Liev Michael Mendoza's Natural Birth at The Farm in Summertown, TN

THE SHORT STORY: Liev Michael Mendoza was born May 22, 2010 at 8:25pm Central time weighing in at 8lbs 14oz and was 21 inches long. The labor was only 5 hours long from start to delivery which included only 45 minutes of pushing. The birth was 100% natural.

THE LONG STORY:
My birth story begins a bit differently than most. The place and manner of my baby's birth was almost as important a decision to me as deciding to have a child in the first place. So to ignore it and not take a moment or two to explain would be, in my opinion, telling only half the story. So I ask you to be patient as I relay to you what led me to the place (emotionally, spiritually, and physically) where my little Liev was born.

When I first discovered I was expecting, (September 10th, 2009) I immediately stepped up the research I had begun months before. I poured over books and by four weeks, I had read about 12 of them. A friend who knows what kind of woman I am (remarkably well for the short time we have known one another) suggested that I view a video called "The Business of Being Born." It was a documentary made by former talk show host, Ricki Lake and Abby Epstein who were examining some of the less positive aspects of our current birth culture here in the United States.

The video introduced me to home birth and it's merits and showed me what hospital birthing had become over the last several decades. The statistics were jarring. The view of what birth could be was enlightening. One of the experts interviewed was a midwife by the name of Ina May Gaskin. That video introduced me Ina May and at the time, I had no idea that only eight months later I would be laying on an exam table in her clinic being examined by her.

Watching "The Business of Being Born" was a jumping off place for me and it led me to Ina May's books. The first one I read was actually her second Ina May's Guide to Childbirth and at the risk of sounding like a cliche, it changed my life. It changed my views on childbirth, on pregnancy, on breastfeeding, on my own body, on my womanhood, and certainly on how I wanted to bring my baby into this world. It turned me into sponge for information and eventually into an activist of my own right. It made me realize that having a baby is not just about the healthy child at the end of the journey as so many claim. Pregnancy and childbirth is a pivotal point in a woman's life. The positive or negative feelings a woman has during this event can determine the course of the birth and it can and often will alter her forever. It is a rite of passage not to be taken lightly and not to be molested. This experience can be incredibly traumatizing to a woman or it can be spiritual and transformative.

I couldn't stop reading. I was amazed by the stories of women who had birthed on The Farm. They seemed so completely different than the stories that I had always heard from my friends and family members. They were peaceful and cooperative. The women spoke of elation and love and not of fear or distress. I read two more of Ina May's books; her first Spiritual Midwifery and Ina May's Guide to Breastfeeding.

I learned that nearly forty years ago, Ina May Gaskin, her husband Stephen and about 60 converted school buses full of hippies made a seven month journey across the United States before settling and forming a community in Summertown, Tennessee. Their community was called "The Farm". Stephen had been a professor at San Francisco State college and had eventually amassed a class size of about 1500 students who attended his "Monday Night Class" which covered important topics of the day like the war in Vietnam, civil rights, the hippy movement, spirituality, etc.

Some ministers from out of state asked Stephen if he would speak at a number of churches and universities across the country and so he headed out and with him The Caravan took off.

Along the road, they soon discovered a need for someone to attend women who were giving birth and Ina May and some other women stepped up to help. They were educated but not experienced in childbirth. They soon became so. During one stop in my home state of Rhode Island, the women met a physician by the name of Dr. Louis LePere who gave them their first lessons in obstetrics, how to handle emergencies, gave them their first obstetrical text books and equipment and sent them on their way. Before finally settling in Summertown, The Caravan's "midwives" had delivered nine babies.

In the years that followed, Ina May and her colleagues became certified professional midwives and delivered all the community's children. Today, they are still doing it. Nearly forty years and more that 2000 babies later, they are delivering second and third generation Farm residents as well as the babies of families from all over the world who come to The Farm to seek their expert assistance. But what makes The Farm so fascinating is not that they deliver babies. It's how!

