Wednesday, December 5, 2012

Aven Lucas's Birth Story


The birth of my first baby, Kellan, was a pretty typical hospital birth. Although I began labor naturally, once I got to the hospital and accepted the epidural, the famous “cascade of intervention” began. I still ended up with a vaginal delivery (despite a few mentions of a c-section when I stalled out at 7cm for 4 hours.) After the birth, I was happy with how things went, but later, as I became more educated and aware of my birthing options and aware of how things could have been, I decided I wanted to approach the birth of my second child a different way.

About halfway through my second pregnancy, I decided to use the Hypnobabies home study course to prepare myself for a natural, unmedicated childbirth. I wrote up a “rough” birth plan and approached my doctor with it. He agreed with most of it, but there were a few things he did not agree with such as delayed cord clamping (he didn’t agree that he could delay AND place baby on my stomach right away) and refusing the Pitocin shot after birth (I hemorrhaged after delivery with my first baby, so he wanted to administer it just in case.) I decided to continue with him despite disagreeing on those points, but continued to research and hit up my AMAZING doula friends for advice. (A big thank you to my doula friend Nikki (In the Atlanta area? Check out her doula page here!)  for sitting down with me and helping me finalize everything!)

On Thursday, two days before my 11/17/12 EDD, I had my last prenatal appointment and my doctor mentioned wanting to schedule an induction date 10 days after my EDD. This upset me a LOT because, although I’d agreed to cervical checks, I wasn’t letting him tell me how far dilated/effaced I was. I didn’t want to worry about numbers that don’t mean much and was feeling pretty confident that I would give birth in my own time, when my baby was ready. He had asked me several times if I wanted him to try to get things moving (via membrane sweep), but it was important to me to let my body do what it was meant to do as naturally as possible, so I declined every time. When he mentioned induction, it immediately  began to rattle me and shake my confidence in my own body. Looking back, that is so crazy because I’d already done it once, of course my body knew what it was doing! I told him I was not going to discuss the possibility of induction until my EDD had passed. I told him that I trusted my baby to come when he was ready and my body to know what to do when he was time, why didn't he? He said he would call me on the following Monday and give me time to think it over. I was prepared to tell him that I would not consider induction until December 1, when I would be 42 weeks pregnant. (ACOG even says you're not "overdue" until after 42 weeks anyway!)

After weeks of prodromal labor that was at times VERY convincing, my EDD came and not the baby. Kellan was born exactly on his EDD - 40 weeks to the day - so going past that wasn't something I had really anticipated since "they say" most subsequent babies come earlier than the first. I started to become worried that induction could be a real possibility. Little did I know my baby was coming SOON. The night of my EDD, I started having sharp pains to my cervix, but they didn’t feel like contractions. This went on for about 2 hours and was so strong it made me gasp and double over at times. I tried laying down and bouncing on my birth ball and eventually they started to go away. I chalked it up to another round of prodromal labor and went to bed, but I knew something about it felt a little different. I had been losing my mucus plug for about two days, but with no show, I wasn’t convinced anything was really happening any time soon.

The next morning, I woke up feeling crampy and a little off. I had plans to go shopping with my mom that day and Jim was at work. I started getting Kellan and me ready to leave and Jim came home early. He said work sent him home because they had expected the baby to come by then so they didn’t need him. He decided he would take Kellan for a “fun day” while my mom and I shopped. I mentioned I was feeling a little off, but didn’t think it was anything to worry about and so off we went. After a couple hours of shopping, my mom and I went to grab lunch around noon and I started feeling a few irregular tightenings. I assumed more prodromal and ignored it although it continued through the next few hours. They weren’t regular enough to time.

Around 2pm, my sister offered me a pedicure which I gladly took her up on! I also decided the tightening was starting to become fairly regular and decided to try timing them. They were coming between 5 & 6 minutes apart. This went on for the rest of the day and by about 6pm they were starting to get a little stronger and were coming about 3-5 minutes apart. I decided it was the real deal and told Jim I thought baby would likely be coming late that night or early the next morning. We were at my parents house for dinner and by about 7pm I was really wanting to leave and starting to feel like I needed to get into my Hypnobabies “zone” right away.

