Jan 9, 2011

Liam's Birth Story

I think I have chewed this over enough in my head that I can finally write Liam's birth story. The only thing I cannot remember, are times near the end, but if I ever get my records, I will come back and update.

I was due with baby #5 on 12/27/10, but given my history of 40+5 - 41 week births, I truly expected to meet my son or daughter in January. Around 33 weeks I was risked out of home birth for blood pressure readings over the 140/90 mark and encouraged to see my homebirth midwife's favorite OB. At first, I was so angry and hurt I was feeling like I was not important in this busy practice. I would drive 45 minutes, wait 45 minutes, see the nurse for 5 minutes and the OB or CNM for 5 minutes then drive 45 minutes back. My kids were frustrated, I was frustrated and I was just so sad every time my blood pressure was taken and they would tell me how good it was. However I kept reminding myself "it is what it is" and each visit got better and I slowly changed my outlook and my attitude. I told myself that everything has its purpose, and there had to be purpose for this. Maybe this would be my healing hospital birth after my first and second left me feeling like a spectator at a sport where I had lost control and dignity? Maybe I could prove to myself I could have a natural hospital birth?

I diligently wrote up my birth plan. I stated I wanted my baby's cord to be cut only after it stopped pulsating. I wanted to labor and deliver in the water, after all, this hospital *IS* the only one in my state that allows planned waterbirths. I did not want medication offered to me. I wanted to push in any position I wanted to be in and I didn't want someone telling me when to push. And most of all I didn't want pitocin or anything else to augment my labor.

So Christmas came and went without even a braxton hick. I just had to make it through my husband's birthday the next day so I didn't "ruin Christmas or my Birthday" as he kept teasing me. My little boy had plans of his own. Around 3pm on December 26th my contractions started coming 5 minutes apart, lasting a little over a minute. They were still pretty mild, so I just went about my routine. After dinner, I needed Bobby to blow up my birth ball so I could rock through them. By the time my kids went to bed, they started picking up and I would have to pause and breathe through them. By 1am on my due date, I decided I needed my doula here to help me through them. They started getting closer together and lasting longer, so around 3am we decided to head up to the hospital since it was an hour away.

I arrived at the hospital and they hooked me up to the monitors. My contractions had slowed down a bit so we decided to walk the halls until they picked up a little more. Around 6am they checked me, and I was only 2cm dilated with a baby who was not engaged. We decided I would go home, take a bath and a nap, and come back when labor picked back up. They did think it would be today though. A due Date baby! I was excited because only about 5% of all babies are born on their due dates, and it was my earliest baby yet!

Instead of driving all the way home, we decided to stay in a hotel down the street where I would take my bath, crawl into bed, and sleep. While in the bath I noticed I was losing fluid of some sort, but it appeared to have color in it, so I assumed it was my mucous plug. When I felt more fluid coming out I stood up and called my husband and noticed green water running down my legs in large gushes. Not only had my water broken, but the baby had passed meconium, which could suggest the baby was in distress. 45 minutes after we arrived at our hotel, we were leaving. Talk about a very expensive hour! Bobby and I joked that it looked like I was just a booty call, and he had some sicko pregnancy fetish.

This time when I arrived at the hospital, it was for keeps; they put me into the water birthing suite and hooked me up to monitors for intermittent monitoring. I called my doula back, and when she arrived we started walking the halls. Around noon, they checked me again and I was still unchanged, so I ask her to stretch me if at all possible.
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She was able to stretch me to a 4-5cm, but my baby was still really high and not moving down. My contractions were mostly in my back, so my doulas did hip squeezes and we do squats with each contraction to move my baby down. While we were walking the halls, I saw my old midwife, who is there with other clients who had to transfer during labor, and she gave me a big hug and words of encouragement from her mentor; "remember, each centimeter is not created equally". Around 6pm my contractions were starting to space out, and my baby was still not dropping, so it was suggested that while our doulas were taking a break for dinner, maybe Bobby and I should try nipple stimulation to pick up labor, because the OB wanted to start pitocin. When the doulas returned a half hour later, we asked for a little more time and tried lunges and rebozo.
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[My doulas, Diksha & Sarah, using the Rebozo on me to get baby to move into a more favorable position]

We decided the baby was in a funky position and that is why s/he was not moving down and engaging, and without strong contractions to push the baby onto my cervix, l just would not dilate. At 7pm I was checked again and I still had not changed at all since noon, when I was stretched from a 2 to a 4-5.
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[Me with my nurse, also named Heather]

My nurse gently suggested that I change rooms, since I could no longer labor or deliver in the birthing tub, because I was getting pitocin, and they were expecting a couple who desired a water birth. I was not about to let someone else lose their chance at a water birth, so we moved. But it was sad to cross another thing off my birth plan. The pitocin drip was placed, and it was a gentle slow process that was monitored closely.

