Wednesday, November 28, 2012

Why I am Choosing Natural Childbirth, Part III

(A pregnant lady who is this calm and relaxed is sure to have a calm, relaxed birth, right? RIGHT??!!)

This is probably going to be my last post on why I am choosing natural childbirth for the birth of our second baby. If you haven't already done so, I would encourage you to read Part I and Part II

I ended my last post with Tony's birth story, with Tony and Will headed off for the newborn procedures to take place, and the OB who delivered Tony was stitching up my second degree tear. The OB asked me if I could feel anything, and I couldn't. The epidural had certainly taken care of that (not to mention, I didn't have the epidural for that long. A lot of women talk about the epidural slowly wearing off and they could tell when they had to push...yeah. I wasn't one of those women. I was completely, totally numb from the waist down). The doctor finished his work on me, the nurses took the catheter out, and Will and Tony came back in the room right as the nurse helped me into a wheelchair, so I could move to the recovery room, where we would spend the next two days. Those first couple of hours passed in a blur of breastfeeding, snuggling with Tony, off again on again sleep, and the nurses coming in to check Tony and I. I remember the exact moment I felt the epidural wear off-I started making "uuggghhhh" sounds and shifted uncomfortably around on my bed. THAT'S when I started to feel the full effects of having just given birth, and the stitches from my tear. I won't lie, it was pretty painful. I really, really had to pee, so I tried to stand up out of the bed (not aware that my right leg was still completely numb), and proceeded to fall over. Fortunately, my husband had more insight than I did at the time, and he was there to catch me. Will helped me to the bathroom, and once I was finished I told him I wanted to take a shower and brush my teeth. I hadn't brushed my teeth since I vomited the night before (gross, I know), and I felt grimy and sweaty after 27 hours of labor, and I wanted to clean up. Obviously standing in the shower wasn't an option, but fortunately there was a small chair for me to sit down on. 

Most of our two days in the hospital were not memorable since we were both so exhausted, and we quickly found out that Tony was one of those babies who wanted to nurse all. the. time. I'm pretty sure he was latched on to my boobs for 20 out of the 24 hours in a day. What I do remember is being in a lot of pain. I barely got off the bed. At one point, after Tony nursed but was still fussing (this was in the middle of the night), Will got up and pushed him around the maternity ward in his bassinet so I could get a little bit of sleep. He saw two other mothers who gave birth the day after me in the hallway, chatting. He stopped to say hello to them, and the new mothers cooed over Tony and congratulated Will. He told me later he was very surprised to see them out and about in the hallway, when I had given birth the day before they did and I was in too much pain to walk around. We left the hospital on a Friday morning, and spent the next week at home. We didn't leave the house much, not only because it was the dead of winter and Boston and we didn't want to expose Tony to any germs, but also because of me. I was just feeling awful. I knew that childbirth wasn't going to be a walk in the park, but I had assumed (and heard from other mothers) that you feel better after a couple of days. I didn't. I was still in a lot of pain, and it just seemed like I couldn't get comfortable in any position. It hurt to walk. It hurt to sit. The pain lessened slightly if I was stretched out on the couch, but not by much. Also, I had absolutely no appetite. This was very surprising to me, since my milk had come in at this point and I was constantly nursing a hungry infant. In retrospect, this should have been a huge red flag for me. 

By the end of the first week, I was pretty sure something wasn't right with my body. I was still bleeding pretty hard, I didn't have an appetite (I ate because I knew I had to, for Tony, but I remember I felt like I had to force the food down). I felt completely run-down, but then which new mother doesn't? I didn't know if this was all in my head, and I was having a hard time with the whole new baby thing, or if there was something seriously wrong. I called the after-hours number for my OB's practice on Sunday night, and as luck would have it, I was put through to the one doctor in the practice I didn't like. I told her my symptoms, but she completely brushed me off. Frankly, she made it sound like I was wasting her time. She kept asking me if I felt like I needed to go to the hospital, and when I told her that I didn't know (let's face it, wasn't that the reason I called the doctor in the first place???), she told me that I was probably doing too much but I was just fine. She hung up the phone, and I felt more confused-and frustrated-than ever. 

