Epidural

Levi's Birth

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All throughout her pregnancy, Hilary wanted to do what was best for her baby. Her pregnancy was a difficult one being that she had hyperemisis. For those of you that don’t know, hyperemisis is a condition in pregnancy where you are sick for the entire pregnancy. Beginning to end. Because of the constant nausea and vomiting, Hilary was very weak during her pregnancy and was afraid that she would be too weak to have her baby naturally. Despite her fears, she wanted to try. The last 2 months before her birth, she was especially anxious. She was definitely ready to have the baby and be done with feeling sick. Her prayer that Levi would be born early. So when Hilary started to feel crampy a couple of weeks early, she was very excited that her prayers were being answered.

It had been very hard for Hilary and I to get together because she caught the flu, then her husband did the week after and I ended up getting sick right after that. So we had planned to meet Tuesday night the 11th the day she started feeling crampy. Her due date wasn’t until January 25. We met and went over a few last minute things. Hilary and Leo never had a chance to go to birth classes so we had a few extras to go over. During our meeting, Hilary was having contractions and by the time I left they were about 10 minutes apart. Leo seemed a little nervous at this time. I went home to type up Hilary’s birth plan and send it off to her just incase she was going into labor. By 9pm, her contractions were 6 minutes apart.

At 12:13 pm, Leo call me to tell me the contractions were close to 3 minutes apart. I headed over to her house and her spirits were high and she was very upbeat. They also called Hilary’s mom who she really wanted to be at the birth. At 1:15, Hilary’s contractions were pretty consistent at 4 minutes apart. Hilary wanted to make cookies for the nurses at the hospital, she was worried about getting a nice nurse, so she wanted to put things in her favor by bringing them something. So we made cookies and she was getting quite uncomfortable. Hilary moved to the bath and her contractions were quite intense. She split her time from the bath, the couch and the kitchen making cookies. She really had trouble relaxing through them and focusing on anything else then the feelings she was having. We tried to get her to focus on Levi, on what her body was doing, we tried visualizations. Nothing would take her mind away from the pain she was having and the thought that it’s going to get worse before it gets better. Hilary’s contractions were 2-4 minutes apart. It looked like labor was progressing really fast. However, her not being able to relax and the fear that she was having wouldn’t allow her body to work with the contractions.

At about 4:30 Hilary was in the bath with Leo. Leo did a great job comforting her and helping her through the contractions. She lost some of her mucous plug and her contractions were pretty close together. Back to back at one point. Some were more intense then others. So at 5:45 am they decided to go to the hospital. We arrived at 6 am, Hilary and Leo went to triag. Nobody else was aloud back with her until she was admitted and in a room. and Hilary was dialated to 1-2 cm! She was crushed, understandably so. It is so hard when labor starts so intense then you find out you are not very far along. It is almost impossible to get your mind back to where your cervix is. So the nurses told her to walk for an hour and they would see if that helped. If she was at 3 cm, they could admit her. Gratefully it worked and she was admitted at 8 am. The hospital policy was only to have 2 people in the room with the mother, however the nurses were nice enough to allow her mom to be there as well. Hilary was so happy we all could be there. At this time she decided she was going to have something to help her with her pain, but didn’t know what.

After she was admitted she had to be monitored for a while and get all the paperwork done and 2 hours later she was at 4 cm. After that she went into the shower to hold off a little before getting an epidural or narcotic. While she was in the shower with her mom, Leo came out with me to figure out what would be her best option. After talking to the nurse about what each medication does, he decided the epidural would be best for this situation. At 11:15, Hilary got the epidural and her contractions were 1 minute apart. At noon, they were 4 minutes apart again. Her body was taking a little needed rest. By 2pm 1-12, her contractions were 1-2 minutes apart lasting a few minutes. Hilary still hasn’t slept. She was able to rest, but not able to sleep. She was just so excited to be done with her pregnancy and meet her little boy. When the nurse came in to check her at 2:15, she was 5 1/2 cm dilated. Her labor seemed to progress with the movement she did in early dialation, but slowed way down when she would rest. Since Hilary and Leo didn’t want any pitocin, she did nipple stimulation for about a 1/2 hour. After that she started feeling nauseous and couldn’t keep it up. By 4 pm that evening, her contractions were back to 4 minutes apart, but an hour later she was at 8 cm. We were very excited that it was finally so close. Hilary’s spirits were way up after this pelvic exam. She threw up a little about 6:30 and felt better after that.

