Saturday, July 5, 2014

Jonah's Birth Story

Here's Part 1, where I gave some background information about what got us to this point. Get ready, this post is even longer than that one.

Also, I'd like to reiterate that this is our story with our thoughts and feelings attached. Parenting is tough, and it begins before your beautiful babe is brought forth into this world. All parents have to make choices concerning prenatal care and delivery. I think it's safe to say that 98% of parents want what's best for their children and would never intentionally do something harmful to their kids. Will and I chose to go with an all-natural route. Just because we chose that path and think it is the best one for our family, does not in any way mean we think you are wrong for choosing a different path. This is no place for the Mommy Wars; I simply want to tell our story.

Friday, June 6th.
Another trip to the birth center in the morning; this time we didn’t even bother packing the cooler. Another clean urine test, another stable blood pressure reading. Another stretch and sweep of the membranes. Another non-stress test that we passed with flying colors.

Friday morning- all smiles at this point!
We reevaluated our plans from that point. My body was clearly as ready as it could possibly be for labor, it was just a matter of the other hat dropping. I was supposed to go home and relax and come back to the birth center at 3 pm for some final decisions to be made. We had discussed breaking my water, but because I wasn’t in labor yet we decided not to, since breaking your water creates a 24-hour time limit on when you can have your baby due to increased risk of infection. We decided we would break my water once I had already gone into labor, if need be.

Will and I went home. I tried to lay down for a nap but was extremely uncomfortable and wasn’t really able to sleep. I also started having contractions around 11:30. They weren’t strong, they weren’t a consistent length, but they were coming regularly. I texted Anna around 1:45 pm and told her they had started.

Back to birth center we went for our 3 pm appointment. I can’t remember, but I’m fairly certain they performed ANOTHER stretch and sweep. By this point everyone was commenting on how thin my bag of waters was, and how easy it would have been to break it. Thankfully they were all careful and it didn’t accidentally break. At this point I kept thinking it would pop as I was walking around, and the midwives felt it was a definite possibility, so they sent us home with a puddle pad to put down in the car just in case. We made plans to meet Anna back at the birth center around 8:30 pm for her to break my water.

Again, we went home. I’m fairly certain I took another nap, although I was scared to since it seemed every time I lay down when I had contractions they would stop. However, when I woke up they were still there and getting a little stronger. I sat on my yoga ball and talked to my mom for a little while. I was still able to talk carry on a conversation, although I was definitely taking notice and having to concentrate a little harder through the contractions.

From this point, time seemed to pass in a blur for the next twenty-four hours. It still amazes me how in-tune I felt with my body; I was able to ignore just about everything else and concentrate on what I was feeling.

Megan, my amazing sister-in-law, came to our house around 7:30 pm to drive us to the birth center. She was our designated “assistant coach” (gotta love Bradley Method!), and her job was to keep our families informed about what was happening and let them know when to come to the birth center. The original plan was for them to come when I started pushing, although they came a lot sooner than that J

Will packed the car for the tenth time that week and made sure to pack my pillow and awesome pregnancy pillow. I remember feeling a little anxious about this trip because I didn’t know if we would be staying at the birth center or if we’d be coming home again because I wasn’t far enough along. Heck, at this point I still wasn't sure that I was actually in labor since I had had contractions earlier in the week but they died away on their own. While we were driving to the birth center, Anna called and said it would be 9:30 pm instead of 9:00 before she got to the birth center, so we made a quick stop at a gas station to grab me some more orange juice (again, a Bradley Method thing) and some ice for the placenta cooler.

Just before leaving home 
At some point between leaving home and arrive at the birth center, labor really kicked in. I was beyond able to really talk to anyone for any length of time. Earlier that evening while still at home, I was surprised at how much I felt the contractions in my back. My mom kept telling me I would feel them wrap around from my back to my stomach, but my contractions mostly stayed in my back with some of the pain around in my lower belly. In the car, Will tried to make me comfortable in the front seat by leaning it back as far as it would go and wrapping me up in my body pillow, but I got out of the car pretty soon after that because I was so uncomfortable.

I wanted to stand up and walk around, but we were stuck in the parking lot of the birth center since Anna was delayed, and there were a lot of mosquitos out so we had to get back in the car. Waiting for Anna was not fun. We only waited half an hour or forty-five minutes, but it felt like an eternity. I counted down the minutes until nine.

When she did arrive, I was out of the car as quickly as I could. She was quite surprised to see me so progressed in labor, since the last time we had talked I told her my contractions felt like “strong PMS cramps.”

Thankfully we all felt it was time to go ahead and break my water. I was a little nervous about this procedure since I had read that it usually involves a crocheted-hook-looking thing (how could that not hurt?), although at this point in the week I was wiling to do whatever it took. Will had made a joke earlier about him being able to break my water at home with a thumb tack since Anna had said it would be so easy to break; we both chuckled when Anna put a little contraption on her pointer finger that was essentially a sterile thumb tack that she would use to break the bag of waters.

