Monday, September 12, 2011

The birth of a mother

Lyndsay shares her son's and her daughter's births:

I always knew I wanted to be a mother. I remember when I was three years old, my mother brought my sweet little baby brother home from the hospital. I watched her gentle hands while she cared for him. I watched her nurse him quietly taking in the moments they shared. I mimicked her behavior with my dolls, nursing and wrapping and holding them close always thinking in my little child-like brain that I couldn’t wait to be “grown up” and have real baby all my own.

It would be a long time before that dream came to fruition. While in nursing school, I did a rotation in Women’s Health … and hated it. It was all I could do to get through the lectures and go to clinical. I felt that way because I feared that I would never have the opportunity to be a mother for 2 reasons: the first was that I was single, coming ever closer to 30, and still hadn’t found “the one.” My second fear was what if I did find a wonderful man, got married and couldn’t have children? I was better off staying far away from anything that had to do with babies, so needless to say the day I took that final was a good day. The second semester of nursing school, I met that wonderful man. I knew he was it for me on our first date and he felt the same way. We were married 11 months later and expecting our first child just 3 months after that.

After graduation, I was offered a great job. Not a job in the Emergency Department like I had planned, but a job in -- you guessed it -- LABOR AND DELIVERY. I hesitated at first, but the director was very supportive of me, and being 5 months pregnant I really needed to take what I could get. I know now that I was destined to be an L&D nurse. Witnessing the birth of a child is one of the most spiritual endeavors on this earth and I feel closer to God every day I am a part of it.

I had a pretty uneventful pregnancy. When I was 38 weeks, I went to my weekly appointment with my OB. My mother had flown in to be with me for the Eric’s arrival, and I was so ready to have a baby. My blood pressure had started to increase, so my doctor and I came to the agreement that I would be induced at 38 2/7 weeks.

At the time, I was still a very new nurse, and an even newer soon-to-be mother. I didn’t realize the risks involved with an induction, and my doctor was not confident that I would delivery vaginally. My cervix was not ripe and my Bishop Score was not promising -- my doctor was proud of his low cesarean section rate and hoped I wouldn’t affect it. Honestly, I didn’t really care, I just wanted to have him here safe and sound.

I was admitted into the hospital at 6 p.m. on March 5, 2008. I was greeted by a wonderful nurse, who coincidentally is one of my dear coworkers today. My cervical exam was 1 cm, thick, and high ... not good for a baby to come out “from below.” I was given a small dose of Cytotec (dun, dun, dun ... ooooohhh yes, the evil drug!) at around 9 p.m. and the cramping and contractions started within the hour. I handled the contractions (sorry I don’t call them “waves”) really well. They are uncomfortable, but I was still able to rest and relax, preparing myself for the work ahead.

I didn’t go into this experience with any other goal than a healthy baby. I knew I would get an epidural eventually but wanted to experience labor without one for as long as I could. I really don’t like pain and I wanted to enjoy this experience as much as possible. I sent my husband home to sleep, as I knew this would be a long haul and I hoped that he would be rested and ready to welcome our baby. My mother stayed by my side as my main support. At 2:45 in the morning, I was awakened by a “pop” and a gush of fluid. It was actually kind of funny because it scared me -- I thought to myself, “What just happened? Did my water just break?” The fluid was clear, my baby looked great on the monitor and the very next contraction I was initiated into the world of active labor.

Oh ... my ... gosh ... and people do this for hours and hours? No thanks ... where is that anesthesiologist??? The contractions were so much stronger without the cushion of water. I remember feeling like someone had taken over my body, like I was not in control. When I was in the middle of a contraction all I could think about was, "When will this contraction end?" And in between them, all I could think about was, "When is the next one going to come?"

My nurse checked me and I was 4 centimeters, 50% effaced, and -1 station, yay progress! I was contracting strongly every 3-4 minutes and the baby was looking great on the monitor. It was really comforting to me to be able to hear his heartbeat. I was progressing enough on my own that I didn’t need any further augmentation. That one small dose of Cytotec had put me into labor. Within an hour of my membranes rupturing I got an epidural ... ahhhh relief. I was able to rest and let my body do its miraculous work.

At around 7 a.m., I began to feel sudden pressure and pain. At the same time, I could hear my baby’s heart begin to decelerate. I knew from my training what needed to be done. I turned over on my side, and within seconds two nurses came rushing in. They started oxygen, gave me some extra IV fluids and checked my cervix -- I was completely dilated and the baby was at 0 station. I knew that decelerations in the fetal heart rate are common with rapid dilation and descent. His heart rate quickly returned to normal, I relaxed and began to mentally prepare myself for the events to come. I think it was divine intervention that my OB was in surgery that morning because it allowed me to “labor down” and let me body work on its own, saving me from possibly hours of pushing.

