Wednesday, March 9, 2011

Henry J.'s Birth Story






It seems that writing one's birth story is a little like looking at a piece of Pointillism art, something along the lines of Seurat's A Sunday on La Grande Jatte. The closer you stand (to the painting and the birth experience), the more raw, unfinished, discrete, and incoherent the separate pieces are. The farther back you stand from the painting (and the more time and emotional distance you put between yourself and the birth), the more it starts to blend into a cohesive whole.

By writing about the experience so soon, I worry that I haven't given myself the distance and space I need to smooth out the experience. With each passing day, however, I feel the discrete pieces blend more and more into a coherent whole. As my love for my son sinks its deep roots into the soil of my heart and sends its strong stem up toward the light, the rawness and difficulty and pain of birth start to blur into the background.

Matt and I chose a home birth with a midwife because of this idea:

"If we hope to create a non-violent world where respect and kindness replace fear and hatred. We must begin with how we treat each other at the beginning of life. For that is where our deepest patterns are set. From these roots grow fear and alienation~or love and trust."--Suzanne Arms


Although I had a clear vision of how I wanted the birth to unfold and did everything in my power to bring that vision to fruition, I also went into the experience with the understanding that we can only control the inputs--not the outputs--of our lives. In a letter to myself, I wrote:

If, at any point, the birth deviates from the plan, you will rest assured that you have done everything within your power. You will relax into the Universe’s intentions and embrace the expertise of your team.


At the very end of my pregnancy, my liver started to malfunction. It's a rare disease of pregnancy, called intrahepatic cholestasis, that usually clears up right after delivery. However, it does come with an increased risk of still-birth, so as the days started to accumulate past Henry's due date, the midwife had many conversations with the back-up physician. He started to push for a "timely delivery of the baby." My midwife, Matt, and I were encouraged by my lab work and didn't want to invite the risks associated with induction into the experience.

Still, it was a scary place to be. We wanted to make the very best decisions for the baby, but the path was never very clear. We didn't want a tragic outcome and then have to look back and think, "We should have made a different decision."

Natural induction was always an option (like Castor oil), but any type of induction is still a potentially risky intervention (not to mention the fact that I really didn't want to go into labor with severe gastrointestinal cramping and diarrhea). Once I hit my due date, the midwife recommended that I start taking Evening of Primrose to help prepare my cervix. As we approached the second week past my due date, she recommended that I start taking a homeopathic remedy that would help "nudge" labor along but wouldn't be as drastic as Castor oil. Both of these approaches were very mild, since we really wanted to let the baby come when he was ready.

When my labor started Saturday night with contractions (at 41 weeks and 4 days), Matt and I headed to Whole Foods to distract ourselves and finish some last-minute to-do items. After we checked everything off our "Birth Day" action plan, we headed to bed around 11:30pm to try and get as much rest as possible.

Around 1am, the contractions got to the point where I had to sit up in order to really relax into them. I concentrated on relaxing my shoulders, face, and the rest of my body while I coached myself with messages like, "This pain has a purpose. My baby is coming to me." and "Open, open, open." I reminded myself to work with my body, not against it and tried to breathe deeply into every contraction to make it count. I welcomed deep, powerful contractions to make the birth as efficient and effective as possible.

At that point, the contractions were about five minutes apart. I was counting down the hours until I could call our doula. I didn't want to call her too early because I wanted to section the labor into discrete parts (Matt and I alone, us with the doula, all of us with the midwife), in order to help the time pass more quickly. She was actually the back-up doula because my original doula was at an out-of-town event (during which she got the flu and had to go home anyway).

The doula came in the morning, but she said I was still very early in labor and that we should just focus on resting. Since my contractions were coming consistently every 5-6 minutes, resting was not much of an option. She got me set up on the couch with pillows everywhere, but I still wasn't very comfortable. Meanwhile, Matt came down with something that seemed like the flu and was in miserable shape himself. We spent all day Sunday alone, trying our best to ride the waves of my contractions and his sickness. Getting in the shower helped a lot, as well as sitting on the birthing ball and leaning onto a pillow on the bathroom counter.

