The Second Birth Story

This birth story is directed at my daughter, written for her.

Just as I was getting ready to leave work at about 7:00 in the morning I felt a strong pain deep in my belly.  I had been having Braxton-Hicks contractions on and off for weeks, but this one took me a bit by surprise. Since I was 5 days past my “due date” I thought ‘this could be it’ but also didn’t want to get too excited. I left for work without telling your dad.

On my way to work, l couldn’t help but notice that I felt that same pain 3 more time, exactly 10 minutes apart each time. A couple more hours went by and my contractions were continuing to come in regular intervals, increasing from every 10 minutes to every 7 minutes. Around noon or so, I called your dad to tell him I had been having regular contractions for about 4 hours. I told him I was feeling fine but very hungry so I was going to eat lunch. He sounded surprised and a little doubtful, even, but I just told him I would call back in a bit.

Around 2:30 p.m. (7 and 1/2 hours after labor had started) the contractions were continuing and I asked your dad come to pick me up at work. As soon as I was with your dad I felt for sure my contractions were suddenly getting closer together. Even I doubted it could be that easy, though, and we decided to go to the grocery store to buy eggs to make your first birthday cake. I know it sounds silly, but we wanted to do that activity to help distract us during labor. While we were in the grocery store I had to stop in the cat food aisle to take a few deep breaths to get me through the ever-increasing contractions. 

We headed home and I finished packing the last few items for our hospital bag. Around 4:00 p.m. we were all finished with the packing and I was not feeling like baking anymore. The intensity of the contractions was increasing and I just needed to get in the water to ease the pain. As soon as I was in the bath tub with the water surrounding me and the shower pouring down on me, I had an immediate decrease in the pain. I brought the iPod into the bathroom and listened to my hypnobirthing affirmations. After about an hour in the tub and shower I decided it was time to call the midwife. 

I had a contraction immediately before calling her. During the call, I informed her of how long I had been in labor (about 10 hours) how far apart the contractions were (every 5 minutes according to your dad) and that my plan is to have a natural labor. The midwife suggested that I give it another half an hour then and call her back to see how things are going after that time. Seconds after hanging up with the midwife a very strong contraction came on and I told your dad that I needed to get back in the water right away. Once again, I allowed the shower water to fall over me as the tub filled and my pain was certainly present but significantly decreased. I rested and time went by quicker than I could ever have expected. Your dad told me that it had been a half an hour and I told him I was beginning to feel the urge to push as he helped me out of the tub. We knew it was time to go. Your dad made a few quick calls and helped me into the car.

As we pulled onto the highway interchange, the cars were at a standstill. 

It was around 6:00 p.m. on a Tuesday, after all. I let out a loud groan. Outside of the tub, the pain was intensifying and I was quite certain those contractions were coming at least every 2 minutes. Your dad was sure that they weren’t that frequent but I was starting to feel desperate to get to the hospital.

Your dad pulled into the hospital parking lot at 6:35 p.m. The pressure as I stood was almost unbearable and it was getting harder to walk. I’ll never forget the look on the receptionist’s face as she pointed us in the direction of delivery, indicating to please not stop and talk to her. We headed into triage and I think I may have told them I was in labor. I’m pretty sure it was not necessary to actually say this. I was shocked to learn that they were allowing me to skip triage and sending me straight to a delivery room. They said it was because I had requested the birthing tub so they had already selected my room. 

As I entered the room I was surprised to not see the birthing tub. I needed to get in that water! I told the nurse that was admitting me that I was getting in the shower while I waited for the tub. She looked at me in surprise since she hadn’t done any of my vitals, or started an IV or any of that stuff. As I undressed, I told her I needed the water now! 

