Ahlia's Birth Story

"Thank you" goes to my midwife apprentice, Janna Grapperhaus, for the labor notes that helped me detail this story. :-) Please feel free to ask me any questions about my pregnancy, labor, or delivery! You may comment here or contact me directly (see the About Me page).

baby shower, 2/14/10

Mon, 3/15/10 - Some surges/contractions in my lower back kept me up for a couple of hours. Finally fell back asleep after listening to my HypnoBirthing Rainbow Relaxation a couple of times. In the coming week, braxton hicks cx continued as they had for weeks...

Fri, 3/19/10 - Weekly checkup - 2 cm dilated, 20% effaced, 0 station. Cervix in a posterior position. Getting increasingly difficult to be comfortable sleeping.

Mon, 3/22/10 - Had some minor swelling over the weekend and gained 5 lb! Midwife wanted to see me. BP normal, 128/70. Need to push fluids and protein. 3 cm dilated, 50% effaced, 0 station, cervix more anterior. Great progress!

Tue, 3/23/10 - Saw a pink tinge of "birth show" late morning and increase in cervical fluid. Feeling a good bit of downward pressure after a surge. Could it happen in the next 2 days? Still no name chosen... Are we really going to be the parents of two any time now???

Thu, 3/25/10 - mw appointment. Actually, I'm 2 cm dilated. 3 cm measurements (above) is a different type of measurement (external vs. internal os). But... 70% effaced!

Fri, 3/26/10 - Sent Zyler to Grandmom's house until Sunday and Jason and I went out to eat at the Outback. My plate included: 6-oz sirloin, sweet potato, mixed veggies, and we shared a very rich peanut butter pie dessert. I really shouldn't have... I was so full! Also saw my friend J.B. there. She was not in a very good place emotionally, but as we chatted outside, she encouraged me and J. to "dtd" (abb. for "do the deed") that night. I had already been considering... maybe tonight, maybe tomorrow? We came home and did decide to, before retiring at 11 PM (2300)!

So, I put in my Rainbow Relaxation CD...

@ 2315, I had a couple of Braxton Hicks type contractions, and I felt a tiny "gush!" It was so small, that I wasn't sure if it was amniotic fluid or any other type of fluid... but I went ahead and called my midwife, Janna. At the time, she was an advanced student being supervised by 2 other women for my pregnancy who are both CPMs and CNMs. (I had a lot of knowledge and expertise at the ready!) She called them to check in and formulate a plan. We had tested with a couple of pH strips and determined that most likely my water broke! It happened that quickly. (J. said later that it was perhaps a coincidence. Did sex really get labor going?? Yes, I believe it did!) The "head" supervising midwife agreed that Janna should go ahead and come to my house to check things out. We agreed to let Jason sleep so that at least one parent was rested. He can be real sleep-deprived grump, anyway. :o)

Sat, 3/27/10, 0135 - Janna arrived. FHT (fetal heart tone) 126, baby LOP (left side, slightly posterior), ctx 10-15 minutes apart, lasting 30 seconds. Once again, as with baby Z., all ctx are felt in my very lower back near my tailbone... I stayed downstairs to labor while we let J. rest in our bedroom. I had to keep going in the room, though, to get labor supplies and woke him a few times.

After much debate, it is finally decided to do a sterile speculum exam to determine for sure if my water had broken. I would have preferred not to, but the supervising midwives wanted to be sure if the "clock" had started ticking or not so we could do everything possible to not need to do a hospital transfer at 12 hours out... So I got our dog, Indy, outside to get him out of the way.

0230 - sterile exam, lots of fluid pooling, vernix is visible (which I now realize I saw in my "earlier" waters), confirmed also on pH test that my waters had broken. Pulse 88, BP 128/82.

There was also debate about an induction via castor oil. Again, my caregivers were uneasy about my water being broken and the "clock" (I was also GBS+), and the supervising midwife really preferred induction via castor oil. In the end, I agreed to it. Janna uses herbs and homeopathy to induce so I had what you might say a triple whammy! I didn't mind too much this type of "intervention" (OK, I did mind the castor oil later on!), but I still wonder what my body might have done on its own...

0235 - 2 oz castor oil in root beer float

0250 - Hibiclens wash (for GBS+ treatment)

0258-0400 - series of herbs and homeopathic tinctures

0310 - FHT 136

0330 - 2nd dose - 2 oz castor oil in root beer float

0345 - ctx 8-10 min, 30-40 sec

0400 - FHT 142; ctx 6-8 min, 30-45 sec

0420-0435 - ctx were clearly picking up... I'm doing the low moaning with each one, as I had experienced with Z. Here is where I got queasy and tried to ignore my tummy cramping. Then I decided I really should let Janna know, and she got a pail for me "just in case." I'm lying on the couch listening to lovely Hypnobirthing music this whole time, and all of a sudden, good thing that pail was there. Up came that second root beer float! Poor Janna said she had quite a time cleaning the castor oil out of the pail! At this point my ctx really pick up and become much stronger and closer together.

