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Monday, August 19, 2013

The Birth of Coralie

I am sitting here with a fully-one-year-old Coralie asleep across my lap. The little lamb is sweaty and kind of inhibiting my typing, but I am too afraid to move her. It's quiet in here and a wakey-baby would spoil that.

Over the past several days, my fella and I have been talking about sweet Coralie's birth. It is undoubtedly the greatest accomplishment of my life to date. It struck me, though, that there are a lot of details missing from the blog version of this story. I blame it on an oxytocin haze, because when I wrote this original post [24 hours post-partum] I felt like it was the most complete version possible. I even gave myself a pat on the back for managing to get it all down in written word so soon after the event. Now, I look back on the day I hit the "Publish" button and realize that I was a lot like a very drunk person, in a complete fog but unable to tell just how foggy things are.

So today, Cori's first birthday, I decided to update the story, to fill in the gaps, and to share some of the post-partum ups and downs that I went through. Please know that this is a story about childbirth. If you are uncomfortable with talk of cervices and placentas, read no further.

This is the story of the birth of my third child. My first two children were born in hospitals with both IV pain medications and epidurals. While I appreciated (and very much wanted) the epidural at both previous births, by the time I was planning my third pregnancy, I knew that I wanted to get off the hamster wheel of the medical model of prenatal care and birth. I knew that there must be a better way to do this whole birth thing, and my many friends and acquaintances that had left the hospital setting to give birth only confirmed that feeling with their positive stories.

When I became pregnant with baby number three, I immediately scheduled orientation at the local birth center. I admit that I was scared to go through with the orientation, and when I filled out the initial paperwork, I thought; Well now there is no going back, I'm really going to have to go through with this in eight months. 

My husband was very supportive, which I expected. He was wonderfully supportive at both of my hospital births and he personally prefers to avoid unnecessary medical intervention and medication, so he was all for doing things the natural way.

I prepared for the birth by reading and watching every natural birth resource I could get my hands on. My favorites were all of Ina May Gaskin's books, and The Christian Childbirth Handbook. I watched The Business of Being Born and More Business of Being Born on Netflix about 10 times each. I also asked all of my friends with natural birth experience for tips and encouragement, and frequently read birth stories on blogs like Birth Without Fear. I had a lot of fear to work through and spent a lot of time praying about the birth and seeking God's peace. The whole pregnancy and birth were such a spiritual journey for me, and I grew as a person so much throughout that time.

The final weeks of pregnancy were plagued with prodromal labor that caused me to lose a lot of sleep, but other than fatigue, I felt great. I didn't gain much weight this time and baby wasn't feeling too large or keeping me too uncomfortable. At my 39 week check up the midwife found me to be only 2cm dilated, and I began to wonder if this baby would be my first to make it to her due date or even beyond. I had reached 4cm weeks before labor began with my other children, so I didn't feel that anything was imminent. Another midwife prediction was that this would be a small baby, with which I heartily agreed. I remember saying "I think you are right! I don't feel big or uncomfortable at all! I can breathe, I can eat! This is a small baby!"

