Michelle's Story
Courage to Choose ---- My birth stories
---- "The following contains information regarding two very different childbirth experiences that may be too detailed for some readers. Discretion is advised."----
The first memory I have regarding the idea of birth was as a child when, after bumping my shin and wailing, my mother said to me, “They're going to have to knock you out when you have kids.” I didn't know then how much that statement would impact my future.
When my husband, Mike, and I first discussed starting a family, I went into research mode. I sat down at the computer and began surfing the information super-highway gleaning all sorts of tidbits about birth, babies and childcare. If there was something to be learned, I wanted to absorb it all.
Somehow along the way I stumbled upon some “alternative” ideas. I found a newsprint magazine with articles on natural childbirth and parenting choices. I poured over the contents of the magazine, which included numerous birth stories. “Truly,” I thought, “there are not women out there who actually want to be in pain?” Certainly not when there is medication available to allow them to be awake and aware during labour, yet pain-free. How could a labour without any pain be undesirable?
Sydne’s Birth
Shortly after becoming pregnant with our first child, my husband and I made the move from Lethbridge, Alberta to Edmonton. I found a great family physician; a general practitioner who also delivered babies. I remember telling her at one of my prenatal appointments, “I don't want to be a hero. Sign me up for an epidural.” After all, if I couldn't handle a bump on the shin, how would I do with real pain? Nope, I wasn't even going to chance it. My doctor was supportive and made the note in my chart. I also included it in my simple, one-page birth plan.
My daughter was born on Saturday, May 10, 2001, ten days after my due date. I was tired of being pregnant. My mom had arrived from the States a week earlier. We walked through West Edmonton Mall, went bowling and I trudged up and down the stairs in our home as much as possible. My doctor stripped my membranes twice and I begged for her to induce me. The night before I was scheduled to be induced, I went into labour on my own.
During one of my many nightly trips to the bathroom, I noticed goop on the pad in my underwear. It was, well, goopy and there was lots of it. I knew it wasn't my mucus plug as I had lost it a week before and this wasn't pink…it was a very pale clear yet cloudy grey-green (*meconium-tinged). I called the local 24-hour nurse line. They said it was probably nothing. I wasn't convinced. So, when I felt a little mini-gush, I knew it was my water breaking, or rather leaking at this point. It was around 2:30 AM when I woke first my mother and then, Mike and we headed to the hospital.
My contractions started on the way to the hospital, which was 10-15 minutes from our home. They were centered in my lower back. At the hospital, I changed into the hospital gown, peed in a cup, left my pad on a paper towel in the bathroom (per the nurse’s instructions) and settled into the bed in the assessment room. The fetal monitor was strapped around my belly and I lay in a semi-reclined position. I had only been in the bed a few minutes it seemed, when my water broke with a gush. The nurse (or was it a resident?) confirmed that there was meconium in the water, meaning the baby had pooped inside the uterus, possibly from distress.
I assume that at some point they must have moved me into a labour and delivery room, but I don't remember when. The contractions were now coming one on top of the other and I had a lot of back labour. Lying on my left-side, I felt like I was going to throw-up with each contraction. I remember feeling so afraid to throw up. I think it was partly from embarrassment and partly because I just didn't want to throw up. Both Mom and Mike tried to help me focus, look at them and breathe through the pain. They tried encouraging me, but all I was aware of was the intense nausea and back pain.
I don't know how long I was in labour at this point, but it didn't even seem like an hour had gone by. I think I was around four centimeters dilated. A nurse asked me if I wanted a shot in the hip or the epidural… I enthusiastically replied that I was ready for the epidural. Once the epidural was in place, Mike and I both slept for several hours. I don’t know if my mom slept at all, but I believe she told me later that she didn't.
The epidural had slowed my labour, so I was started on IV pitocin to increase the contractions. With each increase made to the dosage of the artificial hormone, the epidural lost some of its numbing effect, so an increase was made to its strength as well. This up and down dance kept up throughout the day.
At some point in the afternoon, I had two young nurses taking care of me. One of the nurses was a student. They checked me and found me to be fully dilated. So, without feeling much of an urge, I started pushing. I pushed for almost four hours and moved the baby down, but my progress had stalled and my doctor arrived. She checked me and basically poked the baby in the eye, finding that she was occiput posterior, i.e. head down, but face up. Unbeknownst to me, the doctor reprimanded the nurses for letting me push so long without her being called in and not recognizing the baby’s difficult position.
Because I had moved the baby down so far in the birth canal, a cesarean, which my doctor later informed me she would have called for otherwise, was out of the question. So, she called for the obstetrician on-call to come in and assist with the delivery.
