I had an idea of how I wanted labor to go. For childbirth preparation, I took a class in hypnobirthing. My goal was to have a natural, unmedicated birth. This was not because I think it's the "right" way to do it, or because it earns some mommy badge of honor. I did some research, looked at outcomes, and decided that it was the type of birth that I would prefer to have. What I thought before my labor, and even more so now, is that every woman has the right to decide how they want to deliver. Hypnobirthing isn't for everyone...just like other interventions weren't for me.
I got quite a bit of feedback (mostly skeptical) when I told people about my plan to use hypnobirthing. It was usually something along the lines of, "That's cute. No, really, it's a great plan. Just take the epidural when it's offered to you." So what exactly does it entail? Well, we took a class that reviewed different visualization and relaxation strategies, watched birthing videos, discussed fears of childbirth (because American culture tries its hardest to convince everyone that having kids is the worst thing imaginable), got information about lots of different birthing positions, etc. I also had CDs with relaxation tracks and positive affirmations. I listened to one particular track almost every night as I fell asleep, which triggered my body to associate the track with relaxation. It all sounds a little granola I know, but as a psychologist I also know the benefits of visualization and hypnosis. The goal was to rely on the relaxation and breathing strategies for pain management, and not use medications or epidural.
We had a birth preferences sheet to take to the hospital. I tried to avoid having a birth "plan" because I'd been assured there is no quicker way to have all of your plans go out the window than to show up to the hospital with a very specific list of what you want to happen.
Here was my list:
- Intermittent fetal monitoring is preferred over continuous.
- Freedom of movement during labor - changing positions, walking around, using a birth ball, etc.
- Infrequent cervical checks, only when necessary.
- Do not offer pain medications or epidural.
- Prefer to monitor my own fluids instead of having an IV.
- Prefer to tear instead of episiotomy.
- After delivery, immediate skin-to-skin contact.
- Delayed cord clamping until pulsating has stopped.
- All procedures and measurements for baby to be done in our room, or for our daughter to be accompanied by Kevin at all times.
- Declining Hepatitis B vaccine.
- Do not offer pacifiers or bottles to the baby so we can establish breastfeeding immediately.
I woke up on Thursday morning, 8/2/13, at 3:20 a.m., pretty convinced that I had wet the bed. I made my way to the bathroom and realized that my water had broken. Although there are lots of funny movie depictions about what that looks like (I was kind of expecting a geyser of amniotic fluid), reality was a much more uneventful, slow trickle. The uninitiated assume that labor begins with the water breaking; however, that's actually fairly rare, in less than 10% of births. If labor does begin with water breaking, or release of membranes that hold in amniotic fluid, then contractions are supposed to start shortly after. When contractions don't begin, it's considered a premature rupture of membranes (PROM). Unfortunately, that was me...release of membranes with no contractions. Thankfully, my baby was not premature at 37.5 weeks of gestation.
I woke Kevin up, asked him if he wanted to have a baby today (he said "Sure"), and then got in the shower. After showering, I texted my friend Dani, who had agreed to drive down from Greeley if at all possible to assist as my birthing coach. (Her expertise as a labor and delivery nurse as well as a 2-time mommy and hypnobirther made her an invaluable asset!!) She started her journey to Colorado Springs, and Kevin and I started our last-minute preparations. I called the hospital to let them know we'd be coming in eventually. I had planned to stay home and labor as long as possible. They advised coming in immediately...and I said, "Yeah, ok, we'll be there later today." We put the finishing touches on our hospital bags and took Bailey for a walk. Dani arrived around 7 a.m., right about the time my midwife called and told me I was GBS positive (I would have gotten my lab results at my scheduled follow up appointment that day) and had to go to the hospital immediately to receive antibiotics. I had yet to have a contraction, so although I was "in labor," I was feeling pretty much normal (just a little leaky). We loaded up and headed to the hospital, although we had to make an all-important stop on the way for breakfast tacos.
