Sunday, February 19, 2017

Laura's birth story - January 2017

Laura Rose Wahlund
1/21/2017, 12:28pm
7lb 13oz, 20.75 in long


My entire pregnancy with Laura was fraught with anxiety due to our two previous losses. While I felt slightly less anxious with each positive milestone that we passed, I never was really able to settle down. As my pregnancy drew closer to full-term, I began feeling increasing anxiety about labor and delivery. I was worried that my labor would go so fast that we wouldn't make it to the hospital in time, and that we'd have an unplanned home birth or car birth (this fear stemmed from the fact that Peter's birth as very nearly an unplanned car birth). I was worried that I wouldn't be able to handle he the pain of labor, despite having had five unmedicated births. I was worried that something would go wrong during labor -- hemorrhaging, or placental abruption, or a host of other maladies -- and we would lose the baby. And so on.

I turned to birth affirmations and prayer to help soothe my fears. Every time a fearful thought would enter my head, I would tell myself, "Fear and anxiety are not of God. Get thee behind me, Satan." This strategy helped, but only somewhat.

I started having prodromal labor around week 37. The one day in January I didn't want to give birth was January 13 -- Elanor's 12th birthday -- so I was pretty convinced that was when I'd go into labor. Sure enough, I started having contractions the evening of the 11th and hardly slept at all that night. The contractions weren't terribly strong or regular, but occasionally they would wake me up.

I called in sick to work and kept timing contractions throughout the morning, and I sent the following text to my doula, Laura (the same doula we had for Peter's birth), at 9:38am on January 12:

"I was up all night with contractions 10 to 15 minutes apart... not terribly intense but I think I was just too anxious to sleep. They slowed down around 5am, but seem to be picking up again. They are about 20 minutes apart at the moment, not very intense, about 30 to 45 seconds long. I have a midwife appointment at 10:45; I might might checked to see if I have made any progress. Will text you if things pick up more."

I ate a high-protein english muffin with peanut butter and drank a labor-inducing smoothie. Collin stayed home from work as well, just in case, and I was grateful to have his company. We went to my appointment, and I requested a cervical exam. I was dilated to a 3, 80% effaced, and baby was at -2 station. My cervix was posterior still. I was excited because I'd only ever been dilated to a 2 prior to the onset of labor, so it seemed to me that this might be the real thing. Still, my midwife cautioned that it could easily be prodromal labor. She recommended that I go home and try to nap -- taking some Unisom or a warm bath to relax if needed. I was exhausted so that sounded like a good idea to me!

After I woke up from that nap, contractions were still coming but they were still pretty weak. Collin and I decided to walk to our sons' daycare to pick them up, instead of driving, in order to see if the walking would help strengthen contractions. We did so, walking a total of 1.4 miles, and after we got home contractions did seem to be picking up. They were coming every 10 minutes and lasting 1 minute.

Accordingly, we called my FIL to come and stay with the kids, and set off towards the hospital. It was premature, perhaps, but given Peter's fast birth, we didn't want to take any chances. I had contractions every 10 minutes on the way there, and had a pretty strong one in the drive-thru of the Burger King across the street from the hospital (Collin wanted to grab some supper quickly -- I'd eaten prior to leaving the house, but he hadn't).

We walked through the doors of the hospital... and contractions STOPPED. It was like my body suddenly flipped a switch from "labor" to "not labor." Even so, we went through the whole rigamarole of being checked into L&D triage, being checked (no changed from that morning), and I stayed on the monitors for about 20 minutes. We spent an hour or two walking in the hospital grounds to see if contractions picked up again, which they didn't, and I was checked again. Still dilated to a 3 and 80% effaced. We were discharged and went home.

So, I didn't have the baby on Ellie's birthday... which I was glad about, but at the same time I was rather peeved about the false alarm. I was tired of being pregnant and so anxious to meet this baby.

Fast forward to Sunday night (January 15). Around 10 or 11pm, I started feeling REALLY strange. I wasn't having any contractions, but I was experiencing labor like signs - upset stomach, very shaky, and alternating between hot and cold. It felt like I was either having a panic attack or in transition. I was pretty sure that I wasn't in transition given that I wasn't having contractions, but I worried it meant that something was wrong. We decided to go to L&D triage, just in case. We called my FIL to watch the kids again, and arrived at the hospital just before 2:00am.

There was no cervical change from my last appointment, but our doula came anyway just in case things changed. Baby looked and sounded great on the monitor, which was a relief, and after a while the symptoms subsided and I felt better. We never did figure out what had happened -- our best theories right now are that I had a panic attack or perhaps suffered a very mild case of food poisoning. (We'd eaten at a restaurant with Collin's mother and grandparents earlier that day, and apparently Collin's grandfather experienced similar symptoms the same night.) At 4:50am, we went home.

The next few days were difficult and frustrating because of continual prodromal labor. I had an appointment with my OB on Thursday the 19th, 39w3d, and I was was 3-4 centimeters, 80% effaced. With my consent, he stripped my membranes, hoping to stimulate labor. I'd never had a membrane sweep before. It was very uncomfortable, but not painful.