On the afternoon of August 17th (39 weeks, 4 days), I was feeling my typical "false" contractions, so I hung out on the birth ball to try to get comfortable while Jason and I watched The Godfather II. My 5-year-old son was spending the day and night with his grandparents and our 22-month-old daughter was having a pretty mellow day. All in all, things just felt so relaxed all day. The painless contractions continued all afternoon and into the evening. We went for a walk, and still nothing seemed to be happening. I told Jason that it was just another night of false labor, and that I was sure I would be waking up pregnant again the next day. With that, I went to bed to read and watch tv. Sometime after 9pm, Jason laid down on the bed with me to watch a movie on TV. He rubbed my back and suddenly the painless, sporadic contractions transformed into strong waves coming every two minutes and lasting a minute or longer. When I mentioned that they were requiring more of my attention, Jason suggested that I call the midwife, but I didn't want to bug anyone for a false alarm, so I decided to time them for awhile. After almost an hour, he insisted that I call. I was hesitant, because although they felt powerful, there was really no pain associated with the sensation. As Ina May says, it was just "an interesting sensation requiring all of your attention." I really felt no pain, and I remembered that my "real" labors were extremely painful right from the beginning, so I kept insisting that this wasn't real. But Jason pushed me to call since he was worried about waiting too long and not getting there. No one wants to deliver a baby in their bathroom unless it's planned that way!
The midwife, Judy, told me to come right in. I even gave a disclaimer along the lines of "I don't want to waste your time, this doesn't feel anything like active labor to me!" She told me that when you are having your third baby and you are contracting every two minutes, you don't worry about wasting anyone's time, you just get there. We finished packing our snacks, Gatorade, and popsicles and headed out. Luckily, my friend was staying with us, so we were able to leave our daughter in her own bed and our son was still with his grandparents.

In the car, on the way to the birth center, I really began to doubt if we should be going in. We were laughing and joking between contractions and I still couldn't say that they were painful. I told Jason "I really hope she isn't coming all the way from home, I don't think this is real." I kept reminding him how much agony I had been in with my previous two labors.

We arrived around 11pm and the midwife checked me. "How many centimeters did you say you usually are when your contractions are this close together?" she asked as she checked.
"Four...." 
Oh no! I thought. I must not even be four yet. Now I've made the trip up here for nothing! I was really embarrassed and thought that they would all be giggling when I waddled out of here baby-less, thinking I should know what I am doing by baby number three.

"You're a six!" she said. 

I was absolutely thrilled and so surprised. How could I be six already and the contractions not hurt? Don't get me wrong, they were powerful feeling, and it was an unpleasant sensation, but there was not the same pain associated that I felt in labor with my other kids. Not anywhere close.

As she checked me, Judy started to laugh and said that the baby was moving her head side-to-side and all around as if she were trying to burrow her way out or something. This might have contributed to the rapid labor, with all of that movement and pressure right on the cervix.

The midwife and nurses started to get the room set up and run the tub and I labored on the ball and kneeling on the bed. Someone said "It's Go Time!" and I had a fleeting thought of Oh my gosh, we are really going to do this! Between contractions I was laughing so hard while Jason and I discussed what device might be used to fish...ahem...debris...out of the tub. The nurse brought it out to show to us. It's pretty much a goldfish net. This led to lots of bathroom-type joking between me, Jason, and the two nurses that were on staff that night. One of the nurses [a L&D nurse from MUSC] was training and had already attended two other water births that night. She kept mentioning that it seemed like we were having fun, which we were. That is exactly what I had prayed for. I did not want a quiet, spa-like atmosphere. I wanted it to seem like we were just hanging out and bringing our baby into the world.



I got in the tub and Jason sat on a stool outside of the tub. We thought we had a long way to go, my previous labors were 11 hours and 12 hours respectively. He brought over my Gatorade, my phone that was set for my perfectly planned Pandora station, and a stack of note cards on which I had written about 30 scriptures and affirmations.
 I never got to use any of them, because as soon as I got in the tub I began to shake uncontrollably. I took two sips of Gatorade and knew I was going to vomit. I told Judy and she got me a container and some peppermint essential oil to smell to try to help with nausea. As soon as she walked away, I started throwing up, hard. Between the vomiting and the intense shaking, I could barely feel my contractions. When I finally emptied my stomach I said "Well that was a nice distraction." and again we were laughing. The shaking was making it harder to relax during contractions and I just felt so restless. I could not get comfortable in the tub, I felt like there had to be something I could do to stop this shaky feeling. Still, I wasn't feeling anything nearly as painful as I felt in past labors. I asked the nurses what I could do to stop the shaking and they said it was just a normal sign of transition. No way I am in transition. Things don't suck nearly enough. Transition is supposed to be the worst pain of your life. When I voiced that I really didn't believe I was in transition, they kept assuring me that I had all the signs. I began to feel really restless, like I needed to do something besides just sit there, so I got out of the tub to try to empty my bladder. I went to the bathroom and could not pee, even though I felt the sure sensation of a full bladder. Later, I realized that what I was likely feeling was my baby moving down, because things were progressing really fast.

