Birth High

Totally got to watch a baby enter the world today.  Fresh life, there is just nothing better.

I've kinda lost my mojo with my certification process, but being there firsthand (I was holding a leg people!) really lights a fire under me again.

Mama rocked it.  Seriously.  She went to the hospital at 4cm, broke her water, got pit to augment and still she held on and delivered that baby with no drugs.  We had to talk her down off the ledge a couple times, but the first words out of her mouth after she was holding that sweet babe was, "I can't believe I did this! Thank you so much for not letting me give up!".

That's why I love this job.

Both Sides Of The Fence

I am a self-proclaimed natural childbirth enthusiast and probably more accurately, advocate.  With 3 natural childbirths under my belt, I am the go-to person for advice, suggestions and encouragement among my pregnant friends.  I am halfway through the certification process as a childbirth educator and look forward to the day that I begin to teach classes full of women about the process of birth and the miraculous way the body is created to sustain and birth a child.

I absolutely believe that all women are capable of delivering a baby without drugs.

I also know that not all women want that.

I won't pretend by saying I understand.  But that's ok, because it's not my body, not my experience.

Do I think I can be a well-rounded, natural childbirth advocate and educator and yet be OK with women choosing to use drugs and interventions in labor?  I hope so.  That is my goal.

Because the bottom line is, regardless of the choices you make in the management of your labor, every woman deserves to be educated so you make those choices based on knowledge, not on second-hand information, ancedotal stories and blind faith in those in charge of your care.

I'm not gonna lie, any time I have the opportunity to help a woman see that she is able to do labor on her own, I feel a little thrill.  Only because I know what she is about to experience and the view from the post-NCB mountaintop is indescribable.  But the thrill I get when a woman logically weighs the risks and benefits of an intervention and makes an educated decision to proceed based on her assessment of those risks/benefits and her own desires for her child's birth is equally important (wow, sorry that was a loooong sentence!).  Because even though that woman may not choose to birth the way I did, she educated herself and made decisions to help her reach her desired outcome.  And that means I've done my job well.

Honestly, it's hard to be on both sides of the fence, both professionally and personally.  Childbirth is one of those hot topics that really pushes buttons and gets people fired up.  There is a lot of evidence on both (all?  Because of course there's more than just two ways to birth) sides and everyone comes to the table with their own biases, experiences, prejudices and dreams.  I'm not sure anyone can be completely non-partial when it comes to birth, especially women who have experienced it.

My hope is to not perpetuate the argument but rather halt it with education.  Because once a person is educated, there's really no room for argument on whether or not they made the best choice.

So, if you were to walk into one of my childbirth classes what would you learn?  You would learn first and fore-mostly about the physiology of birth, and about the beautifully intricate way your body is created to support labor.  Because the class is geared towards natural birth, you would learn about the mental game that goes along with the management of labor and techniques to use to help you cope.  You would learn about all interventions that might be offered to you at some point, and the risks and benefits that go along with each one.  But hopefully in addition to all of this, you would learn that you are an amazingly, powerful, inspired human being who was created to sustain life and birth it.  All the tools are there.  You just need to know how to use them.

My friends, tell me about your experience with childbirth education.  Was it well rounded?  One sided?  Did you walk away feeling confident or more nervous than ever?  In retrospect, is there any one thing you wish the class would have covered?

The Birth Series: Chapter 4

My Almost Valentine Baby, born at 12:22 am on February 15, 2009

"We are made to do this work, and it's not easy... I would say that pain is part of the glory, or the tremendous mystery of life.  And that if anything, it's a kind of privilege to stand so close to such an incredible miracle."  

~Simone in Klasson  2001

The first contraction came around noon on Valentine’s Day. I was folding laundry. How romantic, right? Ah well, laundry doesn’t stop for romance around here. This being my fourth time through the ringer, and being 2 days past my due date, I was pretty sure the tightness I just felt was a contraction. I paused for a moment to assess, and then continued folding laundry. I figured if it was the real thing I’d eventually get out of having to finish working my way through the mountain of clothes.

It was a Saturday, so the princesses and hubs were underfoot. I started to put laundry away, mentally noting each time I felt my uterus contract. They were definitely the real thing, but nothing to stop life for. I already felt tired, knowing the night I was in for. I hope that’s normal when you’re about to have your fourth child. Although excited, I no longer had the blissful naivety to hold on to. Labor is no picnic, and I was the one holding the picnic basket.

After a couple hours of light contractions, I casually informed the hubs that I thought I was in labor. We then began to make plans for the princesses. Although unwavering in my resolve to have another unmedicated birth, the reality of that meant that we were at the mercy of Princess #4’s timetable. With no family in town to rely on for childcare, we began calling our back ups.

Around 5pm we loaded up the crew and headed out to our pastor’s house, who would be caring for the princesses until further notice. Contractions were still coming, and some of them quite strong, but despite that I drove our van the 15 minutes out to their house. We needed two vehicles (one to stay with the princesses and one for us) so I had no choice. I sorta laugh about that now. What woman in active labor drives around town? Me, apparently.

Once we got the princesses situated, the hubs and I set out to do our “usual” labor routine. It’s funny to me what a well oiled labor machine we’ve become. I guess when it’s your fourth time, you know what works and what doesn’t. We immediately set out for Target. Our plan was to kill time and enjoy some child-free shopping. Two birds. One stone.

