I was scheduled to go in to the hospital to do a non-stress test and an ultrasound to check my fluids on 2/14 since I was over 1 week past my due date. They found that my fluid levels were at zero (that's pretty bad), so they said it would be best if we stayed to be induced because of the risks associated with not having fluids. This means that the baby isn't able to move around as easily without that fluidity and support, and she also needs the amniotic fluid for nurturing. The midwife on call from the group I was going to for pre-natal care was Lauren, and I hadn't yet met her during my visits, but I liked her right away. She was young and very relatable, and Gabe and I both felt she was giving good information and advice. After she explained everything about low fluids and what the induction would be like, we agreed to go ahead. Although it was not part of our plan to have pitocin or any other medication, we also didn't plan on having no fluids, so we made what we thought was the best decision. Interestingly, my bag (of the bag of waters) was still in tact, so they said that likely meant that my placenta was using up the fluids because of its age - it was considered an old placenta because I was past my due date.
Lauren swept my membranes one more time (I had it done twice over the previous couple weeks) to see if we could do one last thing to try to get my labor started without medication - and trust me when I say she gave it her all. We proceeded to go to our labor and delivery room around noon, and closer to around 2pm my contractions actually did start on their own! Gabe and I got pretty excited and thought we may actually have the birth we planned for. So we held off on the pitocin to see how I would progress. Because I didn't have fluids, Lauren wanted me on the continuous fetal monitoring (which is strapped to the Mom's belly and doesn't stay on very well when moving) because she said sometimes babies don't do all that well through labor without fluids, and she didn't feel comfortable taking the chance using intermittent monitoring (which is when they check the baby's heart rate every once in a while with an hand held doppler). So I was able to move around in the early stages, which was one of the most important things to me. Gabe and I had over 30 hours of Bradley Method childbirth preparation, and read several books, and this was the thing I was looking forward to most about labor (yes, I was actually looking forward to it). But soon after my contractions started and I started moving around , the baby's heart rate decelerated for a few minutes (which was very scary to us because it went from about 140 to 50), so they had me lay down after that. She was probably pressing on the cord somehow or moved so that the cord was in a compressed position (cord prolapse), so they had me change positions until the heart rate went back up. Lauren talked to us after that and said that sometimes happens, and they want to give us the best chance to follow through with our plan as possible, but if it kept happening and they weren't able to help it by position changes, etc., then she may recommend a c-section. To prevent that, she wanted to do an amnio infusion, which was basically like replacing the fluids (artificially) that should have been there with my bag of waters since they were gone to help give baby more of a cushion. So we did that and she also wanted to use an internal fetal monitor to better gauge the baby's heart rate (which was not our first choice because they have to attach it to the baby's head, but we were okay with it after the heart rate decelerated.
Lauren swept my membranes one more time (I had it done twice over the previous couple weeks) to see if we could do one last thing to try to get my labor started without medication - and trust me when I say she gave it her all. We proceeded to go to our labor and delivery room around noon, and closer to around 2pm my contractions actually did start on their own! Gabe and I got pretty excited and thought we may actually have the birth we planned for. So we held off on the pitocin to see how I would progress. Because I didn't have fluids, Lauren wanted me on the continuous fetal monitoring (which is strapped to the Mom's belly and doesn't stay on very well when moving) because she said sometimes babies don't do all that well through labor without fluids, and she didn't feel comfortable taking the chance using intermittent monitoring (which is when they check the baby's heart rate every once in a while with an hand held doppler). So I was able to move around in the early stages, which was one of the most important things to me. Gabe and I had over 30 hours of Bradley Method childbirth preparation, and read several books, and this was the thing I was looking forward to most about labor (yes, I was actually looking forward to it). But soon after my contractions started and I started moving around , the baby's heart rate decelerated for a few minutes (which was very scary to us because it went from about 140 to 50), so they had me lay down after that. She was probably pressing on the cord somehow or moved so that the cord was in a compressed position (cord prolapse), so they had me change positions until the heart rate went back up. Lauren talked to us after that and said that sometimes happens, and they want to give us the best chance to follow through with our plan as possible, but if it kept happening and they weren't able to help it by position changes, etc., then she may recommend a c-section. To prevent that, she wanted to do an amnio infusion, which was basically like replacing the fluids (artificially) that should have been there with my bag of waters since they were gone to help give baby more of a cushion. So we did that and she also wanted to use an internal fetal monitor to better gauge the baby's heart rate (which was not our first choice because they have to attach it to the baby's head, but we were okay with it after the heart rate decelerated.
