Thursday, November 20, 2014

Cyrus Henri // Birth Story

This is a long post, but with good reason. 

I decided to stop seeing clients at work when I was 39 weeks pregnant, one week before my due date, as driving to see my clients, then interacting meaningfully with them - keeping up with them at home and school, getting up and down from the floor, and not getting too distracted by the squirmy starfish baby sitting on my bladder - was getting tougher. 


Then I waited.



My 39 and and 40 week appointments at the midwifery center were uneventful (no signs of action on baby's part), but I was hoping not to still be pregnant at 41 weeks, though I was told to expect to be. I bounced and swayed on a yoga ball, refused to put my feet up, ate spicy food, and went on as many walks as I could manage. I was still pregnant at 41 weeks. I had been home, uncomfortable and bored, for 2 weeks. The morning of May 30th, we stopped for a cappuccino and a pastry before heading down for the 41 week appointment. 


We sat in recliners, drank Izze, and listened to beeps for the non-stress test, which showed no signs for concern. We discussed options with the midwives before a quick fluid and head check on the ultrasound. Again, no cause for concern, so we decided to have the midwife try to sweep my membranes, if possible. I was just barely dilated, so she was able to do a stretch and sweep while I laughed uncomfortably. 

We did all we could to take advantage of this window -- we were ready to meet our baby and I was ready to not be so very pregnant anymore. I was extra uncomfortable after the membrane sweep, but I waddled through a walk and we followed all the best natural induction advice, ahem, that afternoon. We went to Hops & Pie for dinner, where there was an hour-plus wait. We passed the time chatting with owner Leah about her recent birth and she gave us a H&P onesie for the little dude. Leah told us that our pals had eaten there the night before going into labor with their first babe, but I didn’t have my hopes up. I added jalapeños to my usual pizza order and filled up. It was close to 10PM when we left. That late dinner would turn out to be my last real meal for quite a while! 

The next morning I woke early with back pain. Being a million weeks pregnant, I assumed I’d slept in a bad position and tried to find a better one, with no success. I got up and putzed on the computer, but my back pain would come and go. I started paying attention and making some notes, soon realizing that my “back pain” was happening every 7-8 minutes. Koan got up and we took the dogs for a walk, where I experienced a few waves of sensation in my back, but was able to walk without issue. We were pretty sure this was early labor! We had planned to head to the ‘burbs for coffee that day, but I sent Koan without me. He took a book and enjoyed a relaxed morning coffee. In hindsight, it seems strange that I sent my husband away when I was quite certain I was in labor. I assumed we had plenty of time and Koan had been holed up in the house with me often since I really hated sitting in the car by that point. Regardless, he got some down time that morning and I'm not sure he's had any since! 

From Koan's Instagram 5/31/2014

After a couple of hours, my contractions (still in my back) had intensified enough that I had to stop what I was doing to breathe through them. I also began doing Ina May’s “horse lips” to keep from tensing during contractions. The dogs were barking and making me crazy and I really wanted my coffee, so I messaged Koan to hurry the eff up. He was home quickly and assumed duties of rubbing my back, giving me snacks and water, putting on Netflix shows, and timing contractions. And so it went. 

Around 9:30PM that night, my contractions were hovering around 3-5 minutes, so we called Mountain Midwifery Center. Gina was there and told us to come in. She checked my cervix and found that I was 3 centimeters dilated, 80% effaced, and that baby was at 0 station. Progress! But! She thought it was best that we went back home and gave us instructions to call again if/when my water were to break or when contractions were to take a big bump in intensity, like going from 40mph to 60mph on the highway. I was disappointed for plenty of reasons - I wanted things to be moving faster, I did not want to get back in the car, and I liked the idea of Gina delivering our babe, since she is wonderful and she had delivered our friends’ sweet little one. She mentioned she hoped she was still on call when we came back. She would not be, but she would get to see us again before we met our little one!

