Sunday, February 8, 2009

ideal birth

This is my cousin's birth story, see the intro in the post above.
Excuse the length of this post, but here's the story!

Early labor
Wednesday morning at 9 a.m. I had acupuncture. The acupuncturist predicted I’d go into labor with 24-48 hours. (I really need to call her to tell her she was right!). I had irregular contractions all day Wednesday. By 1 a.m. they were coming every 15-20 minutes and were mild. I slept in D’s bed last night because J has had the cold that just won’t quit and was coughing and snoring. I dozed on and off all night between contractions.When I got up I gushed a bit of fluid. I went into our bedroom and told J, “Are you ready to meet your daughter today?” (Even though I knew it could still be a few more days, I was pretty sure she would be born by the next morning.) The gushing continued for a few hours, but as I made D breakfast and did stuff around the house, the contractions went away. J decided to stay home from work, and I called M, our doula, to let her know what was going on. I also called the midwife because I thought I had seen some meconium and that can be a problem. I also told her about the fluid leaking and she said she wanted me to come in and get checked.The birth center had a policy change since the last time I was there--it used to be, if your water breaks, you can labor at home until 36 hours, at which point you have to go in. Then they had a case of a woman developing an infection and had to change their policy so that now if your water breaks, you need to be admitted and in active labor within 24 hours. Needless to say I didn't like that policy at all, and I considered just waiting it out, but we decided to ultimately just go in and see what the midwife said, and then take it from there.

We called J’s mom to come down and stay with D. We gathered everything up and got ready to go. R stopped by to give me a card and we chatted a bit. During this time I kept having light contractions but they weren’t progressing. We got to the hospital and B checked the fluid and determined my water had broken. What I thought was meconium was actually just a part of mucous plug. That was a relief. We talked a long time about why they wanted me to stay, etc. and I noticed something interesting—my contractions were picking up! I thought that maybe being at home with D distracting me had caused my contractions to recede, and now that I was out of that environment and at the place where I knew the birth would happen, they were coming back. We decided to stay and hope for the best.
We got to our room—one of the nice big birth center rooms—and basically sat around waiting for things to pick up. All afternoon I alternated between resting and walking, all over the hospital, up and down stairs. We kept M informed about what was going on throughout. B kept talking about castor oil to get labor going. Inductions aren’t done in the birth center, and castor oil is really all they can do to help things pick up. She was kind of pushing me to take it—I know she was doing it because she didn’t want to see me go downstairs to Labor and Delivery and end up on Pitocin, but something was holding me back from trying it. I really wanted to go into labor on my own.

Active labor
As night fell I started to get serious. I gave myself until around 9 p.m. and if nothing was happening, I’d take the castor oil. J began to press the acupressure point called “spleen six” which can cause contractions, and we did that for probably about an hour—press for a minute, rest for a minute. My contractions began to pick up! M arrived around 7:30 and by then I was having contractions every 10 minutes. I welcomed each one and was smiling through them. Within an hour they became more frequent and intense. The mood in the room was very electric, we were all making jokes and laughing between contractions. J, M and I had spent so much time together in the weeks leading up to the birth that we just fell into our roles so well—J providing strong emotional support and M providing professional experience.

By about 9:30 p.m. I was definitely in active labor. My mood had changed to excited and smiling to serious and focused. The midwife on call that night, H, came in a few times to observe me. I found the best position for contractions was to be squatting on the yoga ball and facing the bed, with J on the bed, holding my hands, and M on a stool behind me, pressing into my lower back/hips. I was able to stay relaxed and open during the contractions and felt immense support and love from J and M.

As things picked up even more, I began closing my eyes during a contraction, and M told me to try to keep them open during the next one and to remain mindful, because by closing my eyes I was closing out what was going on and focusing too much inward, which could brew fear. From then on, my eyes were open for the rest of the labor. It really made a huge difference.H checked me—maybe it was around 10:30?—because I was feeling very nauseated and chilled and thought I was maybe in transition. I was 4-5 cm and my cervix was soft but not fully effaced. Of course I felt frustrated and figured I was in for a long night. M reminded me that it was just a number. I repeated that to myself and remind myself of all the birth stories I had read where women can open up several centimeters in a matter of minutes.

