May 15, 2012

Birth Story: Home Birth With A Transfer To The Hospital


Estimated Due Date- Thursday September 1st, 2011:
Came and went. (Happily, I must say, as I wasn't really looking forward to my baby having the birth day of 9-1-11)

Friday night:
Started to feel some slight contractions but nothing painful or consistent.

Saturday:
Called the midwife, Linda, who of course had decided to take a vacation the week that I was due to give birth. Thankfully she decided to stay on the East Coast but was still almost 4 hours away. I was having contractions that were stronger but totally inconsistent. Looked something like this: 3 mins, 15 mins, 8 mins, 10 mins 5 mins, 3 mins, 20 mins, etc....So Linda said to just keep track and if they start to even out a bit give her another call. It went on like this all day...evening came and I called to tell her nothing had changed except that they were getting a little bit stronger. She couldn't decide if she should start driving back yet or not and I told her it was her call. So she decided to head home (which was 3 hours from her and then another hour or so to me once the time came). I didn't really sleep much that night.....looking back on it now I wish I had tried harder to because I really needed the rest for what was coming.

Sunday:
Morning- called Linda...things were speeding up and getting stronger but still all over the place...not consistent at all. She decided to head over....I was relieved to have her there to see how far along I really was. I mean this was my first birth so I had no idea what to expect or to know where I was at in the process! Once she arrived and checked me the news was a total let down....I was maybe 1 cm dilated. OMG. Ok, re-group. Pull it together.

Linda decided that since I was so far off yet she would head back home and I was to call her when things started moving a little more. She left and then about 20 mins later she called to tell me she had spoken to a colleague of hers about what could be going on with my wacked out contractions. They both thought it would be best if I head in to a hospital to get a scan to make sure the baby hadn't moved back into breech and that the placenta was still in it's place and intact (from the external version I'd had a week prior). Also I guess my BP was kind of high but she hadn't mentioned that to me when she checked it before she left.

Serious stress kicked in..... I DID NOT want to go anywhere near a hospital....

In any case, Tony and I loaded into the car and headed straight out.
We got there and thank goodness it was empty! I was their first patient of the day. So I filled out a little paper work and they put me straight in a room. Now I'd only been there like 20 mins and I'd already heard 3 times..."Oh wow! You are over due! Good thing you are here!" Sheesh I'm only 3 days passed my "due date"...
So they strapped me up to all the contraptions they use to monitor me and and baby. Got out the sonogram machine and said everything looked fine. Baby was still head down and placenta was fine. Great! Get me outta here!! But then came the "well we can't let you leave just yet because we need to monitor you both for 30min-1hour to make sure everything is stable." We got through that and I started getting myself all unhooked and dressed. Just as we were getting ready to walk out of the room the doctor came in and said "Wait!! We need to check you to see how dilated you are." I asked her why they needed to do that as I had already been checked by my midwife a couple of hours ago and she said "Well, in case we need to induce you." What??? I don't think so....I'm outta here!! lol
We checked out and started heading home.

On the car ride home it started....the contractions were coming like every 3-4 mins CONSISTENTLY and the pain had increased quite a bit. I mean increased so much that I had to jam my feet into the floorboard and grip onto the door handle each and every time. I called Linda and told her things were changing. So she started her way back over to our apartment again. By the time we got home Linda was calling to tell me that she was stuck in traffic and was afraid she might not make it in time with how fast the contractions were coming now. So she called a couple of back up midwives both who said they would come right away so someone would be there. Turns out Linda still got there first and then the other two came shortly after. Now mind you, we are in a little one bedroom apartment (approx 470 sq ft) with me, Tony, 3 midwives and a birthing pool blown up in our living room. Needless to say we were "cozy".

When Linda walked in I was sitting on the edge of a chair leaning back as that was the only position I could handle the contractions in. She thought that was strange and insisted that I move to a leaning forward position so as not to slow anything down. That was much more painful and uncomfortable but thought I'd give it a shot for a while. Linda checked me and if I remember correctly I think I was only around a 3cm dilation. Boo.

 
This is the point at which Tony started to fill up the birthing tub. I was looking forward to getting in it as I was hoping it would give me some relief. It took a while but then was called out to give it a try.....hmmmm not what I expected. I think there should have been a lot more water in there but was just trying to get through my contractions that were coming hard almost every 2 mins so I didn't say anything. I'm guessing it was around 4-5pm about this time.

