Monday, August 18, 2014

A Birth Story: Elizabeth

Today's post is another submission to the ongoing A Birth Story Project. With this project, I provide a public space for birth stories that want to be shared. Please contact me if you'd like to submit your own (anonymous or not, as you prefer). The spectrum of birth experiences is wide, and I'm hoping to be able to post an equally broad variety of stories.

Stories and photos are shared with permission. Stories may be reformatted and edited for clarity, but they are not censored. This is meant to be a safe space, so please read with compassion. Comments may be moderated.

Elizabeth's First Birth

This was my first pregnancy.  I was expecting a boy and had planned a home waterbirth in Brooklyn, NY.

On a Wednesday, five days before my estimated due date and the day before I went into labor, I had some watery, bloody discharge and felt just a tad crampy. I'd been having Braxton-Hicks for several weeks, but was experiencing them more as random stomach tightening than as contractions. They certainly weren't something I could time.

Incidentally, I had every expectation of being one of those women who "went over" her EDD by one or two weeks. I'd even hired a midwife who wasn't due to be back from vacation until right after my due date (though her backup would be available while she was gone, of course). That was how sure I was that I would be "late." The only reason my midwife was in town and didn't miss my birth was that she'd had two other clients who'd gone late, and she'd had to cancel/postpone her vacation!

I also "just knew" I'd have one of those 24-hour "first pregnancy" labors I'd been told were typical.

Wednesday night, a friend came over to watch America's Next Top Model (I know, I know) at our place. My husband and I went to bed around midnight. Just before 4 am on Thursday, I woke up and went to the bathroom. I was still having slightly bloody discharge and imagined maybe I saw a tiny bit of mucous (but nothing much) on the toilet paper. I went back to bed but couldn't fall asleep. I had two cramp-like contractions and thought, "Whoa. That's different. This might be something!" They felt like someone stretching a large rubber band across my stomach and around to my back (I may have read that description somewhere while I was pregnant, so it's possibly not original, but that's how I experienced them). I moved to the couch and tried to distract myself, hoping to wait until my husband woke up on his own (rather than waking him). I figured one of us should get some sleep! I tried to watch something on my laptop. I couldn't concentrate on the screen. I timed my contractions out of curiosity. They came roughly every 10-15 minutes and lasted 30-45 seconds. This seemed to be the real thing.

At seven, when he got up, I told my husband I thought I was in early labor. We'd been good students in our childbirth ed. class, which was specifically for planned homebirths, and I had come away with a list of fun "early labor activities" I wanted to accomplish -- going to the grocery store together to buy labor and postpartum food; making a batch of bran muffins, a pan of lasagna, and a breakfast casserole for after the birth; cleaning the bathroom; filling the birth tub, etc. And maybe we'd watch a movie or take a walk, like our teacher had suggested. I love movies, so that (and the baking) appealed to me most of all. First, though, I texted my doula and called my midwife. They both told me to distract myself -- maybe drink a glass of wine (not likely at 7am, as I'm not much of a drinker anyway), and take a shower. The doula told me to stop timing contractions for the time being. I sent an email to my coworkers to tell them I wouldn't make it in to work that day.

In the shower, I had to lean forward under the shower head, with the spray set to "massage," and let the water pummel my back during contractions. They hurt, but I knew it was just the beginning, so I tried to keep a brave face. The shower helped some, but not as much as I wanted it to. At 10:00 am my midwife came by to check on me on her way to another appointment. I told her my contractions were about 10 minutes apart. I was sitting on the toilet then, as I found it the most comfortable place to be between contractions, and she did not do an internal check because we discussed how I thought my water had broken (in a thin stream, not a gush) while I was in the shower. She checked a pad I'd worn after the shower and said, yes, it was amniotic fluid and there was no trace of meconium. She got out the Doppler and listened to the baby's heartbeat before during, and after a contraction.  She said it sounded great, then left to go to her next appointment -- saying she expected to hear from me when contractions were 5 minutes apart, maybe later that evening.

When my midwife left, my husband ran to the grocery store to buy a few supplies (we hadn't had time to do anything on my "early labor" list, and things seemed to be setting us up for a short labor). I resumed timing contractions because I felt they had really picked up in intensity and speed. By 11am, they were averaging 4 to 4 1/2 minutes apart, and lasting for a minute or a little longer each time. And they really HURT! I thought perhaps I was having back labor. I couldn't figure out anything to do to cope with the pain. Leaning over the sink had stopped working. Having someone press on my back (which the midwife had done while she was there, and which my husband had practiced in our class) had stopped working. I got on my hands and knees and moaned and complained. But I couldn't get in the tub because my water had broken.

I stopped being aware of time at this point, and I certainly wasn't checking a clock, so the exact timing of my labor gets pretty hazy here.

I called the doula. I told her I couldn't cope and that things were moving too fast. She told me it would be 45 minutes to an hour before she could get to our apartment and that I should get back in the shower. I did, but the water was only barely helping. I started to feel weird and, I dared to think, "pushy." Uh oh! I tried really hard not to push and was mostly successful. I made my husband call the midwife. She listened to me on speaker phone. I was on my hands and knees in the shower, and suddenly I had a terrible contraction and felt something pop right at my vaginal entrance. I said that out loud, "I feel pushy! I'm trying not to! I felt something pop!" It felt super-intense and wrong. I started to get scared.

My midwife said I should get out of the shower and lie on the floor. She was driving back from an appointment in New Jersey as fast as she could. The doula showed up then (thank God it didn't take her as long as she thought it would!) and she coached me to not push. I tried to moan rather than scream -- to breathe short breaths rather than grunt -- at her suggestion. I couldn't get comfortable on my side or on my back. I ended up on my hands and knees (trying to kneel on towels they were pushing under me, but I kept slipping onto the tile) in our tiny bathroom. We don't even have a bathtub.  It's very small. I was accidentally hitting my head and hands and feet and legs on the walls, the toilet, the floor, the radiator with each contraction. Sometimes that pain actually made me feel a little better! A couple of times, I think I did it "accidentally on purpose," if that makes sense. I think that was the "ritual" part of my labor comfort measures (mentioned in a video we had watched in class).

Then I heard my doula (who was on the phone with my midwife) say to her, "I see a foot." What?! My baby was head down! Every ultrasound and every midwife and doula who checked me had said the baby was head down! Only one time had my midwife been unsure, and that was months ago, and she still thought he was probably head down! Looking back on it, I had noticed that I wasn't getting kicked in the ribs constantly during late pregnancy, unlike so many other pregnant women. I had wondered if it was because I'm tall and I had more room in my torso.

Nope. He was breech and a foot had been pushed out of me. I couldn't bring myself to look at or touch it, but once my doula said that, I could feel there was something between my legs. A poor, little black-and-blue leg and foot. Apparently, it was even kicking! The baby's heart beat was still strong. I was scared, and said so. I said this was all wrong. I said I was sorry. I said it to my baby and my husband and my body. I was so angry at every woman who had ever had an easy labor. I can laugh about that now.  But every contraction was so painful, and the pain in my back continued like the worst backache/kidney infection ever -- even in between contractions. To this day, I get annoyed when people talk about "the break between contractions" as being lovely, peaceful and restful. I'm not annoyed with them, just with the idea. I didn't get a break!

