"Parents are like shuttles on a loom. They join the threads of the past with threads of the future and leave their own bright patterns as they go."
-Fred Rogers

Tuesday, March 29, 2011

Case's Birth Story

Thank you to C and R for sharing the story of their son's birth.  Enjoy!!


Case was such an active baby in the womb that I was certain that he would be born prior to 40 weeks. I figured that he would get too cramped in there to throw the punches and do the squats he had been doing so much in the 2nd and 3rd trimesters, that he would make a break for it in search of more space to stretch. Rob and I -- planning for a natural birth -- had taken a private Hypnobirthing course with Tricia Fitzgerald, taken a crash course in the Bradley method, regularly practiced all the exercises and meditations recommended by both methods, and felt pretty confident that we were prepared and ready.

To my surprise, we passed the 40th week mark with nothing more than Braxton Hicks contractions. My midwives assured me that most first time mothers go into labor around 41 weeks so not to worry. I continued to spin class that week, and visited Debra Christiansen (our fabulous massage therapist, also trained in prenatal massage) of Inner Advantage Massage twice that week in an attempt to stay as relaxed as possible. At Wednesday’s appointment, I told her to go ahead and hit all the labor trigger points that she’d been so carefully avoiding throughout my pregnancy. She reminded me that the baby would come when he and my body were ready so that there was no need to massage the trigger points, but with a little more encouragement, she complied, though very carefully. While I completely agreed with her, I also didn’t want to find myself still pregnant at 42 weeks at which point there would be some pressure to induce.

That evening I joined a group of girl friends for dinner, and towards the end of dinner, I felt a little light headed. I came home shortly thereafter and still feeling odd, and found myself doing about 40 minutes of yoga in our living room before going to bed. I’d missed my prenatal yoga class earlier that day and wanted to get it in before the day was over. I went to bed and was asleep by 10pm.

I woke up at midnight, 1am and again at 2am each time having a mild contraction. I didn’t think much of it and went back to sleep each time. Then at 3am I awoke to a somewhat stronger contraction, and had another at 3:20. I continued having contractions every 15-20 minutes and by 4am had also had a little bloody show. By then I knew I was in early labor. Rob woke up a little after 4am. I shared the news and, with an excited smile, he now couldn’t sleep either. By sunrise, the contractions were coming on stronger and more frequently.

It was a beautiful fiery sunrise that morning over Lake Michigan. We watched it from the living room windows as the sun lit up the clouds, the lake and the sky. We labored around the house changing positions frequently. I used a lot of my prenatal yoga poses, modified child’s pose on the ball and against the counter were particularly helpful. Lela Beem (my fabulous yoga instructor) will be pleased to hear that I used my ujjayi breath lots and lots during this phase of labor. It was extremely calming and helped me stay relaxed and centered through the contractions. An early morning shower was also really helpful in terms of managing the contractions and maintaining a peaceful mind.

At 7am, we called our midwife to give her a heads up that we’d likely see her later that day. We wanted to labor at home as long as absolutely possible and continued through the morning alternating between walking, various yoga poses, and lying down – Rob was great at suggesting we try something new as soon as he could tell I’d had enough of whatever we were doing. Around 11am the contractions were coming on stronger, so Rob ran a bath for me and I spent the next 2 hours laboring in the tub. All the while, Rob made sure I kept hydrated and brought me regular small meals and snacks to keep my energy up for later when I’d really need it.

We updated our midwife on our progress around noon, and she suggested that once my contractions were 4-5 minutes apart that we start making our way to the hospital and check in before they were really strong. By 1:30, they were 3-4 minutes apart and increasing in intensity so we began gathering up our things and headed out. Our midwife met us at Evanston Hospital at 2:30, and confirmed I was at 6.5 cm. I spent the next 4 hours laboring in a big oversized bath tub – very helpful. Rob was an amazing coach and partner. He stayed right with me, breathing deeply and slowly through every contraction I had in order to help me relax my breath, reassuring me that we were doing great, and making sure I stayed hydrated and fed.

