And then there were three...

Week 37 seemed like it would take FOREVER.  In all the rest of my pregnancy I had never felt so impatient.  I did my best to keep busy.  I had a craft day with a girlfriend where I made the sweetest little bag.  We scheduled another craft day the following week.  At 37w4d pregnant I went up to the mountain and had a 5-mile winter hike around Trillium Lake.  It is one of my very favorite places.  The air was cold and clear, the sun was out and the snow was so packed that we managed to stash our snowshoes behind a tree and do the loop of the lake in just our hiking boots.  I had to pee every 50ft but that was old news and didn’t bother me.  By the end of the hike I was exhausted but happy to have made it to the snow one more time.  The dogs were very happy too.

The next day I spent in bed.  I felt exhausted and run down.  I was having a lot of cramping and a backache.  I don’t think it had anything much to do with my winter adventure except maybe I had worn myself out.  I was pretty proud of myself for all the activities I had been able to keep up with during this pregnancy.  I had run regularly until about 18 weeks and then ran a half marathon at 24 weeks.  I had continued to hike almost weekly with Garth and the dogs all the way through.  And I had been pretty regular at the swimming pool since about 30 weeks.  The antigravity effect was wonderful.  Anyway, I spent this day in bed.  I was just feeling punky.  I didn’t want to call my mom because “I didn’t have anything good to say” and I didn’t want to worry her. 

The next day I was feeling much better but was having a lot of cramping and my contractions changed from the Braxton hicks I had known so well to this pressure cramping that felt like a bag being rolled down.  Garth was up the mountain on RAT training and Amy and I had an appointment for pedicures.  I went to get some acupuncture and then I came home to walk the dogs.  While we were walking I started having cramps.  They hurt and at one point I stopped walking until it passed.  When I got home I went to the bathroom and there was this big snotty glob.  I excitedly texted Garth and my doula/friend Beth, “There goes my mucous plug!”  Even though I knew that this was not an actual sign of impending labor, plenty of women lose their plugs weeks before going into labor, it was something.  It was a little sign that my body was moving towards ready.  I used the breast pump as directed for my “cervical ripening” and called my mom.  We talked excitedly that night.  She asked if she should pack or go to sleep.  I jokingly asked “What?! You haven’t packed yet?!”.  She told me she knew I had been feeling crappy the day before because I hadn’t called.  She had been suspicious.  We talked about her coming out early and I told her to wait, that I was sure I was still weeks away. 

That night I was up and uncomfortable with the new contractions.  I slept fitfully and when I woke up in the morning there was a text on my phone from mom “Can someone pick me up at PDX tonight at 7?”  WHAT?!  She had changed her flight and was coming out today.  Infact, she was already on the way to the airport.  I elbowed Garth and told him.  He thought I had called her in the night and told her about my discomfort.  He was spooked out when I told him that I hadn’t but that she had just decided it was “time”. 

All day Garth bustled around the house getting last minute things ready.  I was a bit of a walking zombie that day.  We went to Target and Home Depot and I would have these waves of contractions where I just needed to breathe and rub my belly.  I felt spacey but calm.  I was sort of sure that this was not labor but that I would do this for a while.  I had just heard too many stories of 2-week prodromal labors in first time moms.  I was working very hard not to get my hopes up.  I went to acupuncture that day and came home to more contractions.  Garth was busy getting everything on the list set up and picking up the basement.  I went to get my mom at the airport that night and when we got home I started having even stronger contractions.  I took a shower and tried to sleep.  Things calmed down that night and the next day we went to the midwives all together and then went to buy a vacuum.  Things were calm.  I wasn’t having much in the way of contractions and mom set to work cleaning every inch of the house.  That night I had a brief period of contractions but it didn’t last long.  The next day was another quiet day but I had a lot of cramping and felt very tired.  Garth’s mom came over to join the cleaning party and I spent most of the day up in bed.  Mom and I sent Garth to work and I went to acupuncture.  About 7pm, as I sat in bed writing an email and pumping my water broke. 

