9.09.2011

Madeline's Birth Story: Part III



 Madeline's Birth Story Part III: The Hospital

Day 5 
(July 14th, 2011)

Brett and I drove hand in hand to Intermountain Medical Center. As we drove closer and closer to the hospital I could feel my dream birth slipping farther away from me. The drive was emotional, but as we pulled into the parking lot I reminded myself that the natural water birth at the birth center I had envisioned for nine months was not possible and that a hospital birth was my new reality. I decided I was going to embrace the reality.

Our birth assistant Adrianna followed us inside and started getting us signed in. Our midwife had called ahead so they were expecting us and already had my records and a room ready. However, my initial reaction to the hospital was not a good one.

"Where is this one going?" the woman at the front desk asked another woman behind her.

"Oh that one? I'm not sure." I realized that I was the "one" they were referring to and was surprised they didn't use my first name since it was in the paperwork she was holding in her hand.

"That one's going to room 116." I realize it may be odd to expect to be called by my first name, but while I was at the birth center I had a personal relationship with each woman in the group. I realize that a hospital cannot be that personal, but that moment was my first realization that a hospital experience really would be different than what I had planned.

She typed some more on her computer and started asking questions, "What is your due date?"

"July 1st."

The receptionist raised her eyebrow, pursed her lips and glanced at the other receptionist nearby. I was two weeks overdue. She didn't bother to hide her judgment. I tried to act like I hadn't noticed.

She made a copy of my insurance card and I signed a few papers.

"Alright, you are all set." She motioned to the woman behind her, "Will you show this one to her room?"

After I set down my things and got settled my nurse came in. After my bad experience with the receptionist I was worried about how I would be treated by the nurses and doctors. But as soon as the nurse came in I knew I was going to be treated well. Her name was Mindy. She was cheerful and sweet and made me feel comfortable. Although I am sure she had many other patients she treated me as if I were her only one. Mindy handed me a hospital gown and told me she'd be back soon.

As soon as the nurse left and I had changed into my hospital gown, Adrianna, my birth assistant, asked me if I had eaten anything. I shook my head.

"Do you have anything in your bag? You're going to want to eat something now because once they come in here they are going to cut you off."

Brett grabbed me a granola bar and fruit snacks. I quickly ate the fruit snacks and threw the granola bar into my mouth just as the nurse came back in. I turned the other way and chewed as fast as I could. I took a giant hard swallow just as my nurse got over to the bed.

Adrianna was right, as soon as she came in Mindy asked, "So when was the last time you ate something?"

"Pretty recently." I replied. Brett and I shared a sneaky glance and I held back a chuckle as I could see Brett was trying not to laugh.

"Okay, well we want you to only have clear fluids from now on."

She checked me to see my progress. I obviously didn't have my hopes up considering I hadn't progressed for well over sixteen hours. And I was right. Everything was the same.

She told me to get comfortable and that the midwife would be in shortly. I was so excited that I was transferred to the care of the midwives. I felt that the midwife and I would likely see eye to eye and I'd be able to still hold on to a lot of my birth plan.

Shortly after the nurse left she returned with a petite dark haired woman. She looked confident and relaxed and she wore a wide smile.

"Hello Haley, I'm Melissa your midwife. I understand you were planning to have a natural birth center birth. So what brings you here today?"

I told her about how I had been in labor for days without much progress. "We've exhausted all of our natural options. I've tried tinctures, herbs, acupressure, breast pumping, and I've had my membranes swept." I told her that after exhausting all the natural options my midwives transferred me to the hospital so that I could get Pitocin. I told her that my contractions were consistent and two to three minutes apart but that I still wasn't dilating. "I'm exhausted and I admit I'm a bit discouraged. We're here because we need help, and the hospital offers things that we just can't get at the birth center."

She listened intently and commented on my strength for working for so hard for so long. After I finished the story she sat down on the bed near my feet and spoke openly. "So I know that a hospital birth is not what you were planning or expecting. So it's likely that a lot of what we are going to be doing today wasn't in your original plan. However, we are going to do everything we can to still honor your birth plan and help you achieve your goals. Overall I would assume that having a successful vaginal birth is your top priority?"

"Yes."

"Okay. So here's what I propose. I completely agree with your midwives that the most important thing for you is rest. You are exhausted after days of labor and you still have a long way to go. I would hate for you to be in labor for days and end up with a c-section because you are too exhausted to push.  That would be a waste after all your hard work. So I propose that we start you on Pitocin to help you dilate, obviously, that's what you came in for. And I would also like to start you on an epidural so that you can get the rest you need."