Late that evening, I asked the midwife to come over and check how dilated I was. Right as she arrived, my water broke, which was very encouraging to me. However, I was still only 3cm dilated. The midwife went home to rest, but the doula came back over to provide more support. While Matt tried to cope with his sickness through sleep, the doula helped me work through different positions. For example, I walked around a lot, swayed through contractions, walked up and down stairs, and sat on the toilet.

At various points throughout the process, she would hook me up to the fetal monitor to make sure Henry was handling the labor okay. Once we started nipple stimulation as a way to speed up the frequency of the contractions, the doula got worried about not seeing enough accelerations in Henry's heart pattern. She called the midwife who came right over. The midwife wasn't as worried by the results of the fetal monitor, but she stayed to support the rest of the labor.

We continued the nipple stimulation and then tried an herbal stimulant. Although my contractions were intense and painful, they were only coming about 6-7 minutes apart and I was only 7cm dilated. I did get in the birthing tub a few times, but the contractions seemed to slow down even more.

Around noon on Monday--after 40 hours of labor at home--the midwife suggested that we go to the hospital for some Pitocin. She explained that she was worried that we would run into problems during the delivery if we couldn't get the contractions any closer. For example, we might deliver the head but then need to wait a long time to deliver the rest of the body, which could put the baby into distress.

Although I was completely dejected by the idea of going to the hospital, I had complete trust in my midwife. I knew she would not recommend such an intervention unless she really believed it was necessary. Still, I was in a really bad place as we drove to the hospital. I was scared of what would happen there. I was frustrated with every painful contraction that I had to endure in the car during the long drive to the hospital (plus Matt missed the exit), since they didn't really seem to be helpful to me.

At the hospital, we had to go through a long check-in procedure. While my doula pushed me around in a wheelchair, a woman said something to me. My doula said, "Oh, how nice. I think she said a prayer for you." I said, "That's funny. I thought she was telling me to close my legs because my underwear was showing."

When we finally got into the room, everything I feared started to come true. I was immediately hooked up to an IV, which I had to stay attached to for more than 12 hours, even though I was already fully hydrated and nourished from drinking and eating throughout my entire labor. I was also hooked up to a fetal monitor for constant monitoring, as well as a contraction monitor, which was very tight and uncomfortable around my uterus. Then I had to wear a blood pressure cuff that seemed to deploy and check my blood pressure every minute and a half. When I needed to use the restroom, we had to wheel the entire IV cart with me.

My midwife asked the nurse for a birthing ball, but there were none. My midwife then called her husband to bring us a birthing ball from their house.

At that point, I tried to rouse myself out of my despondency and remind myself that I needed to do this for our baby. The nurse pretty much left my midwife and doula in charge of helping me labor. There are pieces of this part of the story that I hope time and distance begin to whitewash away, like being asked by the nurse to lay on my back through a contraction so she could insert her fingers and try to push back the lip of my cervix. I just kept telling myself that I needed to do it for our baby.

Throughout the entire process of labor, time went by surprisingly quickly. Every time I looked at a clock, hours had gone by. The nights turned quickly into the days. I endured very painful contractions (in my butt, since giving birth to a baby essentially feels like you are pooping it out), for 3.5 hours with Pitocin at the hospital. Then my back-up physician came in for the delivery. I pushed with all my might because everyone kept staring at the fetal monitor, and I desperately did not want to have a c-section. I knew I had to hurry.

I'm still not entirely sure how I managed to push a 9-pound, 4-ounce baby out of my body, but he came to us safely and perfectly. In retrospect, my midwife thinks his position was just slightly off, so that each contraction wasn't quite pushing his head into the cervix in a way that would help it dilate the way it needed to. The back-up physician thinks Henry was completely backwards (i.e., face-up), but that explanation doesn't really make sense, since the baby was never face-up in any of my prenatal exams, and I also never had any back labor. My original doula thinks the fact that the cord was wrapped around his neck twice led my body to undergo a slower and more prolonged labor as a way to prevent the baby from going into distress.

