The Birth I Didn't Want: L

L was born February 9, 2007. Her due date had been Superbowl Sunday: February 4, 2007 and she was 5 days late. She weighed 6 lb 14.5 oz and was 20.5 in long. She was an unplanned baby, but we certainly weren't doing much (well- anything) to prevent her! I had started to consider using Natural Family Planning as birth control and purchased a basal body thermometer. Thru the process of charting and reading, I learned that if your basal body temperature is elevated for 14 days, there is a good chance you are pregnant. If your temp is elevated for 16 days, you can almost be certain you are pregnant. I checked my chart and (on my first cycle of charting) my temp had been elevated for 17 days!

I was home alone and took a test that confirmed my suspicion. I paced my apartment in a panic. D was at our neighbor's house, so I leashed our mutt (truly our first baby) and raced thru a quickly approaching thunderstorm to bring D home. I played it cool at our neighbors and during the walk home, but once we were in the door, I couldn't wait any longer. As he removed his shoes in the entrance way, I sat above him on the stairs and said, "So, I'm pregnant." He turned gray and after some stumbling conversation asked to see the test. I showed him and he said, "MY BOYS CAN SWIM!" Predictable, but nonetheless amusing. We were very young (him 23, me 24 and 2 mon) and had no idea the journey her pregnancy and birth would lead us down.

Flash forward several months later. A wedding and home purchase behind us, we were anxiously awaiting the arrival of our first born. I had been working as an OB nurse for about 4 years and had a lot of experience with assisting birth. I had a pretty good idea of the flaws in the medical model, but realize now that I subscribed to far too many of those flaws. My birth plan was a little less 'crunchy' than the one I drafted for H, but it was to be a natural birth. I had hoped to forgo pitocin and an epidural, but sympathized very strongly with the 'job' I thought the medical staff 'had' to do.

Being past your due date is a miserable place to be. Everyone you know calls and texts and the people you don't know say ridiculous things to you. I was officially on maternity leave- the first time in YEARS that I spent days upon days sitting in the house... waiting for baby. I decided to use the breast pump to get things going and it seemed to work. The doctor stripped my membranes in the office and I had A LOT of bloody show. My husband came home from work exhausted and literally said, "If you could go into labor tonight that would be great because I don't want to go to work tomorrow." We went to WalMart and I was having mild contractions. Anxiousness or impatience or a need to please my husband or even inexperience led me to believe I was in labor (looking back I do not think I was) and we went to the hospital.

It was about midnight when we arrived and the nurse said I was 3-4 cm. I was admitted and my husband promptly fell asleep. I labored thru the night- using the birthing ball, walking the halls, getting into the shower. At about 6 am, I asked for some stadol to get some sleep because I knew the doctor would be in to make rounds soon and break my water. The stadol wiped out my contractions. The doc came in and broke my water (as I knew he would) then suggested pitocin. I declined saying that the AROM would likely get things moving and if need be, I can walk the halls again. He responded with "Do what you want, but I've seen women walk these halls for days and nothing happens. I'm off for the weekend and Dr. S is covering." Dr. S was an OB from another practice who I'd never seen before in my life.

The AROM got the contractions moving again indeed. Within a half hour, I was requesting an epidural. My mother and husband were very disappointed with my decision and tried to deter me. "What about all of those things we said we were going to try, K? The birthing ball? The shower?" my husband attempted. "I did all those things while you were sleeping" I rebutted. End of conversation. Anesthesia was on its way. Looking back I know my 'need' for an epidural was 110% fear based and due to the fact that my body was not in labor on its own.

Getting the epidural was absolutely terrifying. I had imagined a lot of birth scenarios for myself, but suddenly the thought of the needle and catheter going in were more than I could take and I started to break down. My husband was a champ and talked me thru it. After it was placed, the pitocin was hung. I knew it would happen, but I don't remember anyone specifically telling me or asking consent. I don't think I stayed awake too much longer and the rest of my labor was spent in and out of consciousness. I remember throwing up from the epidural and simultaneously peeing myself. And I remember lots of Anna Nicole Smith coverage being on the television (she had died the day before.)

At about 6 pm, I was 9-10 cm and the pushing phase was upon us. By this time, the EFM strip showed frequent fetal tachycardia, my temperature was 103, and thick meconium was evident in my fluid. I needed to deliver this baby. I started pushing, but couldn't feel what I was doing and was exhausting myself. I pleaded with the nurse to let me change position and she humored me for one push and allowed me on my side. I hadn't pushed as effectively she said, so I was flat on my back before the next contraction. I pushed and I pushed and I pushed and I pushed. Then I pushed some more. I could see in the mirror that I had much, much more pushing to do and was getting discouraged. Eventually the epidural started to wear off and I could feel what was going on... this was both good and bad.

The pressure was unbearable. I tried to push into it, but my baby just felt- stuck. I became out of control. Much like with H's birth, I was apologizing for my behavior but could do nothing to stop it. The fetal monitor strip was looking worse and meconium had become thicker. The nursing and medical staff gathered in the room and I realized things were getting dire. The doctor came in and explained he'd be using forceps. This was another scenario that NEVER crossed my mind. Vacuum- yes, forceps- never. Whatever, tho. I wanted that baby OUT. I begged him for an episiotomy before he used the forceps and he agreed. He lied.

