As they sat across from me on the couch, beautiful and awkward, their love for each other was palpable. It felt new and fresh and reminded me of how it felt with my husband when me first met.
As we discussed what a dream birth would look like there wasn't a straight path yet defined. There was however a strong desire to feel safe and protected when they welcomed their baby into their lives.
Karah struggled to feel connected to her pregnancy at first. I appreciated how vulnerable she was with me, even when she didn't think she was being that way. So many of these thoughts are very common, but often pregnant people keep them hidden from others. Even the most wanted and dreamed of babies, sometimes come with hesitation.
Karah's pregnancy was uneventful. While she had aches and pains, she was coping very well with all that was being thrown at her. As time moved on her love and connection to her little began to grow. Michael's was never in question though. He was so excited ALWAYS for this little baby even when it was just an abstract concept.
At the end of Karah's pregnancy we chatted on and off for days, maybe even weeks. She would have signs of early labor and contractions and then things would fizzle out.
The morning of August 10th would start out in a similar fashion. I received this text from Karah:
I understood exactly where she was coming from; while this can be a normal part of the end of pregnancy, Karah seemed to be having an unfair share of it. On top of that, her and Michael decided to hire a doula, in order to help cope with their anxiety. The constant questioning, "Is this it?!" was beginning to weigh on them both.
Karah was napping where she could and staying hydrated during this stage. She at one point said:
"I can't really talk through them maybe cuz I'm a wimp."
I started to plan my evening around heading to Karah. I did not think for one second that Karah was a "wimp", I thought that today could be the day we got to meet their baby. Karah had been having weeks of on and off labor and now surges for more than 12 hours, managing them all on her own. She was insanely strong and I made sure to remind her of that.
At 5pm I called Karah. I wanted to hear her voice and how she was handling the afternoons events. I heard her wince a little bit here and there, but for the most part, she was still able to hold a conversation. She then described the pain as constant, with peaks here and there. She also said she felt a strong low back pain that felt like ripping.
At 6pm, her beau, Michael sent me a text asking me if I could FaceTime. We chatted for a bit about ways to cope and find rest during this early labor phase. Karah decided to take a bath but after one surge, texted me that she had to get out.
At 7:30pm, Karah said that the surges had gotten down to 3 minutes apart and that she could no longer cope without assistance from Michael. I asked if I could head to their house and for the first time Karah agreed.
I arrived around 8:15pm to find Karah kneeling on the couch clenching the wall behind it. I watched her for a few surges and then began to help with counter pressure during them and light touch in between. Karah was having lots of back discomfort and this seemed to provide her the most relief.
Michael began completing last minute tasks and running errands while I stayed with Karah. When he returned I told him I didn't think we would be here for long and getting everything together and in the car, would make the most sense. He was a few steps ahead of me and prepared when it was time to leave.
After 90 minutes or so, I suggested it was time to head to the hospital. I didn't think that Karah was close to having a baby yet, but I did think she needed a change of scenery. That she needed an action to verify that all of this would result in an actual physical human at some point.
When we arrived at the hospital, things had intensified on the 30 minute drive over. We stopped every few feet to manage them as we made our way into the birthing center at Manchester Memorial Hospital. Upon arrival we discovered that Karah was 5cm dilated and 90% effaced.
When the nurses walked out, Karah and Michael were both standing there shocked. It was the first time all day that there was any type of promise that these contractions were doing something. I said, "Do ya'll realize you aren't leaving here without a baby?!". Michael and Karah both started to cry. They embraced each other and kissed and both repeated my statement, "We aren't leaving here without a baby!" Their tears were quickly transitioned back to the reality that labor would need to continue and so would all of the coping skills that they had put into place.
This also meant that Karah could use the tub for relief. Karah was hesitant, but once we discussed that this tub was much larger than the one at home, she agreed. She got in at 11:30pm and the tub provided her a lot of relief. She was breathing through each one and was capable of relaxing more than before.
