Hi friendly readers! Today we have the first ever guest post here on Momsasaurus, and it’s a great one! I couldn’t be happier to share the birth story of a friend and fellow nurse whose daughter, Nolen, was born just five days after Eleanor. While I had a scheduled c-section with Zoey, followed by a VBAC with an epidural and the state’s best NICU only feet away just in case for Eleanor’s birth, Meghan delivered Nolen in a water birth at a birthing center under the care of a midwife. I find her story fascinating because, while wildly different than my birthing experiences, at the core they are really quite similar.We both really wanted what we felt was best for us and our baby girls, and couldn’t have done it without our incredibly supportive partners. Throughout Meghan’s story you can really sense her inner strength shining through – I hope you enjoy it as much as I did!
*With the exception of some minor changes for clarification purposes (i.e. changing abbreviations to full words) the following writing is solely the work of Meghan De Luca. It and the photos are property of Meghan De Luca and all copyright privileges are her own.*
Nolen Grey De Luca, born Wednesday, August 22, 2012 @ 21:16.
My due date was August 18 based on ultrasound, and August 22 based on LMP [last menstrual period]. I was one of the “lucky” ones as far as pregnancy went: very little nausea, minimal swelling, my BP stayed low (80’s/40’s!) and, while tired, I never actually had the “I’m done being pregnant” moment that so many seem to have near the end. I did have a mild scare in July, when a 32 week ultra sound to check placental placement revealed a low placenta with a dangling blood vessel that was between Nolen’s head and my cervix. My midwife casually mentioned this could result in a need for hospital birth, something I was desperate to avoid. Of course I asked Dr. Google as soon as I got home, and discovered this “vasa previa” – per Google – can actually have some significantly poor outcomes for mom and baby, and is most often treated with an early Cesarean birth to avoid any labor and potential hemorrhage. I spent the next 4 weeks convinced that I would die in child birth along with my baby, an excellent reminder as to why we tell patients and families to ask your health care providers rather than trust anything we find when asking “Dr” Google. I was lucky to receive an additional ultrasound in early August to check on this previa, and we were delighted to find that my placenta, while still “over-sized,” had grown far enough away from the cervix, and the mysterious dangling blood vessel was nowhere to be found. My midwife confirmed I would be able to deliver vaginally and at The Birthing Inn! I happily waddled my way down to pay the registration fee that same day as I was now convinced baby would come any minute. The next two and half weeks were spent enjoying the last minutes of pregnancy, nesting and dreaming of my sweet baby’s face.
My first due date came and went, and I reminded myself that first pregnancies on average go to 41 weeks and 1 day. I started to have more and more contractions Monday, August 20th, but nothing too intense and still pretty irregular. They didn’t ever stop, but I decided they must be Braxton-Hicks and I grudgingly went to work. I thought briefly about calling out [sick] on Tuesday as my contractions had continued and seemed to be more frequent, but they were still quite short, not too painful, and still irregular. I didn’t want to “waste” any of my paid time off so I went back in to work where my contractions continued but I was able to get my work done and put them out of my mind. My good friend who had been due August 19th had her baby early on Tuesday, and I had to remind myself to be patient and that I didn’t want Nolen to come before she was ready. I will admit that I was quite jealous that she got to meet her little man already, but it turned out I didn’t have long to wait!
I got home just after 12:30 am, early Wednesday morning (I work evening shift). While the contractions seemed to have settled out a bit, Nolen was moving so much my whole belly looked like a washing machine on spin cycle. I was mildly concerned with the increased movement that she would turn and be breech. I woke Pam to show her my belly, but she was completely unimpressed and went back to sleep. I finally crawled into bed just after 1am thinking there would be no sleeping through this crazy activity, and within moments my water broke! I was thrilled and terrified at the same time, my first thought was, which midwife will be on call right now, and will they let me labor at home like I wanted? Pam helped me to the bathroom, then called in for us, and the midwife decided that even though I had been contracting for almost 30 hours at this point, since they had been so mild and irregular I should try to get some sleep and call back around 8am when the next midwife came on duty, which happened to be my midwife, so I was very thrilled with this.
I had all sorts of big plans for early labor: Pam and I were going to walk the hills, watch Friday Night Lights, bake brownies for the staff, pack some yummy snacks for labor, write a letter to our daughter (we stole this idea from a fabulous mama in our birth class), etc etc. It turned out Pam went back to sleep (I was far too energized for sleep despite the fact that I had been up since 6am and just gotten off work). I took a long shower, baked brownies at 3am, and read a labor book until my contractions had picked up far too much for me to concentrate. Pam seemed to sense my readiness for help at this point and magically emerged from the bedroom with perfect timing. I was grateful she had caught up on some sleep, as we were in for a long night. We called Kay, my midwife, and reported the contraction length, timing, and intensity, and she said it was ok for us to stay home and labor independently at this point still.
