Saturday, May 28, 2011

Tuesday's child: Scarlet's birth story

:: This birth story involves way more preamble than a birth story really ought to, however it felt necessary to include it. It explains why things happened the way they did. It also - I hope - will serve to inform since this birth was a little uncommon, but not unheard of. If you want to read a 100-word version of this birth story, both my girls' stories can be found here. ::

The story of our second birth begins with our first birth. Peanut was born in hospital and caught by midwives. The birthing experience was fine: great, in fact. After she was born, though, there was a lot that was done badly. Despite the fact that she was healthy and strong and vigorous, I didn't get to hold her for over an hour. That is an exceptionally long time to be separated from your first born for no good reason. The hospital staff were also just dreadful. So before we were pregnant again, before we were even seriously talking about when to try to conceive, The Recruiter and I knew we wanted to birth at home. We knew that the things that we had disliked about Peanut's birth would not occur in a home birth. I was also very adamant that I wanted Peanut to be able to be present and involved in the birth. As The Recruiter put it, "The next time you go into a hospital to give birth, you're getting wheeled in there."

In the last weeks of my pregnancy, my blood pressure was becoming a concern.  Despite my best efforts to combat the rising numbers with diet (high protein Brewer diet), reduced stress (early maternity leave from my part-time youth minister position), self-hypnosis and supplements, the readings continued to climb. Eight days before Bubby was born, I had a midwife appointment and my blood pressure was high enough to warrant an in-office non-stress test and a trip to the maternity triage at the hospital where my midwife has privileges to have some labs done. My blood work was, to quote the obstetrician who gave us the results, "perfect". So we were relieved to know that I didn't have pre-eclampsia, just hypertension. But the hypertension really called into question the wisdom of having a home birth. Our midwife advised that it was likely in my and our baby's best interest that I really shouldn't be pregnant too much longer. I was only 36 weeks in at this point, but she suggested that pretty soon it would be wise to start doing subtle things to encourage Bubby out.

On Thursday, I had a doctor's appointment to discuss my iron deficiency.  When I got out of the car, my bum was wet. My jeans, my long t-shirt: both visibly wet. I hadn't felt a gush of fluid but this suggested that my water had broken. False alarm: many hours later we determined that the groceries that The Recruiter had picked up the night before had leaked on the passenger seat. What we had thought was amniotic fluid was, in fact, rotisserie chicken juice.

From Thursday onward, I had a blood pressure machine in our apartment to monitor things. Saturday the numbers were really bad.  Sunday they weren't much better. I was getting really scared: scared for my health, scared for our baby's health, and scared for what was going to have to happen if things continued to deteriorate.

On Monday afternoon, my midwife and I met at the hospital for a follow-up appointment.  Another NST, more blood work and everything looked great, with only the blood pressure numbers looking bad.  Perfect labs. My midwife showed me around the maternity ward in an effort to accustom me to the possibility of hospital birthing. I learned that Peanut could be with us if we wanted her there, which I found extremely reassuring. We talked about the additional risks presented by my hypertension and what we would do if things got worse. We didn't entirely rule out homebirthing, but we talked about the threshold for what would be sufficiently safe.  This was all between 2 and 4 in the afternoon.

That evening, I started to notice a few contractions. They seemed a little different from the practice contractions I'd been having previously, a little more noticeable. I glanced at the clock. When I felt the next one, I glanced at the clock again: eight minutes. And another eight. And another eight. After the first one, I looked at The Recruiter and said, "Huh: I'm having a contraction." After a little while, I went to the bathroom and there was a little 'show', which confirmed that this was probably not just practice or prodromal labour, but the real thing. I was instantly very excited, but tried to remain relaxed to keep my bp in check. I called our midwife and told her what was happening and asked her if, because I was still one day pre-term, if I should run a bath and see if I could slow things down or if we should just go with it, as was my inclination. She agreed. My midwife had previously informed me that I needed to take my blood pressure in early labour: if my numbers were good then, we'd be able to consider homebirth. I laid down, relaxed for half an hour, took my blood pressure and it was...not good. I kept trying to relax and calm down, but my readings were still higher than they should have been.

Here is where I state the obvious: at no point did I want or plan to make a choice that would knowingly endanger my health or the health of our child.  Sadly, I need to spell that out because it's been expressed to me that some people thought that I would do so in order to stay at home. Absolutely not.

