Monday, February 27, 2012

Loss and Glorious Joy- A Tale of Two Births

Such a wonderful birth after an initial tragedy.  I don't think there is anything I can add here, except congratulations to this mother and her family.  You can read her blog about her family and her journey, along with thoughts for other loss mothers, here. 

Enjoy~
My first baby, Charlotte Ava, was born at a birth center.  She died shortly after birth, cause unknown.  Pregnancy, labor and delivery were normal with no complications.  My second baby was born in hospital.  All natural, posterior, born with his hands next to his face - ouch!  The midwife from my first birth provided prenatal care and acted as my doula for Bennett's birth.  I saw a high risk doctor throughout the pregnancy, he was also present at the birth.  I was terrified to birth again, scared I would lose another baby, but I had a great support team who helped me welcome Bennett to the world.  With his birth I learned it is possible to birth naturally despite post traumatic stress disorder and extreme fear.  I also learned the value of loving caregivers.  I delivered at a hospital an hour from my house, though we live ten minutes away from one, so I could have the birth I desired.  

Bennett William
September 9, 2011
3:42 am

The end of my pregnancy was an emotionally difficult time for me.  I felt like I was drowning in anxiety.  I wasn't sleeping well, every morning for a month I would wake up sick to my stomach.  From 36.5 weeks on, my first false labor moment, which turned from labor into the flu, I was sick on and off.  My body was trying to prepare for labor, at least that's what I think, but I couldn't let go, allow it to happen.  I also had a small amount of bloody show and a just kidding, only peed my pants while throwing up, membranes still intact, moment in the days before Bennett was born.  My body was ready, but my mind put its foot down.

I was exhausted and scared.  I cried a lot.  I experienced terrifying panic attacks.  I listened to the Hypnobabies fear clearing track over and over and over.  I talked to my midwife, I prayed, I tried to focus on something outside the pregnancy, but couldn't manage it.  The mind can affect labor and birth in monumental ways.  My midwife and Dr. K were surprised I made it to 39 weeks since I was dilated to 5 cm at 36 weeks.

Dr. K said he would induce no sooner than 39 weeks.  I was set to go to the hospital on the evening of the 8th.  The plan was to break my water, give me a couple hours, if no progression happened Pitocin would be administered.  I didn't like the plan, but I couldn't cope with any other plans.  Dr. K was willing to let me hit 40 weeks before induction, and he said I could go past 40 but he would not recommend it, but the anxiety was too intense for me to contemplate going past 40.

Around 11:00 on the 8th my midwife came over.  I wanted her to strip my membranes, see if I could get a jump start on the hospital induction, render it unnecessary.  The stripping of my membranes was uncomfortable, but effective.  I immediately had bloody show, cramping, and lots of back pain.  

I paced in the living room, waiting for something to happen, while my midwife ate lunch and watched me.  Okay, she probably did more than just stare at me, and I know I sat down and we chatted some while she ate, but it felt like she was watching, waiting to see what would happen.  Dr. K and my midwife were concerned Bennett would come fast because it seemed like my body was doing a lot of work in the weeks before he was born. 

After an hour and a half or so had passed I called J at work, told him he should come home soon.  My midwife called Dr. K's office to let him know we would head down to the hospital in a couple hours.  I was hesitant about going, wasn't sure if it was actually labor because it felt so different from my labor with Charlotte, but my midwife said I went from slightly uncomfortable to very restless in a short period of time so it was time to move. 

We arrived at the hospital in the late afternoon.  After checking in we were taken upstairs to a corner room on the labor and delivery floor.  I was hooked up to monitors, accessed in case an IV was needed, paperwork was filled out, Dr. K came in, at some point it was decided that I was most definitely in labor.

We walked the halls for a while.  My back really, really hurt.  I still wasn't convinced I was in labor because I didn't have any pain in my abdomen.  I couldn't feel my uterus contracting so figured we were in for a Pitocin induction later that evening.

I had intense pelvic pressure as well as back pain.  At the house I would squat to ease the pressure.  By the time we reached the hospital I was squatting and using my hand to apply counter pressure to reduce the feeling.  I looked like a child in need of a bathroom, but I could not stop myself from squatting and applying counter pressure, even in the hospital lobby while we waited to be checked in. 

J thinks I am crazy for wanting to deliver at night because I lose so much sleep, but the idea of going to the hospital on the morning of the 9th only made me more anxious.  It seemed like it would be busy, rushed, hectic, so I chose the late night option. 

We would walk for a while - me, J, my midwife, her apprentice all trailing down the hallway - then head back to the room for more monitoring.  The back pain, oh my goodness, words fail me.  The pain radiated up and down my right side, but not my left, and I could not get relief. 