I started crying because I didn't want to get an epidural but at the same time I was so exhausted and I knew it was the right thing to do. My birth assistant made me feel a lot better about the possibility of an epidural. She told me that while I was strong enough to get through the contractions, sleep would help me to accomplish my most important goal of my birth plan, to have a vaginal birth.

At the hospital with my birth assistant Adrianna


They started the Pitocin through my IV and put me on the fetal monitors. They told me they would start me at four units of Pitocin and increase it every hour or so until I start responding to it.

"We never go over 20 units, and since you are already in labor four units should do it." My nurse told me.

Getting the epidural was easy and quick. My birth assistant and mom left to get me some ice chips and by the time they were back it was done. It felt a little weird but compared to the shot of morphine I had a few days earlier it felt like nothing. As soon as the epidural started to work I fell sound asleep.

..................

I woke up a few hours later panicked. I didn't remember coming to the hospital and I was scared when I couldn't feel my legs. Had I given birth? Where was my baby? I looked around the room for Brett but he wasn't there. My mom was there and she helped calm me down. Brett had just gone to get lunch from the cafeteria. She had to remind me why we were in the hospital, that I was on Pitocin and that I had an epidural which was why it was hard to move. Being reminded of what was going on made me mourn the loss of my natural birth again and then I reminded myself to stay positive.

My mom turned on the TV for me and put on my favorite classic movie, Roman Holiday. I don't remember watching much of it, but it was fun to have it on in the background. When Brett returned I felt much better.

Nurses continued to come in and check up on me. I wasn't allowed to have food, but I could have clear fluids. I sent Brett and my mom to get me chicken broth, jello, and flavored ice-cubes from the food station often. Even though I wasn't allowed to "eat" I definitely snacked a lot on what I was allowed to consume.

My brother came over during his lunch break and rubbed my feet. When he and his wife had their first baby it didn't go according to plan and Mike was able to say just the right things to make me feel better about our change in plans.

That afternoon my midwife came in to check me. It had been about six hours since I had been admitted and started the Pitocin. I was fully effaced, Madeline was at a +1 station still, but I was still only dilated to a three.

She suggested that we break my water to see if that would help move things along.

Artificial rupture of membranes was a big NO on my birth plan and I knew that the second I let them break my water I would be on a time crunch to have the baby. I vocalized this to my midwife and she understood, but also reminded me that I was already on a time crunch because of how long I had been in labor and that breaking my water may help things progress. She let me know that the OBs were keeping tabs on me and were worried I hadn't progressed even with the use of Pitocin. She said that by letting her break my water I would buy myself more time.

I bargained with her and bought myself even more time. I said no for now, and we decided that if in a few more hours I hadn't progressed we'd talk about it again.

She came in a couple hours later and there was still no progress. This time I let her break my water. I was concerned about cord prolapse, but Madeline's head was so low that it wasn't possible. Brett held my hand and we prepared for my water to break.

She took a small plastic hook and moved things around a bit.

"Okay, it's done." She said.

It seemed as if nothing had happened. Brett looked and saw there was a slight amount of fluid.

"That's it?" Brett said. "I was expecting something exciting like a huge gush."

"Well the good news is that it's clear!" The midwife said.

I was relieved that there was no concern about meconium. That was the best news I'd had in days.

That evening Brett and I played games. We played would you rather and the "year game". For the year game Brett would give me an age/year and I would tell him a story about me when I was that age. We had a blast visiting. We also visited with our moms. I noticed as we were talking that the nurses kept coming in and were talking about the amount of pitocin I was on.

"Are you sure it's okay to up it?"

"Yes we called the manufacturer and talked to Dr. Brown."

Apparently they were going over the usual twenty units.

As the day went on the nurses came in more frequently to check me. Each time the news was the same. 100% effaced, +1 station, dilated to a three. "Three" was once my favorite number, but it quickly became my least favorite as time went on.  The best news we received was that our daughter was happy as could be and continued to have a great heart rate through the entire ordeal. It was a relief to know that she was safe and healthy.

I asked my nurse when I would know that I was making progress. She said that bleeding would be a good sign because that would mean I was dilating. She also said she wouldn't be surprised if once I did start dilating it went fast.

"A lot of women who have slow labors from a 1-4 actually transition very quickly."

I hoped that would be me. 

