11 January 2013

A Birth Story: Take 2

From the outset, this birth was going to be very different from the first time around. My pregnancy with E was overseen by an OB on Rodeo Drive in Beverly Hills. Delivery took place at a hospital where celebrity babies make their grand entrances. This time we received prenatal care from midwives at a birth center in rural Pennsylvania. The major traffic concerns during the drive while in labor were horse and buggies or cow crossings.

My biggest hope with the pregnancy was to go into labor on my own. I was a high risk pregnancy but there was no reason that the birth itself would be any more risk than normal. I have done a pitocin-induced birth without pain medication. I know I can do it. I just did not want to have to.

Contractions started making an appearance at about the 37 week mark of my pregnancy. At 38 weeks I was having regular-ish contractions. One night I had them 8 minutes apart for two hours. I was absolutely convinced that this baby would be early. But each night I would go to bed and wake up with no contractions and no baby.

My mum and sister arrived at 39 weeks. The plan was for my mum to team help Matthew during labor again and for my sister to watch E. My first check was at 39 weeks 5 days and I was 1+ dilated, soft, with a baby in -1 station. My body was definitely more ready to give birth this time around. I felt sure I'd have this baby close to my July 4 due date.

Despite that, I was still pregnant more than a week later. My sister had to return home on July 9. On July 13 (a Friday, none the less) we headed to our weekly NST at the high risk OB, which showed good movement. The initial excitement over labor signs had gradually been wearing away as time passed. By this point I had started remembering some of the harder parts of labor and there was a small feeling of dread beginning to make itself known. My previous labor and delivery came up during the NST test and I told the full story to the tech. She had lots of questions about our choice to deliver at the birth center and had such words of affirmation about my rock star abilities to birth that I left feeling more at ease than I had been in days.

At 12:15p we had an appointment at the birth center to start a foley bulb induction. The idea was to try non-pitocin induction methods before I hit 42 weeks, when I would be required to deliver at the hospital. At 12:45p, the bulb was inserted. I was roughly 3 cm dilated and soft. The foley bulb would help me dilate to 4 cm and the pressure on my cervix would help release the hormones my body was looking for to kick start labor.

3 hours later, the foley bulb came out but no contractions.

At 9:45p I added 2oz of castor oil to a chocolate milk shake.

Around 11p, still having no contractions, I nursed E to sleep. As I held her sleeping, curled up in my arms, I realized I was starting to feel something. I carried her up to bed and decided it might be time to download a contraction timer to my phone. Not thinking much of it, I started timing contractions. The were about a minute long and 5 minutes apart. After 45 minutes I decided that they weren't quite close enough to warrant going to the birth center and thought a shower might slow them a bit so I could get some sleep. I spent another 45 minutes in the shower letting warm water run over my back. It didn't have quite the effect I expected. Post-shower, I lay in bed timing contractions that averaged 45 seconds long but only 2 minutes apart. At just before 2, I realized that this was the real thing.

'Um, honey, it's time to go to the birth center.'

Matthew called the birth center to let them know we were on our way. The midwife had delivered another baby just after midnight so they were already at the center and ready to go. I woke my mum to let her know that we were heading in. The plan was for her to stay home with E until morning. I waddled to the car and sat there, smiling and giggling to myself, while Matthew loaded the car. I wanted to make sure Mum knew I was okay since she would not be able to attend as much of this birth as she had the first time. I couldn't quite believe that this was really it. As we started the drive, Matthew realized he had left his wallet at home. He paused, as if to turn the car to retrieve it, just as I had a contraction.

'Just drive- if anyone stops us, they can follow us to the birth center,' I told him.

It was a bit surreal driving through the black countryside on winding roads surrounded by dark fields and farms. During the drive the contractions increased enough in intensity that I started making low throat sounds to help myself relax through them.

We arrived at the birth center at 2:15a and were ushered in to one of the two birthing rooms. The midwife, Merrilee, and a nurse got us situated, turning on low lights and arranging our bags. Merrilee was one of the midwives that I'd only met once during my prenatal care. She was about halfway through her third trimester in her own pregnancy. I couldn't imagine having the energy to deliver a baby at that point in either pregnancy. After a quick check to see how the baby was doing via doppler, I asked if I could get in the tub. My back was starting to hurt with each contraction and soaking in the tub sounded great. I climbed in as the tub was filling and asked Matthew to start doing counter pressure during my contractions. The water felt nice but it was hard to get in a truly comfortable position. Reclining or leaning forward increased the back pain so I sat, cross-legged and slightly slumped, in the middle of the tub.

With each contraction, I did my best to stay relaxed. With my eyes closed, I focused on what my body was doing and blocked out pretty much everything around me. The low vocalizations and counter pressure helped but I was starting to struggle. I had not expected to have back labor again. The pain was different in that it only came during contractions but it kept throwing me off.

