CHAPTER 13
Spring
“Let us never forget that the cultivation of the earth is the most important labor of man. When tillage begins, other arts follow. The farmers, therefore, are the founders of civilization.”
For the three months before the birth, Mary had read and read again everything in their library about pregnancy and childbirth. The book she read the most was the midwife’s training book called Heart and Hands by Elizabeth Davis. She made Todd read all the books at least twice, too. She had a fairly easy pregnancy. Mary weighed herself and checked her blood pressure twice a week. From her reading, she knew her best chance for a healthy baby was exemplary diet and plenty of exercise. Using the test strips provided in one of the birthing kits that were stocked at the retreat, she tested her urine for sugar which would indicate gestational diabetes. She also tested it for protein which would indicate toxemia. However, she never had much swelling of her hands and feet, so she was not really concerned about the possibility of toxemia.
She wished she wasn’t the first woman to give birth at the retreat, since no one else had ever been involved in a birth except herself during her obstetrics rotation in her nurse’s training. Margie had given birth to Della but it was a hospital birth and Margie said that she was “pretty well knocked out” at the time. She had also seen and assisted farm animals give birth. But she had had a pretty difficult time giving birth to Della, and increasingly radiated nervousness about the upcoming home birth. Finally, Mary decided she didn’t want Margie there at all for the birth, even though she was the only one to have gone through it.
Lisa Nelson, who was about Mary’s age, told Mary she would really like to be there for the birth. She said, “Mary, you might not be able to help at every birth here. I really think I ought to learn as much as I can from you. Someday Mike and I would like to have a family and I want to know what I’m getting myself into.” Lisa was a disciplined and dedicated pupil. Mary was happy she would have her help at the birth. Mary wasn’t too worried about the baby needing any special medical attention since most floppy babies are caused by anesthesia. But Mary was concerned about tearing her perineum when birthing the head and shoulders. The last thing she wanted was Todd or Lisa sewing up her most delicate parts. She wished she could reach to sew herself up if necessary—but that was impossible.
On the evening of March twenty-fourth of the second year, Mary had a “bloody show.” This was the mucous plug being dislodged as the cervix began to dilate. Mary, Todd, and Lisa were very excited, because they knew that this meant that labor would be beginning soon. She had about three hours of irregular contractions that night, but then they stopped. The next afternoon, irregular contractions began again.
By dinnertime the contractions were eleven minutes apart. Mary had very loose stools during the day, which was another encouraging sign of early labor.
About 7 p.m. she became nauseated and vomited, but she knew that this too was nothing to worry about. During this early labor phase, Mary went about her usual daily tasks to keep her mind off the discomfort of the contractions, but she was careful not to tire herself.
At 8 p.m. Mary felt like she was tensing up more than she wanted to, mainly because her contractions were so strong. Lisa and Todd were invaluable at this time. They reassured her, and started her on breathing exercises to help her get through the intensity of the contractions, and to distract her attention. Suddenly she felt a tremendous pressure, and her bag of water broke. There was amniotic water everywhere. Todd and Lisa were aghast both to see so much fluid, and to see Mary crouched down over the bedsheets, carefully examining them.
“What a relief! Great!” Todd and Lisa were still quizzical. “Don’t you get it?” Mary asked. “The fluid is clear! There’s no sign of merconium in the fluid. That would have darkened it. That means that the baby probably isn’t in fetal distress.” All three were grinning now.
Lisa asked, “What does it feel like, Mary?” She replied, “I wouldn’t say my contractions are painful. But they are incredibly intense. It is r-really hard to stay relaxed and not tense up.” The contractions began coming closer together.
Todd massaged her entire back and put counter-pressure on her lower back. She remarked that it really helped. She started feeling an urge to push. After scrubbing up with Betadine solution, Todd and Lisa both checked her dilation.
Todd estimated ten centimeters. Lisa agreed that she felt like she was fully dilated. They couldn’t see any more cervix holding back the head. Mary squatted to get gravity working on her side—getting the baby down more quickly. She pushed with each contraction for thirty-five minutes. Gradually, they could see the crown of the baby’s head.
Mary moved to a semi-sitting position on the bed so Lisa and Todd could control the emergence of the head and prevent tearing. If she were to remain squatting, the baby would come too quickly. Lisa checked the presentation and declared with a whoop, “The baby is looking backwards and is well flexed.”
Lisa and Todd urged Mary to pant to ease the baby out as slowly as possible and avoid tearing. They asked her to refrain from pushing hard on the next few contractions. The baby’s head was eased out slowly, with a liberal application of mineral oil. As soon as the baby’s head had emerged, Todd reached down and ran his finger around the baby’s neck, checking to make sure that that none of the umbilical cord was wrapped around it. He let out a sigh of relief, both from feeling the absence of any cord, and seeing the healthy pink color of the baby’s head. Lisa bent down and quickly suctioned the baby’s mouth, throat and nose with a bulb syringe. She knew that this was an important step, so that any mucous would be cleared before the baby took its first breath.
With the next contraction, Todd eased out the baby’s shoulders one at a time, again to prevent tearing. Once the shoulders were clear, the baby practically fell into Todd’s hands, all slippery and gurgly. “It’s a boy!” he exclaimed.
They wiped him and dried him quickly and covered him with sterilized blankets. Lisa waited until the umbilical cord stopped pulsing and then clamped it in two places with a sterilized retractor and a special plastic umbilical clamp from the birthing kit. Todd then cut the cord about two inches from the navel. Lisa and Mary examined the baby. They agreed that his breathing was rapid but strong, and that his color was exceptionally good. Lisa nudged Mary and said, “High Apgar, right?” Mary was too overwhelmed to reply. Todd said, “Thank you for bringing me a son, darling,” and leaned over to kiss Mary.
Then he picked up his son’s impossibly small hand in his own in wonder. “He’s so small, he’s so small!” Mary put the baby to her breast, and he suckled instinctively, but not skillfully. “Don’t worry, he’ll learn,” Todd said.
The third stage of the birth felt like it took longer than the twenty minutes that Todd and Lisa anticipated. Mary was so entranced with looking at her baby’s face, she hardly paid any attention to the passage of time. Lisa noticed the telltale lengthening of the umbilical cord dangling from Mary. She knew that this meant that the placenta was separating from the uterus. Lisa urged, “Come on Mary, you need to stand up so we can deliver the afterbirth.”With Todd’s help, Mary did as she was told. Mary’s knees were shaking from exhaustion. The placenta came out on its own into a large bowl with one easy push from Mary.
Todd and Lisa carefully examined it to make sure that it was complete. Although it was torn, all of the pieces were there, and they felt relieved, knowing now that there was little chance of a uterine infection or a postpartum hemorrhage.