Wednesday, April 18, 2012 at 4:50PM
This is Mary S. a 29 year old sahm with aspirations to become a midwife someday. here's the story of my first baby's birth.
I wrote this story down on the first anniversary of Julia's birth. I'm overjoyed to have the memories of this past year, but the memories of the birth itself weighed rather heavily on me for the entire year after I gave birth. Since writing this, I’ve been able to let much of the weight go and don’t dwell on it nearly as much.
I got pregnant 6 months after my wedding, and while we weren’t trying hard, I had stopped my birth control but still was fairly surprised that it all “worked” and I was pregnant. I took a test the day I was supposed to have my period because I just felt different, and pregnant I was! Dave was a little miffed at my delivery. I came out of the bathroom and announced that I had taken a pregnancy test and in 4 minutes we could go in and see the results. I think he could have used a little more warning than that.
For the summer we were staying at a friend’s beach home and I spent about an entire month laying on a couch feeling terrible and reading every single book in the library related to pregnancy and birth. As fall came closer, we got ready to return to our home, which needs some explaining. Dave was the high school teacher and I was a cook for Holden Village, a Lutheran retreat center constructed out of a former mining town located in the cascade mountains of central Washington.
It was remote! To get there, you got on a ferry that took you 50 miles up a long, narrow lake, a trip that took about 3 hours. You were then dropped off at a landing and school busses from the village were waiting to take you the 11 miles up switchbacks into the mountains to the village. There was no road connecting us to the outside world. You could hike in, but it was a several day-long hike over snowfields and glaciers in all but the peak of summer. The boat ran once a day in the summer and every other day in the winter.
I knew that being pregnant in such a setting was going to be a little bit interesting. I did some research and found a birth center in Wenatchee, an hour’s drive from the boat landing, and made our first appointment for the day before we went up to the village. We sought the care of midwives, because I thought that would be the best way to get the sort of care I wanted. I didn't want a typical hospital birth.
I wanted no drugs, and I didn't want to be hooked up to a fetal monitor and IVs, and I definitely didn't want to be epesiotomied or to have a c-section. If possible, I wanted to labor in a tub and have the option of a water birth. I had to explain the circumstances of our location and they agreed to work with us. There was two midwives working in the birth center, they alternated appointments and either one could be the one on call during the birth.
I had monthly appointments that I had to travel out of the village for. Dave couldn’t accompany me to most because of his obligations to work. He was able to attend our ultrasound, around thanksgiving, and we found out that we were going to have a girl! (I had felt that she was a girl, but was still surprised to be right!) Everything went smoothly, except my weight. I gained a LOT! I started about 175 and ended at about 240! At about 8 months, the midwives nicely said that I should stop gaining, and that was a wake-up call. I stopped indulging and my weight stayed pretty steady for the last month! Too bad I hadn’t noticed how huge I was sooner!
The last month was when it was no longer such a good idea to be so far from medical care. My only option in an emergency from the village would have been a medical evacuation helicopter ride! I moved downlake to a house owned by the retreat center for downlake staff to live in. There was nobody in it at the moment, and it was an ideal place for me to wait for the baby. The only not-ideal part was that Dave still had to work. I was due the 24th of March, and his spring break began the 20th. In addition, he had a week of paternity leave. As long as the baby wasn’t early, we were set. If the baby was early, we had a friend with a boat who agreed to get Dave and bring him down. It wasn’t a perfect plan since Dave would need 4-6 hours notice to get there, and in March, there could be bad weather further
complicating the plan, but it was the best we could do. I had a string of family and friends lined up to stay with me the last two weeks, in case I needed a driver and labor support but we all hoped that wouldn’t be necessary. Thankfully, the wait was uneventful, Dave arrived on the 20th, and labor had not begun.
I spent my days napping, walking, knitting, and reading up on birth and listening to pregnancy podcasts! I seriously read about 45 books on the subject. The reason I wanted a birth center birth instead of a
homebirth was 1, that the birth center would have a tub for me to try, and 2, that we were a long ways away from medical care, if the need were to arise. At an hour’s drive, we were right on the edge of the distance the midwives would go for a homebirth, but I thought I’d be fine with a drive in early labor.
