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!

37w 1d - Doula Visit

My doula came for her second visit tonight. We went over techniques/words/actions that I think will help relax me, and I went over some of the basic HypnoBirthing® techniques that have "clicked" with me to relax me in my practice sessions. She's concerned about J feeling uncomfortable or "pushed aside" but I told her I didn't think it would be a concern, and that he understands the value and importance of a doula. I spoke with him later just to be sure, and he confirmed... He said that if it makes his job of my birth companion a little easier, then it sounds like an excellent deal to him! :o)

My friend J was visiting that evening before my doula arrived and got to meet her. She has a great sense of character and said she got good vibes from my doula. I told her that so did I, or I wouldn't have hired her. :-) My friend asked about how to become certified. I told her what I knew and that I think she'd be an amazing doula! I hope she will be able to look into it more down the road. It would be an excellent line of work for her.

36w 2d – Ups & Downs

I haven’t used this topic in a while so I will use it as the outline for a pretty sizeable update.

Downs

• Last week I tested positive for the Group B Strep test. A pretty thorough explanation of it is provided by americanpregnancy.org. An otherwise healthy mom can pass GBS to her baby during delivery. It is upsetting to me as the treatment recommended by the CDC is IV antibiotics (Penicillin), and therein lies a risk of later developing thrush, and, even worse yet, the baby being exposed to any bacteria that are antibiotic resistant and become “super bacteria.” I plan to ask more questions to Pason’s doctor whom we have selected to see us at the hospital. (We will then transfer the baby’s care to our local area.)
• Our crib arrived with considerable shipping damage, but we’ve already received the beautiful replacement. (This is definitely also an “up!”)
• Bad (icy) weather is possible this Saturday when we are supposed to have another baby shower.
• I’m starting to not sleep as well. I’m definitely in month 9!

Ups

• I've hired a labor/birth doula! We met with her the first time a couple of weeks back.
  
• On the 8th I was honored to attend our second baby shower in Shenandoah. Tremendous thanks go to Andrea & Kathryn for all their hard work, beautiful cake, and other yummy food, and to all the wonderful ladies who attended and who have sent plentiful baby gifts!
• The nursery is close to completion. We haven’t felt rushed or pressured since we plan to keep Pason in our bedroom at first. I welcome feedback on the Arm’s Reach Co-Sleeper that we plan to use!
• Last CNM (certified nurse-midwife) appointment yesterday was excellent. Pason’s heart rate approximately 143. My BP 110/72. My weight gain good—I think around 25 lb, not sure exactly where I started. Fundal height 37 cm. Provided my birth plan to the midwife. We discussed the GBS+ result and how it may affect my labor experience. I got her talking pretty well, and J got to ask a few questions such as what defines fetal distress? We probably spent 45 minutes with her. :) I love the midwifery care model!
• We finally decided about a week ago to stay with the plan to birth at the hospital instead of the new natural birthing center. A lot of factors went into our decision, but overall we are glad we did our research (regarding hospital and birth center births) and feel confident we have made an informed decision. Perhaps, if we have a “next time,” the birth center will be better established and we will feel more comfortable and know better what to expect.

ICAN Information Meeting & A Doula

Tonight I attended a Birth Matters Virginia meeting. The presenter was the founder of the SW VA chapter of ICAN, the International Cesarean Awareness Network. I learned a great deal about what the docs don't want us to know!

I learned a little under each of the following topics regarding c-sections:

• statistics (almost 1 in 3 births in the U.S.)
  
• why they are performed
  
• how they are performed
• benefits
• risks
• how to prevent "the first cut" (c-section in a first birth) and subsequent c-sections
• hospitals that "ban" VBACs
• Under this heading... The hospital where I am delivering is one of them! I had no idea and was appalled. However, a few ladies in the meeting noted that if the mother is outspoken enough, the care giver has happily complied and allowed the VBAC "procedure." (Though there is no "procedure" about it--it's a natural part of life and a mother's choice to deliver at a hospital.)

Also at the meeting I met a couple of doulas who lead the Birth Matters group. I have thought more extensively about using a paid doula instead of the volunteer doula program through the hospital. From what I hear it will be completely worth our money to hire one. I think I'll be looking up a few to interview.

30w 0d - Pre-Registration

We pre-registered at the hospital this evening and asked a few more "newbie parent" questions. I signed up for a volunteer, on-call doula, and the registrar asked which family nurse-lactation consultant (LC) I would want to come visit me at home around day 3 or 5. Whaaaaat? I am so impressed they do this! I don't think the hospital closer to home offers this personal service! You can call the other hospital's LCs, but they don't plan to visit each mom automatically!

I've heard a paid doula is *so* worth the investment, but we're not going for it. I'm crossing fingers tightly that the volunteer doula service will be able to come through and that there will be one available for me!