Thursday, July 9, 2015

Zoe Anne’s Birth Story - All Natural VBAC #2



Below is the full version, it's a bit long, so I wrote an abridged version:

My water started leaking about 6 am Wednesday with only minimal contractions. Went to acupuncture at noon to try to get things going. Lunch from Portage Bay in the park by the lake. Headed to UW at 3, walked and did side squats up and down the stairs which seemed to be doing something before going up to triage. Stuck on monitors for almost 4 hours, during which nothing happened. Doulas arrived and we got permission to do intermittent monitoring while we walked and worked out on the stairs (lunges, squats, etc.). Back to L&D at 10:00 with contractions 11 minutes apart to meet with doctors. Got their buy in to push off pitocin until we had two checks with a few hours in between to gauge any progress. Rested for an hour before first check, during which contractions picked up to 7 minutes apart (did you know rest releases oxytocin, which is why lots of women go into labor in the night?). Checked at midnight and was 3 cm, 70% effaced and midposition. Rested another hour and then walked the L&D halls for an hour with my doula. Contractions were 2-3 min apart so I got in the tub.

At 3:45 am I got my second check which was 6 cm, 90-100% effaced, +1 station. Progress! No more talk of pitocin. At 4:20, 35 minutes later, they were having decels and a hard time keeping baby on monitor. They flipped me from hands and knees to my back and found baby on the monitor...down very low. The nurse checked me and I was 8 cm and +2 station. About 4:35, I was in the middle of a contraction when my contraction suddenly changed to a push completely on its own. My nurse did a quick check and felt baby’s head and called the doctors in while my doula had me puh-puh-puh through the next contraction to keep from pushing. They arrived right after (4:40) and confirmed I was complete and able to push. I did about 2 pushes over two contractions and on the second they lost monitoring, so the doctors said “Let’s just have this baby right now ok”, so they had me grab my legs and do another push before the end of that second contraction, and out she flew at 4:45 am! (Yes, I went from 6 to baby born in an hour, it was awesome.) (I say ‘out she flew’ because I delivered her all at once so fast they couldn’t even see if she OP straight up or angled left or angled right, they called it “some sort of OP”). They put her immediately onto my chest. We were able to do delayed cord clamping since she started crying on her own. Jamie cut the cord and she even started nursing like a pro right away. She weighed in at 6 lb 8 oz, 18.5 inches long, 34 cm circumference head. We named her Zoe Anne which means "Life, Full of Grace".



The full version is as follows:

Zoe’s birth story was influenced quite a lot by the births of our sons and the baggage I brought in from those experiences. So to recap, here’s the abridged version of their births.

Judah’s Birth (full version HERE): Transfered care from the birth center midwives to UW at 39 weeks. Complete rupture of membranes at midnight at 39w6d with no contractions. Called UW and was told to come in. Tried to rest at the hospital with limited success. Still no contractions when we started pitocin at 3 pm (at 15 hours after ROM). By 10 pm was having good contractions but started having back labor. By 3 am I couldn’t handle it anymore, having double humped contractions with back labor that didn’t go away, I asked for an epidural. They checked me before the epidural and I was at 4 cm. After sleeping 4 hours I woke fully dialated and was able to push. Pushed for 4 hours and Judah never left 0 station at which point they recommended a c-section. Judah Michael was born Tuesday, December 28, 2010, his due date, via C-Section after about 36 hours of labor. He was 9 lbs 2 oz, 21.5 inches long, and had a 14.5 inch head. He was OP which was why I had back labor and he wasn’t able to descend after 4 hours of pushing. He and Mom were healthy and he went calmly right into Daddy’s arms after birth.

Samuel’s Birth (full version HERE): Friday night early labor 2-7am, died out during the day Saturday, picked back up at 7 Saturday evening. Lasted ALL night long, 5min apart for 40 seconds long - blah! I was so hoping they would die out so I could sleep Sunday. Laid down at 6 am to try to sleep, second contraction laying down, woosh went my water. Complete rupture, no meconium, thank God we were having a baby today! Jumped in the shower to manage some pain, called the doula and the neighbor for Judah, started for the car. Took 45 min to get into the car at 7:30! Another 45 min to get to the hospital. Arrived at L&D and into our room at 8:30 after feeling pressure in the parking garage. Was checked and was 10 cm complete and baby was at +2 station! Started pushing, baby was delivered at 9:18 (on his due date)! All natural VBAC, in God's providence in the same hospital room we labored for 36 hours in with Judah before heading to a c-section. Samuel John was 21.5" long, 9 lbs, 7 and 9 Apgars. We are so incredibly blessed.