I was admitted around 8 a.m. and began the long process of getting an IV started. It took about 10 people (no exaggeration) and 3 sticks to finally get my antibiotics flowing. The midwife on call immediately introduced the idea of using medication to get my contractions started. She respected my desire to try to for a natural birth and gave me a few hours to do everything I could to start the process (this mostly involved walking laps around the floor for a couple hours). By lunch time, still no contractions and no dilation (I don't count 1 cm as being dilated). At that point, it was presented me to as absolutely necessary to induce labor; now I know that wasn’t especially true, but the hospital staff was still operating on the assumption that the baby had to be out within 24 hours of my membranes rupturing. Around 1:30, I got my first dose of pitocin. Along with pitocin meant continuous fetal monitoring, which significantly limited my ability to move around. Basically, I was put on a leash. The dosing was increased pretty regularly over the course of the afternoon, increasing the frequency and intensity of my contractions along with it.
By 5:30 p.m. (14 hours after my water broke), I was having contractions very regularly - every couple of minutes. I deliberately avoided watching the clock and spent most of my time between contractions doing breathing exercises. I spent a couple hours sitting on the birthing ball and Kevin was tremendously helpful as he massaged my back and tried to keep me hydrated. I was checked again at 8 and was devastated to learn I was only 4 cm. Dani and the midwife assured me this was good progress, but I was thisclose to asking for an epidural when I heard that. I was feeling pretty tired already and couldn't imagine labor lasting for hours longer. Lucklily, Dani and Kevin were both very reassuring, and told me I was wrong when I said I didn't think I could do it.
Luckily things progressed fairly quickly from that point, although it didn't feel like it at the time. I went from 4 cm to 8 cm in an hour, then moved on to 9 cm pretty quickly...then stalled for a couple more hours. Those last two hours of labor were pretty brutal, waiting for the go-ahead to begin pushing. There was one false alarm when one of my nurses said I was good to go and cleared to begin pushing, only to be checked by a different nurse immediately after who said I was not ready. Grrr. There was some other minor unpleasantries (briefly catheterized, attempted manual manipulation of my cervix over the baby's head) that only added to the every-minute, uber contractions produced by my by-then maximum dose of pitocin. Finally, at around 11:45 p.m. (now 20 hours after my water broke), my midwife asked if I wanted to push. I actually just said, "Ok" with somewhat minimal enthusiasm and changed position one last time in preparation for pushing.
The midwife recommended a side-lying delivery, which I was on board with. I may have been willing to go along with just about anything she recommended at that point, with the promise that she was going to help me get that baby outta there! I had the urge to push for the past few hours, which I had been discouraged from doing, so being told I could push with everything I had was a huge relief. The details are a little fuzzy, but I think I pushed about 3-5 times with each contraction, and a few contractions later......we had our baby girl!
I had asked for delayed cord clamping and immediate skin-to-skin contact, so I was a little confused when she was taken immediately away from the bed. Everyone was very calm, but at one point Dani casually mentioned that she came out "in distress" or something like that (like I said, fuzzy details). Turns out Macy had the cord wrapped twice around her neck and once around her foot. Luckily, her vitals never wavered during labor and it wasn't until her exit that the cord tightened. They were able to get her vitals back to normal and brought her to me pretty quickly (within a couple minutes I *think*), pretty much before I really knew what was going on or had time for anxiety. Plus, we could hear her crying right away.
I don't know if I can describe the feeling that comes with having my newborn placed on my chest. Surreal is really the only word that comes to mind. She hung out for a few minutes, then began to eat...and continued to nurse for 30 minutes! She was so alert, it completely reinforced my decision not to receive an epidural. At the same time, I delivered the placenta and the midwife was stitching me up, so it was a nice distraction to have a fresh baby on me. I made a couple jokes during this time and Dani said it was good to see my sense of humor return.
When I look at my birth preferences list, I see that most of them ended up out the window. I do not consider my birth “traumatic” but I also did not think that we needed to have the interventions that we did, and at the pace we did. At no point was I informed that they had continued to increase the dose of pitocin even after labor was progressing. After I delivered, the nurse said, “I”ve never seen anyone on max Pit without an epidural.” I didn’t feel proud as much as I felt annoyed that I didn’t even know I was on the max dose! When I became pregnant again, I knew that I wanted to do things differently next time, and we began to prepare for a home birth.