birth

I am moving into my last week of Maternal-Newborn and feelings are bittersweet. I want so badly to stay right here in my comfort zone of birth, babies and mothers; however I must move forward into new classes to finish out my degree. I’m down to 8 months of school left and I will officially be a RN, BSN! Wow. That is so crazy to write! I have been on this road now for FIVE years. YES, 5! I was pregnant with my daughter when I started my pre-recs and the month I graduate she will turn 5.

The beginning of August was rough. I was so excited to have started clinicals in the hospital! But I had come down with a nasty virus that turned into a sinus infection and I missed two weeks of school and clinical! My heart was broken! I was miserable and also, I turned 33 so I spent my birthday not feeling so hot. A few days before my birthday, B took me to a tattoo shop and I got a tattoo I have been wanting for years! I had not decided where I wanted it until just a few days prior and I can honestly say I am so happy with it! What did I get?!?

OXYTOCIN!

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Everyone asks if it hurt-it was uncomfortable but actually painful? Not really. This is on the inside of my right bicep. The line work is incredible!

This special tattoo could have not come at a more perfect time. I was in my Maternal-Newborn class and gearing up to help women labor and give birth! After I was cleared to return to clinical from being sick, I spent 2 days in L&D and saw two beautiful births. One cesarean and one vaginal (no epidural-just some IV fentanyl). Both births made me feel like I was home, like I was right where I needed to be. My heart was full, my mind was growing with knowledge and happiness. It was wonderful.

I have 4 more days in clinical and then this class is officially over. I head into Population health and then Peds for this fall semester.

Thanks for checking in and sticking around with me! Two more semesters and I’m done! 😉

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Homebirth in the Hospital

For my Human Sexuality class, I had to pick a topic (childbirth) and write a research paper on it. Childbirth is a very wide term that incorporates so many different areas of birth. Below you will read my paper. It is long and, according to my professor, has some technical errors. Poo poo, I say! 😉 Enjoy!

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Giving birth, for many, is one of the most life-changing experiences one can go through. Whether it’s for the first or fifth time, every experience can be different. In the US, women have discovered ways to control her pregnancy, labor and the birth of her baby. She has many options which include giving birth at home with or without the assistance of a medical professional, in a birth center with a midwife or in the hospital, with an obstetrician or nurse-midwife. Safety concerns and control over one’s body seems to dictate how and where a woman chooses to give birth. While the safety concerns surrounding homebirth are greater than those of in-hospital deliveries, having a “homebirth in the hospital” is an option many women are seeking. They want the comforts of home while being in the hospital in case of an emergency. Discovering this balance and improving the birth experience for the woman and her family is quickly becoming the goal of many labor and delivery units across the country.

One of the most important criteria for obtaining the desired birth is who the patient hires for her prenatal and delivery care. Obstetricians (OB) are not well known for their hands-off approach to labor and delivery. Christiane Northrup, an Obstetrician, writes in her book Women’s Bodies, Women’s Wisdom, “For centuries, midwives helped mothers through the pregnancy and birthing processes, standing by them with medical and emotional aide. The very word obstetrics is derived from the Latin word stare, which means ‘to stand by’” (Northrup, 1998). A change in the management of labor and delivery occurred. Northrup goes on to say, “Modern obstetrics, however, has changed from a natural, patient ‘standing by’ and allowing the woman’s body to respond naturally into a domineering and often invasive practice” (Northrup, 1998). In this case, seeking the care of a Certified Nurse Midwife who is naturally-minded, hands-off except when necessary, and well educated in childbirth is the first step in having a homebirth in the hospital.

A Certified Nurse Midwife (CNM) is someone who holds degrees and education in both nursing and midwifery and can attend the births of low risk women in the hospital. “The modern midwife’s approach is to be proactive during pregnancy and childbirth. Instead of aggressively treating gestational problems with the latest medications and the most advanced technology after they arise, good midwives work closely with their pregnant clients to ward off problems before they start” (Margulis, 2013). Because of all the unknowns that come along with pregnancy, especially for first time parents, having a midwife who takes more time with her patient explaining what’s normal and what’s not will greatly benefit the parents, minimizing any fears present.

At times, CNMs may deliver babies at home. This is most common in states which have not legalized home births attended by Certified Midwives or Certified Professional Midwives. “Nurse-Midwives practice legally in all 50 U.S. states and the District of Columbia. Certified Professional Midwives are legally authorized to practice in 28 states. Certified Midwives practice legally in only three states” (MANA). The crucial credential missing between these women and the CNM is the nursing degree.

Once the pregnant woman has chosen her desired provider, she should next consider hiring a doula. “Doula is a Greek word, meaning ‘to serve’. A popular interpretation is ‘mothering the mother’. Doulas are not medically trained and do not provide medical advice” (Ross, pp.9). With this definition in mind, the expectant mother can choose a doula to help her while laboring. Often times the doula and the mother’s partner will tag team, taking turns assisting her in changing positions, providing nourishment, and suggesting ideas for continued pain relief. According to DONA International, an organization that trains and certifies doulas all over the world, having a doula present at the labor and birth of a baby has greatly decreased the length of labor and number of interventions, she has helped reduce the need for Pitocin and labor augmentation, as well as the mother’s request for pain medications and cesarean sections (DONA, 2003). “Having doula support gives couples the confidence to stay home for a good part of the woman’s labor and avoid early transfer to hospital” (Ross, 2012). The longer the laboring mom is able to stay home, the more likely she is to have less time spent in the hospital succumbing to unwanted, and often, unnecessary interventions.