Middle of the night contractions with my best girl.

I don’t remember much about Saturday night. Koan continued to prompt me to eat and drink and rubbed my back, as I was still having back labor. Sometime around 2AM, he tried to get some sleep. I lay on the couch and tried to sleep between contractions, but without success. He slept for about an hour, then also fell asleep during his “wake up” shower. 

The next morning (Sunday) we called MMC again and talked to Tiffany, who had begun her call shift. Koan described the variable pattern of intervals between contractions, noted that some contractions were much longer than others, and that I was still having back labor. Tiffany deduced that baby was likely in a non-ideal position and instructed me to walk up and down the stairs, spend time on hands and knees, and to do all of my sitting facing backwards on the toilet to help things along. Ugh. I continued my horse lips/motorboat exercises throughout, but being on the stairs and/or on my hands and knees during contractions was painful. Surprisingly, the only sleep I got throughout my labor was when I was sitting backwards on the toilet. Who knew it would be so restful?!

Sometime that morning I lost my mucous plug and, soon after, expelled enough fluid that I thought my water had broken. The time between my contractions continued to vary in length, but often stayed between 3 and 5 minutes, so we called and talked to Tiffany again and she told us to come in. 


We arrived around 2:30PM on Sunday and were happy to find a bigger room available this time! Tiffany checked my cervix and found that I was 5 centimeters dilated and 90% effaced, but that my bag of waters was still in tact, as far as she could tell. More progress, but still slow - I had now been in labor for over 30 hours. My contractions had also begun to space out again since we had talked on the phone. Tiffany asked us how we felt about a walk around the block and we agreed. During our walk, I began to say in my head, “My breath is bigger than this contraction.” I told Koan about it and he would remind me aloud while I horse-lipped my way through. We were able to get contractions closer together, then spent more time walking the stairs at the birth center (just like we’d practiced in childbirth prep class), resting in rotating positions, and sitting backwards on the toilet at the birth center. I snacked on greek yogurt and trail mix and tried to keep drinking water. I was grateful to have my “Very Mellow” Spotify playlist I’d made and the blessed iPhone to let us bring the music wherever we went. 

Curiously, my contractions never really stayed in or under a 3-1-1 pattern, but I continued to progress. Sometime after dark, Tiffany suggested we consider taking some herbs to supplement the natural oxytocin surge we’d get during the night. We decided to think about it. I asked to have my cervix checked to help make the decision. Tiffany was gloved up and about to check, when Colleen, the nurse joining her on her shift, popped in and indicated that the baby of the woman in the next room (who we had heard faithfully pushing since soon after we’d arrived) was crowning. They both had to duck out to deliver that babe and we were left to continue laboring. After having one of them checking in and taking vitals regularly since we arrived, we were now alone - and transitioning! 

I’m not sure how long we went without an attendant, but it felt like a long time (likely about 20-30 minutes?). Soon, Gina appeared! MMC always has a back-up midwife on-call for situations such as this. She came in, saw it was us, and sympathetically exclaimed, “Oh mama, you’ve been working so hard!” She took my vitals and baby’s, determined all was well, then left us to keep working. I think at this point, she likely took over with the other family to do their discharge duties because Tiffany and Colleen came back. 

Around midnight, Tiffany checked my cervix and found that I was 8-9cm dilated, but during a contraction, my cervix completely dilated! She readied the birthing tub for me and I changed into my swim top. Sometime around this time I half-whimpered to Koan, “This is hard work...” After having been sitting, standing, and walking for close to 40 hours, floating in the tub was such a relief! I remember laughing and telling Koan how good it felt. Then another contraction hit. I was happy to be in the tub, but it did not make things that much easier. Koan got some cool rags to put on my head and neck and I settled into a half squat and, with some coaching, began pushing. And so it went. 