The OB was a sweet, funny gentleman with a lilting Scottish accent. He was a comforting presence. Yet, I was nervous when he mentioned that they would have to try using the vacuum to help the baby out. They tried. It didn't work. So, the doctor brought out the forceps. Finally after an episiotomy and a fourth degree perineal tear, the baby was out. The doctor held her upside down and Mike announced that she was a girl. We cried.
Our daughter, Sydne Mikaela, was whisked over to the other side of the room so the nurses and doctors from the neonatal intensive care unit could give her the once over. They had been called in due to the meconium in the amniotic fluid.
While Sydne was examined, I delivered the placenta. Then, the Scottish OB oversaw as my doctor stitched up my large tear, which was both interior and through my perineum to the sphincter (in layman’s terms, my “bum”). I was in a haze, from the long pushing phase and the effects of the epidural. Though, I do remember “Dr. Scottie” making some cute jokes to cut the tension.
Establishing Breastfeeding
When I finally held my new baby daughter, I noticed what appeared to be a large blood blister on her forehead. Her face was bruised from the forceps and vacuum and her nose squished from being stuck under my pubic bone. Still, I had never seen anyone so beautiful. We were moved to the postpartum floor and I tried to breastfeed her, but between my clumsiness and fatigue and what I now believe was Sydne’s stress and pain from her difficult birth, we didn't manage it.
That night, the nurses took Sydne to the nursery so I could rest. They fed her bottles of formula. I don't remember much else from that first night.
We continued trying to breastfeed throughout our stay in the hospital. Each time I tried to feed Sydne, the nurses would try to help, but usually ended up shoving her roughly onto my breast. Sydne screamed and pulled away each time. It was as though she just didn't want to do it. Each nurse had a different idea about why she wouldn't latch on. They said perhaps she was tongue-tied or she couldn't breathe because her nose was squished, or maybe because her chin was recessed. Frustrated and hurt, I yelled at the lactation consultant and told her to leave me alone. Finally, my doctor told me just to tell the nurses that I was going to formula feed so they’d release me from the hospital.
The Monday evening after Sydne was born, we went home. I continued trying to breastfeed, but pumped and supplemented with formula as she still refused to take the breast. I cried and she cried at each attempt. The health nurse visited the day following our release from the hospital and I continued to have a nurse visit each day throughout the week, still trying to establish breastfeeding. The day my mother was to return home, I began crying constantly…the beginnings of postpartum depression. Then, on my way to the bathroom, I lost control of my bowels… or rather found that I had no control at all. It was painful reminder of my episiotomy and subsequent tear.
I saw my doctor a week after Sydne was born to see if she could increase the dosage of the medication I was already taking for depression. At the visit, she saw my anxiety, stress and sadness over our struggle to breastfeed and suggested we fully make the switch to formula in order to relieve some of my depression. Reluctantly, I agreed.
Questioning
As the months passed, I experienced intense guilt over not breastfeeding Sydne. I read about relactation and tried without success to get her to latch on and reestablish my milk supply. I just couldn't understand how it seemed to come so easily to most of the women I knew.
One day, on a routine trip to the supermarket I came across an issue of the same newsprint magazine I had read when Mike and I were still in the early stages of planning our family. Reading the birth stories and articles inside, I felt as though someone had just told me that the sky was blue and for the first time I saw that it was true. I read page after page of research findings linking routine interventions with complications postpartum. I started to go over Sydne's birth in my head. I began asking myself if I could have done some things differently. Could the epidural I had in labour have contributed to my lengthy pushing phase? If I had been able to feel more, would we have known earlier that she was in the wrong position? Would we have breastfed successfully if the birth was less traumatic? I had to learn more. So, I began researching once again.
Birth had begun to encompass my thoughts. I needed learn more. I felt the more I knew, the better I'd be able to heal the emotional scars of my first birth experience. I read about doulas (professional labour assistants). I was awed at the thought of someone being able to be a part of such an important event in life, and making it a career. I saw in these wise women someone who supported others in finding their own strength and helped them create beautiful birth experiences. The more I studied, the more I wished I could be one of these women. But, how could I help someone achieve something that I hadn't?
Nicolaus’ Birth
When Sydne was a year old, Mike and I began talking about expanding our family. Regardless of the birth experience, we were so blessed to have Sydne, an incredibly happy social child. I had been diagnosed with polycystic ovaries and had a family history of reproductive problems, so we decided that we wanted to go ahead and have another child as soon as we could. While I was scared at the prospect of experiencing the pain of labour again, my desire for fewer complications and successful breastfeeding was stronger than any fear. So, I knew this time things had to be different.
