Friday, July 29, 2011

Asher's Birth Story



Asher's birth is one of the biggest events that has happened to our family, so I thought I would share his birth story. Because I believe that pregnancy and birth are a normal and healthy part of a woman’s life and that the female body intuitively knows how to give birth, I chose to deliver Asher without the use of an epidural or other interventions. I think that birth has been turned into a medical event rather than the sacred occasion that it really is, and wanted to experience fully the highs and lows of pregnancy and birth. There are many benefits to giving birth without interventions, including less risk to the baby during and after delivery, an easier time breastfeeding after delivery, and a faster recovery time for mom. I also believe that having a positive attitude about pregnancy and birth helps to lessen the discomforts that come with both.
In order to prepare for a natural birth Austin and I took a natural birthing class which taught us different ways of coping with labor pain and I practiced relaxation throughout my pregnancy, especially during the last month or two. I also read quite a few books on natural birth and talked to some of my friends who have given birth naturally. I wrote a birth plan indicating that I did not want any interventions during labor and talked my midwife about it, who was very supportive of my choice and talked to me about how to deal with the nurses at the hospital that might be more interested in routine hospital policy than in my individual choices. I also talked with a nurse and several CNAs about what the hospital policy was regarding routine interventions. My midwife advised me to accept a hep-lock (the start of an IV in case medication or other fluids need to be given quickly) and if I wanted to eat and drink at the hospital to do so without letting the nurses know it. Mostly, she advised that I should stay at home as long as possible since the longer I was at the hospital, the more likely it was that I would be given some type of intervention.
Toward the end of my pregnancy (35 weeks), I began to dilate. I stayed at three centimeters for several weeks, then opened to almost four centimeters at week 38 and almost 5 centimeters at week 39. It’s unusual for a first-time mom to dilate this much so early, so my midwife thought I might deliver early and I began to get excited to meet our little baby. I anxiously waited for him to come but wasn’t having any contractions or even Braxton hicks, despite the fact that I was dilating and Asher was dropping farther down. At my 39 week appointment, my midwife suggested that she sweep my membranes to see if that would get labor started. She said that it only worked about 50% of the time and if it was going to work, I would start feeling period-like cramps and start contractions in 2 to 3 days. She warned me that because I was already so far dilated, that I should come to the hospital when my contractions were 5-7 minutes apart, rather than waiting as long as I could to come in like we had discussed earlier in my pregnancy. A few hours after my appointment I began feeling period-like cramps occasionally throughout the day. They intensified by the evening and started feeling like what I thought might be early contractions, but I wasn’t really sure. I told Austin I thought they might be contractions, but we figured that I wouldn’t really go into active labor for a day or two. We started to watch a movie and I noticed that the contractions occurred irregularly at anywhere from 10 to 20 minutes apart. I felt like I had to use the bathroom really badly after each contraction even though they weren’t very strong and only seemed somewhat uncomfortable. By about 11 pm when we were ready to go to bed, they were getting stronger and a little closer together, but I knew that I needed to sleep as much as possible so that I could have strength for active labor and delivery. When the contractions came I did deep breathing and kept my body as relaxed as possible, then tried to sleep before the next contraction. This was successful for a few hours, except that I had to keep getting up to go to the bathroom and began to not really get any rest between the contractions. At about 2 in the morning, I decided to get up and sit in the living room so that I wouldn’t bother Austin by getting up constantly. I also wanted to