Friday, April 27, 2012

The Nipper's Birth Story

 I absolutely loved being pregnant. It was such a profound experience and taught me so many lessons in letting go and surrendering to my body. Through pregnancy and birth you master your own biological potential and experience the most epic sensations of joy, love, pain, and pride.

Long before I ever got pregnant, or married for that matter,  I knew I would do everything possible have an unmedicated natural labor. It was honestly a bucket list item for me. I believe our bodies are fully equipped to birth this way, and had total confidence in my body to do so. My mother had natural labors with my sister and myself, and so I always thought, "If she can do it, so can I".

Once we got pregnant, I began to read every book I could get my hands on and watched The Business of Being Born over and over again, tearing up when these strong women met their babies. I talked with my husband, Allan, about home birth vs. hospital birth. I ultimately decided to take the somewhat ambitious approach of what I called a "hospital - home birth". I wanted to ensure I could labor at my own pace free from interventions and IVs, but wanted to be seconds away from help if there was an emergency. I've never been bothered by hospitals, and for some reason I was more stressed about the idea of laboring and delivering at home, so constructing a hospital - home birth was the best way for me to eliminate the stresses that could compromise my birth experience.

When I was about 6 months along, we hired our amazing doula, Melissa, and attended some fantastic natural childbirth classes. I cannot sing Melissa's praises enough. An experienced doula is truly worth their weight in gold, and something I wouldn't personally go without when attempting the hospital - home birth. We wrote our birth plan, made arrangements with family and friends for the big day, and waited.


My due date was Friday, January 13th. Since babies are rarely born on their due date, I tried not to get too superstitious about it. The day before she was due, I went in for some acupuncture to my body switch gears for labor. This was my first experience with acupuncture and I absolutely loved it. It felt so relaxing to tune into my body and reasuring when my acupuncturist mentioned how impressed she was with my pain tolerance when she cranked up the electrodes. Since I was planning to go without drugs, this was a huge confidence boost.

After my appointment, I definitely felt some contractions kick in, but nothing too consistent or intense. Since I knew labor could take days to get moving, I tried not to focus on things too much and just let my body do it's thing.


 My due date came and went, and on Monday I went in for what would be my last checkup with my doctor. I still was only about 1.5cm dilated and the baby had yet to drop. This news didn't discourage or surprise me, since I was pretty sure my baby was going to make a late appearance anyway. In spite of the progress I had yet to make, I was having pretty consistent contractions during my exam. I could barely feel most of them, unless I poked my belly to feel the muscles tense, but my doctor suggested I get monitored to get a sense of how consistent they were. Sure enough they were about 5 minutes apart and lasted about a minute long. My doctor joked that maybe she'd be seeing me again the next day!

 Later Monday evening I had another round of pretty aggressive acupuncture. When I was sitting in the waiting room, my acupuncturist said I had a different look in my eyes and she thought I would have my baby the next evening. Gulp. After the second round of needles, the contractions totally picked up, and gradually got more and more intense. I told my husband that he may not be going to work the next day. It was easier to sleep through my gentle contractions than it was the excitement. It was just a matter of time before I would meet my baby.


 I woke up very early Tuesday morning and laid in bed with my hand on my belly. I noticed my consistent, but mild contractions,  then I flipped through some of my favorite pregnancy and childbirth books, Birthing From Within, and Ina May's Guide to Childbirth. I wondered when I would reach another labor milestone: the mucus plug. Sure enough, when I finally got up and went to the bathroom there it was. Without getting too detailed on what the mucus plug looks like, let's just say you know it when you see it.  Now I knew that my baby's arrival could be hours or just a couple of days away. I crawled back into bed and whispered to my husband that "we have achieved mucus plug",  and in his half asleep way expressed excitement and nervousness. He immediately let his coworkers know he'd be staying home in case things picked up. I texted my doula to let her know our progress, then called my mom to let her know we were getting closer, and she drove up to be on standby.