A few days later, I woke up at 2am in terrible pain. Honestly, I felt like I was in labor all over again. I had sharp, shooting pains in my abdomen, I was freezing cold even though I was wearing warm pajamas and covered in blankets, and even though I drank almost 3 glasses of water in a row, I was completely parched. Tony woke up wanting to nurse, and I tried to feed him but everything just hurt too much. Will kept asking me if I wanted to go to the hospital, and I was crying and saying "I don't know, I don't know, I don't want to take Tony to a germy ER if we don't have to," etc. I wasn't making a lot of sense. Around 4:30, the pains were getting worse and Will was getting very nervous. He called his parents, who live in Alabama, and told his father (who is a doctor) about my symptoms. Will told me later that his dad's voice became urgent, and he told Will in no uncertain terms that he had to get me to the hospital right away. He also added that if there was heavy traffic and he didn't think he could get me there fast enough, he should call 911. That spurred Will into immediate action. He bundled Tony up and put him in the car seat, grabbed his diaper bag, threw on some clothes, and brought Tony up to the car in our garage. He ran back to get me, and I was crying and saying I needed to get dressed, Will was panicking and he kept saying we didn't have enough time, and he threw a robe over me, stuffed my feet into a pair of shoes and pretty much carried me out to the car. I was shaking, I was so cold, and Will sped to the hospital while blasting the heat in the car. At that point, I kind of blacked out. When I came to, we were in the ER at the hospital where I gave birth, and we were rushed to triage. The nurse kept trying to take my blood pressure, and she looked at the machine and frowned, and said "this can't be right. The machine must be broken." She got up, left, and brought in a new machine. She took my blood pressure again, looked at the machine, looked back at me, and ran out of the room to call for a stretcher. Apparently, my blood pressure was so low it was almost off the charts. I blacked out again, and when I woke up later I had an IV in me, and the on-call OBGYN (one of the nice ones!) was there holding my hand. 

She asked me a bunch of questions about how I was feeling, how I had been feeling since Tony was born, where it hurt, etc. She did a quick examination on me and determined I had a uterine infection, and I had a fever of 101 degrees. They wanted to admit me overnight, and make sure the antibiotic was working and for my fever to go down. I (obviously) didn't realize it at the time, since I was so out of it and sick, but uterine infections are serious. Very, very serious. The doctor told Will that it was a good thing he had brought me to the hospital when he did, because while the infection itself is very easy to treat, everything could have ended very badly if we had decided to try and stick things out at home. We left the hospital the following day prescriptions for the antibiotic, Percocets, and very strict instructions to either stay in bed or stay on the couch, and to NOT overdo it. My mother in-law very graciously flew up to Boston from Birmingham to help us out of the next couple of days. I took it easy, stayed in bed most of the time nursing Tony or sleeping, and I recovered fairly quickly.

I'm not sharing this story to scare anyone, although I'm pretty sure I did a bang-up job doing just that. I'm sharing it because I want to make the point that even in this day and age, childbirth can still be a scary business sometimes. Although no one really knows how uterine infections are contacted, it's probably safe to say that I came down with it when I was in the hospital. Now, I'm certainly not blaming the hospital for this, but it made me wonder if I would have had the same experience with an out-of-hospital birth. I also wonder if I would have felt so awful after childbirth if I had waited a few days on the induction to see if I could have gone into labor on my own. Maybe if I had a little more patience with my body, and my baby's ability to let me know when he was ready to come out, the Pitocin, Cervadil, Stadol and epidural could have been avoided. I will say, however, that even though my circumstances after childbirth were less than ideal, I don't want anyone to think that I wasn't satisfied with my birth experience. No one in the hospital pushed any interventions on me, nothing was done without my consent, and I was so grateful to have a team of such wonderful nurses and doctors. They were fantastic while I was in the hospital giving birth, and to be perfectly honest, they saved my life not even two weeks later. If we had remained in the Boston area, I would have been more than happy to have our second baby at the same hospital.

We moved to Shreveport, LA almost one year ago, and Will and I were overjoyed this past summer to find out that we were expecting again. I knew that the birth philosophy would be different in the South as opposed to the East coast, but I wasn't prepared for HOW different it was. For one thing, there are zero midwives in northern Louisiana. I wasn't 100% sure at that point if I would have gone with a midwife, but I was disturbed that I was told I HAD to see an OBGYN. I would have preferred to have more options. Not to mention, all the hospitals here have very high c-section rates (around 38%), and while I found an OB who initially seemed very open to me having a natural childbirth, I found that as the months went on, he kept dropping hints that he would be happy to induce me early if I was sick of being pregnant, if I was overdue he wouldn't let me go past 41 weeks, etc. I began to get nervous, and I was suspicious that he was as open to natural childbirth as he initially claimed to be. It was at that point I started researching other options.
(22 weeks! I already have "pregnant face" and someone asked me if I had twins in there. Nope, I wasn't insulted at all...)