The hospital had a "no separation" option that allowed us to keep our baby next to us the entire time. He was never taken away to the nursery. We opted out of the newborn bath and as many tests/procedures as possible. For all the mandatory things, the staff came to our room. We checked out as early as we could the next day and quickly made our way back to the comforts of our own home.

At the end of the day, I am so thankful for the birth experience we had. If we had gone to the hospital any earlier, I probably would have ended up with a c-section because of hospital protocol around how long you are allowed to labor without making "adequate progress." If we had gone in much later, I would have run the risk of being too exhausted to put in as much effort as the pushing process required or the baby could have gone into distress.

I feel so, so grateful and fortunate and immensely lucky that all the choices and decisions we made took us down a path that had a safe and healthy outcome for our son, while maintaining as peaceful and natural birth as possible.




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40 comments:

Mindy said...

What a wonderfully inspiring story! It's nice to hear a birth story that didn't go exactly as planned but worked out perfectly in the end. Congratulations to you and Matt.

Julie D. said...

Congrats on your new baby. I'm glad that he arrived safely and that you are healthy.

Carrie said...

I am so glad that you placed your trust in your midwife to help you with the difficult decision to go to the hospital, Sara. The most important part is that Henry is here, and he is healthy, and you are here, and you are healthy. I hope that you are weathering the sleep deprivation and breast feeding alright. EVERYONE gets frustrated sometimes at this time, so don't beat yourself up if it isn't always rosy and wonderful!

Therese T. said...

What a beautiful story. THanks for sharing it, Sara. We were so worried at school; we're glad you and Henry are ok :)

rachelshoots said...

Props to you for writing such a detailed birth story so soon after birth. I think you might make peace with some parts of the hospital birth if you learn more about it. (For example, they have to hook up an IV line to deliver the Pitocin.)

I'm glad everyone is OK and Henry is a beautiful baby.

Sarah said...

Thank you so much for sharing your birth story. It is inspiring for those of us anticipating our own birth stories in the coming months. I'm so glad that Henry arrived safely and healthily. It sounds like you and your team did an excellent job of balancing your hopes and values for the birth with the reality of the physical and medical situation, and that knowledge coupled with the presence of your baby will allow you to feel at peace with your birth experience.
I wish you the best as you all adjust to your new lives together. Also, the photos are gorgeous.

Alexis said...

Thank you for your honesty and for being willing to share the pictures and the details. I'm so glad you are all safe and healthy!

demandablog said...

Congratulations! I'm excited to see posts about your mommyhood!

DinaBear said...

You told your story beautifully. Congratulations, and I am so glad that you and Henry are safe and healthy!

Carrie Dee said...

Beautiful story, Sara. I'm happy to hear that all went well, even if not exactly as planned. Take care of yourself.

Sara E. Cotner said...

@ rachelshoots: Thanks for pointing out my inaccuracy about the Pitocin and the IV! I did realize--at the time--that the IV was delivering the Pitocin to my body. I changed that sentence to reflect my frustration with having to keep it in long after I no longer needed the Pitocin. It made caring for my baby very difficult because the IV machine in my post-partum room was on the right, the IV was in my left arm, and Henry's bed thing was also to the left of my bed. The cord never seemed to stretch far enough, and when I was trying to breastfeed Henry, his body kept pressing on the tubing. I almost accidentally yanked it out of my arm on a couple different occasions. At that point, they were just trying to hydrate and nourish me (I'm pretty sure), but I had already passed the urine collection test (they were measuring my urine output with a bowl in the toilet), and I had already eaten a full meal.

Definitely let me know if there are other places where you don't feel like I'm giving the hospital a fair shake. Thank you!

Holley said...

Thank you for sharing your story Sara.
I'm contemplating having a natural birth, and my mother keeps telling me to make sure i learn all the options and be very informed. Your story is very informative, and helpful.
Congrats on your healthy baby boy!!

