Tuesday, May 26, 2009

Baby Violet's Birth Story


by Mama Darby Saxbe
At 37 weeks, I was put on bedrest after my OB found my amniotic fluid levels to be too low. I spent the next week lying around and trying to rehydrate my womb. Since my doctor had threatened induction if my fluids didn’t come up, I got serious about birth preparation: I drank a few cups of red raspberry leaf tea a day, and started using evening primrose oil for perineal massage and taking it orally. I was having a lot of lower back pain, which made me think that the baby was in a posterior position, so I spent a lot of time leaning forward and doing pelvic tilts on my hands and knees. I also got a massage from you, which was awesome!
At my 38 week appointment, a week after starting bedrest, I was 70% effaced and 1-2 cm dilated (after being zero for zero the previous week). The night of that appointment, I hosted a book club meeting at my house and felt uncomfortable during the discussion, with back pain and also a feeling of twinging and pressure in my pelvic area that seemed to accompany the throbs in my back. By the time my husband Dan and I were getting into bed, around midnight, my back was bothering me enough that I had trouble lying down and was struggling to get to sleep. I still wasn’t identifying the pain as contractions (and I actually think “pressure waves,” to borrow hypnobirthing jargon, is a more accurate term for what they feel like), but a few hours into the night we noticed that it was intensifying at pretty regular intervals, every 10-12 minutes, and that it seemed to peak for 20 seconds or so before tapering off. Despite many attempts to sleep, I spent a lot of the night pacing around the house and trying to stretch and lean forward to relieve the tension that had built up in my back. I wouldn’t call this “labor,” more like “waves of discomfort” – like when you’ve overstretched a muscle and it is sore and occasionally spasm-ing the next day. I was expecting the pain to recede when the sun came up, which had been the pattern when I’d experienced nocturnal back pain earlier that week. By five in the morning, though, the back pressure was intensifying every four to five minutes and was reliably coupled with the pelvic pressure, and I started to suspect that I was starting labor. I also had some nausea and threw up a few times, which I knew could also be a sign. I wanted to wait until 6 am to call our doula, Tracy – it seemed cruel to wake her up before that – but I didn’t quite make it – I think I finally had Dan call her at 5:45. We spoke while I was pacing around the house and she timed a few of my pressure waves. She thought they were too brief (30-40 seconds at that point) to be “real” labor and suspected I might be dehydrated from vomiting; she suggested I drink some water, take a bath, and see if things slowed down.
Dan ran me a hot bath and I got in, and immediately felt some relief. My back didn’t hurt as much and I was able to doze off for a few minutes at a time. However, our bathtub stopper was broken and water was draining out of the tub as quickly as we could fill it. And then we ran out of hot water completely. Dan, desperate to help, started boiling water in our electric kettle and pouring it into the tub to mix with the cold water that was running in. At this point, I had discovered that kneeling in the tub and leaning forward with my hands up against the tile helped to relieve the pressure in my back. He was emptying the kettle into the tub when a contraction started and I lurched forward, ending up with a nasty burn on my left arm. I’m sure if I hadn’t been starting labor, it would have been totally painful, but I was in such a zone already at that point that I hardly even noticed.
My contractions did slow and got milder while I was in the bath, and I dozed in bed for 45 minutes or so after I got out. But the contractions picked up again soon afterwards and I started pacing around the house again. In addition to the leaning-forward-against-the-wall thing, I had figured out that I could get through the waves by jogging my legs back and forth, rocking on the balls of my feet (Tracy later told me there are pain relief pressure points there, so I guess my body knew what it was doing) and breathing as slowly and deeply as I could. Blowing out the breath on the exhale seemed to help. I remembered the hypno-mantra, “limp and loose as a rag doll” and tried to loop it through my head with every contraction, consciously trying to keep my body relaxed. The other words that came to mind – I think from the Mongan Method Birth Affirmations CD– were “I’m so happy that my baby is finally coming to me.” That reminded me to stay positive instead of afraid. I literally stayed in that leaning-up-against-the-wall position and played those two loops in my head for the entire rest of the labor during every single contraction, all the way up to the pushing phase. Not the most diversified experience!
Around 9:30 am, Dan called Tracy again. The pressure waves were coming less than four minutes apart and lasting a minute or more. She still thought I could be experiencing some dehydration-related false labor and suggested we try going to the hospital to get hooked up with IV fluids. We weren’t quite ready to leave for the hospital – our bags were not packed, since my due date was still two weeks away – and we asked Tracy to come over. At around 10 am, Tracy’s doula-in-training assistant, Ashley, showed up at our house. I started a contraction shortly after she arrived and she immediately started working on my back, squeezing my hips and massaging my lower back. It felt fabulous. Tracy showed up shortly afterwards and the two of them alternated giving me back counter-pressure and massage and along with words of encouragement. It was so nice to have them there – it felt like the birth was suddenly in expert hands, and I could relax and focus on laboring rather than worrying about whether this was really “it.” We lingered at home for a while as Dan ran around tossing our stuff into bags. The next hour or two passed pretty quickly – the pressure waves grew in frequency and intensity, but they never got unmanageable. If I leaned forward, breathed deeply, and felt some massage or pressure on my back, I could get through them with minimal discomfort, and then enjoy the couple of minutes of “rest time” in between. I was already in a pretty tranced out state – I am super nearsighted and hadn’t put my contact lenses in that morning, which actually helped me get more into a zone.
