Manila, Philippines

Manu’s Birth

AN ACCOUNT. MOREOVER, A NARRATIVE.

3:00am. I woke up with mild cramps. Three hours later the mucus plug appears in my underpants, and I then knew that it won't be long before new life is added into this home.

3:00am. I woke up with mild cramps. Three hours later the mucus plug appears in my underpants, and I then knew that it won’t be long before new life is added into this home.

SATURDAY

Welcome, Team!

The first ones to come into our home were my midwife Aileen and her assistant Charmayne, who is a nurse herself. They respectfully stayed on the second floor as I managed through the surges on the third floor. They eventually asked if wanted to check how dilated I was and found out shortly that I was already 6cms open.

The rest of the people I had called in for this birth trickled into our home eventually. My nieces, Nica and Chesca, were to watch over Philip in any case he feels scared or becomes too hard to handle at any point of the labor. My friend, Kaira, volunteered to take videos of the birth and came in ready with her gear. Normi is a friend from church and a fellow pastor’s wife. (Also a lactation consultant!) You will later understand why I needed her to be a part of my birth team.

I cannot remember when my doula, Irina Otmakhova, came in, but she assisted us with the contractions soon as she arrived. So many women tell stories of how Irina was key to the success of their childbirth. For one, my sister-in-law had a successful vaginal birth after caesarian and said Irina was a big help. My sister, too! Considering that she had complications to deal with, she still successfully gave birth without having to resort to caesarian section and said that she couldn’t have done it without Irina.

Indeed, I was blessed to experience Irina’s coaching and support firsthand. Throughout my 25 hours of labor, she made crucial decisions and suggestions that effectively shifted my mind and body to be thinking and doing the right thing for the birth.

For starters, she told us to stop timing contractions. She said we already know I am in labor and that’s more than enough information.

Then, she purposely called my contractions as “surges.” Why? Well, words make worlds. A world of a difference during labor, I must say. Everything would have probably been more painful if we didn’t use choice language. Using softer terms somehow made my contractions gentler.

The Pool

Everybody thought that I’d be having the baby by afternoon. My son even confidently announced that he’d be having his brother by lunchtime. I was getting all excited thinking that we were moving faster compared to my first birth! I thought, why if it happened fast enough, then there might be no need to go to the hospital! But we spoke too soon.

The work of labor used up every ounce of energy from me. So I thought it was time to put the pool to use. I needed a break and knew that the refuge of warm waters was what I needed.

The pool I used was from Intex Philippines. Thank you guys for supporting my journey!

 

Indeed it was so calm and soothing – add that it was especially nice to have the entire team taking turns scooping water and pouring it onto my tummy with a dipper. Hand and neck and back massages while submerged in warm water were also so nice and relaxing.

I definitely found myself relieved of the pain and also asleep. My body was effectively taking a rest in the middle of all the pressure. I think this is essentially what epidurals and sedatives in hospitals offer a woman who’s tired of working her body. Maybe the natural and unmedicated counterpart.

Unfortunately, it all became “too effective” that my contractions stopped working efficiently to get the whole body open and the baby out. Irina suggested I step out of the pool, walk around, so I can get my body working.

Of course it felt bad to follow that command! Who wouldn’t want to stay in the comfort of warm and peaceful water, right?

But I agreed that we have to get back to work and so up on my feet I went, and did some rounds. I went down to the second floor where most of the people were chatting. I remember being greeted by my firstborn with a casual inquiry, “Where’s Manu?” He asked as though we were merely waiting for pizza delivery.

The Sisig

How I wish to have chowed down a whole pizza through what would be an overnight process, but there was a really strong urge to vomit since the beginning of my labor. And while I tried to puke it out, nothing happened because I hadn’t eaten anything. I also refused every food I was offered because it felt like I won’t be able to keep anything down my throat.

But I surprisingly vomited at some point and it took one forceful surge to do that. Now I had to wonder, what does one take out when she hasn’t had much to take in? So I looked down and saw it was a whole lot of water and some dinner traces from the night before: sisig! The telltale signs were those tiny bits of red pepper.