My midwife made it to our place (crossing 2 rivers and the island of Manhattan) in about 25 minutes, which is amazing. She double-parked and left her emergency blinkers on and a "medical emergency" sign on her windshield in the hopes she wouldn't get towed (I found this out later, and she didn't get towed). She told us that we needed to decide whether we were going to go to the hospital for an emergency breech delivery. She said it would certainly be a C-Section. Now, I didn't want a C-Section, but what I really didn't want was to get up, make my way down 3 flights of stairs (naked), get into a car, and be driven to a hospital!! And what I really, REALLY didn't want was to make the decision. I felt crazed and unprepared. I told her I'd do what she advised. My husband said later he'd felt the same way -- completely unready to make that call. We both wanted her to make it, and she did. I can see now that she knew our reluctance to say "let's go" was us wanting to stay home -- us trusting in her years of expertise to know if we needed to transfer. She said she thought we could attempt to see this breech homebirth through. She, like me, didn't know how I'd make it out of the house. She thought I'd probably end up having the baby in the car, I was progressing so quickly. And she knew that breech births are possible vaginally. She had a good success rate turning babies, and she didn't attend planned breech vaginal births, so she hadn't done more than two emergency breech deliveries, but she knew it could be done.

As it turns out, my midwife and the doula had just recently watched three vaginal breech births (on video), so the knowledge that it IS possible was fresh in their minds. They also knew when to be hands-off and let the baby's body shift into the best position, which is what had to happen next. He needed to get into position without them tugging on him, and he did it himself. My body helped, so I guess we did it ourselves. Pretty miraculous, thinking back on it now. In fact, after the birth, my midwife and doula even got down on the floor and acted out how his orientation changed as his body twisted and turned through the birth canal!

Now, they settled in to coach me through the remaining contractions, and they were so patient and kind. I made terrible, low noises and tried to breathe. I felt so awful and thought it would never end. I didn't want to do it. I wanted it to stop. But I knew I had to let my body take over. Oh, it hurt. I kept saying, "I'm so scared." Maybe not the best mantra, but I was being honest with myself. I told my husband I was sorry if I was scaring him, too. I couldn't see anyone, so I couldn't read their faces. I was bent forward over the toilet (which had a pillow on the closed seat by now), kneeling on towels and tile. My knees felt quite bruised! And I was embarrassed and angry about how dirty our toilet looked.  I hadn't cleaned it well enough before going into labor, I discovered, and now I didn't want to touch it, but I had to. I was just along for the ride. My husband breathed along with me hoping it would help me be less embarrassed about the noises I was making -- and I was embarrassed. I thought the downstairs neighbors would call the cops, thinking I was being murdered. I can't believe (my husband saw them the next day) they said they were home during the whole thing and didn't even hear me!!

The first time I felt any relief was when the second leg came out. Oh! I let myself believe MAYBE this would end, but the contractions still hurt terribly. Some of the back pain let up, and my midwife told me later that she thought the second foot/leg had been inside scraping along my sacrum and causing the pain. Birthing the butt also hurt badly. I kept feeling like I'd push and make progress, and then everything would slip back in (though, of course, not everything was slipping back in). My midwife told me, "We can see testicles! We know it's definitely a boy!" I didn't care. After the butt came out, he pooped meconium, but when it first came out the fluid (I felt like water just poured out of me at several points during labor, though it was hours after my water had broken) had not had  meconium in it, so they felt sure he hadn't aspirated meconium inside of me. Since they still couldn't get to his head, this reassured them somewhat.

After the butt, the chest came out in another painful contraction or series of contractions -- I'm not sure how long it took. I guess I was pushing for 30 minutes? I was out of the shower trying NOT to push for 15-30 minutes before that? And in the shower trying NOT to push for 15 minutes before that? That's roughly the timeline.  I wish I knew exactly.

Now only the head remained inside my body. They couldn't get a heartbeat reading on the doppler anymore because of his position (which didn't mean he was in distress; it just meant we couldn't hear that reassuring sound) and the cord didn't seem to be pulsing as well as she wanted, so my midwife said, "I'm sorry, I'm going to have to put my hand inside you." I think I said, "Oh no..." There was a terrible pressure and I had to push. It turns out, she had put fingers into the baby's mouth to tip his head (chin) down so that he could come out right away. The cord was wrapped twice around his neck, so she unwrapped it. He came out into a pile of towels between my legs. I was still on all fours.

I heard him crying right away. My husband said he doesn't even think they had to suction him. I felt like I couldn't look. I was shocked. I couldn't believe it was over. I couldn't believe it. It was around 12:20pm. I sent another email to my coworkers about 20 minutes later, to say I'd had the baby, and they thought I was joking.

I finally realized he was there, between my legs, in a towel, and I could barely touch him. It was a dream. He couldn't be real! But then I was able to get my breath back and move with him out of the bathroom (and off of my knees) onto our couch, which was covered with old sheets and shower curtains and absorbent pads and things. I birthed the placenta there in two painful pushes (I was so annoyed at having to push again!) and everyone said it looked great. I didn't even glance at the placenta.  I could only look at my baby in shock. The midwife and the doula and my husband and I were all sort of in shock, I think. We kept talking about all the details, running over everything that had happened. We couldn't quite believe we had done it -- I had done it. I still sort of can't believe it.

In short, my son was born 4 days before his "due date" on my bathroom floor after 8-9 hours of labor (from first contraction to last push). He weighed 8lbs 9 oz. He was apparently a footling breech (surprise!), or a complete breech with one foot popping out first. He was 20 1/2 inches long and his head measured 37 cm. His APGAR scores were 9/10. 

It was amazing to get that "golden hour" (and more) of skin-to-skin contact after the birth. He was on my chest pretty much constantly, except when he was weighed (and when my husband held him, of course). What a privilege to get to figure out those early hours of breastfeeding as a team. He had some jaundice the first week, and I was quite nervous about the idea of having to take him to the hospital if he needed phototherapy, after all that, but it was nothing our midwife or pediatrician ended up being concerned about. We worked through it.

I can't believe we did this at home. I can't believe I didn't end up in the hospital emergency room. I'm so glad everyone is safe and content today. I did not tear, though I was pretty sore (especially while walking) for a few weeks. My knees were tender for 3 or 4 days. The baby's leg gradually pinked up (the one that was hanging out of me the longest) and was perfectly fine. He had no hip/leg issues.

I just can't believe it.  And I'm so happy.

p.s. I never got into the filled birth tub, of course. There went my dreamy (so I'd dared to wish) ideal water birth!! I always had doubts about renting it (because of the cost), but I'm not pretending I saw this coming! My husband joked that he should've put his suit on and just sat in it for a while, after all the trouble to rent and fill it. Oh well!

p.s.2. When I talked to someone about the birth later, she said, "Did you ever wish you had painkillers available to you?" And, you know, I never once wished I did EXCEPT for a silly, fleeting moment when I thought, "Oh, man, my back hurts so much. But maybe if I took a few Tylenol from the medicine cabinet behind me they might take the edge off." Even as I thought it, I laughed at myself and then transitioned back into another incredibly painful contraction.

p.s.3 After the birth, my husband ordered Thai food for us all for lunch. I remember that I was hungry, but also that I was annoyed that he hadn't ordered any of my favorite dishes! I think he was trying to get a wide variety of things, since we didn't know our birth team's preferences. That night, however, after the midwife and doula had gone, our closest friends brought us fried chicken and biscuits and mashed potatoes. This turned out to be exactly what I wanted. Heavenly!

