Saturday, June 12, 2010

You're never too old...

They say every pregnancy and birth is different, and that's true to a point.  Each of my children arrived in the world in their own way, but there were also alot of similarities.  With all four I was very sick the first four or five months of my pregnancy.  With all four I had an intensely enhanced sense of smell throughout the pregnancy.  Each of my labors lasted between 4 and 6 hours (of active labor).  In fact I'd say that for the most part, most of my pregnancies and births were strikingly similar.  But in many ways Ivy was the exception.

One thing that started out very different about my pregnancy with Ivy was that I had a very difficult bout of depression in the first trimester that returned at the very end of the pregnancy.  I also had really severe pelvic pain towards the end that I had never experienced before.  The biggest difference though was our birth experience.

With Mitchell, I didn't really know anything about birth, and wasn't really sure what I thought about it either.  I was torn between wanting to take advantage of all the benefits of modern medicine and wanting to have a natural birth.  I could see the benefits of both.  So my plan was to just kind of see how it went - try to go natural but be open to an epidural if I thought I needed one.  I ended up with the epidural and it was a really great experience.  I was pain-free, had no trouble dilating or pushing, could rest and sleep while waiting for him to arrive, and was able to fully enjoy the moment of his birth without any distraction from pain or exhaustion.  It was a great birth experience.

Naturally, having such a great experience the first time around, I hoped to recreate that when my second son was born.  I went into the hospital expecting to get an epidural as soon as I was able to, and I did.  The problem was though, that the epidural didn't take.  It only took away my pain on the left side of my body and by the time I was pushing, it didn't seem to be working at all.  To make matters worse, since I was expecting a pain-free birth I had no plan for coping with the pain.  By the time Henry arrived I was so mentally and physically exhausted that I didn't want to hold him.  I waved him away and had the medical staff weigh him and clean him off and do all their various newborn procedures first.  By the time they were done I felt recovered enough to meet him and hold him and I don't feel like it had any effect on our bond, but I will always remember that feeling - not wanting to hold him - and I never want to feel it again.

I had heard that there's always a chance that epidurals won't work so when I found myself pregnant a third time, I figured it was just a fluke and that if I got another epidural, chances were it would be just like it was with Mitchell.  I couldn't have been more wrong.  This epidural certainly worked - it worked a little too well.  The anesthesiologist accidentally gave me a wet tap so I was totally numb from the stomach down.  So while the pushing went fine and I was able to enjoy Violet's birth, my recovery time at the hospital was not so hot.  I ended up having fluid leaking from the puncture hole in my spine that caused massive spinal headaches every time I stood up or sat up.  Needless to say that made taking care of my new babe in the hospital somewhat difficult.  I also ended up needing a blood patch to stop the headaches before I left the hospital which delayed my discharge while they found time for the procedure.

When I became pregnant a fourth time with Ivy, I decided SCREW epidurals.  One in three is not very good odds for a properly working epidural and I didn't want to take the chance.  Remembering how unpleasant Henry's birth was, I decided that if I was going to have a natural birth this time, I was going to arm myself with every comfort measure and coping technique out there to deal with the pain.  I read every book I could get my hands on and learned about everything from hypnosis to waterbirth.  My husband and I attended several great free workshops put on by a local non-profit called The Childbirth Collective.  Those were really eye-opening and I realized some places where I had gone wrong before.

My instinctual method of coping with the pain of contractions had been lying on my side in the hospital bed, tensing my entire body and wiggling my toes frantically.  After some reading and some birth workshops I realized that that was probably the WORST thing I could be doing.  Laying down doesn't allow you to put gravity to work for your baby as it descends and tensing up both prevents dilation and increases pain.  I was determined to not make the same mistake this time.

As my pregnancy drew to a close and the time for Ivy's birth approached some problems began to develop.  My prenatal depression slowly returned, and I began to have horrible pelvic pain as Ivy dropped.  In retrospect, one good thing that came from my pelvic pain was that I was able to practice some techniques for pain management.  I think this gave me both confidence in my ability to deal with pain and some idea of what did and didn't feel good to me when I was under duress.