Nearly every baby born at The Farm is born at home - meaning in a cabin or cottage rather than in a hospital. Their cesarean section rate is only 1.5% compared to the national average of nearly 32%. They have about a 3% transport rate to the local hospital and still deliver twins and breech babies vaginally. Something that is nearly unheard of in today's hospitals. They have remarkably low rates of post-partum depression and inspiring success in breastfeeding. Yet they do it all with little, if any, intervention. There are no fetal monitors, no inductions with pitocin, no epidurals, no hospital gowns, no restrictions on eating or drinking. Women are allowed to move freely in labor or use birthing tubs to ease their discomfort.

I was incredibly impressed by these statistics and The Farm midwives' respect for natural child birth and the capabilities of the female anatomy. What's more, they seemed to take all that is impressive about ancient midwifery and combine it with the best of science in discovering just what a woman could do and why. There was a true respect for the mind/body connection as well that was all common sense and practicality. Reading about this exposed to me how our birth culture's policies seemed to lack that common sense and practicality in the name of streamlining the process and convenience to the medical establishment.

I kept all this in mind as I sought out my health care provider. I interviewed four certified nurse midwives from three different Rhode Island OB/GYN practices. I knew I wanted the closest thing to The Farm experience as I could get. I spent at least fifteen minutes explaining my ideal birth to these midwives and I was amazed at the response. I immediately felt them giving me that "Oh, you are one of those!" looks. They handed me what seemed like hundreds of pamphlets on genetic testing, scary risk factors, what to avoid while pregnant. I felt like I was being treated like someone with an illness rather than someone who was about to experience a completely normal physiological event.

For each midwife I asked a standard question: "If I come into the hospital in labor, and for some reason the labor stops or slows, what will be your first step?" The answer was the same for all four: "We will start you on a pitocin drip." They didn't offer the option of sending me home, of stimulating my nipples with a breast pump to encourage the release of oxytocin which would start contractions. They didn't say they would suggest a walk to get things moving. After listening to me talk for fifteen minutes about my desire for a completely natural birth with no interventions or drugs they offered the only suggestion....an IV drip of synthetic oxytocin called pitocin. A drug that is known to make contractions stronger than they would be normally and harder to handle without pain relief. The drug used in inductions.

Then, they gave me a form to sign. At eight weeks pregnant I was still at least thirty two weeks from birth. I was a rookie. I knew little about pregnancy. The form stated that by signing it, I would be giving all rights to the doctor on call to make whatever decisions he felt were warranted at the time. He need not ask me in the moment. They were asking me to trust someone I had never met to make decisions about my physical health and well being and that of my child's without consulting me. What was more, I had to sign it before leaving that day if I wanted to make another prenatal appointment. I refused and asked for my records.

As I relayed my experience to friends and family, none seemed to understand my concern. The local hospital was nationally recognized. Everyone had their babies there. They were all fine. "Yeah", I thought, "nationally recognized by a country who seems to embrace it's 32% c-section rate!" And as for the mothers and babies being "fine" maybe that was not exactly so.

I spent the next month interviewing everyone I could about birth. I spoke to doctors, labor and delivery nurses, I talked to doulas, hospital administrators, La Leche League and other birth-related organization leaders, childbirth educators, and finally mothers themselves. I interviewed over 23 of my friends asking them to share their birth stories. I also began hosting the Natural Birth check-ins and blog on TheBump.com, a forum for pregnant women. What I discovered was that "fine" was a little hazy. Of those mothers I interviewed, more than half had had at least one c-section. All but one or two had been induced with pitocin. Most of them had had epidurals. Very few felt they had a good experience. More than a reasonable number of them found birth disappointing, excruciating, terrifying, and traumatic. The experiences of the women on thebump.com told me Rhode Islanders were not alone. The number of woman who sought natural birth were inspiring, but those who actually succeeded in having a natural birth were few. When they told their birth stories, I saw the same patterns I had seen among my friends. I was appalled by the number of inductions before 40 weeks, and how many scheduled c-sections there were. What was most alarming is how many of these women felt uneasy about their caregivers but continued to trust them blindly regardless.

