Wednesday, September 22, 2010

My Birth Story

OK, so I have finally gotten around to writing this up, be forewarned, it is long and probably contains too much information :) On Saturday morning, September 11th, around 2 AM, I had just finished listening to a hypnobabies track and gotten up to use the restroom when a gush of water hit my pants. At the time, I thought it was at least a gallon, but looking back it was more like a liter. Still, a ton of fluid. Backtracking to a week before, I had a bit of mucus type discharge, but it was clear and not "bloody" so I though nothing of it. Also, on Friday I had some mild cramping and my legs hurt pretty bad, but I just thought those were "pregnancy pains". So I call my husband into the bathroom and ask "What do I do" He says, call your midwife! So I call the midwife, she advises me to get some rest and call her in the morning. I was still dripping fluid everywhere. Because I live in a state where a certified professional midwife attending a homebirth is illegal (AL), we were driving to a neighboring state (TN) to do the delivery at the midwife's house who my midwife practices under. So in the morning I had what I thought to be contractions, just very mild cramping, nothing to complain about, but then again this was my first pregnancy so I really had no idea what to expect. Also in the morning another big gush of fluid. After talking to both of the midwives I decided to head up to TN and get a hotel room and wait for labor to start. We discussed active management of premature rupture of membranes (PROM), a protocol in which every 4 hours I took my temperature, did a rinse with hibicleanse, took Vitamin C and echinacea, recorded the color of the fluid, etc. I was sure that I would go into labor soon, so we only got the hotel until Monday morning. Once we arrived in TN we went to CVS, went to lunch, then to check into the hotel, then to the midwife's house and I was checked. She said my fluid did not feel low (they can tell simply by palpating the stomach), and to rest and continue active management protocol. We were sure I would go into labor soon. She could even feel small pressure waves. We went to dinner that night and walked around. Although walking is supposed to help stimulate labor, it sucks when you are leaking fluid. Nothing was happening. Every few hours the midwives would call my cell phone for an update and it was getting pretty frustrating because nothing was happening. My midwife was driving up from AL once I went into labor, so I did not want to say I am in labor until I knew for sure, and being a first time Mom I did not know what labor was supposed to feel like. Sunday, we had breakfast in the hotel and went back to the midwife's house to be checked. Active management was supposed to last up to 96 hours, with my needing to go into the hospital if I developed a fever, which would be a sign of infection. It had been about 36 hours thus far. Based on studies I have read, only about 8% of women have spontaneous PROM, and of those, 50% have gone into labor by 24 hours, and 86% by 48 hours. As 36 hours was approaching and my fluid was leaking less and less, I knew the membrane could have resealed itself, but it was a rupture, not a leak, I knew that for sure, and I was freaking out over the possibility of developing a fever and not being able to have my homebirth. The weird thing is, my belly changed shape pretty drastically after the PROM, you could tell our daughter's head had dropped significantly and my belly was much smaller. I was OK with waiting longer than 96 hours, but both of my midwives did not think this was the greatest idea in the world, as there is almost no data on PROM past 96 hours. Not to say that it could not happen, in fact one of the midwifes said she had a client that went 3 weeks with PROM, but I did not want this to be me. So we decided to start on a regimen of blue and black cohosh, to try and induce labor. Granted, I did not want an induction, but herbal remedies far outweigh pharmaceutical (pitocin, cytotec, cervadil, etc.) induction. Little did I know I would have herbal overload in the next few days :) So I start on the blue and black cohosh, 15 drops of each tincture every 15 mins the first hour, then every 30 mins the second hour, then every hour for the next two hours. We went to Plato's closet to get me new pants b/c I had flooded all the pants I had packed (again, thinking I would only be there until Monday), went walking to try to start contractions, went to dinner at a nice Mexican place. Every time I would feel a pressure wave and think "This is it!" they would subside and then it was like nothing at all was happening. When I went to bed that night I was awakened with mild pressure waves but nothing regular, nothing that I could not talk through, basically nothing period. We knew we would have to extend our stay at the hotel until sometime the next week. We decided on Wednesday because that would be right at the 96 hour mark. We checked priceline again and the price of the hotel shot up from $59 a night to $129 a night because there was a different rate for weekly visitors. So Monday morning we had to change hotels. I spoke with the midwives on the phone and they said it was time to start the castor oil induction. Yuck, I thought. But at this point, I was willing to try anything. It had been over 48 hours now and I was in the minority of the 14% of 8% of women with PROM who had not gone into labor yet. The midwife called on Monday morning with specific instructions regarding the castor oil induction. My husband left at 7 AM to get castor oil. I went downstairs to eat breakfast. The midwife came by the hotel Monday morning around 10 AM to check me. I had taken 4 ozs of castor oil at that point, and had gotten in the shower to do nipple stimulation for 30 mins. We made reservations for a new hotel until Wednesday morning, and were changing hotels at noon. Cutting it close, as the midwife said it would take about 4 hours for the castor oil to kick in, and I had taken it at 8 AM. We arrived at the new hotel at about 12:30 PM and the blowout started. I was in the bathroom until about 4 PM. I was getting stronger pressure waves but had no clue if they were coming from my uterus or my gut. That being said, the castor oil had no taste (I mixed it with OJ) and it was actually very mild, compared to the cleanses I have done in the past (hello saltwater flush from the master cleanse, plus two colonoscopies). The castor oil compared to that crap I had to drink for the colonoscopies was nothing. By 4 PM no more pooping, some mild pressure waves, but nothing too exciting. At this point, I had pretty much given up hope. I told my husband I wanted to go