At 7 pm her doctor came in to see her and he said she was fully dialated with just a little lip. She was told to push through it and was able to. At this point instead of the baby laboring down, the doc wanted her to be actively pushing so she did and by 9 pm, the head was visible. The doctor came in and wanted pitocin, Hilary did not. So she kept pushing. She was having a lot of back pain and shaking off and on. At 9:15 she got more epidural and that kicked in for the pain. She took a little break from pushing from 9-9:40. Hilary started up pushing again after a rest and Levi just wouldn’t get in the right position to move past her bone, so we kept moving her from her left to right to her back to get him to move. We got him to move once, but not the right way. So she kept pushing and pushing while getting more and more tired. Finally she came to a point where she had to make a decision, pitocin to help her push, or push till she can’t push anymore. Levi wasn’t making progress through the birth canal at this point, so Hilary decided on pitocin. She pushed for at least another hour before we all realized he wasn’t going to move without being on her hands and knees, which we couldn’t do because of the epidural or the doc had to use the vacume. Hilary very reluctantly decided the vacume would be the best choice at this point because if not she would have gone to a c-section. The vacume took one suck and Levi was born at 11:52 pm 1-12-11.
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Hilary ended up having 20 hours and 15 minutes for 1st stage labor, pushing lasted 4 hours and 7 minutes (not counting the break from 9-9:40) and 3rd stage (the placenta) lasted 2 minutes. It was amazing that she was allowed to push for that long. Hilary had a great nurse that worked really well with me in guiding her on possible positions to get the baby to move. She was very understanding in letting Hilary go as long as needed before making a new decision. It was wonderful that Hilary was able to go until she had to make a change, rather then choosing to use the vacuum or pitocin too soon. If she had gone for the vacuum much earlier, it may have taken more then just a tiny suck, but instead Levi came right out with a tiny little extra help.
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Levi was 5 lbs, 14 oz and 18 inches long.

Jessica's Birth - blessing in disguise

When Jessica found out she was pregnant aside from it feeling so unreal, she new two things, that she didn’t want anything to do with needles and that she birth could be a good experience. Other then that, she just didn’t know where to start when learning about the birthing process and how she was going to do this she was overwhelmed with all the information out there. Jessica loves children and is very close with her brother and sister-in-law (Amber) and their 2 little girls. Amber was one of the first people she called to share the wonderful news, but it was so hard to get used to the idea that there was a baby inside her. Eventually Jessica started having morning sickness, which made it a little more “real” to her and she started to do some research on child birth. Through this research she discovered The Bradley Method of Natural Childbirth and immediately decided she would take the classes because they have such a high success rate of students having a natural childbirth. She also came across Ina May’s Guide to Natural Childbirth and loved reading the inspirational birth stories in the book. It wasn’t long before Jessica knew she was going to try this natural child birth, but if labor was bad enough to actually want the needle, then she would get it at that time.

When Jessica decided on having a natural child birth, she knew she wanted a doula and her sister-in-law present for the birth. She felt it would be wonderful if her mom could be there, they are very close, but also she though her mom might get too stressed and cause Jessica more stress. Naturally her mom wanted to be there as well, so Jessica gave her things she could do to “earn” her way into the birth. For example, going to a prenatal yoga class would buy her 10 minutes in the room and going to a Bradley class would buy her an hour. Ann, Jessica’s mom did many of these things and they really though she would be able to be there for a lot of the birth. So Jessica’s birth team was her husband, Sean, her sister-in-law, Amber, her doula, me and at times, her mom, Ann.

