Sunday, June 16, 2013

I Never Said... by Holly Pepper

   "I never said it would be easy, I only said it would be worth it."  -- Mae West 

   I became interested in natural birthing after my sisters' births but I didn't know if it would be an option for me.  I am a type 1 diabetic so my pregnancy is considered "high risk."  I use that term in quotations because I have tightly controlled my diabetes since I was diagnosed at age 8 and never let diabetes stop me from doing something.  Exercise, eating healthy, and frequent blood sugar checks are my daily routine.  
   However, the next question is: will anyone consider me low risk enough for a natural childbirth, let alone a homebirth.  My doctors lumped me in the category of all other diabetics: type 1 and 2, poorly or tightly controlled, complications or not.  I felt labeled.  I found Maria, someone who finally listened to my story and believed the same thing---As long as my blood sugars are in control, my insulin dosing is sufficient, I'm just like any low risk woman.  With the artificial insulin in my body, I am a normal functioning body....a little more complicated to achieve, but still normal.  She agreed with this after meeting me and so the journey began.

   I was 39.5 weeks and having mild contractions throughout the day starting on Friday. Nothing strong, nothing noting birth was imminent. When I had my last non-stress test, the RN noticed contractions on the strip and I also felt them. In the 20 minute strip, I had 3. Later I asked my doctor what this meant and she said, no it could still be weeks off.  Hearing this, I didn't get excited and just went on with the day. I was getting a bit anxious because the doctors were recommending induction at 37 weeks due to it being the standard with diabetics (every single diabetic regardless of control throughout pregnancy).  Beckett was kicking a lot less in the last week and I was worried about going longer and each day I questioned if I was doing the right thing by letting my body do the work. Also he hadn't dropped as of my last appointment, so this was another reason why I didn't think it was close. We had an appointment with Maria on Monday and were planning on talking about natural induction methods. 4 days leading up to the delivery day, I took long walks (3 miles was all I could do comfortably), had sex, and did lunges and stretches trying to get my body warmed up. Anticipation was building but still needed to keep in mind it could be some time away.
   Sunday night, November 4th, I was sitting on the couch reading a book after talking with a friend about very mild contractions I'd been having since Friday. Nothing to note though, I told her, it still would be a while away. After hanging up, at 8 o'clock my first real contraction hit me. Hit me it did. Out of the blue per-say, it was pretty painful. "Wow was that a contraction?" Then 4 minutes later, another one came, same intensity. I told Mark and really didn't think this was labor, cause labor should start gradually and not be so intense. 
   After about 20 minutes of regular contractions, I started thinking maybe this is the real deal. I started making popcorn on the stove top to snack on and Mark wanted to run to Whole Foods to pick up stuff for the labor.  I was expecting a 24 hour birth so we had time, right?  While Mark was away, I was still having very regular contractions. I called Maria to say I was having contractions 4 minutes apart, lasting 30 seconds, and had been going on for 1 hour and they were very strong. She said something like, "in my experience, if all three components are not in place, this is still early labor. It sounds like you're definitely in the early stages and should prepare for delivering soon. Go to bed, get some rest and call me back when all three are in place. I'm going to go to bed now and I will expect a call when you're there, probably in the morning." I hung up and was excited yet scared cause the contractions were already so heavy. 
   Here we go, this is it. There was no way I was falling asleep tonight either, the contractions were coming regularly and had a strong urge to pace. So no laying down. I started to pop the second batch of popcorn and by the time it was done popping, my pacing became very necessary to deal with the pain and couldn't finish. Mark was back from Whole Foods and started setting up the birthing tub. The birthing tub itself was easy for Mark to set up but the issue came when it needed to be filled with water. Our sink and the hose were not compatible even with the adapter that came with the tub. Mark tried to rig it with a funnel and that didn't work and leaked all over the floor. Water was not even covering the bottom of the tub an hour after starting to fill it. Mark told me "you might not have the tub for the birth." This was not okay, I was having so much pain already.  I told that I absolutely needed it and to start filling up buckets if he needed to.
   An hour and a half after the first call to Maria, Mark called her back saying I was at 4-1-1 legitimately. They were about 3-4 minutes apart, intense and some came back to back without any rest period which made counting difficult and managing the pain. I felt like I'd prepared myself for a birth of increasing intensity starting out slowly and mildly and working my way up to the final show.  This I felt was not right.  I needed more rest periods.  In my birth prep, I planned to have my confidence and energy restored in the breaks between contractions.  With this type of labor, I felt lost and had a hard time coping.  I was scared about it getting even more painful. In other related news, Mark was still filling up the tub and it was slow going. I looked over and the bottom was still not even covered.

