Wednesday, July 15, 2009

birth story/stories plus

I have been meaning to write Oona's birth story for quite a while now. She is almost fifteen months old. Every time I start, though, the beginning of the story gets pushed further and further back in time because so many things lead up to the girls' birth and reflect the choices I made.

This is going to be a really really long post. Feel free to read or not to read as you so desire.

Before I ever thought of getting pregnant with Gemma, I was worried about my fertility. In 2000, I discovered that I had a mass on my left ovary that needed to be surgically removed. It was about the size of a tennis ball and was diagnosed as a fibroma being mostly calcified material though there were some teeth in it which is like a dermoid cyst. The surgery was pretty traumatic for me. I was the first person in my family to have to have surgery and somehow I thought this was a personal failure. Also, my ex-husband wasn't able to be all that supportive through it. I also got pneumonia while recovering. And I've had quite a bit of pelvic pain ever since that surgery. So surgery on my ovary plus pelvic pain equals worry about my fertility.

Fast forward a couple years, my ex and I split and I met Eric. I had been on the pill since I was seventeen. I went on the pill because I had two and a half week long cycles and because I wanted a reliable form of birth control. In retrospect, it probably wasn't the wisest decision to go on the pill, but hey, I was seventeen. Fast forward again, my older sister found out that she had Factor V Leiden which is a genetic clotting factor. If you have this factor, being on the pill isn't the best idea. I didn't have health insurance so couldn't afford to get tested so decided to try the progesterone only pill as a precaution. Estrogen in the pill is what effects clotting. I felt AWFUL on the progesterone only pill so after awhile decided to go off the pill altogether. I felt even more awful after going off the pill. It took me three months to get my cycle. I got a hemorrhagic cyst on my right ovary which, let me tell you, is very very painful. I couldn't even stand up straight. That precipitated my elopement with Eric so that I could get health insurance. Then my ovary pain was a pre-existing condition so I couldn't seek treatment for it for six months. I had three different pelvic exams that came back as normal with nothing wrong and nothing to explain the pain which was very frustrating to me. I had heard about Dr. Fern and what a good doctor he is but he only takes doctor to doctor referrals for new patients. So I went to another doctor (clear pelvic exam once again) and he ordered an ultrasound. I had a polyp in my uterus so he referred me to Dr. Fern. At the first meeting, Dr. Fern could palpate where my pain was and said it was from scar tissue and thought I might have endometriosis and he would recommend a laparoscopy for that and a hysteroscopy to remove the polyp. The polyp could prevent pregnancy in the same way that a IUD does. Yikes, surgery, been there, done that, was NOT fun. After lots of thought, though, I did decide to go ahead with it. Being a massage therapist and also believing in a lot of alternative medicines, I didn't make this decision lightly because I had had so much trauma from my first surgery. Ultimately, what I felt from my gut was that even though I knew I could most likely heal completely with alternative medicines, having a second surgery with a doctor I trusted and with a supportive husband would actually help heal the trauma from the first surgery and I would also know what was causing the pain. For me, knowing that I have endometriosis and that is what causes all the pelvic pain has been comforting and has helped me have more direction as I seek alternative treatments for it. No more wondering why and what and wherefore. The surgery did cause more scar tissue but it balanced out the scar tissue I already had and it seemed to take the emotional charge and trauma out of having surgery in the first place. So now, I have no polyp and fewer adhesions and all of this should help my chance of getting pregnant, though I'm not quite ready to try. My second surgery was summer of 2005.

