Friday, July 16, 2010

Introducing Charlotte Rose--or the story of my hospital homebirth/almost c-section

This rose bloomed during the 4 days I was gone from the house laboring.
It was waiting, welcoming us home when we arrived.

There are two things that I had heard during my pregnancy, neither of them I really took all that seriously.

1--A mother births when she is ready to birth.

2--Childbirth is a state of mind. Visualization is powerful. Mothers have an amazing amount of power when it comes to how their bodies birth.

I spent so much of my energy during this pregnancy imagining worse case scenarios of what could happen during labor. Some of them were actually quite silly in retrospect (like thinking I'd have to birth in a van because there were no rooms left at the birth center). Others were quite having an invasive hospital birth where I'd end up attached to all sorts of wires and tubes and monitors, have no control over how the birth happens, have a c-section, and be separated from my baby.

I never imagined that the one thing I didn't think of would be the actual problem--that my labor might not actually start as it should. I'd have to face that truth, and almost everything on my birth plan before this baby was ready to be birthed.

This picture on the right was taken on
7/4/10. It is my last belly photo. I was 41wks. My water had sprung a leak at 11:15pm the night before and I was happy, thinking I'd have my little girl in my arms later that day. I had a few contractions, but none that were really all that strong, and none with any kind of rhythm.

My midwife had me come to the birth center that night at around 10pm to be checked out. She confirmed that I was leaking amniotic fluid, but I hadn't actually started to truly "labor" yet. She gave me some black and blue cohosh and sent me home with the tincture, telling me to take another dose or two before going to bed, and to see how it goes the next morning. I had a few good contractions that night, but again no rhythm to those contractions. I went to bed, hoping the morning would bring something new.

Monday, July 5th. I labored at home augmented with black and blue cohosh for the first 4 or 5 hours. I took a 1 hour uphill walk in my neighborhood, and did manage to have some good contractions that were 1-2 minutes long about 4-7 minutes apart. Unfortunately, whenever my activity stopped, the contractions would peter out. My midwife recommended taking goldenseal and stopping the cohosh. Again, I experienced the same kind of pattern, but finally I had some contractions on my own without activity involved. Good strong contractions on a regular rhythm, but too far apart (every 30 minutes).

After dinner, it was time for the last resort--castor oil. At this point, I was becoming quite worried. I was hoping this labor would start on its own without needing this. Also, my water had been broken for almost two days. I showed no sign of infection, but it was starting to get a bit worrisome. In the back of my head I was already thinking "What if I have to go to the hospital?"

We were called back to the birth center later that evening. They checked me out and saw that I was still only 2cm dilated, but I was about 80% effaced. My midwife reached inside of me and stretched my cervix open to 3cm. IT WAS THE MOST PAINFUL THING I HAD EVER FELT UP TO THAT POINT IN MY LIFE
(sadly I'd feel alot more pain before this baby made her appearance...sigh). At this point my contractions started to pick up and I was told I could stay. My contractions continued to pick up that evening, and it looked like by morning I'd have my baby girl. So the midwife went to sleep, expecting a long morning while I labored with my hubby, my doula, and an assistant midwife through part of the early morning. The contractions were so hard and fast that I remember whining at one point "no more, please no more." I also remember whimpering "tub...." because they were having no success at filling the birth tub/jacuzzi with hot water. The plumber had turned off the hot water earlier that day when making an improvement to they system and had forgotten to turn it back on, so my doula was trying to fill it by hand by boiling water in a pot on a hot plate--a valiant but futile effort. Meanwhile, I threw up the castor oil and my body started to give up. I needed sleep, so I found a position where the contractions were less extreme and rested for a few hours.

When I woke up the next morning on July 6th, my contractions had almost stopped completely. They checked me out--I had managed to make it to 4-5cm . They were still optimistic that later that day we'd have a baby.

But I didn't progress. They determined I had a posterior baby (facing the wrong direction) and that must be why my labor was stalling. Using two midwives, one working on the inside, the other working on the outside, they very painfully turned the baby, and gave me more herbs (I do not which). I was having some good contractions, so they thought they'd let me try the birth tub. After a bit of time there, I tried laboring on the birth ball and also using a swing of fabric suspended from the ceiling. I could sense the midwives were getting worried because I we were approaching 60 hrs with my water broken and no real progress.

They sent me out for a walk. I walked around Lake Merritt. I also did the large set of stairs in a mini park near the lake, a set of stairs I used for hill training when I was training for my marathons last year. I sure felt like I was in a marathon, but at this point, even with all of this exercise, the labor was getting nowhere.

I was given one hour to turn it around. I tried everything...dancing through contractions, laboring on the toilet, more herbs, laboring on the ball... I was so optimistic that I had progressed. I was certain that she'd be born that evening.
But after all that, when the midwife checked me out, I was back to where I started. My body had closed up and I was only 2cm dilated.

I was told it was time to go to the hospital. They said I would most likely need pitocin, and probably an epidural to help me sleep. All I heard in my mind was "c-section".

That's when my midwife Selena said "we are going there for a vaginal birth. Don't give up!" Part of me listened, but part of me was too busy mourning. Even though I was told it was better I was going when it wasn't an emergency, that I still had options, in my mind I was so terrified of the hospital, always had been from the beginning, that I needed to cry for a couple of hours before I could bring myself to go to the hospital, despite the inevitability of it. I had begun to give up. My spirits were broken and I was resigned to a c-section if that was the only way I could ensure my baby would be born healthy and safe.

