Monday, July 2, 2012

Jonah's Birth

This will be a hard one to write because this is likely my last baby and there are many emotions that come with that.  But, here it goes....
So after 41 weeks, the baby was doing great on all tests, but my midwives were starting to feel the pressure of keeping me as a patient if I went much longer.  I hate that this is the society we live in, but it is and if I wanted to stay with them for much longer, I was gonna need to encourage my baby to come.  I did acupuncture, homeopathy, pineapple, spicy food, sex, exercise, pumping, and finally castor oil (which I swore I would never do again after Elijah).  None of that coaxed either of my beautiful boys out of the womb which when you really think about it, why would they want to leave???
So at sixteen days past my due date (42 weeks, 2 days), I agreed to let my midwife break my water.  It worked like a charm with Elijah and I had waited as long as I could to ensure its chances of working.  At 11am, at my midwives home, she broke my water.  There was a ton of clear water that came out.  And then we all headed home to wait, relax, and pump some more.
At 3pm, they started coming and I was a little surprised because with Elijah it took eleven hours to work.  They were very irregular and about 45 min. apart, but by 6pm, they were 15 min. apart and by 7pm, about a minute and half apart.  They started to even out and around 8pm, I was in a very regular cycle of every 3 minutes or so.  My doula, Genevieve arrived, my midwives, Laurel and Alice came, and there were some laughs in between contractions.  Bob Marley was put on in the background because as Laurel said, "babies love Bob Marley."  Early labor was pretty fun and I was thrilled that it was finally time to meet my baby.
The contractions, as they tend to do, got stronger and more intense and at some point I stopped cracking jokes in between.  The baby was pushing very hard in between contractions as well which made it very difficult to rest or catch my breath for the next one, but I had found my voice, my position, and I think I was handling it pretty well.  I labored on the ball, in the birth tub which was awesome, hanging on my amazing husband, etc....
My husband is amazing!

At about 2am, I was ready to start pushing I told my midwife, but it was not a physical feeling, just more of an, I'm done with all this, lets get going feeling.  She checked me and said it was not time yet. I later found out I was at 6-7cm then.  I labored a few more hours and at some point we all discovered that the baby was on my pelvic bone and posterior and while he was trying with all his might (trust me on this one) to push his way down, it was unlikely I would dialate more until the pressure of his little head came down.   So I was in that same dilation and labor pattern for about 8 hours.  At that point, the contractions felt like they were coming very quickly.  I kept telling Josh that I was not sure I could do this.
Laurel hugging me when it was rough, I remember melting into that hug!