Around this time (I think) I actively thought I might be in that intriguing "transition" period. I actually remember hitting that wall that some many women speak of and thinking during some ctx, "I don't know if I can do this!" I didn't tell Janna my thoughts as I was trying to stay "in my zone."

0430 - I believe this is when we woke Jason and told him to get the birth pool ready!

0444 - Janna calls supervising midwives; ctx 4-6 min, 45-60 sec

0500 - start moving upstairs! Had some strong ctx leaning against the walls... Janna canceled Jason on the birth pool set up. :( No time!

0523 - I got on the bed and Janna finally had a chance to check me. I'm at 10 cm, but with a fat cervical lip. I was really wanting to push, but she tells me to blow through the ctx so as not to tear my cervix and try to get the swelling on my cervix to reduce. I tried hands and knees but it was really uncomfortable during a ctx, so I get on my right side. While on hands and knees, though, I urinated a lot. I actually was a little confused as to what type of fluid it was... It surprised me so! But I remember Janna reassuring me that it was OK; the baby was descending. This was a relief as I had had a bit of anxiety about making sure my bladder was empty since it had gotten so full with Z's birth that I could not push him out without a straight cath.

Jason tries to call the 2 photographers we had lined up but neither answered their phones...

0535 - Midwife #2 arrives. Janna still telling me to blow through my ctx. Can I strangle her instead? ;-) FHT 136; ctx 3-5 min apart. J calls my mom to let her know "it's time." I wanted her to be able to be there to experience a normal birth. She thought he meant I was just going into labor, though, so she and dad were taking their time...

0543 - FHT 145

0545 - FHT 140s; midwives see small bits of baby hair at ctx peak! Can I get this baby out yet??

0554 - Midwife #1 arrives; Janna reduces the cervical lip by pushing it back over the baby's head. I actually felt a bit of relief in the pain when she does this. Time to actively push! I'm still on my right side...

0555-0603 - FHT remains in 130s-140s

0606 - FHT 150s; baby is crowning! The stretching of that tissue is such an intense feeling!

0608 - FHT 130s

0610 - FHT 110; full crown!

0611 - Mom's here! My dad stayed downstairs but she called him up. Poor Daddy, hope it wasn't too traumatic and awkward for you. At that point, getting ready to push her out, I don't think I would have cared what blood relative would have walked in.

3/27/10 0613 - I remember baby Z pretty much shooting out, but Ahlia's head came out and her body stopped! Her chunky shoulders were stuck... I looked down at my midwives, like, what do I do? Midwife #1 asked to give a big push, and Janna helped wiggle her shoulders out. My sweet Ahlia is in my arms! She still didn't have a name at that point, but "Baby Girl Kite" was good enough at the time. :)

0614, Mamma & Baby Girl

I did receive a 2nd degree tear once again due to her chunky shoulders. Midwife #1 kindly and lovingly sutured me, and from what I can tell I have healed well!

I felt tired after laboring all night, but not even close to the fatigue I felt after the 15+ hour labor with Z when I was in "transition" for probably 10 hours!

Ahlia received a healthy exam with 8 and 9 apgar scores.

1200 - Finally, the effects of the first castor oil dose! I spent a half hour on the toilet, almost 6 hours after Ahlia's arrival! Ugh.

What an empowering experience! I still can not put it adequately into words. I felt very empowered with an almost natural birth with Z, but something about having her at home made a big difference. I trust birth, and I trust home birth is very safe for "low risk" pregnancies, so I know we made the right decision... It was not a decision made just for me to have "the comforts of home." I wish all women could better understand their options! I truly believe more women would choose birth with a midwife, be it at home or in a birth center.

Thank you, Janna, for everything! And thanks to the supervising midwives and all who helped us along the way. It was big journey for me and a quite stressful pregnancy. Now, the real fun - the infant stage (again) and raising a brother and sister! Ahlia, you are 5 weeks old now and have brought so much joy to our household already! Our family is so blessed!! Thanks be to God!

Zyler 27 months, Ahlia 1 month. He loves cuddling "Baby Sister" :)

Zyler's Birth Story

Many thanks to my doula, Kelly Kravitz, who provided me a birth log summary of events so I could write an accurate and detailed birth story!

Wednesday, January 2

Have 39 week checkup (due date January 8)... 1 cm dilated and 70% effaced. The nurse-midwife, Melody, thinks my mucous plug is gone already.

