The birth story of Sweet Baby Trevor continues! I felt much better after having eaten, but alas, there was not yet an antepartum room available for me to move into to start the induction. So I worked on my laptop and answered a bunch of work emails letting people know I was going to be having the baby that day. Amazingly, Ben did not have to do much work during this time, and read some Harry Potter in French. By late afternoon, the room was ready -- a small, windowless room with a shared bathroom. The nurse on duty was awesome. She understood that I’d wanted to have an unmedicated childbirth, and she had the attitude that even though I would be induced, of course I could still forego pain medications and an epidural! I honestly had started to reconsider my position on the epidural after realizing I’d have to have pitocin. But the nurse saw in my chart what my preferences were, and she took it upon herself to make sure that the next nurse after the shift change would be someone who would support the effort for an epidural-free birth. I never even ended up showing the hospital staff the written “birth preferences” document I’d printed out and put copies of in the hospital bag. No one at the hospital ever offered me an epidural. So much preparation went into Lesley and Ben’s preferences that when they were with the hospital staff they had never met, there was no issue! She was respected and supported in her birth goals because she and Ben created the atmosphere where this could happen well before they even arrived at the hospital. At 6:30 I saw the midwife I’d expected to have my checkup appointment with earlier that morning. We had a serious discussion about my initial preference not to use Cytotec as part of the induction and the hospital’s position, which I appreciated but didn’t want to dwell on since I had accepted the hospital’s position. Informed consent! She had the midwife trainee administer the Cytotec by placing it up behind the cervix. I was still about 2cm dilated at 50% effaced at this point. I’d also been hooked up to the electronic fetal monitor since arriving in triage. Baby’s heart rate was perfect, and the monitor was also supposed to be tracking my contractions, but I wasn’t yet having any contractions, so that reading was pretty much worthless. I had to stay still and not get up for the first two hours after the Cytotec had been administered. Ben and I watched some Star Trek: Voyager on the iPad. After two hours, I didn’t appear to be having any kind of adverse reaction to the drug, so Ben left to go home to pick up some more things that hadn’t made it into the hospital bag (such as the orange birth ball!) and also to take care of our cat. I watched the “Bride of Chaotica” episode of Voyager and also some Archer. By the time the four-hour period for the Cytotec dose to take effect came to an end, Ben had returned. I begged him to give me something to eat, and ate an entire pint of berries from Whole Foods even though Ben cautioned me to heed the official advice and not eat anything. But I was hungry! A cervical check showed that I was now 3cm dilated, 50% effaced. And here is where she heeds the REST and DISTRACT advice of her doula ;). The care providers were pleased with this progress and deemed my cervix sufficiently ripe to proceed with Pitocin (as opposed to administering further doses of Cytotec). So I was moved to an actual labor and delivery room, which was much larger than the antepartum room and had a pull-out couch for Ben and a private bathroom. It also had a little heat lamp table for the baby, which was exciting to see as it reminded me that I would soon be meeting our baby! Cat had suggested that we try to get some sleep because it was likely that the induction would take a long time and I would be very tired by the time it came time to actually deliver the baby. We had anticipated more than one round of Cytotec, so suddenly things seemed to be happening a little more quickly than we’d counted on. They told us I’d be starting the pitocin right away, but some funky things started going on with the baby’s heart rate after I was settled in the new L&D room (I suspect just as a result of trying to get the monitor set up correctly) so it took a little longer and more observation time before the IV was started. A resident came by and did another cervical check -- still 3cm, 75% effaced. The pitocin drip was started around 11:30 pm, and Ben and I both lay down to try to get some rest. I started to have a dull pain in my lower back, but was otherwise resting comfortably in the dark room. I kept repeating to myself in my head, “Open, open. Spread, spread. Wide, wide” and visualized my cervix stretching open. She rested. Despite the pain and discomfort. Lesley used visualizations to get in the right mind set. Perspective. Is. Everything. Around 1:45 am, I shifted around in bed and felt a pop. It was my water breaking! There was a big wet spot in the bed (which was covered in puppy pads). Ben called the nurse and let her know. At that point, regular contractions finally started to happen. I also had the urge to use the restroom right away and emptied my bowels a bit. I did not want to get back into bed, so I sat on the orange birth ball on top of absorbent pads facing the bed. It was a very strange sensation -- with the beginning of each contraction, a gush of water would come. Ben put on music: Return to Forever’s “Light as a Feather.” I was able to labor on the ball despite being hooked up to both the pitocin IV and the continuous electronic fetal monitoring. After a little while, I