Thursday, December 16, 2010

An 'Easy' Birth, despite the difficult circumstances

I don't have my own blog with this published, but here it is. I've been very hesitant to openly share or publish a birth story of how my first child came into the world because there is more than enough negativity about birth already out there. I often share bits and pieces, specific events and moments from my daughter's birth with friends, but I've only told the whole story once. It was a year and a half after delivery, and I still had to find myself an emotionally detached place to tell it from in order to share. I did realize, at that real life red tent, that my daughter's birth story might be a little different than many of the other negative birth stories I've heard; it's not really a matter of how awful birth was, but how easily she came into the world, despite the awful circumstances.
My daughter was the much cherished result of roughly a year and a half of trying to conceive. My mother had given birth to me via an unmedicated, midwife attended hospital birth that would have been a homebirth if she'd been lower risk. She has always been very open with me about how I was born and, probably due to that, I was a little shocked when I got pregnant, went looking for a midwife, and found that in the U.S., in the modern day, only a tiny fraction of births are midwife attended, even less are in the hospital, and the vast majority are via managed medical care of some kind. Furthermore, our insurance did not cover midwifery care, and I soon found myself visiting an OB that I wasn't really comfortable with, but he was an OB, and I was starting to believe that was what I needed. I can't remember what came first anymore, the birth plan or the hospital tour, but as I approached my third trimester I was told that I would deliver like he decided I would deliver and there would be no birth plans allowed, and my husband and I took a tour of the hospital I had planned to deliver in where the nurses explained that the maternity ward was empty that Sunday afternoon because the doctors generally all induce or schedule the c-sections during the week so they don't have to be there during the weekend (this maternity ward was truly abandoned, with only one postpartum room occupied and that by a woman having trouble recovering post-cesarean who had apparently been there since her weekday surgery). After those two things, my husband and I made a joint decision to run, not walk, to the free standing birth center and a midwife. 

Around the time I transfered care, I suddenly found myself seated in a pool of fluid of unknown origin while out of town visiting family. It was recommended that I visit a local maternity ward for a simple check to see if this was amniotic fluid. While trying to decipher the records from my OBs office, no less than 5 different estimated due dates were found ranging from mid May into June. Regardless of which one was correct, this was March. The midwife (yes, midwife) on call at the hospital met us in triage and immediately began discussing an emergency C-section with us. In retrospect, I should have thought this suspicious since there had been no check of any kind to see if my membranes had, in fact, ruptured at the point he began prepping me for a section. When the fluid was checked, the initial strip was not positive. In fact, several strips came up negative before, finally, after repeatedly rubbing one over and inside me, while pressing on my stomach, one came up positive. Baby's heart tones were fine, and I had no fever, so I was offered an induction instead of a section. I refused both in favor of waiting to see if I went into labor on my own, deeply afraid of forcing out a preemie. I could go into great detail about this part, but I will leave it at that the result of this was that I was bullied, badgered, threatened, and lied to about my rights, eventually resulting in my caving in and allowing an attempted induction. I was strapped to a hospital bed and denied food and water except for one hour in the evenings for a week, while receiving pitocin all day and cervadil all night until, finally, someone who clearly had not read my chart gave me a cervical exam and told me I was barely dilated, but my waters were bulging and offered to break them to speed things up. I began asking a number of questions. Very quickly I was told I had to have an immediate c-section or leave. I was more than happy to take the second option. 

I went home after that, continued to see my new midwife and plan a birth center birth for my baby. I was put on bed rest since I was now considered at risk for premature labor after "my water had broken" and spent the better part of the next two months laying in bed, bored out of my mind and sore from laying in the same position most of 24 hours a day. Ultrasounds to check fluid levels were a regular thing, despite the fact that they were always fine, from the first to the last one I received. I'm thankful I never went in dehydrated. I wanted to take classes, but was told there wasn't time, and I needed to be resting anyways. I tried to hire a doula, but of the only two I could find in my area, one's email and voicemail inboxes were full and the other kindly returned my calls roughly a month after my daughter was born. Regardless, I was not planning to go back into a hospital, and I had a midwife now. I didn't worry about it. 

