Wednesday, April 18, 2012

Worth It

Before I start to tell this story, I feel it imperative that I make one thing abundantly clear: I am passionately for natural childbirth, as our bodies are made and able to do.

I had a perfect little hippy scenario in mind for my own birth, cautious - mind you, and aware that pain would be a big part of it (or, "hard work", as I would try to remind myself), but daydreamy nonetheless.

Though I compromised the home birth I truly longed for because I am uncomfortable with North Carolina's laws regarding midwife choices for that kind of birth experience (and I'm just plain old not brave enough for an unassisted childbirth), I was happy to go with the next best thing: a birthing center with a rock awesome midwife in South Carolina.

My day dreams didn't change much as a result.  My best friend would be there to doula for me and help talk me through the pain hard work. My husband would be there supporting and getting all excited with me, reminding me that it wouldn't be long before we could hold our little guy. We could have birth projects to do so I could keep up and moving and distracted during the beginning stages of labor, and in the end, I would hop in a birthing tub for a water birth. There would be immediate skin to skin contact and establishment of a breastfeeding relationship. They would wait until the cord stopped pulsing to cut it and do the APGAR stuff with my kiddo still in my arms.

In my fuzzy picturings, there may or may not have also been crock pots, paint, henna, and favorite TV shows that my doula friend and I could have either utilized or ignored depending on what labor actually turned out to be like. There was definitely a carefully selected musical playlist.

These musings stayed with me until I hit 37 weeks and discovered my little one was breech.

Well okay. No big deal. Babies are born breech all the time.

Oh, but in SC (and certainly NC) it is illegal for a midwife or doctor to deliver a breech baby unless the mother had already had a kid before. Bother that.

So my midwife scheduled for me this thing called an external version.

I had no idea what that was or what I was in for.

The doctor that consulted with us about it told me that it would be uncomfortable, but overall no big deal. Also that there was a less than 1% chance that I would have to have an emergency c-section, but that even though they did external versions many times a week, they hadn't had anyone go to emergency c-section over it in over 8 years.

That risk seemed minimal enough to me. And given that supposedly only 2% of breech babies turn head down past 37 weeks... I was all determined to have my natural birth, by golly, so I signed all the necessary and dreadful things to sign (Except where they wanted to chuck my placenta afterwards. I may have actually exclaimed, "No, I want my placenta! You may not throw it away!", much to the bewilderment of the man with the paperwork in front of me) and went for it.

I'll spare you all the boring details about how long I went without eating or drinking and how hospital gowns that aren't yet snapped up are really flippin' confusing thankyouverymuch, and how much I dislike IVs.

The ob who came in to do the version reminded me of my dad if my dad was a doctor. That is to say, he was loud and burly, a little too informative, and extremely excited about the mechanics of what he was about to get to do. When I stated that I had been told I had an abundance of amniotic fluid in there, his eyes widened with glee.

Okay, so, I know you're wondering what an external version turned out to be. I'll tell you. First of all: "mildly uncomfortable" my skinny white girl booty. You don't get offered an epidural for mild discomfort. You don't get told that most women can't relax their muscles enough for the version to work without an epidural for mild discomfort.

To flip a baby from the outside, an ob (while monitoring the child via ultrasound) locates the kiddo's head and bottom and then literally crams his fists into one's pregnant belly and draaaaags the babe around.

"Mild discomfort". Snort.

I opted to try it without an epidural. Recovery time and drugs in my body and all that. I was able to call on imagery that my doula best friend gave me to use for childbirth. I intentionally kept my breathing normal and tried my best to locate tense muscles and release them while picturing my little boy in an unpoppable bubble and turning easily.

The first three times the ob tried, it didn't work. And the third time, they came within a breath of sending me into an emergency c-section.

He was telling me what to expect. Prepping me, as he watched my little one's heart beat drop. Total anesthesia. A breathing tube. Blackout.

I knew that my stress would not help my baby's heart rate come back up, so I tried to courage up.

"Fine, God!" I shouted silently, "But don't You abandon me! Fix this!"

It is a good thing Abba still loves me when I'm anguished, angry, and demanding.

Peace. The ob froze. Thinking. Watching.

The heart beat on the monitor started to come back up.

The ob made a lighthearted comment and rubbed where he saw my child's head was and the heart rate came up even more. He chuckled, "Oh, he likes that.", and did it some more until everything was back to healthy and normal.

We waited a few minutes and he said he thought it would be reasonable to try one more time.

So I, with the help of endorphins unleashed to compensate for all that pain and fear, breathed, relaxed, and buckled down to try one last time.

