Monday, October 4, 2010

Annabelle's Birth Story

I'm going to start this, and am even before beginning I have knots in my stomach. I have thought rationally, logically, emotionally, spiritually, and physically have come to many conclusions. All though, agree, this is hard, it sucks, and not fair.

I was a VBAC. I had my first Cesarean with Liam, and swore after going through that, to do everything in my power to not put myself or my baby through that again. If possible, I would do everything I could to bring my next baby into the world peacefully, safely, and with a transition that would leave me feeling empowered and him or her being welcomed into loving arms, and not a team of people who commonly forget they are dealing with two people and not two specimens.

I began before trying to conceive educating myself every way possible, reading, listening, learning, and when we started to talk seriously, I began interviewing. I knew that with the VBAC rates and Cesarean rates in Austin, hospital birth would be possible, but it would be a fight, a stress, and not safest for me. I called 10 different Midwives, some ran birthing centers, some home, and went to 9 interviews with them before choosing. I wanted someone who was skilled, knowledgeable, but understood the journey I was on. I chose Christy Tashjian, who was a Homebirth MW, and who had a Cesarean for her first and then a homebirth for her second and she really understood the path I was on and how much support I would need. She also is the 2nd Vice President of MANA (Midwives Alliance of North America) One of the largest MW groups in the world. She also respected that I was educated, and that I wanted to make fully researched decisions out of safety and out of empowerment.

We ate right, exercised, de-stressed, and I did all the work I possibly could. I went to ICAN meetings, and found our Doula Brielle there. She was amazing. Through my journey I was convinced I CAN do this, and I WILL. I kept my weight down, and hers too.

Our Due date came and went...and became further and further in the past as we approached 43 weeks. Any OB practice I could have gone with would have put serious pressure on me to induce, which being a VBAC, would be very dangerous, or have a repeat Cesarean, which I knew was far more risky than waiting for labor. Beginning Thursday night, we had prodromal (commonly called 'false') labor all through the night. The it would stop during the day. Liam was thankfully in Dallas with Phillip's parents, so we were able to cope well with the adjusted sleep patterns. Finally, Sunday night, it felt much more intense. Monday morning I called our Doula (for the second morning) and prayed she would not have to go home and I would end up with a baby by the end of the day. I labored. Phillip was amazing. He stood by me through the whole thing, and even when I went to the bathroom, he stood by the door as I contracted on the pot supporting me with loving encouraging words. He said "If you don't sleep, I won't either". At one point, on Tuesday I had a very intense vaginal exam, where we found my cervix was still posterior, so Christy held if forward through a contraction while I gently pushed to get the baby to move down and hold it forward. It left me quite shaken as it took me back to when Liam was born and the treatment we got at the hospital, and panic set in when I felt out of control. I got back in the tub to cool down and Phillip and I held hands and cried together as we labored on. I felt much more secure being at home with loving support. In the tub my water broke, and we only saw a slight bit of meconium, which wasn't all that to worry about. I didn't want to go on as I had what I call Back Labor From Hell. Which is not only an intense back pain during a contraction, but pain that didn't go away even after the contraction. The contractions were easy to deal with, but that pain in my back was terrible. That was pain. I had been doing this now for over 24+ hours and wanted relief. Brielle came to the tub side and gave encouraging words and told me that I was 9 cm, and I could do this. It was all about bring the baby down. I believed her and I believed in myself. We labored more, I walked around the house, then when the later afternoon hit, hours after the 9cm exam, we needed to re-evaluate. Chirsty suggested another exam, and this time, hold my cervix through 4 contractions. Before the exam Annabelle repositioned and a large amount of fluid came out with much thicker meconium. It's obvious to tell the difference between old meconium which is not really dangerous and fetal distress meconuim, and this was in no way fetal distress. So we did the exam. As much as I didn't want to, I did. It was still posterior. So, we walked more. She suggested we go on a walk around the neighborhood, briskly for about half an hour. We did, and through the contractions, I'd stop, hold on to Phillip and loudly vocalize and he held be strongly in his arms. I really felt like we were doing this together.

I couldn't go on. I said I was sorry, he said not to apologize, but we should go in and talk with Christy and Brielle. We did, I was in tears, and I knew that staying and doing what we were doing wasn't working. I wept more than I think I ever have in my entire life when I talked of going to the hospital and potentially dealing with the stress of last birth, and knowing that if I went, I would go for an epidural, which would limit my chances for a vaginal birth, but that I wouldn't get my peaceful birth as I wanted for my baby and me.

