The Birth of Theodore Atticus…It’s a Boy!

I am SOOOOOO excited to share this birth story with you all. I have been following Sally and her little family since way back when I still used blogger and had a different blog name. This birth of her third boy is beautiful, but it involves a pretty scary postpartum hemorrhage (PPH). I irony in reading her story this weekend was that last week I had a patient have a PPH. It does not happen very often but when it does, it sticks with you. I find myself reflecting on every moment, each little step we made to help the patient feel calm, safe, and stop the bleeding. As Sally mentions in her post below, the care a patient receives at any time is critical but especially so when something scary happens. Feeling like you’re going to die after giving birth is probably one of the scariest thoughts anyone can have. Thank you, Sally, for allowing me to share Theodore’s birth story.

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Theodore Atticus (Teddy) arrived on Wednesday morning at 11:13AM after almost twenty-four hours of labor. I want to go ahead and give the heads up that, much like my other two births, this labor and delivery did not go exactly as planned. If you’re looking for a natural birth story where every thing goes to a T, you should probably skip this one. However, unlike the others, I had such a better experience when it came to feeling supported and listened to during my experience. My hospital staff was absolutely incredible. My nurses were amazing. The OB who delivered Teddy was perfection. Here’s our story:

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Monday was Memorial Day. At our CrossFit box, the gym was running a hero work out known as “Murph.” Taylor and I got there with the boys around 10:30AM to cheer on the athletes and get a little work out in ourselves. I headed to the squat rack and started doing a slow triplet of three squats, three pull ups, two sled pushes. I added a little weight every round, and I had just done my second squat at 115lbs when I felt a thump. I stood back up, and water gushed down my legs like someone had turned on a bath tub faucet. I racked the weight, turned to look at Taylor, and said, “Um, Tay, my water broke…we need to go.” He started laughing, and we gathered up the boys while I waddled to the car with a towel between my legs.

We were supposed to show our house that morning, but obviously, that wasn’t going to happen. I hopped in the shower while Taylor fed the boys. We made calls to the people who were coming to help watch Sully and Arlo while we were at the hospital and before our families arrived. I went back and forth between the birth ball and sitting on the toilet trying to get some contractions going. They were there, but very mild and not at all consistent. At about 2:30PM, we decided to head on to the hospital. I was GBS+ again, and honestly, being at home was far from relaxing between the kids and the dog. Our good friends arrived to watch the boys, and we made our way.

When we checked in, I was still not having any contractions and was at about 2cm. I walked and walked some more, bounced on the ball some more, and four hours later, still nothing. At this point, I agreed to being put on the lowest level of pitocin in order to hopefully get contractions going. The nurses and OB were all absolutely fine with me walking around, taking a shower, doing whatever I could to try to get things moving. Eventually, the contractions picked up. They became incredibly uncomfortable, but they still were not regular. After about six hours on pitocin, they took me off and checked me again. I was at 3cm. We decided to let me try to labor on my own for awhile off the pitocin to see if I could try to progress some more. For several more hours, I labored in the shower, on the ball, in the bed, whatever I could try to do. The contractions were steady, and I would say they were very painful. It was intense pressure with each wave and very little rest in between. I asked to be checked again, convinced I had to be close. I was only 3.5cm. After being in labor this long, looking at the middle of the night, and recognizing that I just wasn’t progressing like I wanted, I asked for the epidural. I needed rest, and my mom and Taylor were exhausted, too. I hoped an epidural would bring some relief and let me sleep. I honestly could have kissed the anesthesiologist. I told him my epidurals before had never really worked, and I always ended up with “hot spots.” He had to place it twice, but he finally got it working, and I could rest.

I expected to be disappointed by this choice. After all, I really wanted to go naturally. But after having been in labor for so long with no change, I felt like I was only torturing myself. Labor should an experience where you feel in control and on top of all the decisions made. I truly feel like I was in control this time. Every decision made was passed by me and approved by me, and the nurses and OB were so amazing at ensuring my experience was the best possible one for me. I laid down and rested and by 10:30AM, I had a little lip of cervix between me and baby. The anesthesiologist had to do another dose of medicine when I started getting hot spots, but it fixed the problem. My epidural was light enough that I could feel all the contractions and pressure, and I could move my legs, but I was no longer fighting against the contractions. When it came time to push, three pushes, and Teddy joined us, screaming and pink.
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Now, here’s the hard part. My labor and delivery went so well. I had one tiny tear that required a few stitches, and I was able to get up and walk around almost immediately after Teddy was born. He latched like a champ and took to nursing right away. About six hours after delivery, while we were settled into our recovery room and after my shower, I got up to use the bathroom. As I walked into the bathroom, I felt a ton of pressure and cramping. Suddenly, blood gushed everywhere. Huge clots covered the floor, and the walls looked like a horror film. I yelled to Taylor to get the nurse, and more blood gushed again. I stood there completely shocked, and the nurses rushed in. They put me in the bed, where the gushes kept happening. Soon, my room was filled with nurses and my OB. They gave me percocet, a shot of some of sort, and cytotec to try to stop the bleeding. The OB then explained to me she would have to do a manual extraction, where she would have to reach up into my uterus to pull out the massive clots that were preventing my uterus from contracting back to normal size and containing the bleeding like it should have.

