Tuesday, September 27, 2011

My birth story

Forty-one weeks and three days. Our midwives told us this was the average gestation length for first babies. When I hit the mark, my baby had moved further down into my pelvis but still did not seem ready to make an appearance. I expected I might go all the way to 42 weeks.

My midwives weren’t concerned about him taking longer, but as a routine precaution, they asked us to go to a local lab to get a bio-physical profile. This ultrasound checks to make sure the baby is still doing okay.

We went to the lab the morning of Thursday, Aug. 11. This ultrasound was not nearly as life-changing as the first — the baby was so big that we could not discern any of his features on the screen. What we could tell was that he refused to move at all during the test. This didn’t bode well. We got back a score for how he was doing, and it was about half of what it should be. Not good news. He scored low on his respiration rate and movement. Our midwife, Patricia, called us immediately and told us to go straight to the labor and delivery area of Salem Hospital. It was time for the baby to come out.

When we got to the hospital, we met up with our midwives and talked with a doctor who said that based on the low bio-physical profile score, we should induce labor. Our son needed to be born right away. They would manually break my water to get contractions started; if labor didn’t begin, we would consider other methods.

Stuart and I were devastated. All our plans and dreams for a home water birth were being thrown out the window. We were worried about our baby and what might be wrong. But most of all, I cried because I was facing the exact type of birth I had feared — induced labor, in a hospital, with the possible threat of a c-section at the end of the road.

Patricia and her apprentice, Carmen, said that they knew this wasn’t what we had wanted, but they agreed with the doctor that it was the right thing to do. Stuart and I also agreed, and I tried to think about how to still have the natural birth I wanted, even if it wasn’t in the environment I desired. Patricia and Carmen do not have rights to deliver babies at Salem Hospital, but they were willing to stay with me through the entire labor to serve as doulas, support me and help me decipher what was happening.

At the hospital, right before they broke my water.

My midwives, Carmen (left) and Patricia
Stuart rushed home to pack up some items I might need during and after the labor. At 4 p.m., the doctor broke my water. She said that if contractions didn’t start in an hour or two, they would consider giving me pitocin to get labor going. I cried again at the thought of heading down a labor path that was the opposite of what I wanted. When the doctor left the room, the nurse tried to comfort me; she told me that if I didn’t feel ready for pitocin, then I should tell the doctor and not let her pressure me into anything. It was the first of many times where I observed contradictory attitudes between the nurses and the doctors.

Almost two hours went by, and nothing happened. I walked up and down the hallways with Stuart, trying to get things started. Patricia and Carmen bought me a yummy veggie burger and sweet potato fries from the cafeteria — I wolfed them down, knowing that the hospital staff would not let me eat anything during my labor. Still no contractions.

Then Patricia saved the day. She suggested we use a breast pump to stimulate my nipples, which can release oxytocin and help labor along. We began pumping, and sure enough, my contractions started. My relief was enormous — I had avoided pitocin, and still was maintaining my path toward a natural delivery.

The contractions weren’t too bad at first. I sat on an exercise ball while all of us watched one of my favorite movies, “Dazed and Confused.” By the end of the film, I was barely paying attention, as my contractions had gotten stronger and it became harder to concentrate. I had read about multiple pain techniques in a wonderful book called “Birthing from Within,” but it seemed like the only one I wanted to try was deep focus on my breathing. With every contraction, I closed my eyes, breathed in deeply, and let out a long and sometimes noisy exhale, twice as long as my inhale (a breathing technique I had learned in my prenatal yoga classes). In the meantime, the nurse wrapped my belly with a monitor to look for variations in the baby’s heartbeat in response to each contraction.

As the labor moved along, the monitor kept moving off my stomach and it became harder for the nurses and my midwives to discern the difference between my heartbeat and my baby’s. This especially was true as I moved to the bathroom and got into the tub for relief from the pain. Salem Hospital does not allow water birth, but they do have tubs for use during labor. Patricia anxiously watched the heart rate monitor. My baby did not seem to be reacting as he should to the contractions, and we became worried. Patricia suggested that the nurses place an internal heart monitor on the baby so that they could more closely tell which heartbeat was his.

