Friday, February 22, 2013

Birth Story: The Best Laid Plans

Four days from my due date, I was feeling great about pregnancy - as noted here - and fully prepared for our baby to take her sweet time, since we'd learned in our antenatal classes that first babies are often late. So, I was completely surprised when I woke from sleep at 3:30am to what was unmistakably my water breaking. I mentally scanned myself and felt fine otherwise. No contractions, no signs of labor. Just water, water everywhere. Poor Partner-in-Crime was heading to bed when I intercepted him and told him to call our midwife. She instructed us to meet her at the birth center right away.

I felt a little rattled, as this did not fit any script I'd read or heard about. In fact, I'd laughed at P-i-C when he had at one point suggested that we would know to go to the hospital when my water broke. "That's only in the movies," I'd told him. When we got to the birth center, my amazing midwife was calm, but I could tell that this was a bit of an outlier event (I learned later, it's called Premature Rupture of Membranes and is relatively unusual). After checking me over, she told me the news I was dreading. "We're going to the hospital." By protocol, I had to be transferred by ambulance, even though I felt fine. While we waited for the ambulance, she let me know what I might expect at the hospital and what my rights were in this case. She told me that they would want to induce my labor, but knowing that wasn't at all what I wanted, she carefully outlined what the hospital's policy actually was. I could wait up to 96 hours for induction and that if the baby's head were to engage in my pelvis, I could be released from the hospital, wait for labor to start naturally at home, and be back in the care of the birth center midwives. In most cases where the water breaks early, women go into labor within 24 hours and over 90% within 96 hours. I very much wanted to go into labor naturally in the comfort of my home and to avoid the medicalized delivery I'd tried so hard to not have. "You'll have to be strong," she told me, to fend off pressure from the doctors to go the induction/stay in the hospital route.

My midwife rode in the ambulance with me, while P-i-C followed in the car. It took an hour or so for a doctor to see me and, as anticipated, he suggested induction. I told him that I wanted to wait at least 24 hours and then reassess. So, they admitted me to the maternity ward where we'd wait and see. My midwife told me later that he'd put me on the schedule for induction in the morning.

I sent P-i-C home to finally get some sleep and pondered my predicament from the maternity ward. I tried to sleep, but was too restless. I became determined to be released and let the baby come in its own time, so I got out of bed and power walked the hospital grounds for two hours. Then I came back to my room and did every hip opening stretch I could think of over and over. My bed was right in front of the nurse's station, and they must have thought I was insane, as I was just lunging and squatting away all afternoon. I refused to get back into the bed. When a midwife came to check on me, I asked her if someone could examine me to see if the head had descended. I think she felt I was thinking wishfully, but she humored me and then was very surprised when she found that, indeed, baby had engaged. It took three hours for the doctor to come back to confirm (more stretches and lunges for me, just to be sure!). First, he strongly urged me to go on an antibiotic drip, which would have kept me in the hospital overnight. I declined and he replied with just a hint of snark that this "wasn't a prison," that he couldn't hold me against my will (i.e. -  despite my poor decision making skills). Then, he examined me, confirmed the midwife's findings, and sent me on my merry way, back into the care of my midwife from the birth center. We phoned her on the way home and she was really surprised and pleased that I'd been released. We scheduled an appointment for the next afternoon, though she said I'd probably be in labor sooner.

P-i-C and I ordered some pizza and I went to bed at 8pm, knowing that I'd better catch all the sleep I could.

By 12:30a.m., I woke up to what were clearly contractions. I tried to go back to sleep, knowing that I'd hardly slept at all since two days ago, but I was in just enough discomfort that it was a futile attempt. I got up, told P-i-C and started wandering around the house, as I knew it would be some time before we needed to wake the midwife (someone involved in my labor should be well rested!) and go to the birth center. I urged P-i-C to get some sleep, too. I tried to take it easy, so as not to expend too much energy, but sitting was uncomfortable, so I found myself in a middle of the night cleaning frenzy, prepping the apartment to be exactly as I would want it when we came home with a baby. I was beyond relieved to be having this experience in my own home, and not at the hospital.

