A bit of calm in the midst of the COVID-19 storm.
If you read my previous post Embracing change and a shift in mindset you’ll note that I approached the pregnancy in positive light and this is a continuation of that story and me breaking the stigma of birth horror stories.
This post is about the big day; an outward facing version of my story (the personal/intimate version is for my eyeS only :) ). Sharing your story is powerful, informative but also want to help demystify a few things. Enjoy:
I filled out this lovely form to share with my Labor & Delivery team. It’s good to fill out and email or hand-deliver just in case you aren’t able to communicate this face to face or have someone advocate for you. The hospital itself honored much of my preferences and was also able to take a webinar in advance to get a sense of how the operate, what the rooms looked like, what methods and details they cover etc. Knowledge is power and so thankful for that webinar. It answers 80% of your questions up front so you don’t have to sweat it day-of.
+ My birth plan in short was: do whatever is needed to keep mama and baby healthy and safe.
+ My key birth plan items were:
• Sign me up for an epidural please!
• I’d like to limit the amount of folks in the room. This alludes to medical students wanting in on the fun. (In the end we had myself, my husband, one labor and delivery nurse, the OBGYN and one medical student.)
• I’m ok to have me IV’d me up as needed (c-section, complications etc.)
• I’d like to eat, shower, move around, switch positions during active labor (laying on your back the entire time is old news apparently!)
• I’d like to honor the golden hour (bonding with baby immediately after delivery and baby’s shots, bath etc. happen within the same room with you) and delayed clamping of the umbilical cord if possible (this allows for as much blood and nutrients to still pass from mom to baby).
Pregnancy status at 8mos (36 weeks)
The last stretch! At my regular ultrasound appointment at 36 weeks I found out baby was breeched (head was up instead of down). 5% of pregnant women find themselves in this situation. Between weeks 36–37 the chances of the baby flipping back down on its own are slim because of the ratio of baby’s body and the amniotic fluid remaining in the uterus to allow for the real estate needed for the baby to flip on its own. With this in mind, the doctors shared our options ahead:
- ECV: External cephalic version (ECV) is a manual process (!!) by which a breech baby can sometimes be turned from buttocks or foot first to head first. It’s a procedure recommended by national guidelines for breech presentation of a pregnancy with a single baby, in order to enable vaginal delivery. I would have to get an epidural and watch a set of several hands manually try and flip my baby from the outside/on my belly. The chances of this process are 50–50 for the baby actually flipping and if anything goes wrong it could trigger early labor and you would have to move into emergencY C-section. Some have successfully gone through this process, other went through it and the baby never flipped. Like I said, a 50–50 chance.
→ My decision: I knew before even talking about the options with the doc that I didn’t want to proceed with ECV. I simply didn’t like the unknowns — you never know where the umbilical cord is (you can’t see that bad boy in ultrasounds!; wild, right?) so you don’t know what may happen when the baby flips and say the cord is around its shoulder, neck etc. You don’t know if anything internally will tear or be damaged with the manual flip movements (even though they assured me my placenta was in a good position for it) and lastly, I didn’t want to have to deliver early if I could have the baby bake in me longer, as were both healthy at the time being.
- Schedule a caesarean section: At this point, they recommended scheduling this during week 39. Sidenote: American hospitals/health care systems don’t advocate for C-sections as it’s full on surgery and is considered unnecessary if able to carry out a healthy vaginal delivery. There is spike in number of c-sections globally; fascinating data if you want to dive into it.
→ My decision: Scheduled it for 39 weeks and 2 days. Was happy to wait until this date or whenever the baby wanted to come outside of this prescheduled date and in that case it would be an ‘emergency c-section’. At this point, it was good to have this decision made and begin to prepare accordingly, especially dig up our knowledge on everything caesarians from classes etc. we took.
So, from week 36 to 37, life carried on. I had a big meeting to prepare for at work so that kept me preoccupied and had a mini getaway to look forward to at the end of the week. Really wanted to relax in a hotel, swim in a pool and get pampered a bit before the big day. Work week was a smashing success in the end and off we went to get some fresh air in Newport, Rhode Island. On our second day there (a Saturday), and during my epic 80 minute facial I noticed the Braxton Hicks contractions (aka ‘practice’/false labor contractions) picking up in frequency and me needing to actually shift around how I sit. By the time we were walking around the RISD museum later in the day, my husband realized I was taking too many breaks to sit and that I was making funny facial reactions. The Braxtons Hicks were getting stronger but still at the same consistent pattern. I knew to worry if they increased or lasted longer. So we carried on and by the end of day I called the 24/7 nurse line (of my health insurance) to get an assessment before calling my doctor — the pattern was steady, not alarming, so better safe to check in than not. The nurse said to haul my butt to the hospital to check if I was entering preterm labor. Context: on that exact day, I moved into 37 weeks, which marks the pregnancy as ‘full term’, which means if baby came it would be healthy and able— just as it would if it came week 39 or 40, just slightly smaller in size/weight — yet fully developed. Called the doctor next and they told me to keep monitoring and basically alert them if my water broke or saw blood. And so we packed up our mini getaway plans 2 days in/left 2 days early because who wants to potentially give birth in an off season location?, haha.
On Sunday, the Braxton Hicks were still going at it, every 15 minutes, all day long. At this point, I wasn’t even thinking I was close to labor. Labor in general is a mystical journey, it’s different for every one and for every pregnancy and it’s made up of stages: early, active, birth, delivery. You could go into ‘early’ labor and deliver fast or it could last weeks until you transitioned to active labor. So I knew I was in the waiting-dance phase and just made sure I was hydrated, well rested, stretched etc. as per usual.
