My Son's Birth Story

This was originally written on Tuesday, April 22, 2008:

WOW WOW WOW, WHERE DO I BEGIN?!

I can't believe it was only a week ago that I last blogged (aside from my quick post on Friday). . .it seems like months! But, then again, I don't think I've ever had something so major happen in one week!

For those who have been following my blogs you know that last Tuesday my doctor told me that labor could possibly be within the week, based on me being dilated to almost 4 cm that day. However, I then read on the internet that some women were as dilated as I'd been for up to two weeks before they went into labor. Since I technically still had three weeks to go, I began to wonder if the process was going to drag out until my due date.

I had menstrual-like cramps that afternoon & evening, as well as on Wednesday after I forced myself to take a walk around our neighborhood (not something I normally did, but was hoping to induce labor)--but then I didn't have any cramps on Thursday (I felt great). I'm pretty sure I lost my mucus plug that morning, though. After going pee, I turned around to flush the toilet and saw a blob of color go down the drain! I actually wish I had been able to study it better because it happened so fast I didn't know if that's for sure what it'd been. Once again, I read that didn't necessarily mean I'd be going into labor within 24 hours (although that IS the most common).

I'd stopped getting my hopes up and no longer believed labor would happen that week, and therefore was NOT prepared. I'd planned to do the laundry and clean the house on Friday, as well as shave my legs, haha--because I felt tired all of Thursday. I took a three hour nap and sat on the couch watching TV pretty much the remainder of the day. (The last movie I watched was Double Jeopardy on television for the severalth time and the last food I had was popcorn, haha.) I hadn't felt so fatigued since my first trimester. . .but I'm guessing my body knew it was about to go into labor and I needed rest!

Looking back, I should have sensed something was up. At 10 pm I felt a "surge of energy." Not only had I previously been exhausted all day, but my mood had been down. Suddenly I was in the best mood ever. I was laughing and moving around easier than I had in a long time. (I remember actually twirling around in our bedroom.) I mentioned to Joe that maybe I should do the laundry and clean the house now that I felt so good, but I decided it was too late and so we went to bed at 11 pm. It didn't take long for me to be in a sound sleep.

Then. 1:53 AM.

I will never forget the sensation of what happened for as long as I live. It was as if a dam opened up inside of me. . .or someone began pouring a gallon of water out of me! In other words, a "pop" and then a RIVER of water with a ton of pressure shot through me. At first I thought I must be dreaming something scary--but then I snapped awake, realizing what was happening!

I yelled "JOE!" and jumped out of bed, already knowing that I'd lost a ton of amniotic fluid. Water was draining out of me as I ran to the bathroom. He immediately woke up and exclaimed, "What? Your water just broke?!"

"Yes!" I shouted.

I had to tell myself not to panic as I sat on the toilet and more water gushed out. I'd remembered the ultrasound technician telling me I had an above average amount (so I could afford to lose a lot). It was just not like what I'd expected! Everywhere I'd read, every person I'd talked to about this, had all said "it's not usually a gush like on TV--in most cases it's just a trickle and half of the time people never even know their water breaks." But there was no denying mine! (I wish that I had protected our bed, but fortunately it didn't stain. Before walking out the door we threw the sheets and my cozy red pjs into the washing machine, and now you'd never know. Same for our carpet.)

Joe immediately called the hospital (he had to talk to five different people so I kept hearing over and over, "My wife is thirty-seven weeks pregnant and her water just broke"). The last person told us to come in right now and they'd page my doctor. Thinking about my stubbly legs, I yelled, "Ask them if I can take a shower first!"

"A quick one."

So, I proceeded to get into the shower, only to realize at that point that it was going to be too difficult to shave and, frankly, I no longer cared. So, I just washed my face, brushed my teeth, and that was that. I didn't blow dry my hair or anything else--I put on pink sweatpants and my blue Bubba Gump Shrimp sweatshirt (obviously wearing matching clothes wasn't my priority) and joined Joe downstairs where he was making sure we had our necessities and let the dogs out. I typed the quick I'm In Labor post here, and then Joe sent an e-mail to his office telling them it was "go time!"

I was still leaking small amounts of fluid and so we put a plastic sack on the car seat and headed to the hospital. With it being the middle of the night there were hardly any other cars on the road so that was nice--the ride was only 15 minutes (ten minutes faster than it had been on the nights we'd gone to our childbirth classes).

As I stared out the window, I could not believe the moment was actually happening. This was really it! Everything I'd been practicing, preparing for, thinking about for so long--there was no more wait, the time was here!!! I was so pumped, so excited, so motivated--I wasn't scared or nervous at all, I'd been saying "bring it on" for weeks! I kept thinking of what our childbirth instructor had told us: "If your water breaks, you're guaranteed a baby within 24 hours." (Because otherwise infection could occur.) Logan's arrival was no longer a mystery!!!! (I love when mysteries are solved.)

Despite always knowing that my experience would be unique and that no one can ever completely prepare for their childbirth story, I still hadn't expected it to be such a dramatic rush like it is on TV. I'd been taught that I'd probably have all kinds of time during labor (especially with it being my first), so my bags were packed with things to do and we'd planned to call our families (although I knew I didn't want them in the room with me).

But, with my water breaking first, I couldn't even walk once we pulled up to the hospital at 3 am (let alone call anyone or do any activities). My contractions began at that point, although they were (once again) not like I'd expected. They immediately went to the final stage (in other words, they were as strong as they'd ever get and happened every minute). Also, rather than be similar to the tightening I'd had throughout my last two weeks, these felt like serious menstrual cramps. . .in fact, I've actually had the same degree of period cramps before (that's a whole different story).

As we stepped out of the car to head into the front entrance, a male nurse was walking out and could tell I was in labor. He said he'd get us a wheelchair. A guard then led us to the elevator and up to the second floor.

