I should be getting ready for a party right now, but I’m way to distracted by the play by play going on in my head.
I never wrote out Declan’s birth story, never showed anyone any pictures of those first moments, I couldn’t even look at them myself without breaking down for over 6 months. But it is the evening before his 1st birthday and I not only need to process, but finally feel ready to share our story.
We planned, hoped, researched, and readied ourselves in every way possible for a homebirth after 2 cesareans (HBA2C). A lot of thought went into that decision, our only choice of doctors at the time was my OB who delivered Jaron. The OB who led me to believe that if I didn’t have c-section right then, then Jaron wouldn’t survive. Then, in my permanent medical record had the gall to write “patient declined VBAC” as the reason for surgery. According to those same medical records, Jaron was doing beautifully. The OB just wanted to go back to his day off. I did go and see him at the beginning of my pregnancy with Declan, as soon as he walked in he started talking about all the things that I needed to do differently this time so I could VBA2C, primarily make sure that my baby weighed less than 7lbs. (Aedyn was 8lb 9oz and Jaron was 8lb 5oz, for reference). I walked out, and promptly decided there was no way he was attending my birth. So I “might” have a shot at a VBAC with him, every other OB in town would just schedule my c-section and tell me that that’s all they could or would do. So a homebirth or traveling to a hospital over 50 miles away were my only options.
I had wanted a homebirth before I ever got pregnant the first time. It wasn’t an option where we lived at the time due to legislation, and that was ok. I wanted a homebirth with Jaron, but could not find a local midwife comfortable with a VBAC and was unaware that there were midwives in other areas that would travel to Brevard County to attend births. Maybe if I had, this whole story would be different, but I did the best with what I knew then.
When I first saw those 2 lines with this last pregnancy I was still grieving 2 miscarriages in a row. I was terrified of losing this baby too, so I double dipped until we saw a healthy heartbeat, I made an OB appointment and I contacted 2 midwives and chose K, about an hour and 20 minute drive from my home (if you avoided toll roads, which we did). After that first wreck of an appointment with the OB I drove to K’s office every month and then every week. Our appointments would last as long as they needed to, some short, some long. I was careful with my nutrition (I think the first thing my amazing friend and doula, L, told me when I told her I was pregnant was “Aim for 100 grams of protein a day”), practiced yoga, saw a chiropractor, practiced optimal fetal positioning exercises. My pregnancy was nice and boring, and had the upside of getting to eat the 50 Carb breakfast and test my blood sugar after an hour instead of drinking glucola and waiting around a lab for an hour.
I hit a few hiccups emotionally. K got a new assistant about 3/4 of the way through my pregnancy. She and I did not click. I did not feel that she heard anything I said, and any question I asked her was met with what felt like a canned response I would get from a textbook or from Google. And most of all I felt completely unheard when it came to discussing how my prior births, c-sections, would effect this one. I left my first appointment with her in tears and really began questioning my decision to homebirth, purely because I didn’t want her at my birth. After weeks I decided that I could deal with it, it couldn’t be as bad as being in a hospital with nurses changing shift and not knowing who you’d end up with anyway, right? Wrong. But that comes along later.
My due date was August 18th, Aedyn and Jake started school August 20th. I was hoping for either a really early baby or a really late one to avoid that first week of school. Declan was happy to oblige, sort of. I would start contracting every afternoon around 3 or 4. They would get closer together and more intense throughout the night until I couldn’t sleep through them. They would get 3-5 minutes apart and last 1 minute+. And then, as the sun came up and I considered calling someone to take the boys and my doula to come, they’d stop.
I got the house ready, and the boys got it un-ready. I continued to drive 1 hour and 20min to see K (she came for a home vist at 36 weeks to see where everything was and where we’d set up the birth tub.) At 41weeks and 3days I went for an ultrasound, and who in their right mind tells a woman that pregnant to drink 32oz of water an hour before the appt and then not to use the bathroom. Beyond that, who then asks her why her uterus is so tight and why she can’t relax and then sigh like it’s the biggest inconvenience in the world when said pregnant woman says it’s because she’s trying not to wet her pants and sh’ed like to go to the bathroom. Baby and placenta looked great, no reason at all to rush things along. Except that in Florida a midwife cannot attend a birth after the gestation reaches 42weeks.
I saw K’s assistant at my 41w 4d appointment. That was pointless. She told me what K had told her to let me know, but wasn’t able to dialogue with me about it. K had been at all night birth the night before and was resting during my appointment, but I wish now that I had called back that afternoon and talked to her directly.
Something with discussed earlier in my pregnancy was using a cotton root bark tincture. It has no known side effects outside of causing contractions (overdose would cause uterine exhaustion) unlike blue and black cohash or castor oil.
I brought some home and decided to go ahead and start it when my nightly contractions started that afternoon around 3, I made an appointment with my chiropractor for one last adjustment to help my body and baby’s position, called L and my mom to give them a heads up and tried to finish up a few things. I got pretty cranky, pretty fast. Getting the boys in bed was just something to get through while at the same time I held my boys for the last time before their world would be turned upside down.
