My daughter, Hope (24), desired a birth at a local birth center attended by a midwife.
Sept 24, 2013 – ultrasound completed at midwife’s request. No sign of abnormality, normal
Oct 1, 2013 – official due date
October 11, 2013 – returned for an ultrasound at midwife’s request, 2.5 cm of amniotic fluid was noted. Midwife ordered a non-stress test at which the baby was extremely active but the fluid level was confirmed. She was told to be admitted immediately to UNM Hospital for induction. Dr. Leeman, co-director of UNM Hospital Mother-Baby unit, spent time with her going over her choices and giving his recommendations. She was encouraged that in the morning she had been at 2cm and 80% effaced. That was the reason he did not advise the Foley bulb but to begin pitocin. He made it perfectly clear in the end that being induced was entirely her choice but that in his opinion it was the only safe choice.
She returned to her parents' home briefly to eat a light lunch. Her sister, Charity and her husband, Jarrett, accompanied Hope and Lamoni to the hospital to give them assistance “moving in”. I met her at the hospital around 4pm and found she and the hospital staff were trying to determine whether her Presbyterian insurance would cover her stay at UNM. She had previously been told that UNM would only be covered if it were an emergency. Her midwife works directly with UNM, not Presbyterian. Plus, my experience there in addition to their more than 2x the C-section rate made Hope want to stay at UNM. Lamoni, Hope and I spent hours on the phone trying to get a firm answer before the induction was begun. Not only her nurse made inquiries into the insurance dilemma but she was also consulting other staff. The doctor, Dr. Leeman, also spent 15 minutes on hold so that he could give comment on the urgency of the situation. Dr. Leeman was one big reason Hope had wanted to come to UNM and stay. He committed, even though he was only on call until 7pm, to return for the baby’s birth. Dr. Leeman spent considerable time with her and helped her identify that she was actually having regular contractions (3 in a 10 minute period, each about 60 secs long) but he wasn't convinced they were productive contractions and still preferred to add pitocin. He spent time with his hands on her abdomen trying to identify the strength of the contractions. She was encouraged she was having contractions at all. After all was done we were transferred to a nicer room with a tub by a very caring nurse around 6pm.
Her nurse, once she saw that Hope’s veins were deep, called a more experienced nurse who was able to do the I.V. in one try. She carefully explained she was very conservative in her use of Pit and that Hope would not have any surprises in that regard. She and Dr. Leeman confirmed that once the desired effect had happened they would be very willing to decrease the amount of Pit and even disconnect her from the I.V. if her body was able to continue the labor effectively. That gave Hope great hope and it became her goal. I didn’t expect much from beginning Pit at just 1 and so we turned the lights down, drew the blinds and all bedded down for a sorely needed rest. Hope was aware of every little noise and interruption so since my chair/bed was so squeaky I got up and roamed the halls to see what I could find and learn. I was surprised when I returned to her room at 7pm to find her moaning and struggling with contractions. We got her comfortable and encouraged her (and us) to rest a bit more. A bit after 8pm I called her sister, Charity, and asked her to come to the hospital feeling like it may be a looong night and didn’t know how I (2nd night up) and Lamoni would hold up all night. I was also keenly aware that I had been advised by my manager, Kathy, that grandmothers were not meant to be doulas because our emotions are too involved. Hope’s midwife was to be her doula since she would not be her midwife at a hospital birth but she was not feeling well and would not be able to stay at the birth. Charity ended up being an integral part of everyone’s survival through the night, not ever resting or giving up on the situation, always lifting us up and being a total support to each person. She had previously watched one other sister birth. She quickly surmised Hope’s labor was quite different and more intense than Faith’s. We are so glad she didn’t leave us.
