Birth, Death and a Pandemic Postpartum

(The birth story was written when Cruz was 3 weeks old, while the ending was written when he was ten weeks old. Now he is 4 months old.)

As a little kid I would often tell my Mom, “I want 7 kids.” 

She would smile in response, never saying too much.  (Now I realize she was probably laughing inside.)

Over time, I decreased that number. “Well, maybe not 7 kids but definitely 5,” I once told her. Now I laugh at my (maybe slightly) over zealous goal.

Tom had Aaron (who became an awesome step-son), and then Tom and I had Tate, Coral and most recently Cruz.

Now I find myself in the postpartum time period. This time following birth feels full and different­­­—full of physical and emotional changes and full of adjusting to a new normal. It is a time when our world wants new Mamas to somehow continue being who they were before birth when, in reality, a new woman is actually being born alongside her baby. Postpartum is releasing the need to multi-task—being okay with nothing getting done besides the baby being fed and all the kids being loved. Postpartum with social media is letting go of comparisons and recognizing that whatever “I think I should be able to handle and accomplish” during this time actually means nothing. It is okay to know my limits and to ask for help. 

Despite the fullness, this time period can feel lonely and repetitive. And though a new Mama has just witnessed the power of a woman’s body to grow and sustain life and then to birth this life, the postpartum time can quickly forget this, leaving Mamas to somehow feel inadequate. 

During a pandemic that shakes up everything, postpartum can be even more intense and anxiety-ridden. It can feel like a time where birth and death coexist in some strange sci-fi movie playing on repeat against a backdrop of the newest Covid-19 case rates, number of deaths and hospitalization data. Strange. Unnerving. Endless. Repetitive.

But to have a postpartum time, there must first be a birth. I love the empowering nature of physiological birth. Recently, my midwife asked me, “Which are the stories about birth that we hear?”

When I think about the stories that are told they are the ones that take place in the hospital. There is nothing wrong with a hospital birth. If a woman chooses a hospital birth, that is her story. It is certainly no less of a story, no less of a birth. However, I think that more often than not, births in the hospital are not truly chosen by women but instead they happen to women. Pitocin, epidural, and then a 30% chance of a cesarean birth. This birth fits the collective narrative we tell mothers-to-be about what to expect from birth. We hear it from our friends when they tell their childbirth stories. In our society, we seem to accept the idea that birth is not something the mother does but something that is done to her.

As an alternative to this narrative, I would like to tell the story about Cruz’s birth.  His birth is my story to tell. And it is Cruz’s story of his entrance Earthside.

Ever since I was pregnant with Tate, I loved to read and watch home birth stories. There was something about the surrender to birth, the unfolding of the natural physiological birth, that captured my attention. I visualized the birth I wanted with Tate, and it manifested in his beautiful water birth at a birth center. Two years later, with Coral, I had a very special home water birth that progressed so quickly at the end that our midwife arrived only 8 minutes before she was born!

Three years later, pregnant with Cruz, Tom and I actually decided to have a hospital birth—not because we didn’t love our home birth but because our insurance would 100% cover a hospital birth but not cover any of a home birth.  Then March hit and COVID-19 came sweeping in with its plan to undo any plans I had. Once I knew our doula couldn’t be at the hospital birth, I spoke with Tom about switching to a home birth. At the start of the third trimester, we were connected with an awesome midwife and made the decision to have another home birth. (I often try to find the silver linings in all of this Covid madness; having another home birth was certainly one of the positives to come from this pandemic.)

As my due date came and went, and Cruz felt bigger by the day, I tried to stay focused on letting my body begin labor on its own.  Each day I stayed busy (and exhausted) caring for Tate and Coral. One day shy of 41 weeks pregnant (with a recipe from my midwife), I drank a bit of castor oil. Castor oil is known to be a natural labor inducer (though it is not recommended to take it before 40 weeks and never without first discussing it with your care provider). A couple of hours after drinking the castor oil I had what I thought was an actual contraction (not just a Braxton Hicks contraction). I notified my midwife, doula and the family members who were going to come to watch the kids.  I told everyone that I would call back in about 30 minutes if the contractions became more regular. Within ten minutes, I realized that things were kicking in.  I asked Tom to call our midwife.  I texted my parents, sister and doula that they should probably come; they all were about one hour to one and a half hours away. 

At this point, the contractions were still not super intense but they were coming quickly. Sometimes it almost felt like one super long contraction with only 15 seconds in between. Because this was my third birth, I was aware that things seemed to be progressing quickly.  I had been making a lentil salad.  It did not take long before I realized that I could not focus on making the salad.  That was about the same time that I tried to sit down to feed Coral her lunch during her ABA therapy session; I quickly realized that was not going to work. I alternated between sitting on a yoga ball and standing up and leaning on the kitchen counter. At this point, we suggested that Coral’s ABA session end, so her therapist could leave.  Then, it was just Tom, Coral and me at the house. Tom was busy getting the bed ready and the birth tub set-up.  

