Hello again friends!
I do enjoy our weekly "visits" here on the blog. Perhaps you'd like to hear the story of my first birth, and how I declined interventions in the hospital? That experience set the stage for me choosing to have unassisted births in the future, so the story has a special place in my heart. It's also when I started learning that there are "rules" of birth that aren't laws, and breaking them isn't necessarily a bad thing. Really? You'd like to hear about it? Thenlet me see... Where to start.
Finding out I was pregnant
My husband and I got married at the end of March, and I was hoping/convinced we would be pregnant right away. Ignorance is bliss! Or... it started that way. I admit that I'm one of those ladies who thought intimacy = pregnancy. Well, my first period came after our wedding and I was a little sad not to be pregnant, but accepted the fact and mentally moved on. A second period came and I was definitely disappointed. Looking over my charts (I had been taking my basil body temperature and tracking to pinpoint ovulation) there was nothing "wrong" with our timing. Pregnancy just hadn't happened that month. Third month was the charm! Really I didn't have a very long journey
to pregnancy at all, I was just naive.
Finding an OB/gyn
My mother knew we wanted children right away, and invited me to a MOPS (Mother's Of Pre-Schoolers) meeting where the guest speaker was that week a local OBgyn. He spoke about women's cycles, the hormones involved in a non-pregnant cycle, and hormone changes during pregnancy. He answered questions at the end. All in all he was a dynamic speaker, very charismatic, and I liked him. So his practice is the only one I called when I became pregnant. I asked whether he was taking any new patients, and that was my only question. Pretty naive still, right?!
My first appointment was at around 8+ weeks. The doctor asked me questions about how I felt, offered medication for the morning sickness if I wanted it (which I declined), ordered a pap smear (the PA did that), blood work (walked down the hall and had it drawn), told me what foods I should avoid... And that was about it!
I thought I was pretty forward-thinking to have questions already prepared for that first appointment. Like, "What is the reasoning for avoiding lunchmeat?" (which he responded, it's the possibility of Listeria from meat touched/sliced at the deli. There is no risk for pre-packaged lunchmeat if I wanted it) I also declined the STD testing, knowing there was zero risk (my husband and I were both virgins, and we don't have any other risks) which I had to sign extra paperwork to say I was declining... Okay, that's fine.
Additionally, I decided to decline the Nuchal Fold Test, stating that we wouldn't terminate in any case, so we didn't want the test. These were personal preferences of mine, and you should form your own questions and opinions, of course! BUT I was mostly probing to see what the doctor would say or which tests he would insist, and how hard he would press me if he and I differed in opinion.
At the end of the appointment, I was content with the doctor's responses to my curiosity, and thought I was doing well being prepared.
The first trimester
Turns out I'm a pretty chilled out pregnant lady. In normal life I'm kind of feisty, but pregnant I'm compliant and laid back. I followed every instruction, and did everything I was "supposed to do" based on the doctor's recommendation. Somewhere around the end of my first trimester I told my next door neighbor that I was
pregnant. She and I had previously only said hello at the mailbox, or waved as we drove past, but nothing more. She immediately invited me to come in for tea and chat! I was pleased to accept the invitation, and she was excited for me so I figured I didn't have anything to lose.
What I didn't know, is I had everything to gain by that conversation. She asked me questions I hadn't even thought to consider yet like "Will you have an epidural?" Ummmm... I guess so..? I hadn't even thought about that, but I guess that's what people do. My own mother had seven children, all c-sections, and I wasn't particularly sure I'd have a vaginal birth but it didn't bother me either way. She told me of her three births, the first two with epidural, and the last without, and by far the third was the easiest recovery.
What?! That got my attention. Then she loaned me a book by Ina May Gaskin. Reading it over the next few days opened my eyes to so many ideas about birth that I hadn't even considered. Least of all, I determined that my
body is designed to birth and that "If at all possible, I wanted to ensure I had a vaginal birth."
From that point onward I was a reading/researching fiend. My goal was to discover which factors I could control that would increase my chances of a vaginal birth. What I eventually came down to was, "Each intervention increases the potential that my birth will end up a Cesarian Section." Every intervention I could think of, I researched. Epidural. IV placement. Antibiotics for Group B Strep. (Oddly enough "Vaginal Exams" and "Breaking The Waters" are two I overlooked, and they were two things I accepted in the hospital that I may choose differently were I to do it again).
books [this one] and [this one] online, reading blogs like [Birth Without Fear], searching topics and reading every website that addressed each topic to compare notes between sources... I liked the articles on [Evidence Based Birth] because they were written by a research nurse, and had printable information that I could take to the doctor if I wanted to... But I never did.
