 |
 
|
|
  In Melanie's wordsJuly 31st-August 1st
Nothing had really been happening as far as dilation, effacement, and engagement; and because of my blood pressure, it was in everyone’s best interest that Ethan make his debut sooner rather than later. At Friday’s visit, Shanna suggested that I try Evening Primrose Oil and Red Raspberry Leaf Tea. Craig was able to find the Evening Primrose Oil at Wal-Mart, but had no luck with the Red Raspberry Leaf Tea. I told him, no problem, I could just get it on Monday when I went in for my next appointment. On Saturday, I took several doses of Evening Primrose Oil- 3 orally and 2 vaginally. I woke up a couple of times during the night, feeling crampy, but didn’t really think anything of it. Sunday morning, at 4 a.m., I got up for my nightly bathroom trip and realized that they were a little more than crampy now, and they seemed to be coming in a regular pattern. I figured I could be in labor. Around 5:30 a.m., I decided to wake Craig up and let him know that I thought I was in labor. He was planning on golfing that morning and I didn’t want him to get ready to go and then find out he wasn’t going anywhere. This was probably a mistake because the next time I saw him, he was fully dressed with his tennis shoes on. At 7 a.m., I decided maybe I should let Shanna, Michelle and Delilah know what was going on, in case they had plans for the day. I paged the birth center to let them know that I thought I was in labor. Shanna returned my page, asked me a couple of questions, and then got off the phone with me and called Michelle. A little while later, Michelle called, and we decided to meet at Dr. Dharma’s Kaufman office, since it was closer than driving up to the birth center. Craig and I arrived at Dharma’s office at 7:35 a.m. to get Ethan’s vitals checked and to see if I was progressing or if this could be false labor. I was 1cm dilated, 75% effaced, still had a posterior cervix, and Ethan’s head still wasn’t engaged. Michelle let us know that this could be the real deal, but it could also be false labor. We headed home to wait and see what would happen. Between 11 a.m. and 2 p.m., the contractions started to slow down to about every twenty minutes or so. I decided it was probably false labor and was a little bit disappointed. The contractions started to pick back up and we met Joyce up at the birth center around 5 p.m. to get checked for the second time. I was still about 75% effaced, and 2 cm dilated. They wouldn’t admit me until I was 5 cm dilated, so off we went with a prescription for Ambien, so that I could get some rest. Although I have no recollection of this event, we apparently made another trip to the birth center around midnight to be checked once again. I was only up to 3 cm dilated, so once again I came back home. Shanna told us to call her around 5 a.m. and let her know how things were going. The contractions continued to come regularly, but I would sleep in between them, so the Ambien probably helped me a lot. In the middle of the night, probably whenever the Ambien wore off, I became aware that the contractions were coming fairly close together and it was probably time to start timing them again. They were now coming about three minutes apart and lasting one minute. During this time, I also started to throw up. Throwing up is never fun, and it is even less fun when you are having contractions. I told Craig to call Delilah, I knew I couldn’t handle it by myself anymore and needed someone with me. With another trip to the bathroom, I discovered there was bright red blood coming out and I thought that this meant that there was something wrong. I told Craig to page the birth center and they told us to call Delilah and tell her to meet us at the birth center instead of at our house. Around 3 or 4 a.m. when we got to the birth center, I told Craig to leave our stuff in the car. I wasn’t totally convinced that we were going to be staying, and I didn’t want to have to reload the car. Once inside, I discovered that I was 7 to 8 cm and 90% effaced, so I would definitely be staying up there to have a baby! I told Craig to call Mama and Daddy, and ask them to call Jennifer and Cheryl. I felt bad for calling in the middle of the night, but I didn’t want to get in trouble for not calling either. Jennifer, Daddy, and Mama came to the birth center to await Ethan’s arrival. Eventually Jennifer had to go home, but Mama and Daddy stuck it out for the several hours it took for Ethan to finally come. The contractions still didn’t feel that bad, but they were a hundred times worse than they had been on Sunday morning. I kept telling myself, you better deal with this one, because they are going to get worse. I climbed into the tub at the birth center and felt my body relax. At that point, I didn’t think there was any way anyone would be able to get me out of the tub. Lying in the tub eventually became uncomfortable and it was off to the toilet. After a while, it was off the toilet and back into the tub. Shanna came to check me and I must say, I was not too thrilled about it. I was feeling good and didn’t really want