Monday, June 8, 2009

As close as you'll get to a birth story

Instead of telling the birth story, I will do what I love most: give unsolicited advice. You already know we didn't want to be at the hospital for Ira's birth, but it turned out being at the hospital really did go OK. I still wouldn't have chosen it, but we managed not only to avoid the C-section I was so afraid of, but also to have a really good birth. In retrospect, there were several decisions that helped to make that happen, so I want to pass them on.

1) We prioritized sleep. Our process from first hospital admission to baby took over three full days (Sun night 5/24 through Wed night 5/27). I wasn't in labor that whole time, but it was a long haul. There were two decision points where we went against doctor recommendations and prioritized rest over continuing to push an induction that wasn't happening. The first was on Monday afternoon. I had cervadil placed on Sunday night, and had a really good response to it. It popped me into decent early labor and looked like I might not need pitocin. I labored into early afternoon, but then contractions fizzled and it was clear we'd need to soup things up. But at that point, it was getting late, and I really didn't want to start a pitocin drip in the evening, only to be up all night in "real" labor. At our doula's suggestion, we asked our doctor to release us so that we could go home, eat and sleep. She reluctantly agreed, scheduled us for continued induction (with a different doctor) the next morning, and then helped us carry our bags to the car (what doctor does that?!). The next morning we showed up fed, rested and ready to get the show on the road.

The second point that we prioritized sleep was early Wed morning. I'd labored all day Tuesday on pitocin, and eventually reached really high doses that got me close to active labor but not quite. I really wasn't making meaningful progress and the doctor suggested rupturing membranes. I was reluctant to do so and the doctor hesitantly offered a second option of shutting off pit, sleeping for a few hours, and seeing if it might work better in the morning, since sometimes that happens. I asked if I could eat while the pitocin was off and the answer was yes. That, and our doula's comment that Gail needed rest, too, sealed the deal. They shut it off. I stuffed my face with food before sleeping, and in the morning upon waking, and Gail and I grabbed a precious 4 hours of sleep. I never would have made it through "real" labor, once it finally actually started, without those periods of rest (and food)

2) We filtered information on progress through Gail. The strangest request on our "birth preferences" was for me not to be told information about progress at internal checks, especially information about how many "centimeters" I was. Instead, the doctor would check, and then talk to Gail in the hall where I couldn't hear, and she would share some information with me, but not all of it, and she could control the timing. This way, I was protected from that inevitable frustration of feeling like I'd been laboring forever not getting anywhere, and was better able to keep going. This ended up being absolutely critical, especially near the end of labor. At my second to last check, the one we now refer to as "the bad check," the doctor (we were now back to our favorite doctor, the one who was with us on Monday, and who I saw for prenatal appts) determined not only that I'd been "stalled" at about six centimeters for several hours of extremely strong and painful contractions, but that our boy was acynclitic. His head was tipped in the exact same way that Leigh's was during birth, and was pressing on my cervix in a lopsided way, making it hard for me to completely open. If I had gotten this information directly, it would have absolutely crushed me. Instead, Gail got the information. It did crush her (it was, in fact, the low point that she wrote about, where she wonders if she should have encouraged me to have an epidural right then and there). As the information filtered through the room, I felt energy seep away and frustration and fear seep in. But there was enough of a buffer that I was able to move on to the next step. Folks moved me straight away to the tub to change things up. Our midwife and doula dropped hints about the baby's position, and suggested things to try and that I ask our baby to move. I hung in there, but I figured out that Ira was positioned just like Leigh. I was able to do as they asked, but this was by far the hardest part of labor. I was feeling the urge to push far too early (which is what had prompted the "bad check" in the first place), and resisting that urge was the hardest thing I've ever done in my life. An hour later, it was clear that I was only marginally holding off on the pushing and we needed to do another check. I stated very clearly that if I had made no progress it was time for an epidural. I knew that was how Leigh had come. I knew it would be OK. But the next check turned out to be the one I actually wanted to hear. The doctor broke into a huge grin, "You are complete! You can push this baby out! He's at zero station!" The room practically broke out into a party. And wow, did I ever push. Our boy arrived less than a half hour later. If the info from "the bad check" had come to me directly, I wouldn't have been able to stick it out for that last little bit. It would have been fine. Believe me, I would have thoroughly enjoyed an epidural. But now that it is said and done, I'm so glad to have gotten the chance to push him out myself.

3) We had lots of (professional) support. We headed into this labor with an embarrassment of riches on the labor support front. Our midwife for our previously planned home birth was there in a doula role, and we went ahead and kept the doula we'd lined up for home already. We certainly felt a little silly heading in with two doulas, but figured it couldn't hurt. Turns out we needed both of their energy. With the process stretching on and on, they were able to trade off taking time with us, and were each able to get (some) rest and bring in new energy at different times. Our doula knew the hospital procedures well, and was essential in helping us navigate them and advocate for what we needed (see point 1 above re: sleep). They were both absolutely critical in keeping Gail going. After "the bad check" they were able to provide me with support that Gail simply could not have. Our midwife was an absolute lifeline for me through the most difficult parts of labor. Most importantly though, they both helped us understand what was going on and make the best decisions we could. That, more than anything, would have made everything OK, even if we had ended up needing surgery in order to keep Ira safe. No matter how things had turned out, we made good decisions the whole time, and we needed that supportive experienced presence to make those decisions. Now, do you really need two doulas? Probably not. One, and more reliance on the nursing staff would probably work fine (we really were boring for many of our nurses), but should you end up with two by a fluke of planning, go with it.

I guess that ended up covering a lot of the birth story anyway. It isn't the whole story. I left out good parts, like how my mom was there despite my insistence that I'd never want her at a birth, and it was wonderful to have her. I left out how it turns out that in the throes of labor, I'm still bossy, kind of funny, pessimistic, polite and worried about if everyone else has had enough to eat, which means that I'm still pretty much myself. I also left out some bad parts, like about the evil "Dragon Nurse." In any case, it was a wild ride. We're so happy to have Ira here safe.


giggleblue said...

i'm happy that things went so well for you! AND happy that you avoided the c-section! birth is a twisty little thing, but in the end, the result makes it so worth it. i hope you enjoying your babymoon as much as humanly possible!

Dirk Awesome said...

Congratulations on Ira! Also, I was reading your advice VERY carefully - thanks for the help!

Anonymous said...

Sounds like we had a very similar experience... we had three days of starting pitocin, then stopping so we could sleep, then starting again in the morning. We didn't have the doulas, but the nurses at Newton Wellesley were AMAZING. We were also SO happy to avoid a c-section, and I'm so glad to hear that Ira and Mommy are safe and healthy!

Anonymous said...

Glad everything worked out and that you were able to avoid a c-section. Sounds like you all worked as quite a team and were able to take breaks and get rest and call the shots to make decisions. Definitely a fabulous outcome.

Three plus days of labor is exhausting - for everyone!!!

Enjoy your babymoon :-)

Anonymous said...

glad you were able to avoid the c-section and definitely happy to hear that you were able to modify the process such that you got the rest and the breaks you all needed.

Anonymous said...

Wow, congratulations on what sounds like an epic birthing experience. I'll file your advice away for future reference. I hope the four of you are getting well acquainted.

nutella said...

Thanks for the share, Im so glad that you had the support and stregnth you needed to get Ira here sfae and sound.

Anonymous said...

I know what you mean about birth being a wild ride and how hard it is not to push when that is all you want to do. I am really happy that Ira is here safe and sound. xo L