Friday, October 11, 2013

{Becoming Mother II} - A Bradley, Hypnobabies & Preeclampsia Birth Story

In honor of Baby #3's impending arrival, we are launching another {Becoming Mother} blog series. As my own labor and delivery quickly approaches, I find it encouraging to immerse myself in childbirth stories. I love reminding myself that women birth every day, that they survive and that they rejoice in being a mother when it's all over. 

As always, this is not to promote a particular type of birth. These stories are intended to be more of a picture into "what it was really like" for these mothers in their various birth settings. I hope they inspire you to marvel in awe at God's perfect plan of childbirth.

As always, you can check out  my hospital birth story with Cannonmy birthing center birth story with Cason and my reflections on both deliveries. I will be back at the end of this series with some of my favorite birth stories from fellow bloggers, as well as my thoughts in preparation for childbirth the third time around.

Let me introduce you to my friend, Kacie. Kacie is a blogging friend. We've never actually met in person but one comment on her blog, Sense to Save, years ago, led to a comment on my blog, that grew into a few Facebook comments, that blew up into novels of emails we've exchanged over the last few years. If we are ever in the same state I'd LOVE to meet her and her precious kids in person! I think we'd have a great conversation over coffee. 

I'm so excited to be pregnant right along with Laura! My third child has a 40-week date of October 11. 

I wrote a novella of a birth story with my firstborn and another long story with my secondborn (and then the recovery story). Mamas, if you want to go into extensive detail with your own birth stories as I have, you won't regret it. I sit now and re-read them and I'm reminded of details I would have otherwise forgotten.

Those links are full birth stories, but for this post, I'll share a reflective summary of their births, how I prepared for them, and how I'm preparing for baby number 3.

My firstborn -- hospital birth, attended by midwife, prepared with the Bradley Method

My husband and I attended Bradley classes in preparation for Jonathan's birth. My insurance even covered the bill! I appreciated how much information we both learned in the classes and I think it's especially helpful for dads who might not read books on their own.

I wanted an unmedicated birth, since I figured it would be easier on me and my baby. I didn't want a c-section, and I was freaked out by the thought of a botched epidural. Plus, I wanted to see if I could do it.

I was 38w3d with Jonathan when my water broke in a slow trickle. I had no contractions and no signs of labor for several hours. I called my husband and had him come home from work, and called the midwife and she had me head in for an exam.

My blood pressure was a little elevated (though not technically high at that point). My cervix was about as unfavorable as it could get -- high, posterior, not effaced, tightly closed. My midwife wanted to encourage things along soon, and she gave us the ok to go have some dinner and then come back to the hospital to induce. We walked to Panera nearby and at dinner, I started having some mild and fairly regular contractions. Walked back to the hospital and they started me on Cervidil. I was still contracting, but it was mild and probably early pre-labor stuff.

It didn't take long for the Cervadil to get a move-on, and though it's technically a cervical ripener, I did go into active labor.

I tried sitting on an exercise ball, but the monitors picked up some heart decels so the nurse had me get off of that and into bed for awhile. Later, I was allowed to labor in the bathroom and I sat on the toilet for awhile, and then later got in the shower. Loved the shower!

Things got more intense, and I threw up and choked. That caused the monitors to go nuts, so they made me get back in bed.

I can't recall what my blood pressure was at that point, but I do know that my blood labwork came back and I had an official preeclampsia diagnosis. They started me on an IV drip of magnesium sulfate, which is used to prevent seizures. It makes your muscles not work so well, and it can make laboring harder.

Also around that time (or maybe it was a little before?) I started talking about epidurals. I didn't want one, but I just wanted to talk about them and if they were still an option. Heh. I think I was actually in transition at that point.

Fortunately, I still kept on progressing and pushed out a healthy 6 lb. 4-5 oz. baby boy 3 hours later. He had a big head, and I had a 2nd degree tear. The tear required stitches and it didn't heal properly, and when he was 6 months old I had surgery to repair my perineum. How'd I get so lucky?!

He was born roughly 17 hours after my water broke, but only like 11 hours after my contractions started up at dinner time.

Looking back, I'm thankful for the Cervidil to get things going, especially since preeclampsia was taking hold.

My husband was very supportive throughout and I know he was exhausted. He supported my weight during plenty of contractions in the bathroom, and he only left my side briefly to go to the bathroom and to grab a snack from our bag. I think his presence and his own knowledge of how labor typically goes helped me stay focused and avoid pain medicine.