Thursday, January 3

2100
Mucous plug definitely starts coming out and bloody show begins. I start having irregular lower back cramping. Nothing too uncomfortable. Able to sleep most of the night.

Friday, January 4

0400
Wake up early and still see mucous plug in big globs. Worry that water has broken. Since I'm GBS+ (Group Beta Strep) I don't want to alert the midwives too "early" as I want to avoid the IV antibiotics in excess (I am OK with 1 bag but am not thrilled about getting it every 4 hours during labor).

0700
Call my doula and let her know the lower back cramping returned and that I am still wondering if my water has broken. It is hard to tell with the mucous. I decide to go on into work and continue normal activity. Once I sit at the desk at work the surges (HypnoBirthing "speak" for "contractions") stop for most of the day. I am pretty sure I was in prodomal (very early) labor.

Saturday, January 5

0300
Email my doula to let her know I can not sleep any longer! Surges return about 2-3 minutes apart but are not intense enough to warrant going in. I called Ann Schaeffer, the midwife on call to let her know. She confirmed that first labors can really drag on in the early stages.

0830
Talk with doula. Having consistent (2-10 minutes apart) surges in lower back with lots of bowel area pressure. They last 30-45 seconds.

1030
Get in the tub to relax. Talk with a close friend and then my doula. The warm water really helps relax my back and tolerate the surges easier. They get a bit more intense as sometimes I can not speak through them if I was standing. My in-laws are at the house because my father-in-law is helping Jason in his shop. Jason & I had agreed not to alert family when I go into labor and want to wait until the last moment or until after the baby is born to make any calls. So it is challenging to say the least to hide the fact that I am in early labor! I even help make salads for lunch as my mother-in-law brought lasagna for us to share. My father-in-law said after Zyler was born that he could tell I wasn't feeling too great that day. :)

1700
My in-laws leave and my doula arrives to assist me through labor! My surges are every 10-13 minutes, lasting 30-50 seconds. I have continued increase in bowel pressure and lower back aches with each surge. My doula tries the counter pressure near my tail bone and it helps ease the discomfort me a great deal. I have tried to drink plenty of water today, and this evening I have some Red Raspberry Leaf tea. At this point I am still able to talk through each surge.

I call the midwife at some point today and she suggests blue or black cohash if I think my labor need an extra "boost." I tell her also about the bowel pressure and confirm with her that milk of magnesia is OK to take. I try it but nothing productive or relief comes. I also call a good friend and discussed the blue or black cohash and my labor symptoms. She thinks the same as my midwife, that I am still in very early (prodomal?) labor. My doula calls Martin's grocery since it's Satuday night to see if they might carry the cohash herb, but the worker can't locate it. We decide to stay home and see how labor progresses on its own.

My doula really wants me to try to rest, so we go upstairs to my bed. I lay on my left side and she uses the counter pressure and hot rice packs. These coping methods really help, and I don't know how I would have gotten through labor without her!! I also play my HypnoBirthing scripts on the CD to help me focus and remain in a good, centered state of mind.

1930
Surges now coming more consistently and definitely stronger. Lasting more than 1 minute.

2015
Surges 1.5 minutes long and 5 minutes apart!

2100
Surges are 1.5-2 minutes long and 5-7 minutes apart.

2130
Jason is checking on me every 20-30 minutes. I start shaking a little with each surge.

2200
Surges are definitely stronger; 1.5 minutes long, 5-8 minutes apart. I'm finally starting to believe that I'm in active labor! I am a little concerned though that labor was slowing some? My doula suggests switching sides so I go to lie on my right side. My shaking and teeth chattering also intensify. This is hard work!

2230
Surges 2-3 minutes apart! Jason goes to rest in the guest room. Just a little bit later, I confirm that my water breaks! Surges are really intense now. Poor Jason only got to rest 15 minutes before we got him up to leave for Rockingham Memorial Hosp. around 2250.

2330
We get the car packed and finally arrive at RMH. I call my midwife on the way to tell her that contractions are more intense. She doesn't talk to me long and calls me between surges, so I think she still thinks I was still in "false" labor. Is she in for a surprise! I tell Jason I would be pretty upset if we get there and I am only dilated to 2 cm!

Ann (midwife) is ready to put me in a triage room but realizes we needed a bigger labor room for me when she sees me breathing through a surge as I get out of the wheelchair! They get a 20 minute EFM. Zyler's heartrate is normal, about 137 bpm. Surges are good and strong. Ann checks me and says I have done great work--I am in transition at 8.5 cm!! Maybe we'll have this baby before daybreak!?!

