Friday, April 22, 2016

My Birth Story

I promised some people I would share my birth story with them. Unfortunately because of the challenges of being in college with a newborn, I kept putting it off. Recently I had my six week postpartum visit with my delivery midwife, and I realized that I had forgotten a number of details. So even though there are still deadlines looming, I'm taking the time to write down what I remember.

Warning: I'm not really going to spare the gory details. If that's what you want, keep reading. If it's too much for you, you probably want to stop now.

Birth is a really incredible experience. When I first became pregnant, even though I wanted to be a mother so badly, the idea of delivering my child was terrifying. At the same time, I knew a traditional hospital birth was not for me. I still dream of having a water birth at home, but since that's not currently an option (I live in a tiny apartment with very thin walls on my college campus), I found a local midwife Birth Center on the recommendation of a friend. Before you could become a client, you had to attend an orientation seminar. They went over their policies, birth statistics, and intervention studies. The thing I remember most was how they emphasized that the female body was designed to give birth. These days movies and the media make it out to be such a terrible, impossibly painful ordeal. And while it is intense, it is not impossible without drugs. They also explained how many options are available to a woman during labor and delivery that most hospitals won't tell them about. The Birth Center (TBC) is all about educating women to make their own informed decisions about what is best for them.

I lost my first pregnancy (read about that here if you'd like), and TBC was incredibly supportive during that time. When I got pregnant again, I was excited to work with the midwives. They are certainly not anti-hospital or conventional medicine, which I also appreciated. There are reasons for interventions, and I am thankful they exist (C-sections have saved many lives!). But I also knew I wanted to avoid them if I could. We followed the suggestions of the perinatologist I saw after my late miscarriage, and had frequent ultrasounds during my second trimester. I loved the extra reassurance that things were going well, and we were able to find out that we were having a boy at 17 weeks!

Some other time I might write about the crazy roller coaster that is pregnancy after a loss. But every milestone was amazing. We passed 16 weeks (which is when I lost my daughter). We passed 20 weeks (halfway)! We passed 24 weeks (viability). Each week that passed was so encouraging to me as I read about the way my baby was more and more likely to be healthy outside the womb. Then 36 weeks came and went, which is the earliest TBC will deliver. I stayed in a pretty healthy mindset for that last month. I tried to keep the countdown in my head at 42 weeks, since that was the longest I would have to wait. The hardest thing for me wasn't was the fact that I could go into labor at any moment, or still have a few weeks left. As someone who values planning, I was pretty much unable to do that with any certainty.

Up until my due date (a Monday), I continued in that positive frame of mind. The day after my due date, however, was another story. I woke up instantly annoyed that I was still pregnant. The week before I was enthusiastically walking, eating pineapple and spicy foods, drinking raspberry leaf tea, using evening primrose oil...but suddenly I lost energy for all of those things. That Friday at my midwife appointment, she checked my cervix and found that I was 1cm dilated (I don't know which emotion was stronger...happiness that at least something was happening, or annoyance that it didn't really mean anything). She was going to sweep my membranes, but since my cervix was still pretty far back she recommended waiting.

The next night we were up pretty late. Since neither of us were scheduled at church the next morning, we decided to sleep in and watch from home. We knew we were quickly running out of opportunities to sleep in and have lazy mornings (turns out that was a really great decision). We went grocery shopping that afternoon so I could make some more freezer meals. I kept telling Josh that I felt weird and tired, but I didn't really know how to describe what I was feeling. Mentally I refused to ask myself if something was starting to happen, because I didn't want to be disappointed. Josh made us his amazing homemade mac n cheese for dinner. I sort of struggled to eat it because my stomach felt weird, but I didn't say anything yet.

Around 7pm I realized that the Braxton hicks contractions I had been having (for weeks) seemed kind of painful, and that they were coming with more regularity than before even when I changed position. I timed them for about an hour, and they were pretty regularly six minutes apart. I called the midwife to let them know that it seemed like something real was starting. She told me that if I was really in early labor, the best thing I could do would be to get some sleep. By that time the contractions (while still pretty mild compared to what was to come) were intense enough that I wondered if I would be able to sleep. Already when Josh would help me with some of the counter pressure points we were shown in class, it would make a big difference in the intensity. We called our parents to let them know that I was *maybe* in early labor, then we borrowed a heating pack from one of our neighbors and tried to go to bed. It took me a long time to relax enough that I could fall asleep between contractions, and it was probably almost as long for Josh. He could tell by my breathing when I was having one, and I'm sure he must have been pretty nervous.

Around 4:30am I couldn't stand it anymore, so I went into our living room and got out the birthing ball. I was hoping Josh would sleep a little longer, but he woke up and came out to help. The night before when he would apply counter pressure I could barely feel the contractions, but now the relief was a lot less. We started timing again, and I was averaging contractions that were four minutes apart, close to a minute long, and that lasted for an hour (which is 411...the signal for calling the midwife). I was about to call around 6am when all of a sudden (I think because of the intense breathing) I had to throw up. The midwife on call called me back soon after that. She said she wasn't sure if I was in active labor yet, but because we were far enough away from TBC and it would soon be rush hour, that I should go ahead and come in. Even if I wasn't in active labor when we arrived, at least we could walk around the town and not have to fight traffic. (Side note: I pretty much always minimize pain that I'm in, so I think I was subconsciously not communicating how intense it was. Looking back, I was definitely in active labor at that point.)