The midwives suggested that I write a birth plan, but I ignored that suggestion, thinking that the midwife model of care would be in line with my wishes. They provided good prenatal care, and things were fine until about my 39th week, when they said that the baby was posterior, or face-up. This is
not necessarily concerning, as the baby can flip to the better face-down position at any time, but they did suggest I spend time on all 4's, supported by pillows, and to spend as much time resting on my left side as I could, for the benefit of my suddenly slightly elevated blood pressure.
I did these things, napping on my left side, and spent 5-10 minutes at a time on all 4's, but after the fact, I did some research and found a lot more things I should and should not have been doing. For instance, I went swimming, to exercise and relax and feel weightless again, but I should not have been doing the breaststroke, which with the frog leg motion encourages the baby's head to settle down lower, making turning less likely. I also spent time squatting, having read in many books that it is a good position for pregnant women to be in. That also encourages the head to settle. I should have been spending hours and hours on all 4's, and even should have spent time lying in an inclined position with my butt higher than my head to encourage her to float higher and turn. I could have sought a manual turning of the baby, (by a trained professional pressing on specific parts of the belly.) I could have gone to see a chiropractor, to see if being adjusted would help the baby to turn. I should have avoided being reclined on my back, and instead labored in specific positions to encourage turning. Now, a lot of that seems pretty obvious to me now, but at the time, I presumed that the baby would turn when she needed to and that it would all be fine, so I didn't research it, didn’t ask a lot of questions and didn't think about it.
On the 21st, I had felt some intermittent contractions, but they were not painful, and I thought it likely that they were false contractions. Later that afternoon, I mention it to Dave, who got a tad worked up that I hadn't told him sooner, but I was pretty unconcerned, since my due date was the 24th, and
tons of people told me that "the first baby is ALWAYS late." That day, my sister Caroline was visiting, and
our friend Lee. Caroline was going to drive back to her college the next morning, but stated that if I was
actually having the baby that she wasn't going anywhere. Lee stated that he wasn't really keen on
participating in the birth, so if we left, just to leave him a note.
That evening, I noticed some mucus tinged pink when I wiped after one of my many trips to the bathroom, and thought it was probably my mucous plug coming out. This isn't necessarily a sign of immediately impending labor, but I decided to call the midwives anyway. I got ahold of Dzahn, who was on call that night, but she told me that she wasn’t concerned about it, and since she was coming down with a cold, not to call unless I was REALLY sure that I was in labor so that she could get a good night's sleep. Now I think back to that and wish I had asked her to turn me over to the other midwife's care, since it seems very possible that her job performance was affected by being sick, not to mention what a bad idea it would be to expose us and the baby to illness. However, I worry much to much about pleasing other people and not making a fuss, and so I agreed not to bother her unnecessarily and went to bed.
About midnight, I got up to go to the bathroom, and when I was climbing back into bed, I felt a small pop, and a small gush of fluid. Maybe a cup’s worth. I sat there a minute, a little bewildered, wondering if I had just peed, before realizing it was my water breaking. The midwives had told me to call if my water broke, so I told Dave, and went to call again. I didn't have any contractions at this point, so it was sort of weird to know that the baby would be here soon! No extra 15 days of pregnancy for me! My midwife told me to go back to sleep, and to call again when things were picking up, defined as contractions that were about a minute long and 5 minutes apart. I went back to sleep for a couple hours, and by 3 30 am or so, I was feeling contractions pretty solidly. I didn't want a lot of commotion, so I went upstairs alone with a clock and a piece of paper, and timed things myself for a bit, but it soon became apparent that contractions were 30 seconds long and 2-3 minutes apart! The exact opposite of what I was looking for as the sign to call again! It was feeling pretty intense at this point, and I felt like throwing up, so I woke up Dave and Caroline, and Dave called the midwife again. She told us to go ahead and start driving, since we had an hour's journey to get to the birth center.
