Saturday, March 30, 2013

Cassandra's Birth Story

I had posted a rough draft of this story a few days ago but now I am finally sitting down to edit through it a bit. It's still an incredibly long post but it's something that's worth it to me to record.

If you're interested, you can read my post on Henry's Birth and compare them or on my follow up post about the PTSD I had to deal with after his birth.


I am going to do my best to type this up as thoroughly as possible but I am unfortunately limited to the amount of time I have. Right now Ryan is holding Cassandra while we wait for my sister to get to the hospital with Henry. Then Ryan is going home for the night and it’s me and Cassie on our own until the morning. 

As a form of some brief background for perspective, I went into this birth experience pretty afraid. I had had a rough time with my first birth and I was scared of how I might go through something emotionally damaging again and I didn't want that. I had spoken with a doula who had the insight to say that I should view this birth as a chance to heal - that not all birth has to be frightening and traumatic but that I could embrace this birth and use it as an opportunity to heal myself from the fright I still felt at the memory of my first birth experience. I loved that idea and I wanted part of it. 

In general I am a very natural birth, low-to-no intervention kind of person (this applies only to myself, i do not judge anyone ever for how they choose to give birth). I try to be very organic/holistic/generally crunchy in general in my personal lifestyle because that's just what works best for me. There are definitely exceptions to this rule and, well, not to provide any spoilers but Cassandra's birth definitely taught me to be easier on myself in regard to judgement about interventions. 

So here we go, Cassandra's Birth Story:

I was five days past my due date on Wednesday March 20th. The doctors in my practice don't like pregnancy to go past 41 weeks and wanted to induce me. Typical me wouldn't have agreed to this at all, in fact, I had a conversation with my doula about how I was just going to not do the induction and instead agree to the twice a week NST so I could labor at home like my original plan was. However, when I went in to my doctors appointment that Wednesday morning, something just felt different. I suddenly was hit with a big does of intuition about going forth with the induction. Suddenly it felt like the absolute 100% right decision for me. So instead of going in there and telling the doctor I was declining the induction, I spent the morning writing up a list of questions about their method for inducing and grilled her for about ten minutes straight. I left feeling confident and in control of things and also, most importantly, I left feeling like I was doing what was right for me intuitively.  

Up until that day I had been in what is called "prodromal labor" which is also sometimes referred to as "false labor" (a term any woman going through it hates because it does not feel false at all during the experience). What this means is that I had been having weeks of very real contractions basically on and off all day everyday but the contractions weren't organizing into a pattern and they never turned into active labor. I was exhausted from this whole experience because my prodromal labor started at 35 weeks and here I was approaching 41 weeks and I was just so tired of being on the edge of my seat wondering if the hours of contractions would ever turn into active labor. 

Wednesday night I was ready to go in but when I called to find out what time to come they told me that they didn’t have enough beds and I’d have to wait until the morning. I was upset because waiting is difficult for me once I have a plan in place - especially when it relates to something I’m nervous about and just want to get over with (which was the case here - labor scared me after my traumatic delivery with Henry and honestly, I was just so finished with this pregnancy that I just wanted to be done, I wanted to meet my baby). I was also incredibly frustrated because I had arranged for childcare for Henry and he was away from home for his first night ever. I hated that I was home and could have spent another night with him but that he wasn't there. I definitely spent some time crying into my pillow over that (plus, who could sleep knowing that an induction was happening in the morning?) 

I slept for maybe four hours total on Wednesday night and on Thursday they called and told me to come in at 8:00AM. It was snowing a lot that morning and Ryan and I drove there together in a mixture of excited jubilation punctuated with nervous anticipation (he was more the former, I was more the latter). 

Once we arrived it was several hours before I was able to begin the induction but by 11:00 they had inserted the first pill that was meant to soften my cervix and get my body kick-started into labor. One strange thing was that at my appointment the day before I had been dilated to 2cm and effaced 90% but when i got checked in at the hospital I was suddenly only a fingertip dilated and back to 50% effaced. My cervix was so high that they almost couldn’t even find it. I had literally regressed in my labor readiness. 

Anyway, we waited for four hours (which is how long the dose lasts) and during that time, nothing much really happened physically for me. I didn’t have any contractions at all, didn’t notice much going on in my body besides some twinges in my cervix. The baby wasn’t moving a ton but that was normal for her at that hour of the day. We just were waiting. And hanging out. I was checked again at the end of four hours and I was 1-2cm dilated and up to 70% effaced. My cervix was still high and in general my body was still really not ready to jump into labor. 

So they put in another pill and we waited four more hours. I didn’t have a single contraction during that time, either. And remember, this is really weird considering I had been having contractions every single day for almost six weeks at this point. 

