Monday, April 21, 2014

Preparing for Birth: A Lesson in Flexibility

The best laid plans of mice and men often go awry.

I heard this more than once from my OBGYN during my delivery and recovery, and Robert Burns could not have said more true words. 


My previous post focused on creating a birth plan. The time and effort put into it will be helpful, as I mentioned in that post, but I also mentioned that you must be flexible and have a plan for the unexpected. The more you know the ins and outs of giving birth and the purpose, risks, and benefits to all possible procedures, the more relaxed and level headed you will be during a potentially very stressful situation. I can be both very determined and easy going, so knowing the facts made diverting from my dream delivery much easier and less traumatic.

This post will be a lesson in flexibility.

Leading up to the birth of my son, I knew that I wanted to have a vaginal delivery and I was going to do it without drugs! My husband was right on board with me and was ready to keep me on point to my goal (in hindsight maybe a little too focused on my goal).

Then my water broke at 36 weeks and everything slowly started to change, but I had done my research. I knew the risks and I knew what might change with a premature delivery, which already put me on the path to easily accepting change. 

I had wanted only intermittent fetal monitoring and no IV or hep-lock until absolutely necessary. That went out the window right away because I was 4 weeks early and I had only just had my strep B test done, meaning I had to be placed on IV antibiotics in order to protect my unborn child from potentially being infected during birth. Because of this and constant fetal monitoring, I ended up being confined to my bed for the first several hours of labor, again not what I wanted. Once they removed the fetal monitor I was able to walk around with my IV (which ended up being nice because it gave me something else to hang on to).

Eventually they really stressed that I should try to sleep. (We had arrived at the hospital at 10:00 pm, which was my bed time even before being pregnant, and this evening followed a day that had had an early morning OBGYN appointment, then a big grocery shopping trip, a little packing (we moved from NY to WV four weeks after Jr. was born- flexibility!), and then, of course, the excitement of going into labor.) This push for sleep brought on the first offering of drugs. As the nurse said "just a little something to help you sleep," I said no and then we all attempted to sleep. My husband had no trouble falling asleep (and snoring) but I just couldn't do it. My contractions were continually getting stronger (just like they should) and I could not get comfortable, so after about an hour I called the nurse. She came and we agreed I should take the drug and she left to get it. Then Sr. woke up and started in on a mini lecture about how I didn't want drugs, this wasn't in my birth plan, maybe we should get up and walk some because that might make me feel better. Right. My lovely nurse returns and I tell her that I've changed my mind and am not going to take the drugs.

(Ladies, listen to your body and your heart, not your husband.)

We tried walking, standing, a birthing ball, jacuzzi (which they let me do since I had been pumped full of antibiotics), breathing, distraction, everything except standing on my head, and nothing was getting me in the right mindset for what was happening or was allowing me to get some rest in. I was becoming downright exhausted.

After about 12 hours of labor, they realize that things haven't really progressed because the baby's face is coming out first and his head is turned to the side (he was chin high and looking over his shoulder). He was quite stuck and couldn't come out that way so it was recommended that I have an epidural to relax the pelvic floor, hopefully causing the baby to move, and to allow me to sleep. My OBGYN was very doubtful that, if I continued in this way, I would have the energy to push a baby out (I was also very doubtful at this point).

As soon as the baby's position was discovered I made my peace with the fact that it was very likely that I would need a c-section. It took longer to get my husband there. I felt I needed to convince him that I was really okay with having an epidural, though I now know that he didn't need much convincing because he was tired of seeing me in pain (and me whining about it. I get very whiny when I'm tired, hot, and/or hungry.) I should have asked him to support my decision in the moment and not be militant about my birth plan. 

Getting an epidural is painful. Not the injection itself, but the position you have to sit in while they do it. It just puts so much pressure the pubic bone which already had the baby pushing into it. Ouchy! But then the sweet relief comes. Again they stressed that I should sleep. What?!? I'm not in pain anymore and the most exciting thing ever is about to happen and all I want to do is talk about it, but you want me to sleep! Eventually I napped. 

Two or so hours later they do another check and the baby has not moved at all. My OBGYN tells us that he's going to take some time to work out a plan. The best thing about creating a birth plan is that it opens up a serious dialogue with your OBGYN. It's a great opportunity to let them know not only how you would like to give birth, but that you're doing your best to understand the birthing process, which can help create trust. If you don't trust your OBGYN find another one. 

My doctor knew that I wanted to avoid a c-section at all costs and felt comfortable enough to suggest a not so easy option: manually repositioning the baby's head. The other option was to go straight to a c-section. After much discussion, we decided to try moving the baby. I'm really happy that I had the epidural at that point because it still really hurt. The doctor had managed to turn the baby's head and was waiting for my next contraction to end before he would attempt to get the baby's chin down. But the body will do what the body wants to do. My next contraction did not want to stop and before I knew it I was being rushed off to have a c-section. Sure, I had a small anxiety attack, but that was because I didn't know what was happening to me or my baby. Once I knew that Jr. was okay I calmed down and just struggled to quell the excitement that in about 30 mins (or less) I was going to see my baby. 

Mentally preparing yourself for a different birth experience helps to combat any feelings of failure that you may have. During recovery from an unexpected c-section some women may have feelings of inadequacy, but always remember that whether or not the birth goes the way you planned it you brought life into the world. 

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