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hospital induction

How I came to love the hospital birth that I didn't want, Part 2

We’re picking up, right where I left off last time–in the hospital, having rhythmic and mild contractions after taking Misoprostol and feeling vindicated for choosing to be induced after the baby’s heart decelerations returned with my contractions. Between the oxygen and IV fluids they gave me, the baby recovered beautifully, and we all tucked in for some sleep around midnight.

(In the event none of this makes sense to you and/or you’d like to know the back story, here’s Part 1, in all its glory.)

Four hours after I took Misoprostol, the doctor suggested that we add Pitocin to my IV drip. My cervix had dilated to 2.5 centimeters with the help of the Miso, and Pitocin would likely continue that process. If the baby had more decelerations, we could always turn the Pitocin down or completely off (which is not an option with the Misoprostol pills). She made this suggestion at 2:00 am.  My partner, A, asked her if we could start the Pitocin in the morning, after more sleep and some breakfast. “Sure,” she replied, casually.  And with that, he earned me 4 hours of sleep and a big plate of eggs, bacon and toast to fuel my labor.

(Why a doctor who specializes in helping women have babies would not think of this small adjustment on her own, I’ll never know. But I’ve found in my own births and as a doula that when you ask if you can have more time to make a decision or, say, a few hours sleep, or some food before engaging in one of the most taxing experiences known to human kind, the doctor often says “Sure.”)

My doula, C showed up at 9:00 am. We started Pitocin at 9:45, and contractions were strong enough that I wanted to get out of bed by 11. My preferred method for coping with contractions: I wanted to be on the birth ball, leaning back into someone. With each contraction, I would go limp and slump forward into a still, silent lump. And then I would just tunnel into my uterus. The center of all that pain and energy and power. I would think of lightening.

I’d envision this.

Ixchel

It’s a card from a deck of goddess cards my friend A gave me—and when I’m feeling particularly lost or confused, I’ll draw one. So that’s what I did before we started the Pitocin. I happened to draw the Mayan goddess of childbirth, Ixchel (whose name I still don’t know how to pronounce). Score.

Between contractions I felt pretty blissed out. I’d look around at my midwife, my doula, the nurses and tell them all how beautiful they were. At one point, I smiled and cooed, “I love pitocin.” (I’d also like to mention that I knew to look for the bliss between contractions because of Nancy Bardacke’s masterful way of explaining labor in pages 86-89 of her book, Mindful Birthing.)

When contractions got stronger, I got into the shower with A and did my whole birth-ball-still-and-silent thing. When we got out of the shower at 2:35 pm, I confessed to my doula that I was starting to want the labor to be over—and she said, “Yeah, since you got into the shower your contractions have started to space out a bit, so I think you’re having more time to think.” Somehow, that helped.

Ten minutes later, at 2:45, they checked me, and my cervix was dilated to 5 cm. I know better than most that dilation numbers are meaningless–women can stay at 5 cm for 10 hours or go from 5 cm to having a baby in their arms in 30 minutes–but I was still deflated. Then I had a fierce contraction while I was lying in the bed. It wrapped all the way around my hips and down my legs. When it subsided, I told my doula, “That one made me want an epidural.”

With that, I got out of the bed, back on the ball, and thus began the “never-ending contractions” portion of my labor. They rolled in, one after another, hardly a break between. And my still, silent meditation became the still, bellowing moose meditation. It was mind-blowing. To be certain, there was no time to think between contractions.

Fifty minutes after my 5 cm cervical check, and I heard my own power moans turn into pushy grunts. With the first mammoth grunt, my water broke. My midwife laughed and said, “The baby’s right there,” and I reached down and felt the wet toadstool squish of head. In the next few moments, in the stillness between contractions, and as I felt my body gathering up its power into pushing the baby out, an earth-shaking awe flooded my senses. It was as close to terror as I’ve ever been without being terrified. I was laying back, head turned to the side. I could see my doula’s blue eyes and the black plastic side of the computer screen next to me. My eyes were focused to the tiniest pinpoint and wide, all-encompassing, to take in the gravity of the timeless, massive, awe-inspiring place where I was.  My body trembled on the edge and at the center of a shocking and immense moment beyond time.

I pushed with my own instinct and then with the urgings of my midwife. And in 6 minutes, I felt this immensely hard, huge, lumpy head fill up and then come out of my vagina. (There’s really no other way to put it.) And then I pushed out a shoulder. And then I opened my eyes and reached down to grab this warm slippery thing, and bring his body up to my chest.

And that’s how it happened.

Had I known beforehand that this is the birth I would have–in the hospital, induced, pitocin, the works–I would have cringed with disappointment and sadness. On this side of things, I feel aglow and triumphant. What a tumble into the space of letting go! Once I was able to shed my own hopes and expectations, I was just left with what was:

  • my steady and balanced partner A, who should really consider moonlighting as a doula
  • the doula of my dreams, C, who helped me through with her presence and humor
  • my midwife, with her remarkable skill and empathy
  • a rotating array of hospital nurses, midwives and obstetricians, all of whom listened and worked with us towards the birth we wanted
  • baby C’s incredible body
  • my incredible body

It was a beautiful birth.

