Pregnancy
I'm just
going to back up briefly to before the labor began. Michael and I had
decided to be under the midwifery model of care for the pregnancy and birth
instead of a traditional OBGYN setting. We had nothing against doctors,
medication, or hospitals, but we saw many health benefits to pursuing a
natural, out of hospital birth as long as myself and the baby were healthy
candidates. To prepare for the birth we took a Bradley method class and
began meeting with a doula that we hired. (While midwives provide the
medical care for natural, low-risk births, doulas can be hired in addition to midwives to
support the mom emotionally and physically before, during, and after the
birth). I was diligent to stay healthy by working out multiple times a
week up until the birth. I also was at my healthiest eating as I wanted
to be sure to avoid gestational diabetes. The pregnancy was overall a
very healthy one. I was never very sick or swollen. He always
measured exactly on target at our appointments and had a healthy heart
rate. I loved being pregnant and know that I was really fortunate to not
experience many of the common pregnancy woes.
Early Labor
I had an
appointment with our midwives scheduled for the morning of Thursday, February
26th. As I ate breakfast I thought about the month of cramping I'd had and
hoped it had been productive. Wouldn't it be awesome if they told me I was
dilated to a 3?? But I didn't want to get my hopes up. When I was checked at
the appointment I was at a 3 (could be stretched to a 5) and about 70% effaced.
Hooray! I was so glad Michael was with me because I probably would have
panicked at the idea of the baby coming so soon if I was by myself. I agreed to
let them sweep my membranes to try and get labor going - at this point I was 41w
4d. The rest of the afternoon I bounced on the birthing ball at home to try and
get bebe to come down while watching netflix and talking on the phone. I had
saved a few household chores that I thought I would be up for while in early
labor (everyone told me that it's best to carry on with your normal activities
to keep your mind off labor but keep it going) but I just did not feel up to
vacuuming. Around 4 pm my general crampiness would get stronger at times - the
first of my contractions! Hallelujah and what the heck am I doing.
When Michael
got home around 6pm we decided to go to the grocery store to get labor going
with walking and pick up a few last minute items. By the time we got home I had
completely lost my appetite and felt nauseous. We had a fairly normal
evening and contacted our midwives and doula before going to bed to let them
know there'd probably be a baby coming soon! Michael slept pretty much straight
through the night. When the contractions got bad I really wanted to wake him
for emotional support but I also knew that I would need it much more further
down the road, so I let him sleep. The contractions came anywhere from 10-25
minutes apart, i would sleep in between them and wake up for every one. By the
time 4 am rolled around they were getting closer together and more intense. We
texted our doula around 4:30am and she was over by 5:30. Once she arrived the
contractions were about 4 minutes apart and much more intense. I had Michael
call the midwife to let her know we'd need to meet her at the center. It seemed
like we were out the door just a few minutes after the doula arrived, but
instead of having her meet us at the center, I was glad to have her come over
to confirm that it was time to go as I can be kind of a princess about pain. :)
Birth Center
When we got
to the center we waited just a few minutes for the midwife to arrive. When she
opened the door for us she greeted is with hugs and showed is to the birthing
room. I immediately wanted to get in the tub but it needed to be filled. In the
mean time I labored mostly standing up- leaning on Michael during contractions
were the best way I found to cope. I craved feeling his emotional and physical
support. Our doula massaged my lower back.
Both mine and
the baby's heart rate were elevated pretty much from the time the midwives
started monitoring us. I also had a slight fever, so they were diligent to
check on baby and I frequently. Michael and our doula were also determined to
get me to eat but I felt too nauseous. Michael was faithful, however, to make
me take a sip of water after every contraction.
I labored in
the pool for probably about an hour. The doula and Michael stayed by the pools
side the entire time. Our doula would suggest different positions for me to try
to get baby moving down. Sometimes I followed her directions. Sometimes I
completely ignored her because I knew it would hurt more. At one point while I
was in the tub the midwife checked me (ouch) and I was only at a 6. That scared
me because I was already experiencing signs of transition (saying I couldn't do
it, feeling nauseous, having multiple peak contractions) but transition happens
at 9 or 10 centimeters. Our doula suggested that I labor outside of the pool
for a while to get things going. That was the last thing I wanted to hear but I
knew she was right. Once I was out of the tub I paced the room and stood for
all contractions. Sitting and lying just brought on unwanted pressure.
Michael was seriously the best supporter through it all. There were multiple
times during the labor when I would ask him to pray for something specifically
and he would pray over us.
The midwives
continued to check mine and baby's vitals and neither of us were improving.
