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Monthly Archives: December 2014

Birth Story: Naomi

Cesarean Section Birth

There is this nugget of not-so-feel-good wisdom my mom likes to drop on me occasionally which goes like this:

“They say, if you want to make God laugh, tell him your plans.”       – Unknown

Having a natural birth was something I didn’t have to give second thought to. Naturally, it felt like the right and most perfect thing to do for my baby and for my body. No drugs in. No painkillers. I imagined myself tuning in to my body’s commands, obeying them and birthing a beautiful baby at the end. With that being said I’d like to share my original birth plan, avenue I took to get there and additional thoughts. All of the following plans probably had God rolling on the floor laughing.

First, a quote: “Natural childbirth isn’t when you do nothing to prepare for the birth; on the contrary, it only happens when you do many things to prepare.” – Dawn Freeman

In preparation for having my first born I decided to take a 10-week childbirth education course with instructor, Chantal Wilford at Birthways in Sarasota. My mother was in attendance as well seeing how my husband was/is working outside of the country. My soon-to-be-mommy mind expanded to great proportions each week as I learned new and invaluable information, techniques and my rights as a future breastfeeding mom in America. While topics such as breastfeeding, co-sleeping, baby wearing and circumcision were all touched upon, I wouldn’t say this is where I benefited most. Topics that really grabbed me were those in pain management during labor, various birthing videos, making decisions (using your B.R.A.I.N.) in both emergency and non-emerg situations and topics that stressed becoming a more informed patient. I won’t cover 10-weeks of lessons here, but I do suggest moms wanting to have a natural birth take some kind of course if available.

Developing a birth plan was one assignment that proved most beneficial. Here is my exact original birth plan minus some of my personal deets:

  • Allergies to medications: NKA
  • Medical conditions / concerns: Hearing impaired. Please speak up and speak clearly if needed.
  • My support people are: Mother & Husband

I would like to be kept fully informed of my options and be involved in decision making. I am open to suggestions to help me have a safe, healthy baby with the least amount of invasive interventions. Let’s have fun and deliver this baby together!

While at Birthways, I’d like to have the flexibility to try for a water birth if best for baby and mom, but if needed to have the baby outside of the tub. Movement, music, aromatherapy, food & drink, low light are all welcome dependent on my mood. These are things I’d like to go with the flow on at the time of labor. Lastly, in addition to my support team, I’d like for Valerie Joy McClintock-Gipe (Photographer) to be on-site (if available) to photograph my birth story. On the quirky side: I have no desire to keep my placenta, but would like a photograph with me and this amazing organ for keepsakes.

  • If a cesarean is needed, my mother, husband and mid-wife are to remain with me and/or go with the baby.
  • I am aware of my options for pain medications and will ask if desired.
  • I’d like to be up and moving around as much as possible if desired.
  • I prefer to tear than have an episiotomy, unless there is an urgent situation requiring it.
  • I’d appreciate having the room as quiet as possible during the 2ndstage and birth.
  • If baby’s condition is stable I’d like the cord to stop pulsing before it is cut and to have skin-to-skin bonding right away with initial evaluation of baby done with the baby in my arms unless medically needed.
  • I plan to breastfeed and do not want any artificial nipples or formula given to the baby.
  • If the child is a boy, circumcision will be performed at a later date and location. (Note: My hubby and I were divided on the circumsicion issue for a boy even with my showing him all the materials I had from class. Having a girl saved me and the baby this time and I’m hoping to convince him otherwise for any future children.)
  • Vitamin K / Eye Ointment are requested after the baby is born while at the birth center or in the hospital.
  • Student / intern participation is fine, but should be kept to a minimum of one student. Their presence in the room to be re-negotiated if labor should slow down.

Unfortunately or fortunately this birth plan never came to fruition. Having cruised through a fairly low-key pregnancy my baby decided to shake things up a bit and turn at week 36. When I say turn, I mean she went breech, upside-down, a**-backwards, etc. Basically, she wasn’t in the most desirable position for labor and I’m pretty sure I know the exact night she turned on me – Saturday, November 5th.