Samuel woke me at 5:45 on July 8. I walked back to our room to ask if Jamie would take him for a walk so I could go back to bed for a bit. At that point I noticed that I was leaking, my water had broken, though not completely. I laid down to rest not knowing what might happen the rest of the day. Jamie took Samuel for a walk so I could rest undisturbed. However, Judah woke about 6:30. Jamie stuck around a while to get the kids settled before heading to work around 830. I slept during Samuel’s morning nap and had a few little contractions but nothing seemed to be happening. After talking with my doula I made an acupuncture appointment for noon. In the meantime, I sorted out my babysitter for the kids and vacuumed the living room while I cried. I was starting to get emotional that nothing seemed to be happening, much like when my water broke with Judah. My doula was very encouraging that this could take a little time and that the emotions were good signs things were happening. I called Jamie to come home and he stayed with the kids while I went to my appointment. Before I left we checked in with my doctor’s nurse, who of course suggested that we needed to come in to triage.

Jamie caught a ride to meet me at my acupuncture appointment. We decided to take a bit of time to get some lunch and sit in the park by the lake. We arrived at UWMC around 3:00 and had a conference call with our doula to decide what to do. We knew if we went in we would be stuck there, but we didn't want to head home in traffic only to turn around and come right back through traffic. We decided to take a little time to walk around outside the hospital and then decide. We walked and I did side lunges up and down some stairs we found and started to feel a little something. I was afraid that my fear of the unknown was somehow blocking labor, so Jamie said let’s have our doula come down and “work me out” and do everything possible to try to get things going, his thinking was that I can be free of the fear of ‘blocking’ since I’d be physically doing anything and everything to bring on labor. So about 3:30 we headed upstairs to check into triage. They put me on monitors and of course wanted to check that my water had really broken. Jamie then had a bit of a debate with the nurse midwife doing triage about this, since we were concerned about checks introducing infection risk and since it wasn’t going to change what we did next... In the end, we did do the speculum exam to confirm I had ruptured, but not a cervical exam. My blood pressure was also running a bit high (maybe because I was stressing about this seeming to be the same thing that happened at Judah’s birth) so they ordered pre-eclampsia labs. They moved us into L&D room #1, we were hoping for #6 where we delivered the boys, but then were happy as we decided this was a different story and it needed a different room. We got hooked up to more monitors and it was just at the shift exchange for the doctors so we had to wait for them to stop by. My doula and apprentice doula had arrived and we were anxious to get out of the room and start doing something.

Our new nurse was amazing (it turned out that she was a midwife in a former life so we were so blessed to have her a part of our team). She had heard our plans and knew that we needed to get agreement from the doctor for intermittent monitoring. Finally we spoke with the doctors and of course got the spiel about delivering in 24 hours, blah blah blah, pitocin at some point. We said we would like to do the stairs and do everything possible naturally to help labor get started. With some quiet contributions from our nurse, and with Jamie being REALLY clear with the doctor that unless they had stairs in the L&D, we were going to leave, we got the ok from the doctor for intermittent monitoring. They would postpone any pitocin talk until about 10 when they wanted to reevaluate. I’m a VBAC patient, granted I’ve had a successful VBAC, but they usually insist on continual monitoring, its almost unheard of to do intermittent. Once the doctors left, the nurse said something to the effect that we needed to go now if we were going to go. My doulas jumped up and we were off to the stairs. We squatted, lunged, and stretched our way all over the hospital. Literally, all the way to the surgical suites, downstairs, and up to the 9th floor. It was actually lots of fun getting to hang out, explore, chat and spend time with my doulas. Jamie stayed in our room and about every hour would call us back to the floor to monitor. At one point, he brought me a few bites of mac and cheese to the stairwell, and our nurse came out of L&D to the stairwell with a doppler to find baby on the monitor and keep the doctors happy.

By the time we got back to our room at 10 I was having contractions about 11 minutes apart. All the doctors took a while to come in to chat about what our plans should be going forward. I had been resting quietly and by the time finally came by (10:30-40) I was feeling really tired. They really wanted to do a check and start pitocin if I was less than a 6. Jamie asked if we could have some time to talk about it and we would let them know. I wasn’t sure what to do at this point but knew I didn’t want pitocin. I was also really tired after our work out so I said I just wanted to lay down and rest for a little bit. So we went with that and Jamie chased them down in the hallway to see if I could rest a bit before the cervical check. They agreed that I could have an hour of sleep before they needed to do it. Jamie also had a good thought and pressed the doctor that one data point (cervical check number) does not a trend make (we’re engineers, for which we apologize regularly). If they checked and I was only a 3, for all they know I could have been a 1 a half hour previously. So he stressed that they needed two points to establish progress. So he got them to agree to check my cervix after an hour rest and then checking a second time after some time had passed. The doctors said that was a really good suggestion and offered to give me 2-3 more hours after the first check before making any pitocin recommendations.

