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Mia Susan

The last day of my pregnancy was a great day. I spent it doing a lot of little “last minute” things…like packing the rest of my hospital bag. When Steve got home from work we had a nice dinner and then decided we should go create our baby registry…so at about 8 pm off to Target we went. When we got home I had a long, relaxing soak in the tub. We went to bed around 10:30 and I decided I was in the mood to read some positive birth stories, so I began reading from Ina Mays Guide to Childbirth for the second time. I fell asleep repeating a little mantra of “baby moves down, cervix opens, baby comes out.”
My water broke at 1:30 am on the 27th of August. I had been having regular timeable contractions for several weeks, but I did notice a slight increase in the intensity of the contractions about 30 minutes after my water broke. I had been in communication with my midwife, Anne, and we decided that I would just update her about every four hours or so and that I could labor at home for a good 12 hours. Well I tried to get some sleep, but that wasn’t working well so I started walking to get my ctx stronger…it was pouring down rain that day so I was pacing around my house. When I would walk my contractions were strong and regular, but when I would stop moving they would kind of space out. Steve and I got the car packed and made sure everything was ready to go. While we were at home I didn’t want a lot of distraction and kind of just wanted to be left to myself. Anne had to close on her new house at 1:30, so she called us when she was done and agreed it was time for us to go to the hospital…at this point we had labored at home for 14 hours. I was getting a little worried because unless I was in continuous motion my contractions were still not where I knew they needed to be.
When we got to the hospital we immediately had problems with the first nurse. She wanted to start an IV even after we kindly continued to explain that we did not want one and the reasons why. Then I said I thought Anne had called ahead to tell her that, the nurse admitted that Anne had called but that “all of my patients get IV’s.” Are you kidding me?? Anyhow we got to our room and hooked up to the monitor for 20 min, baby looked great. I was just starting to battle with the nurse about putting on the stupid gown when Anne got there and basically told the nurse to get lost…fortunately we only had this nurse for a couple of hours and then she left. Anne checked me and I was only dilated to 1 1/2, but I was 100% effaced. She swept my membranes and we were off and walking again. For four hours we alternated walking and nipple stimulation, we walked for 45 min and then did nipple stim with a breast pump for 15 min…I figured out I walked a total of 10 hours that day.
After those 4 hours it was about 9 pm and my ctx were quite painful and 2-3 minutes apart, but still not changing my cervix, I was still only 1-2. I knew things were not looking good at that point and I had been ruptured for 20 hours with no active labor pattern…I was miserable and tired. At that time Anne started talking to me about Pitocin, and I knew that it was the best choice…despite our best efforts my water had broke before I was ready to go into labor and I knew I was “on the clock.” She hated having to tell me that and was incredibly kind and supportive…her and Steve held me while I sobbed. I was starting to feel like a failure at that point and very angry with my body. Oh also about that time I got my first dose of antibiotics…Covenant’s policy is to give antibiotics every six hours starting at 18 hours after rupture. Anne gave me until 10 and then started me on the lowest dose of pit, which she agreed to only increase every 30 min instead of every 15. She and I were both hoping it would just take a tiny bit and I’d be off to the races. I was still determined to do this without an epidural or other pain meds.
I handled six grueling hours of pitocin contractions and was still only dilated to 2. They were awful, no gradual buildup to prepare for, just right to the peak. During this time I experimented with different positions but just could not get comfortable. Because of the pit I had continuous EFM and was kind of limited in what I could do. As I saw my well thought out birth plan disappearing before my eyes, my focus changed, and my priority became “do whatever you need to do to have a vaginal birth.” I told Anne that I knew if I still had any hope of having a vaginal delivery, that I knew I would need to get some sleep and that was not going to happen with those ctx. I feel I made a very informed decision to get an epidural at that point because I was exhausted, ineffective and very tense. We both thought that if I could relax, things might open up. I asked the anesthesiologist to dose it light because I still wanted to feel my ctx…he did and I could. At that point, Anne tucked me in, turned off the lights and told me to get some rest. I knew she was also exhausted as we had both been in it for over 24 hours…she went and rested in a call room. I need to stop and say that Steve was right by my side the entire time supporting me and loving me through all of this…he cried with me as he knew too that neither one of us thought things would go this way.