Update: My son is three now. I wrote this story the day after my son was born, but time reshapes the edges of the story, both concealing and revealing, and I've added some memories/thoughts since then. Birth stories are tricky! I know that I was in a lot of pain and frightened during the labor, but I also can't deny how much I adore the outcome -- my beautiful, amazing son. The fear and pain have faded a lot, leaving a proud, empowered feeling of competency, but there's still some trauma behind those good feelings. I certainly haven't rushed to get pregnant again, though I love being a mom! 

Still, the bottom line I cling to is: I did it! He did it! We did it! Others can do it! Not everyone will get the chance to do exactly what I did, of course, given how rare a surprise breech baby is (and how hard it is to find a breech-birth-friendly provider if you know in advance your baby is breech), and I hope that my story doesn't cause others pain. Sometimes it's hard for me to share my story, because I worry people will think I'm bragging -- especially in the face of mothers who've experienced breech pregnancies that have ended up in cesarean births the mothers may not have wanted. Still, I also think my story, like so many of the birth stories I devoured while I was pregnant (and since!), is a testament to what a woman's body can do, and how we can heal afterwards. Thanks for reading it.

Monday, July 14, 2014

A Birth Story Project: Kimberly

Here's another terrific entry into the ongoing A Birth Story Project. With this project, I provide a public space for birth stories that want to be shared. Please contact me if you'd like to submit your own (anonymous or not, as you prefer). The spectrum of birth experiences is wide, and I'm hoping to be able to post an equally broad variety of stories.

Photos and stories are shared with permission. Stories may be reformatted and edited for clarity, but they are not censored. This is meant to be a safe space, so please read with compassion. Comments may be moderated.
Kimberly's First Birth (NY):

I had an amazingly healthy pregnancy, doing yoga, swimming & walking til the end,  so I foolishly thought I'd have this blissful Ina May Gaskin-esque experience - it was the polar opposite!

I was 5 days past my due date and had gone for acupuncture to avoid being induced. Not sure that was the best idea - I think it forced G out before she was ready. I'd been having early labor off & on for more than a week, but finally went into "real" labor on a Sunday around 4pm. Immediately, took a nap & during that nap (around 6pm) felt a "pop" and the bed got wet underneath me. I was GBS+ and didn't want to go to the hospital & get hooked up to an IV right away, so I stayed home for another 11-12 hours (!) having contractions that were painful, but manageable, taking showers, eating small meals, took another nap. Had a nice brisk midnight walk w/ my sister-in-law Ruth Ann, who's a homebirth midwife in WV (and had been camping out in NJ at her in-laws, waiting for me to have a baby!).

A little meconium showed up and contractions were getting much closer together, so we decided to head to the hospital at 5am on Monday, before speaking to the midwife on call (at Beth Israel). I lied & told the doctor in triage my water had JUST broken like 2 hours before (not 12!), was disappointed to find that I was only 1cm dilated after all that time/contractions. Had an icky exchange w/ the head resident (who coincidentally is the name listed on G's birth certificate as having delivered her!). Had to do a little fighting w/ a nurse or two about my staying mobile & sticking up for my rights, telling them that I was a midwife patient and they should call her if there were any questions.

Brian was sneaking me food & juice. Ruth Ann went to Whole Foods & got me some castor oil & herbs to hasten things. I kept hearing other women enter the room next door, labor for a bit, scream, move out, next woman, etc. Finally saw Susan, the midwife around 11am. Was glad it was her: she was funny, loving & a tough cookie. She determined I had a "forebag" when your water breaks up high on the sac, so basically the body doesn't know it's broken, and there's not downward pressure from the baby to move things along. Tried to use the amnio hook, but I wasn't dilated enough, so it was Pitocin for me. My heart sank - there goes everything, I thought! Ruth Ann assured me that she's seen women labor on Pitocin, and since I'd already been having contractions I'd have the endorphins to counteract it. I had this idea that I’d get a little Pitocin, it would kick things into gear, and then I could get off it. In reality, about every 1/2 hour or hour, as no progress was made, they'd up it. Bam! I would literally BEG the nurse NOT to up it when she'd come in. “Please, I need a break.” I labored on Pitocin for 8+ hours (in addition to the 20 hours of labor pre-Pitocin). At some point I remember hearing "Always Love" by Nada Surf (listening to the Birth Playlist via ipod) and I hugged Brian, swaying to the music, and cried, I felt so emotional.

It got to the point that I had no break in between contractions. I had smaller contractions, in between the big ones, that were as intense as my previous contractions had been. I had been active the whole time: bouncing on a ball, pacing, swaying, rocking in a rocker (and had started involuntarily banging my head against the back of the rocking chair during contractions trying to make myself lose consciousness). The whole time, Ruth Ann & Brian (and Susan) were very encouraging that I could do it. Susan was the only midwife that day, so I didn't see a ton of her, which was actually nice - we spent a lot of time just the three of us in the room. They kept giving me little milestones to reach to get me through the pain, "Susan will be back in an hour to check you, you just need to make it til then" or "just 20 more minutes til X happens."

At one point, I was on the toilet & Susan told me to stay there for a while (where I was unconnected to monitors) and I recall not being able to sit down any more - I couldn't have any part of my body touching anything due to intense pain. She eventually put me in bed to rest because I was so exhausted & she said I needed to have energy to push. That bed is a thing of my nightmares, like a torture device. This is when the most intense contractions occurred - the ones w/ no downtime. According to Brian, during this time I would pass out cold between contractions & start snoring! For several weeks after, every time I'd lay down in a bed to sleep, I'd be transported to THAT bed and relive the trauma. Every big contraction, I'd climb the bed rails. I felt very alone at that point (even though surrounded by people) as I realized that I WAS alone - I was the only one that could do it and no one could help me. I begged someone to help me, "I can't do it!" “You can! You're doing it,” they said. At some point during labor, my sister showed up, which was really great - I'd thought of inviting her, but hadn't. It's all pretty blurry. I was hinting at pain relief & kept getting talked out of it, because they knew that's what I wanted. Weeks later, I felt like, "why was it OK (from a midwifery standpoint) for me to have Pitocin, but not to have my pain taken away?"

After 8 Pitocin-hours (and 28 hours total), I was 5cm. “I don't have another 5cm in me!” I thought. I asked for an epidural - it was very nerve wracking getting it, staying still during contractions so they don't puncture your spinal cord. Ugh. Brian (& everyone but the anesthesiologist) had to leave the room. My sister whispered to me "you're amazing. You didn't fail! You're only doing what 95% of women do." It was very hard for me to get drugs administered in front of Ruth Ann, who is a total bad ass (40 hour horrendous drug free labor with her 1st kid). She said to me, "when I said I've seen women labor on Pitocin, I meant like for 2 hours, not 8! Holy Shit girl!" I then slept & Brian & Ruth Ann basically watched my monitor, in which both the baby's & my heart rates would take turns skyrocketing & plummeting due to the Pitocin. Now that I had the epidural, they could jack it - still not making progress.

At some point in the middle of the night, I was awoken by the nurse, who sat me up to get the benefit of gravity, as Susan explained I was being examined in one more hour and if there wasn't sufficient progress, I'd likely end up w/ a c-section. So, I actually had this amazing hour to myself while Brian & Ruth Ann slept in the corner & I channeled my inner Ina May, speaking to the baby, meditating & guiding her down & out. And then Susan came in, spread my legs and said "Oh shit! It looks like someone has spilled a can of split pea soup between your legs." Literally like 2 cups of meconium on the bed. And only 7cm. Game over. C-section, it is! I had about 10 mins to talk it over w/ Brian, and the attending surgeon came in to explain everything to me about the procedure. I recall her describing how they double-suture the incision, so that I can have another baby in the future w/out fear of rupture. I thought, "Is she crazy? I'm never doing this again!"

