birth

Trea’s Birth story

| thedarwinsgirl

The delivery was a c-section.  My choice. Many people will silently judge me for making that decision.  Many people will envy the fact that I was able to make the decision, when so often women are forced/coerced into having c-sections when they aren’t medically necessary.  I chose this option.  The OB on-call tried her hardest to talk me out of it–reminding me of all of the benefits of a vaginal delivery and the possible complications of a c-section.  She was very positive, affirming and persuasive; and I love that she tried so hard to empower me.

Here is my story of why I chose an elective C-section for my final birth.

I was in tremendous pain for several days before the delivery-I’ve had pubic bone separation and hip pain for months that made walking, moving and standing painful. I have had this since early in pregnancy, however, the last week of my pregnancy was by far the worst.  On top of being in acute pain every time I moved, I was sick–headache, sore throat, fever and body aches.  I was exhausted and wasn’t sleeping–3 nights running with little to no sleep.

The day before Trea was born, I had my 40 week OB appointment.  Every time someone touched me for the simplest of procedures I cringed.  My nerves were shot–and I was edgy.  I begged (and actually cried in her office) my OB to induce me on Fri morn. She agreed, after giving me the lecture on risks of uterine rupture (up from  0.5% to 1.5%) and other complications. I went home feeling excited about the next day and optimistic that there was an end in sight.  Tomorrow I would be holding my little girl.

Jeff’s parents arrived that afternoon, and I spent the afternoon in bed, hiding under the blankets with a fever.  We got everyone settled for the night and I decided on a bath and then bed, as my indication appt was at 6am.  Best to get as much sleep as possible.  During my bath, I realized that I had not felt Trea move for a while…and she typically moved a lot!  I decided, for the first time in my pregnancy, to do a formal kick count.  I took 90 minutes and had only felt a few movements.  I freaked out.  I made Jeff take me back to L&D to be sure she was OK.

She was fine, but I wasn’t.  I was panicked, my heart rate was high, and I was on edge.  I was scared and exhausted.  We spent a good portion of the night in L&D waiting for tests and doctors.  They were very busy with many women in labor and delivering.

I decided then, just a few hours from my induction, and after considering my mental and physical state, the expected size of Trea (9 lbs or more), my hemorrhoids (out of control!), the recovery experience I had with Spencer and the risks, to opt for a c-section. We went home and rested for a few hours–the first chunk of sleep I had in days!  It felt great and I felt at peace.

L&D was busy when we arrived.  Our appt. was moved back several times for emergent C-sections.  Everything went fine during the procedure, though I was so very nervous!  I was most nervous about the epidural (I received a spinal block).  It went fine–though they did stick me twice!  And to make matters worse the nursing staff was counting their instruments while I was getting the spinal block.  The names of the instruments and the counting of them is a disconcerting experience.  I remember it vividly from Elliott’s birth.  I tried to go to my happy place, and hoped that I wouldn’t feel anything during the surgery (I didn’t).

Jeff was able to capture an amazing picture of Trea’s first moments of life outside the womb.

Welcome to the world!

After they removed her, Trea had some trouble breathing on her own.  They suctioned a ton of fluid from her tummy and gave her oxygen, but she was still struggling.  The doctors brought her over for a moment, and then they took her to the NICU-Jeff went with her.  I was left alone in the OR while they finished up my surgery and transferred me to the recovery room.

Jeff was moving back and forth from the NICU with Trea, to the recovery room with me.  He was giving updates and checking status–back and forth.  At one point, he was returning from seeing Trea and was about to walk into recovery only to be stopped by the nurses and me telling him to not look and stand back.  I had a slow postpartum hemorrhage, and while it was a lot of blood–it wasn’t enough to need a blood transfusion.  But it was enough to cause concern.  After both Trea and I were stable, I was allowed to be wheeled in to see her.  Finally after 4 plus hours–I was able to see my daughter.

During the time that I was in recovery–Trea received an IV, was on CPAP, and oxygen.  She had labs and a chest x-ray.  The initial thought was that she aspirated meconium, as there was some discoloration in my amniotic fluid.  So, they were treating her for possible sepsis.  They also were worried that during her struggle to breathe that she may have collapsed a lung.  Additionally, they worried that she might develop pneumonia, as she had fluid in her lungs.  The doctors didn’t know what would happen and all of these variables were floating around with no definitive answer.  It was a stressful time for Jeff and I both.

An emotional reunion.

Our reunion was cut short by me vomiting again (I also vomited right before I hemorrhaged)… and with all of the very sick babies in the NICU they quickly wheeled me back to recovery.  We made our way upstairs to the Maternity floor a few hours later, and then began our 3 hour rotation of visits to the NICU for the next several days.  I will detail that in a later post.