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The pit was only turned up every 45-60 minutes by 1ml (out of 30) and only if my contractions were not picking up. I tried to rest between contractions and I was able to nap through some of the early ones, but by the time I reached 6ml, I was done. I was physically, emotionally, and mentally exhausted. I don't remember what time it was, but I think by that time I had been in labor 36+/- hours, and I was beat. I asked for an epidural and anesthesia was called while they pushed IV fluids. The contractions were in my hips, chest, back, and lower abdomen, and just felt unnatural. My doulas made sure I really wanted this, and let me know it was possible I was closer than I thought, but respected my wishes when I said I was done. They told me how proud they were of me for sticking it out so long. I had some "rock your world" contractions while waiting for my IV bag to empty, they called them double peak I think? I would have one long strong contraction, with a second, shorter one right immediately afterward. My nurse said it suggested a posterior baby, so while waiting on the anesthesiologist we did some exercises to try to rotate the baby. We had to pause the epidural process three times for contractions, but finally it went in and halfway into my 4th contraction, my feet went dead.

The pitocin was turned up while I rested, but the monitor kept losing the baby's heart beat, and my contractions were not being picked up at all. When we got to 8ml, the OB and nurse noticed the baby's heart was decelerating with each contraction. They placed an internal contraction monitor in to see if they were happening at the beginning or end of each contraction because I guess one was better than the other. The OB mentioned that I may need a cesarean because my placenta may be showing signs of stress at this point, but they were willing to watch and wait. The pitocin was turned off and my contractions stopped and so did the decels. They turned it back on to about 6ml and watched to see what part of my contractions caused the decels. About 3 contractions later it was determined that they were caused by cord compression and that I could continue to labor. Some of the decels scared Bobby though as they dropped down to about 45bpm for a few seconds. I was put on oxygen and they moved me from one side to another. From time to time my legs were moved to open up my hips to encourage baby to drop. Around 7am I was checked and only at about 7cm and a -2 station, but with each contraction I would open to about 9.5 with a thick lip, so she let me try some test pushes to see if I could move through the lip, but baby just would not move down enough and when I stopped pushing, baby would pop right back up. My OB then went off duty and her midwife took over. Finally, shortly before 9am on December 28th, 43 hours into labor and 26 hours after my water broke, the midwife decided we could try pushing again. By this time I could feel my legs and my contractions and I was ready to get my baby out.

NICU was on hand because of the meconium, and my doula and Bobby held my legs since I still didn't have complete strength back. It took 1 or 2 contractions, with about 4-6 good pushes to get baby's head out, it was cocked to one side, asynclitic they call it, and baby had a hand up next to its face. With the second contraction I got out baby's shoulders and then I was told not to push while she cut the cord (it was wrapped around the neck and the abdomen) and she suctioned baby's mouth and nose. Finally with one last push my baby was born at 9:07am. Before passing baby off to the respiratory therapist, she asked my husband "tell them what you see daddy" and Bobby announced we had a baby boy! This was part of my birth plan. Oh, and I was told when I could push, but no one counted or instructed me how to push, so my birth plan was somewhat followed in that aspect too.

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Baby was suctioned and given to Daddy to hold and then handed to me.

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I held him and said his name over and over again, "Jackson", and I nursed him, but then I started shaking so bad that I handed him back to daddy and they did the newborn exam. He was 7lbs 3oz, the same that I was at birth, and 19" long.

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I called my mom to announce his birth and tell her we named him "Jackson Liam", but got off the phone when my shaking got to be too much. It was around this time I noticed Bobby looking at the baby funny. I thought maybe he was disappointed we had a 4th boy, instead of a 2nd girl, but finally he said "he just does not look like a Jackson to me, he looks like a Liam", and I had to agree, he DID look like a Liam.