The surgery was very stressful to me, psychologically, because I feel like it was sprung on me and I hadn't had time to get used to the idea. I had considered doing a home birth w/ Ruth Ann & she said to me on the way to the OR, "If we'd attempted a home birth, we'd have ended up in the same place." And she also said, "I've transferred many women to hospitals who've gotten totally bogus c-sections & I've had to make up lies as to why they needed them (because the dr. wanted it), so as not to make them feel robbed of their birth experience. I don't have to lie to you - you legitimately need this. This is why they exist."

Brian held my hand & I was very cold, arms splayed on the operating table, like I was on a cross.There were roughly 10 people in the room, 2 of them NICU pediatricians just in case, as G had been very distressed during my super-medicated labor (and the ass-load of meconium). I heard, "She has so much hair!" and "She looks just like Daddy!" & then I heard what sounded like a cat in the room & I asked if the baby was crying. She was! Brian was alternating between comforting me -- "Everything's fine, Sweetie! She's perfect" -- and giving permission to the peds to intubate her! She was grunting & not breathing at first & poor Brian thought she was dying!

Before whisking her to NICU (she'd swallowed a ton of meconium, which they'd sucked out of her lungs, and she was running a fever), I saw her for like 30 seconds. I got to touch her cheek. I think I said, "Hi!" No holding, but Brian got to hold her. What no one tells you about c-section is that it takes maybe 10 minutes to get the baby out and about 45 mins to put you back together. I heard the surgeons & nurses counting: every piece of equipment and gauze had to be accounted for. Then I had this feeling that there was a metal clamp on my lower abdomen - I thought that was something from the surgery that they'd remove. Then they said, "OK, you're done!" What about the metal clamp? Nope, that's your new abdomen! Oh, that was Tuesday, December 21, 2010, 6:23am - 38 hours after my labor started. Whew!

I didn't officially get to "meet" Georgia until more than a day after she was born (and we didn't name her until then). I couldn't go to NICU because I couldn't sit up & get there via wheelchair (on a different floor from maternity). As hard as that was (between bouts of being passed out cold on morphine), it was actually an amazing bonding experience for her & Brian. He went to NICU and took off his shirt, doing skin-to-skin contact (the nurses thought he was a rock star!) and feeding her. One of the nurses woke Brian from a nap in our room the day of her birth and begged him to come down and give her formula, as she'd been screaming in hunger. I didn't want her to have formula, but I didn't want her to be hungry and feel abandoned either.

Not being able to breastfeed right away made it difficult, but I had to say that while my birth experience was WAY less than ideal, the nursing staff & lactation consultants were very helpful & supportive of breastfeeding. Also, the NICU staff was great. G spent 40 hours there total & was the pinkest, chubbiest baby in NICU (7 lbs, 10z, 20 inches). I felt very grateful that she got sprung so quickly & felt sad for parents who's babies were in there for weeks. And I remember feeling a bit nervous when at 9pm Weds night the NICU ped said, “You can take her back to your room.” "Right now?" We had a dehydration scare while in the hospital (before my milk came in), but eventually got the hang of feeding.

We brought her home on Christmas day. I was hallucinating in the car; I was so exhausted. My friend/neighbor David was walking down our block when our car pulled up. He took a picture of the three of us in front of the car. Later, he sent me an email saying that seeing Brian and I walk up the stairs to our building, carrying our new baby on Christmas Day, put him in mind of Mary, Jesus and Joseph.

 Mother and daughter officially "meeting" in the NICU

Monday, June 16, 2014

A Birth Story Project: Sarah (2)

Sarah's back with another submission to A Birth Story Project -- the story of her first son's birth. Read the story of her second son's birth here:

With this project, I provide a public space for birth stories that want to be shared. Please contact me if you'd like to submit your own (anonymous or not, as you prefer). The spectrum of birth experiences is wide, and I'm hoping to be able to post an equally broad variety of stories.

Stories and photos are shared with permission. Stories may be reformatted and edited for clarity, but they are not censored. This is meant to be a safe space, so please read with compassion. Comments may be moderated.

Sarah's First Birth

Greyson was 9 days pass his due date and the ultrasound scan was estimating almost 10lbs, give or take a lb. Kyle [my husband] was 13lb at birth so they were slightly concerned. I was freaking out! I wanted him OUT stat. We talked over the options. I wasn't dilated, effaced, nothing... I cried and cried. It was so depressing at the time. Even in Kyle's largest t-shirt, my belly was hanging out.

This was a Wednesday. The plan was to perform a C-section the next Monday, if he didn't arrive on his own. I was really upset, as I was planning on a natural childbirth.

When I found out I was pregnant Kyle had decided to not shave his beard until Greyson was born. We left the doctors office, got Shake Shack, and Kyle said I could do the honors of shaving his beard. Well, halfway into shaving Kyle beard, the contractions kicked in! I didn't say anything because I had had false labor a few time earlier in the week. We made enchiladas for dinner and I baked a cake (I was already huge at this point; I didn't care).
I had contractions all night and the next morning threw up some, etc. The contractions became super close together, but my water hadn't broken, so we stayed home longer.

Things got real, and we called our neighbor to drive to us to the hospital. We checked in around 10am on Thursday. Thank GOD I was 4cm dilated, as I was "nothing" less than 24hrs earlier. We walked around for about 2hr doing squats, etc. I slept for 2hrs, then woke up to "NO PROGRESS."

My doctor wanted to break my water, but I said no waited and another 4 hrs. NO PROGRESS, but the contractions continued. Took a shower, walked more... I was seriously so tired at this point and it felt like I had been in labor for days.

At almost 6pm, the doctor insisted on breaking my water -- and that point, I didn't care. I was over it. Around 8-10pm, no progress. The doctor became worried that (because of his size) he was stuck. They wanted to do a C-section, but I said I wanted to try longer. The doctor said it was fine, but advised me of the possibly of the baby's shoulder getting stuck.

2am: no progress, so I got an epidural in preparation for the C-section, and -- BAM -- within a few hours, right as I was watching the ROYAL WEDDING, I was going through transition and was ready to push! I was screaming I WANT TO PUSH!!!! My doctor thought I was crazy and was shocked that after all that I was ready to go.

It took me a while to get a hang of pushing. I felt the urge to push, but I just couldn't figure it out, I guess. I had an epidural but I was still moving all over the bed. I don't know if it was working or not. After about 2hrs Kyle said, "Holy shit I see his head and he has a ton of hair!!!" I also remember the doctor saying, "You're doing it, you're doing it!"  I pushed him out with the next push: 8lbs 15oz 22in and COVERED in Meconium. He was screaming, with arms straight out. Kyle reached out and touched his hand. I was so glad he was out and didn't get stuck. I kept saying, "I can't believe I did it." 

I did end up having a tear with 4-5 stitches and a fractured tailbone, but I was so happy with how things turned out.

