Tuesday, April 16, 2013

Felix's Birth Story: Part 1 - Beforehand


Part 1: Beforehand

With this pregnancy, I had contractions probably starting somewhere around 36 weeks, which I hoped would mean that we would actually have this child a little early. We went over our due date with our daughter and it was frustrating to have everyone constantly asking when we were going to induce. As everyone knows by now, little Felix had his own plans, but he was well worth the wait to get to do things the way we had hoped and planned!

For this pregnancy (our second), we switched to an OB who was willing to allow us to do things as naturally as possible at the hospital. Also, not only was he willing to allow us to do things naturally, he was also very supportive and respectful of our wishes throughout the pregnancy. In addition, we hired a doula (at his suggestion) to increase our chances of doing things this way. My main goals were to allow our son to choose his own due date (so no scheduled induction!), to have a vaginal birth, and to do things as naturally as possible with as little medical intervention as possible, assuming both he and I were safe. I was hoping to be able to do it without pain medication and everything in our birth plan was based on both of us tolerating labor appropriately. Of course, if something had come up, we would have changed our plans immediately to keep the two of us safe and healthy. Luckily, we had no issues.

The Monday before he was born (April 2), we had an ultrasound with a BPP (biophysical profile) and an appointment with our doctor. Everything checked out fine on the BPP, so there were no concerns about the baby at all. In fact, our doctor gave us the actual report and Felix had earned an 8/8 on the scoring.

In weeks prior, my cervix had still been posterior and we had never had an accurate estimate of how dilated I was, though I had been 80% effaced for weeks, was “very soft” (according to the doctor) and the baby was at the -1 station. The day we met with the doctor at what was our last appointment, I could tell that even he was starting to get a little nervous. If he went by my last menstrual period, the baby had actually been due March 22, though my cycles are always really long so I was certain that was not the correct date to be going by. According to the dating ultrasound, he was due March 26, but my charting showed March 27. The doctor mentioned that if we did need to induce he would just break my water so that I could still do the rest of the labor without being hooked up to IVs and Pitocin, etc. He insisted that this being the second time my body had gone through a labor and delivery and with everything being so “favorable,” things would go quickly once my water was broken. We consented to try a membrane sweep to see if that worked first. Though I would rather have not had any kind of intervention, a membrane sweep was really the only thing I was comfortable with doing because it is relatively low risk. Fortunately, during the cervical check, the doctor said my cervix had moved forward quite a bit, I was 90% to completely effaced, still “very soft,” and 3 cm (though he said he could have “stretched it to 4” if he wanted). He did the sweep but admitted there wasn’t much left to “sweep” because things had already started to separate on their own. He seemed encouraged by the progress and thought it would only be a day or two until we went into labor. However, he suggested that if Felix hadn’t come on his own by the weekend that we consider letting him break my water to get things started. We went ahead and scheduled an appointment for the following week, though I had a feeling we wouldn’t need it.

We went back home and I had lots of cramping and contractions into the evening. Anya went to stay with my in-laws so that we could try to rest in case we went into labor. Unfortunately, by morning, our contractions had slowed down quite a bit and I felt really discouraged. I spent the day doing some housecleaning and trying to stay busy. I also scheduled an induction massage for that evening to see if it helped. I had contractions throughout the day but nothing too intense or consistent at that point.

Right around lunchtime, I felt what I thought might have been my water breaking. I called Megan (our doula) and we decided to stay home for a couple of hours and do some walking to see if we could get things going. After a walk a few hours later, we opted to go to the hospital to get it checked out because nothing seemed to really be progressing, so we met Megan at triage. I was so sure it was my water (though just a slow leak) and we were in the process of making a decision about whether or not to allow the doctor to break the rest of my water once we were admitted. The main reason we did not want to artificially break my water in the first place was so I wouldn’t put myself “on the clock,” so to speak, but if it was already broken, then that reason was no longer an issue. Much to our surprise, when the nurse did the litmus test, she confirmed that my water had not been broken, but we were shocked to hear that I was already dilated to 5 cm. I couldn’t believe it because the contractions weren’t bad at all. In our last labor, I had already gotten an epidural at about this point.

The nurse and ER doctor just assumed I wanted to be admitted but we opted to go home because we knew this could go on all night. The ER doctor was not pleased and tried to get us to stay by saying that the baby’s heart rate had dropped while they had been monitoring, though the times it had dropped happened to be the same times that I had been on my back for cervical checks. She also made several comments about my pregnancy having already been 41 weeks and insisted there was no reason why someone at this stage in pregnancy couldn’t be given Pitocin and have the baby. She clearly did not like that we had waited for our son to come on his own and that we were currently 41 weeks. I really wanted to remind her that not everyone wanted to use drugs to force the baby out when there was no medical indication for it, but I didn’t. When I told her I thought we were fine and would like to go home, she insisted that I would have to have another BPP to confirm that the baby was fine. At that point, we asked to speak to our own doctor to get his opinion. When he arrived, he said he wouldn’t break my water that night (even if we wanted him to) because he didn’t like to start things like that in the evening when we would already be tired. He also looked at the baby’s heart rate and said it was “beautiful” and that there was no reason to keep me at the hospital. So we left. Of course as soon as we got back to the car, my contractions had seemed to become more regular. I had a feeling that we would be back at some point that night.

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