felt a very strong urge to vomit. I threw up into a basin (hello again, berries!) and suddenly needed to use the restroom again. I sat on the toilet and vomited some more. This felt GREAT and I could feel the baby moving down as I heaved. But even though I felt great sitting on the toilet, the nurse told me I had to get back over to the ball and be on the monitors again. I was like, “I’m not ready yet! I need to be right here!” but I did eventually relent. Again, a discussion around where she could comfortably and safely labor. Given the pitocin, the policy of the hospital had her be continuously monitored but she had to use the restroom! So she did! Around 2:30 am, Cat arrived. We had debated whether to have her to come in right when my water broke, still thinking the induction might take a long time, but given how relatively quickly things had progressed so far, we decided we wanted her there sooner rather than later. In retrospect, I’m so glad for this because she arrived just in time to usher us through the overwhelming experience of acute labor. For the next few hours, I sat on the ball and rocked to the music. With each contraction, I would bark at Ben: “Back!” or “Hips!” and he would apply counterpressure to that spot. He also applied a heating pad, which felt heavenly. I was very much focused on getting through each contraction and relishing the relief that came when each one stopped. It was dark and quiet in the room, and I was able to really go inward and keep thinking about how each contraction was getting me closer to meeting our baby. The midwife came by to see how I was doing, and was surprised to find that my water had broken -- apparently no one had told her! Cat continued to give quiet, calm support to both me and Ben. Eventually - very quickly in the mind of this doula, actually. I “blame” this super quick progression on Lesley’s strong belief in herself and her abilities. Perspective is an amazing thing. She had done a lot of work on her mental mind prior to this moment. Books, videos, classes, discussing her goals. She did the work up front and it was paying off! - the contractions became stronger and I began to feel fear that it would continue for a long time. I announced to Ben and Cat, “I am interested in exploring pain relief options.” Luckily, they quickly deflected my statement and changed the subject, as I had not used the code word (“Hufflepuff”). It felt helpful to say that out loud, and also for me to realize from their (lack of) response that I was doing just fine! They both started telling me explicitly how great I was doing and how strong I was after that point. Donald Byrd’s “Blackbyrd” was playing, followed by an Idris Muhammad album. (Ben and I had intended to put together a labor playlist, but didn’t get around to it before the unexpected induction. Ben chose the perfect soundtrack for us to have our baby to, and I still can’t believe that labor only lasted for three albums.) Eventually I felt concerned that I might fall off the ball -- I felt tired and slightly lightheaded. I wanted to get into bed. Cat, Ben, and the nurse helped me, but as soon as I was in the bed, the contractions felt way stronger and more painful. “What have I done??” I wailed to Cat. I felt like I was writhing. The only thing that helped me through the contractions was to exhale raspberries with each breath during the contraction. Cat helped remind me to breathe and not let the contraction control me or tense me up. This was really helpful. Ben was right at my side too, whispering encouragement as I became more and more uncomfortable. The nurse kept fiddling with the belts containing the electronic monitors -- apparently they weren’t working right, or I was moving around too much. She moved me onto my left side, and Cat tried to put a pillow between my knees to help open my pelvis up. It hurt like hell and I screamed at her to stop. Things were starting to get wild! Cat and the nurse took my top leg and extended it straight out at a 90 degree angle. This maneuver felt good and must have really helped get the baby in position to descend, because shortly after that, I felt myself beginning to involuntarily push at the height of the contractions. I probably did that for two contractions before Cat asked me, “Are you pushing, honey?” “I can’t help it,” I replied. By this time I was really writhing and screaming a bit. Cat helped me move into an all-fours position, HANDS AND KNEES, People! ALL FOURS! Incredible. which felt better (and was the position I had visualized and verbalized myself giving birth in). The nurse got me an oxygen mask to lean down into and breathe through during the contractions. They got the midwife to come in to check me. “You are complete,” she declared, meaning I was fully dilated and effaced. It was time to push! I could hardly believe it. Even though I’d felt myself needing to push (little pushes!), to have gone from 3cm dilated to complete without any intervening checks was pleasantly surprising. The midwife settled in behind me and asked if the baby had a name. “Trevor,” I said. “Okay,” she replied. “Let’s meet Trevor.” Pushing felt just like trying to poop -- but the biggest, roundest poop. It seemed unlikely to me that it would ever be productive. I could feel the midwife’s hands in my vagina, stretching me (I guess to prevent tearing?). It felt sharp and unpleasant. I groaned, grunted, and screamed. I tried to work with the contractions. I breathed in the oxygen. Cat reminded me to keep my pelvis angled up so the baby could come through. Ben kept telling me how amazing I