At this point I could no longer talk. I don't remember what the floor or anyone on it looked like, nor what was said. I was "zoned out." As many of you know, I'd chosen to do HypnoBirthing techniques for my labor and so I began to put them into effect, knowing that I must "ride the waves" if I was going to have a natural, medication-free childbirth for Logan. This pretty much meant being in a hypnotic state.

But I do remember Joe giving the staff my information and a nurse taking me to a room. She gave me a gown and showed me the bathroom. My water was still leaking so my sweats were soaked. After I changed into the gown, I was led to a bed where they hooked up the fetal monitor and checked my cervix. I was 5 cm dilated.

The nurse began putting my information into their computer. (I was annoyed it wasn't already there since I'd pre-registered during my childbirth classes.) There were questions Joe couldn't answer and so that made it harder for me to relax since I was forced to answer what seemed like a ton--but otherwise they were very accomodating to HypnoBirthing. (You never know when doing something out of the ordinary, so I was relieved.) The hospital staff was SUPER nice and helpful, wanting to do anything they could to make the experience exactly like what I wanted and for me to be 100% comfortable.

During this time of "riding the waves," Joe went to park the car. When he came back, he thought someone was pouring a pitcher of water. It turned out to be the rest of my water gushing out all over the bed! So the nurse checked my cervix again, at 4:45 am, it was 6-7 cm dilated. They told me that my doctor was now on her way.

I continued my deep breathing exercises as time slipped by. I vaguely remember Joe asking me if I wanted him to turn on my relaxation CDs, but I said no. The nurse also brought in a birthing ball, but everything that I'd planned on using now seemed like a distraction and I needed to keep concentrating in order to not lose my "zone." Joe tried rubbing my back and feet but even that was too much. He told me later that he cracked a few jokes that he thought were at least worth a smile but I completely ignored him, haha.

I tried standing up a few times and using Joe's support during the contractions, but I found it easiest to stay in bed (also not like what I'd thought, as I had figured walking around would be more comfortable for me).

By 5:43 am my contractions no longer had any seconds of break between them -- it was one right after another. The nurse checked me again and said I was between 8-9 cm. I was thrilled, this was faster than I had hoped and the pain not at all untolerable--it hadn't even been three hours since I'd arrived to the hospital and my contractions had started.

Other nurses were constantly in and out of the room and, despite me feeling only halfway conscious, I could hear them talking about the HypnoBirthing. Some were familiar with it and others weren't, so they all shared how impressed they were. They couldn't believe how fast things were going and how well I was handling everything with no epidural or pain medication. One said that in all of her years she'd never seen anything like it--as I'd become nearly dilated by remaining completely calm. (To them I just looked like I was sleeping peacefully the whole time.)

My doctor arrived at 6 am. She was like, "Didn't I just see you and tell you that you'd go into labor soon?" I laughed and said "yep"--she was right. She joked that she was proud of herself; she loves being right. I shouldn't have doubted her!

She was in and out of my room because another patient was delivering a baby down the hall! She said that in the past 16 days she'd delivered 17 babies so she was really wiped out. In fact, she had just fallen asleep at 1 am after another birth, when the hospital paged her again an hour later with both me and the other patient's water breaking! At some point I remember her going to get coffee, lol.

During the time when my doctor was with the other mother (we saw the other baby on Alegent Health's website; his name was Roman and he weighed 6 lbs, 13 oz, and was 20.25 inches long; the picture of Logan at the top of this blog is our hospital photo), I kept feeling the urge to push (my body basically was on its own) although it was not time yet. (If you push before 10 cm you can injure the cervix) So the nurses were telling me to breathe through it which was really hard--I felt like Logan was going to just pop out (I wish).

When my doctor returned, she said that there was just a tiny bit of cervix preventing me from being a complete 10 cm dilated and asked if it'd be okay for her to push it out of the way.

"Yes, please." (So I became 10 cm dilated at approx. 6:15 am.)

Strangely, my urge to push suddenly stopped but I started anyway at 6:30 am . All of the nurses were cheering, saying I was so lucky my labor had gone so fast, as they expected this last phase to be less than 30 minutes (since that is the average for most people with my duration of dilation). They were all congratulating me, saying I'd sailed through the hardest parts, that from my first contractions to birth would only be around 4 hours! My nurse mentioned that my doctor had four surgeries scheduled for that morning and she'd be able to make them all in time.

I was ecstatic I was almost done and had experienced my ideal birth plan. But. . .celebrating was premature. 7:00 am came and went and Logan hadn't budged at all. My doctor turned serious and said, "Okay, so here's the deal. Your pelvic region is small and the baby is facing up." (Remember how I mentioned in a previous blog that that was a concern of mine?! I knew by the way Logan kicked that he had never faced down like he was supposed to.)

I asked her what that meant and she said, "You have two options. You're doing an excellent job of pushing but it hasn't done anything because your baby is posterior which is making it even harder for him to fit through an already small pelvis. I can try and turn him and see if that makes a difference, but I'm warning you it's going to hurt like hell because I must stick my entire hand up there and twist--but otherwise the only other option is a c-section."

I didn't want to have a c-section so I gave her the go ahead to turn the baby. Joe says that was the only time during the experience where he felt like passing out, as blood went everywhere. I almost cried at that point but continued to do my deep breathing and relaxation which got me through it.

At 7:20 am I began pushing again. Unfortunately, my pelvis still stood in the way. I could hear my doctor rescheduling her surgeries and canceling several of her office appointments for that morning, as it became clear that my pushing phase was not going to end any time soon. :-(

I started to lose my zone and get upset, but my doctor helped me go back to my relaxation and deep breathing exercises. It was the only way I could have made it through those next few hours without giving her the go-ahead for a c-section. I pushed. And pushed. And pushed. And nothing happened. He didn't move a milimeter.