to move. Shanna agreed to check me in the water, but informed me that I would have to get out when it came time to push because the tub was too small for me to birth in. It turned out that I was fully dilated, with a bulging bag of water. Shanna was unable to tell from my position if I was fully effaced or not, so I had to get out of the tub and onto the bed. There was only a little lip of cervix left and they told me that if we broke the water, that it would probably disappear and I would soon be ready to push. I decided to go ahead and have them break my water, and it wasn’t long before I REALLY felt the urge to push. I started to give little pushes and it actually helped lessen the pain of the contractions. Several times, I was told that I could feel his head if I wanted to. I thought they were crazy. Anyone who has ever been pregnant knows how hard it is to reach down there, and I figured there was no way I was going to feel a head that was still inside of me. Eventually, I listened to them, and they were right! I could feel his head, and it felt like he was soooo close to coming out! I think that is what I needed to put a little oomph into my push. When the head started to come out, they got a mirror and between contractions, I looked down to see that in fact, we were getting very close to finally having a baby! At 7:47 a.m., Ethan smoothly slid out, and with him, came an instant feeling of relief and renewed calmness. After many months of pregnancy, and several weeks of bed rest, I was finally a mommy, and Craig was finally a daddy. In Delilah's words After I taught their class, Melanie emailed me about my serving as their doula. Over the next couple of weeks, we emailed back and forth, talking about how her pregnancy was going, what her blood pressure was doing, and about her birth plan. Once she completed her birth plan, I met with Melanie and Craig in their home again to discuss their preferences and clarify what they hoped for from me. I brought some homemade raisin bran muffins, which were unfortunately pretty bad, but I promised to bake something more edible after I got my new oven installed and Ethan made his appearance! One interesting thing, which came out at this meeting, was that Craig and Melanie each felt that hiring me was their idea to which the other had agreed. I thought that was pretty cool (and unusual!)- and I was honored and excited about attending them in their birth. Over the next few weeks, Melanie’s blood pressure fluctuated from high normal to borderline PIH levels. We had discussions about what her options would be if she should “risk out” of a birth center birth, and I did some research into what the World Health Organization and MaternityWise organizations recommend as optimal care in cases of hypertension in pregnancy, so that I would be prepared with such information if she needed it in labor. It was a big learning experience for me, which broadened my knowledge base since it was not a topic I had needed to know a whole lot of details about before, and I found it fascinating. Even so, I prayed every day that Melanie’s birth would go smoothly and be just the way she wanted it, at the birth center. Every time I emailed with her, I was very impressed that through readings which ranged from merely elevated to definitely too high, and having to go for a consultation with an OB and do frequent tests to verify that her blood pressure wasn’t worsening and that she wasn’t spilling excessive protein, Melanie remained confident and calm. She seemed to have spent her long weeks of bed-rest educating herself about birth and keeping in contact with other moms via the internet, practicing consciously relaxing, and staying extremely focused on maintaining her health and Ethan’s, without complaint or impatience. She was extremely careful of her diet and managed gestational diabetes very well through her disciplined eating, even though she had orange juice taunting her in her fridge for over a month- what self-control! Many women who have far less reason to have concerns, whether with their first baby or their fourth, spend a lot of energy fretting. Not Melanie! She maintained tremendous calm and confidence through a trying situation, and as far as I could tell, she had a positive attitude the whole time. What an inspiration! Craig was kind enough to come and install my oven on Saturday, 30 July, after working all day. I was so excited! He left his measuring tape behind by accident, and when I called to tell him so, he asked if I was baking yet because I had seemed so excited about my new oven! I said not yet, since he had only left seven minutes before, but I would be soon! Craig told me he would stop by some day after work and get the tape measure, but that he had five others so it was no rush. Sunday morning, 31 July, I missed a call on my cell phone from Melanie at 7 a.m. while I was in the shower and when I saw it at 8 a.m. and called back to see what was up, Craig told me she had already had the baby! I about had a heart attack! Then he laughed and let me talk to Michelle. They were at the birth center. Melanie had