We wandered up and down the aisles, looking at everything from furniture to electronics to toys. We discussed what an ingenious idea it would be to create an iPhone app that would time contractions (of course there are plenty to choose from now - we totally missed that boat). We timed my contractions which continued to roll in, most requiring me to stop talking and focus on breathing. I was definitely in the first stage of labor and we waited for a shift in my focus, when I could no longer bother to carry on conversation at all.

That point finally arrived around 9pm. Following our stop at Target we drove to a Sonic for some dinner for hubs. I was hungry but not in the mood for food, being a bit skittish about eating while in labor (not because the hospitals say not to, but because I ate during my first labor and got to see it later. Throwing up while simultaneously contracting is not my idea of fun). We decided at that point to go to Barnes and Noble (which was in the direction of the hospital) to walk around a little more, but by the time we got to the parking lot I couldn’t get myself out of the car. At this point the contractions were about 2 minutes apart and were strong enough that I had no interest in doing anything but try to manage them. Hubs tried joking with me to see if he could get me to laugh. When he got no response to his stellar joke, he agreed it was time to head to the hospital (see how scientific we are?).

Although my 4th time through the process, I had anxiety for this labor that wasn’t present for any other. I can’t entirely pin point the reason why. It may have partially been because I tested Group B Strep positive for the first time and had to endure an IV during labor, something I never had to mess with before and something that represented a “medicalization” of my labor. I think I also was just afraid. It sounds silly in retrospect. I knew exactly what to expect. I’d been through it before. But 3 times before everything went perfectly. I feared I was tempting fate in some way, like it wasn’t reasonable to expect that I could have 4 perfect deliveries. It’s dumb because I don’t believe life works that way, but in the moment I feared it nonetheless. Perhaps my mother’s intuition knew something I didn’t.

We checked into the hospital around 9:30pm and I went through the usual process (which I have to say is entirely silly when a woman clearly in active labor shows up at the hospital and you make her pee in a cup. Seriously?). In between heavy contractions I got into my gown and made my way to the uncomfortable bed. It took awhile since I only had about 45 seconds in between contractions at that point. It took all my concentration to stay on top of the waves, which threatened to take me down, one by one.

I was poked and started my IV course of antibiotics and then checked to see where I was in the process of labor. I was relieved to hear I was at 8cm and I held on tight for the imminent arrival of transition. I’m not a huge fan of laboring in beds. They are inconvenient and don’t allow for complete control over managing contractions. I definitely do better when I can sit upright or better than that when in a bathtub. But with neither of those options open to me, I did the best I could. The hubs was in super coach mode, and he was amazing, stroking my hair and fanning me when I got hot, reminding me to stay relaxed and vocalizing with me during the peak of my contractions.

And peak they did. Transition hit hard and I struggled to stay on top of the waves. Each contraction arrived before the previous one receded. With no time to rest, I held on tight, fighting to stay relaxed. I concentrated on relaxing my legs which threatened to tense with each contraction and the hubs worked on helping me relax my face and jaw. I began wishing to feel the urge to push. I knew with that urge the end was near and that I’d finally have something I could do with the pain of the contraction.

Around 11:30pm my nurse came in and checked me and announced me complete (yay!). As if on cue my contractions mercifully started spacing out a bit and the urge to push overcame me. I remember at one point saying to the nurse that I hoped I had improved my pushing time over my last births (2 hours, 1.5 hours and 1 hour, respectively). She laughed and said she had never seen a patient of my doctor’s push for over a half hour. With that bit of hope, I began to bear down.

I don’t really remember when things began to deteriorate. I had been pushing for about 45 minutes (so much for a half hour!) and wasn’t making much progress. At this point I really didn’t need to be too discouraged. I had been here before. I’m just not a great pusher. Two steps forward, one step back. Same song and dance. But this time... this time it felt different. I didn’t feel the exhilaration I was used to while pushing. In fact, I was actually fighting sleep in between contractions. I could tell I wasn’t moving the baby down. And something... something wasn’t right.

That feeling began to overwhelm me. I began to beg the doctor to take her. I knew I needed to get her out. And I couldn’t. At first my doctor, being carefully chosen by me as one with an incredibly low C-Section rate and highly regarded as a natural childbirth advocate, quietly chuckled at me and told me that being tired wasn’t a good enough excuse to be cut open. But with the next push, his demeanor changed. I hadn’t noticed him looking at the baby’s heart tone monitor, but he must have.

It all happened very quickly then. In fact, it would probably be more accurate to have the hubs finish the rest of this story as I lived the rest of it in a thick cloud. With that next push, I saw my doctor glance at the nurse, she nodded and darted out of the room. He then calmly told me that my baby was not doing well with the pushing and he was going to have to take her by Cesarean. At first, overwhelming relief washed over me. This was almost over. The pain, the fatigue, the fear... all of it. And then reality hit, in the form of another contraction. I was no longer allowed to push. I completely lost control. The deep breathing, the vocalization, nothing could keep me from the pain of a pushing contraction with no push.

Within less than a minute I was being wheeled down the hallway in my bed, with the hubs jogging alongside me. Visions of TV dramas played out in my mind, I wondered if that’s what I looked like. I was in agony, I remember seeing the bright florescent lights flash by on the ceiling and then the bright white of the OR blinded me. Hubs had disappeared. I vaguely wondered what happened to him, but was too overcome with pain to ask. I imagine at this point I was given some heavy sedative. Somehow they moved me onto another bed and I think I was rolled onto my side (for the epidural?). A heavy warmth washed over me and I was no longer in pain. Someone behind me asked me my name and as I answered I flashbacked to all those episodes of A Baby Story I had watched on TV. “This can’t be happening to me” kept running through my head and I desperately wanted hubs with me.