My doctor said she needed to make an executive decision. Since Logan's heart rate was still doing well, she was going to allow me to have the vaginal delivery that I wanted (the nurses said later that most doctors wouldn't have let me, but she ROCKS), however the only way I'd be able to is by getting an epidural so that my pelvic region would be completely relaxed for her to go up in there even farther and pull him with her hand. (My body wasn't naturally allowing her to do it.) It wasn't what I'd wanted to hear, knowing what I knew about epidurals. But, as I'd often written here, I knew that I might have to compromise part of my birth plan, and so I was okay with it because the alternative was worse, and so would have been taking any pain medication. So, I allowed the epidural in place of the c-section.

Since it is very rare for a woman to get an epidural after she starts pushing, the anesthesiologist said he'd be in after a couple of other labors and a surgery. My nurse was like, "Does he realize what's going on? Um, he's coming in here now!"

My doctor was still in and out, and said I could keep pushing if I felt like it, and so that's what I did on my own until I received the epidural at 8:30 am.

It's really true what they say about all modesty goes out the window in situations like this. I never thought I'd be naked in a bed on my hands and knees, butt up in the air, with strangers walking in and out of my hospital room--but that's the position the nurse recommended I change to in order to possibly help move Logan down the birth canal. I had hoped to have made some sort of progress by the time the epidural came (so that I wouldn't have to have one after all), but unfortunately I didn't. He still hadn't moved at all.

I was experiencing such major contractions that I had a hard time rolling up into a ball as the anesthesiologist told me to, but at least it prevented me from thinking about what he was doing. For those who read my HypnoBirthing blog, my fears of the epidural were the whole reason why I became interested in learning about HypnoBirthing! (But then my reasons for using that method became more for Logan's well being.)

Joe said the anesthesiologist didn't seem to have much sympathy for me. He kept saying, "I can't get at it clearly, you're going to have to do better than that." Finally he sighed and said my position was good enough.

Fortunately, I didn't experience any negative side effects of the epidural (nor did Logan) and it was obviously past the point of it leading to slow or stop in dilation (thus a c-section), which is often the case.

My doctor stayed with me for good at 8:30 am on, and twisted Logan with her hand again -- farther up this time. (Thankfully forceps or a vacuum were never used.) This time things began to move forward! It was still slow, though. . .every push I thought had to be "the one"--but there was always another. I couldn't believe Logan wasn't out yet. It was so exhausting. I really felt like I couldn't do it anymore, but then I remembered that our childbirth instructor had said that when you feel you have absolutely nothing left then you know you are almost done. So, I kept pushing, but I really didn't care about anything anymore. I whimpered, "Can you please just get him out now?" My doctor said that now was not the time to give up, I had passed that point, and I needed to keep going.

The bad part about the epidural is that even though I still felt pain, it made it harder for me to feel when I should push (since I didn't want pitocin). Before, my contractions were very clear to me which is what I'd wanted--I prefer to know what's going on. After the epidural I kept having to ask, "Is this one?" (because you're only supposed to push when having a contraction). I really couldn't tell one pain from another. It was all blended.

It turned out my third push (I always pushed in threes, with Joe counting to ten each time) was always my best, so we began to delay my pushes. It wasn't long before my doctor said, "Look at that head of hair!" I was hoping that meant his head was out, but it was just the top. She said Joe's eyes bugged out of his head, haha. He later said it was pretty incredible.

Those last "however many pushes" are a blur. I swear by the end I was having an out of body experience. I knew that more people came into the room (there was a woman who went right down to the front and started cheering me on. . .I was thinking, who the heck are you?!) but otherwise I couldn't tell you a thing that went on. I was so focused on getting my baby out!

FINALLY around 10 am, my doctor said that I had just a few more pushes to go (I assume Logan was crowning). At this point Logan's heart rate did start to drop. That had always been my fear from watching TV shows, but I was really impressed with the calm way everything was handled from beginning to end. Never did there seem reason to panic or get scared--it always seemed like my doctor had everything under control. I kept feeling her tap his head which got his heart rate going again.

Unfortunately, he twisted again at the end and was side up. Suddenly, it became imperative to get him out fast so that he wouldn't smother, and so my doctor asked if it'd be all right to perform an episiotomy. (Something else I had originally declined in my birth plan.) Between breaths, I said, "Do it." (Once again, it was appropriate for the situation; since she did it while I was having a contraction and pushing, it didn't hurt.)

Seconds later (after 3.5 hrs to dilate and 4 hours of pushing), at 10:30 am on Friday, April 18th, 2008, Logan James entered the world!

Honestly, I don't even remember him coming out. I was still having an out of body experience. There wasn't a big relief "down there" like I'd always thought it'd feel like, nor did I start crying as I always imagined I would (since I did every time I watched A Baby Story and they got to that part). I think I had used up all of my emotions!!!

I saw a group of people pick him up (my doctor had called for assistance) so I asked, "Can I hold him?" (my birth plan had said I wanted him immediately placed to my chest). But then I realized Logan wasn't crying or breathing and so they said they needed to work with him for a minute.

They took him to a table and began suctioning him, stimulating him, and putting the oxygen mask on him. I hadn't really seen him yet so I just stared at the cross hanging on the wall in front of me; I was in a daze but I really felt everything was going to be okay. I knew that I had entered the world the same way, and from carrying Logan I could tell that he was strong.

My doctor congratulated me and told everyone that I'd always been soft spoken--you'd never know I was such a tough cookie, lol. She then sewed me up (after my placenta was expelled--the pain wasn't gone until that was out. . .I was surprised at how huge mine was! They say it usually weighs 1.5 lbs, but I swear mine was more :p), while Joe stood by Logan as they made him cry (he videotaped a little bit) and they did his apgar test (the only score I heard was 8, which was good enough for me), and weighed him. He was higher than the ultrasound technician had predicted on Tuesday--his birth size ended up being 7 lbs, 13.7 oz, and he was 20.5 inches long!