On Monday, I woke up to lose my mucus plug during my morning bathroom visit. Yep, it’s just that, a ‘mucus plug’ that blocks the cervix, and specifically the entrance from vagina to uterus (if you need a refresher on anatomy 101, go here). All that sign means, is, that labor is imminent; could be hours, days or weeks. Doctor said to hang tight and call when water breaks, ie I move into ‘active’ labor. Fun right? So I carried on with my work day knowing we had a regular ultrasound appoint around 4pm and we would really assess where things are at, at that appointment. By late AM, I had to start going off video on calls to move around to manage the contractions but was still not convinced it was anything more than Braxton Hicks. Around lunch time (both my husband and I were working from home that day) my husband commented at how my belly looked different in shape. He was hoping the baby would flip on his own since we found out he was breeched and my reaction was “don’t be silly, my belly is the same as yesterday”. A few hours later at another kitchen break I realized when my husband asked me a question and I hadn’t answered because I was deep-breathing through a contraction — that something was up and there was a slim chance this would be happening today. We called the doc again to note the change in intensity of the contractions and since we were 1.5hrs away from our appointment they said to wait until then. The timing between them was erratic so it was hard to tell.
As we were driving to the doc office, the doctor called us and asked us to reroute to the hospital instead and head to triage at Labor & Delivery instead. Tracking the pattern of my reports the last 3 days convinced our doc of the possibility that I could be in labor. And so we rerouted, armed with my hospital bag in the back just in case!
In the car I started having more frequent contractions and the need to tap into my deep breathing training so I knew this was happening today one way or another. Next step: create family WhatApp channels and surprise the hell out of everyone!
We rolled into triage around 4:45pm, where they checked our vitals and then they proceeded to surprise us with two sets of news:
1. Baby was not breeched anymore! He had flipped back down on his own. It probably happened in my sleep or when I was swimming in the pool.
2. I was 7cm diameter and baby was 3 phases away from crowning. I was to be transported to an OR room in the next 20 minutes, as I was having that baby that day!
Within minutes we had to toss out the window all c-section prep and planning and recall all vaginal birth prep and planning. We did fine in the end, but grateful we spent the time getting educated on all birthing options.
Moved into our own OR room, met with our doctor, labor & delivery nurse and one medical student whom would be our core team for the eve. My hospital bag was in the car. We didn’t think I’d be ready for baby quite as I was so we left it there, thinking we’d run back as needed. Baby and mama were set up, monitored and we tracked my contractions before setting up for the epidural around 6pm. The epidural process was smooth as the anesthesiologist was a calm, kind and communicative professional. I actually felt the tube go in my spine, not in a painful way, but just a feeling of movement — other than that, didn’t feel a thing. I am not a fan of seeing needles puncture skin so thankful this was nowhere near for me to see. Right after the epidural my waters broke. It was so fun to say the line out loud “EVERYBODY, MY WATERS JUST BROKE!”. 30 mins later, the drugs hadn’t fully kicked in and I started feeling a bowling ball coming down my vagina which at that point she topped me off with another cocktail. We started pushing around 7pm. By we, I mean, the monitor told us when a contraction was coming and the team of 4 in the room proceeded to coach me through the concept of pushing. For a full hour, I laughed and giggled with the team, as I could not figure out how to push! I couldn’t feel anything down there so I had to visualize pushing mentally. I sat on the side, propped up, legs in different squatting positions and had to visualize pushing something through my body, pretending to poop and nothing worked. I tried yoga breaths, non-yoga breaths and somehow a mix of non-yoga breaths and visual guidance worked. I mean, it was just comical to me, how you can’t fully prepare for this until you are in it! Secondly the top off of drugs didn’t help; I had to wait for that to ware off a bit so I can feel a bit of my body and muscles to actually get something goin. It was that moment I regretted the epidural but then when we heard a woman scream next door as if she was getting murdered, I quickly retracted that thought. Was happy to have the epidural to ease me into this wild ride. We even tried to get a mirror in the room to see if making a visual connection with the area would help with the mental work. Sadly no mirrors left to be used; they were all taken haha. But also not sad, because I wasn’t 100% sure I wanted to see everything. I ended up holding my breath in at inhales and pushing my diaphragm down as my husband helped me count steady inhales and exhales and the team guided me with pushing segments. When the baby’s head was showing they let me touch it to help me push through. It was slimy and hairy and at that point I was definitely into having a mirror to see/feel more! So 1 hour of pushing endlessly on drugs and having a laugh and 30 mins of actual good pushing got baby Grayson out! He was moved to my chest immediately as they cleaned him, cut the umbilical cord (couldn’t do delayed clamping finally as the cord was super short !) and cleaned me up. I ended up not having a catheter pre birth so they manually drained my bladder just in case. Couldn’t feel anything so I have no gorey details for you. I don’t even know if I pooped during labor (prob did), because the team are pros, and they will never tell you; they just clean it up. I had a few stitches on my lower inner labia (yep, you get TMI version here) but that was it. They gave the baby his shots, ointments all while on me and gave him a bath right beside me.
Wrap up and wearing off of drugs took about an hour and after my first visit to the bathroom, we were wheeled off to our room. Just like that, baby in hand!