Of the women who had had c-sections, nearly every one thought that what led to their surgery was a rare occurrence, freak thing, or a legitimate emergency. But when you trace back their stories to the beginning you saw a lot of the same patterns. First the induction, then the intensity of the contractions that were not as productive as they should be but more painful than the woman could stand. So she would opt for an epidural to relieve the pain, which would slow the labor....requiring more pitocin. So on and so forth this would continue with a lack of progress before the baby would show signs of distress and a c-section was necessary. What did this mean to me? That although I believed that these interventions and procedures represented real opportunities for saving lives in the rare occasions that they were medically necessary, they were being done routinely and unnecessarily and making birth for these woman more difficult and traumatic than it had to be. I knew that was not what I wanted.

I began wondering if it was even possible to birth in Rhode Island (or many places in the US) the way I had come to see as ideal. If I asked for and sought out a natural birth, how good were the odds that I would have one? Would a birth plan be honored or even considered? Would it be too easy for me to "risk out" and end up caught up in that wave of interventions in which my friends found themselves?

I spoke to my husband about it and he said "I wish we could just have the baby at The Farm. It's too bad we don't live closer." I thought, "well, it can't hurt to look into it!" So I gave The Farm Midwifery Center a call.

We talked to both Sharon Wells and Pamela Hunt, two of the original Farm midwives. They gave us the details about how a woman from out-of-state goes about birthing on the Farm. It turned out that it was not only possible, but affordable and the first step was coming down for a visit to see if it was what we wanted to do. So we flew down to The Farm for the weekend of Halloween.

We immediately fell in love with both the Farm and Pamela, who would be our midwife, and decided that this was exactly what we wanted. Only a week before I had been examined by a midwife in an OBGYN practice in Warwick, RI. She had asked me if I had been sexually molested because of my reaction to her touch. During that same type of exam with Pamela, she was able to tell me how wide the spread of the inside of my pelvis was with her hand without me even knowing she had been that far inside me. This woman had skill. She also had tenderness. There was a calm welcoming warmth in everything about her and our first prenatal visit. She knew, not only, how to birth babies....she knew how to treat women. When we read The Farm contract we were expecting a little bit of what we had experienced at home; some sort of "locking in" but there was nothing - just straight forward, easy to understand, we work for you kind of stuff. We signed.

Back at home I found a website for The Midwives Alliance of North America (MANA) and located a Certified Professional Midwife (CPM) near me. To my knowledge, CPMs are not legally able to handle home births or maybe even legally practice in Rhode Island, so I found one in nearby Massachusetts. Sue Smith saw patients in her home office. I would go, spend about an hour with her, talk about everything from my physical symptoms to my emotional state. She would measure my growth, check my urine, and suggest any prenatal needs. I loved working with her. We worked together until my 37th week of pregnancy when I left for The Farm.

On April 19th, 2010, my mother and I started our three day journey from Rhode Island to Tennessee. We packed up a rental minivan with my two cats and about a month's worth of supplies for me and the baby and headed south. We arrived on April 21st. during my final weeks of pregnancy I stayed in a cabin about 20 feet from my midwife, Pamela's home. It was small and rustic but adequate with a kitchen, living room, bathroom and a small bedroom with a queen sized bed. Once a week I went to clinic for my prenatal check-ups. However, Pamela and I spent a little time with each other every day so she always knew how I was feeling and closely monitored my progress, diet, and emotional state.

I met other Farm residents, families who were staying at The Farm for their own births, and even midwifery students. One of the highlights of my visit was during a week where a midwifery assistant training workshop. I met a group of women that week that changed forever how I felt about being a woman. I volunteered to be a model for one of the lessons in which Ina May Gaskin herself taught the students how to measure my fundal height (size of my belly), feel for my baby's position, and listen for my baby's heartbeat with a fetoscope. I participated in their extra-curricular activities, and I ate dinner with them in the evenings. For the first time in my life I was feeling a real bond with women. I had never been one to have a lot of girl friends but with them, I felt proud to be a woman...and empowered by being a woman. Before our dinners we would hold hands and sing a song....the energy in that room was indescribable. I missed them when they left.