Sorry to be so graphic. I know it all sounds gross but it was one of those memorable, very vivid images from my birth, and I also still remember how good it felt after that big blow. It definitely drove the reflux away and allowed me to completely focus on the birth.

I then went up to my bathroom to wash and take a warm shower. It also felt so good, and then so cold afterwards. I remember this to be the beginning of my fluctuating body temperature for the rest of the labor. Sometimes, in a matter of minutes, my body goes from super cold to super hot that I interchanged from my thick robe to my thin linen dress, to swimsuit, to naked body, quite frequently during the entire labor.

A Stall

I continued to work in the room. Lights were dim and between Aileen, Irina, and Normi, I was being massaged. I would lie flat on my bed or sit atop the birth ball, and through them all, I had the best person to give hip squeezes: Joseph. I am not kidding, my husband should be hired at births! I can guarantee that he gives the best and most effective hip squeezes in the world. (Too bad, he is exclusively mine, haha.)

Now for a very long time, it felt as though nothing happened. In fact, I was falling asleep again and again. I guess the lack of it from the night prior was beginning to take its toll on me and everyone didn’t know what to do with a laboring woman who has got nothing in her tummy (I think it is because I generally cannot eat well when I am trying to focus on something) and only had very little energy. Still, we persist.

Throughout the drag of my labor, Aileen would check the baby’s heart rate and my vital signs, and we consistently showed to be okay. Despite that though, the passing of hours made me more and more tired, and consequently, more and more frustrated.

My Body is Not Broken

There are women who give birth without having to feel pain or any challenge at all. Obviously, I am not their kind. Aside from that my surges were painful, I also had about three challenges to work through.

The first was the lip of my cervix that was not fully retracted. I was almost fully dilated but the child’s head cannot descend fully because of that small portion of the cervix getting in the way. Thankfully, my doula knew exactly how to release that and she walked me through a spinning babies exercise called inversions. (You are practically upside down, knees elevated and upper body to the head are inclined downwards towards the floor. You supported yourself through the elbows.)

The second thing was that Manu’s head was in the asynclitic presentation or slightly tilted on one side. Not the most optimal way to slide out, right? So again, Irina walked us through several spinning babies exercises “…to release the soft tissues around his head and help him manoeuver a more straight position.”

The third challenge was getting Manu’s head to navigate through my pelvic inlet to my pelvic outlet. I think that one was the most challenging of all as I had my bone blocking a part of the way. (See Bone sub-story below!)

Again, we try the spinning babies exercises. Tummy tuck, lunges, rebozos – I did them all through my contractions. Quite an exercise, I must say! (If you want to know how it felt, then go ahead and think about doing yoga while your uterus is squeezing a huge baby down into your birth canal.)

I narrate the challenges as though they all happened in a matter of minutes, but in reality, we were counting hours. It took us a while to get everything in order and there was a time when it felt like nothing worked. In my frustration I reverted to the pool and hoped for momentary refuge. I don’t know why but I just slumped my upper body onto the edges of the pool, faced out, and stayed on all fours. At least it somehow helped me manage through the pain of the surges. We later realized that by getting into this position, my body was actually doing exactly what it had to do. Apparently, I was doing a posterior pelvic tilt which was perfect for the problem at hand and I did it unawares.

Now that was my very own experience of what countless literature and stories on the subject always tell us about the best births. The key, they say, is to listen to and believe in our bodies. We must trust that it will know exactly what to do if you allow it to do its work. It is to be fully convinced that a woman’s body is not broken, and that it was actually designed for such a job.

The Bone

Remember the pelvic inlet to pelvic outlet challenge? Well, my OB-GYN from the first birth already mentioned something about this about six years ago. She said that my pubic bone was positioned in such a way that all my babies’ heads, given that I have vaginal births, would encounter it one way or another.