We got home around 730pm and my contractions were still averaging 3-5 minutes apart. I took a shower and immediately afterward noticed I had some bloody show when I went to the bathroom. I decided to call my long-time friend Valerie who had agreed to photograph the birth and tell her to start heading this way. She had about an hour drive, so I wanted to give her a head start. I also called my doula friend Laura (In the Starkville, MS area? Check out her doula page here!) for a quick pep-talk and some advice on when to leave for the hospital. I was getting nervous about possibly having a quick labor and not getting there in time. Laura reassured me and gave me some signs to watch for, which was awesome.

Valerie arrived around 830pm and at that time I also sent Jim to take Kellan to my friend Desiree’s house since she had agreed to keep him during my birthing time. I planned to labor at home as long as possible, but felt he would do better to get tired and fall asleep at Desiree’s since he’d never spent the night away from us before. Once he had left, I sat and talked to Valerie through a few pressure waves, but they were starting to get stronger and coming an even 3 minutes apart, so I decided to return to my room and birth ball and go back into hypnosis. I told her and Jim to try to get some sleep while they could because I thought it might be a late night for all of us. I alternated my Easy First Stage, Fear Clearing, and Birthing Day Affirmations tracks for a couple more hours, but by 11pm, I decided I’d rather head to the hospital to get settled. My pressure waves were getting strong and I was starting to focus more on worrying about getting to the hospital in time (a 25 minute drive) than I was able to focus on my hypnosis and I thought I might be more comfortable if we went in. I woke Jim up and told him and Valerie that I was ready to go to the hospital and gave him a list of last minute things we needed to pack.

We arrived at the hospital around 1230am and they had lost my preregistration information. Great. The lady at the check-in desk wanted me to fill out my info before getting me into triage, so I went through a few pressure waves there rattling off the info again. I handed the nurse, Kara, a copy of my birth plan and our baby plan.



Placenta cooler in tow! ;)
Once in triage, I changed clothes and they checked me. I told the nurse beforehand not to tell me my dilation and effacement, but to tell Jim out of my earshot, which she was cool with. I told Jim not to tell me anything until after the birth because I didn’t want to focus on numbers. I continued to listen to my Hypnobabies tracks while they called my doctor and asked me more questions. Kara was great with letting me pause and get through the pressure waves or asking Jim instead. I was told my doctor wasn’t on call that night and that his partner would be delivering me. I was a little bit upset about that, but too focused on my pressure waves to worry much about it.











Once they had the information they needed (about 30 min after we arrived), I was moved to my delivery room and given a birth ball to labor on. The nurse checked me again and told Jim my progress out of my earshot.

The pressure waves were getting increasingly stronger and I wasn’t able to talk through them anymore, but the ball helped a lot. I could still laugh and joke in between, but once the waves hit me, I had to focus through them. Jim and Valerie started counting during the pressure waves and that helped me to focus on getting through them and breathing. I remembered to keep my mouth loose and open and my voice low. Any time my tone grew higher pitched, Jim and Kara would remind me to stay low. At one point, another nurse asked me if I’d like to try the shower, but I thought it might just get on my nerves to be wet, so I decided not to. I’m still not sure if I would’ve felt better to do that or not, but the ball was working for me, so I stayed with it. I was starting to feel a little “pushy” so I tried moving to hands and knees on the bed through one pressure wave. That was no good, so I went back to the ball.





A few waves later and I was becoming increasingly vocal through them and they were getting MUCH more intense. I started panicking a bit because I was having a difficult time focusing and getting control of my breathing. I forgot to use my "off switch" and couldn't get into hypnosis because everyone was talking to me, but I wanted them to keep talking. I think I would've stayed more calm if I had used my "off switch", but things were moving fast and I was starting to dread the next pressure wave instead of welcome it. I was worried that it was going to go on for hours and I wasn’t sure I had it in me. The waves were incredibly strong and they felt as if they were almost  coming on top of each other. I couldn’t quite catch my breath and started hyperventilating a bit, but Jim and Valerie were able to calm me down. I started saying, “I can’t do this! I can’t do this!” and everyone kept saying, “Yes, you can! You are SO close!” At this time, I didn't know it but I was in transition.

The doctor came in and Kara asked to check me again and said my bag of waters was bulging and it was likely preventing me from dilating the rest of the way and I had a cervical lip. She said if they broke my water, I’d likely have the baby within a few minutes, so I said BREAK IT! I had really wanted to see if baby would be born en caul because I think that is so amazingly awesome, but at that point I didn’t want anything in the way of getting that baby OUT of me!