Monday, May 12, 2014

A Birth Story Project: Beth

I have the honor of posting another submission to A Birth Story Project. With this project, I provide a public space for birth stories that want to be shared. Please contact me if you'd like to submit your own (anonymous or not, as you prefer). The spectrum of birth experiences is wide, and I'm hoping to be able to post an equally broad variety of stories.

Stories and photos are shared with permission. Stories may be reformatted and edited for clarity, but they are not censored. This is meant to be a safe space, so please read with compassion. Comments may be moderated.

Beth's Third Birth

It was 4:00 am. A familiar sensation brought me out of sleep, though I was not quite awake.  “Great,” I thought. “I started my period.” Suddenly, I was wide awake. “Wait a minute. I’m 28 weeks pregnant. I couldn’t have started my period!” I quickly got up and headed toward the bathroom. It had definitely been something, but I couldn’t figure it out. There was hardly anything there and it had no color, nothing distinguishing. Puzzled, I crawled back into bed. I started to wake my husband, then stopped. He had to get up at 6:00 to get ready for work and I hated to disturb him if I wasn’t sure. I lay there, thinking. When I heard the rustling of my husband getting dressed, I told him what had happened.

He assured me it was probably nothing. “You probably just wet yourself a little,” he said.

“What if it’s amniotic fluid? Remember what happened to your mother?” I said.

“Oh, it can’t be amniotic fluid. It’s way too early for that. Let’s just keep an eye on it,” was his reply.

I agreed and got up to get dressed myself. As I got ready, I wondered if I should call the Birth Center where I had been going for my prenatal appointments. If I called, they may have me come in to be checked, which would be an hour and a half drive. My husband would have to take the day off and I would have to pull my oldest child from preschool -- to potentially be told it was nothing. I put on a liner so that if it happened again, perhaps I would be able to see it better, and vowed to keep an eye on it.

I started our morning routine of dressing the boys, fixing their breakfast, brushing teeth and getting on coats and shoes. I dropped my 3 year old off at preschool and my 2 year old and I came home to decide how to spend our morning. He decided he wanted to make biscuits, one of our favorite things to do together. I got out the flour, baking powder, sugar, salt, butter and milk. We had fun making our biscuits. All seemed to be right with the universe.

In fact, everything seemed to be going well lately. After my last pregnancy, I was a little scared to get pregnant again. My son had been transverse, and despite doing an external version, he never stayed head down. To add to it, I had gestational diabetes and a lot of extra amniotic fluid, which compounded the problem of trying to get him to stay head down once he was turned. I ended up with a C-section, something I had desperately been trying to avoid.

My current pregnancy had started out with a lot of ups and downs. The doctor originally thought the baby was ectopic, and wanted me to take Methotrexate to end the pregnancy. They could not see anything on ultrasound and thought they should be seeing at least something in the uterus at that point. We refused the Methotrexate. We felt we just couldn’t take it when there was no proof the baby was outside the uterus. We wanted to wait to do another ultrasound, as I was still pretty early along. That was a hard week of waiting. I went in for periodic hormone level checks and they did not feel that my numbers were going up fast enough. Another sign, they said, that the pregnancy was ectopic. The doctor gave me a card to carry with me in case I had to go to the emergency room. I was counseled to head there immediately with any pain. I was told the risks to me if I were to have a tube rupture. Amazingly, the next ultrasound showed a little something right where it should be! The ultrasound tech was speechless. We were relieved and elated.

At the next ultrasound, though, the Dr said the sac was not growing as fast as the baby. We were plunged back into a waiting game. Finally, after the first trimester, I switched to the Birth Center in Topeka. We knew the sac was small, but there didn’t seem to be anything that could be done about it. We knew this pregnancy was in God’s hands and there was nothing else we could do but wait and pray. The main reason for the switch, though, was for a better chance at a VBAC [Vaginal Birth After Cesarean]. The hospital in Manhattan [KS] had said I could try for a VBAC, but if I came in when they were busy with a lot of other mothers in labor, I would be sent straight to the OR.

My appointments in Topeka went well. I had another ultrasound at 20 weeks where were found out we were expecting a little girl this time! When I asked about the sac size, I was told there was enough room around the baby. There was a little concern about the placenta being low, but I was told this usually corrects itself. At my last prenatal appointment I found out that I didn’t have gestational diabetes this time around. I was so excited to be able to eat what I wanted. Yes, everything seemed right with the universe. I was starting to be convinced that this time around was going to go so much more smoothly than last time. I do admit to having a few nagging doubts about the VBAC. I knew the chances of something going wrong were low, but if they did, could we live with our decision?

I continued on with my day. I picked up my 3 year old from preschool and the afternoon was full of the business of watching two rambunctious little boys and keeping the house running smoothly. My husband got home from work, excited for a weekend off. We talked briefly about what we would do, as his weekends off are few and far between. I ran to the grocery store to pick up some things to make dinner, and even had to run back home for my wallet which I left on the counter. I was tired from a long day and felt a little scattered.

It was while I was putting away the dishes from dinner that I felt the first big gush. I ran to the bathroom. This time there was a pink tinge. I yelled out to my husband. “Something’s wrong!” I said. When I called the midwife, she told me that my water had probably broken. “Is there anything else it could be?” I asked. At that point, anything sounded better than my water breaking. “No,” she said. She told me to head to Stormont Vail Hospital in Topeka. Thoughts were swirling around in my head. I was trying to figure out the logistics of this with 2 little boys whose bedtime was only an hour away. She asked me what time this started. I told her about what had happened early that morning. “I’m not sure if it was the same thing or not,” I said. “If this started at 4:00 in the morning, you need to get to the hospital right now,” she said.

My husband said he was not driving to Topeka. He would drive me to the hospital in Manhattan, which was about half the distance. I remember being really hurt that he didn’t want to drive me to Topeka. What I didn’t understand at the time was that he was afraid I would go into labor in the car and he thought it would be better if an ambulance took me from Manhattan to Topeka.

Later, a nurse told me that this was really the wisest decision.

The next 20 minutes are still kind of a blur. We tried to decide who to call to help with the boys. We knew it should probably be family, since we would not likely be coming back that night. His family was closest, but we could not get a hold of his parents. I called his brother and sister-in-law next. They have five of their own, but she thought nothing of putting the baby in the car and heading to Manhattan to meet us while her husband watched the other four. We threw some things into a bag for the boys, and in the meantime, I had to change to a heavy pad twice. My husband asked if he should just call an ambulance, but we were pretty much ready to go at that point. We piled into the car and headed toward Manhattan.

The ride was a quiet one. I thought to look for the rosary we usually left in the car, but I couldn’t find it. “One of the boys took it out," my husband told me. I quietly prayed without it, looking out the window. I don’t think it had sunk in how big this really could be. I was just worried about going into labor at that point. Every twinge I felt grabbed my attention. It seemed to take so long to get to Manhattan. The boys were exceptionally good for the ride. When we were close to Manhattan, my oldest said, “Mommy, when you get done at the hospital, let’s get something to eat and go home.” At that point, I had to fight back the tears. I knew I wouldn’t be going home that night.

We finally arrived at the hospital and parked. When I got out of the car, I realized that I had leaked through my jeans. We hurried inside and up to labor and delivery, where they were already waiting for us. The Birth Center in Topeka had called them. It turned out that I was not dilated, thankfully, but a swab test showed that I was leaking amniotic fluid. I was definitely ruptured. I heard the nurse telling my husband that I was ruptured and would have to be taken by ambulance to Stormont in Topeka. I felt like I was in a dream. They then wheeled in a sonogram machine to check on the baby and gave me a steroid shot in the hip. I tried not to think about what that meant. I knew they were trying to mature the baby’s lungs in case she was born early.