try to find a new position that might feel more comfortable during the contractions. I found that sitting in a recliner and moaning quietly during each contraction helped me get through it better than lying in bed. By 3:30, the contractions were getting uncomfortable enough that I felt like I needed some support. I asked Austin to get up and sit with me. He asked what he could do for me and I didn’t really think there was anything he could do, I just wanted someone to acknowledge that I was in pain and keep me company. He sat on a birthing ball by my feet and tickled them for me. About this time, I noticed that I would have a contraction lasting a minute or a little bit longer, then a few minutes later have another contraction that was less painful and only lasted 20-30 seconds. I had never heard of this happening before, but decided to call the shorter, easier contractions “after shocks”. I didn’t think that they were real contractions so didn’t assume that labor was advanced enough to need to go to the hospital. Austin eventually started falling asleep while sitting on the birth ball, so I sent him back to bed with a promise to wake him again if I needed him. A few minutes later I felt like I needed someone, but knew that he was exhausted already, so I decided to wake my mom up (we are living with her for a few months before we move to Spokane). She came and sat with me, rubbing my feet and reminding me to relax. I told her my theory about the after shock contractions, and she thought that there was no such thing and that my contractions were close enough together that we needed to go to the hospital. After awhile, I decided that we should go, so I went to wake Austin up at about 4:45. I had most of our hospital bag packed, but not everything, so I finished putting in things I thought we would need. I brought my ipod with my relaxation music, a wedding picture that I could focus on if I needed to, some nice lotion with a citrus smell that I really like, and some snacks in case I got hungry. After I had packed the bag, I decided to change our bunny, Lola’s, litter box since I had planned on changing it that day and I didn’t want her to be mad at us for leaving her alone for a few days in a dirty cage. It took us almost an hour to really be ready to go and another half an hour to get to the hospital. I had heard a lot of people say that the car ride to the hospital is the worst because you can’t really move around and the bumps in the road make the contractions feel more painful. It wasn’t a pleasant experience and I did notice that the road seemed more bumpy than I had ever realized, but it wasn’t as bad as I had thought it would be. At one point when we were just about to pull into the hospital, I told Austin to stop the car until a contraction finished, but of course he couldn’t stop in the middle of the road so he just drove slowly until he got to the parking lot. By the time we got there and got checked in, it was around 6:30. They took me to a small room by myself to have me change into a gown, check how far I was dilated, and ask me some questions. The charge nurse came in to ask the questions and hook me up to a continuous fetal monitor. I had expressed in by birth plan that I didn’t want to have Asher’s heart rate checked this way since it tied me to a machine, was uncomfortable while I was having a contraction, and just isn’t necessary, but I knew that the hospital would insist on at least 20 minutes of using the fetal monitor when I first checked in, so I didn’t argue. A few minutes later my mom and Austin were allowed to come into the room and the charge nurse informed us that she intended for me to be monitored at least 20 minutes out of every hour. I didn’t have the energy to argue with her, but my mom was very forward about telling her that I didn’t want to be monitored this way, which didn’t make the nurse very happy. Since I was dilated to almost an 8 and was completely effaced, I was taken to a labor room which was much larger and nicer than the original room. There was also a large bathtub which I was planning on using, but never had the chance since everything moved so quickly. My midwife was called as soon as the nurse had checked dilation and was there by the time I was moved to my new room. I was assigned a new nurse who gave me the hep-lock, which we never used because I didn’t need an IV for anything.