Finally we decided to go. I started having some bleeding that was heavier than I thought was normal. We got packed up, and headed out. The car ride was torture, every bump, every turn, every contraction was like my back was being hit with a sledge hammer. Phillip pulls up to the entrance and Christy meets us there to wheel me up to Labor and Delivery. "I know that car ride must have been hard" she said, I don't think she will really ever know. We get up to the room, start with the IVs and paper work, and I tell the nurse, I really need some relief, I think she could tell that I wasn't just being a wimp, and got me an epidural with in 20 minutes or so. Before that, I had much more bleeding, which Christy showed to the nurse and she didn't seem to think anything of it. I could tell that Christy thought it was something, I thought it was too. Dr. Sorin came in, and did an exam, and said that my cervix was swollen and I was down to a 7 now. He noticed the bleeding, and said it was 'interesting'. We also noticed that her heart tones weren't fluctuating. A baby's heart tones are supposed to go up or down during a contraction or stimulus or movements and her's weren't. This was no 'emergency' but it was non-reassuring and very concerning. He said since birth is not imminent, that a Cesarean would be best. This is the first time those words crossed my mind. I felt like I my emotions collapsed. I asked for a few minutes to take everything in, he comfortingly smiled, said 'sure', and left. I burst into tears. How could I be here facing this? Chirsty and Brielle agreed. Considering the meconium, the fact I was 43 weeks, the heart tones and the bleeding, a Cesarean was safest at this point in my opinion. So we agreed.

Dr. Sorin came back in, and I started to open up, holding back tears of fear of being discredited and began to tell him how our last birth was very traumatic for me, and I wanted to avoid that. He pulled up a chair next to my bedside and asked "What made it traumatic". I felt more secure knowing that this man would help me. We talked with the nursing staff, the anesthesiologist, and Dr. Sorin, and they all agreed to a 'gentle cesarean' of once the baby is out, in the absence of medical problems, to give her straight to me, so I can hold her, breastfeed her in the OR, and then be wheeled back to recovery with her in my arms. I knew my daughter would still have a gentle entrance. I was also allowed to have not only Phillip but Brielle with me in the OR.

They wheel me back. During the shave and the numbness testing we come to find that I am not fully numb as I'm supposed to be. They give me more anesthesia to a point where they can't give me more with out putting me under. They start the surgery, and I feel them kneading on my stomach and they push her out for me. I felt myself scream, but don't remember hearing it. I hear Brielle say 'she's being born', and I hear two small cries. "she's beautiful" Brielle says. They hand her off to the nursing staff and the next thing I hear is "She's not breathing".

Phillip and Brielle are asked to leave, and Phillip goes up to the NICU with her. I'm there alone, dozing in and out of consciousness, and then I see Phillip come back. I'm glad he's there, I can't stop crying at this point, out of pain, fear, sorrow and joy all at the same time. I hear Dr. Sorin state there was a placental abruption, which later he told me he never thought I had had since I presented no other symptoms of it.

Then finish, and I'm taken to recovery. I'm in total shock as I try and absorb all that just took place. The NICU neonatologist comes in and tell us of the situation. She had meconium below her vocal cords and when they began to suction it, she crashed, her APGARS were 1, 4, and 7, very low. They have her on a breathing tube, a nutritional IV, and a tube down to her stomach to pump out the fluid. I made small talk to try and get my mind off what happened to just get away for a bit.

We get to postpartum and then things slow down. We have a very up beat, friendly nurse who offers me a sandwich and tells me that even though it's in the middle of the night, I only have to be on bed rest 8 hours before I can get up and go see my baby. I'm thrilled even though I know that means it will be 2:30 in the morning, getting out of bed after major surgery, and wheeling and some walking all the way to the NICU. I have no idea what she looks like, how big she is, or anything, just know I'm going to finally meet my baby.

I get there, am told I can't hold her, but they let me pick her up above her bed so they can lay a chucks pad down for her bath. The nurse says most parents don't want to pick up their baby with all the wires and cords, I couldn't fathom how one could resist.

To make a long story not as long, it wasn't till day 3 that I was allowed to actually hold my daughter. I could look, touch, but not hold. Day 4, I could breastfeed, every 3 hrs, and their 'for only 30 minutes a feeding' turned into an hour. So every 3 hours, we made our way up to the NICU, fed for an hour, and then headed back to eat, shower, sleep, make calls, etc for 2 hours before heading back up. She later got to room in, but that was still hard, as she had antibiotic rounds she had to have every 12 hours, and her IV flushed every 4 or so.

Finally we went home.

Was this typical? No, I hope not at least. Could any of this have been prevented, no, not that I know of. If I had to make the choices again, I would still choose everything. Our MW had a great point that while this was a crappy birth, it's the prime example of what Midwifery care is. You have very interactive, supportive, loving prenatal care, supportive labor, and then, if you feel things need further assistance, a transport to the hospital, and great obstetric care when and as needed. I'll give that notion more thought, as I feel it's the only 'good' that came out of the birth experience.

The best thing that came out of the birth is my little girl. She's beautiful, smiley, and while a decent sleeper, she is healthy, and here and in my arms.

Do I feel differently about the birth than I do her? Yes, I love her, I hate her arrival. If she could have been born another way, I would prefer that, but not over her being here now. BUT, I still grieve the loss of birthing my baby. Something I do hold dear, and something that does leave me broken and sad. That's another post though. Am I allowed to feel that way? Yes. Is it okay to feel that way? Yes. Does it change the way I feel about her? No. Does it mean I'm ungrateful? No. It simply means I value and understand the importance of a peaceful birth, and wanted that for me and both my children and I'm sorry I couldn't provide that for them, but know that I did try everything in power to give them the best, and that's what I plan on doing for the remainder of their lives.

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