Tuesday, December 12, 2006

Finally, My Labor Story (The Longest Post Ever)

Note: The following is a very detailed, forthright description of my labor and delivery. Its probably more for the women but if you are an interested male who doesn't mind the yuckiness of all of it, then read on. For those who want to stay innocent or who have issues with medical/physical stuff, you might want to skip this.

SHORT VERSION:
6pm Wed. - started natural induction methods
11:30pm Wed. - labor was going on its own
2am Thurs. - Doula arrived
9:30am - Water broke
11am - Arrived at hospital, 5cm dilated and fully effaced, -1 station
11:30-12:30 - Labored in the jacuzzi tub
12:40pm - 8 cm, 100%, +3 station
12:50 - began pushing
1:31pm - Nicky was born! 8lbs. 3oz., 20 inches

14 hours of labor, 40 minutes of pushing

Techniques I used to go medication free: simple deep breathing (no he, he, ha, ha - it makes me feel like I'm hyperventilating), massage, relaxation, walking, bouncing on exercise ball, visualization, aromatherapy, water (tub), music, sleeping/dozing


THE WHOLE STORY:

WHY NATURAL?

As you might have read on my husband's email birth announcement, I went medication free for the length of my labor and the delivery of my son. This is exactly the way I wanted it, and I feel blessed that this was able to happen. I was fully prepared to accept an epidural or other pain medication if I needed it or if it became medically necessary, like in the case of a C-section, but there were a number of reasons I tried to avoid this. Before I go on, please let me reiterate that there is nothing wrong with epidurals, spinals, or other pain medication given during labor, but like most medical interventions, they have risks and side effects. Same goes for interventions like using forceps or vacuum extraction or having a C-section: when done appropriately, they are very helpful and can save lives. I look at birth as normally a natural event, not a medical one. I wanted to have this natural event be natural, but take advantage of modern medicine if so needed. I have a deep respect for medicine and have chosen to practice my therapeutic skills by counseling mainly medical patients. I also feel for obstetricians and other medical professionals dealing with childbirth because their malpractice insurance rates are so high due to lots of people suing them if anything goes wrong, even if it isn't the doctor's or hospital's fault. This then causes these doctors and the nurses and hospitals to be, in my opinion, overly cautious at times and perform unneeded inventions just to be careful or to try to prevent something that is an extremely remote possibility. I definitely did not want a C-section (kudos to those of you who've had one - recovering from surgery on top of taking care of a newborn is very admirable). And I did not want medication because of a few reasons. These medications can slow labor down (who wants that?!) which can just make it longer or, if it causes labor to take too long, can lead doctors to suggest a c-section. Also, in slowing the labor and relaxing the muscles in the vaginal passage, the baby doesn't always get turned the way it is supposed as it descends; this leads to the need for forceps or vacuum or sometimes C-section. They can also lower a mom's blood pressure and screw with the baby's heart rate sometimes which freaks everyone out and can again lead to C-section. Given all this information, I still understand why many women opt for pain meds. Labor can be very long and extremely painful. However, what upsets me is that most women and their partners are not informed of all of this. There is no informed consent. People deserve to know this stuff.

So, those are the reasons I wanted to go meds free. I had a decent amount of confidence in my ability to do this because: 1) my mom did for all 3 of her deliveries and I hoped to have her strength and fairly easy and short labors, 2) I have training in relaxation and pain management through my psychology studies, 3) Scott & I took a class on natural childbirth methods and I read many books on it too so I had a whole arsenal of methods to practice and try, 4) I thought I had a pretty good pain tolerance (but wondered if this applied to childbirth since I had never done it before:), 5) Scott & I had decided to hire a doula (a birth assistant) to help us with this whole process. So, I was as prepared as I could be. I discussed my plans and desires with my midwife, and she agreed to these as well as the overall birth plan I wrote. I was very optimistic and looking forward to the birth experience as the days leading to my due date ticked by.