The weekend of May 15th brought my estimated due date and with it loads of symptoms. I had been contracting for weeks but on that Saturday, they became pretty intense. I started having some loose bowel movements and menstrual-type cramps both, I was told, were signs of labor. On a walk that morning I even had multiple orgasms as I contracted! I had heard this was possible but didn't think for a second I could be one of the few lucky ones who experience it!

All day, I had a funny high which left me feeling really out-of-body. Pamela attributed this to surges in my levels of oxytocin and estrogen. She checked me and found that I was nearly completely effaced (thinned out) and about a centimeter dilated. She said the baby's head was very low. Thinking that labor was imminent, we set up the birthing tub in my cabin and celebrated a little with some music and conversation.

But that day ended and no labor. Life went on and another weekly prenatal came and went. We hoped it would be my last, and indeed it was. I found out that Deborah Flowers, another Farm midwife who rarely attended births anymore was interested in attending mine. She came to my last two prenatal visits to brush up as her daughter-in-law would be giving birth soon and she wanted to deliver her baby. I felt so honored to have two amazing women who were quite legendary planning to help bring my baby into the world.

Friday May 21st was Deborah's birthday and I promised her jokingly to try to hold out so she didn't have to spend her birthday at a birthing. Friday came and went with the return of that high being the only symptom I felt. I was talking to my mother on the computer and felt very out-of-body and happy. She was convinced that Saturday would be the day. I would be 10 days past my due date (the one my Massachusetts midwife had calculated) and she had delivered both my brother and me 10 days late and 22 was her lucky number. I humored her but didn't think it was going to happen. Or rather, I was afraid to hope she was right.

That night, I inserted a capsule of evening primrose oil into myself (something that had been suggested that I do for weeks to soften my cervix but I had always forgotten to do it at bedtime). I woke up a lot that night cramping but I thought nothing of it since it was
common for me at that point. That morning, I noticed that there was an abundance of discharge with just a slight tinge of blood when I peed. In the toilet, there was a glob of mucus. It wasn't bloody or big, but I suspected it was my mucus plug and signaled that my baby may be coming. I tried to contain my excitement.

By lunch time, I was contracting with pressure. I walked to the Farm Store to have lunch and talked to Louise and Donna (the women who work there) for about an hour. I paid a quick hello to Deborah who was outside under the dome having lunch with some others. I had asked her about her birthday the night before. It was then that I felt a contraction that made me feel the need to steady myself. I walked home with Pamela's friend Juliana. Juliana van Olphen-Fehr is also a midwife and coordinator of the nurse-midwifery graduate education program at Shenandoah University in Virginia and author of the book Diary of a Midwife: The Power of Positive Childbearing. As we walked, Juliana suggested that this was the real thing. Afraid to get to excited, I brushed it off.

I spent some time over at Pamela's house with Pamela, Juliana, a visitor to the Farm and midwife assistant named Claudia, and a friend Tamami. All the time my contractions were becoming more regular and more intense. Not wanting to jinx myself, I carefully texted my mother and mentioned that I thought I "might" be in labor. Soon after it appeared that this was, in fact, the real thing and I could deny it no longer. I went to the bathroom and there was a little more blood. After Tamami massaged my back through a couple of contractions I decided to go to my cabin. Tamami and Claudia walked me over. Claudia stayed while Tamami went home.

When I got there, I immediately began to set things in order. I fed the cats, changed the litter box and set out my birth plan on the kitchen table. I began to get self-conscious because my contractions required that I moan or vocalize my way through them so I went into the bathroom and closed the door with each one. Pretty soon, I wasn't leaving the bathroom at all. Instead I paced back and forth inside and leaned on the bathroom counter when they peaked, looked myself in the mirror and moaned. I realized that soon my moaning turned into a melodic hum. I recognized it as the song the black soldiers hummed between prayers and thoughts the night before they went into battle in the film Glory starring Matthew Broderick, Morgan Freeman, and Denzel Washington. I thought that was interesting.

