Thursday, November 27, 2003

Intervention Free Hospital Birth

Intervention Free Hospital Birth
Blair Henley

Our decision to go the hospital and OB route was based on several factors. First, that’s where my husband (a doctor) works. Second, I wasn’t as impressed with the independent birthing center as I’d wanted to be. Its backup hospital was infamous and there was instability with the midwives. Third, I had to admit to myself that I did not want a home birth. Deciding between an OB and a midwife was much more difficult. I believe midwifery is the way to go if possible, but I simply did not like the midwife I met at the Vanderbilt midwives group. I was also surprised at how “medicalized” the hospital based midwives were, but my only previous “experience” with midwives was the story of my friend’s homebirth with lay midwives and books such as Babycatcher (an awesome book by the way). So our decision to have Kate at a conservative hospital with a traditional OB was made not so much as a decision, but as a rejection of other choices. It took me a long time to accept this, and I was extremely stressed about the problems that go along with hospitals and hospital medicine. I finally called a doula and talked to her for a long time. I was nervous about working with a doula because I’m not used to having people take care of me and I imagined it as somewhat uncomfortable. However, I was reassured when all of the OBs in the Vanderbilt group knew her and other said many wonderful things about her.

I was looking forward to going into labor. Silly, I know, considering the pain and frustration that comes with labor, but when I imagined the contractions starting and the hurried trip to the hospital, I couldn’t wait. For the last month or so of the pregnancy, I was having slight menstrual cramps. No big deal. About three weeks before my due date (July 10) I had an exam and was 2 cm dilated and 80% effaced. Wow, she was ready to just slip on out! Well, of course that’s not what happened, I just seemed to stall there until the big event. I had imagined and hoped that labor would start with a big woosh - my amniotic sac breaking, jokingly in the aisle at Home Depot, since my husband and I had spent so much time there working on a bathroom renovation at our house. So on July 3, as were walking around Target, just after leaving Home Depot, and I felt a light trickle, I just sort of smiled and kept quiet. Every couple of hours that day, things felt a little moist, but certainly this wasn’t the real deal, right? The next morning, July 4, the situation remained, and I figured if I were really leaking, that I better give the doctors a call because I didn’t want to endanger Kate. But oh lord, I did not want a July 4 baby. I knew that if I had ruptured, that I’d have to be induced and deliver that day. I joked that my OB had jinxed my baby into being born on July 4 because he had told me he was on call that day and to come on in. I tried to rationalize the situation by telling myself that I could do worse by welcoming my baby into the world with a whole country full of fireworks. We headed to the hospital.

July 4 turned out to be a very good day. I walked right into an examining room, feeling a little confused, since they seemed to be getting me ready to deliver at some point. Rather than being horrified by the monitoring, I loved it, because it was a way, rather removed of course, of communicating with Kate. I got to have another ultrasound, and she was right there, fists up, ready to fight the world. I half way hoped that this would be it, they’d pump me up with Pitocin, and we’d get the show on the road. At least that way would be definite; I’d be having the baby. There’d be no waiting, wondering, stressing, and it would be over at some point. Well, no luck, there was no leak. But, the good part of this experience is that I got to meet a very important nurse. Susan was amazing, exactly the kind of person you’d hope for. She was caring and motherly, but not condescending. She calmed my fears but didn’t talk to me like I was stupid for coming into the hospital early. Also I got to work with my OB, whom up to that point had been pretty cold towards me and seemingly unaccepting of trying alternative things in the delivery room. I supposed that since I was healthy with a healthy pregnancy, he just didn’t feel the need to educate me about anything, thus our visits were short and sweet and he resisted my attempts to talk about issues and fears. He wasn’t a bad doctor, but I figured that if he was to be doing the types of things necessary to deliver a baby, I had better get to know him a little better. My visit on July 4 relieved so many of my fears of the hospital, the nurses, and my OB. It wasn’t so bad after all. Plus, the OB told me that I would deliver within the next 48 hours.

The impending deadline forced us to get ready. Because we were renovating the upstairs, our house was a total mess. We joked that our living room had become a Home Depot outlet. We hadn’t gotten anything ready for the baby. While I relaxed in bed, because I needed to hoard my strength and because my itty bitty contractions were still around, my husband washed all the baby clothes and put them away. He got the cradle together, put together a changing area, and pretty much got us completely ready to rock and roll once the babe came home. We joked, however, that she would probably still be 2 weeks late, like many first babies. But it was exciting.

July 5 (Saturday) was spent running around the city. I think we did some more baby shopping - but at a different Target this time. We took an old dresser over to some friends’ house. We installed the new bathtub. I wasn’t exactly resting. And, the contractions had gone up a notch in frequency and strength. But I didn’t want to curse things by calling attention to it, so I just went along with a relatively normal day. I remember standing in my friends’ yard, sweating to death, and having my breath taken away by a contraction. But it was still prologue. That night, though, things really started happening. We took a great sexy bath in the bathtub with the jets on, and I swear that’s what really got labor going. The contractions got much more regular. After timing them for a couple of hours, I called my doula to give her a heads up before it got too late. She told me to wait until they were stronger and harder before I called her to come over. Well they got a lot stronger and only 5 minutes apart soon after that. My husband wanted me to call but I wasn’t ready and wanted to wait another hour to be sure. We argued about it, both of us sure we were right. And guess what? The contractions stopped. Not just decreased in strength or became less frequent, just stopped. That was disappointing. So I got some sleep.

