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CAM Birth Story #24: KB’s Birth

In honor of Cesarean Awareness Month 2010, we will be filling the blogosphere with stories from real women (and their families) who know first-hand the consequences of a 32% cesarean rate. Each day we will post at least one birth story submitted by these women. Prepare to be moved (hint: grab a box of Kleenex)!

From Denise…

My entire pregnancy I had envisioned a home birth, in a peaceful setting, with my husband, mom and midwife attending.  I went to prenatal yoga classes twice each week.  We took a natural childbirth class together.  I never expected that with so much planning, and using a nurse-midwife, that I would have the experience that I did.  It was a textbook hospital birth filled with nearly every intervention that I have heard of….I can’t stop thinking about it, I find it hard to understand what all went wrong, and I feel robbed of the experience I had dreamed about for 9 months.  Don’t get me wrong, I am fully aware of how lucky I am to have a beautiful, healthy son, how lucky I am to have been able to conceive and deliver a baby at all, but that doesn’t mean I can’t try to cope with the loss of the birth that I wanted for me and my baby.

From 37 weeks onward I had high blood pressure.  Every stress test is ok, but my blood pressure will not go down.  I feel fine, never feel bad at all.  KB seems to feel fine as well.

At my 39 weeks checkup, blood pressure is still high, no surprise.  An ultrasound shows low amniotic fluid.  MISTAKE #1: I wish I had chosen to delay the ultrasound until Monday.  My appointment was on a Friday and I was given the choice to have the ultrasound right then, or come back on Monday.  If we had not seen the ultrasound I would have had two more precious days.  Thank goodness my husband had decided to come with me to my appointment because I am told we HAVE to induce and my choices are to come in to the hospital for induction that night or the next day.  I don’t argue – MISTAKE #2.

On Thursday, February 5 at 5:00 PM, we check in to the hospital and I am given Cytotec (a vaginal medicine that can induce labor).  I don’t sleep much at all that night because at this point I am just very excited to be having my baby and I trust that my nurse-midwife is doing what is best for me.

By Friday, February 6 at 4:30 AM the contractions have started.  My nurse-midwife informs me that we will let the Cytotec keep working and won’t start Pitocin unless necessary.  But at 10:00 AM we start Pitocin because I am not progressing and the contractions have slowed down.

The next 8 hours are fuzzy, but I remember my mom arrived and I was so happy to see her.  She and my husband started helping me through contractions as they got stronger.  I grit my teeth and clench their hands during each one and then I get a nice break where I can talk to my mom, get excited again, etc.  I don’t do any of the coping mechanisms that we learned in the childbirth class.  And no one reminds me to do them either.  My nurse-midwife came in once during the day to check on me, she sat with me for maybe 15 minutes.  During those 15 minutes she got me off the bed, off the monitors and rocking on the ball.  She talked to me and helped me to envision my cervix opening to birth KB, to let go and let the pain do its work.  This was the best 15 minutes of my labor.  After my nurse-midwife is no longer there the nurses order me back into bed and on the monitors.  They continually come into reposition the monitors, we all watch the screens intently.  No one wants to be the person on call when something goes wrong, they only will allow me to move around when my nurse-midwife is there to be the authority.

My nurse-midwife comes in another time and asks if I want her to break my water.  I understand that this is one more intervention that I had not originally wanted, but it is one more way to get things going.  I consent to the procedure and the water gushes out.

I’m not sure at what time the contractions started getting so strong and close together, but at some point they did.  I bit my husband on the face.  I started wetting the bed, because my bladder was having spasms.  The nurse on call comes in and says nonchalantly, “Oh, you’re not getting any breaks are you?” and I watch her turn the Pitocin down from 10 to 5.  She then checks me, which hurts like Hell, and notifies me that I am 5cm.  This report is devastating, because I have been in labor for 12 hours now, and I was 4 cm many hours before.  I demand an epidural and everyone begins working speedily to get that done – MISTAKE #3.  I don’t even really have a chance to change my mind or think about it, no one second guesses my decision or tries to talk me out of it, and my nurse-midwife is not present when this happens, I don’t remember when I saw her next.  The epidural is administered at 5:00 PM.

After the epidural, I feel fantastic.  I smile again.  I think that I made a great decision.  “Now, let’s get this baby out of here!”  When my nurse-midwife comes to check on me, I am still in good spirits, and determined to have KB on Feb. 6!  She doesn’t disagree with me.  She leaves again.