My mom called my husband to update him on my progress. Her exact words were, “David, things are progressing a little faster than we thought, you may want to start heading over to the hospital.” The pain and pressure had increased but I didn’t feel the need to push ... yet. As soon as she hung up, I told her get him back on the phone and tell him to get over here NOW! I was suddenly afraid he was going to miss the best part! He got there within 45 minutes, pretty good for getting a shower and a 25-minute drive. At 8:15, my new nurse (another sweet and wonderful girl!) came in and informed me that my doctor was out of surgery.

Her timing was perfect because I started to feel the pressure and urge to push. My OB came in around 8:25 and the first words out of his mouth as he entered my room were, “Boy, did you prove me wrong!” At that point I was hurting, and pushing felt so unbelievably good, so good in fact that my body just did it on its own. I was afraid my baby boy was going to just pop out onto the floor! My doctor reassured me that he was ready to catch him whenever he was ready to arrive. I begged him to give me some lidocaine because I knew that “ring of fire” was going to hurt.

Everyone in the room was so encouraging and coached me with care; at 8:35 a.m., my sweet Eric Christopher was here. He was born with a nuchal cord as well as a true knot, which explained the prolonged decel when I went to complete. They laid him on me and I will never forget that moment as long as I live. The feel of his soft, warm, squirmy body, the sound of his sweet cry, the look in his eyes as he peered into mine.

He was here, he was mine, he was healthy, he was beautiful, he was blue! He wasn’t blue all over, just his face. My mother asked the nurse, “Why is he blue? Is he OK?” In a thick accent the nurse replied, “He OK, his lips pink, see?” She pulled his little quivering lower lip down gently to reveal soft pink gums. His face had bruised from the quick descent and as well as sitting in the birth canal for so long while I labored down. My husband cut the cord and we were in love. I am a mother, we are officially a family!

Due to his bruising, he developed jaundice and had to be put under bili lights. I think it was more stressful for me than it was for him. I refused to supplement him because the one time I had given him a taste of formula, he became so sleepy he wouldn’t nurse and I panicked. I spent the next 72 hours alternating between nursing him and pumping every 1½ hours. I was exhausted, but I persevered and successfully nursed him until he weaned himself at one year old.

When Eric was about a year old, I felt like it was time to add to our family. In my faith, we believe that our families are eternal, that we existed in heaven before and will continue to exist as a family for all time and eternity. I felt as though we are meant to be a family of four; little did I know how long the journey would be to get there.

When we started out, my husband and I would joke around that we hoped it didn’t happen right away. Having a toddler and a newborn would be so much of a challenge. In my heart, I hoped it would happen immediately. I couldn’t wait to become a mother of two.

Month after month, nothing happened. I started to track my ovulation, no baby. We saw a doctor for bloodwork; it came back normal, so we kept trying, no baby. I took Clomid, no baby. I saw a fertility specialist and we started being more aggressive. I used injectable fertility drugs with intrauterine insemination, twice, no baby. This went on for months. Every night I would pray, “Please God, please bless us with another baby. Please don’t let my sweet boy grow up as an only child.”

I started with confidence, which turned into frustration, which turned into fear, which turned into hopelessness. What is wrong with me? What am I doing wrong? What am I going to do if this never happens? One night in the throes of desperation I prayed for something different. I prayed to be whole again. I prayed to accept things as they are. I prayed to be a good mother to my son -- I was so caught up with having another baby that it was affecting my ability to be a good mother. I prayed to be a good wife to my husband, who was suffering along with me as I was pushing him away to wallow in my sadness alone. I prayed to have the void in my heart to be filled.

I decided to get a second opinion from another fertility specialist. He went over my records and told me that all of the treatments I had done had been a waste of time and money. Due to my endometriosis, my hormone levels were not high enough to develop an egg that was of high enough quality to be fertilized. He reviewed the literature with me and with the extent of my endometriosis, he estimated my chances of natural conception at 1-2%. His recommendation was surgery to remove the endometrial lesions and to move on with further aggressive treatment. As an expert in his field and highly regarded I was glad to have someone give me a straight answer to my infertility issues, but actually hearing it was very difficult. He told me to talk it over with my husband and to call when I started my period to schedule the surgery.

Two weeks later, while I wondered why my period didn’t start, I decided half-heartedly to take a pregnancy test. When I picked it up and saw those two lines I almost passed out ... I was pregnant ... naturally!! I had saved a Father’s Day card in hopes I could use it to announce my pregnancy to my husband. It took me 10 minutes to find it since it was buried in the bottom of a drawer. With a trembling hand, I wrote out the card: “Dear Daddy, Happy Father’s Day! I can’t wait to meet you in May!” When my husband read it he looked up at me first with confusion, then the tears began to well up in his eyes. “You’re pregnant?” he said. “Yes, we are pregnant!” We picked up our young son and held each other in awe of this utter miracle.

