Fertility Forward

Fertility Forward

Tuesday, May 25, 2010

The Birth of "Baby J" (part 1)

After going almost 2 full weeks past their EDD, Scott and Ginger made there way to the birth center.  Scott called me a few hours before they were ready to leave to give me a heads up since I had farther to drive than they did.  I was much appreciative and took the opportunity to get to the birth center a bit early to help make their location change as smooth as possible.  I wasn't sure how far along Ginger would be...she had been having regular contractions all day (with the help of the blue and black cohosh she had started taking every hour, alternately)...so I wanted to be prepared for anything.

Once they arrived and got settled into their room, the midwife checked her and she was dilated to 4cm (this was at about 7pm).  Contractions were moderate but were pretty spaced out, so they decided to take a walk around the neighborhood to try to get things moving and to get some fresh air before it got too dark.  It was the most perfect night for walking!  The temperature was just warm enough to be comfortable without being too cold or hot.  The stars were out and we stopped frequently to admire the constellations.  I just walked around with Scott, Ginger and Ginger's mother, taking pictures periodically and trying not to interrupt their amazing dynamic.  Watching admirably, I couldn't help but think to myself, "This is how it was meant to be."  Scott and Ginger are the kind of couple that would make some people sick to watch (but not me) because they complete each other so perfectly.  They know each other.  They can know what each other is thinking, feeling or desiring just by being near each other.  The aura, if you will, around them was something to bask in.  As Ginger's contractions began to get more frequent and intense, I just stood back in awe and wonder at how much she depended on Scott to hold her through it and how he lovingly cared for her.  Neither of them ever having experienced this before, they both knew exactly what to do and how to make the other feel loved and needed.

As we made our way back to the birth center, things were really starting to pick up.  Ginger's mother and I walked a bit ahead to give them some alone time, but they made their way in as soon as they could between contractions.  Once we were back inside, Ginger's best friend had arrived with some much needed food (and a nice frozen treat for me too:-) so we all sat in the living room together while they ate, as best they could, between contractions, talking, laughter and excitement.

Now would be a good time to mention that about 20 minutes before Scott and Ginger arrived at the birth center, another couple came in who were having things move along a bit more quickly than Ginger.  The other laboring mother was nearing the pushing phase, and it was evident by the low tones we heard through the walls when we were back in Scott and Ginger's room.  I'll come back to this later...it will be important.  And, also, Scott and Ginger had decided that the only people allowed in the birthing room would be me and the midwives.  Scott's mother, Ginger's mother and her best friend waited patiently in the living room Facebooking periodic updates and trying to get their Skype ready for when the baby arrived.  So with that background stated, I shall return to the story.

After dinner, Scott and Ginger went back to their room, and I took a quick break to do that which all nursing mothers must do at some point when baby isn't around...so I sat in the back with one of the midwives discussing birthy things.  When I got back to their room, Ginger was lying on the bed doing a "rotation" (otherwise known as "the rotisserie") which is when she does 2 contractions in each position: lying on back, left side, hands and knees, right side.  This helps to increase the productivity of contractions.  Scott and the midwife's apprentice were right beside her rubbing her arms and legs.  She told us that she really liked when we did that because it helped her to focus on the good sensations instead of the pain that she felt in her back.  With the three of us there to support Ginger, we divided and rotated our support: one of us would apply counter pressure to her back, one would rub her legs and the other would gently stroke her arms.  This was working quite great for a few hours.  The apprentice continued to monitor the fetal heart tones and other necessary things as needed without disturbing Ginger.