The last week in April, I was taken off bed rest. Thrilled, I hopped in my mothers car and we went out to do all the last minute stuff that I hadn't gotten done while I was on bed rest. After only a few hours on my feet again, contractions started. Absolutely elated, I timed a couple, found them to be around half an hour apart, shrugged it off, and continued on my way. As we finished up grocery shopping, something seemed different, so I timed a few more. Down to ten minutes apart now. I called my husband. He called his boss. Everyone was ready. By late that evening we were down to closer to 5 to 7 minutes apart. Baby had to be coming any time now, right? I called my midwife, we drove to the birth center, and she did a vaginal exam. I was 2cm dilated. She sent me to walk around for an hour and then we'd check again. Did that. Still 2cm. A little disappointed, but still expecting baby any time that night, we went home and went to bed. Contractions continued, creeping down another minute or so closer every 12 hours to a day, for several days. There were more checks, warm baths, a sedative to help me rest in hopes that it would kick start labor, lots and lots of walking, nipple stimulation, hip circles on a birth ball, etc. No dice. Then, finally, I awoke in the early morning, well before dawn, vaguely aware that my water had just broken. For real this time. I was so okay with it, at peace with it, and excited to see my baby, I just tapped my husband and sleepily told him my water had broken. After a second to realize what I said, he was instantly fully awake and just as excited as I was. A few more phone calls were made, breakfast was started, my birth bag was double checked and loaded into the car, then I called my midwife. 

The voice on the other end of the phone, once the answering service transfered me, was not my midwife. In fact, it was someone I don't believe I had ever met who sounded very unhappy to have been woken up so early in the morning. This was my midwife's partner. I told her my water had broken and she told me to meet her at the birth center. My contractions had stopped for a few after my membranes ruptured, but were now back and down around 3 minutes apart, though not super intense. I ate my breakfast and then we headed to the birth center, fully expecting to have some monitoring, then settle into a birth room, find a comfortable spot for labor, and have a baby. About halfway to the birth center, labor picked up. When we arrived, the midwife was not there. Half an hour later, the midwife was not there. I was starting to freak out. My labor was making a rapid move from 110% bearable to can't stand unassisted during contractions. The midwife arrived to me bent over the car, groaning between contractions and freaking out between them afraid we were going to have to have the baby in the parking lot. She immediately made a comment about me being a drama queen and how I couldn't be that far along. She grumbled about the time and the other things she needed to do from car to inside the birth center. I desperately had to use the restroom and dripped some amniotic fluid on the floor getting there. I was berated for making a mess that she would now be stuck cleaning up. She then took my blood pressure, which was, surprise, surprise, a bit high. I was told I needed to relax and get that down or she wasn't going to deal with me and I'd have to go to the hospital. She checked again, still high. Once again, no big surprise. She repeated that I had to get it down or she was sending me to the hospital, that she didn't need that kind of problem. Huge shock, I know, but with this woman standing over me, berating me for not relaxing enough and threatening me with one of the top 5 things I was afraid of, my blood pressure remained high. I was told to leave. I couldn't walk at this point and had to crawl to the door. I threw up repeatedly. She gave me a bowl and repeated that we had to leave. She had to clean up before it was time to open the birth center for the day. My husband helped me out to our car and loaded me up. 

Sitting in the position a car puts you in with a seat belt across my lower belly was miserable. It was about the worst possible labor position imaginable. For me, this was more actually considerably less comfortable than the much loathed laying on back in hospital bed position you hear so much about (not that that was so great either). This was the main part of my labor where I seriously considered an epidural, though, as luck would have it, we didn't happen to have an anesthesiologist riding in the back seat. I realized later that this was probably made much worse by the fact that I was, as it turns out, in transition. 