I laid down and was able to rest well, but my contractions also started picking up to every 7 minutes apart. The doctor came in around midnight to check me and I was 3 cm, 70% effaced and midposition. Since the nurse had seen and now could feel the contractions, and Jamie had negotiated a 2nd data point in a few more hours, there was no further talk of pitocin with the doctor. My doula put a TENS unit on me and I went back to resting for another hour. About 1:00 my doula got me up to walk the halls which was a great change. We were able to talk through some of my fears and contractions were getting closer together. Around 2 they placed a hep lock which totally sucked and hurt. (the phlebotomist sucked and had to try at least 3 times). By this time contractions were 2-3 minutes apart and I was getting some back labor lying on my back. My doula told me later that one of the other nurses suggested to my nurse that she should maybe turn my pitocin down. HA! No pitocin here, that was all my body doing that. I got into the tub for another change of scenery and some relief. I guess my nurse told my doula to get me into the tub right away because the doctors were heading down for the second cervical check, so since I had just gotten into the tub we were able to buy an extra hour. The tub slowed down my contractions a bit and gave me a nice break. I was feeling them in my back while laying on the bed and in the tub which was a bit tough, but it was manageable since they weren’t also being pumped up by pitocin (like in Judah’s birth), and the pain went away in between.

At 3:45 am I got my second check which was 6 cm, 90-100% effaced, +1 station. Looking back I feel like I was in a transition mindset for large chunks of this labor. I said often that I was “done” and “never wanted to do this again”. At one point I even said ‘I want an epidural’. I was so afraid it was going to be a repeat of Judah’s birth and I wouldn’t be able to handle it. Jamie couldn’t handle my verbalizing because he took it to mean he needed to do something, but he knew I didn’t REALLY want to do it, so it was making him very anxious. So he figured my doulas could handle it better (since they wouldn’t let me get an epidural now), so he went to lie down in the waiting room and try to sleep. (which was where my photographer was patiently sleeping).

When I finally got to transition I think something clicked, I was still done, but I went very inward and quiet. We rolled onto hands and knees to labor and try to sift baby’s position with a rebozo to relieve the back labor. I weathered a few more contractions one at a time.

After about 35 minutes the nurse started having problems keeping baby on the monitor and seeing some decelerations so things started getting a little exciting. My doula and nurse were doubtful that the decels could be from her getting into birth canal because I had just been at 6 cm not that long ago. They quickly and VERY urgently flipped me onto my back to better get the baby on the monitor since they knew the docs would freak out if we couldn’t get the baby on the monitor at this point.... Once they did that and got the heart beat back, they noticed it was so low they were having difficulty keeping the baby on the monitor, so my nurse did a quick cervical check and found that I was 8 cm and +2 station. I was a bit out of it at this point and wasn’t sure why they were flipping me over. I got that they had issues finding heart rate and was worried there might be something wrong. By this point my doula and nurse were realizing I was close to delivering and my doula said something like, “you’re going to have a baby, see the nurses are getting everything ready”. Looking back, I had been reading Ina May’s book in the days before labor and really cluing into the mind body connection they talk about in it. I think once I accepted that I was a 6 and at the start of active labor my mind kicked my body into gear since the only way out was to get complete and push.

About 4:35, I was in the middle of a contraction when my contraction suddenly changed to a push completely on its own. The instant that happened both my doula and nurse SHOT upright and my doula said, “I think she’s pushing….” They asked and I said I didn’t really feel like I was pushing (but apparently my body was doing it anyway). My nurse did a quick check and felt baby’s head and called the doctors in while my doula had me puh-puh-puh through the next contraction to keep from pushing. They arrived right after (4:40) and confirmed I was complete and able to push. I did about 2 pushes over two contractions and on the second they lost monitoring, so the doctors said “Let’s just have this baby right now ok”, so they had me grab my legs and do another push before the end of that second contraction, and out she flew at 4:45 am! (I say ‘out she flew’ because I delivered her all at once so fast they couldn’t even see if she OP straight up or angled left or angled right, they called it “some sort of OP”). They put her immediately onto my chest, at which point, I was freaking out that it was over and I had my baby girl on my chest! We were able to do delayed cord clamping since she started crying on her own. Jamie cut the cord and she even started nursing like a pro right away. She weighed in at 6 lb 8 oz, 18.5 inches long, 34 cm circumference head. We named her Zoe Anne which means "Life, Full of Grace".

I was in shock that she was here and that I had successfully gone into labor without pitocin and made it through without an epidural or a c-section, all after having my water break before the onset of labor. We described Samuel’s birth as redemptive, from the perspective of our previous birth with Judah to all of our losses in the last year, we saw God’s hand at work in it in so many ways. Zoe’s birth felt redemptive in a whole new way, basically directly addressing a lot of the things that felt went wrong with Judah’s birth.