But the pain and depression took it's toll and by my 39 week appointment I was feeling worse than I ever had before.  And to top it all off, Dustin was supposed to work that Saturday, on my due date, and this particular work project was one he couldn't skip or leave early from if i went into labor.  I was horribly anxious that he wouldn't be there.  He had come to the classes with me, massaged my low back when I couldn't sleep from the pain, and generally been my rock.  I was sure I couldn't have a natural birth without him and afraid of what a fourth epidural might bring.

So, things were getting to me - and my blood pressure the last two appointments reflected that. Not dangerously high, but much higher than it had been previously.  My midwife asked me how I was doing, and it all came pouring out - the pain, the anxiety, the depression.  She was sympathetic, and offered a possible solution.  She said that since I was very dilated and effaced and the baby was locked into position, on Friday morning, if I wanted, I could come in and have my water broken to get labor started and I would have my baby by Friday night.
I didn't want to do it because after educating myself all about natural birth, I was now very skeptical of any interventions at all.  In the end though, I decided it would be a good idea because I couldn't stand the idea of not having Dustin there.  The lesser of two evils.  And of course, I was very ready to be done.  As soon as I made that decision Wednesday night, I felt instantly more relaxed and happier than I'd been in a long time;  I knew it was almost over and that my husband would be there with me.

I think having that anxiety relieved was one of the things that helped me go into labor on my own on Thursday night.  Well, that and the hearty round of intercourse with generous amounts of nipple stimulation thrown in that we had Thursday night.  We thought we'd give one last ditch effort towards a natural birth.  About 10 minutes after, around 11:30 p.m., I had my first real good contraction.  It was more painful and longer lasting than any of the miscellaneous contractions that i'd been having the past few weeks.  My other labors all started slowly and ramped up, but with this one, as soon as the contractions started, they were coming every 5-7 minutes right out of the gate.
I timed them for an hour and they kept going and getting stronger so we called everyone (the doula, midwife, my mom) and got ready to go.  My midwife said she would call the hospital and let them know we were coming.  The doula was attending another birth at our hospital when we called her but she said that her lady was almost ready to push.  She called the back-up doula in just in case but said she would most likely be ready to meet us soon after we got there. 
As we were walking out the door, the phone rang and it was the midwife.  She said she was so sorry and this had never happened before to her, but our hospital was FULL!  We were being diverted to another hospital in the system instead.  So we googled directions to the new hospital (which we'd never been to) and then headed out.  By the time we headed out my contractions were about four minutes apart and I couldn't walk or talk through them, I had to stop and concentrate when they happened.
Luckily we had no trouble finding the hospital.  When I got there they checked me and I was 7cm dilated!  I've never been that far along before when I get to the hospital - usually i'm at a 4 or 5.  This time though I was really focusing on relaxing my body through each contraction and I believe that allowed me to dilate much more than I could when I was tensing through contractions.  I was feeling VERY good for a 7 - usually i'm crying for an epidural by 6.  Here's me at a 7 this time...

Can you believe i'm SMILING?!

So I had thought that in order to avoid an epidural this time I would try some different comfort measures that I hadn't tried before like using a birth ball or getting in the tub.  I was actually hoping for a waterbirth, but that wasn't in the cards for us apparently since the hospital we got diverted to didn't have birthing tubs.  Instead this time it seemed to work well to get on my hands and knees and rock; or if I was standing, lean over a counter or something and sway.  I tried sitting on the birth ball but it just wasn't as comfy as hands and knees for me.  As the night wore on and I got more tired and the contractions got more intense, I tried laying down for a little bit, but that was the WRONG idea.  It was like a knife in my belly when I was laying down and painful but manageable when I was up on all fours.  So now I know why I couldn't handle it the last few times - laying down does NOT work for me.  But I was exhausted so I just tried to lean back and close my eyes between contractions and that helped. 

