Monday, November 16, 2009

A Perfect Birth Experience: First Hospital Waterbirth in the County

This birth happened at General Hospital in San Luis Obispo in 2002. Kim chose Certified Nurse Midwives: Linda, Lisa and Miday to be her care providers. Although this birth took place nearly 8 years ago, Kim's story has so much clarity because she wisely chose to write this during her first days back at home with her baby.
Second pregnancy, same as the first
When I found out I was pregnant a second time, I scheduled an appointment with the same doctor who delivered my first baby. I had my first 5 months of prenatal appointments, and pre-registered at the same hospital where I had gone before. My second pregnancy was easy, just as it was the first time.

Dramatic change in worldview at 5 months
About 5 months into the pregnancy, however, a friend loaned me a copy of "Misconceptions," a book by Naomi Wolf that completely changed the way I think and feel about childbirth. This started me on a journey toward wanting to do this second birth naturally, which is totally different than the way I felt when I was pregnant the first time.

Learning everything I can
I began reading voraciously about natural childbirth, and talking with my girlfriends who had gone through the experience. These women were crucial in giving me information, support, encouragement, and inspiration. In January, at about 6 months pregnant, I switched from my previous doctor to a group of midwives, who gave me such personalized and supportive care, I was able to work through my feelings about the first birth, and gain confidence about doing this naturally the second time around.

Waterbirth as an option
At our first meeting with the midwives, they mentioned to my husband and I that they were planning to begin offering waterbirth as an option; they were buying a tub to put in one of the labor and delivery rooms. I was immediately drawn to the idea, and shortly thereafter my husband and I attended a workshop that the midwives hosted with Barbara Harper of Waterbirth International. After the workshop, I was even more convinced that waterbirth was what I wanted, so we worked with Barbara to rent our own tub just in case the one purchased by the midwives had not yet arrived at the hospital or was occupied by someone else when I went into labor. It turns out that this was a critical decision, because the midwives' tub wasn't completely operational by the time I needed it, so we ended up using the tub we rented.

Planning in earnest
As the birth approached, my husband and I spent a great deal of time making preparations. We hired a doula(Jennifer Stover) and met with her three times before the birth -- to discuss our past experiences (especially with the birth of our first child), and our hopes for this second birth. We also attended childbirth classes with our doula, and learned a great deal about how to prepare for and manage a natural birth. My husband and I both continued to read, discuss, plan, and make arrangements for the birth. We packed our bags, brought the tub to the hospital, etc. I was feeling confident and excited, and we both felt that I would probably have the baby on Thursday or Friday after my Wednesday due date.

Beginning of labor
Sure enough, I began having more contractions on Thursday than I had been having before that day. By late afternoon, I was contracting several times an hour. This was my last day of work, and by 5 pm I finished everything I hoped to get done before I went on maternity leave. The timing was perfect! My husband and I went for a brisk walk around dinner time, to see if we could kick start the labor.

By about 8 pm, the contractions were pretty regular, at about every 5 minutes, but they were mild and lasted only about 30 seconds. Within a few hours, they were coming more frequently -- about every 3 minutes -- but they were still mild and lasting only about 30 seconds.

A festive atmosphere

Our very good friends arrived at our house at about 9:30pm, which was again perfect timing. They had originally planned to arrive the next morning. However, they were able to get away earlier than expected and arrived just as my husband began keeping track of times for my contractions. At that point, I was slowly beginning to accept that this was in fact "it." I was so reluctant to accept that this was labor, because I didn't want to get excited and then be disappointed if it was only a false start. Shortly after our friends arrived, however, I did acknowledge that I was probably "really" in labor. The atmosphere was festive, and we had a glass of port together while we chatted, laughed, and discussed plans for the birth.

At about 11 pm, everyone went to bed -- I dozed between contractions until they became somewhat more uncomfortable. Then I got up about 1 am, lit a fire and candles, turned on some music, and did chores. I tidied up the house, balanced the check book, mended a shirt for my husband, cleaned up the kitchen, etc. I was very happy, excited, and confident.