Some positions of laboring made baby's heart rate rise even more. As I would
labor I would sometimes leak amniotic fluid and other discharge, and when I
wiped it one time there was a bit of green on the tissue. Our doula took it to
the midwives for them to see. The assisting midwife came in to check on me, and
just then I felt a huge gush and looked down to see dark fluid instead of
clear. She called to the other midwife that we had fresh meconium and that she
should get in here. The lead midwife then had me lay down and checked me again.
I was still at a 6 so she said "Ok we still have time. It looks like you
have an amniotic infection so we are going to transfer to the hospital." I
only felt a small tinge of disappointment, but mostly I just felt relief. Maybe
because I couldn't take the pain, but I think mostly because I knew we needed
help. The midwife asked if I had a preference in hospital and I asked for their
recommendation. She then went and called the hospital to let then know we were
coming and see which doctor would be seeing me.
(As a side
note: one reason that I felt really comfortable seeing the midwives is that I
knew they would not hesitate to transfer us to a hospital at any point in the
process if there was a possibility of an issue beyond their care. This included
any red flags in prenatal care or during or after labor.)
In looking
back on the transfer I'm really impressed with how quickly everyone moved to
get me there but how nobody expressed any panic in the process. The midwives
gathered my files. Michael packed up our stuff. My doula helped me put my pants
on while I was leaking meconium. (Reason #157 to hire a doula.). Off we went to
the hospital - our little caravan of midwives, doula, and us.
Hospital
When we got
to the hospital the midwives dealt with speaking to the nurses about my
situation and getting me to a room. I remember the nurses asking me, at the
counter, all of my info while I was having contractions. Name, dob, etc.
Luckily the members of my entourage could answer those for me, and I hope now
that I didn't give the nurse too many dirty looks. A different nurse then
walked us to our room all the way at the end of the hallway. She told me a few
days later that she chose that room because it was closest to the OR, but that
she didn't want to mention that at the time. I thanked her for both decisions.
The room felt
so luxurious and had an entire wall of windows. The nurse explained that they
had a jacuzzi tub I could labor in and a birthing ball! While she was excited
to encourage me in my natural birth plan, I could see the worry in my midwife's
eye that the nurse maybe didn't understand fully that we had to transfer, so
the birth ball and tub weren't gonna cut it. She told the nurse "we're
beyond that" and continued to ask/make references to be being put on
antibiotics multiple times.
One thing
that I was pleasantly surprised by at the hospital is that the midwives and
hospital staff had a very good relationship. Every nurse who heard I was
with the midwives went on about how much they love the Spokane Midwives.
I never at all felt judged or shamed for attempting an out of hospital birth,
when I expected the attitude to be more of "well of course things aren't
going well if you're trying to do this outside of a hospital."
They got my IV going and I agreed to an epidural. At this point no one was acknowledging it
outright but I think we were all aware of the possibility of a cesarean, so it
made sense to get the epidural going sooner rather than later. The
anesthesiologist had me juiced up in 10 minutes - I was really impressed with
his timeliness. I had a few contractions while he got me going on it, I was
surprised at how casual they were about the fact that I would have contractions
while it was being put in place after stressing how utterly important it was
that I stay still. No pressure. Getting the epidural was not nearly as big of a
deal as I thought it'd be and I was so relieved to have it. Getting the
epidural did slow down my labor, but that lowered mine and the baby's heart
rate so I welcomed the break for both of us. Since labor had slowed they
started pitocin to bring the contractions back up. I labored on the epidural
and pitocin for about 6 hours. I couldn't believe that, because of the
epidural, I was sleeping through the same contractions that we're overtaking my
whole being just hours before.
Once the
midwives had transferred all of my info to the hospital staff it was time for
them to go. The lead midwife came over to my bed and I said "I just don't
think this baby will be able to come by itself" and she said "Honey,
I don't think it will either." That confirmation was actually really
important for me to hear and got me one step closer to the cesarean. If a
midwife, who's mission is to do everything possible to safely ensure natural
deliveries acknowledges the need for assistance, then I wasn't crazy or just
giving up. Our doula did stay with is after the midwives leave - another great
thing about a doula is they are with you for the whole birth even of you switch
care providers part way through.
The doctor
seeing me was great. He would come in every couple of hours and sit down, go
over where we were in labor and asked if we had any questions. The nurse said
that he can be kind of abrupt so I was expecting him to be all about the bottom
line. Whenever we would talk about possibly having a cesarean I would ask how
long we had to decide - I expected him to say "If the baby isn't born in x
amount of hours, then we're doing a cesarean," but he kept the
conversation very open and left it up to us as long as things weren't getting worse.
