My first birth was supposed to be a natural Bradley birth. We knew the baby had a two-vessel cord, but no other problems. After laboring at home for 24 hours, I had a feeling we had to get to the hospital. The initial check showed DS was fine, but the next check 30 minutes later showed his heartrate in the 60's. It never went back up despite multiple position changes, etc. After an emergency C-section we found two knots in his umbilical cord that appeared really tight. That was the only cause that we could find for his persistent distress. DS turned out fine.
Here I am two years later, planning for a VBAC. I'm working with a midwife group who collaborates with the OB group I used last time. They wanted a 20 week ultrasound to check for placenta placement, and I reluctantly agreed. (Off Topic: Why do I feel like I need to keep them happy? They are the only midwife group in a reasonable distance and the only VBAC supportive hospital. Still...) The ultrasound showed great anterior placenta placement and a baby who was 4 weeks further along that anticipated. They promptly changed my EDD from June 5th to May 5th. After a discussion with the OB, we believe that I got pregnant the month before I originally thought. My last "period" was probably a subchorionic hemorrhage.
For this birth I planned to use Hypnobabies. Since February I zealously did the activities, listened to the CDs, followed the program in detail. I had several episodes of pain (rib pulled out of place, symphysis pubis pain) that responded beautifully to the Hypnobabies anesthesia approach. I was really excited to see it in action during my birth.
On Monday May 4th I had mild crampy contractions about 6 minutes apart for 13 hours. They were no more bothersome than Braxton-Hicks, and I was able to sleep through them. I had them intermittently for the next several days.
On Thursday May 7th I started having the mild contractions again around 2 pm. Again, I just went about my business. I had no idea this would be the beginning of actual labor. I nursed DS (23 months) to sleep around 8:30, and noticed the nursing really kicked up the intensity of the contractions. Around 9 pm as I was browsing MDC, I decided to try contractionmaster.com. To my surprise, my contractions were 3-5 minutes apart lasting 1 minute. I got a burst of energy to finish packing - hospital for me, to Grandma's for DS. I went to bed but had trouble getting to sleep. Finally got to sleep around midnight, and woke up at 1:30 with increased intensity of the contractions.
I told DH to get as much sleep as he could. I couldn't get back to sleep, so I went downstairs to listen to my Birthing Day CD. To my surprise, I just couldn't stand the sound of the voice on the CD. I was confused - this had never happened before. I tried my techniques that didn't involve listening to the CD - they helped for a short while. I ended up on our futon mattress on the floor, kneeling over our beanbag or sidelying. I put down some waterproof pads just in case. The intensity was very strong but manageable with relaxation. I was still trying to get into that hypnosis state that I was doing so easily for the last several months.
At 3:30 DH woke up and heard me moaning downstairs. He came down and asked if I needed him. I told him not yet - still working on the Hypnobabies thing. He realized that this was looking very much like labor, so he went back upstairs to his home office to email his boss - "my vacation is starting now!". Contractions were now about 3.5 minutes apart, lasting 1 minute. I had changed into my Binsi birthing tank and skirt, and planned to wear them at the hospital as well. While sidelying during a contraction, I felt a jerk in my abdomen and felt and heard a "thunk!" against my pubic bone. That was a surprise. After the contraction was done I had a gush of fluid as I stood up. I hollered up to DH - water broke, you'd better pack, call your parents for DS. The strength of the contractions increased dramatically after my water broke, and I needed DH to be there for counterpressure. Poor guy - running upstairs for 2 minutes of packing or calling, running down when he heard me moan. He worked up quite a sweat.
DH's parents live an hour away. Our hospital is 45 minutes away. I planned to show up as late in labor as possible - pushing would not be too late! However, I didn't know close I was. We called the midwife - she said to come in whenever we wanted. We called our doula to see if she could come over. She was at another birth, and said she would have her back-up doula call us. This was not a surprise - due to my due date change she warned me that she was really busy in early May. This labor was far more intense than with my previous labor, and we decided to head into the hospital. DH's parent's had not arrived, so we called a neighbor to come over and wait at our house in case DS woke up before grandparents arrived. We arrived at the hospital at 6 am.
Our doula met us at the hospital. The nurse brought us to our room, and gestured to the hospital gown on the bed. Then she noticed my Binsi skirt and immediately said "oh, I see you don't need the gown!" and removed it. My initial exam showed me at 4 cm, 80% effaced, but I don't remember the station. Because I'm a VBAC, the hospital requires an IV Hep-Lock and continuous fetal monitoring. I agreed to the Hep-Lock (I'm a hard stick and didnt want to wait for an emergency like last time) and promptly put a stockinette over it so IVs or meds couldn't be given casually without our notice. I planned to remove the EFM periodically, but the labor was so intense I physically couldn't do it. The midwife had to hold the monitor and press it to my belly during each contraction. It was the source of a lot of my pain, and it really pissed me off. I couldn't seem to argue about it though - I told them it was really hurting. It was pressed for every contraction until Baby was born. This was the main negative thing about my birth. There were so many positives, though.
