I'm a first time mom and this was my first pregnancy. Before I ever got a positive test or even thought we were ready to bring a child into this world, for whatever reason, I'd always wanted an unmedicated birth . So, once pregnant, this plan stayed in place and we hired a doula duo (Denver Birth Services) to help us achieve it. We also took a Mindful Birthing class, I read Ina May's Guide to Childbirth and listening to hypnobabies and hypnobirthing tracks (we didn't take a course, I just sought out tracks on my own after talking with others).
(If you're unfamiliar with a doula, to us it's like a birthing couch. They're not a medical professional, but extra support, especially for pain coping techniques, for the labor and delivery process. We decided it was worth paying someone for their birth experience in hopes to get the experience we wanted. We also agreed that this would take a lot of pressure off of Ben since neither of us knew what to expect).
Around 32 weeks my OB said that baby was measuring about a week ahead. This is pretty common, but for whatever reason she ordered a sonogram to verify measurements. I'm thankful she did; this was when we found out our babe was frank breech position (head up, button down, sitting with their legs up in a pike position). Over the next seven weeks tried everything we could to turn the baby; spinning babies (forward inversion, side lie, breech tilts), pool hand stands, Webster chiropractic, acupuncture and moxibustion.
This time period was an emotional and mental roller coaster for me (details about the techniques and my thoughts in my 36 week update). Up to this point, my pregnancy up had been relatively easy with no major complications. I was so distraught at the thought of having to deliver via c-section.
I sought out advice and experience from others. After discussing options with our doulas and seeking out recommendations from local mom, I was lucky to learn that Denver area has not one, but two OBs that will deliver breech babies vaginally (yep, butt down!) We had not originally considered this, but we researched and learned that the risks, compared to C-section, were relatively low, as long as delivered with an experienced doctor. The problem is that there are not many OBs trained or experienced with this type of birth, which is why the majority of breech babies in the US are born via cesarean.
At 36.5 weeks, I made the decision to switch to Dr Michael Hall, who is known across the country as one of the greatest, most experienced doctors in delivering breech babies. Meeting him made me feel confident and comfortable with this decision and that I could deliver my baby with an unmedicated birth. That became our plan: an unmedicated vaginal breech birth.
However, we had one last turning method to try; an external cephalic version (ECV). This is a manual procedure done by the OB to try to turn the baby in the womb from the outside. It's booked as a cesarean and done in hospital labor and delivery. This is because there's a 1-2% risk that the procedure will put the baby in distress and an emergency cesarean would be required. Because of this risk, the procedure is typically done at week 37, when baby is full term. The success rate is about 58% overall; but lower for first time pregnancies due to the uterus not having previously stretched.
So on August 18th, we checked into the hospital. Baby and I were hooked up on monitors prior to the procedure. The procedure itself is incredibly short (10 minutes max to limit stress to babe). Dr. Hall walked in and I was given turbuteline via an IV port. This allowed my uterus to loosen up. I'd been warned the drug would make me feel jittery. True to the disclosure, as soon as it was injected, I immediately felt it and said "whoa, this is weird"!
I've come across a lot of women with breech babes that elected not to do an ECV for fear of stress on the baby or pain from the procedure. For me, I was willing to do anything to try to improve the odds of a vaginal birth. I went into the procedure with the mindset that this would be good mental practice for labor, so I popped on my headphones and music and focused on my breathing. There was discomfort but more due to the oddity of what we were trying to achieve; it wasn't painful for me. Ben said it was pretty incredible, as the doctor worked, he would see the outline of our baby. However, after three minutes of trying, it was obvious to Dr Hall that this baby wasn't turning and that was that. If I were to encounter this situation again, I would do the procedure again.
On Wednesday, August 30th, I went into my 39 week appointment. I was a centimeter dilated and 70% effaced. At this point, I hadn't had any signs of labor, contractions, etc. However, I learned that Dr Hall was going on vacation. Ugh! After all this time and work to prepare for this, he'd be gone for a week, falling over my due date (9/8), from Tuesday, 9/5, to Tuesday, 9/12. If I were to go into labor during this time, he recommended I call my old OB and I'd birth the baby via c-section. I left my appointment and he said with a wink, this weekend is a good weekend to have a baby.
I started saying my prayers and hoping that something would happen! The following day, I lost my mucus plug; this was encouraging but I still had no other signs. Labor Day weekend (39 weeks), we decided rather than wait around for something to happen at home, we'd keep busy. Friday night we went with my company to the CU vs CSU Football Showdown. Saturday I spent much of the day baking (including these labor inducing lemon cupcakes), and we went to a friends for a BBQ. Sunday we attended a family BBQ and still no signs of labor (even after those darn cupcakes:).
Our Birth Story
On Monday, Labor Day, we were relaxing at home. At 5:45p, I used the restroom and while I was walking back to the couch, I felt a small gush. I went back into the bathroom and felt a pop followed by another small gush. I went to Ben and said, either I just peed myself twice or my water broke (I knew that only 20% of women have their water break naturally). We both laughed at each other and said, well maybe this it. I went upstairs to change my underwear and had a huge gush! I called to Ben, yep, it's broken!! Bring me some Depends!! (Ha! but thank goodness I had this on hand for post-partum!)
