Saturday, April 18, 2015

Reuben's Birth: A Plan!

I went into my pregnancy with Reuben knowing more about birth than ever before.  I was also more aware of the options women have.  I had made many friends in my new town, and some of them had chosen to have babies at home.  Some had been attended by a midwife, some had only been attended by their husbands and family.  I had heard of homebirths, of course, but this was my first experience with meeting people who had done it and were very positive and encouraging to others.

I was also a bit dissatisfied with how things had gone with Mena's birth.  It took me a long time to really put m finger on what had bothered me so much.  It had been so rushed, so frantic at the end.  Nurses and doctors at hospitals have a job, and that job is to do everything they can to make sure that mom and baby survive birth as healthy and happy as possible (and healthy is higher on that list than happy).  I can't fault the nurses for all the checking and monitoring, even though I was so far gone in labor, and starting to panic through contractions and did not want to be up the table to be checked. I did not want to feel panicked and rushed again.  I wanted my labor to be more peaceful.

I was armed with some valuable information about myself now.  First, there was every chance that my next labor would also be hard, fast, and short.  I could plan on three hours (or less) from start to baby.  Second, too much activity, noise, light or other stimuli during labor would increase my stress levels and make labor hurt more.  I needed calm, quiet, dimness.  Third, I could use visualization to help ride out contractions.  I used visualization to help walk my dog.  He was (he has since passed away) a large dog who loved kids and and people, but hated other dogs.  He was insecure and had a "Get them before they get me" attitude toward other dogs.  When I walked him it was imperative that I visualize myself as powerful, calm and in control, because he would pick up on that, relax and feel safe.  I needed the same type of visualization in labor.

Initially, I decided that birth at home would be the best way to achieve the relaxing atmosphere that would help me through labor.  Our little town has no midwife, and as much as I liked Dr. P, he didn't do homebirths.  I found a midwife in the next large town, 75 miles away.  I was very excited, even drove through a snowstorm for my first interview with her, and I felt good about it.  Until I left.  Three steps out of her office, and I was hit with the worst sense of foreboding I've ever had.  I couldn't explain it, but it went on and on, and I couldn't wish it away.  I couldn't feel good or confident about birthing at home with a midwife.  I don't think it had anything to do with the midwife herself.  She seemed to be very experienced and sensible, with all the proper certifications, and my pregnancy with Reuben was about as low risk as a woman can get (except that I was over 35, so I was suddenly an "older mother").  I just didn't feel comfortable, and that would not do for labor.

Maybe it was just the distance, and knowing that it would take the midwife a minimum of 90 minutes to reach me.  Maybe it was that memory, indelibly etched into my mind, of waking up on my back, watching the ceiling lights of the hospital flash by, Dr. K sprinting as she and nurses wheeled me down the hall.  For those few minutes, I knew I was dying.  I prayed for my husband as I was dying.  I know how quickly things can go from apparently perfect to very--even fatally--wrong.

The only other option was the hospital, so I had to plan for a relaxing environment there.  It was the first time I had written a birth plan.  What I wanted was to be left alone to labor in peace and quiet with my husband, but that sounds rather rude.  I wrote about how fast my labors come, about my desire and ability to ride out contractions calmly if given quiet, minimal checks and monitoring, and little noise.  I planned to go to the hospital as soon as the first contractions arrived.

The day before Reuben came was a Sunday, and our parish's church picnic in the park.  It was hot but fun.  When I lost my mucus plug that afternoon, I knew Reuben would be there soon.  I probably should have gone to the hospital right then.  Instead, my parents came to stay in the extra room, and as soon as the contractions hit--sometime around 2:30 in the morning--off we went to the hospital.  Because I had tested positive for strep B, I needed an IV of antibiotics.  Because I had spent most of the previous day sweating it out in the August heat, I was dehydrated.  It's hard to get an IV into me when I'm dehydrated.  It felt like it took a long time, and I had to sit very still through a few contractions while they got it into a good vein.  Of course, the IV pump is usually plugged in, and I wanted to be able to wheel it around with me.  The nurses were concerned because it has a limited battery life--something like four hours.  Oh, this baby will be here before that battery runs out, believe me!

They let me waddled to the bathroom and labor on the toilet, because that was comfortable.  They made themselves scarce, turned the lights down nice and low, and brought a big mug of ice water with a straw.  It was perfect.  My husband wanted to rub my back or do some sort of massage, but touching was too much stimuli for me.  No, honey, just give me water when I ask.  And hold my hand.  There was no clock in the restroom, but that was probably good.  Nothing makes time stretch to its utmost like watching a clock.  Siting in a semi-squatting position kept me progressing at a good clip (I think if I had walked, it would have progressed too quickly for me to handle).

Soon, I had to really focus on relaxing and visualizing something powerful and calm.  My favorite image for dog-walking was a huge, old sailing ship, like in Pirates of the Caribbean. The image of a great, grand ship slicing through smaller waves, and riding over the larger ones was a perfect image for labor.  The contractions themselves were like waves, but as they grew more intense and very close together, the ship wasn't the right image.  I needed something to help me picture riding with it, not slicing through it. Surfing was better.  I no longer felt powerful.  I had to go with the contraction because if I didn't I would wipe out, and it would hurt.  Maybe that's not the  most useful imagery, but it helped keep me focused on the importance of relaxing.  (I have actually never surfed.  I live in the most landlocked state in existence, but the image was the important thing.)

Sometime during my surfing, my water broke.  I told Lupe to get the nurses and tell them.  They wanted to check how dilated I was.  I didn't much feel like getting to the bed, but like I mentioned, checking is their job, and I generally believe in letting people do their jobs.  I got on the bed and that familiar sensation hit.  I needed to PUSH, and I said so!  I'm sure I was fully dilated, because the nurse told me to go ahead.  Someone else ran for the doctor.

Dr. P wasn't there that night.  Dr. J was on call.  I found out later that they'd performed two emergency c-sections that night as well (which might account for why they left us alone so nicely), so I think a straightforward, simple vaginal delivery was a relief.  I pushed, and everything hurt so badly that I asked Dr. J if I was crowning.  He nodded, and I felt like I imagine marathon runners do when they realize the finish line is only 50 yards away.  Two more pushes and Reuben was out.  It was 5:06 am.
Look at all that hair, and his beautiful broad forehead!  This little guy ended up with curls.

I had wanted to let the cord stop pulsing before they cut it, and the doctors and nurses had agreed.  However, Reuben's cord was so short, they couldn't hand him to me, or even see while I birthed the placenta.  Instead of leaving him laying between my legs, they cut the cord and gave him immediately to me.  Yup, my squashy little beet with a brush cut.  After birthing the most enormous placenta I've ever had, all that was left was the clean-up.  The nurses were very impressed with me, which I found a little confusing.  They must see delivery every day, or at least several times a week.  I guess I labor much more quietly than most women (making noise increases my stress level; I like quiet), and not everyone can ask coherent questions in the middle of pushing.  I get that, but knowing women who labor for much (much) longer than I, I didn't think two and a half hours, however intense, really put me in any special category, except "most likely to deliver before the doctor arrives."

Can I give hospitals some advice?  Dear hospitals, feed your new mamas well!  Give them meat and fat, and something filling, warming and satisfying.  Regular hospital food does not cut it!  That's my big change in plans for baby #5:  Before I go to that hospital, I'm packing myself a thermos of bulletproof coffee (coffee blended with butter, coconut oil and gelatin) and a bacon sandwich for my post delivery meal!
And Reuben makes four!

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