I was relieved when I heard him cry, although he was still not breathing the best. I was allowed to hold him then, though--and this is the part that always makes me cry--when I held him for the first time and began talking to him, he opened his eyes and looked right at me. . .and his breathing became normal! They still took him to the intensive care, but he was breathing on his own by then, and within a half-an-hour we were told he'd be released to the regular nursery!

Joe was able to check on him frequently during his time in the NICU, so I felt okay being a part from Logan as I was taken to my recovery room. Before my doctor left, she spoke with me seriously, as well as later on, about my next pregnancy. She said that I need to be open to a c-section if things are identical during my next labor. I understand--since this birth did put strain on Logan. His face was all bruised when he came out and, no surprise, he had a cone head. Most serious is that like 50% of newborns (including me) he had jaundice, which (aside from premies, where 75% have it) it is often linked to trauma during birth.

I'm fortunate that I was able to have at least one experience of a vaginal childbirth and that it was the best I could have hoped for under these circumstances. My pushing phase was the type that often led to stillborn babies centuries ago, as well as sometimes death of the mother. Thank God we live in our current time!

The neat thing about HypnoBirthing is that it doesn't matter if you don't end up able to follow the plan to a T--your preparation makes you able to handle whatever complications arise and to still deal with them better than if you hadn't practiced the techniques. I feel it kept me calm, cool, and collected during my complication (having a small pelvis & baby in a posterior position) and allowed me to not need a c-section this time. Even though I ended up having to have an epidural at the very end (although it wasn't for pain--I still consider myself to have had a natural delivery because I went through everything and even pushed for two hours without it. I could have continued to do it if my doctor hadn't insisted I needed it for Logan to finally come out instead of the c-section, which was true) -- I'd consider HypnoBirthing a success and would recommend it!

It's definitely not for everyone, though. You have to really want it and be committed. You also have to be okay knowing that you won't be "free" of pain (at least I wasn't). But, as surprising as this may sound considering what I went through during my pushing phase, childbirth was definitely not the worst thing I've been through, nor was the pain as bad as I had always imagined. Pregnancy itself was harder and more painful. My childbirth experience was the best adventure of my life! Most importantly, Logan made it through.

My doctor said to me, "You are lucky that he came three weeks early because otherwise Logan would have been 10 lbs and there's no way he could have come vaginally." (UPDATE: This isn't entirely true. It is possible for me to have another vaginal birth next time, even if my next baby is bigger. I posted three blogs on how I could have avoided a posterior baby and how I can work with my pelvis next time. Click on the following links to read how. Part One. Part Two. Part Three.)

I thanked my doctor and have since decided I'm in love with her. :p I guess she's probably used to that with her patients, considering childbirth falls under the category of "traumatic experiences." In other words, it's like my body and mind consider her an angel who helped me come out of this unscathed and almost back to normal. I can't even feel my episiotomy or any other recovery-pain down there anymore! It's really shocking to me, I CAN NOT BELIEVE MY BODY DID WHAT IT DID and I'm not left for dead. Also, I already lost twenty-three pounds in three days (still have nineteen to go, as my final weight gain was 42 lbs) and am wearing the clothes I wore in November, only this time am able to walk fast again, bend over, carry things. . .yes, I've been longing for all of this for so long, so I am not taking for granted every second that I feel like my old self again!

I guess it's just proof that our bodies really were made to do this! My labor experience wouldn't have even been rough if not for my pelvis & posterior situation; But then you would have all hated me because I would have said that childbirth was a piece of cake. :p Because of my pushing phase, I admit it was definitely hard work--but yes the cliche is true--it's all worth it and I'll do it again (just not for a few more years, lol).

I have a beautiful baby boy who I feel more love for than I ever thought possible. I should have pink hearts floating all around me. I can't believe I made a real baby. . .he's the most innocent, sweet, cute, perfect little thing I've ever seen and I am adoring every moment with him. I never want this feeling to go away. . .I'm so happy. In my life I sometimes tend to look forward and not be content with the present unless everything is in place. Right now everything is totally out of place but I am more content than I've ever been. :-)

Birth Plan: HypnoBirthing

This was originally written on Wednesday, March 05, 2008:

Here is my birth plan, finally! For those who aren't familiar with this concept, during your pregnancy it is important to figure out what you want and don't want during childbirth. Studies have shown that childbirth goes better for women (and their babies) who do this, opposed to those who go into it blindly and just let the doctors direct the experience. Hospital staff prefer to have a hard copy of your birth plan, so Joe & I recently wrote out ours.

For my first trimester I was completely clueless as to what I wanted (just the thought of labor made me cringe, so it wasn't something I wanted to ever think about), but as time went on (and I realized that childbirth was going to happen whether I thought about it or not) and the more research I did, the easier it was to figure out my ideal scenerio.

Note that last part--because that's what a birth plan is--your ideal, not necessarily what is going to end up happening. It is important for women to not get caught up in "this is how it has to be"--it is not a success/fail type of situation. You have not failed if you find that life doesn't allow you to follow your birth plan. A person with the opposite birth experience is not more of a success. You're there to deliver a baby, not to stress yourself out with curve balls that might be thrown at you. You can't predict every possible scenerio, nor can you know what you're going to do in every situation. No matter what your story ends up being, it will be special to you and unique. At the end of the day all that matters is that your baby is safe, and once you bring them home you won't think or care about your labor!

Since being pregnant, I've heard a hundred stories, but not one is similar to someone else's. So there's obviously no way of me knowing exactly what my experience will be like. My particular labor is not something I can completely prepare for, but having a birth plan gives me a goal to shoot for, a path to try and follow, and something to focus on while I'm in the moment. For a lot of women, it does end up going as planned, so I hope that things go smoothly and that it can be that way for me. Either way, I've learned some great tips that can work throughout motherhood and life.

It all started when a friend of mine from high school and college had her first child in 2005. I was in awe that she not only had a completely natural vaginal childbirth (no medication, no epidural) but that she said the labor wasn't bad at all. How could that be possible? My entire life all I've heard is how bad the pain is; on TV women are screaming during the birth, etc. But she had nothing negative to say about the experience. I thought she must be a rare exception.