awakened at 4 a.m. with contractions and gone into the birth center at 7 a.m. to get her blood pressure checked and see if it was actually labor. In fact it was labor, but very early- she was 1 cm dilated and 75% effaced, baby still floating. But the good news was, her blood pressure was fine, and everything was continuing well for a birth center birth! I told her “Today is a great day for a baby as far as I am concerned, and so is tomorrow!” and asked if she felt like she needed me yet. She did not, she was going to go home and try to rest, and call me later. I got my family ready and we went to church. Then we came home and I gave Melanie and Craig a call around 1 p.m. to see how things were going and reassure them that I would come whenever she wanted me to. I also had to verify that neither of them were allergic to nuts, and that chocolate was what she wanted once the baby was born! She confirmed that, so my son and I spent the afternoon making chocolate cookies with chocolate chips and Reese’s chips to freeze dough balls of, for fast baking whenever Ethan was safely here. I talked to Michelle twice that afternoon, me checking in to see if she had heard anything and she checking with me to see if I had heard anything. We were both hesitant to call very often as we hoped Melanie was resting, which it is hard to do when the phone keeps ringing! In the early evening, Michelle said that Melanie had progressed to 2 cm and was still contracting regularly, and that she had given her an Ambien and hopefully Melanie would be able to rest, in case labor kicked in fully on Monday. She said she would just check on her again at her regular Monday morning prenatal appointment, unless Melanie slept for eight hours until the Ambien wore off, and then kicked into active labor in the middle of the night. I lined up middle of the night child care plans with my husband, sister, and put an extra sitter on notice to spell my sister, in case the birth went on longer than expected, and went to bed by 10 p.m. after emailing Melanie that I was doing so, and that I would be sleeping with my cell phone. I told Kurt that I was betting she would call me at 2 a.m. At midnight, they went to the birth center to be checked and Melanie’s cervix was 3 cm dilated, and her blood pressure was holding steady at 140/90, so they went home. 2:10 a.m. Craig called and said that Melanie was electing for me to come now. I asked whether she wanted me to come to the house or go to the birth center, and he said the house. I agreed and jumped in the shower- on the premise that nothing could be worse than a doula that stinks! By the time I got out of the shower, dressed, and was loading my stuff into the car, Craig called again. It was now 2:45 a.m. and he said they had decided to go to the birth center, Joyce said to come on in after all. I told him I was on my way. 3:15 a.m. I arrived at the birth center but nobody was there yet. I finished drinking my coffee and reviewed Melanie’s birth plan to memorize the photos she wanted and to make sure I knew some of the affirmations she was focused on. 3:20 a.m. Still nobody was there. I called Craig to find out where he was, and they were about 7 or 8 minutes away. I asked if Joyce was going to meet him there or wait for him to call and say they had arrived, he said she was meeting us there. I had a key but no alarm code, so I didn’t want to go inside and set off the alarm. Feeling a little foolish about it but not seeing any alternative, I brushed my teeth in the yard using my bottle of water- I didn’t want to have coffee breath, since again there is nothing worse than a doula that stinks! As I was wiping off my hands, Craig and Melanie arrived. She was calm and had been throwing up, but not in the car. Craig was glad to be at the birth center, but didn’t want to bring their things in, in case they weren’t staying. I gave him his tape measure back from Saturday’s oven installation. As we chatted at the car, Joyce arrived and we all went inside. 3:30 a.m. We were all delighted to discover that Melanie had dilated to a stretchy 7, almost 8, with a bulgy bag of waters. The baby’s heart tones were in the 140’s, and everything looked great. I asked Craig to go get the camera and bring in “the stuff” because we were definitely staying! Melanie spent a little while in the exam bathroom throwing up some more, while I started the water running in the tub in the birth room bathroom. Then she coped while leaning over the washing machine for a few minutes, and we started trying out things to see what helped most. 3:50 a.m. Shanna arrived at the birth center. Shanna and Joyce called Michelle to come. Joyce was getting all the supplies out and ready. In Melanie’s birth plan, she had wanted to try heat and cold, and had brought a hot gel pack with her, so I heated that up, and also massage. When first coming to a woman in labor, I try things out to see which one elicits a kind of “ahhhh… relief!” type reaction, and try to remain sensitive to her responses to each thing I try, starting with the coping techniques she has requested and then moving along through