The shower was arranged so I could sit right on the side of a ledge while the water ran over me. Your dad had enough space to be in there without getting soaked. The second I was in the shower my water broke (talk about perfect timing!) and it was most definitely the image you see on the movies.  And then…I felt pressure. I reached down and felt the top of your head as you were crowning. “The baby is coming!” I told your dad. He asked me how I knew and I told him because I was touching you. He ran out of the bathroom, expecting to find the nurse in the room. It had been no more than 2 minutes since we had seen her last but she had left the room. Your dad came back about a minute later and said he couldn't find anyone. I screamed, “The baby is coming NOW!”

“The baby is coming RIGHT NOW!”

There was absolutely no way I could stop you from coming as my contraction was doing the work of pushing you out. I heard the nurse yell from the door way, “What?!” She rushed into the shower to help be an extra pair of hands.  And I delivered you. 

You were born at 6:57 p.m. Twenty-two minutes after we parked the car. Almost exactly 12 hours of labor, over 7 of which I spent at work. The nurse had pulled the emergency cord just as you were being born so the room soon filled with all sorts of surprised and concerned looking medical people. The midwife, Stacey, asked if I would like to go to the bed. I told her I wanted to sit a moment. I, too, was a bit shocked. I never expected for you to come so quickly or without me having to push even ONE time.

A few moments after you were born I carried you over to the hospital bed and laid down. Stacey and the nurse did a few necessary things as you began to breastfeed for the first time. The nurse didn’t rush us at all and told us to take as much time as we wanted. A little over 3 hours after you were born you were weighed and we found out you were 9 pounds 7 ounces! 

Several days after you were born I looked at the first phone call I had with the midwife. It turns out it lasted about 2 and a half minutes. I had a contraction immediately before and after the call. The contractions were MUCH closer than your dad had thought. It must have been he was mistiming them because the water was easing the pain so well that he wasn't realizing the contractions were starting much sooner than he thought. I also now know that I was likely doing some light pushing during the time that I was getting out of the tub and while we were stuck in traffic when I was feeling the urge to push. It's just not possible to resist such a force of nature. I'll fully admit that 22 minutes from hospital parking lot to your birth was certainly cutting it close and it would have been preferrable for the midwife to be present. I wouldn't have planned it that way on purpose but now that I know we're all safe I couldn't be happier.

Your birth was truly perfect. No lengthy and annoying triage questions. No vital signs, no blood work or IV. No contraction monitor or fetal heart monitoring and not a single cervical check. Not even the midwife. Nothing. Only the nurse to help guide you into my arms, your dad, me and wonderfully healthy and beautiful YOU.  

You can read about the birth of my first daughter in The First Birth Story which included much more intervention, was twice as long and required a lot more pushing. This story goes to show just how unique each and every birth is, even to the same mother.

Both of my children's birth were done through a natural method called hypnobirthing. This method uses relaxation and self-hypnosis as well as trust and understanding in yourself and your baby during labor and delivery. I have written about some of the things I have learned using this method in Labor Choices and the importance of skin to skin in Moments Right after Birth. Be sure to check out hypnobirthing.com if you're interested in learning more about this method of birthing. 

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Moments Right After Birth

Before I had my own kids, I enjoyed watching other people bring children into this world so I would (not infrequently) watch “A Baby Story” on TLC. I now wonder why I watched it. But it gives me an opportunity to paint (or should I say blog) the picture I saw over and over while watching births on that show.

Very close to what is expected to be the final push from mama - the doctor most often just entered the room at this point -  the nurse places a blanket or towel on top of mama’s belly. Once the baby is born, the baby is then laid on top of that towel. Mom may have a chance to touch the baby’s head or shoulder. Nurses then come in from each side of mom and began to cover baby with warm towels and vigorously rub all that “stuff” off baby’s body. Very shortly after that, the brand new baby is whisked away to be weighed, washed, have hepatitis B and Vitamin K shots administered and ointment placed in her eyes. The sweet baby is then swaddled and placed in the waiting mom’s arms. 