Another thing that helped immensely, which I was not expecting at all, was low moaning.  I never judged women who did that, but I never felt the need to do that myself in previous labors.  I had been told numerous times though at the Childbirth Collective meetings and in the books I was reading this time that it can be helpful, so I gave it a try.  Oh my goodness it made a world of difference!  It prevented my body from tightening up (and increasing the pain) very effectively.  If you tighten up, your noises will be much more high pitched, it's just the nature of the beast.  But it's darn near impossible to give a good, long, low, loud, belly moan if your body is not relaxed.  As things got intense at the end, my moaning started to edge more toward wailing, and I noticed it.  I made a conscious effort to lower the tone of my moaning and almost like magic the pain lessened; it didn't go away mind you, but I could definitely tell the difference.

My son Mitchell attended the birth and when I asked him later what he thought he said "mostly boring" which is true - it's only the last little bit that's exciting.  He spent most of the four hours we were in the hospital reading and playing Crazy 8's with my mom.

They checked me again a bit after four and I was 9cm, fully effaced, and the midwife asked if I wanted my water broken (it still hadn't at that point).  I was ready to be done so I said yes.  After she broke my water I immediately finished dilating and after 4 minutes of powerful, spontaneous pushing (this time I specifically requested NO cheerleading or counting), Ivy  was born at 4:34 a.m.  She was a massive 10lb and 2oz and 22 inches long!  The midwife said i'm made for having babies though and could have probably had an 11 pounder no problem too (NO THANKS!).
The midwife was really great and when Ivy came out Mitchell was just pretty wide eyed over the whole thing so she asked him "So is it a boy or a girl?" (he had wanted to announce it) and he just said "Uhhhh... I don't know!".  She whispered to him loudly "Tell your mom it's a girl" and he managed to tell me.  I'm sure you can have your mom tell you "There's a baby in there" until she's blue in the face but its kind of hard to believe and understand until you see it actually happen.  A little later the midwife invited him over to look at the placenta and showed him all the parts and the sac where the baby was and he thought that was pretty cool.

One thing I found kind of interesting - the hospital's policy is to put you on the fetal monitor when you get there and keep you on just until they get two "accelerations" (baby's heart rate goes from a good steady rate to speeded up due to stress or movement and then comes back down again) to show that baby is tolerating the labor well.  Well I ended up with that darn thing on the entire time because the whole time they only caught one acceleration.  Now that Ivy's here though, I know why - she is just SUPER calm!  It takes ALOT to rile her up and once she's crying, if you just pick her up and hold her close, she shuts off like a light switch.  You don't need to shush her or rock her or anything.  Just pick her up and bam, she's calm again.  So I can see how her heart rate might not have been doing too much even during labor, she's so even keel.

 Some advice I got during one of my classes really helped the fetal monitor from being a major distraction to my laboring efforts.  They said not to worry too much about hospital policy or the medical staff and just to do what you feel like you need to do.  For me that was going from a sitting position to all fours for every contraction.  Which often dislodged the fetal monitor.  If I had been more concerned about hospital staff or policy I might have tried to avoid moving around so much, but I think that would have been very counter-productive to the way I needed to labor.  As it was the nurse and midwife were more than happy to readjust the monitor often and even hold it in place if they couldn't get it to stay properly due to the position I was in.  So they were able to get what they needed and I was able to get what I needed as well.

Ivy's birth was so amazing; I'm glad that Henry's birth wasn't the only experience I had with the pain of childbirth.  Pain doesn't have to be the enemy.  When I was laboring with the mindset that each contraction was bringing me closer to having my baby, I welcomed the intensification of pain because I knew it meant birth was near.  An epidural didn't even cross my mind.  I didn't even think to ask for any pain medication.  When I was laboring with the first three children, each contraction meant something different to me.  It was just one more thing I had to try to bear while I waited for the epidural that never seemed to come quick enough.  With that sort of an attitude, each minute seemed like an hour.

I think Ivy and Mitchell's births epitomized for me what a natural birth can be and what birth with an epidural can be.  I'm glad now that I have been given the wisdom to understand why women love both kinds of birthing.  You're never to old to learn something new - an open mind gets wiser every day.

1 comment:

  1. This is a very cool story! It makes me excited to have my little girl in a couple of months! Thanks!


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