The next step to obtaining a homebirth in the hospital is writing a birth plan. This step requires the woman to educate herself on the processes of both her pregnancy and the birth of her baby, usually by taking classes and reading materials on natural childbirth. She and her support person will sit down and discuss their goals for the labor and birth. She will clearly define the types of pain relief, laboring positions, and interventions she’s open to. Having a plan or a list of desires for the birth of her baby also assists the hospital staff in helping her reach those goals. Most people who write a birth plan understand that the health and wellbeing of the mother and baby are of utmost priority. Communicating their desires both verbally and on paper is critical. Knowledge is power and while laboring, the woman may forget what her goals are. A birth plan and her support people will be able to remind her of those goals when all her power is being focused on bringing her baby into the world. If the staff and her partner do not know what she’d like then reaching her goals will be much more challenging.

Taking childbirth classes is just as important as writing the birth plan and, often, classes offer help in writing the birth plan. “The classes provide training for the pregnant woman and her labor coach in breathing and relaxation exercises designed to cope with the pain of childbirth” (Crooks & Baur, 2014). There are many different types of childbirth classes offered and if the mother is seeking a labor and birth that is natural and “home-like”, then she will most likely be taking childbirth classes that cater to those desires. The Bradley Method is a very common child birthing class that people take. A fee is paid and an instructor meets with the couple, usually along with other couples, to discuss the specifics of her pregnancy, labor and birth with a more natural, pain-free type of birth in mind. “The techniques are simple and effective. They are based on information about how the human body works during labor. Couples are taught how they can work with their bodies to reduce pain and make their labors more efficient” (AAHCC, 2015).

Selecting the hospital in which the mother chooses to birth may be limited to the hospital in her area, however, if she is able to find a hospital that is Baby Friendly Accredited, then she is more likely to have many more options for her birth which are routinely offered by the hospital. The mother and her support people should take a tour of the hospital and ask questions. They should find out what the hospital standards are and use that information to balance out their birth plan accordingly. “Baby-Friendly USA, Inc. is the nonprofit national authority for WHO/UNICEF’s Baby-Friendly Hospital Initiative (BFHI). Our Mission is to assess, accredit and designate birthing facilities that meet the BFHI criteria for implementing the Ten Steps to Successful Breastfeeding and follow the International Code of Marketing of Breast-milk Substitutes — providing mothers and babies with the early support needed to achieve successful breastfeeding, an essential foundation for a healthy nation” (BFA, 2015). Initiating skin-to-skin and rooming-in with her baby are essential in allowing mom to bond with and have a successful breastfeeding relationship with her newborn. These small steps are essential in having a homebirth in a hospital. When one births at home, the baby is not taken away from her, she is encouraged to nurse as soon as the baby cues or starts doing the “breast crawl”, and she and her baby sleep in the same room. Those seeking a homebirth in the hospital will likely have these types of things on their birth plan.

Once the birth plan has been defined and the hospital for birth selected, the next step in obtaining a homebirth in the hospital is managing labor pains. Labor often starts off gradually and increases as contractions come closer and closer together. There are three stages to the laboring process. The first stage of labor involves the uterus contracting and the cervix dilating, usually the most painful part of labor. This stage can last several hours, especially for first time mothers. During this first stage of labor is when having a calm, quiet setting for the laboring mother is essential in having a homebirth setting in the hospital. Since this stage can last for a long time, it is important to allow the mother to eat and drink as she wishes while also resting when she is able. Some things that may help her manage pain include massage, a birthing ball to bounce and sit on, having a tub or shower to relax in, low lighting, quite, clustered care from the hospital staff, intermittent fetal monitoring, and the ability to move freely. These are all things she would be doing at home to manage her labor pains. There is no reason any of these things should be restricted in the hospital unless the mother has other risks associated with her pregnancy.

Labor is exhausting and it usually isn’t until transition when the most severe labor pains are present. Transition occurs just before the mother is fully dilated at 10 centimeters. Feelings of wanting to give up and asking for pain medications are common indicators that the mother is in transition and close to the second stage of labor, the pushing stage. During this portion of the labor, it is essential for the mother’s support people to guide her through the pains of contractions as they are likely on top of each other, offering little to no relief. Providing calming voices, massage and allowing her to vocalize as she feels necessary is all a part of labor and having a homebirth in the hospital. It is likely that the nursing staff and the midwife are preparing for the birth by setting up a baby warmer and sterile instruments for after delivery. While this scene is not one you will see at home, it is the part of delivery that the couple should expect from delivering in the hospital.

“Some mothers enter the pushing stage gradually. They feel a lot of rectal pressure at the peak of each contraction. As their bodies dilate the last 2 centimeters or so, this pressure builds until the feelings associated with dilating are taken over by the sensation of pressure and fullness, and you can do nothing else except push” (Drichta & Owen, 2013). The second stage of labor is much faster than the first stage. For some it can take only a few pushes to get her baby out while for others it may take a few hours for the baby’s head to descend past the cervix and birth canal. If the mother has declined all pain medications up until this point, then she should be fully capable of pushing in a position which feels best to her. This includes squatting, hands and knees, and side-laying. All of these positions work with gravity and the shape of the mother’s pelvis to ensure that pushing is effective.