Dave and I got into our new Subaru and Caroline followed in her car. About 20 minutes along, and a deer ran out into the road! Dave braked hard and the deer ran by. He started to speed up again, and at the last second, the deer turned around and jumped in front of the car, hitting the left fender! Dave said some colorful things, and got out to see what the damage was. I was in a laboring state of unreality. The deer ran off somehow, leaving a good chunk of fur behind and a dented fender. Things looked drivable, and I was still in labor, and moaning pretty loudly, so we kept going. Looking back, the what-ifs of that moment alone are incredible. We were in an extremely isolated stretch of road that had no cell phone reception. What if Caroline was not following us, and we had been alone? What if the car had been un-drivable? What if Dave or I had been badly hurt? Where could we have gone for help? The nearest house was probably 2 miles away… I try not to think about it now.
We got to the birth center about 4am, and I was in such an introverted, intense state of mind that the outside world was pretty much lost on me. I got inside and made a beeline for the toilet dropping my pants along the way. The midwife suggested that I move to the bed so they could check and see how I was progressing, so I heaved myself off the toilet and flung myself down on the bed, butt in the
air, dealing with a contraction, and could have cared less who was seeing the show. There were two
midwifery students who were actively hands-on-learning, and I can't remember either of their faces. I do
remember that the tub had been filling with water, and I remember asking twice if I could get in yet, but
somehow that request was never accommodated, and I was soon too far gone from reality to remember that my own birth wishes included laboring in the tub. After my butt-in-the-air-contraction was over, the
midwife asked me to turn over so she could see where we were. The checking showed that I was 9 cm
dilated so it looked like my labor was barreling along and that the baby might be there quite soon!
I soon felt the urge to push, and then my brain was really gone. I was lost in the intensity of the pushing, and between contractions I tried to relax as much as I could, to help manage the pain. Time passed, and I stayed on my back. My logical mind knew that the back was the least helpful position for a woman to labor in, but my logical mind was far away, and the idea of voluntarily moving seemed impossible. I do know that eventually the room was bright with sunlight, and somehow I became aware that I had been pushing on my back for about 3 hours.
At this point, the midwife suggested we try a birthing chair, which I found to be incredibly uncomfortable. I then moved to the toilet, which was way comfortable, but after just a few minutes the midwife asked me to go back to the bed so she could check me again. (I wonder why she didn't check me right there on the toilet.) Very soon after moving back to the bed she gave me a nasty tasting herbal concoction, but I can't remember what it was supposed to do. Perk me up, probably. I was trying very hard to relax in between and during contractions, and I think this made it look like I was exhausted.
Soon after this, she said that the baby was still posterior, and since my pushing wasn't getting us anywhere, she brought up the idea of transferring to the hospital. I wasn't able to ask questions that I normally would have, or I would have asked what she could do about it, what was likely to happen at the hospital, what our options were. Instead all I could think was that if we had to go somewhere, I wanted to get there fast, before things got worse. Someone put pants on me, and I somehow got out the door and into our car. I don't know why the midwife didn't put us in her car, but I do know that Dave was pretty white-knuckle about the drive.
I felt like there was a bowling ball coming out of my butt from all the swelling so there was no way I
could sit on a seat. Instead I kneeled on the seat with my butt to the windshield and I have a clear memory of the seat belt warning dinger going off repeatedly and obnoxiously, but did not have the mental capacity to fasten the seat belt beneath me to stop it. I also have a clear memory of the oddness of seeing people driving normally, doing normal thing, while I felt like my world was out of control.
We got to the hospital, just a few minutes away and pulled up to the emergency room entrance. Instead of being met with orderlies and a rolling bed, like in the movies, we had to walk ourselves in, and I remember leaning on one of those retracting line-forming railing posts, pushing, (I couldn’t not push) while I heard the counter attendant asking Dave questions like "are you the father of the baby?" and "are you two married?" It was so surreal. There were tvs blaring the news that Obamacare had passed, but I was so self-absorbed that I didn't learn about it until much later in the day. I wish I had started screaming and stripping off clothes to get people moving faster, because the wait was agonizing.