The first time I consciously put my "plan" into action of holding my ground with the doctors was during an appointment where they wanted to schedule the 1-hour glucose tests for gestational diabetes. I said no. The doctor, who up until this point had been very accepting of my opinion and choices blustered a bit and said,
"Actually, this is one test you don't want to skip." I held my ground. "No thank you. It's unlikely I'll get gestational diabetes, and I don't want to take the test." He was nonplussed, and continued to insist, citing that the baby could have all kinds of problems (I could write out the conversation here, but it's a bit lengthy and you get the idea.)
Funny thing is, my husband was actually at this appointment since it was directly after our anatomy scan. The doctor locked eyes with my husband as if to say "you're on my side, right? CONVINCE her!" However my husband knows me too well, and returned the look with a sort of "Yeah right. I doubt you're going to win this one" look of his own. Eventually the doctor visually wilted and gave up, asking "Okay fine. Are there any more tests that you're going to have done?"
But should I have?
Now before you think to yourself that I was hasty in my decision to choose this as my hill to die on... I had done a serious amount of research on gestational diabetes, and had determined for myself that if I felt or had any of the symptoms that indicated I was possibly developing it, then I would request the testing myself. Extra thirst, peeing frequently, faster than expected weight gain, swelling ankles/limbs, etc... My personal background of an intolerance to soy products has made me choose foods extremely carefully, and junk food is totally off the list due to the high use of soy products in those items. Gestational diabetes is often diet controlled, and would have to be quite pervasive to cause problems that diet alone could not solve. In other words, "I would notice."
Once I knew that the doctor had his own opinions, but would respect my choices, I felt much more confident about my ability to have the birth I wanted. I still researched everything that came to mind, but I felt more confident than I had before.
Many people suggested (online) that I should write a birth plan. I never did. Though I talked to my husband about what I wanted, what I *didn't* and what I expected them to say or do about it, so I felt confident he would support my wishes when the time came.
Labor started about a week before my due date. I was *very* excited! Contractions began around 10pm and continued through the night around 7 to 10 per hour. Excited, I called my mother in the morning and let her know that baby was coming that day! She startled me with the question, "Why do you think you're in labor?" Uhh... well, because I've been having contractions all night (?!) that's why. We packed our things and headed to her house to labor there, since it was much closer than our house (remember, 45 minutes to the hospital from my house? She was only 10 minutes away from it). And... I continued to have contractions Allllllllllll morning, afternoon, and evening. Now that I look back I smile knowingly at the memory of my excited self, and realize that those contractions were uncomfortable but not painful.
My mother commented, "When I was pregnant and in a similar situation my doctor said to drink a glass of wine. If the contractions went away, it wasn't real labor. If they stayed, then it was real. Would you like to try that?" I agreed it would be a good thing to try. One glass of wine later and the contractions fizzled to nothing. Thirty minutes without contractions and my husband and I decided to say goodnight to my mother and go back to our house. Huh!
The next day I had a doctor's appointment and he checked my dilation -- I was a bit dilated, and somewhat effaced, but he wasn't giving me any indication that he thought I was close to "the real deal." Ahh, to be naive as I was back then!
The REAL birthing time
A few days later the pattern began again. Contractions starting at 10pm, more than 8 per hour, Alllll night long, but this time there was a painful edge on them. In the morning I called my mother again and let her know we were on again. Same pattern, labored at her house all morning, afternoon, evening, very consistent (and painful this time!) but never getting stronger, longer (than a minute) or closer together (5 minutes apart). Mom got out that 1/2 bottle of wine and the three of us had another glass that evening... And this time my contractions didn't fizzle. We went to bed in her spare bedroom and I slept as best as possible between contractions.
As each contraction came on I'd tap my husband and he'd reach over to press on my back (at the time I didn't know that my back labor was indicating I had a mal-positioned baby. Have I said that ignorance is bliss yet?) then we'd both relax and go to sleep once it was over. However, my husband is allergic to cats, and my mother has a cat. He took a half dose of Benadryl at some point, and eventually he stopped responding to my tap. The contractions came closer together. I started to dream (in between contractions) that I was at the hospital and the nurses were going into labor! I was trying my best to help them through contractions, and that's when I'd wake to my own contractions!
