Sunday, February 24, 2013

Baby Hazel's Birth Story

If you are a past client, please feel free to submit your birth story along with pictures. I am always happy to share them on my blog! The following is an unmedicated hospital birth with an OB. 

Baby Hazel
Posted with permission from parents
Hazel Kathleen was born in the wee small hours of the morning on February 21st weighing 6lb 13oz and measuring 20" long. I had an unmedicated birth with a doula and OB and spent roughly 12 hours in labor.

The morning after her due date, I arose to find copious amounts of bloody show. I was so excited by this--with my first pregnancy I had non-progressing contractions then an induction. My cervix would not open on its own until the very end, which ended up being a big but unrealized fear of mine that cropped up during labor this time around.

I had some cramping in the morning of the bloody show and decided to rest up for labor after a short morning walk. I watched tv for a while then after a walk with my husband relaxed in our bedroom listening to a playlist he created. At 12:52 I had a painful contraction and started to think that I might actually be going into labor.

I had a BPP (since I was overdue) and doctor's appointment already scheduled for that afternoon but was concerned about fighting rush hour traffic home after the appointment while in labor. After some back and forth with the nurse, I spoke with my doctor and decided to go in for just the appointment. Sure enough the contractions in the car were awful.

During the conversation with my doctor and before my exam, I expressed concern that my cervix just didn't know how to dilate on its own. She had to manually dilate my cervix until I hit transition with my first labor, and I guess I was carrying a lot of the fear still. She thought I was joking at first but quickly reassured me that my body knew what to do.

When she examined me, I had dilated to three centimeters and was having minute long contractions every four minutes. We talked about the frequency of them and while she said I could go in to the hospital at any point, she was also open to me continuing to labor on my own. We decided to grab some food, mainly for my husband, then walk around a nearby park.

This is when things got a little ridiculous. I could barely handle being in the car but found the contractions really manageable when I could move around. My husband picked up some carry out as I labored in our Corolla in the parking lot for a while. I decided I needed to use the restroom but couldn't handle walking into the restaurant and having one or two contractions there. So we tried calling one of my brothers who lives close by, but he was out. We finally agreed to go to the park and see if the bathrooms there were open. They weren't. My lovely husband ended up getting a security guard to let us into a nearby church--while waddling to the bathroom, I had to laugh at myself and the ridiculous situation we found ourselves in.

After eating in the park, I was pretty reluctant to leave. The picnic table was the perfect height to lean on during contractions, it was pretty quiet and pleasant outside, and we could faintly hear children playing on the playground behind us. My husband was getting anxious though and we were both irritated by the mosquitoes. Once the bats came out after them, I became creeped out and agreed to at least go to the lobby of the hospital.

During my first pregnancy, I really wanted to try and go meds free. We took Bradley classes, my husband read parts of the Birth Partner, and we practiced varying labor positions frequently. I ended up having a difficult and long induction and chose an epidural to get me through on the third day of the induction. While I still feel like that was the best decision, I wanted to try and experience a meds free birth with spontaneous labor. We hired Kristi very late in my pregnancy—she was a doula in training at that point--which was an awesome decision. I didn't want to go to the hospital until I was well along into labor to try and achieve the meds free birth.

The drive to the hospital from the park should have been very simple, but my husband lost his mind and ended up getting us lost in a maze of streets at Rice University. I yelled at him after every painful contraction, which I'm sure was helpful, and we eventually got to the hospital after a couple more wrong turns. I wanted to labor in the car in the parking lot, but he begged to go inside so in we went.

We checked into the L&D department around 8:30pm. We went to the assessment room and found I was four centimeters and contracting every three minutes. After the monitoring, we got into a room and I promptly flung myself into the shower as my husband got ahold of Kristi, who was already at the hospital. I was disheartened that the contractions were so close together and felt like I was making slow progress, but Kristi reassured me and calmed us both down.

After maybe an hour I had to leave the shower to have ten minutes of monitoring. This was around 10pm and I planned to try using the birth ball after the monitoring. My husband left our birth plan at home, so my brief version for the nurses was that I didn't want to be offered drugs and wanted freedom of movement. Luckily Kristi had our birth plan on hand and was able to give it to the nurses to reference.

I laid on the bed for the requisite ten minutes, which became thirty minutes, then sixty . . . I ended up having to labor on the bed the rest of the time. The nurse and the doctors were concerned about some decels they were seeing in the baby's heart rate after contractions, so I ended up having to lay on my left side and breathe in oxygen. Kristi and my husband helped me find a rhythm in my breathing and endure the contractions as I laid on my side. I started throwing up at that point and peed all over the table. Lovely!

Around 11 or 11:30pm, the doctors asked to rupture my membranes to place a fetal scalp monitor since the baby's heart still looked 'concerning' to them. I was reluctant to do that because after they broke my water in my labor with Adeline, her heart really went all over the place. Hazel was also still very high up at that point, so I was concerned about causing a cord prolapse. After looking at the strip more, the doctor on call told me we could wait since the strip looked better. Half an hour or so later, they were concerned again so the resident very slowly broke my waters to give the baby time to move down and prevent her cord from prolapsing. The water was filled with meconium, so the NICU team was called.