I requested the birth tub be filled up and while it was, I went into the shower where I directed the hot water on my belly during contractions. When I got out, I went back to my favorite position on the ball. The tub was still filling. By now, a different midwife, K, had come in and introduced herself. She said H had called her in as backup because “everyone has decided to have their baby tonight!” (I later found out that there were five births in the birth center that night, C being the first.) By now the contractions were coming very fast and furious, and I was beginning to be more vocal. I was very nauseated and was shaking uncontrollably and even though it had only been less than two hours since I was last checked, I really wanted to be checked again. This was a bit after midnight, I guess. I was 8 cms! That gave me such a burst of energy.

After I was checked, I went through a very intense period of several excruciating contractions right on top of each other and tons of pressure. I kept telling everyone that I had to push but I couldn’t believe I had gone from 8 cms to fully dilated in just a few minutes. I had told K that I wanted to squat for pushing so they set up some chux pads on the floor next to the bed, where the ball had been.

J was on the bed, facing me, and I gripped his hands and started pushing and yelling so loud I was hoarse the next day. The M told me to make my screams more low-pitched and that helped so much. Within a minute K told me to reach down and feel the baby’s head. Of course, that gave me the energy to push a few more times right away. I felt the ring of fire, which I hadn’t felt with D due to the epidural. I paused and then pushed again, and felt her head come out, and then pushed again and out she came. It was about five minutes in all. K immediately passed her to me through my legs and I climbed up on the bed. My first thought was how tiny she was! My second was, I can’t believe I just did that!

From several seconds after her birth until about three hours later, she never left my bare chest, except to spend a bit of time on J’s bare chest. I had a first degree tear which the midwife stitched up. She said I was bleeding a bit more than she’d like to see so I got a shot of Pitocin. We had requested to spend at least an hour with C before she was weighed, etc., but it ended up being about three hours since they were so busy that night. That was so lovely—the midwife and nurse left and within a half hour of birth C latched on perfectly and nursed for an hour! We just sat there and marveled at her and talked about the birth. I was so high from the intensity of the last couple hours.

I don't think I could have asked for a better experience... now I'm glad that we were in the birth center when active labor began and didn't have to try to drive to the birth center in time. It gave the experience a much more relaxed feel. I think I have more to say about my experience with this unmedicated birth vs. my epidural birth with D, but I think I'll have to save that for another day when I have more time and more coffee!

The only thing I'd pick up on is that ideally, the midwife would be guiding the baby out slowly, slowly, that you breathe her out rather than push, and give the vaginal tissue time to adapt and stretch, perhaps have a warmed cloth pressed to it, and this way it's completely possible to avoid any tearing. Sometimes though, you just can't hold back! Most community midwife programmes have a very low tear rate and virtually no episiotomy, compared to something like 80% of first time births in standard hospital procedure.

Pitocin is called Syntocin in Ireland, I think.


Holemaster said...

Thank God I am a man.

jothemama said...

I don't know. Giving birth is the single most amazing thing I've ever done. I'd do it again in a flash if it didn't mean suffering through another pregnancy and further years of sleeplessness.

I'd rather give birth than run a marathon...

Xbox4NappyRash said...

Very good story, and good account of a positive experience.

Must be quite fascinating to be present from the start to finish of labour.

Xbox4NappyRash said...

Obviously the mother would be, but you know what I mean.

Anonymous said...

So relaxed and with so much love :)

This is an ideal situation, really. I'll be stealing snippets from this story to tell mums to be :)

Tell you what though... I highly recommend the rubbage of Vit E oil into one's perineum for a few weeks beforehand. I did that and birthed a 9 pounder with not a stitch in sight :)

jothemama said...

Yes. Definitely.

I wonder should I do a post on that? Why not?

Xbox4NappyRash said...

You absolutely should.

There are hundreds of simple tips that could make huge differences to people.

An awful lot of us are fairly thick in fairness.

Rechru said...

"The mood in the room was very electric" ... my heart skips a beat! Oh how exciting! Huge congrats to your cousin!
I feel sorry for men that they can't experience this feeling of giving birth! Really. I'm hooked on giving birth. THanks for posting this.

jothemama said...

I know! You should see the beautiful photos!

I'm so sad I don't get to do it again.

I wish I could go back and redo mine :(