Views on Childbirth - part 5

Read part 4 here

M&M's Birth
For the most part, my pregnancy with M&M was pretty normal. I had some high blood pressure now and then but I think it was mostly due to white coat syndrome (my b.p. rising when having it taken at the office). I was also retaining a LOT of water for about the last month. My ankles were HUGE towards the end. A lot of this can be attributed to a very hot summer (with no central air in our apartment & no air conditioning in the car either) as well as the fact that we moved to a new apartment when I had just a little over a month left & I did a lot of the moving of the smaller stuff. DH & I were happy with our decision to see the CNM group for maternity care and we loved the natural childbirth class that we were taking. My due date was August 11 and everyone told us to plan on the baby being late with the first pregnancy. So I was all set to have the baby in the middle of August and my mom was set to fly out from Virginia to help out around that time.

On Wednesday, July 29, I went to a regular prenatal appointment with the CNMs. The night before I lost my mucous plug and I mentioned it to the midwife. She did an internal exam and was a little concerned because there was a little bit of blood. She said that I was dilated to about 1 cm and was 80% effaced. She checked my chart and noticed that with my first ultrasound the placenta was low-lying in the uterus. She recommended that I have a follow-up ultrasound done to make sure that the placenta had moved up in the uterus and wasn't anywhere near the opening. They were able to fit me in for the ultrasound not long after that so I called DH at work and he drove up to join me. The ultrasound showed that everything was fine and there was nothing to worry about with the placenta.

DH & I drove separately back to work (we worked at the same company) and once I got there I sat at my desk and not too long afterwards started noticing what I thought were contractions (after all this was my first baby). They were fairly mild & far apart but they were also fairly regular. I went downstairs and told DH this. He was quite surprised (as was I) and I decided to go home to rest a little. When DH came home the contractions were still coming and we realized that we needed to go to the store to buy some last minute things. So we headed off to the mall and we had to pause every time a contraction came on. Unfortunately I was having back labor and was starting to get somewhat miserable.

Around midnight we decided to phone the CNM on call and head up to the hospital. When we got there I was checked and found to be 2 cm dilated & 90% effaced. I was informed though that this could still just be false labor and could stop at anytime (especially since I had another 2 weeks until my due date). The CNM recommended I get a shot of morphine and go back home to try and get some rest. I was somewhat disappointed at this point because I was in some pretty intense pain and was only at a 2!! So we agreed to a morphine shot and drove home. The CNM was pretty sure that I would be able to get a few hours of sleep after the shot and then would be able to tell afterwards if I was really in labor or not.

We got home around 5 a.m. and I slept for maybe an hour and then was up again with contractions. I let DH sleep as long as I could manage without him so he was able to get a couple of hours. After that I woke him up and with every contraction I had him press on some counterpoints on my back to try and relieve the back pain. It ended up being a pretty long day and we put off going into the hospital again as long as we thought we could - the last thing we wanted was to be sent home again. Around 3 p.m. DH called the midwife office and said that he would bring me in to the office to have me checked out there before the office closed for the day.

It was a very hot day & as I mentioned before we had no A/C in the car. When we arrived at the office DH & I walked in and they quickly rushed me back to an examining room. I'm sure that I scared all of the pregnant women in the waiting area with the moaning noises that I was making and the fact that I looked (and felt) utterly miserable. Two of the midwives came in and helped me up onto the examining table to check me out. As they had me laying there I tried to get up saying that I really needed to use the bathroom. Well, they quickly kept hold of me and said that I wasn't going anywhere and when they checked me I was dilated to a 10! The midwife also asked when my water broke because there apparently was some amniotic fluid present. (We think that it was just a small break because I hadn't felt any gush of water or any wetness up to this point.) Looking back now I laugh at myself because I didn't know at the time that the urge push out the baby is the same feeling like you're having a bowel movement. At this point we had one more childbirth class left and it was the class where we were going to discuss the actual delivery & how to push... I think also that up to this point I was still in denial that I was really in labor and going to have this baby. I was still planning on 2 more weeks of pregnancy!

Well, the midwives quickly went into action and prepared to deliver the baby there if they needed to, but at the same time called 911 so we could take an ambulance to the hospital. At this time the midwives' office was across town from the hospital. (They later moved to a new building right next door to the hospital.) I'm sure that everyone in the waiting room was scared once again when an ambulance pulled up to the front door and I was wheeled out on a stretcher. The midwife that was on call for the day went in the ambulance with me and DH was told by the ambulance driver to follow closely in our car. My midwife advised me before we got into the ambulance to NOT PUSH if I could absolutely help it. She wanted to make it to the hospital first so that she could deliver the baby and not the paramedics. She said that paramedics usually have to deal with tragic cases such as car accidents & traumatic events at people's homes and that they absolutely love anything to do with happy events such as birth. I thought that it was a pretty funny advice. The paramedics kept trying to give me an I.V. or oxygen but the midwife kept declining.