By noonish, we decided to head to the hospital. I have a vague memory of Dan and the doulas lining the back seat of the car with trashbags and towels, and of Ashley steering me into the back seat, where I kneeled forward with my head up against the rear window. She sat next to me and rubbed my back during every contraction while Dan white-knuckled his way through the 15 minute drive to Good Samaritan. I remember Ashley leading me by the elbow into the hospital lobby and up to the 8th floor, then getting to the front desk and trying to fill out paperwork in between contractions. It was funny – I was pretty lucid in between waves, able to fill out my insurance information and chat with the nurse, and then the second a contraction started my body would take over and I’d go completely into my zone. We were taken to triage and I was given an internal exam – the first time I had tried to lie down since the night before, and one of the first times during the whole labor that I was truly uncomfortable (not from the exam, just from the fact that I had to lie supine and couldn’t do my leaning-forward thing during the contractions). The nurse said I was totally effaced and six centimeters dilated, and I remember Dan and the doulas cheering and clapping. I think if I had been 2 or 3 cm, I probably would have asked for an epidural, but at this point, I realized I was going to be able to have the natural birth I had been hoping for. Tracy was really encouraging and told me that getting from 2-6 centimeters was the hardest, slowest part of labor. I remember saying something like, “I know I can do this, then.” I also remember saying “Anyone who tries to give birth without a doula is an idiot” and Tracy saying that she wanted to put that quote on her website. I probably wouldn’t word it so harshly now, but I really do feel like the doulas made such a massive difference to my labor. With them there, I was able to really stay in my body without needing to control the process. I am pretty Type A, but I was able to abdicate the “management” of the birth to Dan and the doulas and just focus on laboring.
For some weird reason, there weren’t any labor and delivery rooms available when we checked in and it felt like we were in the tiny triage room forever – at least an hour, if not two. I spent every contraction leaning up against the same part of the wall – I remember Tracy joking that they should put a plaque with my name on it there. My water broke while we were in triage, although it was more like a trickle than a gush. At some point, Dan got frustrated with the delay and went out to find our nurse, who apparently was totally clueless and kept asking whether I needed pain medication. He said, “No, and also, don’t ask her if she needs it, because she is trying to have a natural birth,” and two seconds later the nurse came into the room and asked me when I was going to need pain medication. He requested another nurse, who was much better – she came in and looked at our birth plan and got us into a room pretty quickly. In fact, the room we ended up in was the same one we had seen when we did a hospital tour during our (fantastic) childbirth preparation class (Heart for Family) at Good Sam. I remember thinking of that as a really good sign, and finding out around the same time that the doctor on call was Allison Hill, who had been my primary doctor throughout the pregnancy.
Our room was super nice, with a great view and a fancy bed that could be positioned in zillions of different ways. That said, I didn’t really appreciate it, because I spent most of my time there in the bathroom, laboring up against the tiled wall next to the toilet. Dan and I got into the shower, which felt great, and I dozed off a little while we were in there. He later told me that I said only two things to him during the hour we were in the shower – “back,” and “lower back.” I still needed to feel counter-pressure with every wave. After we got out, I changed into an extra-large men’s T-shirt for the last stage of labor and moved to the bed, kneeling over the squatting bar with the doulas behind me rubbing my back. Towards the end of my shower, and then in the bed, my pressure waves took on a new intensity and started to feel more localized in my cervix – like the baby was really pushing down. They were also coming more and more on top of one other.
The doulas had told me to tell them when I felt like I needed to have a bowel movement, because that would signal the beginning of the pushing stage. I wasn’t really feeling this, but I told them I thought I could try pushing. Everyone had told me that the pushing stage often felt good and could be a relief, and I think I was hungry for this after being in transition for a few hours. Dr. Hill came in, and checked me – I was 9 centimeters, but she thought she could massage me open a little more. Even though I had spent almost the entire labor standing up or kneeling, she really wanted me on my back for this last stage. It was really challenging for me to get into this position since it intensified the pressure in my lower back so much, but I was also ready for the labor to be over.
The pushing stage was really different from the rest of the labor for me, and in retrospect, by far the hardest part, mentally and physically. The rest of the labor had been very instinctive – I was moving the way my body wanted to move, and staying very much within the bubble of my trance state while Dan and the doulas bustled around me. In the pushing phase, I was suddenly following someone else’s instructions. Dr. Hill is very high energy, which can be motivating but was also very different from the mellow vibe of the rest of the labor. Dan and the doulas circled around me in a cheering section which, again, was motivating but also took me out of my body and put me more into my head. There were suddenly a lot of directions to follow: count to ten, hold your breath, pull your legs back and relax them at the same time, bear down and push out. They all felt confusing and counterintuitive and I had a hard time doing what everyone wanted me to do. I think everyone got frustrated with me, and I got frustrated with myself and with the process. Contrary to my expectation, pushing did not really feel good – it mostly felt weird and unnatural. Dr. Hill was stretching and massaging my perineum with her hands, which added to the strangeness. In retrospect, it might have been better for me to have labored another hour and get fully dilated, rather than trying to force things along.
