Monday, June 6, 2011

Confessions of a Mama with an Awesome Hospital Experience

©Molly 2011. Molly provides perspective on the experience of birthing with a supportive OB. She shows us a great balance between the patient/doctor relationship and how being informed can drive positive outcomes.



"If you would have told me when I was pregnant with my first child that someday I would have a perfect birth in the big bad hospital, I would have laughed in your face. And then I would have told all my Internet mama friends about you.


But here I am, three years later, and I have done just that. I had a perfect hospital birth, with an OB even!

I didn’t set out to birth in a hospital, or to even interact with an OB. But I learned from my first birth that birthing unassisted isn’t right for me and since we didn’t have funds set aside for a midwife I had to go with what my insurance would provide. And so I reluctantly made my first OB appointment.

My doctor is respectful of informed refusal and consent, even when she disagrees with a patient's choice. That mindset is the base of our good patient/doctor relationship and without it I would be writing a much different story. She never pushed me to have the glucose tolerance test, to have bloodwork (I’m severely needle-phobic), or any other tests. She just said "okay" and moved on. This relationship is a two-way street though, and although I am a paying client she is also a caring person and a part of my birth team so compromises were made on both sides. I allowed non-stress tests after 40 weeks and at 42 weeks I had a biophysical profile done to ease her mind about my son continuing to gestate.

Yes, continuing to gestate. Past 42 weeks. With an OB.

My doctor was initially uncomfortable with my pregnancy going postdates and it created a few waves in our relationship. It caused me a tremendous amount of stress and I felt as though I was going into battle rather than preparing for a peaceful birth. You can imagine how incredibly relieved I was when, at my next appointment, my doctor said that she had consulted with a local midwife about my refusal to induce based only on gestation length. The midwife helped ease my doctor's fears and she actually found herself excited to see how birth goes on its own when no one interferes with the natural process. She was about to go on vacation but kept me as her patient rather than sending me to someone else in her practice. She gave me her cell phone number. She was emotionally invested in me and excited to attend my birth. Leaving her office that day I felt reassured and at peace about her being a part of my son's birth.

My labor started on my daughter's second birthday, at 43 weeks, 2 days gestation. During her birthday party I started to become reclusive, isolating myself from the party, going within myself. I was subconsciously preparing for labor.

Labor seemed to progress pretty quickly. I labored in the bathtub and bounced on my birth ball and rhythmically vocalized. After a while I had my mom pick up my daughter for her first overnight visit. Then I called my doula, Madeleine, and asked her to meet us at the hospital. Contractions were becoming painful and I was losing control in a bad way.

Madeleine joining me was a turning point in my labor. We met in the hospital parking lot just in time for another contraction. We hugged and swayed while she helped me vocalize effectively and “ride the wave”. She had a calming presence and simply being near her lessened the intensity of my contractions.

The next few hours are blurry to me. I bounced on a birth ball, hugged and swayed with Madeleine, vocalized, and passionately kissed my husband, Zach. Kissing Zach and smelling his scent made many of the contractions painless. It didn’t erase all the pain from all the contractions, but it definitely made a huge difference.

The lights were turned off in the room, I wasn’t attached to anything (not even a hep lock), I was wearing my own clothes, and I was free to move about as I pleased. For the most part, no one spoke during a contraction (probably because I would hold my hand up and make it clear that everyone should shut up, heh), and when people did speak they spoke softly. My OB touched me all of once, and it was for a cervical check that I requested.

Transition was rough. I don’t recall much of it but I do know that I said things like “transition stupid” and “take break, more later”. I remember thinking about how speech shuts down as you enter Laborland and wondering if having that thought meant I wasn’t in Laborland. Talking with my birth team a few weeks later and hearing what all went on that I wasn’t aware of, I think I was definitely deep in Laborland.

Eventually my son, Phoenix, was ready to be born. I stood by the bed and leaned over it. I pushed with my natural urges while Madeleine helped me focus and vocalize effectively. Phoenix would come down some and then go back up, easing himself down and gradually stretching me out. At one point I was so sure that his head was out but apparently it was only the top of his head (!!!).

Once his head was born Dr. Harris saw that his cord was around his neck. This is the point where I consider the birth to have ended and everything after this I consider to be after the birth. The labor and birth were beautiful and empowering, healing and redeeming. I couldn’t have asked for a better birth or a more respectful birth team.