The procedure was more or less painless. Anna had to use more force than I thought she would. When my water broke it came out in a warm gush and I was surprised at how much there seemed to be. When we were finished I got to put on a lovely Depends. There was a small space of time that I don’t remember clearly, in which I think Anna talked to Jackie, the other midwife who would be there to assist us at the birth, about whether we should stay or go back home to wait. I do remember that my contractions got much stronger almost instantly after my water broke. Thankfully, Anna came back and told us we could go to the back birthing room and I let out a sigh of relief as I waddled back there in my awesome Depends.

I was taken aback at how strongly my contractions started slamming into me when we got to the room. All I wanted was to get in the birthing tub, but Anna worried that might slow down labor too much and wanted me to try to stay out of it for a while. After a minute or two I told Will I wanted to sit on their yoga ball and lean against the bed; after he got me situated he ran out to the car to grab our bags.

Jackie came in not too much later and said she heard I wanted to get in the tub; I practically begged her to let me get in so she went ahead and started filling it for me since it would take a while. They have some flameless candles around the tub that she turned on for me after she lowered the lights in the room. This was the perfectly calm and soothing birthing environment I had dreamed about.

I had packed a swim suit bottom to put on while I was in the tub but as most women find once they reach a certain point in labor, I did not care about modesty at this point. I sunk into the warm water and allowed the contractions to consume my attention. Will sat beside the tub and held my hand, allowing me to squeeze his hand through the contractions. Later the next week when we were home, I noticed Will wasn’t wearing his wedding ring and I asked why. He showed me a huge blister on his ring finger and said, “ You were squeezing pretty hard. That, combined with the water from the tub under my ring did this.” Oops.

Will and I had prepared for this event by taking Bradley Method childbirth classes. While I felt like I already knew quite a bit of the information we were taught, we still learned quite a bit and I would highly recommend the classes to any first-time parents. One of the big components of the class was learning relaxation techniques so that you can relax through the contractions in order to minimize your pain. I knew managing my pain was going to be key in keeping my blood pressure low enough to stay at the birth center, so I spent a lot of time in the weeks leading up to our due date typing information from our Bradley Method workbook and finding different relaxation scripts and techniques online to combine into one awesome binder we brought to the birth center. I also had typed up quite a few birth affirmations and scriptures that I thought I would set out around the room in order to give me some mental strength when I needed it. Will and I had also planned to play my favorite Pandora stations on a phone to help me relax during labor.

Will did turn on Pandora and set his phone by the tub, but honestly I was simply aware that there was music and paid no attention to the words. I was mentally so far inside my body that my surroundings faded away into the background and all I knew were my contractions, my breath, and Will’s hand. The birth affirmations stayed in the binder; the relaxation massages we had practiced remained unused. I tried to visualize my contractions as waves in the ocean, coming and subsiding gently, but honestly it was really hard for me to relate the pain with something so calming.  

I was unprepared for how much I felt the contractions in my back. Anna offered me a foot-long piece of pool noodle and said it might help if I put it between my back and the side of the tub and pushed on it during the contractions. It did help, but it was hard to concentrate on pushing it hard enough so that it didn’t float to the top of the water.

Time passed without my awareness. At one point Jackie said, “Today is going to be your baby’s birthday, Abby.” I thought it was still Friday, but when I asked what time it was she said it was just after midnight.

Soon, my contractions started coming so quickly I had almost no time to rest in between them. Later, Anna told me from what she could tell my contractions were about two minutes apart, but they were lasting a minute and half each. Two contractions would come back-to-back and then I would have a small space of time to rest. My method of coping with the pain and riding the contractions was to moan “oohs” and “awws” and squeeze the heck out of Will’s hand. I find it a little funny that I was so concerned about how I was going to manage pain before I went into labor and spent so much time learning different pain management techniques, but when it came down to it, I only used perhaps one of the most basic and oldest techniques there is.

The double-peaking of contractions was definitely the transition phase of labor. Deep down I knew it, because a few times I cried out, “I just want this to be over!” Through our Bradley classes, we had learned that transition was the time that most women give up, so-to-speak, and ask for pain medication. There were a few times I had to fight down an almost panic-y feeling inside me because the pain was so overwhelming. My moans, which had been very low-pitched up until then, suddenly crescendoed into a higher-pitched half-scream when my contractions would peak. At one point when I cried out for mercy, Anna came and sat by the tub with us and asked if I remembered what transition was. “This is it,” she said. “Your baby will be here soon.” Even though I thought I was in transition, hearing her say it made me feel a lot better because it wasn’t just my wishful thinking.