my repertoire as we figure out what works for her in that situation. I started with the massage, some of her affirmations from her list, and the heat pack, but didn’t feel that swift “yes, do THAT” vibe from her although I didn’t get a negative vibe either. She was very self-possessed and quiet. I asked if she was enjoying listening to idle conversation during contractions as she had specified in her birth plan, and she smiled and said she hadn’t gotten a chance to try it yet, since she and Craig had been alone. I told her I would give it a try, and to stop me if it was annoying instead of helpful. Melanie asked for a suggestion of something else after doing a few contractions leaning over the washing machine, and we tried one or two squatting up and down, before she decided to get in the tub even if it wasn’t completely ready. Craig’s cell phone went off during a contraction, causing Joyce, Melanie and I all to about jump out of our skins. 4:10 a.m. Ahhhh, relief! There was the reaction I was looking for, as soon as Melanie got in the tub and settled into it, and I started pouring the water over her. She was completely relaxed- the Bradley description of mommies seeking a small, private space and laboring with calm breathing and appearance of sleep came to my mind while watching her. She was just letting the contractions roll right over her. Shanna came in and checked, and her blood pressure was 136/50, the baby’s heart tones were in the 150’s. Craig’s cell phone went off for the second time, and she opened her eyes to give him “the look of doom”, so I suggested maybe he could turn the phone to vibrate. He offered to start the music CD’s that she wanted but she only wanted quiet. Craig came and sat on the toilet and held her hand while she soaked, after taking some video of Melanie relaxing beautifully in the tub. She started vocalizing during some of the harder contractions a little bit- in a very low, quiet voice. 4:45 a.m. Melanie got out of the tub to use the restroom and felt like she might vomit some more. Craig held the bucket for her in case she needed it while I went to find her some ice water. She did not really want the water but consented to having sips here and there anyway. She was leaning forward sitting on the toilet, and didn’t want to move. We tried the affirmations again, but she seemed to be calmer with quiet, so Craig and I were quiet. 5 a.m. Michelle arrived and said hello. 5:07 a.m. Baby’s heart tones were still 140’s, and everybody was looking good. Melanie remarked that she thought she needed to poop. After talking about whether it was actually poop or potentially just rectal pressure from the baby, she was pretty sure she really just needed to poop, so I gave her some privacy, though Craig stayed with her. Joyce left at this point because she had a homebirth client in labor also, and Michelle and Robin were now there with Shanna. I visited with Michelle and Robin a little bit, from a few yards outside the door of the bathroom while I waited for Melanie to call me back in. 5:15 a.m. I knocked on the door and asked if they needed anything. Craig welcomed me back in and said that Melanie needed to be fanned. They were still sitting together with her on the toilet and him on the edge of the tub, so I fanned them both, which she did feel was better. Melanie was feeling a lot of pressure in her back and I did the double hip squeeze through a couple of long, hard contractions. I was having trouble maintaining my balance from my precarious position between the pedestal sink and the toilet, and I told Melanie that I could do the DHS much better if she sat backwards on the toilet and asked if she felt she could turn around. She didn’t think she could move. I did a couple more contractions’ worth before I had to stop because my legs and one arm were having spasms. 5:30 a.m. I asked again if Melanie thought she could turn around, but she decided that if she had to move, she wanted it to be back into the tub! Her reaction was again, ahhhhh- relief! We used the pitcher for pouring water over her and the wet washrag for wiping and wringing- pretty much, if it had to do with water, it was a relief. (Other than having to drink periodically, which she did but without much pleasure.) I found a barrette for the front of Melanie’s hair which was dangling in the water after having escaped from her ponytail. 