I was doing my first primary prenatal care with a past client - now friend (This was her 6th pregancy, babies #7 and #8). This pregnancy was a surprise and seemed like the perfect "first" for me as she was a repeat client and a very responsible couple - easy birther. WELLLLL.... at about 34 weeks we were certain that she was either a month off on dates or we needed to talk seriously about the possibility of twins. Sure enough at the next prenatal we detected two very different heart beats - the couple laughed and shared with us that they had dual hick-ups going the night before.

Prenatals were increased to weekly and the senior midwife attended them with me. We reviewed twin homebirth risks and focused heavily on her nutritional needs. At 38 weeks we were still uncertain of the positions of the twins and a vaginal exam revealed a moving part. Ultrasound was performed showing baby A in a complete breech and baby B a high transverse lie. After a great deal of processing of the risks of a vaginal birth (not to mention the risks of prolapse cord with the breech or this baby going footling) verses a cesearean-section, this couple decided that if they couldn't find a MD who would be willing to try induction 'on stand by' that they would have an elective cesearean on Monday (this was Friday evening). We had discussed at length the risks we would be taking if we attended this birth at home and had a bad outcome. The senior midwife and myself decided that we could not attend them at home unless baby A presented more favorably. We left them with our doppler in case her water broke before they could have the cesearean and prayed that all would work out.

Well, Murphy's Law being what it is... I received a call Saturday at 2:30 a.m. from her husband that it was time and that she had been in labor for an hour and everything looked fine. I called the senior and said that I would take heart tones and do a vaginal exam and let her know what I find. I arrived with their 10 year old daughter, who had been spending the night at my house (while rushing to the birth she received a crash course on how to be a birth assistant if her mom had this baby fast). Mom was sounding pushy. I learned that she had spontaneous rupture of membranesat 1 a.m. with clear fluids. There was no gush and heart tones stayed good. A vaginal exam revealed a well applied bottom and 9 cm dilation! In between contractions I called the senior midwife on her cell and told her that "We aren't going anywhereshe is having this baby now and that everything looks great". I kept her on the phone while I quickly set up and told the dad what I would need him to do to support mom and to help with guiding the second baby down after baby A was born.

The dad sat on the bed with mom on his lap. During contractions I had her resist pushing and focus on relaxing. The baby descended beautifully and within 10 minutes of arriving baby Jacob started to rump. Tones where great and from here on out I went by skin color (very pink). It was a textbook perfect breech with the baby coming very smoothly. He was frank and after the posterior leg, then the anteriorleg and he was out to his chest. The cord was loose enough and I decided not to mess with it. I reached my hand up and put my finger into his mouth and he slid out easily. He had a nuchal cord x1 and was a beautiful 10/10/10 Apgar 6 lb. baby. We knew we had two placentas so I didn't put a huge rush on clamping and cutting but did so within 90 seconds. I wrapped him up and placed him into the arms of his sister and made sure mom was stable. Jacob soon went into her arms and nursed for a while. I sat back and tried to catch my breath and take in the wonder that I had just experienced.

The midwife arrived and soon the mom's contractions resumed. Baby B (Alicia) was not descending as we had hoped and we tried gentle fundal manipulations in between contractions. Baby sounded great and mom was doing well so after one hour we did a phone consult with an MD with lots of twin experience (and midwife friendly) and were reassured to give it some more time. After another hour mom started to complain about getting light headed. We made the decision to transport for further evaluation. The calls were made and we were off to the hospital.

To back up a bit... Jacob wasn't getting to nurse as mom was busy contracting with his sister so we called in a friend of the family who was lactating to give us a hand (or should I say... a breast). We were able to relax a bit by seeing Jacob getting some nourishment and were even more thankful for this extra adult when it came time to transport mom. We left her home with a content Jacob and his 5 other siblings.

The hospital transition was disappointing. It had been 90 minutes since they had been called to say that we may be transporting if we did not see improvements. We called in again at the time of transport (which took 15 minutes) and yet when we arrived there was only one nurse in OB who was going crazy with so many doctors and nurses calling. We reassured one very nervous nurse that mom and baby were stable but that we did want to put things in high gear" just in case". 90 minutes after we arrive baby Alicia is born by c-section and four hours later her twin brother was finally reunited with her at the hospital.