When I had been there about 6 hours the conversation got real, as I hadn't
progressed at all since arriving at the hospital and the doctor was concerned
with how big the baby was, especially since he wasn't descending. While I
personally don't think that a big baby is usually reason enough for a cesarean,
I knew that both the baby and I were sick and a section would be the safest way
to go. The doctor left the room and both our doula and Michael said we should
do the section now instead of waiting and having to do an emergency one later.
It didn't seem like a hard decision at all, or even like there was a decision
to be made. This was how my son was going to be born.
Once we
decided to move forward with the procedure I signed a few papers, Michael and
the doula got suited up in their space-suit looking scrubs, and I was wheeled
into the OR. I made it my mission to mentally disengage while they
performed the surgery, I knew that if I caught wind of anything going on on the
other side of the curtain I would lose it. Michael was on my left, faithfully
holding my hand, and the anesthesiologist was on my right. After having been
laboring so long I was used to dealing with any type of pain with deep breaths
and mooing sounds. At one point during the surgery I was doing this to calm
myself and someone in the room asked if I was ok. The anesthesiologist, who had
been with me since my epidural, explained "She moos! You have to get used
to it but it would be great if all moms did that." Haha.
The one time
I tuned in to what was going on was when I heard our little boy cry when he was
born. I immediately looked at Michael with tears in my eyes - that was our son.
He was real and out in the world with us. I didn't see him until after he was
cleaned up, Michael brought him over to me before he was taken to the special
care nursery. I intentionally didn't look for him when they carried him to the
crib to be cleaned, I didn't know if I could stomach (emotionally and
otherwise) seeing him covered in the mec and blood. He was born at 5:27pm
weighing 9lb 14oz. When they announced his weight the doctor looked over
the curtain and said "he was NOT coming out!"
After Michael brought Atticus to me he went with him and the nurse
entourage to the nursery where a was put on oxygen and iv antibiotics. Our
doula stayed with me through the rest of the surgery. After it was done all I
wanted to do was sleep. I'll chalk it up to the pain meds but I was okay not
being with Atticus right away. He was on oxygen so he couldn't nurse and I knew
he was getting the best care from the nurses and had his daddy's company.
The first time I went to see him was about 6 hours after the surgery. I didn't
hold him until the next day. I knew that this was when all that blissful bonding
was supposed to happen but as I was going through the initial recovery and
dealing with a lot of pain I didn't miss those moments together at the time,
and I have no regret now. He needed the special care more than he needed
my snuggles. The nurses were really helpful with and supportive of
breastfeeding, they brought me a pump within an hour after my surgery and
explained how often I should be pumping. I was so glad that they were proactive
in getting me started because it was the last thing on my mind as they wheeled
me out if the OR. As soon as A was off of oxygen they would wheel me down
to feed him and helped me navigate those waters of newborn nursing. Even
though the circumstances were not ideal I was glad to be figuring out the whole
nursing thing in both hospitals with the assistance of the nurses.
The first time I got to see him and then holding him for the first time the next day
Atticus and I stayed at that first hospital for the next 2 nights, both
of us on antibiotics. I was also being monitored due to blood loss from
the birth. Michael split his time between me and A, and I was really
grateful that he had a chance to establish a relationship with Atticus as his
papa. On Sunday evening the pediatrician on call who was observing Atticus said
they had decided to transfer him to the NICU at a different hospital for
further observation. The main reason was that his eyes were having some unusual
movement and they wondered if it could be seizures. The staff offered to
discharge me the same night if I wanted to be with him but at that point I
still couldn't get out of bed without assistance so I waited until the next
day.
NICU
On
the following day, Monday, the discharge process began. I was able to walk
around more and was feeling great. They sent us off with prescription for some
pain meds, I knew I would be utilizing those a lot with spending time in the
NICU while I was really supposed to be in bed. The medicine was such a
blessing and a curse: a blessing in that it allowed me to be with our son, but
a curse in that they made me fall asleep almost instantly. I remember
after I had been discharged on Monday we went to the NICU to visit
Atticus. I was holding him and trying to nurse but I couldn't stop dozing
off. I woke up to a few nurses peering around the curtain at us, seeing
that we were struggling with nursing, and offering, "maybe if you could
engage with him a little bit more, you know hold him closer and talk to
him..." and I just broke down crying. All I could think was
"that's what I want to do, all I want to do, but I'm physically unable
to." Exhaustion overtook me so at that point we put him back in the
crib and went home to sleep.