L arrived around 9pmish, contractions were already 3 minutes apart and lasting over a minute and I couldn’t really talk through them. She recommended that we go ahead and call K to start to head over, so we did. I had been checking my own dilation for weeks at this point and knew I was around 4 or 5 thanks to all that prodromal stuff for the past 2 weeks; but that I could stretch it farther and his head was easily reachable. (Easily is a relative word once you have contorted to check your own dilation and effacement by the way.)
K came with her assistant and my contractions spread out a bit while I was distracted by everything transitioning and them getting the birth pool ready. But the got back on track, I labored through the night, in the tub, out of the tub, L squeezing my hips and reminding me to keep my shoulders relaxed through the peak of each contraction. My mom came at some point and was there supporting me too, and Jake was up and present until we sent him to bed so he’d have more energy for when I’d really need him.
I did’t have a specific method I was trying to use, but with each contraction I’d turn myself inward and focus on open, open, open, down, down, down. Around midnight I finally let K check me for herself and I was 5 that easily stretched to 8. Not exactly thrilling to here since that’s what I had felt 3 hours earlier, but I knew at least I wasn’t crazy that I had dilated unlike my previous labors and my body was working.
L helped me try some different positions, but I could not lay down as much as I would have liked to, it brought a whole new meaning to the word excruciating. Being upright was my friend, squatting was my friend, laying down was directly from the devil. By morning I was sleepy, L & mom had made sure I was eating and drinking but by morning even the thought of food was nauseating, I got down half a protein shake and that was about it. L & Jake took me for a walk…it was hot…it was not fun. I let K check me again and she pronounced 9-9.5…well that explained the nausea. She offered to break my water. I didn’t want her to, I kind of had the idea in my head that it would be cool to have the baby born in the caul. It was also an above and beyond answer to prayer that it was still intact. With Aedyn & Jaron my water broke first, and contractions didn’t start, so I had prayed that with this baby I’d go into labor before my water broke. Thanks to L’s advice to eat so much protein and straight up prayer, that happened.
So I was trying to decide if I wanted my water broken or not (no, I didn’t) when K’s assistant came in my room while K stepped out and told me that if they broke my water then the baby would definitely be out in 2 hours. My strong side knew that she couldn’t and shouldn’t promise something like that, but my weak side was tired. So I asked K to break my water. It took her 2 attempts because the bag was so strong!YAY!
And them we saw light meconium. K wasn’t worried, L wasn’t worried. I wasn’t sure what I felt, that wasn’t something I expected or felt prepared for. I labored for another couple of hours. No baby yet…then while doing a periodic fetal heart rate monitoring K detected his hr down in the 70′s, she immediately had me change positions a couple different times and got me some oxygen and it slowly resolved to normal. She kept listening for awhile, through several contractions and he was just fine. So we kept going, they worked on warming that pool back up and I got back in for awhile. And then we caught his heartrate down again. changing positions didn’t seem to help, oxygen wasn’t helping, K tried scalp simulation and that didn’t work. Finally it resolved, but we all already knew that that meant a transport. 911 was called and an ambulance showed up.
They had a trainee or something with them, so Jake had to ride in front and 3 paramedics were with me. As they jolted me up and in, Declan bounced out of my pelvis and turned oblique. I gave up hope at that point, of anything but another c-section and silently cursed whoever decided that ambulances didn’t at least need to carry a fetal doppler.
We arrived and went straight up to L&D, I was moved into triage and as the nurse hooked up the monitors, Declan rotated back vertex and dropped. She said she’d never felt such dramatic movement before. The monitors showed that his heart rate was on the high side of normal, but what do you expect when the mama just had her ideal birth swept away, terrified that her baby was not going to make it, and a whirlwind ambulance ride to the place that she least wanted to be, adrenaline much?
The hospitalist came in, Dr. C. She was very blunt and at the time seemed very anti VBAC (found out later she’s not, just doesn’t support VBA2C). She told me that she would honor what I wanted, but in her opionion I should just “cut your losses and go ahead with the c-section”. I said thank you but I wanted to wait a little while.
She said similar things over the next couple of hours and while she was never mean, her demeanor made it difficult to want to do anything except exactly the opposite of what she said. I said a few times, “she’s just making so hard to be objective, I feel like I can’t consent to a c-section even if I need it because that would be letting her win.”
I did allow her to check dilation and found that between the stress and Declan bouncing up I had reverted to only 6cm.
My mom, L, K, and K’s assistant had all arrived while I was in triage and then came to my room with me, K was having trouble getting my records to transfer over to the hospital, so she and her assistant wound up leaving to go back to her office so she could transfer them from the desktop instead of the tablet/cloud. L stayed and continued to support me and help monitor Declan, who would not stay in one spot. I pulled my records up on my computer, Mom had gone back to my house to get a few things for us, weirdly enough, the first thing on my list was eyeliner, and I didn’t use it the entire hospital stay; but the computer was helpful, Jake was able to pull my labs from my records that I could access online, the nurses were amazed when he walked down with the usb and said forget the fax machine, I have what you need right here. Welcome to 21st century birthing.
