Views on Childbirth - part 6

Read part 5: M&M's Birth here

Luke's Birth
When I became pregnant with Luke I did a lot more reading about natural childbirth and there was someone in my ward that had recently had a homebirth. The more I read the more I knew that natural childbirth was the best & safest option for me & my baby and I was increasingly interested in homebirth where the natural process would be uninterrupted. I also had a good conversation with the mother in the ward who had had a homebirth an learned that the homebirth midwives carry things like oxygen & pitocin for emergencies. I didn't think though that DH would ever agree to a homebirth, not in a million years. I was talking with someone in the ward once about childbirth and they asked me if I had asked my husband about homebirth. I responded that I had not so I vowed to go home and ask him that day. When I got home and just mentioned, almost in passing, that I would really like a homebirth - to my surprise he said sure, why not. After talking over the subject a little more with him I realized that he was really put off by the hospital with M&M's birth and if things could be carried out just as safely at home then he would support me in my decision. At this point I had been seeing the CNM group again and we decided that I would stick with them until my 20-week ultrasound and then provided everything looked healthy with the baby I would look for a homebirth midwife to switch care to.

Well, everything went fine for the ultrasound & we found out we were having a boy (yea!). I called up the homebirth midwife that my friend in the ward had used and found out that she was already full of clients for the month that I was due but that she had a partner that had just started attending births on her own that I could interview with. So I interviewed with "Hugs" and I really liked her. She has a very laid-back attitude, is LDS and I just felt good about choosing her as my provider. I found out in the interview that in this practice they always have a backup midwife there at the birth as well as one or two apprentice midwives who are studying to become midwives. I also learned that this practice did waterbirths as well for those that wanted one. They provide the pool and you just have to set it up during the labor. When I mentioned the back labor that I had in M&M's birth Hugs told me of some things they can do to relieve back pain if I experience it with this next birth. She also didn't sound concerned about M&M's trouble breathing after the birth and that it wasn't unusual. The midwife practice had a "library" of birth books & videos that you could borrow and I certainly read my share during this pregnancy. I was excited & nervous about the upcoming birth, but even after four births under my belt now, I still get the same feelings when my due date approaches.

Luke was due on Friday, February 2. My mom decided to fly out about a week before the birth and stay for 2 weeks. That would give her a little bit of leeway on either side of my due date (you have to remember though that she missed M&M's birth because M&M was 12 days early). I was a little more anxious to have my mom at this birth because she could take charge of M&M for us. M&M was 2 1/2 at this time and I wanted her to be present for the birth so she would feel included in this big family event and so she didn't feel left out and jealous of her new baby brother.

The Saturday before Luke's due date I had some pretty intense baby pain all day long. I was very uncomfortable and was wondering if this meant that I would be going into labor soon. As it turns out I wasn't in labor and we think that the baby was just moving positions which caused the pain. I was afraid that my mom would miss the birth again though because I don't think she flew out until the next day, on Sunday.

Well, nothing happened for the next couple of days and then on Wednesday night I got up around midnight to use the bathroom and felt a little "ping" and then next thing I knew there where water gushing out. My water broke! (Luckily for me it happened over the toilet...) I woke up DH and we decided that we would go back to bed and get what sleep we could before labor started. I knew at this point that the baby's head was engaged in the pelvis so there was no chance for a prolapsed cord and that the baby doesn't have to be born immediately after your water breaks. About two hours later I started having contractions and couldn't really sleep anymore at that point. So I stayed up managing on my own for several hours and then I woke DH up. I was having back labor again and wasn't too happy about it. DH called Hugs around 6 in the morning and then we woke up my mom shortly after that to let her know what was going on. Hugs arrived around 7 to see how I was doing. We discussed some options for dealing with the back labor and I decided to try a device called a TENS unit. This is a device where some electrodes are connected to the skin and there is a controller that sends electric pulses to the electrodes. These electrodes were placed over my lower back and then I could control how strong & how often the pulses were sent. I think that the device helped a little at first but as labor progressed I think the unit got bumped and I ended up having severe pain afterwards as a result of it. (I don't think that I will ever use it again during labor...)

After Hugs arrived we also were trying to decide if there was enough time to set up the birthing pool and get it filled with water. The problem with the birthing pool is that it takes quite a while to get it filled with water. It has to be filled with hot water because the water heater can only maintain the water at a certain temperature, it can't heat the water. So once you've emptied the hot water heater, you have to wait for it to fill up again with hot water. Hugs thought that I was far enough along in my labor that there wasn't going to be enough time to fill up the pool so we decided not to try this time around. I don't think I really cared at this point but it would have been nice to have soaked in some hot water to help relieve some of my back pain...

