Archive for December 2010

A birth that shattered all my expectations

December 2, 2010

In answer to my own question in my last blog post, I think it’s safe to say I was insane with wondering by the time I finally got to hold my new baby in my arms. Everything about this one surprised me…

Before I go into the story of this birth, I will mention that I’ve always desired to have an all-natural labour and delivery. I pretty much had that with my second (the only thing outside myself I had with that one, was the gas in the last hour of my labour). But with my first and my third, I had my labour induced.

Not that I didn’t fight it to the bitter end, both times. I was 11 days overdue with my first when the doctor called my husband’s cell phone, and was appalled to learn that we were at the cottage, out on the boat, avoiding him and his demands to induce. We did end up driving the two hours back to the city that evening (after my husband pointed out that the doctor, not he or I, was the professional, and that maybe he knew something we didn’t about possible health complications with overdue babies). I had the prostaglandin gel application in the hospital that night, went home, woke an hour later in labour. I did the rest on my own – with my husband’s wonderful support of massaging my back, and whispering in my ear to remind me of my “happy place” (where we had been to avoid the doctor the day before) to get me through contractions. Our daughter was born after no more than nine hours of labour, and 15 minutes of pushing.

With our second child, I got to experience what it was like to go into labour naturally. The timing couldn’t have been better – three days before my due date, and my parents were already there at our house visiting (we had been ‘sitting their cat while they were away on a trip, so they came from their home three hours away to pick up their pet, and were planning on coming back sometime the next week to look after our daughter once I was in labour). That time, our son was born 12 hours after I felt the first twinges of labour; only six hours or less of active labour, and again, about 15 minutes of pushing.

Not only have I now had three different birth experiences, I have also had three very different medical experiences. You see, all three of my children have been born in different cities/towns (first in Oakville, Ontario; second in Sudbury; third in Thompson, Manitoba). I was with a family doctor for my first, a midwife for the next two. A midwife suited me best, I felt, since I’ve never had any complications during pregnancy or labour, and this time around, I was even hoping for a home birth.

But that was not to be. Being in a smaller community means smaller resources. A home birth requires two midwives present; there is only one here (imagine her workload, in a community with one of the highest birth rates in the country!). It also means more stringent hospital policies – whether to avoid hefty medivac costs, or law suits, I can’t be sure, but probably a bit of both.

So Halloween, as I mentioned in my last post, was my due date. It came and went. That week, I had two more midwife appointments, and she tried to “stir the pot” but that had no effect. In the meantime, I was trying pretty much every natural induction method I knew of. But my body didn’t want to go into labour, and I think I was experiencing a combination of sinking hope that it ever would do so on its own, and a disappointment that it was now November and I still didn’t have my baby.

After my second midwife appointment that week, I got home and listened to a phone message she’d left me: “Carrie, I’ve spoken with the doctor, she’s going to induce you tomorrow.”

Woah, woah WOAH!!! I was furious. That was exactly what happened with my first baby – I was TOLD I was to be induced, not asked. And, with nothing but stats to say there was any good reason for it (and the fact that I was only five days overdue this time, the normal induction date being 10 or 11 days overdue), I had no intention of being ordered up for induction.

Still, I was anxious for this pregnancy to be over, and I felt deep down that the baby should have come by then. So I agreed to meet my midwife and the doctor at the hospital the next morning for a non-stress test and consultation.

My husband was giddy. Finally, he had an excuse to be with me, not at work, and he was hoping we would be meeting our baby later that day. I was still upset about how it was all happening – not the natural way, like I wanted.

The consultation was even more upsetting. The doctor – who, I should mention, I did like right away – explained that down south, closer to a major centre and bigger hospital, women are “allowed” to go into their 42nd week of pregnancy; but that up here, hospital policy is more cautious, and states that 41 weeks is long enough.

So I asked what method of induction she was proposing. When she told me she’d break my water and put me on the drip, I was horrified. That was about the worst thing I could imagine! I had heard only bad things about the pitocin drip – how it makes labour so much more intense; how it more often than not leads to an epidural – my other worst nightmare, a needle in my back and drugs to make me unable to feel my own body doing its most amazing work, ugh! – and perhaps even c-section, again, another thing I was terrified of, having to be cut open, when I already have an opening that I know from experience is perfectly capable of delivering a baby.

