Here is the labor timeline:If you want more details, you'll get them below...perhaps in more graphic detail than you thought you wanted.
Here is the labor timeline:Kim's water broke at 12:30 that day after we had taken a long walk to get things going. It was a pretty dampening gush - the midwives asked if it was about a cup, which it was, so we assumed that was pretty much it. We were pretty surprised by the few quarts that flowed over the next day.
Kim entered the
second phase of labor at about 11:30 that night. Yes, it was clear that this
truly could be termed active labor. We called the midwives at 1:30
unceremoniously from the bathroom...Kim swears that toilets are the best
designed seats for labor. But as an alternative, we had rented a tub for the
labor and maybe the birth - an inflatable hot tub that we set up in the baby's
room. Kim really liked being in that, and we both were interested in the
possiblility of a water
birth.
Well, when Flame, one of our midwives, arrived Kim was already 5 centimeters dilated. Flame is a tall, strong woman who can be gentle but certainly command attention when necessary. Kim's primary midwife is a woman named Terra. Flame is Terra's assistant, along with Elizabeth and Olga (a woman with blonde dreadlocks). Although Terra was the head midwife, Kim connected more with Flame than Terra so Flame was pretty much the primary midwife for us. Should also note here that these midwives had two other women who gave birth within the last two days. A busy month indeed.
By 9:00 Monday morning Kim was 8 cm dilated. That's over three inches. 10 cm is the magic number at which the pushing really begins. 10 centimeters. Four inches. Go get a ruler and look at four inches. Now try to stretch your mouth open four inches in diameter. Oh my!
We intended to send out periodic e-mail updates, but somehow all that became a rather low priority as the labor progressed. A friend suggested that we get a camera and hook it up to the computer for live feed of the labor and birth (perhaps the first web e-birth?), but it was not to be.
Throughout the day, Kim went through phases of intense contractions and periods
of stalled labor. When things got stalled, we would walk around the house, go
up and down the stairs, crank the music, and dance...did you know that the most
effective music to get contractions going is "Stop Making Sense"
by the Talking Heads? It's true!
Particularly the songs "Take me to the River" (appropriately enough) and
"Burning down the House". We would dance, then Kim would have a contraction,
put her arms around Joel's neck and groan/scream/push and yet more amniotic
fluid would gush out on the floor (adds a good polish to the wood). Quite the
intense pagan ritual.
Kim's parents from Iowa were here visiting, and this was probably something more than they expected to experience for their daughters birth. But they were wonderfully supportive throughout. Kim really appreciated having her mom there as support from a woman who went through this experience. Kim's friend Delisa, a performer from Jerome, Arizona, was also visiting for the birth.
By 1:00 in the afternoon Kim was at about 10 cm and started pushing. Of course, Kim's parents had to leave by 3:00 to catch a plane back home to Iowa, and we were sure that the baby would be out by then...but come 3:00 Kim was still pushing. We would have bet that the baby would come out five minutes after her parents left, but still an hour later and Kim was still pushing. The baby was soooo close, but just couldn't get past Kim's pelvis. The midwives realized that the baby's head was presented somewhat to the side, and tried their best to reorient him, but Kim's strength started to wane (no surprise after 40 hours of labor!) and we decided to go to the hospital around 5:00.
It was a pretty intense ride to the hospital - Kim was incredibly, intensely past her limits of exhaustion. Delisa was driving Joel's van, which isn't exactly the easiest beast to drive. It has a very strong engine and brakes, so it was a rather jolting drive, considering that we hit every red light on the way (rush hour, dontcha know?). Joel was in the back with Kim and Flame, and Flame was getting very concerned since she couldn't hear the baby's heartbeat (no surprise if you know how loud it is riding in a 1971 Chevy van).
Remember that Kim's parents left at 3:00. When they got to the airport, they called to see if the baby came...but we had already left for the hospital. Imagine their situation. They leave with their daughter in intense labor, then when they call, no one answers. They called a couple times from the airport. No answer. Called a couple hours later from Omaha. No answer. Drive two hours to home in complete worry. Fortunately, after the birth we asked Delisa to call Kim's parents, so she left a message on their answering machine which they heard with mixed relief when they got home.
At the hospital, when they hooked up the fetal monitor the baby's heartbeat was strong and amazingly unstressed and regular. The doctor on call at the hospital was a very young (under 30? fresh out of med school?), and very crisp and take-no-shit but wonderful woman named Doctor Crochet (how appropriate...). She said that they would try to use the forceps, but if it didn't work after a couple of tries, she would have to do a c-section. Meanwhile, the anesthesiologist, another Doogie Houser young doctor, was putting an epidural in Kim's spine. Flame and Joel were given scrubs (blue surgical suits) and we joined Kim and the doctors to the operating room.
If you have never seen forceps before (big, metal salad tongs - about 18 inches long with about 4 inch wide paddles) they produce quite the effect. Even though we had seen them before, there is something very intense about seeing them in action, being put into your loved partner and squeezed around the head of your as-yet-unseen child. The doctor then gave the forceps a mighty twist to rotate the baby, an incredibly bizarre feeling for Kim to feel everything in her lower abdomen spin around. Then was time for the pushing. Kim found new reservoirs of strength and with the doctor pulling with all her strength, the baby finally got past Kim's pelvis. Joel was standing by Kim's head helping her concentrate and push, but did get a good glimpse as the baby's squished head (squished amazingly elongated by the birth canal and the forceps) started to come out. Without any discussion, Dr. Crochet did a quick episiotomy (a bit of a surprise, but probably Standard Procedure even though it seemed somewhat unnecessary especially with all the perineal massage we did for weeks before the birth). One more last, exhausting, groaning, crunch bearing-down with every reservoir of energy Kim possibly had remaining in her body, and our baby was successfully pushed and pulled into the outside world.
