Thursday, July 22, 2010

Chavi's First Birth

Birth #1:

1. When and where did you give birth?
April 2005, White Plains, NY

2. When did you decide who (if anyone) would care for you during your pregnancy and birth, and why?
When I first became pg, I chose an OB, because I thought that's what you do when you get pregnant. Later on, as I educated myself, I realized that in order to achieve the non-interventionist birth I desired, I would be better-served with a midwife. I switched in my 8th month to midwives.

3. What interventions (if any) did you request during your pregnancy and birth?
None. I wanted no pitocin, no induction, no episiotomy, no augmentation, no IV's, no internal monitor, no epidural, no breaking of waters, etc.

3a. What interventions did you receive?
Frequent sonograms, especially early in pregnancy - I was in treatment for infertility, and frequent U/S was protocol for treatment and early pregnancy. The only birth intervention done was (I think...we can't prove) that the MW tugged on the placenta after the birth, which may have been why I had a hemorrhage.

3b. When did those interventions occur, and how much input did you have in the process?
After I hemorrhaged, I consented to an injection of pitocin and then an IV of pitocin to stop the bleeding. I was completely involved in the decision and felt I had control over interventions.

4. Did you feel empowered during your pregnancy and birth? Why or why not?
I felt very empowered. As I educated myself throughout my pregnancy about my birth choices, I felt empowered and strong as a woman that my body had the opportunity to do what its supposed to do, and I re-learned to trust my body to do what it should. I felt very empowered and strong in my strength as a woman.

5. If you could change the decisions you made during your pregnancy and birth, what would you change and why?
I was very happy with my first birth and the only thing I would have done differently was to switch to the MW's early on! I had a lot of anxiety and worry about the OB's doing episiotomies on me, but once I switched to MW, stopped worrying and was able to focus my positive energy on birth, not conflict.

6. If applicable, how did your birth change the decisions you made during subsequent pregnancies? What would you do again and what would you change?
Because I had such a powerful and wonderful birth the first time, I felt empowered and ready to give birth at home for #2, which was also an excellent experience.

7. What did you learn from your experience that you would like to share with other women?
I learned that pregnancy and birth is a time for a woman to really gain knowledge, confidence, awareness, and strength about her body's innate abilities, and she can become her own "expert" and make decisions for herself with information and confidence. I also learned about the importance of a supportive birth partner - be it a husband, partner, doula, or friend who will support you and be rock-solid for you when you need them the most.

Here's my full (long) birth story:
In the months before I gave birth, I was very determined to have as natural and intervention-free birth as possible. I invested much time and energy into researching my options and choosing the best people for my “birth team” to achieve this goal.

My team was:

-Janet, my birth instructor. [My husband] Daniel and I attended a series of 6 classes taught by her. Her classes were a combination of Lamaze, Bradley, and other childbirth methods. The class was attended by couples who also want to achieve a safe, as natural as possible delivery. In the classes, we learned about the birth process, medical technology and pain relief, as well as practical exercises, & tools to cope during labor and achieve a healthy birth.

-Julie, my doula. Julie is sort of related to me, as we have relatives who are married to each other. So even before this birth, we knew each other. She is very experienced with helping many other women have a positive birth experience. I looked forward to having her help me and Daniel during labor.

-Lucy, my midwife. In my 8th month, I switched from the OB’s in the practice to the midwives. This decision reassured me that I would have all the help I needed to achieve a safe, natural childbirth. And if intervention would become necessary, I would have excellent doctors at hand who know me. Lucy is Scottish. Think Mrs. Doubtfire (just skinnier and younger).

- Daniel. A loving DH, who also happens to be a chiropractor. He wanted to help me achieve the kind of birth I wanted. He would use his knowledge of me and of the human body to help me through labor, with his hands (as long as halachicly [according to Jewish law] possible), his words, and emotions, and knowledge of ME.

-The Baby. This was a big unknown. We did know that the pregnancy was a perfectly normal and healthy one, so we prayed for an uneventful delivery.

I was due on Tuesday, April 5th.
On Monday, April 4th, I went to my midwife, and at the examination, she determined that I was barely one cm dilated and maybe 10% effaced. She predicted that I wouldn’t give birth in the next few days.

That Friday, I went for a “non-stress test” at the OB (my midwife wasn’t there, so I got my favorite OB in the practice to do the checkup). They placed me on an external fetal monitor for about 20 minutes, and got a reading of contractions (yes, BH [Braxton-Hicks] contractions) and the fetal heart rate during the contractions. The baby responded beautifully, so we knew it was okay for me to hang in there and let nature work its course.

The OB also examined me and determined that I was 2cm dilated and 50% effaced. Wow!!! That was a big difference from Monday. The OB also did a sonogram and predicted that the baby weighed about 7lbs.

We were scheduled to come back on Monday (1 week post dd) for a level 2 sonogram.

