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Old 02-09-2012, 08:47 PM   #1
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Palooka
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Avoided a c-section, but with mixed feelings

Upon learning we were pregnant for the first time, I made an appointment with an OB at our nearest hospital. I knew they had a group of midwives in the same office, but I thought I should see an OB first. The male OB turned out to be curt, dismissive of the miscarriage I "just thought" I'd had (turns out I probably did have one right before that pregnancy) and responded to my desire for a natural, drug free birth with "Yeah, that's what every woman says at first."

Last appointment with that OB! I went straight across the office and became a patient with the midwives. They were caring, attentive, and very knowledgeable. When I told other people I was using midwives instead of an OB, I got a lot of concerned looks. My mom kept asking "so will a doctor be in the room at least?" My birth was at a hospital, and yes, there were plenty of doctors available, but I wasn't going there for the doctors. I was going there for the group of amazing midwives!

Jump ahead 41 weeks... still no baby! At 10 days overdue my midwife did a membrane sweep and I visited family still feeling years away from labor. We spent the evening playing cards and chatting. I went to bed late, and 30 minutes later awoke with what were unmistakably contractions! I stared at the clock and thought "noo, that can't be right..." They were coming 8 minutes apart. I ran a bath and tried to relax, but they only got closer together. I woke my husband who didn't believe labor would come on this fast. Soon they were 5-3 minutes apart and very painful. I got my shoes on and announced I would drive to the hospital myself if he didn't!

He drove, and by the time I was in triage the contractions were so heavy I was vomiting with each one. I knew I might vomit during labor, but after 4 or 5 times in a row it was getting pretty unpleasant. My midwife and I agreed to start IV fluids, and later added a dose of Zofran; not things we'd planned on but the puking had to end. Once the nausea lessened and I was hydrated again, the contractions were much more bearable. The next 6 hours were spent with me standing over the bed, then letting my face fall into the mattress to moan out each contraction. Six hours is probably a long time to most people, but it felt completely timeless and calm to me. My husband and doula squeezed my hips at every contraction, which helped immensely. Over that time I went from 2 to 5 cm gradually and with a slow, gentle leak of amniotic fluid. My bag never ruptured with a dramatic gush.

Then, somewhere between hours 7 and 8 my cervix kicked it into high gear... I went from 5 to over 8 cm in less than 45 minutes. There's probably a moment when every mother realizes what her pain level is, and that was mine. I never said epidural or drugs, but I did look at my husband and cry for him to help me. No one ever offered pain meds, but continued to tell me how strong I was and that I could handle this. I wasn't sure I agreed.

My baby's heartrate had been dipping with each contraction, but as I approached 10 cm baby's heartrate was starting to plummet with every contraction. We tried different positions to see if the heartrate would improve. The most painful laboring position for me was flat on my back, and that's just what the baby seemed to need. It was a pinched cord; laying on my back the cord was still pinched during contractions, but not as severely as when I stood or squatted. I labored on my back for an hour, and the baby was moving down, but the heartrate kept getting worse.

When baby's heartrate dropped into the 60s during a contraction the room suddenly filled with people. Doctors, nurses, residents, a second midwife... uh oh. I was just getting the urge to push when I heard a man's voice. The midwife told me they had called an OB in to perform a vacuum extraction because the baby was in distress. I looked up and guess what OB was on call that day? Yup. It was the doc that sent me running to my midwives 9 months ago. He reached in and felt around before announcing he would need both the vacuum and the forceps. My husband and I pleaded for them to not *extract* our baby, but our midwife explained that the baby couldn't wait any longer. I pushed for several contractions while the OB got his equipment, and baby's heartrate kept falling. When he returned to attempt the vacuum baby's heartrate was in the 50's, and he said the baby wasn't down far enough for him to attempt extraction. For a brief second I was relieved.

The OB watched me give another push, checked again, and casually turned to a resident, saying, "She can't do this, it'll have to be a C." Now this part of the story comes from my husband, because I don't remember doing this: Apparently I heard the OB say that I couldn't do it, and immediately I sat up, looked him dead in the eyes, and yelled "F*CK YOU!" Then I started pushing like hell! I hadn't cursed or said a rude word to anyone during 11 hours of labor... but don't you dare say I can't push out my baby! Forget contractions, I just pushed. Hard. My midwives, husband and doula coached me as the OB stormed out. My husband's mother was just outside, and she got to witness what happened next: The head of OB was called to my room, and she ran into the male OB. He was insisting on a c-section, and everyone could hear me pushing like mad inside. The head of OB looked at the baby's strip, watched me push, and then came out and instructed the male OB to give me 10 minutes. If after 10 minutes the baby wasn't out he could do a c-section. Again, he said there was no way.

Nine minutes later the OB reappeared, ready to wheel me away. When he walked in the midwife yelled "You need to do an episiotomy, she can get him out on the next push!" My hubby said that I wanted to tear, but my midwife explained tearing could mean several more pushes and we didn't have that. They did a small cut and baby was indeed out on the next push. It was a boy, and he came out kicking and screaming! Little boy didn't need any extra medical care. He was just fine, and so was mommy.

Every nurse and midwife in that room said they never saw anyone so close to a c-section. And frankly, if I hadn't been a patient of the midwives I would have been cut open hours earlier. I'm also certain that if I had received an epidural or drugs I wouldn't have been able to focus and push as hard and as fast as I did. Everyone around us had been worried that our natural birth with midwives wouldn't be safe, but it turned out to be the best possible decision.

Holding my son, knowing I had given birth to him the best that I could, I felt like super woman. My husband told me he couldn't believe how strong I was, and I realized I was a different person now. No one could ever intimidate or bully me, no one could ever tell me I couldn't do something for my child. It was the most empowering moment of my life.

That's the positive side of the experience. The negative side is the guilt. My baby was in distress. My baby could have died. I told myself a vaginal birth was best for him, but maybe it was also selfish. I wanted to push him out. I needed to push him out. I can't reconcile that instinct to give birth with my knowledge that I was putting him in jeopardy by not letting them cut him out sooner. Everything turned out fine, but what if it hadn't? During the last few minutes of pushing I was frantically apologizing between grunts. As soon as I caught my breath I would turn to my husband and sob that I was a horrible mother, my body had endangered our baby. When my son was born everyone congratulated me for pushing so hard and so fast... but it felt wrong to be proud of myself, still feels wrong, because that pride comes from a moment when my baby could have died.

I know this is a happy story with a happy ending, and I want to encourage every woman to believe that she is stronger and more capable than she had ever thought. But whenever I tell it I end up sad and wanting to hug my little boy close. I guess giving birth was my first lesson in being a mother: you will do the best work of your life, and still wonder if it was good enough.
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