This is the last technical thing I remember. I read in “Birthing from Within” that women move into a state called Laborland where their mindset and sense of time completely changes, and this is exactly where I went. The contractions were so intense and close together that I could only think about them and how to get through each one. I lost my ability to form complete thoughts. People asked me questions, but it took me a minute or so to register what they said, and I could only respond with one word. Sentences left me. I only wanted two things: the end of each contraction, and Stuart glued to my side.

Stuart was my rock during all of this. He stayed right by me, whether I was in the tub, on the toilet, in the bed, or in a chair. He let me grab his finger during each contraction and squeeze with all my might — I don’t know how I didn’t break his joints. He only left me briefly when he had to go to the bathroom. He put water to my lips when I asked, moved hair out of my face, helped me in and out of different positions, continually whispered in my ear that I was doing great and that I was strong and that I could do it. Feeling his fingers in my hand and his lips at my ear made all the difference in whether I could get through each contraction.

As the contractions got stronger, I found that my exhales became noisier. This was another suggestion from “Birthing from Within,” to let it all out and not be afraid to make noise. I started my moaning loudly during my exhales, because it felt right. As labor progressed, I found my moans converting into what sounded to my ears like low growls. Sometimes, when a contraction was particularly intense, these growls turned into outright hisses, like an angry cat. Even in my murky Laborland, I was astounded that these sounds came out of me. They were so primal, so animalistic. But they made me feel better. Sometimes I wasn’t ready for a contraction, wasn’t prepared for my deep breath, and instead of a low sound I would let out high-pitched screams. I know these scared Stuart because they sounded more desperate. Patricia prodded me to return to my low sounds, and I did, which made me feel better.

Eventually I ended up on the bed on my knees and elbows, and I stayed in that position for so long that my knees were numb. But it felt better than any other position, and I did not want to move an inch. During these hours of labor, the doctor came in periodically to check the dilation of my cervix. Two centimeters, then four, then five, then seven. Each time she checked, I had made progress, and the midwives cheered that I was doing great. Even though I was glad to progress, I still said, “That’s all?” I couldn’t wait to hear that I was fully dilated.

I finally reached a point where I felt like I hit a wall and I couldn’t handle the pain anymore. All I wanted was to get the baby out immediately. I told Stuart, “Just get him out of me. I don’t care what you do. I want a c-section. I want an epidural. I want him out.” I was completely serious as I said these things, but I was greeted with silence from my midwives and Stuart. They wisely ignored me. At the time it irritated me, but now I understand that they were sticking with my natural birth plan. I’m thankful that they didn’t listen to me.

Eventually I hit a magical number: nine centimeters dilated. Almost enough to start pushing. I had already wanted to push for awhile because of an incredibly frustrating bowel movement that wanted to come out with each contraction. I eventually got most of it out and was ready to focus on the real pushing. When the midwives said I had reached 10 centimeters, they gave me the go-ahead to push. Stuart whispered in my ear, “You’re almost done. You can do this.” But I remembered many of the birth stories I had read where the pushing lasted several hours, and I knew I might still have a ways to go.

I also remembered multiple birth stories where the mom said the pushing was her favorite part — that it wasn’t nearly as bad as the rest of labor, mainly because she felt she could finally do something active to make the baby come. While I admit it was nice to finally feel more active, I found the pushing to be much more difficult than the contractions before it. I tried multiple positions — on my hands and knees, laying on my side, in the yoga child’s pose — but none of them seemed to work as well as laying on my back. This surprised me, because everything I had read and been told was that being on your back was one of the hardest labor positions because it makes the pelvis opening smaller. But this was the position that I gravitated toward, and the one that seemed to work the best for me.