Her next child was born in 2007 the same way--just a day after I found out I was pregnant. When I revealed my news to her a few weeks later, she recommended the book HypnoBirthing: The Mongan Method by Marie F. Mongan, M.Ed., M.Hy. She insisted that she wasn't "lucky" or "special," but that this method could work for anyone.I was definitely interested in giving it a shot. My worst fear since I was a little girl is being paralyzed. The thought of having an epidural stuck into my spine and not being able to feel from my waist down is scarier to me than any pain! (And, although very slim, there is a chance of error that could lead to permanent paralysis.)

Plus, it is no secret that epidurals slow down labor (the purpose of contractions are to push the baby out--when a woman can't feel "down there," she misses a lot of cues and her cervix may stop dilating and the baby may stop moving), so labor is often dragged out/longer for women with an epidural, which means more need for pitocin (because epidurals completely cut off the flow of natural oxytocin)--but pitocin causes more pain than the natural oxytocin (what causes contractions). . .thus, a cycle.

There is also an increased likelihood of bladder catheterization, internal monitoring, and operative (i.e. forceps, episiotomy, cesarean) delivery.

According to the internet, other reported side effects include:

Dural puncture
Hypotension (29%)
Nausea, vomiting, shivering (frequent)
Uneven, incomplete or nonexsistent pain relief
Feelings of emotional detachment
Respiratory insufficiency or paralysis
Convulsions
Toxic drug reactions
Slight to severe headache
Septic meningitis
Allergic shock
Cardiac arrest
Maternal death

Long term for the mother:

Neurological complications
Backache (weeks to years)
Postpartum feelings of regret, loss of autonomy
Fecal and urinary incontinence or bladder dysfunction (inability to urinate)
Paresthesia ("pins and needles")
Loss of perineal sensation and sexual function

For the baby:

Direct drug toxicity
Fetal distress, abnormal FHR (can lead to emergency cesarean)
Drownsiness at birth, poor sucking reflex
Maternal fever (impeded thermoregulation from numb skin) leads to fetal hyperthermia and neonatal
NICU workup (spinal tap, etc.)
Poor muscle strength and tone in the first hours
Neonatal jaundice
Decreased maternal-infant bonding, behavioral problems
Hyperactivity up to seven years

Economic:

Increased costs (all epidural patients)

After hearing stories from women I know who did experience plenty of these, it just seemed that in a world where you can't avoid many negative things, I might as well avoid what I can--i.e. the epidural. Especially since another "ideal" for me is to not have a C-section, and as stated above, they've been linked to epidurals.

A Cesarean section, or C-section, is the delivery of a baby through a surgical incision in the mother's abdomen and uterus. It is a major abdominal surgery, so it is riskier than a vaginal delivery. Moms who have C-sections are more likely to have an infection, excessive bleeding, blood clots, more postpartum pain, a longer hospital stay, and a significantly longer recovery. Injuries to the bladder or bowel can occur. Also, a mother is not able to hold her child immediately after birth--she has to wait until she has been returned to her post partum room.

This is what my friend Kendra said after her VBAC (when comparing her cesarean and vaginal birth--she, too, had a natural labor without drugs):

Why I Loved my VBAC: The SMALL Stuff!

1. I ate lunch IMMEDIATELY after I delivered my daughter (Isabelle). I believe I was munching on my rib sandwich while I was being stitched.

2. I am able to pick up my toddler daughter with no restrictions.

3. My husband can never complain about getting hit in the genitals again (not like it happens frequently). I have him beat!

4. I have an ongoing excuse for taking long whirlpool baths 2 or 3 times a day.

5. I was able to quickly leave the hospital and get some REAL sleep.

6. I have no numb areas (I was numb around my abdomen for months after my cesarean)

7. People who know nothing about VBACs look at me like I have achieved some unbelievable feat.

8. I can compare vaginal birthing stories AND cesarean birthing stories with other moms. I love being versatile!

9. NO CATHETER!

10. Did I mention: NO CATHETER!?

As Kendra said, after a Cesarean delivery, you'll be dealing with a sore belly for quite a while. C-section patients typically stay three or four days in the hospital (opposed to one or two) before going home.

You'll either get a shot of pain medication every three to four hours or you'll use a system called "patient-controlled analgesia": You push a button when you're feeling discomfort and medication is delivered through your IV.

You may feel groggy and possibly nauseated right after surgery. Nausea can last up to 48 hours. Many moms also feel itchy all over, particularly those who received narcotics in their epidural or spinal.

You may feel numbness and soreness at the incision site, and the scar will be slightly raised, puffy, and darker than your natural skin tone. Sneezing, coughing, and other actions that exert pressure on the abdominal area can be painful at first.

If everything's okay, your doctor will remove your IV and urinary catheter, usually within 12 hours of surgery, and you'll be able to start eating when you feel like it.

You might have some gas pain and bloating during the first two days. Gas tends to build up because the intestines are sluggish after surgery.

In three to four days, your doctor will probably remove your sutures or staples. After that, if all's well, you'll be sent home.

Expect to need help — and lots of it — once you get home. Don't expect to toss your pain medication as soon as you get home. You may need prescription pain killers for up to a week after surgery, gradually transitioning to over-the-counter pain relievers. (If you're breastfeeding, don't take aspirin or drugs containing acetylsalicylic acid.)

Drink plenty of fluid so you don't become constipated. Your incision will continue to be tender for several weeks.

While it's essential to get plenty of rest once you're home, you also need to get up and walk around regularly. Walking promotes healing and helps prevent complications such as blood clots, but don't overdo it. Start slowly and increase your activity gradually. Since you're recovering from major abdominal surgery, your abs will feel sore for some time. Take it easy and avoid lifting anything heavier than your baby for eight weeks.

