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Thursday, 08 March 2012 23:31

Isabelle's Unmedicated Birth

Early Halloween morning, I realized that I was leaking amniotic fluid.  I spoke with my midwife, Sara, around lunchtime.  Although I felt no contractions, she recommended that I come in to be sure it was fluid that afternoon.  We arrived at the hospital late in the afternoon on the 31st.  I felt strongly about receiving prophylactic antibiotics for Group B strep.  This was mostly because I was born six weeks prematurely with an infection that kept me in the NICU for two weeks.  My mother has always been very honest with me about how frightening it was to give birth and not know if that baby would come home.  This profoundly affected my own decision making process.  Had I more thoroughly researched the risks and benefits and been more proactive, Isabelle’s birth story would be quite different.
    
I saw Sara that evening, and she agreed that to watch and wait was the best plan.  She left orders for the attending doctors that I be allowed to eat anything I wanted, that I could leave the hospital (not the base, though we should have gone home and slept) between bags of antibiotics, and not to do any vaginal exams. That night, as unmistakable contractions tugged steadily, we were excited that labor was progressing.  My husband and I walked the grounds of the naval base.  It was surreal to walk the hiking trails and golf course in darkness, knowing that I was on the cusp of biggest change of my life.  Around 6:00 the next morning, I was 80% effaced and 1 cm dilated.  I was angry and disappointed, and cried as the nurse started Pitocin.  Sara felt that induction was the best course of action given my GBS status and prolonged ROM.  Frank and I both wish that we had refused this and continued to allow things to progress on their own.
 
Once my doula arrived, I relaxed and began to work with my body.  Thus began the constant tension between the calm confidence that I felt in my ability to give birth and the hospital “on the clock” feeling.  I walked, rocked, moaned, and swayed through the contractions.  I remember leaning into Frank’s chest and dancing as the contractions got stronger and closer.  It also felt great when he and Stacey, my doula, rubbed my back and feet.  Contractions went from nothing to tough stuff within an hour—thanks, Pitocin.  Yuck!  They were at least 90 seconds and about 3 minutes apart.  I hate to think what Isabelle was feeling without the protective bag of waters around her.
 
By 11:30 I was hiccupping, restless, shaking, and wanted to be alone in the dark bathroom.  Sara said she would be back around noon, but didn’t get there until much later.  At 2:30, I was completely effaced and 3 cm.  I absolutely believe that my body was in transition, regardless of being so little dilated.  After two nights of not sleeping and laboring hard all day, I was exhausted.  I felt like the only chance I had for a vaginal delivery was to rest and let my body open.  That exam was the most upsetting part of the whole process.  No one had told me so plainly how much more painful Pitocin makes things for most women.  To experience contractions like what I expected in transition before even 5 cm dilation was disappointing to say the least.  I realized later that I was waiting for Sara—she was the person I trusted to take care of me.  Her not coming back on time was very upsetting.
 
Fentanyl and Nubain were horrible.  We hoped the first would take the edge off and allow me to rest, but it made me feel out of control without lessening the intensity of contractions.  The second was no better.  I was sleeping between contractions, and then waking up at the peaks.  It was humiliating to be completely out of control and too stoned to get out of an uncomfortable hospital bed and move around.  All of the powerful sensations of birth were still there, I just couldn’t move around and mentally prepare for them.      
At 4:30, I received an epidural.  It was a small and non-narcotic dose.  It took the head of anesthesia three attempts before the catheter was in the correct spot and numbing both sides of my body.  I was disappointed but relieved to escape effects of the narcotics.  My midwife said she would probably see us again in the wee hours of the morning.  I was asleep almost before she left the room, and woke up three hours later feeling lots of pressure. It took 2 hours for the anesthesiologist to arrive after I decided that I wanted the epidural as she was in with a cesarean.  She asked if I was a runner after briefly feeling my spine.  Apparently, my spine is compressed from years of running.  Special.  After it was placed, I begged Sara to get me something to eat.  When I woke up, I rolled over to find a tray of crackers, jello, and chicken soup.  I ate a few crackers and wolfed down peach jello before calling the nurse.  Frank was passed out in the chair and wouldn’t wake up.
 
What a relief it was to know the baby was coming and to be able to actively participate in her birth.  By the time my midwife arrived, I was changing positions and moving as though I never received an epidural.  All that felt right was squatting, so I slid to the end of the bed and squatted unassisted.  Then with the squat bar, I finally started to really make progress. It was a positive outlet for all of the earlier anger and frustration as I lifted myself completely off of the bed, pushing my feet against it and pulling the top towards me.  Isabelle was born at 8:53 on November 1st with her right fist pressed to her cheek.  She was very, very alert and nursed within her first 20 minutes of life.  The middle-aged attending doc was a family practice guy and didn’t seem to know his ass from his elbows about labor.  He had me flat on my back and in the stirrups before I knew what was going on.  He told me not to push if I wanted Sara there to “deliver” my baby.  My doula was over his shoulder mouthing, “Push as hard as you need to.”  I told him that I needed to get up and squat, because it would take me all night to get her out in that position.  He said that he hadn’t been taught how to deliver a baby in that position.
 
