my conscious birth

This is a very special guest post provided by my dear friend, Amy. She has a unique perspective to share, as she chose a hospital water birth with midwives to welcome her sweet girl into the world. I know you will be inspired by her story and strength as much as I was. I might have cried.

Amy writes,

“I found my OBGYN office like I think most women do- convenient location and hours.  When I found out I was pregnant with my baby girl, I initially had no reservations about continuing with my current providers.  They had always been kind and gentle with my uneventful yearly check ups.  For the early few months of my pregnancy I continued there with routine check ups and ultrasounds.  I loved the nurse practitioner caring for me but it soon clicked that this would not be the person in the delivery room with me.  It wasn’t until the 2^nd trimester that I met the two doctors working for the practice, only after I pushed to be scheduled with them at the front office.  

I was very fortunate to have a community of strong moms around me who had non-medicated births with no interventions.  They opened my eyes to books written by Ina May Gaskin, and to the Business of Being Born documentary. I soon began to question why things were being done at my OBGYN office.  Appointments always seemed so rushed and I wasn’t really given the opportunity to ask questions until the exam was finished.  I remember telling my OB that I was preparing myself for an un-medicated birth. I asked if she had experience with this type of delivery and for any advice she could give me.  Rather than helping me toward my goal, she told me that I was silly for making a plan and that we’d have to “just see how things go”.   I knew that without a plan my personality would feel lost and out of control.  I had asked for hip opening exercises because I had a hip injury that worried me for labor and she told me that she strongly recommended I get an epidural so “I wouldn’t be flailing all over the table” during delivery (startling for many reasons, one of which was that I had planned to deliver in any position other than laying down on a hospital bed).   Another woman in my prenatal yoga class had the same provider and talked about how they scheduled her induction because the hospital was really busy during the time of year she was due and they didn’t want to run the risk of there not being a bed for her.  I asked if I could be allowed to go past my due date as long as everything was healthy with the baby and placenta, and was told 10 days was their policy and beyond that I would have to get an induction.  At this point there were so many red flags that I told my husband I needed to switch providers at 34 weeks pregnant.  It didn’t make sense to me why decisions were being made about a hypothetical future problem when my pregnancy had been so healthy and uneventful.  Worse yet, I was not being given options with risks and benefits to make my own decisions, but was being told what I “had” to do.   I consider this my first “mom-gut” decision.  Looking back on this whole experience I’m not quite sure why making this switch was so emotional for me.  Healthcare providers are there to work for YOU.  I continue to feel this way about my daughter’s pediatric care.  I am the parent and it is my job to make parenting decisions.  It is my pediatrician’s job to help me make sure these decisions are done in the safest way possible.   

I was treated so differently at the Midwives office.  I wasn’t made to feel like a patient with a problem but as a perfectly healthy pregnant woman.  All procedures were run by me first and I felt fully in control of my care.  The majority of each appointment was dedicated to answering any questions I had, talking about my goals during the birth and discussing ways to make my goals a reality.  I took a birth course with a local doula and it was the first time having a water birth was ever discussed with me.  I had swam during my whole pregnancy to stay active and the thought of having Nora in the water just seemed right.  My midwives were very excited to help me and I made the next best decision of my pregnancy at 36 weeks pregnant- I hired my doula.  My OBGYN practice had actually encouraged me not to work with a doula because they saw it as an insult to the labor and delivery nurses who were perfectly capable of caring for me.  My midwife felt just the opposite.  In her experience, your doula is not there to be in the way but to be your advocate when you’re in transition and can’t talk or when your husband needs to run to use the bathroom!  Doulas work with your nurses to make sure you are not only medically taken care of but emotionally supported.    

Okay so now to the actual birth story!  One week before Nora arrived I began having strong Braxton-Hicks contractions that felt like electric shocks down my inner thighs and a general feeling of exhaustion.  I no longer wanted to attend my yoga classes or lap swim.  Friday, August 25, I woke up at 5am to mild burning menstrual-like cramps deep in my pelvis.  I soon realized that these were contractions!  I wanted to labor at home as long as possible and worked to keep my mind off early labor, so I went off to work.  By the time I went home at 1pm I found that while I could still talk through the surges, it brought my mind inward and I could no longer multitask.  I had to start using the tools I had learned to relax through contractions.  I spent time on an exercise ball or kneeling next to the couch.  My husband and I went for a walk but only made it half way around our neighborhood before we realized it was making my contractions more intense and I was having difficulty continuing.  Back home I tried taking a shower, but again, the pressure of the water on my back made the surges far too intense.  I tried laboring on the toilet (a position a friend of mine swore by) and I ended up breaking the toilet! (Such a fun surprise to come home from the hospital 2 days later to!)  We settled on a bath and I was able to breathe through contractions.  Around 8pm I had run out of ideas for tools to use to relax through the labor and we called our doula, Rose, and our midwives. Everyone agreed it was time to go to the hospital.  Matt and I wanted to wait as long as absolutely possible because we knew it would give us the best chance at an uninterrupted labor and birth.  I was slightly nervous we were arriving too soon since my contractions were shorter in length (only 30-45 seconds) but were at this point happening every 5 minutes for about 2 hours.  

