Part 1: You can't always get what you want ...
But if you try sometimes, you just might find you get what you need.
Our birth experience was a powerful opportunity for growth, acceptance and personal transformation.
As many of you reading this will know, what we had wanted was an uncomplicated birth center birth attended by a midwife. I have a strong distrust of hospitals and of much of what modern medicine has to offer (especially where it relates to childbirth), and wanted nothing more than to avoid it. We spent our first 37 weeks of pregnancy in the care of Rainy City Midwifery, but were forced to transfer to a hospital birth after I experienced a blood pressure spike in week 37 that put me into the hospital overnight.
During our stay at the UW Medical Center (during which pre-eclampsia was ruled out and my blood pressure remained perfect after the first hour), a resident OB, Dr. Emily Amarosa, offered to take over our care until delivery. Seeing little in the way of other options, we thanked her and started seeing her twice a week for blood pressure checks and for fetal monitoring. All went well at our first and second appointments, but at our third appointment, this past Thursday, the baby's heart rate took a rather alarming drop during one of my Braxton-Hicks contractions. It went right back up after the contraction was over, but they suddenly wanted to know a *lot* more about whether I frequently had Braxton Hicks that strong and lasting over five minutes. And, yes, I certainly did.
So off to the hospital for admission into labor and delivery we went.
Dr. Amarosa, to my shock and undying gratitude, found someone to cover her last appointment and drove us there in her car and personally took care of our admission. Once there, we were placed on continuous fetal monitoring that was, in the end, to remain in place until we delivered our son about sixty hours later.
After we had been there an hour or so, I had another very long contraction. Pretty soon, our nurse Kelly (almost as awesome as Dr. Amarosa, and would also be there for the delivery) came rushing in, checked some things, explained that the room was about to fill up with people, and hit the emergency button. I was almost immediately surrounded by five or six people administering oxygen, placing an IV, and turning me this way and that. By then, his heart rate had righted itself and the room slowly emptied leaving us feeling shaken and bewildered.
This happened twice more.
People gently explained to us the possibility of an emergency c-section should his heart rate not recover quickly, and what that process would look like for us. I would be put out and David would not be allowed to come into the operating room. All understandable ... but also my worst possible nightmare. I shed many tears that night imagining our beautiful son coming into the world with neither mommy nor daddy present to welcome him. And with neither of us there to keep an eye on what happened to him. *shudders*
By this point, it was hard for either David or I to take our eyes off the fetal monitoring, watching his heart rate, my positioning, and hoping to avoid another influx of doctors. Not a restful state of being!
Sometime around eleven PM, the night shift doctors came in to discuss what they had been seeing. They suggested that, over time, as they watched more and more questionable responses from our son, the likelihood of a C-Section increased. They respected that we wanted this to be a last resort, and suggested we begin an induction.
David and I both agreed.
My body was not at all primed for labor, so a foley bulb was placed to help prepare my cervix and to kick things off (by a very young resident who tried hard but had to take three prolonged tries at it to get it done). This was done about midnight, and we were told it would be removed at noon - and to try and get some rest. My mind, at this point, was much more on helping kick labor off than on resting, especially as the device seemed to quickly set into doing its work, giving me much stronger and more frequent contractions. We spent much of the evening stretching, moving around and preparing to have the baby the next day. Alas, that was wishful thinking.
Fast forward to noon the next day (Friday), and the foley bulb was removed. I was dialated to 3cm, and all was "very favorable" for induction. Pitocin was started right about 1PM. Because Little Pirate had been having trouble, the pitocin was ramped up very slowly. Contractions started about an hour later, and about fifteen minutes after that I had a super-long contraction that caused Little Pirate's heart rate to drop again. This was incredibly disheartening thirteen hours into the induction. The pitocin was stopped, we rested for an hour or so, and Dr. Amarosa came for a chat. She explained that pitocin contractions simply don't behave that way and that her strong hunch was that the contraction that he objected to was another one of my body's own over enthusiastic (and six-minute long) contractions. Getting my body into a good rhythm would stop them and likely stop his distress. Pitocin was started again, and some time later our favorite nurse Kelly was back on shift wondering with us whether we'd deliver on the 11th or 12th. Everyone was hoping a little that I'd hold out until Dr. Amarosa got back for her (30-hour!!!) shift that started at 9 Saturday morning. As it turned out, no-one had anything to worry about there.
By now, we had been up for two exhausting, emotional and bewildering days. I was in a place going into labor that was not at all what I had wanted or envisioned. And as we entered the wee hours of Saturday morning, I felt rather resigned that it was all for nothing and that we were just going to end up having our child surgically removed from my body and that I would never experience the powerful and mysterious life-giving wonder that I imagined was childbirth. David and I talked about all that and much more, and spent a fair bit of time that night walking the halls and trying to help encourage my body to ramp up the contractions. The pitocin was turned up and down as the night wore on, and although I had much stronger contractions, we were still nowhere near active labor. As night became morning, Kelly came by to introduce our day nurse and I cried when she left.
After a while Dr. Amarosa came back on shift and made her rounds, returning to spend some time really talking with us. We talked about my fears and David's. My worst case and David's. And I asked her, as she reviewed everything from the previous 36 hours or so, how she *really* felt about our little guy and going into labor. "Honestly", she said, "very encouraged." She carefully and thoroughly explained what she saw that made her feel good and reiterated the kinds of signs that would send us to the OR. For the first time in two days, I really started to believe that we might actually get to birth this baby. She checked my cervix for me, and found that I was at 4cm. This was a bit disheartening after more than 36 hours of on-again off-again and often uncomfortable early labor, but she indicated that this was very encouraging in that it meant that my body was now making cervix-changing contractions. Our super-cute day nurse got very excited and said that this is the point where things really started happening. She kept telling us "slow and steady wins the race too!" She was right.