I mention this because not all people are aware that at birth, the baby has some work to do also. Maybe this is simplistic, but I explain birth as Mama opens while Baby slides out. My pubic bone issue made it more obvious for us as it was definitely immovable and my son is the only one who would be able to find his way around it. And that’s exactly what he did. With a few instructions here and there from the world outside, Manu made some stellar moves and successfully went past my bone.

One thing that made me desire a home birth was the fact that my eldest son could also participate in the process of his brother’s birth. If we chose to labor at the hospital, he would automatically be excluded as they consider my delivery as only possible in the high risk pregnancy unit. No kids are allowed in there and I knew in my heart that I wouldn’t want that. Why should his kuya be the last to see his coming into this world?

Dinner is over

It is now way past dinner and our challenges have all been solved, and yet, the main course still hasn’t arrived. Manu, when will you come? I was beginning to be weary and a little less optimistic. Is it time to go to the hospital yet? I think of this even more as the surges intensified upon the water bag breaking. Yet my dilation still wasn’t a perfect 10 and he wasn’t stationed low enough for me to push. I was becoming desperate. What is wrong?

It was a long wait but we eventually delighted in the news of reaching a full 10. We were expectant and positive that pushing will soon follow. But I felt none of it. We tried to get into position to encourage it. Still, nothing happened. The only present thing was pain emanating from the surges.

I was on my wits end and consequently asked for the following: hospital, epidural, vacuum. Anything to get the baby out and for the pain to end. Now labor and birth stories always say that this is completely normal – even expected behavior. They say that it is common for women to ask for intervention just when the end of labor is near. That you will feel like giving up right around the time when the baby is already coming. So is this why I am beginning to ask for intervention?

As far as my team is concerned, in compliance to my request to not mind me when I begin asking for medical solutions, none of them readily said yes. They did their best to keep silent or give me open-ended answers. (But should I really want to, or emergency truly arises, I am grateful to my manager, Chere Gioskos, for ordering an ambulance to be on standby!)

On the other hand I was also thinking of the possibility of regression. Like, what happens if I ride the car fully dilated? Would I regress and go back to being a seven? Six? Or maybe even five? Anyone who’s gone through labor will understand that moving is not an option when you’ve reached this far and you would rather stay focused on making it work right where you are.

But still, I couldn’t help myself from saying, “Ayoko na. Ayoko na….” while I pulled all of my hairs out. (Literally, sinasabunutan ko ang sarili ko at some point.) I would cry to everyone and say that I don’t have the energy to do this anymore, that I simply have no strength to give anymore. And I would have gone on confessing defeat over myself and my body if it hadn’t been for Normi.

She, who with a gentle voice but a firm resolve, looked at me and said, “But Carla, do you not realize that it hasn’t been your strength all along? You got this far and none of it has been you. This is God carrying you through.”

Now that is why I needed her there. She was sent to say exactly what I needed to hear. Because while birthing looks like a purely physiological process, I dare say this view is incomplete. I personally believe it is more spiritual than we think, and so it is important that Normi and I connected deeply on that level.

SUNDAY

Last stretch

We move upstairs at some point. I will not lie that the thought of going to the hospital was still very much on my mind but my spirit, body, mind and soul always found a reason not to go. One of which was, who knows if this really was meant to be a successful homebirth? And the more important thing was that no one, not mom or baby, is in danger.

I think of these as we wait for the guttural noise a woman makes when she is already pushing. But it simply isn’t there and I am devastated. Not only was my energy fluctuating, but even my confidence. For the first time in this very long day, I begin to seriously doubt myself. Why do I not know how to push? Isn’t that instinctive? Shouldn’t that just happen? Maybe I really cannot do this.

It surely didn’t help that everything was beginning to feel ominously familiar; this was exactly how I labored for Philip! And I still vividly remember how all of that ended: with a C-section. So I solemnly and vulnerably wrestled with God. Is this how You want it, Lord? Because while I don’t like it, please, let Your Will to be done.

He answered me through His Word. A Word which He had given to me few weeks before birth.

“Remember not the former things, nor consider the things of old. Behold, I am doing a new thing; now it springs forth, do you not perceive it? I will make a way in the wilderness and rivers in the desert.”