Fast forward 8 months. I was 39 weeks, swollen, tired and ready to have a baby. I had been on modified bed rest since about 32 weeks due to preterm contractions, which hadn’t changed my cervix but may have caused trouble, especially since my job entails long hours of being on my feet, not to mention I that I am a nurse and somehow we seem to be cursed. Things rarely go as planned for us, especially in pregnancy.

I was a much more seasoned labor and delivery nurse now, and being a nurse, especially in this field, is both a blessing and a curse. I know all too well what can go wrong and I deal with it all the time. Pregnancy and birth, as I have learned time and time again, are NOT to be trusted; they are to be highly respected. There are so many variables to be considered, and while most of the time everything goes as planned, the alternative is tragic and heart-breaking. I knew in my soul that I could not carry this baby past my due date. I had nightmares that she would be stillborn and I felt like she would be better off on the outside.

I had a different OB this time, a friend of mine who I admired and trusted immensely. We both agreed that an elective induction at 39 weeks would be the plan. At my 38 week visit I was only 2 cm, thick, and -3 station, again not a great scenario for a vaginal birt,h but since I had done it before, we were both pretty confident it would work out. I honestly didn’t care if I delivered her vaginally or via c-section. All I wanted was for her to be safe and healthy, and I felt like that needed to happen soon.

My induction was scheduled for Wednesday night, May 11, 2011. As I was instructed, I called the L&D unit to make sure there was a bed for me since my induction was not medically indicated. It was just my luck that the unit was bursting with women in labor as well as sick antepartum patients. I was so disappointed but tried to stay relaxed. The next morning, after a completely sleepless night, I called again. Of course, more women had arrived in labor and it was not looking good to get in anytime soon. I messaged my friends at work, as they were all anxiously waiting for updates.

Since Eric wasn’t home, my mom and I decided to go up to my unit so I could say hello and give her a tour. I had been contracting since the night before, but since I had contracted fairly regularly during the last half of my pregnancy, I didn’t think much of it. Once we got there around 1 p.m., we walked around, and I showed her the rooms and all of the cool “bells and whistles” we had there. It really is a beautiful place. All the while I continued to contract, and they were starting to hurt a bit! I told my friends, jokingly, that maybe I was going into labor.

It was just at that time that a big thunderstorm rolled in. Although my OB did not have privileges at this hospital, I agreed to be evaluated because I knew there was no way I was going to drive 20+ miles in a severe thunderstorm to be checked, just to be sent home because I wasn’t in labor. One of the great physicians I worked with agreed to assume care of me while I was there. My nurse applied the fetal monitor, and again a wave of relief washed over me as I heard my baby girl’s swift heartbeat. I wasn’t really worried about her, as I could feel her regular movements, but a visual of a reactive non-stress test put what little worry I had to rest.

When my nurse/friend checked my cervix I was totally surprised: 5 centimeters, 70% effaced and -2 station ... I WAS in labor!! Making the phone call to my husband was actually quite amusing. He had decided to go into work while I waited to be admitted for my induction. To hear from me that I was in labor, not at the hospital where we planned to deliver, but at the unit where I worked, was not something he had planned for. I actually had to explain it to him more than once. Luckily, he worked just down the street so his drive in a South Texas downpour was short.

Once I was admitted, I called my OB’s office and let her know that I was in labor. I thought I was going to just leave a message with her nurse, when she answered the phone, “What is going on? Where are you?” When I told her, she was really disappointed to not be the one to deliver my baby, as was I, but as I knew well when you are having a baby, plans change. She insisted that I call her as soon as the baby was born so she knew everyone was ok; I agreed and smiled to myself, appreciating her sincere concern for me and my baby girl.

Although I was 5 centimeters, I was not in “active labor.” My contractions were somewhat irregular and not really strong. I opted for Pitocin augmentation. I was well aware of the risks and I trusted my caregivers implicitly. At 4 p.m., one of my favorite anesthesiologists came through my door to visit. He talked to me about my options and told me he would be available to me anytime. I opted to get the epidural before my water broke this time, as I had already experienced enough contraction pain with my first baby. He placed it without difficulty. Thankfully, the epidural was light and I was able to move around as I needed. I was also able to get a short nap, since it seemed like ages since I had been comfortable enough to actually sleep.

At 5:30 p.m., my wonderful substitute OB came to see me. I couldn’t have had a better replacement for my regular OB; she has expert skill, a warm heart, and was pregnant as well! I was still 5 centimeters and we both agreed that rupturing my membranes would get things moving since I had PLENTY of amniotic fluid to keep her head nice and cushioned on my cervix. My poor friend taking care of me got drenched when the doctor broke my water -- it was like someone had breached the Hoover Dam! It was clear and the baby continued to look great on the monitor. My OB sat at the nurses’ station and visited with the other nurses while she watched over me as I labored, which didn’t take long.