I don’t know if my decision to have a C-section caused the respiratory distress in Trea or if the way I was feeling was an external trigger that something was wrong and she needed to be delivered ASAP.  Respiratory distress can happen when babies are delivered via C-section or through a very quick vaginal delivery.  Contractions serve a greater purpose–they not only open the cervix to allow the baby to be born, but they push fluid from the lungs and stomach of babies on their journey out of a woman’s body.  I will never know the reason, and I am OK with that.  I do not regret my decision.  I do not mourn the loss of a vaginal delivery like I did after my first c-section.  And I am grateful that Trea was able to get the care she needed right away.  There is no way to know if she would have experienced the same distress during a vaginal delivery, or if she would’ve needed to be delivered emergently as a result.  All of these factors put my mind at ease.   I knew in my heart that I didn’t have the strength to endure labor.  Looking back, I needed to save all of my strength for handling my baby being in the NICU.

I am at peace with my decision.  My daughter is here, she is healthy and she is home.

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Trea’s Birth day

| thedarwinsgirl
 The morning of Trea’s birth.  One last picture with our family of 4.  
 Grandma and Bobbots welcome their last grandchild into the world.  
 The big brothers finally get to meet their sister.  They look so proud and sweet!
Trea Madaline, born April 5th, 2013 8 pounds 15 ounces 21 inches long.  

Birth Story-Part I

| thedarwinsgirl

My mucous plug was lost gradually over the morning, but I first noticed it at about 8:30 am on Saturday June 30th. I started to feel what I thought might be contractions beginning very shortly after that. I wasn’t sure they actually were ‘real labor’ contractions or if it was false labor, or if the contractions were going to start and then stop a while later.

The contractions felt like menstrual cramps (I only infrequently get cramps during my period, but imagine that this must be what they feel like when they are more pronounced) and they were in my lower belly. I continued cramping lightly throughout the morning, and with more intensity as the day wore on. The key for me was monitoring the time and continuous rhythm. Since I still wasn’t sure that real labor had actually begun, or for how long these contractions were going to last, I was intent on making the best of it.

We had a bar mitzvah’s temple services to attend and a birthday party gift that needed to be dropped off. So, we dropped off the party gift and joked with our friends that our son might be born today, and headed up to the temple for Saturday Services. We arrived a few minutes late, but stayed the 2 hour service and for the kiddish, and then went back to our friend’s hotel to hang out for a bit. At around 3:00 pm, I suggested that we go home, and get changed for the party. It was again a joke that I was in labor, and everyone kept telling me to sit on a towel for fear that my water was going to break. I reminded them that often times a woman’s water doesn’t break, and that wasn’t always the next step in the labor progression. I didn’t want anyone to panic, or get all freaked out and start worrying.

I had expressed my desire for a particular bottle of pink champagne that I wanted to open after Elliott was born, in the hospital. Hubby hadn’t purchased it yet, so on our way home we stopped by BevMo and bought a bottle of pink champagne (although not the one I wanted…).

The whole day I vacillated on if this was it or not. I knew in the back of my mind that this was it, but I didn’t want to say it out loud for fear of freaking myself out. I was handling everything calmly, taking it one step at a time, and up to this point wasn’t making any assumptions. When we arrived at home I had decided that I was likely in early labor and should let my doula know so she can possibly begin planning, just in case something else happened. We agreed to keep one another posted if anything progressed, and hung up. I suggested to my hubby that he set his out of office assistant and tie up his loose work ends, and gather his things together so when I give the high sign, he is all ready. I also started to gather and pack up the last few things that I needed to take with me to the hospital. I was pretty much ready for whatever came next. Hubby was working on the computer, apparently putting the finishing touches on a few last things (though not with any sense of urgency).

I went to use the restroom. After emptying my bladder, I was just about ready to finish up, and a flow of liquid was released. I immediately knew what had happened, and there was no doubt in my mind that my water had indeed just broken!

I told my hubby what had happened, and in typical hubby style, I had to offer up all the reasons why I think that it happened, walk him through the details, and practically convince him that it was in fact true. (This is an ongoing conversation with hubby-ever since the positive pregnancy test-more on that later). I had to make a solitary decision, since it didn’t seem like I was going to get his buy in that my water had in fact broke. So, I called the Midwife hotline from our kitchen phone, which BTW is the only phone in the house. As soon as the answering service gal answers-my water really breaks. This was a main line fracture, just like every woman fears will happen while they are out in public. I start gushing amniotic fluid, and it is pouring out of me. I can’t stop laughing (I often laugh when I am nervous or don’t know exactly how to handle a situation), as I try to explain who I was and why I was calling the Midwife Hotline. I hang up the phone and turn around to a look on hubby’s face that I only wish I could have captured on camera. He looked totally freaked out-a combination of terror, shock and total disbelief (now maybe he will believe me is what I was thinking!).

