Friday, July 31, 2009

Brynna's Birth Story

My birth story was written to post to a listserv of other hypno-moms, so it sometimes uses different, non-medical language: “birthing time” instead of “labor,” “pressure wave” instead of “contraction,” and so on.

Brynna was due on August 4, but I expected her to be late, like many first babies. (Only 5% of babies are born on their due date.) I even had clinic rotations scheduled through the following week, so I wouldn’t be sitting at home, burning up maternity leave, waiting for her to arrive. But at 2 AM on July 30th (the time of day, if not the date, being what I had visualized in my practice sessions), I woke up to a pressure wave. Then I had another one 10 or 15 minutes later. I was pretty sure that this was it—they felt a lot like menstrual cramps, totally different from the mild Braxton-Hicks that I’d have to be touching my belly to notice. I put on one of my hypno CDs and dozed off again. At some point, I told Alex that I thought things were getting rolling, and he (mellow soul that he is) said “yup, OK” and then carried on sleeping. Around 6 AM, still having waves every 10 minutes or so, I called my parents, 1200 miles away in Connecticut, and told them that it was time to start driving in our direction so they could meet their first grandchild.

Then I headed out to our sunny front porch, where I leaned forward over some pillows (leaning forward encourages proper baby positioning) and alternately read a book and listened to my CDs. I was amazed at how completely calm and confident I felt. After Alex got up, we both emailed in to work to let them know that this was the day and not to expect us, then just relaxed around the house. I also took a shower and shaved my legs, figuring it might be a few days before I’d have a chance to do that again!

We'd also meant to take some "belly photos" before the crumpet arrived, so Alex snapped a few in the yoga room. It's hard to believe that I was ever this enormous!

I remember Alex looking at the camera after he took this one, saying "you'll probably never want to show this one to anyone!" But here are Brynna and I in all our glory:

Mid-morning, we decided to make cookies to bring to the L&D nurses, and Alex had to run out to the store because we didn’t have all the ingredients on hand—we’d been planning to make our final preparations that coming weekend. I helped with the cookies, pausing to lean over the table and relax through each contraction.

We also finally picked the crumpet’s name, which we also thought we would have more time to do! (We were down to two, we just had to choose.) All morning, I was careful to keep taking sips of water and eating snacks to keep my energy high.

The pressure waves were slowly getting closer together. Sometimes I walked around in between, then paused to lean over the table during a wave. Other times I sat and bounced on my exercise ball, then leaned forward onto the arm of the couch during a wave. I eventually asked Alex to start cueing me with each one, and it was very helpful to have that hands-on support. I stayed very calm and comfortable, the cues working very well to help me relax with each wave. A couple of times I used my stethoscope to check Brynna’s heartbeat right after a contraction, and she was always trucking right along.

Mid-afternoon, I began to get a bit impatient! It had been twelve hours, and though things were progressing, I had sort of hoped to be holding a baby at that point. I checked my cervix and thought I was at about 5 cm dilated and very effaced—it just felt like a big rubber band. Alex and I lay down to try and take a rest, since I had been sitting and standing and walking a lot to encourage progress. However, it was hard to get comfortable, so we got back up pretty quickly.

I was hoping to get to the hospital, which was only a few minutes from our house, at 8 or 9 cm dilated—essentially ready to push. One of the midwives had told me that if this was my goal, we should come when the contractions were two minutes apart for an hour. As my waves got more intense, however, I started worrying a bit about how I was going to get from the parking garage to the hospital door. I didn’t want Alex to just drop me off at the door and go park, because I was relying on him a lot for the cues. So around 5:00, with waves coming every two minutes, we made our transition to the car. I did have three waves on the way from the car across the street to the hospital, and luckily there was some handy scaffolding to lean onto.

(No more pictures now until after Brynna arrives—remember, we're the people who didn't even have photos during our wedding. I sure as heck didn't want photos of Brynna being born!)

A very nice nurse helped me get settled in a triage bed, let me know that the midwife was on her way (she had been out jogging), and specifically said that she was going to step out and read over our birth plan, which was really encouraging. It took about half an hour to meet with the midwife (the only one we hadn’t met during prenatal care, oddly enough), get a 20 minute fetal monitoring strip (all was well), and have a cervical check: 7 cm. The midwife also made a point of taking a few minutes to review our birth plan and then letting us know that she was completely on board. She and the nurse stopped talking to me during pressure waves so that Alex and I could do our thing, and they were very admiring of how we were working together and how relaxed I was.

We then moved to one of the actual birthing rooms. Over the next couple of hours, I continued to use a birthing ball and then we spent some time in the shower, which felt very nice. The nurse and midwife were in and out, and the nurse made the intermittent fetal monitoring very unobtrusive—she caught me when I was sitting down on my birth ball anyway, and never asked me to change position or stay still.