The cesearean section was a mutual decision from everyone as it had been 3 hours and baby Alicia was not descending. Mom is recovering well and I am still amazed that my first catch was such an unusual one. The greatest thing to come from this birth was that we have finally been approached by a couple of local doctors (the ones we called in to help with the second baby) who want to meet with us to brainstorm ways to make transports go more smoothly and to see how they can help us care for our clients. We have been praying for a doctor to find it in his heart to be a friendly aid when the need for labs, transfer of care or transports arise. Our fingers are crossed that a warmer climate continues between the hospital and the homebirth community.

What first seemed like such a blessing (a twin homebirth), that turned into a serious concern (breech and transverse positions), has turned into the birth that may make the biggest difference in how well we can serve our clients in the future. Friendly medical back up!

Once we began walking I remember passing the hedge and talking about going to the movies. Shelly was trying to distract me. We both had seen "Practical Magic" the day before. What would we see? I could only go if I promised not to make too much noise. She was teasing me and I enjoyed it. I had another contraction and I reached out and held onto her. My arm across her shoulders. I could feel her upper back. She was wearing a tank top and sweats. Glass, we all had sunglasses and Anna was holding my water bottle. I was keenly aware of my surroundings. It was a beautiful day. The sky was blue, the breeze was refreshing and alive. There were birds and lawnmowers. The Saturday energy of relaxed chores. People working without a structured boss. We walked and with each contraction I would gently squeeze Shelly. We turned onto Montana and continued to talk about past lives, but the talk and surroundings were fading. I was fading into myself, and I needed all of them for support. It was then that Shelly suggested turning around and I was very relieved. And just as I turned back onto Centinela I truly fell into labor. It was a downward force that pulled me to the center of the earth. A drawing down that took my legs with it. I grabbed for Steve's hand and fell into the three of them, howling back into the world as if to remind them, me, not to get lost. To yell, to howl, to scream so that everyone could find me. To descend but leave notice. We walked on.

Only flashes come back to me. Someone on the hill throwing out the trash. Two men coming out of a garage. A car driving past. The very long way back to my house, which at this point could be no more than a block. Shelly musing "Wouldn't it be lovely if all women could labor outside on the streets freely, if we all considered it an honor to come across a laboring woman, considered it a blessing, a good omen". And I thought how wonderful it would be to consider all of this normal. Where a woman's pain wasn't hidden, but was moving, breathing within the community. Not hidden behind medical walls. These thoughts were floating through my head, but at the same time how the hell was I going to make it across the street and the last block. I remember saying to Steve "Get the fucking car" as I collapsed into his arms once again. I was being sucked into the very ground. To stay up and moving - how? And before I fell again I was flinging off my shoes and walking across the cool, wet grass of our lawn. My front porch. The railing. Squeezing the wooden frame and howling deep so they could find me. Then there was Davi's beautiful face, comforting music, broken light. Home. My bed. But no, "Lisa, pee first". I ripped off my dress as I moved down the hall. I had to concentrate. I no longer really remembered how to pee. I sat there hoping it would fall out. I wanted to lie down. To sleep. To stop. Next the cool pillows were beneath my head, the soft flannel. Beautiful yellow lilies. The purple grapes on the blanket. Michael Stillwater's music gently breaking through. I just wanted to rest, to sleep. "Please Shelly, I want to sleep, I need a rest". Her hand pressed against my thigh, pushed my hair across my face. "Rest now." And I did. I don't know how long, but long enough to let the panic subside. To let in silly thoughts. "Lisa, you are a stupid woman. You could be at the hospital getting really good drugs." It passed. "Where's Eliot? Please call."

My back. My front. It hurt. The baby was moving through me and I was spreading out across the room. I was being pulled in every direction. Stretching up, and down, sideways, long ways and it hurt. The pain of opposing tension. The force of pulling apart. Being stretched thin and the bliss of snapping back to fullness. The quiet fullness between contractions when the baby and I were still one, rocking and waiting to pull again.

Shelly was holding my lower back and Davi was anchoring my feet. I didn't want to fly away. Not now. I wanted to follow the suction downward. They would find me. I was hollering loud enough. Davi had my feet. I was safe. Stephen was there too. I could fall into his eyes also. Sink deep down into love.