NATURAL INDUCTION

Then my due date came...and went... My midwife expressed that medical professionals get more nervous as due dates pass because rates of birth complications and stillbirth increase. I did my research and found that this is true, they do increase, but the rates are still extremely small. Also, normal lengths of gestation range between 38-42 weeks, so going 2 weeks past the estimated due date is completely normal and is not indicative of problems in and of itself. In a small amount of cases, some babies go overdue because they get too big and can't fit through the pelvis or there can be problem with the umbilical cord or placenta as they get old and can't function as well as they used to. All of these are rare, but still very scary. So, now I had this battle going on in my head: I want to do this naturally, trust my body and baby to know when the right time is, and not induce this labor unless a definite problem is identified. But what if the problem isn't caught and something does go wrong - I will feel like its my fault for not airing on the side of caution like the midwife and doctors had suggested. Uhhhh! It was mentally draining and confusing. And I just wanted to meet my baby already. Being overdue sucked. I talked with my midwife, doula, and lots of my great friends who all offered me a ton of support.

When I was a week overdue, my midwife had me do a non-stress test where they hooked me up to a monitor that recorded baby's heart rate and any contractions or activity in my uterine muscles. Baby did fine and passed the test. My midwife wanted me to come back in 3 days for a biophysical profile test which is a detailed ultrasound where they check the baby's vitals as well as the placenta. I researched this like I had the non-stress test and found out that both are not that accurate and can give false positives where a problem is indicated when there really isn't a problem. This then leads to an induction or an emergency C-section. Scary! So, I really wanted to avoid that and was praying that labor would be begin before the Thursday of the test. My spirits were low that Wednesday. I called my brother Dusty and he cheered me up a bit. Then my doula, Stefanie, called and I admitted to her what was on my mind. We discussed natural induction methods, and I told her I had tried many of them but they not had worked for more than an hour or so. She probed deeper into how I was using them and told me that I needed use them in a more consistent pattern. She told me how to use nipple stimulation every 5 minutes to bring on contractions. The idea was to do this for an hour or two to bring on a rhythm of contractions that were 5 minutes apart and then see if my body could pick up the pattern on its own. She suggested I pair this with the use of castor oil. It is a tasteless oil that you mix with juice or other liquid and drink. Its a natural diuretic so it gives you diarrhea. The idea is the intestinal cramps it causes bring on uterine contractions as well since they are in the same area of the body and use some of the same muscles. I know, it doesn't sound pleasant. This was something that has worked for many people, but I can't imagine doing it other than as a last resort.

I was so ready to be done with being pregnant that I was up for trying both methods. I did not want a medical induction because there was still a decent chance that if it did not work and I did not go into labor with the medication's help, I would need a C-section. Also, pitocin, the medication they give you during induction can cause super mega horrible contractions that are very hard to deal with without pain medication, they can also distress the baby leading to c-section, and you need to be on a monitor continuously so I could not use the jacuzzi tub or get up and move around to help deal with my labor. Basically, my chances at going for a natural delivery were greatly decreased if I had to be medically induced. My only dilemma was if I tried the natural induction methods that night or waited until the next day. I considered waiting because I knew my midwife would be in the next town at the medical practice's other office that day and might not make it back in time for the delivery if I did go into labor during business hours. But I couldn't take it anymore! At 6pm when Scott came home I told him the plan and then started implementing it. I began the nipple stimulation at 6. Then at 8pm, I took the first dose of castor oil. It was like drinking vinaigrette dressing - the oil was yucky in texture but it didn't have any flavor so I didn't mind it that much. I took the second dose of castor oil at 10pm. By this time, my body had picked up the 5 minute contractions but I did occasional nipple stimulation to keep them going because I had had false labor before with contraction only 4 minutes apart so I knew they could still stop.