But there was no time. I heard some counting and then someone said “oh boy!”. I panicked, thinking I had just given birth to a boy. The person behind me (I assume the anesthesiologist) laughed lightly and said, no, it’s a girl! I remember feeling tremendous relief and a simultaneous surge of love and disbelief at the way this birth was playing out. I asked how much she weighed. From behind me I heard, “they’ll get to that, they have other things to worry about right now.” Suddenly deafening silence filled my ears. I realized then I hadn’t heard my baby cry.

I think they may have knocked me entirely out at this point, I’m not really sure. I absolutely have no memory of anything between that moment and finally waking up in the recovery room. A nurse was sitting at a desk across the room from me, and my doctor walked in. After he assessed me, he spoke with the nurse. Through a fog I heard him ask what their response time was. She replied 6 minutes.

6 minutes that changed my life. 6 minutes that meant the literal difference between life and death. A couple days later as my doctor visited with the hubs and I, he informed us that Princess #4 emerged from my womb with the umbilical cord wrapped around her head. He also went on to say that given the size and shape of my pelvis he thought it was a miracle I was able to give birth vaginally at all.

I held my newborn Princess #4. The world in my hands. So many times I have played out her birth in my mind. So many times I’ve relived it. So many unanswered questions, so many what if’s. But beyond that, so many miracles. There is a reason I chose to deliver my babies without drugs or interventions. It’s because I was created to give birth. Because I instinctually know what to do. And although Princess #4 was birthed differently, she lives because that instinct was intact. I’m forever grateful for the experience, which has changed the way I view the birth process. I still strongly believe that every woman should prepare for a natural childbirth, because there’s no guarantee that the epidural will work or that you’ll even have time to get one. But I also now know that the attitude of “it won’t happen to me” goes both ways and not being prepared for all aspects can be traumatizing and leave alot for a mama to process. And no one wants to be burdened with that when there is a new baby to love. Ultimately, we got our happy ending and our family is complete. To be a participant in a miracle is an incomparable honor and bringing a new life into the world, no matter the means is a miracle like none other.

If you haven't already, be sure to check out the other chapters to my Birth Series:  Prologue, Chapter One, Chapter Two, and Chapter Three.

The Birth Series: Chapter 3

By the time I was pregnant with #3, it was all old hat.  I knew before I even took the test that I was pregnant.  As soon as I got that plus sign I called my provider and got a prescription for Zofran, knowing I was predisposed to hyperemesis gravidarum, and I started the very important task of finding the person that was going to help bring our new little bundle into the world.

In a new city and state once again, I began my search with Doulas of North America.  Doulas in your area can be a wealth of information when it comes to hospitals and doctors.  They've seen it all, worked with it all.  And most are more than willing to share that knowledge, even if you don't intend to hire them as your doula.  I located all the doulas in my area and sent them all a lengthy email, describing my past births and telling them about my hopes for my current pregnancy and birth.  Then I asked if they would please recommend a physician in my area who would align well with my desires.  Without exception, every single doula I contacted responded with the same recommendation:  a certain group of midwives who work within an OB practice and deliver at a local hospital.

just seconds old

So that part was easy.  The hubs and I made an appointment and met with a midwife who we quickly agreed would be the perfect person to partner with.  She was laid back and relaxed and not at all concerned about making my pregnancy or labor fit into a certain box.  We were eager to begin the journey with her.

The next several months flew by and before I knew it we were fast approaching my due date.  How different it was this time around!  With Princess #1, if anyone asked me how far along I was I could tell them, down to the day (14 weeks and 3 days thankyouverymuch!).  But by this time?? (uh, 4 months?  I think...)  Like my other pregnancies, I didn't have much lead in or warm up for labor.  A few Braxton Hicks in the weeks proceeding my due date, but nothing remarkable.  Given the fact that Princess #2 was fashionably late, I wasn't expecting anything different.

I saw my midwife for hopefully my last office appointment 2 days before my due date.  During a very uncomfortable exam I believe she tried to "stir things up" a bit.  She announced that I was already 4-5 cm dilated, a fact which made me very very happy.  I went home feeling a bit crampy, and very anxious.  I was certain I was going to wake up in the middle of the night in labor.

my biggest baby

The next day dawned and I was still in my bed at home.  A bit discouraged and still uncomfortable, I got out of bed to begin the day.  It wasn't long though, before I started getting those telltale blood pressure cuff type sensations in my lower abdomen.  I braced myself for the worst, given the fact that my labor with Princess #2 started out hard from the very beginning.  But this contraction was mild, and I allowed myself to breathe again.

The contractions continued erratically throughout the morning.  They weren't incredibly painful, but disappointingly, they were also very irregular.  It was hard to tell if I was actually in labor.  The hubs was scheduled to go into work at 1pm, so at noon we made the call and decided he better stay at home, just in case.  My parents came to pick up Princesses #1 and #2 to keep them at their place indefinitely.

