Monday, January 25, 2010

The Birth

I wanted to write the story of the birth before the details fade for me.  If you don't want to read about the actual birth, just scroll past this part to the pictures. 
It's hard to believe that the birth happened 4 days ago.  In some ways it feels like a lifetime ago and in others like it was yesterday.  Wednesday night my contractions started up a little before 9 and once they got going they were organized and it was feeling like this had to be labor.  Aaron went on to bed planning to go to work the next day not wanting to use up another day of leave before she made her arrival.  Mom and I started timing them after a couple of hours and realized they were coming consistently and lasting about a minute.  I would move throughout the house leaning on the counter, sitting on the ball, and rocking on my hands and knees.  I tried taking a bath as that had made the false labor contractions stop the night before, but these just kept coming.
About 1 AM Mom and I decided we should get Aaron up becase this seemed like the real thing with contractions lasting about a minute and a half and coming about every two and a half minutes.  We made phone calls to our doula, Pam, and Anjli, the midwife on call. Then, we loaded up the car and made our way to the hospital downtown.  I had been dreading having to get through contractions in the car, but somehow it wasn't so bad and we got there quickly. 
We arrived around 2:30 and were brought to a triage area and when the nuse checked she told me that I was dilated 4 - 5 and 90% effaced.  What a satisfying feeling to know that we were well into active labor and making progress.  Jeanne' arrived quickly and so did Anjli and Pam.  While in triage they want to see that the baby's heart rate is reactive so they monitor you for at least 20 minutes.  Our girl's heart rate was hanging out at 150 and not changing much.  Dad arrived at the hospital and gave me a "Live Strong" bracelet to wear.  I needed all the strength that I had for the work I was doing.  Anjli suggested that I eat something to get my blood sugar up and her heart rate reactive, but that only made me sick and turning on my side helped some, but not exactly what they wanted.  Finally, they announced that we could go to the labor and delivery room.
At this point I was well into laborland, that place where your thinking mind has turned off and you have a focus that is just on each contraction.  I found breathing and making a deep noise in my throat helped as I swayed back and forth through each contraction.  No one offered me an epidural and I never thought to ask for one.  Somehow the pain just seemed manageable.  Anjli would hold the monitor against my belly so that I could be out of bed and Pam gave me encouragement as Aaron kept the icewater coming to keep me hydrated.  They were setting up the tub for me to labor in the water when a nurse noticed that I was leaking fluid and it had meconnium in it.  I was a little disappointed that I couldn't get in the tub, but it somehow didn't really matter.  I just kept breathing through each contraction.  Anjli checked again after we were there a while and let me know that I was 8-9 and I think she said it would be okay if I gave into my urge and made little pushes. 
I started getting really tired at one point and someone suggested that I kneel on the bed with the bed sitting up so that I could rest my head on the top.  I was able to doze during contractions this way and found it very helpful.  About 5:30 Anjli said it was time to push.  My memory gets a lot more fuzzy, but at some point I was aware that baby was having heart decelerations and they were putting oxygen on me.  Aaron was there by my side still offering water in between pushes. Anjli and Pam suggested different ways to try pushing to bring the baby down.  I was feeling so tired, but so excited that we were finally to that phase of labor.  Mom and Pam held my legs while I pushed.  It took what felt like forever for anyone to be able to see her head coming down.  With each push Mom would let me know that she could see dark hair like Aaron and to keep pushing hard.  I was getting more and more tired, but everyone was very encouraging.  Her heart rate kept dropping, so there was some urgency to get her out as the team of peadiatrician and nurses began to assemble to check her out the moment she made her appearance.  Anjli suggested that she make a very small cut to allow her head to come through more quickly and I agreed.  Once her head was out, I expected that the rest of her would be easy, but not so much.  It took a while to get her shoulders and body out.  Then, at 7:21 Anjli layed her on my chest and I felt her warm body against me.  She was quickly taken to the pediatrician to start making sure she was okay.  What a relief! 
I had read that the last phase of labor was delivering the after birth, but everyone made this part sound simple after getting the baby out.  It wasn't simple for me.  The placenta would not come out on its own and Anjli worked a long time to try and deliver it.  While she worked, I could see them checking out my sweet baby and could hear her strong cries.  They brought her over to nurse while they continued to work to get the placenta out. She took to nursing instinctively and I was so proud and happy. Anjli called her partner, Margaret, and she came to go in and get the placenta out.  Getting the placenta out was very painful, so they started an IV and gave me some pain meds to make me sleep while they worked to get it out.  Once it was out, I was able to wake up quickly.  Because it was so hard and long to get it out, I lost a lot of blood.  It took a while for us to be able to leave labor and delivery because I was so light headed, but we had our beautiful, healthy baby girl there with us and didn't care. 
I am so grateful for the people that were there with me.  Aaron stayed by my side and kept giving me encouragement.  Pam was a huge support not just to me, but to my Mom and Aaron as well.  Mom was right there with me the whole time and stayed strong for me even when she was scared.  Anjli was there the whole time I labored and I felt so safe knowing that she was keeping an eye on everything and was supporting me in the kind of birth that I wanted.  I don't think I could have had the empowering and fulfilling birth experience that I did with the other medical practice or at Northside.  The people with me that morning got it and knew just the type of birth that I wanted and didn't give up on it easily. 