In the next several pushes, she was delivered. She had a nuchal cord and was OP. I had made it clear to the medical staff that I wanted my husband to announce the gender and after she was out the doctor looked at him and said, "Well..." I didn't know she was fully delivered and was completely confused as to why he addressed my husband in that manner, but then D very solemnly announced, "It's a girl." He brought her over to me rather quickly (she was not placed on my stomach) and held her up to my face. "Oh," I said. "She's cute." It never occurred to me that she might be. "Take her to the nursery. She's grunting." I was in OB nurse mode and hadn't yet learned to be a mommy. Off she was whisked and there I sat on the table being stitched for well over an hour. My tear was a 4th degree- that's the worst you can get. And apparently my delivering doc (you know, the one from a mysterious different practice) had a unique repair method. This was made known to me on the post partum floor when a nurse said, "Oh, THAT'S S' work for sure." I still have no idea what that means nor do I want to.

I endured an hour of stitching (that I could feel) and listening to the medical staff discuss Anna Nicole Smith. I was alone and my baby was in the Special Care Nursery meeting the rest of my family. My family all went home as I recovered in my LDR and about 3 hours after she was born, I asked where exactly she was. The nurses said they'd bring a picture and after more than an hour, they did. I asked when I could nurse her and they said they didn't know. I'm not sure how much longer it did take before I held her, but I know now it was too long. She nursed well and I weeped alone in the room as she suckled. The nurses were busy and didn't stay with me because they knew I was one of them.  They assumed I didn't need help. I probably told them I didn't. I know now that I did need help and I did not want to be alone.

I still mourn her birth and regret nearly every decision that was made. Ultimately, tho, she and I made it thru. Healthy and strong and here to tell our story. Thanks for reading.

H's Birth Story: A(nother) Tale of Disappointment

I found out I was pregnant on my 3^rd wedding anniversary about a week and a half after my husband, D, and I decided it might be time for L to have a sibling. H was born on May 5, 2010. He was 9 days late (due April 26^th.) He was 9 lb 6 oz and 21.5 in long- a full 2.5 lbs larger than his sister. I’d planned his labor and delivery to be as natural as possible- no pitocin, no AROM, no epidural, no excessive monitoring, or general obstetric dilly-dallying. I wanted to labor at home until I felt the urge to push and the prospect of delivering in the car on the way to the hospital didn’t faze me in the slightest. However, I was seeing an obstetric practice, so as they say ‘the best laid plans…’

Being that he was 9 days late and my OB was ‘suggesting’ an induction soon, I decided on May 3 to take castor oil. I took it after my daughter was in bed and just before my husband had come home from work- at about 8 pm. Thru the evening and into the night, I was unsure if anything was going on, but as we got into bed at 1 am, I was becoming surer the castor oil had worked. I was having difficulty falling asleep, but the contractions were quite tolerable until 2:20 am. I then got a much stronger, longer, and quite painful contraction and my water broke. The contraction was the only one of it’s caliber until late evening the next day. It was as if my brain somehow told my body- now is the time to break the waters. Now although we had been preparing for this and talking about this for weeks; and even though we had been thru this before, when my water broke: panic hit.

I immediately called my mother and told her that my water broke and to take her time driving. (I am pretty sure she arrived 15 min later and lives a 35 min drive away.) My husband and I changed the sheets and I got into the tub. Upon entering the tub (in a panicked haze, mind you) I felt rectal pressure and thought ‘holy shit, I’m gonna deliver this baby in the tub right now!’ I got out of the tub and onto the toilet and realized the pressure was just the OTHER effect of castor oil… I decided I didn’t want to be in the tub after all and drained the water. D came in quite confused and asked to take a shower. I don’t remember much more until some time later, but I know we called D’s parents and my mother arrived. Fluid was coming out in gushes with contractions and I soaked about 10 pads, pants, and underwear. I sat on the birthing ball and my mother, husband, and I talked for some hours. Labor seemed to be slow coming, but definitely moving along. At 6 am, we decided that my mother and D should rest and I was getting uncomfortable enough to get into the tub again.

While in the tub, I was dozing off and eventually came out. I remember feeling uncomfortable, but exhausted and the house was eerily quiet. I didn’t know where to go with myself, as there were essentially sleeping people in every room but the nursery. I had to focus thru some contractions and I thought of L. Somehow the labor died down, tho, and I slept for an hour or two. Morning arrived and I woke shortly after the sun rose. I got D up and we went for a walk around the neighborhood to get contractions going again. The school bus was picking up the local kids, so all the families were out to wish us luck with the delivery. When we came home, I used the breast pump and it seemed labor was picking up.

L woke up at some point and I’m sure we told her that the baby was coming soon. I got tired again and decided to take a nap after she and I watched Sesame Street together (11 am) thinking that my body was telling me to rest. I woke up an hour later with no signs of labor. D and I decided we should go to the hospital because my water had been broken for so many hours and I ‘needed’ pitocin. Also, there was a change in my amniotic fluid that was determined later to be meconium. We arrived at the hospital at 3 pm.