Part of having a homebirth is not being directed or instructed on when to push. Self-directed pushing as the mother feels the urge to do so should be well supported in the hospital. Only if the baby or mother was showing signs of distress would directed pushing or pushing in a certain position be important. The last part of this stage which should be defined in the birth plan would be who is going to catch the baby as she slips into the world. At home, the mother and/or fathers are encouraged to catch their baby. The midwife will assist the head out as it crowns and direct their hands into a position to catch the baby. This option may not always be available in the hospital, depending on their guidelines, however if the desire is there then it should be encouraged.

After the baby has been born, she should be placed directly on her mother’s bare chest. The second stage of labor is now complete. A common practice in home births, which is also increasing in hospital births, is delaying the clamping of the umbilical cord. This is the lifeline between the mother and baby. As the baby takes breaths and begins to cry, the pulsing blood through the umbilical cord from the placenta decreases. Many couples request that the cord is left pulsing for several minutes to allow for the blood from the placenta to be received by the bay. Doing so has many benefits, the greatest of which is a lower risk of having iron deficiency issues in the first six months of life. “Several systematic reviews have suggested that clamping the umbilical cord in all births should be delayed for at least 30–60 seconds, with the infant maintained at or below the level of the placenta because of the associated neonatal benefits, including increased blood volume, reduced need for blood transfusion, decreased incidence of intracranial hemorrhage in preterm infants, and lower frequency of iron deficiency anemia in term infants” (ACOG, 2014).

The third and final stage of birth is the release and delivery of the placenta from the uterine wall. As soon as the baby has been born, hormones race through the mother’s body, signaling the change. This biological message expels the placenta as its job of nourishing the fetus has come to an end. The delivery of the placenta also signals the uterus to continue to contract and shrink which should, in most healthy cases, stop excessive bleeding. This stage of labor can be handled the same at the hospital as it would at home. The mother may need to give a few small pushes, but abdominal massage and pulling on the cord to get the placenta to come out faster is not necessary. The midwife will inspect the placenta to ensure that all its parts are intact. If the mother happens to retain any part of the placenta, she may experience continued bleeding and clotting issues.

Birth, while not a disease or illness, can come with a host of risks. People who want to give birth in the hospital but also desire home qualities are usually doing so just in case something were to happen in which a fully-staffed medical team would be necessary. Maternal risks include preeclampsia, which is pregnancy-induced hypertension, gestational diabetes, placenta previa, where the placenta covers part or all of the cervix, being Group-B Strep positive, placental abruption, wherein the placenta prematurely detaches from the uterine wall prior to the birth of the baby, infection, and postpartum hemorrhaging. All of these risks also pose different risks to the unborn baby. Fetal-specific risks include a cord prolapse, where the cord exits the birth canal before the head, causing life-threatening pressure to the cord and cutting off blood supply to the baby. Other risks to the newborn are meconium aspiration and shoulder dystocia. For many of these situations, the baby may need to be delivered by cesarean section to ensure the life and safety of both mother and baby. These are also risks which a homebirth midwife is not equipped to handle at home. If any of these things were to arise during a labor at home, immediate transfer to a hospital would be necessary. Something like a placental abruption offers very little in the way of time. It usually occurs quickly and without warning. For this reason, giving birth in the hospital would be safest. Labor and delivery nurses and the extended staff of midwives and obstetricians are trained to identify these kinds of risks quickly.

If a mother has a known risk factor, such as preeclampsia or Group-B Strep (GBS) positive, are risks which can be easily managed in the hospital with medications such as magnesium for the preeclampsia and antibiotics for GBS. While these risk factors exist, it is not out of the question for a mother to be able to still have a homebirth in the hospital. She may require extra attention and monitoring, however, none of this should discourage her from having a natural birth if she so desires. The key is to be open to the necessary interventions that will keep her and her baby healthy and safe. If she lacks an openness to the required protocols of the hospital, she may become disappointed and unhappy with her birthing experience. Should an emergent risk arise during the labor or birth, the mother’s midwife and hospital staff should clearly explain everything that is happening and ensure that she understands the procedures that need to be done are to keep her and her baby safe. Too often staff do not inform their patients well enough about what is happening and this can leave her feeling very confused and hurt.

Having a homebirth in the hospital is possible. Certain steps need to be taken prior to and during the labor to ensure that as many of the mother’s goals are met. She and her support people need to clearly communicate what they would like to see happen and to feel confident in the interventions they may decline unless medically necessary. The expectant mother and her partner need to understand the ins and outs of her pregnancy and labor by taking classes, having a hospital tour and educating themselves so that they are well-prepared for their baby’s impending arrival. Having this knowledge will give them the proper ammunition needed to meet their goals while in the hospital. The mother must be upfront with her midwife about her health and pregnancy history and discuss her options freely. All this and more will help enhance her child birthing experience and goal of having a homebirth in the hospital.

References

Crooks, R., & Baur, K. (2014). Our sexuality (12th ed.). Redwood City, Calif.: Wadsworth

Cenage Learning.

Drichta, J. Owen, J. (2013). The Essential homebirth guide. New York, New York: Gallery

Books.

Margulis, J. (2013). Your baby, your way. New York, New York: Scribner.

Northrup, C. (1998). Women’s bodies, women’s wisdom: Creating physical and emotional health

and healing (Completely rev. and updated. ed.). New York, New York: Bantam Books.

Ross, S. (2012). Doulas: why every pregnant woman deserves one. Summer Hill, Australia:

Rockpool Publishing.

American Academy of Husband Coached Childbirth. (2015) The Bradley method classes.

