Saturday, June 23, 2012

Leah's Birth

I want to thank my client, Chelsea, for being willing to share her story for the benefit of other mothers. Her story is a long one, but it's well worth the read.
-- Mary

How do I even begin to tell this story that is so full of heartache, joy, love, pain and so many other emotions and feelings?

To really understand the meaning of all of this we need to back track a bit, to the birth of my son, Will. I saw an OB throughout my pregnancy with Will, had him at the hospital, including getting an epidural, having my waters broke and receiving pitocin. He was healthy; I was healthy and yet so many things happened on that day that I didn’t like. The nurse telling me to be quiet during pushing, the OB yelling at the nurse for more light while stitching me up and just the general feeling I got from the staff that I was “just another patient” to them.

I began wearing Will when he was 5 months old, which lead to cloth diapering at 11 months and my parenting philosophy began to evolve and change. I had become friends with several natural minded moms online through Babycenter’s Community website. One of those lovely ladies had had a homebirth with her daughter and had a slideshow of pictures from it on youtube. I watched it and was instantly moved to start researching this other world of birthing. We weren’t trying at the time and wouldn’t be for a while but I kept on with my research off and on for the next 2 years, until we had Leah. So when we found out we were expecting, we already knew what we wanted – a homebirth. I could go into great detail about why and all the statistics about homebirth but that’s not necessary here. Just know that having a homebirth was truly the desire of my heart.

We found out we were expecting May 13th with a home pregnancy test. We were instantly surprised but very, very happy and excited. We didn’t tell many people of our plans for a homebirth, mainly because I didn’t feel like defending my decision for the rest of my pregnancy. A friend of mine who had had a homebirth just months before we found out we were expecting recommended her midwife to us. I contacted her and we did an interview. We knew instantly that Mary was the midwife for us. I began seeing her for my prenatal appointments and LOVED the time I got to spend talking with Mary about everything pregnancy related. When I would go to see Mary, I didn’t have a wait and I spent an hour (sometimes more) with her. It was already so much better than my experience with my OB during my pregnancy with Will.

Everything was going well until one day at 15 weeks pregnant, I was having some minor cramping and lower backache at work. I called Mary and was given a list of products to pick up from the health food store and told to go home and rest. Mary was concerned that the pain was possibly being caused by uterine contractions. The rest and the products didn’t help – by that evening I was timing my contractions like early labor. They weren’t painful but they certainly were very concerning. We had ruled out a urinary tract infection, but things only seemed to be getting more serious. There was no point in going to the hospital because they wouldn’t do anything to stop early labor before 20 weeks. Finally, my midwife recommended that I drink a few ounces of wine to see if that would stop them. Sure enough, it did the trick. They stopped. I rested for the next few days after getting an ultrasound to make sure that nothing was wrong with the baby. Baby was perfect.

At 20 weeks, we had an anatomy scan done. We found out we were having a girl (yay!), but we also found out she had a little bit of excess fluid around her heart. It was recommended to come back at 26 weeks to check to see if the fluid was still there. At 26 weeks, the fluid was still there. My midwife set up an appointment for us to see a Maternal Fetal Medicine doctor. After having another ultrasound and having a video of her heart taken and sent off to a pediatric cardiologist, they saw nothing threatening with the fluid. The structure and function of her heart was perfect and there wasn’t fluid anywhere else. Thank God she was ok. Two scares already this pregnancy but we were so grateful to know that our little girl was ok.

The rest of my pregnancy went pretty smoothly. Leah’s position was constantly changing. So when she was sitting breech at 36 weeks, I wasn’t too worried yet. Mary massaged on my belly gently and was able to get Leah head down. Yay! However, at 39 weeks, my stubborn baby girl decided to flip…again! I went to the chiropractor, had the Webster technique done, put ice on my belly and even took a flashlight to my belly before bed and the next morning she was head down once again. Now it was a waiting game, just waiting to go into labor.