Around 4a.m., I felt I'd reached the point where I should call our midwife. She joked that I was getting into the habit of calling her at that hour, and told us to meet her at 5. When we left the house, I fully expected that we'd be back later that day with our baby, as there is no overnight hospital stay for deliveries at the birth center.

Aside from making P-i-C pull over the car mid-ride so that I could throw up (sorry people whose yard I did that to ...), the next few hours went pretty smoothly. Some of the other midwives who were on duty knew that I'd "escaped" the hospital and told me how happy they were for me that I was there. I was, as well, and feeling very empowered and in the right frame of mind. The birthing room was so calm and serene - dim lights, my yoga music and just me, doing my thing, supported by P-i-C and our midwife with very minimal intervention. Though I was in pain, I felt so strong and in control for the next few hours.

I was in the birthing suite for 14 hours, and I remember it as a combination of intensity as the pain got worse and more frequent, calmness as I spent hours in the birthing pool doing my hypnobirth breathing and taking micro naps between contractions, and sort of boring as the monotony of the hours ticked by. I do remember telling P-i-C a couple of times late in the day that I "didn't think I could do this," though how I planned to get out of it, I'm not exactly sure. The worst pain actually came when an IV had to be inserted into my hand for the antibiotic drip I finally said yes to. Apparently, I have minuscule veins, and it took attempts by two midwives and eventually a doctor was called over to insert it. One failed attempt after another - it was excruciating.

I didn't know it at the time, but by about hour 12, there started to be some concern about the position of the baby's head. While I was on my way to being fully dilated, she wasn't in the best position. Often babies adjust themselves, though, so my midwife told me she wanted me to go for another hour with the contractions. The thought of another hour before I even got to the pushing stage completely overwhelmed me. I know I could have gone on if I'd felt we were moving to the next phase, but this seemed sort of hopeless to me. So, I opted at that point to use the gas for pain relief. I hated saying yes, but I'd reached the point where I felt it was necessary for me to carry on.

Because my midwife had been on duty for so long by then, and there was clearly so much more to go, she gave me the sad news that she had to end her shift and turn me over to another midwife. I'd overheard her telling P-i-C this in the hall, so I knew it was coming and I gave her a resigned look, which I think she took to mean that I felt she was giving up on me. What I really meant was that I understood, as she'd put in so many hours with us over the last two days and I was just sad that she wouldn't be there to greet our baby with us after so much care and work on her part. I saw her wipe away a tear as she left, which seemed pretty uncharacteristic of this very strong woman, and I still get a little choked up thinking about it.

I was turned over to the new midwife, who was also caring and professional, but by then everything aside from contractions and my precious gas mask were peripheral. After a little while, she examined me and then had to break the news. We were going back to the hospital. I must be the only woman in history of the birth center to be transferred to the hospital twice. Apparently, I was really a special case. I felt pretty devastated as she talked to me about impending induction, epidural - everything I'd tried to avoid. I also knew that the ambulance ride was not going to be nearly as pleasant as my first one in my current condition.

It took the ambulance about 30 minutes to arrive, and it was maybe another 20 minutes to the hospital, though it may have been shorter, as they went lights and sirens blaring this time. Once in the hospital, the midwife was still trying to do things naturally, and she asked for a birth stool to be brought into the room and urged me to try pushing. The pushing attempts did nothing but make me feel worse, and soon an OB from the adjoining private hospital was on site taking charge. She examined me and let us know that the baby was posterior and deflex - meaning she was the wrong direction and with the whole front part of her head in the pelvis, rather than just the top of her head. Basically, one of the worst positions she could have been in. I was later told that in an era before surgery, this is the sort of situation that mothers and babies died from. And so it was that the OB said my most dreaded words ... C-section. This was my absolute worst case scenario, and one I never even gave any real consideration in all my preparation. But, a quick look around the room told me that it was inevitable. P-i-C was asking the OB to show him the baby on the ultrasound machine and he agreed. The midwife from the birth center was agreeing. I knew that these people, who were so supportive of my non-medical birth choices, would not let me go ahead if it were not the only option.