Knowing baby was breech still, we called Dr Hall and he said to come get checked. We notified our doulas and didn't know what to expect. It was a gray area knowing that Dr Hall was going on vacation the next day. How long was he on call for until then? Would he pass me back to me old OB for a cesarean? Would he want to induce labor? There were so many unknowns but nothing we could really do except wait.
We checked into the hospital by 8pm. First time rookie mistake, nothing was really happening contraction-wise, but they didn't want us to leave so we were admitted and staying until we had a baby! Around 10:30p Dr. Hall came in and my immediate question was: when are you leaving? He smiled and responded to me, not until I deliver your baby. I was SO relieved! Because I wasn't having contractions, we didn't do an exam, but he suggested walking and moving to try to get things going. Because my water broke on it's own and baby was breech, he wanted us to have this baby within 24 hours.
Overnight we tried to sleep. Ben was able to get some decent sleep. I had about three contractions per hour overnight, nothing consistent but enough to constantly wake me. Around 5:30am they were getting stronger but there was no pattern. Ben drew me a bath (we were able to get one of two labor rooms with a large tub; thank goodness!) and we decided he should go home to pick up Oscar and get him to daycare for boarding. The contractions' consistency started to pick up at this time (of course!) but the pain was manageable and comfortable in the tub. After Ben got back, our doula arrived and I bounced on the ball, both to try to induce consistency and get through the pain I was having.
Around 9:15am, Dr Hall came in. It'd been 14 hours since my water broke and the clock was now ticking. I was at 2cm. Hall said we needed to do a low dose of pitocin to try to pick up the contractions if I wanted to try vaginal breech birth (VBB). I knew this would be a possibility and even though I hadn't wanted to be augmented, I knew accepting pitocin likened my chance for my VBB. I received a small dose (I need to confirm with my doula but the labor nurse said 1 millionth of a dose) at 9:30am.
This picked up the intensity of contractions and we moved into a normal labor pattern. Around 10am the contractions were coming quick and painful enough that I moved into a warm bath again. With Ben and my doula by my side, I worked through contractions for roughly an hour. To me, I had no sense of time, just a focus to get through one contraction at a time and rest in between. I kept telling myself, that's one contraction down and one contraction closer to meeting this baby.
(Due to receiving pitocin, it was required that the baby's heart rate and my contractions be monitored. The only downfall with the tub was that the monitors kept shifting and the nurse was constantly coming in to adjust them between contractions. I wanted to note this because at the time is was such a nuisance but was so important).
Eventually, I started to feel an urge to push (or poop; as I told my doula: "I either need to push or poop right now!" The nurse and Dr Hall were called. In between contractions, we scrambled to get me out of the tub and over to the bed. In about two and a half hours time, I had dilated from 2cm to 10cm and it was time to push!
Dr Hall had told me upfront that he allowed one hour to push breech babes, otherwise anything longer is typically too much stress on the baby. Although I had the urge to push, pushing was SO hard! Each contraction I tried to dig down and push for three breathes. Again, I had no sense of time, just trying to get through each contraction. The baby's heart rate started to drop so I was given oxygen. I continued to push through contractions and eventually Dr Hall said, okay, last try to push; we have to get this baby out. I tried with all my might, but baby didn't budge. It was time to switch plans to a cesarean.
At this point, the medical staff was worried that baby's blood pressure was dropping so quickly that I'd have to be put under general anesthesia to get baby out as soon as possible. I was given terbutaline to stop my contractions. I had one contraction after this and then they stopped. Thankfully with this, the baby's heart rate began to rise. Because of this, I was given spinal anesthesia in the OR and awake for the birth. I remember getting the spinal, but due to adrenaline (and perhaps having already gone through the labor pains), it didn't hurt at all. My legs immediately started to loose feeling and I was laid back for the procedure.
I had no idea where Ben was until the anesthesiologist said something like, stand here sir, and I looked to see Ben by my side in scrubs. We notified everyone that he would be the one to announce the gender and we'd also like to know when the baby was being birthed so that he could take pictures.
It seemed like an instant later and the anesthesiologist said, okay, get ready. I could heard Ben crying and the drape was lowered for me to see. I don't remember seeing much, but the moment I will forever remember is the anesthesiologist saying to Ben: can you tell the gender? and Ben's response, with the biggest smile on his face, as he said "it's a boy!"
He taken to the station for a once over and I remember them counting out, 10 fingers and 10 toes. As soon as I knew it, he was placed on my chest and looking into my eyes. He was so incredibly alert. This little beautiful creature that we had made and waited nine long months to meet; absolute perfection and I was overcome with love. Our little sweet baby was finally here.
Our son, Grayson James, was born at 12:24pm on Tuesday, September 5th, 2017, weighing 6lb, 8oz and measuring 19" in length.
We learned that his umbilical cord was short and had been wrapped around his leg. With this, I truly believe that he came into this world as intended.
In the end it was the best outcome for a cesarean birth that I could have asked for; my water broke, I experienced unmedicated labor, and I had the chance to push for delivery. While I've cried many happy tears since then (including while writing this post), but I haven't cried or felt any remorse about needing a cesarean. I'm at peace with it. With all of the research and emotions leading up to his delivery, I feel knowledgeable, empowered, and grateful to have had the birth we did. His birth was so beautiful and unique to us. It is, and will be, one of my greatest life accomplishments.
No comments:
Post a Comment