At 6:30, I began to feel that familiar pressure and pain. It came over me quickly again, just like it had with Eric. I turned onto my side and began to breathe deep and focus on staying relaxed. I was preparing for something I had waited so long for! When I started to feel like I had to push, I asked my husband to “push the button”. When no one arrived, I asked him again and still no one arrived. When I turned over and yelled, “I need to push! Push the button!” He said, “I did!” He was pushing the button on my epidural (that wasn’t working anyway.) I yelled again to push the call light, as I felt like the baby was going to come out any moment. My OB as well as a group of great friends came to my room immediately and were quickly ready to help me deliver my baby.

After pushing for less than 10 minutes, at 7:10 p.m., Emmeleia Ryan arrived pink and perfect. They laid her on my chest just as Eric had been and again I felt that comfortable feeling like I already knew her. She was so beautiful and I was so thankful that I had been blessed to add this new little spirit to our family. She was perfect in every way and I knew that she arrived just when she needed to ... we were now a family of four!

When Eric came to see his new baby sister, he was ecstatic! He hugged and kissed her just like he had always known her, which I knew he had. After all the heart ache and longing, I finally had my family, complete and whole. I finally had my heart, complete and whole. The birth of me as a mother was the most intense, scary, elating, fulfilling and by far the greatest blessing I have ever received. It is so much more than the event of their actual arrival. It is the journey of me as a daughter, a woman, a wife, and the evolution of me from within. It is so much more than what is encompassed inside me or the mechanism of my body, it is spirit and body coming together, it is life, and it is the greatest miracle of all.

Sunday, September 4, 2011

Baby Aline's birth story

Lauren shares her daughter Aline's birth story:

On Wednesday, July 7th, we had an appointment with the midwife at the OB clinic. At that point, she expressed concern with me going very far past my due date since I have a heart condition.

We went ahead and set an induction date, and hoped that I would go naturally before that. The next Friday, I started to feel some contractions and thought it was the real deal ... nope. Not the real deal. Ugh, how frustrating.

Saturday evening, my best friend called me crying because she'd had yet another fight with her fiance. ... I told her that I was being induced on the 15th and that I'd love for her to come out if we could figure out a way to get her out to Maryland from Indiana. We ended up booking her ticket the next day, and I sat and prayed that she'd make it out in time and I wouldn't go into labor before Becky got here. Tuesday morning, Becky arrived and we went back to my house to hang out.

Thursday morning dawned bright and clear, and I called Labor and Delivery at 0700 as requested. Nurses were in reporting, so they told me to call back in 15 minutes. Ugh. I didn't WANT to wait, I needed to know when I was to come in. I called back exactly 15 minutes later, and got my time ... 11 a.m. I tried to go back to bed but that didn't work out, so I just stayed up and watched the news. I took a long hot shower, shaved, and had some freak--out moments ... then we headed out the door and down the road to the hospital. We got there and waited for about an hour to get a room. I thought things would get going pretty fast ... they didn't.

First, the doctors wanted to evaluate my heart and make sure I was healthy enough for laboring. Yep, no problems there. Then, they wanted to make sure I'd be good to get the epidural. I have a genetic condition that can cause tumors or lesions to form on the spinal cord. Since they didn't have a recent MRI of my back, I had to go get one of those done. Horrible experience ... I had to lay on my back in the cramped quarters of the machine. Not fun.

Oh, did I mention I was in isolation the WHOLE time because of my MRSA infection? [Lauren had contracted MRSA about two weeks before her deliver.] Yeah. I couldn't leave my room, even before they hooked up all the machines and IV and everything. I couldn't get up and walk more than just around my room. I understand why they had to do it, but it was frustrating as anything.

Anyhow ... the MRI came up clean, so they knew they were good to start the epidural. Around 4 p.m., I started getting good solid contractions, even without the pitocin. It wasn't hard labor by any means, but they hurt bad enough that I asked for pain meds. I cried when I asked for them; I had hoped to go without the narcotics but I was miserable, and it was going to be a good 2-3 hours before I could get the epidural. They gave me the Nubain and Phenergan, and I passed out. This is when the scary stuff started to happen.

Around 8:30 p.m., Aline's heart rate plummeted into the mid 90s, from around 130. I was very drugged at this point and don't remember anything, so this is all just what I was told. They got me onto my hands and knees, and her heart rate came up with that and oxygen. I ended up on the oxygen mask most of the time I was laboring, and spent a good 75% of it on my side. They went ahead and gave me Terb to get the contractions to stop for a bit, and I passed back out.

A little while later, the anesthesiologists came in and gave me my epidural. I was so special, I got the head of all the OB anesthesiologist team to do mine, lol. Once it was in, they started me on a low dose of pitocin. That went well, so they stepped it up every few hours. I wasn't really dilating well ... oh wait ... I forgot something. That first night I was in, they put in a Foley bulb to try to get me to dilate, I got to like 3.5 and stalled. Ugh.