So. His cord was around his neck and when Dr. Harris went to unloop it, it tore. Dr. Harris said, “oh shit!” and then said that he needed to come out NOW. The nurse helped my get on the bed (she was strong!) and I had to get in the knees-behind-your-ears position to get him out ASAP. We got him out with the next push and 20+ people rushed into the room to save Phoenix, who had lost a lot of blood. Madeleine covered me with a blanket so I wasn’t so exposed. Phoenix was white as a sheet from losing so much blood, his heart wasn’t beating and his lungs weren’t breathing.

Dr. Harris had tears in her eyes as she said, “I’m so sorry. I know this isn’t what you wanted”. I was lucky enough to go into shock. My brain was like, “oh hell no, we’re not going through this right now”. I was aware of what what happening but I was so detached, I wasn’t there, I was nowhere. My *me* shut down and my body and basic awareness stayed on. Poor Zach was fully present and had to experience what was happening. I remember hearing, “1, 2, 3, breathe, 1, 2, 3, breathe”. I had a quick glimpse of Phoenix on the table before he was completely surrounded. After two minutes I heard, “we have a heartbeat!” and he was rushed to the nursery to be intubated. Zach, of course, went with him.

The next while is pretty blurry but I remember shaking and getting really cold. When I birthed my daughter, Lotus’, placenta it just slithered out and felt so good, relieving. Phoenix’s placenta, however, HURT when it came out. That was lame. I had been looking forward to that feeling of the placenta just slipping out easily.

We were lucky that circumstances forced us to birth in the hospital. Phoenix was one of those rare babies who wouldn’t have been okay had he been born at home. He wasn’t able to room-in until his second day but by his first night he was able to come to my room to nurse every two hours for one hour at a time (and then he had to go back to some machine in the nursery). A nurse was heard saying that she, “has never seen a baby recover so quickly from a full code”.

I’m not sure how to end this, so I’ll end it with this: He was 10lbs 3oz, born completely naturally, and I didn’t tear. That part rocked.

Reflections on my birth plan vs my birth:

My birth care plan was followed almost exactly:
- We maintained a calm environment. Dimmed lights, soft voices, closed door, etc.
- I used a birth ball to ease discomfort.
- My water was not artificially ruptured.
- I labored and birthed without an IV or Hep Lock.
- I did not rate my pain, nor was I asked to.
- No one even mentioned medical pain relief.
- A nurse monitored my son's heart rate with a doppler wherever I was at the time, and she was always respectful.
- I had only one cervical check, and it was at my request. There was no pressure to have any.
- I pushed in a position of my choosing with my body’s natural urges, and without being shouted at to “PUSH! PUSH! PUSH!”.
- Our placenta came on its own.
- Our son was not circumcised or vaccinated, and he did not get the eye ointment.
- Our son was (and is) exclusively breastfed on demand. The hospital was great at encouraging the nursing relationship!

However some changes did have to be made:

- I wanted the amount of extra personnel in the room limited and until my son was completely out, this was followed. Once he was born, 20+ people rushed into the room to bring him back to life.
- I wanted to do "delayed" cord clamping. Obviously this was not possible.
- I really wanted to have immediate skin-to-skin contact with my newborn.
- Mommy or Daddy weren’t with Phoenix all the time. My Zach had Lotus to take care of and I was fell asleep in the wheelchair in the nursery. I even had to send him back to the nursery once when I was falling asleep with him and there was no one in the room to keep an eye on him (we bedshare, but his breathing needed to be monitored at all times for a while so someone had to stay awake)."

5 comments:

  1. Aw, I love that you included a picture of Phoenix :)

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  2. I remember reading your fb statuses the minutes after he was born. Phoenix is an amazing boy and you are a phenomenal mama who is completely in tune with her baby. Both times. I admire and respect you immensely.

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  3. I'm so glad that you had an awesome experience of labor, and even gladder that your little guy was able to have the staff on hand to take care of his needs after the birth. You did an awesome job, mama, and I'm so glad that everything worked out! Thanks for sharing!

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  4. Dr. Harris delivered my son as well :) mind you, this was before I had any desire to have a medication free birth...but looking into a natural birth for the next baby, I'm so happy to see Dr. Harris in this light...

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