The next morning, they started up again, not hard, but pretty frequent. I called my doula again, who said to give her a call after a while if I wanted her to come check me. I almost didn’t call, because I didn’t want to waste her time. But I did, and she came over and unbelievably, I was 4-5 cm already. We talked for a while, ate some snacks, and discussed what to do. We tried a few things to see if we could get the contractions more regular. They all worked. The best was nipple stimulation by my husband. That brought on some big ones. But still, I could talk through most of them. I didn’t understand - if I was this far along and really in labor, why wasn’t I in pain? We checked again and my doula decided I was far enough along (6 cm) to consider going to the hospital. We wanted to get there before 9pm, because after that you have to enter the hospital through the emergency department rather than just walking up to the labor and delivery floor. I called the OB service, and the OB called the hospital and had everything ready for me. There is nothing worse than having strong contractions while driving over potholes. Even though I was much more comfortable going to the hospital, I still was a little nervous about the nurses. I expected confrontation and was relying on my doula to advocate for me.

When we arrived, the OB checked me and said I was 4-5cm. That was upsetting, but everyone still expected me to go pretty fast. I changed into a hospital gown and ate tons of ice chips, which were perfect. During the last few months of my pregnancy, I developed an addiction to ice, so I was pretty damn excited about having all the ice I ever wanted while I was in the hospital. The nurses all knew I wanted to give birth without pain medication, and never once did I hear anything close to a suggestion that I should have some. In fact, the nurses were amazing. Usually, you have to at least get a heparin-lock IV, in case of emergency. Somehow I managed to get away without one. I had intermittent fetal heart monitoring, which didn’t bother me, because my labor actually went better when I was in bed. I never once had my contractions monitored, which kept me free to move around when I wanted. The contractions were still strong, but unfortunately not too regular. I ate a lot of ice. I peed. Later my doula pressed on my hips the perfect way to ease the contractions. We talked, but not too much. She taught me how to breathe, how to sink into the contractions. I managed to have some major contractions during transition that I just breathed through and no one knew I was having them. I walked the halls. My main nurse, Mickie, was awesome, so perky without being irritating. She even brought us chocolate!

The night wore on. I got frustrated. I was enduring very strong contractions, but nothing seemed to be happening. Yeah, I was dilating, but everyone thought I’d have the baby by midnight or earlier. I walked. I swayed. I showered. Surprisingly, lying in the hospital bed was the best. My husband was amazing. I don’t know where he learned to be with me the way he did that night, but I will always be impressed with how he was. We danced together, he held me up, he showered with me when I wasn’t sure I could stand up. But I still no baby, and my sac was still intact. People told me how great I was doing, which was nice, but it didn’t make the baby come any faster. I was exhausted and mostly frustrated. I paced the room, staring at the huge clock that should never be on the wall in a delivery room. I told myself that I’d go another hour and then tell them to call anesthesia. I’d go another hour and not call. I was bored with my choices - walk the halls, pace the room, shower. Never did I wish for any of the things I thought I was supposed to take with me. No music, no pretty lavender candles, no dried fruit. I was completely focused on the contractions.

Around 4am I had had it. I cried. I wanted to yell at the baby giving god. I said I wanted an epidural, even though I knew that the end was close. Instead, I took a nap. Yep, a 30 minute nap. I had a couple of very strong contractions which finally broke my water. A lot of nurses started coming in, and then the doctor. I started pushing with contractions. It took a long time to learn how to hang on to my legs the right way and to make the pushing efficient. I gave it all I could. I kept pushing as the nursing shift changed. My angel nurse from July 4, Susan, appeared. I was so excited. I continued to push as the OB shift changed. I kept pushing. The head appeared and slipped back for about 2 hours. I took naps between contractions.
Finally, I got pissed off. Really pissed. Frustration is what finally got Kate’s head out. It took over 3 hours to get her head out most of the way. Once I managed to get a shoulder out, the OB pulled her out the rest of the way because her tone was a little limp. I got to hold her, but it was almost like I was looking down at the two of us. I had the most shocked expression. Up until that point, I was still slightly in denial. But there was the proof. A real baby, ours.

Against many others’ experiences, against many natural birthing books, and against the culture of hospital medicine, I succeeded in having a safe delivery with no intervention. I am still amazed by the nurses’ professionalism and caring. Never did I feel silly, insignificant, or unworthy. The two OBs who assisted in the birth were great and basically left me alone. Even being moved to the post partum room was nice - Susan went with me, and it was as if I were literally transferring to a new stage in my life, one with my daughter.

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