By that time, my sister in law had arrived and was helping distract the boys with snacks. I was glad to have someone else there. The doctor came in to do the sonogram and I was told that I had just “bought myself a ticket out of there.” It was agreed that Jeremy would take the boys home and I would go by ambulance by myself and call my Mother to meet me in Topeka. I happened to ask my sister-in-law if she had a rosary. She lent me hers to take with me. It was comforting to hold it during the ride to Stormont Vail and really came in handy that week.

Two men came in to load me onto the ambulance. One of them ended up knowing my husband’s family and we were able to make small talk about that. I don’t even remember which way we ended up leaving the hospital. I just remember being put into the ambulance and driving off. I was so scared that I laid there stiff as a board for most of the ride. I continued praying silently and tried not to think of the boys.

When we arrived in Topeka, I was put in a temporary room to be checked in. The nurse was very smiley and perky, which grated on my nerves a bit. I was terrified. I just wanted the Dr to come in and tell me when they would be delivering. I assumed it would be later that night. The nurse asked a lot of questions and kept saying, “You know we don’t do VBAC’s here, right?” I told her I did. Finally, the Dr came in and told me that I had Preterm Premature Rupture of Membranes. They would be doing a few tests, but he said that usually no cause was found. It was just something that happened sometimes.

I was told that I would be on bed rest in the hospital -- hopefully until 34 weeks. I felt like the world was crumbling down around me. 34 weeks? That was a full 6 weeks away. What would we do about the boys? I wanted to bawl, but I couldn’t. I was moved to a room in labor and delivery and was told that my first 24 hours would be spent on complete bed rest (not even any trips to the bathroom). I would also not be allowed to eat that first 24 hours until they were sure things had stabilized. By the time I was finally settled in my room, it was around 11pm. I was exhausted and terrified. I kept thinking about the boys at home. I should have been there to tuck them in that night. I had never been apart from them both and I felt like someone had just ripped my heart out. I was worried about this baby who would be premature and I felt sorry for myself too. Our whole plan was out the window. I wasn’t proud of these feelings, but I acknowledged them. I didn’t get much sleep that night. When I did fall asleep, it would be for very short periods of time. When I woke, I cried.

By the next morning, the tears were flowing freely. I couldn’t talk without crying for awhile. I was told that I would have a sonogram that morning, but would not see the perinatologist until Monday, as he was out of the office. I had heard of him before and knew that he was good. The sonogram showed that the baby was sideways but growing fine. Amazingly, the amniotic level was at 14; still normal! I did not have any leaking that day and was encouraged, but the leaking returned that night, with cramping. I was told that I would probably leak the whole time. I had to wear these things around my calves that pumped air and lowered my risk of developing blood clots. I was started on large doses of antibiotics through an IV to lower the risk of infection setting in since I was ruptured. I had my second and final steroid shot that night. Somehow, I was given the strength that day to accept that this was our reality. I knew we would get through this, and I was determined to be as positive as possible.

The next day was Cinco de Mayo. It was also the day of the super moon that year, which unfortunately I could not see through my window. I was disappointed that we would be missing the Cinco de Mayo celebration at church that night. I had been looking forward to taking the boys, as I knew they would enjoy it. However, my husband brought the kids to visit. It was so good to see them! My 2 year old climbed right up in bed with me to snuggle, like always. My 3 year old seemed a little taken aback and quiet. They played throughout the afternoon and had supper with me. They were so excited that they could see the Lifestar helicopter from my window. I was able to get out of bed to go to the bathroom and take a very brief shower that day. I had a new appreciation for the small things in life!

I had almost no leaking that day or night. That evening, while I was praying and trying to keep the fear away, I had a vision that I was walking with Jesus and he took my right hand. It was the most comforting, peaceful feeling. I wished that I could hold onto that forever! Sunday was very uneventful. There was no leaking or cramping.

Monday was roller coaster ride. The nurse came in and told me that I would have a sonogram with the perinatologist that morning, who was back in the office. However, she said that my Doctor was so encouraged by my lack of symptoms that they thought I had sealed over and I would probably be allowed to go home. They just needed the perinatologist’s approval. I couldn’t believe it! I was so excited and thankful. However, when I arrived in the perinatologist’s office downstairs, the nurse asked why I was in a wheelchair and not in a hospital bed. I thought once they did the sonogram, they would see that I was sealed over, but that was not the case. The doctor said that that baby was now head down, which was probably creating a cork-like effect, keeping me from leaking. The nurse told me that there were still pockets of fluid outside the amniotic sac and that I would probably have at least one more big gush. The amniotic fluid level was still on the low end of normal, though, and all her growth was still normal! They estimated that she weighed about 2 pounds, 12 oz, more or less. I decided to be encouraged by that, even though I was disappointed that I would not be going home. I still felt very lucky.

Tuesday morning was a scary one. I had a big gush of blood in the early morning hours. I just remember lots of nurses in the room, calling the Doctor. I passed a very large clot. They put me back on complete bed rest with no eating or drinking all day, just in case. They did a quick sonogram to be sure that the placenta didn’t appear to be separating, and they checked to see if I was dilated (I was dilated to a 1). They kept the baby monitor on for a good 12 hours (normally they put the monitor on twice a day to make sure she wasn’t in distress). It was very soothing to hear her heartbeat while I rested.

On Wednesday things had calmed down again a bit. I was able to eat and drink again but the bleeding continued, so I remained on bed rest. They said they would continue just monitoring things. I looked forward to seeing my husband and the boys on Thursday or Friday.

Thursday was pretty much the same. They continued monitoring the baby twice a day. I remained on complete bed rest. That night after supper, I began feeling a little anxious. My heart seemed to be beating fast. The nurse noticed my heart rate and when I told her how I was feeling, she said it was very normal to feel that way when you’ve been cooped up for so long.

On May 11, 2012, at around 8:00am, the Doctor came and told me that my lab results that morning showed that infection was setting in, and because they didn’t know where all the bleeding was coming from, they would be delivering by C-section in about 3 hours. I called my husband who left work and began the long drive to Topeka. They started me on Magnesium Sulfate. They usually try to give it 12 hours before delivery, but since they had to deliver quickly, they gave a large dose, then went down to a smaller dose for the remainder of the 3 hours. Unfortunately, I got the large dose in, but then felt like my chest and throat were on fire, so they stopped it. I began having contractions that morning as well.

My husband arrived about 5 minutes before surgery, just in time to put on his scrubs. I was glad he was able to make it and could hold my hand throughout the C-section. The operating room looked so different from the last C-section I had. There was a lot of equipment for the baby and a team from the NICU. They assured me that most of the equipment was there “just in case.” During the surgery, I could hear them counting, but I’m not sure what the counting was for. The hypnobirthing that I had been practicing for my big VBAC actually helped keep me relax during the procedure. I was very calm this time around.

Jeremy and I were both surprised when Lucy started crying after she was delivered! They wheeled her around for me to see before she was taken to the NICU. She was so tiny! They told me that she was a good size for 29 weeks, though. She weighed 2 pounds, 13 ounces. Our precious little girl was born one day before Mother’s Day. She stayed in the NICU for 6 weeks but did amazingly well. She never had to be on oxygen, but did stay on a CPAP for her breathing pressures for quite a while. She passed a lot of blood that she had swallowed. They eventually determined that the bleeding was due to placental abruption. I kept a journal of her stay in the NICU.