I labored in the living room for a time and then decided to move back into our bedroom. I tried laying on the bed for a little while and then Hugs checked me and I was dilated to a 10 finally! I tried pushing a little on the bed and then we decided to use the birthing stool. DH sat on the bed behind me to help support me. As I was pushing Luke out the apprentice midwife was listening to his heart rate. Apparently whenever I would push his heart rate would drop. This is usually a sign that the umbilical cord is around the neck. Hugs told me that I really needed to concentrate and I needed to push hard and deliver him. After another push or two Luke's head came out and Hugs unwrapped the cord from around his neck and then I delivered the rest of him. Luke was a bluish color and wasn't trying very hard to breathe at first. The midwives tried putting an oxygen mask on him but for some reason the oxygen tank wasn't working quite right so Hugs gave Luke 2 quick puffs of air into the mouth. After that he started to breathe and started to pink up finally. We think that what happened is that the cord was pulling tighter around Luke's neck as he was being pushed out of the birth canal. (I have since found out that the cord around the neck is a very common problem and that it occurs in about 1 out of 3 to 1 out of 4 births.) I could see my mom holding M&M in the doorway of the bedroom and could tell that she was somewhat concerned over what had just happened so I invited her over to see her new baby brother. She was very sweet with him and I was excited to have the birth part finally done with.

After the placenta was delivered they moved me onto the bed to check me out a little. This involves massaging the uterus to get the bleeding to stop and checking for any tears. I think that I was most nervous with this birth about tearing again. As it turns out I only had a really small tear that didn't require any stitches. I was really excited about that! I think that the part I dislike most about birth though is what happens afterwards. Hugs started massaging my uterus to get out any blood clots and to get the bleeding to stop and it HURTS!! When M&M was born in the hospital the CNM gave me a shot of pitocin afterwards to help the uterus stop bleeding and I don't remember her doing any massaging (I also think it doesn't need to be done as much after a first birth). Hugs was concerned that the bleeding wasn't stopping and was considering giving me a shot of pitocin. First though she suggested that I take a trip to the bathroom since I hadn't been in a while. After they helped me into the bathroom I apparently sat down on the toilet and then passed out... The next thing I remember was DH carrying me back to the bedroom and laying me down on the bed. The midwives put the oxygen tube near my mouth & nose and then proceeded to check on the bleeding once again. Well, apparently the trip to the bathroom helped (or maybe the fainting) because after that my uterus started to clamp down and I didn't need the pitocin after all. (I found out later that at this point it was actually illegal for these midwives to be carrying and administering pitocin which is why they later pursued legislation to legalize it.)

The other thing that I dislike more than the birth itself is the afterbirth contractions that you feel for several days every time you try to breastfeed the baby - they are PAINFUL! And since I have back labor with all of my births, the afterbirth contractions I feel afterwards are also in my back - and they get worse with each child! (Actually I think they were the worst with Luke because of the TENS unit that got bumped into overload at the end of the labor.)

The other not so fun thing after Luke's birth is that we had to go to the hospital for me to get a rhogam shot. I have O- blood and DH has O+ blood so after each birth the baby's blood has to be typed to determine if I need a rhogam shot or not. M&M was born with O- so I didn't need the shot after birth, but Luke has O+. That means that within 72 hours of the birth I need to get a shot of rhogam so that my body does not build up immunities to the positive blood which could result in a miscarriage of a subsequent pregnancy. So the day after the birth DH & I went to the local hospital to get the shot. We brought Luke with us because we weren't sure if they would need to draw his blood or not. The hospital staff was all confused about how to handle my case. At first they thought that I was there for a 30 week rhogam shot (it is typically given during pregnancy as well) and then once they figured it out they sent me back to get my blood drawn. I was trying to explain that I didn't need my blood drawn because I knew that I was O- and my baby was O+, but I got the response that that is just what they have to do... (I found out later that the reason they do this is to test the sensitivity that my blood already has to the positive blood so that they can give me the right dosage of the shot. It would have been nice if they could have told me that upfront.) So, I had my blood drawn and then we had to go home again and come back the next day for the actual shot - what a pain!!! When I went the next day to get the shot, the nurse that administered it to me had to relate to me how unsafe homebirth can be and that one of her babies would have died if it had been born at home... (Unfortunately, this is a response that I hear quite often when people find out that I give birth at home. With each case that I hear about though, when I ask my midwife about it she explains to me how they would handle that particular situation at home - and usually it is not an emergency situation that will result in death, no matter what the doctor may tell the mother.)

Luke was born on Thursday, Feb 1st, at around 10:23 in the morning. So my labor with him was around 8 1/2 hours, much better than the 29 hour labor with M&M. He weighed 8 lbs 4 ozs and was 21 in long. It turns out that we probably would have had time to fill up the birthing pool because the labor took a little longer than Hugs thought it would. The thing I would change about Luke's birth would be not to use the TENS unit - other than that I was really happy with the way things turned out and it was a nice, peaceful, natural birth. I talked with Hugs afterwards about Luke's breathing problems at birth and she said that they were never terribly worried about him since he was still attached to the umbilical cord. As long as the umbilical cord is still attached and pulsating, there can be up to several minutes before the baby has to make a total switch over to breathing on its own. That is why most homebirth midwives don't cut the cord immediately after the birth - there is really no need to. With M&M's birth, M&M probably would have done better if we had left the cord attached and just tried to stimulate her breathing while she was resting on my chest. Also, M&M must not have been in too much danger or they wouldn't have had DH over there doing the work...