About 7am, my midwives had me on my side, on the floor trying to help the baby move off my pelvic bone.  This was extremely hard for me and my contractions were not coming as often as they needed to be even though it felt like they were with the baby pushing so hard in between.  So the midwives used the pump a little bit.  It was just awful there on the floor and at some point I asked for a break.  Josh and I went outside and did some lunges in the backyard per Laurel's recommendation.  My midwives had told me that the baby and I were handling this beautifully and that all it was gonna take was more time, but I was convinced they were holding something back so outside I kept crying and asking Josh to tell me what I needed to do differently.  There is a very frustrating feeling when you know you are making zero progress for hours on end, you are tired, and just want it all to be over.  Josh told me the same thing, that I just needed to be patient and it would turn around. 
Well then we came inside, I overheard my midwives say something about giving me another hour or two and I was convinced (as convinced as a determined exhausted woman who cannot clarify anything her midwives are saying can be).  I was convinced that they did not think this baby would come and I knew the hospital was 45 min away.  I was not gonna lie on that ground for another two hours and THEN take a 45 min car ride.  So..... I gave up.  I said to myself, "I am gonna regret this."
But then I told my midwives to take me to the hospital for an epidural so I could relax a bit.  Interestingly enough, even though the midwives tried to talk me out of it, when they finally agreed, my contractions were coming back to back and I was handling them on my own because my doula was lying in bed with Elijah, and everyone else was scrambling to get ready to transfer.
Around 8am we left, and that car ride was excruciating.  I kept telling myself not to faint, the baby was pushing so hard during and in between, and I was in the most awkward of positions.  45 minutes later, we arrived at the hospital.  I did not have the energy to cry anymore.  I just kept asking for meds, actually begging.  But they had to ask me intake questions before they could call the anesthesiologist.  I do not think I answered one.  At one point I was in my gown, in the bed and a big contraction was coming.  I made a moaning sound that made everyone in the room including my midwife whip their heads around and say. "wait a second, that sounded like a push."  They checked me and what do you know.... the baby turned anterior, came off my pelvic bone, I was completely dilated and the baby was coming.  I was so tired, even this news did not derail me from continuing to ask for pain meds.  But then, it happened.  What I needed to happen, but did not know I needed.  My midwife got in my face so to speak.  She told me absolutely not (it was too late anyway) was I going to get an epidural when the whole reason we came to the hospital was now gone, I was gonna push this baby out right now.  I think I whimpered knowing this was gonna be work.  And it took everything in me.  BUT, he was moving, I could feel him.  I felt his body coming lower and lower and this was such a relief.  I felt him crown, the ring of fire, and his head pop out.  Everyone in the room was commenting on what a tight squeeze and big baby this was.  The doctor on call did not pull him, but let me do the work, so he slowly emerged.   When his body was half way out, they suctioned him, I pushed him the rest of the way out and he came right to my chest.  He stayed there for two hours before I let Josh hold him. 
It was another beautiful baby boy... I love boys.  Jonah Cameron Roberts was 9lbs, 3oz and I pushed him out in about 20-30 minutes and I was on my back.  I love to stand during labor so this fact still mystifies me.  I always thought I would push my babies out standing up.
When I think of the decision I made to go to the hospital I am frustrated and disappointed in myself.  I should have trusted my midwives, I took away an opportunity for Josh to catch his son as he wanted, I took away an opportunity for Elijah to see his brother be born, and I took away from myself forever the right to say I birthed my baby at home.  I know what everyone will say to these complaints. I know some people will think they are silly.  I am of course so grateful that I have been able to conceive, have two beautiful incredibly healthy little boys, and that we are all well.  But I find myself mourning the end result of each birth none the less.  Jonah's birth was ten time more difficult than Elijah's and I have always known that one reason for me to choose midwifery care was to avoid the temptation for pain meds.  I know myself well and I did not want them to be an option.  I did not really even think about them with Elijah so I was surprised at how much harder this was.  My midwives have been so incredible helping me along this postpartum path.  They call me all the time, visit me at home, and give the kind of care that makes me feel like I am their only patient.
Alice and baby Jonah, one week old

And to me that is the moral of both of my births.  If I had not chosen midwifery care and to labor outside the hospital for all but 45 minutes of each of my sons, I am convinced without a doubt, that both of my boys would have been cesareans.  Elijah was breech at 36 weeks (the midwife turned him), I was diagnosed with a muscle disease, and his heart rate dropped a bit too much during labor (which is why we transferred in his birth).   Jonah was stuck for a long time on my pelvic bone despite handling it very well.  These situations are not ones hospitals will let you stick with for long.  My midwives trusted my body to do its job while keeping us safe at the same time.  Because of this, I had two unmedicated vaginal births.  I am so thankful for that because I believe we are all healthier for it.  This is what I try to remember when the sadness hits.
And now I am off to figure out how to be the best mama I can be to two little ones who both seem to need me constantly.  This may be tougher than transition. :)
And now for our new life...