Standing, and being out of the water, made the power and energy of the contractions harder to manage. I began to vocalize in low moans and feel a little panicky at the peak of each one. The shaking continued. I hung onto a rail in the bathroom and then to Jason's neck through a few. After each one I would say "I made it through that one." And I would think to myself that it was going to get much worse. It had to get worse, because it wasn't anything like the pain I had prepared myself for. The restless feeling persisted, and I wondered if I should try the nitrous oxide to relax me. But after each contraction I would think That wasn't bad enough for $150 (the cost of using the laughing gas). At one point Jason asked me if I wanted to try the laughing gas (because it was part of our birth plan) and I told him that I wasn't really in pain. The only thing I can compare the sensation to is a "charlie horse" type tightening cramp, but throughout my abdomen and back. It was a full-body experience and intense, but not really in a painful way.

 I said I wanted to rest, and Judy said I could try a contraction lying on the bed. I laid on my side and when the contraction hit I jumped right up "Help me up! Help me up!!! Don't let me do that again!!!" It was awful feeling. If you are reading this and considering natural birth, do not lie down!!! Everything, absolutely everything feels better than lying down! Judy said I was probably getting close, and  I asked her to check me again. I kinda think that I wanted to prove her wrong, like This is not transition, I am not moving fast, you people don't understand how much pain I prepared myself for! She said I was "at least an 8" and I could not believe it! I had been at the birth center for maybe an hour, in labor for maybe two hours!

Jason put on his swim trunks and we got back in the tub together. I tried leaning on him but found it really hard to rest. As each contraction would peak I would get this unbearable to urge to do something to make it stop. Maybe that is type-A personality in labor? I don't know, I just wanted to manage the sensations, and you really can't do anything, it is just happening to you. I would hop up on my knees, or roll to my side, straighten and bend my legs...it was as though I was trying to escape it instead of just letting it happen. 

At this point I would say that the intensity was becoming overwhelming, and there was some pain associated, but it was the power and the energy that was so uncomfortable and hard to handle. Judy was amazing, reminding me to relax between and telling me it was almost over. 

She said "Justine, it seems like you might be pushing a little. Are you pushing?"
"Well....I don't know...." I squeaked. And of course everyone laughed again. How do you not know that you are pushing a baby out?

I asked her if it could just be done now and she went ahead and checked me again. She felt a small lip of cervix left and said that I could push if and when it felt right. I didn't feel an urge to bear down, yet pushing gave me something to do during that intense peak, so I tried it, grunting while doing so. I rolled over and, kneeling, leaned my face into Jason's chest. As I was bearing down I felt something leak, which may have been my water breaking, I don't know. But I said "Oh no you guys! I think I peed!" and they all laughed, because really, that is what you are going to stress about while you are pushing out a baby? My grunts got louder and more primal with each push and I said "I just wish you could do this for me!" at which everyone laughed. I said "Is she almost out?" and Judy told me to check for myself. Now, pushing and delivering was the part I was most afraid of. The idea of feeling my baby come out just really unnerved me. At the time I really didn't think of it, and I just checked for myself. I felt something hard and smooth not that far in, and I could not believe it was her head. I rolled back over to a semi-reclining squat and asked Judy to check. I said "I can't tell if it is the baby! It's just something hard!" And of course, that got another laugh. Laboring mamas can be quite comical it seems. She still felt a little cervix and gently slid it over the baby's head on my next push. "That hurts! That hurts!" I yelled [really loudly Jason says] and she so calmly said "I know it does. I know." and for some reason that was so soothing. Just the fact that she knew how I felt and sympathized and I could tell. 