I started having irregular contractions during the day December 29th, almost 2 weeks before my “due date” of January 12th. I knew we were in the safe zone for having a homebirth, so I was okay with her coming then. The contractions continued after I got off work, so I went to Walmart after picking up Will from the sitter’s to pick up last minute food and supplies should this be the real deal. Jay and I got everything ready that night, including hanging the clear Christmas lights in the bedroom for the soft ambiance I wanted for our birth. It was calming and peaceful. I had texted Mary that my contractions were 3.5 minutes apart but weren’t painful yet. I took a nice long warm bath and went to bed knowing that if it was the real deal, I would be back up soon. About 1am I couldn’t sleep. The contractions were irregular and I was uncomfortable. I went to the living room, sat on the birth ball, and put on a movie. By the end of the movie, my contractions had fizzled out and I went back to bed. I took off Friday to rest, just in case we were in for a long night. After a few days of off and on contractions almost continuously, I had to get in the frame of mind that I wasn’t in active labor until I had to stop and breathe through the contractions. That night finally came almost two weeks after my labor initially started.

Around 10 pm on January 11th I noticed that my contractions were different than what I had been having for almost 2 weeks. I tried to lie down and get some sleep. Knowing how long my labor had been with Will (28 hours); I wanted to be rested in case I was in for a long labor again. Around midnight, I realized I was barely sleeping and was going to have to start working with my contractions soon. I had read some natural child birthing books about how to cope with labor and was putting those methods into full use. Back labor was in full swing already and I could tell this was going to be an intense labor. I kept telling myself that I would have the birthing pool later to labor in – I just had to make it until I could get into the pool. That was my motivation – that is what kept me going, knowing that some type of relief would be not too far down the road. I woke Jay up at 1:30am to come put counter pressure on my lower back – it helped tremendously!

I had been texting Mary during this time as she was finishing up at another birth an hour away. I continued to work with Jay through my contractions. Mary let me know that she was sending her assistant, Corina, to get the pool and she was on her way to my house. I was so relieved to know that my method of relief was on its way. I was so excited that our baby girl was on her way. We called my mom at 3 – she was here within 15 minutes, with Corina and Mary not far behind her. The back labor was already so intense that I had thrown up twice and was nauseous by the time Corina and Mary got to the house. Corina and my mom began setting up the pool and I was so looking forward to getting into it for some type of relief from all of the intense contractions. My water broke as they were setting up the pool.

And then Mary checked my cervix. She told me I was at 5.5cm. I was so excited to hear that! I had been a 2 at my last appointment so knowing I was in fact making progress was a real joy to hear. And then I could tell something was wrong. I could see it on Mary’s face. She asked Corina to come check me as well, for a second opinion. I had to get up to work through a contraction and then she confirmed what Mary had found – Leah wasn’t head down anymore. But she wasn’t butt down either. She was presenting knee first (at the time they actually couldn’t tell if it was an elbow or a knee). Leah’s heart rate was also going down on the Doppler during all of this, which they told me might be indicating a compressed cord. Mary was most concerned about her cord prolapsing because there was a lot of space near my cervix due to Leah’s odd positioning.

She immediately told me that she thought it was best that we transfer to the hospital. Right then I just went numb. Everything I had hoped for, dreamed for and yearned for with this birth was slipping through my fingers and there wasn’t a thing I could do about it. Because my water was already leaking, there wasn’t anything Mary or Corina could do to try to turn Leah around. My biggest fear of having to deliver at the hospital was quickly becoming a reality that was no longer in my control. The midwives called the hospital and told them we would be there soon with a footling breech and a decelerating heart rate and called 911, asking for an ambulance. While we waited, they kept me lying on my side, listening to Leah’s heart rate and Jay and my mom gathered our things for the hospital. I continued to work through the intense contractions during this time, which were now intensified because I had to stay laying down.

The paramedics were on their way and I remember thinking, I can’t believe this is happening. I didn’t cry. I didn’t act like I was upset. I was just…numb. I also wondered how in the world the paramedics were going to get a gurney into our bedroom. I started wondering how things were going to go at the hospital. I didn’t know if I would be able to continue to labor with this much pain in the position once we got to the hospital, if that would even be an option. I even remember talking briefly with Corina that if I had to get an epidural and deliver vaginally, that would be better than getting a c-section. It would all just depend on what they would say when we arrived at the hospital.

