Tuesday, December 27, 2011

An OB Pushing Her Baby Out At Home? Say It Ain't So!


Is it wrong to admit that when I got this birth story I thought I was being Punked?  Only the sure knowledge that Ashton Kutcher couldn't waste his time on me assured me that this wasn't the case.  Though probably rare, this is a birth story from an obstetrician.  (I admit, I still have doubts.  I must be very, very jaded!)  

Seriously though, I have had four medical doctors in my classes trying to have natural births.  Sometimes even the people who are part of obstetric America realize that "that" kind of birth isn't what they want.  

Congrats to this mom on her lovely home water birth.  May we all have beautiful births like this.

Enjoy-


C's Home Waterbirth


This was my first pregnancy. My “guess date” was Monday, Sept 19. I had a wedding of a close friend to attend Sept 17 and joked at the party to everyone that 'Peanut' & I had had a discussion and that he/she was going to arrive the next day. I had seen my MW, Lisa, on Friday, Sept 16 and had had my membranes stripped. 

I was currently the chief resident in charge of the gynecology service at a busy inner-city hospital and we had a busy week planned – a week full of long surgeries and although I had prided myself on plowing through 60-80hr work weeks with nary a complaint, the thought of doing another week was almost more than I could handle. We made an appointment for her to come back on Sunday to restrip them again.

At the wedding I did dance a lot, which caused some non-laborish contractions but otherwise nothing to get excited about.

We had a late night and I didn't sleep all that well. I woke up at 6am with contractions that were uncomfortable but not really painful. I had watery bloody discharge in a fairly large amount and was concerned my water was broken. I was timing contractions at this time and when I had woken up they were about 5-6min apart. I gave up laying in bed about 7am and got up, sitting on an exercise ball, moving my hips during contractions. The contractions persisted and about 8am I decided to call Lisa and let her know that I had somehow managed to make an appointment for my labor! LOL 

She thought I was just having bloody show and was not ruptured. About 9a I went to pee and there was just more of the discharge than I wanted to clean up, so I decided to get in the shower. The shower was really relaxing and made the contractions seem less intense but still frequent. However, once I got out they became more intense and required more attention. I could no longer sit on the exercise ball during a contraction so I went to kneeling on the floor and leaning over the exercise ball which worked great. Although they hurt more, I still felt in control. I was able to snack on some fruit here and there – luckily I thought to eat a substantial breakfast right when I got up before things got intense – my mom kept me supplied in cut up fruit and water.

Lisa arrived at 11:30a and I asked to be checked – I was 4-5cm, 100% effaced and -1 station! Progress!! Things continued to progress and I asked if we could get the birth pool set up. While they were doing so I got back in the shower for relaxation purposes and had a smaller exercise ball that fit in the tub with me!! Between contractions I'd sit on the ball and during them I'd either be standing with the water running over my belly or bent over with it running over my back. I stayed in there until I started to run out of hot water. 

Once I got out of the shower, the contractions took on a whole new personality. I then realized I'd have to wait for the birth pool as I'd used up the hot water. However, totally worth it, so I thought at the time.

I came back downstairs and went back to kneeling over the exercise ball. And I think this is where I hit transition – they suddenly got much less manageable, and I was vocalizing through them now. Lisa showed DH how to push on my hips and massage my lower back with some oil she had – they also lightly massaged my shoulders and upper arms, and this was awesome for a while. I think relaxing through this kicked me over into transition and when the birth pool was ready, so was I!

I had two crippling contractions walking up the stairs, then Lisa insisted I try to void before getting in the pool, so I did and had another crippling contraction on the toilet. After that was over I wasted NO TIME and stripped off all of my clothes and basically fell into that pool, which felt AWESOME.

And I credit that awesome pool with helping me to relax that last little bit and take me into the final stretch of transition, because then things became Unmanageable. I'll be honest, I kind of lost it. I vocalized through some, swore through others, and pleaded/cried through the rest. A few I swear I had an out-of-body experience that made me stare at a spot on the wall and I think I believed that I was, in fact, dying. I did get rechecked at 2pm and was 7cm and now +1 station! Progress!

I thought 2 hrs had passed and asked to be checked again – I told Lisa that I needed to KNOW that I was progressing with contractions like this – Lisa said if I really wanted to, ok, but she needed me to get out of the pool to really get a good check, though. I reluctantly got out and laid on my bed on my side. 8cm. “GODDAMN IT, LISA, THAT'S IT?!?!”

I wanted her to tell me I was complete.

“Uh, Rebecca, it's only been 45 minutes – you've made great progress in that amount of time.”

Forty-five minutes?!?! It felt like ten years.