Coincidentally, this action occurred the same day I had gone in for prenatal acupuncture treatments. The acupuncture was to help with spontaneous labor and with thinning the cervix and so forth. The treatment I received has never been known to turn babies breech and I do not blame the care provider. This type of treatment is practiced quite commonly in German hospitals and other parts of the globe outside of America. Again, it could be one strange coincidence.

In order to remedy the big turn the baby had made I visited a chiropractor to try the Webster technique 3x and I continued to work with the acupuncturist doing moxabustion treatments daily. Both of these techniques are said to have a 80-85% chance at turning the baby and I certainly did feel movements when they were performed. It just wasn’t enough movement to make the full flip. My midwife then recommended I see a OBGYN / specialist in performing external versions.

I met with him the week of Thanksgiving and after a review of my ultrasound the Doctor explained the likelihood of the baby turning. He said chances were slim, but that he could try. It was my job to go home that night and think it over. I felt like this was a test, like if I attempted the external version it would prove how stubborn I was and how much I wanted a natural birth. Given the risks involved with the procedure and that it would need to be done the day after Thanksgiving, I decided to pass and plan for a C-section.

Having my mind locked in on a planned C-section with spontaneous labor gave me the opportunity to try to make the best of things. Of course I needed to revamp my birth plan and here is how the new one went for the section:

Thank you for being a part of the birth of my baby. I appreciate your expertise and experience during this incredibly important day – the day I meet my baby. I would like to be kept fully informed of my options and be involved in decision making. Please remember I am hearing impaired and may need you to speak louder at times and/or repeat yourself a number of times. With that in mind, we (my mother and I) have a list of preferences that we would like respected whenever safely possible. Let’s deliver this baby together!

Environment

  • Please refer to us by our first names, Adrienne & Sharon.
  • Please refrain from having side conversations in the OR during the surgery.
  • We would like to play our choice of music during the surgery.
  • We would like Sharon to be with Adrienne during the surgery.
  • We would like either Sharon to be with Adrienne at all times before and after the surgery when necessary.

Surgery

  • We prefer not to schedule our cesarean but rather wait until Adrienne goes into labor naturally.
  • Please narrate the surgery.
  • Please lower the drape so we can see the baby as soon as possible.
  • We would like the cord to remain unclamped and for the placenta not to be removed and kept with the baby. Please put the baby skin to skin on Adrienne’s chest with the wrapped placenta. We would like the cord to be clamped and cut after it has stopped pulsating.
  • Sharon would like to cut the umbilical cord.
  • We’d like to delay newborn exam until after Adrienne and the baby have some skin-to-skin contact and time to bond.
  • We’d like to try to initiate breastfeeding while in the OR.
  • Please use a double-layer suture to repair the uterus.

Recovery

  • We’d like to avoid any separation of mother and baby and for the baby to be with Adrienne in the recovery room.
  • We’d like a private recovery room.
  • We’d like to be fully informed of the risks and benefits of pain management drugs.
  • I plan to breastfeed and do not want any artificial nipples or formula given to the baby.

Misc

  • If the baby is a boy, we do not want him circumcised at this time.

Again, thanks for being part of my special day. –Adrienne

I actually stumbled across a sample C-section birth plan from the local ICAN group here in Tampa and used their sample to guide my own.

[Note: there’s a Facebook group for ICAN of Sarasota too.]

Now that I’ve shared all my plans, let me tell you how it all went down and offer some unsolicited advice.

My water broke shortly after 1:00 AM the morning of Monday, November 28th. I had just gone to bed about a hour before after my usual Sunday evening routine. I had been camping in my mother’s room the last few nights in the event that I went into labor or started feeling funny (this was the final stretch) and woke her to let her know the water had broken. At least I thought it to have broken given the contents in the loo. My mother readied herself for the trip to the hospital as I was slowly gathering last minute items and meditating through contractions. We were at the hospital by 3:00 AM or so.

