Wednesday, May 27, 2015

Abigail's Birth Story

My little Abigail is nine months old already, and I haven't even announced her birth here. We had some complications during her birth that left this story a somewhat difficult one to tell. Not because of a bad outcome, because everything ends up as well as possible, with a healthy mom and baby at the end, even if a bit tired an bruised. Rather it was difficult because everything was jumbled and chaotic. It has taken me this long to sort everything out to the point that I felt I had a coherent story. My apologies for any inconsistencies to anyone who knows better. I've done the best I can. Here is Abigail's birth story:

We spent my due date with Chris' mom and grandma. We went swimming in the evening. During the walk home from the pool, I lost my mucus plug and baby got much lower. Contractions started an hour or so later, but they were light and infrequent, so we went to bed. Contractions continued throughout the night, and around five, I couldn't sleep anymore. The contractions were much more intense, I needed to breathe through them, but they weren't very frequent. I got up for awhile, but really wanted to be by myself, so I went into our room and laid on my side, switching every two or three contractions. It continued like this for most of the morning and into the early afternoon. My midwife wanted to know how far apart they were, so I started timing them. 10-15 minutes apart, sometimes 20, lasting anywhere from 1-2 minutes. We shared the assessment that I probably wasn't in active labor yet. But these contractions really hurt for early labor contractions. With my last labor, I didn't have contractions like this until transition. I began to lose hope that I'd be able to handle active labor if early labor was this bad. Chris came in (I'd been laboring alone in our room until this point) and laid with me for a little while. His touch seemed to really help. Contractions got less intense and more frequent. We decided to call his family to take care of the girls so he could stay with me. We were hoping that having him near me would finally kick things over into active labor. Unfortunately, the contractions ramped back up and spaced back out. I gave it few more hours and finally called my midwife. I didn't understand how it could hurt SO MUCH and not even be labor. She offered to come over and check me out, make sure baby was in a good position. I took her up on the offer. Something just seemed wrong about the whole situation. She came over at about 5:45 pm (all times are taken from my records. I had no concept of time by this point.) When she checked me though, it was clear I WAS in labor, despite the space between contractions. I was seven cm. I thought knowing any numbers would be discouraging, because no number seemed like it would be high enough, but knowing I was nearly done did actually help. We set up the birth pool and got ready to birth. The water seemed to help at first, but quickly things got almost unbearably intense. I started to push a bit during contractions, which felt awful. I've always liked the pushing stage the most, but this didn't feel good at all. My water bag was still intact, which has never happened to me before, and I thought that might have something to do with it. I told my midwife I felt like if the bag would just break, the baby would come rushing out. I was partially right. The next contraction broke the bag and I was so relieved! This was about 7:10. The next contraction brought full, huge pushes, but it still felt wrong. My pelvis started to stretch as the baby moved through, and it hurt so badly, especially in my hips and over my pubic bone. The third contraction birthed her head, or at least some of it. From this point on I couldn't tell when I was having contractions or not, all I knew was I was splitting apart in pain, and I could NOT move the baby at all. She was born to the ears, but would not come further. Until this point, my midwife had been sitting in a corner, watching carefully, but letting Chris and I do our thing, as we'd requested. Now she jumped into action, trying to maneuver the baby out. She told me to push, and I tried, but it hurt so much and felt so wrong to push. But I couldn't not push either. My body wanted that baby OUT! I was screaming in pain, begging someone to just get the baby out! When the midwife said "pull her legs back!" though, I knew. I knew exactly what was happening. Shoulder Dystocia. I grabbed my own legs and yanked them back as far as I could make them go. When she said, "get her out of the pool!" I did my best to help as the assistant pulled me over the side of the tub. I very ungracefully flopped over the side of the tub, spilling a ton of water with me. I don't know what the midwife did that finally worked, but eventually there was movement. [It was apparently the movement of getting out of the tub and then pulling my legs back again that freed the baby.I asked her later.] The shoulders were free and the midwife stepped back and let Chris catch the rest of the way. I was practically upside down, supported by my head and shoulders by the time the baby came free, and was now flat on my back, in a puddle of water and the huge gush of blood that followed the baby out. She was placed on my chest, beautifully pink, and obviously breathing despite not crying, but she was pretty floppy. It was clear that she was going to be okay, though, and didn't need resuscitation. A towel was thrown over us, but I could feel that she was a girl and I announced it to the room. I was disappointed when no one seemed to care, and I heard someone say "We know." This bothered me for a long time, but when I finally asked my husband about it, he said no one knew she was a girl and I must have either misheard or they were discussing something else, so I feel better about it now. She was born at 7:25 pm.