Suddenly, I started having a weird urge at the peak of my contractions. Obviously it was the urge to push, but it did not feel like what I thought it would. Anna and Jackie recognized it immediately because my sounds changed, and they told me to not push yet because I wasn’t ready. “I don’t know how to NOT push!” was my desperate reply. “You have to do it with your breath. Breath out really hard when you have that urge and keep your tones low,” was Anna’s answer. That technique certainly helped, but it was still quite the fight.

Finally, Anna said it was time to check me again to see if my body was ready to push. She decided I was eight centimeters dilated, but there was a small lip of cervix that was still in the way. She tried pushing it back for me, which she said would be extremely uncomfortable, but honestly I didn’t really feel it. Unfortunately, she wasn’t able to get it pushed back, so she had me try sitting backwards on the toilet for a few contractions with the hopes that the lip would push back by itself. Soon enough, though, I was asking to get back in the tub.

I labored there for a while longer; I’m not sure of the time. I remember Jackie saying we would have a baby by sun up and I was elated. Eventually, when the urges to push were coming more frequently, Anna told me I was probably close enough that I could start following my body and push if I felt like it.

On my next contraction I flipped over onto my knees in the tub and held onto the sides and pushed when I felt my body start to ascend the mountain it’d been fighting for a while. After that first time pushing, my contractions immediate spaced out to several minutes apart, a welcome relief from the double-peaking I’d been having for hours.

Here was another example of how truly awesome our bodies are. I did nothing other than actually follow my instinct and try to push, and my body immediately got the signal that we were switching gears and then allowed me some much needed rest in order to conserve energy for pushing. I was able to actually look up and talk to Will for the first time all night; I suddenly had energy and felt more alert than I had all night. This was it! I was actually having a baby! My moaning sounds changed yet again; I felt like a wild animal letting loose. I had been afraid I’d be too embarrassed to make the “labor noises,” but just like my complete lack of modesty, I simply did not care who heard me or what they thought.

I’m not sure how long I pushed before Jackie wanted to check me again to see if I had made any progress. That’s when she determined the lip of cervix was still there, which basically meant all the pushing I’d done was for naught. Jackie said she was going to try to push back the lip while I was pushing, and we tried that for a while. Unfortunately, not much progress was made. However, I did receive a small ray of motivation: “Your baby has a lot of hair!” Jackie revealed.

Jackie told me I was going to have to let my body labor some more to try to move that last piece of cervix, which was incredibly frustrating to me. To go from pushing and thinking you were within an hour or so of meeting your baby to not pushing and reverting back to laboring was incredibly frustrating.

At one point Will left me and told Jackie he was going to have his mom go get him some coffee. Jackie made a request for her and Anna; I was in the tub thinking, “Why do they need coffee?” I cannot stress how unaware of time I was that entire night.

Eventually Jackie had me get out of the tub and try a few other positions. I tried the birthing stool, sitting backwards on the toilet, and eventually a side-lying position on the bed while holding up my legs.

I saw this post on Facebook a week or so after I came home and burst into tears. All of those people were thinking about us and praying for us, and we had no idea. 
I did make progress in bringing down the baby, but the lip of cervix remained. I was getting tired and a little less “present,” but I was still focused on the job of pushing and bringing the baby into the world. Will and Anna focused on making sure I was taking in some calories in the form of orange juice, coconut water, and even some pretzels. My mouth was so dry I couldn’t really swallow the pretzels, though.

Slowly, sunlight was filtering into the room through the blinds. That was the first time I started to feel a trickle of worry. Jackie had predicted my baby would be here by sunrise. Obviously, I knew that wasn’t a guarantee, but I felt I had been work so hard and there still wasn’t much progress.

Kathey came back with everyone’s coffee and Anna and Jackie approached Will and me with new vigor and a plan. I vaguely remember Jackie saying we were going to have to make some serious progress soon or else…

That “or else” was what I had feared the most my entire pregnancy. Transfer to a hospital, where the likelihood of drugs, medication, and a cesarean section were almost inevitable. I made up my mind that I was going to get this dang baby out right here, right now, because I was not going to a hospital.

Will, Anna, and Jackie surrounded me on the bed. Anna looked at me with a tired smile and half-apologetically said, “This is where we have to do some directed coaching for pushing like they do in the hospitals.” Fine by me; I was ready to do what needed to be done.

I’m not sure how long we pushed on the bed. Everyone was so encouraging and positive, but I was getting tired. I kept trying to give it all I had; I felt like I was giving it all I had. I kept wondering to myself, “Why is he now crowning by now?”

I will never forget the feeling of utter defeat when Jackie stood up and said, “I’m sorry. We’re going to have to go the hospital. This just isn’t working.”

I looked at Anna in panic. “What are they going to do there?” My question really meant, “Am I about to get a c-section?” and thankfully, Anna knew that. She said they would probably try to let me continue pushing and do it on my own, but a c-section was not out of the question.