Pit was slowly increased to 3 over the next several hours, resulting in bouts of vomiting where Hope could barely breathe. Hope’s method of coping with the strong contractions was developing a rhythm with her head, neck and sometimes arms plus having Lamoni very close to her. She preferred to stay on the ball and was very consistent with figure 8’s and rocking even between contractions. She leaned forward when possible to rest between contractions. She wasn’t as happy in bed but sometimes changed to get a little more rest. She would have done beautiful journey dancing except that her extreme head movements made her quite dizzy and light-headed. At times her eyes rolled back and she was clearly somewhere else. Lamoni held strong through all she went through rarely leaving her side nor letting go of her hand. Seeing her struggle so much with the pain and nausea I requested after consulting with Hope for the pit to begin being decreased from 3 to 2 and shortly to 1. After a period of time in the bathtub which was very relaxing to Hope pit was completely turned off around midnight. Hope had been showing all the signs of transition and I was quite confident she was a speedster laborer and she was ready to birth. 2 residents had offered to check her earlier but she had declined after one seemed very eager to do a check. She asked for the other resident to come and check her but said she did not want to know the # unless it was good news. The resident stayed quiet but did say that the station had dropped from -3 to -1. Aside, she let me know she was a 3 at best. I thought my ears were lying to me, I was a bit delirious from lack of sleep. It seemed so discouraging I could hardly face Hope. Hope, intuitively, did not quiz me but kept working. Little by little I let her know it would not be ending soon and she seemed quite down but kept working. I didn’t see how she could keep going much longer.
After a while they wanted to increase pit again to increase dilation but her friend Sophia had come and asked for 15 minutes without pit before they decided again. She did acupuncture (around her ears) and the hoku spot consistently for every contraction no matter how much Hope was rhythmically waving her arms. It was determined she would not have to return to pit about 2am. During a hard contraction about 15 minutes later her water broke and things started progressing again. About this time her midwife brought some supplies Hope had left at the birth center and remained for about 2 hours giving some good input. Hope wasn’t aware who was suggesting or what was being suggested but tried different ideas and was open to keep going. From about midnight on Hope repeatedly asked how much longer, why wasn’t it ending, saying the baby wasn’t coming down, that it wasn’t going to end and how many more contractions she waould have. It was very hard to answer these because I was realizing her emotional signposts were not indicative of dilation. About 3am they again did another cervical exam and aside let me know she was a 4 at best. I could not even face Hope and tell her that and felt I had nothing left inside of me to encourage her with. This seemed to be my nightmare. I had already been dreading an induction from my experience with birth plus knowing how imminent a C-section seemed to be; I so badly wanted her to have a successful and happy first birth. I plead with God to comfort her and make this birth possible. Sophia needed to leave because she had patients the next day and her midwife needed to go because she didn’t feel well. Nobody had any more suggestions. I asked Charity to have my husband come knowing what a strength to me he was during my 9 labors since I had nothing left in me to support her or Lamoni, who had never let up. I asked our new nurse (as of 1am) what else Hope could do, I was quite desperate. She seemed surprised. She listed all the reasons she was very positive on this labor and had no concerns. Baby was doing wonderfully, she had support (unlike the laboring woman next door with 2 men watching a game), she was progressing and everything was great! She was very proud of Hope. I shared my concerns that Hope wanted to end, that showed every sign of transition (twice now) and she couldn’t keep going. Her wise words were that she felt Hope had something inside of her she needed to answer; to solve before further dilation would happen. She was holding back on something; some fear that none of us could solve for her. Thinking about this and knowing Mike would be with her and Lamoni I decided I would leave the room, rest and get my head together (if possible) because nothing positive was coming from me anymore. I figured Charity would either rest with me or find a place to rest. She had served everyone in the room constantly for 8 hours and I know watching her sister in such immense pain was traumatic for her. While I was quietly letting Lamoni know what the nurse said Hope picked her head up and clearly said, “what am I not doing”? So I let her know the nurse felt there was something she had not solved in her head yet, that she was holding back and needed to figure it out. She had previously been chanting things like, “the baby is NOT coming”, “this is NOT going to end”, “I AM going to DIE!”