THE LABOR:

By midnight, my contractions were still going regularly and a bit more intensely. I allowed my myself to get only a bit excited because of the false labor experiences I'd had, but I did call my doula to let her know what was happening. She instructed me to take a relaxing shower and see if that changed the contractions or not. If the contractions went away after the shower, if was false labor again. But they didn't! So I called Stefanie again, and she asked if I wanted her to come to the house. I said sure, because although my contractions had been 5 minutes apart for a few hours now on their own, they were pretty mild and I knew I was a long way from delivery. Being completely inexperienced (and Scott being so as well), I wanted her input on how things were progressing so I knew when would be the right time to go to the hospital. Stefanie arrived a 2am and we three talked and watched some late night television while monitoring my contractions. She suggested I try to rest and maybe take a nice bath. I said I could try to dose in the bath and did so for a good half an hour. Then I got out and took a little nap on the bed. At 5:15am I woke up and Scott was napping while Stefanie dozed in the living room. Stefanie asked how my contractions were feeling. They were still 3-5 minutes apart but not too intense, so she suggested we go for a walk at about 7:15am. We walked around my neighborhood for a good half an hour. It was a beautiful fall morning with bright blue skies and fairly mild weather. The walk did help to make the contractions stronger and by the end of it, I was not able to talk (or walk) through the contractions, but I was still dealing with them very well. Stefanie helped my massaging my back during the hard contractions.

When we got home, Scott was awake. I ate a little bit of breakfast (a yogurt smoothie) and talked with Scott & Stefanie on if I should keep my chiropractor appointment that morning at 10am. We figured that if my contractions were still this mild then I could go. The chiropractor's office agreed when I called and told them of the situation. Stefanie then suggested I take another shower and do some more nipple stimulation to see if I could get into active labor. It seemed to work, and my contractions were getting stronger. My midwife appt. was at 10:30, right after the chiropractor, so we decided to pack up the car just in case they decided to send me to the hospital from there for some reason. I bounced on the exercise ball during contractions to help cope with the pain which now took some concentration to deal with. Stefanie and Scott continued to use massage to help as well. Just as we were gathering our belonging, I felt a big gush of fluid and announced that my water had broken. It was 9:30am at this point. I was rushing around trying to put on a pad to catch the fluid, but really, I could have used an adult diaper because it kept coming in gushes. Stefanie suggested I use a baby diaper to catch it. I called the chiropractor and canceled my appointment, then called the midwife and they said to go to the hospital.

THE HOSPITAL:

After my water broke, my contractions reached a whole new level and became extremely intense. Bouncing on the exercise ball continued to help me stay in control and ride out the contractions. I decided to try to eat some peanut butter toast since I might not eat for a while in the hospital. We finished gathering our things and headed to the hospital. Scott put down a garbage bag and then a towel on the car seat:) I still had my baby diaper as well. The car ride was none too fun, let me tell you! When we got there, I even agreed to have Scott park the car and walk through the parking lot and into the hospital instead of being dropped off at the front entrance, the idea being that walking was good for me. Am I crazy or what! Try walking through a parking lot, through the hospital, and then going up the elevator, trying to act normal the whole way as you are soaking wet like you just peed yourself, having massive and painful contractions the whole time! It was about 11am at this point. I told Scott & Stefanie I had better be 5 centimeters dilated when the nurse checked me or I would be disappointed (remember, I had already been 3cm for 5 weeks beforehand). When I checked in and the nurse took me to my labor room and checked me, I was indeed 5 cm. Thank God! I tried to answer some medical history questions as the nurse hooked me up to the monitor for the first 20 minutes. The contractions were still very intense, but I could breathe through them.

