**Graphic content** Placenta Delivery and examination

This post is for all my nurse friends that like ALL the details!

Things tend to simply move slower in a home birth, and as long as mother and baby are doing fine, the midwives tend to follow the mother's lead when it comes to the delivery of the placenta. With Kylie's birth there was a good amount of blood in the water, I had a tear and ended up loosing enough that I was given some oral methergine and herbs to help. I had simply stood up in the birth tub and one of the midwives guided the placenta out. With Cooper i wanted to deliver it myself (i didn't tear, and i was not loosing blood in the tub), so I stood up and tried to deliver it myself, but had a hard time guiding it out. So the student midwife guided it out for me. With Wes, I really wanted to deliver it on my own. I had been looking for the gush of blood that indicates that the placenta has released, but it never came. We waited and waited, I think it was just about 50 minutes  in the pool before we finally got out. Since I had not seem the gush, I was worried that maybe the placenta was not ready to come, but it had been so long. So after cutting the cord, handing Wes to Craig.

There was a lot of the membranes just hanging out, it was interesting, I wonder what it is like when babies are born in the bag of waters, but I imagine the membranes are kinda like this.  I asked the kids if they wanted to feel them and they both did.

I still up and tried to guide it out, I could feel that it was right there, but the cord was so slippery, it was hard. 

 I continued to try, putting a little more traction on the cord, and pushing, but I could not get it to come out. I was pulling enough on the cord to break down some of it's structure, which is why you see blood in this photo.

 We decide that I just cant get a good angle and the student midwife goes behind me and tries guiding it back while I push.

With the slightly different angle she is able to guide it out easily while I give a little push.

 And into the bucket it goes.

 After the newborn exam, we took some time to look at the placenta. My bleeding had been minimal and my fundus was very firm, so we did not think there was any reason to believe there was placenta left behind. But there is always a full exam done of the placenta anyway. They look at the size, shape, how/where the cord is inserted and look to see if there are any signs of aging.

 Here we are showing Kylie the two different membranes that held the baby and waters.

 this is the side that baby saw, the "tree of life" is always so amazing to see.

 and this is the side that was attached to my uterus. When the placenta detaches, it is common to bleed from the spot where it was attached. Our body naturally releases oxytocin when we breastfeed which causes the uterus to contract and keeps the area from bleeding too much! So amazing!

Newborn exam and early postpartum

After cutting the cord I stood up to deliver my placenta. Since I know that is not everyone's cup of tea, I will put all the placenta pictures in the next post :)

I got out of the tub and was asked if I wanted to take a shower before getting in bed. I was feeling really good and since there was not blood in the water, I decided to skip the shower for now and just get some rest instead. 

Karen just catching up on some of her charting. It is always fascinating to look back over the charting and notes after a birth. I have asked for both Kylie and Coopers chart and I plan to ask for a copy of Wesley's too, the nurse in me likes to see the birth from the care providers side :)

My mom got a little snuggle time in while I was getting settled in bed. the midwifes took a couple minutes to assess me and how I was doing. They checked my uterus, bleeding, vaginal area looking for tears and gave me herbs and meds for the postpartum cramping. all of this was done in my time, I let them know when I was ready to be assessed, ready to have meds and ready for the newborn exam to start.

 I think they are looking at how big his feet were.

I got snuggled in bed and started my second tandem nursing adventure while Kylie had her breakfast too. Often people tell me "I would have a home birth, but I just dont want to worry about the mess." I wish I had a photo of the bed before I got in, this is what we did to make sure I didn't make a big "mess" all over the place. First we washed our favorite sheets and put them on the bed, next we covered them with a waterproof mattress pad and put old sheets on top of that, just in case I ended up delivering on the bed. Then (in my part of the bed) there was a disposable paper-like "sheet", with 2 more pads (similar to the ones that puppies are trained to pee on) then 1 large postpartum pad under me. We had it covered, especially since I was not bleeding hardly at all :) By that afternoon, my bleeding had slowed even more, we removed all the extra pads and paper sheets, we even took off the old sheet and waterproof pad and jumped right into our favorite clean sheets :) Easy Breezy.

 Facetime with family.

 "Look at his feet!"

 Post birth exhausted/oxytocin high. 

 In a home birth the midwifes do all the newborn cares and exam. They sat in my living room and visited until I said I was ready for the newborn exam to happen. Many parts of the exam were done while Wes was nursing and skin to skin with me.

 checking reflexes

 listening to heart and lungs

 when he wasn't skin to skin with me, he was simply next to me in bed.

 he was not happy during some parts of the exam, so my mom and Kylie held his hands and talked to him. It is considered a top priority to be very gentle and respectful to the newborn during the exam. He was talked to in a soft sweet voice, they told him everything they were going to do and went very slow and stopped when he was upset.

 instead of using a plastic clamp for the umbilical cord, there is a little rubber band that is placed, it allows for the cord to be cut nice and short and is much more comfortable for mom and baby during skin to skin.

 Kylie jumped in and cut the cord again.

As part of the newborn exam you have the option for vitamin K injection or oral treatment and eye ointment (just like in the hospital). We decided not to do either one, I knew I did not have the STD's that cause the eye infections that require the ointment and since we were not circumcising Wes, and his birth was not traumatic, we decided not to do the Vit K. 

 stepping reflex

 and this is how we weigh a baby at a home birth.

 just a baby in a basket :)

 Cooper started bringing in his favorite Paw Patrol characters to give to Wes.

 the midwife assistant, Karen, showed Kylie all the parts of the placenta (there are more placenta pictures in the next post if you are interested)

 Kylie had been waiting and waiting for her turn to hold the baby.

 Once everything was complete, the midwifes tucked us all in bed and we took a nice long family nap. The rest of the day was wonderful and restful. I was brought food in bed while I cuddled with Wes and enjoyed lots of skin to skin. I took a shower at some point later in the day. I felt SO good after his birth. My swelling went down right away and since I didnt tear, and pushing was so short, my body truly felt great!