In the meantime, he doesn’t know what to do, and is just standing there. What does he do first? No, not get me a towel or ask how he can help, or if I am OK. No, he gets the camera, and wants to start snapping photo’s to document the event. We are both hysterical and can’t stop laughing at the sheer amount of fluid that is freely flowing from my vagina. Once we got some sort of control over the flood gates, hubby realizes this if for real, and starts running around frantically to finish up what he needs to get ready. In the meantime, I am calmly waiting for him on the couch to leave for this hospital.

We pack up and go, and arrive at the hospital (5:30 pm). After we check in, we are notified that there isn’t a nurse available in the birth center, so they have to temporarily triage us in Labor and Delivery (bummer). We are laboring there (the 2nd floor of the hospital) for a while, and the midwife on call-Jasmine checks in on us periodically. But, we hadn’t officially checking in to the hospital yet.

Around 9 or 10pm, we are notified that a nurse has arrived and we can be moved to the birth center (4th floor of the hospital). While we are being transferred, they are filling up the tub with warm water for me to labor in. The birth center was nice, the room was big and private, and most important to me it was relatively uninterrupted. Things seemed to be moving along well, and looking back it was really all a blur to me now. We tried different positions on the ball, in the rocking chair, laying down, squatting, sitting in the bed, walking the halls, the tub, and anything else you can think of to ease the pain. I felt ultra focused and introspective. I felt very much inside of my head. I didn’t have much to say, and was really trying to concentrate on the contractions, not think about their length or time, or look at the clock. My Doula kept me hydrated and using the bathroom and she kept me active and calm.

My husband told me later that he and the Doula spoke around 3am, and consulted the midwife and guessed that based on my progress I would have the baby some time in the AM hours (9am was the estimate). Up until this point I had not had a vaginal exam (the midwives feel that exams are disruptive to labor, and are often counter productive to a laboring woman’s progress. I too was worried about having an exam, for fear that if I hadn’t progressed far enough that I would be disappointed by my own progress). Around 4:30am the Midwife comes in to check on me and see how I am feeling, and offers me an exam.

At 4:30 am I was dialed to between 5 and 6 centimeters. It was kind of disappointed that I wasn’t farther along, but I was still in good spirits and felt strong. By 9am, there was a shift change and a new midwife came on staff (the new midwife was my favorite one, so I was happy about that). Rebecca did another exam and I was dialed to 8.5 centimeters. She noted that my posterior cervix was still thick and wanted to help me loosen it. So, over the next hour or so, during a contraction she manually attempted and succeeded in bringing me to 10 centimeters. It was about 11:30 am and I was fully dilated. I didn’t feel the immediate urge to push, perhaps because she had manually manipulated my cervix, or perhaps because the babies head was only at a 0 station. During the exam she noted that the babies head was not facing the correct direction, but that it might shift during the next stage.

I began pushing to try to get the babies head to come down a few stations. So from 11:30 to 2:30pm I pushed, and pushed with each contraction trying to birth my son. However, in that time he only moved 1 station.

This is where my troubles began. I hadn’t be able to urinate for a few hours, and they had to insert a catheter to temporally assist with that. My bladder was FULL. By 2:30pm my contractions had slowed down dramatically, and I was exhausted. I hadn’t eaten since lunch time Saturday, and couldn’t eat while I was in labor as I was nauseous the entire time. The Midwife, then based on the length of time I had been pushing, the fact that I had only moved 1 station, the time that had lapsed since my water had broken, and the fact that my contractions were now 5 minutes apart–she suggested we move downstairs, and they administer pitocin (an epidural was implied as well, since I was already at 10 centimeters and pushing).

I broke down and cried for a long time, I realized then and there that my hopes of an unmedicated vaginal birth were not going to play out the way I had intended. I was grieving the loss. I thought for an even longer time about what that meant to me, what I was willing to do, and what I felt I was capable of. I had been in labor for more than 28 hours with no drugs and had gotten so far, but from the looks of it the babies head was not descending.