Retrieved May 3, 2015, from http://www.bradleybirth.com/WhyBradley.aspx

American Congress of Obstetricians and Gynecologists. (2014). Timing of umbilical cord

clamping after birth. Committee opinion No. 543. Retrieved May 3, 2015, from

http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-

Obstetric-Practice/Timing-ofUmbilical-Cord-Clamping-After-Birth

Baby-Friendly USA. (2015) Mission and vision. Retrieved May 5, 2015, from

https://www.babyfriendlyusa.org/about-us/about-baby-friendly/mission

DONA International. (2003). Why Use a Doula? Retrieved May 1, 2015, from

http://www.dona.org/mothers/why_use_a_doula.php

Midwives Alliance of North America. Legal Status of US Midwives.  Retrieved May 1, 2015,

from http://mana.org/about-midwives/legal-status-of-us-midwives

What’s up?

It’s been awhile since I actually wrote something with decent substance and I am not promising that this will have any of that, but I’ll certainly try.

A few weeks ago I floated to another hospital and was able to witness an amazing, unmediated, beautiful birth led by a midwife I had not yet seen deliver a baby. My mind was blown. Mom was trying to push on her side and baby was unhappy. The midwife gently suggested she adjust her positioning and just like that baby was happy again. The mom let her body do all the work. She pushed when she felt like it and rested when she needed to. Then, she realized her body could not stop pushing and less than a minute later the baby’s head was born with a nucal cord x1. A few seconds later baby was out and up on mom’s chest. I took over the camera so dad could cut the cord and I caught it on film for him. Every time I see a birth, my heart literally explodes with joy and excitement. I know birth is not always like that, but it is BECAUSE of births like this that my passion is fueled and I am reminded once more that yes, Sarah, this is where you belong.

My mom is doing ok. She is on a new chemo med that is not nearly as hard on her body. She still gets really tired but has had a lot more energy to spend time with the kids and work in the classroom. This is all so encouraging. Looking back to when this all began on October 24th, it’s hard to believe almost 5 months have passed since the diagnosis.

School is going alright. I don’t feel like this semester is better than last semester, which is strange because the load is not harder. I have been struggling with one of the professors but I *think* we are finally on the same page. I always wish I was doing better grade-wise, which is me just being too hard on myself. I am doing FINE. As and Bs are great! I just want more As than Bs and sometimes it’s just not in the cards. I’m learning not to be so hard on myself, especially with the load I have while in school between work and family.

My son, Logan, turned 5 a month ago. We got him registered and accepted into the school of our choice for kindergarten which is pretty crazy and exciting! Evelyn is a ball of fire as usual. She still doesn’t sleep through the night and is starting to show her girliness more with more diva and sass. You can follow me on instagram if you want more current, daily updates.

Have a great weekend!

I am not “anti-home birth”.

This post has been quietly brewing in my mind for awhile now. It’s hard to define where exactly I stand on home birth but what I do know is that I am anti-bullying, anti-discrimination, anti-judgement, anti-disrespect…but I am NOT anti-home birth. Somehow the subject of birth and how one chooses to do so has become almost as delicate a subject as religion and politics. Oh wait…maybe that’s because those two things happen to fuel a lot of how and why someone chooses to birth. There is a terrifying birth story that is making waves and going viral all over the internet right now. You may have read it. Here is a link. The comments on the post itself as well as on a number of birth communities on Facebook have ranged from empathy, sorrow, love, and kindness to blame, distaste, and apathy. This is not a dead baby story. But it could have been.

Many of the more negative comments talk about how the writer is clearly anti-home birth and how “that’s just not fair” to happy home birthers. I get it. I had two beautiful hospital births and when people talk about how bad hospital births are I get a little defensive. Truth is it really doesn’t matter. We are humans with our own emotions and we get to own them whether someone else agrees or not. Maybe the writer is anti-home birth. She is sending a message that “hey, there are crappy home birth midwives out there. Be careful.” Maybe not everyone is hearing that but I am. But NO ONE has a right to say her feelings are not valid or that she should have picked a better midwife, etc….

I cannot emphasize the importance of education any more than I already do. This includes the client but more than anything includes the provider, or any professional one may hire for a service. Our country has a problem with how it manages home birth deliveries and the midwives and people that attend them. States vary on their regulations and standards of education. Many midwives are not bound legally by any form of liability insurance. More than anything, this just makes me sad. So I’m not anti-home birth….I am anti-lack of education, lack of experience…so many mistakes were made in that birth. It’s not the first time and sadly, that won’t be the last time either. An educated, proficient provider would have called 911 the moment she noticed the waters were stained with meconium. This is just one of the many problems with the birth and I am not going to keep breaking it down. Anyone can see from reading the story that there were many mistakes made.

Lastly, I would like to address a comment that keeps getting thrown around by many people who are clearly “anti-hospital birth”….”Babies die in the hospital ALL THE TIME!”. You guys. This is NOT true. In fact, it is RARE for a baby to die in hospital and most of the cases in which one does not make it is due to some kind of fetal anomaly that could not have been prevented (like a cord accident or genetic issue).

Anyway, I had to get these feelings out. I had to express how sad I am that, 16 months later, this mama is experiencing so much birth trauma. I have no doubt that writing about it helps her. I had to share that, though I may have concerns about home birthing, I am not against it.

Behave in the comments. Remember to be respectful.