. She instantly changed to, “The baby IS coming”, “the baby IS moving down” and “I'm glad another contraction is starting!”. I left her with those words but walking out on my daughter was one of the hardest things I’ve ever done and her eyes were on me. I felt, “what a mother, what a grandmother, what a doula” but later it was told to me that a doula knows when to walk out and I already knew mothers can rarely stay a whole labor. I bedded myself quiet miserably on the cold hard floor next to some gabbing and profane women in the waiting room and fell asleep profusely praying for Hope and only woke a few times to relieve my sore hips and cold shoulders. After almost 2 hours I texted Charity to see if Hope was still alive and she responded…. “her contractions are really close together and stronger and longer. ( L) and she is handling them really well (J). That the doctor is coming at 6 to check everything. She said she feels like pushing but it doesn’t feel good yet.” Those words resulted in a lot of mixed feelings. I laid there still until Mike came to give me a report. He seemed cheery and hopeful. I did not feel that way. I limped back to the room but still had a hard time getting my emotions in order. He firmly told me not to enter until they were because she needed strength. I unconfidently walked in but after a few moments of watching her and Lamoni labor together, so differently than the 8 hours I had witnessed I became excited and strong again. I couldn’t imagine what she did but now they were laboring as we had practiced during our classes and she was so in control. The doctor didn’t come in until closer to 7 but thankfully her cervical check showed her at 9.5 with just a slight lip left, such immense relief and joy!!! She changed positions to help with that lip to hands and knees and stayed in control. After a few minutes the resident doctor returned and I reminded her that Dr. Leeman had offered to come for the birth so she summoned him. We spent that little while waiting for him working with Hope who was surprised she didn’t feel a pushing urge, nor did it feel good to push. When Dr. Leeman arrived he did a quick check and said everything was ready and she could push! After a few painful tries he suggested she might like to be in the shower. Just standing up was a big deal for her, and very slow progress was made towards the tub but then she settled down sitting in the tub facing all the eager faces in the bathroom. He let the lights stay off and used my cell phone flashlight to check for progress. Nobody minded getting sprayed and gave her lots of encouragement to bring the baby down. The warm water spray really comforted her. At one point the Dr. asked if she would like a picture, she vehemently said, “NO!” but he asked if she was sure because it was quite a pretty site: a non-medicated, in control woman, relaxing in the tub, her belly protruding quite cutely and blissfully wet. She still turned him down. I had attempted to take pictures at various times but between her threatening looks and words, Charity’s strong looks towards me and lack of lighting there aren’t any. This is my attempt to remember these intense and special hours. I would most like to remember that her body’s way of coping with the pain was extreme rhythm and counting and that she allowed her body to move as it was directed. I was afraid her head would fall off and dreaded the neck ache that would surely come the next day but it meant sooo much to her to keep moving. I've never seen Hope dance as she did and didn't know she had such rhythm. She was moving so quick that her hair was a blur. I also felt she returned to her two year oldness as far as being spontaneous, expressing her motion, and relying on her intuition, her naturalness. It was very endearing to watch her, especially when her most intense suffering was relieved by smothering Lamoni with her lips, caressing him with her face and kissing him. If he ever broke their hand hold she was instantly looking for him like a blind person. When Mike tried to take Lamoni's place she instantly knew it wasn't Lamoni's hands on her.
Sept 24, 2013 – ultrasound completed at midwife’s request. No sign of abnormality, normal
Oct 1, 2013 – official due date
October 11, 2013 – returned for an ultrasound at midwife’s request, 2.5 cm of amniotic fluid was noted. Midwife ordered a non-stress test at which the baby was extremely active but the fluid level was confirmed. She was told to be admitted immediately to UNM Hospital for induction. Dr. Leeman, co-director of UNM Hospital Mother-Baby unit, spent time with her going over her choices and giving his recommendations. She was encouraged that in the morning she had been at 2cm and 80% effaced. That was the reason he did not advise the Foley bulb but to begin pitocin. He made it perfectly clear in the end that being induced was entirely her choice but that in his opinion it was the only safe choice.