At that point I was free to just be in labor.  But labor did not cooperate.  Although I thought the contractions might have been getting a bit stronger, they stayed irregular and weren't settling into a good rhythm at all.  Knowing that my midwife would not be able to do anything for us other than to suggest to take walks, baths and um, have sex, we decided to not bother her and just set out on our own.  I should mention at this point that this was the first labor that we did not hire a doula.  With my first labor we wanted a doula because we were completely clueless, and I wasn't sure I could manage going natural on my own.  With the second, we knew we were using a doctor and hospital that were not natural childbirth friendly and we wanted someone we could count on to advocate for us if necessary (which it was).  But this time around, with a midwife by our side and experience under our belts, we felt we could make it on our own.

We pulled our labor #1 trick out of our bag and headed out to the mall to walk around for awhile.  We window shopped and chatted and timed contractions the best that we could. They were still sporadic and not incredibly painful.  It made timing difficult because I'd barely notice I was having one before it was nearly over.  I have no idea if my pain tolerance is really high, or if I was just really used to being in labor.  After a few hours of walking the mall we decided to get dinner at a nearby Chili's.  I have such fond memories of that meal, sharing chips and salsa with the hubs, hoping the spicyness would kick out that baby.

Finally, around 7pm we headed home.  Still with nothing exciting to report, we decided to walk around the neighborhood a couple of times.  It was March and fairly comfortable out, a storm seemed to be brewing.  We passed by a friend's house and stopped to chat a bit.  I remember as we stood there I began to question if I was really in labor at all.  My contractions had not gotten harder, were not in a pattern and quite honestly, didn't feel like they were doing much of anything.  If it weren't for the fact that I was mere hours away from my due date and I knew I was walking around at 4-5cm dilated, I probably would have just called it a night.  But instead, we pressed on, determined to have a baby.

We headed home and began a chick flick marathon.  I can't even remember what movies we watched.  I sat on my birth ball and tried to visualize the baby moving down.  Each time a contraction would come, I'd sink into my ball and relax as much as I could, hoping that doing so would enable my body to kick it into gear.  At one point, exhausted from anticipation and the late hour, I started to cry.  I was resigning myself to the fact that the baby wasn't ready to come yet.

We decided to attempt one last ditch effort.  Hubs put water in the tub and around 1am I eased myself into it.  I don't know what it is about water, but clearly it works magic on my body.  My contractions started coming harder and faster.  They still weren't in a pattern, but I was having to work to get through them.  Using the water to aid me in relaxing, I floated, and concentrated on the sound the water made lapping against the side of the tub.

In a matter of 2 hours I went from wondering if I was in labor to full blown contractions and heading to the hospital.  The roads are eerie at 3am.  As we raced down the highway I held on and worked at keeping myself on top of the contractions.  Still no rhythm, but no doubt that I was about to have a baby.

We arrived at the hospital shortly after 3:30 in the morning.  My midwife greeted us in my room, after I had gone through the ridiculous routine triage exam (yes, yes, I'm really in labor...).  She examined me and found me to be at 8cm.  Pleased with that progress I asked to return to the tub.  She immediately went to go run the water.

I only sat in the tub through 3 contractions.  They were closer together than any of my others had been.  They were hard, although honestly they weren't the hardest I'd ever felt.  My midwife watched me from the side of the tub curiously and after the third contraction she requested I get out of the tub and sit on the toilet.  When I asked her why, she said that she was suspicious that I was in transition and in fact fully dilated and she wanted to check.  I thought she was crazy.  I'd been through transition a couple of times.  Transition feels like your insides are going to be squeezed out through every pore in your body.  Transition makes me throw up.  Transition is hell.  I had not yet been to hell with this labor.  I thought I had a long way to go.

But she was right.  She checked me and found only a lip of cervix remaining and with the next contraction was able to push it out of the way.  Suddenly, hell was upon me.  In hindsight I wish I had stayed on the toilet because I think I could have gotten the baby out without even trying from that position.  But relying on familiarity, I got back into the bed and prepared to meet my nemesis:  pushing.

The pushing phase was really sort of a blur to me.  Except I remember clearly the atmosphere in the room.  It was quiet.  Dim.  Only my midwife, hubs and a nurse were present.  It was almost reverent.  And given the atmosphere at my last birth, I so appreciated that.  I worked hard, pushing against my midwife's fingers, struggling to find a place to focus the energy in the midst of managing the pain of the contraction.  At one point I remember the pain getting the best of me and crying out, "why am I doing this??"  Hubs and my midwife seemed amused at that, but kept themselves in check.  At long last, the baby began to crown.

A few weeks earlier at an appointment, my midwife asked if Hubs would like to deliver the baby.  At first we thought she just meant cutting the cord.  But no, she meant actually deliver her.  Hubs didn't even have to think twice.  He was thrilled at the thought.  She talked him through what the process would look like and prepared him the best she could.  And suddenly, that moment was upon us.

My midwife had Hubs take her place of honor at the foot of the bed.   As I began to push with the next contraction, she vocally guided him in easing the baby's head out and turning her to let out a shoulder.  One little hand was pressed up against her cheek as she emerged.  And in one smooth movement, she was there.  In his arms.  A daddy and his daughter.  Princess #3.

Hubs placed her carefully on my chest as my midwife clamped off the umbilical cord.  Hubs cut the cord as Princess #3 simultaneously let out a wail.  We both noticed at the same time a little dimple, placed carefully on her upper cheek directly under her right eye.  Even now only visible when she smiles or cries, she's going to break some hearts with that dimple.

I was hooked up to an IV at that point, having received the hep lock upon arrival at the hospital. I was given pitocin to aid my uterus in contracting down, due the hemorrhaging I experienced with Princess #2's birth.  But there was no trouble this time.  My midwife delivered my placenta and allowed Hubs to actually take pictures of it.  No, we're not crazy.  It's just truly amazing to see the miracle that kept your own miracle alive for 9 months.