Karuna said...

I hear that it wasn't as you had hoped but as a former doula I can tell you that you are one of the strong, focused, brave minority of women who have to go to plan B and are still able to push that baby out in what sounds like a very peaceful way. Way to go. What a beautiful story. I hope you are enjoying every second with that little bundle of magic. You are an inspiration for sure.

Sara E. Cotner said...

@ Karuna: Having a doula and a midwife in the hospital with me helped a TON! I had total trust in them.

Kristin said...

This is a beautiful story, Sara. Your writing conveys your frustration with not having your original birth plan come to fruition but also how you've come to terms with the circumstances that gave you your wonderful baby boy.
I'm really proud of you and Matt. It sounds like you both handled a scary situation with dignity and grace and for that, you should both be proud!

Anonymous said...

I think your repeated comment, this is for the baby, says it all. Before we have children, we can't comprehend the sacrifices and the change of self that will happen to us. I find so many birth plans to be all about the mom because truthfully, until we have children, what else do we know. In my own experience having two children, how they were born, while interesting and fun to talk about, really has very little to do with them and who they are.

agirl said...

How beautiful.

Allison Campbell said...

Sara, you write in such an inspirational way. I'm so happy for you!

Andrew and Cara said...

A very beautiful and touching story. Congratulations to your family!

Leslie said...

I was waiting on baited breath to hear your story; it was truly a telling tale (sorry about all of the unintentional alliteration) of how dedicated you are to your son. I feel so inspired by your tenacity, adaptability, and grace. I also appreciate how you kept reminding yourself of the mantras to keep your mind and body focused on where it most needed to be. Did you feel in control of your emotions and pain, or did you feel overtaken? As I've not given birth but hope to have children someday soon, I'm absolutely interested and concerned about that. Many women describe trying to fight it, but then giving in to it. I wonder if you felt that same way or not?

Julie said...

Thank you for sharing your story- reading it really touched me. I am sorry that the birth deviated so much from your original plan, but happy that you seem at peace with that and you all are doing well!

diana said...

Congrats on your safe delivery and healthy baby boy.

It is unfortunate that you had to transfer to a hospital, but it sounds like you did a fantastic job of keeping things in perspective. I'm very glad you were able to avoid the C-Section.

I'm 10 days from my due date right now, so your birth story is incredibly inspiring. I hope I'm that strong throughout my labor and delivery.

rachelshoots said...

Re: giving the hospital a fair shake:

I don't think you were too hard on the hospital in your birth story. I had a Pitocin and no epidural hospital birth as well; I know they're no picnic. The Pitocin did it's job, you did yours and you have a healthy baby boy.

Ananda said...

Congratulations on a healthy birth and a healthy boy! Sending positive energy to you & your family.

Jami said...

Thank you for sharing your story, Sara. You ar truly an inspiration (as always). I wish you lots of cuddle and bonding time with your new family. Happy Baby to you and Matt! and Hoss!

-Jami

Anne said...

Dear Sara, what a graceful, positive and inspiring birth story! You make the gift of 46 hours of labor for your baby boy seem so natural, never really mentioning the pain of it all. I guess it shows how generous of a person you are.
I think you had the perfect birth given the circumstances! Congratulations to your whole family!

Holli said...
This comment has been removed by the author.
The Great Askini said...

Wow--Sara, you are a ROCK STAR. I had a natural childbirth as well, but it only lasted 8 hours from start to finish. I am not sure if I could have made it one more hour, much less thirty-something! I am so happy for you and Matt and I hope things are going well with the little man!

Amber said...

Congratulations. I think that writing the story so soon after birth is great. You won't have the perspective quite yet, but you'll have the details so right for future reflection. I think that it is a great tool for self reflection to be able to read through the account. I know my memory fades very quickly as day to day life happens. I hope to have the energy to write my experience so soon afterward.

amber said...

congrats! i gave birth on the 14th of february and still havent gotten around to writing and posting my birth story... mostly because i have been trying to resolve myself to the fact that it didnt go as i planned. i too ended up at the dreaded hospital with pitocin after 36 hours and being at 5 cm for 30 hours. ahhhh!!! congrats again!

