Monday, March 30, 2015

Little Lion's Birth Story

It took us 5 months of trying to conceive this pregnancy. Having never had any trouble before, I was truly concerned and had begun tracking basal temperature. I had one month where the home pregnancy test was ambiguous... almost a line, but not very distinct... and then a week later, nothing. Finally I read something about certain kinds of blood pressure medications preventing conception (calcium channel blockers) and my husband went off of one of his medications. The next month we we had a positive pregnancy test!

This time our care was in the hands of our favorite midwife, the one who had delivered Bug, from the beginning. We had a confirming ultrasound at about 8 weeks, and everything looked great. Our midwife knew of a new blood test that could check for chromosomal abnormalities with 99 percent accuracy (Panorama), which was certainly preferable to the CVS we had done last time-- no miscarriage risk and none of the discomfort of having a needle stuck into the womb. The local hospital lab hadn't heard of the test and was uncooperative, so I ended up traveling to another hospital 40 minutes away. By the time we had the lab order the kit, had the testing done, then waited nearly 2 weeks for the results, I was almost 16 weeks, so I was very, very thankful when it all came back totally normal.

We did was a variation on gestational diabetes screening-- instead of drinking the evil syrupy chemical filled soft drink, I ate a balanced, carb-counted breakfast at home and had my glucose tested an hour later. It came back completely normal.

We also did the 20 week ultrasound, and it was beautiful to see our little baby on the screen. We also had a big surprise-- he was clearly a boy, whereas we had thought the Panorama test had concluded that there were two X chromosomes. That turned out just to be a mistake in reading the test, when we went back and looked the Panorama had also concluded we were having a boy. I was thrilled, and also terrified... what did I know about raising a boy? I suppose that is a silly question, since all boys are born from the bodies of women, but strange to me all the same.

I turned down GBS testing after reading extensively on the subject. While a baby getting GBS is scary, my research led me to conclude that hospital practices were contributing to the transmission to babies (constant internal exams, internal monitoring, etc) and the risk of a baby contracting GBS at a home birth where interventions are limited is very, very small. I agreed to take probiotics prophylactically to improve the chances of a beneficial vaginal bioflora. If I ended up transferring to a hospital, I probably would have to consent to all sorts of things such that being given antibiotics for an unknown GBS status would be the least of my worries.

The pregnancy overall went beautifully. Every test came back completely clear. In so many ways, it was an easier pregnancy than my first. With little Bug, I was swollen from the second trimester on, and it only got worse, progressing into carpal tunnel in the third trimester, such that it was hard to do simple tasks with my hands-- I couldn't open bottles and I dropped things all the time since my fingers were numb. My feet were so swollen that the only shoes I could wear were a pair of big, slipper-like UGGs that were a size too large. I also had terrible hip pain starting at the end of the second trimester, and general joint pain, almost like I had arthritis.

This pregnancy I had almost no swelling-- I wore my wedding ring on its proper finger right through labor. I had mild, persistent nauseau for the first trimester, which I took as a good sign that my body was making lots of pregnancy hormones, and I did have some hip pain in the last few weeks. The biggest discomfort was indigestion and acid reflux, which was so bad for me that I wouldn't eat anything after 6pm other than yogurt or fruit. This was really hard when I was commuting since it meant I basically had to consume all of my calories on the road or in my office, but once my maternity leave started, I would just make myself a big, nutritious lunch.

I was, however, HUGE. I got huge really fast-- I started "showing" almost as soon as I got a positive pregnancy test, and I'm sure my attempts to hide and deny pregnancy until we were past miscarriage risk were laughable. People were constantly asking if I was having twins (which is really, really annoying!). In second trimester, people would ask when I was due and show disbelief and pity when I stated my due date.

I had strong Braxton Hicks contractions all through my third trimester. Sometimes my uterus would be hard and contracted for hours at a time when I was active... such as shopping, or cleaning. As my dates came closer, I had cramping and also stronger, sharper BH contractions, but nothing that was regular or timeable.