The above scenario doesn’t occur on every single episode of “A Birth Story.” Just most of them. And this is the version I have most often seen on fictional TV as well. And it’s not just TV. I saw the same thing when I was completing my rotation in labor and delivery while I was in nursing school. 

I recently posted my oldest daughter’s birth story and it got me to thinking even more about the moments right after birth. My story is a little different than the one above:

My midwife had been with me, for the entire 80 minutes, while I pushed. She did occasionally leave the room to check other patients but she was there nearly the entire time, encouraging me through the exhausting process. Towards the very end, when the midwife expected me to be near my very last push, she told the nurse to take off the fetal heart monitor and contraction monitor. The nurse looked at her in question at this but the midwife nodded for her to do it and the nurse proceeded to hold the fetal heart monitor by hand against my sore belly. I was so relieved to be freed from the straps because I really didn’t want those things on when my baby was born.

I put absolutely everything I could into that final push – using every ounce of effort I had left in me. And finally, finally, my sweetness was born. She was immediately laid on my belly and warm receiving blankets were gently placed on her back. She held her head up high and looked me in the eye. I could tell she was a bit tired too but she began to, ever so slightly, wiggle her little body up to my chest. The nurse was able to complete the APGAR checks right on my belly. Although we had grandparents anxiously awaiting to meet our new arrival, we didn’t have any visitors back to our room for about two hours. It was wonderful to have this special time with our brand new family. My plan was to have two full hours of immediate skin to skin time with my baby right after birth. Unfortunately, I had some complications and this time was shortened to about an hour and a half so I could get some much needed medical care. While the midwife took care of my needs my baby was weighed, had those adorable little footprints completed and swaddled. She was then placed in her daddy's anxiously awaiting arms.

Something I am passionate about is letting women know that have choices – they can make their own informed decisions about these things. You can choose what you want in the moments right after birth. Just as I wrote about Labor Choices; you do have a choice and you can vary it depending on what may work best for you. I would like to add the disclaimer that this is for uncomplicated labor and delivery for a healthy mom and baby. The health needs of mom and baby are always a priority. And we have to be able to trust our health care providers to make those decisions. However, the majority of the time there is absolutely no reason why a baby has to be washed, weighed and measured in the first 10 minutes of life.Your baby never has to receive eye ointments and shots if you decide against those things. If you are giving birth in a hospital there are some policies they follow such as completing the APGAR checks. Also, if you simply want your baby to be cleaned right away - that is your choice too - and certainly no judgment here for that!

The point is, though, the birth plan goes beyond the labor and delivery to the moments right after birth. You can add this to your birth plan if you wish to do so because it is simply your choice. And I cherish those moments right after birth more than I could ever explain in words.

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The First Birth Story

A little intro before the birth story itself: 

The first birth occurred in October of 2010 (and is of my daughter, who I am calling Autumn in this blog). This birth story was written long before I entered the blogging world and (although I also have a saved copy on my computer) it is printed and stored in a box with other mementos from my daughter's life. Her birth story is nestled in the box with the card with her footprints, the little knit hat they put on her right after birth and the tiniest little blood pressure cuff you can imagine from when she was hospitalized when she was only 3 days old. This birth story was written for her so that she will know the beginning of her journey into this world. As she reads it, I hope she may also look at the other items - the foot prints, the hat, the blood pressure cuff - and be able to imagine herself being that small but changing our lives in the biggest way possible. 

I decided to include the birth story here because I cannot imagine having a mommy blog without sharing this story. This version is slightly shorter - with some of the finer details removed. 

At 41 weeks I had an ultrasound that showed marginal amniotic fluid (but everything was looking good with the baby) so I was told to return for a second ultrasound in half a week for a recheck. At the second ultrasound the fluid had decreased further. After more tests and long talks with the midwives, discussing risks and benefits, we decided to start an induction. I had been having contractions for the past month (on and off) and they picked up a little more on the day of induction (maybe 3-4 every hour). I had my first “check” of my pregnancy that evening and found I was 2cm and 80% effaced at the start of the induction. The induction started at about 10 PM with the placement of a Foley bulb. This is a procedure used for induction by placing a tube in the birth canal and inflating the balloon on the catheter. Unfortunately, my water was broken by accident by my midwife while placing the Foley. 