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[Liam with my amazing doula Sarah]

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[Liam with my incredible doula Diksha]

Liam and I both had fevers, so it was decided that they would take blood samples and allow them to grow for 48 hours to make sure he didn't have an infection. My water was broken for 26 hours and I declined antibiotics, so I decided not to fight the doctor's orders. I got my first shower and Bobby brushed my hair for me and we discussed middle names while we were waiting on the Dr. to get back from lunch. We decided on Liam Michael, we liked how it sounded and I have an uncle and cousin and we have a good friend named Michael, and it just fit. After the blood draws, Bobby headed back home to relieve the babysitter and get some rest. Our fevers went down, and Liam got his first bath.

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The next afternoon, Bobby brought the kids up to meet their brother, and it was love at first sight. Sophie was a bit standoffish with me, like she had been when dad first came home, but warmed up quick when she saw the baby. They each got to hold him, and then it was time for us to rest. I was released on the 30th, once his 48 hour culture came back negative.

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Liam is 12 days old now. He's doing well. He sleeps great during the day in his swing, our arms, or on our bed. Night is a different story, seems he only wants to sleep in my arms, while nursing, which is counterproductive to me sleeping. I love the age old question "Is he a good baby??" Sometimes I can resist the urge to say "well, he's not paying for hookers or betting on the ponies, so he can't be that bad", usually though something smart slips out. We do seem to have some gas issues, which may be related to tongue-tie that I intend to talk to his pediatrician about this week when I see her. Other than that, he is gorgeous, and we adore him.

Sometimes birth is about letting go, and making compromises. As much as I didn't want pitocin, or an epidural, even more so I didn't want a cesarean. I wanted another home water birth, but I can only speculate that I would have been too tired and ended up transferring to the hospital and getting an OB I never met, who didn't know my history and possibly was not as open minded about about my choices, or desires for a vaginal birth. As difficult as his birth was, it was also a healing birth. I learned that not all OBs are surgery happy, and some are very trusting of the birth process. I learned that having a good nurse and being in a good hospital can make all the difference in the world on what kind of outcome you can expect. And of course, your baby's birth plan ALWAYS trumps your own birth plan, so expect the unexpected, and learn to roll with the punches and let go of expectations.

I want to mention how much I appreciated the support I received from my amazing husband, my wonderful doulas, my incredible RNs, my awesome OB & midwives, and everyone else who offered support, advice and encouragement. I love you all so much.

7 comments:

Loretta said...

Oh how I recognize that "done" moment you had, I had it during my labor with my oldest son - 38 hours of exhaustion with those double peak contractions you mentioned. They just wipe you out completely of everything! I literally passed out after mine, my nurse was afraid I would be unconscious and not able to push when the time came. And I was crazy enough to have three more kids after that, what was I thinking? LOL

Liam has an amazing birth story and I'm so glad you shared it with us :)

Beverly said...

I love the age old question “Is he a good baby??” Sometimes I can resist the urge to say “well, he’s not paying for hookers or betting on the ponies, so he can’t be that bad”, usually though something smart slips out.

I love it! :D

I just came over from MDC to read your birth story and say congratulations again! Liam is beautiful, a lovely addition to a gorgeous family.

Catharina said...

I loved reading this birth story. Congrats on the latest baby.

You will have to add baby#4 and #5 to your header.

Heather said...

Baby #4, Sophia, is the very first picture. But yup, I need a crying Liam pic up there.

Sheridan said...

Congratulations on your birth! I am glad that you had such wonderful support and had a vaginal birth too. I was getting nervous for you.

He does look like a Liam! :)

Lori said...

What a great story, I really thought you'd end up with a cesarean. What a victory that you didn't!

SumnerRain said...

You and me both Lori. My husband was very scared when his heart rate was dropping into the 60's and said he almost pulled the doctor into the hall and asked her to proceed with the surgery. What she was saying about it being cord pressure because it recovered made sense to him and my hubby watched us like a hawk. I trusted my placenta. I felt deep down in my gut it was his cord, I was very lucky to have a doctor who agreed and allowed me to labor in my own time.