Monday, January 18, 2010

Birth Story

It is sort of like we won the lottery. Not only did we end up with Miss M who is quite magnificent, but I also got the birth that I wanted.

We are absolutely enchanted by the baby, and it's hard to imagine that she's only been with us a few weeks. But before I talk about the last few weeks in any more detail, I want to write about her birth, because it was amazing, and I don't want to forget it.

I was sound asleep on Saturday morning, January 9, when something woke me and made me leap from the bed. I suspect I felt a trickle of something, and my subconscious knew enough to get me out of bed just in time. The second my feet hit the floor, there was a huge gush of fluid that soaked my new $9 pajamas that I'd bought while doing my walking a few days earlier. "T," I said to my still sleeping husband, "I either just peed myself, or my water just broke." T. immediately jumped out of bed, awake but not particularly coherent. "What should I do?" The look on his face was priceless--a combination of excitement and utter confusion.

I admit, I wasn't so coherent, either, and I told him to go and get some paper towels so I didn't leak all over our brand new floors. It cracks me up now that this was my response. He got the paper towels and mopped up around where I was standing, and I made my way into the bathroom, where it became clear that in fact my water had broken. I wasn't having any contractions, however. I was remarkably calm and at peace that it was all starting.

Since it was so early on a Saturday morning, I waited a bit before I called the doula. Around 7am, I called her and let her know that my water had broken. I told her that I didn't want her to come right away, though, since nothing much was going on. We agreed that I would call her when I was ready for her, and that I'd keep her posted in the meantime.

During an earlier appointment with my OB, she had said that if my water broke, they would want to see me immediately at the hospital to monitor me. Knowing that I wasn't having any contractions, I wasn't eager to get to the hospital, so T. and I showered, ate breakfast, and slowly prepared to head to the hospital. After learning of my doctor's policy on being in the hospital if your water broke, I had talked with the doula about possibly waiting it out and not notifying the doctor until I was actually in active labor if my water broke. But, that day I just didn't feel comfortable waiting too long. After we had showered, pulled our hospital stuff together, and eaten breakfast, there was nothing left to do, and I started feeling antsy. Just sitting there was making me anxious, so we finally called the doctor's office at around 8:30 and left a message with the answering service.

The on-call doctor was one that I thought I liked, but when she called me back she seemed irritated that we hadn't called sooner. She said they worried about the cord moving when the water breaks, and she wanted me at the hospital immeidately for monitoring. (This should have been my first clue that we were not going to love her during this process.) I wasn't worried about the baby, because I could feel her moving. So, we headed for the hospital with just a quick stop at Starbucks so that T. could pick up a large coffee for the road.

Once at the hospital, they brought us to Labor Room 3. We had a very nice nurse named Barbara assigned to us. I changed my clothes, and she hooked me up to the fetal monitor and the contraction monitor for about 20 minutes. I had been planning to labor in my own clothes, but for some reason, the johnny and bathrobe at the hospital felt more comfortable. The fetal monitor showed the baby was in good shape, but as expected, the contraction monitor showed I wasn't having any contractions. The nurse told me that she would want to monitor the baby every half an hour, but that until then, I was free to roam around, although they preferred that I didn't leave the maternity ward. There was a nice long hallway in the ward, so T. and I walked up and down the hall for the next half hour in an effort to get things moving along. Actually, I was walking so fast that T. couldn't keep up, so he sort of stood in the middle, near the kitchen, and talked to me as I walked past him. I eventually caught him eating a bagel, and I scarfed down half of it (the kitchen was stocked with snacks for patients and families).

When I returned to my room for the next monitoring session, the baby still looked fine, but there were no contractions. The doctor had arrived by this point, and came in to talk to me. Although it had only been a little over three hours since my water had broken, she proposed starting pitocin. I told her that I didn't want to use pitocin at that point, and I wanted to see how things went. She said that she thought that if things were going to start naturally, they would have already, and then proposed using cervidil to soften my cervix. It's interesting, because she didn't try to explain what either drug was. I knew what they were, and didn't need to ask. It only struck me recently, long after Miss M's birth, that we didn't have any discussion about what pitocin and cervidil were, and the risks/benefits to using them. She mentioned them, I said I wasn't interested, and it went from there.