Isaiah 43: 18-19

For quick context, I have memories of “failure” from a 22-hour-birthing-work from my firstborn. Strangely similar motions for everything, quick dilation, a halt somewhere in between, and a baby who would not descend completely.

Perhaps God knew my first birthing experience would haunt me somehow and this is why He had to give His assurance in advance. But the assurance did not come without Him asking that I also be in faith. Like, big, huge, unwavering, crazy faith, which I didn’t realise until the time of doubt had come.

Read the verses closely and you’ll see He wasn’t only inviting me to believe a possibility, but to be fully convinced that this was going to be different. How wild is it that I cannot even consider anything of the past (while everything looks just like it!) as I go through the present birth? And He was asking me to be sure, even when there didn’t seem to be any other way anymore.

Like I said, one way to for this birth to happen was to trust my body and even that was challenged. And only when I reached the end of myself that I was reminded of how this birth was never about what I can do, neither was it about what my midwife or doula can do, but it is about what only He can do, all along.

Now I have to add that the kind of faith I describe here is not merely wishful thinking. It surely wasn’t a reckless and blind kind of faith that looked away from reality. We always made sure that the supernatural and natural agreed at all times, and the truth is, between God’s Word, my blood pressure, and Manu’s heart rate, none showed a single sign of distress.

Transfer of Care

So there was no compelling reason to give up. No reason, yes, except that I might just be too weary to wait, too tired to trust.

My impatience caused the team to convene about the possibility to do transfer of care in the next few hours. If I really thought that the hospital was best to assist me, the last thing they wanted to do was force me otherwise.

So then Irina calls the attention of everyone in the room and announced that I will be made to rest for the next two hours. She asked everyone to do the same. All complied and left the room except for my husband, Joseph. They settled into the other parts of our home and themselves got some shuteye.

 

When the people left and rested themselves, I began to regain some energy. I realised we were 1) sharing so much of it in one tight space and 2) we were also sharing each other’s exasperated energy. We were all tired, no doubt, and it didn’t help me to get more of that weak energy from others. Books on natural birth always talk about who is in the room when a woman is birthing because we really have the capacity to alter outcomes just by mere presence and energy. I believe this is also why I was never able to labor properly at the hospital five years ago. Because I was surrounded by people I didn’t really know and it prevented me from opening myself up as I was going through what was one of the most private and precious times of my life.

Snores and Surges

I was frankly so sleepy and so tired that I couldn’t wait to just be comfortable in my bed again. Though I continued to get surges, it surely felt better to do them side-lying and with a firm body pillow was wrapped between my legs. But alas! That relief only lasted through three surges because, by the fourth one, I felt something different. I feel like pooping! It felt like a massive thing was about to slide out from somewhere down there and I couldn’t stop it no matter what.

It took me a while to realize that, aha! I am finally pushing!!! And through the deep snores of my very tired husband, I was, at last, heard to make the exact sound that Irina was looking for. Together with Aileen, she then immediately made her way up to our room and quietly sat down on the floor from where they occasionally gave feedbacks.

“That’s it. You are doing the right thing.”

“Push it inside and not outside.”

“Try not to shout.”

I was at first very disappointed that just when I decided to rest, also was when the natural pushing had come. I was so keen to sleep!

But there was also an overwhelming feeling to get up, work, and just bear down. I couldn’t ignore it and all I could do was follow my body. Entering the second stage is quite different from the first as there is, overall, less control one can exert over the situation.

And being out of control is not the best feeling in the world so I had to make an effort to remember that God is still over and above this situation. Even better is that in my weakness, His strength is made perfect so I made sure to call out to Him.

“Jesus, you said ask and it shall be given to you and so I ask You right now, let me have this baby out! Let it be done in Your name!”

“As Sarah received the power to conceive, so do I receive the power to birth this baby right now!”

“You started this good work, Lord! You shall carry it to completion!”