I agreed to go down stairs and be assessed. The labor and delivery doctor came in and performed an ultrasound, they did a blood draw and an exam. She spoke with the Midwife and then presented me with my options. They went like this:

Based on the ultrasound the babies head was crooked in the birth canal and that was why he wasn’t descending.
My white blood cell count was high, which meant that an infection could be brewing (it had been almost 24 hours since my water had broken).
I still couldn’t urinate, and my full bladder might be in the way of my progress.
They estimated the babies size at around 9 pounds. Because of his size and head position they didn’t feel that an assisted birth using forceps or a vacuum were recommended. They felt he was too high in the birth canal and assisting could cause him to get further loged as well as cause me vaginal and possibly cervical trauma (not to mention all the risks to my baby).
I would therefore have to push the baby out and they would only allow me to push for another 30 or so minutes, even with the epidural and pitocin.
If I couldnt push the baby out in that time frame, I would have to have a c-section anyway (and I increased the risk of the c-section depending on how far I was able to push him down the birth canal).

So, after I shed another 20 plus minutes of tears, and talked out every option and risk with the doctor, midwife, my doula and most importantly my husband…we opted to skip the pitocin and have a C-section. After more than 30 hours of natural, wonderful, unmedicated labor, pushing for 3 hours, and wanting more than anything to have a vaginal childbirth…I was going under the knife.

The countdown has begun

| thedarwinsgirl

Me and Hubby start our birth class tonight. I am a little nervous, not about the class content though. I am nervous because if we are starting the birth class, that means the birth is getting closer, and Elliott’s arrival is just that much more real! Up until this point, I realized his birth was eminent, but still far off. While he is safely nestled in my tummy, it is only partly real. I can still deny the fact that I am going to be a mother, that I am going to have a son. Once he is here, there is NO denying it. A mix of excitement and a tremendous amount of fear and anxiety. Whoo hoo for new things!!!

Midwife fallacy

| thedarwinsgirl

Vegas baby-On a spur of the moment decision, we decided to go to Vegas this weekend. Prince is playing at his club, and with the help of another couple we were persuaded to drive 5+ hours tomorrow for his show, stay the night and then drive home on Sunday.

I am pretty excited actually. This is likely the last time I will be in Vegas for quiet a while, so even though club clothes for me consist of stretchy waisted skirts and larger size tops…at least I have more on the top to fill it out with–hubba hubba if you know what I mean.

On a different note, I decided yesterday that I wanted to use a Midwife to deliver, rather than an OB. So, I called Blue Cross of CA and asked about the process. When I called yesterday (and spent over an hour on the phone and searching their website, the CSR didn’t know what I was talking about-she had never heard of a Midwife.

We both did some additional research and it turns out that the Medical Group or OB has to refer you to a Midwife. OK, easy enough. I called my Medical Group-who conveniently doesn’t have any Midwives available.

So, I called Blue Cross and asked if I could change groups. Blue Cross said yes, of course, as long as you can find a new Medical Group who will accept you. Again, I thought, “no, problem”. I should know better by now, you are thinking, right?

I did some additional research, and found 3 prospective medical groups, all assigned to a premier women’s hospital. When I called the medical groups I was advised that because I was out of my first trimester that they wouldn’t accept me. All three declined, and as a side note-none have midwives.

For those of you who know me, you will know that I almost always get what I want. I am a fighter. Let this be evidence of one of the times I didn’t. And for the record, this is a pretty big deal. I cried on the phone with the last Medical Group. I have to go through my entire pregnancy, labor and delivery at a sub-par hospital. It wouldn’t suck so bad if I didn’t know any better…but I do. I just know it a little to late.

It hardly seems like a fair process. I forced the gal to give me a reason why they wouldn’t accept patients past their first 3 months-after she researched it, her response was that changing medical groups was considered an interruption in services, and that the new medical group couldn’t be financial at risk. Ahh, the truth seems to have come out in the end. HMO-need I say more.

I am trying desperately to ‘get over it’ and accept that this is somehow how it should be, that I have nothing to worry about, and that thousands of women have babies every day. But the more I read, and the more informed I become the more afraid of the medical system I become.

While I am supporter of western medicine on a lot of fronts, I am also a scared to death of hospitals, episiotomy, needles, c-section, and things that I have no control over (like emergency treatment, and doctors who make medical decisions without my full informed (no-pressure) consent).

The only thing saving me from flying off the handle is that currently I am on Cobra (at least I am insured-I cant imagine what my choices would be like if I was uninsured). And my company is going to be offering medical benefits (effective 03.01.07), and we have our intro meeting on 01.30.07. I can only hope that they have to allow me to join (pre-existing pregnancy and all), and that I can move medical groups at that time.

How do pregnant women find Midwives that are included in their insurance plan? From what I can tell, my plan covers it but conveniently-there are none available. There is a huge movement for natural births, home births, midwives, doulas, and holistic medicine. But, who pays for it? Is this a luxury for the wealthy?