The midwife brought a wheelchair up, and since I couldn't sit in it, I kneeled while we went on what felt like a tour of the hospital. When we got to the delivery room, it was a buzz of activity. People took off my clothes and put on a gown, they somehow got me into a bed, and attached a fetal monitor to my belly, and someone put in an IV for pitocin. We hadn't been there more than a couple minutes before the doctor arrived, and she told me that she was going to reach in and turn the baby. And she did, which was VERY painful, but everything else was so painful too that it didn't really register that much. I do remember thinking that all I wanted was for the baby and the pain and everything to all just go away.
Then the doctor and all the nurses were telling me to push, and after a minute the head was crowning. Someone held a mirror, but at the wrong angle, so I couldn't see it but I could feel it. The head came out, then the whole baby was there, put on my stomach. It was 10:35 am. It was truly surreal. I knew that I should be feeling happy, but I really just felt a fuzzy sense of relief but I did things I thought I should like smile at my husband (who was crying) and look at the baby.
She looked huge to me. Her head was pointed from the extended time in the birth canal, and she was kind of purply greyish. Her eyes were dark, and sort of swollen, and she had a lot of dark hair. Her hands were really big! She stayed on my belly for a little while, maybe 10 minutes. The doctor said that she would have thought I had an epidural from how little pain I showed. The midwife offered the comment that we were lucky to get the doctor we did, because anyone else would probably have given me an episiotomy and vacuum extracted the baby. Then the midwife left. I did have a small tear, and they put in two stitches. They also kept pressing hard on my belly, which hurt a lot, but served to help my uterus contract properly.
I think I tried to offer a breast to the baby, but I don't think she really nursed at all. They took her over to be weighed, and since she was 8 lb 15 oz, they said she was at the edge of the "normal" limit and had to be tested for gestational diabetes. I was still not in my right mind, or I would have protested. I was 8 lb 14 oz, and Dave was 11 lbs 7 oz. We would naturally have a large baby.
Getting tested meant heel pricks, and she cried. A nurse came with a bath cart, and right-minded me would have protested that too, since amniotic fluid scent helps a baby to nurse and bond, and the cottage-cheese vernix left on her skin could have been rubbed in to keep it moisturized. But shell shocked me was fine with the idea of a bath, and Dave was helping, so the bath happened, and she cried. The blood test established her glucose levels and the nurse told me something like
that if it didn't go up in the next half hour, she would have to have a feeding of formula. Another heel prick, and I guess it was decided, because while another nurse was having me stand up and walk to the bathroom to see if I could pee, someone else was sticking a tube down Julia's nose and putting formula in her belly.
I can't believe that I didn't protest that. I don't even know if I could have refused. The midwife was gone, and when you are in a hospital, they act with an air of authority that is very very hard to question. Julia promptly spit up that formula, which secretly made me pleased, and somehow her blood sugar tested fine the next round of pokes, so we were thankfully done with that ordeal. We moved to a recovery room, and recovered. I wish I had asked that everyone leave us for an hour right after birth before all the poking began. I would have liked more time to accept and welcome Julia with Dave in the moments after birth.
In recovery Julia slept and nursed, which I was anxious about. Was she latching properly? I wanted to avoid bleeding nipples and knew a good latch was key, but how do you know a good latch? A lactation consultant peeked and said she looked fine and left, but I was still anxious. This was something I planned on the midwives helping with. At some point, my midwife had told us that since we were now hospital patients, they wouldn't do the postpartum follow up visit at home on day 2, and day 10. They could see us for the 3- week check up, but in the mean time, we had to find a pediatrician for follow up care.
We stayed the night at the hospital, and thankfully they let Julia room in with me, and sleep with me in the bed. She got less swollen and more baby-like as the night went on, and I started to feel more in love with her. Dave and I decided on her name from a long list of possibilities, Julia North. (Funny story, about 3 days later at a grocery store someone asked me what she was named, and I totally forgot! I had to think a looong minute, and the woman gave me a really odd look!)
