Tuesday, May 22, 2007

Birth of Rose Marie N.

My sweet Rosie (whom we swore we would never, ever call Rosie, but Lacy calls her that, and it suits her) is coming up on her first birthday later this week. Now that it's been a year, it is time for me to heal from her birth and write out her birth story. Rose's birth did not go how I envisioned, though it was still an unmedicated vaginal birth, with very little tearing, and I felt great immediately afterward. I was going to wait until Rose's birthday to publish this, but I've written it out now and I just want to get it out there now. It's really long, so don't start unless you have a little time on your hands! There are a few photos at the end, from May of last year. Enjoy!

Rose was supposed to be born at home, like Lacy was. I planned for a homebirth, seeing the same midwife and setting everything up at home for a homebirth. The only difference was, this time we weren't using a birthing tub. That was okay with me, because I had done it once and I could do it again, and supposedly it is faster and easier the second time around. On Tuesday afternoon, I had an appointment with Constance, the same midwife who helped with Lacy's birth. She asked me if I was ready to have a baby tomorrow, and I said I was more than ready, since tomorrow was my due date and I had a feeling this babe was huge. Since my last iron levels were borderline, we did a quick iron test and had to wait until 7 for it to come back. The three of us (Dave, Lacy and I) went to dinner at Sizzler which was nearby. We came back and Constance checked me. This was my first internal exam of my pregnancy. I was about 1-2 cm at this point, I think, and not much effaced yet, which is common for a second pregnancy. She vigorously stripped my membranes and by the time I left, I was 4-5 cm dilated. Now we just had to wait it out, and labor would soon start.

The next day, I wasn't feeling too well so I decided to call in to work and maybe go in the afternoon if I was feeling a little better. I decided to give myself some time to get ready for the birth should it happen that day, so I took Lacy over to the babysitter's as usual. Dave and I spent the morning picking up the house. We ended up going to the chiropractor for one last adjustment, and then went to lunch to El Nopal with our chiropractor Burt, his wife Jainnine (who was at Lacy's birth and did Rose's belly cast), and his office manager. I started feeling some contractions during lunch, so I just ordered a salad, beans, rice and tortillas, knowing that I wouldn't want anything heavy. Before we were finished with lunch, I was sure I was in labor so I paged the midwife and Dave and I went home. Constance called me back and said that the birth assistant would come over soon to set up, and she'd be there in a while if I felt like I needed her. So the assistant came over and we chatted, I felt like I had some time to go still after she set up, so she left and let Constance know. I called my mom and the babysitter and a few other people, letting them know there would be a baby today, but it was going to take a little more time. Dave and I decided to watch a movie early in the afternoon. We only made it halfway through the movie when I started hard labor. Constance returned at 3:30. Before she returned, my mom arrived with food for everyone to much on as the labor progressed, and a couple of my friends who were going to support me had arrived (Jainnine and Bethany), and my dad and Dave's dad and fiancee I believe were also outside. I spent some of my labor walking around the streets moaning and frightening small children, and a lot of time was spent in the bathtub. This was an especially hard labor and the water was very relaxing for me, and really helped me cope with the tremendous back labor.

While I was in the tub, Constance came to check on me several times, and some various girlfriends and my mom would come in and out to help me by pouring water over my belly, which helped sooth me. At some points I was alone, and my late mother-in-law, who was at Lacy's birth, was definitely with me. It was only at those times when I was alone that she was with me in the bathroom. She was pouring water over my belly. I could literally feel it being poured over my belly. It was a really neat experience that I will always remember. I know Kathleen was with me and with Rose the whole time I was in labor. Constance felt like she was intruding when I told her that I felt the presence of my mother-in-law, and she told Dave with a tear in her eye that she knew she was with me, too.

Things did not progress as easily as they did with Lacy's labor. In fact, several things happened that made Constance start thinking that a hospital transfer would be in our best interest. 1) baby's heartrate was in the 190 range, which is too high. We weren't sure why it was so high, and changing positions did not do much for the heartrate. 2) the baby had at one point descended into my pelvis, but she had floated up again. Because my membranes were still intact, there was a slight chance of cord prolapse if they ruptured at that point. Cord prolapse is extremely dangerous and requires an immediate c-section. Because of the high heart rate that wasn't coming down, we couldn't just wait around to see if the baby would descend again. We needed to get the baby out sooner. 3) I developed a slight fever, so there was a small worry of infection. If I had just one of those things without the others, we would have been able to continue at home. With the high HR, but with baby in the pelvis, she would have ruptured my membranes and baby would have been born shortly thereafter. With the baby high in the pelvis with intact membranes and a normal HR, we would have waited it out. The fever was probably the smallest concern of all three, but because it was there we had another thing to worry about. So she said we needed to go to the hospital, I had a good cry, and we loaded up in her car, with the midwife assistant driving, Dave riding shotgun, and the midwife in the back with me on my hands and knees driving down the freeway during rush hour. Hands and knees seemed to be the position that Rose tolerated best at this point.