CsBirth
Cbirth2Csbirth3

How I came to love the hospital birth that I didn't want, Part 1

Two weeks ago today, I had a baby.

He’s right over there, in bed next to me.

Photo on 2013-06-15 at 09.58
He is very blonde.

Two weeks and one day ago, I agreed with my midwives that the home birth I had hoped for was not the safest option, and I sobbed while I packed my hospital bag.

Three weeks ago, I was 41 weeks pregnant with an emotional state the equivalent of soggy tissue paper, battling the daily mind-game of “Why isn’t my body going into labor?”

I had forgotten, since the birth of my three-and-three-quarters (!) year old, J, how strange and vulnerable it feels to stay pregnant significantly past the “due date” of a baby. I mistakenly thought that my experience as a doula and of birthing J 13 days after he was “due” would carry me through. I know that statistically, most women carry their babies past 40 weeks. I talk my doula clients through this all the time—and even gave myself the same pep talk I gave one of them in the latter part of this blog post (which may also delight you if you like gluten free baking).

But memories and knowledge barely stack up against the gravity of an extremely pregnant body and the wash of emotions constantly lapping at the shores of the extremely pregnant brain in a culture that celebrates planning and “due dates” and has erected a very intimidating, medically-recommended cut off date of 42 weeks to most pregnancies.

Let’s just say that in those last couple weeks, I swung dramatically between 1) a tower of mindfulness and brave surrender and 2) a complete disaster puddle.

One day, I would feel completely unfettered and at peace—enjoying the relative simplicity of life with only one child and eating these incredible doughnuts.

Thank you, Doughnut Dolly.
Thank you, Doughnut Dolly.

The next, I would be plagued with worry that despite all my efforts at natural induction—sex, acupuncture, membrane stripping—that I would reach 42 weeks and, according to my home birth midwives’ policy, no longer be able to have the home birth that I wanted. And then I would envision a whole host of unlikely and horrendous birth defects that might be the reason I wasn’t going into labor, and also the complete financial disaster that would ensue once we had our complicated hospital birth of our very sickly child on our not-so-great insurance policy.

And then, it happened. I had to jump headfirst into my hospital birth fear and let go of the last shred of control I thought I might have when my midwife said, “This looks like a baby that wants to be born in the hospital.”

At a routine non-stress test (used to assess the health of the baby by monitoring its heart rate and amniotic fluid levels) the nurse saw one significant deceleration of our baby’s heart rate. And my amniotic fluid levels were quite low. My midwives consulted with their back-up obstetrician and recommended that I check into the hospital for an induction in a few hours. Their concern was that the low fluid levels were leading to cramped conditions in utero and that some sort of compression was leading to the heart deceleration that we saw. If those decelerations continued and intensified, they would lead to consistently reduced blood flow and oxygen to the baby.

I was devastated. I would never light all the candles that my friends had given me when I went into labor at home. I wouldn’t hear my own moans in our living room as I labored our baby into the world.

I was scared. Would I feel cornered into making decisions that I didn’t want to make at the hospital? Would the Pitocin make my contractions unbearable? Would the post-partum nurse cram this baby’s head onto my breast in those first few minutes instead of giving me and the baby time to try breastfeeding on our own?

The questions rolled through my head and I cried. I packed. I ate dinner at our house. And said goodbye to my mother and J. It felt like I was heading to a kind of death. Two hours to pack and say goodbye, and don’t forget to pay attention because your family will never be like this again.

We drove to the hospital and stopped on our way to get a popsicle. I allowed myself the extravagant purchase of a local, artisanal, tangerine gelato version from Whole Foods. My partner A. and I scarfed them down while we lugged our bags up to Labor and Delivery.

Photo by sleepyneko/flickr.
Photo by sleepyneko/flickr.

That popsicle was my turning point.

We settled in and unpacked. Hung some colorful scarves on the wall. Chatted with our midwife and laughed with our nurse.

I took some Misoprostol at 10:30 pm, and contractions started 5 minutes later. Sweet, blessed contractions that I’d been dreaming of for days. They were nice, rhythmic, easy ones. The baby had more heart decelerations with those contractions. They gave me oxygen started an IV drip so fast that it left me shaking with the flood of cool fluid in my veins. The decelerations stopped. And I knew at that moment we had made the right decision.

When I agreed to be induced at the hospital, I was overwhelmed by disappointment. This was not what I wanted. And I needed to sob myself silly over it. Now, here I was, thanking my baby for those heart decelerations. They helped us all make what we hoped was the best decision for him. And they confirmed, as I breathed in oxygen and watched the methodical IV drip, that it was.

***

It has taken me the better part of a day juggling one toddler and one baby to write this, so in the interest of my own sense of accomplishment, I’m going to post this now. I hope to deliver part 2 “soon.” ((And here is part 2…only took me 3 weeks…))