Pam and I took several walks up the hills in our neighborhood with the dog, and just when it would seem like the contractions were getting more intense and regular, they would start to slow again. We spoke to Kay a few more times, and at 2 she said we should probably make it in to see her by 4pm even if things still seemed slow, as with my water breaking so early we had entered a 24 hour countdown before we would need to start pushing things along. I really did not want any sort of “help” that would require being admitted to the hospital and possible leading down the slippery slope to Cesarean birth. In the excitement of thinking “this is it. We get to meet our little girl today” we of course forgot to pack any food, diapers for baby, or extra clothes. The lack of food would be our biggest and only real regret later that night.
We arrived to the office just after 4, and Kay hooked me up for a non-stress test. After 5 minutes without a contraction, she came in and did “More Cowbell” (Had I mentioned my obsession with Christopher Walken to her at an appointment and forgotten, or was she just the best freakin’ midwife EVER?) It turns out Nolen has an affinity for the cowbell as well, and we had a quick response. It seemed this was the magical moment, and Kay walked us down to check into our room in The Birthing Inn. I had my first cervical check ever at this point, and went from a 4 to a 5 with a contraction right as she was checking. From this point on things finally began to move faster. (This is after 30 hours of mild labor prior to my water breaking, followed by an additional 16 hours of early labor).
It was very important for Pam and me to maintain our privacy and intimacy during labor, so we did not invite any family. I’m sure after learning how vocal I was they were all appreciating this, as the rooms are most definitely not sound proof. Kay got us all set up and allowed us free range of the laboring space and tools. Our room was cozy, with an I-pod dock, a large birthing tub, a walk in shower, and a sliding door onto the back yard that had a looped path for us to walk. We spend the next hour walking laps, and were thrilled to be able to time contractions this way. When we first started we could go an entire loop before pausing for a contraction, but towards the end we were stopping 4 times. I spent some time on the birthing ball, bouncing and relieving some pressure on my hips. As things finally started to feel pretty darn painful I opted for another shower. This turned out to be my most favorite method of pain management. The heat and pressure combined were amazing. Shortly after the shower, Kay came back in and looked at me and said it was time to get in the tub. It was around 7pm at this point, and things seemed to be moving much faster.
Susan, the birthing assistant came in to introduce herself, and mentioned there was a newborn class being taught. I thought this was fun, as I remembered a birth had happened during my breast feeding class, and I had felt excited and terrified to hear her progress, and thrilled to meet the tiny baby right after. I thought about my instructor and wondered if she was also teaching this class (yes), and whether or not my baby would come in time for the class to meet her (no). Once I entered the tub, the real work started, and I realized how I really had no idea how much my body would take control of the situation and a lot of the things I had learned in birth class were really for those earlier hours. I have to admit to being quite the screamer, even though I had been so sure prior to labor that I would in fact birth in near silence. (I’m not sure how I came up with this idea, I look back and think how crazy I was to think I could work through some of those intensely emotional contractions without vocalizing).
My contractions stacked back to back, and I felt like there were no breaks for me to catch my breath and get any rest. At 8:30 pm I felt my body start to push, and Kay checked me one last time. She said I still had a lip of cervix and I should try not to push just yet. I was not able to stop though, and made quick progress, it was interesting and exciting to see her moving slowly down in my body. After 30 minutes, I became (irrational, crazy, exhausted, take your pick) convinced that I was giving my baby brain damage and that she actually did not fit. I told Kay and Susan that there was no way this baby was coming out and she was going to die if I kept trying. Kay’s first response was that almost all women start to feel this way, and it’s usually right before their baby is born. She explained that if she truly did not fit, we would have figured that out already, and that at this point there was no where to go but out, and in fact she was on her way and we would be meeting her very soon. Of course I disagreed and remained convinced that my baby was not going to fit. They thought a mirror might help ease my fears, but it turned out the sight of her head looking quite pointed only convinced me my brain damage theory was accurate and I was actually killing my baby with every push.
I should pause and say here that I feel so incredibly lucky to have such an amazing partner in Pam. She stayed cool, calm, collected, and completely supportive of me throughout all the crazy I was spewing like vomit all over the room. She let me squeeze her hands, pull her (fully dressed) into the tub to hold me, and cry into her shoulder without ever wavering. She was truly my rock and I could not have done this without her. I should also mention that Kay and Susan were so supportive and despite my fears, I never stopped trusting them. The only rational thought I was having was surely they wouldn’t let me or my baby die at The Birthing Inn, because there’s no way they would want those statistics! (Morbid yes, but completely true. When I told Kay this thought had given me comfort during labor, she chuckled and said while she of course did NOT want that statistic, she would be far more concerned about my safety and Nolen’s during labor and would have transferred me to the hospital to maintain our safety if needed, not just to avoid a statistic).