I have never had anything done that felt so horrific. I was screaming and crying and begging for them to stop, but they were pulling out baseball sized clots of blood, and I knew it had to be done. I think this was the point where I honestly thought I might die. I’ve never seen so much blood in my life, and I have certainly never seen so much blood come out of someone and them still live. The OB explained that if they couldn’t stop the bleeding, I would have to go under anesthesia for an emergency D&C and then possibly a hysterectomy if it continued. Once the manual extraction was over, they began a blood transfusion. I received four pints of blood because it was estimated I had lost about two liters (the human body generally has 4.7-5 liters of blood). They pumped me full of fluids. This part is pretty hazy, but I remember being cold and not being able to stop shaking. They kept asking me how I felt and random questions to keep me alert. Poor Taylor and Teddy had to be there the whole time.

Once they had me stabilized, they inserted a postpartum balloon. It was basically a massive balloon that they filled with water to put pressure on my uterus and hopefully help the blood vessels seal. They kept it in overnight, and in the morning, they removed it. I had no more clotting, so I was asked to stay in bed twelve more hours before I started moving around. They kept me another couple of days, but I was finally in the clear.

They speculate that my long labor exhausted my uterus, and when it was time to contract back to normal size, it was contracting but not shrinking. Blood vessels never sealed, and it started a vicious cycle of clotting, releasing the clots, and clotting again. There is no real way of knowing WHY this happened.
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I can tell you a few things about this experience:

1) Teddy was our last baby. I can’t risk something like this happening again. Thinking I was about to die was the most terrifying thing in this entire world, and while he is so, so, worth it, I want to be here for Taylor and my babies.

2) I appreciate my little family so much more.

3) I am so incredibly grateful for my medical team. Had I given birth at home or had I been released earlier than 24 hours, I would have bled to death. An ambulance would not have made it in time for me to survive. Which means, if I had birthed anywhere but the hospital, I wouldn’t be here today. That does not mean that I am against home or birth center births, but this experience made me realize how grateful I am that I personally did not chose that path.

4) Having a good hospital staff and OB makes an absolute world of difference. My labor and delivery could not have been more precious to me. My OB that had privatized me the entire pregnancy was actually out of town. I ended up with another female OB, Dr. Jones, who is my new best friend. She was so incredible, and I am so grateful I had her. My nurses handled our labor and following emergency so well. No one panicked or made me feel like they were not in control. Even at the worst moment, Taylor says he did not really think he would lose me because everyone was so competent.

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We are home and settled now. I feel pretty rough, but I guess that is to be expected. Teddy is nursing so well, and the big boys are loving him. Teddy has a little jaundice, but we are staying on top of it, and his numbers are lower today, so we feel better about that. I am so grateful things turned out the way they did, and now we are just hunkering down to enjoy this newborn phase.

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

Making Home Birth Safer

I never sign these things. I am not one to get all up in arms about petitions and change and such–unless I feel strongly about it. And maybe there just hasn’t been a petition out there that has stirred me so much, until now. The Coalition for Safer Home Birth was started on Change.org to encourage our legislatures to recognize the safety standards that are lacking in home birth. The coalition does a wonderful job summarizing exactly where the issues in home birth safety rest which largely is in the hands of the home birth midwife who is lacking a certain level of education. I feel that it is best for me to leave you to read what the coalition has written as I could not have said it any better so I won’t even try.

And maybe, if you feel moved enough, if you want to see change, sign the petition.

Protect Mother’s and Babies: The Coalition for Safer Home Birth

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.

two births

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Two births. Two mamas. Two babies. Two nights ago. I finally witnessed two vaginal births in person. No more you tube! There is nothing like it. Birth in person is something of its own outside of my own births and watching one on TV. I’m still having a hard time finding my words to describe how amazing they both were, but the point is that I have no seen it and everything I have felt in my heart without ever having seen a birth in person (outside of the OR) has been reaffirmed. I’d be lying if I said I was afraid that I’d go through all this hard work in school and find out it wasn’t what I wanted. Not the case. This is exactly what I want.