As my contractions got closer together and more intense, I found it difficult to relax and found that the best way for me to get through each one was just to lean against Austin with my hands on one of his shoulders and my forehead pressed into the side of his upper arm while I rocked my hips back and forth and moaned quietly and my mom stood behind me and rubbed my back lightly while reminding me to relax. My mom and Austin also got wet wash cloths that they put on my head or shoulders to help keep me cool. That hour or so is kind of a blur, but at one point I had to go to the bathroom and found that sitting on the toilet made my contractions a little more bearable, so I stayed there for awhile, but eventually decided to get off because I kind of felt like bearing down. I walked around the room a little more and I started feeling exhausted and like I just wanted to take a nap. Since there was no way I was going to be able to sleep, my midwife suggested that we break my bag of waters which would intensify my urge to push and speed up the delivery. As soon as she broke it I started feeling a very strong urge to bear down during each contraction. These contractions were very strong and it was here that I started to think “I can really understand why someone would want an epidural.” However, when I did bear down, it made the contractions a lot better. When I got to the stage when Asher was about to crown, I had a difficult time pushing because I was so tired and because it hurt to have my pelvic floor muscles stretched so much. For me, this was the most painful and difficult part of labor and I remember thinking that I wasn’t going to have any more kids. At this point, my midwife began coaching me on when to push, which is something that I thought I didn’t want, but it ended up being very helpful. She was very good about talking me into pushing at least two, if not three times during each contraction. While I was pushing, my mom stood by my head and put cold washcloths on my forehead and hair and Austin held one of my feet, which I kicked against him while I was pushing and kicked the other foot against my midwife. I wasn’t really aware of what the nurse was doing except that sometimes she would put the continuous fetal monitor on me, but would take it off again when I said it annoyed me or when my midwife told her to stop. After some time of pushing, my midwife asked if I would like her to numb my perineum a little with a shot of litocane. Because I was having such a hard time pushing Asher through and I knew that the shot would have no effect on him, I decided to do it. Soon afterward, Asher began to crown and I was able to touch his little head. Very quickly after that with a few more pushes, his head came out and his body followed very easily. When they laid him on my stomach I felt something that is difficult to put into words: a mixture of elation, joy, accomplishment, and relief. And I remember thinking that I would go through all of that again in a heartbeat because I got him out of it. At first, he just laid there quietly looking around while my midwife helped Austin to clamp and cut his umbilical cord. After 30 seconds or so, he began to cry the sweetest cry I have ever heard. The nurse dried him a little while he was on me, then wrapped a blanket around us both to keep him warm. While I was snuggling and bonding with him, my midwife delivered the placenta then gave me more litocane so that she could stitch up a second degree tear. I don’t remember a lot about any of that and can’t really say what Austin or my mom were doing at that time because I was so engrossed with Asher. Looking back, I think that the contractions were easier than I had expected them to be, but pushing Asher out was just as difficult as I thought it would be.
Something that has really stuck out to me in my journey of learning about birthing naturally and preparing for and giving birth to Asher is how little choice is given to women in typical hospitals. The view that giving birth without an epidural is a horrible ordeal that no woman should have to face is prevalent in our society and many women are unaware that there are plenty of alternatives to an epidural for managing pain. I was a little shocked at how many interventions are given routinely without even asking the woman if she wants that done to her body. Most women just assume that something is medically necessary because the hospital automatically does it. Two examples of this in my situation are the continuous fetal monitor that the charge nurse insisted that I wear and another nurse trying to give me pitocin (synthetic oxytocin) after I had delivered Asher to help my uterus contract and prevent hemorrhaging. I had stated explicitly in my birth plan that I did not want to use either; however the nurses tried to do them because it was routine hospital policy. I got out of both by knowing that they weren’t medically necessary and speaking up (or having my mom do it for me) and by having a midwife who knew what I wanted and was willing to tell the nurses to stop. In the case of administering pitocin after the birth, it was completely unnecessary since the nurse didn’t even wait to see if my body would do it on its own. I wasn’t paying attention to what the nurse was doing since I had Asher, but luckily my midwife caught her and told her that I didn’t need the pitocin because my body wasn’t having any difficulty doing exactly what it was supposed to do.
Overall, I was very satisfied with how Asher’s birth turned out and plan to birth the rest of my children naturally as well. I feel like I was really prepared, but think it is funny how many things I brought to the hospital thinking that I would use them and the only thing I really needed was support from my husband and my mom (and some cold washcloths). I hope that in future births I will be able to give birth without having my perineum numbed.
I don’t want to push natural birth on anyone since it is a personal decision and a sensitive subject; however, I do hope that women will take the time to question why certain interventions are being used, what the benefits and risks are to themselves and the baby, and if the interventions are really necessary. I am pleased that I wasn't detoured from what I felt I should do when people tried to talk me out of doing it naturally or acted like I was crazy because I didn’t yet have any experience with what childbirth was actually like. Asher's birth was an extremely positive and rewarding experience for me. I am glad that I took the time to look in to my options. If any of you are interested in natural birth, I have lots of good resources and am super enthusiastic to share!

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