While in the shower, I started to feel a little bit different with my waves, almost “pushy.” (Though in hind-sight, nowhere near as pushy as I would feel later!) I let the midwife know, and she checked me and said that my cervix was almost completely open, with just a little lip, and that I could go ahead and start pushing with each wave if I wanted to. I started feeling nervous at this point because of the unknown...I didn’t really know how to push, wasn’t sure if I was really ready to start, and was also getting tired both physically and mentally! I tried to remind myself that I would figure it out and to try and stay calm. Intellectually, I knew that this transition time is famous for causing a lot of out-of-control, scared feelings (and often vomiting—though thankfully I avoided that!). The midwife and nurse were very reassuring when I shared my fears, reminding me that they were there to help and that I would be fine.

I had planned to push leaning forward, so I asked the nurse to get the bar for the bed, and then started to do some tentative pushing with each contraction. It took me awhile to get organized, and it didn’t feel quite right. The midwife encouraged me to conserve my energy a bit by leaning back on the bed, with my upper body quite elevated, rather than squatting fully upright. This did not feel right to my body either, but I took her advice. She checked my cervix again and said that my bag of waters was bulging and would break very soon, or she could do it now, which would probably take care of the posterior lip of cervix and make me officially “complete.” I gave a few more pushes without my water breaking, and since I was starting to feel quite tired and ready to move on to the next stage, I told her to go ahead and do it herself. Unfortunately, in my case, this didn’t make the little lip of cervix go away. After feeling quite comfortable through my labor up to this point, I was now feeling some discomfort but it was very controllable.

I was very definitely feeling pushy, so taking a break was not an option. The midwife then tried to hold the lip of cervix back while I pushed. That was very, very painful. I tried to use my Hypnobabies techniques, but nothing seemed to work. I’m not sure if this was because I had lost some focus being tired or because a foreign element had been introduced into the system. Finally, the midwife recommended turning onto my hands and knees and trying not to push for about 20 minutes, to see if my body could take care of the last little bit of cervix on its own. This was very difficult, as I was feeling really powerful urges to push. I was also feeling quite discombobulated, and would definitely have benefited from some strong coaching to guide me back into really good hypnosis. Unfortunately, Alex was understandably thrown by seeing me in pain over the last half hour or hour, and so neither of us really thought of that. (This is where a doula, or birth attendant, would have come in very handy.) We did know that B’s heartbeat was doing great throughout this entire period, so there was no thought of needing any intervention other than waiting it out. The midwife assured me that the baby would indeed come out eventually!

Once I waited out the 20 minutes, the midwife checked again. Complete! Hurray! But…now Brynna’s head had rotated slightly to a less favorable position for descent. I wanted to cry. If they had offered me a C-section in that moment, I would have been tempted! This led to some further pain as the midwife reached in and rotated her back to the proper position. Yikes. In hindsight, I really wonder if I had been more patient, not had her break my water, just waited longer, if I could have avoided all of this. Agreeing to lie back on the bed, which went against my instincts, could have played a role, as well.

Finally, I was complete, B was in the right position, and we were ready to go. At this point, pushing felt really good because I was DOING something. I was on my back at this point, head of the bed still quite elevated, and Alex and the nurse each helping to hold a leg up. That wasn’t at all the position that I had planned on, but it actually felt OK, and I started to make some progress moving Brynna down right away.

After about half an hour—it was about 11:30 PM at this point—I asked the midwife if she thought I would have the baby anytime soon. She asked me what I meant by “soon,” and I said in the next hour or so, and that if she thought it was going to go on for many hours, to please tell me so I could mentally prepare myself! I was definitely tired, and pushing was quite a lot of work. She said she couldn’t guarantee, but that she thought Brynna would come around midnight.

I did watch myself push in a mirror a few times, and eventually reached down and touched Brynna’s head as she was coming down, which was very encouraging! Finally, the midwife turned away briefly to put on her gloves, and the nurse reached over to unsnap my gown so that Brynna could go directly on my skin. I got a last burst of energy, knowing that it was almost time to meet her. A couple of pushes later—and just over 22 hours from my first contraction—Brynna made her entrance. Her head delivering was a super intense sensation, and then there was a similar feeling with the next push as her body followed on out. Then Brynna, screaming her head off, arrived on my chest. It was a good thing I had stopped looking in the mirror a few minutes before, as she had “terminal meconium” (pooped as she was coming out), and it was apparently a giant mess. The midwife had been just about right, it was 12:08.

I tried to soothe her and to relax myself, which was really tough, as I was exhausted and a bit overwhelmed at finally meeting this new little person. The nurse checked Brynna out quickly while she was snuggled up with me, though it was clear from the yelling that she was having no trouble breathing whatsoever! Although she was a little blue when she first arrived, as are all babies, her excellent lung function pinked her up very quickly. After a few minutes, I was surprised to realize that the umbilical cord was still attached—the midwives apparently wait a little while to cut it. (I had done some research and seen benefits and risks for both immediate cutting and waiting, and had decided that I didn’t have a strong preference and we'd just see how things went in the moment.)