Fast forward again to winter of 2005. We decide to try and see what happens. I get my period and am disappointed and am worried because endometriosis and surgery on your ovaries can cause infertility. I know in my head that is only one month, but I still worry. My twin sister calls and tells me that she is pregnant on the first month. She had assumed it would take her awhile to get pregnant and it doesn't so the timing is a little stressful for her. I burst into tears at the news (not the best reaction and did I mention my twin sister and I were barely on speaking terms at this point in history?) Little knowing that I was already pregnant, two weeks later I had the positive pregnancy test. I was on top of the world. I had felt this little girl soul calling to me telling me that it was time for her to be born. And here I was pregnant. I didn't know that she was a girl yet and even at the first ultrasound when she was old enough to be able to tell, she kept her legs together and you couldn't see anything. Now comes the question of whether I continue using my gynecologist as my OB or find a mid-wife. I like my doctor quite a bit. He has even done a c-section using acupuncture as the anasthetic so I know he isn't closed to natural childbirth and if something were to happen, I would trust him to handle it and he explains things well and has an excellent bedside manner. Plus I want to keep him as my gynecologist and he's hard to get into. The easiest path is to have him as my OB. His one drawback is that he is conservative about inducing and doesn't like his mom's to go far past forty weeks gestation (as confirmed by ultrasound.) I decide on hypnobirthing and natural childbirth in the hospital. I never really seriously considered home birth at the time. Partially because I like my OB. Partially because I don't want to labor in front of my two step-sons, our relationship especially at that point didn't really allow for that kind of intimacy. And partially because my safe place, like a cat or other animal who finds their place to birth, is the hospital. I'm very clear in my birth plan that I don't want any intervention unless it is medically necessary and is clearly explained to me. I do find comfort that if something does happen, I have medical support.

Pregnancy with Gemma - we move to our new house in early pregnancy. There were mice and the smell really got to me. I was really exhausted throughout the first trimester. I never threw up but sure felt like it. I could not eat eggs or black pepper at all. The second trimester was much better. I had more energy and unpacked more boxes and got the house set up. I continued to work at my job as a massage therapist. Acupuncture helped a lot with heartburn and nausea and everything like that. Third trimester, I find out I have gestational diabetes but that I can control it with diet. Because of the gestational diabetes, Dr. Fern really doesn't want me to go too far past term but will let me go to 41 weeks. At 34 weeks, Gemma drops (I have learned that she is a girl by now and we're pretty sure what her name is) and I'm having five to ten minute mild contractions but don't think anything of them because they're mild. They must be Braxton-Hicks. I see the nurse practitioner and I have some softening and effacing of the cervix. She sends me over for a non-stress test which monitors babies heart beat which should go up a bit every time they move. This is a precaution for mom's with gestational diabetes which can be a stressor on babies and they want to know how the baby is handling the blood sugar issues. Turns out I'm having five minute regular contractions (Braxton Hicks contractions don't show up as contractions on the ultrasound monitors) and since my cervix has softened, they count it as pre-term labor. I have to have the awful shot to stop labor but they do let me go home. My doctor puts me on Procardia which makes me feel absolutely awful and gives me really restless legs. He puts me on another medicine to stop the restless legs. So I'm on bed-rest for two weeks which is not easy when you're used to working, even if only part time. At 36 weeks he takes me off the meds but recommends that I rest for another couple of weeks. Somewhere in there, I think that since I was considered to be in labor at 34 works and the contractions are the same as they were then, then I must be in labor now. We go to the hospital as a false alarm and it was not a fun experience. The nurse who checked me was not gentle. It just wasn't a good experience. After that, I was determined to stay at home as long as possible and my doctor said to wait until it was difficult to walk through my contractions. At 38 weeks, I start moving around and start going for walks, etc. My twin has her baby October 18. I pass the forty week mark. How in the world can I be going past-term if I had pre-term labor? I get acupuncture. I have sex. I do nipple stimulation. I eat spicey food. I notice that the right side of my uterus is contracting harder than my left so I get some bodywork and visceral manipulation which helps balance my uterus. I go on my hands and knees to effect the position of Gemma's head. I get acupuncture again. My sister comes to help with the baby who isn't born yet. We walk, we go grocery shopping, we talk, we walk some more. I try a small dose of blue cohosh and a little castor oil (not enough to cause intestinal distress). This whole time, since 34 weeks, I've been having five to ten minute contractions and have been about two centimeters dilated for about a week. The day is October 27 and I'm scheduled to be induced November 1. At the grocery store they become a little stronger. We have dinner. We're sitting and watching a movie and they're kind of a little stronger and I squeeze Eric's knee every time I have one. I decide to go up and take a shower. They get stronger and closer together (like three minutes or so.) I want to lie down. My sister sees me and suggests that I might want to head into the hospital. She stays with the boys which was awesome because I didn't have to worry about the boys at all. The more serious contractions started around 7 pm. We get to the hospital at 8 or so. NO cervical change at this point which I find disappointing and have a moment of panic about being able to do this for how long? We do our hypnobirthing and put Steven Halpern music on the cd player. I get in the tub but get overheated and am not comfortable. I mostly sit on the bed and rock which suprises me. I thought I'd be able to lay on my side and really relax. I have to go to the bathroom a couple times. I have a really supportive nurse who likes natural childbirth. My contractions are really strong and right on top of each other - every minute and a half. I don't get to rest between contractions but that's okay. I focus on how effective they're being at opening my cervix. I'm fully dilated at 11 pm, my water breaks and I'm ready to push. The doctor isn't there yet and they've called the on-call guy. I don't care if the doctor is there or not. I'm pushing. I remember a pause in contractions and just resting for a moment. And a couple more pushes and she was born at 11:30 pm, about ten minutes after the doctor got there. They gave her to me right away. I was on top of the world. I had done it. Hypnobirthing was wonderful. I had a beautiful baby girl. I couldn't wait to do it again. She was beautiful and perfect and high apgar. She stayed in my room with me and we nursed and nursed and nursed (she was a cluster nurser so would nurse for a really really long time and then sleep for a really long time.) Her blood sugar was low when she was born and she had a little bit of formula but barely any. Eric stayed in the room with me. The only problems I had was that I had second degree tearing and I couldn't adjust to the difference in fluid pressures and so passed out whenever I stood up. I distinctly remember hearing the roaring in my ears. So I couldn't go to the bathroom and they were worried about my bladder being too full which can cause too much bleeding and I had lost a fair amount of blood already. So they did a catheter which kind of worked. And ultimately I laid on a bed pan. My uterus was firm enough, too. So I just stayed up most of the night watching my baby and loving every moment of it. Gemma Winifred. Winifred for my great grandmother. Gemma for St. Gemma and also a name that starts with g like her Mom and her grandmother and also Eric's great grandparents were John and Emma and my grandparents were Gerald and Irma and if you mush all that together you get Gemma.