The nurses had begun commenting that they didn’t like how baby’s heart rate was doing sometimes. They said that she would go into these patterns of not moving much and having a dropped heart-rate and that those patterns were worrying them. They would make me lay on my side and drink something periodically. 

Then, around 7:00 or so in the evening when I was still on my second dose of the inserted medicine (cytotec is what it was called) a nurse came in and said that she needed to give me oxygen because the baby wasn’t happy in there. Both sets of parents were visiting us then and i had to lay on my side with the oxygen. I was a little freaked out but tried not to show it bc i didn’t want my mom being scared and stressed. The nurse made me come back in and flip to my right side bc baby was generally happier when I was on my right so I did that too. Eventually they let me sit up and take off the oxygen. Shifts changed and the new nurse and the doctor spent a lot of time looking at the print out of baby’s heart rate and they said they were just gonna keep watching it. 

I was allowed to take a shower and walk around for a while at this point before starting the pitocin. Once you start pitocin they want you continuously monitored in bed so I really loved getitng up and getting the chance to walk around, shower and just be a normal person again. They put me on pitocin around 9:00 i think and Ryan and I tried to get some sleep. 

The way pitocin works is it’s an IV drip and they start it off really low and gradually increase it every four hours at first for the first four doses and then every hour after that until your contractions are 1-2 minutes apart. I slept through the first four hours of it without any contractions at all however I did have to go back on the oxygen once and the nurse would come ask me to be on my right side several times too. 

All of this time I was obsessively watching her heart rate on the monitors. Under normal circumstances (when I would go to office visits, etc.) Cassie’s heart rate was always in the 140s when she was awake and the high 120s when she was asleep - this was true of my entire pregnancy. However slowly over the course of the induction her heart rate stopped being in the 140s or anywhere near it and descended into being almost exclusively in the 120s. Even when I knew she was awake. I wasn't worried bc 120s is still okay but I was definitely taking note of it. 

I had my first contraction on pitocin around 1:00 or so in the morning on Friday morning. I checked the monitor and saw that her heart rate had dropped to 115. I didn’t like that at all so I kept watching it. and it stayed around there for quite a while thereafter.  I had a stronger contraction a while later and i didn’t even have to look up to know that something was wrong. And I was right, my nurse came immediately into the room, threw the oxygen on me and started searching for the baby with the monitor. They couldn’t even find her heart rate and then when they did it was absurdly low - I couldn’t see the numbers from where I was but when I heard it I was terrified. They were about to call a resident in but i was concentrating on being calm and breathing deeply and she recovered back up to the one hundred-teens level again. They obviously at that time turned the pitocin off. 

By then I was crying and Ryan was freaked out and white like a ghost. We waited for the doctor to come in and talk to us. He explained that as we already knew, the baby was going through these strange periods of deceleration where her heartrate was dropping but it wasn’t due really to sleep, it was just strange and they weren’t sure what was going on. They also weren't sure what was going on with my contractions causing it to plummet like that - whether it was just a fluke or not. The doctor said it could be a one time incident or it could be a sign that something is going on that’s not good. He said he wanted me to rest for an hour or so off the pitocin and we’d see how things looked from there. 

During that hour Ryan and I talked. I had a very intense intuitive feeling that something was wrong and that this wasn’t just that she was coincidentally unhappy or that she was in a weird position or something. I didn’t think that she was handling labor well at all. In fact, the way i saw it, my body was doing its damndest to fight labor off. We had been there for 15 hours already on powerful medications designed to induce labor and I had had two contractions total. And both of them had had an alarming effect on her little body. I mean, clearly my body and her body were each trying to communicate something here: we do not want contractions. 

I knew the doctor was going to come back in and give me the option to go back on the pitocin or to have a c-section. And despite my complete and total paralyzing fear I also knew that I was going to choose to have a c-section. 

Ryan and I talked and talked and talked it out but it was the obvious choice and we both knew it. We didn’t want to risk that she might go into another episode where her heartrate dropped like that again - what if they couldn’t get her back like they did last time? Then i’d be in the positon of having an emergency c-section anyway. And what were the odds that i’d go back on pitocin and the labor would somehow suddenly start on it’s own and everything would be fine? Pretty slim considering that we were on hour 15 and I was still only 3cm dilated and still hovering at 70% effaced. It wasn’t worth it to me - it didn’t seem SAFE to me to put her through hours and hours of labor after what she had already gone through when her heart-rate was already indicating that it wasn’t good for her. And the hard stuff hadn’t even begun yet - I wasn't even in active labor yet. She had already struggled so much and I'd only had two contractions. The answer seemed obvious to me. 