After 9 months of disbelief, then acceptance, excitement and planning, Jessica went into labor 1 day after her due date on July 12 in the early morning. Sean stayed home from work and they made a birthday cake for Connor. Labor stopped about 10:30 am that morning, but picked up again around dinner time that evening and by 7 pm her rushes were getting intense, but very bearable and with long breaks in-between. That evening she had dinner with Amber and two friends, Alana and Kayla. Amber went home to put her kids to bed and Jessica’s friends stayed. It was about 9 pm when I talked to Jessica and she was really excited and wanted Connor to arrive. So, I gave her the suggestion of getting in the shower with Sean and doing some nipple stimulation to see if they could strengthen the contractions and get them to be more consistent.

About 10:45 I arrived with Jessica on the couch, her mom, Amber, Sean and two friends Alana and Kayla were surrounding her. I talked to her to see how she was doing and where she was at. The rushes had some intensity, but she was still pretty early in her labor. She started to have some difficulty, so we got her in the bath. The rushes got to about 3 minutes apart and the position in the bath was not so comfortable. Sean really thought they were ready to go to the hospital and Jessica was ready so we left at 11:45 on an incredibly slow drive to the hospital. Her dad was outside waiting with a wheel chair when we arrived.

In the hospital room, the nurse was checking Jessica in and going over the birth plan. We got the feeling the nurse wasn’t too happy about all the people there to support her and the birth plan. We were told that she could only have 3 people, that the doctor wouldn’t let the cord pulse and she kept trying to explain to Jessica why she needed a hep loc when the doctor had already approved not having one. Then the baby nurse said she would only allow the baby to be on Jessica’s tummy for 5 minutes before she had to take him. The labor and deliver nurse was just seemed pretty negative all around. After Sean and Jessica were talking to the nurse about letting the cord pulse, she brought the doctor in to see if they could express their wishes to him and if he would allow it. The doctor told them that it was unreasonable to let the cord pulse for 10 minutes and if they really wanted the baby to get more blood, that he would hold the baby under her for a couple of minutes. Needless to say, they were not too happy with the nurses or the delivering doctor that evening. Luckily, they left us on our own, so Jessica could labor in peace.

Jessica was dilated to a 5 when we got to the hospital and 70% effaced. So after she did her necessary time on the monitors she wanted to get in the shower again. Jessica and Sean spent the next hour in the shower with Jessica moaning through the rushes. The rushes were pretty close together with not much of a break inbetween. Amber and I would go in every few minutes with water and crackers for her. After an hour in the shower, Jessica was still dilated to a 5 and the baby was still at a -1 station, but she was 100% effaced. +2 is what the baby needs for pushing.

About 2:15 am, Jessica had to be back on the monitor and after that I had her walk and do hanging squats during contractions. The squats were to help bring the baby down and put more pressure on her cervix to dilate more. Towards the end of the hour, Jessica got very nauseous and threw up. At that point she felt like she was going to faint, so she went to the bed and was sweating. We then got some wet towels to wipe her down. That helped a lot and felt really good for her. After about 10 minutes like this, the monitors got put back on which were very uncomfortable to Jessica and all of a sudden, she started to cry and beg her husband for the epidural. Sean was so wonderful with her throughout the entire night, he was so encouraging and supportive. This support and encouragement continued while she was saying, “Please, Sean, can I have an epidural, can I please have one?” Sean just kept on encouraging her and talking to her about why she didn’t want one and telling her she could do it. At this point everyone in the room started to cry with her. Was telling her that she could do it, that she had for all this time and she was so close, but with Jessica being a friend also it just got so emotional. I looked at Amber and she just looked at me like we need to do something. The next thing I told her is she will have to get an IV if she wants an epidural, she said she didn’t care, she just wanted it. So I told her she had to go to the bathroom first before she got it, but that darn nurse was there when Jessica asked why she had to go to the bathroom so she gave her a towel to pee in instead. With all the emotion in the room we just all wanted to give Jessica what she wanted and she got the epidural at 4:15 just after she hit transition.