Pamela came in and said it seemed that I was progressing quickly and she wanted to set up the birthing tub which we had dismantled the day after the last set up. Another birthing mother had needed it. She wanted to check me. She said I was completely effaced and about two centimeters dilated. She went back home to gather the materials to set up the tub.

About fifteen to twenty minutes later the tub was up and being filled. I was pacing harder and faster, moaning louder and more often. Pamela mentioned she had "no desire to leave me" but wanted to start setting up for the birth and needed to go back to her house to gather her supplies. She said she would be right back to check me again. When she did, she found I was four centimeters dilated.

We went outside in the back and Pamela swept the deck figuring I might like to walk it. But I was hot. It was a humid day and I felt like the bathroom, with its window air conditioning unit was really the only place I was happy. I also felt a bit on display which doesn't sit well with me when I am feeling vulnerable. So I went back in and continued to pace the bathroom. It seemed the only place I could concentrate on the contractions.

She checked me again after what seemed a very short period of time. It got to the point where time was starting to not make much sense to me. I was too wrapped up in managing my breathing and concentrating on the contractions. She discovered I was now at eight centimeters! Pamela had explained that she didn't like to have her birthing mothers use the tub until they were at least six as it could sometimes slow down labor.

I had been looking forward to the tub. I had heard that it was a great way to relax and reduce the discomfort of the contractions. So I climbed into the hot water. It definitely did slow the contractions and reduce their intensity but I couldn't stay in long. The water had me out of breath and completely overheated. I climbed out and headed for the bathroom again to cool off and regain my lost control.

During the next several moments, I heard Pamela on the phone telling the other two midwives, Stacie and Deborah that if they wanted to be there for the birth, they needed to hurry over now.
By the time they arrived, I was dilated nine centimeters and required only one more before I could start pushing. Of course, at this point, the sensation that I needed to push was present. I was surprised to find that the urge was not what I thought it was going to be like. I felt like I was about to lose my stuff - like I would take a crap right there on the bed if I didn't hold my butt tightly together! These contractions had gone from really intense to nearly overwhelming. I have to admit, at this point, I felt like I was drowning. Panic hit me for a second.

Deborah was on one side of me and Stacie was on the other while Pamela remained between my legs and Claudia looked on over her shoulder from the other room. I was too tired at this point to walk anymore but I hated lying down. I actually felt the urge to run from the feelings I were having as if I could escape my own body.

Sensing this, Deborah got my attention and said, "Look at me and slow your breathing, Keri....Sloooooooow in.....Sloooooow out." She coached me through a few breaths and the contraction had passed and I was calm again. Pamela checked me again and triumphantly announced that I was at ten centimeters and I could push whenever I was ready.

At that moment, I realized...really realized...I was having a baby! Just like all the fictional and documentary videos I had seen with women grunting and panting, legs spread, people surrounding them, I was about to have a baby!

The contractions felt just like an overwhelming need to have a bowel movement. Why did I not know that? I thought of all the women who talked of their fears of pooping on the delivery table. Now consider this: there is no person I know who has bigger bathroom phobias and hang ups than I do, but at that moment, I said to myself...."ok, so if you shit on the bed in front of everyone, than you shit on the bed in front of everyone. So what?!? You need to have this baby and there is only one way to do it."

So with each contraction, I gripped the hand of Deborah on my right and the hand of Stacie on my left, pulled myself upright and bore down with everything I had like I was taking a massive poop right there in front of poor Pamela.

This went on for what seemed like forever and I could feel the baby moving down. I could feel it move back ever so slightly inside me for every little bit of progress forward. I felt myself stretching. I visualized a film I had seen just days before when the baby's head was crowning and then out with only the body left to be born and I tried to focus on working toward that.