For the next 4-6 hours I visit with my parents, watch tv, eat popsicles, eat ice, and just wait for KB to be ready.  My dad eventually goes to the hotel, mom goes to waiting room, and my husband takes naps in the room.  I get to 7 cm.
The entire time, we are all watching the monitors very closely, to see my contractions and to see KB’s heart rate.  They are watching him close because he is having decelerations with his heartbeat with each contraction.  They are constantly moving the monitors around on me.

At some point, I have no idea what time, my nurse-midwife comes to see me.  Nothing is happening, no progression, and she just says keep on waiting.  Just a few minutes after she leaves, I get extremely nauseous and nearly pass out.  Nurses and the OB on call rush in – they toss me over (I can’t move with the epidural) and lift my butt in the air and start rolling me around.  I remember thinking “this is it, we’re about to roll out of here and go to the OR, please Lord let KB be okay.”  But then calm returns.  KB’s heart beat is back again and they now have internal monitors on KB and on my uterus….at least that’s what I think happened.  I remember the doctor saying “I bet you’re glad you have that epidural now!” because it would have felt awful to have them doing all that without one.  The explanation I got for that episode was that KB may have yanked the umbilical cord or something, causing my blood pressure to plummet; this caused him to stop getting oxygen and blood, which caused us to lose his heartbeat.

We go back to napping and waiting, I am starting to feel the contractions again, I worried that the epidural was wearing off.  I guess I had decided at that point to never feel the pain again.  At some point I get nauseous again, but this time I just puke.  My husband awakes to me puking and throws his hands up like “what else can possibly happen?”

At 3am I am still at 7cm, KB’s heartbeat is still decelerating with each contraction.  It seems the labor has stalled out, I am not given much of an explanation and now that I have the epidural I feel helpless to the situation.  I can’t move around, envision opening up, release, etc.  I am at the mercy of the pitocin to do all the work.  I am presented with a choice.  I can continue for up to 12 more hours, or we can c-section.  My nurse-midwife will not give me her advice, she says the choice is mine.  I know that is the midwifery model of care, but at that point, I wanted someone to tell me what to do.  I am pissed.  So, I ask what the doctor would do, and the reply is that he would have c-sectioned me two weeks ago, because of the BP.  My mom encourages me to have the c-section, and my husband tells me he thinks its time and that I am exhausted.  No one thinks I can get to complete and then have the energy, or the stable BP, to push him out.  Then there is matter of KB’s heart rate.  I start to feel as though I am being selfish for trying to have a vaginal birth and that it is time to get him out and safe.  Defeated, I consent to the c-section.  MISTAKE #3.  I wish more than anything I had tried to keep going, that we had turned the pitocin up, taken out the epidural, something, anything to get him out vaginally.  I can never take that back now.  It’s devastating.

But I have given the verbal consent and everyone is preparing.  I am scared to death.  But then I start to get excited, I will be meeting my son very soon.  The doctor is very confident and reassuring that everything will be alright.  The Doctor made me feel very good about the situation, he was comforting, and he was in control.

Again, everyone works very speedily; they have this routine down pat.  In no time at all I am wheeled into the OR.  The anesthesiologist talks me through the process.  My husband and my mom suit up in scrubs and arrive.  My husband holds my hand and I count to ten more times that I can remember.  I just keep counting to ten and keep my eyes closed, grip my husband’s hand tightly.  At 4:30 am KB is born, they show him to me briefly over the curtain, I cry for just a second, but then I have to return to eyes closed, and counting to ten over and over again.  They still have to pull, tug, suction and sew me up.  It feels like an eternity.  I had envisioned him being plopped onto my chest, and holding him immediately.  It was so different.

The bright light at the end of this story is that KB is brought to me immediately as I am taken to the post-op room.  He breastfeeds and we all enjoy being with each other.  My husband and I never let KB out of our sight after that.   I fall in love with KB and I fall in love with my husband all over again.  He has been a joy that I could have never imagined.  Being parents has come very natural to us and we are excited to have more children.  KB and I have been together constantly since he was born and a bond has developed that I know is no less than if he had been born at home.

If I do get another chance…here is my advice to myself
1.    Don’t try to plan everything or envision anything particular – just go with the flow
2.    Hire a doula – a nurse-midwife is too busy to be at the bedside, I didn’t understand that
3.    Trust myself – I didn’t trust myself, because I was a first timer, and I was surrounded by people who knew a lot more about birth than I did….but now, I get it.
4.    Don’t trust anyone else – unfortunately it seems that everyone has their own agenda….and it’s not necessarily aligned with your agenda

Unfortunately, I now have to deal with another host of issues should I get pregnant again.  The risks involved with vaginal birth after cesarean (VBAC), the blood pressure returning, etc.  It might be easier to just plan for a section from day one….but we’ll cross that bridge when we get there.