Born on her due date, at 6:32 am after a long 20 hours of labor (although I really only count the last 4 hours as real labor) and 45 minutes of pushing.  She weighed in at 7 pounds, 10 ounces.  I remember being shocked at that size.  She weighed a whole pound heavier than Princess #2.

The rest of the hospital stay is a blur.  My parents brought Princess #1 and # 2 to meet their brand new baby sister the next day.  Postpartum rooms are definitely not as peaceful when you have 2 little kids running around in them.  We didn't stay long.  I was eager to get home and begin our life as a family of 5.  I had no idea what I was in for, but I was ready.  We had our Princess #3 and our family was complete... or so I thought...

Hang on!  There's one more chapter to come!  Want to read about the birth that changed everything for me?  You can read it TOMORROW over at Ingenue Mom where I will be guest posting!  Hope to "see" you there!


*Want to read more posts like this?  Head over to Giving Birth With Confidence!

The Birth Series: Chapter 2

With Princess #1, we were ready to be pregnant.  Knowing my cycles were irregular, I bought the book Taking Charge of Your Fertility by Toni Weschler (an absolute MUST READ for any woman, regardless of the state of her uterus) and threw myself into taking my temperature, charting and noting my (ahem) fluids.  It took one cycle (which, incidentally, was 88 days long) to get pregnant.  The getting up every morning at the same time to take my temperature was a bit draining, but I was highly motivated, so I dealt.

When the hubs and I started talking about having baby #2, I broke out the old basal thermometer and began the same routine.  I wasn't as excited about the "clinical-ness" of it all this time around ("oh honey, look I had a dip in temp" doesn't exactly inspire romance) but I was afraid given the length of my cycles we'd never "catch" the egg if I didn't.  But I needn't have worried.  I didn't know it yet, but I was pregnant with #2 before I even picked up the thermometer that first morning.

My first clue was the ever-present nausea.  I had been through this song and dance before so I was pretty suspicious right from the beginning.  An EPT confirmed it and the hubs and I began to wonder what we had gotten ourselves into.  #2!

Since we had Princess #1 we had moved to a new city and state, so I had the task of finding a new doctor.  We lived in a large city but in a rather isolated part of Oregon.  The only hospital there was very high-tech, serving as the main medical center for all of Eastern Oregon and Western Idaho.  Therefore, the maternity services there weren't known for their approach to "natural" deliveries.  I immediately contacted a local doula to reserve her services (the hubs and I thought we had the labor part down, but I thought she might come in handy as an advocate for us and our desires for labor).  I researched and researched (PLEASE ladies - don't skip this important step!!) before finally settling on a doctor in a very small practice (only 2 doctors total) who came recommended as the most likely to accommodate my requests for a natural delivery.

My due date was December 20th.  I didn't have any hopes of the baby coming early since Princess #1 came right on time.  And I was right.  December 20th came and went with no sign of baby.  I know most people with this due date would have just scheduled the birth at that point, to be sure to be out of the hospital by the time Christmas rolled around.  But I was stubborn and refused.  My baby would come when she was ready!

She decided she was ready on Christmas Eve.  It was about 9pm.  We had finished opening our stockings (family tradition) and eating pizza and sugar cookies (another family tradition) and were settling down to watch 'Jingle All The Way' (nothing says Christmas like Arnold Schwarzenegger).  The first contraction hit hard right out of the gate.  It sorta took me by surprise.  I had such a long build up with Princess #1's labor that I assumed this one would go the same way.  That was not the case.

The next two hours I watched the movie with my family (my parents were in town) on my birth ball, periodically losing interest to concentrate on a contraction.  They came very irregular both in occurrence and duration, but they were very hard consistently.  Once the movie finished my parents left to go to their hotel and the hubs and I called my doula.  I was fairly certain that I was in active labor or at least the early stages of it, even though I couldn't pinpoint a pattern.  My doula arrived around 11:30pm (on Christmas Eve, God bless her!) and began to assess my progress.

She immediately noticed the inconsistency and suggested I try a few different positions to try to get myself into a regular pattern.  When nothing worked we agreed to just pop in another movie and wait awhile to see what happened.  I *think* we put in 'A Christmas Story'.  I can't be sure as I was lost in my birth ball.  It didn't get much use during my first labor, but this time around it was a God-send.  As each contraction washed over me I sunk down into my ball, almost as dead weight, I closed my eyes and allowed myself to go completely limp.  As the contraction would release I'd open my eyes and continue with the movie.

I still had no pattern.  My contractions would come 20 minutes apart, then 45 minutes, then 10, then 55.  It was frustrating.  I felt like I couldn't gauge where I was at.  I was getting tired, having had to deal with hard contractions from the start.  Now coming up on 3am, my doula suggested we all lay down for awhile and try to get some sleep.  I think she was testing to see if my contractions would go away altogether once I laid down.

And they did.  The hubs was snoring the second his head hit the pillow.  My doula was asleep on the couch.  But I couldn't sleep (obviously!).  I felt completely out of control lying down.  As a contraction would hit, I had no way to make myself relax.  Laying down made everything worse.  And my contractions started spacing out big time.  A whole hour went by with nothing.  Already 5 days overdue and desperate I got up and went back out into the living room to labor on my own for awhile.