I was so sure that for a second pregnancy, I would come on or before my due date. But my due date came and went. As I went into that overdue waiting period, I felt massive, was never comfortable, and felt the veiled pressure of the dangers of allowing a pregnancy to go too long. I actually got no pressure from my midwife, who was content to wait until 42 weeks and perhaps longer... but just felt it from family and friends. With induction being so prevalent, it seems like so few women go very far past their due dates. It is almost like a cultural taboo in the US.

I was due on March 10th, a Tuesday. We had every birth supply on hand that I could think of, and a lasagne in the freezer. A week later, we were still waiting. I finished the second baby sweater, and made a hat to match. With every one of my strong BH contractions, I was looking for a pattern and frustrated at not finding it.

I went for acupuncture on Friday, which I find to be a strange experience-- this time I found myself in a dream-like state, with visions of the baby and my body as a vessel, and was surprised when I left and realized that 1.5 hours had passed-- I thought it had been perhaps 20 minutes. I was also very energetic, and went for a walk afterward and stopped at the store on the way home for a few more labor food items. I got home and was in the bedroom with my husband and Bug, getting up off the floor after kneeling down to help Bug with something, and I fainted. I didn't fall far, but had a good bruise on my shoulder and head.

I started a pair of baby booties to match the sweater, and was dreading Monday, where I would probably start consenting to things, in the order of least invasive, but all stressful in their own ways. Probably an ultrasound, which would have us traveling 40 minutes away to visit a technician that our midwife would find appropriately experienced, and maybe my first ever visit to a chiropractor. More acupuncture, certainly.

I went online seeking comfort. So few women go over their dates in the US, but in the UK where there is nationally supported home birth program, I found a message board devoted to stories of women who were over their due dates and had successful home births. I found it comforting that very few of them had huge babies (one of the cited risks) and most of them had short or at least reasonable length labors (a concern of mine after the marathon labor I had for little Bug). I also found an article that suggested that women are often very consistent in their gestation times. So since Bug was 12 days overdue, maybe my body would go into labor in a similar time frame.

Twelve days over my date was Saturday. David dreamed that I said I would have the baby on Sunday. A friend also texted on Saturday to say she had a dream that I had a healthy baby. I finished the baby booties, then stayed up too late posting them. I went to bed, and got two hours sleep before Bug woke up with an earache or a bad itch. I spent two hours comforting her before I finally resorted to baby Advil, and then got another 2 hours of sleep before she was up and dragging me out of bed.

Sunday morning, and still not in labor. I wasn't too unhappy about that, since I was exhausted from the sleepless night. In the afternoon, I took Lilly to bed for her nap, hoping to get in a nap myself, and had a contraction lying down. I started the timer, and tried to go to sleep. Twenty minutes later I had another. I snoozed, then was woken up 16 minutes later. Then 18. At this point I was so excited that it was pretty hard to sleep, so I got up.

The contractions started coming 6 minutes apart. I started vigorously cleaning the house while timing them. They weren't so strong, but I would stop when I had one to sway and concentrate on the feeling of opening up. My husband was on the phone with his sister, and I showed him the contraction timer. He got off the phone and started cleaning and preparing things- plastic on the bed, towels under the pool, etc. We called the midwife, who was on a home visit halfway between her home and mine, and she said she would come my way to finish some errands and call me afterwards. She told me to try to rest, which just made me laugh... there was no way I could go back to sleep now, despite the restless night before and not very restful nap. By the time she called back, I was moaning through the contractions, although they were still no closer-- 6 minutes apart, 1 minute long. She said she would be there soon.

Before my previous birth, I had spent a lot of time trying to practice techniques from Hypnobirthing and reading Ina Gaskins book. It seemed to me that a lot of the point of all of this was trying to convince yourself that you were not in pain, which just didn't work very well for me. I envy those women who seem to have "easy" labors, who can self-hypnotize their pain away and breath their babies out without pushing, but I think this just isn't how my body and mind works.