The next day, I started losing my mucous plug, which was an encouraging sign. With all of the other kids, I had the baby within 24 hours of losing my plug (some within 12 hours). I had irregular contractions 20-30 minutes apart all day. Even after a bath and hydrating with plenty of Laborade, contractions kept coming. I couldn't sleep and wasn't hungry. Finally, around midnight, I called Collin. He was at his weekly Dungeons and Dragons game, and would have been home shortly, but I told him I'd prefer if he came home immediately because the contractions seemed to be getting closer together, and I'd feel better if he was here. He immediately packed up and came home, calling his dad on the way and asking him to come and watch the kids (again). My FIL was such a saint that week for putting up with the middle-of-the-night calls! We eventually made the decision to go into L&D yet again, and called Laura to ask her to meet us there.

We arrived around 1:20am. Contractions were about 7 minutes apart, but getting stronger. An exam showed I hadn’t had much change from my appointment on Thursday, and was still 4 centimeters and 80% effaced. However, with contractions that were persistent, the nurse suggested that we walk and be checked again in an hour or two. Laura arrived at the hospital around 2:00am.

We walked the halls, rested while Laura tried some acupressure spots, and returned to L&D for an exam at 4:30am. The nurse said my cervix was slowly changing, as I was now at 5 centimeters. Amanda, the CNM from my practice who on call, agreed to admit us to the natural birthing suite in the hospital. I was happy to hear that she was the one on call, as I've known her for several years and she had been so helpful and supportive when I lost Francis in June of 2015.

The natural birthing suites were brand new, and had just opened for business around Thanksgiving. Four rooms had been outfitted with a full-size bed with memory foam mattresses, and there was an option to buy an inflatable tub (we declined, as we preferred the jacuzzi tub already in the room -- you couldn't birth in the tubs, otherwise we might have gone with that option).

I labored for a few more hours, getting more and more frustrated. Contractions were not getting closer together. They stayed at around 7 minutes apart, and the intensity wasn't changing either. I tried to rest, and laid in bed with Collin for about an hour (those memory foam mattresses were SO NICE), but the contractions were just strong enough to prevent sleeping. We walked down to the hospital cafeteria to have some breakfast (I had bacon, eggs, and juice) but that didn't help either. Once we returned to the room, I tried sitting in the shower for a while, but the apparatus to hold the removable shower head in a fixed position above the tub was broken, so Collin had to manually hold it -- not fun for either of us. We also joked about asking Laura to leave the room and trying more intimate ways to kick labor into gear (that bed was REALLY nice, after all), but decided against it. ;)

I was checked again at 8:30am, and was only 6 centimeters. Contractions were still only 7-10 minutes apart, only lasting about a minute. At that point, I felt utterly defeated. I was exhausted from the long night, as well as the preceding weeks of prodromal labor. I started sobbing and told both Collin and Laura that I simply could not handle a full day of slow labor. I was too tired. I wanted an epidural and pitocin to move things along.

Both Collin and Laura knew that my birth plan specified that I did not want an epidural or pitocin unless medically necessary, so they both tried to encourage me toward other, more natural methods of speeding up labor. Laura suggested trying herbal tinctures or perhaps castor oil (Laura, in addition to being a doula, is also a Certified Professional Midwife, and thus very knowledgable about what to use to speed up a slow labor), but I was resistant. I didn't want to keep puttering along for the next day, trying one thing after another. I was too tired to keep walking. I felt like I had no more energy left. I kept sobbing, insisting that I wanted an epidural and pitocin, in that order. Collin reminded me that we'd have to move to a different L&D room for those options, but I didn't care. At that moment, even a C-section sounded good to me.

Finally, Laura suggested calling in the midwife and discussing our options with her. Amanda was doing rounds, but made it to our room about 15-20 minutes after we asked to speak with her. She came in and noticed right away how upset I was. She pulled up a chair across from me, took my hand, and asked me to tell her how I was feeling.

I kept sobbing and told her what I had been telling Laura and Collin for the past twenty minutes. I was too tired to go on. I wanted an epidural and pitocin because I could not keep going.

Amanda let me cry for a minute, and then she quietly asked if she could pray with me. I was surprised -- it isn't a suggestion that you usually hear from a doctor or midwife in a secular hospital -- but I readily agreed. So Collin, Laura, Amanda, and I (and maybe one of the nurses as well, I can't remember) bowed our heads in prayer. Even now I can't remember the exact words of the prayer, but I know she prayed for strength for me, and for discernment and wisdom for all of us as we decided what steps to take next.

After praying, we discussed options. Amanda said that she felt I was experiencing heightened anxiety and fear due to my previous miscarriages (very true), so we needed to be sure that we didn't make any decisions based on anxiety and fear. While an epidural and pitocin weren't out of the question if that's what I truly wanted, she knew me and knew my passion for natural childbirth, and encouraged me to try some other strategies first, just so we would know that we had exhausted our options before resorting to medication.

In the end, Amanda proposed doing a vigorous sweep of my membranes to see if that would make contractions stronger and closer together. She suggested that I get into the tub, turn on the jets, and try to relax as much as possible, because it was possible that stress and anxiety were keeping my labor from progressing. She promised to return in an hour or so and at that time we could re-evaluate, and perhaps break my water to speed things along if baby was low enough.