If only my water hadn't broken when it did. If only it had waited until my body was and mind were ready to birth. I would have been sent home and told to come back when the contractions really started. I wouldn't have needed the induction.

After being rejected due to overflow at our local Kaiser, we were transferred to Walnut Creek. What I didn't know at the time was that my midwife and doula fought to get me in. We quite literally got the last bed. They wanted us to go all the way to Vallejo or Hayward. That was outside of my midwife's range, as she had other expectant mothers in Oakland that she needed to be able to rush to if something were to happen. If we couldn't get in there, I would have had to go alone with just my husband, and no one to advocate for me.

9pm, we arrived. 12pm I was hooked up to IVs, had my epidural inserted, and the pitocin had started. Now before I get started talking about this part of my labor, I want to say that the care I received from the CNM's and RN's in the Labor and Delivery at Kaiser Walnut Creek was top notch. I was treated well, my midwife was treated with respect, and my wishes were respected as much as was possible in that setting.

The whole idea of coming to the hospital and getting the epidural was for me to rest. But after being hooked up to so many tubes (the catheter being the worst by far--it took them 4 times to insert it properly, and I could feel the discomfort of it through the epidural) the sound of the IV pushing water, antibiotics (because they lost the part of my chart that said I am GBS negative) and pitocin into my veins, and the feeling of that blasted blood pressure cuff going every 15 minutes (most of the time unsuccessfully gathering my blood pressure measurements, followed by an annoying grunt of a beep) I really didn't rest well. I was told I'd get the epidural, fall asleep, and then wake up ready to push. Instead I watched everyone else sleep around me and I felt very very alone.

Not only was I not ready to push when I woke up, by the time they checked me at around 11pm, I had only progressed to 6cm. When I first came into the hospital, I had been at 5cm. This wasn't good. The midwife, who had given me extra time on the pitocin to labor, had to bring in the OB to talk about my options, which at this point pretty much meant prep me for surgery. As Selena, and my doula Gionna spoke to me about the inevitability of my situation, as I was coming to terms with the necessity of the c-section, apparently something was happening in my body that I wasn't noticing. The OB came and did her internal check to confirm what the nurse midwife had determined, only to find I was not 6cm at all. She brought the CNM back for a second opinion--and she was also shocked. She then tells us that she had said I was 6 before to make me feel a bit better (I was really closer to 5.5) but now, not only was I about 7.5, but one whole side of my cervix seemed to melt away as they touched it. They decided to turn me onto my other side, hoping that would help that side open up the rest of the way. They were going to let me continue to labor! I went from having the OB write me up in the system as having a baby "too big" to fit through my pelvis, to having another hour or two to get this baby out.

The next two hours were better than I expected them to be. At some point my epidural stopped working as I entered transition. This was the second time the epidural had worn off--last time I had the dosage adjusted and my position changed to increase the effectiveness. This time, however, I decided to use the pain. I used breathed through the contractions which came rapidly on top of each other. During each contraction I visualized round things, thing that open, that are wide open. I envisioned wormholes and tunnels that end in waterfalls, bags with drawstrings opening, large silver rings, round rings of flesh that opened from the center. As I breathed out I vocalized "O" sometimes, and "open" other times, imagining my pelvis opening and my baby moving down. It was actually the most fun I had experienced the entire labor. I could almost smile through the contractions. I felt my breath and my voice generate a great energy that I could send downward to help the baby, to help me open the rest of the way.

They checked on me an hour later and I had progressed to 9.5cm, the baby almost completely in position. An hour later I was confirmed to be "complete" with my baby ready for me to push (nevermind that we had already figured this out and had begun pushing before the CNM's had returned. We figured, if anything were to happen, with my midwife and doula in the room, there was nothing to worry about.

1hour and 53 minutes later, my beautiful little rosebud was born.

I am very grateful for the help of my midwife Selena, and my doula, Gionna. Without them I do not believe it would have all ended the same way. Selena knew exactly what to say to me to get me to concentrate on birthing my little one (especially important during the pushing phase--I found it hard to remember my breathing with the pain of her head crowning).

Although I ended up going against just about everything in my birth plan, n the end, it was all worth it.

6MONTH UPDATE--Well, its taken me 6 months to post this. I'm not sure why. Life got in the way, perhaps? I needed to think about things a bit before I posted this.

It's interesting how important certain things were to me at the time I started writing all of this and how my perspective has changed so much this half year. In the end, all that really mattered was that Charlotte arrived safely, and that both mama and baby are healthy and happy.

If I were to do this again, I'm not sure I would approach this whole thing the same way. I only feel a little bit cheated in that I wasn't successful with my non-hospital
birth. Would I try for a homebirth? Maybe. Do I even really want to think about this right now? Not really. Right now its back to concentrating on my other two passions--running and textiles. More from me to come soon.

Charlotte and Daddy at the Oakland Zoo for Charlotte's 6 mo celebration

1 comment:

Anonymous said...

Hi, I just found your blog from your pattern on this month's Knitty and somehow wandered back to this post about your daughter's birth. Our birth stories are so similar and I have struggled so much to come to terms with my grief about not having the home birth I wanted. I am working in a coffee shop this morning and sat hear reading your story with tears on my face. Thank you for having the courage to share your story. I know first hand how complex the emotions can be around this kind of story. Thank you.