I felt lost and like I didn’t know what to do. Anna told me I could keep pushing while we waited. I thought we were going to drive to the hospital in our car, but then I heard Jackie in the background on the phone ordering an ambulance. I was relieved that I would at least be able to lay down in the back of an ambulance, and hey, I’d never been in an ambulance before so at least it would have that novelty factor.

I stayed on the bed, pushing when I felt the need, while everyone bustled around me getting things ready to leave. The sun was completely up at this point.

The birth center has two backup doctors they try to use in situations where patients have to transfer. One of the doctors is the OB who they had been consulting about my case of high blood pressure, so he was their first choice for me. Unfortunately, he wasn’t answering his phone and the other backup doctor up in Houston wasn’t available, so our next option was to go to another hospital in Houston.

This last choice hospital was the midwives’ choice over any of the other hospitals in the area, including the one that is closest to our house and probably closest to the birth center, because Anna and Jackie knew it was my best shot at a vaginal birth. They knew through experience that most other hospitals wouldn’t allow me the chance at a vaginal birth and would admit me for a c-section immediately. However, let’s just say that this is not exactly a desirable hospital in terms of its location, amenities, and the chaos that fills the waiting rooms and ER. When our families flipped out about where we were headed, Anna and Jackie explained that there were midwives on staff there and they would be my best shot at getting the birth we wanted. While our families had every right to be concerned over the choice of hospital and wanted us to go somewhere closer to home, Anna and Jackie did not waiver. I was the patient. It was their job to honor my, and not anyone else’s wishes, and the only shot of those wishes coming true was at this hospital. This is also a good place to insert that throughout the night, my blood pressure had been low enough to stay at the birth center, and the baby's heart beat, which was checked every fifteen to thirty minutes, had remained stable and strong. In addition, the baby was in the optimal position for birth.

Eventually Will told me I needed to get dressed. We found my shorts from the night before and a nursing tank from my bag. As Anna helped me put it on, I smiled and said, “The next time I wear this I won’t have such a huge belly to pull it over.”

Will came in and said my mom wanted to come see me, but I was still overwhelmed with contractions and told him I couldn’t see her.

Anna encouraged me to keep pushing while we waited for the ambulance if I felt like it.
Anna and Jackie got together an emergency-type kit for Anna to take on the ambulance with us. When a patient has to transfer her midwife will go with her to the hospital to act as a doula and try to maintain the patient’s original wishes as much as possible.

I heard Anna and Jackie talking about the hospital where we were going. They said we were going to have to be admitted to triage before they would admit me to Labor and Delivery. When I heard that, I started to panic again.

I was leaning over the foot of the bed and I looked at Will with tears in my eyes. “I can’t make it through an hour-long drive in an ambulance. I can’t do this on my back. I can’t keep going in pain like this. I think I’m going to have to get some pain medication.”

Those words were the last words I thought I’d say during this process. I mean, I had already thought to myself that I understood why people asked for pain medication, but it had never even been an option for me up until this point. All our careful plans were spinning out of control at this point, and I felt so defeated to have to ask for some kind of pain medication now when I had already basically gotten all the way through labor. Actually, I was mad at myself and at the situation. I had come all the way through labor. I had pushed for almost three hours, for crying out loud. I had done ALL of this completely naturally, and here I was, having to now ask for what I wanted to avoid the most.

Will knew how hard it was for me to ask for the medication. “Are you sure?” he asked me a few times. The thought of enduring an hour-long drive on my back (the most painful position through contractions), waiting in triage to be admitted to Labor and Delivery, and then waiting for who-knows-how-long to do who-knows-what was impossible for me to wrap my head around.

Finally, the ambulance arrived with two very kind men. I asked Anna if I could at least lay on my side in the stretcher while they were bringing in the gurney, and she said she would take care of it. It was time for me to go out into the hallway where they were waiting, and I told Will to get my mom. I waddled out of the room where I had been for the past twelve hours and fell into my mom’s arms. She had tears in her voice, and while I don’t remember exactly what she said to me, I know she was so encouraging and proud of me. “Let’s get this done,” were her last words.

I went back to the stretcher, where  Anna stuck out her hand to the EMTs and introduced herself as a CPM, and with authority in her voice said that I was her patient and she needed to ride with us in case the baby was delivered en-route to the hospital. Oh, and that I had high blood pressure and needed to be on my side on the stretcher. The EMTs were, thankfully, on board with this all and helped me get settled. I ask for a pillow to put under my belly for support, and Anna got me one from one of the birth rooms. The men wheeled me out to the ambulance while Anna gathered a few more things. Will walked beside me, and our families were picking up in the waiting room getting ready to follow us to the hospital.

Suddenly, Anna came running out of the building saying, “Change of plans! We’re going to Mainland Medical in Texas City. Our backup doctor finally answered his phone!” This was hugely welcomed news to us all for a variety of reasons, and once we were all in the ambulance we were on our way.