Eventually I was fed up, further along, or just couldn't cope. Abruptly I sat up and (unkindly) told my husband to WAKE UP! At the same time I suddenly had the urge to vomit and quickly commanded that he find me a trash can!!! Poor guy, he was very compliant and quick, and had a waste basket for me just in time for me to vomit.
"Go upstairs and wake my mom." He left, and I'm pretty sure I was a bit delirious and possibly in transition. In my mind I was contemplating having her start me a bath, and wondering if I could just have the baby in the bathtub and not go to the hospital at all. When she arrived in the room she was smiling and said, "I think it's time to go!" Now that I know myself better I know that I'm extremely obedient while I'm in labor, even if I'm also demanding... It was her comment that erased my thoughts of birthing at home, and we got ourselves to the car.
Actually, the drive wasn't as bad for me as it is often painted to be. It was about 1am on Saturday morning, so there was zero traffic to content with, and we literally only made two turns - one onto the road, and one into the hospital parking lot. Even so, contractions were every 3 minutes and quite intense.
We went in through the emergency room doors, and followed the signs to the Maternity Ward. My husband pressed the buzzer, and he was asked over the intercom, "Why are you here?" My sweet husband answered, "My wife thinks she's in labor." I'm sure it was adrenaline that made his wording come out that way, and hormones that made me think, "THINKS?" in my head... But we were let in promptly and I forgot about it quickly.
The nurse at the desk, a man, asked me directly, "What makes you think you're in labor?" just as a contraction hit. I braced myself on the desk and let him wait for my answer. Ha! He figured it out and had my husband fill out the paperwork, except for my signature, and we were ushered into triage.
Triage: Declining Interventions
Again, I overheard the nurse being told, "This woman *thinks* she's in labor." I was changing into a hospital gown. Ha! I AM in labor, I thought to myself... But when the nurse checked my dilation her eyes grew huge and she said I was 6cm with a bulging sack. Vindicated! She tried to then place a heplock in my arm for later access should I need an IV. This was my shining moment. I said "No thank you."
"Oh, honey, sorry. You can't decline, it's standard for all patients." Ummmmm... No. "Thank you, but I'm declining it." She looked at me quite startled and repeated herself. Then I repeated myself, "I understand, but I'm till declining." She tried a different tactic, "The doctor on call really insists that all of her patients have a heplock, even if you were here for a skinned knee you'd get one." So I responded with, "Ah, okay. I understand. But I'm still declining."
"Honey, if something terrible were to happen, and when things go bad they go bad FAST... We need to be able to get medication to you and the baby QUICKLY or your baby could die." Ahhh, the baby can die tactic. "Thank you for explaining that. Yes, I understand. But I'm still going to decline." At this point she gave up. I didn't have anything in my arm, and I was still laboring away..
In the delivery room
The new nurse introduced herself to me, very sweet lady, and *also* tried to convince me to get the heplock placed. Again I declined, and that was the last I heard of it.
Mom and I walked the halls, and my husband re-parked the car. When we got back from one lap I felt nauseous and wanted to be checked again. The nurse was doubtful, "Honey, you've only been checked an hour ago." I insisted. She was surprised that I was complete, and the sack was bulging. She asked if I wanted the doctor to come in and break my waters? "Yes please." And then I waited...
2:30 to 8:30
Apparently the doctor on call was *very* busy that night, because at 2:30 I wanted my water broken We waited... and waited... and waited... then it was 7am and shift changed. I met the new doctor, not my doctor but also a male obgyn, and he assured me that he'd come right back to break my waters as soon as he finished meeting all the patients. <sigh> Okay... 8:30 he came back. Immediately I knew I liked him better even than my own doctor. He said to me, "I know that you're wanting this birth to be as natural as possible. I'm happy to help however you want, and otherwise I'll just be out there in the hall if you need me. Would you like me to break your waters?" Oh yes, please!
Breaking the waters
The famous "crochet hook" did its job and my waters gushed. They were clear. The doctor was happy with the color. He did mention that my son's head was a little crooked, and called it asynclitic saying "don't worry, he just needs a little time to wiggle around and get into a better position. He'll figure it out. I'll let you labor down for a while."
I wanted to know, "Okay doctor, I'm not going to hold you to any number but.... How much longer do you think this is going to take?" He looked at me with kindness and said, "I think two or three hours and baby will be out." Oooooh, in my heart that sounded so long. But I'm glad he didn't give me false hope for a shorter time! As it was, my son was born in just under two more hours, which suited me fine!
Though I'd never heard of the term "laboring down" I soon discovered that it just meant laboring while fully dilated to let baby get into a better position. At least, that's my interpretation. I'm EXTREMELY glad for my doctor choosing this. It allowed me to change positions on the bed, and get more comfortable.