So, the mirror didn’t work. Kay’s next technique was to have me reach down and feel Nolen’s head and how it moved during my pushes. I was able to feel her pulse, which surprised me, and swirl my fingers in her hair. This was far more calming than the mirror. I finally decided she was in fact, NOT dying, and I was able to really find some strength for one big push. Her head popped out, and I felt her little face with my hands! I think I started to go into a little shock at this point with the rush of the accomplishment. I pushed her the rest of the way out, and it was immediate relief. My perfect little baby was born at 9:16p after 50 hours of labor and only 45 minutes of pushing! So much of the next part is a blur, but through asking Pam and Kay in the months after the birth, I have been able to piece most of it together. Kay brought Nolen up to my chest to get her out of the water. She was quite slippery and I was exhausted, so it took 2 tries and some towels for me to be able to hold her. Pam got to cut Nolen’s cord. I had wanted to birth the placenta prior to cutting the cord, but Kay decided we need to move things along as I was bleeding quite a bit. After cutting the cord, Pam took Nolen and Susan helped Pam get her wrapped and warm and waiting for me on the big double bed. I don’t remember pushing the placenta out, but I do know right after I delivered it, Kay and Susan helped me onto the bed so my tears could be repaired.
It turns out I had 2 third degree tears and 1 second degree, with the largest 2 being internal and more difficult to repair. Kay was busy stitching me up, and it took a little over an hour. Pam was holding Nolen, and bringing her to my chest and up to my face as best as she could. I continued to bleed throughout the repair though, and was in a lot of pain. Kay was concerned for fourth degree tear and checked (yes, this means exactly what you think it means) multiple times, which as you can imagine was very uncomfortable. I was anxious to hold Nolen myself and try to nurse, which finally got to happen at 1030. She latched beautifully and nursed for half an hour, until Kay checked my uterus and decided I needed to pee pronto.
She got me up to the bathroom and as soon as she stepped away to give me some privacy I had to call her back as I got very dizzy. I passed out several times, and Pam has had to fill me in on the next several hours as I have little memory of the events. Pam says it was almost comical to watch our midwife using a towel to try and get the smelling salts off the wall as she held me up on the toilet passed out. Susan quickly came to help and they were able to revive me, but I passed out again immediately. I remember briefly waking up as she attempted to start an IV. They had slapped a blood pressure cuff on me, and oddly enough told me my pressures were never lower than 100’s/50’s. They finally ended up carrying me back to the bed before they could get an IV started and keep me conscious. She started some fluids with Pit (I had declined these earlier, but my main goal was to avoid a hospital transfer), and they gave me some pain medication. I ended up coming in and out over the next 4 hours, and I feel so blessed yet again to have such an amazing partner in Pam and amazing midwife in Kay. Nolen needed to nurse several times while I was coming in and out, and I woke to Kay and Pam holding her to my breast and helping her nurse. It was such a beautiful sight, and I’m again grateful for these few moments of lucidity so I can appreciate the care I received. I am certain that had I experienced these same relatively mild PP complications in a hospital I would have been given blood (which I did not want) and my baby would have been given formula (which I definitely did not want, so much in fact, that I had pumped colostrum in the weeks leading up to her birth to bring if I ended up in the hospital so I would have something to demand the nurses use if they tried to force a bottle on my baby).
Our birth plan had included wanting to go home 4 hours after birth. This fits nicely with The Birthing Inn’s normal 4-6 hour post birth discharge times. However, I was exhausted and completely depleted (my hematocrit* dropped to around 21 after birth), so Kay kept us until 9 the next morning, nearly 12 hours after Nolen was born. The three of us snuggled in the bed together and Pam stayed up all night watching over me and Nolen. Kay stayed all night with us (usually the midwives leave after an hour or 2 and the birthing assistant stays until discharge).
I can’t emphasize enough how my experience was so perfect and amazing, despite my complications. The complications just showed me how I made such a great choice because despite the little hiccup, Kay kept me and my baby completely safe. She followed all my wishes as best as she could, and never pressured me to do something unnecessary. In the months following, Kay saw me several times, first to check on my repair, and as I battled postpartum OCD, she continued to call me and even bring me in, she offered me books, homeopathics, and directed me to the most wonderful PP counselor. My birth journey has been filled with people that have supported me and shown me how capable and strong I am. I feel so proud of myself, not only for accomplishing my goals in childbirth, but also for doing my research and learning to trust my body and my recovery.
* Hematocrit levels are a way of judging amount of blood loss. 21 is pretty low, meaning some significant blood loss. Meghan is correct that, in a hospital, most doctors would have wanted to give her a blood transfusion at that point.