Friday, July 4, 2014

All the Other Info

I'm working on finishing up Jonah's birth story (who knew it would take almost four weeks to write a story with a newborn to take care of?), but I felt there was some information that would important to know in order to truly understand what happened surrounding Jonah's birth. The word document I've been typing in is over 18 pages long, so I thought that definitely called for at least two posts.

The main purpose of writing all this down is for our family and, someday, Jonah's family. All birth stories are beautiful in their own way, and Jonah's birth was something beyond my wildest dreams. It was so much harder, so much more spiritual, so much more heartbreaking, and so much more beautiful than I ever anticipated, and I want to remember it in as many details as possible. The secondary purpose for these posts is a selfish one. Unfortunately, Jonah's birth has been labeled as a traumatic birth, or if you're a little more optimistic, a "stressful" birth. I've spent the past four weeks examining the events of those few days and really thinking everything through, what that means for Jonah in the future, what that means for me in the future, and what that means for us as a family in the future. Writing everything out has, in some ways, helped me heal from a day that I had hoped and prayed would unfold in such a different manner than it did.

And finally, if you're reading this, let's all remember that birth is an intimate and messy process. I've tried to give enough detail that I'll remember it exactly as it happened in thirty years, but at the same time keeping it friendly for all audiences.

I hope you enjoy this long novel of a story.

Our Birth Center

Will and I had done the research and chosen to give birth at a wonderful birth center about an hour from our house. I had been interested in birth centers for a few years, even before we were really thinking about starting a family, but it took Will a little more convincing to accept the idea of our children being born in a place that didn’t have all the marvels of modern medicine, you know, just in case.

Giving birth at a birth center with a midwife is not for everyone. We could discuss whom it would be great for and who should probably stick with the traditional Western-world OBGYN, and honestly I don’t think either one is bad. But for Will and me, the birth center was the right decision. I am young. I am healthy. We focus on eating a healthy diet. Neither of us have anything in our medical histories. I profoundly believe that usually, pregnancy and birth are normal, natural processes that our female bodies were divinely created for, and that most women are capable of a natural childbirth. Now whether you want one is an entirely different story, but I wanted one. I wanted to experience the roller coaster of labor. I wanted to actively listen to my body and let it lead the way as I pushed and brought forth life. I wanted our baby to be born without any drugs in his system. I wanted to have immediate skin-to-skin so our baby could “imprint” on me and form that special bond. I wanted to breastfeed immediately, and for his cord to be cut an hour or so after birth, and I wanted to have my placenta encapsulated. I wanted to go home a few hours later to recover in my bed with my hours-old newborn and my husband at my side. I trusted that my body could do it. I trusted the expertise of the midwives. I trusted God to protect us from harm. All in all, I was the perfect candidate for receiving my prenatal care and delivering at the birth center.

There are two birth centers in our area of Houston. When I found out I was pregnant back in early October, I scheduled appointments at both of them to see which we liked better. I also promised Will we would also explore some different OBGYNs  just to make sure we didn’t want to go with a hospital birth. The first birth center we toured ended up being the only place we looked because it just felt right. Anna, the lady who was to become my midwife, gave us a tour of the small cottage-like birth center and sat down on the bed across from us for at least an hour, patiently answering all our questions. As you can imagine, my questions were more along the lines of, “What can I expect from you during labor?” while Will’s questions got down to the nitty-gritty: “What happens in an emergency?” “How far away is the hospital?” “What exactly are you prepared to handle?”
She must have passed the test, because when we left Will set up our first appointment.

Our prenatal care at the birth center was everything I had hoped for. All the midwives greeted us by name every time we walked through the door.  The appointments were mostly held in a small appointment room in the back where I got to sit on an actual twin-size bed covered in a quaint quilt while at least one, usually two and sometimes a student midwife attended the appointment to answer my questions, give advice, and chart my progress. Sometimes the appointments would take place in one of the two birthing rooms, which was pretty cool when I thought about how I’d be giving birth in one of these comfortable bedrooms in several months.

My midwife was perfect for us in every way. She was very realistic and down to earth, and she offered so much advice throughout the pregnancy that is the kind of advice I’d been seeking. By that I mean, instead of suggesting another brand of face wash to deal with horrible acne breakouts I was having at the end of the first trimester, she suggested nettles, red raspberry leaf tea, and dried wheatgrass juice. I tried that and after two weeks my face was completely clear. I haven’t dealt with acne since then.

I was comfortable with Anna. I was comfortable with all the other midwives, really, but I wanted Anna to catch my baby. She was always up to date on the latest research and always offered scientific data to back up her layman’s answers to our questions. I never felt silly asking something, and my appointments would often take an hour or so because she so thoroughly answered me and explained things to me.