to the mall. I suggested we go to the Sprint store so he could get a new phone, he has really been wanting one lately and he has not gotten a new phone in like 4 years. Going to the Sprint store really helped. I stared out of the window at some turtles swimming in a nearby pond and I remember feeling so peaceful. After getting the phone we went to the mall, walked for about an hour, had dinner in the food court, and went back to the hotel to do the last dose of castor oil. I took it at about 9 PM, knowing that it would not be that bad. I had a total of 6 ozs of castor oil for the day. I am not sure what changed with the last castor oil induction, but pressure waves started picking up and by 2 AM I pretty much knew I was in labor because I passed some blood. I was so excited I called the midwife immediately "blood!" She told me to get back in bed, which I did. I started timing pressure waves on my iPhone and they were about 30 seconds long, every three to five mins. Nothing too serious, but by 6 AM I knew it was time. We called the other midwife to drive up from AL, I had breakfast, took a shower, and headed over to the midwife's house to wait for the other midwife to arrive. Pressure waves were getting intense but never to the point that I felt out of control or anything. I had been listening to my hypnobabies tracks from about 4 AM onwards. Around 6 AM I stood up to go to the bathroom and my water broke again! This time there was just as much fluid but there was blood too. I was starting to really feel the pressure waves pick up now. My midwife arrived around 7 AM, and we decided to call a doula to assist in the birth. The doula arrived around 10 AM and she was asking me what I wanted to do, how I wanted to handle pain management, etc. I told her about hypnobabies, and I also told her I could feel the baby and thought it was time for me to be checked. I had not been checked yet, with PROM there are no cervical checks, and with a midwife there are typically no checks anyway. My midwife entered the room to check me and just grinned. She told me to put my hand between my legs, and I felt the head! It was time to push. I was thinking how easy this had been so far. Boy, was I in for a suprise! I wound up pushing for about 4 hours. I pushed in the water first, mother directed pushing. Then I got out of the water because my contractions were slowing and pushed squatting. Enter the maze of herbs! More blue/black cohosh to stimulate contractions. Nipple stimulation. Pushing on my side. Pushing on the birthing stool. I was eating almonds, apricots, water, gatorade, protein bars, etc. I had gone to pee around 10 and at 1:30 we realized I had been to try to pee several times but the head was putting so much pressure on my bladder I could not go. So I had to get a catheter. I did not want one, but I tried and tried to pee like three times before they did it. I was under the impression that it had to stay in, but it only went in to drain my bladder and then it went away. So no biggie, and it really made me feel better. Still pushing, changing positions, etc. Nothing was working, her head would come over my pelvis and then move back in. I had to get oxygen once by this point because I felt like I had to pass out. At this point we decided to try directed pushing. Also something I did not want but after over two hours of me pushing myself I decided I needed some guidance. We did directed pushing in at least five different positions before finally just deciding to go with the hospital position. Yes, I delivered my baby on the floor, on my back. I have pelvic misalignment from a previous back surgery and had been to the chiropractor several times to help correct it. I also had Symphysis Pubis Dysfunction, so her head kept coming over one side of my pelvis more than the other, and it seemed the only position that was working was the birthing stool and pushing on the floor, so we alternated. At one point I could feel her coming out but everyone could tell I was about to tear so I held back. I kept alternating positions and at a certain point blood started gushing everywhere. This was the only point that I was scared at all, but her heart rate never dropped or anything, and my husband and doula were so great, reassuring me that everything was OK. At this point we decided to cut an episiotomy and just get the baby out, as I had been pushing from 10 AM onwards and it was almost 3:30. Again, something I did not want but I was so tired I did not even care. I wanted to see my baby and was tired of pushing. My husband watched while the midwife cut the episiotomy and he said she cut it to the side and only made one snip, less than 4 cm. as soon as that little snip was made she came barreling out, I think it only took two pushes after that. I was so happy, she latched on within ten mins. We did delayed cord clamping, she nursed while I delivered the placenta, and we waited about two hours to weigh and bathe her. I can not believe how long it took! Between PROM and delivery was four days! I thought my delivery would be this nice, relaxing waterbirth, but hypnobabies and the water were just not working with me. I thought pushing would be easy. Down and out like a slide, right? Um, not so much. One thing I did learn through the whole experience though was to be flexible with your plans and your delivery will be just what needs to happen for your baby to arrive safely. I was very fortunate to be in the care of such great midwives and an awesome doula, and I accomplished my natural, unmedicated birth. After all, that is what really matters. And my husband was great, he was with me the entire time, holding my hand, helping me push, hanging out with the midwives, never complaining or anything. Having him there was so calming, and I really feel we have grown closer from the whole experience. Another thing, I did not know just how many herbs I would wind up taking, in fact I smelled like blue/black cohosh for days! I also took shepards purse, arnica, and a few other herbs after the birth for recovery. But herbs are still natural :) In the hospital I would have been induced for PROM for sure, they don't "let" you go over 24 hours. Also, I would have been sectioned for "failure to progress" as there is no way they would have "let" me push for 4 hours. I am so proud of how our little girl entered the world! She was born on September 14th, 2010 weighing 8 lbs, 4 ozs. and 22 inches long. The picture of her is about two hours after delivery. The picture of us is the next day after we arrived back home. Although I felt really weak after the birth, I still felt amazing and refreshed! It is an amazing feeling, giving birth and caring for a newborn. I am such a happy mommie!