After the resident broke my waters, I was at 6cm or so. The contractions started coming constantly and it was hard to get on top of them. I began to panic which made my husband worried. Kristi calmed us down, reestablished a breathing pattern and basically was worth her weight in gold. According to her notes, I went from 6cm to baby in my arms in less than forty-five minutes. It's such a blur of pain and confusion. 

Once I was past seven centimeters, my body started pushing with each contraction, which freaked me out. I was worried that I would cause my cervix to swell if I wasn't fully dilated, but my nurse reassured me that it was okay to listen to my body. Within minutes from that conversation, I announced that I had to PUSH. The resident was trying to check and I said through gritted teeth, "Doctor, please move your hands right now!" She moved out of the way to suit up and I asked the nurse to get the fetal scalp monitor and uterine catheter out of me. She told me she couldn't, that the doctor needed to do it, and I yelled out, "Do it now, she's coming out!" Just like in my first labor, they parted my knees and could already see the head. Suddenly the OB on call for my doctor appeared and told me to stop pushing. Kristi led me in panting as Hazel crowned. A few more pushes and they were lifting her up for me to see!

Hazel was whisked away to be checked out by the neonatal team in the room and had to have meconium pumped (vacuumed?) out of her stomach. I couldn't see her and was worried to the point I was shaking until I heard someone say her Apgars were 9 and 9, so I was able to relax and push out the placenta. I had a small first-degree tear that the doctor put two stitches into plus a 'skid mark'.

With all the concern about the swallowed meconium, they forgot to weigh or measure Hazel until we asked how much she weighed. Since the room was calm and mostly empty at that point, I got to watch which was really nice.

My OB came by the hospital that afternoon to chat with me about how everything went. She thinks that my contractions were so close together and so strong that that is what caused Hazel to be stressed. Hazel is doing wonderfully though and is perfectly healthy and just a delightful newborn (meaning she makes wonderful snuffly noises while nursing around the clock and snuggling into our arms) and a wonderful baby. She nursed really well right from the start. We were able to leave the hospital after her second bilirubin screening came back very low, so we only spent a day away from our toddler who we missed a ridiculous amount.

My husband and I spent a lot of time discussing our love for her on her first day with us. With Adeline it was almost shocking to me just how much I loved her and yet how much my love continued to grow each day. With Hazel there's just total contentment and such an incredibly strong, solid love to join how we feel about her sister. Like yes, there's the missing part of our family, and now we're complete. It's lovely and our memory of the birth is lovely too.

My thoughts on medicated versus unmedicated birth (from right after giving birth plus an addendum):

One of my hopes for this labor was that it would go so quickly that going unmedicated was really the only option. I read and reread birth stories, especially about those with very short second labors. I went back and forth about hiring a doula then realized that while I might *hope* for a very quick labor, I wasn't guaranteed to have one. I compromised with myself and decided to hire someone who is getting her DONA certification after we met with Kristi and both liked her. During my first labor my husband had a hard time implementing the different strategies we learned in the moment, so we mainly wanted someone to help guide him and step in if he needed it. I felt like it was unfair of me, knowing his personality, to expect he could be an expert in helping me through the pain during a situation where he was sure to be anxious.

I had some typical second pregnancy stuff especially with the prodromal labor, but I think my actual labor and dilation was more similar to a first labor in the length and speed of dilation, at least the first six centimeters. Assuming I started the labor dilated around one centimeter, where I'd been at my last check a few days before, it took nine or ten hours from the first "ouch!" contraction to get to six.

I thought labor was incredibly, unbelievably painful. It was really helpful and reassuring to be told throughout from Kristi, my nurse, and the resident that I was doing really well. When the resident first told me, "You labor extremely well!", it felt like a little gold star and gave me something to hold on to. Until the transition part of labor, I was able to focus enough in the minute or two between contractions to talk to my husband and Kristi to request things (extra help, not to touch me, etc). We also came up with things I wanted to hear ahead of time. I especially asked for help staying in the moment (being told, "Just get through this one contraction, you just have this one to get through", etc) and the phrase for that were super helpful. I mentioned that when I got dejected and said things like "I can't do this!" that I be reminded I *am* doing it. Stuff like that was helpful. There were some phrases my husband learned quickly to stop saying when we were alone before checking in the hospital. When he said, "It's only a minute" during a contraction, I wanted to deck him. Ahead of time, I would have thought being reminded of that would be helpful, but I hated it during labor.

My biggest fear about going unmedicated was that if I was trapped on the bed, I wouldn't be able to handle the pain. Because of my husband and our doula supporting him, though, I was still able to labor on the bed, on my side. That was awesome.

With the epidural, I had an urge to push but couldn't feel much of anything else going on. Without it, the urge to push was way stronger and I could feel tons of different sensations as she descended. With the epidural, my mind was more in control. Without it, I had no time to really think things through and just had to do whatever my body was demanding. I'm not explaining it super well here, but that was a huge difference.

In the year since I’ve had Hazel, I think back to her birth and feel incredibly proud of myself and my body. I was able to do something that was a big goal of mine, and I know that having Kristi there to support me and my husband made an enormous difference. We’re done having children now, but if we were going to have another, I would want to have another unmedicated birth with Kristi’s help.