was, how great I was doing, how strong I am. Finally I declared to Cat, “I am going to meet my baby!” I pushed harder and harder. The contractions started to be spaced further apart. I said out loud that I was concerned that they were coming too slowly -- wouldn’t the baby get stuck in the birth canal if things didn’t move along? Cat reminded me that in the pushing phase, there’s more rest time between contractions -- totally normal. I felt better. I pushed with the contractions as they came. I roared with every push. Did you read that, Reader? “I roared with every push.” Doesn’t that statement just affirm the power Lesley displayed the moments before her son was born? Amazing. Finally his head was visible to the team. The midwife asked me if I wanted to feel it. At first I felt negative about this -- I wanted to just focus on pushing and get this thing over with! But then I realized what a cool opportunity it was. As soon as I reached down and felt that he was really there, right between my legs, I felt a burst of energy as I realized just how close we were to being done with labor and meeting Trevor. I bore down hard, again and again. I was pushing without there being any contractions, just trying to get him out. It was burning. “Just one more push to get the shoulders out!” the midwife said cheerfully. I could do this! I pushed, and Trevor shot out of me with a plop and a splat at 5:15 am. He was here! I couldn’t believe it. They told me to turn over to meet my baby. I lay back and they put him on my chest. He was a little goopy but I could see his head, his hair, and his alert dark eyes looking right into mine. It was unreal, it was perfect. Ben was right at my side, gazing at this little slice of perfection right along with me. Cat captured these first moments together for us. I’m so grateful she was there, from the first panicked moments about needing to be induced through to the blissful end. Although I had been hopeful that I wouldn’t need an induction, and had strong feelings about certain interventions (including one that ended up being used), I definitely felt empowered throughout the entire experience and was able to process and accept the interventions being recommended. I feel like that acceptance and empowerment allowed the rest of the labor to go smoothly, quickly and unselfconsciously; and I was very much able to have the birth that I wanted and had envisioned for myself. I seriously felt like a superhero in the days and weeks following the birth, and still enjoy sharing our story with anyone who wants to hear it. I’m looking forward to the opportunity to do it again, hopefully with Cat once again by our side. Lesley and Ben did such an amazing job together in the birth room. Ben’s presence was calm and positive which helped Lesley such a powerful force as she labored and birthed their child. I thank both of you for honoring me with the privilege of being your doula and for allowing me to share your story here. Trevor, you are a lucky guy to have such remarkable partners as parents! 
1/7/2018
She did it HER WAY - part 1
When Lesley sat down at our first interview, I asked her, as I do everyone who interviews me to be their doula, why she wanted a doula. Her response was “because birth is so mysterious.” After reading her two part story on the birth of her son, Trevor, I hope you realize that through dedicated preparation and support, the fear and mystery of birth can be replaced with confidence and empowerment - even despite certain obstacles. Cat asked me to write a blog post about our birth story on our baby’s first birthday, and I could not be happier to oblige and share with others what was such an empowering and intense experience! Much of the detail below was written about a month after the birth, but I was glad to revisit it on the occasion of my little guy turning one on November 1, 2017. Shortly after I became pregnant, I watched “The Business of Being Born” and started reading lots of Ina May Gaskin and birth story blogs. I realized that I very much wanted a doula to attend my birth, and that I wanted to aim for minimizing interventions as much as possible. Meeting Cat and talking with her about evidence-based birth practices, I immediately knew that I had found the right person to support me in this mission. I saw the midwives at a local hospital throughout my pregnancy, which was generally uneventful. In addition to reading Ina May, my husband and I did our prenatal education sessions with Cat and also attended a three-week birth education class, both of which helped us understand informed consent. I easily came up with a detailed birth plan aimed at preempting unnecessary interventions, which Cat helped me distill down to bullet points. I shared the final “birth preferences” list with Cat and my midwives about a month before my due date. In my mind, I would go into labor and have a day or two to “rest and nest,” rewatch some sci-fi television series, and go for long walks along Kelly Drive. I thought about this a lot when I was heavily pregnant and stressed out as almost a reward I was working toward. (In retrospect, this mindset ignored the fact that I would be having contractions during this time, but I was still looking forward to it.) I also visualized my ideal birth process and would verbalize it to anyone who was willing to listen (Cat; my husband; a friend who had recently given birth), detailed down to my anticipated laboring and birthing positions. Alas, the “rest and nest” stage was not meant to be, and I ended up facing a major intervention at the outset of my labor: induction! I went into the office for my 39 week appointment on October 31, 2016. I was supposed to see one of the midwives at 8:15 and I arrived promptly at 8:00 after skipping breakfast. I had a work call scheduled at 11am that morning and was looking forward to a productive last week of work before my due date. I sat in the waiting room for quite a while, watching other people arrive and be promptly called back. I became more and more anxious and agitated as the time approached 9am and my nose began to bleed. (So many nosebleeds during pregnancy!) Finally I went up to reception and asked what was going on. About 20 minutes later, I was called back and ushered to a room beyond the exam rooms I usually went to. I asked the nurse, “So who am I seeing?” It turned out that the practice had fit me into one of the OBs’ schedule. Apparently there had been a scheduling snafu: the midwife who I was scheduled to see was actually over at the hospital on delivery duty that day. I hadn’t seen an OB at any point during my pregnancy, so it was odd to see one at the very end. The nurse took my blood pressure and it was high, around 140/90. I’d had a high reading at my last appointment, too, so the doctor was concerned. It was taken again after the checkup, and hadn’t gone down to normal range (unlike what had happened at my 38 week appointment when my pressure was normal by the end of the appointment). The OB did a cervical check and found me 2cm dilated and 50% effaced. She offered to strip my membranes, but I declined. Because my pressure was still high, she sent me over to the hospital for further blood pressure checks and evaluation. I started to cry when she told me this, as I knew it meant that an induction would be likely. I had really hoped for spontaneous labor, and was looking forward to the “nest and rest” portion of early labor. I wasn’t ready! I wanted to rewatch some Battlestar Galactica! And plus, I still had a couple projects I was trying to wrap up at work. I’d prepared myself mentally, as a first-time mom, to go past my due date, and had planned at work accordingly. Plus, induction at my hospital meant Cytotec (misoprostol) and pitocin. I was anti-Cytotec after researching the medical rationale for off-label Cytotec inductions as a standard of care (largely cost- and convenience-driven, in my assessment), plus I was somewhat irrationally affected by the fact that I had done a science fair experiment on goldfish in the 9th grade where I fed them Cytotec (my dad was a pharma sales rep) and it killed them all. Most disappointingly, induction meant continuous IV and electronic fetal monitoring, and no birthing suite. Continuous monitoring was anathema to my birthing preferences; I wanted to be able to move. I called my husband through my tears and asked if he was still at home. Luckily, he was just about to leave for work but was still at the house. He grabbed my computer charger and the hospital bag I’d packed a week previously (but hadn’t finished packing completely!) and met me at the labor and delivery triage area at the hospital around 11:00 am. In a shared room in triage, I had my blood pressure taken a couple more times and it was high for all but one reading. I explained that I’d been upset by the scheduling issue and not being seen for so long for my checkup, but in the end, that didn’t matter. The midwife on duty in triage and explained that since the placenta is one big blood vessel, high pressure could potentially cause a placental abruption and threaten me or the baby. Thus, I would have to be induced that day -- I was full term and baby would be safer out than in. I needed some time to process this. I considered going home and waiting for labor to begin on its own. I was also fearful that they wouldn’t let me eat anything if I was going to be induced. I hadn’t eaten anything all day at this point, around 1pm, and I was very cranky! Ben and I talked, and we spoke to my mother-in-law (a pediatrician) and to Cat to try to process the advice we’d been given. Induction at our hospital meant Cytotec, and no 9th grade science experiment on the effects of Cytotec on the circulatory systems of goldfish would change that, Honorable Mention notwithstanding. (I had discussed alternatives such as cervadil with the midwives during routine prenatal appointments, but was advised that it was not an option due to cost.) It is important that you know where you are choosing to birth for many reasons and this is one! The alternative was not available at this hospital. Although Lesley did not plan on an induction, when the unexpected happened, she and Ben kept their heads above the water. They discussed every option. They got their information. They leaned on their supports. Then, they made their decision. So important since true informed consent doesn’t mean that you get your way; it means you get the information you need in that moment to make the best decision in that moment. POWERFUL. We agreed to stick around and get induced. Ben went down to the Italian Market to get lunch. He came back with hoagies from Sarcone’s and they were delicious. The “Exotic Veggie” (breaded eggplant, roasted peppers, broccoli rabe, abbruzzi spread and mozzarella) fortified me for the effort ahead. And here is where we will break. Part Two of Trevor’s story will be continued in a few days!  |
AuthorCat is the founder of Birth Freely Birth Services. Her passion is empowering women through education and providing them with continuous labor support so they can have the birth they desire! 
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