In Ina May Gaskin’s book, there is this woman in labor who mouthed, “I just want this baby out!” Story goes that soon as she said that she really was able to get the baby out. I was hoping that the same thing would happen to me and that it would be far more effective as I was relying not only on myself but on God’s powerful and creative word.

And you bet it did! Because upon checking, Aileen reported that the head is already at station 3. Manu is now so low that Aileen and Irina started to talk about where we wanted to have him. Bed? Bathroom??? Pool????

I opted to do the work in the bathroom because I could squat and hold on to something as every surge asked me to bear down. At this point, I felt like I was doing something like crossfit! There was total bodywork and all the effort made my head produce sweat enough for a lifetime.

Now strange as it seems and hard as it was, it all felt good. Mind you, it wasn’t painless but I felt good and right and strong and I was excited to work the baby out. This was actually the part when I felt confidence and power; I was totally in charge of the birth and there was tremendous fulfillment in knowing exactly how to do it. It was like driving a car that was made specifically for me.

The other thing was I strangely looked forward to every surge of the second stage. So many women and birthing books have said it before me: “to ride the wave,” and I never quite understood that until this point. It is apparently because of the momentum these surges provided. I found that only by riding them or using them as I bore down, was I able to push effectively. Any work without the surge was basically useless. At best, I could try, but it’ll probably be out of sync. Oh yes, the surges weren’t easy, but they were surely on my side!

Crowning

Some women will tell you baby was out in 30 minutes or in just three pushes. Well, I had to work on it for two hours. And it included changing positions from squatting, to all fours, then finally, up on my feet.

Somewhere in between it all I decide to stick my finger inside and felt the boy’s head and his wet hairs. Now I cannot tell you how encouraging that felt. My baby is really almost here!!! 

Things began to feel even more real when I was crowning. I would push and feel the topmost part of his head pop out of my perineum then revert back inside whenever the surge finished. While it was frustrating to feel his head retract after each push, Irina assured me this was alright, and it was actually beneficial that my perineum stretched gradually so to lessen chances of bad vaginal tearing.

Manu is actually a huge baby. He was born with a whopping weight of 4kg! And yet, I only bore a second-degree tear. I didn’t even feel any pain down there and I think it’s because none of us rushed the process. If there is anything I am so grateful about when it comes to this birth, it is that not a single person was too tired and too busy to wait for the natural progression of my labor. Contrary to how most births are depicted in films and on television, this one felt so gentle, respectful, and loving, as design had always intended it to be.

Gravity 

It was a good amount of time spent on the bed on all fours when Irina said, “Why don’t you stand up and use gravity?”

I obey. With complete resolve, I get up on my feet and remember making my way to the bathroom when a surge came over me. I hold on to the edges of the inflatable pool, while my husband scoops his arms right around my armpits in order to prop me up. I was already losing power in my legs and I realized it was because of this tremendous force that was requiring my entire body to just be.

I stay there for a while, feeling as though my hips would break. Little did I know that was only moments before my baby’s head is to fully slide out. I was then so deeply focused on the work that when I opened my eyes, I was surprised to see that Manu’s face was already there. This is it! He is here!

From that point, it took only one surge more for the rest of the body to get out. I surely used that one to breathe the rest of this baby down. Gratefully, it was enough to cause his torso, arms, and his back covered with vernix, to free-fall into Aileen’s ready hands, giving me enough time to regain footing and strength to scoop the softly whimpering baby up to my chest. He really is here. At 5:15 am, My Manu Raphael is born in our very own bedroom, and I couldn’t help but think that God’s mercies are indeed, new every morning.

Breakfast Baby

I cry for a few good seconds before concern and joy and hunger took over me. Is he okay? Is he cold? I love him! I am done! Wow, I did all that? I want a burger! I am so hungry! No, I mean, I am hangry!

People started to trickle into the room to see the very thing they were all waiting for since 25 hours ago. I was so amazed to think that the closest to my heart were right here in the house, in the room, with me. And can this be true?? That I hadn’t stopped holding Manu since he came out of my body? There were no bright lights, no unfamiliar faces, no cold and overly sterile atmosphere to deal with. He only had to peacefully stay on my breast as the third stage of my labor commenced and ended with Aileen closing me up.