The next day, we got our ok to check out, and to help us do so was a hospital volunteer. But first, she told us, we had to bring in the car seat to make sure Julia fit it properly. This was a little interesting, since I found the car seat manual to be a bewildering piece of literature, I had found a trained fireman to install it for me. Dave had been up in the village while I was figuring out that project, and so he had no experience installing or uninstalling it, and for him to have to go out and uninstall the seat probably involved much swearing and ended up involving cutting at least one piece of plastic. We didn't buy one of the typical bucket-style seats that detaches from the base. Figuring that Julia would have outgrown it before we left the village, (no cars in the village = no carseats either!) we bought a large "convertible" car seat that was supposed to fit her from birth to huge. Our new car came with The Latch System which turns out to be an incredibly poorly designed system involving unseen latches way back in small crevices next to other latches that are incorrect, and the hooks you are supposed to hook onto the unseen latches are next to impossible to open once they have closed, especially in an unseen area of 1 inch x 2 inches. We have since switched to using the regular seat belt instead of the latch system, but
in the moment, it was an exercise in extreme frustration for Dave. He managed to get the thing out of the car and inside and we dutifully put Julia in it, and la, everyone said that she fit. Dave picked up Julia in the car seat, and I sat in the wheelchair, and before we could get more than 10 feet, we had all the nurses in a commotion. Apparently we couldn't carry the baby out in that sort of car seat. Neither could Dave take her out of the car seat and carry her in his arms. He might drop her and sue. About 10 nurses had a back room huddle while we sat there in the hall and waited and eventually it was decided that I had to sit in the wheelchair and hold Julia (though they weren't too thrilled with that, because what if I dropped her and sued?) Dave could carry the empty car seat and the volunteer could wheel us out. I wonder what would have happened if we just kept walking? Dave brought the car around, and then the fiasco of re-installing the car seat ensued. The volunteer informed us that she was not allowed to help us install it for liability reasons, and so we drove off into the morning with a beautiful baby in what was likely an incorrectly installed car seat thanks to hospital bureaucracy designed to protect themselves in the name of protecting babies.
That is the birth story. While I am absolutely happy and grateful that I was able to have a drug-free vaginal childbirth and that our baby was healthy, there’s a few more things I wish had happened differently. I wish I had hired a doula. A doula's role is to support the laboring mother and to advocate for her wishes. I thought that Dave could take care of that, and while he was very supportive and wonderful, he was not at all experienced in labor. I also didn’t cound on my own brain being so messed up, to the point that I couldn’t advocate for myself at all. I can't help but think that a doula would have filled some of the gaps that I perceived in my labor care.
I wish I had not spent so much time on my back and more time in good posterior turning positions!
I really wish I could have tried laboring in water. I wish I had been able to ask the midwife to turn the baby herself. I asked about this at the 3 week follow up and I was told that during one of my pelvic checks the midwife tried very gently to see if she would easily turn, but that flipping the baby internally is on the border of what they are really comfortable doing. I can understand this, but in the midst of labor, there was no discussion about it being a possibility, and I really wish we could have avoided all the trauma of transferring to the hospital, or at least discussed the option.
I also really wish that I had done my own reading up on posterior positioning, as there are many things I
could have done that might have caused Julia to turn on her own, resulting in a much easier labor. (If she hadn’t been posterior, she might have been born in as little as 4-5 hours from my water breaking! So much for the oft repeated “first time mothers having long labors”…)
I wish the midwife had taken us to the hospital in her car, as that drive was scary for Dave.
I wish the midwife had stayed longer at the hospital and perhaps been able to help me avoid or discuss the
gestational diabetes testing and to establish breastfeeding with less stress.
I wish someone had taken a video of the birth. I wish I had specifically asked my sister to be the media
person. She said later that she didn’t want to do anything against my wishes, but you can always delete and you can’t go back and catch it on film later!
Finally, I really wish the midwives had done the 2 and 10 day follow up care. Even though breastfeeding
went fairly smoothly, It would have been much less stressful for me to know that there would be skilled
help checking up on me, and it would have saved us several long drives into Wenatchee for pediatric care and the stress of finding a pediatrician. (I didn't really care for the first one we chose, the one who came recommended by the midwives and ended up switching to a different one who was much more personable)
I wish I had made a birth plan, if only to lay out for myself and Dave what our wishes were, especially once we went to the hospital.
Tags: Birth, birth stories, birth stories on demand, birth story, posterior, posterior position, midwife, birth center, hospital transfer, rural setting,