Then there was a quietly efficient bustle from the midwife and nurse, who said very calmly that I was losing a little more blood than they would like. Alex cut the cord, and then the midwife started “massaging” my belly to encourage the uterus to clamp down. I was really shocked at how painful this was—no one on my OB rotations had told me that this could hurt, and when I had done it myself, the women had had epidurals and they had never mentioned it being painful. It was pretty awful for me, though! Since I hadn’t expected it to be a problem, I hadn’t had a chance to relax or use a technique to get back into my hypno-anesthesia, either. Coping with that made it hard for me to attend to Brynna, though I understood why they were doing it with some urgency.

It was during this bit of controlled chaos that two of the other L&D nurses came in with little plates of cake. As it turns out, our wonderful nurse, who had been expertly attending to us this whole time, was celebrating as well. She and Brynna have the same birthday by a whole 8 minutes!

The cake was placed on hold, but after a few minutes and a shot of pitocin in my thigh, all was once again well. The midwife and nurse quickly tidied me up. I didn’t need any stitches, yay! (Won’t go into details here, but would be happy to discuss with those who are interested what we did before and during labor to help prevent tears.)

The nurse helped us try breastfeeding, though Brynna was a bit snoozy and uncoordinated. She stayed skin-to-skin with me for a couple of hours, and we had some time just the three of us, before we decided that it was a good time for weighing and measuring. Though Brynna did not agree:

She was BIG! 8 lbs, 8 1/2 oz, in fact. This was a big surprise, as Alex and I were both sub-7 lb babies, and I had not gained too much weight or had gestational diabetes or anything. Our theory is that it was the strawberry shortcake I was eating every night for the last few weeks of pregnancy!

Around this time, Alex started making calls to the anxious grandparents. My folks, who had been driving since that morning, pushed on only a little farther, into Wisconsin, which shows both how quickly they were moving and what a long day it had been for everyone.

When we arrived on the postpartum floor a little while later, I started to wonder where Brynna would sleep. If she stayed in her bassinet, how would I get to her quickly when she cried in the night? Alex had to run home and let Jasper out and get a bit of sleep himself, so he wouldn’t be there to help. The nurse solved that problem by tucking Brynna down inside my hospital gown to sleep. Waking up the next morning, with a slumbering baby on my chest, was really my first “mommy moment.”

My recovery was amazing. When I had visualized our birth, I had thought about walking Brynna home from the hospital, and that is what we did after about a day and a half, once we felt that she was getting the hang of breastfeeding. The nurses were very concerned that I would fall over or pass out on the way home, but we were politely insistent that it would be fine. We took Brynna to the hospital door in her car seat, per institutional policy (which makes all kinds of public health sense, I’m not arguing with that), then switched her into her infant carrier and wandered on home.

I went right back to walking a mile or two a day, and started running again two weeks postpartum. I felt like Superwoman—incredibly powerful, like I could do anything. I still feel that way when I think about Brynna’s birth.

I am really excited about how well Hypnobabies worked. I was comfortable, calm, and collected for the vast majority of my labor. The only parts I would really call “painful” were the bits that involved the midwife maneuvering things around with my cervix and Brynna’s head, and then the uterine “massage” afterward. (Interestingly, over the last year I have forgotten just how painful those things were. Alex has not.) I will definitely use Hypnobabies again if we decide to have another baby!

Though right now, we have our hands quite full with just the one.

Happy birthday, Little B! We can’t wait to see what you’ll do next!


Beth said...

What a treat to read this story and look back to one year ago! I will never forget standing in the midst of the GIANT Exhibit Hall at the AAFP National Conference, getting the voicemail from Hilary ("the Crumpet decided not to wait for you") and then, of course, calling to get more details as I stood by the window looking at the ridiculously hot Kansas City day outside!
My heart is so sad to not play with Brynna on her big day, but please know my heart is with you all as you celebrate her big day! She has a little something coming in the mail, but (you know me) it's going to be late...and I'm still hoping her (very) early birthday sweater will still fit her when the weather is cooler!
Missing the 4 of you TONS!!!

Martha said...

Happy Birthday B! You are one very loved little girl! I'm so proud of all your accomplishments so far and look forward to what tomorrow brings!

and of course to the proud parents, congrats on such a wonderful baby girl! =)

Kate said...

I got one of those middle-of-the-night calls too :) Later that day, the NY part of the family happened to be together and we were all overjoyed that our niece/granddaughter had finally arrived!

See you all soon...

Allison and Jared said...

Great story! And I super love that you were making cookies while in labor.. my kind of girl :)

Miss you!!