We got everything into the car and I sat in the backseat in child’s pose.  At this point we realized that any movement caused the contractions to speed up!  Matt was worried while driving to the hospital that this baby may just be coming in the car because contractions had sped up to only 2 minutes apart.  We pulled up to the hospital and met our doula.  I just remember feeling intensely excited.  Matt and I had developed a birth plan that the hospital very respectfully followed.  I refused an IV and vaginal exams after the initial triage exam.  I asked to be interrupted as infrequently as possible and to avoid questions like rating my pain during labor.  What I believe was most helpful for my experience was asking that no one tell me how dilated I was.  I worried that the number would disappoint me and I would focus on progressing at a certain rate rather than just leaning into the experience.  The nurse hadn’t even started the exam but watched me have a contraction and said “well it looks like you’ll be staying here with us tonight!”  

We settled into our delivery room and the nurses immediately started filling our birth pool (which took a LONG time to fill!).  While I read a lot of birth books, in the moment I couldn’t remember any of the positions that were supposed to help me relax during labor!  Our doula, Rose, stepped in and helped guide Matt and I through different suggestions.  I found leaning into Matt and swaying during contractions very helpful and also leaned over the raised hospital bed while Rose put pressure on my hips.  Once the pool was filled I got in and loved the relief the weightless feeling gave me.  Swaying in the water during the surges was definitely what felt most comfortable to me and I could then rest my head on the side of the pool in between.  I had absolutely no concept of time passing.  At one point Rose suggested we try getting out of the pool, and very quickly after, my water broke with an audible pop on the exercise ball.  After this event, I could feel Nora in my bones.  I got back into the water.  I remember looking up at Rose during what I now can recognize as transition and telling her I didn’t know if I could do this. I vividly remember telling her “this sucks” to which she replied “It’s going to get worse before it gets better”.  This was weirdly exactly what I needed to hear- no sugar coating the situation.  She continued putting pressure on my hips while Matt held my hands and continued to tell me our mantra: Relax and Open.  I focused on the idea that each contraction was one less until we met our baby and that I was working toward a medication free birth for her health and safety.  A few times throughout the night a nurse would come and monitor the baby’s heart beat while I stayed in the pool.  Her heartbeat was always strong and steady so I never questioned that she could do this.  The room was dark and for most of the night the only people near me were my husband and doula.  It allowed me to feel relaxed and safe.

Transition was intense and seemed to last longer than the entire labor experience. There were less breaks between contractions, but the amazing thing about contractions is that you can feel them grow and subside, like a wave, so you know they will end and can prepare yourself for the next one.  Toward the end of transition I looked up at Rose and asked her if I was close.  She said I was (at this point the room was filled with nurses and our midwife but I really had no idea).  I worried that I was barely dilated, which turned out to be pretty irrational since I had checked into the hospital at 6cm, -2 and fully effaced.  During labor you are in your own world.  What I didn’t know was that our midwife had another delivery at a different hospital and was not sure if she would make it for our delivery.  The hospital paged an OBGYN on call.  Rose, knowing our wishes for minimal interventions and a water birth, immediately pulled a nurse aside and told them to find me a midwife because I had no plans of leaving the water to push on a hospital bed.  If she had not been there to advocate for me, this news would have sent me into a panic!  Luckily our midwife made it with time to spare.

All of a sudden my contractions stopped.  I found myself grunt at the end of a contraction which hadn’t happened before.  I asked our midwife, Pam, if it was time to push and started worrying about how to best push to avoid tearing or be most efficient.  Pam told me to get out of my own head and push if it felt right.  I could no longer feel the wave of my contractions and found it hard to figure out when to push.  In most birth stories I had read women talk about their sudden intense need to push or intense pressure.  My experience was more like a sudden lack of intensity and contractions.  Matt got into the birth tub with me and I sat between his legs.  He helped hold my knees so I would have something to push against.  I found this stage of labor both scary and extremely satisfying.  It was great to have an active role in labor after trying to passively relax during contractions and let my body do the work.  It felt powerful to yell as I pushed and try to focus my energy.  After just a few pushes I could feel Nora’s head emerging and reached down and felt her.  30 minutes or so of pushing later, Nora slid out into the water and I was able to pick her up and place her on my chest.  Picking her up was the most exhilarating and surreal moment of my life.  I was in utter disbelief that my body had worked so well and that my baby had been so strong and powerful during the entire labor.

We left the pool and I had to have a few very minor stitches.  I was oblivious to what was going on as I held Nora and watched her rub her face with her hands and look directly at me, so alert.  We refused the hepatitis vaccine while at the hospital and did not let the nurses bathe Nora, allowing us to have uninterrupted skin to skin cuddles with our baby.  Matt and I soaked her in.  Looking back, I’m so thankful for the team we chose to surround ourselves with.  The entire experience left me feeling so strong and I truly feel that I delivered Nora.  Without their support and confidence we would not have had the opportunity to have the birth we wanted.”