The paramedics arrived. It was 5am now. My mom stayed at the house with Will. I wanted her at the hospital with me but my son needed her more. I shimmied onto the gurney, they covered me with blankets because it was snowing outside - our first snow of the year - and they wheeled me out to the ambulance. Mary rode with me in the ambulance so she could monitor Leah’s heart rate and Jay rode with Corina, who followed the ambulance, even through the red lights. The contractions continued and now I didn’t have my rock of support with me. Mary tried her hardest to give me some relief with counter pressure on my lower back in between listening to Leah’s heart rate, but we were in a moving vehicle and she’s just not as strong as Jay. But I know she did her absolute best to help me. The paramedic kept trying to ask me questions. I was like, Really? You want to talk to me now? They got an I.V. started and took all my vitals on the way to the hospital. We arrived at the hospital and I remember thinking, wow, I’ve never entered the hospital this way before. I work for the hospital I delivered at, but never had I been through the ambulance entrance before. I’ve walked those halls that they wheeled me down several times, but I didn’t think they’d be wheeling me down the hallway because we couldn’t have the homebirth we wanted.

They got me up to the Labor and Delivery room and immediately they started asking both Mary and I a bunch of questions. Not a minute later, Jay walked through the door of my room and I was so glad he was there. They hooked me up to the monitors and did an ultrasound, confirming that Leah was sitting completely breech. I wondered what the different members were thinking. Did they think I was the crazy homebirth chick who couldn’t hack it? Did they think I was stupid for making the decision to have my baby at home? None of that really mattered but the thoughts were still running through my head. They told me I had no choice but to have a c-section. Once again, my choices were taken out of my hand and I was just along for the ride. I just looked at Jay and his face just told me everything would be ok. Mary told me she would be waiting for me when I got out of surgery, which was just amazing. I gave Jay a quick camera tutorial so that he could get those first few precious moments of our girl on film.

They wheeled me to the OR and I had to once again move to a different bed. The OR table was very flat, hard and not comfortable at all. And cold – man, was that room cold. They had me sit up at this point while I waited for anesthesia. I was praying that Leah was safe and ok as my contractions continued. I probably sat there for 10 minutes waiting for my spinal. As much as I hated the way things had turned out, I was very much looking forward to the spinal because I needed some relief from the pain. The nurse in the OR was really sweet and held my hand through my contractions as I breathed my way through them. I got my spinal. My toes got tingly and they started to prep my belly to bring my daughter into the world. I was still very concerned about Leah since they didn’t have a monitor on me. After they put the brown stuff all over my belly, they had to wait 3 minutes for it to dry. Those 3 minutes felt like forever.

I just wanted Leah here, safe and sound. I’m so glad Jay was in the OR with me that day. The surgery itself was a very strange sensation. I thought they would have her out pretty quick. I’ve watched so many baby shows and have seen how quick they can get a baby out. After feeling them tug and pull and tug and pull I was starting to get concerned. I know Jay was completely oblivious to the fact that it was taking longer to get Leah out than what it should have, which I was ok with. I didn’t need him to panic on me in the OR. And then I heard the OB say that Leah was stuck and she couldn’t get her out. I almost lost it right there, but I knew that hysterically crying on the OR table wouldn’t be a good idea so I fought back the tears and sheer panic. The thought of, Are we going to be one of those families that leaves the hospital with no baby? Am I going to be the woman who planned a homebirth only for it to go horribly wrong and end up with a c-section and no baby? ran through my head.

I quickly snapped back to reality when I heard the OB ask for another doctor to come assist her. I could hear the panic and concern in her voice which worried me even more. They finally got Leah out at 6:36am, but we missed that moment. I knew she was out when I looked over at the warming table and it was surrounded with staff as they worked on her. All I could think was, Cry, Leah, cry. After what seemed like an eternity, she finally cried. I had never been so, so happy to hear a baby cry before!

They said she weighed 6lbs 2oz, almost 1.5lbs lighter than Will. I was surprised she was so small. They wrapped her up and I finally got to see her. Our eyes met and I instantly fell in love. I gave her kisses and they took her away to get cleaned up. As they began to sew me up I started to get really nauseous. I needed to throw up but was too scared I was going to aspirate it. The anesthesiologist told me it was from the spinal, gave me some more fluids but it didn’t help. I finally did get sick in a bed pan, but it didn’t really make me feel any better. They finally finished sewing me up, put some warm blankets on me since I was freezing and took me to recover in the labor and delivery room we started in.