At 2 AM  I began to have regular and more frequent contractions (every 5 minutes). When the stronger contractions started, I had been sleeping comfortably for about 3 hours. It was not the contraction that woke me though. I felt very strong kicks from my baby and then the strongest feeling of gastric reflux imaginable, followed by a contraction. This is how my labor continued for the rest of the night until about 7 AM when I was ready to get up and get moving. We walked the halls for a couple of hours. My contractions continued to be every 5 minutes apart.  We were mostly just experiencing giddy anticipation and labor was completely tolerable.

The midwife came in about 9 AM and removed the Foley. I was 4cm, no change of effacement. I walked and walked some more to try to increase my contractions. I had my ear phones in and was listening to my birthing affirmations during my hours of hallway pacing. I also spent some time standing in the shower (which felt wonderful and relieved much of the discomfort). After about 5 hours (at 2 PM) my contractions continued to be 5 minutes apart and I was checked for the 3^rd time during my pregnancy. I only had a 1cm change (now 5cm). After much discussion it was then decided to start a Pitocin drip. As much as I didn't want to do so, it seemed my progression was not increasing and I was getting some pressure from the MD on-call because my water had been broken 16 hours earlier. My midwife started me on a very low dose with the plan to go up every hour, as needed, and to continue walking. 

Despite being on the Pitocin drip, I was able to continue my labor as I had planned. I ate and drank until I no longer wanted to do so (which was when I threw up on my RN's shoes in transition!). I was put on the portable monitor and allowed to walk and get in the shower for pain relief. I was checked about four and a half hours after the drip was stared (about 7 PM) and was still only about 5cm. I cried at that news because the contractions had picked up in frequency and strength so much and I was certain that I was going to be further than that. At the time of that check I had forgotten what I had learned in birthing classes - that our labor and body is often ahead and the "checks" may reveal a slower level of progression. I felt a bit defeated and I decided to get in the shower again to help ease my growing discomfort. I was in the shower for about 30 minutes and it was during the shower my contractions increased further- I didn't even truly notice because it came on so quickly.  

As soon as I got out of the shower - transition was in full force and everything does get a little blurry after that! I do remember being freezing after the shower and was distracted by getting dry and warm. As crazy as it may sound, the distraction of being cold helped me get through the new intensity of the contractions. During this time, I was only comfortable in a standing position. As a contraction started, I would grip the bed's side rails and lean over to get through each one. Thankfully, this intensity only lasted about a half hour (although at this point I had no concept of time). At some point during this I requested my midwife to come in my room and although I never articulated the reason I wanted her, she came and sat with me anyway. And an hour and a half after that check when I felt defeated - I started pushing!!

It took me about 80 minutes to give birth to my baby. I used my breathing and self-hypnosis throughout and my husband was by my side and encouraging continuously. There where times when I felt as though I was not in full relaxation and I was thinking too hard about things but then when I was told that I napped (and didn’t even realize it) I knew I really was relaxed.  There are a few special memories for me during the birth. As the baby crowned, my midwife asked me if I wanted to touch my baby. I declined at first because I was very focused and I think I must have been worried it would take me out of my concentration. A few moments later, she asked again and this time I was ready. For the very first time, I touched my baby. This must have been motivation not distraction because I got strength and pushed on. There were times that I thought to myself during both the transition and the birth that I was really tired and it was getting quite difficult. Each time, something happened that was able to motivate me through it. Another time like this was when the midwife asked me if it would help me to hear that my baby had a head full of dark hair. Very soon after learning that my sweet baby was born.