 We spent the morning walking up and down hills in our neighborhood, which totally kicked my contractions up a notch.  They shifted from slightly painful cramps to more intense surges that required some breathing to cope. I could still talk and walk through everything, which told me I still had a long way to go. I made sure to eat lots of good food and stay hydrated, since I knew I was going to refuse an IV and it seemed like I was in for a long labor. In the afternoon, we pulled out the sleeper couch and settled in to watch Wes Anderson movies and the first season of Downton Abbey. The contractions kept on going at a steady 5 minutes apart. My mom arrived later that afternoon and we picked up some things at the grocery store and got the house staged for leaving at a moments notice. She went to check in at her hotel, and Allan and I resumed our contraction counting - Downton Abbey marathon.

 My contractions had definitely become more intense late that night, and I found it difficult to sleep. I was really needing to breathe through each one, focusing on relaxing my body. At about midnight, my husband looked out the window and noticed it started to snow. Now,  a little snow may not seem like much, but in Portland people kind of lose their minds. Most Portlanders have such little experience driving in snow, they either abandon cars on the highway or attempt to drive in places they really shouldn't. Allan, however, is not one of these people. He learned to drive in the high country of Colorado, so a little snow doesn't scare him. But this night, it did. We didn't have chains or an all wheel drive vehicle, and the snow was sticking pretty quickly. Pair that with a hugely pregnant laboring wife, and my sweet husband was nervous that if we didn't get to the hospital soon, we may have trouble getting there at all. I, on the other hand, good give a crap about the snow and would rather call an ambulance than arrive at the hospital before I was good and ready. After a bit of a freak out, I locked myself in the bathroom and told him that I wasn't going to hospital until I knew it was time. All of the stress of arguing slowed my contractions down. My heart sank and I decided I just needed to lay down and get centered again.


 By dawn, the snow had pretty much melted and my contractions were back to where they'd been, a steady 5 minutes apart, lasting a bit over a minute now. I called my mom and told her to hang tight, and arranged to have our doula come over later that morning. When Melissa arrived, my contractions were intense enough that Allan and I were "slow dancing" through each of them, and I had found moaning in a sing song of "ah - oh" really helped me move through each surge. Melissa was calm and cool, and reminded us that were doing everything right by following my body's lead. She said that even though my labor was taking a long time to progress, it was ultimately going to be easier on my body, since I was getting "warmed up". Since my contractions had been so close together from the get go, Melissa suggested I really pay attention to when my gut was telling me, and that I would know when I was ready to be in my birthing place. After hanging with us for about an hour, she left and told us to call when we decided to head to the hospital.

 About two hours later, my contractions were getting really strong, and I wanted to make the trip to the hospital. It was so exhilarating and scary to feel myself in that moment. I remember tearing up when I was locking the house thinking to myself "This is the last time we will be just us two." Allan was thrilled we were getting in the car, and joked that he wanted to drive like a cliché father to be, speeding and running red lights.

 We arrived at the hospital at around 1:00pm. Melissa was already waiting for us outside of the elevators, and I was surprised to see my dad and sister there too. My mom arrived just seconds later. We all sauntered down the hallway to our birthing suite, which was right next door to the jacuzzi tub, since we informed the hospital staff that we were going for a natural labor. We got settled in, and my dad and sister left.  The baby looked great on the monitor and the nurse was going to check me to see how dilated I was. I was nervous about finding out how far along I was, because if it wasn't as far as I hoped, I worried I may feel discouraged, and I knew how important it was to keep my confidence up. Melissa smartly suggested that the nurse check me and only tell her how far along I was, and then if I really wanted to know, she would tell me. I thought this was brilliant, because even if I got news that I wasn't as far along as I hoped, Melissa would deliver the news compassionately and would know how to keep me motivated. After I was checked, the nurse and Melissa went outside of the room. When they walked back in, Melissa winked at me and gave me a thumbs up, which made me so happy. I immediately said "Ok, tell me!" and learned that I was fully effaced at 5cm with a bulging bag of waters. Awesome. I was halfway there.

 Soon after, my doctor walked in to see how I was doing. She asked me if she could break my water to see if I had any meconium in there, since I was past due. I was a little disappointed that she even mentioned this, since my birth plan was clear about not wanting an amniotomy unless it could help a stalled labor or something. I told my doctor no, and that I wanted to try getting into the jacuzzi. She said ok, and that she would check in later. Allan and I continued to slow dance.