Eli’s Birth Story

October 2

I woke up feeling crampy. I remember telling Geoff it felt like my period was on its way (which I know is ridiculous, but I was crampy, with lots of backache) I was some what uncomfortable throughout the day, and thought maybe my body was starting to get ready for labor.I asked Geoff to walk with me, so we went to Wal-Mart because it was cool and dark out by the time he got home. We walked around for an hour or two and I was just really uncomfortable. When we got home, I had a cup of  Red Raspberry Leaf tea and took some evening primrose oil (I had been doing both for a few weeks, because they are both supposed to help with labor in different ways) so I drank a cup of tea and we went to bed. I thought I was having contractions, but I was feeling it mostly in my back and hips. I was able to get to sleep with back rub from the hubby.

October 3
I woke up at 2am with a bad gall bladder attack. I went into the bathroom and vomited several times and took a percocet and zofran. I vomited again shortly thereafter, and took another percocet and woke Geoff up. He decided we needed to head to the hospital because in the past, the percocet had not been enough to get the pain to a tolerable level. We got to the hospital around 3am and they checked me into labor and delivery (standard procedure for pregnant women). The nurse tried to check me because I was having contractions on the monitor, even though I wasnt aware of them. I was in a massive amount of pain, so she wasnt able to get a definitive measure of my cervix but thought I was about a fingertip dilated. I ended up declining pain meds at the hospital because the percocet finally kicked in, and I was feeling better. I felt stupid for going in, but in the end our experience has been that at home meds dont usually work, it has had to be IV pain meds because of the intensity of the pain. We left the hosptial at approximately 5 am and went home to sleep. Geoff fell right asleep in bed, and I curled up with him and my cat and tried to sleep. I slept for about 45 minutes or so, and woke up with back labor. I got up and made myself a pillow nest on the couch and put in a movie to try and center myself. I made myself some hot apple cider and toast and laid down on the couch. At around 7am I called my mom and chatted with her for about an hour. It was a really meaningful conversation for me, in the quiet of the morning there were no distractions or background noise on her end, which can be extremely difficult because they have a busy house :o). My mom said then that she thought I was in labor and that he’d be here by Wednesday, but I dismissed it and thought we were just warming up because I wasnt expecting him til after his due date (October 13). My mom and I made arrangements for her to come up on Monday because I wanted the company really badly and sometimes there’s nothing like time with mom. I was planning to have her come up and we could walk, and just hang out because I wasnt feeling great. After we hung up, Geoff woke up and we spent the day hanging out and resting from our looong night before. My contractions starting picking up around dinner time and lasted through the night. Geoff and I spent the whole night going from the bedroom to the living room to the bath tub on my hands and knees and so on. My contractions were irregular, and I was only feeling them in my back. Geoff spent the night providing counter pressure for the increasingly uncomfortable contractions I was having. We laid on the couch from about 11pm until 5am and watched Netflix while I worked through each contraction.
October 4

 

I spent a lot of time on my knees, bent over the ottoman while Henry ran back and forth between me and Geoff, worried about my groans and sways. I felt so powerful and womanly swaying and vocalizing through the contractions. Around 5am Geoff suggested a hot bath. I spent about an hour in the tub, trying to relax and welcome each contraction. At this point I was trying not to get my hopes up because my contractions were still very irregular ranging from 2 minutes to 10 minutes apart. At 7 am, as the sun was coming up, Geoff made some coffee and we decided to go for a walk. We slipped on our slippers and hoodies over our pajamas and walked around the neighborhood for half an hour. That walk was one of my favorite parts of the day, the neighborhood was very quiet, the sun was still low in the sky and the air was cool and we spent the time talking about our future son and labor and delivery. We discussed our hopes for our son, and about how we want him to grow up to be a sweet, loving, respectful man who is strong and hard working. I felt so close to my husband in those moments. I had a few contractions as we walked, and I stopped and held onto his neck and swayed through them. When we got home we rested some more and waited for my mom. My mom got here around 9:00am and suggested we call my midwife and see if we could go in and get checked. I was resistant because I didnt want to go in and be told I was at 1/2 cm and go home, it was a false start. Nevertheless, Geoff insisted so we called and made an appointment for 11am. We finished picking up a few things around the house and made sure the bag was packed just in case. We got the doctors office, and Terri Gross (one of the four midwives at the clinic) saw us. It took a while to get in so I spent 20 minutes on my knees, leaning over the back of a chair with contractions off and on. When we got back into the exam room, Terri checked me and excitedly announced I was at 6cm, 100% effaced, and +2. I was thrilled! We headed over the hospital! On the way, I called my dad and texted my siblings with the good news. Geoff called his parents and sister, who helped spread the word that we should have the baby that day!! Once we got checked in, I realized I forgot to bring a copy of my birth plan. I told my nurse that, and explained to her that I wanted a natural childbirth, I would prefer not to be asked what my pain level was or be offered pain meds. I also stated that if I got to the point where I was asking for pain meds, I was open to alternative means. This may have come back to bite me…Somewhere in there Geoff called Katie (our doula) and she arrived a few hours later. Once she got there we settled into a routine of me laboring while walking around the room, on my hands and knees leaning over the back of the bed and so on. My labor was all in my back and my contractions were getting quite strong. Katie had some great techniques to help me cope, including the use of a rebozo wrap, which went around my hips and allowed her to simultaneously help squeeze my hips, and put counter pressure on my intense back labor. I am not really sure how long we labored like that, because my sense of time disappeared.