Sunday, January 6, 2008

0015
I get right into the jacuzzi after Ann offers it. The jets really comfort me through surges and Jason turns on the HypnoBirthing scripts.

0110
Jason lies down to try to get some rest again. The nurse gets another EFM reading. Zyler is doing great. Kelly continues to use counter pressure on my lower back which helps me cope.

0300
I get a new RN, Cindy, who had both of her children naturally. She is very supportive throughout the remainder of my labor.

0500
Still no baby!! Cindy wants to check my cervix for progress. Jason rouses and comes to me. Cindy can feel that the left side of it is swollen and in the way. She actually uses the phrase "possible c-section." I am so exhausted by this point that I just want to cry! I can't believe she would even mention that phrase. Luckily it is never mentioned again!

0530
My labor support team continues to suggest I change positions, so I try the birthing stool for a while. Jason supports me from behind, sitting on the bed. The surges feel a little less intense. I sense that nothing very productive can come of them at this intensity level.

0600
Ann returns. She had gone for a nap around 0100. She expresses her disappointment for having slept so long, because she was confident she would have been woken up much earlier when I was ready to birth my baby! She checks my cervix and feels it is still off to the side. She suggests I get in the hands and knees position since Zyler is not quite turned all the way anterior yet. If this doesn't work I should consider Pitocin to help the surges become more effective. (I was definitely committed to a fully natural delivery so this is not what I wanted to hear!)

0700
I finally am exhausted with the hands and knees position. The baby did turn another 10%, but is still partly posterior. I decide to start the Pit with Fentanyl (narcotic) to help me relax and rest some. (I emphatically decline the offer of an epidural as I do not want my mobility compromised and want a natural labor/delivery as much as possible. Turns out I stayed in the bed the rest of the time anyway.) I start crying a little out of frustration and exhaustion. Jason & I am very committed to my having a totally natural birth, and I am so disappointed that surges have slowed down and that the Pit would be necessary. I understand it to be a very good reason for this intervention though. My uterus and I am so tired!! I ask Jason if he is angry, and he says if I need these interventions then I should take them!

0730
The Pit starts at the lowest dose, 2 ml. Every 20 minutes it raises 2 ml. I receive the Fentanyl which should metabolize in about 1 hour. I am finally able to rest!! Only a few of the surges woke me...

0800
Pit is up to 6 ml. Surges are definitely stronger and faster. I'm feeling a little rejuvenated!

0845
I start pushing more, and Zyler is moving down! Ann checks me, and he's at a +2 station and I'm fully dialted! Woohoo!!! I start bearing down a lot more and soon the room floods with hospital staff to prepare for the birth. By this point also I have totally lost all modesty and the hospital gown is gone! My doula is great at telling me to "breathe my baby down" and this allows me to use very low pitches in my voice when bearing down and really push in the right place. (Even though HypnoBirthing tried to teach me not to "push.")

Ann and all the support staff in the room are wonderful at encouraging me through the pushing and not prompting me when to push. They allow my instincts to tell me when to push. I get to the point of exhaustion where I don't believe I can do it! I even doze once in between surges! They also bring the mirror out to encourage me, too, when Zyler's head becomes visible! That is pretty amazing for me to see. I seriously do not understand why it is taking soooo long though to get him out!!

1005
Throughout the night I had continued sipping water, and Kelly & Cindy continued reminding me to urinate, but I couldn't go! Ann finally looks up and sees an extra bulge on my belly--my bladder was extremely full! I get up and try going 1 more time, but to no avail. So I get back in bed and Ann uses a straight catheter and got 1 LITER of urine!! I think she realized my bladder was prohibiting him to move down any further.

Then just 15 minutes later....

1021
Zyler is born! Finally, at 39 weeks 5 days gestation. I finally feel his head come and was preparing for the next surge to push the rest of his body when I finally realize Ann telling me to take my baby! She had pulled the rest of him out for me. Fine by me! :) I grab him and pull him to my chest and my head collapses against the pillows in exhaustion. Zyler has a 6 cm "conehead," and Ann tells me his hand came out beside his face! If it hadn't been for that I would have had plenty of room for him. However, I ended up with a 2nd degree tear on my perineum that requires stitches. Not too bad...

At Ann's suggestion, I push gently 1 more time to expel the placenta which is just near the vaginal opening. I am fascinated by it as she inspects it, showing me the sac and what had fed my baby for the past 9 months.

An RN brings me some Sprite, graham crackers, and Ibuprofen. The Sprite tastes just heavenly! Zyler has Apgar scores of 8 and 9 out of 10) and is in perfect health. With my exhaustion and the newness of motherhood, it takes me several days to get used to the idea that I'm a mom!

Monday, January 7, 2008

We are discharged and go home!