We arrived at the hospital around 6 or 6:30 (everything's kind of blurry at this point, since I was deep in laborland). Constance instructed Dave to run into the emergency room entrance and tell them that his wife was READY TO PUSH which wasn't exactly true since I was still 7-8 cm dilated with intact membranes and a high baby. So they brought out the wheelchair and the lady who pushed it sternly told me to sit back in the wheelchair. I yelled at her, no I wouldn't because "I'm in labor, dammit!" I don't swear, even in hard labor, but this lady really struck a nerve in me. She looked like she was 20 years old and probably hadn't ever been pregnant, so it irritated me that she was bossing me around when she had NO CLUE what it felt like to be in transition! I had been a 7-8 for a few hours so I had quite a long transition already and wasn't going to be bossed around by someone who was just pushing me to L&D!

The L&D nurse we were given was great and shooed everyone who wasn't necessary out of the delivery room. She was fully supportive of natural childbirth, and I think had several NCB's herself, and the on call OB was very supportive and wonderful, as well. I had been terrified of a "cascade of interventions" once I stepped into the hospital, but the support I got from these two ladies was great and helped me through it. For some reason labor got a lot more painful once I got to the hospital (probably due to my fear of being in the hospital!) but Dave was really supportive and somehow I got through it without drugs. I kept telling everyone, "I can't do this anymore! I need something!" I wasn't going to ask straight out for drugs, I wanted them to suggest it so it would be okay for me to get some. But nobody ever suggested anything, they just kept supporting me and saying that I could do it, and I was doing it, and that I was doing a great job. Dave and I were in the bathroom alone at one point and I told him that I really needed drugs. He told me, "you made me promise that I wouldn't let you get drugs when you were in labor. So you can't have any or you will be mad at me." I realized that he was right, and that it wasn't going to be much longer. I was just discouraged because I had been at 7-8 cm for about 3 hours at this point.

When I got out, the general consensus was that I should have my water broken because the baby's heartrate wasn't recovering so this would speed up the process. I looked to my midwife who said she agreed that this needed to be done. They broke my water pretty soon after I got there which helped me progress the rest of the way, and also for some reason brought Rose's heart rate down to a more normal range (140-150). As they were breaking the water, the nurse pressed on the top of my belly to help the baby descend quickly to hopefully prevent a cord prolapse situation. It only took about a half hour or so before I was completely dilated, with just a lip left that the OB thought I could push away. I gave a push, and the lip was gone.

I wasn't feeling much like pushing yet, but I felt like this was a huge emergency so I needed to push to get her out as quickly as possible. So despite my instincts to just let labor continue for a while longer, I started pushing in a semi sitting position, not the most effective position for pushing out a baby because it can compress your pelvis causing less room for the baby to fit through. But I only needed to push for 12 minutes and she came out (I pushed for 22 minutes with Lacy) Rose was born "sunny side up" with her chin sticking out, which is a fairly difficult position for babies to be born, because you're not starting out with the smallest spot on the head going through the birth canal first (actually my posterior baby is one reason why my labor was so tough-- back labor hurts!). Even though it seemed like this huge emergency, the OB let Dave catch his baby, and he passed her to me after she was born, still attached to the placenta. I was expecting her, with her long brown hair! I knew she was my daughter. looked just like me when I was born! Even huge, like I was. Everyone was guessing at her weight, and I was sure she was over 9 pounds. I held my baby and cuddled her for a while, and then they said they were going to cut the cord, so Dave got to cut his first umbilical cord (he didn't cut Lacy's because it was wrapped tightly around her neck several times so it needed to be cut right away). Eventually, they took her away briefly to weigh and measure her (21 inches and 9lb 6 oz!!!) and gave her a vitamin K shot. We were able to get out of the eye goop and they didn't give her a bath. She was only gone out of our sight for seconds.

I had considered going home, but I thought I needed to stay at least a few hours to recover, and since she was born at 8:18 pm and we didn't have a car there, we decided to stay overnight. Big mistake.