She returned to her parents' home briefly to eat a light lunch. Her sister, Charity and her husband, Jarrett, accompanied Hope and Lamoni to the hospital to give them assistance “moving in”. I met her at the hospital around 4pm and found she and the hospital staff were trying to determine whether her Presbyterian insurance would cover her stay at UNM. She had previously been told that UNM would only be covered if it were an emergency. Her midwife works directly with UNM, not Presbyterian. Plus, my experience there in addition to their more than 2x the C-section rate made Hope want to stay at UNM. Lamoni, Hope and I spent hours on the phone trying to get a firm answer before the induction was begun. Not only her nurse made inquiries into the insurance dilemma but she was also consulting other staff. The doctor, Dr. Leeman, also spent 15 minutes on hold so that he could give comment on the urgency of the situation. Dr. Leeman was one big reason Hope had wanted to come to UNM and stay. He committed, even though he was only on call until 7pm, to return for the baby’s birth. Dr. Leeman spent considerable time with her and helped her identify that she was actually having regular contractions (3 in a 10 minute period, each about 60 secs long) but he wasn't convinced they were productive contractions and still preferred to add pitocin. He spent time with his hands on her abdomen trying to identify the strength of the contractions. She was encouraged she was having contractions at all. After all was done we were transferred to a nicer room with a tub by a very caring nurse around 6pm.
Her nurse, once she saw that Hope’s veins were deep, called a more experienced nurse who was able to do the I.V. in one try. She carefully explained she was very conservative in her use of Pit and that Hope would not have any surprises in that regard. She and Dr. Leeman confirmed that once the desired effect had happened they would be very willing to decrease the amount of Pit and even disconnect her from the I.V. if her body was able to continue the labor effectively. That gave Hope great hope and it became her goal. I didn’t expect much from beginning Pit at just 1 and so we turned the lights down, drew the blinds and all bedded down for a sorely needed rest. Hope was aware of every little noise and interruption so since my chair/bed was so squeaky I got up and roamed the halls to see what I could find and learn. I was surprised when I returned to her room at 7pm to find her moaning and struggling with contractions. We got her comfortable and encouraged her (and us) to rest a bit more. A bit after 8pm I called her sister, Charity, and asked her to come to the hospital feeling like it may be a looong night and didn’t know how I (2nd night up) and Lamoni would hold up all night. I was also keenly aware that I had been advised by my manager, Kathy, that grandmothers were not meant to be doulas because our emotions are too involved. Hope’s midwife was to be her doula since she would not be her midwife at a hospital birth but she was not feeling well and would not be able to stay at the birth. Charity ended up being an integral part of everyone’s survival through the night, not ever resting or giving up on the situation, always lifting us up and being a total support to each person. She had previously watched one other sister birth. She quickly surmised Hope’s labor was quite different and more intense than Faith’s. We are so glad she didn’t leave us.
Pit was slowly increased to 3 over the next several hours, resulting in bouts of vomiting where Hope could barely breathe. Hope’s method of coping with the strong contractions was developing a rhythm with her head, neck and sometimes arms plus having Lamoni very close to her. She preferred to stay on the ball and was very consistent with figure 8’s and rocking even between contractions. She leaned forward when possible to rest between contractions. She wasn’t as happy in bed but sometimes changed to get a little more rest. She would have done beautiful journey dancing except that her extreme head movements made her quite dizzy and light-headed. At times her eyes rolled back and she was clearly somewhere else. Lamoni held strong through all she went through rarely leaving her side nor letting go of her hand. Seeing her struggle so much with the pain and nausea I requested after consulting with Hope for the pit to begin being decreased from 3 to 2 and shortly to 1. After a period of time in the bathtub which was very relaxing to Hope pit was completely turned off around midnight. Hope had been showing all the signs of transition and I was quite confident she was a speedster laborer and she was ready to birth. 2 residents had offered to check her earlier but she had declined after one seemed very eager to do a check. She asked for the other resident to come and check her but said she did not want to know the # unless it was good news. The resident stayed quiet but did say that the station had dropped from -3 to -1. Aside, she let me know she was a 3 at best. I thought my ears were lying to me, I was a bit delirious from lack of sleep. It seemed so discouraging I could hardly face Hope. Hope, intuitively, did not quiz me but kept working. Little by little I let her know it would not be ending soon and she seemed quite down but kept working. I didn’t see how she could keep going much longer.