I moved back to the bathroom and asked Tom to make me a piece of peanut butter toast. I knew the importance of eating and drinking in labor. I think there was still a part of me that thought this may last awhile. Approximately two minutes later, I told Tom, “Forget the toast. Please call Tatiana and see when she will get here.”  

That was the point when I felt my water break, and I knew it was going to go fast from there. The contractions were intense. (In labor terms, I went through early labor and active labor in about 40 minutes.  I was now in transition, which is the time when the cervix dilates from 8 to 10cm.) I tried to continue to focus on my breath, as I sat on the yoga ball through the contractions. At that point, Tatiana arrived. She came into the bathroom and encouraged me to relax my shoulders during the contractions. About one minute later I got off the ball and told Tom, “I need you now.” 

Up until this point, Tom was setting-up while attending to Coral. But now I knew I was entering the part of labor and birth when I needed him to be by my side. I walked from the bathroom to the side of the bed and hung on Tom’s shoulders through two very intense contractions. 

After those two contractions, I immediately felt Cruz moving down the birth canal. He would be born very soon. I looked at the birth tub and saw only one inch of water in it. I knew the tub would not be filled in time. I looked at the bed and couldn’t imagine laying on my back on the bed. That seemed so uncomfortable. So I dropped onto my hands and knees, draping one arm over the birth tub.

To feel this part of birth is incredible, to know that our baby would be here soon, to surrender completely to the pressure, to not actively push but rather to not resist Cruz’s downwards movement. During this stage of birth, I try to keep my mouth loose and let my body naturally move the baby down without actively pushing. After having two water births, I do believe that not being in the water makes the sensations more intense. I knew he was getting close. I could feel the “ring of Fire”, which is when the perineum is stretched out completely by his head. Intensity. And then relief as his head entered the world. At that point, it took a minute or so before I had another contraction and actively pushed out the rest of his body. 

Just like that, Cruz entered the world. Tatiana passed him to me between my legs. I held him tightly. So relieved. So full of joy. So in love.

Safe in our home. Together as a family. My birth. My way. My story. Cruz Thomas Keswick entered the world 1.5 hours after my first contraction. 

The first minutes after Cruz was born…

Cruz has been part of our family (outside of the womb) for about 3 weeks now. We are all adjusting to our new family of five (really six with our very important biggest brother Aaron). Cruz is getting bigger by the day, literally. 

During the blur of days and nights—nursing, diaper change and repeat—I find myself thinking back to Coral’s first weeks of life. I somewhat expected to have some feelings revisit me, and recently they have. When I look at Cruz and think about this time we have with him at home, I am so grateful. I recall watching Coral turn blue over and over again from not breathing during her first weeks of life. The traumatic postpartum irony of birth touching so closely to death is something you never expect to experience as a mom. The memories are vivid and the emotions are just as real. And I can’t help but think what a blessing it is to have Cruz breathe everyday on his own. To see his pink skin. Everyday I thank God for Cruz being here with us at home, breathing, growing and thriving. 

There are other emotions, too. When I watch Cruz learn things so naturally-like tracking with his eyes, turning his head to the sound of his brother’s voice, practicing holding his head up and reciprocating smiles with me— I find myself grateful, amazed and at times emotional. It reminds me of how hard Coral has worked and how much time we spent facilitating practice for her in all of these areas. I recall her being a few months old and working with her OT to help her visually track from left to right a motivating toy. Practice, practice, practice. 

It also reminds me that even when Coral reaches a goal or meets a milestone, her version always looks a bit different (from walking to playing to everything). This is not a problem for Tom or me. We are always thrilled when Coral begins to do anything new. But as Coral gets older, her differences become more apparent to others. Watching kids’ and adults’ reactions to seeing Coral move, vocalize or even have a sensory meltdown brings yet another reminder of how disability can evoke discomfort for many people. It is a glaring reminder of how far we still have to go before those with disabilities are seen as equal and valuable members of society, worthy of dignity not pity and friendship not fear. 

Fast forward to the present. Cruz is ten weeks old. He is becoming more interactive. The days are busy, as we embark on new unexpected adventures, like homeschooling. We are finding our way as a family. Coral is showing jealousy, and (oddly) it makes me happy to see her react so “typically” to her baby brother.  

I know time is moving quickly. I am trying to enjoy the moments I can, while recognizing that it is natural to not enjoy every moment of this exhausting, joyful, challenging, busy and full time. 

More importantly, I am trying to breathe, to take one day at a time and sometimes even one moment at a time. I know too well how closely birth and death sit together—whether they are separated by minutes, weeks or years. So for now, I want to soak up all of this beautiful life that I get to live with Tom and all of the life I am lucky to watch unfold through the lives of our children.

(Note: If you are looking for an amazing midwife who recognizes the importance of providing mindful and thoughtful postpartum care, as well as prenatal care, please reach out to Tatiana Koontz at Birth Waves Midiwfery. We had the same doula for all three of our births, Debbe Cannone. We have been so blessed to have her care at each birth and beyond. She is amazing!)

Pure post-birth bliss with my new love…
Big sister Coral

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