Back to May 2nd. At this point it was pushing 9pm, my contractions were still coming but were very much early labour, and my blood pressure was significantly elevated. I looked at The Recruiter and said "I don't think we'll be able to stay home with numbers like these." Peanut was still awake, so I sat down with her, took her on my lap, and told her that the baby was coming out soon, but that the baby might have to come out at a different place and not in our home. I asked her if she would like to come with us when we went to have the baby, or if she'd rather stay at home with Gran (my mother). She said she would go with us, and that she was ready to go to sleep. I carried her for the last time on the bump to the bathroom, brushed her teeth, and took her to bed. We laid down and she snuggled into my shoulder while I read her Dr. Seuss stories and she fell peacefully to sleep. It was a wonderful, blissful, perfect last evening before our new family member joined us.

As I lay there, I thought "I'm so relaxed: I should check my bp now." So I grabbed the machine from the side of the bed, put on the cuff, and got two fantastic readings. I sent a text message to our midwife, giving her my readings and suggesting that perhaps these recent ones changed the landscape a bit. Maybe we could stay home.

This was also the day of the federal election: when I first noticed the contractions, The Recruiter joked that I must not make him miss watching election returns (he does, after all, have a blog about Canadian politics).  So all through that late evening, The Recruiter and I watched election returns while Peanut slept and I did henna on my belly since I was keenly aware that I would not make it to my blessingway planned for the coming Saturday. Since I had slept through early labour with Peanut, it was wonderful to be awake and alert and experience those early hours of labour with Bubby. It was a great night: everything seemed so normal, so ordinary, but I was very aware that something extraordinary was about to happen, that my body was hard at work getting ready for this extraordinary thing. It was just flat-out fun!

Around 11pm - after the thorough routing of the federal Liberal party was thoroughly determined - I started to feel heartburn. "This isn't fair!" I said to The Recruiter, "I'm not supposed to have heartburn while I'm in labour.  That's just mean!" Since it was getting late, I was still having very mild contractions and I wanted the heartburn to go away, I decided to go to bed and sleep it off. I climbed into bed next to Peanut and tried to get comfortable. For over 45 minutes I tried to get comfortable. Eventually I realized that I was no longer tossing and turning: I was writhing in pain. What had started as mild heartburn-like pain was not agonizing upper abdominal pain. I could sleep through it: I couldn't even sit through it. It was unbearable.

Then I realized that I felt sick to my stomach. I went and sat on the bathroom floor and called to The Recruiter to rub my back because my muscles were starting to seize up on me. As he rubbed my back I commented to him that I actually wanted to get it over with and just get sick so that I could feel better. A few minutes later my stomach obliged...but I didn't feel better. I felt just as wretched and in just as much pain as I had previously, but now I was also shaking with cold. I went to the bedroom to get warm socks and a sweater but had to have The Recruiter help me get them on because my abdominal pain was now so bad I couldn't bend enough to dress myself. That's when I finally admitted to myself that this wasn't just heartburn, it wasn't normal, and it was really not good. I said to The Recruiter, "I'm afraid that we should call Gen [our midwife]." He said, "Do you want to call Gen?" I wanted to say no; I wanted to say that I was overreacting and just needed to go to sleep and that we would wake up the next morning, healthy and safe and have a lovely homebirth as planned.  But I couldn't. "Yes."

So he paged our midwife. I crept into the living room and sat on the birth ball and tried to feel better.  After a few moments, I had to kneel on the floor and lean over the ball. I wasn't even noticing contractions at this point: I hadn't really noticed them since while I was laying in bed. As I leaned over the birth ball, rocking back and forth, I talked. I whispered and I talked and I pleaded. I remember saying that it couldn't be my liver, since I'd just run perfect labs. I remember saying that I couldn't be dying. I remember saying that this was not going to be my story, this was not how I was going to end. I remember saying to God that He could not take me away from my other little girl. I remember thinking - knowing - that my health and my baby's health were in very, very great jeopardy.  And over and over I said in tones of utter disbelief, "This just isn't right!"