This time, I had prepared by reading hundreds and hundreds of birth stories from various online sites, and watching a few on youtube. I pulled from the experiences of other women to try to find something that would work for me. I decided to concentrate on getting "into" the pain instead of trying to will it away. During Bug's labor, I kept moving around, looking for positions that would help progress my labor and make my contractions more bearable, but this time I didn't try to make myself more comfortable. Instead, I tried to welcome the pain and feel it as my body working towards a goal. It worked much better for me. Contractions where I fought the pain or tried to get away from it were more difficult to manage. When I was able to concentrate on feeling how the contraction was opening and preparing my body the pain felt more manageable. I doubt everyone feels labor pain in the same way, but in both of my labors I had contractions that were concentrated in the lower front of my belly, sort of in line with where my cervix was, so it made sense to see the pain as the act of my cervix opening. Fortunately I had almost no back pain to distract me. Maybe the advantage of being so massive in pregnancy is that I carry so far forward that the baby doesn't press against my back. He was also in a good position, with his spine against the front of my belly. 

I did use some general techniques from Hypnobirthing... I used a version of relaxation breathing and visualized my cervix as a flower opening. To strengthen my visualization, I had watched and re-watched time-lapse images of lotus flowers opening, and this helped me hold the image more strongly in my mind during labor.

I also very deliberately used vocalization, intoning a low ah.... or oh..... during contractions. I had read of women using a mantra of oooo.....pen and I started doing this also when the contractions became more intense. It gave me something else to do and concentrate on. I'm sure it was funny to the people listening, but I didn't care. Later in labor, I started adding a vibration to the toning, like vibrato... I don't know why, it just felt good, and somehow made me feel more like I was in control.

I labored mostly in the bedroom, with the lights dimmed, standing and leaning against the wardrobe or on the birth ball. I had gotten in the birth pool really early last time which my midwife did not discourage, but after reading so many birth stories, I decided that it would be best to wait until labor was well along-- 5 cms at least. I asked for a check when I thought I might be there, and I was 4-5 so there was a sudden flurry of activity to fill the pool. My husband had been reluctant to start too early, but they quickly ran out of water from our over-taxed water heater and started boiling pots on the stove. As soon it was ready, and I jumped right in. I don't know if the water made the pain any less, but it was certainly a comfort that I welcomed. I also loved the mobility the pool gave me (it was a La Bassine birth pool which was nice and deep and roomy). I mostly hung out on my knees, leaning heavily on the padded edge of the pool. My husband sat on a stool and held my hands. After he had finished filling the pool, I pretty much wouldn't let him leave me! It was just a comfort to have him there.

Throughout it all, and especially right around 7cm, I kept declaring that I couldn't do it, that I didn't have the strength. Which is sort of out of character for me, since I usually have a lot of confidence in myself, and I know that despite what I was saying, I did have confidence in my ability to give birth. I think I was saying this because I was so fearful of a repeat of my first labor, where I was frustrated at the very slow progress, and I really was close to not having the strength or energy to continue. I also wanted the encouragement of the people around me, and it is a lame way of getting it, but it did make people say to me that I could do it, and that is what I wanted to hear.

After awhile I was getting really tired, and tired of waiting, and I asked to be checked. I got out of the pool and my midwife said I was 7-8, which everyone said was good but I had been hoping to be even further. So I stood and labored for awhile, hanging onto my husband, which made the contractions more intense and closer together. When I couldn't take it any more and needed a rest, I got back in the pool and contractions seemed to space out and give me a bit of a rest. I almost fell asleep between one set, and I heard my husband snoring.