I began calling midwives within a week after finding out I was pregnant with our second child. Our family doctor was supportive and kind, but I wanted to make sure we had the best possible chance at a natural and intervention-free birth. Midwifery wasn't publicly funded and as we didn't have additional health insurance, we weren't in the position to pay the fees. So, we looked to a small hospital about 20 minutes from Edmonton that had the province’s only funded midwives through a pilot shared-care program. We went to an orientation session and signed up for the program.
Our midwife, Noreen, was a grand motherly woman. She was very noninvasive and made us feel very comfortable. However, after only a few visits, Mike had a job change and we were no longer able to make the drive out to the clinic. So, we had to transfer back to our family physician.
I explained my enlightened and informed plans for our second child's birth to our doctor. Having hopes to start a family herself, she was wonderfully open to our wishes and promised to do all she could to help us have the birth of our dreams.
Since we were unable to have a midwife assisted birth, I knew the best thing for us to do was to start looking for a doula. I called the local doula association and requested a volunteer as doula fees were also out of our budget. I was referred to one woman, who later found she was overbooked for the month my son was due and in turn connected us with a volunteer named Kim.
As a volunteer doula, Kim had recently completed formal training and was required to attend a certain number of births prior to becoming certified. She lived an hour and a half out of town, but was more than happy to come into the city to meet with us. At our first meeting, I told Kim about Sydne’s birth and the concerns which had stemmed from that experience. Kim looked over my birth plan, a much longer version that the one I'd had for Sydne, and we discussed my wishes. I felt very comfortable with Kim and knew she was the right fit for our family.
During the last two months of my pregnancy, Kim and I talked often. She met with Mike and me and showed us an amazing video of a newborn baby pulling itself to its mother’s breast and instinctively latching on. When my doctor expressed concern over the size of the baby, Kim found natural birth stories of moms with babies over eight pounds. I was inspired and encouraged.
At 5:22 AM on March 8, 2005, thirteen days before my due date, I had gotten up to use the bathroom and thought I was leaking amniotic fluid. But, I wasn't certain, so I went back into the bedroom. Sydne, who had been sleeping at the foot of our bed, had fallen out of her toddler bed. As I squatted down to pick her up, my water broke with a pop and a whoosh! I yelled to Mike that my water had broken and told him to call Kim. I was group B strep positive, so we had agreed to go into the hospital as soon as my water broke so that I could be put on IV antibiotics to prevent it from passing to the baby.
After Mike got off the phone with Kim, who agreed to set out right away for the hospital, he called our friends in the apartment building next door. They had agreed to watch Sydne while I was in the hospital. So, I waddled around the house, leaking all the way, getting everything together for her to take with her. Then I stopped to call my parents and let them know we were going to have the baby. Either Mike or I got Sydne dressed in her snowsuit and wrapped her in a blanket. On our way out the door, Mike forgot the keys. I laughed. I think he was more nervous this time around, without my mom there to keep him calm.
We dropped Sydne off with our friends; she'd slept through all the excitement. We headed to the hospital. My contractions had not started yet, so when we arrived shortly before 6 AM, I insisted on walking to the assessment room. I went in and went through the familiar motions of changing, peeing, etc. This time, though I consented to the twenty minutes of external fetal monitoring, I insisted that I remain seated upright on the bed to let gravity do its work.
My contractions still had not started after the required monitoring period, so Mike and I asked if we could walk around the labor and delivery floor. We returned to the assessment room at 7. Kim still wasn't there and I was beginning to feel anxious. Finally, a half hour later, she arrived.
Our doctor came around 9 AM. There was once again meconium in the amniotic fluid. We began carefully weighing our options. I considered the GBS + factor and the length of time my water had been broken without contractions. I had done my research and knew the risks of labour augmentation, but felt confident that I would be able to have a natural birth without any other interventions. I had the support of my husband and doula to help me feel secure in my body's ability to birth. My physician was also aware of my desires and had been extremely supportive of my decisions thus far. So, I decided to go ahead with the labor augmentation. We were moved to a labour and delivery room. A nurse came in and hooked me up to the IV antibiotics and pitocin, while Mike, Kim and I settled into a game of Crazy Eights.
The rest of the day passed without much change. I felt mostly Braxton Hicks contractions, but nothing painful. Mike, Kim and I ate and laughed, played and prayed. Still nothing much happened. Nurses came in and upped the pitocin every hour or so. I sat on the birth ball, a large exercise ball also used for core training, and tried to stay upright and off the external fetal monitor as much as possible. Kim tried acupressure and massage to stimulate contractions. Mike looked for Pepsi in the hospital vending machines, but found none. Kim took pictures of us, including a couple of cute ones of Mike and me with our hands on my round belly. I was still excited, but started wondering when things were going to get rolling. “Did I shave my legs for this?” I asked.