 The nurse went to get the jacuzzi ready for me and Melissa followed, so she could help get the room ready for us. She dabbed lavender oil on towels for aromatherapy, and placed battery operated votive candles all around the tub. She totally transformed the clinical jacuzzi room into a calm and soothing space.

 Allan put on his swim trunks so he could be with me in the tub. It felt so wonderful to be warm and weightless in the water. I continued with my "singing" and really focused on relaxing all of my mama muscles through each contraction. I was in active labor now, and it felt like it. We stayed in there for about and hour before I felt ready to get out and move around.

Melissa had warned me that my contractions may start to feel much more intense upon exiting the tub, because you can really make a lot of progress quickly while relaxing in the water. This was so true. As soon as I stood up, the surges rushed over me as I slowly made my way back to our room. I gradually climbed up on the bed and was checked again by the nurse. I remember Melissa looking and the notes the nurse was making, and said "Is that the number? Is that how far she is now?" The nurse said yes, and Melissa told me I was already at eight centimeters. Hallelujah. I had made a huge amount of progress in just an hour. It was only 5:00 and my baby would be here soon.

 The next several surges were much more intense.  Allan had me take a drink of ice water or coconut juice after each contraction to keep me hydrated. I continued to move around as much as I could, but fatigue was starting to set in. It was becoming more and more difficult to find a comfortable position. Allan was amazing in the way he helped me keep my rhythm, singing along with each contraction, even when I could bring myself to make a sound. He was an incredible birth partner.  

 At around 6:30 there was a shift change with my nurse. The new nurse was also an advocate of unmedicated birth, and I was stoked to have her join my team. My doctor checked back in and let me know that she may need to hand me off to one of her partners, since she was traveling the next morning. I didn't really care at that point, as I was in throws of transition, the most painful part of labor. My doctor suggested I hop back in the tub, since it was so effective the first time. I was anxious to get things going and happy to get back in the soothing water. I stayed in the tub for another hour, becoming really vocal with each surge. An urge to push began to join each contraction, and after a few really pushy contractions, I wanted to get out of the tub to see how far I had progressed. At around 8:00 or so, I learned that I had progressed to about 9.5cm. There was just a bit of a cervical lip that needed to go. I was so close, but getting so totally exhausted from coping with the exquisite pain.

 I stopped being able to move around and slow dance with Allan. Time passed. I laid on the bed, writhing around, attempting to find some relief.  A little bit of my water appeared to break. It looked meconium free. My doctor's partner came in to check on me. She had poor bedside manner, was rude to my doula and had a pretty lame attitude all around. My nurse let her know we were just trying to work out a bit of a cervical lip. When I was checked by the doctor, she dismissively said, that it felt like more than a cervical lip, and that she thought I had farther to go. My heart sank. The wind left my sails. I was afraid that this new doctor was going to suggest interventions, and I was right.

The new doctor suggested I get some pitocin to help move things along. Really? Pitocin? My contractions were strong as hell at 9.5cm, pitocin seemed like a moot point. I said that I didn't want pitocin, and instead would try position changes. If that didn't work, I was ok with them breaking my water. The doctor left.

Every surge began to take all of my focus to cope with. I tried laying on my side, lunging, getting in the shower, and leaning over the back of the hospital bed. Melissa placed hot compresses along my side and back, where I had developed a side stitch. Melissa wanted me to try and inversion, since she was pretty convinced that the baby just needed to drop into position. To do an inversion, you basically get into a child's pose position with your legs elevated on a couch our chair with your forearms flat on the floor. The hope is that by leaning in an inversion, the baby can disengage from a poor position into one that is more effective for birth. I was so physically uncomfortable, that I couldn't bring myself to do it. My confidence was really waning at this point. Melissa, my nurse, my mom, and Allan all jumped in to rally me on.