When we walked out of the OB, we realized that ‘things were happening’ and that labor was likely to happen soon, especially given the progress that my cervix had gone through just in the last few days.

That afternoon, Daniel convinced me to buy some Castor oil, just in case.
So we decided to try to use a VERY LITTLE bit.

On Saturday morning, we woke up and I ate some breakfast (starving pg woman!). We decided that we’d try to use the castor oil, but if after 2 doses nothing happens, then that would mean the bb wasn’t ready to arrive. I took 1 tbsp of the castor oil at 8am and we sat around and waited. By 12 noon, no labor. So we decided I’d take 2 tbsp now, and if nothing happened, we’d leave it alone.

So I took 2 tbsp of castor oil. We had lunch, and then we laid down for a nap. Around 2pm I started to feel very minor back cramps, so I continued napping (we figured this may be the last good sleep before the baby arrived!). Around 5pm, we got up from our nap, and I definitely felt more crampy. It felt like menstrual cramps.

I was feeling energized and excited. I also didn’t want to get my hopes up, as I knew from others that labor can be a LOOOONG process, and in fact, it could stop and start at a later time. So we decided to go for a walk, as that’s recommended during labor. It keeps labor going and it also helps ‘distract’ from the contractions.

We decided to walk over to our friends who live nearby. On our way to our friends’ house, we bumped into another friend whose wife had given birth 7 weeks before. We spoke for a few minutes (he saw I was in labor and handling the contractions well), he wished us luck and then we continued on our walk.

When we got to our friends’ house, they had some neighborhood teenage kids over. My friend, Miriam saw I was in labor, so she subtly got the kids to leave, without letting on to them that I was in labor. After they left, I started using different tools I had learned in my birth class to cope with the contractions – going into my (yoga) squats, leaning over a chair, leaning over the couch, going down on all fours on the carpeted floor… Miriam, who has had one epidural birth and one c-section, kept on saying “I don’t know how you’re doing this, Chavi. Right now I’d be begging for the meds.” Miriam helped us time the contractions – at this point they were about 30 seconds long and 5 minutes apart. We knew it was early yet, and that it could still be a while before labor was ‘active’ so I told Daniel he could go out for a bit to take care of something. Before he left, Daniel took Miriam aside and taught her not to say the comments that she had said before. Instead, he asked her to be encouraging to me and help me cope through the contractions. She turned her comments into the encouraging type, and made me some cream cheese sandwiches to eat. She also kept me well supplied with drinks. I continued the squatting, leaning, etc, and Miriam continued to time the contractions. Daniel came back and saw we were doing well. I sent him back for a few more minutes (20-30minutes?) reassuring him that I would be fine without him.

By the time Daniel returned, my contractions were about 40-60 seconds in length and 3 minutes apart. We got a ride home from my friend’s husband, and he wished us good luck as he dropped us off at our house. It was around 9pm, and labor was definitely active.

When we came home, we called our doula, Julie to let her know what we were up to. She had to go give a birthing seminar, and she could tell it was still early, so she told us to call her in an hour or so, when things progress. We also called my midwife to alert her that I was in labor, and she spoke with me to hear how I was doing. I was talking up a storm, so she said that it’s early still. She told us to call back when I had a bloody show.

By this point, the contractions were like the worst menstrual cramps I’d ever had – it hurt, but I was coping. I decided I wanted to go into the bath, as I knew the water would help me through the contractions. So I went into the tub. Daniel asked if I wanted him to stay or go, and I asked him to give me some time to myself. He kept me well supplied with raspberry tea and I ate a granola bar.

I stayed in the tub for a good while, constantly replenishing the hot water, shifting my position, and generally just trying to stay relaxed as possible during the contractions. I used my low, deep breathing through each contraction. (I call this my ‘cow breathing’ as it almost sounded like a cow mooing!) At some point I would close my eyes and try to think about other things. I zoned out. After about an hour in the tub I felt nauseous and told Daniel that I needed to throw up. I got out of the tub and made it to the toilet, where I promptly threw up the granola bar and tea I had consumed. I know that at some point Daniel told me that Julie would be there soon. After about 2 hours in the tub, I felt like the contractions were getting worse and the tub wasn’t helping anymore. I decided I wanted to lie down in my bed, and try to do the Bradley Method relaxation. I laid down in my bed and tried to deal with the contractions lying down, but it felt worse to lie down, so I got up after about 5 minutes. I heard my doula arrive at this point, and I was relieved that she was here, because I had just started to feel like I needed her help to cope with the contractions.

It was about 12:30 am. Julie came with a bag of tricks. She brought a rice sock, which she heated up in the microwave. She also brought a birthing (exercise) ball. So we sat in the living room, and we had a whole routine. As each contraction would come, I’d be sitting on the birthing ball, leaning over into Julie’s lap. She would place the warm rice sock under my belly, and Daniel sat behind me and used an electric massager on my back. Daniel would remind me to keep my breaths/groans low and deep, and this helped. We did this for about an hour or more.