The placenta came quickly. The cord had a double knot in it, the second tied around the first, which may account for the widely-spaced contractions.

It felt like I laid there for a long time. Everyone was shaking, especially my midwife. We all just took a few minutes to recover and breathe.  After I was cleaned up some, and moved into my bed, she told me that the shoulder dystocia had lasted a full five minutes and was the worst she'd ever personally dealt with. She said it's the only time she's ever considered breaking a baby's clavicle to get them out. She hadn't had to do it though. She also told me that, despite the severity, her color never changed, she had stayed pink and healthy looking the whole time. [Later she said that her head had started to turn purple, which is a sign that the blood is having trouble getting back out of the head.] While I was being cleaned up, they'd weighed the baby. Everyone was interested to see just how big she was. Ten pounds even. My biggest by half a pound. The assistant mentioned that even after the shoulders were born, she still didn't come out. I'd had to push out her belly and hips. Somehow, miraculously, I hadn't torn at all during all of this, but some of the membranes had torn when the placenta was born and were now hanging out, stuck. We tried several things to get them out, but they wouldn't come, so we decided to just let them stay. They'd likely come out in a few hours on their own.

After the midwives cleaned up some and left, we did our introductions to the family and then tried to get some sleep.

The next day, the midwife again tried to remove the membranes, and they stayed stuck fast. She recommended we go to the local emergency room to have them removed. I really, really didn't want to go. But my husband wanted me to go, and ultimately, my own gut feeling told me that I should go, even though I didn't want to. I went into the ER alone, while my husband kept the kids in the car. He brought them in a few times for Abigail (as we eventually named her, a few days after her birth.) to nurse, as I ended up being there for eight hours. In the end, the membranes were removed easily, but they found a cyst in my abdomen the size of a small watermelon. This probably contributed to the shoulder dystocia. 

I've had further testing on the cyst, and it is completely harmless, cancer has been ruled out. It was originally believed to be an ovarian cyst, but further testing indicates it is more likely to be a paratubal cyst. I will probably have it removed at some point, but there is no hurry.

Abigail Renee was born at 7:25 pm on August 10th. She was 10 pounds, zero ounces and 20 inches long. It was an ordeal, but left us with no long-term harm. Her face was swollen for a few days, and I was extremely sore for a week, but after that we have been fine and healthy. As scary as it was, I see this story as proof of the safety of home birth. In a hospital, Abby would likely have been born by cesarean, as the time between the contractions would have been unacceptable. We would have been given pitocin which, due to the double knot in her cord, would likely have resulted in fetal distress and cesarean. The discovery of my large cyst would possibly have resulted in the unnecessary removal of some or all of my reproductive organs as they attempted to remove it in a hurry. As for the shoulder dystocia, unseen complications happen. My midwife was very well trained, and knew when to act and how to handle it. She also knew how to step back as soon as the crisis was over to re-normalize the birth as much as possible. As such we came through a potentially life-threatening incident with nothing more than some bruising.  

Abby at 3 days old. Finally named!

Abby at one week. Her chest circumference was huge. I was not diabetic.

Three or so weeks old. Gorgeous girl.
Abby at 8 months. Sitting, crawling and into everything!


Sunny said...

beautiful story! Thank you for sharing.

Bonnie said...

I've been waiting a whole year for this. Closure. Healing. The gift of time.