All of this is logic and explains the thought process Ryan and I went through but again what really led me to my conclusion was my intuition. I KNEW in my absolute heart of hearts that she should not go through even another attempt at labor. And I knew that we needed to have a c-section. Despite my terror at the thought of it I also knew that it was the right decision for her. Maybe it's because I was already a mom but my need for a natural birth experience for myself just did not matter to me nor did the fact that they were going to have to cut open my body and perform major surgery on me - something I was absolutely terrified of. It just didn't matter. My general feeling is: do what you want to me - just make sure my children are safe.  I didn't care that this was scary and would be tough on me. I just wanted this baby to be okay. 

So just as Ryan and I concluded our conversation (in which Ryan, who never has “vibes” said that he felt very strongly that we should not try pitocin again and that it was wrong for her), our doctor came in and he said, “Well she’s not doing worse but she’s not doing better.” and then he said, “I will respect your choice whatever you want to do here - we can try pitocin again but to be honest, I can only give you one shot at it before I have to really call it and c-section you because I can’t risk it more than that but if you want to try again we can.” and I said, “No, I don’t think it’s worth the risk” and i explained all of my thinking to him and he said he fully agreed with me and that honestly, it was his gut feeling that we should just do the c-section. 

I told him in had a strong feeling that we shouldn’t do pitocin and he said, “That’s all i ever need to hear. When a mom has a strong feeling - I always go with it.”

So the decision was made around 4:30 in the morning on Friday morning. I had enough time to call my mom, talk her through it and tell her that if they wanted to be there for the birth they should come now. Ryan called his parents too and suddenly before I knew it Ryan was in scrubs and I was signing consent forms and getting prepped for surgery. My room had nurses in it ready to go and I was being walked to the OR. By 5:05 I was getting the spinal tap put in (and shockingly to me it didn’t hurt at all) and then I was laying down on the table and they were asking if I felt anything (i didn’t). Ryan was brought in around 5:15.

Ryan was incredible during the whole experience. He talked to me and kept my mind off of everything. The doctors and nurses were all so nice and honestly, as weird as this sounds, the whole experience was almost pleasant. 

Then at 5:36 the baby was born! I heard her cry and honestly, even though this is beyond cliche, my whole world got just instantly better. Instantly. She was here and she was safe and I knew it was going to be okay. 

She weighed 7 pounds 1 ounce and was 20 inches long. 

They finished putting me back together and I was out of the OR by 6:15. It’s surreal how fast the whole thing goes once things get moving and forms get signed. 

But let’s talk about what happened because there’s more to the story...

When they went in to take her out they discovered that she had the cord wrapped around both her neck and her body twice. Every time I had a contraction during the induction she was losing oxygen and it put pressure on the placenta. There was the risk both of her just completely losing oxygen and the risk of the placenta tearing from the uterus...both of which can be fatal to both of us (if the placenta tears, I can easily hemorrhage and of course she could be in incredible amounts of danger from too much laboring under those circumstances while being deprived of oxygen). I seriously tear up thinking about what could have happened to either her or me and honestly, I am SO grateful that the Forces That Be alerted my intuiton to just stop everything right then and there.

The whole experience was remarkably healing for me. Somehow this intervention-loaded-birth that was nothing like the meditative experience I had planned was what saved me. I now have a renewed sense of faith in my body and in my intuition. I now know that I CAN trust my body, even though I felt betrayed by it after Henry's birth. I also know that sometimes the 100% All Natural way to do things isn't always the best way - that every single situation is different.

Sure, I do still feel that it's best to try and live as natural of a life as possible and I do completely support women on a path to natural birth. But I definitely now also know that it is not something to be ashamed of if you need interventions. It's not something that means that you've "given up" or that you aren't strong or any of the other things I had been telling myself would be true of myself if I couldn't just have this perfect beautiful natural birth like women are "supposed" to have where the baby descends into the birth canal and you just give birth and it doesn't leave you in therapy for months lol. That was what I wanted and I didn't get it either time but you know what? That's okay. This birth has seriously saved me, it healed me, it made me feel like I am able to trust myself again and that is a very, very valuable gift.

I don't advocate people having c-sections just for fun or anything. Hell, I don't advocate anything at all honestly. The only thing that MAYBE someone could say I'm an advocate for is people making their own choices that are right for them because honestly, at the end of the day, that's all that freaking matters. Do what is right for YOU because that is all that matters.

Birth is a miracle no matter how it happens and i know for a fact that in this situation, Cassandra’s birth was absolutely miraculous. I am so, SO blessed to have her and I am SO grateful that she is safe and she’s here and we are both alive and well. I’m glad I followed my intution and even though it hurts to stand up and recovery is gonna take a lot longer I would do it all again in the blink of an eye for my little baby girl. 

She’s screeching for mommy, gotta go <3 p="">

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