Karah was impressive. She had been telling me all through her pregnancy, that she wasn't good with pain, that she was fearful her anxiety would take over, and that panic could set in. However, none of that was present. Her strength and power was leading this labor. I was in awe watching her.
Every time there was a surge Michael and I assisted in ways that helped her to cope with pain as well as give her relaxation. Karah looked at me clearly and with confidence and said, "I feel a little bit more than before, but I know I can do it." Then she turned towards Michael and managed another surge.
At 1am, Karah said she was hot, needed a break from the water and wanted to try nitrous. We walked down the hall and went back into the room. Suzanne, Karah's midwife, decided to check Karah's cervix. As Suzanne began the exam, Karah's bag of waters ruptured, and sprayed out across the room. Suzanne and I both made audible noise and then laughed. Amniotic fluid hit my lips, but somehow Suzanne managed to stay dry.
I looked up at Michael who was wide eyed and looking a bit nervous, "Totally normal", I said, "that was just the water and means things are moving right along." Suzanne confirmed that Karah was 9cm dilated and 100% effaced.
Twenty minutes later, Karah had an urge to push and she began to bare down. The baby was still high in the pelvis, and based on the amount of back pain, I assumed the baby's position was a little wonky too.
At 1:20am Karah would begin to push on her own. As time went by, we would suggest Karah move positions in hopes to help baby come down. The first hour and a half of pushing wouldn't result in much sustained change.
At 2:45am, I suggested we try "tug of war" pushing. I wrapped the rebozo around the squat bar, handed Karah both ends, and I added extra tension to the rebozo, while Karah pulled and pushed that way. We started to see some progress and baby's head was visible at the perineum.
Things were still moving slowly, but not at any point did Karah complain. When she doubted herself, Suzanne would step in and get Karah back to being centered and focused. Michael would occasionally get welled up, as he was also in awe of Karah's ability to keep pressing forward.
After about an hour of tug of war and us seeing the baby continually rocking in and out, Suzanne suggested a true squat position at the bar. Karah pushed there for 15 minutes or so, but wasn't making any more change and the decision to go back to tug of war, made the most sense, as that's where we saw the most movement with pushes.
At 4am, we started to see the baby's head slowly emerge. I couldn't believe how much control Karah had. Most people without an epidural would struggle to handle this long stage of pushing and then crowning, but she was still handling every thing so well and calmly. She even reached down to feel her baby's head.
And then Michael made a loud and excited noise. He could see his little girls face for the first time. At 4:30am, Karah gave one more push and their little lady came earth side. Karah opened up her eyes for the first time in what seemed like hours, and with her hands on her new babe, glanced at Michael with a big and proud smile. Michael had tears rolling down his face. He kept telling them both how much he loved them.
The pushing phase length would be easily explained once we saw her! The molding (cone-ing) of her head was very low and almost at the back of her neck. Her cord was very short, maybe the shortest I've ever seen, measuring around a foot. This little lady was very smart and had gotten herself into a position, almost ball like, that allowed for her to get the most length out of her cord, to allow for her to be born vaginally.
The cord was so short in fact, that once she was born, in order to not tug the placenta or her belly button, her little face had to stay on Karah's lower belly and her feet were dangling down, touching the bed underneath them both.
Michael began to sing to their baby and tell her all kinds of little things and then Karah said my most favorite thing I have ever heard a new mom say:
And Karah was brave too. She had managed this labor epidural free, which at times she thought was an out of reach goal. She empowered her birth team to help her by being clear with direction and needs. She was open and honest when fear came in and allowed for us to help her move it out, so she could continue on.
She was so damn powerful.
And then Karah asked for her Mom. Isn't that always how it goes and who could blame her?
I took pictures and videos of Michael and Karah and their baby. I at times welled up watching Michael cry and watching Karah's joy. She doesn't know it yet, but their little one is about as lucky as they come, for she will receive all of the most beautiful and awkward love that these two have to give.
They're also totally hysterical.
Thank you Karah and Michael for allowing me to be a part of such a wonderful and peaceful birth, I can't wait to see what your next adventures hold.