They started an IV, I had them take it out and lock it off. I decided to stay on the monitors after asking Dr. C if I could come off and she said that she wouldn’t advise it but I could do what I wanted. I labored at the hospital for 4 hours. It was a very rough experience, my nurse was very brusque and borderline rude. I didn’t feel like I could trust her or the Dr. to do anything other than try and convince me to give up. And I found later out that that was not just a perception. Several more times Declan’s heart rate randomly dropped and had a difficult time coming up. It didn’t matter what position I was in or how I moved, it dropped and recovered independent of what I did.
Finally I asked L and Mom to give Jake and I some time to talk. I had been 9-10 cm dilated at home. My body worked. I had no doubt I could push this baby out my vagina if I wanted to but his heart rate was concerning. K had already told me that early decels were normal, but these variable and late decels were the baby trying to tell us something and we would have to figure out what that was. I knew that I could have the Declan come into the world that way I wanted him to, but I also knew that low heartrate meant low oxygen to him, and low oxygen is not good on a baby’s brain. Jake and I talked and prayed and I had peace about calling the c-section.
After that decision was made it was a lot harder to handle the contractions, I just wanted to get it over with and wasn’t happy at all at having done everything “right” and still winding up in this position, I wasn’t coping with the pain as well.
We called in Dr.C and the nurse and told them that since he was continuing to have variable decels we were ready to go ahead and get him out. Both of their eyes got big and immediately went to the tape, no one had been monitoring him. Only myself, Jake, L, and my mom knew that he had continued having decels. That was more disturbing than anything else.
At that point Dr. C became amazing.
The anesthesiologist, Dr. H, came in, she said the biggest thing was that she needed my bloodwork that they drew earlier to know my platelet count. “238, or it was when we did my blood work earlier this week.” She was shocked that I even knew what platelets were, much less my count and why it mattered. At this point she realized I was off the iv and pushed as much fluid into me as possible trying to get me ready for the spinal block. I talked to her and to Dr. C about any possibility of a Gentle Cesarean, no go. Oh well.
I told them that I have low bloodpressure, Dr. H said that’s normal no worries. I told her, that it drops really low with spinals and epidurals, she said she wasn’t worried.
We got to the OR and I had a strong contraction right before Dr. H placed the spinal, she said not to worry, the pain would be gone soon. I felt like telling her that it wasn’t pain, it was just hard work (dancer background identifies good pain v bad pain, and this always stayed in the good pain region) and that the pain wouldn’t actually even start until the meds wore off in few hours.
Jake came in and I didn’t even know that they had started surgery until I heard Dr. C say “Hi baby. Welcome to the world, baby.” That changed the whole procedure, with Jaron the OB was talking the entire time about his weekend and what have you. Dr. C actually helped this be a birth, she actually cared about welcoming a new life into the world.
Jake went over to the warmer to see him and them I got to kiss his cheek way to quickly, before the RN insisted on taking him to the nursery to check him for meconium aspiration even though his APGAR was 8/9. Jake went with Declan and L came in to sit with me while they closed me up. I started to get dizzy and told Dr. H. She said that my BP was the highest it had been and she’d already given me 4x the normal amount of meds to keep it up, but she bumped it up some more.
I was taken to recovery and L went to get something. Dr. H called the nursery and I overheard her tell them not to bring the baby, I had to stay flat on my back and couldn’t hold him anyway. I came up almost off the bed at that and yelled, “I want my baby now, I don’t care if I can’t hold him!” the recovery nurse pushed me back down and yelled at Dr. H to tell them to bring the baby in. Dr. H gave the nurse instructions on how high my BP had to come up before I could sit up and left.
While all of this was going on Jake was with Declan in the nursery. The nurse walked over, arms full of everything she needed for all the standard newborn procedures and Jake told her we were declining everything, including the bath until after the baby breastfed. The nurse told him that I hadn’t signed the papers to decline and continued moving towards the baby. My wonderful 6-ft tall, burly, bearded husband told her, that he was the father and if she tried to give the baby that shot then she’d have to stick him first. She backed down, took Declan’s temperature and made him cry to make sure his lungs were clear and left them alone to wait.
So Jake brought Declan in and my mom followed. I asked Jake to hold the baby so he could latch and nurse, which he did, then when Jake’s arms got tired, Mom took over. L came in at some point and checked on us and headed home, she’d been with us somewhere around 24 hours at that point. Dr. H came in saw and did a double take, almost like she couldn’t believe I could hold of breastfeed a baby while flat on my back…seriously? She signed off on me and my BP slowly rose until I could sit up.
We were transferred to the postpartum room and my dad brought Jaron and a sleeping Aedyn to meet their brother.
Declan Gabriel, August 30th, 2013, 7:16pm, 9lbs 8oz, 22″