Since then I've analyzed every bit of what happened, questioned every choice we made.  Thank God I got up, or I am not sure I would have been able to move her down with that nuchal arm.  I am so grateful to my midwife for treating me with respect and kindness.  My birth team was amazing in their patience and support.  I am still unsatisfied with some choices that I made, but it is a blessing that they were my own.
 
This experience helped me to see how unnecessary interventions are in normal birth.  They turn birth into an excruciating ordeal.  I realize that there is an enormous difference between unmedicated birth and natural birth—I may have labored with no medicine for a long time, but what I felt was far from natural.  So many people said, “As long as the baby is healthy,” but I matter, too.  There was nothing wrong or dysfunctional about labor because it was long.  My baby was more at risk of being negatively affected by the interventions (the first being getting to the hospital too early) we chose than a long labor.  GBS is a concern, but I did not know at the time that a dose of antibiotics within even 30 minutes (ideally within 4 hours) of birth will do.  Military hospitals are typically able to provide more evidence-based care than a civilian, particularly private, hospital may.  I saw this present in the standard of care that I received both in labor and postpartum.  Had I been in a civilian hospital, I probably would have had a cesarean no later than lunchtime that day for “failure to progress,” or in my case failure to wait.

It took me a few months to begin sorting through the disappointment and figure out how I felt about things.  I decided that I would do my best to give our 2nd child a more peaceful, less hectic and medicated, start.  A big part of that was avoiding the GBS/antibiotics debate and better understanding prelabor ROM. 

Long before we were even thinking about adding another baby, I started reading and researching online.  I knew before Will was on the way that I wanted to have the baby at home.  The hospitals around Memphis are not friendly to natural birth, and that’s putting it mildly.  So, pregnant again, I figured out how to get Tricare to cover the homebirth and began seeing the midwives of Trillium Womancare.  They were amazing.  I had information and guidance on prenatal testing, which we chose to avoid except for basic bloodwork and the mid-pregnancy anatomy scan. 

Throughout my pregnancy with Will, I was well-cared for and well-supported.  They liked the homeopathic protocol for avoiding GBS colonization that I had saved from our Bradley instructor.  I started the regimen at 36 weeks.  At 38 weeks, I did the swab myself at an office visit, and it came back negative.

So, with not a single vaginal exam in pregnancy or labor, Will was born.  His birth is what truly helped me make peace with the experience of having Isabelle.  Her birth wasn’t a bad one, but it was not at all what I wanted.  I experienced far, far less pain with him than with Isabelle.  Part of that was because the pump was primed, so to speak, but also because of my comfort level and the calm atmosphere we created in our birth “nest.”  The urge to push with Will came on slowly, over a few contractions.  It felt like trying not to throw up, just from the opposite end.  Instead of someone telling me not to push for whatever reason, my midwives calmly suggested that I get back in the pool for the next contraction.  They could tell just from the sounds I made and my body language that he was coming soon.  It took a few contractions for my head to catch up with where my body was.  In that time, I told them that I didn’t feel ready to push.  All they did was smile and tell me to trust my body and the sensation. 
 

Published in Birthing Stories
Tuesday, 31 January 2012 01:22

Super-mama, super-baby

I hadn't planned to get pregnant again. It was barely a thought that had crossed my mind. Our first child was only 8 months old and breastfeeding around the clock. My husband and I had been going through a rough patch. Let's be honest...a really rough patch! 
I began to notice those familiar signs again. I bought a test at a downtown drugstore and took it in a local cafe bathroom. Just as I thought. Two lines. Staring me in the face. Now what?
I felt so many emotions. I was sad that my first-born was still so young, sad that my husband and I were on bad terms, and afraid to tell him about another pregnancy. 

I slept on it for a few days and let it sink in before approaching him. It was August 2003, and I had figured that I would be due in late March or early April 2004. My husband and I had been working opposite shifts and he was asleep before I came home most nights. 
On his next day off, we took our son to the park and I decided to tell him. He was shocked, afraid and happy. We vowed to make things work.
Just after our son turned a year, we moved into a bigger apartment and began to plan for our new baby's arrival.

Even though I had the same doctor, I knew I wanted a different birth. I wasn't going to be in that hospital any longer than I needed to be.
I joined an online pregnancy/birth forum and began speaking with other mothers about their birth experiences. So many women were having such traumatic births. The women all accepted all these procedures without questioning. My first birth had very few interventions, but it left me feeling very low afterward. I felt the desire for a better birth.

I joined an Aqua-Fit class during the winter months of my pregnancy. It felt great to stay active. 
I enlisted my husband into helping me create a birth plan that included mobility during labour. 
We found out we were having another boy and I could tell he was going to be bigger than our first. 
Our sweet toddler Dimitrius would come over to my enormous belly, lift up my shirt, and kiss my belly button. "Na na", he would say, which meant "tiny". 

Around 38 weeks, we had our hospital tour. The nurse, who was our guide was very personable. She told us she had 5 kids and that the obstetrical unit had been updated over the past year. They had added a birthing tub and birth balls to use during labour. I gave her my birth plan with confidence, trusting things would be different. 