Then our midwife called back and The Recruiter relayed her questions and my answers. She said we should get to the hospital right away. I called my mother and asked her to meet us there, since it would take at least twice as long to first wait for her to get to our apartment to watch Peanut. I called our doula to tell her what was happening. I didn't even know what I wanted her to do, I was so confused and thrown by the turn our birth had taken. She had to ask me if I wanted her to come to the hospital to help me realize that of course, I wanted her there: I needed her there! The Recruiter was getting the few odd bits of things I needed for the hospital bag, which I had thankfully packed up and kept handy. I leaned on various surfaces and tried to acknowledge that I was probably going to have a very medical birth. The Recruiter got Peanut out of bed, put some warm pants and her boots and a sweater on her and gently explained that the baby was ready to come out and that we needed to go and Gran would meet us there. She was so sweet and helpful, considering it was the middle of the night and this kid does not like to be woken up. Then we grabbed the bags and left. It was about 1am.

We had no gas in the car. Like, NO gas. It was like some sick, cruel joke. We stopped at the gas station near our apartment and got some gas. I was essentially thrashing around in the passenger seat and making some pretty horrible sounds, but Peanut was calm and quiet. We got back on the road. As we approached the on-ramp, there were three police cars lined up on either side of the street with their lights flashing, the officers standing on the street. We live in the National Capital. It was the night of the federal election. It was a freaking R.I.D.E programme. The first officer waved us to stop. The Recruiter said to him before he could speak: "My wife is pregnant and we have to get to the hospital NOW." He waved us on. The next one waved us on. The third one - a young guy - stopped us, so The Recruiter repeated his spiel, to which the cop said, "Ok, sir...but have you had anything to drink tonight."  And I yelled at him, or rather, I yelled, loudly, at the dashboard, "Oh, come on!" while The Recruiter answered no, and we were back on our way.

I'll hand it to The Recruiter: despite the fear we both had, despite the noises I was making, the writhing I was doing in the passenger seat and his knowledge that I do not get freaked or scared of birth so this must be something particularly unusual, he didn't speed. I glanced over as we drove down the 417 and the needle was solidly at 100 km/h. I don't know if he was tempted to go faster, but we got there pretty quickly, regardless.

In the car, I decided that I should reconcile myself to a surgical birth. I gave myself from the gas station to the hospital to get used to the idea. I was in so much non-birth-related pain that I simply couldn't fathom effectively birthing a child in the midst of it. I was also appreciative of the fact that if something was really this seriously wrong with me, there was likely a rather short timeline in which we could safely get Bubby out, both for her safety and for mine. So that was my thought process on the way to the hospital, along with some pretty heave praying that God would help me have peace with a surgical birth and keep me and my baby alive and healthy.

As we pulled into the hospital around 1:30am, I realized that I could not walk from the parking lot to the hospital: it was just too far. But with Peanut in the car, we couldn't just abandon it somewhere. I had to go into the hospital alone. I told The Recruiter to drop me at the door, and that I'd make my way to the maternity ward on my own. He didn't question me, and did so. I had noticed wheelchairs near the door earlier that day. My plan was to walk in, yell "Help" as loudly as I could, and get in a chair. I couldn't get to Maternity on my own. As I walked to the door, though, I heard my mother call my name. She was just arriving at the hospital herself, which was amazingly good timing. I looked at her and yelled, "Run!" and walked inside and got in a chair. She pushed me up to Maternity (I had the presence of mind to remember how to get there, at least).

We had some fun with the elevator: one of the two cars was out of service, the other took forever to arrive and when it did it went to the basement instead of the second floor. While we were waiting, I was angry with myself for not telling The Recruiter that if I died I wanted him to get donor milk for Bubby rather than using formula. I wondered if he'd think of that on his own if it came to that...

When we got upstairs my midwife was waiting for us. I looked at her and said, as I'd been saying to myself so often, "This just isn't right! This isn't labour: I don't know what this is." She got me into a triage room and hooked up to some monitors.  Bubby looked good - great, in fact - and my contractions, though I was too distracted to notice them, were still coming regularly and fairly strongly. At least my body was staying on task through all the craziness. She drew some blood and sent it to the lab. At some point The Recruiter and our doula came in - I can't recall how long I was in there without them - and my midwife started iv fluids. She asked for a urine sample to check for proteins, a sign of pre-eclampsia.

