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03 January 2012 @ 12:33 pm
I had a baby.  
Yes I did. I still have him. He's right here. For real.
Here is the thing I wrote about how the birth went to send to our Bradley Method instructor, not comfortable putting it on Facebook yet, don't know where else to put it.


Our Birth Story


Our birth story begins with a GBS+ culture at week 36. I had been following an herbal and probiotic protocol recommended by our midwife to clear the colonization in time for the birth. We were scheduled for a repeat culture in week 38 during our midwife and her assistants’ home visit on Dec13.

My water broke at 11:27pm on Dec 12, with my first real contraction. We texted our midwife to let her know what was going on, and agreed to keep the home visit appointment for the next morning at 9:30am since nothing else was really happening yet. 9:30 and our home visit came and went without much action on the labor front. Our midwife recommended going about my day as usual and having a lunch of spicy food to get things moving. I went to the post office and bank, and we went out for lunch, and all day contractions remained around 3 to 4 an hour. We didn’t do any physical exams since the membranes had already ruptured.

Later that night things picked up. Sometime between 9 and 11pm contractions started coming much harder and faster. I waited as long as I could before waking M. up – around 3 ½ hours – because I knew this might take a long time and wanted us both to be as well rested for the serious phases of labor as possible. He woke up to me toning and called the midwife around 3:30am to come over as contractions were 5-7 minutes apart and seemed to be coming faster.

After this point, time was moving very differently for me and things are not so clear. I know that I transitioned at some point before or around noon because I remember throwing up and getting the shakes and everyone was sure the baby would be here by 2pm. Contractions had become continuous and very powerful, and I ended up on the bed in a birthing position and our midwife and her assistants were ready to catch the baby and provide any necessary support.

Around 2:30 I remember kind of waking up from being passed out. Contractions were back to 10 minutes apart, so our midwife asked me to try the next five back on the toilet. I remember a lot of powerful contractions, bracing myself and toning, M. guiding me to relax, midwife and her assistants coming in and out, and occasionally becoming aware of how much time was passing. I was having back labor most of the time and needed M. pushing on my lower back, and later when even that became too much, just putting his hands over my sacrum to make the contractions more bearable. I know I was in and out of the shower a few times, and remember that we did a lot of slow dancing around the room in between contractions, and then the baby’s head would hit my cervix, I’d pee on the floor, and I’d brace myself in the doorway for a contraction. I transitioned once more on the toilet, and then after continuous contractions and everyone being ready to catch the baby, again woke up to contractions that had backed off to 9 – 15 minutes apart. At this point it had been around 36 hours since my water had broken. We had already been doing IV antibiotics to control any GBS infection (I think we ended up doing 4 doses through an IV pump) but we were becoming very aware that we were on a timer for how long we could let this labor continue without progressing. At this point, since we felt time was getting tight and it seemed very strange that I was repeatedly so close to giving birth only to have it not materialize, we decided on a vaginal exam to check my dilation.

During the vaginal exam we discovered that, though the entire interior of my cervix was dilated to 10 cm, there was a ring of scar tissue around the outside that was only dilated to 6, which was holding our baby’s head in like a rubber band. Now my water had been broken for an extended period and we were somewhat compromised by an exam, but we had discovered the problem. At this point our midwife suggested herbally augmenting the contractions, and manual massage of the cervical rim to try to break up the scar tissue. We augmented with a homeopathic blue cohosh preparation and went through two episodes of massaging the cervical scar tissue during a contraction, one with arnica, and one with evening primrose oil. Again contractions moved up to every three minutes, and the scar tissue dilated to 8 cm. Then the contractions became continuous once again, and everyone prepared themselves to catch the baby within the hour.

And the next thing I knew, my contractions were back to 9 minutes apart and, after 2 more hours of augmented labor, the cervical scar was still only dilated to 8 cm. The baby’s heart tones were monitored throughout, as was my condition, and we were both still doing well, but after a third transition with no birth everyone was getting very concerned. At exactly 48 hours since commencement of labor, M. pointed out that I and the baby were still strong and healthy, but things were obviously not progressing, and that we should consider transporting to a hospital now, before either of us were in distress. So we did the one thing I was sure would never happen during our otherwise carefully planned and joyfully anticipated home birth, and packed our bags and went to the emergency room at a local hospital.

Up until the point where we left the house the labor was challenging but I could handle it, knowing that it was bringing my baby. Once we got in the car, the sensation changed to unproductive pain, and I was having a very difficult time coping. At the hospital, we – especially our midwife – were met with a great deal of hostility for attempting a home birth. Several individuals assumed that I had had no prenatal care whatsoever, and did not accept that a licensed midwife counted as a valid care provider. Wisely, she had all of my medical records with her, and could prove that I had been receiving antibiotic treatment for the GBS, which later saved my baby from being placed on a spinal tap in an isolette in the NICU for suspected sepsis.

But back to the present point in our story. Upon admittance I was required to lie flat on my back with an electronic external fetal monitor, which made the continuing contractions extremely painful and much more difficult to cope with. I was still toning and breathing through them, which apparently made at least one person believe I was on illicit drugs. From all we can tell, that person most likely had never seen a woman in advanced, unmedicated labor, despite working in a labor and delivery ward. The doctor ordered a drug test (later, everyone became much nicer to us when the results came back clean).
The last hour and a half of my labor is a whirlwind of an elaborate hospital song and dance routine. Several people – four or five – came in to point out fetal heart rate decelerations (though none were outside of the normal range on the monitor, and they only began when I was required to like flat on my back, and not allowed to stand back up). Two different people, one nurse and the OB, performed vaginal exams without first either asking or informing me of what they were about to do. According to the L&D nurse, I was now 4 centimeters dilated with an extremely swollen cervix, and the baby was at 0 station (he was at +2 before we left the house; later the OB performed an extremely perfunctory exam where I did not feel him actually check my cervix at all, and insisted the dilation was down to 3 cm). After the nurse’s exam, we were told that the on call OB was “on the phone right now and recommending an emergency C-section,” and that we had about 2 minutes to decide if we would consent.