In six to eight weeks you'll be able to start exercising moderately — but wait until your caregiver gives you the go-ahead. It may be several months before you're back to your former fit self. You'll be able to resume sexual intercourse in four to six weeks if you're feeling comfortable enough, with your caregiver's okay.

I think by now you can see why I don't want a C-section. (Before Joe knew all about it, he thought that concept sounded better.)

Unfortunately, though, sometimes it's clear that a woman will need a Cesarean even before she goes into labor. Conditions that may require a planned C-section include:

• You've had a previous Cesarean with a "classical" vertical uterine incision or more than one previous C-section. (If you've had only one previous C-section with a horizontal incision, you may be a good candidate for a vaginal birth after Cesarean, or VBAC.)

• You've had some other kind of invasive uterine surgery, such as a myomectomy (the surgical removal of fibroids).

• You're carrying more than one baby. (Some twins can be delivered vaginally, but all higher-order multiples require a C-section.)

• Your baby is expected to be very large (a condition known as macrosomia). This is particularly true if you're diabetic or you had a previous baby of the same size or smaller who suffered serious trauma during a vaginal birth.

• Your baby is in a breech (bottom first) or transverse (sideways) position. (In some cases, such as a twin pregnancy in which the first baby is head down but the second baby is breech, the breech baby may be delivered vaginally.)

• You have placenta previa (when the placenta is so low in the uterus that it covers the cervix).

• The baby has a known illness or abnormality that would make a vaginal birth risky.

Conditions that may cause an unplanned Cesarean delivery:

• Your cervix stops dilating or your baby stops moving down the birth canal, and attempts to stimulate contractions to get things moving again haven't worked.

• Your baby's heart rate gives your practitioner cause for concern, and she decides that your baby can't withstand continued labor or induction.

• The umbilical cord slips through your cervix (a prolapsed cord). If that happens, your baby needs to be delivered immediately because a prolapsed cord can cut off his oxygen supply.

• Your placenta starts to separate from your uterine wall (placental abruption), which means your baby won't get enough oxygen unless he's delivered right away.

According to the September issue of Mothering magazine, in 2005 30.2 percent of the nation's births were by Caesarean. That's the highest rate ever recorded. The World Health Organization says that any time a country's Cesarean-section rate rises above 15 percent, the dangers of C-section surgery outweigh the lifesaving benefits it is supposed to provide. But it doesn't seem to matter that, in the U.S.:

1) A woman is five to seven times more likely to die from a Cesarean delivery than from a vaginal delivery.
2) A woman having a repeat C-section is twice as likely to die during delivery
3) Twice as many women require rehospitalization after a C-section than after a vaginal birth
4) Having a C-section means higher rates of infertility, ectopic pregnancy, and potentially severe placental problems in future pregnancies.
5) Babies born after an elective Cesarean delivery (when labor has not yet begun) are four times more likely to develop persistent pulmonary hypertension, a potentially life-threatening condition.
6) Between one and two babies of every hundred delivered by C-section will be accidentally cut during the surgery.

So then why so many Caesareans? Doctors are making the decisions based on fear of malpractice suits rather than medical necessity. But biologically, birth is a normal life process that is more likely to go well on its own, with little or no intervention. Women in comas have given birth undetected! Animals give birth easily, without screaming!

Instead of everyone being scared of birth-related morbidity, why aren't women and their doctors concerned of the chemicals that are dripped into their spines and veins--the same substances that have been shown to lead to more C-sections? Why aren't they worried about the harm those drugs might be doing to the future health of their children, as studies are now beginning to indicate is the case? Why aren't they afraid of picking up drug-resistant Staphylococcus infections in the hospital? And why, aren't women terrified of being cut open?

Because we've put more faith into science and technology than in allowing natural processes to carry on. Nature is to be feared, technology to be trusted.

That didn't logically make sense to me. But I knew from my experience with off-the-chart menstrual cramps that not having an epidural might be easier said than done. On the other hand, I've been told that the type of cramps I personally experience when having my period are similar to labor pains, and therefore I might be so used to them that I have a higher tolerance for pain. But imagine this: what if you don't have to suffer horribly without an epidural and can also reduce the need for a C-section? What if you can be 100% present and actually enjoy the experience as pleasant? That's what HypnoBirthing is all about.

On the East and West coasts this method is becoming more and more popular, which means in several years we should all be hearing about it in the Midwest, haha. In places like New Hampshire, where it originated, there are hospitals designed to help pregnant women throughout their pregnancies to prepare for this type of childbirth. For those who aren't that lucky to be able to deliver in a Hypnobirthing hospital, the book does a good job of teaching us the techniques, and there is a CD that comes with it.

Its main message is that we have programmed ourselves with the wrong message. For centuries we've set ourselves up to fear childbirth like none other. But, according to page three of the book, when fear is not present, pain is not present. Fear causes the arteries leading to the uterus to constrict and become tense, creating pain. In the absence of fear, the muscles relax and become pliable, and the cervix is able to naturally thin and open as the body pulsates rhythmically and expels the baby with ease.

Thousands of couples who have followed HypnoBirthing swear that this is true. After learning to embrace the body's innate knowledge of birthing, relaxing into the birthing process, and working with body and baby, a woman trusts that each knows how to do its job. In doing this, she also eliminates fatigue and shortens her birthing time.

HypnoBirthing is about women reclaiming their right to call upon their natural birthing instincts. It helps you to frame a positive expectation and to prepare for birth by developing a trust and belief in your birthing body and in nature's undeniable orchestration of birthing. By teaching you the basic physiology of birth and explaining the adverse effect that fear has upon the chemical and physiological responses of your body, you learn simple, self-conditioning techniques that will easily bring you into the optimal state of relaxation you will use doing birthing. The four basic HypnoBirthing techniques are: Breathing, Relaxation, Visualization, Deepening. (These are good to use in any stressful situation, throughout the rest of our lives!)