I had only a few contractions in the ambulance, but I was feeling pretty exhausted at this point. I turned to Anna and asked which pain medication was the least bad for my baby.

“Probably an epidural,” was her answer. We discussed a few other options, but we all agreed I needed some kind of pain relief in order to let my body rest for a little while if I wanted to still attempt a vaginal birth. I was afraid I would feel like Anna was judging me if I asked for pain medication, or that she would disapprove of it. I don’t know why I ever felt that way. Even though Anna is a huge advocate for natural birth, she is not unrealistic, and Mom’s safety and Baby’s safety are her number one priorities. She knew that I was going to have to have some kind of intervention to get our little man here safely, and she supported me 100% in figuring out what the best option was.

We arrived at the hospital soon. I saw my sister and father-in-law as we were entering the ER entrance. They looked tired (um yeah, they’d been up literally all night, too!), but I don’t remember what they said. Thankfully we were admitted immediately into this hospital and we were directed straight to a delivery room. We said goodbye to our awesome EMTs, and I was handed a hospital gown to change into.

I looked at Anna before I started changing with a knowing look in my eyes. We had talked about that I didn’t technically have to put it on if I felt more comfortable in my own clothes, but at this point I also knew I still had a long road ahead and I wanted to make things as easy as possible.

Our charge nurse was really great. She got our information quickly and was supportive of our goal for as natural a birth as possible. Anna ran down our birth plan with her, and the only thing that we had trouble with was the release of the placenta. Apparently the hospital had just passed a new rule the week before that all placentas had to be sent to pathology and could not be released under any circumstances. We tried to figure out a solution, but the only one we could come up with was paying one of Anna’s friends, who is a funeral director in Austin, to come down and take it. Though I still regret not being able to encapsulate my placenta, at the end of the day it wasn’t worth the worry.

We soon met the nursery nurse who would be there when the baby was born. Anna gave her our requests, which included immediate skin-to-skin with me, delayed cord clamping, natural birth of the placenta, etc. She, like our charge nurse, was 100% on board. Though the hospital was the last place I wanted to be, I was shocked at how supportive and kind everyone was. I made sure to repeat how grateful I was to them several times.

In the mean time, an external monitor was strapped to my belly. I saw this continuous fetal monitoring as yet another thing I had wanted to avoid since it can give false reads of fetal distress. Eventually it was decided I would receive an epidural for pain relief and then they would start a Pitocin drip since apparently my own contractions had basically stopped.

The anesthesiologist rolled into the room carting a red Craftsman toolbox to hold all his supplies. I knew that an epidural involved a pretty large needle in my back, and I had heard horror stories about them not working or being extremely painful when they were put in. The nurse had me swing my legs over the side of the bed and lean over the side table. Will stayed in front of me while the anesthesiologist got to work. He cracked jokes and kept talking the entire time, which really helped keep me calm. I could hear him slamming his drawers around and Will told me later he looked like a bartender, but with all his drugs. He let me know what he was doing through every step of the process, which also helped me stay calm. Soon enough, he was taping the line all the way up my back and I was laying on my back to let it start working. Thankfully, the epidural worked and I was quickly pain-free. Will later mentioned how big the needle was, and I’m still glad I didn’t see it before he put it in.

I think I was only smiling at this point because I knew a baby HAD to come today, one way or the other.
Just after the epidural went in, a boisterous man wearing shorts and flip flops entered the room. This was our doctor. Today was his day off, and he was here to deliver our baby as a personal favor to our midwife. We quickly learned why Anna liked him so much. He was quirky, personable, and hilarious. He was not at all what I expected in an OB, but I am forever thankful for him. The nurse had warned us that he tends to get a little “excited” during pushing; once we started chatting with him he mentioned the same thing and warned me not to get offended if he yelled at me. Of course, it wasn’t mean yelling, but rather an excited, “You can do it” type of yelling. He stayed and talked to us for a little while before everyone vacated the room.

We had to wait about half an hour for the epidural to completely take effect and then another half hour after they started the Pitocin drip before anything could potentially happen, so a nurse brought in a cot for Will. Will snuck me a handful of almonds and a muffin, even though I wasn’t supposed to have anything to eat or drink. I knew the research that said that is an outdated policy and knew I would be fine if I ate a little something, and truthfully, I needed some energy. He conked out as soon as his head hit the pillow. I slept a little, too, in between the nurses coming in to check everything. It was surreal to go from the pain I had been feeling with contractions at the birth center to not feeling anything at all except itchiness as a reaction to the epidural.

After an hour or so the nurses and doctor came back in, announcing it was time for a few trial pushes to see how everything was going. The nurse sat me up in the bed and started getting me ready, when I asked someone to please wake up Will “just in case.”

The nurse had to tell me when I was having a contraction and the doctor did, indeed, get quite excited and enthusiastic with coaching me through the pushing. 