We are so grateful to have our little girl here with us. She is now a healthy and happy one year old and we can’t imagine life without her. That week in the hospital was the hardest thing I’ve ever had to go through, but it taught me more and caused me to grow in ways I never imagined. It’s been so therapeutic to write down my experience. For months I felt like I was stuck in May of 2012. I felt (and still do feel) things more acutely than I ever have.

I am so thankful that the angels were surrounding us that week and for all the prayers and support. We are also thankful for all the skilled doctors and nurses and all the medical advancements that have been made.

Monday, May 5, 2014

What do postpartum parents want? Part 3

I've compiled another "Postpartum Wishlist" for your perusal, listing requests and thanks for support shared by parents who've given birth or who are preparing to. As usual, I find these candid answers to be incredibly illuminating.

See parts one and two for more responses.

Q. What kind of support did you need or want from a postnatal doula or other postnatal helper, if you had one? What kind of support would you hope for if you were to hire one in the future?

Cook me breakfast!

I didn't have a postpartum doula, but I would have paid anything just to take a daily shower that lasted more than two minutes, and to do some light cooking and light housework while I breastfed baby. Having a newborn baby at home is the worst time to be drowning in dust and unswept floors.

Just sit and listen and talk. What a new mother needs more then anything is someone to listen to her, especially to help her process her birth, and someone to give her positive feedback.

I wanted time for a shower and to get other things done, so my doula held the baby while I did that.

I needed emotional support and just the company of another person. 

My postpartum doula was awesome. The most useful things she did were to talk to me, be there for me, help me feel what I am doing and thinking and feeling is 'normal' and on the right track, and to model some good, practical techniques (like swaddling) for me. She also cooked a huge vat of lentil soup that kept us going for days. She rocks!

After I had my baby, I loved helpers cooking for me, watching my older kids so I could nurse/sleep in peace, and cleaning my kitchen.

I'd love a doula to help with placenta encapsulation or recipes for eating it.

I had a doula. It was great to be able to talk with someone who understands what I was going through, helping me round the house and picking my older kids up from school once a week. I also got great lactation advice from her.

Talk and debrief about my birth experience, be a shoulder to cry on, assist with breastfeeding, wash the dishes, wash clothes, vacuum, cook, tell visitors to leave or come later if I'm resting, organize appointments, tidy up, entertain older children for a short time... 
 I would have liked some actual help around the house -- dishes, laundry, cooking, holding baby so i can poop, etc. I wanted someone I could express my overwhelming feelings to, someone who would console me or tell me it would get better or do something concrete to help the immediate situation.  

I only had a labor doula. I was lucky enough to stay with family. My MIL and my mom provided all the meals and my hubby was really great. He went back to work after 1 week, though, so that was hard. I do wish I had had someone warn me what it was going to be like after having the baby. I was in shock. I guess I should have used my common sense, but it never occurred to me that I was going feel like I had been run over by an eighteen wheeler. I wish I had had someone who had good natural remedies for the pain and swelling. My husband did a great job making my baths for me, helping me get dressed, bringing me ice packs or anything I needed, watching the baby so I could nap or bathe. He even helped with getting the baby to latch! Had he not been there, and also for the days after he went back to work it would have been great to have a postnatal doula to help with those things. I can imagine needing help with the older kids too, if there are any. 

I desperately needed someone to tell me I was doing fine and to stop panicking... And to distract me while I was breastfeeding.

Preparing food and clean up afterwards is most important to me... Is 6 months TOO postpartum to hire one?? LOL. 

We had our babies at home, and the doula came the next day and raised the bar for my husband, who does not cook, as to what a meal for a woman who has had and is nourishing a baby should look, not cereal and rice milk AGAIN. She brought and prepared in my kitchen grilled salmon, wild rice with toasted almonds, sautéed spinach. She then massaged my back and shoulders so I could relax, cleaned the whole kitchen, took out the trash, folded the laundry and quietly left us to truly rest. Very professional financial arrangements. She was an ANGEL! The world needs more like her! 

Bonus: A postpartum doula speaks!  What does she think her clients need and want?

In my work as a postpartum doula, I offer light housework and cooking as part of the package. I like to help parents grocery shop for lots of fresh veggies, then cook a big pot of some all-in-one dish like veggie-spaghetti and freeze it for them in portion-sized containers, so they have several weeks of go-to food that's healthy, organic, homemade, and has the nutrients that a birth parent especially needs, like added iron and fiber and things like that.
I figure my job is also to make sure that parents and baby are healthy and bonding. The house needs to be clean (but not spotless). There needs to be plenty of clean laundry and good food available, and basic supplies. I usually teach various swaddling tricks, help my client get a good latch, etc. I have connections with so many people who can troubleshoot feeding or other issues that I can get an answer fast for any problem.
Most importantly of all, I constantly reassure the new parents that they are doing all right. New parents may worry about everything, from the size of the diaper to the state of the cord stump. Those little details are usually really flexible, but it takes awhile for parents to learn how to trust their instincts, and I just keep helping them see that they're doing great -- asking them what their guts are telling them, and reinforcing their own instincts (which are usually right on).
When I leave, I want parents to be totally empowered. They're all caught up with chores, they have plenty of good meals available, and they have eased into life with the new baby. They feel confident in their abilities to make decisions, and they have learned to trust that little voice that says, "This is what my baby and I need right now."

I will be asking more postpartum doulas to share their favorite ways to help families. Look for that in a future post.


Postnatal families deserve support! Discussions like this make me excited about offering my services to another family soon. The shape of a particular client's need informs and shapes my work, so I am always learning and growing as a caregiver.  What would help look like to you?

(Quotes above have been edited for clarity and to preserve anonymity) 

Monday, April 7, 2014

A Birth Story Project: Sarah

Welcome to the inaugural post of A Birth Story Project. With it, I'm providing a public space for birth stories that want to be shared. Please contact me if you'd like to submit your own (anonymous or not, as you prefer). The spectrum of birth experiences is wide, and I'm hoping to be able to post an equally broad variety of stories.

This story is shared with permission. It was reformatted and edited for clarity, but no part of the story that was submitted has been removed. This is meant to be a safe space, so please read with compassion. Comments may be moderated.

Sarah's Second Birth

It was a regular Friday morning, my due date. I had donuts for breakfast with Grey. We went to the playground. I napped when G. napped. We went to the grocery store in the afternoon, and I felt fine.

Walking home around 4pm, I started getting Braxton-Hicks contractions. At 5pm, Kyle got home and I sent him to the playground with Grey so I could lie down.

I didn't want to get out of the shower at 6pm because the contractions were so painful.

By 7, I was calling my OB, bawling, because I was in so much pain and didn't want to get in a taxi.

Friends arrived to pick us up at 7:30. Somehow we got to the hospital by 8, even with tons of traffic.

When I got out of the car, a hospital worker saw me pause during a contraction and came running out with a wheel chair. "That baby is about to drop!" He ran us through the lobby and up a service elevator to L & D. I only remember gripping the wheel chair and looking down at the floor. The hospital was FREEZING and felt amazing.

L&D was hopping. My doctor checked me in triage and I was 4cm, so I could be admitted right away. I asked for an epidural immediately. My contractions were so close together I could hardly keep my breathing going. I kept saying "I just need a break to rest a minute" and another would come and then another.