Still, after twenty minutes or so, I slowly figured out “how” to push and the baby’s head started to appear. Everyone got excited, and Dan, who was holding my hand, started to cry and tell me that our baby was coming. I kind of wanted to stop pushing and go home at this point, but I tried to focus on the baby and how much I wanted to meet her. Once her head was really ready to come out, Dr. Hill had me reach down and feel it. I wish I could say this was a transformative moment, but the head felt bizarrely soft and squishy, like a wet puppet. A couple more pushes and it was time for the “ring of fire.” I pushed through it and felt intense pain for just a few seconds – this was the only time during the whole labor that I screamed – and then she was entirely out and on my chest, a gray, wet creature that seemed half human and half space alien. I thought I would instantly feel elated, but I was shaking and shell-shocked – the “high” didn’t really set in until an hour or two after the birth. All in all, I had pushed for 40 minutes and, amazingly, I didn’t tear at all. For this, I have to credit Dr. Hill and her perineal massage: as much as I disliked being on my back and losing some of my mental focus, I have to say it was worth it to make it through the labor without needing a single stitch.
Violet was born at 5:33 pm, about four or five hours after we got to the hospital, and about 8 hours after labor started “for real.” She was 7 pounds, 5 ounces, which made me happy that she didn’t come two weeks later and a couple pounds heavier! I wouldn’t say it was an easy or entirely pain-free experience, but I would say that it was much more manageable than I had thought it would be. Until I got to the pushing stage, I felt very calm and in control. The pressure waves were sometimes intense, but never unbearable. As long as I breathed deeply and stayed relaxed, I could get through them with very little pain. I remember saying to Dan at one point during the labor, “This really isn’t that bad – it’s just extremely time-consuming.” I wouldn’t say that I felt that way the whole time, but it is true that a lot of the experience was just about staying in the moment and being patient with my body.
I spent a lot of time studying and practicing hypnobirthing before the birth – I sampled three different programs (Mongan Method, HypBirth, and Hypnobabies) and listened to the CDs almost daily during the last couple of months of the pregnancy. When I imagined what my labor would be like, I pictured myself lying down, in a trance, with headphones on, listening to CDs and practicing specific self-hypnosis techniques. But my labor was nothing like that – I was on my feet almost the whole time, I was feeling most of the pain in my back, which I hadn’t expected, and I repeated the same two phrases to myself throughout the entire experience. I didn’t use any of the “tools” I had prepped with. That said, I still think the hypnosis practice was incredibly useful. I was able to zone out and stay relaxed throughout the labor. I was also able to stay positive and not panic. The hypnosis practice also made the last few months of my pregnancy a really relaxing and special time. Prenatal yoga was helpful in a similar way – it helped me get connected with my body and practice staying relaxed even in uncomfortable positions, and it hooked me up with a supportive community of women. And I can’t say enough about how amazing the doulas were. For eight hours, I had someone rubbing my back during almost every single contraction. I can’t believe how strenuous a doula’s job is – and incredibly, after my birth was over, they had to head straight to another one! I am so grateful to them, and to Dan, for making the birth such a great experience.
Now Violet is almost two weeks old and we’re approaching her official “due date.” The first week postpartum was hard – probably tougher than the actual birth experience – but we’ve hit our stride since then and are having fun getting to know each other. So far (knock on wood) V is a really sleepy, mellow baby. We feel really lucky and we’re definitely counting our blessings. Yay babies!

4 comments:

Jennifer Olson said...

What a great birth story! I found it especially inspiring because Dr. Hill is my OB and whenever I watch her television show it makes me think she doesn't really support natural childbirth. Sounds like you more or less had the kind of birth you wanted and that's so great. Congrats!

Darby said...

Hi Jennifer...yes, I watched the Deliver Me show during pregnancy and was worried that Dr Hill would be really intervention-oriented. But she was actually super supportive of my desire for the natural birth. I have heard that she would like to incorporate more natural births into the show but the producers tend to favor more "dramatic" births. Good Samaritan was great, too, in terms of letting us have uninterrupted time right after the birth and not whisking the baby away for weighing, measuring, shots, etc. until after we'd had at least an hour together. Good luck with your delivery!

Nicole Martin said...

Oh my Gosh Darby, I cried through your whole story! I am incredibly thankful to have read it because it gives me hope and reaffirms that I CAN trust my body to know what to do.

We miss you at yoga.
Please keep well.
Nicole.

asher said...

oh my gosh darby thank you so much for all the information. your story is super inspiring, mostly because you said that the labor felt manageable. i am so so happy for you and your new family. violet is adorable and i hope i get to meet her! we miss you at yoga but are all so happy for you. thinking of you often.

asher