Tuesday, August 21, 2012

Carter's Birth Story


If you don't want to read all the details, then skip this post!! I spared you the awesome pictures but there are some cute ones at the end. =)

At 4:30am on August 15th at 38 weeks pregnant (LMP) or more likely 37w5d pregnant (ovulation), I awoke suddenly feeling like I had peed. Unlike last pregnancy when my waters also broke, I didn't feel or hear a pop. At first, I really thought it wasn't my waters as I could stop the flow and Carter's head had apparently dropped and sealed the flow. It wasn't as much as last time nor as frequent. A few minutes to wake up and I knew what was happening. I tried to relax but gave up and got in the shower. I came out and told Tim he wouldn't be going to work this day.

Knowing that I had 12 hrs to be in active labor or the birth center would have to transfer me (state law), I headed outside to walk. It was nice, cool, and dark still and with some curb stepping I got regular contractions started. They weren't super painful but I hoped they'd progress. They were short, 40s each, but occurring every 2 minutes. At 7am, I phoned the birth center. They were aware that this same situation happened with Nolan and I didn't deliver him until 36hrs later and a whole lot of Pitocin. My midwife on call suggested I start nipple stimulation and once contractions picked up start walking. She said to rest if I felt tired and she’d call back in the early afternoon. Not sure if you’ve ever had to do it, but it’s a little weird, okay a LOT weird, to have to manually roll your nipples hoping your uterus will start contracting. It does, however, work like a charm!! I tried the breast pump but it was way too harsh so manual it was. 

Early on in my pregnancy when I chose to deliver at a birth center instead of a hospital, I researched the laws to make sure it was going to work for me. Florida requires moms whose water break prematurely to be in active labor, defined as 5cm dilation, within 12 hours. I spoke at my consult with the birth center about my worries. I was reassured that it’s highly unlikely for premature rupture of membranes (PROM) to happen twice and that since my body had been in labor it would be much easier to get into labor this time around. Besides that, I was told that there were tricks and tips to get me going so I could continue to labor at the center. I asked up front if my waters break early if I should keep it to myself and therefore not invoke the 12 hour clock. I had in fact done this with Nolan in order to avoid getting pushed into Pitocin immediately. We didn’t even go to the hospital until 12 hours after my waters broke. I was reassured that there was no need to do so because by calling in early they’d have all 12 hours to help get me into labor. 

Apparently though, in the end this really wasn’t the case. Looking back, I should not have called in until I was in active labor. The 12 hours is arbitrary and premature breakage of waters only increases the risk of infection by 0.5%. It’s a risk I would be willing to take as the risk of c-section increases by many, many times if you’re pushed into induction. When my midwife called back at 3pm I asked for more tips to get things going. Walking got contractions but every time I stopped they stopped and I was worn down and melting in the heat. I couldn’t be exhausted before true labor began. She mentioned continuing what I was doing. She started to suggest something else but changed her mind. I was told to head into the birth center at 5pm. 

At 5pm we arrived and I was checked for dilation. Contractions had begun again but weren’t super strong yet. I was only at 3cm and really disappointed. Ashley (midwife) went ahead and manually stripped my membranes in the process hoping to move things faster. After the exam she stated that since it had been 12 hours I needed to go to the hospital. Instead of screaming which was my first thought. I calmly explained how I felt. I had told them from the beginning that this was a likely situation and was over and over at each appoint told I’d be helped to get into labor. I thought this meant more than being told to walk and stimulate my nipples and come in at 12 hours. Ashley left the room to consult with the other midwives on the phone and came back a few minutes later. They had decided to let me have another bit of time and suggested a few more things. Yum…castor oil. Tim headed to the store and grabbed castor oil and orange juice. This natural laxative brings contractions on as it makes your bowels contract. Fun times. I took it and we headed home for a few hours to return at 8. This gave us time to get Nolan fed and into bed for the night. Our great friends came down to sit with him and we headed back our bags fully packed and prepared to have a baby in hand the next time we came home. 

The castor oil hadn’t actually done much yet but by the time we got back to the birth center I had regular contractions at about 5-7 minutes. They were painful in the normal early labor way. Seeing I had progressed, we started walking the halls with our midwife and again doing manual nipple stimulation. I walked and walked and walked! The castor oil kicked in too which was lots of fun. We gave it a straight hour and a half and by the end I was in pain and not able to talk through contractions. They were three minutes apart. Ashley gave me one more check and afterwards we discussed my options. I was still only at 3cm. Ashley was kind of astounded and said she was certain I would have progressed to a 6 by this point but my body wasn’t cooperating.  I basically had two options. I was being released from their care at this point. They would transfer me and accompany me to Shand’s hospital in town or I could have my charts and would be on my own to go elsewhere. Tim and I considered our options and narrowed it down to two paths. 

One: We follow their recommendations and go immediately to Shand’s. It’s a more non plush hospital but as part of the University of FL it has amazing care and is one of two level III NICU’s in town. Not that we would need that, but it’s nice to know the specialist are there. Our birth center recommends them because they are familiar with the center and understand the patients coming in without their own doctor. They staff OB’s ready to take in walk in pregnancies. They let mothers labor naturally and try not to push c-sections. If I was being transferred though, it would be with the recommendation that Pitocin be started immediately. My hopes for a natural birth would be slashed as Pitocin is pretty horrible when not taking any pain relief. I labored for hours with it last time before finally taking the walking epidural and just didn’t want to do it again.
Two: We take my charts and head home. Once in active labor, we’d head to the close and very nice comfy, and new hospital (where we actually delivered Nolan). This would mean we’d be on our own and hope they had an OB on staff ready to deliver. This could lead to lots of questions and likely a hostile environment. We were also a bit concerned that it would possibly take Pitocin to get me going so I would not go into active labor in the next 12 or so hours. Last time I was on the max dose of Pitocin for hours without progress so what was the likelihood that this time I’d progress on my own? I’d hate to show up not in active labor and without a doctor. 