Exercise and Staying Healthy During Pregnancy

One of the big parts of our lives is Crossfit. I know there’s a lot of controversy surrounding its safety during pregnancy, but given our circumstances Anna was really supportive of me continuing throughout the pregnancy, so long as I truly listened to my body. I had started Crossfit in February of last year, knowing that we would want to try for a baby in the next year or so and I wanted to make sure I was in much better physical shape than I currently was. College and student teaching had taken its toll on my body, and I was the heaviest I had ever been and I really had no motivation to work out. Will caught the bug and wanted to “try” Crossfit a few weeks after I started, and we were both hooked after that. Last summer, since I wasn’t working (yay teaching!), I was going to the box five to six times a week and running three or four times a week. I lost twenty pounds over the course of seven months, and when I found out I was pregnant I felt so confident in my body. Even though I hadn’t met my weight goal, I know that is the most fit I’ve ever been. I had muscle. I was strong. I could deadlift over 200 lbs. More importantly, we had made big changes in our diet and I knew I was much more healthy on the inside than I had been in a few years.

I was worried about what Anna would say regarding continuing Crossfit into pregnancy. I was ready to fight with her, armed with research studies that show how important exercise is to both mom and baby while mom’s pregnant. I was ready to actually show her some of the moves we do to prove that I know proper form and am not likely to injure myself that way. But Anna was completely supportive of me continuing, so long as I promised to listen to my body. She always asked about it at my appointments to see how it was going and encouraged me to keep going so long as I was comfortable.

I have to also give credit to our incredible gym trainers. They were the first people to know about the pregnancy aside from our families, and they really kept an eye on me. At first they were kind of sneaky about trying to modify things for me, such as suggesting a lower weight than normal for the WOD. But I made it clear I wanted to continue at my current levels until my body said to slow down.

6, 26, and  36 Weeks at the gym
Obviously, this isn’t the right choice for everyone. But it was for me. I was able to make it about half way through the second trimester before I really started modifying workouts. A few changes I did make, though, include switching to step-ups instead of box jumps since I have had such bad luck with them in the past, no wall walks, and I even though I had just figured out rope climbing, I never went more than two pulls up in case I were to fall. I also skipped out on all the one-rep maxes on Fridays and simply performed our regular weight-lift cycle instead since my goal was to maintain as much as possible instead of improving my stats.

In addition, in my first trimester I honored my body by dropping from attending four to five times a week to only going once or twice for those few weeks when I was so exhausted I could barely drive home. I found myself missing the actual workout and endorphin high it created, but I didn’t feel guilty about “skipping” workouts. I knew that my body needed rest more than it needed to exercise, and that in a few weeks I would be back to a relative normal.

The biggest difference I noticed in my performance was my cardio abilities. Like I mentioned, I had been running all summer to work on it since I was always the last person, but I found myself out of breath much more quickly than I ever had been by the second trimester. I allowed myself to slow down, take more breaks, and I always claimed the spot by the fan so I wouldn’t over heat.

By the time my bump was actually getting in the way of some things, I found most moves were easily modified. For a while, when I could still do full burpies, I “caught” myself on the ground with my thighs instead of instantly slamming my stomach to the ground. By the third trimester I would barely touch my stomach to the ground, which resulted in a kind of half-burpie (but let’s be real, they were still just as hard as regular ones at that point.) I did push ups with paralette bars so I could still get the full range of motion. I switched out toes-to-bar with sit ups. At the very end, I cut down on the number of double-unders  to about half of what everyone else was doing. Thankfully we didn’t have any double-unders in our workouts in the last few weeks, or else I would have substituted rowing for them like I did for running.

I had really hoped to continue Crossfit until the end of May. My goal was to finish Memorial Murph and let that week be my last hurrah and then put my membership on hold starting at the beginning of June. However, due to my blood pressure issues, I skipped Murph and worked out twice later that week, going on “maternity leave” after week 38.

Memorial Murph consists of a 1 mile run, 100 pull ups, 200 push ups, 300 air squats, and another 1 mile run

My last pregnant workout 

SO SO swollen, you guys. This was the worst part of pregnancy.

The Last Few Weeks
Because I had a high blood pressure reading at my Week 37 appointment, I was scheduled to go back after the weekend to have another mid-week appointment to see if my blood pressure had gone down and to re-do my lab work to make sure I didn’t have preeclampsia. My blood pressure hadn’t gone down, but all my lab work came back negative for preeclampsia.  We began having the hard discussions of what this could mean for us in terms of our birth. If I did develop preeclampsia, I would have no choice but to transfer to an OB. If my blood pressure went above a certain number during labor, I would have to transfer to a hospital.