We checked in at Labor & Delivery, informed the nurses I was in labor and that my baby was breech. This basically meant: sound the alarm and let the Doc know a C-section is needed. One of nurses checked things out with another ultrasound and confirmed what we had stated. I was still feeling the contractions and I felt like water was leaking everywhere. It was not a pleasant feeling. They prepped me for the section, gave me the spinal tap and the Doctor came in shortly after. Before I knew it the baby was delivered. Bada-bang. Bada-boom. I had skipped ‘GO’ and collected my $200 or baby without the trouble of pushing, panting and doing it the natural way. As supremely bummed as I was the last couple weeks leading up to the C-section, I sure wasn’t bummed when they announced I’d had a baby girl.

I wanted to cry, but my eyes were so itchy from the anestesia that the tears didn’t fully form. Still a well of joy filled in my throat. I felt speechless, blessed and beyond words to see God’s latest work of art in my hands. Once I returned to my room for recovery I proceeded to breastfeed and bond with my baby girl skin-to-skin.

It wasn’t how I had imagined it, but things happen for a reason, plans change and it all works out in the end. Just go with it, be prepared, be flexible and and be happy with the outcome. This was the watered-down mantra I sorta said to myself. My advice to self for the next baby and for other moms who are open to it is the following:

  1. Don’t tell people your birth plans. Don’t get into discussions about natural vs. un-natural labor unless you are in a supportive and flexible environment of like-minded individuals. In the long-run the baby will ultimately decide how it wants to be born and no one needs the added pressure of trying to adhere to a plan that may no longer work for them or the scrutiny afterwards about why original plans didn’t stick.
  2. Be flexible. Be informed. Know your rights inside or outside of the hospital.
  3. Be happy.

Lastly, I went back and looked over my C-section birth plan. I didn’t get everything I wanted, but I had most of it. I’d say about 80% and most of the super important stuff at that. My mom did the best she could in helping to be my advocate, but I’d probably hire a doula for future labors and would recommend that as my final piece of advice. Husbands, parents, sisters and friends are all great support teams, but when your emotions are running as high as theirs it is sometimes better to have someone detached from all of that and focused on one thing – your health and your birth plan. A doula can’t make everything desired happen, but I will be looking for one next time for certain.

That’s my plan and I’m sticking to it.

Birth Story: Katherine Elizabeth

April 16th, 2012 Birth Center/Hospital Birth
Healthy Mom, Healthy Baby

The experience of a laboring mother, father and a grandmother at Sarasota Memorial Hospital

Brief Overview:

“You have your birth plan, I have mine. When yours does not agree with mine, we will go with mine,” Dr. Abu declared. We were at SMH for a 36 week pre-term delivery. My husband had to fight passionately against unnecessary medical interventions including pitocin before and after delivery, a continuous IV, episiotomy, and immediate cord clamping. The tension in the delivery room was so high that it was a miracle my labor did not stop altogether. We sacrificed a peaceful, joyful delivery for my health and the health of baby Katherine. With the exception of delayed cord clamping, we got the birth experience we wanted. Unfortunately, we had to fight tooth and nail.

My experience:

April 16th, 2012. 12:50 AM, 36 weeks gestation, my water broke. We knew before calling Birthways, the birthing center where we had planned to deliver our first child Katherine, that we were headed to Sarasota Memorial—Katherine was one week too eager to enter the world.

3:15 AM we were admitted to the hospital. Triage had confirmed Katherine was indeed on her way. Our midwife, now doula, Kaitlan waited outside as two nurses introduced consent forms and performed preliminary exams.

We wanted Kaitlan in the room as we waded through the decisions and paperwork. She had been through this process before, and as doula, would have been able to offer invaluable advice. We requested her presence three times. The fourth time, the nurses finally called her, but she never came. Labor and delivery turned her away, inconsiderate of the fact that she was our hired doula.