And now I have to admit something: I was very relieved to be at the hospital. I don't like hospitals, and I hate that hospitals have become the norm for birthing, and I positively loathe all the standard interventions that are used without necessity in hospital births. But that monitor drumming out Bubby's heartbeat, telling me that despite how ill I was feeling she was just fine, knowing that if things continued to deteriorate that we were in the best place to be assisted really allowed me to find my focus and reclaim my birthing body.

With this re-found awareness, I was able to use the information I've accumulated over the past few years. So when my midwife checked for proteins, I asked her what the result was. "Plus two," she said.  Ooh, not good.  And I'd been protein-free twelve hours earlier. That got me thinking, or rather, it started to confirm my suspicions.

Time passed extremely quickly while we were in triage. The Recruiter popped out to the waiting room a few times where my mother - bless her - was hanging out with Peanut, my sweetheart, who seemed to just get that things were strange and that she needed to be calm and that Mommy needed help and needed to be there. No tantrums, no fussing, despite the extreme hour, except for when our doula went out to grab my water bottle from my bag, which I'd left with my mother. Peanut was enraged! "No, that's mommy's!" My protective little warrior. After our doula explained that she was bringing it to me, Peanut relented. I remember hearing her screaming, looking at The Recruiter and saying, "That's Peanut." It was pretty funny when our doula came back in and explained that our darling daughter had made it pretty clear that she thought our doula was a thief.

While we waited for the blood test results, my midwife gave me some antacid to try and settle my stomach (I can't recall if this was before or after I was sick again) and she talked to us about various ways that things might go. She mentioned that if my labs were good we might be admitted over night for observation or we might just go home. I'd been pretty dehydrated when I got to the hospital, and the iv fluids (I was almost through my first bolus at that point: she had it just pouring into me) and antacid, as well as the feeling of sanity and safety I had from knowing that we were being cared for had really mitigated the pain I'd been feeling earlier, so it seemed quite conceivable that I didn't need to stay in the hospital. Our midwife stepped out of the room for awhile, leaving our doula and The Recruiter with me. Our doula started talking with me about the benefits and risks of staying in hospital vs. going home. We were using the BRAIN acronym: Benefits, Risks, Alternatives, Intuition, Nothing. When we got to Intuition, she asked me, "What is your intuition telling you? What do you feel?" Just like back at the apartment, when The Recruiter asked me if I wanted to call our midwife, I wanted to say that I wanted to go home, that I felt better, that I didn't need to be there. But it would have been a lie. My gut was telling me to stay right where I was. I told her, "The thought of getting in that car and going home just seems...wrong." "Ok," she said, "you need to listen to that." It was around 3am.

A few minutes later, our midwife came back in holding a piece of paper. The look on her face was something like I have never seen before. My doula, days later, would tell me that our midwife looked almost hysterical, as though she were almost so confused and upset that she was going to burst into nervous laughter. She told us she had my blood test results. I asked her if they were ok, and she just shook her head in disbelief: "No." Her voice sounded nervous and incredulous. "You have pre-eclampsia and HELLP syndrome." She came over to the side of the bed and showed me the results. The page she was holding showed my results from 12 hours previous, the acceptable range for the different things being checked, and my results from around 2am. One of the liver readings (ALT or AST, I can't recall which) had gone from safely within the acceptable range 12 hours earlier (I seem to recall it being an 82) to about 832. 832!! The tone in my midwife's voice as she showed me the results was nervous - I could hear the adrenaline in her voice - and it sounded as though she was trying to impress upon me the seriousness of things. Oddly, though, I felt strangely peaceful and reassured. I had been absolutely right and I hadn't overreacted: things were very, very wrong indeed. Without even waiting for my midwife to say it, I turned to my doula: "Well, that whole conversation is moot: I'm staying right here!" Her eyes were wide and she nodded sagely: "Yes!" I think my midwife was very relieved: she knew how devoted I was to homebirth, but there was no way that homebirthing was a safe idea at this point and I knew it.

"So," she said, "we need to get this baby out now." "Yes," I agreed, "What do we do?" She said that because I was already in labour, my body was obviously getting ready to birth and all we needed to do was help speed things up. She said they'd start with amniotomy - my membranes were still intact - and see if that was enough before trying anything more interventive like pitocin. She also noted that she had to transfer care to an obstetrician because my condition was now outside her scope as a midwife, but that she would be with me through my labour and would be there for my birth despite that. I told her that that was all totally fine: I just wanted her to do the amniotomy, and she assured me that she would definitely be the one to do so. The ob came in - I had happened to meet him in the afternoon, and he seemed very nice and laid back - and repeated what our midwife had said. He said that we'd wait two hours after the amniotomy and if there was no progress, then we'd investigate pitocin and other options. He seemed very calm and relaxed and appeared to respect that this was not the birth I had planned or expected at all.