Elijah's Birth

Tracy, Josh, and Elijah Roberts:  Birth Story
We found out that we were going to have a baby in mid October after trying to conceive for 4 months.  We were as prepared as we could be with all our research done and having decided that an out of hospital birth was the safest option for our baby.   We wanted a natural birth and we knew that this would be a sensitive time in our lives and we did not want to be pressured by a hospital with their own standard of procedure.  I also felt that if I was gonna do this without drugs, I needed drugs to not even be available.   When the time came though, I never wanted them.  Maybe I had prepared myself well enough and I had heard the horror stories about how most women ask for them at some point, but that was simply not the case for me.  I never even thought about it once in 18 hours of labor.  I say this only because as women we have all heard how awful this experience is, how some people even commented that they thought they were gonna die.  Awful is just a word I would never use for this empowering experience, but let me go back further….
I was so exhilarated to finally be going down a road I had seen so many go, after 14 years as a preschool teacher and director, it was finally my turn to be the mom.  Pregnancy was tiring and so full of ups and downs.  I did not want to have any interventions if possible, but at 12 weeks, Lorri found a fibroid, I had thought it was our babies head.  This meant ultrasounds to watch the growth and position 3 times during the pregnancy.  I was also diagnosed with Myontonia Cogenita, a muscle disease that made me even more tired and difficult to walk, this led to some invasive genetic testing including tiny electric shocks and sticking needles in my muscles…  Yikes, that was a hard day.  Then at 30 weeks gestation, the baby turned breech.   I spent the night I found out, crying while lying upside down at a 45 degree angle on our ironing board pretty sure at any moment all that extra weight I was carrying would end up crushing my head.  The baby did eventually turn back with the help of many exercises and some great midwifery massage.
In the end, all of these complications had been evaluated and followed by every specialist we could think of and all of them said they were not affecting the baby and I was cleared for an out of hospital birth.  Ironically with all these “issues”, the most concern my midwife had was to make sure one of my fibroids (yes, I had several) was not blocking the cervix.  Not sure if it was her experience or just plain instinct, but I had no idea how right she would be.
So then the final few weeks approached and I was doing all the natural things that can help with getting labor started, homeopathy, Chinese herbs, raspberry, drinking lemonade, eating pineapple, eating spicy food, walking, having sex, acupuncture, and then…. It happened or at least we thought it did.  I had some severe pains that lasted many hours.  We tried to walk, eat, sleep, drink, and shower ( all the things Bradley tells you to do to test if you are in real labor) and they kept coming.  Even our midwife thought this was it over the phone.  We called the family and then, just as the mother in law boarded her plane to come home from vacation, they stopped.  We were so disappointed.
The waiting game then commenced.  And when the “due date” ( I think they should be called guess dates) came and went, the midwives prescribed more of the same and they even stripped my membranes TWICE, but nothing worked.  You have until 2 weeks after your due date to give birth with the midwives and then your care is transferred to an OB, so 2 days before this time limit was up, y midwives suggested Castor Oil.  I can barely type those words without gagging.  We attempted to mask the flavor with two very big root beer floats and lets just say I will not be drinking root beer floats ever again.  And, it did not work either… no labor, just vomiting.  Ugh…..Horrid.
Lorri suggested after determining that my cervix was "ripe", that we rupture the membranes.  I was two weeks “overdue” at this point and while they always left the decision to me, I was unsure.   I was really worried this would not work to start labor as nothing else had, but my midwife was very sure and I trusted her.   We went into the birthing center that morning and I was so nervous, but as soon as I saw Lorri, I calmed down.  I remembered that she was the reason I had so much faith in this birth and my body. They broke the bag of waters and all was clear. That was a long day, they sent us home to pump and wait. It was a tough day.  Around 3pm, I was in tears thinking I had rushed the baby and that it was not going to work.  My husband was so great though, he jumped right in and took my mind off everything assuring me we would be OK.  I spoke with Lorri and Angela a few times that day and at one point they found out that my inlaws were at our house with us.  They told me they needed to leave.  I was nervous to ask them to leave and wasn’t sure I wanted them to go, but my husband again reminded me that we needed to trust our midwives and follow their instruction so he asked his parents to go spend the night close by.
