Saturday, July 21, 2012

A Birth Story

I've been inspired, now that I am expecting another baby, to revisit the birth of my first.  Most of this was coming from memory, but I did make a lot of notes in the first few weeks of being a mom.  My tone in those notes was, um, a little more freaked out.  I was probably not sleeping.

One thing that I do remember was my due date: June 1.  I loved that date because it was my dad's birthday, and my husband and I were secretly talking about kind of naming the baby after him and it all had such a sweet symmetry.

But, of course, as a first time mom, people told me to expect to go past this arbitrary date.  I had a visit with the midwife the Friday before my due date and she told me that she didn't think the baby would come on time.  "He hasn't dropped yet," she said. "It's pretty normal."  My due date was a Tuesday and it came and went with no baby and no contractions.  I went back to see the midwives later that week and again, they told me the same thing.  I was dilating well, probably around 1 cm, but he hadn't dropped into position and I really couldn't expect too much until he did.

On the Tuesday after my due date, when I was officially 41 weeks pregnant, I went  back and they told me the same thing again.  But by now, they were starting to look a little concerned about it.  I was still dilating, but nothing was happening.  I called my mom and gave her the update.  She had gone into labor with me and my siblings about a month early each time, so for her, this all seemed impossible.  To her, I was already six weeks later than she had been expecting.  She was coming to visit in a week, supposedly to help out with my weeks old baby, but I told her that maybe she would end up being there while I was in labor.  I wasn't really looking forward to that.

Wednesday, I returned to the midwives where they hooked me up to the fetal monitor for twenty minutes, just to see if maybe I was having contractions that I couldn't feel.  I wasn't.  For the whole pregnancy, I never even had any Braxton-Hicks contractions.  My sister-in-law had them for a month before her baby was born, and we all thought it strange that I'd never had any.  Now, it was seeming even stranger.  The midwives conferred with each other as they looked over the printed strip from the monitor.  Not that there was anything to look at.

They sent me home with castor oil and instructions for how to drink it.  Castor oil is the age-old midwife treatment to get a labor going.  I mixed mine dutifully with a bunch of ice cream and ate it for breakfast on Thursday morning.  Nothing really happened.  One of the midwives called me that afternoon to see how things were progressing.  "Come in tomorrow," she said.

So, back I went on Friday.  It was almost mid-June and the weather was just crummy.  Hot, humid, thick.  I had gained over 50 pounds during my pregnancy.  I spent most afternoons at this point laying on the couch, the fan pointed directly at my nether regions, drifting in an out of uncomfortable sleep.  I stopped calling friends to go to lunch with me, because every time they answered the phone they thought I was in labor.  No one wanted to hear, "I'm just bored, come meet me somewhere."

Jean was the midwife who saw me that Friday.  She stripped my membranes, which meant that she got what looked like most of her forearm into my pregnant body and swished it around a bunch of times.  "I feel like I can get you to dilate easily," she said.  "I bet I can get you to four centimeters just with my hand, that's great.  But the baby still isn't really in position."  She was frowning at me when she finished and sent me home with this dire warning.  "Call me tomorrow at two.  If you're not in labor, I think we'll just have to take you to the hospital."

I cried all the way home in the car.  I had been planning to have my baby at this birthing center, with the midwives who had been caring for me during my pregnancy.  Everyone who knew about this plan thought it was crazy.  My mother still said the word "midwife" like it was some foreign language.  She thought my fears of drugs and needles and unnecessary surgery were out of whack with reality, even while she refused to read anything on current statistics.  Other friends who had children already looked at me with wide eyes, and I could see them mentally spinning their fingers around their ears: I was coo-coo.  "Why would you ever try to have a baby without an epidural?" one of them said to me.  When I replied that it can be healthier, she scrunched up her forehead, as if the thought had never occurred to her.  That afternoon, when I broke the news to my closest family, that we were looking at a hospital transfer, everyone had the same paliative response: "A healthy baby is the only thing that matters."  Which, especially right then, was not what I wanted to hear.  It sounded like, "See, we all told you this was a crazy plan, now maybe you'll listen to reason."  I felt like everyone was treating me like a child, one who was due some kind of punishment for straying into this unknown territory.