At that point we sent my mother and Peanut home to my mother's house. As much as we had wanted Peanut to be a part of the birth, as desperately as I wanted her there, I also knew that my health - and this birth - had and could again turn on a dime. I knew that there was the very real possibility that this birth would not be the peaceful, calm birth I had been foreseeing, that it might be far more intense than expected given the need to speed it up or even chemically augment it, and I didn't want to frighten her. I wanted her to see a good birth, and I no longer felt like I could guarantee that that was what I'd have.

As opposed as I am to intervention or to augmenting normal labour, our circumstances were far from normal, and the result of augmenting meant that I'd likely be meeting our baby pretty soon, so I started to get excited again. My contractions had been coming pretty regularly every 7-8 minutes and while I'd been breathing and relaxing through them to try and maximize their effect, they weren't particularly demandign. We did the amniotomy at 4:20am before leaving the triage room and she did a stretch and sweep at the same time for good measure. Our doula had been rubbing my feet, working away on the labour-inducing pressure points, pretty much since we learned how bad things were. We were going to do everything non-chemical we could think of to help things along.

I stood up, got fully dressed again (I was wearing my comfy fleece pants which, oddly enough, I'm currently wearing) and went to move into a birthing room.  Bam! I was hit by a hardcore contraction which was mentally and physically demanding.  After it passed, we moved down the hall to the room. About two minutes after the last one, another contraction hit. And I do mean hit. Suddenly I was having pretty serious contractions every couple of minutes.  I leaned against the counter in our birthing room and swayed back and forth. I needed to stay loose and keep everything happening. Our doula knelt on the floor, continuing her pressure-point massage. Between contractions I was conversational and positive, taking drinks of water and generally trying to enjoy myself. Our midwife was trying to get the EFM set up, though the machine was giving her trouble. She looked into telemetry,  but either the hospital doesn't have any or didn't have any available. We got hooked up with the monitors and I continued to stand. Contraction after contraction came, fast and furious. I was starting to vocalize during them, long, low moans. Between them, our doula joked, "He said you had to make progress in two hours, not that you had to have the baby in two hours!" We all laughed: there was no question that rupturing membranes had been really effective in this case.

As with my labour with Peanut, I leaned over through most of the birthing. After awhile I was sick again. I leaned through a few more contractions after that, then wanted to know how long it had been since the amniotomy. I knew that focussing on time was a bad thing, but it felt like it had been a long time, though I suspected otherwise. I said, "I'm not worried about the time, but I'm curious: how long has it been since we ruptured my membranes?" I expected to hear that it had been about an hour and a half. "45 minutes," was the answer. I was amazed: things had changed dramatically in such a short time. It also reassured me: I was starting to feel overwhelmed by the experience, which was proving to be very different from Peanut's birth, and no wonder if it was moving at such a rapid pace.

That was the only point at which I asked for the time, so I'm not clear on how long different parts of the rest of labour were. At some point after that, my midwife asked me to try to pee. At the time I thought it was suggested only to help labour along - a full bladder can get in the way - and also to give me a chance to rest by sitting, but I realize now that she was likely trying to ensure that my kidneys were still functioning and capable of producing urine. I must have sat there for quite some time. The Recruiter was rubbing my back and, I later learned, nearly falling asleep on me: I had the benefit of adrenaline to keep me awake and working, but he did not. But he stayed with me, as did our doula who stayed at my side the whole time, holding the monitors on me. I started to get a little grunty while sitting on the toilet, and did a little very light pushing there, which felt good, though Bubby was still far from descended.