After I told the OB that I really didn't want cervidil or pitocin, she began to lecture me about how when labors drag on like mine was (yeah, right), as time passes it increases the likelihood of needing antibiotics, which increase the likelihood of other interventions. She also said that at night, there are fewer people around, and the hospital isn't staffed as well. I was incredibly annoyed, because what I heard was that she didn't want to be at the hospital at all hours of the night, and I didn't appreciate the scare tactic of "there are less people around the hospital at night." She chose the wrong mama to mess with! I stood firm, and we agreed that we'd talk in two hours about pitocin/cervidil (although I had no intention of giving in in two hours even if my contractions hadn't started). She then disappeared, and I actually didn't see her again for hours.

Per my reading, there doesn't seem to be a medical need for antibiotics until 18-24 hours after your water breaks. And, I don't think any reputable medical professional has any business trying to use scare tactics on a patient who doesn't want medications when there is no need for them. It had been a mere three and a half hours since my water had broken, and she made NO suggestions for alternative ways to induce labor. I was very put off by this, and I can only imagine what other, less-informed or more easily frightened women would have chosen to do when faced with the lecturing, somewhat hostile doctor. Luckily, I had my doula.

As soon as the doctor left the room and we had some privacy, I called my doula. Actually, the nurse walked in shortly after that, and I had to hang up just as someone answered the phone. Luckily, my doula totally got it--she left me a voicemail back saying she'd either just missed my call, or perhaps someone had come in the room as I was trying to call. Now THERE's a smart woman!

Once the nurse left, I called the doula again, and told her what the doctor had said. She was, of course, horrified. She made a bunch of suggestions for trying to kick my labor into gear, which included nipple stimulation and bouncing on the birthing ball, among other things (I can't remember the other recommendations right now). She made me promise that if I tried nipple stimulation, I would let the medical team know that I was doing it. She offererd to make her way to the hospital, but once again, I told her that since nothing was going on, it didn't yet make sense for her to be there. There wasn't really any point in the three of us sitting around and staring at one another!

I decided to try the birthing ball. The doula had said that the theory is that the bouncing causes the baby's head to press on the cervix, which releases hormones that get the contractions going. I have to say, she was right on with this suggestion. Within a very short time, my contractions had not only kicked in, but they'd kicked into high gear. They became regular, and somewhat painful. Within the hour, I had T. call the doula back and ask her to head for the hospital. This happened around 11 am.

I continued to bounce on the ball, while T. watched television. Nurse Barbara would come in periodically to monitor me. Thankfully, after the initial session of monitoring, she didn't make me hook up to both monitors, and she didn't do the monitoring for long periods of time. She simply would set the fetal monitor on my belly for a minute or so, and I would stop bouncing while she did it. Miss M was a champ--her heart rate stayed right around 150 the entire time I was in labor, and never waivered.

After a bit of bouncing on the ball, I asked T. for my iPod and went into my own zone. I had loaded all sorts of things onto my iPod, unsure of what I'd be in the mood to listen to while I was in labor. At first, I tried a little Coldplay, but it just didn't seem right. I moved on to one of the guided imagery for pregnancy and labor cd's I'd bought a few weeks earlier. The one that felt right was by a woman named Bellaruth Naparstek, called Medidations to Support a Healthy Pregnancy and Successful Childbirth. I didn't really have a chance to listen to the pregnancy cd, but I'd been using the successful childbirth cd for several weeks, and really liked it. The childbirth cd essentially had two parts, one with her speaking, and one that was just music. Initially, I listed to the part with her speaking, over and over again. As my labor intensified, I switched to just listening to the music. I listened to the music throughout my entire labor, until it was time to push. It was so relaxing, and kept me in the zone. I had read about laboring women going into the zone, and didn't really understand what it would be like until I was in it, but I really was in my own little world. I had the iPod loud enough that I couldn't hear anyone who was talking in the room. I was completely oblivious to time. It was just me and the baby and my iPod, taking it one contraction at a time.

I was in labor from about 10:30 or 11:00 am until Miss M. arrived at 10:49 pm. During that time, my contractions gradually intensified and became closer together. I never did get to the point where the contractions were one on top of the other, as I had read would happen. I always had a few minutes between them. The pain was never more than I could handle. I never even considered an epidural or other pain relief--it didn't even occur to me. I would say that at their worst, the contractions were no more painful than the worst stomach cramps I've ever had with a bad case of stomach/intestinal upset. In between contractions, I felt great, for the most part. In fact, I was so relaxed by the music on the childbirth cd that I almost fell asleep in between contractions at a few points. I thought it was crazy when I read such things before my own labor, but it really did happen. My doula even noticed it, and later commented on it.