I went for three walks the next morning, trying to finish them up before the oppressive heat settled in for the day.  I could get a few cramps going if I walked fast enough, but when I fell asleep around lunchtime, they went away.  We went in to see Jean again, my husband with me this time since it was a Saturday, and she fired up the ultrasound machine.  My fluid levels were good, she said.  The baby was healthy, the placenta was still functioning properly.  She stripped my membranes again, and again she commented on how easily I was dilating.  "But it just doesn't look like he's dropped yet," she said.  Then she gave me another day.  I had until 3pm on Sunday to go into labor naturally and then it was hospital time for real.

I called my mom and told her not to come, even though my parents were already on the road to my house.  I asked her to visit my sister for a day and said she could come on Monday, when I expected I would be in the hospital, hooked up to various IV's full of induction drugs.  On Sunday morning, I took more walks and was able to get a few contractions going.  But by the time we were in the car to visit Jean yet again, they had faded to nothing.  We were pretty quiet in the car.  We had our bag of baby stuff for our stay at the birthing center, but now I was rethinking everything.  We hadn't packed for the hospital; we didn't have a birth plan.  I looked at my husband and said, "If something happens, promise me you'll stay with the baby no matter what.  I'll be ok, but you have to stay with him.  Promise me."  He promised.

The birthing center was dark and quiet and we had to search through the hallways to find Jean.  She did another ultrasound, checking fluid levels again, and then she laid out our options.  We could go to the hospital right now, get some pitocin and see if that jump-started things.  She said she would come with us.  We could break my water at the birthing center and then, if that didn't work, go to the hospital at the end of the day for pitocin and more regulated monitoring to keep an eye out for infection.  "You have about a day to have the baby if we break your water," she said.  "If it doesn't work, they may want to give you a c-section as soon as you show up.  The longer we wait to go over there, the more chance you have of going right into surgery."  I said we might as well try breaking my water first to see what happened, and then head over there later if it didn't work.  I was pretty calm when I reached this decision.  It was true that I had been fearing and obsessing over an unnecessary surgery for months, but by this point, I felt like we had literally tried everything we could think of to get the baby out ... if this last ditch effort didn't work, then maybe surgery wasn't going to be unnecessary anymore.

We moved from the exam room to a birthing suite.  Jean set me up on a big comfy bed in the afternoon sunlight and explained everything she was doing as she broke my water.  Then she made me a castor oil milkshake, dosed me with a tincture of herbs, and hooked me up to a breast pump.  Within minutes, I was sick to my stomach and wanted to get out of bed.  The breast pump was making me feel like throwing up.

I walked the halls for about an hour, chatting with my husband and looking at the pictures of new babies tacked up to the bulletin boards.  He kept track of my contractions, which started to come about every five minutes.  They were crampy and uncomfortable, and a few of them gave me pause.  We watched a movie, but about halfway through I found I couldn't concentrate on it anymore.  I spent ten minutes or so in the bathroom, sitting on the toilet, feeling nauseous again.  Jean tried to get me to lay down, but every time I did, I threw up, so I just kept walking around.  I heard her on the phone with another midwife, saying that I was having contractions, "but not the real doosey ones."  I didn't believe her.

It grew dark outside.  My in-laws arrived with dinner for us, but I couldn't deal with seeing anyone so my husband talked with them in the kitchen for a few moments.  While he was eating his dinner I asked if I could have a tiny taste of a cookie.  I threw it back up.  I had a drink of water and threw that up, too.  Jean went home around 8pm and another midwife, Roswitha, came on duty.  She had just spent the previous night at the hospital with a difficult birth, so she went to lie down for a while.  She checked on us about once an hour, sometimes scolding me for sitting down or my husband for dosing in his chair, sometimes reminding us of the equipment we could use: the birthing chair, the exercise ball, the shower.

Because my risk of infection was greater since my water had been broken, no one checked how dilated I was until about 11pm.  Around 9 or 10 at night, things started to get very difficult for me.  Jean had told my husband that maybe, just maybe, we would have a baby by morning and I couldn't get those words out of my head.  Maybe by morning?  I would have to do this all night long?  I sat on the birthing stool until it didn't help anymore, then I sat in the shower until that didn't help anymore, then I leaned over the excerise ball propped up on the bed until that didn't help anymore.  Finally, I was leaning against the back of a chair while my husband pressed inward on my hips.  Until that didn't work anymore.  And by work, I mean, these things stopped even easing the pain.