After that, I wanted to change position and try other things. Julie suggested I should go back into the tub on my hands and knees. We placed some towels on the bottom of the tub to make it comfortable on my knees. I laid in the tub on all fours, and as each contraction hit, Julie would aim the shower head onto my lower back to help with the contractions. Julie asked me where I felt the worst pain, and I showed her that I felt it around my belly and my lower back. At this point, Julie realized that I was having back labor. I got up and sat on the toilet through a few contractions. I saw some bloody show, so we called the midwife (it was now about 3:30am.). Lucy told us to call back when I felt an urge to push (She told us later on that many first-timers feel some sort of an urge at around 5 or 6 cm). I was starting to feel like ‘when will this ever end?’ and wondered when the midwife would finally tell us to go to the hospital.

Since Julie realized I was having back labor, she decided we should try something different. I lay on the bedroom floor, with my head and shoulders resting on a chair. She got a scarf out of her bag and wrapped it around my belly. She held onto one end of the scarf and Daniel held the other. Through each contraction, they pulled on the ends of the scarf, to support my belly. This is supposed to help during back labor and help turn the baby. We did this for a while, and then we decided to try something else. At some point during this, I remember saying to Julie “I want to poop” – she asked me if I ‘need to’ or ‘want to’, and I told her ‘I want to.’

Daniel has a 2-level chiropractic table, a knee-chest table. So he set that up in the bedroom and I laid on it. Julie used a massager on my back and Daniel helped me keep my breaths nice and low and deep. After doing this for a while, I said to Julie “I want to poop” – she asked me “Do you need to or want to” and I replied “I have to.”

I said to Julie, “See, I’m still smiling, so I can’t be that far along!” She told me to stop trying to be my own birth coach!

I went to the toilet and wanted to call the midwife. As I was on the toilet, I felt each contraction hit, and they were intense. My legs started to shake. I said “See, my legs are shaking, I am in transition!” Julie said to me “Stop trying to be your own birth coach!”

It was 4:45. I said “let’s call Lucy.” We called. Daniel spoke, and described to her how I was doing, saying the whole time how incredible I was and how strong I am. He wanted to stay home a little longer (we really wanted to get to the hospital late in labor, and not have a long labor in the hospital). But I insisted and said, “no, I want to go now.” So we told her we’d be leaving in 10 minutes…

30 minutes later, at 5:15 we finally left the house. I had had a labor bag packed, but during the laboring at home, some of my ‘tools and tricks’ had been unpacked and had to be repacked. I had to get dressed, Plus, Daniel needed to take the dog out before we went (she was in the crate the whole time I was laboring), and he threw some of his own clothes into a bag. Julie also needed to gather her stuff back up into her bag, and Daniel loaded up the cars (our car and Julie’s car) with all the stuff. Right before we were getting ready to leave the house, Daniel’s shoe broke! So he had to go and change his shoes. Julie stayed with me through the contractions, and I squatted through each of them, feeling motivated again – I was excited to get to the hospital! Julie said to me – “Listen, we could get to the hospital and find out you’re only at 2cm, so I want you to pray for 8! Hope for 10, but pray for 8!” As she helped me into the car, I asked Julie how I was going to cope through the car ride (it’s a 20 minute ride to the hospital). She told me that I should sit like I was on the toilet, and just breathe through each contraction, and I’ll do fine.

As we drove to the hospital, Daniel told me how wonderful I was doing, how beautiful I was, and how strong I am. I remember as we neared the highway exit, Daniel started to take the wrong exit, so I screamed at him through a contraction “No! take the next exit, the next exit!” In retrospect, I also noticed that my contractions slowed down in the car. I also know this is normal, as a laboring woman can sometimes slow down when she changes environments. Throughout this time, I was doing what Julie calls “cheat pushes” – because I felt like I needed to.

We arrived at the hospital. As I got out of the car, another contraction hit, and I squatted and breathed through the wave. I walked slowly toward the hospital entrance. Another contraction hit. By now, Julie was with us, and she had the birth ball with her, so I leaned over onto at as I rode the wave of the contraction. We entered the hospital at 5:45am and I had another contraction on the way to the elevator and another one in the elevator. I kept leaning over the birth ball, and Julie would massage my back through each wave. We arrived onto the maternity floor, and as each contraction hit, I would sink down onto the ball, and rock through the waves. Julie would rub my back and Daniel would coach me to keep my groans nice and deep. We walked through the doors of the maternity wing, and I saw my midwife, Lucy, down the hall. She came rushing toward us, and another contraction hit. She saw how well we were all handling each contraction, and how we had it down to a routine. I stood up, and then I felt a ‘pop’ – I exclaimed in an excited voice “Oh! My water just broke!” (I had totally been focused during the labor that I had FORGOTTEN that was going to come!)
(Daniel told me later that it also broke all over his shoe as he was standing behind me!)

