Monday, March 31, 2014

Guest Post Allison- Natural ...Inductions?

From Kellie:  Allison's birth stories have so much useful info in them, if you are a first time preggers doing a hospital birth I would read this a few times! 

Natural ...Inductions?
When I got pregnant with my son I'd never really heard about natural childbirth, let alone thought about it. I was perusing a local mommy forum one day during my first trimester and stumbled across a member's birth story. She had a successful home birth with a midwife using the Bradley Method. I was mesmerized - I never knew childbirth could be like that. It sounded so different from what I'd seen in the movies or docudramas on TLC. I was struck by how in control she was of her labor and delivery.
After some research I located a local Bradley instructor and dragged my husband to a weekend well baby/well mamma seminar. I LOVED what I heard and was immediately sold that the Bradley Method was for me. I signed us up for classes the next week.
Hubby was skeptical at first. We have doctors on both sides of the family so we're definitely not anti-hospital or anti-doctor. However, I really liked the idea of having options to manage my labor other than medication. I ruptured a disc in my back several years earlier and had surgery. I knew this could potentially impact the effectiveness of an epidural and I wasn't about to go into labor totally unprepared.

By the end of the 12 weeks we were really glad we'd gone to the classes - we both felt prepared and knew the kind of birth experience we wanted to try for. I wouldn't say my OBGYN was pro-Bradley Method or pro-natural childbirth, but he was supportive of what I wanted and signed off on my birth plan.

Our son was due on March 8th, but was too comfortable inside his mommy to cooperate.  When we went in for our checkup on the 10th, I was 75% effaced and 2 cm dilated.  The doctor felt I would probably go into labor spontaneously over the next few days, but we did schedule an induction for the 16th just in case. I was thankful he was letting me go a week past my due date.

Well after much walking, nipple stimulation, thumb sucking (not kidding - it's supposed to start contractions) and other attempts at getting labor underway, the morning of the 16th came.  We were pretty discouraged that we were going to have to be induced, but were hopeful that we could follow at least some of our birth plan. We called the hospital at 5:30 am and were told to arrive at 7 am. They started the Pitocin around 7:30 and I was having mild contractions about 30 minutes later. Our Dr. said he would give us until noon to see how we were doing, but that he might need to break my water if things didn't progress.

From 8 to 10:30 or so the contractions were regular and very manageable.  I was sitting on my birthing ball and we were watching the Today Show.  DH had to come rub my back a few times, but I could easily relax through most of the contractions by myself.

At 10:30 the nurse bumped up my pitocin dosage and things started to change fast. I could no longer handle contractions on the ball - and I moved to the bed.  By 10:45 the contractions were much stronger and very close together.  There were maybe 3 to 4 minutes at most between contractions and many of them were very strong.  Hubby did great coaching me to relax, but sometimes the sensations were very overwhelming.

At 12:30 they came to check me and I was fully effaced and 5 cm dilated.  Since I was progressing so well my Dr. was ok with me continuing to labor with my bag of waters intact.
This was the point that things really got down to business.

I spent the next hour or so either on the bed or on the toilet. It was surprisingly comfortable to labor there - a tip from the Bradley classes. Another good tip - we broke the rules and brought in snacks. DH did great getting me water, a few slices of apple and peanut butter crackers when I was hungry. He also helped by counting down each contraction and put on Enya to help me relax.  I was very focused and was starting to vocalize through some of the contractions.  When the stronger ones hit I did start to wonder if I could make it through the rest of the labor.  The hardest part was that I had so little break between contractions - around 2 minutes at most.

At 2:15 I was checked again and was 7 cm dilated.  We decided I just couldn't relax laying down any more and moved a chair to the side of the bed.  I would sit up during the breaks and lean forward on the bed during the contractions.  At 3:30 I was checked again - I had progressed to 8 cm and my bag of waters broke while they were measuring me.

At this point it was impossible not  to bear down during the peak of each contraction. We lowered the bed and I got down on my knees on a pillow beside the bed and leaned over on the mattress.  I had less than a minute between each contraction and several of them double peaked.  I just remember being very tired and wondering if I was going to be able to finish the labor. This last hour flew by and when I was checked at 4:15 I was 9 cm dilated and they called our doctor.
I want to stop here and say that a few times during my labor I felt like I was "doing it wrong" because I wasn't laying down and relaxing the way I had been taught. However, I was listening to my body's cues. Laboring on the toilet actually felt good, so I recreated that posture with a chair on the side of the bed. After my water broke and my body started bearing down during contractions I HAD to be on my hands and knees - I honestly can't imagine laboring in any other position. When they asked me to lay on my back for them to check my progress, it was definitely the most painful time of the entire labor. I also felt helpless - like my labor was happening TO me. When I was up on my hands and knees I felt like I was laboring WITH my body. I felt much more in control and able to deal with the sensations.

The Dr. arrived at 4:30 and gave me several local anesthetic shots to numb my bottom.  I started pushing at 4:35 and pushed through 10 contractions over the next 20 minutes. Each contraction I averaged about 4 pushes. Pushing did not hurt - it felt good! But I didn't like pushing on my back, it just felt awkward. The baby's heart beat started falling into the 90s and I had some scar tissue that was stopping his head from completely descending.  After asking my permission, the doctor cut a small episiotomy and my son was delivered 2 pushes later at 4:59 pm.