At some point I decided to get in the tub and put on my swim suit. While I was in the tub, my brother and Geoff’s sister got to the hospital. They were able to come in a visit for while, since I was sort of dressed. Laura sat with me for a while and her and Katie kept my shoulders and hips warm with wet wash clothes while I lay on my side in the tub so they could help apply counter pressure. I dont know exactly how long I was in the tub because at this point my sense of time sort of disappeared. My midwife, Kelly Jean came in and checked me and said I was about 7cm and station +1. I was not progressing very fast at this point and becoming frustrated. We kept laboring, walking and doing counter pressure. My mom went out and got the family at some point to come in and say hi. Geoff’s dad, his dad’s girlfriend, his mom, stepdad and sisters where all there. I only saw them for a few minutes because my contractions were getting really strong at this point.

 

We continued laboring together, Katie providing constant counter pressure and Geoff and my mom offering moral and emotional support. I cant give a definitive time line at this point because, like I said, my sense of time disappeared. At some point Kelly Jean came back in and wanted to check me again and I declined, because I knew I hadn’t progressed. I was getting frustrated and exhausted at this point. I had been awake roughly since 2 am Saturday morning, and we were now at 6 pm Monday night. My contractions were getting increasingly intense, but not becoming more regular. I think around 8 or so Kelly Jean came back in and decided to check me again. I was at 8 cm at this point and starting to feel despair. She thought breaking my water might help labor pick up so I tried to get comfortable on my side in bed so she could. This is one part of my birth experience i am not sure I would repeat. By breaking my water, I doubt the baby had any chance to turn, but at the time we werent sure what his position was. Once she broke my water, she was able to tell he was occiput posterior.http://www.birthingnaturally.net/birth/challenges/posterior.html That basically means he was facing my stomach instead of my back, so the back of his head (the occiput) was against my back, so it makes entering the birth canal extremely difficult. If they hadn’t broken my water, maybe he could’ve turned…but maybe not. He had a long time with lots of contractions to turn and didnt so there’s no telling what would have happened if we hadnt ruptured my membranes. My contractions became MUCH stronger at this point, and I was becoming extremely discouraged because I wasnt progressing very quickly and my contractions were starting to become unbearable. Before this point I was able to groan, moan and make throaty, low noises to cope through them, but at this point I was screaming. I have never felt anything so intense in my life. I started begging for it to end and was screaming for some one to make it stop. I finally asked for pain medicine, much to my own chagrin. I felt my hopes for a natural  birth experience slowly draining away at this point, but I could no longer cope. The gave me a shot of something, and it helped for all of two contractions. I tried to keep laboring, but the pain in my back was becoming so intense I couldnt deal. My midwife suggested I get back in the bath tub to see if that provided any help, and I agreed. I dont know how long I was in there, but my mom sat with me for a while so Katie and Geoff could step out. I started becoming afraid of contractions at this point and remember being overwhelmed with the intensity of them. I got out of the bath tub and had a few contractions while sitting on the toilet. For some reason, my midwife wanted me to try laboring on the toilet but I HATED it. That was the worst position for me, I had to be either on my hands and knees or standing, I couldnt bear to sit through them. I remember holding onto the rail in the bathroom watching my legs shake. At this point, I was butt naked and remember registering some embarrassment that my doula and good friend was seeing me naked but mostly I didnt care. My legs felt like jelly and somehow I got back to bed and begged for the epidural. Kelly Jean suggested a sterile water block in my back at this point to help with the back labor, because it was supposed to act like counter pressure. My poor doula and hubby. Their wrists, hands and arms had to ache by now from the intense pressure they were applying. We tried the water block and it made it worse because they couldnt put pressure on my back anymore because it would undo the water block. I decided I had to have the epidural. I always thought once I asked for an epidural, it would be instant, but its not. It seems like it took at least an hour between finally convincing them to give it to me (remember I told them not to offer…yeah) and then I had to have at least half a bag of fluids in me and so on. Finally the anesthesiologist came in and I was sitting on the bed in a tank top and nothing else and I didnt care. He was really kind and helpful and got the epidural in place quickly and efficiently. He didnt do it too heavily, thankfully because once he left my midwife turned the lights off and told me to try and rest. I collapsed into bed, exhausted. Katie let me lay there for a few minutes or so and then told me I needed to get up on my hands and knees. I was able to do this even with the epidural, I still had control over my legs. She was hoping if I kept turning the baby would turn. At this point I became aware that his heart rate was dropping. My blood pressure was really low and I felt like I was going to black out. Katie helped me get on one side then the other so the epidural didnt pool on one side of my body. Kelly Jean came in and put two monitors on us. One under the scalp of the baby to better monitor his heart rate, and one next to his head to measure the strength of my contractions since I could no longer feel them. My contractions were getting less intense, which at this point told us that my labor was stalling.  I was really distraught and Kelly Jean and another nurse came in and were surprised to see me up on my hands and knees, but were concerned about the baby. My blood pressure was very, very low and the baby’s heart rate was no longer indicating he was responding positively to the contractions. In fact it was the opposite, as my contractions peaked, his heart rate dropped. I was scared for my baby. They put me on oxygen to help my heart rate and blood pressure, and some where in here Geoff stepped out.

