Fiona Jane Mulder’s Story
A birth, a lot of midwives, and a rogue perineum
Fiona’s story really began more than 3 years ago. After a 12 hour labor attended by my lovely midwife Susan in Michigan, following an awesome pregnancy that was unfortunately fraught with personal and occupational angst, I transferred to Mercy General Hospital for a cesarean to bring my son Ethan Frederick into the world on November 20th, 2005. At 9 lbs 8 oz and leading with his ear, the general opinion was that 5’2” 110 lb me was never going to do it, and thank goodness for modern childbirth medicine. Maybe so.
My niece Lily arrived in August 2007, at home. Witnessing her birth was a special event for me, for she too had a cesarean incision to bypass on her way home. Her brother John had also been “too big” and positioned “wrong”, and of course her mother had a “marginal” pelvis. Sue and Lily helped restore my faith in birth again.
In October 2007, a few weeks after being surprised out of my mind by a positive pregnancy test, I met Kathy. We sat in Starbucks and talked. After 2 visits, I lost that little angel at 13 weeks. Kathy thoughtfully sent me the Blessings Midwifery newsletter in January, and I remember reading those names and wondering if my child’s would ever be among them. This was a pretty tall order: I am a 33 year old professor at a local university teaching midwifery myself, with a medical family, and I had a history of a great big baby who refused to be born a little over 2 years ago. According to most in the obstetric community, I was not exactly what you would call a “good candidate” for successful homebirth. Though many doubted, Kathy never did.
I had the pleasure of calling her again in February 2008, the day I had another positive test. I joked that she should pencil me in; it was so early. She replied that she would use ink. J Fiona’s pregnancy, just like Ethan’s, was uneventful and wonderful. On Kathy’s advice, I used the Polly Jean’s herbal preparation from 35 weeks on. At 36 weeks, we discovered that I was GBS positive. Great news; one more risk to make me think through my decision. As I neared 38 weeks, I began (like a good midwife) to recognize that I was indeed pregnant, and had better make a few preparations. I ordered my birth kit, thinking I had 3 or 4 weeks to go. Despite my epic belly, it took that long for the reality to hit. At 39 weeks and 5 days, on Friday October 24th, I proctored a final exam for a group of students from 9 AM to noon. When it was over, it was like I woke up from a brainless hibernation and realized how much I had to do, 2 days before my due date. I stopped by an antique store on my way home and carried a 3-drawer dresser 2 blocks. I arrived home and got on Craig’s list because I needed a double bed, and a mattress for it. Today. Some strange guy in a pick up truck was at my door within the hour, and we carried the mattress and boxspring inside. Shortly after, some special friends arrived, for reasons entirely exclusive of my condition. This weekend, October 24-26, marked the 5 year reunion for my own Nurse-Midwifery class’ graduation from Vanderbilt. Several classmates were scheduled to arrive that day and evening, and they came to my house for a chance to see and touch the planetary belly. They were glad for the opportunity, but disappointed that they would not get to meet baby. Ha. After hours of visiting, Italian take-out, wine and laughter, punctuated by bursts of bizarre activity such as building a bookshelf and Organizing Ethan’s toys, everyone went home to sleep, strangely unsuspecting and ignorant for a bunch of midwives who just watched a day of uber-nesting unfold right under their eyes.
Saturday October 25 (my brother Fred’s 35th birthday) dawned, as usual, with Ethan waking up mid-sentence and embarking on a day of activity. After breakfast and in the midst of “LEGO-time”, I was interrupted by a loud pop and miraculously landed on the toilet 2 rooms away before the torrent began. Hooray: rupture of my waters before labor—not a terrific heralding of a smooth VBAC with positive GBS, and even better, meconium!! Now I was really embarking on crazy. My medical friends would be thrilled. But even larger in my mind was that today was the day! Believe it or not, I was surprised. My goal for the immediate future was to expel my nervous husband and my 3 year old son from the house until things got further along. I called Kathy to inform her. At last my friend Melissa arrived with bags of treasure from Whole Foods. Matt and Ethan quickly escaped. I also texted my classmates, who at first I think didn’t believe me. By noon, several had shown up and were soundlessly preparing things and providing back and hip pressure. Somewhere in this blur of crawling around on my hands and knees moaning I looked up to see Kathy and Shannon. I was surrounded by trust, deep inside my labor, and ready to go. The only things I remember thinking at all in this period were fears of the same situation that had led to my section, cushioned in an overwhelming sense of calm, and they competed moment to moment. At long last I felt enough urge to push to have Kathy check me, and was not happy to be only 7-8. I spent a lot of time 7-8 with Ethan, and it felt just like this. I recall one of my midwife friends whispering that she had to go catch a plane, and she wanted this baby born before she got off the ground at Nashville Int’l Airport. I would later learn that she was on a 4:20 flight, and that is the moment Fiona was born! After this came that terrible stage where no position is comfortable or even tolerable at all. I had to pray, and other prayers were emerging all around me; I didn’t hear them but I felt them. At 3:35, in the bathroom, the weird gutteral “THIS ONE FEELS DIFFERENT” contraction occurred. I was complete. Melissa would later tell me that after I pushed with the first contraction after being complete, I laughed out loud. Pushing was the greatest relief—I was one of those. In what seemed like a flash, Matt and Ethan were there and watching, Kathy was getting the mirror, and I was thinking, no way—she can’t be that close. She was. She emerged slowly, great stretching all was well, and then BAM. She was in my arms, and she had torn me a nice deep 3rd degree. After much examining and some discussion, it was decided that this was indeed a deep 3rd and not a 4th. I could stay home, and Kathy could fix it. Indeed she did; in 2 weeks I had essentially no lasting reminders that it was ever there. I am forever glad that she was the one to repair it. I can think of not a single obstetrician who could do as well.
So, in the presence of 5 CNMs, one CPM, one doula, one birth assistant, one husband and one toddler, Fiona Jane VBACed her way into This Tennessee October day in the dining room, amid happy celebration and joy. When I used to ask God why someone like me, who respected birth so much, had to endure a cesarean, I didn’t yet know that the greatest victory was the one that had been taken away before! Thank you Kathy, Shannon, Melissa, Leslie, Kristie, Carrie, Mary, Nikki, Matt and Ethan, for supporting me and helping me realize the single most transformative experience of my earthly life!