 "The lady next door" was nearing completion, but wasn't handling things as gracefully as Ginger was at this point.  We tried to suggest that they put on some music (they had brought their ipod with a "baby" playlist), but Ginger kept saying, "No, not yet.  It's fine."  It was very coincidental that Ginger and "the lady next door"'s contractions occurred at exactly he same time.  It became so predictable that when we heard "the lady next door" start up again, we knew to get in position to help Ginger through her next contraction.  After about 30 minutes of this, Ginger's labor was starting to pick up, and she was also starting to experience fear...no doubt influenced by all the happenings next door.  She said to us once, "How bad is it going to get?"  It was at this point that I pulled the apprentice aside and mentioned that we had to do something about the "torcher chamber" next door.  (The lady was screaming things like "Take me to the hospital!", "I can't do this!", and other negative things.  She really was having a hard time with a few non-emergent complications, but there was not really any good way to explain this to another woman in labor without having her subconsciously accept that as her own "fate".)  So in an effort to reset the atmosphere, we suggested that Ginger try getting into the tub to see if it would help relieve her back labor.  She agreed, so while she and Scott got into the tub, we put on their "baby playlist", with their permission.

A few more walls in between them and some music to assist, Ginger was finally able to relax a bit...but things progressively got more intense.  She said the water helped ease the pain, but her contractions started coming one on top of the other.  Sometimes she would say her pain was continuing for 5 minutes or more at a time.  One of the midwives came in and sat beside the tub with me while the apprentice went to assist with the other birth.  Both of us were encouraging Ginger to let the contractions work for her and reminding her to relax, while Scott sat behind her, massaging and gently stroking her arms and then we would apply counter pressure during contractions, as we could.  She continued to do another "rotation" so I sat back to give them space between contractions, taking pictures and video as I could.

After the "rotation" was complete, we figured she had made some serious progress and was probably nearing the pushing phase, so the midwife asked her if she wanted to be checked again to see what was going on inside.  Ginger was eager to see how much progress she had made.  Her cervix had effaced (thinned out) a bit more, but was barely 5 cm dilated, if stretched.  It was now about midnight.  I don't think the midwife gave her the numbers, but she said something like "you're progressing slowly" or something of that nature, trying to soften the blow of the news.  I could tell Ginger was really discouraged because she was really having to work hard with these contractions and they weren't doing what they were supposed to do.  The midwife suggested she try another herbal treatment to help soften the cervix (belladonna, I believe), and Ginger and Scott agreed.

While Ginger and Scott got out of the tub and dressed, we spraying some lavender essential oil in the room and turned the music down so that maybe they could try to rest between contractions.  Ginger tried laying on the bed on her side for a while, but she could no longer get comfortable anywhere.  It is at this point that things start getting blurred in my memory because everything was happening very fast.  I kept taking breaks, when the apprentice and midwife were with Scott and Ginger, to go out into the living room and give the mothers and friend updates and show them selected recent pictures (with Ginger's permission) so that they would feel as included as possible.  I can only imagine how much anticipation they must have felt watching the clock go by and not having any real-time visualization of what was happening...thus my idea of photo updates.  I'm quite sure I would not do this in every case, but this family just has a dynamic like no other.  They are so close, so in tune with each other, it is truly a breath of fresh air.  I have never seen a family so supportive of what the birthing couple wanted as I saw at this birth.

After giving updates to the family I returned to the birth room with Scott and Ginger.  This is the "blur" I was speaking of earlier.  At some point during this time, "the lady next door" (finally) birthed a baby boy, so we heard the lovely noises of baby cries instead of agonizing screaming, which was a nice change.  This was both encouraging and discouraging to Ginger, but happiness prevailed.  (*Just an aside, Scott and Ginger both remained so positive and gentle the entire time.  As much emotional and physical pain as they endured, they countered it with graciousness.  It was an honor to be in their presence and observe how they treated each other, as well as everyone around them.  Very moving.*)  "The lady next door"'s husband happened to be a chiropractor, so at some point, he came over and adjusted Ginger (with a mutual agreement, of course).  Then once, when Ginger was sitting in the bathroom, the apprentice checked the fetal heart tones while the midwife and I waited in the birth room (we were only separated by a thin door, so we could hear the heartbeat as she was listening with the doptone).  She and I both looked at each other with surprise as we could immediately hear a deviation from what it had been being...it was much faster.  The midwife calmly walked into the bathroom and said she was going to listen also.  She then went to go discuss things with another midwife while we helped Ginger move to back to the bed.