I was in the operating theatre in minutes and from there, the whole thing took maybe 15 minutes. I felt disembodied, as the contractions suddenly  ended with the anaesthesia and feeling people working on me, but no actual pain. P-i-C sat by me and talked to me through the procedure.

When the baby was presented, P-i-C declared it a boy. The anesthesiologist laughed and told him to look again. It was pretty funny, but also the strangest feeling because I was confused when he said boy. Though we hadn't learned the sex, we'd both felt certain it was a girl, though I'd tried to suppress my certainty, telling everyone that there was just no way to know. But, I guess I did know because when P-i-C said, "it's a girl," I thought, "yes, that's right." Somehow, we both had some sort of primal sense.

I do wish that I had prepared myself for the possibility of a C-section because I knew that there were things that I could ask for that would help mimic some of the post-birth immediate benefits for mother and baby that come with a normal birth, but I did not have my wits about me or the information in my head. So, rather than getting to hold my girl right away, my first glimpse of her was across the room as she was weighed and wiped down. I was so relieved to see P-i-C go right to her side and start singing to her the songs he'd sung her in the womb. I could see her quiet and look right at him. It was a beautiful second choice for her first moments of life and first meeting with her parents.

Finally, she was brought to me and laid on my chest. I stroked her tiny head and talked to her for awhile, and she just stared at me with her soulful, jeweltone blue eyes. She didn't make a sound or shift her gaze, just looked at me. I don't know if she recognized me as her mother, but it certainly felt that way in our first moments together.


On her way out, the OB told me that all had gone well, and she gave me a kiss on the cheek and said that she, too, had an emergency C-section with her son, so she knew what I was going through. It was a very kind gesture that I remain grateful for.

Having undergone surgery, I now obviously had to stay in the hospital. We were scrambling somewhat, as I had not packed a bag for an overnight, let alone multi-day stay, and we also realized that the one outfit we had for the baby was far too big for our tiny bundle. We had to buy her a going home outfit from the hospital gift shop. Because she was 5 grams under what is considered "normal" weight, we were once again a "special case," and hospital midwives attended to us every 3 hours to make sure that she was feeding and gaining weight. They were all lovely women, but between their constant presence and array of different suggestions, sharing a room with another new mother and baby, and all the other random doctors and staff who were constantly in and out of the room, the whole hospital experience completely stressed me out. I broke down by the third day, and P-i-C helped me fight to get released. Because of the baby's size, they wanted to keep us an extra two days, but I knew that we would flourish so much more in the privacy of our own home, attended by visits from my original midwife, who had been with me through my whole pregnancy. It was my first bit of mother's intuition, and I was right. Though life with our newborn has not been easy, all has gone well in our first days and weeks at home, and we have been supported by the baby whisperer midwives from the birth center.

I am still coming to terms with the loss of my dream delivery, though I think my biggest regret is that, because of the C-section, I will not be able to have any subsequent children through a birth center. The care we received there was a blessing, as I was told at every step that I was capable, knew my body better than anyone, and empowered to see just how strong I could be. Of course, in the end, our girl doesn't care how she came into this world, just that she's here - a healthy daughter who only wants to be nurtured and part of our family. 

4 comments:

  1. I am so sorry that things didn't go according to plan. This has gotten me to thinking that I ought to do a bit of research for baby #2, just in case there's an unexpected c/s. Thank you for sharing! The part about P-i-C going over and singing to her post-delivery made me catch my breath - so sweet!

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    1. I really do wish I had done more research on C-section so that I could have empowered myself more. It just never crossed my mind that I would have one. So, I highly recommend just having that information in your mind in case, and hopefully you won't ever need it!

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  2. Wow...this made me weepy! Thank you for sharing your blog, and these great stories. I may be contacting you for advice in the future!

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    1. Oh, thanks so much! And, definitely happy to help. Australia is a great country to have a baby.

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