The Birth of Ruth, Part 4: The Afterbirth

**Content warning: this post contains graphic images of birth and descriptions of blood and retained placenta

10:44pm

After the intensity of her arrival, I was looking forward to resting and savoring our first family snuggles. And we did...for a few precious minutes, at least. 

All of the photos in this post were taken by Lauren LaBarre

But then my midwives announced it was time to expel the placenta.  I reaaaallllly didn't feel like pushing (like, ever, ever again), but knew it was my "ticket to freedom," so I mustered some strength and tried, while still comfortably reclined against Justin.

In looking back at the birth notes and images, I see now that there was substantial blood loss already in the tub. But in my post-birth haze, I wasn't really aware of anything other than feeling mildly inconvenienced.

 
As soon as the cord stopped pulsing, Justin was given the symbolic honor of cutting it, which felt strange since the placenta was still inside me. Rather than bind it, however, a hemostat was left in place and I was calmly instructed to hand Ruth to her dad and get out of the tub.

Here I am, still smiling in my post-birth glow, blissfully unaware of the concerned look on Justin's face in the background...or what was about to come.

I will never get over the way Justin looks at our daughters. (Also, check out the change in tub water. I'm told the water actually makes it appear as though there is more blood than there really is, but holy smokes! By the time I got out, Justin said he could no longer see his legs.)

10:53pm

My feet had barely landed on the ground when I was injected with Pitocin. Hoping gravity would assist, I attempted to push in a standing, and then supported squatting, position while my midwife applied gentle pressure externally on my soft belly to prevent my anterior placenta from "catching" on my pubic bone. 

10:55pm

I was instructed to lay down, and informed my placenta had only partially detached. My body continued to supply blood to what it interpreted was still an attached organ, therefore resulting in significant blood loss each time I attempted to expel it.

These next two minutes (and honestly the 20 or so after that) were the most chaotic of my entire life. In a trauma-response, I felt as though I were outside of my body, watching it all occur. I marveled at how swiftly I had transformed from the most powerful woman in the room, roaring my new baby into the world...to this woman, laying on the floor in a pool of her own blood. I looked up and saw it streaking the sides of the birth tub...my thighs...my midwife's arms and shirt. It felt so surreal. And yet, adrenaline kept me feeling more inconvenienced than afraid. I just wanted to "get it over with."

I heard Ruth screaming in the background, and a suggestion was made for skin-to-skin, hoping that might promote more contractions. 

10:57pm

Ruth was placed on my chest.  I don't remember doing so, but instinctively I must have softened, clutching her to me and shushing in her ear. 

I will forever be grateful for these images and the way they show me that there was still calm and connection, even amidst chaos. As I later engaged therapy to process my trauma, these pictures became my anchor. My proof that motherhood is the most powerful and protective force in all of nature.

With Ruth quieted in my arms, I attempted to push some more before I glanced up at Justin (who was still standing in the birth tub). The look of concern on his face caused an overwhelming sense of terror for me. It didn't matter that my (incredibly calm and competent) midwife was actively reassuring me that we still had plenty of time and everything would be just fine; Justin was my personal barometer of safety. After the next attempted push, I was certain I had finally done it...only to be told the excretion I felt was actually another blood clot. 

Despite the extremely cramped surroundings (none of my imagined birth plans involved me laying on the ground next to the birth tub), I requested he come near me.  Strengthened by his support, clutching our tiny newborn to my chest, I resumed my determination. 

It still took far longer than any of us had hoped, and I was understandably exhausted and discouraged by the end, but again I'm so grateful for the way these images show my continued focus on Ruth. This wasn't the way I dreamed it would be, but I soaked as much of her in as I could in those tumultuous first moments of her life.

11:10pm

Twenty-six frenzied minutes after Ruth emerged, I finally birthed the placenta with the aid of cord traction and assisted squatting. 

It wasn't until I saw this image later that I remembered or appreciated how freaking badass this moment was. Here I am bracing Ruth with one arm and propping my weary body up with the other, having just managed to finally expel my stubborn placenta. It certainly isn't a glamorous photo - in fact, some might even find it gross. But I think it captures the raw, heroic glory of childbirth. Women are incredible.

I'm including this picture - even though the mess and the crowding and the chaos make me cringe a bit - because it also makes me laugh. Here is my completely unflappable midwife, Sharon, literally covered in my blood and crouching on the ground...still smiling. (Also, I feel like its worth nothing that even after all this saga, somehow miraculously, I did not hemorrhage.)

Finally. Finally, it was over.