I had put a pad down on the bed 2 days earlier “just in case” and had come very close to taking it off of the bed that night, convinced that this was NOT real labor.  As I sat there in bed pumping and typing all of the sudden I felt a ‘pop’ and a gush.  It was as if someone had pulled open a beer tap.  Water was literally running between my legs.  “Oh shit!  Mom!  MOM!?  Anyone?!  My WATER BROKE!”  I tried to scoot off of the bed without the water running all over the mattress.  As I stood up it continued to gush and I stood on the dog bed grinning and trembling.  I thought to myself “This is it.  I am going to meet this baby soon”.  I worked my way downstairs to the mom’s busily making dinner and informed them that my water had broken and there was a puddle upstairs.  The mood was joyful and excited as we cleaned up the dog bed and myself.  I called Garth and told him the news.  He was halfway up the mountain and I told him not to worry, this could be a very slow, long start and I would call him if things started to change.  He agreed and we decided we would check in in an hour.  I called the pager and Linda called me back.  “Well, it is really happening” she said, “Call when your contractions have been 2 minutes apart for at least an hour.  If nothing is happening by morning we will have to talk then and work on getting things moving but for now, try to get some rest and eat as much as you can”. 

I sat down to lemon “breast” chicken.  Mom had shoved 2 halves of a lemon under the skin of a chicken and roasted it.  It tasted SO good.  I ate a big dinner and then Mom and I went for a walk to the park.  It was sprinkling and dark but I didn’t mind at all.  I had contractions the whole way and a few “big ones” at the park.  I was happy to be able to walk around there. 

By the time we got back from the walk I was a bit more uncomfortable.  I took a long hot shower and sat on the ball.  Garth had decided to call it a night and come home.  He had stopped for “Birthday Cake Oreos” and firewood.  He was excited and nervous.  I was too.  Suzann left to go spend the night at Amy’s and Mom went to bed.  Garth and I sat in the living room in the dark in front of a fire snuggling and talking, I was chatting on the computer with a pregnant friend on the east coast.  It was a very lovely, intense night.  Eventually, Garth and I went to bed and got some sleep.  By the time morning arrived I was having periods of regular contractions requiring my full attention.  I was trying hard to squat and sit on the ball through them.  I was trying hard to vocalize “down” sounds to help move this baby lower and open my cervix.  Sometime later in the morning I got on the phone with Sarah, one of the midwives.  I was uncomfortable and my contractions were variable but close enough.  Sarah, and Lisa, the student came over and set stuff up and hung out.  Beth, my friend/doula also came over.  I was still eating and drinking and in between waves of contractions I was hanging out and joking around with everyone.  It was nice. 

I don’t remember what time, but somewhere in the late morning, early afternoon I threw up everything I had been eating.  Fruit, hard-boiled eggs, toast…It all came up.  I was so excited.  I knew that throwing up was a sign of transition.  Maybe I was really close!  I was feeling so tired at this point I wanted to lie down for a while.  Sarah said she would check me and see how far along I was.  If I was progressed far enough she wanted me to stay up and walk and dance.  If it were still early it would be ok to go lay down for a while and get some rest.  She never told me the number but she said it would be fine for me to go get whatever sleep I could between contractions.  Lying on my left side made things very intense and uncomfortable.  I cried out for my mom she came and snuggled in bed with me.  She rubbed my head as I “Ooohhhhed” my way through contractions.  Then she fell asleep and I was comforted by the sound of her breathing next to me. 

When I woke up and headed downstairs things seemed more intense.  It was starting to rain. I decided I wanted fresh air and Mom said I needed to go walk stairs.  We got me all bundled up and Beth and I walked to the school down the street where I walked the stairs and oohed through contractions.  We got home and decided it was time to make cookies.  I stood in the kitchen and got in the way in between contractions.  Mom and Beth were very patient with me.  At one point the cookies were sitting on the stove over the heat exhaust vent (to melt the butter) and I was leaning over the trash can with my head squashed up against the door jam swearing and yelling at the cookie dough though the contraction.  It must have looked very funny from the outside. 

I went back to the living room and spent some more time bent over the window seat.  I was feeling so tired.  The contractions were very painful and I was intermittently quite doubtful that I could “do this”.  I was afraid I was getting in my own way psychologically.  I was afraid.  I was afraid to admit I was afraid. 

The midwives had left a few hours ago thinking that the watched pot never boils.  Early that evening, Garth surfaced from his nervous energy projects in the basement and joined me in the living room in front of the fire that had been burning since early that morning.  Our dear friends had sent him a text asking if there was anything we needed and he said half jokingly that we could use some firewood.  They brought over an entire carload and put it on the front porch. 

Since it had now been about 24hrs since my water broke Lisa came over to grab vital signs and a blood draw.  Risk of infection occurs and increases with time after the water breaks and they wanted to be sure we were still in the safe zone.  I had no fever and my vitals were good and the baby sounded strong on the Doppler.  Lisa checked me again and I was not much farther along than I had been that morning.  I didn’t know the numbers but I could tell it wasn’t much.