We had a semi-lotus birth. Lotus birth (or umbilical cord nonseverance – UCNS) is the practice of leaving the umbilical cord uncut after childbirth so that the baby is left attached to the placenta until the cord naturally separates at the umbilicus. In our case, “…we waited for placenta to be born first and for the cord to be transformed from pink and bluish (full of blood) to thin and whitish. Basically to complete the transfer of any blood together with the stem-cells, T-cells and anything else baby needs from the placenta back to the baby.” A full lotus birth is when they wait for days without cutting anything and they simply wait for the cord to naturally dry up and fall off.

 

Note that I am a person who is afraid of needles so being stitched up mattered a great deal to me. But thanks to my natural oxytocin high that it didn’t feel as bad as it normally would. Moreover, I was awake and energetic! I was actually talking and laughing so much as I recalled every funny and unfortunate thing that happened while I was going through the course of labor.

Manu himself was also so alert. He wasn’t drowsy at all and his eyes told me he was curious about the buzz of the room. Can I just tell you that this is one of the best benefits of natural, unmedicated childbirth? Where none of us felt drugged and hampered to fully enjoy the moments immediately after all the hard work!

New Season

People started to leave in the next five hours. My natural high was also beginning to wear off and I was becoming more and more sleepy. My body was beginning to realize that it was tired. So Manu and Mama eventually succumbed to the call of sleep and cuddle. After all, we did some intense work just a few moments ago.

That night, I do remember waking up to soft rain. How apt, I thought. For today was gentle shower of birth blessings. Moreover, it reminded me of how the season is changing, both for my nation and our little family. We now leave summer for storms, as our lives shift from prenatal to postpartum.

Surely, there are new challenges that lie ahead of us. That which is a story I reserve to tell another day. Nevertheless, this birth tells me that whatever it is, my team is still around to help me raise this baby in the world and that God continues to guide us every step of the way, just as He had been so faithful during Manu’s unforgettable birthday.

When the Spirit of truth comes, he will guide you into all the truth, for he will not speak on his own authority, but whatever he hears he will speak, and he will declare to you the things that are to come.

John 16:13

 

POSTSCRIPT

It takes a village to raise a child, they say, as it also takes a team to bring a child into this world. Please indulge this acknowledgment as this redemptive birth process wouldn’t have been possible if not for these people who braved Manu’s birth with me.

Aileen, Irina, Normi, Charmayne, Chesca, Nica, Kaira, Mel, and Renilda:

You are definitely my Birth Team from God. It is my honor to share a sacred space with you all on those two days. I will be forever grateful for the way He used you all to bring this precious life into this world and I will never forget how you’ve chosen to be there for my family in this very special moment. Until we co-labor again!

To Joseph:

You were the very first member of my birth team. You have believed that I was born to do this as early as six years ago. I have no doubt that you are the perfect partner in everything — making, birthing, and raising children. Thank you for never giving me an opportunity, not even once, to think that I would have to do any of these alone.

To Philip:

You prayed that I won’t have to be cut open for Manu’s birth and I want you to remember that on your brother’s birthday, God honored your prayer. You are only five but you have prayed for more honorable and more profound things than many of the adults I know. Love you deeply.

To God:

You had the power and my only job was to believe. It was only possible because of You. Thank You for the wonderful design you’ve reserved for the woman’s body, and all honor and praise to You for authoring and sustaining the life of Manu.


If you want to get in touch with my midwife and doula, here are their contact details.

Irina Otmakhova

www.ConsciousBirthManila.com

consciousbirthmanila@gmail.com

09279146955

IG: @irina_doula

Aileen Gay G. Vinoya

agvinoya@ymail.com

Marikina Maternity Clinic and Lying In: 6252682/09177090925

 

If you are interested, here is my vlog of the whole birth! Just a note: keep the sounds on. Haha! Enjoy!

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