At some point, Nurse Barbara went to lunch, and another nurse took her place monitoring me. Unfortunately, this nurse was very "by the book," and insisted that I get into the bed and that she put both monitors on me and monitor me for 20 minutes every time I needed monitoring. Needless to say, this was uncomfortable, and it completely interrupted my labor and slowed down my contractions when she did it. My contractions had been regular for a while, but them became irregular every time she would monitor me. Nurse Barbara stuck her head in and tried to prevent the other nurse from doing this, but the nurse insisted on following "protocol". As noted above, Nurse Barbara had been terrific, and was completely unintrusive and got where I was coming from. Fortunately, the nursing staff was terrific--they didn't send the other nurse in again. When Nurse Barbara came back, I told her less monitoring was better than more monitoring, and she seemed to get it. She only made me use the baby monitor on my belly for a minute or so from that point forward.

As the contractions intensified, I did throw up after some of the worst ones. I probably threw up 3-4 times. I would get really nauseous at the end of a bad contraction. They wouldn't let me have any food once I was in labor, so the last thing I had to eat was at 11:15. After that, it was just juice and ice chips, which I ate copious amounts of. T. would be there in between contractions with ice chips, water, juice, and cherry Chapstick, which I also needed to reapply frequently. He was so amazing--calm, and ready with whatever I said I needed. The doula would have the plastic bucket at the ready for when I said I was nauseous, and would bring me a cool cloth for my neck each time I got sick, and then my toothbrush.

My back bothered me a bit toward the end, although I didn't have back labor. I had brought an old fashioned hot water bottle with me--the one I'd picked up from the drugstore during the bout of sciatica weeks earlier in my pregnancy--and we filled that with hot water and put it on my back. After a long time on the birthing ball, I switched to the rocking chair that was in the room, and I spent a very long time rocking away in the chair. The hot water bottle fit perfectly between my back and the rungs of the chair.

The doula and T. chatted in the background about things, with the doula providing T. with reassurance and guidance. I have no idea what they were saying, though, as I couldn't hear them over my music. I do know that T. told me later that he went out at one point and asked them not to send the other nurse back into my room.

Lucky for me, but unfortunate for some other woman, my doctor had to go and perform a c-section at some point during my labor, so I went a very long time without her checking in with me. At initial check, I had been 2 cm dilated and 80% effaced. At the second check, I think I was 4 or 6 cm dilated and 80% effaced. When the doctor returned from the c-section, I was almost to the finish line. Nurse Barbara's shift ultimately ended, and another nurse named Sheri came and replaced her. I had actually met Sheri at my doctor's office the week before. She apparently works there part time, too, and had done the monitoring on me while I was there. At the doctor's office, she had joked that maybe she would see me in L&D that week, and later told me that she didn't really think that I was that close to delivery. I was vaguely aware of Nurse Sheri and the OB floating in and out of my room and watching me labor, but no one bothered me. Sheri ultimately suggested that I try other labor positions, because I wasn't quite fully dilated. I tried getting down on all fours, and it was so horribly painful that I had to get out of the position. I walked around for a bit, leaning on the bed when the contractions came. I also tried sitting on the bed for some of the contractions. Truthfully, all of these things made my contractions more painful. Perhaps this made them more effective, but it was far less comfortable than I had been in the rocking chair.

After a bit more labor, they began asking me if I felt the urge to push. Truthfully, I felt only a slight urge to push during my contractions and felt no urge to push in between contractions, and I told them that. My doula said that I should feel like pushing the entire time when it got to be "time" to push, and that seemed consistent with what I had read. However, the OB and the nurse wanted me to try pushing at that point, regardless.

I could tell that my doctor was getting antsy again, and although I felt great, I was also ready to meet my daughter. I knew I was close, and I was just ready to finish. I wasn't tired and I wasn't in terrible pain, so I'm not sure what made me "ready." I just was. I got into the bed, and the doctor checked me again. She said there was still a small lip of cervix left, but she thought she could manually push it back during a contraction, so that's what she did. It was somewhat uncomfortable, but not horribly so.