I stayed at 9.5cm for about 4 hours. The doctor came back in, and suggested the pitocin again after still feeling the lip and that the baby's head was still high. Damnit. I said no, and that she could break water, since only a small trickle came out before. She reluctantly agreed, and a bit more water came out. It had a small amount of meconuim in it, but nothing that made her suggest another intervention. Good.

The doctor left, and I asked Melissa if she really thought an inversion would help. She said that really thought it would. I was so ready to get on with things that I agreed. Melissa laid towels on the floor in front of the couch in my room for traction. I got up out of bed, had a couple of contractions, and then made my way over to the couch. I held the inversion for a few deep breaths, and then got back up into a slow dance with Allan. Melissa and my nurse noticed that I was no longer relaxing my hips and legs through contractions, so they suggested I sit on the toilet for awhile.

 Changing to the seated position was so effective, because it made it much easier to relax my pelvic floor through each contraction. The contractions were so intense now, and I was so exhausted. The urge to push was compelling. I was yelling and crying. I clawed at Allan's arms as I officially reached the "I'm done, I can't do it" mark. I asked him for an epidural, I was so damn tired. Allan began to cry, and reminded me of how much I've wanted this and to not give up. Melissa reminded me that I was doing it. My amazing nurse said she didn't want to hear any more negative talk and that I was doing an amazing job. "Ok," I thought, "I'll keep going." I starting chanting "Yes!" through each surge, hoping I could bring that baby down to meet me.

After a few more contractions, I walked back to the bed to get monitored and checked. The baby still looked amazing, and my nurse said, "I don't feel one bit of cervix, let's start pushing!" As soon as I heard her words, a huge surge of energy came over me. I ripped of my gown and starting really pushing and working with each contraction. I was my most primal self, growling and howling with each surge. I moved back to the bathroom to do most of my pushing there, since it has been so effective in getting me through transition.

This point of my labor wasn't the most painful, though it certainly appeared that way to my mom and Allan, who were having a really hard time watching me writhe around as I worked with each surge. Melissa and my nurse stepped up to relieve Allan for a moment. I remember sitting on the toilet in the dark bathroom, watching Allan and my mom cry with each other on the couch. Melissa and the nurse were seated at my feet to coach me along and check my progress. After about 45 minutes, we moved back toward the bed to deliver the baby. I pushed through a contraction while standing up. Then, I reached down and felt my baby's head. Wow. I knew now, that I was so close to meeting my baby. Another huge surge of energy came over me.

I chose to deliver in a modified squatting position on the bed using a sheet that had been tied around the center of the squat bar for leverage. I pushed and pushed. Allan and my mom gathered around to support me. The nurse paged the doctor to come back in. The baby was almost here. A few more people entered the room. In my haze of pain and excitement I notice a few nurses along with the doctor, enter the room. I continue to push, and feel "the ring of fire", it lasted a long time. I focused on the feeling of relief I would have after I finished. The baby's head was having a hard time budging. The doctor used some lubricant to help slide her out. The baby crowned, and my urge to push was the most intense it had ever been. Then, the told me to stop pushing. Something wasn't quite right. Five more people enter the room. I begin to pant like a dog. My baby had shoulder dystocia and was hung up inside of me. The doctor and nurse quickly perform a maneuver to help push the baby's shoulder past my pelvic bone. The move was more painful than any of my contractions, but over in seconds. My mom started to squeal "The baby is coming! The baby is coming!" Allan looked super excited and nervous. Seconds later, the baby emerged and any sense of discomfort melted away from my body.

They announced that it was a baby girl (I was convinced I was having a boy!). My mom jumped up and down. Allan cut the cord. Since there was some meconium to deal with, my new daughter wasn't place on my chest immediately, but Allan brought her to me very quickly. I remember watching him walk towards me with our baby, he looked so natural and confident. He placed the baby on my chest, she felt so heavy. I studied her little body. She was nice a chunky and had a ton of hair. She latched onto me right away. I was in heaven.

 I understand now what so many mothers have written about before me, when describing how much their heart expands for their new baby. It is beyond profound, it is bigger and wiser than anything you could imagine, it is overwhelming and humbling. The only thing that will amaze you more than the tiny fingers and toes that you made, is your capacity to love.

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