It worked on that last try. My little one flipped. I would have high-fived him if he'd already been on the outside with us.

As far as we know, he stayed head down for the next week and a half or so. My midwife had a hunch it wouldn't stay that way forever, though, so she made a strong recommendation that we try a natural induction. She promised that if my body and my baby weren't ready, it wouldn't work, but felt confident that it was worth a try.

This was hard for me because I believe in babies baking until their little lungs develop enough to let loose proteins that tell the preggo body that it's go-time. But being reassured that if it wasn't time, it wouldn't work, and it was more like encouraging labor than a true induction I decided to call my best friend and get to work.

The process I went through with this involved lots of swallowing a horrific tasting herbal tincture, and running on my elliptical while breast pumping for 3 straight hours. (And now you have that mental image in your head. Have fun trying to get rid of it. Maniacal laughter.)

It didn't work.

When I hit 39 weeks and 5 days, my midwife's nurse practitioner sent me off to another ultrasound because she couldn't tell for sure if he was breech again or not.

Yeah, he was breech again. This time he was footling breech. Which is basically the worst kind of breech you can be. I would have to be some kind of hardcore fearless rockstar to choose to naturally birth a child who was footling breech. Footling means he had one foot down in the birth canal. If he came out that way, we would have to try to stuff that foot back up in there and hope for the best. And it could still end very badly.

There was also some bothering about abdominal measurements on the ultrasound. But that was tiresome and not worth talking about, really. I thought it was probably bunk (Hello, full term baby all balled up in there and they're trying to get accurate measurements on a blurry ultrasound? Psh.), and once he was out here it was confirmed that it was bunk. Whatevs, medical culture.

So I was told that I had a few choices. I could either try another external version which would be followed immediately by a real medical induction (Ah. The spastic, violent contractions brought on by pitocin. Awesome.) in a hospital (Sigh. Goodbye hippie birthing-center birth.) if it worked. Or I could go ahead and just have a planned c-section.

Of course I could choose to just wait and hope for the best. That maybe by some freak chance my kiddo would flip head down on his own. I know this happens. It's not unheard of. But deep in my gut I just didn't believe that would be the case for me and my child. And if I went into labor while footling breech, I would again be staring down the barrel of an emergency c-section.

The last time I tried a version, it came so close to ending in emergency c-section. And this time, the risks would be even higher. A bigger baby is harder to turn, and more likely to get tangled in his umbilical cord, which would be very dangerous. A footling breech baby would be much harder to turn than a frank breech baby (which is what he was last time - with his feet up over his head).

I told the ob that I would like to talk to my midwife, get a referral to Mission - a hospital that was closer to my home (and that I trusted more, but I wasn't going to tell him that), and then I would make a decision.

By the time I got to Mission, I was exhausted beyond all reason. What with all the waking up early, the hearing of bad news and coming to terms with it, the making big decisions quickly, and the barely eating all day.

Around 7:30pm an ob came in to speak with me.

I was expecting another hyper, burly man like the guy at Spartanburg Hospital, and was relieved when a lady came in who moved and spoke in very similar ways to one of my most precious friends. She sat with me and explained everything clearly and with compassion and understanding.

When she started to explain what I should expect when going through a c-section (new baby going straight to the warmer to have all the fluid that would have normally been squeezed out of his lungs on the way out of the birth canal beaten out instead, cord cut immediately so they could get straight to stitching me back up, etc) I started tearing up.

She squeezed my knee and stopped to offer validation that it is hard to make a choice like this, and that this isn't how it was supposed to go.

A little validation goes a long way with me. It meant the world to me that the person explaining my choices to me understood the gravity of them. That she understood how many ideals I would have to let go of no matter which way I turned at this point.

In the end, it became clear to me that my real choices were pretty much between a planned cesarean and an emergency one.

There is, as it turns out, a significant difference between the two. The biggest being, for me, that for an emergency c-section, they knock you out completely, as opposed to a planned one in which they just numb you from the ribs down.

It was desperately important to me that I at the very least be present for my wee lad.

So I surrendered to a planned cesarean birth. I couldn't believe it, but that's what was happening.

Joseph handed me my phone to call my best friend when the nurse left to gather surgery-prep supplies. I told him it was wildly necessary that he see our child be born, even as intense as it would be. Because I couldn't see, with that divider up and all, and even if this wasn't happening how we hoped, it was still our baby's birthday!

He told me that he couldn't watch them cut me open. That he would pass out. Not because it's gross, but because it was me.

My best friend asked to speak with him, so I handed over the phone.