We got to the hospital and I was forcibly seated in a wheelchair that I absolutely did not want to be in (see note above about being seated). I was taken to the maternity ward where my husband was told he could not come with me to the delivery room, and that they would come and get him once I was "settled" there. I've never seen my husband come so close to a fist fight. We both got very upset at this, I started trying to get out of the wheelchair, and a nurse told the orderly that he could go with me if it was that much of a problem. I was taken to a room, placed on the bed, strapped down, an IV inserted against my very clearly expressed wishes, and made to sign a bunch of stuff I wasn't allowed to hold, much less read (I probably should have put up more fight against this, but I was starting for feel like I should push and I was ready to do almost anything to make people shut up and go away at this point). My midwife (mine, not her partner), showed up around this time. Whatever else I can say about this mess, she was a godsend at this moment, coming in and ushering everyone out. She calmed me down and I told her I needed to push. After a quick cervical check, she confirmed I was fully dilated and told me to push when I was ready. 

Through pushing I was able to relax again for the most part, as odd as that sounds, chatting and joking between contractions. The pushing went very slowly, probably thanks to a combination of being on my back, having a ten pound baby, and being a first time mother. After maybe two hours, the midwife got a mirror for me so I could see what I was doing. I had initially been very uncomfortable with this, feeling like I didn't want to see the descent, but seeing my baby's head, knowing she was right there and almost out, gave me renewed energy. She was born very shortly after that, placed on my belly (her cord was short and she couldn't reach my chest initially). She was so beautiful, warm and snuggly. She's been a cuddly girl from birth, happiest snuggled up to mama. I got to hold her for a few minutes before the cord was cut and she was taken away from me. She nursed for a few minutes right after the cord was cut, but after that a nurse plucked her from my chest and took her somewhere else. This part is a little hazy as, about now, while I'm mostly nude, in stirrups, being stitched up, a nurse felt it was a good time to bring in all the family that was waiting in the waiting room. I don't think I've ever been so uncomfortable in my life. My mother wasn't allowed to be with me when I wanted her in labor, but my father in law got to see my perineum being stitched back together without my permission after. At some point during this, my daughter was taken to the nursery. 

After stitches, my midwife left and I was taken to a postpartum recovery room. We were not allowed to see my daughter, no one would bring her back, tell us why she was taken away, when she would be back, or even if she was okay. One nurse even went so far as to hint she didn't make it. I spent a good deal of this time trying to mentally distance myself from this baby I had just delivered who was, clearly, gone or not going to make it. For several hours we sat waiting, periodically pestering staff or trying to go find her in the nursery. I don't even want to know what my blood pressure was at this point (it was totally normal, bordering on low, when my midwife checked it at the hospital, by the way). Finally, at the next shift change, I asked again about my baby, and was told nonchalantly that they knew I needed rest after delivering that gigantic baby (she was just under 10 pounds), but if I wanted her back now she could be brought to my room. 

Now, many hours after her birth, for the first time I really got to hold and look at my baby for more than a few moments. She was already bundled up, bathed, fed, and asleep, but she was okay and she was back with us. She is now a happy, healthy, very active toddler who is soon to be a big sister. She was delivered after around two hours of active labor and just under three hours of pushing. Despite all the commotion, she arrived via a quick and medically uneventful labor. Mama sustained a minor tear, somewhere between first and second degree, but, by intention or accident, was given a extra stitch which has lead to the need for some far more extensive repair as the labia healed together. Bonding was somewhat difficult, probably in no small part because mama started mourning the loss of baby before getting to really start bonding with her, but things have evened out over time for the most part. Baby number two is expected to arrive in the summer of 2011 and, barring major complications, will be born at home surrounded by his or her family at attended by a midwife chosen for not only my comfort with, her but also comfort with her backup. 

1 comment:

  1. This sounded like it was a story from the 1960s or something! I can't believe you went through all that!! Praise God your baby girl is ok and you have a good plan started for next time. Congratulations on #2!


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