The birth of Esther Maia Amick

We decided to do a home birth because we wanted as little doctor intervention as possible and Abby wanted to have a drug-free, natural birth. Abby’s mother, Mary, came to support us for about 6 weeks before the event. Nathan’s sister, Anna Amick is an experienced midwife and came down four weeks ago, along with her friend and assistant Silver, and Beth Amick, Nathan’s mother. We have had a lot of fun living here together in Mexico and waiting for this birth.

Abby started having real labor contractions around 10:30pm on November 10th. We timed and logged those contractions in previous posts till about 2:30 in the afternoon the next day. When we got into more serious stages of labor, we stopped logging to let Abby focus and concentrate.

Here is an overview of the events from that time leading up to the birth.

2:55pm - Abby threw up. Walked around some more through some contractions.
Abby’s midwife, Anna Amick was continuously monitoring the health of Abby and unborn baby Esther. Abby is now 6cm (out of 10) dilated and 80% effaced. Her blood pressure is 110 over 65 and contractions are coming faster and harder. Esther’s heart rate is 160bpm (which very normal for an unborn baby).

4:20pm - Walked some more. Still nauseous. Blood pressure: 119/76

4:20pm - Esther’s heart rate is 160bpm and Abby’s blood pressure is also the same.

5:35pm - Abby has started saying “I want to be done with this.” She is 8cm dilated and 90% effaced. Contractions are coming now very hard and with much pain.

5:45pm - Abby feels slightly like pushing, but its not quite time to start that yet.

5:55pm - 9cm dilated and Esther’s heart rate remains good.

6:20pm - Started pushing slightly. Almost fully dilated. Bag of waters still intact. Esther’s heart rate is 124bpm. Normal heart rate should be between 120 and 160bpm. Esther’s heart rate is on the low end of the normal range.

6:22pm - Esther’s heart rate is climbing to 132bpm.

6:35pm - Esther’s heart rate is back to normal.

7:05pm - Esther’s heart rate is at a solid 142.

7:10pm - Water broke.

7:58pm - Esther’s heart rate is 136.

8:09pm - Esther’s heart rate is 144.

8:12pm - Esther’s heart rate is 132.

Labor is now very very intense. Abby is full on with pushing contractions now. Abby is on the bed with 2 breaths, then a third and push…. with cries of pain she is giving everything she has to this. The pain is nearly indescribable, and now Abby is facing it with new determination. She gets about one or two minute breaks between them which she uses in full on silent eyes closed mediation and silence. Then, here comes the next one, Abbys controlled and powerful cries increase as she lifts her body by gripping Nathan’s hands and pushes with every ounce energy in her.

Around this time, during a pushing contraction, Esther’s heart rate drops to 80bpm. This is a major concern but her heart rate increased again after the contraction passed.

The next contraction caused Esther’s heart rate to drop again, this time to only 72bpm. There are several possibilities here, pinching of the umbilical cord will cause the baby’s heart rate to drop, as well as problems with the placenta or distress caused by other reasons. All of these issues will require more advanced medical equipment than we have at this home birth.

We have a serious problem. There is still a possibility that Abby can push this baby out without incident. However, the risk to the baby and the mother has just skyrocketed. The baby has not crowned yet and Abby has been pushing for two hours with very little progress. At over 100 births, Anna, our midwife, has never seen the heart rate drop like this. A decision has to be made right now to transport to the hospital or wait it out here. If we need to transport, we need to do it now, not after the baby has crowned.

8:30pm - Our midwife Anna makes the call, “Abby, stop pushing. Nathan, start the car, we are going to transport.”

We are not going to risk the life of Abby or Esther. Abby and I have been to the hospital a few weeks earlier and notified them of our upcoming birth. They have a nice but small 24 hour clinic in this city, San Cristobal de Las Cases.

Ten minutes later Abby is in the back of our 1973 VW Microbus with Nathan’s Mom and Anna’s assistant Silver helping her to breath through the contractions without pushing. Anna is keeping a monitor on Esther’s heart. Esther’s heart rate stayed in the 140s or above. Nathan is driving through the streets of San Cristobal as quickly as possible. No need to run red lights yet because as long as Abby is not pushing, Esther’s heart remains in the safe range.

The Sanatorio Ornelas Clinic is on an extremely narrow, one-way, one-lane cobblestone street with 4 parking spaces.. that are all taken. Nathan stops the vehicle in front of the clinic, unavoidably blocking all traffic. Getting Abby into the clinic and into (their only) wheelchair takes about 7 minutes - to the great dismay of the rest of the traffic on that street. The San Cristobal night sky lights up with the sound of honking angry drivers.

It is nearly impossible for Abby not to push at this time. She is the quintessential mother-in-labor with strong hard breaths, long cries of deep pain, body is generally and involuntarily freaking out. The women are by her side and helping her focus and Nathan runs out to fix the traffic problem.

Moments later we are all talking to the doctors. Nathan explains a bit about what is going on in Spanish. When the doctor hears that the baby’s heart rate had at one point dropped below 80bpm, he immediately calls for a Cesarean. Abby is prepped in a slightly 3rd world looking room and is then whisked off. Nathan and Anna are turned away at the operating room, nicely at first, and then every more insistently even after asking for masks and scrubs. We got a glimpse just long enough to see Abby wheeled into an operation room containing 8 waiting doctors in full Grey’s Anatomy gear… thats a bit of a relief, despite the smallness of the clinic, it looks like they know what they are doing.

Twenty minutes later, with tears all around, an extremely beautiful baby girl is turned over to us. Twenty Mexicans in the waiting room are holding their children up to see this newborn. Everything is perfect with her and the doctors and everyone are very happy. Abby takes another 40 minutes to stitch up and is also returned doing very well.

Pictures, video and more info to follow.