They handed him to me immediately and the first thing I thought was wow - what a big baby!  They took his apgar measurements and he was a 9.  While the Dr. was delivering the placenta and sewing up the episiotomy they took him to the warmer to start cleaning him.  His color went gray pretty quickly and they were concerned about his oxygen levels. The neonatalogist came in and said he had really low blood sugar and needed to be given some pedialite quickly to keep him from being stressed out.  We weren't excited about this, but agreed that his coloring was really bad and we should do what was suggested.

DH went with the neonatologist to the nursery where our son was given pedialite through a small tube.  His coloring improved within seconds and his blood sugar got a lot better. Hubby came back about an hour later with the news that he was 21.5 inches and 9 pounds 1 oz!  I couldn't believe I had just delivered such a big baby without pain medicine!

DH went back to the nursery to help with the bath and then baby boy was brought to our room at 8pm.  We started breastfeeding immediately and he was a champ - he had a really strong suck and went 15 minutes on each breast.

Overall I was happy with the birth. I hated that they took my baby away so soon - it felt like it took forever for me to get him back. I liked my nurse, but I got the impression that I was one of her first "natural" births. She didn't interfere with my labor, but I didn't feel like she was totally part of my team.
Thankfully when my daughter was born I got the labor and delivery I had "almost" been hoping for.
Luckily I have pretty easy pregnancies. However, my second was rougher than my first. With my daughter I had morning sickness from the week I conceived - NO LIE - until almost 20 weeks. It was also the lovely all day sickness and didn't stop after lunch the way my first pregnancy had. I also got varicose veins in a very "sensitive" area - yes this apparently happens and it does hurt just as badly as you would think. Thank God for compression garments.
Other than that, it was smooth sailing. My Dr. was a little worried that I would have another 9 pounder so he ordered an ultrasound to get an estimate of her size around 37 weeks.The ultrasound estimated that she weighed between 7.5 and 8 pounds. However, I knew that late term ultrasounds are VERY inaccurate.

Fearing a 10 pound baby, my Dr wanted to induce me a week early, but I held him off until two days before her due date. I so wanted to go into labor on my own, and was disappointed that once again I was going in for a scheduled induction.  And yes we did ALL the same antics trying to induce labor this time that we did the first time.
I started off my induction similar to last time - I was about 70% effaced and 3 cm dilated. I do think that it helped that my body was "ready" to go into labor. Both times I was already very effaced and had started to dilate.
We didn't record our daughters birth the way we did our sons - the curse of the second born. :) But overall this labor closely mirrored the first, just on a faster timeline. The one difference was I had an INCREDIBLE nurse! She actually asked to be assigned to me when she heard I was going to have a natural birth. She had helped lots of Mamma's have a medication free labor and delivery and had such a great demeanor. I totally felt like she was on my team the entire day - she was a huge help.
Pitocin drip started around 9am - I was able to lay in bed and read and watch TV through contractions until about 11. Things started to get a little more serious around lunch time and when my Dr. came in and checked me, I was already a 6. The stimulation seemed to speed up the intensity of the contractions and remembering how I felt better laboring on the side of the bed with my son, I had DH pull up a chair and I tried to recreate my first labor experience.
This is when my nurse really was a life saver. Instead of coming in and re-positioning the fetal monitor every five minutes (that happened in my first labor) she would come in every 30 minutes or so, get a quick check and leave. During one of these checks she saw me laboring on the side of bed and made an awesome suggestion. She had me get on the bed on my hands and knees. She raised the head of the bed into an upright position (like it would be if you were sitting up in bed). During a contraction I could rest my arms and head on the raised part of the bed and sit back on my heels during the break. It was a similar position to what I had created on the side of the bed, but SO MUCH MORE COMFORTABLE! If you can call labor comfortable. ;) She also never checked me - just said to let me know when I started feeling pressure.



I started feeling pressure around 1:30 - she came and checked and I was complete! They called the Dr. and the room was a flurry of activity. I suddenly felt like I REALLY had to go the bathroom. The nurse said she would take me, but warned "You better NOT have that baby in the bathroom!" Made it to the bathroom, but couldn't go - I was really starting to feel like I had to push. She helped me back into my all fours position facing the head of the bed. This was absolutely the most comfortable position I could be in - I also appreciated that I didn't have to look at the 8 other people in the room with me. Yes I had 8 people other than myself in the room - husband, nurse, delivery tech, pediatric nurse, two nurse trainees, one paramedic trainee and finally the doctor.
The Dr. confirmed I was complete and then asked me if I could turn over on my back. I REALLY didn't want to, but probably would have anyway. Then my nurse stood up for me! She said "I think she's doing just fine where she is." BLESS THAT WOMAN!
I couldn't see my doctor's face, but I got the impression that he shrugged his shoulders and then said "Here we go!" He broke my water - it was still intact and I can tell you that it is SO MUCH BETTER TO LABOR WITH YOUR BAG OF WATERS INTACT. I know many of us don't have that choice, but labor was much less intense compared to when my water broke at around 7 cms during my first labor.
Two pushes and I gave birth to my daughter at 2:02 p.m. She was only 8 pounds, 3 oz - so much for the 10 pound baby. I flipped onto my back and they put her right on my chest. And this time I got to hold her for almost an hour before they bathed her in the room with me while I got to watch. :)


While we were both getting cleaned up (and I was getting stitched up - I did have a small tear) I heard from all 8 people how impressed they were that I had a natural delivery in a very "surprising" position. None of the trainees that had been watching had ever seen a natural birth and certainly never one where the mom delivered backward.


I'm disappointed that I never got to spontaneously go into labor, but I'm so thankful that I had the labors and deliveries I did. I'm not sure more children are in our future (I'll be 35 this year), but if I ever have another you better believe I'll be delivering on my hands and knees! ~Allison





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