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.