As a side note, I cannot imagine being a first-time mom and pushing with an epidural. My situation was unique because I had already pushed for several hours, so I “knew” what to do. But now, pushing with the epidural, I had no idea if I was doing it right or hard enough. You literally cannot feel anything, and even though they tell you to bear down like you’re having a bowel movement, you still have no idea if you’re actually doing it right.

During one of these practice pushes, the baby’s heart rate decelerated to the point of concern, and the doctor shouted for them to flip me over on all fours, a position which apparently puts the baby in a better position if he’s in distress. Before I knew what was happening, the doctor had his arms around me, supporting me since I couldn’t feel my legs, and I was on my hands and knees.

The baby’s heart rate quickly went back to normal and everyone seemed satisfied that he was perfectly fine again. I can’t remember how much time passed before the doctor said it was time actually start the real pushing (because I wasn’t really pushing before? I don’t know…) and I asked someone to go get Anna, who was taking a nap in the on-call room.

I should probably mention that Anna was herself pregnant, almost to her third trimester. I can’t imagine doing everything she did for me while I was almost thirty weeks pregnant.

Anna arrived and helped hold one leg while Will held the other. At some point in here, we realized that Jonah had flipped sunny-side up (OP), or in other words, his face was facing my abdomen instead of my back. This is not optimal presentation for birth because it can be much more difficult for the baby to descend through the birth canal. While we had been at the birth center, he had been  AP, or his face was facing my back.

This is where things start getting a little hazy for me. I know that I pushed in many different positions for a few hours. I was given an oxygen mask. I pushed three or four times through each contraction. The doctor was my biggest cheerleader, but hearing affirmations from Will, Anna, and Jackie (who showed up at some point to see how things were going) were what kept me going and kept me calm. The doctor manually tried to turn the baby as I was pushing to get him into AP, but it wasn’t working. I remember Anna asking him how he was doing that. The doctor was also actively massaging me with baby shampoo so I wouldn’t tear, which I greatly appreciate. At one point Will got up on the bed behind me to help support me while I was pushing, but it didn't helped much. 

I really thought I was smiling when this was taken. Ha.
And then I started having some blood vessels burst. The doctor had me push every other contraction so he could repair them with stitches. Thank God I had the epidural. Towards the end a nurse brought in a mirror so I could see the progress, since everyone was saying they could see the baby and all his hair. I didn’t particularly want a mirror because I didn’t want to see all the, um, damage. Surprisingly, though, looking at the mirror did not affect me one way or another. I was back inside my head, in a similar yet different place I had been at the birth center. I couldn’t understand why he hadn’t crowned yet. It felt like I was working so hard, but not much progress was being made. I didn’t think that was right. At this point, I thought about asking the doctor if he could use a vacuum extractor in order to simply get the job done and avoid a c-section. Everyone kept asking if I was okay, and I always responded that I was. And truly, I was. But I was also extremely tired. I could feel myself loosing power behind my pushes, and while I had been so excited when we began, I had reached the point of just wanting it to be over.

And then the baby had two decelerations in heart rate back-to-back. The whole room stopped and waited with bated breath to make sure his heart rate went back up. On the second time, the doctor said it was time for a cesarean.

I wish I could exactly remember my emotions at this point. I know I was extremely upset, but I think I was also numb from exhaustion. It seemed cruel to have gone through so many hours of labor and so many hours of pushing, just to have an end result be something so totally different. But I also knew that at this point, I had done everything I possibly could to give my baby the birth I wanted for him. I never gave up. I gave it everything I had (evidence of this is in the broken blood vessels in my eyes and my still-sore abdominal muscles at almost four weeks post-partum. One of my other midwives told me I was this sore from pushing for so long and so hard.).

I asked for some water because I was parched after so much pushing and heavy breathing. The nurse said I wasn’t supposed to have any. I definitely thought some hateful things about her at that point. Really, lady? Do you KNOW what I've been through at this point? Thankfully Anna spoke up and asked if I could have some ice chips at least. The nurse made it clear she didn’t think it was a good idea, but “allowed” me to have a few. Anna ran to get a cupful and fed them to me while no one was looking. I'm pretty sure I ate the entire cupful of ice, and I was eternally grateful to Anna for sneaking me so much.

Anna also took out my earrings for me and stuck my chapstick in her bra since I insisted it go with us to the OR (WTH was I thinking? Why did I need chapstick during surgery?!) but neither she nor Will had pockets. They started wheeling me out while she and Will stayed for a few seconds to get their scrubs on.

I don’t remember the walk down the hall to the OR, but I remember the room. It was bigger than I thought it would be, but it was bright like I anticipated.

The next few events are even more hazy, and I’m not sure the exact order that everything happened.