My midwife suggested that I try to rest, but I just wanted to move forward. Then she suggested I eat something, so ate a spoonful of honey, which seemed to help pick things up. I thought I might be feeling a little bit pushy, so with my midwife's encouragement, I tried pushing, but it seemed like I could feel I was pushing against the pain at the front of my abdomen, so I thought that perhaps I wasn't all the way. I stood in the pool and labored that way for a few contractions, supported by my husband. I still wanted to push, and asked to be checked, so flipped onto my back in the pool and my midwife checked. No lip! She suggested I try pushing on my back in the pool with my legs held up to my chest on the next contraction and I tried, but it felt like I had no power in this position.

I went back to my favorite place on the edge of the pool, on my left knee and squatting with my right leg. There is no way I would ever have been able to hold this position on dry land! But in water it was possible, and I was even able to reach down with my right hand and feel the water bag. At the end of the next contraction, my body started pushing for me. I was surprised, since this hadn't happened during my first birth, but I had read about it happening for other women. It felt like my body was telling me how I needed to push. After that I started pushing on my own. At first I was making a lot of noise, and my midwife said it would be better to put the effort into the push rather than the noise. I started concentrating on the pushing, getting 3-4 pushes into each contraction. I kept my hand in my vagina, feeling my progress. The water bag move just a little bit, then slide back in between. I knew that this would happen, but it is so disheartening to when it does happen. I asked if it would help to have her break the bag, and she said that she could do that, but didn't think it was necessary. She thought it wasn't hindering my progress, and it would break on its own.

Sure enough, my water did break after a few pushes. I had my hand on it as I was pushing, and I felt it break and the fluid rushed past my fingers. It was sort of amazing. On the next push, I could feel his head making its slow progress down the canal. It was soft and squishy and hairy! A little further on his head started staying in place between contractions, and I made my husband feel it too.

After what felt like forever (but probably wasn't nearly as long as I thought), his head was right against my perineum, and I could feel the burn. I tried for a few contractions to push him out past the perineum, but wasn't feeling like I was getting anywhere, and my midwife came to help, trying to work him through. She had me push, even without a contraction, then had me pull my right leg up into a squat too (another thing I couldn't have done on dry land), and push some more. I pushed harder than I thought was possible, and could feel her encouraging him out.

Suddenly she was passing him up between my legs and telling me to reach out for him, and I was holding my slippery baby and pulling him out of the water. I flipped over hand held him on my chest, overtaken with amazement that this little tiny perfect person had just been inside of me. I very smartly declared, "it's a baby!" He was very calm, just looking at me. They were trying to suction and get him to cry to see him breathe more strongly, but also saying that he was just fine. He didn't seem very interested in feeding, so I just held him against my breast, resting, so glad that he was finally with us. I birthed the placenta in the pool, while it was still attached to him. We waited for it to stop pulsing, then my husband cut the cord. He took his shirt off and I passed the baby to him and was helped out of the pool.

He was born at 6:01 am. My husband took him to meet his big sister who was in the living room. My best friend (and Bug's favorite"aunt") had come to be with her. Little Bug (who is 3) slept through most of the labor, apparently waking up for a couple of hours and choosing to stay on the couch with her aunt, then going back to sleep though the loud stuff at the end. She woke up just in time to meet her new brother! "He came out of Mommy," she declared. We had watched several birth videos together, so she knew how it all happened.

I had a small tear on the inside of my labia that needed a few stitches and a tiny one on my perineum that could probably have healed without stitches. They said I hadn't lost a lot of blood and I didn't need a shot like last time, but I was still a bit lightheaded when I stood up, so I opted to stay horizontal for awhile. After I was cleaned up a little and propped up in bed, I nursed him for the first time. Then they weighed him-- 9lbs 10.5 oz, only .5 oz larger than his sister.

Overall, labor was about 10 hours. For me, it was the perfect labor and birth, just what I wanted for our son. After the midwives left and we were all cuddled in bed, I was just so magical to be there all together, just enjoying being with each other.

Born March 23rd
("Due" date March 10)

9lb 10.5 oz
22.5 in length
15.25 in head circumference
14.75 in chest
14 in abdomen

10 hour labor (by the midwife's count)

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