Thursday, September 25, 2008

Kyra's Birth Story (written by Donna)

I was due with my 9th baby on April 22nd. However, since 6 of my babies came after my due date, I knew it was a likely possibility that I would go past my “due date”. So, April 22nd came and went, and I remained pregnant. By this point, it wasn’t so bad. I had gotten rid of a horrendous back pain I developed several weeks earlier, and it was more the anxiety of not knowing when labor could start that I was dealing with. I had a bout of regular, 10 minute apart contractions for 5+ hours on Friday night, the 27th , but it fizzled out to nothing by Saturday morning.

On April 29th, 7 days past my due date, Barbara came to my house for a pre-natal. We talked about doing things to work on getting the baby out, but nothing drastic. Baby was posterior at this point, and I was concerned about starting things before he or she was in a good position. I really didn’t want to be too aggressive. It suddenly dawned on us that we have an acupuncturist in our office! I had no problem having some acupuncture done at all. We called Evelyn and set up an appointment for the next morning and if things didn’t start, we would do it again in the late afternoon. That night, Darren and I went to dinner with Barbara and Sarah at Fleming’s. It was a wonderful evening, great food and great company. We had such a good time, joking with our server about my water breaking there in the restaurant.

We went to bed around 11:30 Sunday night, and like 6 out of 8 of my previous labors, I woke up to contractions in the middle of the night, at 2:16am. These were of a different quality than the ones on Friday night, but I didn’t want to get too excited. They were anywhere from 8-15 minutes apart, some lasting 1 minute or more, some only a few seconds. I was able to ignore them for the most part, and slept off and on until about 7:30am. I got up, ate breakfast, told Darren it might be the start of something, then called Barbara and cancelled my appointment with Evelyn. I puttered around the house, Darren filled the AquaDoula, and most of the kids stayed home from school. (They were all given the choice of staying or going to school. Talyn was the only one who chose to go.)

During this time, beginning at around 2am, one of our cats became my guardian. When I woke up in the middle of the night, he was sleeping on my pillow. He was by my side the entire labor, while I was at home. He followed me from room to room. When I went into the bathroom, he sat outside the door, meowing and stretching his paw under the door. He did not want to let me out of his sight.

Around 11am or so, things slowed down a lot. I figured it probably had to do with baby still being posterior. I was doing a lot of hands and knees and kneeling forward on pillows, my bed and my ball during this time, trying to encourage the baby to turn. I wasn’t worried, I just figured he or she would turn eventually. I had no back pain at all, which I was very happy for. I tried to keep busy, and organized all of my yarn, which I had saved for a labor project. It did keep me busy!

Around 2 or 3pm, it seemed as though everything came to a complete stop. I decided I needed to get out of the house. I don’t remember if it was hot or cold outside, but I remember telling Darren I wanted to go walk around at an indoor mall. The closest one to us is about 30 minutes away by freeway, and we were getting into rush hour. We were a little unsure about driving in it, especially if contractions picked up while we were out. We definitely did not want to get stuck in traffic. We decided to go to an outdoor mall much closer to home.

We got to the mall, and walked around a bit. Within about 30 minutes, I started having contractions again, and they were more intense than before, although still about 15 minutes apart. We went into a few stores, then sat down on a bench. Contractions had started getting a little more regular, closer and more intense, but still manageable. I was still able to walk and talk through them. We decided to go to dinner and then go home.

While we were eating dinner, contractions got a lot more intense. At one point, I had one that was so strong, I shoved the table away from me and into Darren’s stomach! We left shortly after that, and got home around 6 or 6:30pm.

Contractions continued, and I spent a lot of time in my bedroom. I was still kneeling forward a lot, trying to get baby to turn anterior. Darren asked me several times if I wanted to get into the pool, but I had checked myself, and knew I was only about 3cm. I didn’t want to get into the pool and have everything slow down. I continued laboring in my room, walking around the house for a few more hours.

This labor felt different than my others, and I can only assume it was because of the baby’s position. I never had any back pain, or really any pain at all. It just felt different, intense. I would check my cervix, and I could tell the head was not anterior. I found out by accident that standing up actually felt very good during a contraction! I decided to finally get into the pool, I think it was right at 10pm. I called Barbara right before that, maybe 10 minutes, and told her it would be a good time to come and do pictures. I really felt that I still had hours to go, and that I would probably have the baby by the morning.

Once I got into the pool, the intensity reduced by a tremendous amount. A few minutes after I got in the pool, I checked myself again and I was about 5cm. Darren was in the pool, and I would lean on him during a contraction. It was really good, and felt so much better than being on land. Things were picking up, and Darren said a few times that my labors always moved fast once I got into the water. It usually did, but I wasn’t thinking about previous labors at that point. Barbara arrived, set up some stuff and started taking pictures. I STILL thought it would be hours before the baby came.

Within minutes of Barbara’s arrival, my water broke (10:20pm). At that time, I am sure the baby turned anterior. Suddenly, things felt different, better! I checked myself, and I felt like I was almost completely dilated, with just a bit of a lip in front. I thought, “That can’t be right! I was just about 5cm a few minutes ago.”