My due date (April 3rd), came and went, but I had been having many braxton hicks' contractions and was starting to have some light bleeding and mucous. I had even made it to Aqua-Fit that week to try and get things moving. I was really hoping to go into labour on 04/04/04, but since when do babies cooperate with due dates?

I had been feeling exceptionally tired on April 4th, and asked my husband if he wouldn't mind letting me rest. He made breakfast for Dimitrius and I, and then took him out to the library and out for lunch. 
I slept until 1 pm, woke up briefly, then slept again until 5.
I felt great! I got up, had a shower, and made dinner. We ate stir-fry and baked potatoes with garlic bread. We put Dimitrius to bed and cuddled up on the couch. We watched a bit of T.V., made love, and then retired to the bedroom to read. I was reading a great V.C. Andrews book and I noticed that my husband had drifted off around 10 pm. I was wide awake!

At 11 pm, I noticed a stronger tightening. I kept reading, but payed more attention to the clock.
11:20pm. It came again. I rolled over and continued to read. 11:30. They began to come every 10 minutes, then 7. Around 2 am, I got up and walked around for a while. Things slowed down, but I still felt crampy. At 3 am, I poured a hot bath. It was so soothing. I washed myself with olive oil soap, shaved my legs and lay in the warm water for a long time. I only felt two mild contractions during my bath. 
I emerged at 4:30, dried myself off...and then it started. The sensations came in waves. They were stronger than before and much closer.
I dried my hair, put on my make-up and got on the computer. I sat on my purple exercise ball while telling the world I was in labour. I rocked back and forth, and then decided to call my mother. She was going to take Dimitrius to hang out with his Aunt and Uncle for the day.
I finally woke up my husband after getting fully dressed and putting my hospital bag at the door. 
Dimitrius sensed the excitement and woke up too. My husband got him dressed while I waited at the door on my ball, rocking back and forth...

My mother arrived at 5:45 am, and we all headed to the hospital together. We checked in and I was in my room by 6. My mom and Dimitrius stayed for a few minutes before she took him to my brother's house. She wanted to be back for the birth.

The sun was coming up and it was a beautiful spring day. I was well rested and ready for the challenge. My contractions were strong, but I was mobile. I sat on the ball until I felt the need to lay back down. Things were picking up fast. Any time I would start to panic, my husband would take my hand and say, "Don't look anywhere else. Look into my eyes. Breathe with me...slowly." 

The nurse who had lead us through our tour came on shift at 7 am and I was glad to see her.
Before I knew it, my mom was back, sitting on the birthing ball beside the bed. She watched intently and tried to comfort me. My teeth started chattering again, just like my first labour. I was approaching transition.

At 7:30, I was 6-7 cm dilated. I noted seeing a Michael Jackson video on the music station in the corner.
Around 8:05, my doctor poked his head in. "How are we doing?" he said. 
"Ugh", I said. 
"I'm just going to check you, and see how things are going. OK. It looks like you're about 8 cm. How about we break your water and speed things up a bit?"
"No. I'm comfortable with things right now and I can't handle anything stronger", I said. 
Before I finished the sentence, he had broken my water. Against my permission!
The next contraction was violent. 
As my doctor left, he said, "You'll probably be a little while longer. I'm going to slip out and see a patient on another floor".
Next contraction... overwhelming urge to PUSH!
The nurses came in and said, "You're not ready to push yet. Just breathe". 
The baby's head started to crown. 
"Page the doctor!" one said to the other. I heard it over the loud speaker. 
"It feels like fire!" I said.
Out came a head, and with it, an arm, like Superman flying through the air. 
The fire sensation was gone as soon as the head emerged, and I pushed out a big, wet body. The doctor had come at the last moment. 
I had him on my chest, kissing him. He had black hair and a squishy, red face. I put him to my breast right away and he stayed there for 45 minutes! He was a natural pro. My mother joked that he ate like a lumberjack.
I looked at my husband a few minutes after birth and said, "Let's do it again! I feel like Super-Woman!"
I felt so invigorated and alive, like I could do anything I imagined. I called my whole family from the delivery room. 
The nurses eventually took my baby to get weighed. He was 7lbs, 8oz., and 22 inches long. He was born at 8:17 am on Monday, April 5, 2004.

When my mom brought Dimitrius to the hospital, he kissed his new brother right away and said, "Na na (tiny)". It was such a beautiful moment we shared. We named our baby Gabriel Simon, our little angel.

More family visited us in the hospital and we were discharged the next day. I was eager to get home and settle in with my boys. I had no tearing whatsoever and recovery was a breeze.

My birth was an empowering experience for me. I was proud of myself for trusting my body to do the work it was made to do. I was proud to have an un-medicated, hospital birth. I believe staying active during my pregnancy and labour were the biggest factors in having the birth I planned, but also having a goal in my mind and accepting nothing less. I also had a great partner and mother by my side, keeping me focused and offering so much support during the postpartum period also.

The nickname 'Tiny', gradually evolved into 'Tin-Tin'. Even though he's 7 now, he still hasn't outgrown it, and he and his brother are still the best of friends.

 

Published in Birthing Stories
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