Tuesday, October 12, 2010

The Way It Was Meant To Be

We welcomed our beautiful baby boy on July 14, 2010 safely in the comfort of our home …That’s how I imagined the birth announcement would read. Unfortunately, as much as I planned, researched, prepared and waited for my peaceful home birth, it was not meant to be.

Deciding to have a home birth for our second baby was pretty easy for me and basically done before I even knew I was pregnant. After the experience of trying to have a natural birth in a hospital setting ended with what I felt was an unnecessary cesarean, I was bound and determined to have our second baby without all the interventions that normally lead to cesarean. Because we planned to have a natural birth for our first baby, we had done a lot of the research already so I saw our second pregnancy as really just brushing up on what we may have forgotten and learning all I could about vaginal birth after cesarean (VBAC). After finding a midwife who wasn’t scared off by the whole VBAC issue (which by the way is WAY overblown), we were on our way and feeling confident in our decision. We watched The Business of Being Born, only cementing in our minds that we were railroaded by the hospital protocols and policies resulting in the first cesarean. There was no looking back, only waiting and preparing.

I had my 40 week appointment with the midwife on my due date which was a Wednesday, where she started me on some supplements and said to get moving, swimming, walking, sex, whatever it took to get things going. So off I went trying to stay as active as possible and even though contractions came and went beginning the next day, it was an exhausting weekend of contractions during the night only to have them die off once the sun was up. We were both getting a little impatient wondering when things were going to actually get going.

Monday (7/12) night things started to feel different, soon after going to bed I was too uncomfortable to stay in bed but the contractions were still 10 or more minutes apart. I checked in with the midwife who said to try and get some rest and to call when they got within 5 minutes apart for at least an hour. By early morning they had teetered around the 5 minute mark but still sometimes as far apart as 6-7 minutes apart. I gave her a call and she decided to send her apprentice out to check me out and get things set up as she felt that things were definitely getting started. Soon after the apprentice midwife showed up and examined me (only 1 cm) and I had breakfast and went for a walk, the contractions died down again. I was beginning to feel like my body only wanted to labor in the middle of the night and it was getting to be tiring as I had a nearly 2 year old to deal with during the days so rest was fleeting at best. So, we spent Tuesday (7/13) trying to lay low and rest up as I figured it would be another eventful evening ahead of us.

Sure enough, that night the contractions began sporadically around dinner time and continued throughout the evening only picking up after I decided to go to bed. Around 10 pm I began walking the floors trying to get the contractions to pick up and remain steady. By 11 pm they were reaching the 4-6 minute mark and I was asking the husband to begin filling up the birthing tub. It was about half past midnight when I was getting some relief from the warm water and calling the midwife to tell her that the contractions had been within 5 minutes for over an hour and I felt they were getting more intense since getting in the tub. She and her team had just finished attending a birth around 10pm that night and she said she would call back-up to come out and check me while she got showered and notified the rest of the team. By 2 am our birthing team had arrived and got set up and the contractions were becoming more and more uncomfortable, requiring me to really concentrate through them and I had stopped keeping track of them at this point. When the midwife checked me she was shocked to find out that I was at 7 cm already and that I had apparently gotten there on my own with little discomfort, she was confident a baby would be born later that morning, we just needed to get the baby to move down since he was still pretty high.

So, the next 6 hours were spent squatting through contractions, breaking my water, walking the stairs in between contractions, and trying to stay hydrated. The contractions were getting pretty intense and there were several times where I complained of either being hungry or feeling like I wanted to throw up, the midwife said that was common during transition and that this was the hardest part of labor. Around 8 am, the midwife did a final exam and found the baby’s head still hadn’t budged in spite of all we were doing to get him to move down. At this point she felt that my level of exhaustion and his refusal to budge left us with only one option, a cesarean. To describe how I felt at that moment is so difficult when you think about the emotional and physical exhaustion of labor coupled with the emotions that accompany the impending arrival of a new baby; disappointment is an understatement, heartbreak also doesn’t quite encapsulate how I was feeling. I guess the best way to describe it is simultaneous disappointment, frustration, trepidation, relief, anxiety, confusion and that’s just to name a few. I was disappointed and sad that I wasn’t going to welcome our new baby in the comfort of our home and be able to recover from a natural birth at home, I was anxious about how the hospital staff would treat us when we got there as a home birth transport, I was fearful of having to undergo yet another surgery with the subsequent recovery, I was concerned about how our daughter was going to react to all this and I also couldn’t believe that I was going to have to get in a car and ride in rush hour traffic while in the peak of labor. All of this resulted in my blood pressure sky rocketing (much like it did during my first labor when they started talking about pitocin, epidurals and such) so it became even more necessary to get to the hospital but clearly it was not an emergent issue, the baby’s heart rate was perfect and it appeared he was still quite cozy.