Garth talked to Laura, the midwife on call now, as I was contracting.  I was having very strong, rather long and close together contractions at this point.  There was a grunting “pushy” quality to my voice I suppose since Laura said it was convincing on the phone and she raced to us.  I had gone to the sofa to lie on my left side and “embrace the suck” of the discomfort thinking it would allow me to rest and to dilate faster.  I was so tired.  I woke up to Laura and Lisa taking vitals. 

The night progressed.  I gave up on pants all together as I was leaking more fluid with almost every contraction.  I was still drinking between every contraction and I was praised like a picky third grader for it.  I grew to hate hate hate the toilet.  My contractions were so intense on the toilet that I would try to get to the bathroom as quickly as possible to pee and get up before another one could start.  I spent hours bent over the bookshelf right inside the front door, leaning on two pillows and the folded up quilt I had made for the baby trying hard to squat into every contraction.  I remained optimistic in my own ability but also a little afraid that this was not right and that I was getting tired.  I told myself, this is labor this is the run.  You can do it.  And I believed myself. 

At some point I decided that contractions only really lasted about as long as it took someone to count backwards from 30.  So, I told Garth to count backwards from 30 for me during contractions.  I had no idea that this would become my total crutch.  Poor Garth. 

As night ran into morning I was still working hard.  I spent lots of time at the bookshelf and then tried squatting into the contractions to see if that might be the key.  Squatting was as intense as the toilet and it made me afraid.  It hurt so intensely; it was so hard to relax.  Finally, I settled on hands and knees between Garths feet.  He would rub my back and manage my blanket demands “lose the blanket!”  “Get blanket” in between contractions all while counting down backwards from 30 sometimes twice during the same contraction. 

At somewhere around 0100 Laura checked me again.  I had not changed since Lisa checked me hours ago.  Also, my lab results were in and my white blood cell count (a key indicator of infection) was very high.  I still had no fever but everyone there had caucused and agreed that this was “not Anna”.  Laura sat on the floor with me and told me she thought there was a good chance that I had an infection and that it was causing me to have this whacky labor pattern without progress.  She said she thought it was time to go to the hospital for some antibiotics. 

I was ashamed at how relieved I felt to hear her say that.  I was so tired.  I could hardly stand anymore.  I felt like I had next to nothing left with such a long way left to go.  I wanted medicine to let me sleep so I could try again in the morning.  I felt so guilty asking if they would give me an epidural to let me sleep but the words fell from my mouth and Laura said “Of course.  Let’s get you some antibiotics, some rest and we will reassess”.  I looked at Garth and said, “I’m ok with this.  I tried so hard and it just isn’t working.  I need help.  I’m scared I can’t do this.  I keep forgetting that we are working on getting a person.”  He kissed me and said he loved me.  Then everyone set about getting ready to head up to the hospital.  As the bags started to stack up at the front door Beth knelt down next to me and put her mouth to my ear.  She told me she had been there and she knew how hard I had been working.  She told me I could still have a wonderful birth and a healthy happy baby.  She told me this was all still, just fine.  I believed her.  One of the things that had allowed me to trust my ability to birth at home safely was hearing Beth’s birth story of her son.  She labored at home for 2 days with disorganized painful labor before Linda had a very similar conversation with her about exhaustion and the need for a little help.  Beth went to the hospital and after a little rest and a little help gave birth to one of the most beautiful little boys I have ever met.  She told me the story very early in my pregnancy and included her feelings of empowerment and joy at having been able to labor at home and then feel the benefits of a truly necessary trip to the hospital for the help.  She seemed utterly unscarred by it and that was so reassuring.  I kept that in mind any time someone would ask, “Well, what if you have to go to the hospital?”  I knew in my heart of hearts that if there was any way possible to still have the best, most empowering birth I would be able to.  Beth had and I held tightly to the belief that I would to.  Because of this I was sad but totally ok with our trip to the hospital.  The cars ride on the other hand….not so much.