After the epidural things slowed down a little bit and Jessica was comfortable enough to sleep. She slept for a couple of hours and just before 7 am (shift change is 7:30) the nurse comes in to tell her that if she hadn’t made progress, the day shift is much more strict and they were going to give her pitocin. Sean said, “Absolutely not! We are not having pitocin.” The nurse then asked, “I would like to know what your problem with pitocin is?” Sean responded with, “It not natural and there is no reason for it.” The nurse tried to argue with him and told him that is just what is going through her body, but Sean explained to her the truth that it’s not the same as “oxytocin” and he doesn’t want the synthetic form given to his wife. The nurse had nothing left to say after that. So when she left, I went right to him and said since she can’t move, your best bet is nipple stimulation until the next nurse comes in to check her. I think he was already planning on doing that anyway, but he got right to work and watched her contractions take off. There were no breaks again and they didn’t stop until the baby’s heart rate started to drop a little. Sean was watching all this on the monitor, knowing the nurse would come in if she got alarmed and he kept right on going until exactly that happened. That’s when we met the new nurse.

Liz, the new nurse told him he could stop and she checked Jessica at which point her water broke, came flooding out all over Liz. Liz was so positive and encouraging, a complete contrast from our night nurse. She checked the color of the fluid, saw that it was clear and told Jessica how good she was doing and what to expect for pushing. Jessica was at a 9 at this point. We were all so relieved to meet this new nurse, she didn’t have a problem at all with who or how many people were in the room. She was cheerful and encouraging. She just helped create the perfect environment for Connor to be born into. The new delivering doctor came in and gave us all a totally different feel also and the baby nurse seemed to have a much different attitude.

It was finally time to push, what everybody was waiting for and Liz coached Jessica through it, Alana was still there and she was able to video, Ann was there and she got to watch her grandchild be born. At this point I have to say it was so awesome that Ann got to stay. She was wonderful, she was very calm and helpful. It was a blessing for both of them that she was able to stay. Jessica wanted her mom there, but she didn’t want to be stressed out by her being there. So, back to the pushing, the on call doctor had a surgery at 8:30 am and Jessica was pushing. When the baby’s head was crowning, the doctor was still in surgery so they called Jessica’s doctor and he came right over from his office. He got there and with one push Connor’s head was out, he was suctioned, then another push and his body was out. The doctor put Connor on Jessica’s tummy and didn’t cut the cord. He waited till after the placenta was birthed and let Sean cut the cord. The baby nurse took the apgar scores of 9 at 1 minute and 9 at 2 minutes and never took the baby from Jessica. Jessica’s doctor left after the placenta and the on call delivering doctor arrived to finish.

So, in the end, the epidural gave Jessica those extra hours of labor to push her into the next shift. The labor and deliver nurse allowed everybody to stay in the room, the doctor did exactly what Sean and Jessica wanted with the cord and the baby nurse never took the baby away. She actually after about a half hour told Sean and Jessica, “When you are ready to have him weighed, come and get me.” Sean and Jessica ended up with a beautiful, healthy little boy born the way they wanted, no pitocin, the cord pulsed and lots of bonding time. He entered in a friendly, safe and positive environment. All of this happened because the epidural gave Jessica a couple extra hours of labor. So, in the end, that epidural was a blessing. God knew what he was doing when everybody got so emotional. It was amazing to see how it turned out in the end.
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I have learned so much from this birth. I am so grateful to have been a part of it as with all my births. There are things I will do differently from hear on out because of this birth. There are also things I will talk to all my clients about before labor begins and things I will be very strict on because of this birth. This was another beautiful birth. And, I do have to mention, it had perfect timing again. Jessica went into labor when my husband was off work and had the baby before my husband had to go into work. That’s just a funny side note.

Connor Timothy Mackay was born at 9:56 July 13, 2010. He weighed exactly 8 lbs and was exactly 21 inches long.