4:00 AM found me one centimeter dilated. By this point, I was overwhelmed with the sheer number of things vying for my attention—two nurses asking questions, the paperwork I was trying to read and the contractions just beginning to come. Kaitlan was still not present when Dr. Abu entered the room and we truly needed her input.

“You have your birth plan. I have mine. When your birth plan does not match mine, we will go with mine. You need a continuous IV, and because your labor is not strong enough, I am putting you on pitocin,” he commanded, leaving no room for discussion.

This was not the birth I wanted. I knew the effects of pitocin, and I knew that my situation did not yet merit such a drastic measure. My water had broken only three hours before, and my contractions had been increasing until the nurses and Dr. Abu entered the room. The stress of the current conversation was slowing labor. If time proved that my body was not acting as it should, I would have considered the drug as a means to prevent a C-section, but currently, it was an unnecessary measure whose consequences for baby and I far outweighed the benefits.

Neither did I want a continuous IV. If getting my labor going was a concern, I wanted to use natural methods, namely walking and nipple stimulation. A continuous IV would limit my movement and therefore limit my progression.

If dehydration was the doctor’s reasoning for the IV, the doctor did not take the time to ask about my liquid consumption. I had drunk more than a liter and a half since my water had broken, and I was continuing to drink.

“Give us four to six hours to get labor going. Then we can consider the pitocin,” my husband and I countered. We did not agree to the IV.

“I’ll give you two,” he responded brashly and then tried to motivate us with fear. “Your water broke at 36 weeks. There’s probably something wrong. You may have an infection.”

I broke into tears shortly after his departure, not because I was afraid there was something wrong with my body, but because the doctor was threatening to take what I had spent eight months preparing for with excellent nutrition, water intake and research. I wanted a natural delivery. I knew the pitfalls of the drugs and interventions the doctor was so adamantly pushing.

The nurse began to prepare the IV. “We didn’t agree to the IV,” my husband looked at me. I was willing to take it, but he knew how important my freedom of movement was. We asked the nurses for a few minutes alone. Kaitlan was still not present. Knowing her knowledge and experience would bring peace to the situation, he called her directly rather than ask the nurses, and then he left the room to find her.

Make peace Kaitlan did when she came into the room. “You could come to a compromise. Ask to be connected to the IV for twenty minutes to receive the antibiotic for Group B Strep. Then ask to be removed to allow movement.” The hep-lock we had requested would make this possible.

The nurses agreed to our suggestion and allowed us time to walk the halls. Walking and stimulating my nipples, labor progressed rapidly. Contractions came closer together and stronger. When the nurses asked us to return to the room for the IV, I was satisfied.

6:00 AM. By the agreed-upon time, I was in active labor. The contractions required my full attention, and I was more than moaning in pain. The nurse checked me. I was three and a half centimeters dilated. There was no more mention of pitocin until the baby was crowning.

I am grateful we fought against pitocin. Had I accepted it, my contractions would likely have been too strong to manage. I would have required other interventions.

As labor became more intense, time blurred. The nurse allowed me on a birth ball for a short time before requiring me to lie in bed, once again attached to the fetal monitor. I respected their desire to keep tabs on Katherine’s health, and the nurse said she would detach me after ten minutes.

Ten minutes never came. The monitors would not stay attached long enough to acquire ten full minutes of data. Except for bathroom breaks, I was attached to the monitor and confined to bed for the duration of labor. Thankfully, the nurses were gracious about allowing my movement within the bed.

9:00 AM. I had dilated quickly. Sitting on the toilet, I suddenly felt the urge to push. The nurse rushed me back to bed and confirmed what I already knew. I was at ten centimeters.

“Don’t push!” the nurse directed as she left the room.

Don’t push?’ I thought. ‘There’s no way!” I pushed anyway.

The nurse returned shortly and directed my pushing. Her counting was very helpful, and before long, to my surprise, the nurse called for the doctor. Katherine was close.

As Katherine was crowning, Dr. Abu held up the scissors to perform an episiotomy. “I’m going to cut her,” he announced without asking permission.