It was getting hard to concentrate on anything.  I felt claustrophobic.  I wanted to take a break from my body.  I wanted things to slow down, I wanted them to speed up and be over.  I wanted to go somewhere away from the pain, but my legs didn't work like they used to and moving was so difficult, I don't think I could have gone anywhere even if that would have helped.  I burrowed into myself.  I thought my hip bones were breaking from the inside out.  The room was so still.  It was the middle of the night and I was all alone, leaning against part of the bed, trying to imagine how long it might be until morning, until the baby came, until Jean said maybe he would be here.  My understanding was limited to about five minutes into the future; everything farther away than that was just blackness that I could not comprehend.  I kept telling myself that I could make it for five more minutes, until all of a sudden, I knew I couldn't even do that.  Maybe I could make it three more minutes.  Maybe one more contraction.  If someone had offered me an epidural, a c-section, a pill, ANYTHING, at that moment I would have taken it.

Roswitha came in shortly after this, probably around 11 or 11:30.  She grimly helped me onto the bed and did a cervical check.  I think she was planning to tell me that we had to go to the hospital now that midnight was approaching.  But instead she beamed and patted my leg.  "Good girl," she said, "you're at nine centimeters.  You can get into the birthing tub now."

Oh!  The tub!  I'd forgotten there was a tub!  Jean had told me I couldn't use it since it sometimes slowed down labor, something I couldn't afford.  I got excited.  Water birth!  Something new to make the pain go away!  I heaved myself across the floor with lots and lots of help.  I managed to get into the tub and Ros turned on the water for me.  I braced myself against the side of it, and before the water was much past my knees, something changed.  "Something's different," I called out to Ben and in that moment, my voice dropped about three octaves.  I think I may have mooed the end of that sentence.

A birth attendant showed up and turned off the water.  Ros was there, trying to tell me how to brace myself against the side of the tub for the pushing that was coming next.  It was difficult to get leverage in the water, so out I came again, and up I went on the bed.  The pushing was very confusing to me; I didn't understand what was going on.  The contractions felt different, they didn't feel painful anymore, but like a rising in my chest, like adrenaline or that moment when you go down a roller coaster.  Ros was yelling at me to keep pushing, but I couldn't do it as long as she wanted me to.  The birth assistant was very encouraging and my husband was holding my hand the whole time, telling me that I was almost done.  "One more push should do it."  He told me this about twenty times.  When the baby began to crown, they left me feel his slick little head.  I could feel my face going red with all the effort.  It was so hard to use the right muscles, all I wanted to do was kick out my legs.

But finally the baby's ears came out and then the rest of him.  Then they were heaving this creature onto my stomach, still covered in birthing goo, and I was holding him.  He cried and then he calmed down and he looked at my husband who was right in front of his face.  We were covered in blankets to keep warm while Ros and the assistant finished up.  They gave me a shot of pitocin to get the afterbirth to come out; my contractions faded away immediately after the baby came out, even though my husband said it seemed like I was too distracted to keep working.  He cut the umbilical cord shortly after that.  It was a little after two in the morning.

I had a first degree tear and although Ros offered to sew me up, I was done with people messing with that part of my body.  They said it would heal up in a week or so, as long as I took it easy at home.  They showed me the placenta and Ros said it was a very good one.  They pushed down on my puffy stomach to get out some blood clots.  Then they rubbed the baby and me off and settled us under a comforter while we nursed a little.

The baby was born with a tongue-tie and Ros told me a little bit about what that meant.  Not a birth defect, she said, just something that happens sometimes.  Then she said that she didn't think my due date had been right.  The baby, she said, didn't look like a post-term baby at all.  She had noted the amount of vernix covering his skin and had counted the wrinkles on his feet.  "You said you were sure about his due date," she said.  "When did you actually take a pregnancy test?"

I had thought we had gotten pregnant in mid-September, my last period had been at the end of August.  But when I told her I had taken the pregnancy test the first week in October, she declared that I had probably gotten pregnant around October 1.  "Those tests work a lot faster these days," she said.  "You can get a positive result very soon after it happens now."

As the sun came up, the baby was weighed and measured.  Eight pounds even.  We filled out his birth certificate information and made little baby footprints on a piece of paper.  We took pictures and texted everyone.  Then, the three of us laid down on the bed together and fell asleep.

UPDATE: The midwife noted in my chart that I only pushed for 45 minutes.  I swear it felt like 4 hours.

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