Atticus was in the
NICU for the next week to finish out his antibiotics and continue to be
tested. Each day when we got there they would explain the tests they had
recently run and that things were continually looking better. It seemed
like we could follow when the doctor was explaining things but it was
impossible to regurgitate when people asked us. Our heads were swimming,
and as long as they said he was getting better, that was all that we
needed. One thing that I do remember clearly is that when his sodium
levels improved, almost all of his other symptoms did as well, included his eye
movement that they had suspected could be seizures.
One side effect of him
fighting off this infection is that he would easily be overstimulated.
When we held him we would be careful not to hold eye contact if he looked away,
indicating overstimulation. I didn't rock him while I nursed as that
would overwhelm him. No more than one of us at a time would talk to him
in order to not overwhelm him. All of this makes it all the more amazing
to me that he now is so alert and loves to hold eye contact with whoever is
talking to him. He'll look back and forth between Michael and I, and not
look away when we are both playing with him. It was 8 days after he was
born that he looked me in the eye, and it wrecked me. Now he'll stare me
down for minutes at a time and it's the best thing ever.
On
Wednesday of his week in the NICU my mom came into town. Selfishly I
loved her being here during that time to help Michael and I with the normal
operations of life: laundry, dishes, runs to the store, etc. so we could come
home and crash after our days at the NICU. She was such a servant.
But for her sake I was sad that her time with Atticus was enjoyed in short segments
and spent in the hospital. He had an IV in his head and chords connected
to his chest and heels, so maneuvering him around to hold him was an
ordeal. I'm glad that she got to spend the time with him that she did,
and she also got to see him improve by leaps and bounds. He was
discharged an hour after she had to leave for the airport, so the timing of her
departure was unfortunate, but I'm glad that she was at least able to see him
well before leaving.
Anyways, Atticus continued to pass his various tests with flying colors
and was discharged on Monday March 9th. We couldn't wait to have him home
with us and bond as a family. Michael had been given 2 weeks paternity
leave from work so he was able to spend Atticus' first week at home with
us. It was such an amazing blessing for him to be with us, I am really
grateful for him to be working in such a supportive work environment.
A's home for the week |
Discharge weight of 10-5! |
Off to the car! |
Home
The first week at
home was emotionally the hardest. I realized I had been in survival mode since
labor, and everything that happened was often more serious than I let myself
believe at the time. Shortly before we left the hospital, I started to wonder
if this was true because every nurse we came in contact with was familiar with
our situation and apologized for it. Even the nurse at his pediatrician apt a
few days after we were discharged acknowledged the ride we'd had.
One thing that was
hard in emotionally understanding was that it was never made clear what caused
Atticus's distress in labor. Was there anything I could've done to have
prevented it? Will this happen again? Did I cause him to become
sick or did he cause me to become sick? In one of my follow up visits
with the midwife, she explained that it was a uterine infection. GBS
(Group B Strep) is one of many kinds of uterine infections that you can
develop, but GBS is the only one that they are able to detect and treat early
enough for it to not affect the labor. I tested negative for GBS, but ended up with a similar infection that wasn't able to be detected ahead of time. While knowing that it was an
infection is still kind of vague, I was glad to have some light shed on the
situation. Atticus's health has been stellar since he was discharged, there are no remaining side effects from the infection that we see. Everyone who meets him comments on how alert and engaging he is.
Even in preparing
for a natural birth, I was always aware that it doesn't work out for everyone.
I'd read birth-positive people write "your body is made to do this"
and "your body knows better than the doctors" and every time I just
thought, "but what about when it doesn't." Maybe it's the pessimist
in me but I just had an inkling that I would be in the small percentile that
sees a midwife and ends in a cesarean. I am glad though that we didn't hold to
the out of hospital birth dream too tightly. I fully appreciate the staff and
my experience at both hospitals and knew from the moment we got there that it
is what we both needed.
All of this to say,
thank you SO much to those of you who prayed for us before, during, and after
our time in the hospital, to those who brought us meals, and also to those who
came over to help me and take Atticus and I to appointments after he was home
and I still couldn't drive. We are surrounded by so much love and support
that really stepped in knowing that our families lived far away. I know
that our transition out of the hospital and into full time parenting would have
been a very different experience without all of you.
And here's a few that Michael took when we first got home from the hospital. :)
Katelyn, this is such a beautiful birth story! You should consider posting this on Bloom Spokane's birth story page-so many would benefit from your therapeutic words. Thank you for sharing this with us. Your incredibly beautiful account will be treasured by Atticus. You are an amazing mother. Love to you, your midwife -Jane
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