So that is the Gemma portion of the story. I return to work when she is four months old, two days a week. She does fairly well in daycare. I enter into the most bizarre of all bizarre conflicts with my boss at work and ultimately decide to leave that job. I felt that I had to love my job and the work situation enough to make up for leaving my baby at daycare and after that conflict and foreseeing the future effects of the conflict, it just wasn't enough. That was really hard for me because I had truly loved my job. But the relationship with my boss and where she was heading, just wasn't the right thing. I worked out of my home for a bit. I knew I wanted a second baby so that Gemma wouldn't be like an only child, being ten and twelve years younger than her brothers. And I knew that I didn't want to work really hard to build up my practice then go on maternity leave again. My work life was on hold. So Oona's conception was wrapped up in that conflict - the conflict between my work and being a mother and finding a balance between the two. And it was pushed a little ahead in time because I left my job and was in limbo. If things had been different, we would have waited a bit longer. Gemma was about nine months old. I planned on tandem nursing. I had had a few cycles and we went ahead and went for it. I could also sense Oona out there waiting for me to be ready though she wasn't quite ready yet. Then she was and I was pregnant and my milk dried up and I had to wean Gemma because she would not take a sippy cup at all and I did not have any milk left. I was excited to be pregnant and happy about having another baby. But it wasn't the top of the world. There was some compromise there. I had absolutely no energy. I did a couple massages a week, got Gemma food, changed her diaper and that was all I could handle. I couldn't clean, cook, do laundry. I was a mess. My Dad came out, even, because he wasn't employed at the time and helped do laundry and take Gemma for a couple walks so I could REST. Second trimester was better. I cooked a lot of double meals and put the extras in the freezer. Then right before Christmas at 22 weeks pregnant I started getting regular five minute contractions that wouldn't go away until I had rested for several hours and they started up again if I did any activity. I did NOT want to be on the meds again so put myself on partial bed rest. Gemma and I read a lot. I knitted and crocheted a ton. It was one of the hardest things I ever did because you don't feel that daily sense of accomplishment. You succeeded in incubating a baby for one more day which is huge but doesn't feel huge when you're in it. We rented the series Monarch of the Glen. The boys had to help out a ton, vacuuming, dishes, you name it. Eric had to do a ton. I would see Eric for about twenty minutes a day as he was trying to keep it all together. And I would sit on the couch and watch it all go by. Knitting and crocheting saved my sanity. I also did some homeopathics which helped a lot. My doctor let me do daily blood sugar tests instead of taking the awful sugar tests. I had gestational diabetes again and this time, it couldn't be diet controlled and I went on meds, though not insulin. Having gestational diabetes makes your pregnancy considered to be high risk. I had considered switching to a mid-wife if I had a low risk pregnancy but with my history and with my pregnancy being considered high risk, I decided to stay with my OB. It was a hard winter with a lot of snow and I went a period of six weeks without going further than my front porch except to go to the doctor's office. My friendships from my old job weren't strong enough to withstand not seeing each other regularly at work. I was really completely isolated. I make it to 36 weeks. Yay! I made it! I take myself off bedrest because I don't want to go post-term. I start moving and walking, slowly. I start to dilate and am three centimeters dilated. I have so much false labor it isn't even funny. I try homeopathics, walking, sex, nipple stimulation, spicy food, acupuncture, blue cohosh (which doesn't work this time). I did visualizations. When I did my visualizations I saw this darkness blocking Oona from being born. During acupuncture, this cleared but she still felt really hung up to me. Something was happening that was keeping her from fully engaging the cervix. Finally, I hit the day where I'm scheduled to be induced, April 25. I'm so disappointed. I thought there was no way I could have gotten to this day with all the contractions I had and being dilated for so long. But I showed up at the hospital. The only thing I question is whether I could have pushed Dr. Fern to let me go longer. They don't want to break my water because her head isn't fully engaged and there's a chance the cord could fall through and cause problems for the baby. So they start the IV. I do my self-hypnosis. I have contractions and they get really close together but they were nothing to write home about. Dr. Fern comes in and wants to break my water and almost gets there and it's really uncomfortable and I say no, it doesn't feel right so he doesn't push it. I go to the bathroom. I walk around the room. I get bored. I fully expected things to take off because that is what my sister experienced and because Gemma's labor was so fast. I sit on the birth ball and focus on engaging Oona's head with my cervix and envisioning my cervix opening to help things move along. Oona's heart rate dips quite a bit several times and the nurse comes in and wants to put a monitor on her head. We try some different positions and with my laying on my side, Oona's heart rate is fine. I lose it and become super emotional. All the natural birthing books say that not being able to move makes labor stop so I feel doomed. I have to lay down to keep the baby safe and now the nurse wants to put a monitor on the babies head to make sure it is doing okay. I'm doomed, this is horrible, I can't handle it. I cry, I try to get Eric to understand, he doesn't seem to get it. Finally, Dr. Fern comes in and explains it to me and I do better. I say no to the monitor unless Oona shows more signs of distress and he is fine with that. I have to continue to lay down to keep Oona from showing signs of distress. I finally let him break my water. I'm getting really tired from the drama of the day at this point. The contractions automatically become five times as strong as before they broke my water. I can't relax into them and this is when the effect of the pitocin became too much. I couldn't relax and I couldn't anticipate the contractions as well because something from outside of me was controlling them. I very clearly in my mind knew I needed an epidural. I couldn't relax and I was getting exhausted. It was very matter of fact and I asked for one and the anesthesiologist happened to be right there and she set me up and I lay down on my back for it to take effect and was able to relax and in that space of time my dilation completed and Oona was in the birth canal. The nurse put in a catheter and drained my bladder which I was thankful for. I pooped on the table - geez, I thought I was already empty but nothing I could do about it. I still had enough feeling that I felt the poop come out and could feel my contractions and that Oona was in the birth canal but I kept quiet. The nurse wanted to put the monitor on Oona's head and went to do it and Oona's head was right there which really surprised the nurse. She called Dr. Fern and I got ready to push. Maybe four pushes later, her head was out and Dr. Fern told me to stop because the cord was pretty tight around her neck. He cut her cord then which tells me it was too tight to unwrap without cutting it. And then she came the rest of the way out and the cord was around her wrist as well. No wonder I felt like she was hung up. She was! A nurse practitioner said she was accessorizing which helped me laugh about it. She was born at 5:56 pm after twelve hours of being at the hospital. I held her right away and nursed her but could tell something was off. They tested her blood sugar and it was really really low and they took her to the NICU and put her on an IV. I was stitched up for slight tearing and had a mole that had gotten really big removed from down there and then I got settled in a room. They took me up in a wheel chair to NICU and I nursed Oona. The NICU doctor told Eric that if I insisted on nursing exclusively that Oona would be in there for two weeks. It can be hard for babies to regulate their blood sugar if their mom had gestational diabetes and glucose feeds their brains so their brains can be starved if their blood sugar gets too low. But I nursed her for as long as she wanted every three hours and her blood sugar stabilized in two days and she didn't need to be supplemented at all. Thank goodness for that. It was hard to have Oona in the NICU instead of with me. It delayed our bonding and Gemma couldn't meet her and the boys couldn't meet her. And it was really hard to have been induced. When I ask whether it was in my best interest to be induced, I get a decided "no." But when I ask whether it was in Oona's best interest for me to be induced, I get a decided "yes." I have grief about how Oona's birth went, but deep down, I know it was what she needed and I have learned to trust my gut.