Stuart held my hand, and my two midwives acted as braces for me to push against with my feet as I tried to imagine my pelvis opening extra wide. With each push, I clenched my shoulders and neck forward and tried to move that baby out. I pushed so hard that a rash broke out on my face and arms. It felt like I was doing this over and over with no result, although my midwives kept assuring me that I was making progress and that they could see a bit of the baby’s head. However, I began to lose hope that I could make it, and I told them this — after so many hours of difficult laboring, I just didn’t have any energy or strength left for the difficult work of pushing. Eventually the nurses gave me a saline drip to provide me with some energy, as well as an oxygen mask to help me breathe.

The moment that finally gave me some hope was when I heard the midwives say, “Look, he has so much hair!” Stuart looked down and confirmed this. The fact that they could see hair had to mean I was getting close. Then I reached down myself and felt the top of his little head, and it gave me more confidence that he was almost out. I still had many hard pushes ahead of me, but eventually the nurses asked the doctor to come in because the baby was nearly here. His head finally started to emerge, and I felt the burning that many moms call the “ring of fire” — this provided me with the strength to give the hardest push of my life and not stop until his head popped all the way out. From there, it was a cinch — another small push and my son was born. The doctor caught him and I reached down, immediately took him into my arms, and brought his red, writhing body up to my chest. He cried immediately — a nice, healthy cry that showed us he was okay — and then pooped all over my chest. But I didn’t notice. I was too busy looking at him, smiling, and telling him how happy I was to finally meet him. Stuart also gazed lovingly at him, and though I didn’t know it at the time, Stuart almost cried. Our son was born at 9:37 a.m. on Aug. 12, after 15 ½ hours of labor, two of which were spent pushing.

Unfortunately, I wasn’t done with the pain. I still had to birth the placenta, which only took a gentle push, but then the doctor told me that I had torn as the baby made his way out, and she had to stitch me up. It took 15 stitches to close the tear, and the pain was so strong. It was strange to me that I felt so much pain from the stitches after all I had been through with the birth, but I think it was because I wasn’t expecting it — once the baby was out, I thought I was done, so I wasn’t mentally prepared for more pain. Patricia kept telling me to focus on the sweet baby in my arms, so I tried, although it was tough until the stitches were complete. Finally I was able to just hold my baby and start to fall in love. Someone asked me about his name. I looked at Stuart and said, “Are we sure?” He nodded, and I said, “Archer.” It was the only name we had agreed on, and when I saw our baby, I knew it was right.

We left the umbilical cord attached until the blood stopped flowing between it and the placenta, about 10 minutes. Then Stuart cut the cord. As I watched him try to snip through it, I was surprised at how difficult it seemed — a sentiment he also shared. We let Archer lay on my chest for quite awhile, and eventually he started to make his way over to my breast to attempt his first feeding. It’s amazing to me how natural this is for babies and how they basically know what they need to do, if only we give them the time to do it.

Stuart and I were both so exhausted that we tried to spend much of the rest of the day asleep, although it was tough in the hospital with all the nurses constantly interrupting us to take tests, give me pills or ask how we were doing. There were many things I did not like about the hospital, but overall, I am grateful that after they broke my water, I got to have the birth I wanted: completely natural, no drugs, and without a c-section. Patricia later told me that with the way the baby’s heartbeat was not reacting properly during labor, she would most likely have transported us to the hospital if we had been at home. So I take comfort in knowing that at least we were at the hospital from the start, rather than having to attempt a transfer during labor, which would have been more difficult and frightening.

Giving birth to Archer was the hardest thing I have ever done — but also the most rewarding. Knowing that I was able to bring him into this world in the best way possible — without the interference of drugs — makes me confident that he got a great, healthy start. But more important, I feel empowered by the fact that I was able to deliver him naturally, the way I was built to, something that many of today’s women don’t even attempt and something that I often doubted I could do. Stuart has told me many times since the birth that he is proud of me for being powerful and strong, and he often thanks me for birthing our son. I truly feel that if I was able to do this, I can do anything. Which is a good sentiment to hold onto, since my life with Archer is only beginning.

Stuart holds Archer for the first time.

Our family enjoys a laugh with Patricia.

Archer weighed 7 pounds, 4 ounces. He was 19 1/4 inches long.