My doula and DH were the primary caregivers. The midwife sat back, pressed the fetal doppler, and made quiet suggestions for positions occasionally. They were very hands-off midwives, and DH and my doula were so perfect in their support. I labored on a mat on the floor, kneeling over a birth ball, on the toilet, in the Jacuzzi tub. At around 9:30 I started getting pushy during some of the contractions. I expected to be told not to push or that I needed another exam. No, the midwife just asked if I was pushy, I said yes, and she said OK. I stayed in the tub and gave a tiny push when I felt like it. When on the toilet I had a couple of reflexive pushes.
During this whole labor the pain was far worse than last time, and each contraction I was struggling. I was praying silently for an epidural during each contraction, but refused to say it out loud for fear that they would believe me. I strongly believe in an unmedicated birth - I can't have narcotics because of an allergy/sensitivity to them. I tried using my Hypnobabies - still couldn't stand the sound of her voice, but was able to relax a little between contractions.
Around 10:30 I quietly mentioned to the midwife that I was getting tired of all this and wanted it to end soon. She cheerfully mentioned that I might be in transition and would I like an exam? Since I had been getting progressively pushy I agreed. I got out of the tub and assumed I needed to be on the bed. She suggested I lie on the mat on the floor - cool! No bed! I was fully dilated, ready to push. As I sat upright on the toilet the pushing urge really kicked in. I pushed on the toilet, kneeling over the ball, sidelying, standing, kneeling on the bed facing the head, on a birthing stool, and tried the squat bar. I ended up on the bed because I was getting dizzy and was too wobbly to hold myself upright. The biggest problem is that I have exercise-induced asthma, and would have panicky gasping after 2 pushes.
After 2 hours the contractions petered out. I had been drinking Recharge (natural gatorade), but now they suggested I try an energy bar if I had one. What? Eating in a hospital? I did have food because I planned on eating anyway if I wanted. The food didn't help, and at this point I barely felt any contractions at all. The midwife suggested augmentation with low-dose Pitocin, but didn't pressure me. If I were at home I would just rest, but being in a hospital, VBAC, with waters broken, I made the decision I swore I never would - I agreed to the Pitocin.
The Pitocin worked great - contractions picked up to what they were before. I ended up pushing for another hour, and the position that worked the best was on my back. I still tried all the other positions frequently because I wanted the upright gravity assist. I remember feeling discouraged - the midwife was sitting down by my feet, but she wasn't even wearing gloves. Obviously, I had a long way to go. Once baby got out from under my pubic bone, he crowned in one contraction. She suddenly called for a baby nurse and jumped into gown and gloves so fast. Baby was out in the next contraction.
The midwife told me to reach down and catch my baby. I helped bring him up to my chest and covered us with blankets. The baby cried for a minute or two - just enough to clear his lungs. The nurse wiped him briefly, then left. No suctioning, no other interference. He stopped crying and lay quietly on my chest. Cord was clamped after 5 minutes and placenta came right after. After a few minutes, the midwife asked if we knew the gender. Oh, yeah! DH and I were so entranced we forgot to look! Another boy!
Baby lay on my chest for the next hour. I shifted him over and he latched on like a champ. I was stitched up - first degree tear with 12 stitches. After an hour I really needed to pee, and the nurse offered to weigh and measure him on the warmer in the room while I was up. DH carried him over and watched while the doula helped me to the bathroom.
Born May 8 at 1:18 pm
7 lbs 5 oz, 20.5 inches
So, two interventions - fetal monitor and Pitocin. However, the other natural processes were great for a hospital. Midwife, birthing ball, birthing stool, rarely on the bed, mat on the floor, suggestions to eat, use squat bar, minimal exams, delayed clamping, baby on chest for an hour. They didn't bat an eye when I declined Hep B or eye abx.
I wish the Hypnobabies had worked. I have no idea why that voice irritated me so much during labor. I worked so hard for so many months, and it worked beautifully for other pain. I'm still a strong supporter of Hypnobabies. I wish I could have handled the pain out of the tub more so I could do more upright positions - maybe I could have avoided the Pitocin.
We went home the next afternoon. This baby is so calm, so relaxed, and nurses like an expert. So, a successful hospital VBAC is possible!
: DS - June '07 : DS2 - May '09 : (may be delayed a really long time!)