5:40 a.m. FHT still 140’s. 5:50 a.m. Shanna suggested checking Melanie’s cervix because she was 7 cm two and a half hours earlier and she was feeling a lot of pressure. Melanie was in the hands and knees position in the tub and not inclined to move out of it. Shanna checked and found no posterior cervix, but couldn’t tell from the anterior in the position Melanie was in. Shanna suggested getting out of the tub so she could check better on the bed, and Melanie suggested two more minutes in the tub instead. Shanna also asked about potentially rupturing her membranes, and suggested she consider it. Melanie asked me what I thought about AROM at this point. I told her it was her birth and up to her what she wanted to do. She asked if it would make it hurt more- I said that it was true that the “cushion” would be gone, so maybe- but that since she was pretty much fully dilated, and all that was left was pushing, it might just feel “different”, because pushing IS a different feeling from “riding the wave” during contractions. I told her that it might shorten the rest of her labor, but that baby was tolerating labor just fine and that she herself was coping beautifully and there was no particular reason to shorten anything, if she preferred to keep going as she was. I also said that if she felt at all “pushy” when she felt that pressure, she could just push against it a little, and her membranes might rupture spontaneously, but she didn’t have to push- if it didn’t feel good, to stop. She did a little push and said it didn’t feel good. 6 a.m. Melanie went ahead and got out of the tub and went to the bedroom and leaned against the bed- like sitting on the edge of it with both feet still on the floor. After about ten minutes, she let Shanna check her again and indeed, she was completely dilated with a small lip on one side. 6:15 a.m. Melanie agreed to let Michelle rupture her membranes. Baby’s heart tones were holding steady in the 140’s, and Ethan was at 0 to +1 station. She coped through a few contractions on her left side. 6:27 a.m. Melanie’s blood pressure was 128/64. She was done being in the bed and headed back to the bathroom. 6:35 a.m. The toilet didn’t feel good either. She was tensing her shoulders during contractions although when I touched them and whispered “Relax” she immediately did so, every single time- her conscious relaxation was amazing. She went back to the bed to stand up beside it and lean forward onto it. She had to throw up some more, and drank a little more water to replace it. During some of these contractions, she would squat up and down, or sway her hips back and forth, and vocalize very low. Heat and cold were too much sensation for her, or distracting- massage was too much- Melanie was extremely inwardly focused at this point. I mainly sat near her and watched her for any sign of a need I could meet- a sip of water, a tissue, the Corona bucket for when she was sick. As one who loves to help, sitting and waiting to be needed was hard- I wanted to help! But Melanie was “in the zone” as Craig described it later, and to do more than wait would have been a hindrance more than a help, so I spent awhile just taking notes and photos occasionally, without speaking or touching. Michelle whispered to me that she felt the same way- wanted to be able to DO something to help, and I said I knew- but Melanie was doing great and didn’t need our help to cope- we had to just wait for her to need something! We were so impressed with her ability to work with her body without fighting it, and her calm manner and instinctive ability to give birth. 6:45 a.m. Melanie headed back to the toilet. Baby’s heart tones were still in the 140’s. We were a little concerned that she truly might birth the baby into the toilet, because she had been pushing little bits for awhile now and feeling a lot of pressure, and talked about how the baby’s head really did feel like the urgent need to have a bowel movement. Michelle made a joke about knowing someone who had made a turd as big as a baby’s head before. This struck me as outrageously funny for some reason. I kept an eye out for if the idle chatter was bugging Melanie, because she had been so quiet herself. I couldn’t tell from observing how she was feeling at that point, she was so quiet and inward. Robin put a phone book under each of her feet so that she wouldn’t get a leg cramp from sitting on the toilet. I made a mental note of that little trick for my next client’s benefit- great idea! About this time, Michelle sent Craig to go lay down because he was so tired. He was a little worried about missing anything, but she assured him that him getting some rest would be a good thing and Melanie would need him to be conscious more, later on than at that moment. Michelle told him she would wake him up before the baby came. 6:55 a.m. Melanie went back to standing beside the bed. FHT’s still in the 140’s. More sips of water, more squatting, more calm contractions with QUIET. Sometimes Robin or Shanna would murmur some encouraging comments or rub Melanie’s back for a minute, but we didn’t want to throw her off her groove, which was obviously working for her so well. 7:18 a.m. Baby is definitely +1 or a little more. Melanie says her bottom hurts, so she gets in a right side-lying position and Robin applies hot compresses while she pushes. 7:30 a.m. Ethan’s head is a little visible during pushes now, so Michelle sends someone to wake up Craig. He comes in to take some video. We are telling him where the head is, but he has to take our word for it that that’s what that is that he is seeing. 7:40 a.m. Got out the mirror, but Melanie wants her eyes closed while she is pushing, so isn’t watching right now. However, she reaches inside and feels how close his head is to coming out, and begins pushing with renewed energy. She still barely makes a sound. 