And, no, this doesn't go against the Bible. Scholars have found that there was never an actual curse placed exclusively upon Eve. In Genesis, God uses the very same wording in speaking to Adam as to Eve. The translators, though, influenced by the terrible conditions surrounding birth at the time, chose to translate the dictum delivered to Eve differently. So even church has falesly programmed us to think that childbirth is supposed to be horrible!

According to page 40, with our modern knowledge, we understand more clearly how fear of complication and resulting in death, not fear of birthing, caused women to look upon labor with horror. Extreme fear created extreme tension, and the tension, in turn, resulted in a taut cervix, unable to perform its natural function. Those who lived through the ordeal, as well as those who witnessed it, attested to the agony that was experienced in birthing.

Deaths in hospitals were the result of lack of sanitation and exposure to the contagion of illnesses of other patients, rather than complication or the danger of birthing. Nevertheless, deaths occurred, and the fear of death became even more strongly associated with giving birth.

It wasn't until the mid-nineteen-seventies that it was discovered that a source of natural analgesic lies within the body itself. American researchers discovered that opiate molecules, locking onto special receptor sites of neurons in the central nervous system, slowed down the firing rate of the neurons. They found that if they decreased the firing rate of the neurons, it resulted in a decrease in the sensation of pain. A state of calm was the missing ingredient that made the decrease possible. Endorphins--neuropeptides in the brain and pituitary gland--have an effect 200 times that of morphine. Endorphins produce a tranquil, amnesiac condition.

This was reassuring for me to read because I also didn't like the idea of any other medication during labor, either. It is a myth that the drugs they give don't cross the placenta to the baby. The placenta has no barrier.

The well-respected Physicians' Desk Reference clearly states that at this time there are no adequate and well-controlled studies for the use of these drugs with pregnant women. The PDR also points out that it is still not known whether these drugs can cause fetal harm when administered to laboring women.

Even pills, or any of the injected drugs used to take the edge off, can supress a laboring mom's efforts to work with her body's surges, as HypnoBirthing moms are trained to do. These narcotics can cause reduced muscle tone and prolong labor. Because of the numbing effects of drugs, the laboring woman is less aware of her surges and may not be able to efficiently assist in working with them to facilitate opening.

Fetology experts are now saying that the disorientation that a baby experiences when his mother has accepted drugs can result in disconnection between mother and baby and cause a long-term feeling of abadonment on the part of the baby. Studies have shown that babies whose mothers were medicated lacked the ability to crawl to the breast and were unable to suckle even with assistance. As long as indications point to a healthy, strong baby and you are in no dnger, be willing to protect your baby from the assault of drugs.

There may come a time when all accomodations to your wishes has been extended, but for some reason, your baby is not weathering it well. In such an instance, it may be determined that your birthing needs medical assistance. In this kind of situation, you will find that your relaxed HypnoBirthing attitude and techniques can still help you through whatever turn your birthing may take. Understanding the need for medical intervention and, along with your birth companion, being a part of the decision-making team will help you accede to whatever preparations need to be made. You will remain calm and in control of your circumstances.

So, to sum it up, Joe and I will be requesting that there be no medication administered, no epidural, and hopefully no pitocin or episiotomy.

As my HypnoBirthing book says, The more nature is able to take its course, the less likely you are to need an episiotomy. The thick rim of the perineum needs to gradually thin and unfold through each surge by natural pressure of the baby's head until, at last, it folds open fully to allow the baby's head to pass through. Tears in the skin can be avoided if the mother has practiced perineal massage and there are no rushed, violent pushes.

I would like L.J. placed immediately on my chest for skin-to-skin contact (it has been known to help with bonding, plus it is the most natural thing, as all mothers' body heat adjusts to the needs of her newborn!), some extra time before they put ointment in his eyes (an anti-biotic given to all babies since they are sensitive to germs for the first time), no hepititus B shot (as stated in one of my prior blogs, completely unncessary if the mother isn't sleeping around or using drugs), and Joe doesn't want to cut the umbilical cord--so the doctor can do that when it has stopped pulsating. (When it is prematurely cut, it abruptly cuts off the flow of blood to the baby, depriving him of that source of oxygen and of the many nutrients that will affect his health for a lifetime.) Finally, L.J. will be circumsized, although there is no medical reason to do so nowdays (it's our aesthetic preference).

The best part about all of this, is that I am actually looking forward to labor now, rather than dreading it. I will let you know how it goes!

UPDATE: You can read Logan's birth story here.

Small Pelvis: It's Non-existant!

Continuing from where I left off in my last post about small pelvis' leading to c-sections. . .(click here for part one, click here for part three)

Unfortunately, learning whether you have a small pelvis doesn't happen until you're in labor. You can't simply look at someone and say, "they have a small pelvis" or "they don't." Otherwise you wouldn't see tiny women popping out five children easily and big-boned women still needing c-sections for this reason. It has nothing to do with your body type or size. I'm five foot-two-and-a-half but never during my check-ups with my doctor did she say I had a small pelvis. It wasn't until I'd pushed for two hours and my baby hadn't moved the smallest of a fraction when I was diagnosed.

Now I must point out that my baby was face up--because I think that actually had more to do with my long pushing phase (one, it's simply harder for the baby to move when it's in the wrong position and two, it's nature's way of protecting the baby's face from suffocating). But my doctor explained that my "small pelvis" was what caused my baby to be posterior.

If I hadn't practiced HypnoBirthing techniques, I'm confident I would have ended up in a c-section. When women have the "small pelvis" AND they're not 100% relaxed it's even less likely that the baby will move. I believe that's why my doctor let me push for the total of four hours--because she knew I was HypnoBirthing and so my chance of delivering vaginally was higher than someone who wasn't. (#1 rule: learn relaxation techniques so that you are in the most relaxed state of your life!) In the end I did indeed deliver vaginally, but it still wasn't the smoothest sailing so I want to do what I can to make the pushing phase easier next time so that 1) I don't need to worry about my baby's journey out and 2) I don't end up in c-section.