“You will not cut her,” my husband responded.

Dr. Abu was aggressive, “I’m going to cut her. I need to do it now.” The discussion turned into a full-on quarrel, and the atmosphere in the room was so intense that my mother could no longer stand. Gone was the hope of a peaceful delivery, overrun by the fight for a “Healthy Mom, Healthy Baby.” Incredibly, I was still able to focus, and the war raging around me did not affect my ability to deliver Katherine.

“Everyone be quiet,” I groaned, “ I need to push!

The room quieted temporarily before the volume rose again. “Ask her,” my mother practically yelled.

All eyes turned to me, and between pushes, I made my wishes known. “No! Do not cut me. I’ve done my research.”

“This is not about research,” Dr. Abu negated my hours of study, “This is about what needs to be done.” He and my husband went at it again.

“I would rather tear than be cut,” I interrupted. I repeated myself to make sure I was heard, “I would rather tear than be cut!” I knew Abu heard me, but whether he would comply was another matter. My care was in someone else’s hands, and I was incapable of protecting myself. In the end, Dr. Abu did not perform the episiotomy.

Next came the dispute over cord clamping. The blood in an umbilical cord is the baby’s blood, and research shows that babies fare better when the cord is allowed to stop pulsating before it is clamped. My husband requested multiple times that Dr. Abu refrain from clamping until Katherine had received its blood. Abu refused and clamped the cord immediately, insisting he needed the cord blood to do tests because of her pre-term delivery. I cannot fathom that medical testing outweighs the overall health of my infant. We would have been pleased to have her blood drawn after her cord had finished pulsating. Instead, Abu disregarded our wishes.

I was very pleased that Dr. Abu placed Katherine directly on my chest after delivery. This was one of my greatest desires, and he made it happen.

After delivery, he once again tried to put me on pitocin. “She needs pitocin. Her platelet count is low. She may bleed out if we don’t.” My body, at that time, was showing no signs of hemorrhage. We understood the doctor’s concern, but stood firm against the force of his words. “Give us an hour. If I start bleeding, then administer the pitocin.”

I never hemorrhaged. My platelet count began to rise within 48 hours. The nurses in recovery were surprised at how high the other aspects of my blood count were compared to the norm they encountered in the hospital. Now, only a week after delivery, my bleeding has practically stopped. The pitocin was once again an unnecessary fear-based measure.

We did not need any of the medical interventions Dr. Abu so aggressively pushed. With natural means, labor progressed more than twice as fast as the average of over 20 hours for first-time Moms. Katherine was in my arms nine hours after my water broke. If I had accepted the pitocin, the contractions would have been too strong, and I would have required additional interventions. I did not need the continuous IV to ward off dehydration nor the pitocin to prevent hemorrhage.

Katherine required no interventions after birth except the suctioning of mucus from her airways. With a little coaching from our nurses in recovery, who were fantastic at what they did, we are breastfeeding eight times a day, and a week after delivery, she is only one ounce shy from her birth weight. Her pediatrician at her one week check-up declared her lungs, heart, weight and color excellent.

I am grateful that my husband fought for my health and the health of my baby. I am grateful for the natural childbirth we had as a result of his strength. We did not have pitocin. I was not connected to a continuous IV. I did not have an episiotomy.

“Healthy Mom, Healthy Baby.” Though Sarasota Memorial’s labor and delivery team touts this as their end, I would invite them to reconsider their means. A woman’s body knows how to give birth and in most cases, does it naturally.

Birth Story: Elijah

August 18th, 2011 Birth Center Water Birth
A Mother’s Birth Story of her Second Son

I was driving to work on my last day of work. It was two weeks before the baby’s due date. I felt a few contractions on my way to work but they stopped when I got to work. I got off work thrilled that I had two weeks to relax, clean and prepare for the new baby. At least I thought so, but the baby had other plans.