From what I was told it took about 45 minutes to get to the hospital (I had my eyes closed most of the way while I focused on breathing through the contractions) and I felt every minute of it. Moving had become increasingly uncomfortable as it seemed like the contractions were right on top of each other by the time we got there and I was wheeled to labor and delivery. The midwife had called and let them know we were coming and she had established relationships with the doctors there so they were ready for us when we got there. I put on the customary hospital gown and was on the bed while the husband handed off our daughter to a wonderfully available friend who met us at the hospital.

Once they saw how high my blood pressure was they had me on my back, which was excruciating…no wonder most women complain about labor being so painful as most of them are lying in bed, I was so much more comfortable and the contractions were much more manageable when I was able to sit up, stand or adjust as needed but they were having none of that, they wouldn’t let me sit up even a little bit. While they did their initial tests and started pumping me with fluids, I was literally out of myself, I didn’t know which end was up and I just kept waiting for the relief of not being pregnant anymore, having the contractions stop and finally meeting this baby. It was so frustrating to have gotten so close to the end but still have to wait. What's more, the contractions are much easier to deal with when you are of the mind set that they will result in a baby, these contractions (in my mind) were now just pointless discomfort that weren't accomplishing a thing. When I asked about an epidural I was told that they needed to get the ‘two bags of fluid’ in me before that could happen and the doctor actually said, “Plus, we never know, once we get a good reading on what’s going on with the baby, it may just be time to go have this baby.” In my mind I was thinking “If you think I came here to push this baby out, you must be nuts!”

When finally the doctor came over to the husband and began explaining the situation, “blood pressure is very high, much higher than normally seen as a result of labor pain...” “...contractions are strong enough for a vaginal birth but baby is not moving down...,” the husband kept asking “how soon can we get this done?” When finally the doctor said “I think the best course of action at this point is a c-section,” the husband snapped “We get it! How soon can we get this done?!” Finally, I was getting prepped to have the baby we had worked so hard to have naturally, surgically. The time between us arriving at the hospital and the birth of our beautiful, healthy baby boy was approximately an hour…it felt like eternity.

Although we did not get the home birth we had hoped for, I do believe that our son benefited from my laboring at home and only going to the hospital once it was absolutely necessary. I never got the epidural, only the spinal required for surgery once I got in the operating room and afterwards I was glad for two reasons. First, the difference between the sound of a healthy, alert baby the minute he hit the open air was quite different than the groggily cries that our daughter gave after I had only been on the epidural for 2 hours before her birth were like night and day. Secondly, although I did have some mild shaking in the recovery room coming down from the spinal, it was nothing like the first experience of uncontrollable shaking and according to the husband ‘looking grey and dead’ coming down from the combined epidural and spinal. I will say that recovering from a second c-section was quite different and substantially more painful and I am thankful that the husband was home during the day for my maternity leave, entertaining our daughter and taking care of me. It's a gift I think all families should have, being home as a family while adjusting and getting to know the newest family member.

I’m sure most people would use my story as an example showing why babies should be born in the hospital, I would disagree. I believe my story shows how babies benefit from the least amount of intervention necessary. There are women that absolutely have no choice but to birth in the hospital in order to safely deliver their babies, unfortunately it appears I am one of those women. But the fact remains that most women are fully capable of delivering their babies at home or in a birthing center under the care of skilled midwives and if more women chose this option there would be fewer c-sections, healthier babies and mothers, and women would be getting quality prenatal and maternity care for a fraction of the cost. I share my story in the hopes that women can see that even when you find out during labor that you are unable to birth outside of the hospital, it does not have to be a horror story where someone dies, under the care of skilled midwives you are monitored and a decision is made to transport before it becomes an emergency. It is unfortunate that there are babies and mothers lost in childbirth; it is even more unfortunate that there are some losses that could have been prevented, both at home and in the hospital. I can only hope that more women will become educated about their options and demand quality maternity care in which doctors work cooperatively with midwives so only the women that absolutely need medical intervention can receive it in the most efficient process possible. As long as pregnancy is viewed as an illness, needing medical intervention or as a means for doctors and hospitals to make the most money while trying to avoid litigation, there will continue to be unnecessary interventions resulting in unnecessary loss.