I continued bearing down and grunting and looking back I cannot even believe the sounds that I made. I got pretty loud. I never thought I would make noise or vocalize or anything like that. Its just not how I pictured it. At one point I pushed down so hard and for so long that Jason had to remind me to breathe. All of this, from the first push to this point, happened in about 10 minutes time, but it felt like we were frozen in time, I had no concept or awareness of how long. It could have been one minute or one hour. It seemed like such a lot of work to get her out, which surprised me, because my second baby had practically flown out. "Here she comes! Here's her head!" Someone exclaimed and Jason was supporting me from behind, saying "That's it babe. Here she is! She's coming out!" I prepared for the "ring of fire" that I had heard of, but it didn't come. I had prayed fervently that my perineum would numb naturally, as I had heard of happening. That was a truly answered prayer, because I felt absolutely no pain in my vaginal area whatsoever. There was just such a fullness. It wasn't pleasant, but still, nothing like the pain I prepared for. When they said "Her head is out!" I didn't believe it, because the searing pain I expected never came. 

Within seconds, almost as soon as I had the thought that delivering the head wasn't as painful as expected, I felt like I was being ripped in half. I screamed and began yelling "Get her out! Get her out! Oh my God get her out! HELP ME! HELP ME!" It was so frightening, and such a blur of just blinding pain and fear. All at once, Judy got so serious and quickly said something very medical-sounding to the two nurses. Each leaned down into the tub and grabbed my feet and pulled them up and back into your typical, hospital-style frog squat and Judy reached down, telling me very firmly "Keep your bottom in the water!". I was still yelling this whole time. I don't know exactly what she did, but it felt as though she reached both her hands into me and freed to baby. It turns out that she had shoulder dystocia, meaning that her shoulder got stuck behind my public bone on the way out. According to Jason, this all happened in a matter of seconds, but to me it felt like an eternity. It was the only part of the whole experience that really and truly hurt. All I can say is that I panicked, I freaked out, I did not handle it well at all, and I was loud. Later, she explained that she used the McRoberts Maneuver, in which the mother's legs are hyperflexed tightly to her abdomen to make extra room in the pelvis, while the midwife simultaneously applies external pressure above the pubic bone and gently guides the baby the rest of the way out while freeing the obstructed shoulder. 

The very instant she was out, it all went away. Like nothing ever happened. It was the most amazing feeling, nothing like the epidural-numbed moments after my hospital births. I was so elated. I held her and looked at her and said "I can't believe it's over!" a lot. After a moment or two, she was still not breathing or crying, which was okay since she was still getting oxygen from the umbilical cord. I asked if we needed to do anything to get her going and Judy took her from me gently and told Jason to help me stand for just a second. She held Coralie low, and I stood up, shaking, and sat right back down. As soon as I stood, she began to cry. Judy explained that raising the placenta [still in my uterus] above the baby for that split second gave her a big surge of cord blood and got her started. It was really cool and to this day Jason talks about all of the knowledge that midwives have and how they are so in-tune to the mom and baby.




  I peeked up at the clock and couldn't believe it was just after 1am. No one had made it to take pictures or anything, so the nurses took photos for us and the three of us snuggled in the tub as we waited for the cord to stop pulsing.
When it did, I cut it myself, which was so cool! Then Jason got out of the tub and took the baby over to the bed for some skin-to-skin bonding and Judy helped me out and over to the bed to be checked out and deliver the placenta. As I walked over to the bed I asked if I had any tearing from when she got stuck. Everyone just said "I don't know....I don't know...." so I think that they really needed to assess the situation. At this point I really did not realize how big she was or I probably would have been more concerned about it. It was so wonderfully different than the hospital experience, lying on the bed next to my husband and baby while waiting for the placenta. Everything was perfect. Healthy cord, healthy placenta, and no need for stitches despite the large baby and shoulder dystocia. I really don't know how Judy was able to maneuver the baby out and keep me intact, but I am so thankful for her skill! Since Coralie's birth I have heard many stories about moms whose baby got stuck during hospital births and they ended up with 4th-degree episiotomies, vacuum or forceps deliveries, and lots of pain and rough recoveries. I had none of that. In fact, I really didn't experience any vaginal soreness at all in the days and weeks following her birth.