My husband got up about 2 am, and we enjoyed being together. The contractions were still about 3 minutes apart, mild, and lasting 30 seconds. At about 3 am, our friends got up, so we sent the men to the hospital to set up the tub. This took them about an hour, and apparently all the nurses were excited that the first waterbirth would actually be taking place very soon.

While the men were gone, my girlfriend and I talked with the doula and discussed when to go to the hospital. I began to think that the contractions were building in intensity, and I called my parents to come take care of our first child. My girlfriend made noodles for me to eat, and muffins for everyone else. When my parents arrived, the atmosphere was again like a party. We had music on and ate muffins, and we all chatted and laughed while the men returned from the hospital. I was relieved that the tub was filled, warm, and ready for me.

Losing steam
Unfortunately, I started to feel that my contractions were losing steam. I became somewhat discouraged, and after a while we sent everyone back to bed -- and my parents back to their condo. My girlfriend and I went for a brisk walk (with stops for contractions) to see if we could boost my progress. When this didn't work, I took a very long shower to relax, and then laid down to rest again. Through the early morning, I again dozed between contractions and became increasingly discouraged when they failed to build momentum. At about 7 am, I talked with the midwife on call and my doula. Both gave the same advice, recommending a very brisk walk to move things along -- and if this failed, to take a long shower or bath and then try to rest. I settled in for a very long continued labor, or even a false start that would stop and then resume later. My girlfriend again went to sleep, and when she woke up at about 7:30 am, she made breakfast for me. We talked about my concerns, and discouragement. When my husband woke up shortly thereafter, I burst into tears, saying that I was exhausted, but not getting anywhere with the labor.

The power of a good cry
A good cry may have been just what I needed, because at about 8am it felt like the length and intensity of contractions increased quite suddenly. I felt that something had changed pretty dramatically, and it was definitely time to go to the hospital. My girlfriend called the midwife, doula, and my parents. The men helped me to the car.

Driving to the hospital
The drive to the hospital was very difficult, because the motion made it hard to concentrate on breathing and managing the increasing level of discomfort. I made my husband pull over to the side of the road, just around the corner from our house, and he was afraid we were going to have the baby right there! As soon as that contraction subsided, he pulled back out to drive (I didn't feel quite ready yet!), because he knew we had to drive in the few minutes remaining before another contraction hit. I was briefly enraged at the driver of a white minivan, who was driving *way too slow* in my opinion, but with my husband ignoring most traffic laws we made it to the emergency room at the hospital. I struggled to get out of the car, and into the wheelchair that someone rolled out to the parking lot for me.

Getting into the tub
Getting up to my room, I clearly fit the stereotype of a woman in labor from TV, chanting and moaning loudly as I was quickly wheeled into the elevator and down the hall. As I was wheeled into the room, I started sobbing uncontrollably, and I told my husband it wasn't from the pain -- I didn't know why I was crying. In retrospect, this must have been my “transition” phase and the start of really serious active labor. When I arrived, the nurse checked the baby's heartbeat and encouraged me to get into the tub. "That's what you got it for," she said encouragingly. I was afraid that getting into the water would stall my progress -- especially given the long night of slow early labor. However, the nurse assured me that it was okay. I suspect she could see that nothing was going to stop this baby from coming at this point. With some help, I climbed into the tub and the feeling of relief from the warm water was immediate. I got on my hands and knees, and felt like nothing was going to make me change positions from that point on.

Meanwhile, the midwife and doula arrived in the room, and took their stations. My husband and doula were positioned at my head, near the wall, while the midwife was behind me -- watching and waiting. My world was focused on my body, on the doula’s coaching, and my husband's loving presence. The doula helped me to keep my vocalizations low, and as my voice creeped higher I could feel the tension increase -- so she helped me bring the pitch of my voice down where it definitely helped me to relax. I could feel a dramatic difference with her help, pushing out the pain with my breathing and letting each contraction go while I rested in between. My husband gave me loving encouragement, and kissed me in between contractions. It was all perfect. My girlfriend was snapping pictures, and Handel's Messiah filled the room. I couldn't help but sing along at some points, because I love the music and it helped me to concentrate.