We called our parents to let them know that this was the real thing. Josh's parents were in Pittsburgh, about five hours away. My parents were only two hours away, but my mom was at work. Fortunately she had a list of people who had agreed to cover for her if they could, and she found someone pretty quickly.

We were mostly packed at that point, but it took way longer than we thought it would to finish packing and getting ready (mostly because I was pretty useless, and Josh would stop every few minutes to help me through the contractions). We left home sometime after 7. That car ride was pretty much the worst thing ever. The backseat was full with the carseat and our stuff, and being in the sitting position or lying on my back was really horrible. I can't imagine being confined to that position in a hospital bed for all of labor. We had Google Maps up so I could see what time we were supposed to get there, and I was counting down the number of contractions I probably had to get through before I could get out of the car and get some relief.

We got to TBC around 8am. The midwife (Jane) checked me, and I was 6cm dilated already! I was pretty proud of myself for getting that far on my own. They started filling up the tub, and told me I could get in whenever I wanted. I think I was trying to wait as long as I could...I'm not sure why. The whole time I was standing or walking around between contractions. During one I would lean forward over something (on my knees over the ball at home, and standing leaning over a counter at TBC), and Josh would apply pressure on my back. His chest and arms were so sore by the time we were done! Soon after getting checked, I threw up again. I didn't really feel nauseous...I think my stomach muscles were just reacting to the really intense breathing. After that, Jane and the nurse (Jill) suggested that I get in the tub for some relief.

(Side note: because of the national certification TBC holds, they can't do water births. This certification requires that there be two entrances to a tub in order to give birth in it. So I could labor in the tub, but had to get out to actually deliver.)

The water felt SO good. The jets really helped me to relax. I couldn't stand staying on my back for contractions every time I would roll over on my hands and knees and hold on to the side of the tub. Then I would kind of collapse back into the water. I think my knees were red and bruised for days from this part! They brought me a cushion to kneel on, but it would float, so it was pretty difficult to get it to stay down and I didn't use it that much. I'm not sure how long I stayed in the tub, but it was definitely longer than I expected. After a certain amount of time it can slow down labor, but Jill said she thought because I stayed so active during contractions that it didn't for me.

Eventually I got tired of the tub. My parents had arrived by then, and we had planned to have my mom in for the delivery. I was going to have her come in after I put my nightgown back on. But I found that I could not stand wearing anything...maybe because I was so sweaty at this point. This is one of the things that was unexpected. I'm a pretty modest person, and I thought I would want to stay as covered up as possible for the birth. But when it came down to it, I just did not care at all. Labor was intense enough, and I barely even noticed that I was totally naked in front of other people. I also tend to get quiet and internalize in order to deal with pain, so I didn't think I would be very vocal during labor. But I found myself just naturally moaning during every contraction...I couldn't really help it.

My mom came in and relieved Josh so he could have some lunch. They had been trying to get me to eat or drink juice or popsicles most of the morning since I had thrown everything up, but I just really didn't want anything. Josh kept giving me my water bottle after every contraction, so at least I stayed somewhat hydrated.

The whole time Jill had been regularly checking the baby's heartbeat before, during, and after contractions. She and Jane and Josh were all so encouraging. During every contraction they would all tell me how well I was doing, and that I was so strong. Josh repeatedly reminded me that with every contraction, we were a little closer to holding our son. I was so grateful for their support. Even though I had mentally prepared as best I could, there were so many moments after I got out of the tub that I didn't think I could do it anymore. Their support carried me through that time in a very real way that I've never experienced before. I joked with Jill between contractions that I wished there was a pause button so I could just catch my breath or take a little nap (since I had barely slept the night before). I should have known when I wanted to give up that I was probably in transition. I'm grateful that we weren't in a hospital, because I may have ended up asking for drugs. But that would have required getting dressed, packing everything up, and driving to the hospital across the street...somehow that seemed less possible than finishing the birth. Later Josh said that he was prepared to fight me on it, since I had talked so much about how important it was to me to give birth naturally.

I was pretty tired, so I sat down on a ball and got up to lean on the bed during contractions.

Eventually Jane checked me again, and I was 9 or 9.5cm dilated. It felt almost impossible to lie still for that. She suggested that she break my water, which would probably get me the rest of the way to being able to push pretty quickly. She did that around 2pm, and immediately I felt an irresistible urge to push (and also the crazy weird sensation of so much amniotic fluid gushing out of me...gory detail #1!). I quickly rolled over onto my knees on the bed saying "oh my gosh oh my gosh oh my gosh"...haha! They got a small birth ball for me to lean on and try to push in that position.