I was lucky enough to get a room with a jacuzzi tub in the bathroom as I had requested. After I was done with the monitoring, Stefanie drew me a bath and put rose oil in it, my favorite. Before I got in the tub, I was nauseas and threw up - boy did I feel better after that! For an hour, I laid in the tub, breathing through contractions and using visualization to imagine each of them as waves that I was riding like I was surfing. I also visualized my uterus contracting and my cervix opening like a rose blooming. I listed to music on Scott's IRiver MP3 player and even dozed in between contractions. Scott thought it was crazy that I could sleep between contractions, but honestly, it was my escape and I was so concentrated inward that I could drift off when the pain wasn't present. But let me tell you, the last 15 minutes in the tub, the contractions grew to such a height that I was just about at my limit. They were now so intense a quarter of the way through that knowing that the peak was still yet to come and I still had 3/4 of the contraction to go, made it hard to stay so centered. Before this, I was able to stay still and relaxed in the water through each contraction. Now, I had to riggle a bit as the pain surged at its highest for each contraction. My labor nurse and doula were nice enough to give me privacy while I labored in the tub, so only Scott was in there with me. I admitted to him that the contractions were becoming way more unbearable and I could see why women asked for meds at this point. He was so supportive and calm through the whole thing. He never once got freaked out when I started to feel like the contractions were kicking my butt. No one ever asked me if I wanted medication, just as I had requested.

I wondered if I was nearing complete dilation and the transition phase as its called. My nurse said that she would need to check me in about 10 minutes. When it was time for her to check me (around 12:30pm), I had to get out of the tub again, and I told Scott I hoped I was 8 cm now. Guess what? I was, and I was fully effaced! Being able to predict how dilated I was made me more sure that I really was in tune with my body and exactly what it was doing. Anyway, after the nurse checked me, I had to go on the monitor for another 15 minutes again. Let me tell you, the water and the tub really did help and take the edge off the contractions, so now without that, I was even in more pain. I think I surprised the nurse by how quickly I had progressed. If she thought that was impressive, she must have been blown away by the speed of the next phase.

PUSHING:

Only 10 minutes after being checked, I suddenly felt a wave come over my body and my muscles instinctively started to bear down and push. That was kind of creepy because no one told me that that could happen. I thought you got a "feeling" that you needed to push, and then you consciously had to go about doing so. I didn't think your body could just take over like that! Anyway, my doula alerted the nurse who asked me to stop until she could get the midwife. Yeah right! I wasn't even trying to do this! My doula made me feel better by telling me it was okay and this was normal. She instructed me to just go with it and give little pushes. Once I accepted that this was normal, I was able to trust my body and let it do its job.

The midwife on call (my regular midwife was still in the next town:( ) arrived quickly and checked me again. I was now complete and the baby was in the birth canal so birth was imminent. I had been on my side while on the monitor because laying on my back was just not comfortable. The midwife allowed me to stay on my side as I pushed. I pushed along with the natural pushes my body was giving. Scott continued to be invaluable. He stayed up at the head of the bed and talked to me, whispering supportive things and being a total sweety the whole time. My doula, Stefanie, kept feeding me supportive and instructive comments while supporting my one leg for me during the pushes. The nurse and midwife also gave me encouragement, but supported my wish not to count out my pushes (as in 1 to 10) or cheer me loudly. I wanted things to be calm and somewhat quiet. Instead of counting, I pushed instinctively, giving about 3 pushes per contraction, each lasting about 6 seconds or so.

The midwife massaged my pereneal area and used warm wash clothes to support stretching in that area. I continued to rest in between contractions by closing my eyes. Let me tell you, I found the pushing stage to be a relief - it felt so much better than the crazy contractions of the transition phase. Plus, knowing that completion was close was very motivating. I did not scream at all, but I did quietly groan some, especially with those first unexpected, instinctual contractions. Stefanie asked for a mirror to be brought in so I could see the progress I was making. I was then able to see baby's head and all his dark hair and my midwife had me feel his head as it was crowning. I think I said "Wow" or something like that. As my midwife pushed back on the back of my pereneal area, it hurt but reminded me exactly where I needed to push. I pushed for about 40 minutes until Nicky emerged at 1:31pm. I had no idea that despite all the pereneal massage and the fact that pushing on your side takes pressure off the pereneum, I still was destined to tear. However, I did not tear my pereneum as most women do but instead tore one of my labia. The midwife later explained that I have a long pereneal area which helps me not tear back there, but with there only being so much room, I had to tear somewhere. Also, Nicky came out a little sideways so I don't know if that contributed to it. Anyway, my midwife put a few shots of Lodicain in the area and stitched it up. However, the stitches did not hold because they would have had to be super small plastic surgery type ones to stay and that would have taken too long and caused me too much pain since I wasn't medicated at the time. So, for now, I am deformed:( but I can have plastic surgery in the future if I want it fixed. Luckily, my midwife assured me that future labors and other activities would not tear it more. Honestly, this was the hardest part of the whole process for me because my body is forever changed.