I was confused about where to put my hands. In the movies, there’s always these little side tables for you to put your hands on, but when I reached out there was just air. I was really concerned about where I was supposed to put them, because when I tried to put them by my sides they touched the surgical drape and I didn’t want them to get in the way of the doctor. Anna was already in the OR at this point and must have noticed I was trying to do something with my hands, because she firmly grabbed my right hand and held it. 

The nurse, who had been so calm the entire time, franticly told the doctor, “Oh my God. I can’t find his heart beat.” Later, the doctor told me it was down in the 60s, which is extremely difficult to hear because it’s so slow. This triggered the emergency.

“There’s no anesthesiologist on this floor.”

Will came in. He saw the chaos that was ensuing but had no idea what was going on. He saw the doctor cut me open, and then the nurse frantically said that he and Anna had to leave and pushed Will out, but Anna was holding my hand like it was an official job and it would have been a bigger hassle to leave than to stay. Although it would have been more ideal to have Will there, I am so glad Anna was there. Having her there helped me stay calm. I know she talked to me throughout the procedure and also conversed with the doctor. She had never seen a real-life c-section, so it was an awesome learning opportunity for her.

Will tried to watch from the window in the door, but eventually a nurse made him leave.

The doctor told me I was going to feel a sting and a tug. Um yes, feel it I did. The only anesthesia I had was what was still pumping through my system from my epidural, which I had been unhooked from at some point, and the topical cream the doctor merciful spread over my incision sight since he knew I had no anesthesia. Unfortunately, even though he had spread the cream over my incision sight, I still felt him cut me open, except I felt it up near my belly button. At this point I started to get worried. (And how the heck did I not worry when I heard them say they couldn’t find my baby’s heartbeat? Told you I was out of it.) I knew that incisions for this type of surgery were supposed to be below the bikini line, so the fact that I felt it at my belly button, I knew, was wrong. The next day when the doctor came in to talk to me he said it was because my nerve endings were numb where he cut, but because he didn’t put the numbing cream all over my stomach the nerves by my belly button felt it. Super crazy how our bodies work.

After he cut me, I felt him rip through my layer of muscles. At least, it felt like his was ripping something, and obviously it wasn’t organs. Anna told me later that it’s similar to the idea of tearing vs. an episiotomy, and that usually the muscles will heal better if they aren’t cut with a knife. It makes sense, but it was a little traumatic for someone who wasn’t expecting it. Oh, and also for someone who had no pain medication.

“He’s stuck.”
 Later I learned the doctor had to reach inside me from the, um, other end, and push the baby up out of the birth canal. At least all my pushing had done something.

“You’re a mom, Abby!”

“He’s not breathing.”

“Look to your side, Abby. You will see your baby as they take him out.” I kept looking around but I couldn’t figure what side I was supposed to be looking at. I finally found Anna with my eyes and she motioned towards the door. I looked over in time to see the nurse who was holding my brand new baby leave the OR.

And then I was waking up.

You know how in the movies when someone wakes up from surgery and it’s all hazy and someone else has to say their name over and over before they really come to consciousness? Well, for me, it was like someone snapped his fingers and that was it; I was awake.

“He wasn’t breathing when he was born, but his color was good.”

“We’ve got to bring that baby in here. He has been crying, looking for his mom for a while. We can just put him on her breast.” My doctor agreed it was fine for them to do this, but the stupid anesthesiologist wouldn’t allow it.

“Please don’t give him formula.” I think those were my first words when I woke up. I was still clinging to any part of our plan that I could.

“How long ago was he born?” I managed to get out.

Someone, I think the anesthesiologist (um, where were you two hours ago when I was being torn open?), looked at the clock and told me it had been two hours. What on earth? Why had it been so long?

“Would you like your glasses so you can see?”

“The blood bank is on the way with another unit of blood.”

I heard the staples. And then there was another layer of staples. I thought to myself, “Well that’s going to be fun to deal with.”

I was being wheeled back to my room. I think I saw my mom and/or mother-in-law on the way.

I was in my room. The lights were dim. Will was there. He asked if I wanted to meet my baby. He brought Jonah over so I could see him.

Jonah’s nurse came in and asked if I wanted to try and breastfeed him. I asked for my feeding pillow. I held my baby for the first time and the wonderful nurse helped me get him to latch.

He didn’t eat very long, but the only thing running through my mind was how terrified I was that I was going to drop him because I was so tired.

When he was finished, the nurse asked if we wanted her to give him a bath. We said she could wash his hair, but not his body. I was really grateful they waited for me for that.

Then we were being taken to our postpartum room. I held on as tightly as I possibly could to Jonah so I didn’t drop him in the hallway. Everyone we passed commented on all his beautiful hair. I think I was grinning ear to ear.

Our new room was at the very end of the hallway, and I appreciated the privacy. There were two beds, so Will got one to himself. I had a new nurse at this point since there had been a shift change. Jonah’s nurse brought us one of the plastic cribs and put it by Will’s bed, since I wouldn’t be able to get out of bed to get him.