We heard from a number of women in our birthing class that pushing felt really good for them. I would not describe it that way! Although it was great to know that I was nearing the end. Pushing is so bizarre...your whole life you save using those muscles for being on the toilet, and all of a sudden you're supposed to do it in a totally different context. It took me a little while to get the hang of it, as odd as that sounds. During the first contraction it felt like everyone was in my face yelling at me to push...that might be helpful for some women, but not for me! It was so distracting, and I felt like I couldn't focus on what my body needed to do. I yelled "stop!" And after that they all took a little more of a gentle approach to help me figure out a good position.

During one of those first contractions when I felt like I just didn't have the strength to push, I remember lying my face on the ball and looking into Josh's eyes. He was crying while he was telling me that he was so proud of me and that I could do it. I'll never forget the way he looked at me right then. I asked him later why he was crying, and he said that it meant so much to him that he was the one I would look at for strength during that time.

Leaning over the ball wasn't working so well. As tired as I was, I got back up to lean over the counter I had been using before, and squatted down to push during contractions. That worked a little better...I had bruises on my arm later from bracing myself with Josh's hand and leaning against the corner of the counter. And now there were more things I didn't expect. I had already gotten used to being pretty verbal during labor, but now I was full on yelling during pushes...pretty much exactly like you hear in the movies. I didn't think I would do that. (My poor dad in the waiting room next door had a hard time listening to this part!) I also didn't think I would poop since I had thrown up everything I had eaten in the last 24 hours. But again, it was so intense that I just had no mental space for thinking about it and didn't care at all.

I pushed for awhile in that position. They told me to push for 10 seconds at a time, and Josh would count for me. I remember being so mad because he counted so slowly! Jane kept suggesting that I try the birth stool. Here's a picture, if you've never seen one before. The handles are for bracing yourself to give extra strength to the pushes.

I put off her suggestion a few times, because sitting down sounded like the worst thing in the world. Eventually she just told me that we were going to try it, and they guided me over to the stool and sat me down. I wish I would have moved to it earlier, because it felt like it really got things going. Pushing was so much easier in this position. It basically puts you in a squatting position, which lines everything up correctly, without taking all the effort to actually squat. I was able to push so much more effectively, and I didn't really feel the pain of the contractions anymore...just a sense of when it was time to push.

Jane told me to try to keep my mouth closed and push all my vocal energy down through my body during the contractions. It sounded so weird, but visualizing it this way really did help my pushes to be more effective. She had a mirror in case I wanted to see what was happening...I cannot imagine why any woman would want to see at this point! But apparently some each her own. After he had crowned, she told me that I needed to hold off on pushing for a little to make it more gradual to help with tearing. I remember looking at her with wide eyes and shaking my head frantically like there was no way I could do that! But somehow I did, and when she told me to push again I did it with great relief. Two more pushes, and he was out! ...along with a river of fluid. Jane joked that she probably needed to empty out her shoes. Josh and Jane caught him, and they handed me my perfect little (bloody, messy) baby boy! Somehow I moved up onto the bed, and they wiped him down a little while I held him. He was born at 3:08pm. I had only pushed for about an hour!

Leading up to that point, I always wondered what this skin to skin time would be like. But somehow I didn't at all notice that he got blood and poop (meconium doesn't smell at all anyway) all over me. I was just holding my baby, and it was amazing! He latched almost right away, and I was so grateful for that.

I had a 2nd degree tear. Even though they used local anesthesia, I hated getting stitches. It didn't really hurt, but I was pretty ready to be left alone down there.

The rest of the day was a flurry of activity...weighing and checking Max, getting to meet his grandparents, trying to eat some food, barely peeing in time so I wouldn't have to be catheterized, and finally around 11pm we were left alone to go to bed. TBC is an early discharge facility. You have to stay for at least 4 hours after the birth, and you can stay up to 12 hours. Since I was GBS+ (by the way, hauling the IV around with me during the antibiotics rounds was pretty annoying), I had to stay the whole 12 hours, and a pediatrician came to check on Max that night.

When we were finally ready to sleep around 11 (for the first time for me since Sunday morning), I felt for the first time (and not the last) that I was pretty clueless about what to do with my baby. He wasn't really ready to go to sleep, so Josh kindly sat up with him and let me rest. He woke me around 2am so I could nurse Max. Soon after that, a nurse came in. They were originally going to let us stay longer than the 12 hours so we wouldn't have to leave at 3am. But they had filled up overnight, and she came in to tell us that there was a woman pushing in the waiting room, so they were going to need our room after all. We were both actually relieved to be going home to our own bed. So after Max finished nursing we packed up and went home.

The rest of that first week is pretty hard to remember. There are little glimpses...the nurse coming for a home visit, weight checks at the pediatrician, and four hour cluster feedings in the middle of the night. These past few months (almost 2!!!!) have been pretty indescribable. At times we've barely felt human. New levels of joy, frustration, and fear that I couldn't have imagined.

But mostly we just can't remember life before we were a family of 3. Max has changed everything, and I am so incredibly grateful.