I was so ready to see our baby girl. We got back to the room. Mary was still there and then the OB came in to talk to us. She then told me I had a 7cm fibroid on the top of my uterus, which probably contributed to Leah not staying head down. And that she had to give me a t-incision in order to get Leah out. Out of everything that had gone horribly, horribly wrong that day, this was the cherry to top everything off. With a c-section, I knew that I could at least attempt a homebirth again someday if we decided to have any more kids. But a t-incision…that just took everything away from me. The risk of uterine rupture during labor would be really high. All of my choices, all of my options went flying out the window with those words. I tried not to focus on that.

I just wanted to see Leah. They brought her in not too much longer after that. They told me she was having issues regulating her temperature, but they brought her to me anyways so I could nurse her for the first time. I prayed that this first nursing session would go well. After a few latch attempts and some repositioning (nursing after a c-section is not easy since you can’t sit straight up), she latched on. It was amazing. They took her back to the nursery, needing to monitor her temperature and blood sugar. Sometime after the surgery, we found out that her 1 minute APGAR was a 1. I couldn’t believe it. That made me wonder how long she had been in distress before they were able to get her out of me, but I was just glad that they had gotten her out.

They got me moved to a room. Mary and Jay left to go home and get some sleep and I was left with my baby girl. I wanted Leah to room in with me so that we could get as much time together as possible. The first night, they did take her to the nursery since I was still so fresh from surgery and still had an i.v. and my catheter. They brought her to me for feedings though so I was happy about that. Nursing was going well, not perfect, but very well. There was lots of re-latching with most of the feedings, but I was determined to have a successful nursing relationship with Leah.

Friday night she got to stay in the room with me. She slept peacefully on my chest with the Boppy wrapped around us. She knew that was where she was supposed to be and I was so happy she was ok. I remember waking up Saturday morning to see the sunrise through my window. It was beautiful and it reminded me that even though we had just been through something very intense, there were beautiful days ahead. They drew blood from Leah Friday night which showed her to be jaundiced, enough for light therapy all day on Saturday. It was hard to be away from her for most of the day except for feedings, but I knew the more time she spent under the light, the quicker her billirubin would go back down to a normal level.

We were finally able to be discharged on Sunday. I was so happy to be going home. It was a tough recovery after my c-section. Not only the t-incision, but all of the tugging and pulling left my abdominal muscles very sore. When I got home I was ready to settle into a new normal. I’ll never forget putting Leah’s first cloth diaper on her thinking, We can do this. If we could get through the past 4 days, we can do it.

It’s 5 months later and I look back and know that there’s nothing that could have been done differently. That c-section saved my daughter’s life. My heart is still continuing to heal. I know it will continue to take time. I will never have the birth I wanted. I’ll never get to pull my child straight to my chest and latch them on right away. I’ll never get to delay cord clamping because that cord blood belongs to my child. I’ll never know what it’s like to crawl into my own bed right after birth with a new baby. But for everything I will never have, I have gained the world with the addition of Leah to our family. I have mourned the birth I lost and will never have and still have days where I mourn it. It is getting easier with time, but I think there will always be a part of me that will at least be sad for what I will never get to experience.

I am so very grateful to Mary and Corina, the two best midwives a girl could ask for. They may not have been able to bring my daughter into this world, but they provided me the support I needed in my time of need, not to mention the best prenatal care I could ever ask for. My mother was amazing and just stepped in the fill the role of taking care of Will while I was in the hospital. I will be forever grateful to her. And my husband -- I would not have been able to get through this experience without him. He was and continues to be my rock. I love him more and more each day. Breastfeeding is still going strong and has been a large part in the healing process for me. It was been incredibly bonding and I am very grateful that it has been without issues. I have a healthy baby girl and our family couldn’t be better.

- Chelsea Kaster

(Photos are not the author or her baby.)


Rebecca said...

I'm so sorry Chelsea didn't get to have the birth she always wanted. It's hard to give up something that you've planned and prepared for. So glad that Leah made it here safely though! Thanks for sharing her story.

Anonymous said...

Thank you so much for sharing your story! I had a similar experience, and afterward I wrote: "Before the birth I had this picture in my head, like a tactile dream, of the way the baby's head would feel in my hand as he came out. That I would have this constant contact with him, an unbroken connection, a physical affirmation that he was mine. I know that others have lost much more, and so it feels selfish, yet still I mourn the loss of that dream."