I managed on my own for about an hour.  The contractions hurt.  A Lot.  And they started coming more often (thank God!).  Still not consistent, but more frequent than before.  Finally around 5am I couldn't handle it anymore on my own and I woke up the hubs and my doula.  She observed me and agreed that the rate at which the contractions were occurring now indicated that I was indeed in active labor, although we still had no pattern to go by.

Hardly even realizing it was Christmas morning, my doula made the hubs and I eat something.  I barely managed to get down a granola bar between contractions.  By 10am things were getting pretty intense.  In training to become a midwife, my doula wanted to check me to see if we could figure out how far along I was.  We had agreed early on that I didn't want to go to the hospital until the last minute, to avoid all the routine procedures like IV's and continuous monitoring. When she discovered I was at 8cm, we were reenergized.  The hubs, remembering what a help the tub was in my previous labor, suggested I try that again.  So he ran a bath and I eased myself down into the water with a great deal of relief.  I labored there for a couple of hours when suddenly transition hit me like a bullet train.  Where we were trying to find a pattern in contractions before, there was no need to now.  They came one on top of the other, with no start or finish.  Just a long line of peaks and valleys.

Hubs and my doula helped me out of the tub, just as I threw up everything (awesome).  At that point I nearly lost control altogether.  I was shaking (a sign of transition) and crying and just desperate for relief. As I sat on the toilet to regain some control, my doula knelt over me and prayed a prayer of peace and encouragement.  It was just enough to get me back on track.  It was noon and we decided it was time to head to the hospital.

The drive was only 10 minutes, but it felt like a lifetime.  My doula was listening carefully to my vocalizations, watching for signs I was trying to push.  She had her birth kit ready, but fortunately didn't need to use it.  We arrived at the hospital and entered through the special Labor and Delivery door.  The floor was dead quite (no one plans to have a baby on Christmas Day) except for me.  My groans signaled our arrival.  True to the nature of the hospital, the nurse who greeted us asked me to change into a gown and pee in a cup (?!?!) and then get on a gurney in their triage room so she could asses to see if I was really in labor (REALLY?!).  Well, she got what she asked for.  As she was checking me she caught a glimpse of my intact bag of waters.  She mistook it for the baby's head.  Suddenly the triage room looked like a scene out of ER.  The nurse ran out yelling things like "Baby crowning!  Get the On-Call STAT!"  Another nurse came in and quickly wheeled my bed (with me on it) down the hall to a labor and delivery room.  I remember as I was being rolled down the hallway how relieved I felt.  If the baby was crowning that meant I wouldn't have to push for 2 hours like last time!

They got me in position and the on call doctor came in and examined me.  That's when they discovered that the baby wasn't crowning at all.  Everyone in the room relaxed except for me.  I knew I had a big job ahead of me.  My doctor finally walked in after all the hubbub died down, dressed to the nines in a black suit and cheerful holiday tie.  That's when I remembered it was Christmas.  We had called him out of Christmas Mass.  I still giggle when I envision he and his wife sitting in the pew as his pager goes off. I can almost see her rolling her eyes.  Hehe.

I began pushing immediately.  Once again, I sucked at it.  My water broke with the first push.  At one point the nurse started using her fingers to direct my focus and that helped immensely.  I pushed and pushed, and in between I panicked about being too hot and nauseous.  Thankfully my doula had packed a fan and set to work fanning me in between pushes.  I had been pushing about an hour when my doctor started dropping hints about using a vacuum to get the baby out.  I knew he had the tendency to like to use that, as a friend of mine had delivered with him using that method just a few months before.  At that point my doula earned her money.  She requested he give us just 30 more minutes, since the baby wasn't in distress.  He agreed and I got to work.

I remember at one point during pushing being highly irritated at my doctor and the nurses in the room.  In between my pushes they were just shooting the breeze, joking and hanging out as if it were another day.  I wanted to scream at them through my agony, "HELLO!!  See me over here?  This is all about ME!"  Fortunately, I refrained.

Finally, at 2:28, after 15 hours of labor and an hour and a half of pushing, Princess #2 entered the world.  She was tiny, weighing in at 6 pounds, 9 oz.  She was perfect.

I wish that was the end of the story, but it was not to be.  Shortly after delivering the placenta I started to bleed, alot.  My doctor later told me that my uterus was simply tired after contracting hard for 17 hours and it just didn't have the energy to contract any more.  Well, the uterus contracting after the baby is born is essential for the bleeding to stop.  And often women are hooked up to IV's already so giving them a bag of pitocin to aid in the clamping down of the uterus following birth is routine.  Since I came into the hospital ready to push there was no time to give me an IV.  A nurse had to open a line under emergent conditions.  She was terrible at it and had to try about 3 times.  While she fumbled around with that I was given a shot of methergine.  Once the IV got going I was pumped full of oxytocin and had to endure rough manual massage by 2 nurses.  Apparently the bleeding was very bad because the massage was graphic and worse than the 17 hours of labor I had endured prior.  But they finally got the bleeding to stop.  Following that experience the hubs and I decided that for any future births I would get a hep lock (an open IV line) just so I could avoid anything like that again.

Regardless of the aftermath, I was in love.  Another princess in the house.  And now a big sister too.  I was thrilled to have accomplished another natural delivery and under less than accommodating conditions as well.  My doula took some amazing photographs of the delivery (the only birth I have photos of) and I still love to look at them from time to time, to relive the miracle that occurred that Christmas day.  My Princess #2 was 5 days late, but she was born right on time.  She shares a birthday with her Nana (hub's mom) and her late great-grandfather.  Christmas is a special day in our home for many reasons.  We have much to celebrate.