From here on it all starts to blur together a little bit which is why, now that I'm finally writing this, I wish I had done this sooner because I'm a detail kind of person. So I'll just do the best I can and if things are a little bit out of order I guess you won't know the difference.
So far my water still hadn't broken and I hadn't seen the mucus plug pop out anywhere along the way. I knew labor was going to be painful and it was. However, you never can really understand what it's going to feel like until you are in the heat of it. I remember being told a few times at our birthing class that your body knows what it's doing and when it's time you will feel the urge to push. When the baby and your body are ready and you've transitioned into the next stage of labor...it will be time to push the baby out and you will know because your body will tell you to push. But of course, this wasn't so for me....I was feeling the strongest urge to push already and my cervix wasn't anywhere near being ready to let that baby come through. I struggled with this for a little while when I finally mentioned it to Linda in between contractions. I told her it was becoming almost impossible for me not to start pushing. In no uncertain terms she was very stern and clear that I was NOT TO PUSH under ANY circumstances. What? Wait....what? This pain was so strong and mind blowing itself but then on top of it to have to fight my body's urge to push every 2 mins was something I just couldn't wrap my brain around. Then a contraction...pain...more pain...worse pain...and all through that having to be so present in my mind to tell my body "DON'T PUSH.....DON'T PUSH.....DON'T PUSH". Whew. Ok, rest for 2 mins. Then here we go again. Looking back on this now, I can't believe how strong I was physically and mentally to be able to do this for something like 16-18 hours. Needless to say there were a handful of times that I just couldn't help it and I HAD to push so I did. I would find out later that the reason this was happening was because the baby was Posterior (face up towards my belly button instead of face back towards my spine).



I vaguely remember what was going on around me over the hours that passed while I was in the midst of repeating the above experience over and over again.... Tony ran outside to get something to eat. I was in the bedroom by myself. I could hear the midwives in the living room chatting and laughing and having a grand old time. (and thinking to myself...one of you should get your ass in here now and help me!!!) Then Tony came back and the midwives all went out to eat together. In the back of my mind I remember hearing the soothing sounds of Call of Duty war games in my living room. (I'm sure that was a figment of my imagination...Tony wouldn't have been playing that while I was in labor in the next room....wink wink).



Note: I have to give Tony much credit- when it came to applying the counter pressure to my lower back throughout the entire Labor (and I mean entire labor...because of the back labor pains from the posterior baby I needed him to put as much pressure as he could onto my lower back with each and every contraction) he was on top of it. I think I only had to elbow him or yell at him 2 or 3 times that he wasn't right there. I know his arms were burning and he was exhausted as well. He was so good.  I mean look at him here with the cold wash cloth on the back of my neck trying to help me feel a little bit of comfort. I love him for all his efforts! I know his stress level was extremely high feeling so helpless and just having to watch me go through so much. Playing the game for a few mins was a good way for him to try and de-stress and I'm totally ok with that!!




At some point, as I wasn't progressing much and was in so much pain and so exhausted (I think I was running off of something like 4 hours of sleep in the last 40 hours or so), Linda suggested I take some Ambien to get some rest. I wasn't so sure that was a good idea but she assured me that it was ok....so Tony ran out to get a prescription filled. While he was gone I remember being in the shower sitting on my yoga ball with the hot water pounding on my back...ahhhhhhhhhh now I felt like I was in heaven!!! That was by far the best I had felt the entire time. It was like every time a contraction came while I was in there the hot water spraying on me just sucked the pain right out of my lower back. I did not want to get out! It was so hot and steamy and I 'm sure I was in there for at least an hour if not more. The Doula in training kept bringing me water....oh wait, yes I forgot to mention that part. Let me go back:


The 3 midwives all agreed that I needed a Doula to come help me through this labor. One of them started calling some she new and giving them my cell number so they could call me to talk about prices/etc.... I spoke with and texted a couple before I came to my senses and put the phone away. This was not something I need to be focusing on right now not to mention we couldn't afford the $500-800 fee they would charge. Then one of the midwives remembered a student of hers who was a Doula in training and called her to come over for free. Poor girl....she didn't know what she was walking into and really wasn't far enough in her training to be of any use to me. She did take all of the photos you'll see on here that I didn't even know she had taken until later that week. She was also bringing me water all the time (probably too much because I hadn't peed in hours and wouldn't until much later on with some "help"). You might ask, at this point, why I would need a Doula when I had 3 midwives there with me. I can not even answer that question for myself so I'll leave that for another time.