I got home at about 7:30pm and, like any other pregnant woman, went to the bathroom again for the millionth time that day. While in the bathroom, I noticed that I started spotting and knew that the baby will come sooner than I planned. I went to pack my bag with the baby clothes and few items that I needed. I called my midwife and told her that I was spotting so that she would be prepared to wake up at night if I went into labor. I went up to go shower and prepare a few more things while I told my husband to prepare some snacks and call the babysitter for my older son.

Right after I got out of the shower, my water broke and started leaking out. It was at about 11:45 pm and at first I was not sure if it was my water but when the contractions started coming quickly after that and strong, I knew that I was right. After my first contraction, the next one came in ten minutes. The one after that in seven minutes. After that they were coming every 3-5 minutes and getting stronger and more intense with each contraction. I told my husband to call the babysitter and get them to come over ASAP and to call the midwife again. I was lying down most of the time on my side. I still felt like I needed to pee every 5 minutes and was irritated by it but went anyway. I was even more irritated every time I went because I would get a contraction on my way to the bathroom, a contraction while I peed and then another contraction on my way back to the bed or couch. So in other words, if I moved, my contractions came every 30 seconds to a minute and if I was lying down, they would come every 3 to 5 minutes. When the baby sitter came, we left right away to the birth center knowing that the baby was going to make me work extra hard after working all day and didn’t want to wait. So much for relaxing for two weeks, I thought.

2 We got to the birth center at 2:30am and by then I was moaning to get through every contraction. Before I was in labor, I told my husband that I wanted him to massage me and showed him a list of things that I wanted but once I started labor, all I needed was him to hold my hand. If he tried to massage me, I could not concentate on relaxing during the contractions and felt worse in the process. I told him that he can squeeze my hand and nothing more. Once I was in the birth center at 2:30am, the midwife checked me and said that I was 8+ cm dilated and that I can get in the tub. I thought that when I was in the tub that I would feel better but because my labor was progressing so quickly, I was in just as much pain and it kept getting worse.

My other midwife came to help with the delivery and within minutes told me that I can take my bottoms off. I asked her if she really thought that the baby would come that quickly and she said that the baby could come in the next contraction. I was like WHAT!! I just started my labor! I am so not ready for this!

She was not joking. Within the next few contractions, that were now coming every minute, I felt the baby start crowning. When I had my first son, I was cut and then I tore 3rd degree. It took 45 minutes to stitch me back and it took months for me to start feeling normal again. My biggest fear with my second was that I did not want a tear. I expressed this fear to my midwife during my prenatal visits and she told me that when the baby is crowning it will be intense and it is 3called the ring of fire because it really feels like it. She also told me that if I feel it, it’s a good sign and that it means I did not tear yet. If I don’t feel it, it means I had a tear. SO, when I felt the baby crown and I felt the ring of fire, I was telling myself that it’s a good thing, I did not tear. I just kept repeating it in my head during the pushing phase till he was born. My midwives kept reminding me to breathe. I knew that with him coming so fast that I should not push hard like they say in the hospitals. I knew that the faster he came out, the higher my chance of getting a tear was. May I say that it was hard not to push hard because all my body wanted to do was push as hard as I can.

I gave birth to my second son at 3:24am in the water and my husband got to catch him. He was a small 6 pounds 6 ounces and only 19.5 inches long. He was born two weeks before my birthday. He was not breathing and his heart rate was in the 50s, my midwife later informed me. The midwives stayed so calm and started giving him oxygen and rubbing him to get him crying. He did and is now the healthiest baby ever.

And guess what, I did not tear. I did get a skid mark because he came out so fast but it healed on its own and it did not need stitches. Boy, was I thrilled. And my blessing was that my labor started at 11:45 pm and I had him at 3:24 am the next morning! The labour was less than 4 hours! I did not relax for two weeks but I did have a very good experience at the birth center with my birth. I had all the privacy that I needed and great midwives. Big brother was excited for his new brother and runs to him first thing every morning. Thanks to my wonderful midwives, Christina and Kristin, at Birthways for making my experience wonderful! And thanks, Chantal, for helping us be prepared!

Happy Parents

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