After a while they wanted to increase pit again to increase dilation but her friend Sophia had come and asked for 15 minutes without pit before they decided again. She did acupuncture (around her ears) and the hoku spot consistently for every contraction no matter how much Hope was rhythmically waving her arms. It was determined she would not have to return to pit about 2am. During a hard contraction about 15 minutes later her water broke and things started progressing again. About this time her midwife brought some supplies Hope had left at the birth center and remained for about 2 hours giving some good input. Hope wasn’t aware who was suggesting or what was being suggested but tried different ideas and was open to keep going. From about midnight on Hope repeatedly asked how much longer, why wasn’t it ending, saying the baby wasn’t coming down, that it wasn’t going to end and how many more contractions she waould have. It was very hard to answer these because I was realizing her emotional signposts were not indicative of dilation. About 3am they again did another cervical exam and aside let me know she was a 4 at best. I could not even face Hope and tell her that and felt I had nothing left inside of me to encourage her with. This seemed to be my nightmare. I had already been dreading an induction from my experience with birth plus knowing how imminent a C-section seemed to be; I so badly wanted her to have a successful and happy first birth. I plead with God to comfort her and make this birth possible. Sophia needed to leave because she had patients the next day and her midwife needed to go because she didn’t feel well. Nobody had any more suggestions. I asked Charity to have my husband come knowing what a strength to me he was during my 9 labors since I had nothing left in me to support her or Lamoni, who had never let up. I asked our new nurse (as of 1am) what else Hope could do, I was quite desperate. She seemed surprised. She listed all the reasons she was very positive on this labor and had no concerns. Baby was doing wonderfully, she had support (unlike the laboring woman next door with 2 men watching a game), she was progressing and everything was great! She was very proud of Hope. I shared my concerns that Hope wanted to end, that showed every sign of transition (twice now) and she couldn’t keep going. Her wise words were that she felt Hope had something inside of her she needed to answer; to solve before further dilation would happen. She was holding back on something; some fear that none of us could solve for her. Thinking about this and knowing Mike would be with her and Lamoni I decided I would leave the room, rest and get my head together (if possible) because nothing positive was coming from me anymore. I figured Charity would either rest with me or find a place to rest. She had served everyone in the room constantly for 8 hours and I know watching her sister in such immense pain was traumatic for her. While I was quietly letting Lamoni know what the nurse said Hope picked her head up and clearly said, “what am I not doing”? So I let her know the nurse felt there was something she had not solved in her head yet, that she was holding back and needed to figure it out. She had previously been chanting things like, “the baby is NOT coming”, “this is NOT going to end”, “I AM going to DIE!”. She instantly changed to, “The baby IS coming”, “the baby IS moving down” and “I'm glad another contraction is starting!”. I left her with those words but walking out on my daughter was one of the hardest things I’ve ever done and her eyes were on me. I felt, “what a mother, what a grandmother, what a doula” but later it was told to me that a doula knows when to walk out and I already knew mothers can rarely stay a whole labor. I bedded myself quiet miserably on the cold hard floor next to some gabbing and profane women in the waiting room and fell asleep profusely praying for Hope and only woke a few times to relieve my sore hips and cold shoulders. After almost 2 hours I texted Charity to see if Hope was still alive and she responded…. “her contractions are really close together and stronger and longer. ( L) and she is handling them really well (J). That the doctor is coming at 6 to check everything. She said she feels like pushing but it doesn’t feel good yet.” Those words resulted in a lot of mixed feelings. I laid there still until Mike came to give me a report. He seemed cheery and hopeful. I did not feel that way. I limped back to the room but still had a hard time getting my emotions in order. He firmly told me not to enter until they were because she needed strength. I unconfidently walked in but after a few moments of watching her and Lamoni labor together, so differently than the 8 hours I had witnessed I became excited and strong again. I couldn’t imagine what she did but now they were laboring as we had practiced during our classes and she was so in control. The doctor didn’t come in until closer to 7 but thankfully her cervical check showed her at 9.5 with just a slight lip left, such immense relief and joy!!! She changed positions to help with that lip to hands and knees and stayed in control. After a few minutes the resident doctor returned and I reminded her that Dr. Leeman had offered to come for the birth so she summoned him. We spent that little while waiting for him working with Hope who was surprised she didn’t feel a pushing urge, nor did it feel good