I have had it come up that Oona only had low blood sugar because they didn't let me eat at the hospital. I did eat a really big breakfast before I went (in spite of being told not to) and they did let me have some soup. I think it did make her blood sugar lower than it would have been but Gemma also had low blood sugar and I had had a full meal five hours before she was born and wasn't hungry during the labor at all. Then it came up that she only had distress because I had pitocin. Well, yes, the pitocin probably added to the stress but maybe her cord had something to do with it. There are babies who are born with the cord wrapped around with no ill effect. It just depends on how tightly the position of the baby and the shape of the mom's pelvis and location of the placenta and everything else. I chose the care I chose to help protect my baby and myself and if I were to do it again, I would make the same choice, even though the outcome wasn't exactly what I would have hoped for for myself and for Oona. I believe that it was right to take the gestational diabetes seriously, especially in Oona's case because I couldn't control it with diet and almost had to go on insulin in the end. Gestational diabetes isn't that big of a deal if you can control it with diet but if you can't, it can cause serious problems for the baby. Contracting a lot before term without any cervical change could have been no big deal but it also could have been pre-term labor and a preemie baby which can be a really big deal. I think the precaution of resting and listening to my body and keeping myself from having frequent contractions was a wise decision. The only think I would have done differently is ask the doctor for another week. But I didn't because I thought it was impossible for me to go post-term when I was already dilated so much and having had sooo many contractions.