Then came the pushing. T. held one of my legs back and the nurse held the other. This wasn't a position I had thought I would want to labor in, since I had read it actually makes labor harder (gravity isn't working with you) and makes a tear more likely. However, I just went with it. I started pushing with each contraction, three pushes to a contraction. A baby nurse joined us a short time later, and there might have been one or two other nurses in the room, too. People were cheering me on and commenting on how amazed they were at how much control I seemed to have. I didn't think much of it at the time, as I was so focused on pushing.

I have to say, the pushing didn't hurt at all. I had thought it would, but it did not. I felt a very tiny amount of burning when she crowned, but that wasn't even very uncomfortable. It really must be true that your body produces hormones that block the pain. I remember telling everyone in the room while I was pushing that it actually did not hurt. I was just amazed at that. They asked me if I wanted the baby on my chest right away, and of course I said I did.

The doctor was clearly getting nervous. She was really experienced, but she seemed very uncomfortable toward the end of my labor. She expressed concern over the baby's heart rate, although the nurses all said it was staying consistent and just fine. The doula also later told me that baby's heart rate never waivered during my labor, including during pushing. The doula also later told me that she thought that perhaps the doctor had done so few natural deliveries that she was uncomfortable with mine, and that's why the OB seemed so nervous. In any case, the doula noticed the OB's discomfort, as well. The OB said at one point that if I would let her make just "one small snip," the baby would come right out. Needless to say, I knew she meant an episiotomy, and I declined. She also said, a short time later, that they might not be able to put the baby on my chest right away, because they might need to work on her. I wasn't concerned though, and felt like she was being a Nervous Nellie, so I told her to do what they needed to do with the baby. I knew she'd be fine.

I probably pushed through 7-10 contractions. They kept saying I was almost there, but I didn't believe them (sort of like working with a personal trainer who says "just 10 more situps," only to make you do 50 more). But, all of a sudden, she just shot out of me in one big slippery mess. I had expected that her head would slowly come out, and then I'd slowly push her body out, but she sort of just came out in one big gush. The doctor said she had a really short cord. She apparently asked T. if he wanted to cut the cord, and he said that she obviously had much more experience (which he thought was funny, but she did not). Then, they put her on my chest.

It was just amazing. She was still completely covered in vernix, which reminded me of zinc oxide. It was thick and kind of sticky, but I didn't care. I just loved having her there. T. was right by my side, and we'd given the camera to the doula, who started taking a million pictures. It was a few days before I got a chance to look at them, and I have to say, the pictures alone made the money spent on the doula worthwhile! T. and I are absolutely beaming in every photo, and there are all kinds of candid shots of not only us and the baby, but also the medical staff doing their thing with Miss M. I had a small superficial tear, and the doctor was working on stitching me up, but I barely even noticed, I was so entranced. After a few minutes with us, they had to take her away to work some mucus out of her chest. They brought her back a few minutes later, and she nursed a little bit, and held my finger with her little hand. I had thought T. and I would get really emotional and tear up, but we were just so absolutely joyous. It was truly magical.

I am so proud of Miss M. and I that we got the birth I wanted. I'm proud of myself that I did it. I am so thrilled that it was everything I hoped it would be. And of course, it is so wonderful to have her here.


Good Egg Hunting said...

What a great labor story. Thank you for sharing it! I am so very happy for you that you got the labor you wanted -- it sounds truly amazing. It looks like I will have to be induced unless this baby comes soon, but your comments are a cautionary tale to maybe not always listen to everything the medical staff say -- to try and let nature work when possible. Anyway, keep enjoying your time with Miss M!

Heather said...

Congratulations! Sounds amazingly beautiful! I especially love a great story of a natural childbirth. I had it with both my pregnancies and they were both amazing!!!!

~Jess said...

What an awesome thing! I swear by the birthing (yoga) ball...I think that is what made my delivery go so quickly.

My favorite laboring position was on my knees leaning on the bed.

It's rather sad that doctors are so used to medicated births that unmedicated ones make them so nervous. That was one thing I was grateful for....the doctor didn't even show up until I was desperate to push.

I'm so glad it went well for you guys...I can't wait to see pictures of Miss M.

JamieD said...

I am so very happy for you! Not just because you had a great labor and delivery but also because it was just what you wanted. And Miss M arrived in perfect condition!

Congratulations, again!!

Rebeccah said...

Good for you, good for you good for you, Good For You! I love that you knew what you wanted and that you got it. I'm sure you did make the OB nervous ... and I bet she learned a few things too! : )

Darla said...

Very precious story! I'm so excited for you all!