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.
Saturday, September 3, 2011
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1 comments:
What a beautiful story! :)
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