In the car I perched on my hands and knees draped over the back of the back seat.  I tried hard to be quiet thinking of how hard it would be to be Garth, in the driver’s seat.  I don’t remember how many contractions I had on the way there.  I just remember wishing I could curl up in the car seat between my mom and I.  This was the most uncomfortable place I could imagine contracting.  At some point I looked up and saw that we were most of the way up the hill.  I knew I could hang on just a little longer.  We piled out of the car, Mom, Beth and I.  I had just a momentary spark of awareness that there was an ambulance in the bay in front of the emergency department and I hoped that the crew would not walk out and see me.  I was about to walk in when I felt another contraction coming on and I opted to ride it out hanging onto the bar outside of the emergency room doors.  Once it had passed we walked inside and an unimpressed CNA escorted us to the elevator. She asked me if I wanted a wheel chair and I said, “I can’t even imagine sitting right now!”.  The elevator took FOREVER to arrive and once we got inside the doors on the other side opened up and a nurse pushed a pt in a giant bed towards us asking us if we could take the next one.  The CNA said “sure” and we were back standing in the hallway in the ED.  I couldn’t believe it but I was about to have another contraction so whatever.  We walked what I am sure was 18 miles down a hallway, stopping to bend over trash cans so I could swear and demand someone count me down.  Finally we got to the labor and delivery floor and walked in to the nurses’ station.  They wanted me to fill out paperwork and sign a bunch of stuff.  I am sure I had the signature of a serial killer at that point.  There was no way in HELL I read any of it.  At long last, they walked me down to the very end of the hall and it was a mad dash to strip and pee before the next contraction.  The bed looked hard and uncomfortable, the room was freezing cold and there was a rather unimpressed nurse who asked if I could pee in a tiny cup.  I told her the only way she was getting pee was if she put a hat in the toilet and she seemed a bit put out but complied.  I came out of the bathroom half dressed in the most awful hospital gown.  It was WAY too small and had Velcro patches.  I asked for a “big girl gown” and striped the tiny one off and tossed it on the floor.   I bent over the counter and had another series of contractions so forceful I couldn’t stand flat on my feet.  I was hollering and standing on my very tiptoes and just about ready to wish for death.  This was the worst any of it had been….then the nurse walked in.  She wanted me to sit on the bed and dangle my feet so she could put me on the monitor.  She seemed utterly oblivious to my being in labor.  Her hands were cold and rough and she pushed so hard on my aching belly.  By this time Laura and Lisa and Garth had all arrived in the room and thank god.  I would look at them from time to time and I could see the heart in their eyes.  They were sad that we were here and that I was having such a rough patch.  I didn’t want to lean on the ball or sit in the bed.  I wanted to be flown to the moon where my contractions couldn’t follow.  I had totally lost touch with the notion that I was going through all of this to meet my baby. I just felt like I was being tortured.  The nurse tried to talk to us about when to call the anesthesiologist and when she was going to start an IV and I could hardly hear a word she was saying.  At some point she was done talking and asked when we wanted the anesthesiologist to be called.  I answered her “I want it RIGHT NOW!” It was only minutes later that I was bent over the bed contracting when I turned my head and saw a very tall, blonde, young man who I recognized from Emanuel.  “I know you.  You were a student at Emanuel.  You had a decent bedside manner which is something for an anesthesiologist”.  I went back to my contracting.  Everyone tells me he had this sort of shocked look on his face.  He said something to the effect of “Uh, yeah, I was an intern there.  Thanks.”  He set to work consenting me for the procedure, gathering my health history (mostly through Garth as I was too busy focusing on not breaking into a million pieces with every contraction) and then started to get my back ready for the placement.  I had to sit on the edge of the bed with my feet over the side.  The anesthesiologist was about seven feet tall so the bed was then raised up to accommodate his height.  Contracting with feet dangling off the bed was something I only wanted to do once.  Garth brought me a chair and I put my feet up on the armrests of the chair and tried to round my back the way they wanted.  All the while I am contracting and trying so hard to stay still for the very kind doctor.  The nurse was digging around in my belly trying to place the fetal heart monitor.  I am sure it wasn’t ACTUALLY that bad but at that moment I wanted to scream at her to stop touching me.  I felt so over stimulated and so out of control of everything I was feeling.  It was like being caught in a waterspout.  I was using all of my energy to hold Garth’s hands and sit still.  This was the lowest of low. 

A few minutes later the medicine was starting to work.  My legs felt heavy.  My back ached and my stomach hurt.  I was sore all over and Laura and mom helped me lay down in bed.  I was so uncomfortable.  My stomach ached so badly.  I was so sleepy but so uncomfortable.  I finally asked for a blanket to “wheel chalk” my belly.  I don’t know why it hadn’t dawned on me sooner but I had been sleeping with a pillow under my belly for months now…why should today have been any different?  I started to drift off into sleep as the doctor came in to check on the epidural.  He bent over my bed and spoke quietly asking how I was feeling.  I told him I was still uncomfortable but I was feeling sleepy.  He asked if I wanted the medication to be stronger and I said, “no thanks, I still want to feel all of this.  I just needed the edge taken off.  Thank you.”  He reassured me that we could increase the strength at any time and that he was on the unit all night if I needed anything.  I drifted off to sleep but according to Garth, he was in several more times in the next few hours to check on me and to adjust the medicine. 