Oona Cecilia - Cecilia for Eric's Dad's aunt who was killed in an airplane crash and Oona because we were trying to find a name that went nicely with Gemma and when I read the name Oona to Eric and he said it back to me, there was a bubble in my stomach like Oona was telling us that was her name. She came home Sunday afternoon and slept in her car seat and spent time with Dad while Mom and Gemma had special time together and Gemma cried and let her Mom know she was mad that she had been gone and then went and brought an interloper in. After Gemma got it all out, she did really well and loved her baby sister. My Mom came the next week and Eric took off for a couple conferences. And we all adjusted to being a big family now - four kids.

1 comment:

  1. I enjoyed reading your birth stories. :-)
    Wow, you've been through quite a lot!

    My MIL works at Dr. Fern's office and I was with him for the first part of my pregnancy. He found out I had also been seeing a midwife (Linda Marks at Spokane Midwives) and gave me some scare stories about her and water birth... and told me I had to chose him or a midwife.

    I'm glad I chose the midwife after learning that he doesn't let you go past 41 weeks. (Seems like that's the case for so many doctors!)
    My MIL was getting worried that I was going "late" ... went to 41 weeks, 3 days, and I guess I would have be having to "miss" induction appointments or else have been scared into having one... I'm so glad I didn't because for me, pregnancy and birth were really problem-free.

    On the other hand, Dr. Fern's scare stories about Ms. Marks caused me to do more research on her, couple that with the fact that I didn't quite feel comfortable with her, and go out and meet Cathy. And Cathy was just _perfect_ for me, I am so glad I ended up with her.

    But yeah, that's just kind of funny about Dr. Fern. I guess I was lucky too, since you say he only takes referrals? Although maybe that's for non-OB stuff?
    Well, my MIL got me in with him though, so it was sort of a referral. Almost makes me feel bad... apparently he had rescheduled a vacation because it was during the due-time for myself and one other of his patients... I also felt a little bad about that, hah. But boy, if his vacation was for the week after, I guess there would have been issues if I hadn't been induced.

    Hmm, but yeah, totally rambling now.