I started screaming (bloody murder) and moving all over the bed, so she checked me again. This was maybe 10-15min later and I was 8cm. All the labor rooms were full so Kyle walks back over to me in scrubs and says "We are heading into the OR," and I freaked out. "Why do I have to get an operation?" And "Where are my DRUGS?!" I was seriously begging, but they were so backed up no one ever came.

I was in the OR for 5 minutes, tops, and I was at 10cm, but still at station -3 and my water hadn't broken. My doctor said "We can wait for him to move down or I can break your water." Wait for him to move down ?!?!? I wanted him out -- stat -- or I wanted the pain to go away... not to wait for him to move down!

She broke my water and just a little trickle came down. With the next contraction, his head came all the way down and the biggest gush of water came. I started screaming and laughing at the same time because it was just so surreal and painful. I could feel everything, and it was happening so fast I couldn't even catch my breath. It hurt so bad I really thought I was going to die for a second. I refused to push because I just couldn't.

Kyle helped me focus again and got me to breathe, drink some water and stop screaming. I felt for the first time, "OK. I can do this. I'm going to do this!" So I start pushing and OMG it's so hard, and it hurt to the point that I can't stop screaming. I move slightly to my left side and that really helped for some reason.

Suddenly an alarm starts going off. Heartbeat of baby completely drops, stops, and people start running in the room. Doctor says to take a huge, deep breath to get oxygen to him, and I did, and it picked back up again. She says, "We have to get him out now." A nurse basically puts her entire body weight on my stomach and pushes down. I'm pushing myself, my calf is clamped on Kyle's forearm for resistance, foot against his chest and the doctor is reaching in and like corkscrewing him out, and he comes out in that moment.

He doesn't cry at first and I'm very nervous. They whisk him over to a table next to me and he starts crying (thank God). The ped shouts out "10lbs 8oz." Kyle and I look at each other and I just say, "you are lying." Honestly, I'm still in shock. They bring him over and I see for myself that he is a man-baby !!!

They take me back to triage to hang out till our room is ready, and I finally ask what time it is. He was born at 10pm on the dot on his due date, only 2 hours after arriving at the hospital. Greyson's labor was 36 hours, so I was definitely in a state of shock. I did tear this time, but not even close to as bad as last time, and my tailbone was bruised but not broken (yay)! I had been for a growth scan 4 days prior and they guessed he was 8lbs 4oz. I'm so glad they were off because it would have definitely affected my labor and I would have most likely just opted for a section.

I still have no idea how I got him out. Maybe it was my crazy side position? Not sure but I'm definitely never doing it again :)

It was a very shocking but wonderful experience. I am so happy at the way it turned out.

Thanks for letting me share my story with you.

Wednesday, April 2, 2014

The Family-Centered Cesarean.

I am excited by a shift I am seeing (but very rarely, so far, in this country) in the way cesarean births may be supported. I am speaking of something often called the "family-centered cesarean" or "natural cesarean." Cesarean rates are high in many parts of the world (beginning to climb above 1 in 3 births here in the USA), and the family-centered cesarean is a response to problematic practices (dehumanization, non-individualized care, the all-too-routine separation of parent and child that makes for less-than optimal bonding and lactation, among other factors). It is still major abdominal surgery, of course, but with more thoughtful, evidence-based, and human-centered procedures woven into its medical protocols. These might include allowing a doula or midwife in the room with the surgical team, not strapping one or both the laboring parent's arms down, facilitating immediate skin-to-skin contact between birth parent and baby in the first minutes (and so-called "golden hour") after the birth, etc. 

The goal is not to make elective cesarean births more "desirable" than vaginal birth. It seems clear that work must be done to decrease the rate of unnecessary cesareans. The climbing cesarean rate is not making gestational parents and children healthier, ACOG just released a statement that cautions against many of the "traditional" non-emergency reasons for cesarean surgery, and the WHO suggests the rate should be well under 20% -- more like 10-15%. As this is a life-saving surgery, absolutely necessary in some situations, it will continue to be done, so it behooves us to improve the experience and its outcomes (both direct and related) if we can do so in ways that not only "do no harm," but may actually help families and babies. 

In one of my recent childbirth education training classes, there was a discussion about whether a particular video on this revolution in cesarean birth should be shown to local pregnant "consumers." (i. e. those taking a childbirth class we teach, or other prenatal clients).  

I've embedded the video here. It is not graphic, to my mind, but some of the surgery is shown. I understand if you would prefer not to watch for any reason. I also hope that anyone reading this who has had or supported a loved one in a previous cesarean birth will know I understand that, like any birth experience, feelings around it are very personal. I validate and value your thoughts and emotions, whatever they are. We do the best we can with the information and support we have. My thoughts continue below. 

Does this vision of a "kinder" surgery and explicitly compassionate caregivers set US (or other) pregnant people up for disappointment if/when their cesarean births are (likely) not done with this much care and respect? Or might it spur more people to reproductive rights activism -- on the world's behalf and/or on an individual level -- at the very least encouraging conversation with care providers (including surgeons and anesthesiologists) about how an all-too-often impersonal and medical cesarean experience can become more "family-centered" without compromising safety? Even if a caregiver says it can not, this may lead to an important discussion with that caregiver of why he/she disagrees.

I don't know if I would use this video in a class, but my gut says we should show this video to pregnant people -- and those who may become pregnant or who care about pregnant people (i. e. Just about everyone) -- because I think people should know it COULD be a different experience. I think it empowers "consumers" to know this kind of "customer service" (for it is a business, after all, at one level) is not fantasy. 

I was surprised by how many of my fellow teachers-in-training said they would absolutely not show this video to clients. I was surprised even though I know they made that decision out of compassionate consideration for people giving birth and the tender borders between hope/expectation/reality/disappointment. I can understand intellectually and emotionally that some (not all) pregnant people who watch this video and hope for a "natural cesarean" experience, if a cesarean becomes necessary -- but who go on to have an unwanted "traditional" medicalized cesarean birth experience -- could feel more traumatized by the birth because they know "there's another way." Once a person watches this video, that person is aware that there are practical choices (both a family's and a surgical team's) that can be made, and which are realistic and possible, but which a laboring person may still be denied. I can also imagine a pregnant person who feels empowered in a pregnancy after watching this video -- empowered to use this information to seek out a receptive caregiver, or even just to spread the word that these practices are possible, while choosing a support team and preparing for the birth experience.

I would love to know your thoughts. 

Disclaimer: of course, this video is a window (and a "produced" one, though not "faked") into an experience, not a complete picture. The risks that come with any c-section are real, and not discussed in this video. The nature of a surgery that may be done in a very immediate, emergency situation is that it will look different from birth to birth. As just one example, sometimes general anesthesia is necessary in an emergency cesarean, as opposed to an epidural/spinal, which would change the experience quite a bit. I still think the scenario of a family-centered cesarean -- whenever possible -- is one that is worth fighting for, especially when so many cesarean births in this country are planned and scheduled in advance. And even if we can't change it for every person who is pregnant now (though I am hearing encouraging stories of "natural" cesareans in the United States, as I seek them out), even if it takes a generation or two or three, it's still a worthy goal.

UPDATE! This story is an example of why I feel like pregnant people and partners SHOULD see this video. What an amazing birth -- and she advocated for herself! I'm so glad I came across her story.