When I awoke several hours later everyone had gone to get some rest except mom and Garth.  Garth was asleep in the chair by my bed and mom was sitting in the rocker at the foot of my bed.  I felt so much better.  Physically speaking I was feeling stronger and rested. I looked around the room and saw the picture Garth had grabbed from our bedroom the night before, as we were packing for the hospital.  It is a print of a woman sitting, very pregnant, on the rocky shore of the ocean.  She has on a snorkel and a two-piece swimsuit.  The only word on the picture is ‘Trust’.  I had looked at that picture last night and dug down deep to find my trust in myself.  Now, in the light of day I could feel that trust had grown stronger after a little rest.  My legs felt like they do just before they get pins and needles and fall asleep, heavy but not numb.  I could move them myself and best of all when I thought about it, I could feel myself move my perineal muscles.  I wasn’t numb.  They had hung pitocin to try to override my crazy, erratic contractions and get my uterus working as a unit.  I could feel the contractions very clearly.  They no longer felt “wrong” though.  I could feel the same sort of downward pressure and full squeeze that I had felt at the beginning of labor days ago.  My morning nurse was sweet and kind.  She came in and talked to us and brought me a lemon ice “for breakfast” she said with a smile.  She too had to dig around to keep the monitor in a good spot but she actually looked me in the eye and warned me before she went pushing around. 

Next, Linda came in to visit.  Garth was awake by now and I was getting more, strong, regular contractions.  Linda was the midwife who brought me to this practice.  Linda reminded me of my mom.  She is no nonsense, very smart, very tuned into the process and no bullshit at ALL.  She talked to us about what would happen if the baby were sick or in distress and who we wanted to be the primary team to take care of her (Pediatrics or Family Practice).  She advised us of the different philosophies of each team and we chose family practice since they seemed the more likely to let us all stay together and go home fastest.  She also talked to us about what would happen if my vital signs did not stay within the acceptable range and if my labor pattern did not progress efficiently.  OB/GYN came in and consented me for an emergency cesarean section if it came to that.  At this point I didn’t know what to expect anymore.  I felt so far from where I had started, so far from where I had hoped to be…. I felt a little adrift.  Garth and I took a moment while mom slept in the chair and promised each other that no matter what, this was going to be ok.  We vowed to get through whatever the day brought and to process it together when the dust settled.  Having him there beside me meant everything.  I was starting to worry that I was headed for a c-section as I was now almost 48hrs ruptured and I didn’t know if I had made any real progress. 

That afternoon Nora, the attending CNM at the university came in and chatted with us.  I was still having intensifying contractions.  I even pushed the button to give myself a little boost of medicine at one point.  I had to concentrate on the contractions again but they still felt like waves moving forward and I wasn’t afraid of them or feeling tortured by them any more.  Nora asked if she could check me and I said sure not really expecting much.  When I moved my legs apart she said, “Well what do we have here!?”  What I thought was the catheter tubing on my inner leg was actually a bulging bag of water.  My membrane had gathered down low and sealed over the opening and I now had a big bag there.  She gently checked my cervix around the bag and announced that I was fully dilated and all we needed now was for the baby to descend.  She said she would be back in a few hours. 

I was SO excited.  I drank a big jug of water and sat chatting with mom and Garth.  Soon Laura and Lisa and Beth arrived.  I was so happy to see them.  I was so sorry to have kept them up so late but everyone seemed happy to be there so I just focused on enjoying having them around me.  It wasn’t long before Nora and her student came back in.  The baby’s heart rate was getting a little fast.  Nora told us that she was going to have to have the family practice team and the peds resuscitation team ready in case the baby had trouble.  We waited a little longer and the heart rate stayed elevated.  Nora looked at me and told me that any time I felt like pushing I could because it was time for my baby to be born.  I grew up listening to and bearing witness to my mother attending to women.  I had heard her tell women “it’s time for you to push your baby out” and I knew she didn’t say that lightly.  It was a message to her body more than her brain and I didn’t need to be told twice.  I asked for help holding my legs and told them all I was ready to try.  They put the bar up on the end of the bed so I could brace my legs on it and then tied a sheet around the middle of it for me to pull on.  I can’t say I felt the “urge” to push as much as I felt the urge to push my baby out before they told me I couldn’t.  I pushed and smiled and pushed and smiled.  Twenty-nine minutes later I pushed out the most beautiful 8lb 1oz baby girl.  Ramona Fern. 