More to come this week in the Birth Series!  

The Birth Series: Chapter 1

My first pregnancy had been relatively easy, once I got past the first trimester.  I puked more than I care to remember in those first few weeks and came to rely heavily on God's gift to the puking pregnant girl Zofran.  It's almost cruel that immediately after getting that plus sign the body starts rejecting everything.  I couldn't even enjoy the fact I was pregnant for the first 3 months.  After losing 10 pounds and a trip to the ER for fluids, things started to turn around and we began marching down our little pregnancy journey, headed toward the finish line.

I couldn't wait for labor to begin.  I was ready.  Most of my friends thought I was crazy, but I knew I wasn't.  I felt it in my soul.  I was meant to do this.  I had read and researched and practiced and was ready.  I just needed my babe to be ready.

The morning before my due date I was awakened at 5am.  It was a Saturday so I wasn't really thrilled with being up so early.  But the reason I woke up was intriguing: a tightness across my belly.  It didn't hurt, but it was definitely present.  It felt sorta like someone had put a blood pressure cuff around my abdomen and it was squeezing to take a measurement.  I wasn't completely sure what I felt was a contraction, so I laid in bed for awhile, waiting for another one.

It took awhile, but a couple hours later I finally felt another one.  The blood pressure cuff feeling again.  I felt a little thrill of excitement.  Maybe this was it!  I got into the shower and let the water run over me.  I had a little conversation with the princess in my belly, requesting she hold off for just a few hours.  My doula was out of town for the day and wouldn't be back until evening.  Although I felt like I was capable, I didn't want to venture too deep into labor without her by my side.

The rest of the day went by without event.  My blood pressure cuff feeling came and went, painlessly and routinely.  The hubs and I meticulously recorded their coming and going.  Finally, around 5pm we decided to head out to the mall to walk around for a little bit.  We wandered in and out of stores, pausing to chat with store employees (yes, yes, I'm actually due tomorrow... in fact, I'm in labor right now!) and to take note when my contractions hit.  While at the mall they got to the point where I had to stop talking to manage them when they hit.  We stopped at the food court and I got a pretzel to satisfy my growling stomach, then I called my doula (who had thankfully returned home) to let her know what was going on.  At that point my contractions were coming about every 5-10 minutes apart and were lasting about 45 seconds.  She agreed it sounded like I might be in early labor and she suggested we head home to rest.

We returned home and settled down to watch mindless TV.  We were in the middle of an episode of Trading Spaces (remember that show?) when things suddenly weren't very fun anymore.  I laid down on the couch and tried to get comfortable, but laying down made it worse.  We got out my birth ball and I sat on that for awhile, trying to manage the waves as they overtook me.  We called our friends to come over and pick up our dog (our "baby" at the time, had to make arrangements for him!) and I remember not being able to talk to them at all when they appeared at our door.  Once they left we called our doula and requested she come to our house, we were ready for some hardcore labor action.

And then began the part no one told me about.  (*Total TMI alert*)  I had to go to the bathroom, bad.  Alot.  You know how they used to give enemas to women in labor?  Well, sometimes there's no need...  I had no idea.  As I sat there, I began to panic that I was going to have the baby on the toilet.  All I knew was that they told me that the urge to push felt like needing to poop, so....

The hubs called our doula and told her we were headed to the hospital and would meet her there.  That was the longest 30 minute drive of my life.  For all I knew the baby was about to pop any moment.  Everytime I moved I lost my concentration and the contraction would get the best of me.  We finally arrived and went directly to Labor and Delivery.  It was just after 9pm.  My doula and nurse were waiting for me.  I was ushered into a room and given a gown.  I remember almost laughing in between contractions.  The gown was HUGE.  I was the size of a 15 year old with a basketball under her shirt and the thing wrapped around me about 3 times.

Hubs helped me get into bed and the nurse strapped the monitors on my belly.   I was checked then and was discouraged to discover I was only at 4cm.  All that for 4cm - and here I thought I was going to have the baby at home!  The hospital (and my doctor) only required 20 minutes of monitoring upon admission, so we patiently worked through contractions from my bed until we were released to go get in the jacuzzi tub in the bathroom.

That jacuzzi was heaven.  Truly.  The difference between managing labor in a bed and in a tub is night and day.  I floated as the water bubbled around me.  With each contraction the hubs lightly poured a stream of water over my belly, to give me a sensation to concentrate on.  I was doing fairly well, staying on top of things, when suddenly, I wasn't doing well at all.  Transition hit hard as the contractions came one on top of the other.  There was no break.  My legs ached and I writhed in the tub, struggling to grasp some relief.

My doula suggested I get back into the bed so they could check my progress.  I had only been in the tub for about 45 minutes and I loathed the thought of getting out, but I complied.  The nurse came and checked me and surprisingly announced me complete and left to call my doctor.  At this point I felt a tremendous amount of relief midst the pain of the contractions.   I was so elated to hear I had dilated from 4cm to 10cm in less than an hour.  I knew that was uncommon and I was grateful.  But I also knew the hard work was yet to come.

I got situated on the bed and my doula and nurse began to help me push.  I had absolutely no idea what I was doing.  Trying to manage the contraction, take a deep breath, muster up the strength to sit up and bear down was almost too much to try to do at once.  I couldn't tell where to focus the push or whether or not I was doing it right.  The hubs, my nurse and doula were all encouraging, but there wasn't much they could do.  I remember feeling surprised at what hard work pushing was.  I felt like we sorta glazed over that part in my childbirth classes and I certainly didn't feel prepared.

