Friday, November 29, 2013

Leah's Birth

The story of Leah's birth begins the morning I was 40 weeks and 1 day pregnant. Ben (my husband), Ella (my 4.5 year-old daughter), Brenna (my 2.5 year-old daughter), and I dog-piled on the couch for a snuggle, and when I stood up to go make breakfast, I felt a warm gush. "Ooh! I think my water broke!" I walked upstairs to my bathroom and stood there a second, thinking, "Maybe I just peed myself..." but then woosh! My waters released with a cartoon splash on the floor. Still disbelieving, I touched my amniotic fluid indicator to the puddle, and yes! It was bright blue!

This would be my shortest pregnancy yet. My other two were 42w2d and 41w5d. I was still scheduled to work through that weekend (I'm a night nurse on a mother/baby unit) so I called in to say I wouldn't be there for my shifts.

I contacted my midwife and doula, and had Ben take the kids to my mom's house so we could nestle down for labor. We headed to the chiropractor to get adjusted, then to the midwife's office for an assessment. All was well, and ultrasound showed us that baby was in great position and very active. We went home for lunch and a cuddly afternoon nap. We woke up ready for a walk around our neighborhood, and I went to prenatal yoga that evening, feeling just crampy.

Once we got home, Ben and I finished cozying up our birth space. I spent time dancing, rocking on the birth ball, and doing lunges on the stairs. Our midwife came over to evaluate and listen to baby some more. Time was dragging on. Here I was, feeling like all my ducks were in a row, birth supplies set up, kids taken care of, and I was left twiddling my thumbs. It was clear I was still in early labor, so my midwife left in the very early morning, and I went to sleep.

I slept well for several hours into the late morning. Contractions were virtually gone, and now that it was 24 hours since my water broke, I knew Ben and I had better have a good talk-through of the possibility of transferring to the hospital. Transferring would put us on a particular trajectory, one that had caused much trauma in our past. Our first planned homebirth ended up as a hospital transfer, 30-hour induction with no pain meds, tough labor up to 9 cm with a malpositioned baby, and Cesarean birth. We hadn't prepared for the possibility of transfer. Our second birth was a healing VBAC at home. With the experiences we'd had and now being so much more equipped with knowledge and confidence, we could heart-to-heart and hand-in-hand face and discuss those hard questions.

We thought a change of scenery might shift things, so we headed to the grocery store, visited my mom at our family restaurant, and caught up with Ben's mom and sister who had Ella and Brenna for the day. We stopped at our midwife's office for another assessment. Contractions were very spaced out, but baby and I were still doing well. Ben and I headed home for another solid rest, then later, my dear friend stopped by with snacks, a massage, and words of encouragement.

At this point, I had been ruptured for 36 hours without sustaining a labor pattern. I had tried different labor-encouraging techniques. I tried being up and active and I had tried sleeping and resting. I was hydrated, had eaten, prayed, done all the tricks and hadn't turned the corner into active labor. My midwife called to check in, and we all felt like it was a good idea to go to the hospital. Despite being sure that was the right decision, I had to let go of my hopes for this to be a homebirth. I allowed myself to grieve and cry and shift gears. I called in to see who was working and would be my nurses that night.

My doula and midwife arrived at my house. I dallied my way through packing my bags for the hospital. I was very distracted and couldn't quite focus, and I was still holding onto a shred of hope that simply making the decision to transfer would ironically put me in labor. My kids arrived at my house with my sister-in-law to stay with them overnight. It was time for them to get ready for bed. I hugged them tight, telling them that I needed to go to the hospital for baby sister to be born. Ella said, "You're going to the hospital? But Leah's supposed to be born here!" My sensitive, sweet Ella shed tears right along with me, feeling my heart's sadness. Brenna snuggled up and nursed for her last time. As their bodies quieted into sleep, I gathered my resolve for the next chapter of this birth.

We left my house close to midnight. In the car, I was feeling contractions pull from my back, the kind of labor that I'd experienced when my other two girls were malpositioned. Crap. I don't want an asynclitic baby.