Coralie Mae was born at 1:21am weighing in at 9lbs 1oz and 21 inches. I think it was about 3 1/2 hours from my first noticeable contraction. 
My mom and Jason's mom both arrived in the next couple of hours and we hung out and visited and ate goodies from Panera. We were discharged at 5:15am, just shy of 4 hours after the birth of our daughter. I climbed into my own bed and slept with sweet Coralie on my chest for about an hour before my 22-month-old  woke up. And I wouldn't do it any other way. Ever.
As I said earlier in this post, Coralie's birth was an accomplishment that I still sometimes can't believe that I did. My prayers were so faithfully answered, including the countless times that I prayed "Lord, if there are any complications, give the midwife skillful hands and a sound mind." 

The first few days home were hard. We had a lot of help and received dinners for almost a month from friends and family. But, Coralie had a rough start. She slept in 10 minute increments for 2 days, and I was exhausted. I could not figure out how to make her happy, and I cried a lot. I ended up giving her a pacifier on her second day, something I avoided for several weeks with my other two. I told Jason one day "I love her and I have every desire to care for her...I am attached to her....but I don't like her at all." And that was rough, because I felt guilty for resenting my baby. The day after delivery a nurse from the birth center visited us at home for a check up. I told her about how cranky the baby was, and she assured me that in a few days when my  milk came in things would be fine. She was right! It was like someone flipped a switch and suddenly we had this placid, happy baby! 



At my one-week check up I reported that she was right! The baby did calm down when my milk came in! She said "Oh thank God! I really wasn't sure but I wasn't going to tell you that!"

The afterpains were intense, something that I am told is normal the more babies a woman has had. I was often doubled over in pain for at least a week after delivery. I also experienced more post-partum depression than I had with my other babies, which really manifested itself as anxiety and compulsive tendencies. I felt that I had to keep everything spotless for the people that were dropping off meals to us. I wigged out if there was even one dish left in the sink. It didn't help that my oldest started kindergarten the day after the birth, so we were in an entirely new routine and recovering from birth. There were lots of tears as I told Jason "I can't do this" and "I'm never going to be able to keep up." I got so tired and so resentful and sometimes felt angry that I had been pregnant and/or breastfeeding for so long. I wanted to feel "normal," whatever that means!

Slowly, though, things got better. I started taking a blend of B-vitamins and an additional calcium supplement and those things really seemed to level out the anxiety and OCD. One day I realized "I haven't cried in several days!" and I realized that I was out of the woods. In the future, if I have another biological child, I will look into options like placenta encapsulation to assist in regulating the hormonal drops that can lead to PPD. I decided to include this "negative" information about the post-partum time period because I realized in this past year that I have been living so much of my life to impress other people, and putting way too much stock in what people think of me, both the good and the bad. I don't want to just show people the highlight reel of my life, I want people to see the real me.The real me is someone that had a great birth, a great recovery, and dealt with PPD anyway. 

Now I sit here, with my one-year-old on my lap. It has been a great year with this girl. I can't tell you just how awesome she is. She still nurses once or twice at night, but my expectations have changed to match her needs, instead of trying to change her to match my expectations. She is sweet and funny and the perfect addition to our family. Happy Birthday, Coralie Mae!


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2 comments:

  1. Absolutely amazing! You are a brave and inspiriational child of God!

    ReplyDelete
  2. Great birth story! Thanks for sharing, and happy birthday to your sweet little one!

    ReplyDelete