I was fortunate that my doctor was patient.  I know now that had I had a different doctor, I probably would have been wheeled down to the OR.  But, he waited.  At one point, in the middle of a push I saw him walk into the room and stand at the back with his arms casually crossed, just watching.  After a few minutes he walked back out.  With a sinking heart I realized in that second that I wasn't even close.  I pushed harder.  I threw everything into it, even though I still felt like I wasn't doing it right.  At one point my doula suggested I try to use the squat bar, but I was so weak and worn out at that point I couldn't support myself on my legs.  So I stayed on my back.  Finally, FINALLY, after about an hour and 45 minutes of pushing, things started to pick up.

For a first timer, I didn't really know how this part went down.  Several nurses came into the room in a flurry and began breaking down the foot of my bed.  The warmer above the baby's isolette was turned on and blankets were warmed.  It struck me that in a mere matter of minutes my baby would be in those blankets.  That surge of motivation pushed me forward to the end.  My doctor appears and with the hubs and my doula by my side I gave the last few pushes I had left in me.

And that was it.  Princess #1 emerged shortly after midnight on her due date, 7 pounds 5 oz.  A shocking  weight given my size.  The back of her head was scraped up, presumably from passing through my pelvis, her nose was smushed and her ears were flattened, but she was beautiful.  She was mine.

I was on a high for weeks following her birth.  I felt exhilarated at having accomplished something as great as birthing my child all on my own with no aid of pain relief.  I had a goal set and I achieved it.  And my reward was great.  And that feeling followed me into motherhood.  The hubs and I embraced being parents and looked forward to growing our family one by one.

Stay tuned for more installments in The Birth Series this week!

The Birth Series: Prologue

Birth is a defining moment a woman’s life.  Whether we like it or not, our body is not our own, acting against our will in many cases, controlled not by our own power but by the instinctive forces within us that were created to sustain and eventually bring into the world human life.  

Of course, as a young 24 year old, my thoughts were not turned to the wonder and awe of my body’s natural abilities, but rather to all the cute clothes I was going to get to buy my soon to be baby girl.

From the beginning of pregnancy, one question is asked in more frequency than I think any other question, and usually it’s asked by seasoned mamas, AKA. Ones Who Have Gone Before. 

“So, are you gonna use drugs?”

It looks hilarious to type out, as though these Ones are pushers.  And I suppose they are in a way, looking for one of like mind, some solidarity, a common bond in sisterhood:  Natural or not?  That is the question.

With my first baby in my blossoming belly, my response to that question was the typical, “I’ll go as long as I can without!”  And I truly meant that.  I think instinctively I wanted to do what my body was created to do, but the fear of the unknown with only terribly written labor stories on TV as my guide, well, I don’t blame myself for wanting a security blanket.

When I first got that plus sign on my pregnancy test, I eagerly called the first doctor I could find and scheduled my first appointment, with no concern given to the doctor’s labor and birth philosophy, or his epidural and C-Section rate.  I didn’t even know a rate existed.  I just knew that I had a plus sign and I was going to be a mommy!  I gleefully went to my first appointment and met my doctor and did all the required blood draws and guesstimating of due date.  As the hubs and I left that appointment, I gave little thought to the book now in my possession, given to me along with all the coupons, magazines and free samples in the office’s ‘Congrats on your Pregnancy!’ kit:  The Thinking Woman’s Guide to a Better Birth by Henci Goer.

It sat on my night table by my bed for several weeks.  Untouched.  I read many other pregnancy books during that time, but that book, it scared me.  It looked like a text book.    And I was cynical about what I might find inside, surely just a bunch of horror stories designed to scare me into not wanting drugs during labor.  Finally, in about the fifth month of pregnancy, having run out of other books to read, I couldn’t ignore it any longer.

I couldn’t put it down.  It wasn’t an overnight change of heart.  In fact, at first I was very reluctant and hesitant to even begin to believe I might be able to do this on my own.  Goer’s book didn’t sugar coat anything, and it really did read like a text book - just the facts on the effects of interventions in labor.  It gave no tips on exactly how to accomplish labor without them, just the details on what you might expect should you choose to use them.  It covered it all, from eating only ice chips during labor to C-Sections.  I was left thinking that I didn’t want to go down that road, but was uncertain how to get down the road it appeared I was choosing.

Fortunately, my doctor’s office was prepared for that.  Working alongside my doctor was an OB Specialist.  She was a L&D nurse of 25 years who left to become a doula and childbirth educator.  She provided classes to my doctor’s patients.  And it was she who made me believe I could do it.

For 8 weeks we met, learning about the physiology of birth, labor symptoms, coping mechanisms, interventions and the postpartum period.  Although a well rounded class, the weight she gave to going as natural as possible and allowing your body to take over and do what it was created to do left me feeling empowered and dare I say, excited to take on the challenge of labor.

We hired her to be our doula during labor, believing that having her there would further encourage our (my) efforts and would be a welcome source of comfort for myself as well as the hubs, who was jumping into his role as coach with gusto.  We practiced coping techniques.  We bought a birth ball.  We reviewed our birth plan and packed our bags.

At that point, all that was left to do was wait.  And wait.  And wait.

*next installments of The Birth Series coming soon!*