She told him to just ask the Dr to tell him when they were gonna pull the kid out and only watch that.

Hospital gown. IV fluids. Paperwork.

The ob I had spoken with promised me she would find something to put my placenta in to take it home with me so we could encapsulate it.

I am still not entirely convinced that the team that did the actual surgery were people and not angels.

The ... I guess she was the anesthesiologist's nurse? Anyway, she had a Wizard of Oz print on her scrub cap. This was significant to me because a dear friend of mine's name is Kansas for Wizard of Oz-ly reasons.

These people kept reminding me of my friends. I was outrageously comforted by that.

Anyway, the anesthesiologist's nurse (because Joseph wasn't allowed in until I was all ready to go - too many people in and out and whatnot), as I geared up for the spinal and the epidural (hatred of needles and all), stood in front of me and held my face. She actually put her forehead on my forehead and told me to just close my eyes and breathe. I literally didn't feel a thing. It was like the anesthesiologist only touched my back.

And then my right foot went all tingly and warm.

That sensation climbed up my leg, all the way up to my chest, and then went back down the other side.

There we go. I couldn't move or feel most of my body. How awkward. I didn't like it.

As they tested my numbness with something that looked like a tazer, the nurse asked me if there was any music that I liked that I would like my son to be born to. It was so kind of her.

I couldn't think of any of the songs on my playlist, so I just requested Josh Garrels and she pulled it right up for me. Thank you, human compassion and also the internet.

Joseph came in to hold my hand all gowned up, looking like a duck with the mask over his face.


After that, it was relatively quick.

One of the Dr's said "Alright, it's time for a birthday party! Joseph? Come on over here!", and Joe popped his head over the divider. 

My husband gave me a running commentary. 

"Oh there's his feet! They're so little! And there's his butt... and his back... oh he's stuck... he's stuck!" 

And I'm laying there, "What do you mean he's STUCK?!" 

And then, before I knew it, they were holding him up for me, all gooey. Our little Silas Ezekiel. 

The cord was cut. He was dashed over to the warmer. I was able to watch him the whole time on screens. Even though he never left the room, they had cameras to make sure there was never a doctor blocking my view. That was nice. 

They made as quick work of it as they could. It wasn't long at all before he was all swaddled up and in Joseph's arms. 

Of course, Joe came straight over and put him on my chest. He had to hold him there for me, though, because my arms and hands were shaking uncontrollably. I was told this is a normal side effect of the anesthesia wearing off. It was rather unpleasant. 

But Joseph held Silas there for me so we could all be close while they finished stitching me back up. 

When it was almost time for them to push me on into the recovery room, they had Joe take Silas and go sit with him so they could tie up loose ends that required moving me around a lot. 

I watched my husband in his first moments of being a new dad, sitting in a chair with our eensy newbie, holding him with such care, all curled up with his cheek pressed against that tiny forehead with a look of overwhelming gratitude, astonishment, wonder, and responsibility. And love, of course. Heavy, change-you-forever, Daddy-love. He looked like his heart had been split wide open to make room for this newness, this totally trusting little squisher. 

This is the image that makes me cry every time I revisit it. My husband sitting in that chair experiencing what it is like to hold a brand new life in his hands. 



I will add here that the recovery room was a bizarre experience in and of itself. They wouldn't let me leave to go to a regular room until I could move both of my legs. 

And by then it was 4:30 in the morning. I would have been exhausted without major surgery. I was fighting sleep harder than I've ever fought it. I had to stay awake and figure out breast feeding. I was not about to sacrifice that as well over all of this. 

Someone was sitting there trying to show me how. She kept grabbing my breast and smashing it down, telling me to cram it in his mouth like it was a hamburger. She had me holding him in what I now know is called the clutch hold. This was really awkward because I had the IV fluids all hooked up in one arm, and then the arm I was holding him with was attached to a blood pressure reading machine. Every five minutes or so the dang thing would squeeze me to try and get a reading, but it couldn't get one if my arm was bent. So then it would try again and try again until it worked.

But of course my arm was bent and had to stay bent in order to continue to hold the babe to the breast. So psh, blood pressure reader. 

At some point I finally lost my battle with sleep and began to doze off. 

I heard a nurse comment that I was breathing like a rabbit. Whatever that means. 

It was weird, too, when the time finally came that I was asked, for the seemingly thousandth time whether I could move my legs, tried to move them, and then said once again that, no, I could not - only to be told that I was, in fact, moving them. 

I looked down and saw the lady was correct, and it was just insane. I was temporarily certain I would spend the rest of my life with freaky robot legs. 