Around eleven o' clock I started feeling nauseous and vomiting. I was also shivering. My nurse came in to make sure things were going well and noted that I was bleeding. "These are all good signs of progress" she said. I remembered what I had read in my birthing class about transition and this seemed like textbook. Am I transitioning already? I wondered. The shaking and vomiting continued for an hour. I'm going to have this baby tonight I thought to myself.

Day 6

My nurse said that the midwife would be in by midnight to check me, but there was a birth going on so it took longer than planned. I kept checking the clock and waiting eagerly for her to come. 12:15 came and went then 12:30. Based on my symptoms I had to be dilated to an eight by now. I was in pain. I could feel the contractions but didn't want to push the button to increase the epidural. I wanted to be able to feel as much as I could and to be able to move my legs so that I could feel as I was pushing. I couldn't wait to finally hear my midwife give me good news.

Finally around 12:45 she came in. I told her proudly that I had been vomiting, bleeding, and had the shakes.

"That's a great sign." She said while she put on her rubber gloves.

She went to check me.

As she was checking me I could see the look of disappointment on her face. She continued to check me much longer than before. I could sense she was trying to buy herself some time. Okay, so maybe I am still a three. I thought to myself. When she was finished checking me she took off her gloves and shook her head. I knew it was bad news.

"Fully effaced, +2 station."

I waited to hear how far I was dilated.

"You are now less than a two."

What? How was that possible! I thought to myself. My midwife was incredibly sensitive and came over to hold my hand. She looked like she was going to cry.

"We've hit a wall Haley. Your cervix is swollen and exhausted. It's been working for days and these strong Pitocin contractions have been hitting it hard. I told you earlier that we never go more than 20 units of Pitocin. Right now you are at 38 units. We've never had a mom on that much Pitocin."

She continued to tell me this was a flukey thing and that it wasn't my fault I wasn't dilating.

"We've done everything that we can and you've worked so hard. These things just happen sometimes."

She let me know she had to go out in the hall for a bit but that she'd be back soon.

She returned with a group of people and a woman who introduced herself as Dr. Melissa Brown.

"This is Dr. Brown. She will be performing your c-section today."

The midwife, doctors, and nurses kept talking to me and giving me sympathetic looks but I don't remember anything they said. My mind wandered as I tried to accept this new development.

I had done everything in my power to avoid a c-section. I chose a provider with a c-section rate below 5%. A far cry from the national average of 34%. I ate well, I stayed active during my pregnancy, and I worked hard to become educated about childbirth and my options. I didn't induce labor, I tried every natural method of encouraging my cervix to dilate, I used the necessary interventions when we realized the natural methods weren't working, and here I was being prepped for surgery.

It was even more difficult to realize that I didn't have a choice in the matter. Up to this point I was able to choose between different options.  I chose to not induce labor when I was over a week late. I chose to try all the natural options to help my cervix progress and dilate. I chose to have Pitocin when those natural options didn't work. I chose to let them break my water when Pitocin wasn't quite doing to trick. Now I was out of options. There was no "or". Having a c-section was my newest reality.


Once the doctors and nurses left, my mom and mother in law stepped out so that Brett and I could have some time alone. Again, this is another one of those times I wish I had recorded exactly what Brett said to me. All I really remember is that Brett held my hand while I cried. My tears were both of sadness and relief. We had a wonderful moment together. We were sad, yes, yet were so happy and excited that after days of working to get her here we would finally meet our baby girl. Even though I was sad that I was having a c-section after planning a completely intervention free childbirth, I felt calm and accepted what was happening. I couldn't wait to meet my little girl and finally give her a name. We had a list of names we liked, but we didn't get attached to any of them. So we decided to wait to name her till we met her. Through the pregnancy we just referred to her as "baby girl". 
The nurses came back in with the goofy looking "Daddy scrubs" for Brett to change into. My mom called my brother and my dad so that they could come and help Brett give me a Priesthood blessing before I went into surgery. They got there just after the anesthesiologist had come in to prep me for surgery.

Brett did a wonderful job giving me the blessing and I felt a wonderful calming spirit in the room. I felt so happy that my husband was a worthy priesthood holder and could give me a blessing of comfort and healing.

When the blessing was finished I said goodbye to my family and they wheeled me into the operating room. In one hand I held Brett's strong hand, in the other were my birth beads from The Birth Center. As we neared the operating room Brett could sense I was starting to get worried.

"Remember the words of the blessing Haley." I calmed down a bit as I remembered the words Brett had said.

As we got into the operating room I started to worry again. I imagined them cutting me open and seeing my insides. I started to feel sick.