 

 He came back and saw me oxygen and he became really upset and concerned about both me and the baby. My dad arrived at the hospital shortly after and I remember him coming back to see me, and holding my hand. All I could do at that point was lay there and hold my dad’s hand and try not to cry. I was so distraught at this point and discouraged that I had labored for so long for nothing. Kelly Jean came back because she was worried about the baby, she said we should monitor him for a few more minutes and see what happened and then decide whether to go forward with pitocin or a c-section. At the words “C-section” my heart went through my stomach. That was the last thing I wanted, but at the same time it meant my baby was so close to being in my arms and out of harms way. His heart rate continued to not respond the way we wanted and we made the decision. They told me two people could come back with me. I was torn. I knew Geoff would be there, but I didnt know if I wanted Katie or my mom to be the other one. I wanted my mom there because she’s my mom and I didnt want her to miss anything but Katie had been so supportive and she is an RN, so I felt safe having her there to lean on. We decided to have Katie and Geoff accompany me into surgery. The got me prep’d and wheeled me back. I dont remember the trip down there really, I just vaguely remember them transferring me onto the board and upping the epidural so I could go through surgery.

The curtain went up and Geoff sat by me and distracted me through the beginning of the surgery. Katie took some pictures for us and once our son was lifted out, Geoff went with him to see him be weighed, measured and cut the cord. Katie stayed with me as they sewed, stapled and otherwise put me back together. I could hear my baby crying and I started crying. I wasnt responding well to the anesthesia and started shaking violently and feeling very nauseous. The wonderful doctor who did my epidural and Katie worked together to get me stable and stop the shaking. Once I was ok, Geoff brought our son over for me to see. I remember crying my eyes out because he was incredibly beautiful. I wanted to kiss every inch of his tiny face.

They took him away again and Geoff went out into the recovery room to show him to our family. The wheeled me into recovery and I could see my whole family standing outside the window waiting for me. They had to put up the curtain at this point though because I started vomiting again. Once I was OK, they let everyone come back a few at a time to see me. My mom and Geoff and Katie were back there for a few minutes and I took the baby and held him to my breast and like magic, he latched right on! I could feel my heart swell at this little miracle in my arms. I had to have help holding him because of the epidural, but I felt my life change as I held my son for the first time. Eventually everyone came back for a few, and left, and they moved Geoff and I to our room. Katie accompanied us for a few to make sure we were OK and then she left. In hindsight, I am glad I tried everything I did before the epidural and c-section. I am sad that I failed in giving birth to my son naturally, but am thankful that we were in a safe place where we were able to use the miracles of modern science to deliver my son safely. It was worth it in the end and I am thankful everyday for this precious baby boy.

Clark’s Birth Story

No better way to kick off new birth stories than to share one from a mom who’s already shared a previous birth story! Heather is a dear friend and recently had her second baby last spring. You can read her first birth story of her daughter Julie HERE. This is an amazing display of natural, hospital birth where mom and dad maintain control, while also allowing their midwife and staff to care for them. Also, this is the definition of a precipitous birth! Heather, you nearly had a baby at home, my love! 😉

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Clark’s Birth Story

I started losing my plug at 35 weeks and 2 days. That combined with the fact that my first baby arrived at 38 weeks and 2 days had me convinced this one would be early too. I was a little worried because my husband was best man at a wedding in Texas (we live in Colorado) that fell right on my 38 week mark. So, while I was very ready for the baby to come, I was hoping he/she hold out so that Dad could be there too. As it turned out, there was no need to worry.

Despite wind storms, snow storms, and lots of false starts, May 10 came and went. Although I knew it’s not physically possible to be pregnant forever, it was sure starting to feel like I would be! I made my appointments for non-stress tests and ultrasounds and my induction date was set for May 24. My husband and I agreed that we wanted to leave no stone unturned before then in terms of getting things moving without medication. We continued walking everyday, I ramped up squats and started drinking more raspberry leaf tea. I went to the chiropractor and she suggested acupuncture, which we ultimately decided was worth a try.

Monday, May 12, I went to work as usual. As I was expecting to be gone by this point, there wasn’t much for me to do. I tinkered around with some things and then left a little early and headed to the chiropractor for my acupuncture session. I left feeling no different and with a follow up appointment scheduled for the next day. About 4:30 or so on Tuesday morning, I woke up with a useful feeling contraction, but after so many false starts that petered out after an hour or so, I refused to get my hopes up. I went to the bathroom and lie back down knowing that my daughter would be up soon.

Contractions continued, strong enough that I had to concentrate on them, but still nothing I hadn’t felt before.  Like clockwork, my daughter got up at 5 and I went in to get her, thinking I’d let my husband sleep in a bit since I was already up. I had another contraction in the middle of our good morning conversation and I actually had to stop talking and brace myself. That’s when I knew the baby was coming for real. I went in to tell my husband that I was pretty sure it was the day, but I wanted to eat something and see how things played out before we alerted everyone (my in-laws were staying with us to watch our daughter while we were in the hospital). I texted our doula, around 5:30 or 5:45 just to let her know I’d had a few pretty serious contractions and that I was planning to eat breakfast and keep her posted.

My husband made my daughter breakfast and I started making some cream of wheat for myself, but the contractions were strong enough that I really wanted to be in a quiet area so I headed back upstairs. By the time my husband came up with my abandoned cream of wheat, I was starting to need help during my contractions. I had set up the heating pad on my back and was riding through contractions as best as I could on my hands and knees.  My husband called our doula and the midwife’s office a little after 6. The midwife on call asked if we’d like to meet her at the office for a check before going over to the hospital or if we’d like to stay home a bit longer. My husband told her we were going to stay home; I was convinced I wasn’t very far along.