After some time - again, not sure exactly how long - we left the bathroom and I lay down on the bed. I'm not sure why we moved me, since I'm quite certain it wasn't my idea, but I had been sitting in the bathroom for quite awhile (The Recruiter seems to recall that the intention was to get me moving again; a wise plan, to keep labour progressing and help ensure Bubby was well positioned). Regardless of the reason, it didn't bother me to move and though it initially wasn't comfortable to lay down on the bed, fairly soon I started to drift to sleep between contractions. I lay on my back in a reclined semi-lotus and felt like my limbs melted. Once I started to snore between them, our doula looked at The Recruiter, pointed at the fold-out chair-bed and said, "Go sleep!" because he had been fading for sometime. This was around 6am, so he'd been up for nearly 24 hours straight. It was sometime around then that the ob popped in to see if I'd made any progress. I'll say: I was practically bearing down. Neither The Recruiter nor I actually remember him coming in at all, so he certainly wasn't there for long, which I appreciate: no need to mess with what's working.

So I slept and came to a bit during contractions, then slept some more and The Recruiter got some rest as well. I recall hearing our doula say to someone, "She slept through early labour with her first and now she's going to sleep through active labour with this one!" Our midwife left very briefly to move her car, and in the few minutes that she was gone, I woke up and looked around. Only my doula was left: everyone else had disappeared! I wasn't upset, but amused and definitely confused until she explained where The Recruiter and midwife had each gone.

Our midwife came back in shortly before my body started bearing down. In my labour with Peanut, I had decided to push, so I never felt the undeniable urge to do so. This time my labour was so quick and so intense that it never occurred to me to choose to push: my body just did it. It was strong and it felt like my entire body was pushing, from my head to my feet. The secondary midwife showed up around then as well. I hadn't met her before, but her down-to-earth, matter-of-fact energy was a great addition. At this point, our midwife said she wanted to do a cervical check. I agreed, and she found a slight lip. Through the next contraction she pushed it out of the way while I pushed. That was definitely one of the more dreadful feelings I've experienced, but it also contributed to keeping the labour from slowing down to allow the lip to move on its own.

Then we (I say 'we' because I was largely beyond the point of actually thinking of moving at all, and certainly incapable of doing so without help) moved me into an upright hands and knees position, the head of the bed raised vertically, as I leaned against it and hugged the bed. It was 7am. I felt her crowning, the ring of fire and remembered to do exactly what I had forgotten to do with Peanut: I slowed down. I panted. I kept panting, but something felt wrong. I didn't feel any movment. My body told me to keep pushing. I recall saying as I knelt there, "I'm scared," and my doula and our midwives and The Recruiter all telling me that everything was fine, that I was doing great, that I was listening to my body and doing exactly what I needed to do. I was scared of tearing again, but knew that I needed to listen to what my body was saying. I pushed, felt the silent *pop* of the small tear, just as I had last time, and her head was out.  I later learned that I likely would not have torn had it not been for her posterior nuchal hand, which accounted not only for the damage but also to the very different sensation of her descent and my very sore tail bone afterward. Two more pushes, and at 7:13am she was out. I heard my midwife say, "And now we pass her underneath..." as she passed Bubby between my knees and into my hands as I reached down and lifted her up. And I looked at her, all tiny and purple and pink and covered in vernix - as my tiny, early babies are - and exclaimed, "You're real!" Someone asked me if we had a girl or a boy, so I looked and said, "I got another girl!"

She stayed on my chest for over an hour. Whereas Peanut was whisked away, Bubby and I got to sit with one another and be just as we were meant to for a long, long time. She stayed on my skin through the third stage of labour, through the repair sutures, and until after Peanut arrived with my mother. It was as our midwife had promised: a very different experience from what we'd had following Peanut's birth. Peanut arrived with my mother and her boyfriend shortly after the repair was finished, and she met her sister. She was also the first person to hear Bubby's name: we didn't share it until Peanut arrived. She looked so big and grown up and shy when she came in.

Because of my health concerns, I was admitted until Thursday morning. The concern was that my condition could worsen post-partum, a concern that was partly born out when my lab results from a blood draw at one hour post-partum were significantly worse than they had been at 2am. I can honestly say that I thoroughly hate staying in hospital, that by Wednesday night The Recruiter and I were bored out of our minds but that I could also appreciate the fact that our circumstances were not those of a normal birth. By 6am Thursday morning, my blood test was fine and both Bubby and I were discharged. By noon, we were all four of us home together as we should be.

My health has continued to improve, and I have felt fine since then. My blood pressure continued to be higher than ideal for about two weeks but then a couple of things happened that reduced my stress enough to cause it to drop significantly. So all looks pretty good, though I will be investigating what more I can do to further improve my health and best my chances of avoiding any future hypertensive issues.