I screamed, I roared like a lion. I felt so dramatic but it seemed to work for me. I never thought I would be one to yell but here I was doing it. I apologized for my drama. the women all laughed and said it was fine. I didn't need to apologize for anything. They said I was doing a wonderful job and they could feel/see the head of the baby getting closer. I pushed and pushed. I felt overheadted again and asked for something to cool me down. Someone put a cold, wet, washcloth on my forehead. I wondered if I could do this any longer.

The pushing helped with the contractions. If I didn't push hard they were more uncomfortable. I began to wonder if I would tear and thoguht I should just do it. So what if I tore? Women had before and survived, so would I. But I confess, I was a tiny bit afraid of that. Up to this point of my pregnancy I had had absolutely no fear of labor and delivery which I thought was pretty amazing. But here I was wondering...."Will I survive this? Will it ever end?" The women reassured me that there was nothing to be afraid of, I was doing great and the baby was coming. "You are having your baby!" they told me. And I was. They asked me if I wanted to see my progress in a hand mirror. I said "NO! JUST GET THIS KID OUT OF ME!"

The last few pushes I felt the burn I had been warned about. It was what scared me the most. It didn't last long but it was intense and I pushed with everything I had despite it just to bring it to an end. Then poof just like that, I felt the head come out. I paused for what seemed only a second to catch my breath as they congratulated me and some fussing was being done and I said to myself, "Ok, no sense in prolonging this any further." With the next contraction I spit the rest of my child out. That is exactly what it felt like and the relief was instant and complete.

In a flurry of activity, they were wrapping him in a blanket and putting him on my belly. All I could say was "I had a baby!!!" over and over. Then, before I knew he was a boy, I said "he is so handsome!" Feeling silly for saying this about a potential baby girl, I took a look down below and confirmed my baby was indeed a little boy!

The next few minutes were a blur as I heard Pamela say that the cord was pulsing and she was preparing to cut it once it stopped. I watched her clamp and cut it. They began talking about the placenta and how easy it would be because there were no bones in it and I was thinking, "oh right, there is one last thing....well, let's do this and be done with it all!" I didn't even wait for a contraction. I just pushed and out it came. In that moment I rejoiced. My pregnancy, labor and delivery were complete!

Deborah took little Liev to weigh and measure him in the next room. I was too preoccupied with disbelief and awe that I had a baby to worry about attempting to breast feed quite yet and there was some stitching to do for a minor tear.

That seemed to take forever but it was relatively painless. I hear the announcement from the other room that Liev was 8 pounds and 14 ounces. He was 21 inches long. I had delivered him in five and a half hours and pushed for 45 minutes. This was impressive, they said for a first baby and for a baby so large. Pamela called me an efficient birther. She also mentioned how neat I was. The baby came out relatively clean with not much blood or any vernix. It was a great mystery when my water bag broke as it hadn't been noticed by anyone.

I was a mommy! My love for this little guy was something I could never have fathomed. I realized that all the inconvenience of driving down to Tennessee, eighteen hours from home, defending my reasons for doing so over and over and over to doubting friends and family....it was all worth it. I never had so much as an IV. Liev was not exposed to pitocin, an epidural, dilation drugs like Cervadil or drugs used off label for birth like Cytotec. There were no hospital gowns, fetal monitors, hospital beds or policies, no shift changes or strangers. My baby was born in the cabin I had lived in for a month, on the bed I slept in every night, among women I had grown to love and trust. I was free to labor in whatever way felt comfortable for me. I had made the journey from a girl to a woman...from a woman to a mother. I had done it all trusting that my body was designed to birth my baby with little fear.

I did what every woman should have the right to try to do. I did what so few woman have the chance to do across our country. I birthed my baby naturally. I went after what I wanted, what I thought was best for my baby and myself. I felt now like I could do anything! The reward for chasing after that dream was this beautiful, perfect soul! Liev....Liev....Liev....Liev. How I love him!