I had some awesome massagers on my calves to keep my circulation going, and I had been given some kind of pain medication that was supposed to last for 24 hours.

Eventually everyone left us alone to sleep.

At some point, someone told me what had happened to Jonah and me. His heart rate dropped to a dangerous level, they discovered he was stuck in the birth canal, when he was born he wasn't breathing on his own. He received CPR and chest compressions for a short period of time; however, on his second Apgar test he received an 8. They then took him out to Will for skin-to-skin time. 

If that's not a face of pure joy, I don't know what is.

Jonah's first close-up

At some point during the surgery, I hemorrhaged. I'm still really unclear about exactly when or why it happened, but I'm fairly certain it happened in their attempt to get Jonah out so quickly. The reason I was in the OR for two hours after he was born is because they had to go back and do some damage control (like bringing in an x-ray machine to make sure nothing had been left inside me in the rush to get me sewed back up). 

These stories of what happened in the OR to Jonah and me came to me in pieces over the next few days from our parents, the nurses, and the doctor.  Everyone kept saying it was a traumatic birth. One nurse mentioned I should be aware that I might have PTSD from it. But I really did not understand the ramifications of what had happened until I got home from the hospital a few days later. Our baby and I had both almost died. 
Back in our postpartum room,  Jonah woke up. I had to practically yell at Will to wake up, bless his heart he was so tired. I tried to feed Jonah again and his nurse came in to help us, but he wouldn’t latch and eventually fell back asleep.

A little while later she came back in to do his heel-prick test, which he did not like one bit.

And then, at two a.m., his nurse came back into our room and said, “This is the doctor on-call in the NICU at Clear Lake Regional, and she is going to explain to you why your baby needs to go to the NICU.”

I talked to that doctor, who explained that  Jonah’s blood tests had come back with an elevated white-blood cell count, which indicated an infection that could possibly  turn deadly. The hospital where we were didn’t have a NICU, so he was going to have to transfer up the road to their sister hospital. They were going to perform a 72-hour blood culture test, and if that turned up clean then he would be good to go. 

I fought back my tears and asked her to talk to my husband to explain everything to him since I knew he would have questions I couldn’t answer.

Over the next hour or so while we waited for the transfer team to arrive (not one, but TWO ambulance rides for the Walker family this weekend!) I tried to nurse him again but he wouldn’t latch. The nurse brought me a pump so I could try to get some colostrum to send with him, but nothing came out. I knew I couldn’t control anything else, so I focused all my efforts on getting him breast milk so he wouldn’t have to go on formula. I was devastated when I couldn’t get anything to pump for that first day or so. However, I learned later that he was hooked up to an IV with sugar water and wasn’t even given formula those first few days, so essentially it didn’t matter.

The transfer team arrived; they brought Jonah in to see us one last time before he was taken to a different hospital. The nurses from his new hospital were incredibly kind to us and tried to answer all our questions, but at the end of the day, taking a child who’s less than twelve hours old  away from his parents is simply not easy for anyone involved.

And just like that, the beautiful, perfectly healthy-looking baby who had come into our lives after so much work was wheeled away with strangers to a different hospital, where he ended up staying for the next nine days.

Though our baby’s birthday did not go at all the way we had prayed, at the end of the day, or rather should I say week, the end result was a healthy baby and a healthy mom. We couldn’t ask for more than that. And hey, we have a pretty cool story to tell Jonah when he grows up. 

We are so thankful for everyone around us during those two eventful days. Ours families gave us the space we asked for but they were also always there, behind the scenes, ready to jump if and when we needed something. Our wonderful midwives who gave us (almost) everything we had hoped to get out of a birth center experience, and gracefully made the tough call that it was time to hand things over to a different team. Our hospital team of nurses and doctors took such good care of us and were gracious and kind, even knowing they were our "second choice." 

I know for some people it is hard to understand my reasoning, but I was more scared of the hospital than giving birth naturally at the birth center. While I have a deep respect for doctors and what they do, I had hoped that our birth would fall into the "normal" category that did not have a medical reason for intervention. I still believe that midwifery care is the best care I could have received during this pregnancy, and I would recommend that route to anyone who is interested in it. I am still a believer that birth is, for the most part, a natural and safe thing that our bodies were divinely created for. What happened to us is outside of normal and something no one could have predicted. 

Though we hadn't wanted to end up in a hospital, I am very grateful that the midwives knew we needed to go, and I am grateful for the hospital where we went, and I am grateful for the OB who came in on his day off to deliver a baby to a woman he'd never met before. I know that he is a big reason why we had such a great hospital experience; he is a big supporter of midwifery care and vaginal birth, and gave us every opportunity he could to have a birth we wanted. 

Let's be real here, though. What we wanted the most was a healthy and happy baby and mom, and after a short delay, that's exactly what we got. 

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