So my contractions continued to intensify for several hours until midnight, but I wasn't making much progress in terms of dilation (I think I started at about a 3, which she kind of stretched me to). I was trying my best to use the techniques we learned in class and to relax and breath through the contractions. Gabe and our Doula, Hallie, were supporting me through each one. I squeezed the heck out of Gabe's hand, and Hallie was rubbing my feet and talking me through them. However, after intensifying for 10 hours. I felt like they couldn't possibly get much worse and I really thought that I had progressed quite a bit and maybe was even ready to push (funny now to think I was so naive). But when Lauren checked me close to midnight, I was only at 5, and she said she felt in order to progress to the kinds of contractions that would help my labor progress, I'd either have to find a way to relax my body more, or to intensify the contractions more. I already felt like I couldn't handle much more pain, if any, but I wanted to try my best to follow through with our plan. So she suggested sort of a hands and knees position leaning against the top of the bed, and I tried that, and the contractions did feel more intense quickly. I felt like I really couldn't handle the intensity though, and after going through a few of them in that position, and noticing that I was not relaxing at all (in fact, I was gripping and shaking the bed with great ferocity!), I decided I wanted an epidural. I felt like I was only making things worse, and knowing how much longer I might have, I just felt like that was the best option for me. Gabe and Hallie had encouraged me throughout the whole time up until this point, and Gabe wasn't sure how serious I was (because I think I said "I can't do this anymore" about 20 times!), but our doula knew I meant it this time and helped me ask for the epidural.
Once I got the epidural shortly after midnight, I just focused on relaxing and trying to envision what the baby was supposed to be doing. My contractions weren't regular enough to progress much, so they suggested pitocin at around 2am. We were okay with that at this point. By 6am, Lauren checked me, and I had only progressed to 6 cm, but she said as long as she's seeing some progress, then she's okay letting me labor as long as I could. Her shift was over shortly after that, so the new nurses and midwife (Beth) came in. The baby's heart rate decelerated again, so they did another amnio infusion and had me change positions again (mostly just from one side to the other). When Beth checked me at around 7:30am, I was somehow at 9 1/2 cm, so things looked pretty good. Then the baby's heart rate decelerated again (4th time), and they brought the OB to meet me and talk about the very near possibility of a c-section. When Beth checked me again though, I was at 10, and she said she wanted to have me push to see if I could do this naturally without a c-section. Because I couldn't really feel the contractions much, she told me when to push and for how long, and when to slow down or just do mini-pushes. Apparently I did really well at this part, because I got the baby out in 4 pushes in 15 minutes. I think I was so scared that the baby wasn't going to make it or that I'd have to have a c-section that I did everything I could to get her out. That part made up for everything else! I felt her fuzzy head after the 2nd or 3rd push, and once her shoulders were out, they asked it I wanted to take her, and so I pulled her out of me and put her on my chest. It was the best moment ever. Gabe and I both started crying, and couldn't believe we were seeing her for the first time and that she was really real. The midwife and all the nurses and everyone there (there were several people because of the decel and chance we might need a c-section) were really happy for us, and helped us do the things we had on our birth plan for the baby. A couple nurses thanked us for allowing them to be part of our experience.
