Wednesday, June 20, 2012

A Birth Story

As I work my way toward month four of my second pregnancy (yep!), this is the story of my daughter's birth.

On March 30, 2011, at 9:57pm, I gave birth to a beautiful and healthy girl. The short version is that I labored for 44 hours ('active' labor for 22 hours) and pushed for 3.5 hours. My daughter was in what is called occiput posterior fetal position, or OP, or 'sunny-side up'. The OP position is when the back of baby's head is against the mother's back. This can cause painful "back labor," which I didn't have, but basically means the baby's head doesn't "head" into the birth canal in the most efficient way, meaning a longer labor and a higher chance of intervention. I learned that a 'successful' birth does not necessarily equate to an 'easy' birth. Although it was difficult and I STILL remember how it felt and how tired I was, it was an amazing experience I won't soon forget!

Birthing, and talking about birthing, can be a tricky thing. If you've ever been pregnant you know that everyone has an opinion (or a story) and wants to share it. Some people have very strong opinions on the topic. The opinions expressed are my own and I don't judge others for theirs. If you've never been through it, are pregnant or are considering getting pregnant, I would just like to say: It can seem really scary. It doesn't have to be!

Some friends had taken Bradley classes and spoke very highly of the experience. Early on in my pregnancy, I looked up and exchanged emails and phone calls with the three instructors in our area (I think there is now a fourth). Different friends had taken classes by two of these women, and they were all helpful and thoughtful in their communications with me. We actually settled on the third instructor, Susan; I just got a good vibe from her. We started her 12-week course in the Bradley Method in about my 12th or 13th week, much earlier than most but we were glad for the 'extra' time to learn. Her class was small, just three or four couples at a time, and I'd recommend it (the Bradley Method or Susan's class) to anyone.

The more I learned from class and from reading other books, the more I understood that birth is not something we can control. As the birth process became less of a mystery I also became less worried. I realized that there were two things that would go a long way toward giving me the birth experience I wanted: knowing my options and having a birth team on board with my plan. Having a supportive team of midwives and nurses, Susan as our doula and DH at my side, I could decide what was best for myself and my baby. When the big day arrived, I never felt afraid and DH never panicked because we knew the kinds of things to expect and how to face them head on.

I worked hard to stay fit during my pregnancy; walking our dogs (a lot!), practicing squatting, and trying to keep my body in alignment, all to prevent discomfort in my muscles & joints and encouraging good positioning for the baby. I ate healthy and, although I never had much nausea, stuck to higher protein and "whole" foods and lots of water! I continued to work full-time up until I went into labor but I didn't push myself unnecessarily and took naps when I needed them!

Later on in my pregnancy, I remember worrying about a long labor, that my endurance would run out and I'd wish for 'help' of some sort. I had heard stories of healthy, active women exceeding their endurance and experiencing problems due to sheer exhaustion. Our midwifery practice was the Women's Birth and Wellness Center, in Chapel Hill, NC, so medication was not really an option.

I woke with my first contraction at 2:30 am on March 29 (Day 1) and was able to sleep through most of the night, waking when the alarm went off and answering DH's question of, "how long has that been going on?" I had my 40-week checkup scheduled for that morning but spoke on the phone with the midwife on call, Leigh Ann, and postponed the appointment to see how I progressed at home. DH didn't want me to have to drive to his office (half way between home and the Birth Center) by myself, so he stayed with me and we ended up spending the day relaxing and breathing through steady but not truly 'hard' contractions. We walked our dogs (miles and miles!), I took a bath and a nap and we stayed in contact with Leigh Ann and our doula, Susan.

At 10 pm on Day 1, we drove to the Birth Center to have Leigh Ann check my progress, knowing full well that we'd probably be going back home for the night. The Birth Center won't admit a patient until she is 4cm dilated. Leigh Ann confirmed that I was 2-3cm dilated and recommended that we go home and that I try to relax and get some sleep. At about 12:30 am on Day 2, I had the first of what I then understood to be "hard" contractions. My body had been working for about 20 hours to build up to active labor!

I didn't sleep very well that night, waking for probably every third contraction and mostly waiting until morning to wake DH and start timing contractions again. We woke up on the morning of March 30 (Day 2), took showers and DH timed my contractions while I sat on my knees, facing the back of our couch to lean on it for support. We also spent a lot of time doing what is called the 'labor dance,' DH and I standing facing each other, my arms draped around his shoulders so he could support my weight as I relaxed with each contraction. We wanted to wait until the contractions were between 4 and 5 minutes apart, for at least an hour, before we went to the Birth Center. We waited until the contractions were consistently 5 minutes apart, and growing closer, then left for the Birth Center. It was raining and I felt every bump in the road but managed to doze for most of the 45-minute drive. I only wish I had thought to tell DH to stop and get himself some lunch. I had packed lots of snacks for labor but nothing really substantial for him!

We arrived at the Birth Center and were shown into one of four labor rooms they have equipped with a queen bed, a water closet and a large tub. Tamara, a midwifery intern, checked my progress and found that I was now 7cm dilated. We were excited and relieved at our progress! We unpacked some of our things, between contractions, and Susan arrived shortly after. We pointed out the things we might need from our bags and cooler and DH went over our camera's settings so Susan could help with the photos, as well.