Part of the reason I had chosen a home birth was that I had a strong feeling that once I entered a hospital, I would be railroaded into a cesarean. After more than 48 hours of labor, here I was, in the situation I had been trying to avoid, with every message sounding like I had to make a decision fast. I couldn’t imagine trying to go through another 10 or so hours of Pitocin-augmented labor in a hostile environment, probably with an epidural, too. The most important thing to me at this point was to finally get my baby out.

So we agreed to the emergency c-section. Transport was the first point in my very long labor that I felt in distress, and when they separated me from Mike to do the spinal block anesthesia, I felt my body starting to shut down. The process went shockingly fast from here. They let M. back in and literally about 5 minutes from the time they injected me I could hear my baby crying. He was born 50 hours and 23 minutes after onset of labor. I couldn’t see him around the screen. By the time I saw him he was already swaddled and wearing a little hat. The L&D nurse held him against my chest for about 2 seconds, ordered M. to take a picture, and they whisked him away, and sent me to Recovery. This was another one of my greatest fears – being separated from my baby, but I knew everything would be okay because M. stayed with him the whole time. I was in Recovery for 2 ½ hours with uncontrollable shaking before they decided I was recovered enough to go to a private room with M. and our baby.

There are several things I am grateful for that I think made my recovery much smoother than it would otherwise have been. The one at the top of the list is that I’m allergic to opiates. This made for some humorous moments, like hearing the anesthesiologist say, “I didn’t put any narcotics in this at all, so I don’t know how it’s going to work,” right before they started cutting me. It turns out you can ask, “What do you mean, you don’t know how it’s going to work?” all you want, they will all still ignore you. But this meant that I did not suffer any of the mental or physical effects of morphine or related drugs, and neither did my baby. He was out literally within minutes of the local anesthesia being administered, and he was alert and breathed on his own right away despite the fact that they clamped and cut his cord faster than M. could protest. Another thing I am grateful for is every one of those 50 hours preparing him for life, and getting him ready to breathe on his own. After the fact, everyone was talking about how healthy he was, and how strong his heart tones were.

Our stay in the hospital was quite the adventure. It is definitely not a good place to get any rest, with nurses and CNAs coming in every hour on the hour, especially since everyone had heard about the crazy hippies who tried to have their baby at home. A couple of people were compassionate and understanding, but most thought we were completely insane – even though everyone was also talking about how great we were doing, and how healthy the baby and I were.

One of the things that helped me most throughout was a commitment to not complain. It helped me keep my focus and cope during labor, but it helped me even more in the hospital because we were determined to be released and get back home as soon as possible. Every time anyone came in the room I was polite and cheerful, we were compliant, and it was as clear as possible that I was very strong and healthy and that the baby was doing great. We ended up getting released in 2 ½ days even though the OB who did the surgery has a reputation for never letting anyone out early, and hospital policy is to keep c-section patients for 5 days. Again, I believe not receiving opiates truly helped. Oddly enough, the OB did prescribe two opiates during my stay even though he knew I am allergic, but the nurses said they did not feel comfortable administering them, and I agreed that I did not wish to have them. I am recovering from the c-section on nothing stronger than Tylenol and Motrin. I also avoided pitfalls I was warned about from the c-section, particularly that I would have trouble breastfeeding. In actual fact, my full milk came in on day 2 of our baby's life, and I have been able to exclusively breastfeed since his birth.

The thing I am most grateful for, though, besides having a healthy, live, perfect baby, is M. I knew throughout the pregnancy that I’d be okay no matter how labor went as long as he was with me, and he was absolutely perfect. Having my partner go through the labor for our son with me was the most profound experience of my life, and even though it did not end in quite the way we had planned, and we ended up making some choices that we had worked very hard to avoid, it was perfect because we put everything into doing it together and bringing our son into the world in the best possible way regardless of the circumstances in which we found ourselves.

I am also extremely thankful for everything we did – the prenatal yoga, midwifery care, high protein diet, supplements, exercises, and the Bradley classes, and finally, agreeing to reasonable interventions such as the antibiotic treatment for GBS – to stay strong and healthy in preparation for this birth because being strong and healthy is was got us through an extended labor and allowed me to labor at home for two days, got me safely through major, unplanned abdominal surgery, allowed my baby to be healthy and alert afterwards, and allowed me to recover quickly and get my family back home. The final part of the birth was somewhat traumatic, and there are issues to deal with for future pregnancies but our baby is beautiful and healthy and perfect and that is ultimately exactly what we wanted from this birth.
 
 
 
Movie Geek: james garnermarc_e_heuck on January 9th, 2012 11:58 am (UTC)
Thank you for telling this story in your honest and open manner. This has taught me a lot that I can carry with me.

I have visions of what your new family will look like, and it makes me very excited. Bless you all.
Alouiciousalouicious on January 11th, 2012 09:03 pm (UTC)
Thank you, Marc.