Ok, back to Friday. I was making some slow progress with dilation, and was feeling pretty well. I hit about 5 centimeters and was really looking forward to getting this kid out and in my arms. She decelerated again and we had to stop the pit again. The Terb was HORRIBLE. Gave me the shakes like nobody's business. I didn't like that and if I can avoid pit in the future, I will. I just do not react well to it.

Anyhow, around 1 p.m., the docs checked me again. They noticed that Aline seemed to be face up, so the midwife helped me roll over on my hands and knees and kinda hug the back of the bed. Not easy when you can't feel your lower body!! I was there for about 10 minutes when I felt (and heard on the monitor) a very loud and strong kick. All of a sudden, I felt this WEIRD feeling between my legs. I don't even know how to describe it now ... it just felt mushy and wet. Becky grabbed the nurse and told her what I felt, and she came and checked me. Turns out, my water broke all on its own! I was psyched about that; they had talked about AROM if it didn't break soon since I was nearing the 24 hour mark.

After that, everything started moving much more rapidly. Within an hour I was 6 centimeters, then another hour I was about 7.5. I was also effacing very quickly, I went from 50% to 90% in about 2.5 hours. Next check I was 10 centimeters and fully effaced. Now we just needed to wait for me to feel the urge to push. They were watching the monitors and could tell when my contractions were amping up.

Soon I could feel the urge to push, so we started pushing. By the second set of pushes, they could see her hair! Unfortunately, I had a long time in between contractions and she kept sliding back up. I pushed and pushed, she continued to not cooperate -- two steps forward one step back, so to say. I was getting exhausted, my heart was starting to palpitate (symptom of my heart condition) and her heart rate was dropping again. They had me laying on my side pushing, they tried having me on all fours ... nothing was really helping her descend. They finally asked me if I would be OK with the forceps delivery.

I decided to go ahead with it .. I didn't want to make her suffer anymore and I just didn't think I could do it by myself. Boy was I glad we went with the forceps ... after about 4 sets of pushing with the forceps, she was born. She had the cord around her neck and was not looking well. She also wasn't fully face down, she was kind of looking at my left thigh, if that makes sense. I did end up tearing when they brought her shoulders out; I had a second degree tear that had to be stitched up. They don't do routine episiotomies at this hospital, so tearing was to be expected.

The docs quickly cut her cord (I was a bit sad cuz I wanted Bobby to do it, but I understood why they had to) and got her off to the warmer. I still had the oxygen mask on at this point, and I couldn't hear her crying over the sound of the air. Needless to say, I freaked out. Completely lost it. I was sobbing and asking why she wasn't crying. They were all like, "Don't worry, she's crying ... she's perfect ... she's ok ..." and me still freaking out over on the table. Finally they went ahead and turned off the air and I heard the sweet sound of my baby girl screaming her head off.

They handed her to Bobby and she immediately stopped crying and just looked around for the source of his voice. I have the most precious picture of him holding her right after they handed her to him ... thank god my best friend was in there to get the picture. Daddy got to hold her while they stitched me up, and then she was handed off to me. Absolutely best moment of my entire life. Holding her made everything we'd gone through the past 9 months worth it.

She was born at 10:32 p.m., July 16th, after about 28 hours of labor and 2 hours of pushing. She was 7 pounds, 3.7 ounces, and 20 inches long. She's a skinny one! Too cute though, and she's a wonderful baby. I am one hundred billion percent in love with this baby.

Saturday, September 3, 2011

Baby Liam's med-free hospital birth

Johanna shares her story of a medication-free birth in the hospital with a Certified Nurse Midwife (visit Midwife{ology} for an explanation of the difference between CNMs and Certified Professional Midwives, or CPMs):

Shortly after I woke up on Tuesday, November 24, four days past my “due date” (HA!), I lost my mucous plug. I hadn’t had any other signs of impending labor and had pretty much resigned myself to being pregnant well past Thanksgiving. When I told Evan about this new development, his eyes lit up and he said, “I think today’s the day!” I told him not to get too excited because I wasn’t having any contractions.

I dropped Evan off at work and once I got home, I started having irregular contractions. I didn’t think too much about them because there was no pattern and they weren’t too painful. I went about my normal day, except that I spent a lot of time moving back and forth between sitting on my yoga ball and tailor sitting on the floor. The contractions go a bit more serious, but I was convinced this was not the real thing yet, so I tried to keep myself distracted. I finished knitting a blanket for my sister’s baby and picked up around the house, breathing deeply through each contraction. I called my mom to see if there was anything she needed me to pick up at the grocery store for Thanksgiving dinner and I let her know that I might be in early labor, so I asked her to not tell anyone and to say a prayer for a safe and easy labor.

I went to the grocery store, and I had to stop periodically and lean against the cart to breathe through a contraction, but I was still not convinced that I was in labor. I picked up what my mom needed and got some frozen pizzas for our dog sitter “just in case” she needed to come that night.