I found out about the Edenway Birth Center in Marshall, TX by doing a quick Google search for birth centers in the area. The closest freestanding birth center in Louisiana is in Baton Rouge, which is a good 4 hours away from us. That was a no go. However, Marshall is only 45 minutes away, and that's the exact same distance we were from our hospital in Boston. That, I was completely okay with. I sent them an email, and soon afterwards I spoke to the CPM, Charlotte Russell, who runs the practice. She encouraged Will and I to come in, meet face to face with her, take a tour of the birth center, ask questions, etc. We scheduled a meeting with her for the following week, and we made the drive to Texas. Let me first say that just walking into the birth center had a calming effect on me. Everything was very clean, very quiet and it had an extremely peaceful atmosphere. We met with Charlotte and Britteny, who is training to be a midwife. We were first given a tour, and I oohed and ahhed over the facility (and the glorious birthing tubs! I was very excited about the prospect of laboring and/or delivering in a birth pool), and then they sat down with us for an hour and answered all of our questions. They were friendly, professional, very knowledgeable, and both Charlotte and Britteny did a great job of putting my mind at ease. In the unlikely event of needing to transfer to a hospital, it wouldn't take long at all-the hospital is right across the street. They are trained to repair up to a second degree tear, they are trained to do all the newborn procedures, and they are trained in resuscitation of babies. Also, if I needed to go to the hospital, I wouldn't just be dumped there and left to fend for myself; Charlotte would stay with me and act as my doula. I can't even begin to describe how relieved I felt after meeting with these two women-I felt like someone finally got where I was coming from. Back in the Boston area, no one would have batted an eye at me if I said I was interested in a birth center birth with a midwife. Let me tell you, if you dare to utter a similar statement in this area, people will look at you like you just announced that you're planning on joining the Hari Krishnas. A lot of women have different ideas about the birth experience down here, and that's fine, but that wasn't the experience I was looking for.

We made the official decision to switch care providers for my pregnancy, so that week I canceled my upcoming doctor's appointment, informed his office that I would be switching providers, and had my medical records transferred to Edenway. I've had two appointments since then, and our ultrasound scheduled for this Friday evening. We're not going to find out the sex of T-Quad, but we just want to know that our baby is progressing normally and everything is looking good. Oh, and did I mention that the midwives and midwives in training at Edenway are also trained as doulas? Not only will they be delivering my baby, but they will be providing the much-needed labor support before I give birth. As far as childbirth classes go, I will be taking a class through the birth center, which is given by Jen, one of the other midwives. I took Hypnobirthing with Will when we were in Boston, and I have mixed feelings about it. On one hand, it was a great tool to learn during my pregnancy. The whole purpose of the course is to learn how to relax your mind, relax your body, and to put yourself into a hypnotic state during labor and delivery. I was a bit skeptical at first, but I will say the class did wonders for my nerves. If you're a high-strung, Type A personality (cough cough like myself), this class may prove to be beneficial to you. I had a much easier time relaxing during my pregnancy, I slept very well while listening to my hypnobirthing tracks at night, and I actually did manage to put myself into a hypnotic state on more than one occasion. The problem? I think Hypnobirthing is great if you go into labor on your own, progress at a normal rate, and don't need any interventions. That was not my experience, and once I had the Cervadil inserted and my contractions hit me like a brick, Hypnobirthing went right out the window. I also feel like we didn't learn enough in the class about different positions that could alleviate labor pains (because the whole idea is that you will be in a hypnotic state and not really notice the pain?), different birthing positions, etc. So yeah. We're going to try something new and see how it goes. I'm feeling really optimistic about everything, and I'm so glad that once again, I found wonderful care providers.

Resources

If you are interested in natural childbirth and want to do some reading up on the subject, here are some books, movies, and websites to check out!

1. Natural Childbirth the Bradley Way
2. Ina May's Guide to Childbirth (really, anything written by Ina May Gaskin is fantastic)
3. Natural Hospital Birth, for those who are most comfortable delivering in a hospital but still want the natural birth experience
4. Birthing From Within
5. The Thinking Woman's Guide to a Better Birth
6. The Business of Being Born, which was produced by Ricki Lake and Abby Epstein. This documentary, along with the follow-up More Business of Being Born, is available on Netflix if you have it. While I really enjoyed this documentary and certainly recommend it, I will encourage you to take it with a grain of salt. Like most documentaries, it's very biased and comes across as very one-sided. Decide for yourself.
7. Have a Natural Childbirth This website was created by doulas, midwives, and natural childbirth advocates. Includes birth stories.
8. Mama Birth A blog written by a mama who is a childbirth instructor.
9. Edenway Birth Center For those of you living in the Shreveport area or in East Texas, I strongly encourage you to check out Edenway's website!

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