If I did anything different about that birth, I would have hired a doula. My husband was great for sure. I just think a doula would have helped even more, since by the end of it he was exhausted without the benefit of birth hormones. I was surprised at how hands-off my midwife was. I barely saw her. The nursing staff checked on me from time to time, but they mostly fiddled with machines. A doula would have been right at my side.

I think if I just showed up to this birth without Bradley classes or any preparation, I would have had a very different birth. I doubt I would have avoided pain meds. Also, my midwife actually wanted to induce with misoprostol (Cytotec) which I refused. It can hyperstimulate the uterus, cause it to rupture, and you can't turn it off like you can Pitocin or Cervadil. I only knew about misoprostol from my Bradley instructor. I opted for Cervadil, which is actually approved for this use vs. Cytotec which carries a black box warning.

My secondborn -- birth center turned hospital birth, attended by midwife, with a doula present, prepared with Hypnobabies

I switched to a different midwifery practice for this pregnancy because I wanted to give birth at a freestanding birth center. I thought I'd have more attention during labor from the midwives and nursing staff.

My pregnancy went well up until around 37 weeks, when I had an elevated blood pressure reading at the office. It was 130/90, and only the diastolic was clinically high but given my preeclampsia history the midwife sent me to the hospital for a non-stress test and evaluation. My blood pressure lowered on its own and things seemed fine, but we were now on more guarded alert.

I enjoyed what I learned from Bradley, but with this pregnancy I decided I wanted to try something else. I felt that Bradley helped me physically, but my mental state could have used some support while in labor.

I bought the Hypnobabies home study course. I blogged my way through it with the posts linked in my sidebar.

I loved it. I enjoyed the CDs and the time to relax, listen and prepare.

My labor with Vivienne started early in the morning of 40w1d, much in the way that I had previously visualized. Hypnobabies has a few tracks to listen to specifically while in your 'early birthing time' and I listened to some of it for a little while, but decided to switch to a music playlist of choral hymns instead.
We went to the birth center a few hours later when I needed to focus and be quiet for each wave.

My blood pressure was 140/90. Too high. And yet, they kept me at the birth center for awhile, hoping that it would calm down and I could progress further. The midwife there didn't think I'd necessarily get preeclampsia again.

I was about 4cm dilated. I tried a few positions on a bed and upright and couldn't get settled, so I asked if I could get in the tub. I was surprised that they agreed, since I didn't feel like I was very far along yet. The tub was fantastic.

I had a doula this time, and she and my husband were helping me by pouring water over my back, using Hypnobabies cues, and just keeping me focused and calm. I wasn't listening to any Hypnobabies tracks, but did use the "special place" and other cues.

A few hours later, my blood pressure kept going up and the decision was made for me to go to the hospital. Driving through downtown Pittsburgh during morning rush hour while in transition and starting to feel pushy? Not my idea of a fun time, but I had the presence of mind to think that would be an interesting detail to share with my daughter later. I tried to slow down my labor, by keeping my eyes wide open, looking at people, and trying to send my baby and my body the message to STOP.

We showed up to the ER, and no one took me seriously. My husband fetches a wheelchair, and unfortunately my doula was parking her car. I wish she was with me, because the intake person just had no clue how close to giving birth I was. I sat in the wheelchair for a few minutes and asked to get to a room, and heard someone say "man, people are pushy around here." I was not able to look at him and tell him that yes, I literally was feeling pushy and I was potentially going to take my pants off right there. I just wanted to keep my wits.

The orderly finally got me moving and was actually chit-chatting with me. What. He had me get up and get on a scale to be weighed, when I had a large wave. He then saw that, hey whaddya know this lady is for sure in labor.

We got to my room and I finally relaxed -- I was where I needed to be to give birth, finally. The nurse was placing my IV and getting blood for labs, and my water broke. A huge bubble-up feeling, and tons of fluid everywhere.

I pushed while laying on my side, since that was supposed to be a better anti-tear position. I resisted the urge as long as I could, mainly because I didn't want to tear. But fighting it hurt, and I decided I was done being pregnant so I gave in. It took a few pushes and roughly 15 minutes, and my 8 lb. 2 oz. daughter was born. Just a skid of a tear, no stitches!

Vivienne was born maybe an hour after arrival, and about 9 hours after my first contraction. The timing and pace felt so perfect to me. Started slow and gentle, and gradually increased. I was so aware of my body and how things were coming along. It was an incredible birth, despite the complications.