Labor Choices

There are only a few lessons I can clearly remember from elementary school. Of course, I can attribute elementary school to my ability to do basic math, (mostly) write in cursive, make a tiny volcano, and find a library book among many other important skills. But I’m talking about life lessons.

One that has stuck with me was about choices. One day the principal came over the intercom and discussed this topic saying something like: We make around 610 choices every day. Some of these are minute, like which shirt to wear or to brush our teeth, and we spend little time thinking about them. Others are very important and it may take a lot of consideration before we decide on something. Some decisions we make are impulsive like pushing someone back who has pushed us and some choices are even involuntary. From the very smallest to the biggest choices; every choice has some consequence, some kind of reaction.  And, he explained, that sometimes a small choice (like not brushing our teeth) can lead to a bigger consequence. So it's important to consider what choices we make each day.

From the moment we find out we’re pregnant (or even start trying) we begin to make choices. To continue to drink caffeine or not (I chose to drink it and enjoyed it every day), to eat or not eat lunch meat (I opted against this one). And what about alfalfa sprouts and soft cheese and on and on. And that’s just the VERY beginning. 

One of the things that I find the most frustrating about the birthing process, though, is that it often seems women really aren’t given a lot of choices. They are told about policy and protocol and asked a few questions about preferences. But often it seems like the doctors or hospitals are making most of the choices. So what happened to the lesson I learned in elementary school? What happened to us getting to make choices? We can decide what we want to do with our body and baby for 9 months but when it comes down to the day of their births - seems like choice isn't always in the discussion.

There are 3 things that I have decided to detail regarding my experiences with what I feel are limited birth choices (although there are many more examples). And this isn’t about a natural, medication-free birth. I completely realize the thought of that alone would make many women not want to read this. This is just about options about natural choices.

1. The Checks: In no other medical setting is a test performed just to “check” - there has to be some purpose, some indication that the finding will result in a change of care. The checks before labor even begins can tell an anxious and anticipating soon-to-be mother absolutely nothing about when her baby will come and often just induces more anxiety! However, this is a standard practice around 36 weeks of pregnancy. The important thing to know is if you are 3cm dilated you might not go into labor for 5 more weeks or you can be zero centimeters and go into labor tomorrow. The “check” can not guide or predict anything about your baby's birth day. There’s even some risk associated with them. So, why do it?

My story:  

Baby #1 - My very first check was when I was 41 weeks and 3 days and was on the day of my induction. The check was done to determine what type of induction I would need. And throughout the induction, my checks were only performed to determine the next intervention in the induction. I fully understand the purpose of checks in this setting. But we made it clear that no other hospital staff were to perform these checks – only the midwife I had agreed to provide my care.  After about 17 or so hours of active labor, I was checked for the fourth time during my labor. I was told I was 5cm dilated (only a 1cm increase) from the check 4 hours earlier. I felt defeated and began to cry. How was that possible? I had been walking in circles for hours and each lap around the nurses’ station I was having to stop more often and for longer to get through the contractions. I was certain I had progressed further. My family was watching me and they were certain. The damn check indicated otherwise. Defeated. To my core. I went back into the shower where I got the most pain relief.  A very quick hour after that check, I was fully dilated and pushing. Case in point – the check was not a predictor of time for my baby’s birth -even in the middle of labor!

Baby #2 – I labored for 11.5 hours out of the hospital. After being in the hospital for 22 minutes I gave birth to my perfectly healthy baby with NO CHECKS!!!

2. Timing: I hear it over and over again. The doctor or a practice will not “let” a woman be pregnant for longer than 41 weeks. The length of pregnancy is different for all women. A recent study reports that pregnancy length doesn't just vary due to inaccuracies of dating conception, but that it naturally varies up to 5 weeks for different women. So, in effect, many offices don’t allow women to be pregnant for their entire term and induce on an arbitrary timeline (meaning for no medical purposes). Now, that being said, I do understand there are potential risks to mom and baby that often need to be evaluated. That’s why open communication with providers is so important. So the question here is, why are there policies on the length of a pregnancy in the absence of any medical concern?