Around 7:30, the midwife checked again and I had progressed to 9.5 cm., and there I stayed for quite some time. So we began labor Olympics, moving and rotating from one position after another hoping the contractions and the movement would get me to 10 cm. Finally, our midwife suggested breaking the bag of waters so that the baby’s head could also help by applying pressure to my cervix. Between my pushing with the contractions and my midwife applying pressure to the cervix, over time it eventually reached 10 cm, and I was given the “all clear” to push Case out.

Somewhere between 90 minutes and two hours of pushing later, over the course of 7-10 contractions, I pushed little Case’s big noggin out one centimeter at a time. Apparently he decided to make his exit in a posterior position (facing up instead of down) and presented with the flat top of his head instead of the smaller crown. Luckily he turned from posterior to facing down at the last minute – helping mom out at least a little at the very end.

Reflections on getting through those last few hours:

1) My husband: I couldn’t have done it without Rob. He was awesome. Not only did he somehow manage to not hyperventilate even after taking one huge breath after another with me for hours on end (my nice calm ojjai-ocean-sounding-breath had by now progressed to a much more forceful-prehurricane-ocean-surge), but he was so calming and reassuring. And when a less than considerate labor nurse made some seriously unhelpful comments about natural childbirth during the height of the pushing phase, Rob put a cork in her and ended her negative comments immediately. I was so grateful.

2) Meditation class: I attended a meditation session at the Heartwood Center in Evanston for the months prior to Case’s birth, and I found the practice was unbelievably helpful to me during labor. In one of our meditations, we focus on breathing in white light, filling our body with it one part at a time and then visualize releasing the exhalation out the top of our heads. I used this exercise throughout second stage labor, but instead visualized the exhalation out the birth canal and focused on relaxing those muscles at the same time. It was exactly what I needed to focus on relaxing through each contraction. While relaxing and pushing at the same time, seem at odds with each other, this visualization and breathing technique harmonized the two for me beautifully and was particularly helpful as I pushed out Case’s gargantuan noggin.

3) Vocalization: Always pictured myself as the silent, focused birthing mother, but thank goodness for Lela Beem at Grateful Yoga in Evanston for all the vocalization practice during prenatal yoga - or perhaps because of her – I found that using their techniques really did help me relax through contractions. Hopefully all my variations of aum didn’t carry down the hall too far and annoy the other birthing mothers.

4) Hypnobirthing: I think the single most important tool I took away from this method was the simple conviction that birth is a normal, natural process and that by relaxing instead of panicking and fighting it, a woman’s body will do exactly what it is supposed to do without the need for any drugs and interventions. While labor isn’t easy, it certainly is not the fearful, painful experience regularly portrayed on TV. I used most all of the relaxation techniques that I learned in this class throughout labor, and we alternated listening to the Hypnobirthing affirmations CD and quiet music during most all of labor, which I used to refocus myself when I occasionally lost my concentration.

5) Lastly, I remember towards the end just as Case’s head was close to crowning, I remember deciding I was done and ready to go home. It felt like the wall I always hit in mile 20 of a marathon. We’d tried all the pushing positions and oddly, I seemed to be able to push most effectively on my back. As I lay there between contractions, I remember very vividly having a mental conversation with myself about the pros and cons of going home. I reasoned that this baby had to come out of me one way or another, and I suspected that if I didn’t get it out somewhat soon, ultimately the hospital was going to want to C-section him out of me. I remember thinking that there was no way I was going to let that happen, so that I’d better just suck it up and get fierce about getting him out. And with that I went into my “final 6 mile marathon zone”, bitched out someone for turning on a light and a nurse for talking while I was pushing, and then focused everything I had in me and got it done.

I remember opening my eyes after the final push just as Case was born, and looking in awe at what a huge baby he was. He was so red and wiggly – and looked so very healthy and strong. Rob cut his umbilical cord, and Case quickly came to lie on my chest where we marveled at what a perfect, beautiful, wonderful little boy had come to join our family.