So I asked about the prostaglandin gel (this is one case where I thought, the devil I knew was at least better than any alternative; I felt that since it had worked with my first pregnancy, it would most likely work again). The doctor said yes, they could do that, but then I wouldn’t be able to leave the hospital, because they’d have to monitor me.

That was actually a load of crap, I realize now; they couldn’t have made me stay, I could have signed their form to leave “against medical advice” and gone home to hopefully labour in comfort. Because again, ANOTHER worst case scenario for me, was the mere thought of having to be at the hospital the entire time.

So I asked the doc and midwife to leave the room so I could discuss these very limited options with my husband. He was biting his tongue, allowing me to run this show (smart man!), and so we emerged from the labour room with our coats on. I asked for the form to sign (to leave, as mentioned, against their advice), and we were prepared to go home. I told them that yes, I would come back again the next day, I just needed to give myself one more day to either go into labour naturally, or at least to get my head around all this new information (and all the doors closing in my face!). The doc offered to give me one more internal exam, to try, again, to stir the pot or to see if my cervix had changed states since the day before. I agreed, and that’s what changed everything….

The doctor broke my water. Apparently by accident. Lucky for me, I did like her – otherwise, I’m sure I’d be carrying around this grudge against her, always and forever wondering just how accidental it was. As soon as that happened, I sobbed. Oh my god I sobbed, like a child whose puppy has just been run over. I cried so hard I think that everyone really did feel bad for me (even though it was Friday, and I’m absolutely sure they were hoping to get this woman’s baby out, and have the weekend off).

I heard my midwife say, “Now you’re committed,” and I heard the doctor say, “I’m sorry.”

Upset as I was, I am also an adult, and not so caught up in my own daydreams and fantasies that I couldn’t face the truth and what would have to come next. I wiped my tears (mostly all over my husband’s neck), and looked the doctor in the eyes as she told me I could go home. Horray! So the benefit of the “accident” was that I would not be restricted to the hospital for the entire day (and it was a beautiful sunny one, I needed to be outside!).

Somewhere during the late morning we picked our kids up from school, fed them lunch then got them off to our dear friend’s house, who kept them all the rest of that day and all night, so we could focus on welcoming our third child into the world.

We went for a walk out our backyard, through the forest to the trail leading to the river. I had imagined, during my entire pregnancy, doing that walk while in labour, over a light dusting of snow in late October. Instead, it was early November, and I wasn’t in labour. I waddled with one of those over-sized hospital pads between my legs, uncomfortable – not physically, but mentally and emotionally – with the fact that my amniotic fluid was draining out of me and I could barely feel the baby, who had been extremely active for the last six months, moving.

The walk did calm me down though, and I drank in as much of the fresh air as I could, savouring it to last me for what would come next. The good and bad thing about having done labour before, was that I knew what to expect… I knew it was going to be hard work. I had, the last two times, done it with only minimal pain relief (the gas), and in a relatively short period of time. I was desperate to make it through once again.

My midwife had asked that we be back at the hospital by 2 p.m. Again, I was victim to hospital policy and the limited resources up here (normally, after the water has broken, you have 12-24 hours before you need to be back at the hospital, for risk of infection). I had hoped to be in labour by then, but alas, I still had no contractions.

We did get back to the hospital around 2:30 pm. Still I stalled, trying to avoid having to be put on the IV and drip. I had an enema (loved it, and not too proud to admit! Why NOT get all that waste flushed out before pushing?!?), and asked lots of questions. But finally, I couldn’t avoid it any longer.

It took four tries, between the midwife and a nurse, before they got the needle threaded into my vein (I was so worked up that each jab felt like a knife slicing through the top of my hand).

Once it was in and I was hooked up to the monitors, I calmed down a bit more. My husband and I chatted with the midwife, her assistant, and whatever nurse was around. We read our books for a while. And finally, I felt a contraction!

I think I was on the pitocin by about 4:30 or 5 p.m. The contractions were mild for a long time, and I began almost singing out “there’s another one!” every time I felt them (even though everyone else present could see them clearly on the monitor). I was finally getting excited that this was it, and no matter what happened in the next several hours, the end result would be the birth of my baby.

Unlike my other labours, I wasn’t able, with the IV hooked up, to take a shower (and I sweated my way through this one, so that seemed a little disgusting to me, but oh well). I wasn’t able to walk around (but didn’t really want to be walking the one hallway of obstetrics anyway). I was able to be up, changing positions as I felt the need. I asked for the birthing ball at one point, and leaned back into my husband’s hands as he massaged my back. Another time I was on my knees on the bed, leaning into my husband as he again massaged my back (I found out later the baby had been posterior right up until the end when it turned, so I was probably suffering a bit of back labour, although I wouldn’t have called it that at the time).