I was not prepared for how difficult pushing in the tub would be - the bottom of it is slippery! I was pushing and I knew I was progressing, but it didn’t really feel like a baby was making his way down. I was so tired, feeling quite out of it (maybe falling asleep?) between contractions, and beginning to get discouraged. At least a couple of times, I emphatically shook my head in disagreement when the team would tell me I was doing a good job. 

Just after 2AM on Monday morning, Tiffany prompted me to change positions and put me on a birthing stool. Baby’s heart rate had been dropping throughout the last few vitals checks and Koan remembers feeling like the attendants were starting to get nervous. I remember exasperatedly trying to answer when they asked, “How tall are you?” as they chose the best stool. 

Once I was on the stool, baby crowned within the first push or two. They checked his vitals again and Tiffany said, “This baby is ready to be born,” in what I imagine is her sternest midwife voice. The lights were switched on and Colleen, Tiffany, and on-call doula Carrie switched into action mode, gathering extra towels and supplies. Tiffany coached me on how to use the handles on the sides of the stool and curl in to push baby out. Koan had wanted to catch the baby, but at this point that wasn’t really an option as the pressure was really on. He stood behind me and was able to see the action via a mirror on the floor. 

At 2:30AM on Monday, June 2, I pushed our baby out into the bright light! His cord was wrapped around his body two times and he brought a lot of meconium out with him. Tiffany caught him and placed him onto towels on the floor after she got him unwrapped. She had to do some suctioning and used a hand-operated oxygen bag to get him perked up, but I remembered from our prep class that that is not uncommon and I wasn’t afraid. It felt like hours though that I sat on that stool staring at my baby’s face as a flurry of hands moved all around. I was so in awe that he was really finally here. 

He remained quiet for a few minutes, but was breathing and pinking up. He was handed to me wrapped in a towel to get warmed up and began scream-crying as we moved to the bed. 


And that’s where it ends, right?!? I of course had to still deliver the placenta, then endure some lidocain and stitching, both phases approaching the limit of what could be done at the birth center. I strained to hear over the baby's cries as Tiffany explained that I might have to transfer to the hospital at that point. In the end, it wasn't necessary. I was so grateful not to have to transfer, since that would have meant leaving Koan and the baby there at the birth center.


We placed the baby on my abdomen to allow him to make the breast crawl and self attach for breast feeding. We were amazed as he scooched and squirmed, doing tiny newborn pushups to make his way. Before he was able to finish his journey though, the three of us all fell asleep! I think we napped for about half an hour.  



Some of the timing is fuzzy, but I know Koan and I passed the babe between us a bit, reconsidered our name front-runners, snacked, and drank water before I got to take my herbal bath. As Tiffany and Colleen had just finished a long and busy call shift (4 babies!), Susan, who was just beginning hers, took over. Her sweet energy was really a gift after what had been, at that point, 48 hours of hard hard work. When she took me to the tub for my bath, she encouraged me to rest and lay low for as long as I wanted. I tried to breathe a bit, get comfortable with the reality of what we had accomplished over the last two days, and even started to feel a little proud of our story. After 2 days of natural labor, we got to welcome our Cyrus Henri in the peaceful environment we’d imagined and hoped for. 

After getting dressed and giving breastfeeding another go, we loaded up the car and Koan valiantly drove us home (holy heck, were we tired). We let the dogs sniff Cyrus’s hat, then sniff Cyrus himself. We ate some leftover pizza and went to bed, entering our 48 hour skin-to-skin cocoon. 


**

I am so happy that we entrusted our prenatal care and delivery to Mountain Midwifery Center. I am thankful that we had choices and were able to educate ourselves and feel empowered about those choices. Knowing now how our path unfolded, I’m certain that, had we been in a more conventional medical environment, I would have felt pressure to choose other interventions that we did not, in fact, need in order to have a healthy birth. I am grateful to have modern medical interventions available when they are necessary; I am proud that I made the choice to give my body a chance to show me what it can do. 

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