So anyway, the rest of the story is all rest and recovery, staring and stammering and lovesickness. 







Our precious pastor friend came over a day or two later and anointed that sweet little forehead. And then some of our other innermost circle dear ones came bearing love and contact solution, flowers and food. 

And finally, when it had been about 3 days, we went home. Where it all begins. 




















8 comments:

  1. Precious story, I had an emergency C section years ago, (my daughter is 34 now) It is a strange and bizaar feeling but to see that precious baby it makes it all worth while. She was a 'breech' baby with her feet against her head and her bottom down. There was no way for her to be born normal plus she was 5pds and three weeks early. Congratulations.

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  2. Loved Reading your story. My second son was breech too. I was hoping for a natural birth but was ready to change my mind if I needed too. By the time we figured out he was breech, I just called 'uncle' and scheduled the c-section for the next day. I was just very thankful that I did labor for hours and then have to have a c-section. The bonus was that the recovery wasn't that different from delivery the 'other' way. You're sore no matter what :)

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  3. My healthy baby is worth every single shred of birthing rigmarole :) ... But I'm not gonna lie. I do feel pretty much like I was robbed of my natural childbirth. I hate that I never got to feel one single contraction. Hate it.

    Babies can be born breech, absolutely they can, and if he had only been any kind of breech but footling, I would be having some major feelings about having to go through a csection just do to legalities.

    I'm still trying to work through how my birth went down. Trying to whittle out the beautiful parts that I was given, salvage the humor, and learn from/discard the rest <3

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    1. Ahem *due to * ... Not "do to " ... Facepalm :P

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    2. Ps though, thank you for your comments :) I am just working through my own stuff here and clearly know nothing about your own individual situations. Nothing I'm sayin here rs meant to disparage your own stories in any way. <3

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    3. Every birth has to be processed for what it is, and every birth is different for every person. Thank you for sharing with us. The story and birth were beautiful, just like mama and baby.

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  4. I wish there were a way I could private message you because this story brought up so very many emotions for me and my second birth and I wanted to share my story with you.

    I also had the perfect birth planned for my son in a birthing center with midwives and love and all that jazz. But my world turned upside down when I heard my child was breech (didn't know he was a boy then, my surprise child). We elected to do an external version the next day (I had also never heard of one), but in the meantime I went to work. I looked up every method there was to naturally turn a baby and literally spent the entire night trying them. Most of the time it was the flashlight method where you use a flashlight to guide the baby's head down. Anyway, next morning I go in and they hook me up, get me ready to go and flip on the ultrasound. By golly, my baby had flipped! It was amazing!

    But the story wasn't over. See, my husband was working away from home (a plane ride and three hours drive away from the hospital) and so I told him to go on and come home that day (Friday) in case anything else happened. He got on the plane and made it home.

    That night back home (oh, I guess I should add that I live in Alaska so the hospital is a couple hours drive from home) my mom took my daughter to VBS. Afterwards, we went and picked her up. As it was the last night, I started cleaning up and vacuuming. And my water broke. Well, I thought it was my water, but it was really super bloody. Called my midwife (because at this point I was still planning for my birthing center birth) and she said to go straight to the tiny hospital in my town to get evaluated first as it didn't sound like it was just my water. I went in and they checked me and discovered I was bleeding, but didn't know why, didn't have an ultrasound tech in town so I was put on a helicopter to go to Big Town. My husband couldn't fly with me so my mom did. They gave him my daughter to drive over thinking that would slow him down, but he still made it only about 10 minutes after I did.

    The doctor came in (amazing doctor that he turned out to be, truly a blessing from the Lord right there) and did the ultrasound. He told me I had placenta previa with placental abruption. Scary words and the scary reality set in that I would not be having my perfect birth (wow, almost 8 years later and that still brings tears to my eyes). Thankfully, they didn't have to do it that night (I really don't know why I got to wait til morning?) and so we waited.

    Son was born healthy, won't bore you with more details, but I guess I said all this to say this. 2 reasons God had my son be breech even though I was able to turn him. 1. He wanted me to get to meet the dr. who would be doing my c-section beforehand. 2. He wanted my husband to be home for the birth. If I hadn't been breach, my husband wouldn't have been able to be home until Sunday! (no flights on Saturday) and that would have been so hard for both of us.

    Like I said, it's been 8 years, but reading your story still caused me to bawl like a baby. It's so hard to lose the dream of an amazing birth to a c-section. It's also hard to see God's hand in it sometimes, but you found his loving hand guiding you all through this. I'm so thankful you shared your story.

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