I chose to turn around, have the back of the bed raised like a chair, and I hung onto the back. It was sort of kneeling and resting between. Soon the contractions changed their quality, though I didn't notice it at the time, and I felt like I was giving in to them. They sort of swelled and took over, and I let them. My body started to gently push at the peak, and I let it without realizing what I was doing. Eventually the nurses asked me to turn around so they could check me again. I didn't want to and was as slow as possible in complying with their wishes.
Finally they got me turned around, and checked to find "Oh my, baby is crowning! Stop pushing honey." "I can't! I haven't been pushing." "uh, well, okay, but don't TRY to push. We need to get the doctor." What felt like an eternity, but was probably only 5 or ten minutes later the doctor arrived.
Again, the doctor very kindly told me, "Feel free to push as you like" and he never counted or directed me at all. I started bearing down during the contractions and pushing with them, and two or three pushes later baby was out! (Had I not been told to push, it's likely baby would have come anyway within a few more pushes due to fetal ejection reflex. That's what I had been "floating through" up until the doctor came in. Neither of my subsequent births gave me an option of fetal ejection reflex... so I quite treasure the memory of his birth with it.)
I wanted delayed cord clamping, and he was happy to let me wait. He even lifted the cord to show me that it was white and limp and asked if he could clamp it? Yes. My husband cut the cord. The nurse wanted to get pitocin but the doctor knew my wishes were NOT to get pitocin and to wait and see if my body would do what it was supposed to. He told the nurse "No, she's doing great on her own." I have never heard or read any women's birth story where they got a luck-of-the-draw-on-call-doctor that was awesome like this, but I was so blessed.
My son Noah was born in February 2014, he was 7lb 4oz and sweet as could be. The doctor and nurses all commented on how alert he was, already looking around at people and the room. At the time I thought it was just the nice things people say to EVERYONE but don't really mean them. Now that I've had other children I realize that he really was quite alert for a newborn.
My placenta came, I had a small tear, and the doctor asked very gently, "I know you didn't want any intervention or medication, but I really would like to stitch you and I really prefer to give you something to numb the area first." I laughed and immediately agreed that would be fine.
We spent the required 24 hours in the hospital, took the "new parents class" we were required to take as new parents (how to keep any wounds from birth clean, baby's cord care, sleeping, feeding, signs of problems, etc.) and exited as soon as possible. We wanted to be home!
In the week that followed I sweated a LOT at night. When I say a lot, I mean I had on underwear, pajamas, a terrycloth bathrobe, and a towel under me and I sweated through EVERYTHING. When I got out of bed I was literally dripping sweat on the floor. Perhaps this can be normal. It may have been normal for my body that pregnancy. BUT, about a week later I was still getting the jitters, sweats, and taking tylenol periodically when I felt ill. Day 8 I woke up with a fever that would NOT go down below 103.6 even with a full dose of both Tylonal and Ibuprofen. We went to the Urgent Care and had urine tests and antibiotics... Two shots in the bum, AND oral. A few days later the culture came back as "Group-G Strep" and it was a uterine infection, not bladder.
If you remember, they typically test for Group-B, not G. I was negative for Group-B so I didn't have antibiotics during the birth... Upon further research I found that this strain is more often found in people who work with livestock. (???) Also, it's more likely to get a uterine infection when your water is broken for an extended time (nope) or a long labor (yes, almost 36 hours) and with many vaginal checks. It's my assumption that I contracted the Strep during the hospital portion of my delivery.
When the whole thing was said and done, I decided in my heart that my hospital birth was good. At least it was fine and everything I had wanted... But I really could have done it myself. With my next, I told my husband I wanted a home birth. But that's a different story.
Breaking the rules
Did you see how I started out following the rules, then started breaking them? There are lots of "rules" in parenting that we don't even realize are negotiable until something comes into life to cause questions. I'm forever thankful for my neighbor's asking me, "Are you going to get an epidural?" because that started me questioning what I wanted, and pushing back against the things I didn't want. Perhaps I was "one of those difficult patients" for the doctor and nurses. But when it all came down to it... I had the birth I wanted, and I started on a journey of making my own birth choices. That lead me to birthing my next two children unassisted.
When you read or hear birth stories that contain words like, "They wouldn't let me [x-y-z]" take note, and start to think. Is it possible that you would "break the rules" if you were told the same thing?
May God Bless Your Journey!
[/caption]Read Keziah's Birth Story <---