Once Tony returned with the Ambien I took it. (maybe more on that in another post....I'm not sure I'd make that same choice again now that I've been able to do some research on the dangers of using it during labor. I know for a fact I was not as present as I needed or would have liked to have been). I was trying to find a position comfortable enough to try and get a little rest. I had wanted to be out on the couch as I knew I could prop myself up just the way I wanted and still have the chance of sleeping. But for some reason (maybe because they were all so comfortable on the couch) the midwives didn't want me out there and thought I should stay in the bed. Tony lay down next to me and was knocked out and snoring in a few seconds. I did my best to get some sleep and I know I probably got an hour or two broken up in between all of the contractions. I remember Linda telling me afterwards she had no idea how Tony slept through all of that without waking to a broken arm. I do remember squeezing the shit out of his arm every time I woke to a contraction. At some point I was 9.5 cm dilated but there was just a little lip of cervix left that she was trying to massage back so we could get the ball rolling. Holy Shit that cervix "massage" was painful...to add to the pain I already felt. But it wouldn't budge.

Then around 6am or so my water finally broke. That felt like a sign pointing me towards the light at the end of the tunnel. Linda was sure that this, in addition to the 9.5 dilation, was a good sign that in no time we would have our baby in our arms. Unfortunately, that was not the case....


After a few more hours of  struggling not to push Linda thought that maybe I should go ahead and give it a try to help relieve some of the pressure as it was unbearable for me to fight it any longer. Shortly after that she checked me again and I had regressed....I was only 5cms dilated now. All of those times I pushed when I wasn't supposed to had caused my cervix to swell. For those of you who have labored a baby you can imagine how hearing this felt. From a 9.5 to a 5. I don't know how I didn't just fall into a heap of tears on the floor. But my job was not yet finished so I had to tighten my boot straps and keep on moving.....




Around 10 or 11am on Monday morning (ironically Labor Day) the baby's heart rate was starting to get a little decelerated. This was the point at which I remember Linda looking at Tony and asking him how far the nearest hospital was. Again....no heap of tears but I remember thinking there was no way I was going to be able to walk out my front door to the elevator, ride it down and then walk up the street to the car. I mean it was going to be impossible. They were going to just have to carry me out. I was just standing there looking like a deer in headlights while Tony was frantically running around the apt looking for clothes for me to put on and a pair of flip flops that I could get onto my fat swollen feet. I hadn't packed a hospital bag because after all I wasn't going to the hospital! They got me dressed, hooked up to an oxygen tank and opened the front door.

That's when the fear crept in, I froze and then I swiftly kicked it out!

Somehow I made it to the car and the ride was probably just as you can imagine it was through the pot hole filled streets of New York....not very enjoyable.

It was probably only a 10 minute ride and then we arrived at the front doors of the ER.

My posse (Tony, 3 Midwives and a Doula) all walked into the ER. They got me into a wheel chair and the interrogation began...Name? Rank? Address? Insurance? How long have you been in labor? What's going on? Due Date? And it went on and on....After the first couple of questions I completely shut down. I was looking back and forth from my squad to the captors that were now questioning me and decided I was no longer going to answer any more questions. If they needed info one of my soldiers could give it to them.

Once one of the nurses yelled at me "WHY DID YOU WAIT SO LONG TO COME IN????" with pure contempt in her face and voice, I felt myself drop deep down within myself so as not to completely loose it. I remember Linda kept telling them they needed to check the baby's heart rate, check the baby, check the baby...CHECK THE BABY! And all they could do was ask more questions and then finally got me in on a table, striped my pants off, spread my legs, someone stuck their hand in to check me then everyone looked at me and someone said "Well, you're not crowning yet." NO SHIT! REALLY? Then they put me on a bed and started to wheel me off to Labor and Delivery. I was then stopped mid-way and put in a room the size of a closet where a couple of nurses slowly started flipping through some paperwork and chatting with one another. Linda pushed past them and got the oxygen mask on me and grabbed a Doppler off the wall so she could hear the baby's heart rate herself since no one wanted to listen to her. After all, she was encroaching on their turf now...and I wonder if they were less responsive to me because she was there trying to tell them what was going on. It was then that they decided that they weren't going to let her continue on and asked her to leave that room and they would "take care of it".