I continued going to the birth center every two days for repeated blood work and to make sure the baby was still healthy. On Friday, May 30th I went in for another appointment and a few things happened. First, one of the midwives preformed a stretch and sweep to see if it might send me into labor that weekend. Second, we discussed that it would be best for both the baby and me for me to deliver him sooner rather than later, and starting the next week (Week 39), they would start some relatively aggressive “natural” induction methods to get me going. At this point an OBGYN who works with the midwives had been consulted and he was on-board with everything we were going to do, including not admitting me to a hospital immediately to deliver.

Anna also talked to me and encouraged me to take some time off work the following week in order to relax a little (which should help with my blood pressure) and to really keep the baby and me safe. I was slightly disappointed to hear that the midwives were so strongly recommending I take time off work because that was the last week of school, and I really didn’t want to use my leave days on what are really the easiest days of the whole year. The last week of school is finals testing, so we didn’t have to teach; we administered tests in the morning, the kids left at 11, and then we had the rest of the afternoon to grade and get everything finalized for the year. However, I wanted to follow their recommendations because I still had my heart set on giving birth at the birth center. I talked to my boss and she okay’ed me taking half-days so that I could take the mornings off (and not have to deal with the stress of students), and then come in in the afternoons to grade the tests and get my grade book finalized for the year.

Will and I went home that weekend ready to relax and take it easy, knowing this would most likely be our last weekend without a baby. It was kind of surreal leaving with that knowledge. Most first-time moms deliver during the 41st week, and I had always assumed I would fall into that statistic, too. Now, here we were talking about trying to get labor started during week 39 and the semi-high possibility of having to transfer to a hospital for birth.

That car ride home was a difficult one for me. I wrestled with all the emotions that had been welling up inside for the last week or so; while I was excited to meet our baby sooner rather than later, I felt cheated in a way. I had done everything to get and stay healthy during pregnancy for my baby and for myself. I was young. I followed all the rules. I had researched, read, studied, and planned. I wanted an all-natural birth and had pursued that route for almost nine months. And yet, here we were.

I worried about the limit the midwives had put on my blood pressure readings during labor. I knew that pain made blood pressure rise, but I also knew that many labor management techniques included movement, like walking, which would probably raise my blood pressure.

During that car ride, I had the tearful conversation with Will about how I was feeling. We know that God is in control of all things. We know that He does care about the desires of our hearts, and I truly and deeply desired this birth experience. I knew that what I desired was not a bad thing; after all, what could possibly be wrong with desiring something to happen the way God designed it? I also told Will that I knew this was God calling me to have open hands. This baby, though he grew in my womb, was not truly our child. He is God’s child, who is being lent to us for his earthly life. I knew that God was calling me to release my perceived control of our baby and his birth and trust Him. I told Will that I knew this was a lesson I was going to have to be taught over and over again through all our children’s lives.

That weekend passed uneventfully. We were very aware of that precious time of anticipation; we were so excited for the years to come with a new addition to our family, but we were also very aware of the chapter of just the two of us closing. Since I was supposed to be taking it pretty easy, we mostly stayed home and spent some time just the two of us. The only sign of impending labor was when I passed my mucus plug Saturday night.

Birth Week
Monday morning I was able to sleep in a little since I had the morning off.  I also sent Anna an email with the concerns and questions that had been plaguing me all weekend. I went to work and during lunch Anna called me to answer all my questions. She suggested I take castor oil that afternoon in an attempt to induce labor, and also wanted me to call the OBGYN to schedule an appointment with him for Tuesday or Wednesday so that I’d at least have met him and gone over our birth plan with him in the case we did have to transfer. She also said that our “d-day,” or the day they’d let me go to without sending me to the hospital for an induction, was Friday. In addition, we planned on me coming in to the birth center Tuesday morning to have a Cook Catheter inserted in another attempt at induction.

I called the doctor’s office, but he didn’t have any openings until that Friday.

I went to the grocery store to get the castor oil and then I went to Chik-fil-A to get a vanilla milkshake to mix with the oil. My instructions were to take two ounces, wait an hour, and then take another two ounces. I mixed it with the milk shake and chugged it through a straw; I could definitely taste it but the oil didn’t gag me like I was afraid it would.

Will and I waited with bated breath that night for any sign of labor, but none came.

Will and I both took off work the whole day Tuesday. We had an appointment at the birth center at 9 a.m., and before we left the house Will packed the car with all our bags and the cooler for my placenta, thinking that today might be the day. Little did we know we would be loading and unloading that silly cooler for the next five days.