I cried through a contraction on the bed and got the hell out of there and back into the pool, where I continued to have contractions. I won't lie – it wasn't pretty. I asked for people to kill me, and when DH joked “ok,” I punched him. Twice. I begged for an epidural, and I'll be honest, the only thing that kept me from going to get one was the thought of going anywhere to get it. If I had been in a hospital, I TOTALLY would have caved. And regretted it later. Yet another reason I'm glad I had a HB.

I want to take a moment to give my mother a little credit, too. She is a retired hospital-based midwife and was my doula through the ordeal and was a great source of support. I spent a lot of transition alternating between clinging to her and DH. I remember at one point begging her to help me, and she told me “No one can do this for you, honey. This is your mountain to climb. And you are.”

Not long after that the contractions changed – they seemed to develop a downward force and I was feeling a lot of pressure in my bottom. I voiced this and shortly after Lisa appeared having changed into scrubs and I saw her lay out 3 crocheted baby hats. “Welcome to the second stage, Rebecca.”

More beautiful words were never said. I pushed some with a few contractions and was pissed she couldn't see the head yet. She knotted a sheet and I played tug-of-war with DH and felt even MORE pressure. I was still upset she couldn't see the head (I mean, GOSH, I had worked hard for like, 3 whole contractions!) she checked and told me to reach down and feel his head – it was only a short ways in, in OB-speak we would have called it +2-3 station.

And I decided I was done with this labor thing. This child was going to come out, and SOON. The next contraction I pushed hard and felt him crowning. Definitely the 'ring of fire' burning sensation everyone talks about. The next contraction I was ready to suck it up and then pushed through that, and his head was out. Evidently the shoulders came out with the head, but I just felt that he was still there. 

I felt a little panicked, worried that I still had the shoulders in and had a shoulder dystocia. I guess I was just expecting to have the baby pulled out the rest of the way, the way we do in the OB-world. But they were just waiting for another push from me. So I did, and then he was here.

They passed a wet, slippery baby up to me, and I pulled him up to my chest and sat back. He didn't cry, but was breathing fine and pinked up well! I remember looking up at my team around me, almost in disbelief, saying “Oh my God, I did it. He's here, I did it.”

It was 4:08pm. Not only did I do it, I had done it in only 10hrs, with only 25 minutes of that pushing!

I was reminded to look down and see what we had – and it was indeed a boy! We didn't know the gender beforehand, but I had trouble seeing the baby as a girl – although I would have been fine with either. 

His APGARs were 9 & 10! After a few minutes I felt another contraction and pushed for the placenta. Then his cord was finally clamped and DH got to cut it :). I eventually got out of the pool and the damage was assessed – only a few minor tears, just a couple of stitches for cosmetic reasons more than anything else, and we were good to go! 

I was helped into a quick shower and then tucked into bed. During the shower DH had done skin-to-skin time with the baby, and now it was time for the full newborn assessment – it was cool that DH got to weigh him, and he weighed in at a startling 9 lbs 5 oz!!

The recovery so far has been great! I have some discomfort down below and I feel a little worn out, but no big deal. So far breastfeeding is going great, and little Caden is thriving. So far he's very laid-back, only seems to cry if he needs something. I like to attribute his chill attitude with being born into water into loving hands, and not spending his first moments being suctioned, rubbed and then tag & branded like cattle by strangers. I love that he doesn't have a single drug in his little body and take pride that I was able to provide that for him.

And I especially love that I was able to birth my beautiful boy without interventions and can focus more on learning to be a mother than on making it through my own recovery. I'm so glad my spine remains unviolated by an epidural and my bottom wasn't victim to an episiotomy. I have no hemorrhoids from pushing because I was able to push from an advantageous position and have every push be an effective one. Many hospitals would have stuck my poor baby every hour for a blood sugar value due to his size, even though I had good prenatal care and tested negative for gestational diabetes.

The best part was DH & I spending our first night together with our LO snuggled in our own bed uninterrupted by vital signs and other hospital protocol.

Many of my co-workers were shocked when they found out I delivered at home, but overall I have been pleasantly surprised by most people's reactions – what can anyone say when we had such a wonderful outcome? I tell them I didn't expect anyone to understand, so I lied to avoid the unproductive discussions (I had told all of them I was delivering w/my GYN at a nearby hospital). 

I'm sure that I've been the talk of the residency program for the last week, but I don't care. In fact, a lot of stories have been pretty hilarious!! I have told my coworkers that have visited that it's a choice I would definitely make again, and it was worth every penny I spent on it!

I remember at my first Hypnobirthing class, 15wks pregnant, and my instructor asked every couple to share what they hoped to gain from taking her class. I said, “Well, I really don't want a c-section, and I really want my birth to be a satisfying experience.”

I'm so happy to be able to say that it was.

~~~~~~~~
(I have since done an interview with this mama and you can find it here!)

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