I had a midwife appointment that afternoon, so I headed there a little hopeful, but still skeptical that I was actually in labor. I told Judith (the midwife I met with) that I had lost my mucous plug and I had been having contractions all day, but they still weren’t too strong or regular. She said that it might be early labor, but it might stop still, which was common among first pregnancies. She offered to check my dilation, but I declined because I was afraid it would either crush me if I wasn’t dilated, or possibly make me overly excited if I was. I asked who the midwives on call were for that night and the next, in case I ended up going to the hospital.

On the drive home, I was hit with a contraction that made me get serious –- I had to grip the steering wheel and breathe very slowly and deeply. A few minutes later, I was hit with another one. When I got home I checked the clock, and it was exactly 10 minutes from when I had left the midwives' office. I called Evan and told him he’d need to find a ride home because I wouldn’t be able to make the drive to pick him up with the contractions as strong as they were. Evan got very excited and said he’d finish up and get a ride. I paced and bounced on the yoga ball as I waited for him to come home.

Evan blew through the door, super excited and ready to go. I was still willing to believe that it wasn’t the real thing (talk about denial), so I suggested we order dinner and then see how I felt. We had a big pasta dinner, and I drank a small glass of wine, but the contractions kept coming. I went upstairs to take a bath to see if that would slow things down. As I was about to climb in the tub, I noticed a trickle of pink-tinged fluid. I called the midwife on call, Melissa, and she said that it sounded like a rupture in my membranes, and that I should take my bath and call her if my contractions got to be one minute long and three minutes apart. As soon as I climbed in the tub, my contractions became much stronger. I kept an eye on the clock and noted that they were roughly three minutes apart. I got out and got dressed, and brought my hospital bag downstairs.

I let Evan know how the contractions were going and he got even MORE excited! We started Contraction Master on the laptop, and while he gathered up what we needed, I paced around the living room, stopping and kneeling against the back of the couch when a contraction came. Evan called Melissa back and she told us to come in to the hospital. We called our dog sitter and our parents to let them know we were on our way to the hospital.

The car ride was rough, but not as bad as I thought it might be. Thankfully, I had Contraction Master to distract me. As a contraction would start, I’d hit the “S” key and say to Evan, “Here comes another one,” and breathe or moan through it. We arrived at the hospital, and the nurses at the emergency room sent us up to OB triage right away. When we arrived at triage, Melissa greeted us and a nurse hooked me up to the EFM to get an initial reading on my contractions and Liam’s heartbeat. Melissa told us that she had to go deliver another baby, but that once the 10 minutes for the strip were up, the nurse would be able to let me walk the halls until Melissa could examine me.

Those 10 minutes were really hard -– we propped up the back of the gurney I was sitting on so I could lean over it during contractions. At this point, I had to moan to get through them. I was drinking a lot of water and beginning to feel nauseous. Finally, I was released from the EFM and Evan and I walked the halls of the birth center, stopping for every contraction so I could kneel and rest against the railings on the wall. We walked for about a half hour before I wanted to rest in triage again.

Quickly after that, Melissa came in and examined me –- I was 6 centimeters dilated, and she was admitting me. She also noticed meconium in my waters, so she said that their protocol required continuous EFM at this point. Evan and I talked it over and decided to agree if we were able to get a telemetry unit so I could still use the tub and move freely. No problem –- she got one for us right away!

As soon as we got into our room, I stripped my clothes off and put on a hospital gown (I knew I’d be more relaxed if I wasn’t concerned about messing up my own clothes). I was hooked up to the telemetry unit. I labored draped over the back of the bed as the admitting nurse asked me a bunch of questions. I remember thinking, “How long is this going to go on? Can’t she see I’m in labor?” As soon as she was done, our nurse Sara came in and asked if I wanted to use the tub. YES! I ripped off the gown and got in the tub. Such a relief!

I don’t remember much about the order of events after that. I know at some point, Sara and Melissa brought Christmas lights into the bathroom and my room so we could turn off the overhead lights, and someone got out my necklace from my Blessingway. Evan stayed right by my side, holding my hand, pouring water over my belly, and encouraging me every step of the way. Sara was in and out, bringing juice for me and Diet Cokes for Evan. Sara was an amazing nurse, more like a doula actually, and she supported both of us beautifully. I know I was in and out of the tub. I labored on a yoga ball, leaning over the back of the bed, and on the toilet. Melissa was in and out of the room, encouraging us.

Somewhere around 2 a.m., I started to feel pushy. Sara called Melissa in and she checked me –- 9 centimeters! She said I could start doing little “grunt pushes” if that made me more comfortable. It did! Soon after, the pushing contractions got more intense. I started pushing in every position I could think of -– on all fours, on the yoga ball, standing and squatting, and on a birthing stool. I was having trouble getting the pushing “right” -– that is, doing it in a way that helped Liam descend.