And Bubby has fit in just beautifully to our family.

scarlet two weeks

:: post scriptum ::

The Recruiter was right: I did get wheeled in to our hospital birth. This was not the birth that I had expected or had planned. In fact, nearly every point of the birth plan we had written ended up being thrown out in the midst of the circumstances we encountered: hospital birth, constant monitoring, amniotomy, multiple cervical checks, no hydrotherapy, active management of the third stage. But for every one of those points in the plan I had written "barring medical emergency".  And what has felt so entirely surreal since Bubby's birth was that my health truly was in danger and our circumstance did present a medical emergency. Despite the fact that I believe, whole-heartedly, that birth is normal, natural, not inherently dangerous or frightening or urgent and that it belongs, under normal circumstances, at home and not in hospital, my birth did not play out that way. As much as I wanted a homebirth, when my health and my baby's health were at risk, I knew that where I needed to be, and at home in our apartment was not it. As dedicated as I am to natural, non-intervened birth, I knew that my birth needed to happen as quickly as possible and that making concessions to what my choices would be under normal circumstances was necessary and wise. And that feels strange, because it feels almost as though I am saying one thing while doing another, but that isn't the case at all. My dislike of intervention has not changed: I simply dislike liver and renal failure a whole lot more. It's tempting to frame birth in an 'all or nothing' manner, but that isn't reflective of reality.  "Birth is always safe" is as erroneous as "birth is always dangerous" and neither is of any help to birthing mothers. I believe, without question and without any hesitation, that birth is normally safe, that pregnancy is usually not dangerous or synonymous with illness. Sadly, that simply wasn't entirely the case for me this time.

About two weeks post-partum it struck me that there was almost nothing done or used during our birth that could not have happened at home, the exception being continuous EFM, but even that can be essentially effected through some diligent and tireless use of doppler. Knowing this, however, does not sadden me, however: I needed to be in hospital. We needed to know what was happening to my health, but even more importantly, I needed to be there to birth. My body and my intuition made it very clear that the safe place for me to be was in the hospital, and it was there that I felt capable of labouring efficiently. I feel certain that had I continued to be healthy I could have laboured and birthed efficiently at home, but I didn't, and sick as I was, I simply could not have done so at home. As so many great birth workers and writers have said, from Ina May to Sarah J., women birth well where they feel safe. And I knew I wasn't safe at home. It's hard to admit, but it's true.

It's been tempting in the past few weeks to feel like my body failed me, that it failed Bubby, by putting us in danger. The lesson I am choosing to take from this experience, though, is that I am wise. I listened to my body, I paid attention, and it kept us safe. Though I didn't want to birth in hospital, though I didn't want to admit to my illness, though it wasn't the sort of birth I would normally have chosen, I acknowledged the truth that my body was expressing to me, followed it, and it kept us safe. I recently corresponded with Gail Tully of Spinning Babies and she told me,
...though no homebirth, look at how your hard work benefited you adn your baby when you needed it most! Not for your dream birth sadly, but for your very safety! and ability to avoid Pit and a possible C/S which is even more dangerous with HELLP. So you are your own heroine in your story! My goodness! Its hard to be a hero, Darlene, as you know (now if not before) but there you have it! You are amazing! All things come together though not in ways we expect.
What I've concluded from all of this is that, I believe, our fundamental responsibility and job as birthing mothers is to listen to our bodies. I think that, regardless of how we are choosing to birth, whether it's an entirely natural unassisted homebirth or a prophylactic elective c/s, our bodies are giving us important information and we ourselves are the best people to apprehend that information. My experience also confirmed for me the vital importance of being well informed before birthing. Because I was well informed, I was able to immediately understand the implications of the diagnosis my midwife delivered and appreciate the risks associated with the interventions used without a lot of time-consuming explanation.This gave me a feeling of control and peace, and I am certain that it made the entire experience far less stressful for my birth team. We could all focus on the job at hand and, ultimately, have a good birth.

1 comment:

  1. wow. your birth story brought me to tears. it's really the nature of the beast--childbirth is so unpredictable. i'm sorry your birth experience didn't turn out the way you envisioned it, but so glad you and little scarlet are safe and healthy.