With the next contraction, my body pushed. I was taken by surprise. For some reason, I didn’t feel ready to push. I said a few times “My body’s pushing, I’m not doing it.” I still felt a cervical lip, but it was shrinking with each contraction/push. Somewhere, a part of me worried about it being the cord and not a lip, and I asked Barb if she wanted to check it. She said no, that I was fine.

The baby’s head was really low, but I didn’t realize how close to birth it was. My brain had not caught up with my body, and I wasn’t in the place of mentally being ready to birth this baby. It went faster than I thought it would. With the next contraction, the baby was almost crowning, but not quite. One more contraction, and the head started coming, and I realized that this was it and I would be holding our new baby very soon. This is usually my hardest point in labor, I am usually very scared and I tend to freak out. But this time I didn’t, and I am so proud of that fact. It was intense, but I only felt a little bit of burning. I kept my hand on the baby’s head, and slowly it crowned, then was out. Well, mostly out. It actually came out slower than any other birth I have had. I had to push a little more to get the head all the way out.

There was a slight lull, then another contraction came. I pushed, but the baby didn’t budge. I felt the head, and thought it rotated, but it actually hadn’t. I tried changing position, and lunging my leg to the side, and still baby wasn’t coming. I knew it was a shoulder dystocia. I said something to Barbara, although I don’t remember what I said exactly, but I think I told her I needed help.

She told me to stand up and put my leg on the side of the pool, so I did. She asked if she could reach in, and I said yes. At this point, we knew the baby’s head hadn’t rotated. Barbara tried to get the baby out, but it was not budging in the least. She told me to get out of the tub, and get on the floor. I knew from another shoulder dystocia birth what she wanted me to do, so I got on the floor, and pulled my legs back into McRobert’s position. I started freaking out a little bit then, and it hurt like hell. The assistant, and friend of mine, D., arrived right as the baby’s head came out. Now she was on my left side, holding my leg back, but I was fighting against her. Barbara got the shoulders out, then the rest of the body, and she put the baby on my stomach.

As the baby came out, we heard a little sound, and thought everything was okay. But once he/she was on my chest, there was no response. I was rubbing, and trying to stimulate him/her, but there was nothing. Barbara asked for oxygen, and told me she was going to use it. I said okay. But when I saw her put the mask on my baby’s face, I thought it was over and that the baby was going to die. I almost lost it, I was never so scared in any of my other births. 10 puffs of oxygen in 15 seconds, and finally baby started breathing. The relief I felt was incredible, overwhelming. I found out later that there was also had a nuchal cord, and it was very tight. The cord was white and limp by the time the baby was born.

I stayed there for a few minutes, and then I needed to get up. I wasn’t very comfortable, and I needed to be able to get a good look at my baby. I wasn’t bleeding more than normal, which was a good thing. I asked Barbara if I tore, and she just said she didn’t know. I didn’t think I did, but with a shoulder dystocia like that, I would not have been surprised.

I got onto the couch, and after a little while, I started feeling lots of cramps. Some were horrendous. I knew the placenta had to come out, and I tried pushing a few times, but it hadn’t completely separated yet. I also knew from previous experience that it was starting to separate, and that the pain would stop once it was out. I was really uncomfortable, and I had to hand the baby to Darren a few times to hold, because the pressure was just too much on my stomach.

Finally, I felt something give, and I was able to push/pull the placenta out. (Looking at my chart later, the placenta was delivered at 11:38pm) Barb brought a bowl over, and I put it in. There was a HUGE clot, almost the size of a liver. And this was one big placenta. We weighed it later, it was 2 pounds. It was really cool to completely deliver my placenta by myself. Kyra looked a bit bruised to me, so I asked Barbara about giving her a vitamin K shot, which I didn’t do with any of my other homeborn babies. I really felt it was appropriate this time. Barbara asked if I wanted to give it to her, but no…..I was the client this time, not the apprentice.

I don’t remember how long we waited, but I decided it was time to find out what kind of baby we had. I looked under the towel, and saw we had another girl! (In looking at my chart later, it was 16 minutes) Darren was right, he said it would be a girl. She had a ton of hair too, which is blonde. She started nursing after a short time, and didn’t need much instruction. We sat in the family room, next to the pool for a while, then we went to our bedroom. We weighed her, and I was shocked when she tipped the scale at 10lb 7oz. I never thought she would be THAT big. I did her newborn exam, including measuring her head, which was a good 15”. Also another surprise to me, so I had to take a picture of the measuring tape around her head. Her chest was 16”, and according to my back-up midwife, this would classify her as macrosomic. Eh, I don’t care much, because she is here and healthy.

I went to the bathroom, and was 99% sure that I had not torn. By the second time I went to the bathroom, I was 100% sure. Not even a skid mark. No more bleeding than is normal. I used a frozen pad, just because I had them. There was some normal swelling, and the cold pad really did feel good, even without any tearing.