Finally I got into my own room and damn these contractions were crazy making.
They did let Linda come into the room with Tony and I. The other midwives and Doula had all left I'm sure around the time I was wheeled off into the cold, sterile, florescent blinding abyss.
The Doctor on staff seemed pretty nice and was now fully updated on the fact that I had been attempting a home birth, was approx 21 hours into it and that I had lots of requests and opinions on how I wanted things to go from this point on. There were 2 or 3 midwives on staff that day as well so the doc turned me and my care over to them for the most part. I have to say that I was happy to have my primary care givers, at this point, coming from somewhere in the vicinity of the same mindset as myself. I gave them my list of requests and they didn't even blink at them: skin-to-skin immediately, breastfeeding only, delayed cord clamping, delay of weighing/measuring/eye ointment/vitamin K shot all until at least 1 hour after we've had the chance for our time together with skin-to-skin and breastfeeding. And lastly, no wiping the vernix off or washing the baby.

Intervention #1:
The doc on staff told me I should have an epidural because we needed to do everything we could if I wanted to avoid a c-section. After discussing it with Linda and Tony we decided that if I was going to try and get any rest and still have a chance at delivering my baby vaginally I would need to go ahead and do it. I really didn't think I could take much more and if the swelling of my cervix didn't go down I was afraid that c-section they were already threatening would be my doom. (sorry to make it sound so horrible but it's just the way I felt)
So it took an hour or so I think for the guy to come in and give it to me. Still having contractions every 2 mins that were so crazy painful and this guy was telling me not to move at all or I'd end up with a serious headache or worse. Then I had a contraction while he was preparing things and he looked at me and said "I told you you can't move when I'm doing this!" I told him that I heard him the first time and that he would have to just get it ready and wait for me to have a contraction in 2 minutes then he could start right afterwards and we shouldn't have any problems. He followed my direction and we were fine. Then he told me that the next time I get a tattoo I should make sure that it's not on my back near the other one I have because he only had a very small window in which to place the needle and the next time I needed to have an epidural I didn't want to have another tattoo in the way. Wow, ok thanks for the suggestion.

I thought that an epidural was supposed to make you not feel anything from the waist down. Well, I guess it affects everyone differently. It definitely took the edge off and I think I was able to smile and fully breath for the first time since this all started but I still felt that severe pressure like I needed to take a serious poo. It only lasted a couple of hours before it felt like it was wearing off. I was already starting to have to grip the rails on the bed again with each contraction.

Intervention #2 (I have to admit this was a pretty cool one for me):
The midwives thought that since my water had broken around 7 or 8 hours earlier that day the pressure of the baby's head on my cervix wasn't allowing the swelling to go down as quickly as we wanted. So they told me that they wanted to do an Amnioinfusion. This is where they insert a catheter into your uterus and infuse it with saline solution. This helped to lift the baby up off my cervix just enough so the swelling was able to come down. I wasn't so sure about it so, of course, they mentioned that we wanted to do everything we could to avoid the c-section that I said I didn't want to end up having. I consulted with Linda and went ahead with this procedure. They also inserted a catheter so that my bladder could empty....it hadn't emptied since before I started labor I think because the baby's head in the posterior position was blocking it from doing so.

This is the point at which Linda decided to leave. She was tired and couldn't really do much for me anymore (except be there for support....but who needs that anyway...). Tony also left to get something to eat. I told him I'd call him if anything started to progress so he could rush back. His mom stopped by for a few mins to keep me company but then had to head home.

Intervention #3:
So there I was alone in a hospital, the last place in the world I wanted to be, with all kinds of tubes coming in and out of me, still feeling contractions and fighting that urge to push. I had an oxygen mask on my face that I kept trying to remove and a nurse would come back over and make me put it back on. I had those annoying monitors strapped to my belly- one for my contractions and one for the baby's heart rate. A nurse would position me in a way that she could hear the best heart beat and told me not to move.
This was the perfect time for them to make their next move....I noticed a nurse hooking a new bag of something up to my IV line. I asked her what it was and she told me "it's medicine your doctor said you needed". I asked her what, specifically, it was and again with a vague answer "something to help move things along a little". I asked her if it was Pitocin. She gave me a strange look and said yes it was. I asked her why they wanted to use it and how much of it were they planning to give me. She again gave me a strange look and asked if I wanted to talk to the doctor about it. Of course, I said yes. Look, I may or may not agree to what they were trying to do but I felt that I should be fully informed before they just started pumping stuff into my IV. The Doc came in and gave me what seemed to be their standard line, they obviously figured out what my "hot button" was, that it was the next step we needed to take to help keep me from having a c-section. I think I either called or text messaged Linda for her recommendation and, not surprisingly, she said it was the best option. I'm so exhausted that I went with it. I called Tony to tell him to hurry back because I had no idea what was going to happen or how fast it would come after that.