The pitocin was running at 66 mL an hour. I sat on the birth ball near the bed with my belly hanging forward between my legs. At 3:09 PM, the first painful contraction swelled. I told Mike and Kim and they began timing it. It was deep in my bones, like ice, but without the chill. I rested my head on the bed and went into myself and breathed through the contraction. I could feel my body working to move the baby down. The next contraction came five minutes later; then another one only a moment after that. I got up to go to the bathroom and worked through another contraction by myself, moaning a low “Ohh...” It was painful and yet, blissful. I was doing it on my own.
As I exited the bathroom, another wave began. I leaned against the door for support, my head down, breathing through the intense tightening. It was time for the nurses shift change. The new nurse flew into the room and quickly introduced herself, ignoring the fact that I was concentrating on my working body. The nurse instructed me to lie in the bed so she could attach the fetal monitor. I was not about to be immobilized and unable to work through the contractions the way I needed to. I refused. Irritated, she said curtly, “For the sake of your baby, you need to get in the bed.” I told her that no, she needed to get me a different nurse. With that, Nurse Ratchet stormed out of the room. I smiled, pleased at my ability to advocate for myself. Kim and Mike beamed.
I waddled to the birth ball and Kim suggested I kneel down and drape my upper-body over the ball for support. The waves were coming hard and fast. I could barely catch my breath. Thinking back to Sydne’s birth, I began to feel unsure of my ability to carry on for hours more. Fear crept in. I started sobbing. Kim moved from my rear, where she had been doing the hip squeeze through the last couple of contractions, and positioned herself near my face. She talked me through the next contractions, helping me focus on getting through them one at a time. My moans became longer and higher. “Ohhhhhhh…” Mike rubbed my back and told me I was doing great. I told Kim I didn't think I could do it anymore. Everything had gotten so intense so quickly. Kim suggested moving into the shower. I couldn't even think of moving at that point. I really felt at that point I wanted drugs.
Kim, knowing that I was in transition, agreed to ask the nurse for the epidural order, but also knew that the required exam would most likely indicate it was too late. She had the sneaking suspicion, which was entirely correct, that I was in transition. At 4:15 PM, the nurse checked me and I was almost fully dilated. I was so relieved. I hadn't truly wanted the medication; I just thought I had so much further to go. Within moments of the nurse’s exam, I felt the overwhelming need to push and loudly proclaimed it.
Our doctor arrived at 4:30 PM. Mike held my right leg and Kim held the left. I put my fists under my tailbone to relieve the increased pressure. A mirror had been set up so I could see the baby crowning, but I was in a primal place. I grunted forcefully and focused only on pushing my baby into the world. As he crowned, Mike announced that he had hair. The doctor began manually stretching my perineum to prevent tearing. I pushed through the burning sensation. I could feel my baby’s head expanding the opening. With a feeling similar to a pop, his head was out. A few more pushes and his body slipped into the doctors hands. At 4:54 PM, Nicolaus was born. The doctor laid him directly on my chest. I cried, kissed the top of his head and told him how much I loved him, as Kim took pictures. I was elated and empowered and floating on a cloud of such unbelievable love and strength.
Nicky was checked over by the NICU team because of the meconium in the water and the GBS + factor. Mike stayed by his side. Kim spoke softly to me as the doctor stitched up a tiny tear. The local anesthesia had not taken effect, so I was given a bit of gas, but that was worse. After nearly passing out, I decided that the gas was not for me.
My eight pound one ounce son was brought back to me, swaddled like a little burrito, and Kim helped me put him to my breast. Now was the moment I had been waiting for. Nicky latched on, and I watched in wonder as we worked together to nourish his newborn body. Tears of joy once again ran down my cheeks.
Around seven or so in the evening, Kim left the hospital. Nicolaus had been given his first bath while I ate supper. Mike stayed with us for a while before leaving to pick up Sydne from our friends' home.
Alone in the dark, I lifted my new son from his bassinet and held him close to my heart as we slept. It was the nights that would be the most special in the coming weeks; when it was only the two of us cuddling close as he was nourished by my breasts. I felt satisfied, peaceful and enveloped in a dream come true.
In giving birth to my children, I experienced so much more than I ever thought possible. I learned my own strength as a woman. I trusted in my body to accomplish what it had been created to do. I was awed, inspired and utterly transformed.
My daughter, at six years old, has already filed away her own early ideas of birth. (When Mom is a birth doula, books and videos on birth litter the home.) When Sydne sees a labouring mother on the television she watches intently, waiting for the baby to be born. However open I am with Sydne now, I can still only hope that as an adult, her feelings towards birth are not motivated by fear. Whatever options are available to her when she embarks upon the adventure of motherhood, my greatest desire for her is simply that she has the courage to choose.