I spent more time "labor dancing" with DH and leaning on a birth ball on the bed. We wanted to try to birth in the tub so Tamara filled it for us and I changed clothes. I'm a modest person, something that didn't really change even as labor progressed, so I had brought plenty of clothing changes so I'd be comfortable. I wore a tank top and skirt in the tub! I spent about 45 minutes in the tub, lying mostly on my side while DH and Susan took turns pouring water over my shoulders. Sarah, another midwife, came in to check on me and found that I was a "stretchy 9cm." She asked if I felt pressure "down low" and, if so, to try pushing. I realized, after the fact, that it was not the true "bearing down" sensation of the second stage of labor. I don't know that it would have saved me any time, pushing, but I definitely feel like I started pushing a little too soon. I've heard, since, that it is not uncommon... and frequently leads to long pushing stages or even interventions. We decided to get out of the tub to let gravity help move things along and never actually made it back to the water! Now that I have a better idea of what everything feels like, I hope to get another opportunity to try water birthing!

I had no sense of time while I labored. I had left any tracking or checking to DH and Susan so I could concentrate on breathing and doing what my body needed. I knew things were moving along, because I would occasionally think I needed to vomit. I had read that the body will sometimes eliminate anything extraneous, in preparation for birth. Fortunately I never actually got sick but the urge came and went up until I was very close to delivery. I think, after I exited the tub, I walked and labored for another 60-90 minutes before I actually felt the urge to bear down and begin the second stage. As I mentioned before, that process took about 3.5 hours. I tried leaning on the birth ball, sitting on a birthing stool, sitting on the toilet and lying on my side. Sitting was very uncomfortable, both because of the pressure "down low" and also because my baby was pushing back with her legs and it made my abdomen very sore and tender. Leaning over the ball was better, but what turned out to work best for me was to lie on my side with my knees to my ears! I leaned back against DH and he talked to me, telling me what a great job I was doing. He later confessed that he was mostly at a loss for what to say, so would repeat what the midwives and Susan said. His voice was often the clearest, calm and warm, against my ear. When a contraction started I would pull my knees back and groan loudly as I pushed through it, then relax and breathe as it subsided. Shifts had changed somewhere along the way so, although Tamara was still with me, Allison was now the midwife on call and Nicole was our nurse.

At some point, they discussed breaking the amniotic sac ("bag of waters") to try to make my contractions and pushes more productive. We knew I'd been leaking water, so it was only the sac itself that might have been between my baby's head and my cervix. I told them I wanted to wait a few more contractions and they were fine with that. Throughout my labor, they had checked my temperature, my blood pressure and my baby's heartbeat to make sure we were both doing okay. At no point were we ever in distress, so although they made suggestions to move things along, they honored my decisions. When I told Tamara and Allison that I was ok with them trying to break the bag, Tamara checked and said that it was actually already broken, she felt the baby's hair!

My birth preferences had very specifically stated that I wanted to avoid an episiotomy, so Allison, Tamara and Nicole worked diligently with oil and hot compresses to massage and allow my perineum to stretch in preparation for crowning. I was still, at this point, turning back and forth from one side to the other and also up on my knees, trying to get my baby's head to emerge. With each contraction she would move a little further down but when the contraction subsided her head would ease back upward a little! This was something we'd learned about in our Bradley class, that it is just part of how the muscles work and also allows the mother's body to accommodate the baby's head without tearing. Those last several contractions, Allison suggested I try to not vocalize but to put all that energy into the pushes. This was both hard to do but very satisfying to me, maybe just in the idea that I was finding new strength! Before her head fully emerged, the contractions were some of the hardest I'd felt, just knowing my baby was SO close. Having everyone cheering me on, telling me what a great job I was doing, helped me power through! Once the head was out, the midwives cheered me on even harder as they cleared her nose and mouth and unwound the umbilical cord, which was wrapped twice around her neck. It was wrapped around twice, something we'd also learned was fairly common and not always a sign of a problem.

They laid her on my belly and wiped and warmed her with towels. She smiled and gave a faint little laugh, and then someone asked if it was a boy or girl. We didn't know her gender until she arrived, so Shawn leaned over me to look and then announced, "It's a girl!" Allison offered Shawn the scissors so he could cut the umbilical cord after it had stopped pulsing (I'm not sure anyone was watching it, we were all distracted by the baby).

The midwives asked if they could give me a shot of pitocin, as a form of "active management" of the third stage of labor. They were concerned, after 3.5 hours of pushing, that my uterus would have trouble pushing out the placenta. I was ok with that, since the baby would not be affected in any way, and so agreed to the shot. They then asked if they could weigh her and clean her up a bit. They also wanted to make sure she would cry, to make sure her lungs were clear. My precious girl weighed 8lbs, 2oz and was 21" long.

They put a diaper and knit cap on her, swaddled her in blankets and gave her back to me to nurse and admire. When it was over and I could hold my daughter in my arms, with DH's arms around us both, I was so grateful for the whole experience.

1 comment:

  1. Hi Cyd! It was so nice to get your email today!! Reading your birth story brought "tears" to my eyes...tears of joy and excitement reading each line! Congrats on your current pregnancy!


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