Here are Pam's notes from the birth:
January 21, 2010

1:40 am - After a couple of days of prodromal back labor and little rest for Natalie, Aaron calls to say contractions are two minutes apart and intense. Anjli, Natalie’s midwife, says it’s time to meet her at Atlanta Medical Center. Natalie and Aaron are headed that way and I leave too. Yay!

3:00 am – I arrive at triage to find Natalie in bed, being monitored. Her support team is all there, Tricia, Jeanne', Flip, and, of course, Aaron. Her nurse examines Natalie and finds her 4-5 cm dilated and 90% effaced, with a bulging bag of fluids. She described the baby’s station with, “I can feel baby’s head”. Natalie has been on the monitor for a while, but is still waiting for Sarah Graves to be reactive. Anjli arrives soon after I did.

3:25 am – We are moving to L&D room 9! Flip and Jeanne’ move to the waiting area. Melanie is Natalie’s new nurse. Natalie is working hard, with Aaron right by her side. Jeanne’ is in the room a bit and Tricia lends her support the rest of the time.

4:05 am – Anjli’s exam finds Natalie now dilated 8-9 cm! All her hard work is producing change.

4:20 am - Natalie has been on the ball, standing by the bed, slow dancing with Aaron and just keeps doing whatever is needed to birth her sweet baby. As the tub is being filled, her water breaks. It has meconium in it - so, there’ll be no getting in the tub. Everyone is disappointed, but none of us more than Natalie. She was so looking forward to the comfort of the water. She’s feeling “pushy” and just keeps going. She’s doing amazing work. Aaron, Tricia, and I support her through every choice.

4:35 am – Anjli checks Natalie again, hoping to find her complete and ready to push, but instead, finds a “lip of cervix” and a bulging bag. She suspects that the first fluid we saw was from a forebag of waters. The baby is at -1 to 0 station. Natalie is frustrated that she can’t push yet, but begins candle breathing through each contraction. Having that urge to push and not being able to is really tough.

5:09 am – This time, Anjli’s exam reveals great news! Natalie is completely dilated, with Sarah Graves at +2 station. Natalie still has a bulging bag, which she chooses to let Anjli break. The pushing begins.

7:21 am – After just more than two hours of powerful pushing and an episiotomy to allow her shoulders to pass through, Sarah Graves Caldwell is born! She is beautiful and healthy (with apgars of 8 and then 9), weighing in at 8 pounds, 6 ounces and measuring 21 inches tall. Everyone is relieved and so excited to meet her.

8:35 am – Margaret, Natalie’s other midwife, is doing a prudental block so she can remove Natalie’s placenta manually. This has been an arduous journey for Natalie and for her loving family. It takes a real warrior to face the challenges she met and Natalie stepped right into those shoes. It is an honor to share her remarkable journey and a joy to meet her precious daughter. What a dear family! Sarah Graves chose wisely.

Pam Roe

Labor of Love Doula and Childbirth Services

1 comment:

Nikki said...

WOW!!! What an experience. You are such a trouper Nat!! Way to go!!