I tried hands and knees on the bed with my midwife, or her apprentice, massaging my back and legs.  I tried the birth ball.  I tried standing.  I tried squatting.  Eventually I ended up in the shower, standing under the hot water, squatting or kneeling when I got tired of standing.       

J said he had no idea what to do, how to help.  He said I asked him to support my back without touching me at one point.  He just stood behind me, hands spread wide, uncertain how to proceed.  I really didn't need J until the end of my labor, when transition happened and things went from intense to out of this world crazy.

My midwife's apprentice brought a camping lantern for me to use in the bathroom so I wouldn't have to labor with bright lights on.  Dr. K found it amusing, but admired the idea.  I have no idea how long I labored in the shower, but it felt like years.  My midwife sat on the other side of the curtain while J and the apprentice sat on the couch in the room and chatted.

Late that night my water broke.  I thought that would get things going, but it turned out that was my fore bag, which was holding me open to 8 cm, and my hind bag had yet to break.  At the time no one knew I had two bags of water though, so everyone prepared for things to speed up.  But they didn't.  Instead I went from 8 cm down to 4 or 5 cm and my contractions dropped off.  

That was so frustrating for me.  I would feel the contractions building, think progress was happening, and then find out one of two things: I was not progressing, or I had regressed.  If I ever have another baby I am not having cervical checks NO MATTER WHAT.  I had way too many during Bennett's pregnancy and labor and knowing what was happening, especially knowing I was regressing, led to lots of disappointment and frustration.  

I would know that the contractions were slowing when I would start feeling distracted, followed by feeling hungry, which was soon followed by feelings of frustration and anger.  I could not focus myself enough, or I was just too scared, to keep the contractions going. 

Around midnight Dr. K offered Pitocin to help things along.  He said we could keep going, keep waiting to see if the contractions would eventually sustain without augmentation, but I couldn't get my head around that prospect.  I felt like it would never happen, and I just wanted to be done.

I was started on a low dose of Pitocin and it worked really well.  I labored on the toilet for a while, though this stressed the nurse out a bit, I think, and then I alternated between leaning on the bed and a big stack of pillows and dropping down to squat on the floor.  While leaning on the bed I felt a huge gush of fluid, it was my second bag of waters breaking.

Once that happened I had my first major this is not a joke, it hurts, what the world was I thinking wanting to do this without medication contraction.  My labor with Charlotte followed a similar pattern.  The last two or three hours of labor, also known as after transition, are PAINFUL for me, but the contractions before then are manageable.  Although the back labor I had with Bennett required more from me than the early contractions with Charlotte.

At this point I pretty much lost my mind.  Thankfully this made the nurse stop talking about how fabulous I was doing at 8 cm.  That nurse .... she was very cheerful and encouraging and amazed by my laboring skills. I wanted to punch her face in.  Earlier in my labor she asked me to come out of the bathroom and I said, "Sure, if you'll leave the room."  She had a good heart, but she talked a lot, even though I asked her to be quiet.

From the initial serious contraction, which was my first uterine contraction the entire labor - at least that I could feel - until Bennett was out and breathing was emotionally and physically difficult.  I screamed with each contraction.  I said (yelled more like) I don't want to do this, I don't want to do this.  Last time I did this a baby died.  He is going to die, he is going to die.  I don't want him to die! over and over and over.  My midwife rubbed my leg, my ankle, my foot.  She was sitting on the floor, I was standing my arms wrapped around J.  When the contractions hit I would slide down J to a squat, screaming all the way.  Contraction over I would climb my way back up until the next one hit.  Initially I was clinging to my midwife, but when the big contractions really got going I wanted J.

And then things get a bit hazy.  Or I've blocked it out to the extent that I've made it hazy.  The end of labor, as well as the pushing stage, was terrifying and is difficult for me to remember.  Dr. K asked if I wanted something for the pain.  I said no.  The nurse insisted I get on the bed, though I was quite happy squatting on the floor.  I asked for a birth stool once or twice, even though I had been told the hospital did not have them.  I started pushing.  An hour or so after I began pushing, my arms hooked around my midwife and her apprentice's neck, Dr. K using oil, massaging,and coaching so I wouldn't tear, Bennett was born face up (according to J who caught his head) with his hands right by his face.  

Ouch.  I can't believe I birthed a posterior baby with his hands by his face  That's something to be proud of! 

I reached down, because someone told me to, can't remember who now, and pulled Bennett the rest of the way out and up to my chest.  Dr. K looked at my midwife, who had tears streaming down her face, and said, "Congratulations."  I cried a bit, held Bennett close, asked if his color was okay, if he was okay, pointed out that he was breathing.  I was shaking all over from hormones, happy to be done with labor, which was twelve hours long this go round, almost unable to believe I had a breathing baby.  

Bennett nursed, we snuggled, his life outside the womb began.


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