So what exactly does it mean to have a small pelvis during childbirth? Cephalopelvic disproportion is when the baby's head is not in proportion to the mother's pelvis (i.e. too big to fit). But my son was average in size (7 lbs) and his head was actually smaller than the average newborn. Therefore, I find it hard to agree with this theory for me.

As I made my way through cyberspace researching this topic, I found that there are millions of other people who completely disagree with the small pelvis theory--and many doctors say that it doesn't even exist!

The truth: it simply varies from woman to woman how the pelvis stretches (just as we all vary with everything). . .but in the end (unless there is a medical reason) they can all make enough room! That's why the exact same woman can have a hard time with one child but not another--in fact I've been reading stories of women who were told there would be no way they'd birth a larger baby than their first. . .but they proved their doctors wrong!

We need to have confidence in our pelvis' ability--the stretching is just another part of pregnancy--we need to remember that our bodies are designed for childbirth! The problem lies because what works for one person may not for another. It's about trying different things and learning what helps YOUR pelvis stretch easier. According to the Australian site bellybelly.com:

1. The pelvic girdle is not a fixed, solid structure

During pregnancy and labour the hormone relaxin softens the ligaments that join the pelvic bones, allowing the pelvis to give and ‘stretch’. The degree of pelvic expansion achieved will vary from woman to woman and from pregnancy to pregnancy.

2. Babies’ heads mould into shape

Babies’ heads are made up of separate bones which move relative to each other, allowing the baby’s head to ‘mould’ and thus reduce its diameter during passage down the birth canal. No one can predict the capacity of an individual baby’s head to mould and, as this is a feature of the normal birth process, should not adversely affect the health and well-being of the baby.

3. The position that a woman adopts during labour and delivery makes a difference to pelvic dimensions

Squatting, for example, can increase pelvic measurements by up to 30%. One of the most common positions in which women give birth, that of being semi-reclined where the mother’s weight is on her coccyx, restricts movement of the coccyx, which can severely compromise a below-average pelvis.

4. Baby’s position

The position of the baby can be crucial, and whether its head is well flexed or tilted can mean the difference between an easy delivery and delivery being impossible.

I wish that I would have tried squatting during my labor. I did learn about that position prior to my labor experience (from my friend's blog that I referenced in my last post), but since I (obviously) didn't know I was going to have this issue, I didn't put it front & center in my mind. . .and so I forgot while I was in the moment.

It's too bad that these things are left up to us to remind ourselves. . .I was in the #1 hospital for births in my city and yet none of the nurses suggested I squat to help move L.J. down the birth canal. I'm curious as to whether it would have gone easier/quicker had I tried that position. That's actually the ONLY way women deliver in many other countries. I read somewhere that the U.S. is one of the few places where women give birth lying on their back (the least effective position). I did try the "all fours" position for a while, since that is best for posterior babies (the hospital staff did remind me of that one) but unfortunately I didn't notice improvement.

There's no denying that my pelvis didn't stretch like some women's--my doctor has delivered a ton of babies and could definitely tell the difference--but the diagnosis of "small pelvis" is misleading. It doesn't mean my pelvis will react that same way next time or that I would have needed a c-section had my son's head or size been larger. It simply means during this pregnancy there were factors that slowed down the stretching process. . .but obviously it still eventually happened, as L.J. did come out!

Aside from his bad positioning, maybe my body didn't release enough relaxin. (Relaxin in pregnancy is secreted by the corpus luteum, the placenta, and part of the decidual lining of the uterus. In certain rodents, it relaxes the symphysis, inhibits uterine contractions, and softens the cervix.)

There are DVDs and books that can teach you about your pelvis and how to find out which unique shape your pelvis has, providing suggestions on positions based on that shape and as a result reduces fear and increases confidence in your body’s ability to birth well. There are also positions you can do in the weeks leading up to the birth to prepare your pelvis. And, if you're like me, where the pelvis may prevent the baby from getting into the best position, you can read about optimal fetal positioning HERE or check out Spinning Babies.com

I will expand on the positioning topic in my next/final "small pelvis" post, as there are even more things you can do to prevent posterior babies. But the message of today: don't just assume because you've be given the diagnosis of a small pelvis that it means you can't birth a normal-sized baby. It just means you have a couple of extra steps to get to where "Jane Doe popping out a ten pounder is." We've all heard of the rare women who have twelve-pound babies. . .we all hope we're not them, but they should actually be a positive reminder to us that we all have the ability to do it. Our pelvis' are all different, yes, but after doing my research I can't use the "small pelvis" excuse anymore. It will not be an issue for me next time because there's no such thing!

I will end with more suggestions from my friend's blog that I referenced yesterday:

--Yoga during pregnancy. The mind and body work closely together. The mind has a large influence over what the body can do. Yoga helps to stretch and strengthen your mind and body. The stretching during pregnancy can help your pelvic ligaments loosen and stretch during labor. The more they “give”, the more room your baby has in the birth canal.

--Sit on a birthing ball during prenancy and labor. Birthing balls are wonderful to sit on because they encourage your pelvis to widen and open. Doing figure eights is a great exercise for mothers.

--During pregnancy try to keep your baby from settling into a posterior position. When a baby is posterior it means that his/her spine is lying against your spine. The ideal position for a baby to be born is with his/her spine against the front of your belly. This is the perfect fit for any baby. To encourage this position, try not to recline too much in late pregnancy. Always sit up straight and never lie directly on your back. Also, the hands and knees position works great to rotate your baby.

--When you come to the pushing stage of labor, don’t lie on your back or sit. This prevents your sacrum from fully flexing and allowing the baby’s head to pass. The best pushing positions for a smaller than average pelvis (or any pelvis for that matter) are the squatting position and the side lying position. This allows your pelvis to stretch and accommodate your baby while he/she travels through the birthing canal.

P.S. I didn't do any of these but you can bet I will next time!