My contractions were strong but coming at very irregular intervals. I’d have a long one and then right after it ended, I’d have a shorter but just as strong piggy back contraction and then get a break (my midwife later told me she believes that this is because the baby was too big for my uterus to tighten all the way around him in a single contraction). My husband suggested that I get into the shower because he needed to load the car and get things ready and he knew from my first labor that I should be able to labor in the shower alone. I turned the hot water all the way up on my back and leaned my head on the cool tile and braced myself on the shower door handle. I was still having strong but irregular contractions when my husband got back. I told him I needed our doula and I couldn’t do it alone anymore. She arrived around 7:20 and I was on my hands and knees laboring in the way that worked best with my first labor. My arms were so tired though, so my doula brought up the exercise ball for me to rest my upper body on. My husband was squeezing my hips during contractions and my doula was rubbing my back and hips and legs between. The between-contraction massaging was so nice, because it kept me in the moment and didn’t let me dwell on the upcoming contraction and get scared. I was still sure I wasn’t far along because of how irregular the contractions were and the fact I had not had any show.

By 8, I was ready to go to the hospital no matter how far along I was because I really wanted to sit in a Jacuzzi bath. My husband called the midwife’s office and told them we were on our way. Meanwhile, I was starting to feel pushy during my contractions and my doula was worried we might have waited too long to leave. I kept repeating that I hadn’t had any show and she said that doesn’t matter. As she and my husband were helping me into the car, she started coaching him on when to pull over if things kept progressing. I knelt in the front seat facing backwards. My husband had kindly put a Tupperware back there in case I got sick. My doula had put a portable heating pad on my back before we left the house. I was still feeling pushy with every contraction and my poor husband was trying to drive as quickly and safely as possible while coaching me to breathe through the contractions and not push.

We arrived at the hospital and my husband asked if I wanted to go through emergency or if I wanted to park and walk and I chose to walk. It felt so good to be outside and the cool morning air gave me a second wind. My doula and my husband walked on either side of me and we made it in without having to deal with any contractions. I wanted to walk up to the labor and delivery floor but my doula talked me into using a wheelchair. I didn’t want to sit, so she helped position me kneeling backwards with my head resting on my husband’s chest. We made it to the hospital room around 9 and they hooked me up to the fetal heart rate monitors while the midwife checked my progress. To my total shock (and relief!), I was already 10 cm dilated. The midwife gave me the ok to push if I wanted to.

I started out on all fours with the back of the bed raised, the same way I pushed with my first. The nurse wanted to give me a hep-lock (which is something we said we were fine with in the birth plan), but in the moment I really didn’t want to have to mess with that. Plus I was holding pillows during contractions and I was paranoid that I wouldn’t be able to do that with a needle (or whatever) in my arm. My husband had to refuse a couple of times because the nurse was harping on the fact that if I needed a blood transfusion, this refusal would cost us precious time. My husband confirmed that that was alright. Meanwhile, pushing was getting me nowhere and the midwife said if I couldn’t make some good progress moving you down with the next few contractions that she wanted to go ahead and break my water. The baby was still at a -1 station and she thought that breaking the water would help move things along. She also suggested waiting to push until the contraction built some momentum so that I’d have that to help me.

After a couple more useless-feeling contractions, Someone (I have no idea who…it might even have been me!) decided it might help to squat and they got me a squat bar and everyone helped me change positions. The midwife said this would be a good time to break my water and stepped away to get her tool—just in time because my water broke on its own just then and would have covered her if she was still in the splash zone! It was like a movie, spurting several feet across the room! The baby didn’t like the new squatting position and both of our oxygen levels were too low for comfort so I got an oxygen mask and LOTS of reminders to breathe deeply between contractions. The baby’s heart rate was still dropping too low during contractions so the birth team helped me to get onto my left side first (no change) and then my right, which the baby seemed to like, but I was convinced would be a terrible position to push in. My birth team helped me to kind of squat on my side though, which seemed to help.

With everyone coaching me, I started to push with everything I had during every contraction. I could finally start to feel the baby sloooowly moving down. For sure it was the hardest thing I’ve done, physically. The baby started crowning a little after 10am and my midwife told me he/she was very big and I’d need to keep pushing hard to get the shoulders and the rest of the body out.  A few more difficult contractions later, my son was born and my husband told me “It’s a boy!”. Everyone in the room marveled at his size as he was moved to my chest. He had some fuzzy hair and very large hands with long fingers and big feet—his footprints were bigger than the box on his chart! My midwife was also was shocked by the size of his placenta. I guess a big boy needs a big support system!

My midwife was concerned that I had a very bad tear, but the doctor that came in to consult deemed it only a 2nd degree, same as with my first despite 2 lbs difference in their sizes. While my midwife stitched me up, I held my son (he was completely uninterested in breastfeeding right away) and chatted with my husband and doula, and the nurses. My doula helped me order some food and brought some for my husband and then left to attend another birth and said she’d be back later to check on us. I got a shot of pitocin and cytotec to help shrink my uterus and curb the bleeding and had some blood drawn to determine my iron levels while my son was weighed and measured. He came in at 9 lbs, 7 oz, and 21.5”. I couldn’t believe it! All of the nurses we had that day kept commenting on it too. Around noon we finally moved to the maternity ward and enjoyed our first few quiet moments of the day.

Calling all BIRTH stories!!

It has been FOREVER since I posted a few birth stories and we need to change that. I will post ANY kind of birth story. Home, hospital, c-section, loss…every birth story matters. YOUR birth story matters, no matter what. Please consider sharing your story, with or without pictures. As long or as short as you want. Leave a comment here or send me an email. Thanks!!

midwife101blog@ gmail . com

In the mean time, check out my kids’ birth stories by following their links above. Enjoy!

Sarah