The urge to push
At some point, a very intense contraction ended with an uncontrollable urge to bear down and push. I could feel the baby moving, and I remember saying that the "baby is coming, baby is coming!" The feeling took me by surprise, because I didn't expect it to be time to push so quickly. I was afraid it would be too soon, and I didn't feel like anything could make me resist the urge to push. I was very relieved when the midwife did a quick vaginal check and said that it was okay for me to push.

Women have babies out here?!
Twice while I was in the tub, the midwife asked me to pull my belly up out of the water so she could check the baby's heartbeat with a Doppler. It was very difficult to change positions, although it was probably good to help the baby's progress, and it was incredibly reassuring to hear her say that the baby was doing well. I hated being out of the water, and I remember thinking: "Women have babies out here?!" The second I got out of the water, I felt an increase in discomfort with all the gravity and cold air. It seemed like the most natural thing in the world to be in the water, and it was a great relief both times when I sank back into the warmth.

Making progress

Now I was pushing hard with every contraction, and although it definitely hurt I remember thinking that it was definitely manageable. At some point early on, the feeling of the baby’s head was so intense that I insisted that the baby must be out. Of course, the baby wasn't even close to being out yet, and I snapped at the doula when she said that I was making progress and that baby was coming out. I remember saying that I didn't want to hear that I was making progress -- I wanted to hear that the baby was out! Fortunately, I didn't have long to go.

As pushing went on, I could better distinguish the progress of the baby's head, and the most intense feelings came as it moved toward crowning. Each push hurt quite a bit, but I deliberately pushed as hard and long as I could, hoping that this would be the last one. The doula continued to help me focus on my breathing and vocalizations, and helped me to grunt while I pushed. I was afraid I would forget to grunt, so I actually repeated the word "grunt" while I pushed -- which fortunately served the same purpose of helping my breathing and effort. Later, the doula laughed and said she had never had anyone actually say the word "grunt," instead of just doing it! I literally was afraid I would forget what I was supposed to be doing, and it worked just fine.

Crowning and birth
When the head crowned, I insisted that my husband go around behind me to see it, because I couldn't see it or feel the head with my hand while in that position. It was important to me that he watch for both of us, because it felt like that allowed me to see it as well. Then when the head finally emerged, I felt intense pain and an even more intense feeling of relief and joy that immediately made the pain irrelevant. I was so excited, and relieved, knowing that the worst was over and the rest of the body would be a piece of cake by comparison. After a long rest, with the baby's head submerged in the water, the next push brought the whole body slithering out, with a little gentle tug from the midwife.

Joy, triumph, and falling in love
There simply aren't words for the feelings of joy and triumph as I turned over into a sitting position (with the cord still attached), and they laid my brand new baby on my chest. The moment was pure ecstasy, as I looked at this new little person and kissed my husband. I couldn't believe how much this new baby looked like our first child! It was almost confusing, because it looked like I had the same baby again. It did make it even easier to fall in love with this new person, however, because it looked so much like my beautiful firstborn.

It’s a boy!
Immediately, someone put a hat and blanket on the new baby, and I was very concerned that it stayed warm. In fact, concern over keeping the baby warm kept us from wondering about the gender for a few moments. When we remembered, my husband and I fumbled with the blankets to check between this little person's legs. It was a boy! I was so thrilled, because I felt strongly throughout the pregnancy that this was a boy. Finally, this was our little boy, and I got to smother his little wet head with kisses. He was so cute! He had arrived at 10:35am on Friday, about an hour and a half after we arrived at the hospital. The birth had gone quickly, smoothly, and perfectly.

A perfect birth experience

Afterward, the midwife helped me to deliver the placenta, and gave me two shots to control some excess bleeding. I was thrilled when she did another vaginal exam and said that I had no tearing whatsoever. The nurse did an exam of the baby and helped my husband give him his first bath. Within an hour, my parents arrived with our daughter. I was so excited to see my little girl, and it was sheer bliss to have everyone I loved so much there in the room together. I could not have imagined a more perfect birth experienc

1 comment:

  1. Watching the first water birth at SLO General Hosp. was the most amazing thing! Thank you for sharing your experience. Made me want to have another baby. I loved working at General and water births added a wondrous new element to our last years as nurses there.