Elaina said...

Congratulations! You and your family are such an inspiration and it's been so great to be able to follow along on your journey. I'll be re-reading all your posts when I decided to have kids. Thanks so much for sharing!

Onnie said...

Amazing story, Sara! And I love your preface: I'm sure your interpretation of the birth story will change as your life and your family's changes with time. But even within this very raw time, you still sound very frank and yet positive about your 45 hours (pictocin with no pain meds!) this past week. It sounds like you had a wonderful team assisting you, who really helped you and Matt attain what was most important to you in your birth (even when it clearly didn't go the perfect "natural" route). These stories are so important, because every birth really is unique, and it's so important to recognize how powerful it can be to let go of what you can't control, while still being logical about everything you can do to help the birth progress as naturally as possible. You really sound as if you tried to balance that control and power, and even though you were dejected at some points, that you had a strong team to turn to when you weren't sure of the right next step. The pics are lovely too! Thank you so much for sharing!

Sara E. Cotner said...

Hi, Leslie: I tried to do a lot of mental preparation before the birth to get myself ready to relax into the pain instead of tensing up and fighting the pain. I didn't feel like I was in control of the pain, but I did feel in control of my response to the pain (i.e., as much relaxation as possible). It only really got incredibly hard to do that at the very end when the contractions felt like they were in my butt and when I had to actually push Henry out.

mama mia said...

sara,
I am amazed at your strength and power, and am so happy that you and Matt and Henry got to go home so soon after the hospital delivery. Your preparation ahead of time, and positive outlook, is an inspiration. I can't wait to see you and baby. Keep resting!
Marie

Annie said...

Wow Sara! I love your pictures in this post :) Women usually have this glow surrounding them after giving birth, with beautiful dewy skin after all the hard work of labor. You don't look dewy at all though - just nice and dry! It's nice to see some variation!

Festive Attire said...

Sara, thank you for sharing your birth story. I very much needed to hear your perspective. I'm a fellow home birther who also was tranported after many hours of labor. Unfortunately, I did have the entire cascade of interventions including a c-section on my 4th day of labor, which included 7 hours of pushing and staring at my daughter's head who I just could not get under my pelvis.My husband and I were also both sick, vomiting but nobody knows what it was. It still brings me to tears to think about it. My daughter had difficulties afterward and we were in the hospital for almost a week. It is by far the most difficult thing I have ever endured. It was traumatic, so again I am so thankful for your story and the inspiring tone it gives to Henry's birth. I hope that I can find that peace in Rachel's birth.

Cate Subrosa said...

So glad it worked out well for both of you. What a birth story! So well told, and in such short time. (Mine took me months to finish if I remember correctly!)

kahlia said...

@Cate, yes, it did. But it was worth the wait! And it was the first account of a home birth I'd ever read (we're not even TTC yet), so I was fascinated! Still don't know what "gas and air" is, though (I'm American).

Sarah, thank you so much for sharing your story. It sounds like you did a good job of letting go of control and letting things happen as they were going to. Congratulations to all 4 of you!

Monica said...

Sara!
I'm so behind on your life. Congratulations on your baby Henry! Was lovely to read your birth story. You are a wonderful writer. Would love to catch up on your professional path post-baby too.

Halley said...

I know this is coming pretty late, but I wanted to make a comment about the IV hydration pre-delivery. It's standard to put in a lot of fluid to prep in case you needed an epidural. Having an epidural causes your blood pressure to bottom out and having the extra fluid beforehand helps mitigate these effects. I'm sure you can imagine passing out from low blood pressure wouldn't be good for delivery...

In this case, I think it was a good idea because you'd been laboring for 40 hours and probably were close to exhaustion, so an epidural wouldn't have been out of the question, had the delivery gone on much longer plus if you ended up needing a c-section, then they could paralyze you with the epidural too...

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