Upon arrival, the medical staff was annoyed we’d waited so long to come in and not called to say we were on our way. At least 3 nurses saw us prior to official admission and at one point the doctor had told me my water hadn’t broken. I assured him that I had experience with birth and that I knew my water was in fact broken, but he said there was no clinical evidence that it had. (Note to physician- believe patient over ferning test every once and a while.) My cervical exam was 3 cm and 90% according to the doctor who didn’t believe my water was broken. I was left on the monitor (and nurse-less) for about an hour and a half before the doc checked me again and said I was 4 cm and 100% and that the EFM strip had a period of ‘low variability’ and that I’d better just stay and ‘get this over with.’ He also determined on that exam that my water was broken to which I replied, “I know.”

I was getting annoyed about being at the hospital and being on the monitor and all the control they were taking of my birth. I refused the monitor for about an hour, but was informed that doc’s orders said I wasn’t to leave the room! Time passed and few strong contractions came. The doctor examined me and: alas- no change. We decided I should have pitocin. I had what seemed a rotating door of nurses, but shortly after my pitocin was started, the best one assumed my care. She was very supportive of natural birthing and actually seemed to have some experience with it. Contractions got strong at about 9 pm and D played Bob Marley. The contractions were unbearable at 10 pm and I asked for pain medicine. The nurse was going to get me stadol as I get up to the bathroom, but while in the bathroom, I saw quite a lot of bloody show and called for her to come back. She examined me and determined I was 7 cm. This was less than an hour after the doc had determined me to be ‘still 4 cm.’

I felt good about the quick change and hoped it would be over soon. The doctor came in to do another exam (I am pretty sure this is at least the 5^th ) and said he would consider me ‘maybe 5 cm.’ This is the first time I remember him casually mentioning a C Section. When he left, the nurse assured me I was ‘a good 7 cm’ and I believed her. The pitocin rate kept increasing and so did my pain. I very quickly hit a wall and lost control. I remember being in more pain than I could handle and wanting to rip my IV out to make the pitocin stop. I knew my body was not compensating with endorphins like it would if labor was happening naturally.

I begged the nurse to decrease the pitocin rate because knew I had too much pain to relax and allow my body to open. She wouldn’t decrease the rate, so I had to have the epidural. My husband (god bless him) did everything he could to deter me from getting it. He tried to distract me with watching ‘The Deadliest Catch’ and said how proud my mother and I would be when I had achieved a natural birth. I knew when he said it that I wasn’t going to achieve that. He was so adamant, in fact, that I said to him, ‘If you don’t say it’s okay for me to have the epidural, I am going to make you leave the room.’ The nurse came in shortly after that and told him we’d done everything we could and we’d fought the good fight, but sometimes (especially with pitocin) pain management is necessary.

The doctor checked my cervix before the epidural and said ‘no change.’ Which, I guess means I was ‘about 5 cm’ and he more obviously but still casually mentioned that perhaps I needed a C Section.

I was a mad woman during the epidural. My pain was unmanageable and I was totally out of control. I constantly apologized for my behavior, but could not stop from yelling and wiggling as the contractions hit and he tried to place the needle. It was a difficult placement as I bucked wildly, but the anesthesiologist was able to get the catheter in. He was very nice, especially for an anesthesiologist and waited until I had full pain relief to leave. Upon achieving full pain relief, I thought 2 things: 1- I hated the dead feeling of my legs and would almost rather feel the contractions and 2- the urge to push.

It was change of shift, tho and I wanted a nap so I didn’t say anything about the pressure I was feeling. I dozed for an hour and when the new nurse came in, I told her I would NOT sign the consent for a C Section and she quietly supported me. Before too long, I admitted I felt pressure and she checked me. ‘Just a lip’ she determined and said to give a practice push. I took a deep breath and gave it my all. My husband’s face was priceless as the nurse said, ‘OKAY, don’t push again.’ The pressure was pretty intense and I considered pushing despite her request, but waited for the doc to show up. He whizzed in, gowned up, and gave the go ahead. H crowned with my first push. His head delivered with my second. The shoulder seemed a little tight and took 3 good pushes, but then… he arrived! He was placed on my belly and I looked at my husband and said, ‘What is it?!’ He was slightly tearful and said, ‘It’s a boy.’ I said, ‘Oh, he’s little’ and the nurses said he was big and probably 9 lb. I thought they were crazy! (They were right. As I said, he was actually 9 and a half pounds.)

I had a slight tear which was repaired quickly. The nurses took him while I was being stitched to clean him up and document his arrival. They brought him back when I was situated and he nursed vigorously for at least an hour. D went home at some point and my mother came to meet the baby. I was cleaned up and moved to my post partum room and L came with D to meet her brother in the morning.

All in all, this birth was much more satisfying than L’s. I am amazed my petite frame so easily gave passage to such a large baby. I could never have handled the pain from the pitocin contractions without the epidural and my labor was stalled, so we thought pitocin was necessary. If I had it to do over, few things would’ve been different, but ultimately, it was as gentle a birth as I could facilitate at the time.