The Hypnobabies absolutely helped me to stay calm and focused. I can't imagine how I would have handled that transfer otherwise. Also, having a doula was so awesome. Because once again, the midwives and nursing staff pretty much left me alone. Maybe it was because I had a doula, with me, but I think I originally thought a midwife would be more doula-like in labor. Some probably are, but I think if you want someone to be with you every step of the way, a doula is the way to make that happen.

Vivienne was an entirely unmedicated delivery, and it was much easier than the Cervadil + magnesium sulfate I had with her brother.

Unfortunately, my labwork came back a few hours after she was born and it showed that I once again had preeclampsia. They started my IV of mag. sulfate. A little more than 12 hours after she was born, I had a killer headache, my blood pressure skyrocketed and they needed to use IV blood pressure medicine to lower it. They were concerned I could have a stroke or seizure. I felt horribly ill and it was so scary.

To top it off, I was all alone. My husband was home with our son, since we had no local family. I can't think of what would have happened if I was home at the time instead of at a hospital.

The medicine worked and my blood pressure came down to safe ranges after that. I'm so thankful that I was at the hospital, and that my baby was already born.

Baby #3 -- OB managed, hospital birth, doula, minimal preparation

As I write this, I'm 37w3d pregnant with my third child. I am terrified. One and a half weeks ago, my blood pressure went bananas. I felt just really strange, and took my pressure (I bought a home cuff for this pregnancy) and sure enough, it was 150s/103. It was 120s/70s at my appointment earlier that day. I went to labor & delivery for monitoring. It was up and down while there, but still high. The baby looked good on monitors and since I was only 35w6d, they were hoping to keep me pregnant for awhile.

The next day at my OB appointment, my BP was still high so I received a prescription for blood pressure meds. The meds are controlling my BP ok, though we've had to increase the dose. This is only treating a symptom and hopefully protecting me from organ damage from high BP, and it's buying me some time to keep on growing this baby inside.

The only cure for preeclampsia is delivery. I don't technically have preeclampsia at this point -- it's gestational hypertension since my protein is still just a trace. I do have a dull headache that I can't shake, but no swelling, visual disturbances, right upper quadrant pain, or any of the other preeclampsia symptoms.

I'm mad that my blood pressure is acting up so much already. I was hoping to at least be further along, or better yet already in labor like the other kids. Now, we just have this watch and wait game going on and it's driving me nuts.

I'm hoping to go into labor soon. I'm not sure that I can convince my OB to induce at 38w, despite the studies that show it's a really good idea for moms and babies in my situation. I'm printing off some of the ACOG recommendations and various studies that are backing up inducing at this point, and will go to my appointment on the 26th to make my case for induction.

Based on my history and how sick I was after Vivienne was born, I am just really nervous with all this. I am the most prepared now, since I am more familiar with preeclampsia and the symptoms. And it helps that I can keep an eye on my blood pressure at home.

At first, I thought I'd do the Hypnobabies home course again. But when I started the affirmations and heard the first one: "Pregnancy is natural, normal, healthy and safe...for me and my baby," it just struck a nerve. It's just not true for me. Maybe I should have just skipped the affirmations track and done the course, but it's too late for me to do the other stuff now. I am listening to the "Baby Come OUT" track which can also stand alone, I believe. I think I will also do the fear-clearing track as well as the birth visualization.

Further rubbing me wrong is in the Hypnobabies course materials, it emphasizes diet as a way to prevent preeclampsia. False.

I hired a doula and I think her presence and knowledge will help me a ton. I know an induction is quite possible, and I know that could mean an epidural this time or a c-section. I am open to all outcomes, though I'd certainly be thrilled to go into labor and not need medication. I hope for a good birth experience but at this point, I am so freaked out by what preeclampsia can mean for me and my baby, I welcome a medically hands-on birth if it comes to that.

By the time this post runs, I may have already had my baby (and maybe Laura can add a postscript!). If not, feel free to keep an eye on my blog for an eventual update!

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 Photo credit Christine Wright

Kace was induced on Thursday, September 26th. Early Friday morning she safely delivered a baby girl, Amelia Faith, with no epidural. She did develop preeclampsia once again, but magnesium sulfate kept everything under control. They are now home and enjoying life as a family of five! I stole the photo below from her Facebook so you could see her THREE beautiful children! You can read Amelia Faith's birth story on Kacie's Sense to Save blog!
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