Sensing my discomfort Brett said, "Think about your trigger word Haley."

While I was pregnant, Brett and I had practiced a bit of hypnotherapy. For this particular technique, you practice deep relaxation and pick a "trigger word". You focus your energy on that word and it helps to relax you. My word was "temple" because the temple is a place that I feel calm. But as I laid on the operating table, the only word that came to mind was "Madeline."

Madeline. I thought to myself.

I instantly felt calm.

Madeline. 

The anesthesiologist did a few tests to check that I was numb. Once it was clear that the anesthesia was working he said, "Are you ready for them to make the first cut?"

"Yes."

"Good, because they already did it."

I laughed a bit because I hadn't felt a thing.

Then I started feeling tugging and pulling. It wasn't uncomfortable, but knowing what was going on made me feel a bit worried. It was strange to realize that beyond the blue cloth, surgeons and nurses were looking at my insides. Brett could see the worry on my face.

"Haley look at me."

I looked him in the eyes and I could tell he was smiling. I couldn't help but smile back.

"You'd doing such a great job. Just a few more minutes and we'll meet our little girl."

I felt so lucky to have Brett there with me. He knew just what to say and do to help me feel better.

"Okay you're going to feel a lot of pulling and tugging down."

Two nurses pushed hard on my ribs. I could feel a lot of movement and tugging. Then I heard it. A beautiful raspy cry like the bay of a lamb.

"Here she is!"

Relief and joy flew out of me in the form of tears and joyful sobs. Brett kissed me and squeezed my hand as if saying Great work honey!

She was finally here.

Brett went to see her as they wiped her off and weighed and measured her.

"She's beautiful!" was all he could say. And he said it over and over again.

One of the nurses gave us her stats.

"She's a big girl! 8 lbs 13 oz and 22 inches long. "

Brett took a picture of her and brought it over for me to see.



I wished they would hurry and bring the real thing over.

Finally they wrapped her up and brought her to me. I turned my head and met eyes with my beautiful daughter. Though I had envisioned having immediate skin to skin contact with my baby, this moment was still incredible. She was amazing. She looked so calm and happy. I kissed her over and over again and told her how much I loved her.

"So does this beautiful girl have a name?" The nurse asked us.

"Yes." I looked at her and then at Brett. "I think it's Madeline."

Brett smiled, "I think so too."

...........

Our visit couldn't last long. After a couple minutes Madeline had to go to the NICU. Just before the c-section I had a fever and when Madeline was born she had a fever as well. They were concerned about a possible infection because I had been in labor for so long, so they had to give Maddie an IV. Brett left with Madeline after asking me where he should be. Without question I wanted him with our baby girl. He kissed me again on the forehead before he left with the nurses to the NICU.


Laying on the operating table for another thirty minutes while they stitched me up was almost unbearable. If I'd had any ability to jump up and run down to the NICU I would have. I tried to distract myself as they stitched me up. I'm sure I annoyed the surgeons as I asked over and over again how much longer it would take. They were very polite and understanding and gave me updates as they stitched each layer of tissue they had cut through.

Finally they were finished. They wheeled me into the recovery room where I immediately prepared for my "skin to skin" contact with my baby girl. I took off my gown and waited for Maddie to come back from the NICU. I texted Brett over and over again and asked him if he could hurry. Though Brett couldn't control how long it was taking he was sweet and understanding. He texted me photos of her in the NICU and kept me updated on how much longer they would be.

After another half an hour or so the door opened and Brett came in with Maddie.

He unwrapped her from all the blankets they had bound her in and set her on my chest.


It was in this moment, holding my beautiful daughter in my arms with my husband at my side, that I knew it had all been worth it.




4 comments:

C. Jane said...

Congratulations! This was an incredible read! You had me totally engulfed in the story.

Thank you for writing it, making it accessible and emailing me. So happy for you!

perilsea said...

Haley, you are one incredible woman, that's all I can really say. Your birth story made me cry both times--the first when I heard you tell it at the birth center, and the second as I read it here.

You are so inspiring! You were so strong, positive, and incredibly brave, and you should be proud of what you accomplished. I'm glad Maddie is doing so well, and though you didn't get what you planned for, you fought every step of the way. You fought a perfect fight, in my opinion, no one could have done it better.

you're just awesome!

perilsea said...

This is Cassie, by the way.. sorry my google account doesn't tell you that :)

Haley Jaye said...

Thanks so much for saying such wonderful things Cassie. I appreciate your kind words and your support. It means more to me than you know.