Lucy walked me toward the Labor and delivery area. In my hospital, they usually make laboring women go to a ‘triage’ area, where they put you on 20 minutes of baseline fetal monitoring, hook you up to an IV, and check to see how dilated you are. Lucy escorted me right past that area and into the L&D room she had prepared for me. She shoved me into the bathroom and told me to take a few minutes to myself. (I love that my midwife insisted on this! She took me away from the nagging nurses who wanted to question me) I was able to see that my water had in fact broken. After a couple of minutes of privacy, Julie came in to check on me, to make sure I was okay. I came out of the bathroom, and Lucy looked at me. She said “you’re much too chatty! (to be as far along as I hoped to be)”

She told me to lie down on the bed. I asked her if I had to (I hated to lie down during labor.). She said it would just be for a minute, so she could check me. She examined me, and said “you’re there.” I said “WHAT?!” she said “you’re baby is at +2 station and you’re fully dilated, you can push.” I remember yelling out a whoop of joy! I was so thrilled that I was 10cm dilated! We were almost done! I said “Right here?” she said “if you want to.” I told her I wanted to push on the birthing stool (Julie had brought one with her). So I stood up and they placed the stool by the foot of the bed. (At the end of the bed was a handle I used to grab on through each pushing contraction).

Meanwhile, what I didn’t realize was that even though I had pre-registered at the hospital, they somehow had no records for me, so the nurses started to ask me my info…name, address, etc. Daniel got so upset at them (and I was actually answering them as I sat down on the birthing stool to push!). He told them “Listen, my wife is incapacitated. I am a physician. You can ask these questions later.” Thank God for my wonderful Daniel, he came to the rescue and prevented an inquisition!

So I sat down on the birth stool, Lucy on the floor on front of me to my right, and Julie on my left. Daniel sat in a chair behind me, so he could coach me through the pushing breaths. (or not breaths!) A contraction hit, and Lucy said “push whenever you’re ready” I told her I wanted to wait until the next one, and she said okay. As the pushing contractions came, I tried to hold my breath to push, but I kept on breathing out and groaning. Daniel reminded me and verbally would breathe with me through the push, telling me to hold my breath through each push. At some point, Lucy told me if I wanted to, I could feel the baby’s head. I reached down and felt something very soft and I remember thinking “THAT’S a head?”

After 40 minutes of pushing, the baby was born. I felt the baby crowning (it hurt a lot- very strong burning sensation, but it was very quick). Lucy told me to stop pushing as the baby crowned (to prevent tearing). Apparently, the head came out & then the baby did a 180 degree turn! As I felt the next push, Lucy said to me (I was leaning back on the stool) “lean forward, you’re not going to want to miss seeing this!” and I leaned forward and at 6:42 AM watched my baby being born. It was SUCH an emotionally intense moment. Our baby was brought into the world as the sun was rising, its rays filtering though the window.

Before the baby was born, Daniel had reminded the midwife that we didn’t want anyone to “announce” the gender of the baby – we wanted to find out what the baby was on our own, to discover it together. So the baby was born, and Lucy put the baby into my arms. I remember looking at the baby and thinking “wow, it looks like my father-in-law!” Then I realized I didn’t know if it was a boy or a girl, so I looked, and saw he was a boy. A beautiful, perfect little boy!

I said “I have a son! Daniel, I birthed our son!” I was crying with joy.

While I was holding our son, Lucy coached me through the afterbirth (which was no big deal, as I was so enthralled by the beautiful, perfect baby in my arms!). I looked around the room and said “thank you” to all the nurses, the midwife, my doula, and Daniel. I also said “I gave birth to him, nobody else did!” (Julie told me later that I had said all these things!) I was so proud of myself. I also was so grateful to God for giving us our perfect baby.

Before I got up from the birthing stool, Lucy told me that I had lost a lot of blood, so I shouldn’t be shocked when I see it. Apparently, my uterus conked out on me after I delivered the baby, and never contracted properly at the end. They gave me an injection of Pitocin to get my uterus contractions, and after about an hour, they gave me an IV. (I had been IV free during labor and pushing). I was too distracted by my beautiful son to care or notice any of this, even my weakness after the birth.

After the birth, Daniel and I cried in joy. We kept on saying how lucky we were to have such a beautiful birth experience. We felt that after waiting so long for our baby, we were truly lucky.

I had a VERY minor tear. Lucy told me later – “you’re a white woman, you’re likely to tear (we don’t have very elastic skin).”

My perfect son was born on Sunday, April 10th at 6:42am at 8lbs. and .08 oz.

I still cry thinking of that moment!

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