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!