Back to the delivery: Nicky came out very alert but also very pissed off! He screamed as he was placed on my belly. I cut the chord (not Scott's thing - too yucky). Nicky checked us out and calmed a bit as I held him but then continued to scream some. I think he was ticked off that I kicked him out of the uterus. The midwife and nurse commented that he had a lot of the white vernix stuff on his skin which usually decreases as babies approach term so they wondered if he wasn't a bit early, which would mean that my due date was wrong again and all this worrying and induction stuff was unneeded! Anyway, Nicky wasn't interested in nursing right away. He got sleepy and only latched on for a few seconds each time. I did not force him and after a half hour, I let the nurse take him to bathe him and do weigh him and stuff. Then he was ready to nurse and be cuddled.

My midwife kept saying I should be on a birth video because I did so well at staying calm and controlled and the birth went so smoothly. She also said I had amazing pain tolerance and probably could have my arm cut off and do okay! I don't that I'm anything that special. Seriously. I credit my preparation, the people around me supporting me the whole time, and my ability to trust my body to do its thing and then go along with it for this outcome. I totally see where fear and tensing up can add to pain and slow or stop the process. The key is staying as calm and relaxed as possible, not fighting it, and keeping confidence in yourself. That said, I am proud of myself for this accomplishment.

MY FEELINGS:

It felt so normal and just right when Nicky was born. It wasn't surreal or overwhelming or anything like it is sometimes described by others. It just felt comfortable and natural, I guess. Scott says he had the same feelings. Things were how they were supposed to be. I was most surprised by Nicky's dark hair and how much of it there was. That was totally unexpected, and I still love that. I also don't recall any wave of major relief or awe or love coming over me. I guess I was too relaxed or something! Everything came in stride.

THE RECOVERY:

While nursing came pretty naturally for Nicky and me, I was not prepared for the recovery down under, so to speak. It hurt to sit much of the time, and I had to be careful how I shifted pressure around as I moved. I stayed in bed most of the time in the 2 days in the hospital, and I'm glad I did! Once we got home, I was still very tired. My midwife had instructed me to rest, stay off my feet, and no stairs until she saw me in a week. I followed that until the night before the one week mark when I went downstairs to finish a load of laundry while Scott was upstairs holding Nicky. I though it was no problem because I was feeling so much better, but as soon as I walked through the cold garage and went down the stairs to the basement, I got a huge chill over all my body, felt really weak, and thought I was going to pass out! I quickly got back upstairs. I felt like crap the rest of the night with continuing chills and faintness. I even wondered at one point if I needed to go to the hospital. Luckily, by the next morning it had passed, and my midwife confirmed that I had just overdone it and needed to back off. Since then, I have felt more and more like myself but still feel like I am recovering. I am not sure that my energy is completely back and I know my muscles in certain places are weak. I think recovery was harder than the labor!

As if this wasn't long and detailed enough, if anyone wants to know anything else, please just email or call me. Like Jenny McCarthy said, people don't talk about this stuff and there is so much that many women don't know about labor and delivery beforehand. I really enjoyed my pregnancy and delivery, and I think it helped me to read and share stories with my friend and family who'd been through it before. Thanks everyone! I hope this will help pay it forward.

1 comment:

Aimée Sturley said...

Wow, what a fabulous post!

I am a doula in Vancouver, British Columbia and I was looking for a good birth story to share with one of my clients who is past her expected due date; what luck that you posted this on the very same day!

I want to thank you for your very candid descriptions; they are so helpful to women who have never been through the experience. Too often the intensity of it all gets glossed over.

Congratulations! Well done!