Both the midwives and the apprentice came in and worked together to get a good charting of the fetal heart rate.  Everyone was still very calm and relaxed, but I could sense the concern (subtly) from the midwives.  After this listening session, Ginger wanted to go back and sit on the toilet because that was the only place she seemed to get a break from contractions.  They were fiercely strong and constant whenever she was lying down now.  She would at least get a minute or two in between when sitting on top of the toilet.

It was at this point that the midwife came back in and said, "Ginger, I need to talk to you..."

I somehow knew exactly what that meant, but tried to stay objective and think about how to help Scott and Ginger process the news they were about to hear.

"I'm really concerned about your baby.  The heartbeat is staying very high...," the midwife stated simply and firmly, yet with great gentleness, "I'm going to recommend that we transfer you to the hospital.  I'm really concerned about your baby."

Immediately, Ginger broke down, tears streaming down her face, "No, no, no...", she kept shaking her head.  Scott held her and stroked her hair, his eyes filling up with tears as well.  I knelt in front of her and held her, too, trying to exude calmness and confidence in the midwife's decision (because I too was concerned about the baby) but I knew the pain Ginger was feeling.  I knew what she meant.  She wasn't meaning, "no, no, I won't go to the hospital," she meant, "no, no, this can't be happening.  It's not supposed to be like this.  We're supposed to have this beautiful, natural birth center birth!  This can't be happening now..."

Saturday, May 15, 2010

The Birth of Necessary Intervention (an introduction)

I recently attended a birth that was strongly desired to take place at a local birth center.  In an effort to preserve the emotions we encountered, I'm not going to give away the ending (although I'm sure you can gather a bit from the title;-)  I am of the opinion that "if it ain't broke, don't fix it" in regards to fertility and birth.  I firmly believe that when birth takes place at a hospital, the staff is so "on the alert" looking for problems that unnecessary interventions occur far too often resulting in more harm that benefit to both the mother and the baby.  Many movies and books are dedicated to the cause of raising awareness of the way technology has been and is being misused to help inform women and couples of their real options (as they are sometimes lead to believe they have none).  This story is a bit different.  We (who were in attendance at this birth) are very much against unnecessary intervention...that's what drives me to do what I do as a doula and to continue studying to become a midwife.  But sometimes, as you will read, there are situations that need and will benefit greatly from certain interventions.  There is a proper time and place for the use of technology and medical intervention, but a woman or couple who is to going give birth should be well educated in all the options (both natural and medical) in order to make the best choices when faced with the need for intervention.  The couple in this story were exactly that: well educated and well prepared (for a natural birth).  The only sad thing was that their education was lacking in one aspect...they were not emotionally prepared for necessary intervention because of the negative connotation associated with "intervention" itself.  Since it is misused so casually and haphazardly, it is perceived as a "failure" on the part of a dedicated, natural birthing woman when intervention occurs.  Some will say, "oh, I knew you couldn't make it through without pain medication," or, "I told you it wasn't safe to deliver outside of a hospital," etc., etc.  That is a maddening thought when your only desire is to have a natural, vaginal delivery then suddenly and unexpectedly, intervention becomes absolutely necessary.  My hope is that this story will inspire people (both those who have preconceived opinions and those who haven't yet formed an opinion) to see natural birth and out-of-hospital birth in a new light.  The desire and goal of out-of-hospital birth experiences it to avoid unnecessary intervention, and this environment is the safest place to begin that journey (with high hopes that it will end there as well).  Judgment need not be placed on the couple for any interventions that they may need to endure to ensure a healthy birth.  The ultimate goal is "healthy baby, healthy mother", and this story should help you understand that, sometimes, the choices leading up to that end can be difficult and emotional to make.

(The Birth of "Baby J.", part 1 will be posted soon)