I felt like I was in and out of awareness, but I kept hearing encouraging voices around me. Evan reassuring me that I was making progress and that I was doing a great job. Melissa and the nurses commenting to each other how “beautifully” I was laboring and how well I was listening to my body. As I progressed, my vocalizations became louder and more primal. I started making noises that I didn’t know I was capable of.

I was exhausted from pushing, and from being awake for nearly 24 hours. Finally, Melissa suggested that I try pushing in the side-lying position to see if that would help me conserve my energy. I agreed to try it (I would have tried anything at that point).

Melissa had me hold my left leg up, while I had a death grip on Evan in with my right hand. Melissa checked me and told me that the baby had started to descend, and with a few good pushes he would be born. But, I was still having trouble making my pushes “good.” I felt stuck and exhausted. I started saying over and over, “I’m so tired.” Evan kept encouraging me and everyone was telling me I was almost there. We started talking to the baby -– Evan saying, “Come on Liam, help your mom out, she’s working so hard.” I started chanting, “Come on, baby!”

I felt him move down ever so slightly and slowly. I felt my body begin to stretch and Melissa told me to rest for a moment and reach down to touch my baby. I felt the top of his head and his hair, which I was told by the adoring nurses, was curly. Melissa supported my perineum and told me to push on the next contraction. I pushed and pushed with each contraction, and his head slowly emerged -– first a forehead, then eyes, then a nose, and then his whole head. It hurt so much and I had to focus every fiber of my being on pushing beyond the pain and with all my strength.

At this point, Evan was super excited, telling me he could see the head. Melissa told me to open my eyes and look at my baby. I remember shouting, “I CAN’T! I’M PUSHING!!”

So we kept pushing, and with one incredible push and a sound that seemed to at the same time come from deep inside me and from somewhere beyond myself, it was over. I opened my eyes when I heard a squawk and there he was – Liam, all pink and covered in vernix and meconium.

Melissa suctioned his nose and throat and placed him on my chest. At some point, the NICU team had assembled in my room –- another standard procedure when meconium is present. As soon as Liam was checked out by Melissa, they cleared out immediately.

I was totally in awe of him. I remember repeating over and over, “I can’t believe we did it. I can’t believe you’re here.” Liam nestled right up in between my breasts and gazed up at Evan and I, and he stayed there for his first hour. He never left our room the whole time we were in the hospital. His Apgars were 8/9. Evan gave him his first bath in the room and spent lots of time with Liam skin-to-skin on his chest.

I am so grateful that I was able to give birth without augmentation or pain medication. Evan was the perfect coach and we had a great team at the hospital. Giving birth to Liam was one of the most powerful experiences of my life, and I am so grateful to have him.

Friday, September 2, 2011

Diana's happy induction

I hail from a crunchy, liberal, overly educated neighborhood of Washington DC. When I got pregnant, I went to my gynecologist (now my OB) of several years. Every appointment I had was a dream. The doctors were very patient listening to my first-time jitters and concerns and paranoia and easing my anxiety (especially when it came to putting me on drugs for my severe morning sickness -- I had visions of Thalidomide in my head, but Zofran has been used safely for decades).

But no sooner did news of my pregnancy get out than suddenly neighbors and acquaintances began pressuring me to abandon the safe approach I had taken as a given for years in favor of homebirth or lay midwives or etc. Even women who had horrible experiences (one friend's baby nearly died after 48 hours of failed labor using "the Bradley method" with lay midwives in a "birthing center" in the middle of nowhere) tried to convince me to try it. They told me to "educate myself" -- but they never accepted that all my reading and talking to experts on both side of the line (a bit of a false dichotomy, since the scientific evidence is overwhelmingly in favor of hospital birth!) resulted in true "education." To them, "education" only counted if you came away agreeing with them.

Because of my husband's schedule, we were unable to attend the hospital's birthing class. I thought Lamaze was the same thing. It's not. We wound up in a class with a doula instructor who treated the entire thing as one long advertisement for her services-for-hire. It was overt and really left a bad taste in my mouth. To make it worse, there was a lot of bad advice. She showed us propaganda films about the evils of epidurals. I had to pull up statistics -- on the miniscule chances of any of the side effects the film put in blood red bold type actually happening -- in order to ease my husband's sudden fears. She actually recommended to a class full of first-time parents that they LIE to their doctors about their medical conditions. She wanted us all to drink castor oil milkshakes. I didn't learn a thing, except to be even more skeptical about the methods my friends were advocating.

I did end up watching the Ricki Lake documentary ["The Business of Being Born"], and then spoke to my doctor about it. She was more than helpful pointing the way to all kinds of literature showing how biased and ill-informed and just plain wrong the movie was. On one hand, my homebirth friends and my Lamaze instructor were pushing unproven methods and telling me to lie to medical professionals. On the other hand, my doctor and her staff were giving me facts and figures and informing me of the risks and safety precautions. I learned just how quickly your low-risk birth can turn into a high-risk one (seconds) and how a good hospital can save you and your baby through an emergency C-section in mere minutes.