Luckily it was a relatively short ambulance ride (a first for me) and I didn't have any urges to push. I think that when the midwives told me at the office that I was dilated to a 10 my body went into a time-out so I could get a grip on the situation. We arrived at the hospital with plenty of time to deliver the baby there and DH arrived a few minutes later (he got stopped by a red light at one intersection and didn't feel right about running the red behind the ambulance). The ambulance driver actually apologized to him afterwards for losing him.

Once at the hospital they got me into a room and we got ready for the birth of M&M. The midwife that attended me was not one of the 2 midwives that I had gotten to know really well but that was okay. I had an awesome delivery nurse who was really positive and gave some great help & support during the pushing. The midwife broke my water the rest of the way once I started to push and I definitely felt a gush after that. M&M was born about an hour after arriving at the hospital. As I was pushing, the midwife wanted to give me an episiotomy because she could tell that I was going to tear, but we didn't want one and she didn't push the issue. DH & I were grateful about that. (What I had learned about episiotomies is that if you start a tear by cutting an episiotomy, it is much more likely that you will tear even more. I also learned that a natural tear will actually heal better because it is not a straight cut so the tissue will fuse back together better & stronger. Unfortunately, though, most doctors & some midwives don't believe this.)

When M&M was finally born the midwife put her briefly onto my belly and then they quickly took her away because she was having problems breathing and was "floppy" (poor muscle tone which is a result of breathing problems). They had DH go over to the warming table with M&M and had him hit her on the back to try and stimulate her breathing. DH said that they kept telling him to hit her harder - which he felt really weird doing to his newborn baby...

After they got M&M breathing they still had to take her to the nursery for additional oxygen - she had a low blood/oxygen level so they wanted to keep her under an oxygen bubble. DH was able to carry M&M to the nursery and he kept asking when I would get a chance to hold her and be with her - to which they didn't really give him an answer or said that it was up to the pediatrician. She ended up being put on an I.V. which complicated the initial breastfeeding somewhat.

I did end up tearing somewhat (a deep 2) but I had a relatively pain free recovery afterwards and healed up just fine. After I was stitched up they wheeled me to my recovery room and we stopped at the nursery on the way to take a look at M&M. Once we were situated in the recovery room DH & I proceeded to call our families with the surprising news. She weighed in at 7 lbs 6 ozs and was 18 1/2" long. DH left for the night because there was really no place in the room for him to sleep.

I slept for a couple of hours and then I woke up around midnight and felt very much awake. I wanted to know what was going on with M&M so I got up and walked down to the nursery to look in on her. I felt like I was a stranger there and didn't even feel comfortable walking in to see her. I think that the nurses noticed me though because a few minutes after I returned to my room they brought her in for me to hold & try to nurse. They said that she was doing much better. There was a sensor attached to her foot to measure her blood/oxygen level. The nurse handed M&M to me and I ended up just falling asleep with her resting on my chest. I was so grateful to finally be able to hold her & was in tears when I called DH in the morning to tell him.

The most irritating thing for us about M&M's whole birth experience was all of the hospital rules & procedures that we had to follow. There was a lactation nurse at the hospital who came in to help me with nursing. They had a chart that we were supposed to fill out on how much the baby nursed and how often we changed a diaper. At one point one of the nurses said to me that they would have to start supplementing with a bottle if M&M didn't nurse better. That's when the lactation nurse told me to just make up numbers for the chart because the worst thing you can do with a newborn is to supplement with a bottle when they are learning how to breastfeed. We also had to stay an extra day because the pediatrician didn't want to release her the first day even though they could find nothing wrong with her. No one that I told the birth story to afterwards seemed alarmed at all about M&M's breathing problems and just said that she had a rough transition which is not an uncommon thing to happen. The other rule that we didn't care for was that I had to be wheeled out of the hospital in a wheelchair even though I was up and walking perfectly fine on my own. It was also frustrating that none of the nurses seemed to be able to answer any of our questions on M&M's condition or on when she would be allowed to go home. Everything that happened just made us feel like we were patients, not parents, and that the hospital definitely had control over everything.

Aside from the hospital rules, the thing that I would change the most about M&M's birth would have been the whole pushing stage. I think that the midwife was too anxious to have me push M&M out - that my body wasn't given enough time to stretch and the result was the tearing that occurred. I also think that I would have done better if I had had more support at home in addition to DH. DH was just plain worn out at the end and having never had a baby himself or attended a birth didn't quite know how to best help me at times during labor. He also learned that I turn into a completely different person when I am in labor. :) I was also told by several CNMs in the practice that if we had arrived at the hospital earlier I probably would have asked for pain medication because of the back labor I had (but I'm not so sure of that).

Overall I achieved my goals of a drug-free labor & no episiotomy which made me feel great! I actually did it (and thanks in large part to the support I received from DH, who initially thought I was crazy for wanting to try)!