Our birth experience was a powerful opportunity for growth, acceptance and personal transformation.
As many of you reading this will know, what we had wanted was an uncomplicated birth center birth attended by a midwife. I have a strong distrust of hospitals and of much of what modern medicine has to offer (especially where it relates to childbirth), and wanted nothing more than to avoid it. We spent our first 37 weeks of pregnancy in the care of Rainy City Midwifery, but were forced to transfer to a hospital birth after I experienced a blood pressure spike in week 37 that put me into the hospital overnight.
During our stay at the UW Medical Center (during which pre-eclampsia was ruled out and my blood pressure remained perfect after the first hour), a resident OB, Dr. Emily Amarosa, offered to take over our care until delivery. Seeing little in the way of other options, we thanked her and started seeing her twice a week for blood pressure checks and for fetal monitoring. All went well at our first and second appointments, but at our third appointment, this past Thursday, the baby's heart rate took a rather alarming drop during one of my Braxton-Hicks contractions. It went right back up after the contraction was over, but they suddenly wanted to know a *lot* more about whether I frequently had Braxton Hicks that strong and lasting over five minutes. And, yes, I certainly did.
So off to the hospital for admission into labor and delivery we went.
Dr. Amarosa, to my shock and undying gratitude, found someone to cover her last appointment and drove us there in her car and personally took care of our admission. Once there, we were placed on continuous fetal monitoring that was, in the end, to remain in place until we delivered our son about sixty hours later.
After we had been there an hour or so, I had another very long contraction. Pretty soon, our nurse Kelly (almost as awesome as Dr. Amarosa, and would also be there for the delivery) came rushing in, checked some things, explained that the room was about to fill up with people, and hit the emergency button. I was almost immediately surrounded by five or six people administering oxygen, placing an IV, and turning me this way and that. By then, his heart rate had righted itself and the room slowly emptied leaving us feeling shaken and bewildered.
This happened twice more.
People gently explained to us the possibility of an emergency c-section should his heart rate not recover quickly, and what that process would look like for us. I would be put out and David would not be allowed to come into the operating room. All understandable ... but also my worst possible nightmare. I shed many tears that night imagining our beautiful son coming into the world with neither mommy nor daddy present to welcome him. And with neither of us there to keep an eye on what happened to him. *shudders*
By this point, it was hard for either David or I to take our eyes off the fetal monitoring, watching his heart rate, my positioning, and hoping to avoid another influx of doctors. Not a restful state of being!
Sometime around eleven PM, the night shift doctors came in to discuss what they had been seeing. They suggested that, over time, as they watched more and more questionable responses from our son, the likelihood of a C-Section increased. They respected that we wanted this to be a last resort, and suggested we begin an induction.
David and I both agreed.
My body was not at all primed for labor, so a foley bulb was placed to help prepare my cervix and to kick things off (by a very young resident who tried hard but had to take three prolonged tries at it to get it done). This was done about midnight, and we were told it would be removed at noon - and to try and get some rest. My mind, at this point, was much more on helping kick labor off than on resting, especially as the device seemed to quickly set into doing its work, giving me much stronger and more frequent contractions. We spent much of the evening stretching, moving around and preparing to have the baby the next day. Alas, that was wishful thinking.
Fast forward to noon the next day (Friday), and the foley bulb was removed. I was dialated to 3cm, and all was "very favorable" for induction. Pitocin was started right about 1PM. Because Little Pirate had been having trouble, the pitocin was ramped up very slowly. Contractions started about an hour later, and about fifteen minutes after that I had a super-long contraction that caused Little Pirate's heart rate to drop again. This was incredibly disheartening thirteen hours into the induction. The pitocin was stopped, we rested for an hour or so, and Dr. Amarosa came for a chat. She explained that pitocin contractions simply don't behave that way and that her strong hunch was that the contraction that he objected to was another one of my body's own over enthusiastic (and six-minute long) contractions. Getting my body into a good rhythm would stop them and likely stop his distress. Pitocin was started again, and some time later our favorite nurse Kelly was back on shift wondering with us whether we'd deliver on the 11th or 12th. Everyone was hoping a little that I'd hold out until Dr. Amarosa got back for her (30-hour!!!) shift that started at 9 Saturday morning. As it turned out, no-one had anything to worry about there.
By now, we had been up for two exhausting, emotional and bewildering days. I was in a place going into labor that was not at all what I had wanted or envisioned. And as we entered the wee hours of Saturday morning, I felt rather resigned that it was all for nothing and that we were just going to end up having our child surgically removed from my body and that I would never experience the powerful and mysterious life-giving wonder that I imagined was childbirth. David and I talked about all that and much more, and spent a fair bit of time that night walking the halls and trying to help encourage my body to ramp up the contractions. The pitocin was turned up and down as the night wore on, and although I had much stronger contractions, we were still nowhere near active labor. As night became morning, Kelly came by to introduce our day nurse and I cried when she left.
After a while Dr. Amarosa came back on shift and made her rounds, returning to spend some time really talking with us. We talked about my fears and David's. My worst case and David's. And I asked her, as she reviewed everything from the previous 36 hours or so, how she *really* felt about our little guy and going into labor. "Honestly", she said, "very encouraged." She carefully and thoroughly explained what she saw that made her feel good and reiterated the kinds of signs that would send us to the OR. For the first time in two days, I really started to believe that we might actually get to birth this baby. She checked my cervix for me, and found that I was at 4cm. This was a bit disheartening after more than 36 hours of on-again off-again and often uncomfortable early labor, but she indicated that this was very encouraging in that it meant that my body was now making cervix-changing contractions. Our super-cute day nurse got very excited and said that this is the point where things really started happening. She kept telling us "slow and steady wins the race too!" She was right.