At 8pm that night (just as the in laws were walking out the door…smart midwife) contractions started, but I had had these mild ones for weeks so I did not get my hopes up.  By 10pm, they got much stronger and about 12-20 minutes apart. At midnight, I woke up Josh cause I could not handle them alone anymore. The entire night they got stronger and closer together and progressed exactly like a text book case. I tried to sleep in the beginning between them.  That worked for a little while.  We went on a walk, took lots of showers, and called Laura Jane (our doula) around 5:30 am to come help us at home.  I remember the first thing I said to her was, "this is really hard" (as if she didn't know that).  With every contraction, the best way that I could allow them to do their job was to stand and put all my weight on Josh.  I tried very hard to focus on not tensing up with the pain and to allow Josh to hold me up.
Around 7:30am, I wanted to go to the birthing center because I felt like I was ready, we called the midwife and she agreed to meet us at 9:15am. That felt like an eternity to me then. The car ride over there was horrid  cause I could not stand or deal with them the way I wanted (I think a home birth next time).  We got there and the midwife checked me, I was 7cm plus she said. I remember being satisfied with that ironically.
I got in their birthing tub and in about 2 hours, at 10:55am (not that I had any idea of the time then), I was fully dilated and my body just started pushing. Wow! Pushing! That is the most primitive feeling in the world. Nothing has ever overtaken my body like that .  Josh was so supportive.  He was talking me through every one, but I told him to just be quiet at one point.  I felt like the talking was distracting me from the all important job of pushing.  I just had to focus.
At some point, I just felt I needed to stand up and push so I got out of the tub, squatted and pushed.  I felt like I was making the most progress here and when the Lorri finally started saying, "yes, yes".   This is when they started noticing the babies heart beat dropping.  They said I could not stand, they put me in a few different positions on the bed and the heart rate was fine, but I felt like I could not get any leverage to push him out. I was getting hot and tired and they put me on oxygen.  I asked to stand again after a while and they said OK, but his heart rate dropped again.  I could see and feel him moving down when I stood, I felt like I could get him out so I was very disappointed to be put back in the other positions even though it was necessary.   I was squeezing Laura Jane and Josh’s hand with every push and I had Cheryl, the midwife assistant(the human epidural they call her) and Lorri coaching me through every one.
Apparently there started to be quite a bit of meconium coming out around this time too. The baby was trying to come out sideways also which is the way he sat inside me the last 2 months or so. The midwife tried to reach in and turn him a few times, but it didn't work and we didn't know why at the time.  I remember seeing one of the other birth assistants face at the time and thinking she looked terrified (not sure how many times she had seen a birth), but I remember feeling very calm inside, not a bit worried, just tired and wanting the baby out.
After 2 hours of pushing with heart rates dropping and meconium coming out with a baby that appeared to be stuck, Lorri said, lets go to the hospital. I was so ready thinking they would "take him out".
They put me in the car and told me not to push, that was the hardest thing I think I had done so far to try to stop something that was so instinctual.  Its akin to telling someone with the violent flu not to vomit anymore.
When we got to the hospital, there was like 12 doctors, nurses, and midwives waiting for us. They hooked me to IV's and I thought, here comes the medicated birth I didn't want, but was just so wanting him to be out. They just gave me saline though and told me I had to push him out, no epidural or c-section was possible because he was crowning. Thank Goodness!
I remember thinking at that moment that I was going to kill him. I had very sad visions flash in my head. The OB said to me that she was going to help me 1% with the vacuum, but that he had to come out now and I had to push him out. I was crying and so not sure I could do it, but I pushed as hard as I could and with the vacuum and an episiotomy,  and only 45 minutes in the hospital, our little BOY came out at 2:10pm on Friday, July 17th.
Even though he was whisked right away to the pediatricians in the room, he cried immediately and got an apgar score of 8.5. Josh held him skin to skin pretty quickly after that and he came to me pretty soon too and nursed.
It took an hour and a half for the placenta to ease its way out cause it was stuck on my fibroids which we later found out the baby was too.

So there you go, and unmedicated birth with some interventions that I of course did not want, but seemed necessary at the time and I am glad the hospital was there for us when it needed to be. I am glad I did all my laboring at home and the birth center.  I, of course, am sad I scared my family, but I never felt unsafe or like we were not in the best hands. I knew if anything like this happened, Lorri, our midwife, was so experienced and able to handle it and I have even more respect and admiration for her now than I did before. I think I even said immediately after Elijah was born, "Lorri, I love you!" Poor Josh :(.