Once they broke my water, I immediately started pushing. Just before I started pushing, they put a monitor on my stomach for the baby. I was stuck on my back from the check and I asked to sit up so they moved my bed upright. I actually wanted to use the squatting bar, but I was too exhausted and panicked to get that out, so I just kept pushing. I felt like gravity was working against me a bit, which I’m sure it was. In hindsight, I think I needed some traction to help me push, as I was holding my legs up myself. It was SO hard and the doctor kept stretching my cervix for some reason which was super annoying and uncomfortable to me. All of the sudden, they called in a NICU nurse because Aven’s heart rate was dropping. This had also happened with Kellan during delivery. They gave me some oxygen and the nurses were saying, ”You have to push this baby out NOW.” The waves were so intense I felt like I couldn’t really get it together because I didn’t know whether to try and catch my breath or just keep pushing, but Jim says I was not as panicked as I remember. I kept saying, “I can’t do this, I can’t!” Everyone kept saying, “Yes, you can! Push!” I yelled, “HOLY SHIT!” at one point. Finally, I felt him come out and I yelled, “I DID IT!” Aven was born at 3:17am. Just short of 3 hours after we arrived at the hospital. I pushed for 30 minutes.

 
Jim later told me I had been dilated to 5cm when they first checked me in triage and 7cm when we got to the delivery room. I was almost complete when they broke my water.


They put Aven on my stomach and Jim cut the cord. I told him happy birthday and how happy I was to finally meet him. After I delivered the placenta, they took him to wipe him off a bit and check his vitals while the doctor stitched me up. I had a second-degree tear (same as I had with Kellan.) They told me he weighed 7lbs 15oz and was 20.5 inches long (just a little bigger than his brother.) They put him back on my chest and covered us with a blanket so I could do skin-to-skin and breastfeed him. He latched on right away.








 

After the doctor stitched me up, I started to hemorrhage. They said my uterus was not contracting as it should and they started pushing on my stomach. It was VERY painful. They asked if I would be willing to agree to a shot of pitocin to try to start my contractions and I agreed. The pitocin didn’t work and so they called in another doctor for assistance. She said I was passing baseball-sized clots and gushing more than they’d like to see, so she wanted to try to manually remove some of the clots. This. Was. AWFUL. At this point they did offer me some medication because it was intensely painful especially after my body had just been through birth moments before. I made sure the medication was safe for breastfeeding (it was) and accepted it at this time. I yelled just about as loudly during this as I was during the birth. Jim held my hand and said I was squeezing off his fingers.

The doctor finally decided it was causing me too much pain and asked if it would be okay to try some medications to get my hemorrhaging to stop and my uterus to contract. She said she was starting to become concerned that if the hemorrhaging didn't stop I would need a transfusion. I agreed this would be better than having her elbow-deep in my uterus. I had agreed to an INT port when I was admitted, so they hooked up an IV and gave me some more Pitocin that way. They also inserted some Cytotec and gave me a shot of Methergen. They told me they were going to let me rest for a bit and give the meds some time to work. They never took Aven from me during this time though, and he slept peacefully on my chest. An hour later a nurse came in and checked me again and said the meds appeared to be working but they wanted to keep me for observation for a few hours. Around 8am they finally cleared me and moved me to my hospital room and Aven went to the nursery for his first check-up with the pediatrician.

This was the most intense and empowering experience of my life. It was by far the hardest thing I have ever done. Even though I did my best to prepare myself, I wasn’t expecting it to go so quickly or to be so incredible. I am so glad I did it and so proud of myself. I knew if I set my mind to it that I would be determined enough to stick it out and I never once asked for meds. I am so grateful that Jim was so strong for me and such a huge support. He continually encouraged me and reassured me that I could do it. He knew how badly I wanted this birth and was just as determined as I was to make sure that happened even when I started doubting myself. Part of the reason I chose to go natural this time was because I felt that the interventions that occurred during Kellan’s birth caused his heart rate to drop and caused my hemorrhaging, but these same things happened during Aven’s birth too. My recovery this time has been a million times easier than my recovery with Kellan was. I’ve taken 3 ibuprofen total after delivery and haven’t needed any more. I feel fantastic. I’m not sore at all and everything seems to be healing more quickly. My doctor asked me the next day if I’d do it again and I said no more babies lol. But IF we decide to have another, I would totally do it this way again.


 

All photos courtesy of Valerie Holifield Photography

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