I was in the tub for a while when I felt like I needed to either use the bathroom or push. Matthew got Merrilee and they helped me to the bathroom. I sat on the toilet and worked through some more contractions. Merrilee asked if I wanted her to check my progress. I said yes, expecting to hear that I was well into, if not through, transition. Dilation was actually only to about 5 cm. This was surprising to both Matthew and me. Based on my vocalizations and general mood, Matthew thought I would be well into transition. Since I was expecting to be told that this baby was ready to birth I would have estimated I was much further along. I reminded myself that I went from 5 cm to baby out in just over an hour the first time around. Focusing on the number would only lead to negative thoughts. The toilet was comfortable so I sat there for a while longer, with Matthew and Merrilee sitting on the floor.

I moved to the bed next. Merrilee left us to ourselves. The birth center has full-sized beds to labor in which was quite the upgrade from the hospital. It allowed Matthew to lay next to me for counter pressure. I tried multiple positions. A favorite was on my knees with my chest and arms resting on the birth ball in front of me. I'd swivel my hips through each contraction, easing the pain in my lower back. I would have stayed that way indefinitely but my belly was too heavy! Prior to going into labor with E, I read many books on the subject of birth. Many included pictures of mothers laboring and delivering partially or entirely nude. In my pre-baby mind, I thought, 'Who would do that? Why not be covered?'
As I was laboring on the bed I was struck by the fact that I was completely unclothed and could not be bothered to be embarrassed about it. I had a small towel keeping my hips warm but the thought of distracting my focus by finding something to wear seemed ridiculous.

Settling in on my right side, with Matthew spooned behind me, I tried to be calm and relaxed. The back labor continued to stress me- I kept expecting the labor to go out of control the way it did when my pitocin was too high during E's birth. An irrational fear since I was not on Pitocin but labor isn't really the time for logic. There was alot of pressure on my tailbone, making me feel like I needed to push, plus lower back pain that came with each contraction. Matthew gently reminded me to breath deep and make lower pitched noises as I would start to panic. Merrilee came and sat next to me, holding my hand. I remember thinking that I needed to stay relaxed because I didn't want to hurt her hand. At one point I said that I couldn't do this and she responded, 'But you are doing this.'
With their help I was able to drift off to sleep. I woke with each contraction but slept again in between. Matthew dozed next to me, providing counter pressure and soothing words as I needed them. I tried to be clear about what was and was not working.

At about 5a, my water finally broke with a giant gush. I felt immediate relief in my lower back but still had the hard part ahead- a baby was about to make his or her entrance into the world!

Ten or so minutes after my water broke, I started to feel my body pushing on its own. I let Merrilee know and, with the help of the nurse, I was positioned on my side for some slow pushing. Merrilee was aware of the tearing issues I had with my first delivery and was aiming to avoid a repeat. Pushing lasted about 20 minutes. Compared to having two pushes total the first time around, it felt like and eternity. I growled, 'Get this baby out of me!' at one point.

Finally, with a last push, there was relief and a warm, wet, squirming baby on my chest at 5:34a! After cuddling for a moment, we realized we didn't know the sex of the baby yet. A quick peak revealed that we had a little boy. We've had a boy name ready since we were dating and now we had a boy to give it to: Owen Alexander. Together the name means 'well-born protector of mankind'. A big name for such a tiny person.

The cord was cut after it finished pulsing and the midwife showed me the placenta, something I didn't get to do after E's birth. I offered to nurse but he wasn't interested. We cuddled and between 6 and 6:30, E and my mum arrived. It was incredibly sweet to introduce E to her new baby brother. She had been so excited about the prospect of becoming a big sister and meeting the baby in my 'baby belly'.

I had a little bit of clotting issue so the midwife gave me a shot of pitocin to help clear things out and get my uterus on its way back to proper shaping. I was slightly amused that I didn't manage to completely avoid the awful stuff this time around. A shot in the thigh is not really comparable to an IV drip of the drug so it was not a big deal.

We spent time as a family, cuddling and resting. I gave nursing another try. O was having a little trouble with sucking so Merrilee used her finger to show him how to use his tongue. A few minutes later, he was latched on and enjoying his first meal.

Merrilee and the morning nurse, Karen, asked if they could do the newborn examination about 2 hours after he was born. Healthy baby boy measured in at 8 pounds 9 ounces and a whopping 22" long. After ensuring that my bleeding/clotting was resolving itself, Merrilee, pregnant and exhausted herself, wished us the best and excused herself, leaving us in Karen's care. The birth center requires that new moms and babies stay for a minimum of 4 hours. As the time was approaching, my pulse rate was higher than normal, running around 110-115. Karen told me I could go home when my pulse was under 100. We did some more resting and family time. I got dressed and read to E while Matthew snuggled O.

At just past 11, Karen okayed me to leave. My pulse was still slightly high but she decided I would have an easier time relaxing in my own home. We dressed O in the same outfit that E wore home from the hospital, along with an airplane print diaper. Just under 6 hours after his birth, O was strapped into his car seat and headed home.

Welcome to the family, baby boy!

1 comment:

  1. Thanks for sharing your story! My name is Heather and I was hoping you could answer my quick question about your blog! If you could email me at Lifesabanquet1(at)gmail(dot)com that would be great :-)


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