   Maria came at 11:40. She came in, gave me a big hug and asked how I was doing. "This is exactly what we wanted, you to go into labor naturally." (We were going to talk about inducing labor naturally the next morning at our appointment) She asked me to get into the shower and that was the best thing cause it separated me from the commotion, allowed me to focus deeply, and was very calming to my contractions. I stayed in there for over 30 minutes and honestly didn't want to get out but I started to get hot and felt a bit glutinous using all that water. After I got out, I sat in the rocking chair and closed my eyes and rested my head against the back of the chair. I was getting waves of nausea and then did actually throw up and felt better. Then sitting on the glider, Maria got me to focus on each contraction, not think about the next one, but just get deeper with my energy. The pain was mounting and the contractions were unrelenting going to a peak then 1/2 way back down and then back up again for 3-4 times. Then after this cycle, I'd get a break. My contractions were 2-3 minutes apart and 1 minute long at 1:20am. Scared again of this pain mounting throughout the night. I didn't dose off but I was able to manage the pain slightly. I kept having to run to the bathroom with feelings of pressure and urge to poop often and would just end up sitting on the toilet, doing nothing productive.
   About 2am, I got into the tub finally since it was partially full. As I did, I immediately started squatting and very mild relief came. The buoyancy of the water was the best thing and I felt I could really open up my pelvis. The water temp was warm though it read at 99. Just after getting in, my water broke spontaneously with a literal 'popping' sound underneath the water and then a gush into the water. There was no meconium and only vernix and blood. Good signs. Feeling like I was making some headway and things were really happening. Though I was still for sure in the Fight or flight adrenaline mode of "running away from the bear."
   Progress was made by my water breaking, but hearing that I was only two centimeters dilated, I literally, literally couldn't believe it.  WHAT?! This is where I started to flip out. I started talking about going to the hospital and needing pain medication---this was out of control. If I was at 2 cm, what would 10 feel like?! I cannot deal with a more intense pain than this. I understand mental focus and how important it is but I couldn't focus enough to think this way.  Maria started to say that another woman who birthed recently told her that the intensity didn't really get much worse and she was so scared of the pain of 10cm but that the pain plateaued and just continued until full dilation.  Those words were very important for me to hear, even though in the back of my head, I felt like it was just a story to help calm me down. However, I trusted that it could possibly be true. 
   Eating ice chips and drinking lots of water, I was not hungry. My blood sugar was trending up at this point so I didn't feel hungry. Before my blood sugars had been 70-100 and now they were 120-130 from all the adrenaline and labor hormones. Mark was giving me boluses of insulin through my insulin pump to aggressively manage it now before it got out of control. The pain was unbearable and I was constantly fidgeting and saying I couldn't do it. I started to say I needed to go to the hospital that I was in too much pain. Maria told me to focus on each contraction, not think about the next. At one point when I said I wanted to go to the hospital, Maria said lets give it 30 minutes and we'll re-evaluate. I never asked again, this was very clever! Mark was great this whole time and was saying you can do it, which I remembering repeating back, I CAN'T do it. Finally got into a rhythm and said I can do it. Holding his hands for each contraction was just what I needed and felt he could do nothing else to help me.
    At 3:35, one hour and 20 minutes after being checked at 2 cm, I felt the urge to push. It was like a powerful reflex that my abdomen just clenched with a tremendous force. I pushed, I shouted. Maria needed to check me again b/c pushing without being fully dilated could cause swelling and potentially very bad. So she checked me again and I was now 9.5 cm! Whoa! Less than 1.5 hours and had gone from 2 cm to 9.5, this was the most glorious, relieving news I could have ever heard. I had made great progress and also this race was nearing the finish.  Mile 22 of the marathon and I could see the finish line. I was finally going to get to meet my baby and realized it was only a bit away. What a relief. 
Maria needed to call the other midwife, Sue Balen. I kept pushing with the urges. Sue arrived shortly after being called at 4am, my eyes were closed and I welcomed her without looking at her.  Little progress was being made so I needed other pushing positions. After 20 minutes of various positions on the birthing stool, there was little progress so we then moved to the bed.
   The bed was not much better but did allow for another set of positions. It felt like I was doing something wrong or for some reason he was stuck. With each contraction, I pushed as hard as I could and then he'd slip back in. I asked if there was something else I could do. At some point, Mark said he could see the head which was a great sign of progress and I just kept trekking to the end. 
    Getting close was so exciting. I never did feel the 'ring of fire' and pushed out his head with a big push. The cord was wrapped around his head twice and Maria told me not to push until she got it off.  I then pushed his body out and he was placed on my abdomen. He felt like a warm fish and started crying right away and I took him up on my chest. I started to cry out, "my baby, we did it!!!" again and again.  We waited for the cord to stop pulsating and then Mark cut the cord. My placenta came out quickly afterwards and bleeding was controlled with quick massage.

   The feeling of being done with labor and having a small baby to cuddle with was quite spectacular.  Seeing Mark falling in love with our little one was paramount.  After a couple of phone calls to family, I walked in to seeing my husband sleeping with our baby on his chest---something I'll never forget.  Our homebirth is something I was so fortunate to experience thanks to Maria and Sue!    

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