Shift change was at 7pm. New nurses started coming in already which sucked because they weren't all that nice. However, the midwives told me that they decided they were going to stay, off the clock, to help me through the rest of my labor. It was probably about 6:50pm or so and I couldn't take much more...I just had to start pushing. Finally the doc came in to check me and with a big smile said "Ok! You're at a 10!" I almost couldn't believe it. At 7pm I started pushing. Waiting for the contraction to start and get to it's peak then push with all I had. I remember just holding my breath, bearing down and pushing till I didn't think I could push any more and then I'd find a little extra something inside me and push a bit more. There was no moaning, groaning or screaming. Just intense concentration and pushing. Tony was right by my side the entire time holding my hand and one leg helping me as much as he could. I could still feel everything that was going on inside me which I think is why I was able to push so hard every time. After a little while of this they told me to reach down and feel my baby's head. I did and it was so warm and soft and mushy it kind of freaked me out. I wanted to get back to business so I could have that baby in my arms. At 7:43 pm I pushed my last time and out came this tiny little human that was brought straight up to my chest. I wrapped it in my arms and was so in the moment and feeling such bliss until I heard a bunch of strangers yelling (well it felt like yelling to me...Tony said it was only the doctor asking excitedly what it was) at me to check if it was a boy or a girl. It was the moment that I wished more than anything I had still been at home. Here I was having this most precious and amazing experience and it felt like it was being interrupted by people that shouldn't really be there. We had waited 9 months already so what was 5 more minutes to allow me to just be in this moment? So, I lifted a leg and announced to the room that it was a girl! Wow...a girl! Just what Tony was praying for and I couldn't have been any happier. We were just looking at her and each other with pure love.

I checked the cord and it was no longer pulsing or filled with blood so Tony cut the cord.

I held her on my bare chest with a blanket over her trying to nurse her but mostly just feeling each others warmth, smelling each others smell and staring into each others eyes. It was magical. I probably held her for an hour or so while I was delivering the placenta. Once that was done it was time to stitch me up. I guess I tore pretty badly. Looking back I wish I had known that it's better to take your time and push slowly as you'll be less likely to tear so bad. That's what I read about it anyway. I handed her over to Tony and he held her for an hour or so himself before they insisted upon taking her to get weighed and measured. Then they took her off to the nursery.

Kayla Lynn      9-5-2011        8 lbs 3 oz         21 inches


I couldn't get out of that room and to my baby girl fast enough. Again, wishing I was at home so I would never have had to let her out of my sight or out of my arms! Tony went with her but, of course, they told him he wasn't allowed to stay with her in the nursery while they gave her the vitamin K shots but that they would bring her to us once we were moved out of Labor and Delivery.

As we all know, in life things don't always go as planned. I remember reading through the blogs and forums online while I was pregnant to be prepared for all outcomes including delivering in a hospital if you are planning a home birth. I would also suggest the same thing to anyone else planning a home birth. Also pack a spare hospital bag just in case. It sucked being at the hospital with nothing of my own that first day (the ER people lost my shoes on top of it all). I also wasn't prepared to be stuck in a hospital for 2 days afterwards either. I have to say I felt like I was being held hostage. I wasn't able to get any rest because either Kayla or I were constantly being poked and prodded at all day and night. Tony wasn't allowed to spend the night either which I wasn't prepared for. Needless to say the entire experience was so far away from how I pictured and planned it all out in my mind. I would do it all again though and without a doubt the next baby will also be a home birth. But this time I will be more prepared mentally for any alternate outcomes. I know that if I had started out in the hospital and not labored at home as long as I did I would have been c-sectioned way earlier on in the process.

I could go on about the rest of my hospital experience from this point on but I'll save that for another day.

In the end, I have my beautiful baby girl and couldn't be any happier!
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