I went overdue. No spicy foods, no hiking, no sex was helping things along. But induction was the best choice -- overdue babies have a much higher rate of stillbirth, and your placenta can crap out at any moment. I had been scared stiff by the Lamaze instructor and the movie about the "evil" pitocin, and my doctor didn't sugar coat my chances -- my induction might fail, and then I'd wind up with a section. I was a C-section baby, and my mother had successful VBACs after me. I wasn't thrilled about the possibility of abdominal surgery, but I also knew from my mother that it wasn't the end of the world. Also, one of my closest friends (who helped me laugh off a lot of the pressure I'd been getting) had 3 C-sections and loved them.

The night of the induction, my husband and I went out for a fancy dinner then checked into the hospital at 8 p.m. My L&D room was beautiful -- soft lighting, wireless internet access, a couch for my husband to sleep on. There was even a bathtub. I won't lie -- the bed was not the most comfortable I've ever been on, and the fetal monitor isn't exactly comfortable either, but when you're 9 months pregnant, it's hard to find a comfortable position to sleep in anyway.

The staff was wonderful. I changed, got my IV and fetal monitor set up, and then they inserted the Cervadil (to ripen my firm, thick cervix) and left my husband and I to watch DVDs on my laptop. The plan was to let the Cervadil work overnight, then start pitocin at 7 a.m. Around 1 a.m., I told my husband to go home and get some sleep, figuring I'd be in for the long haul. At 2 a.m., I was awoken by nurses rushing into the room. One checked the monitor, one put an oxygen mask on my face, and one reached inside me and yanked out the Cervadil. They explained that the baby was not responding well to that drug. I was scared and wished my husband was still there, but one of the nurses stayed with me and explained exactly what was going on and showed me what she was reading on the monitor. At first I thought for sure I was in for a section, since the Cervadil has been in for less than half the recommended time. But soon after, contractions started in earnest. They checked and I was completely effaced and 4 centimeters dilated!

The next few hours were kind of a blur, as I drifted in and out of consciousness in between increasingly painful and close together contractions. My Lamaze class had taught me that my contractions would be regular and only last for a minute (WRONG). Finally, they were so painful that I wasn't able to sleep in between. I called in the nurse, who told me I should go ahead and get my epidural. I don't know why I still believed the misinformation my Lamaze instructor had given me, but I do remember saying to the nurse that I was hoping not to get my epidural until they started the pitocin at 7 a.m., since I was afraid it would slow down labor. The nurse laughed at that and said, "Honey, you're going to have this baby by 7."

I called my husband and told him to get his butt back to the hospital. Then came the hard part -- waiting for the anesthesiologist to show up. He's my hero. He had that epidural placed in no time flat. I thought that since it was a needle, it would be instantaneous like an IV drug, but it's not. It takes a while to numb you, and it starts at your toes. Nevertheless, by the time my husband arrived, I was pain-free and excited to get word that I'd reached 10 centimeters and was ready to push. (Apparently, the epidural had relaxed me enough to give me those last few centimeters of dilation. Yay, epidurals!)

While we waited for the doctor, the nurse suggested we try a practice push. (My Lamaze instructor had warned us that the first 40 minutes of pushing for first timers are just for practice.) I don't know if it was the prenatal yoga I was doing or what, but she stopped me right away and said that I was not to push until the doctor showed up. Which she did a few minutes later.

I pushed for 25 minutes, and then my beautiful baby girl was born at 7:30 a.m. I'd been warned by my crunchy friends that the epidural would make it hard to push -- it wasn't. I'd been told they'd take the baby away from me. They didn't. I'd been told an epidural would damage my ability to bond with the baby, and breastfeeding. I started breastfeeding right away, with the nurse's assistance. We hung out in the delivery room for a while and then they moved us, together, into our mother and baby suite, which came equipped with a private bath, a pull-out bed for my husband, a TV and DVD player, warming lights for the baby if necessary, and a rocking chair.

I'd been told that hospitals were horrible, sterile places. This was cozy. We could even bring in our own food. I'd been told the staff would be mean -- they were fantastic. They sent around a lactation consultant and a pediatrician, and the nurses taught me how to bathe and swaddle my daughter. We didn't even have to move -- just got to sit for two days and hold my baby and nurse her.

A few months after my daughter's birth, once I got adjusted to taking care of a newborn, I began to question the disparity between the fears being put in my mind by natural childbirth advocates and the actual pleasant experience I had. Everything they told me had been wrong, and had seemed designed NOT to alleviate my fear about birth, but instead to create in me a fear of modern medicine that was wholly unfounded. Go take a tour of your hospital -- it's not a torture chamber. It was a lovely, safe, comforting space to have my baby.