So, this birth was not quite as romantic as Landen’s. Barbara apologized for having to step in and catch my baby. But I have no regrets, no unfulfilled wishes, no feelings of disappointment AT ALL. I have told her not to apologize anymore. Yes, we wanted to catch our baby, and have everything go smoothly and beautifully, without a hitch at all. But what we wanted much more than that was a live baby, and a live mother. And we got those. Barbara did EXACTLY what I had her there for. She was here as our lifeguard. Would Darren and I have gotten Kyra out eventually? Possibly, probably. But I feel much better knowing that I followed MY instinct, my “feeling”, my “knowing” while I was pregnant. I feel that I protected myself and my baby exactly the way I needed to. I am grateful that Barbara was there, that I could trust her to only do what was necessary, what I asked her to do. If you read Landen’s story, you will know that I did ask for her help in his birth, but she knew I didn’t need her to take over, and she didn’t even touch me. For Kyra’s birth, I needed her to take a more active role, and she did just that. Once we were both stable, maybe 5 minutes, Barbara again stepped back and just observed. Exactly what I needed. I do feel that Kyra’s birth went perfectly, and exactly as it was meant to.

One last tidbit, and then you can read the post script if you choose…..One of my back-up midwives practiced for a while in Guatemala, where they did not wear gloves to attend births. At a pre-natal appointment, she asked me if I ever caught a baby without gloves. No, I never have, I have actually only caught one baby. Barbara mentioned that in all these years, she has caught one baby without gloves. She had to pull down a woman’s pants because the baby was actually already born, but mom’s pants were still on, and there was no time for gloves. Well, Barbara had been taking pictures of me laboring, and when it came time to help get Kyra out, she had no time to put on gloves. Neither one of us realized it until days later.

****As a sort of postscript, there is another part of all this that I need to include. It may sound odd to some, but most will get it and understand what I am saying. There are times, lately related to the births I have been going to, when I “know” things. It is hard to explain….I don’t see visions, really, but I have a sense of knowing, and sometimes there is a bit of “seeing”. I can sometimes envision a scene, but it isn’t specific or clear, more like a feeling.

We had a birth in December, in which I was going to catch the baby. It was going to be my first catch. Neither mom nor dad had any desire to be the one to catch. Barbara asked me often if I was excited, nervous. I said I was excited, but that the birth wasn’t about me, or my first catch, it was about the mom and her baby. I really felt that something was going to happen at the birth and that someone else would catch the baby, and I assumed it would be Barbara. I also mentioned a few times that I couldn’t see this mom giving birth. Usually I can imagine what it would be like. But this time, I just couldn’t visualize a picture in my head. As it turned out, I didn’t catch this baby because we missed the birth completely. I believe that is why I couldn’t “see” this mom giving birth, because I wasn’t meant to be there.

Our next birth was in February. This mom always had her babies very, very fast. Barbara often felt that we wouldn’t make it to her birth, but I felt very confident that we would be there. I often “saw” myself on the floor, next to the mom on her left side, and she was laying on the floor. There had been no discussion about me catching, I think the plan was for mom and/or dad to catch, although I can’t remember specific conversations. As this birth turned out, I got there before Barbara, and mom had the baby only minutes after I walked in the door. It was my first catch, as mom wasn’t in a position to catch herself. And after baby was born, and things started to settle down a bit, there I was, sitting next to mom, on the floor, on her left side.

So, I give this background to explain this part. Way back in the beginning of my pregnancy, I had a feeling, a knowing, that “something” was going to happen. I felt it was important that Barbara be there. I didn’t know what was going to happen, but I was scared of whatever it was. I tried very hard during my pregnancy to be positive, to not give into fear, to visualize a perfect, peaceful birth, much like #8 had been. Darren was going to catch our baby, and everything would go smoothly. But always, there was this feeling. During my pregnancy, my iron levels were very low, and I almost missed out on a homebirth, and I though “Is this the “thing”?” So, when my labor started and stopped and baby was still posterior, I thought “Is this the “thing”?” Then, when I felt the cervical lip, a thought went through my head that it was the cord, and I though “Is this the “thing”?” And when she was stuck, and I had to get out of the tub, I thought “Oh, this MUST be the “thing”!” But then I saw her on my stomach, not breathing, not responding, and Barbara breathing for her with oxygen, I thought “Oh please, DON’T LET THIS BE THE “THING”!!!” And thank goodness, it wasn’t.

When I was pregnant with Landen, I really wanted a UC. I had Barbara there because I trusted that she would respect my wishes and sit on the other side of the room until/unless we needed her. And she did exactly that. This time, I just knew that Barbara HAD to be there. I am very glad that she was.

I do wish every woman could have the same kind of gentle, respectful birth attendant. Some women want much more hands on, some need and want more guidance, and some want something completely different. I am forever grateful that I have Barbara as my mentor, my midwife and my friend. I am learning how to be the kind of midwife I feel is every woman’s right.

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