When I got to L&D triage, I was 6 cm and the nurse could feel one of baby's hands by her head. I spent three contractions in open-knee-chest position, and I could distinctly feel when baby shifted her hand and aligned beautifully for birth. The OB asked if I wanted to be admitted or go home, and I said I wanted to stay, that it felt right to be there.

Later, my midwife and doula would tell me that they both saw a discernable change in me when we arrived at the hospital, that I went from putzing around with my labor to ready for this work. I was committed to the change in plans with the hand I'd been dealt.

I had been sure that going in to the hospital would at the very least mean IV antibiotics, possibly Pitocin, and close monitoring. When I asked about getting my IV started, my nurse said since I wasn't having symptoms of an infection, the OB didn't order antibiotics, and since I was a VBAC, she wasn't comfortable using Pitocin. She chose to monitor me with a Doppler. As we got settled in my labor room, contractions really started to pick up. These were strong, regular contractions! Finally! Active labor! My doula gave Ben a rebozo to do abdominal lifts, making baby's head put good pressure on my cervix. As with my other two labors, I found it helpful to relax my pelvic floor with contractions. The negative to that approach is that I end up peeing, so my birth team just follows me around with chux pads. "Watch your shoes!"

It was wonderful birthy juju with my midwife, my doula, my photographer (who is also a midwife), and Ben (who missed his calling as a doula) there supporting me (a former doula and current maternity nurse). I could feel my team holding my space despite the change in scenery. I was in the zone, doing my work, rocking this labor.

At one point a little while later, another woman arrived at the hospital complete and pushing. We could all hear this woman screaming at the top of her lungs in the hallway as they moved her into a labor room. Our focused, calm, tranquil labor space totally erupted into hysterical laughing at her screaming. Here I was, moaning in low, primal tones, and this lady is hollering like a banshee. It was like a scene from a movie! I got to laughing so crazy hard that I'm sure it opened my cervix right up with all those good giggle hormones. Soon I started throwing up between bouts of laughter, so I was puking and laughing and laughing and puking. When a mama starts throwing up, birthy folks get excited - it's a pretty good bet that mama is entering transition and a baby is coming soon.

I felt surprised that I liked being in a semi-reclined position. I laid back on the bed with my feet propped against the bottom of the squat bar uprights. I was thinking, this is totally the "no-no position" that encourages baby to rotate to OP, but it felt like her head was applying good, even pressure on my cervix. I was reassured that listening to my body was the right thing to do. I felt best in a mostly-lithotomy position with my feet propped up on the squat bar and a slight left-tilt.

Not long after laying in the bed, within the space of two or three contractions, there was a dramatic shift in my body. Oh my goodness, could I be feeling pushy already? Things went from completely able to work with this labor to holy crap, my body has a mind of its own. I hadn't ever experienced involuntary pushing before! I was no longer the engineer on the I-know-I-can birth train. I became a bystander, a passenger with total surrender as my only option. I closed my eyes, then heard a whole lot of movement and shuffling and shouting. Someone told me to stop pushing. Someone called out the time of birth. Multiple hands moved my body to assist baby's rotation for birthing her shoulders. And suddenly there was a baby on my chest! I opened my eyes and saw my beautiful Leah, and I inhaled her intoxicating, fresh new baby smell.

Leah Jo, born October 18, 2013, at 4:22am, 7 lbs 8 oz, 20 in.

She cried right away, then quieted as she nestled against my skin. She nursed well, I got cleaned up, and we headed up to the mother/baby floor (my home-away-from-home... where I often spend more hours than at my house in any given week), where I was cared for by my friends and peers. Several of my co-workers expressed how sorry they were that I had to come in to the hospital, but I had such an overwhelming sense of peace about the transfer. I felt prepared for whatever this birth would bring. I feel like I worked through all of the possible physical and emotional dystocias before we transferred. I don't know why labor didn't start at home. I don't know why labor waited until we got to the hospital. Despite my membranes being ruptured a total of 44 hours, this was my shortest labor at only 3 hours from active labor to birth. It wasn't what I had envisioned, but it was a beautiful, natural birth surrounded by so much love.