Wednesday, January 4, 2017

The Arrival of Abner Emmanuel


As with pretty much ALL the THINGS, there is disagreement and debate about women choosing to give birth at home. I am trying to think of something we all agree on and I have been sitting her for four days and have come up with nothing so it feels like it is time to stop trying. 

To quote the American Congress of Obstetrics and Gynecology -  'The relative risk versus benefit of a planned home birth, however, remains the subject of debate.' 

It does.

There are those that are highly opposed to any and all home birth and there are those that think if criteria is met, home birth is a truly safe and lovely thing. Some people think hospitals are for sick folks and healthy women don’t need to give birth in a hospital. I actually fall in the middle of those schools of thought so with this post I can likely tick off either of the far ends of the spectrum. 

When you can make all of the people mad at once, that’s good times. 

I’m sharing for the sake of sharing, not in order to convince anyone of anything. This is a personal choice and I think each individual has the right to choose wisely.  I'm not making a judgment about hospital birth or any other non-home-birth option. 

The goal of labor and delivery is a living mom and living baby. Well, at least that is our goal at Heartline Maternity Center in Port au Prince. It is also my personal goal at any birth I am invited to attend.  As trained and experienced midwives working in a high risk country, we get very very good at knowing the signs and indications for a hospital birth. 

Some people really should never ever consider home birth.  Other women could have a baby all alone in the Alaska wilderness without a single medical tool or human being around and use their teeth to cut the cord and a strand of their own hair to clamp it and do just fine. 

There are enough angry polarized arguments on the interwebs, let us not add to that noise. If you feel you MUST send your horror story or your oh-my-gosh-awesome, please know that I live in grey area. I cannot go black or white with you on this, or most things. I will simply say, I would never participate in something that was not well planned and prayed out, nor would I do so without a transport/emergency option. I think Paige made the right choice for her and I was giddy to help support her decision.

I approached a few folks in the Maternal Health field to run it by them that I was considering being Paige’s primary midwife at a home birth. It was risky, in that putting myself in a position to need to make emergency decisions for a family member and remain objective can be (and is) difficult. Had any of my trusted co-midwives or OB friends told me that they thought I was unwise to agree to a home birth for Paige, I would have reconsidered. 

With all those caveats, I bring you the beautiful SHORT story of the birth of Abner Emmanuel.  His mother also delivered Graham in October 2014. You can read about that utter chaos at this link.

Paige decided for several very respectable and valid reasons that she wanted a home birth with her second pregnancy.  Paige has zero risk factors and is the perfect candidate to consider a home-birth. She and I talked and prayed about it for a couple months. We made back up plans (I was not going to be in TX until late in her 39th week so she needed to have a plan). We found our midwife friend, Betsy, to ask if she could attend too if the baby waited until I could get to Texas.  

In the room at the time of Abner’s entrance into the world was his mom (her role was fairly crucial), his dad, his aunt Britt, his grandma (me), his uncle Isaac, and Midwife Betsy.  Isaac stayed off in the corner and got some photos. His words, "That is something I will never forget (literally)."  When I asked him what he thought about it all he said, "Well, the placenta was very red and blue." 

If at this point you’re thinking, “These people are strange”, that is okay.  We know it is not typical for a 15 year old boy to see his sister give birth. We are not so much aiming for typical.  I figure we were all born and birth is an everyday event and there is no reason to make it a scary or taboo thing. 

Paige is a cervical ninja warrior.  I don’t even understand her way of being female human.  It is astounding.  Her first birth was a wonder. Her second birth just the same. I did not give birth this way.  I know very few people that do. 

She basically started the game at 4cm on December 27th with zero pain and made it to 7cm over a 30 hour period of very little pain.  She went for long walks, she took care of Graham and her house, she did lunges and drank a Castor Oil smoothie, she slept when she wanted.  

On the 28th of December she started having a pattern of not too painful contractions at about 4pm.  We decided to call the other midwife to head to Waco and we played Monopoly and found ways to distract Paige.  Graham left to go to a play date for a few hours. Paige finished up a three mile walk and decided she would go lie down around midnight at the end of December 28th.  

At 1:45am I was in her room checking the little man's heart-tones and woke her up while doing it.  She got up and asked if we could check to see if her power nap had gained her another centimeter.  At 2am she was 7cm, totally effaced, and baby had moved down quite a bit. She had been sleeping soundly for an hour and thirty minutes but once she woke up it was go-time.  At 2:20 she was vomiting. At 2:25 she was yelling at us that she changed her mind and was not interested in having the baby after-all.  

At 2:30 I had to switch from empathetic Mom to bossy midwife when Betsy said "I see the bag" - We moved her (told her she did not have a choice) from the bathroom to her bed and the moment she laid down she said, "I can't this hurts too much to be like this". In the same 30 seconds Abner's head emerged, at that time his amniotic sac tore a bit right at his neck, while still covering his face. All of that happened without much of a push on Paige's part.  That is the part that I find utterly confounding. Oh, Hi, no pushing, here, have a head. In less than one minute another contraction and one push from Paige and we all joyously officially welcomed Abner to the world at 2:35am on December 29th. 

After Abner was dried off and handed up to Paige she said, "Well that did not even hurt that bad."  I think she said that before he was two minutes old. 

For his first hour of life he stayed on his Mom and began to nurse. Michael and Paige announced his name for the first time after his arrival. 

Abner Emmanuel Gonzales was born early in the hours of December 29, weighing 8 pounds 13 ounces, he was 20.5" long. 

Once the adrenaline high wore off a bit, Paige and Michael and Isaac caught a nap while Britt and I went to get pancakes and Betsy headed home.  When Graham woke up he found this other small human being in his house and he is working hard at making sense of how life has forever changed.

The births and adoptions of my own children are key memories and moments of my life. The specific and sharp memories that surround each special day are a part of our family story and a part of me. Not surprisingly, the joy of assisting with the birth of these grand-babies ranks right there at the top, with the other sacred events. I cannot believe how special and holy it was. 

I am so grateful. 
Thank you God for another healthy baby boy. 








 "There days and deliveries where I couldn't believe it either! Birth was and will always be the most commonplace of miracles. An event at once familiar and phenomenal, timeless and immediate, briefly making angels of us all."

Jenny, Call the Midwife