Born at home on May 11 at 3:15am, released from NICU May 20
9 lbs 12 oz, 21.5 inches long
I had gone to bed at 10 the evening before Mercy was born, somewhat discouraged and anxious. I was 41w4d, and getting nervous. I felt like my baby wasn't actively in danger, but that something was definitely "up" and I wanted her out ASAP. Mercy had passed her contraction stress test with flying colors that afternoon, so I thought that my anxiety was probably due to how complicated our pregnancy had been. With a history of pregnancy loss, including Mercy's twin lost to H1N1 in the early 2nd trimester, I felt that I was probably just overthinking things and causing myself unnecessary stress.
However, when I woke up at 2:30 with terrible, wrenching contractions and I knew that something was wrong. My water broke with that first contraction, but there wasn't much of it even though it was clear. I woke up my husband and told him to get my midwife there NOW. I had already had 4 births, but I knew this one was moving fast and I was scared by how strong my labor was. The intensity wouldn't let go, and it was excruciatingly painful. My uterus felt inflamed and, for the first time in my life, I was giving high pitched screaming in agony during labor. My "normal" in labor is playing board games and quietly saying that I need to push once I'm at the 10cm mark, so this was a very very big difference for me.
My midwife was on her way, and I told my husband that there was something wrong and I needed to go to the hospital. He thought it was just the normal transition thoughts and did his best to reassure me, but I knew that this labor was not going the way labor "should" go. In the meanwhile, I told him to fill up the bathtub, because I needed to do something to knock down the intensity of those contractions. So, he filled the tub with hot water and I got in.
The contractions kept coming hard and furious and my husband called my midwife back to make sure she was en route and to let her know that I felt like I needed to push. I spent those last 15 minutes in the tub, trying very hard to not push, but by the end I couldn't help it. I'm not normally a water birth person, but I was still frightened by the intensity of those contractions, and thought my best shot of having an assisted birth was to knock down the intensity and try to slow things down.
5 minutes before Mercy was born, she absolutely panicked. She rose clear up out of the nice LOA position she had been in, thrashing her arms and legs around and came crashing down posterior, hard enough to have had a bruise in the shape of my pubic arch on her forehead for the first week of her life. Two contractions with pushing later, and her head was coming out. Just as her head emerged, our secondary midwife came through the door. She asked my husband if he wanted to catch our baby, and told me to push with the next contraction.
When that contraction didn't come, she checked for cord, and my wonderful primary midwife came in. When she heard head was out but body wasn't, she asked me to pull my legs up and push. That didn't work, so she said "out of the tub" and I pulled myself to standing and climbed out of the tub and got on all fours. Upward traction, downward traction, no movement. Onto my back into a full McRoberts with my husband applying suprapubic pressure, and as soon as he used that pressure, something seemed to click into place and we got her out. While it wasn't a true shoulder dystocia with bony impaction, my daughter seemed to have thrown her arms out in a startle reflex, essentially bracing herself in.
While Mercy had strong heart tones, she did not want to breathe at first. It was almost like looking at her underwater and waiting for her to come to the surface, that she was in some sort of in between state. While my MW and the 2nd MW were vigorously stimulating Mercy to get her to come around, my placenta came free. It was literally within 90 seconds of Mercy's birth that we had a separation gush and I was ready to push it out. The active management I had wanted I didn't even get because the placenta came out too fast! We still did the shot of pitocin I had requested once Mercy was more stable, and it looked like my blood loss was quite mild, but later I lost a blood clot the size of a lemon or orange.
Shortly after her birth, Mercy stopped breathing while I was holding her. She had been seeming like she was slowly transitioning to extrauterine life, but we were watching carefully and prepared to transfer when she had her episode of apnea. My midwives started suctioning her to get her breathing again and we called 911. We arrived at the hospital quickly, with my complete medical records and my CNM present to speak with the NICU staff.
Mercy's NICU stay was 10 days total in length, although she was off a ventilator within 24 hours and off all respiratory support completely within 24 hours after that. While theories abound on why this is, Mercy's condition is best explained as being caused by fluid overload seen on her x-rays which was severe enough to spill over into her lungs. The majority of her time in NICU was spent in a sling on my chest, to receive the twice a day antibiotic therapy ordered for her on the suspicion that she had sepsis. In consulting with our pediatrician, as well as several other MDs, it seems that the diagnosis of presumed sepsis is not remotely consistent with her clinical course, and therefore it is likely that the majority of her stay in NICU was flat out unnecessary. Why she was as sick as she was is something of a mystery, with several possibilities tossed around, but with so many odd factors in play we are never going to have the answers that I want.
At 3 months old, Mercy is thriving and bears no outward markers of how close we brushed to catastrophe. She took to nursing very well once she was off the ventilator, and is about 15 1/2 lbs at this point.
We are so grateful to our wonderful CNM for the care that she provided, because her skill, training, and compassion made such a difference in our birth and post partum period. While the complications we encountered I absolutely would have preferred to face in the hospital, the fact that we planned a home birth is why our daughter is still alive and healthy. There is no way we would have made it to the hospital ourselves at 2:30 in the morning with 4 other children sleeping. Even just three minutes difference in either direction could have been disastrous, because we did not have the skill to resolve Mercy's positioning issue on our own if she had come sooner and we had been completely unassisted, and she could not have handled that labor much longer.
I intend to expand on Mercy's story when I'm in a better position to do so, but this is the story that I can tell right now, at 3 months post partum and having suffered from a degree of PTSD due to our NICU stay. We are so grateful for the care we received, and so grateful that in this roll of the dice we got lucky. There were so many ways that things could have fallen through the cracks, but God kept us safe and our daughter Mercy's life and health are the greatest gift we have ever been given.
Catholic wife in with my husband, mom to x5, x2, x6. Birther of babes, baker of bread, and connoisseur of human folly. WINNER OF THE SILVER BIRTH STOOL, APRIL 2010 DDC! Happily hospital birthing with my BFF, Epidural Man.