Case was born completely naturally at 11:25 PM on November 4th, at 22 inches long and weighing 9 pounds and 7 ounces. He had sandy blond/brown hair and deep blue eyes, unbelievably defined shoulders and biceps, and the most muscular quads you ever saw! He is an absolute joy – a strong eater and sleeper, curious and active, and has big smiles to share with everyone.

What a beautiful story!  Welcome to the world Case!!

Wednesday, March 2, 2011

VBAC Times Two

When I received the Birth Stories of Paul and David, I almost couldn't believe that it's been more than 5 years since I helped Elizabeth and her husband welcome two of their sons into this world.  Boy, how time flies!  Below Elizabeth describes how she was able to have 2 VBAC births after her first son was born via C-Section.

Paul’s birth – July 19, 2005

As a VBAC mom-to-be, I started a little late in my search for a better birth experience. I was about 25 weeks pregnant and went to a trusted chiropractor who just mentioned seeking out midwives as care providers rather than the same OB’s who induced and delivered via c-section my first son. I had heard of doulas and started my search with looking them up online, and had a few recommendations to a group of midwives. I made my first appointment and was convinced that that was the level and kind of care that I needed to have a natural birth.

I became obsessed with learning about natural birth, and knew that I wanted to hire a doula because that has been shown to increase VBAC success rates. I found Tricia through some recommendations and she made my husband and me so comfortable from the first time we met.

As it came closer to my due date, Tricia started her support – encouraging me to try acupuncture and other natural labor starters so that I didn’t go too much past my due date and get even the midwives anxious about a VBAC.

During my third acupuncture appointment, I started labor. I was able to drive home, care for my toddler, do some laundry, take a nap, and wait for my husband to arrive home from work at his usual time. I ate a pasta dinner (carb-loading for labor!) and went to my dark, quite bedroom around 7:00. My husband put our toddler to bed, checked on me, and around 10:00, I almost fell out of bed with my first strong contraction. We called Tricia, and since we were having a very major thunderstorm and rain she walked my husband through some ideas. Getting in the shower (didn’t work), sitting on the toilet or birth ball (didn’t feel too great) and getting into the bathtub. I loved the tub and stayed there until about 2:00 am. The storm was dying down, we called the midwife and Tricia and everyone decided to meet at the hospital. After about a 45-minute car ride (during which I’m pretty sure I was in transition!) we arrived at the hospital! Some of the sweetest words I’ve heard in my life were Tricia saying “I’m here” as she raced down the hall to where I was alone in a wheelchair!

Since I’d had a c-section due to failure to progress, I REALLY didn’t want to know how dilated I was in triage. I had only progressed to 5 with my first induced labor and didn’t want to show up at the hospital less than that and get into a mental game with myself. Tricia and I had talked about this and she had the triage nurse whisper to her the news…..I will never forget (and thinking about it now is making me tear up 3.5 years later) when Tricia leaned down and whispered….”you’re almost at 8”.

In that moment I just knew I could do it. I moved to the birthing rooms and expressed I really felt best in the tub, so they prepared that for me. I got in, closed my eyes and really don’t remember much of the next few hours. My eyes were closed, Tricia was whispering in my ear and my body was doing the work. She kept telling me where to relax when she saw tension somewhere, she was reminding me of the work that my body and my baby were doing. She gently guided me through the decision to break my water to get rid of the last bit of cervix. I was not pushing very well in the tub, and the midwife had me move to the bed. I pushed on the bed for what seemed like a short time due to my eyes being closed and staying pretty relaxed. It was about an hour though and finally the midwife said….”if you don’t push this baby out now – we are going to have to start pitocin”. Three pushes later I delivered a healthy, 8 pound, 3 oz baby boy!

After delivery, the midwife suggested that my labor had really stopped during that hour of pushing and that was why it was so hard for me, that I wasn’t having that hard of contractions and so was doing all the “pushing” on my own.