My post partum nurse was really mean and kept disturbing me all night long. One of the reasons we decided to stay was because we wanted to get a little sleep. Yeah, right! She kept wanting to prick Rose's heel and take my blood at 4 am. Why can't my blood work wait until the next morning after I get some sleep? I just had a baby, darn it! Let me be! The meanest thing she did was not let me nurse Rose for an hour so she could check her glucose levels. Since she was so big, there was a worry of low blood sugars, and they had "forgotten" to check her levels after birth. So now it was 5 hours later and baby is nursing well, and they ask me to stop nursing her so they can check her levels? I did this, and Rose screamed and screamed to nurse, but I wasn't supposed to. I almost cheated and let her nurse, but I just wanted to get the heel prick over with. So we stuck it out. Her levels were well within the normal levels, but the nurse informed me that we would need to perform this test twice more that morning. The thing that really made me mad was that Rose then got tired and didn't nurse well for the next 12 or so hours. She just nibbled and slept for a while. When the nurse came again for the next heel poke, I informed her that because the glucose levels were so good (I think they were 42, and the low normal level is 30, so pretty good), I was going to decline the next two tests. I wanted out of there! The next morning, I pretty much said I wanted to go home ASAP, but it seemed like whenever we were ready to get going, another road block was put in our path. We actually fell asleep around 1 or 2 when they were doing the hearing exam, which took a loooooooong time (and since I am a conspiracy theorist, I think they did this on purpose to keep me there longer!). So we waited a little while longer and then I decided I was going to go now, so get me the discharge papers, darn it. They started the ball rolling on this, the lactation nurse visited with me, I got my free bag of goodies from the formula company, but the lactation nurse had taken the formula out already. She told me she always takes the formula out of the bags (I wonder what she does with all that formula?). It actually had a couple really cool things in it, including a nice board book that I still read to my kids a lot.

Finally at 5, rush hour again, my mom came by with Lacy to take us home. We got settled in, I nursed both the girls together for the first (but definitely not the last) time, and then mom took Lacy with her so we could have one last night of just the three of us before we brought Lacy back home.

One more thing to add, that wasn't part of my birth, but is important to Rose's story. Many people who were there were worried about the hospital transfer, because it wasn't clearly articulated to everyone why we were there. We transferred to the same hospital that Dave's mom had died in less than a year before. Dave's dad was sitting outside on the steps contemplating everything that was going on, and he saw Kathleen rocking a baby. She looked at him, and turned the baby around so he could get a good look at her. He wasn't sure why she did this, and was afraid that this would be the only time he would know what she looked like (remember, he wasn't clear on why we transferred!). A little while later, he saw her again, this time there was no baby, and she got up and left. A few minutes later, it was announced that the baby was born. Dave said, "she has a lot of dark hair, doesn't she?" Just an amazing part of this birth story that I love!

Rose's birth was a very healing experience for me and our family. Dave knew from the beginning that this baby wouldn't be born at home, but in the hospital, and now we know that it was so we could all heal from the death of Kathleen which took place in the same hospital Rose was born at. The birth wasn't really that bad overall, and wasn't as bad as I had envisioned a hospital transfer to be. In fact the birth part was great! My only interventions were an IV and AROM (artificial rupture of the membranes). Not too shabby! It was just the post birth stuff that I disliked. Another interesting thing-- Rose was over a pound bigger, presented poorly, and I pushed in a worse position than with Lacy's birth, yet she was born after 12 minutes of pushing (10 minutes less than her sister's birth) with less tearing than her sister and I felt better sooner than I did with Lacy. However, this labor was 9 hours from start to finish (11am-8pm approximately) whereas Lacy's was only 4.5 hours (7-11pm)

While I'm not eager to add another person to our family just yet, I am looking forward to someday having another child (in probably 3 or 4 years, we'll see!) to hopefully have a smoother birth... this time at home! And next time, I will definitely be spending the $200 on the birthing tub... it is worth every penny!

Little did Lacy know at the time, there was a baby in that belly! Today, Lacy can't remember a day without her sister! Lacy and Rose are best friends now. I love that they're so close!

My first look at Rose. Look at all that lovely vernex!
My first attempt at tandem nursing, the day Lacy came to visit at home. She didn't come home for good until the next day. She was spending the night at Grandma and Grandpa's.
The girls together, Rose is about 6 days old, Lacy 22 months.


christine said...

Wow--what a story. Am I right you did it without drugs? Impressive! I don't think I could ever do that! Everything is for a reason and it sounds like you having a hospital birth was one of those things. :0)

alisaterry said...

Birth does help one heal from a death. What an amazing story. Thank you for sharing it publicly.