As mentioned, his stats were 8 pounds, 10 ounces. 21.5 inches long. But the important statistic is the head circumference: 14.5 inches, plus an extra inch or so for the hand that he had alongside his head. His APGAR score was 5-9, a pretty healthy score.
The forceps caused quite a bit of internal damage to Kim (she had over 50 stitches) and she lost a lot of blood. One lasting image of our hospital stay was filling latex gloves with ice every hour to put on Kim's crotch...and yes, this was an Official Medical Treatment. Kim also had to (and still has to) use a squirt bottle to spray her perineum every time she goes to the bathroom (you don't really want to wipe with all that pain and stitches). But Kim's recovery was extremely remarkable and she was discharged from the hospital the next day.
The baby stayed in the hospital one more night due to jaundice (from the bruises he incurred during birth). So Kim and Joel stayed in a border room in the hospital (for only $10 a night!). Baby Boy Hansen was getting oxygen because the doctors were concerned about a slight extra sound in his heart and a minor grunt when he exhaled. This is not uncommon - it takes a while for a baby's circulatory system to reorganize itself from depending on the umbilical cord to depending on his own heart and lungs. And, in fact, the sound went away within 12 hours. Similarly, the grunt was probably due to fluid in his lungs, and that also was gone within a few hours.
However, they kept him on oxygen for two days. The problem was that he was on a monitor that showed the oxygen saturation level of his blood every second. Now of course there naturally will be fluctuations, and this machine wasn't even able to show an average over time, so every time the level dropped a few points for a second or two, the nurses would say that hes going to have to stay on the oxygen even longer. They took a long time to wean him off and we eventually had to just sit there like perched parents and keep nudging them to decrease the oxygen until he was just breathing room air and he did just fine.
Similarly, he was fairly jaundiced due to the bruising he got from the birth. Jaundice is very common, and often goes untreated, but once you are under hospital supervision, every detail is monitored so closely that everything becomes a concern. Nurses and doctors even admitted that their own kids were born more jaundiced and did fine without treatment, but ya gotta follow Standard Procedure. They kept bringing out this graph (they loved this graph) that showed bilirubin (jaundice) level as a function of time, and if his bilirubin level was above the line, he needed phototherapy, which is a fancy and more expensive term for sitting under a sunlamp. (Joel sez: Now, as a scientist, I know how vague graphs of simple averages can be. There was no information about range of errors or scatter of the average. It's unsetteling to see people put so much belief in oversimplified numbers and graphs - at least an overinterpretation of results in my research won't affect someone's health!)
He had so many things taped to his body:
five monitors, the oxygen tubes taped to his cheeks, 
velcro tabs taped to his temples to hold
these cloth sunglasses while he lay under the sunlamp. Getting poked all the
time for blood tests... and all this for a basically healthy baby that
everyone admitted would be just fine at home. Nothing like getting tortured
some more after a difficult birth (after a few months of relative peace and
quite in a warm, dark, moist room), but, ya gotta follow Standard
Procedures.
Once he got weaned off oxygen, we were able to get him discharged from the hospital and we all got home around 11:00 Wednesday night with the agreement that we would continue the sunlamp treatments at home. A woman came by with sunlamp equipment (actually, a light vest that was wrapped around his body), which had a long cord that made him look like he had a tail. We were told that we had to bring him back to the hospital every day to get blood tests for the jaundice, but after a lot of phone calls to doctors and insurance companies, we finally got them to send a nurse out each day to do the test so we wouldn't have to drive out every day (Kim could hardly step up into the van without pain). The nurse who came over the first day was wonderful - she had worked as a midwife for 10 years before being a nurse.
Anyway, his bilirubin level increased a little, then decreased a little. We decided to take him off the sunlamp lights, take off all his clothes, and put him in the warm sunlight (rotating him like a roast chicken). The next day, his bilirubin level dropped more than it ever had, and the doctor said whatever we were doing, it was working and to keep doing it, and that we didn't have to use the sunlamps anymore. Another victory of common sense over Standard Procedures.
Everyone is now home and very happy and unplugged and in recovery mode. Yes, we are somewhat disappointed that we did not have a home birth (although we did have a home labor), but this is exactly how it should work: for normal births (90% of the cases), have the birth attended by a midwife or doctor at home, where everyone is more comfortable and relaxed and the mother feels the freedom to move and act however she feels. This results in a much lower-stress and safer birth without the interventions of unnecessary but Standard Procedures. But for the few cases where medical assistance is needed for the mother or the baby, that's when going to the hospital is appropriate and you are very thankful to have everything medicine has to offer to help birth a healthy baby. But a normal birth is neither a medical emergency or a disease, but that is how it has come to be treated these days...at least in this country.
We had not decided on a name yet. Over the next few days we worked through our Top Ten list of names, trying out a different one each day: Gavin Parker, Max Hansen, Aidan Parker, Parker Hansen (Joel sez: I really liked the idea of that one, Parker as a first name, but I just couldn't get used to calling him by my last name). We were going to pick a first name, then pick the last name that went best with that first name. According to The Law, we have to decide on a last name in 10 days, but can take years to decide on a first and middle name. We finally decided on Jake Parker Hansen (none of that hyphenated name stuff...Parker as a middle name).
We appreciate all the support we have received from everyone during this intense and exciting time. Come by and visit...and we always appreciate any food you might scrounge up.
So...would you like to hear more graphic birth stories?
So much for Jake's entrance to this world. Now, let's find out what the first month of exploration of this bizzarre planet reveals.
Joel Parker
(joel@boulder.swri.edu)