7:43 a.m. A half-dollar sized amount of head is visible even between pushes. Between pushes, Melanie looks in the mirror, and Craig is able to tell for sure that that is baby he is seeing now. 7:45 a.m. Ethan’s head is out! Shanna says the cord is not around the neck, then says she isn’t sure, then says no, it isn’t- so Melanie could go ahead and push him out. 7:47 a.m. Ethan Michael Craig is born, (with both hands up by his face- which was what Shanna was feeling that she was momentarily unsure about) over an intact perineum! Robin remarked that they can nickname him “Jet” because he was born at 747! Craig was completely speechless but I think and hope that he caught it all on video. I took some pictures but have no idea what they looked like- we were so excited! As soon as he came out, he went straight into Melanie’s arms- what a joyful moment!!! He was not too happy and was crying within a minute, and pinked right up, with 1 minute APGAR of 8 and 5 minute APGAR of 9. He snuggled at Mommy’s breast and didn’t really latch on, but nuzzled and screamed and licked a bit. 7:50 a.m. (or so) After asking if Melanie had any preferences regarding delaying cord clamping/cutting or not, and Melanie saying she did not care, Shanna clamped and Craig cut the cord. 7:57 a.m. The placenta came spontaneously, and Melanie had no excessive bleeding trouble. She had one tiny “skid mark” of a tear that was not even worth a suture. We took photos of the placenta. 8:00 a.m. Michelle took Ethan to be weighed. He was 7 lbs and 6 oz. Craig and I took video and photos of this moment, but we rushed through it because the scale was right under the air conditioning vent and it was too cold for a naked newborn baby! Then we took photos of introducing the baby to Melanie’s mom and dad, who had been waiting patiently in the waiting room for a couple of hours or maybe a little more. 8:15 a.m. Craig held his baby for the first time. Although he appeared to approach this new task a bit gingerly, he cuddled his son like a pro. Melanie’s blood pressure was 134/70 at this point. She obviously tolerated labor better than pregnancy! And was rewarded for all her hard work with a long-awaited chocolate chip cookie and two orange juice boxes, which she savored with gusto! They tried nursing again, with some success and some frustration as everyone tried to get the hang of it. 8:25 a.m. Craig told Melanie’s dad about Ethan’s middle name being after him, and then the grandparents came in to see Melanie and tell her what a great job she had done. 8:45 a.m. Shanna and Robin did the newborn exam on the bed while Melanie watched. Ethan did not care for this process much, and screamed through most of it, although he stopped screaming and was quite content during the part where they checked to see if his testicles were descended and to verify that his penis was as it should be. We all had a good laugh at him definitely being a boy. He had the Vitamin K shot, and the antibiotic ointment for his eyes. Interestingly, he found the eye ointment far more distressing than the Vitamin K shot. His head circumference was 14” and he was 20” long. We wrapped him all back up, and got the “too girly” hat off of him and into a nice blue and white striped one instead. Unfortunately I later realized that he was laying on a pink blanket for all those photos. Oops! 9:00 a.m. Melanie got back in the tub and had a nice soak, and Ethan got in with her too. They did a little more nursing practice, and he latched on a bit and seemed quite content. Like mommy, like baby- put either of them in the water and they feel much better! After soaking for a while, Ethan was getting a little chilled and was done nursing. 9:30 a.m. Robin suggested we dress Ethan while Melanie got cleaned up. She asked Craig if he would like to dress Ethan, but Craig demurred, so I did it, while Craig watched and then helped. I showed him how to diaper a baby boy, and put something slippery on his behind until the meconium is finished, and dress him. By the time I had his clothes partially on him, Craig was helping me get his arm in and the snaps done up- he will be a natural at this in no time flat! I made a mental note about Robin’s setting out for us a heating pad to dress the baby on- Ethan was the most cooperative baby I have ever dressed, another great tip I filed away to use again! 9:40 a.m. Ethan was all dressed and snuggly. His temperature was 96.8. Melanie was out of the tub and comfortable in clean pajamas and tucked into the rocking chair with the baby. Her blood pressure was 146/84, temperature was 98.6 and pulse was 100. Everyone looked great, so after Robin gave her postpartum instructions, and Michelle loaded their things to the car for them, Melanie, Craig and Ethan were released to go home around 9:55 a.m. However, Melanie’s sister and nieces and nephews arrived then, so we stayed to visit for another half an hour. I asked Melanie if it had been like she expected, and she replied that actually, she had thought it would be harder than it really was. What a wonderful birth, and a joy to me to have gotten to be a part of it. |
||