I slept until about 5:30, as did Anne and Steve. She checked me and I was only a 3…she was able to stretch me (very painfully) to a 5 and baby was at 0 station. The ctx were getting more painful so I started pushing my epidural pump…I did not want to do this but because my legs were numb I couldn’t position myself to be more comfortable. I slept for a little while longer. Anne put in a pressure catheter to measure the strength of my ctx…yet another intervention. However, I understood why as I was having very regular ctx on the monitor, but my cervix was not changing so she needed to be able to judge how high to continue going on the pit (I ended up at 20 by the time this was all over). Anne had to leave at 7:30 to get to her clinic hours for the day, so our other midwife, Kim, came in at 8. At 8 I was still only a 5. The ctx were again unbearable, and because of the epidural I couldn’t get out of bed to do anything productive about them. I decided I needed more pain relief to continue so the doctor came back in to give the normal dose of meds. Also, baby Mia was doing great this entire time…no heart problems and crazy active. Well, the second dose of my epidural did NOTHING except totally and completely numb my legs but I had total sensation in my belly and perineum…looking back I see this as a positive because I could feel the urge to push, could feel my contractions and was able to be in control during pushing.
Kim was awesome during this time. Her and Steve would position me differently to try and get the baby to move down more and positioned more favorably (she was OP). She rubbed my back and face and never left the room. She told me that because of the amount of time I’d been ruptured that she had to talk to their back up doc…he’d told her if I hadn’t made significant progress by noon that I would have to have a C-section. Kim said she had to give the doc a status update at 11. She checked me at 10 and I was 6. And then magical transition happened…I started shaking and puking, which was a welcome relief from the ctx. But with almost zero sleep and no food I was so weak and tired. At 11 I was 9 + with an anterior lip of cervix…thank God. Kim and I both cried because she was just as happy as I was.
She had me start “laboring down” to bring down baby without wasting my energy…that was incredibly difficult not to be able to push when I started needing to. Also baby was posterior so she was changing my position every 20 minutes to get her to turn…it worked. I pushed for about 15 min and then labored down some more. My body was pushing on its own by this point and is was very difficult not to push on top of this. At this time Mia’s heart rate increased and I had to wear oxygen. Because my legs were SOOO NUMB and the top of my pelvis quite narrow and my baby freaked out, Kim was only letting me push on my side or almost flat on my back. I was frustrated because I knew that neither of these positions was doing anything and I was wasting energy I didn’t have to waste. After another hour of pushing I just lost it and screamed at Kim and told her if I couldn’t push with the help of gravity then I was “done” (right). She wanted the baby out too and agreed…I sat up with the help of Steve and Mia came out in less than 15 minutes!!
Kim was getting ready to place her on my chest and then she got very quiet. Mia was covered in thick meconium, which must have happened at the very end. So the cord was cut in a hurry and Mia was taken to be stabilized…she was not crying and had an Apgar of 4…subsequent ones were 8 and 9. After what seemed like forever (probably 15 minutes) I finally got to hold my precious baby. She didn’t inhale any of the meconium and was fine! I had a partial 2nd degree tear and needed a few stitches. Kim finished my repair and then came over and helped Mia get latched on to my breast.
Anne came back after office hours to see us…she hugged me and we both cried. She said she cried for me in the office all am and had to take a few breaks. I LOVE our midwives and will be eternally grateful for them and my amazing husband for helping to bring our beautiful little girl into this world.
Although I did not get the birth that I hoped for, my birth experience did teach me one very valuable lesson. It taught me that there are a hundred “right” ways to have a baby, that what really matters is that women feel continuously supported throughout their journey and in their decisions. Never once did I feel alone or like I was making a bad decision, I felt so loved during the entire experience. And although this was not the picture perfect Bradley birth we had dreamed of, it was still an utterly amazing, awesome and beautiful experience because it is all mine. And my baby is healthy and gorgeous, so what more could I really ask for?

Mia Susan
August 28, 2009
6 lbs.  14.6 oz.
​20 1/2 in.

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