Ramona was a little wet right afterwards.  She wasn’t breathing perfectly and the pediatric team decided to take her over to the warmer before I could even hold her.  I am still working on how I feel about all of this and what actually happened.  Not holding her for the first hour of her life broke a little piece of my heart and I think hers too.  When I finally saw her for the first time and held her in my arms she was all hooked up to a machine that was pushing air into her nose to help flush the fluid from her lungs.  She was pink and pissed off.  She looked perfect beneath all that tubing. 

They took her up to the ICU and Garth stayed by her side every second.  They took me to my room on the mother baby floor and I got cleaned up, ate a sandwich and mom and I walked down to see her.  She was getting poked for an IV for antibiotics.  They never managed to get an IV even after 8 pokes.  Poor thing would have to have all of her antibiotics through shots 3 times a day for the next 24hrs.  By the time I arrived in the NICU though, she was off of the breathing machine and the tube into her belly was out.  Garth said her blood sugar had been low and they were trying to get an IV to give her fluids and when they couldn’t he suggested the breast milk I had pumped (2 days ago at home and frozen) be given to her.  They decided that she would be taken off of the machine for a trial while given a bottle of my breast milk.  She gulped it down and then did so well they decided not to put her back on the machine.  Small victories.  Than GOD for Garth. 

The rest of our hospital stay was sort of a blur.  I went up to nurse her three times that night.  We were both pretty new at nursing but she seemed to do a good job.  The next day mom came back to the hospital and we got to go pick her up from the ICU and bring her down to my room.  That day breast-feeding was harder and hurt for me but we muddled through.  The next day we finally got to go home.  We packed up all of our stuff and put the baby in the car seat.  It felt so overwhelming and surreal to be leaving with her.  Like we were taking something home from the zoo.  I kept waiting for the ‘adults’, the ‘parents’ to come and take over for us.  But we headed home, together, a family.  The last 72 hours had not gone as we had planned or as we had hoped and there would be time to think about that and be sad about that later.  For now, we were a team of three ready to start our lives together on the outside. 

The real “moral” of the story is that while everyone says, “well, just be happy you have a healthy baby” that is crap.  It is not enough for so many women to “just have a healthy baby”.  The journey to motherhood is long.  For some of us it takes 43 weeks from start to finish, for others it takes years and years.  Why do people assume that the last few days or hours, hell, even the last 5 minutes don’t matter?  They do.  They really do.  The last few minutes mattered more to me than I could have predicted or imagined.  The last 48 hours before she was born were some of the happiest and strangest, most powerful and most groundless hours of my life.  I can’t remember the pain at all, only the joy at being able to do this work.  Being able to labor at home in front of the fire, with my mother, strong and wise, my husband, tender and awake, my friend Beth, raw and hopeful and my midwives, excited, committed and grounded, means everything to me.  Garth and I had written a half-assed birth plan including things like “bake cookies, dance to Bob Marley, have a fire, walk around the fountain at the park” I did all of those things.  With the exception of pushing our daughter out in the living room, we fulfilled all the details of our “birth plan”.  It is hard to be sad about that but there is a small sadness.  Not holding her right away continues to be a hurdle I need to clear.  It makes me sad and angry when I think about it.  In some ways I feel like her first hour was stolen from me and given as an offering to the education of some students at the university.  I am not certain I will ever totally get over it.  I know I will make peace with the emotions but I hope my feelings of the importance of mom and baby bonding immediately after birth never fade.  It will make me a better provider when it is my turn to do battle with the peds team as the attending midwife.  I will remember how I felt days later, sad, robbed, angry and utterly powerless to do anything about it.  So, yeah, those last few moments of her labor were filled with the joy of pushing and feeling it.  They mattered immensely and still matter to me. I think the power I found in those 29 minutes of pushing is what helps me feel a little more peace about the first hour of her life on the outside and helps me feel confidant in my ability for “next time”.  From the second my water broke on the 19^th to the afternoon of the 21^st when she was finally born into this world, those were the best hours of my life so far.  Sorry Ultra Marathons and wedding days, you pale in comparison to the joy of the work I did with so much love and support, to bring Ramona to the world.