In the end, we decided to head to Shand’s with our midwife. She sent over our paperwork and a room was waiting for me when I arrived. On the drive and especially in the gravel parking lot, my contractions became even more intense. They required concentration and I could not move during them. Squatting helped but I felt positive things were moving. Once checked in, I got in to my room and the nurses started things. I had to have general bloodwork done before they would start any pain relief so they drew blood, took vitals, and got things going. The Pitocin pump was ready but would not be given to me until my labs were closer to coming back. The labwork was slated to take an hour and I got into the room just before midnight. Once there, things progressed pretty speedily. My contractions were up to about a 7 on a pain scale of 1-10 and after 40min they decided to check my dilation. I was now suddenly a stretchy 7. They agreed to hold off on the Pitocin since I was moving along. I became nauseous and, yep, puked all over the place. After a gown change and a nice shiny larger pail placed next to my side, they decided to transfer my room. My equipment wasn’t reading at the nurses’ desk so we went to a new room. Once in the new room, the OB that would deliver me came in. Memories here are a little fuzzy but he was really nice and asked me what I was wanting. 1.) healthy baby and 2.) no c-section were my main concerns. We talked about immediate skin to skin and delayed cord clamping as much as one in late labor can talk! He was calm, collected, and non judgmental. I never felt like I was inconveniencing him which I felt a lot during my last labor. 

At this point, Ashley started commenting that I was definitely getting close. Hormones had kicked in and I was shaking and having other odd symptoms. I had to lift myself off the bed with each contraction as baby was very low and felt like he was trying to come out the wrong way!! I knew everyone said they always felt like they need to poo but it was just baby. I kept telling myself it was baby and I was fine. At this point, I felt like I wanted to push but figured it was too soon. Instead, I started pushing just a tiny bit while lifting myself during each contraction. It relieved a bit of pain but wasn’t enough that anyone noticed or told me to stop.  I had moments of doubt and wasn’t sure I could do it as pain was at the most I thought I could take and baby wasn’t here yet. Everyone reassured me but of course it didn’t help! I managed the contractions with low moans and avoided any hysterics or screaming. 

Finally, I told them I was gonna push. The nurse checked me and said yep I was ready. They called the OB and still were trying to get equipment in the room. As soon as I saw stirrups, up went my feet and regardless of if they were ready I sure was. The OB entered again and asked if I had been consented. Apparently they have to ask you a ton of questions before he can touch you. So while contracting constantly and trying to push all alone I was answering whether or not I consented to have a baby and a bunch of other things. My humor was at least still present so while pretty much yelling at him I said of course I consent to anything let’s get going. At one point, Tim laughed at something and I remember telling him to stop laughing. Everything was too much to take at that point. 

As I got ready to do the first real pushes with doctor in place and everyone ready, Tim got the camera. We had planned to videotape the birth at the birth center but had to settle for pictures at the hospital. I pushed with all my might and it was the most painful thing I’ve ever felt. Any descriptions I’d read just didn’t do it justice. Once that contraction was over, I voiced my concerns that I didn’t think I could take 45 minutes of that level of pain and Nolan took 45 minutes of pushing. Ashley assured me that Carter was right there. He didn’t need pushing down, he just needed pushing out. She was certain it’d go fast and commented that he had a full head of hair, just like his brother. I got ready and pushed 2-3 times with each contraction. At least with pushing you are doing something instead of just getting through the pain but it is in no way the “relief” I’d heard about. I also always heard it felt like a burning ring of fire moments before baby emerged but I always thought that meant once not with every push. I could feel the stretching with every push and each time I pushed was the most intense and painful thing I’ve ever done. I’m not sure how long I pushed nor could I keep my eyes open to see progress. I felt him crown though and every said his head was out. I tried to go slow to avoid tears but just couldn’t a strong push later and my baby came out. Immediately the pain was gone and I felt 95% like my normal self. 

Tim says the view this time was much different too. I wasn’t able to watch just from the physical aspect my eyes were not focused on the mirror this go round. Nolan got close to delivery and you could see the top of his head for numerous pushes. With Carter, apparently the entire area bulged and then moments later his whole head came out. The resistance was definitely not as strong and my pushing was very effective.

Carter Ridley was born at 2:28am on August 16th weighing 6lbs 13oz and measuring 19.75 inches long. I held him right away and he was a champ at nursing. After the cord stopped pulsing, Daddy got to cut it. A bit more painful moments and it was all over! This time I only tore a little bit (2nd degree but not bad) and truly felt so much better after the birth than I did last time. I was able to get up and walk within moments and felt pretty normal. 

If you’re thinking of having a natural birth, I urge you to do so. It’s the most empowering thing you can ever do and you can definitely handle it!!

Last belly shot. After water broke!










3 comments:

  1. I am so proud of you, momma!! Great job staying calm and having the best birth story you could have given the circumstances :)

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  2. Awww! So sweet! He is just perfect :)

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  3. thank you for sharing this. it was very inspiring!

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