to push. When Dr. Leeman arrived he did a quick check and said everything was ready and she could push! After a few painful tries he suggested she might like to be in the shower. Just standing up was a big deal for her, and very slow progress was made towards the tub but then she settled down sitting in the tub facing all the eager faces in the bathroom. He let the lights stay off and used my cell phone flashlight to check for progress. Nobody minded getting sprayed and gave her lots of encouragement to bring the baby down. The warm water spray really comforted her. At one point the Dr. asked if she would like a picture, she vehemently said, “NO!” but he asked if she was sure because it was quite a pretty site: a non-medicated, in control woman, relaxing in the tub, her belly protruding quite cutely and blissfully wet. She still turned him down. I had attempted to take pictures at various times but between her threatening looks and words, Charity’s strong looks towards me and lack of lighting there aren’t any. This is my attempt to remember these intense and special hours. I would most like to remember that her body’s way of coping with the pain was extreme rhythm and counting and that she allowed her body to move as it was directed. I was afraid her head would fall off and dreaded the neck ache that would surely come the next day but it meant sooo much to her to keep moving. I've never seen Hope dance as she did and didn't know she had such rhythm. She was moving so quick that her hair was a blur. I also felt she returned to her two year oldness as far as being spontaneous, expressing her motion, and relying on her intuition, her naturalness. It was very endearing to watch her, especially when her most intense suffering was relieved by smothering Lamoni with her lips, caressing him with her face and kissing him. If he ever broke their hand hold she was instantly looking for him like a blind person. When Mike tried to take Lamoni's place she instantly knew it wasn't Lamoni's hands on her.
After a bit the Dr. suggested she return to the bed and she opted to stand next to it but ended up in it. About that time there was a knock at the door. Now all this time different residents were in and out of the room, peeking into the bathroom and all. But this time it was Faith. She was curious why Faith had come (earlier she said no to Charity coming in but we think she just didn't want anyone seeing how hard she was laboring) but I said since Faith had just gone through this she wanted to come for moral support. She quickly got to work providing support to everyone, (it was nearly a full-time job shoveling ice into her mouth, just 2-3 pieces at a time, rhythmically her entire labor!), telling Hope encouraging things and definitely showing excitement as Hope made progress pushing her baby down the birth canal. Everyone was reminded that Lamoni would announce the sex of the baby, the cord would not be cut until it stopped pulsating and that Lamoni would cut it. She still didn't feel pushing contractions but quickly got into definitely giving it her best pushing. Dr. advised her to push even in between contractions to help bring the baby down because she was working so hard (2 steps forward, one step backwards). As a small circle of skin appeared in the birth canal it seemed VERY shiny, even glossy, I was thinking "saintly"! We later found out it was because he was born in the sac! It was hard for Hope to keep her head up and then drop her chin curling herself around her baby to push and she now wishes she had tried a different position. The Dr. did not tell her to hold her breath or all of us to count to 10 like maniacs but I do think too much energy was escaping as she exhaled versus holding and bearing down. I commented this to him a couple of times but he felt self-directed pushing was better and he was, with his fingers, helping her know where to bear down. Pushing did take a long time but later when we found out HE was 9 lbs it all made sense; plus it was her first baby. Everyone was very patient but so excited. It took quite a few pushes to actually crown, there were "false crowns" as more and more of this big head presented itself! As soon as his face was born it was seen in the "caul" and a small hand caught right near his mouth (and has never left!). Even though the resident had held and moved the labia lips out of the way, cupping the baby's head and Dr. had worked with the perineum with warm compresses this hand caught as the head naturally turned from face down to the left giving her a small tear (1 stitch with 4 punctures). Once his whole head came his body quickly came, was lifted and put directly on her abdomen pooping as he went! I got busy taking zillions of pictures but I remember seeing immense joy on Hope and Lamoni's faces, quite a few tears and from all of us such relief it was over (and yet it was just beginning!). There was lots of cuddling during Hope's "cleanup" and I should have prepped Lamoni for the sight as it hit him with Great Concern! A little while later Hope was sitting on the side of her bed, swinging her legs like a little girl as others took turns holding little Benjamin and taking pictures. She didn't stay quite that comfortable and had some recovery to do but I think the immense power of that incredible labor kept her mind going while she was resting, wanting so much to be all better so she could fully enjoy Benjamin.
No comments:
Post a Comment