed again and Cara Nicole Frantz was born at 8:10AM while Maurice Ravel's Bolero played softly. Missy reached down to bring the baby up to her chest from Eric and Audrey then she called out with a hint of terror in her voice, "Her cord broke!" Audrey immediately pinched the cord stub closed and asked Sonya for a clamp--"quick, quick"--which she used to stop the bleeding. "Light please", Sonya found the switch and lit the room. Eric leaned in and announced, "It's a sister!" Audrey monitored Cara's vital signs while Missy, moving back from fear to overflowing with joy, held her. Curt, still behind and being a chair for Missy, pleaded, "Let's hear some crying. We need a cry. Cry Cara. Come on and cry baby." Cara was quiet. Pale from losing blood. Not obviously breathing. She lost her oxygen pipeline before her lungs had a chance to assume that responsibility. Audrey suctioned her nose and mouth then Cara made a soft cry and we all exhaled.

Audrey, who had respected Missy's need to hold her baby immediately after birthing and who had found a strong heartbeat, reached out and asked in a calming voice to Missy, "May I have the baby for a moment?" Missy handed over Cara, who was now making little crying noises and gasping. Audrey laid Cara beneath us beside the tub and rubbed and oxygenated her with a CPR pump and mask placed over her nose and mouth. Within a minute, Cara's vital signs were all good and she was coughing, grunting, and crying, though still not loudly. She was back in mommy's arms while we were still in the tub. Eric noticed the reddish brown water we were in and remarked, "This water's yucky and I don't even care." Weeks earlier he had said he would bolt from the tub if the water got messy.

Audrey checks Cara's vital signs moments after birth. Eric inspects the darkening water.

We moved from the tub to the bed where Missy kept a tube flowing oxygen near Cara's face for a couple of minutes as she rubbed her and they cuddled.

It seemed the fundamental problem was that the umbilical cord was an extremely short one, perhaps twelve inches long (one third to one half the normal length) and had probably begun to weaken due to its age. Though Curt had his heart in his throat for about a minute, wanting to hear a loud cry instead of whimpers, Missy felt relief the pushing was over and complete confidence that Audrey would address any problems Cara was having. Audrey later laughed that while working on Cara, she looked up and saw six anxious eyes looking down on them.

After Cara was breathing fully and returned to Missy, Audrey kept a flow of oxygen near her.

After the birth we were flying high and did some abnormal stuff. You can read about it and check out the photos on our Postpartum Weirdness webpage.

© 2003 frantzml@juno.com