We were the first patients at the birth center that morning. My urine test again came back negative for protein and Mona Lisa, one of the midwives who had been keeping a close eye on us, discussed getting a prescription for a blood pressure medication that would hopefully lower my blood pressure to a safer level.  Anna, Mona Lisa, and Sandy, a student midwife, performed another cervical check, swept my membranes again, and inserted a cook catheter with the hopes that it would dilate me to between a 4 and 6, which would theoretically push me into labor.

The catheter had a really strange effect on me. When I tried to stand up for the first time I almost passed out; luckily I could feel it coming and told Will so he was able to get me laying back down so I didn’t pass out. Because of that, Anna performed a non-stress test, which we passed with flying colors.

Feeling much better during the non-stress test

Our next task was to go have a biophysical profile completed, which would give both the midwives and the OBGYN a much more complete picture at how the baby was doing. This test would tell them if we needed to medically induce labor because of some kind of distress with the baby.

Leaving the birth center, I suddenly felt very, very sleepy. As in, I could barely hold my head up. We went to Walgreens to pick up the blood pressure medication and then went to the imaging center for the BPP. At some point between those two places I started having mild-ish contractions. I remember feeling the pain, but I was so sleepy I could hardly respond to Will when he tried to ask me questions. All I wanted was to lay down and sleep.

We finally made it to the imaging center; after a long wait we were finally called back for the test. The table where the tech wanted me to lay down felt impossibly uncomfortable and my contractions were extremely uncomfortable at that point. I remember having a really hard time laying down because everything hurt, and I had to position myself on one side of my hips because laying on my back hurt too much. The tech, bless her heart, asked why I wasn’t already admitted to Labor and Delivery. After we explained our situation, she promised to get the most vital information first in case we needed to leave early. I dosed on the table while she worked. Even though I’m sure she was moving as quickly as she could, it still felt like it took her forever to get finished. When she was finally finished, she said the baby had scored eight out of eight points, which meant he was perfectly fine and there would be no need to medically induce me yet.

We drove home so I could nap for an hour or so before we had to go back to the birth center for Anna to remove the Cook catheter. At that point I was still so sleepy and all I could think about was laying down in my bed. We finally made it home and I slept while Will went on a last-minute cleaning frenzy, thinking that we might have a baby that night.

By the time I woke up about an hour later, I realized that my contractions had stopped. I was disappointed, but knew that sometimes contractions could stop when a woman is resting and then pick back up soon. On the way to the birth center I had a few more contractions but they were nothing like what they had been early that day.

Anna removed the catheter once we got there (ouch!), and we made a plan for me to come back in Wednesday. She told us to be sure and call her if and when I went into labor or if my water broke that night. Leaving the birth center, everyone felt fairly confident that tonight would be the night for Baby Walker. Of course, he had other ideas.

By this point I had emailed my boss to let her know that I was going to be out for the rest of the week, which meant the school year was over for me. I was a little disappointed to not make it until the end, but at this point I was concentrating on getting the little man here safely.

We went to the birth center again for another urine and blood pressure test and a cervical check. My blood pressure had dropped a little, probably due to the medication, and my urine was still clean for protein. The cervical check revealed that I was dilated to a four and I was about 85% effaced. Anna said she could feel the baby’s head, and that labor was looming. I was slightly disappointed that I was only dilated to a four, since the catheter could have gotten me up to a six, but Anna reminded me that four, without having labor, was still significant progress. We went home again, hopeful for some sign of action.

I texted with Anna Thursday morning, and she said they wanted us to stay home that day and rest as much as possible. I was to take my blood pressure a few times and check in with her so she could make sure it was staying under control. I was getting  a little nervous at this point about our Friday “d-day” deadline, so she suggested I try castor oil again and going to get a massage to get my fluids circulating.

Luckily I still had my Valentine’s gift card to Massage Heights that Will had given me, so I called and booked a prenatal massage for noon. The masseuse was awesome; she had actually given birth at one of the other birth centers in the area a few years prior and was really excited for me. She did a fantastic job, although rubbing my ankles was particularly painful because I was so swollen. She also took me outside when the massage was over to show me how to “curb walk,’ which is what she swore finally made her go into labor. At that point I was desperate to try anything, so that evening Will and I walked up and down the block a few times trying it out.

I also picked up another bottle of castor oil and a milkshake on the way home to give that another round. Unfortunately, none of that did the trick. It would appear that Little Man was quite comfortable inside and did not like being told what to do.

Up next: Jonah's birth

No comments:

Post a Comment

Related Posts Plugin for WordPress, Blogger...