Eliot came in bearing roses. Three beautiful roses. What if men always came bearing roses. There would be no war, the fear could not take hold. The smell of roses. Remedies under my tongue. I would be all right. Where was Aimee? "Call Aimee" Everyone shifts their attention. I am alone. "555-1212" I blast again. I had blown up a few moments earlier when the disc changed from my birthing music to African dance music. Not the heavens now. I am in the earth. Toiling. I want to hear the river flowing, the wind, the earth. All weather. Ice splitting. Mother earth moving. No time for flying now.

Stephen looked into my eyes. Trying to find me. His words seemed slow and syrupy, "I am going out for evening primrose", "No" I order back, clutching on to my counterweight. "You can't go, I think the baby is here."

Shelly had checked me when we returned from the walk. I was hovering around 7 cm. Where was I now? Fear kept invading. I was afraid. Then I looked into Shelly's eyes. She had been there. She had also been sucked into the earth and had returned. I could fall too. I would come back. I wanted to not waste a single second of a contraction being afraid. Shelly whispers, "Lisa, remember making love, how you got this baby inside of you, now make love to this child. Love your baby out. There is only one safe place - your heart." Stephen put his hand between my breasts, held onto my heart tightly - down I went again. Then I felt a transfer of energy. For the first time something was moving up and out. I wanted to get below it. Hell, I was below it. Now I wanted to lift, to push, to raise my baby up high. It was time to push. "Lisa, how do you want to do this? Your side? Sitting?" Shelly didn't offer me squatting. Good thing we would find out moments later. I think the little one would have come too fast. Bursting out, taking me too. I thought side, no, no, sitting. Shelly made sure someone was holding my feet. Stephen was massaging my belly. Anna was caressing my thoughts with her gentle whispering. I was totally embraced. Then I felt the head. A tiny bit of hair. I wish I had lingered there longer, but there was work to be done. Me, always efficient at the cost of experiencing the moment sometimes.

Up, up, up I was now feeling. I was deep under this child and we were rising. I felt the head between my legs. The full, tight stuck feeling and then one howling push and the baby was free. I was aware of being comfortably around his neck. I could actually feel him moving inside of me. It was very sensual and exciting, but he didn't want to stay. He didn't want to linger, he wanted out. I was so open that I touched my very edges, and just as I was about to fall off of myself, he fell out. I was in empty space. I felt so empty. For a second I am lost. All this effort, concentration, focus and now nothing. I am not being sucked down. There is no one to push up. No heaven, no earth. Then I see Shelly's arms pushing my little one towards me. "Lisa, hold your baby." And I am back. This wonderful wet, warm breathing baby brings me back home.

Everything moves quickly now. There are tears in everyone's eyes. Anna is holding the camera. Eliot is embracing Stephen. Davi is laughing. Then I am reflecting. I now remember Shelly saying "Davi Kaur these cloths are not hot enough." Davi remarking on how there wasn't time for the crock pot to heat up. Everyone laughing when I shouted out Aimee's phone number. Eliot responding to Shelly when asked if he had delivered babies before "Yes, but not in this consciousness."

I deliver the placenta. We cut the cord. I receive a single stitch. I breast-feed. The midwives move about working efficiently. The storm has passed and now we clean up. But oh how good everything feels. Back to earthly movements and chores. I get up and am escorted to the shower. Eliot passes the soap. Shelly combs my hair. I am back in bed and my little man lies naked across my chest. Isadora arrives, "Mummy, he has a penis. He's a boy." The look of all the faces around my bed. Eddy, Constanza, Stephen, Tony, Davi, Anna, Aimee. Eliot has left. Shelly cleans and gently checks our little boy. He sucks my finger for comfort and cries when I complain about my back. Aimee massages it. Then slowly everyone leaves. All of us open, happy and free in this moment of birth.

I am so tired. It is dark out now and the candles in my room throw off a comforting light. I pass my son over to Constanza and fall into a deep sleep. When I wake up a few hours have passed. The house is very quiet. I look at the clock, it is past eleven. I shuffle out of bed and I hear them first. I pause to listen. Stephen is singing to our little boy. I want to touch them. Be close. I sit on the sofa as close as I can get. They smell so good. I check on Isadora. She looks as always like an angel. I fall asleep this night, and now there really is three of us in the bed. Kai breathes on his own between Stephen and I. Life begins again for all of us.