Suddenly, my midwife ordered me on my side. She had warned me, during our prenatal visits, that this might happen. Again, I learned only later, that the baby’s heartrate was dropping – it wasn’t in distress, but I needed to change my position to relieve whatever pressure (probably on the umbilical cord) was causing the drop in heartrate.

This happened many more times during the rest of my labour, and it was terribly uncomfortable since I was always ordered to change position during a contraction. At the same time, my midwife kept asking me if I had any pressure in my bum. I finally asked what the heck she meant by that, and she said that basically, if I had the urge to push, I should go for it. I was very confused by this, because I wasn’t yet at 10 centimetres dilated, and with my second child, I was told to hold off pushing until I was fully dilated (which is why I said yes to the gas, to help me ease up on following through with those urges before being fully opened).

I had it in my head that I wanted to make it ’till midnight. Meanwhile, the midwives and my husband were banking on me having the baby at 7:30 pm. I was annoyed by that bet, because I knew if I got my hopes up that it would come that quickly, I would have a hard time enduring the contractions if it went on much longer. So I kept my own time goal in my head, and ignored their wishes.

7:30 came and went, but I still wasn’t in excruciating pain. In fact, right up until the very end, I had at least a minute in between contractions, which was very helpful. The midwife tried twice during my labour to stop the drip, but both times my contractions became more than 5 minutes apart. My body really didn’t want to be in labour! Thankfully, the drugs did what they were supposed to do, no more, no less.

By 9 p.m. (or it might have been sooner, I’m not quite sure) I was fully dilated. I remember looking up at the clock and saying that our daughter had been born at 9:10 AM, and wouldn’t it be neat if this one could be born at the same time in the PM. Again, that time came and went, but by 9:15 I was pushing hard (but not hard enough) with each contraction, and struggling to catch my breath in between.

I think it was about 9:15 when the doctor was called in. The pediatrician showed up too, and my husband said it was suddenly like a symphony in that labour room. The baby’s heartrate had dropped again, and no chances were taken. I was given oxygen through a tube against my nose, and asked to be on my back this time. Then the vacuum came out. I never imagined I’d have to have a vacuum extraction, but there it was – the little donut-looking device my son had found in the midwife’s office during one of the prenatal visits, I never would have known what it was otherwise (not that I saw it during my labour, but hearing it was coming out was less frightening since I’d seen one before).

Our little boy was born at 9:39 p.m. Well, not so little, because, at 7 lbs. 15.5 oz, he was exactly a whole pound bigger than our daughter was at birth! Also, he was the longest of our babies – 22 1/4″! Our other two babies were each 19″.

He was placed on my chest, and I heard my husband giggle as he said, “It’s a boy!” I had thought, for most of the pregnancy, that this baby would be a girl. I wouldn’t trade this little bundle for the world, but I admit, I’m sad every time I look at all the girl clothes I’ve saved over the last six years!

He was taken to that little heated basinnette thing they have, in the room with me, to be looked over, and brought back to my arms wrapped in a receiving blanket. I kissed his head of dark hair, so similar to that of my other two. But this one looked like a little alien, and I loved every inch of him. The conehead he had from the vacuum disappeared within two hours, and his eyes bugged out a little less by then, too. He was, and is, perfectly healthy and dreamy.

So it all worked out in the end. I am humbled by how different this went compared to my expectations. By the fact that I did, in the end, listen to the medical advice I was given, even though I know I could have fought harder against it. But my placenta showed signs of being “old” and I know that being induced was the right thing to do. I had watched too many “unassisted home birth” stories on youtube, and had hoped to be home for this birth. But even as I watched those silly homemade videos, I knew that I wasn’t willing to take any chances with the life of child I had carried inside me for over nine months. After all, if anything terrible were to have happened, I knew that I never EVER could have forgiven myself.

So I trusted the professionals, and they did not, in the end, let me down. I am also humbled to be in a position to better understand the millions of other women whose labours and deliveries don’t go as planned. I was always so stuck on “all natural” that I must admit, I thought it was a cop out to have anything less. But at least it’s not a tragedy. My second son’s birth is just another story – one with a very happy ending.