David’s birth – April 19, 2010

I was getting ready for my third baby. The first delivery was an induction resulting in c-section and the second was a beautiful, natural, hypnobirth experience with Tricia as my doula.

I knew immediately I would ask her again to help us deliver using hypnobirthing and even though it was only 5 months after her own baby was born, she agreed to help us out as a returning client. My pregnancy was healthy and safe until a horrible rash returned again during this third pregnancy. The first pregnancy it was diagnosed as PUPPS, the second pregnancy it was diagnosed as PUPPS, but they ran a blood test to rule out cholestasis of pregnancy. When it returned this third time, they ran the same blood test and the results came back showing that I may have this liver disorder. Issues that can occur from the disorder include still birth if babies are carried past 38 weeks. Since my first pregnancy was induced when I was two weeks overdue, and my second ended the day past my due date (with the help of acupuncture and other natural help), this was of great concern for both my midwives and myself. During one particularly hard day when it looked like they would want to schedule an induction, Tricia took time from a family event to talk me down from my stress and talk to me about non-medicated induction methods.

On the eve of having to make the induction decision, at precisely 38 weeks, labor started naturally at home. I was able to mover around all day, caring for my two sons and my nephew with contractions about every 20 minutes from 1:30 am until about 3:00 pm. After 3:00 pm, contractions picked up, but I was still able to manage them and since Tricia had her own new little one, we agreed to wait and see and plan to meet at the hospital when it was time. Although my contractions never moved closer than 5 minutes by 10:00 I was feeling a lot of pressure and really having to work hard to stay relaxed. We decided to head to the hospital even though the midwives thought I’d be fine at home a little while longer.

We had about a 45 minute car ride to the hospital and I can remember sitting in the wheel chair while my husband checked us in thinking….these contractions aren’t that close, I bet I’m not very far along. Upstairs in triage, that was confirmed, but I was at least at 5 so they weren’t going to send me home. They kept in my triage for almost 45 minutes, asking me seemingly ridiculous questions about my knowledge of the risks of having a VBAC, and making me sign all kinds of forms. During this time, Tricia and my husband did a fabulous job of keeping me calm, of pushing the triage nurse to get out of my way, etc. Tricia just kept telling me where in my body to relax and to remember that it was doing the work it needed to birth the baby.

When it was time to move to the room they asked me if I wanted to walk or ride in a wheelchair. Even though at this point the contractions were coming much closer and were really strong, I decided to walk knowing that that movement might help the labor along. Once in the room Tricia suggested getting the shower, hoping that the warm water would help relax me like the tub, but keep labor moving along. She turned on the water, my husband sat on the edge of the tub and I sat on the toilet waiting for the water to warm up. Within seconds I felt a huge gush of water into the toilet, and instantly knew my water had broken. I screamed and my husband said “I’m right here”. I knew I needed more than him because I screamed again “ I need help” and started walking out of the bathroom. Again, within seconds, Tricia had pulled the midwife out of another delivery room and I birthed my third son standing in the doorway from the bathroom to the room. With the door to the hallway open, and with the nurses, Tricia and the midwives having to explain to me what was happening!

After my son was born, they helped me to the bed, he latched on so beautifully with Tricia’s guidance to really let him do the work of deciding which side, and how to do it. Since there were no other birthing moms that needed the midwife she was able to stay and visit with Tricia, my husband and our baby for about 45 minutes. Those first minutes are so precious to me as we all wondered at the super fast birth, the speed with which the staff responded, and of course of how gorgeous my baby was!

The take away I have from my three births, each very different, is that birth is a one of a kind experience between mother, baby and whoever mother wants supporting her. Each one is precious and each one makes me smile thinking of all the little things that happened; the sweet sound of my doula whispering just the right things during a long labor, and then that same doula looking straight in my panicked face and telling me I was going to birth my baby standing up in the bathroom! Each birth left me feeling so strong and they are memories I draw on all the time to get me through this life!