My story:

Baby #1 – During the 41st week of my pregnancy, my amniotic fluid levels had continued to decrease after 2 separate ultrasound checks that week. My husband and I discussed options with my midwife and weighed the risks and benefits and made the decision to proceed with an induction at that time. My induction ultimately went very smoothly and I gave birth at 41 weeks 4 days to a perfectly healthy baby girl. My induction wasn’t arbitrary; there was a medical reason, but it was still a choice. We had no way of knowing what would have happened otherwise and had to make the best choice we could with the information we had. But part of me, even today, still wonders if I should have waited for the next day.

Baby #2 - I had anticipated my second pregnancy to be as long as my first so I was pleasantly surprised when my baby decided to enter this world at 40 weeks and 5 days!!

3. Nourishment: Labor is called labor because it is one of the most physically demanding things your body will EVER go through. So hydrating and nourishing it through hours and hours of intense work is just simply logical. However, once a woman enters a hospital setting she is most often made NPO (medical lingo for “nothing by mouth”) or limited to ice chips, popsicles and little more. I would like to use the example of a marathon runner here. Lets take away her water, her Gatorade, her Goo. How well do you think she would perform? Would she win? Would she even finish the race? Doubtful. So why would we do this to women during labor? The reason is because the medical world is overly cautious. There is a (very small) risk that you may have to have anesthesia during an emergency caesarian and you may vomit  into your lungs. Yup, that’s the reason. You also risk having the unpleasant experience of vomiting during regular labor...as if thirst and starvation aren't also unpleasant! I definitely think it's worth asking the question of your providers if you may have something to sustain you through this time. 

My story:

Baby #1 -  Was born at 9:57 PM and I ate lunch that day. I didn’t eat dinner because I was in transition and didn’t want to eat. In fact, I vomited on my nurse's shoes. Although it was probably not all that pleasant for her, it didn't really bother me much. (I was a little busy). I also drank my labor beverage of choice (Peach Snapple) until I no longer wanted to drink it. 

Baby #2 - Was born at 6:57 PM and I ate lunch that day. I also drank a latte from Starbucks around 3:00. I had sips of water up until about an hour before the birth.

I ate and drank a considerable amount during labor for both of my children. Even with this, I don’t think I can explain to you the hunger I experienced after giving birth. I have never, ever been hungrier in my entire life. I asked for food immediately and was given peanut butter crackers and juice in the delivery room. Once I got to the post postpartum room, I had a white bread turkey sandwich (one of my least favorite sandwiches, and I found it delicious), some fruit, and more juice. My husband scrounged more food for me from the patient area. I rested on and off through the night and counted down the hours until breakfast. I had a near panic attack when I found out it didn’t come until 8:00 (it’s served at 7:00 at my hospital).  The kind nurse brought me a pre-breakfast bagel and fruit and then I ate the hot breakfast an hour later. I ate and ate and ate. And the thirst is the same or worse!! Every time I think back on the experience of my post-labor hunger and thirst I can't help but feel for the moms that are cut off from this basic necessity for hours while putting their bodies through the demand of labor.

 

Now in closing: I’m not suggesting that all women go out and refuse cervical checks, refuse inductions, or demand to eat and drink whatever they want during labor. Only that I have noticed that we are often told what will happen, rather than being given options on these things. We just get instructions on the way it shall be done based on the obstetrician’s office policy or the hospital policy. I didn't accept many of the "norms" as part of my pregnancy and labor and asked questions to find out if there were alternative options. I did lots of research, attended 10 weeks of birthing classes and read my hypno-birthing book. I'm certainly glad that I did these things and I just hope that more women can be empowered to ask more questions and make more choices - whatever the right choices may be for them. 

You can't make positive choices for the rest of your life without an environment that makes those choices easy, natural, and enjoyable. - Deepak Chopra

 

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