Evelyn had terminal meconium (pooped on the way out, but not before), but there didn't seem to be any side effects from that. She was perfect, and we got to just hold her for at least an hour before we moved to the post-partum room. They did some of the tests while she was on my chest.
Some things we were really impressed by were that all shifts of nurses and midwives (and even the pediatrician) took our birth plan seriously, and made copies for us and uploaded it into their system. They made sure we understood what interventions they were suggesting, and when possible, gave us the option of trying different things (the internal monitoring wasn't an option, though). We felt that with our situation, many OBs would have taken me straight to a c-section early on, so we kind of felt like they saved us from that. We felt that they were open and honest with us, and in most cases we knew the risks and benefits of the interventions, and for the ones we didn't, we felt able to make good decisions for us. Everyone was friendly and encouraging, and we were just really happy with our experience there.
I still don't know what I would do differently for a 2nd birth - I'd probably stick with the same group and hospital, but I'd have to find better ways of coping with the pain and relaxing (I wouldn't want to get an epidural again, even though it was really helpful this time). Of course, we weren't set up for the best success from the beginning with the zero fluids and restrictive monitoring, so perhaps more movement or position changes and having more fluid would have helped the labor progress faster. I knew going into this that I was going to be open about the possibility of medications if circumstances called for that, so my mindset alone may have allowed me to feel more comfortable with those things.
Every once in a while I feel a tinge of regret or slight failure that I didn't have my natural birth. I think that when it all comes down to it, the main reason is that I couldn't cope with the pain. That's really hard for me to admit, because it was the last thing I thought would happen. I thought I'd be nervous about certain interventions, or how I was being treated, or how hard they would make it for us to have a natural birth, but I thought that as long as I was prepared, I'd be able to handle the pain. Granted, I couldn't do a lot of things I wanted to (like labor from home first, go into labor naturally from the beginning, move around in different positions, use water to help with pain management, etc.).
I also can't help but think of what would have happened if I went with the birth center, like we almost did. I think that if we did that, they wouldn't have been able to deliver us there because we'd be considered high risk because of the lack of fluids. In that case, we would have had to go to the hospital and be seen by an OB we would have never met, and if they were not as supportive of our wishes for a natural birth, we likely would have ended up with a c-section. Also, if we stayed with our original group of OBs, I think it's highly unlikely that they would have allowed us 4 opportunities for her heart rate to decel before doing a c-section.
So I am ultimately so grateful to have been able to have her vaginally, as it was one of the most amazing experiences I've ever had, even if I didn't feel every little thing.
Maybe we did make the best choice in the end.
Every once in a while I feel a tinge of regret or slight failure that I didn't have my natural birth. I think that when it all comes down to it, the main reason is that I couldn't cope with the pain. That's really hard for me to admit, because it was the last thing I thought would happen. I thought I'd be nervous about certain interventions, or how I was being treated, or how hard they would make it for us to have a natural birth, but I thought that as long as I was prepared, I'd be able to handle the pain. Granted, I couldn't do a lot of things I wanted to (like labor from home first, go into labor naturally from the beginning, move around in different positions, use water to help with pain management, etc.).
I also can't help but think of what would have happened if I went with the birth center, like we almost did. I think that if we did that, they wouldn't have been able to deliver us there because we'd be considered high risk because of the lack of fluids. In that case, we would have had to go to the hospital and be seen by an OB we would have never met, and if they were not as supportive of our wishes for a natural birth, we likely would have ended up with a c-section. Also, if we stayed with our original group of OBs, I think it's highly unlikely that they would have allowed us 4 opportunities for her heart rate to decel before doing a c-section.
So I am ultimately so grateful to have been able to have her vaginally, as it was one of the most amazing experiences I've ever had, even if I didn't feel every little thing.
Maybe we did make the best choice in the end.
1 comment:
Amazing Anna, really. Your "birth story" simply proves how brave you and Gabe were; not to mention determined. I am completely happy for you both.
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