Somewhat reluctantly, I agreed. She did the vigorous membrane sweep (and boy, she was not joking when she said it'd be vigorous), and I got into the jacuzzi. Laura dimmed the lights and turned on my iPhone's "Labor" playlist. Collin pulled up a chair and sat next to the tub. Laura suggested that he try nipple stimulation while I was resting, because that might help too.

So, for the next two hours, that's what we did -- and it worked. (Mad props to Collin, because he did nipple stimulation for two hours straight -- poor guy, his hands must have been sore!) Contractions sped up and got closer together. I started needing to vocalize through them, which took the form of saying "Ooooooooopen, ooooooooooooopen" over and over, as I tried to visualize my cervix opening up. 

Around 11am I announced my intention to open a cause for canonization for the inventor of the Jacuzzi (He was Italian, so he was probably Catholic!) as at that point, I was begging both Jesus and Mary to be with me and help me get through labor. I made it a point to offer up my contractions for specific prayer intentions (I'd asked friends on Facebook to give me intentions to pray for a few weeks previously).

Amanda came in about 11:10 (according to my doula's notes) and did a cervical exam. She did it while I was still in the tub! I was so grateful I didn't have to get out. I was 8cm! I was also starting to get those panicky, "I don't think I can do this anymore" feelings that indicate transition. I stayed in the tub for about half an hour longer, until I started feeling enormous pressure.  I had to leave the tub (to my great displeasure), but I was given the green light to start pushing.

I was hoping the pushing stage would be similar to previous births, in that I'd push twice and baby would be here, but alas -- it was not to be. I tried laying on my side and also going on my hands and knees. They cranked up the head of the bed and I leaned against that, and pushed that way for a while. I was peeing and pooping all over the place because baby was putting pressure on my bladder and rectum, but it still seemed to take forever for baby to descend. At some point, my water broke, but it probably happened while I was peeing so no one noticed. (Gross, right?) We only realized it had happened when Amanda checked baby's station and could feel hair instead of the amniotic sac.  

Finally I announced, "I can't push like this anymore!" and turned over so I was sitting up. Finally, things started to happen. I pushed, and pushed, and pushed again, and finally baby's head was born. Amanda quickly told me to stop pushing -- she wanted to ease baby out so I wouldn't tear -- and then instructed me to push again, more slowly. With one final push, baby was born at 12:28pm. I'd only pushed for 40 minutes, but it had seemed like 40 hours. 

My doula took a video of the actual birth, but I haven't watched it yet. I may add it to this story at some point, but I haven't decided if I want that online yet -- from what she tells me, it doesn't leave much to the imagination. :) 

The baby was put on my chest immediately, and I was crying in relief that it was finally all over. Unlike previous births, this time I looked for myself to see the gender, and burst into fresh tears of joy when I saw that we had a baby girl. I'd felt she was a girl all along, and I'd been hoping for a girl so that we'd have three girls and three boys. 

We told Amanda and the nurses that her name was Laura Rose. (The fact that our doula's name was Laura was a happy coincidence -- you can read the reason we chose her name at the end of this story.)  She laid on my chest as we waited for the cord to stop pulsing. I tried to latch her onto my nipple but it was a little difficult due to the position I was in -- I'd ended up nearly flat on my back as I was pushing (my choice). I did eventually get her latched on, but I think it wasn't until after I birthed the placenta and the cord was cut.

Unfortunately, despite having taken alfalfa supplements since 34 weeks to reduce chances of postpartum hemorrhage (as I did with Peter), I had heavy bleeding and was passing large clots.  Apparently this isn't uncommon with moms who have had six or more births. Amanda explained her concerns and asked for my permission to administer pitocin and methergine, and I consented to both. They did help slow the bleeding. 

Happily, unlike four of my other births, I did not have a second degree tear! I had torn very slightly, but it was so small that I only needed one stitch. Amanda numbed the area with a shot of lidocaine and put in the stitch. 

Amazingly, other than the lidocaine, pitocin, and methergine, I didn't need any other medication during my stay -- not even acetaminophen or ibuprofen. My afterbirth pains were minimal and I had very little discomfort from my tiny tear. Laura nursed very well from the start, and our hospital stay was uneventful. We were discharged from the hospital on my due date, January 23.

I have mixed feelings about this labor. I was glad, in the end, that I did it unmedicated, but at the same time the slower pace was very mentally difficult and exhausting for me. As always, though, the moment she arrived was absolutely incredible, and she was worth every minute of the pain.

I am grateful for my rockstar care providers, though -- I could not have gotten through this birth without my midwife Amanda: 


Nor could I have managed without our doula, Laura (if you're in the Phoenix metro area, I highly recommend her as a labor doula or a homebirth midwife!). 



You can read about why we chose her name here (we didn't name her after our doula - that was just a happy coincidence!).

Baby Laura Rose is so sweet and so beautiful -- I am so in awe of how God has blessed us. And she's a big hit with her older siblings! :)