Our birth story…
The nurse put her arm around my shoulders and said, “That’s why you don’t have a birth plan, Sweetie. They always fail, especially your first time around., but she’s totally worth it. She’s so beautiful.” I wasn’t sure how to react so I just grinned and forced a fake laugh (more of a grunt).
“Fail” – I didn’t like my child’s birth being described that way. It didn’t go the way I hoped. My labor was much harder and longer than I expected it to be, but I wouldn’t call it a fail. We went through Hell just to get pregnant, did everything we possibly could to ensure a healthy pregnancy, and I am sitting here holding a perfectly healthy baby girl who everyone says is the most beautiful baby they’ve ever seen. How is that a fail? After the nurse left my room I let one tear roll down my cheek. Looking down at that perfect little soul I couldn’t stay sad; however, the nurse’s words really burned. My birth plan had failed? Just because my child’s birth didn’t go the way I hoped, did that make it a failure? If it had failed, did that mean I had failed?
Our birth plan in a nutshell involved a “soft induction” at 39 weeks, using a Cytotec insert to ripen my cervix and hopefully coax my body to go into labor on its own, then a natural labor from there. It wasn’t something we just slapped together. We did a lot of research, consulted our midwife, and hired a doula. I have a narrow(ish) pelvis and the baby was already measuring around seven pounds at 37 weeks so we were concerned waiting much longer would mean a certain c-section. We took seven prenatal/birthing classes between our doula, midwife, and the one-time class offered at the hospital. The recurring theme in all of them was a birth plan is less about an actual “plan” and more about making the hospital staff aware of anything you want that might be outside the hospital’s standard operating procedure. Everyone said we were the most prepared first-time parents they had ever met. I felt (almost) totally confident going in. I provided a typed copy of our birth plan to the nurses so if things didn’t go as planned, or if I couldn’t communicate my wishes for some reason, they would know what to do. I had faith the plan would be the guiding voice in my care.
The Cytotec did its job. My water broke on its own about 2.75 hours after the Cytotec dose was administered.
(Side note: The nurse had short, fat sausage fingers. We called her “Gherkin Fingers” behind her back. When she inserted the Cytotec and/or checked my cervix it felt like she was shoving her fist through my perineum. While we did go through three shift changes during my labor, I ended up with Nurse Gherkin TWICE – 24 of the 36-hour labor.)
My contractions started on their own just as planned shortly after my water broke. I didn’t want any Pitocin (to advance contractions) or pain medication. However, we had agreed (along with our midwife and doula) to a “progressive” plan, meaning we would start with Cytotec only to induce and see how it went. In the event something wasn’t working we would take the least invasive next step available- including Pitocin if needed, and all the way up to an epidural. We would avoid a c-section at all costs. It was a simple but mostly natural plan we were all comfortable with, leaving room for change along the way if needed.
(IMPORTANT NOTE: Every hospital, provider, and/or facility is different. Know what options will be presented to you ahead of time. Research those options and make your birth plan based on what your delivery facility/provider offers. There is no sense in asking for something that’s not available, or using a facility or provider who doesn’t offer what you want.)
When my contractions were not productive (I wasn’t dilating quickly enough) my midwife suggested a very small dose of Pitocin. I wasn’t thrilled with that idea but most hospitals will force a c-section if labor goes longer than 24 hours. I was aware of this and adamant that I WOULD NOT have a c-section. At 18 hours I agreed to the Pitocin. Well, all that did was make my contractions more painful, and they got really sporadic after that, but they weren’t productive and I wasn’t dilating properly. They said it was because the dose of Pitocin was too low but I don’t know if I agree, especially since I later discovered the Pitocin was increased without my knowledge. I’m not sure what others’ experience might be but Pitocin contractions hurt FAR worse than natural contractions! They were excruciating! By increasing the Pitocin without telling me I couldn’t prepare for the increased pain, which was nearly debilitating. It was so bad I couldn’t breathe at times. Had I been warned I might have been able to adjust my coping mechanisms but as it was I felt like I was just along for the ride. I think my body just wasn’t ready, or that my water broke too early. What I do know is Ol’ Gherkin Fingers was the one calling the shots while making me believe she had confided in my midwife when she hadn’t. Believe me when I tell you I spoke to the midwife about it. (#pissed)
Around 30 hours the midwife came to see me (after my doula insisted the nurse call her in) and said she would not let me have a c-section but we needed to get the baby out as I was getting too weak, my blood pressure was dropping, and I was losing too much blood. I still wasn’t dilating properly so she recommended a low-dose epidural that would allow me to move, feel pressure, and maybe a small amount of pain but would block the extra pain of a rapid, full dose of Pitocin. She said it was my best bet to avoid a c-section if we could hit it with a full dose and get me fully dilated. I agreed to the new plan reluctantly. I looked at T and my doula and said, “I just can’t do this anymore you guys.” I had endured 33 hours of labor, could barely walk to the bathroom, and could literally feel my torn ovarian ligament that plagued my entire pregnancy getting worse.
I had to argue with the nurse that she was NOT increasing the Pitocin until after the epidural had been administered. She tried to fight me on it and I told her she could call my midwife again and we could wait for her to come back before moving forward or she could hold off on the Pitocin to allow time for the epidural to be administered. She agreed to hold off. It literally took less than 30 minutes for the epidural, which was fairly easy. Take that with a grain of salt because I was a med tech for years and actually used to assist with epidurals at a neurology clinic. It might seem less traumatic for me than someone else. However, it really wasn’t bad at all, and the damn nurse didn’t even “hold” me like they’re supposed to. (I’m kind of glad actually because she was dripping sweat like a pig in a smokehouse.) I chatted with the anesthesiologist while he did it.
Once we did the epidural and increased the Pitocin I got to a “9” within an hour. I honestly think the added pain from the Pitocin without any pain medication was what stalled my dilation. Once I got the epidural and could focus on the contractions without the pain I progressed really quickly. Just as I was getting really confident and felt ready to push they came and told me to “hold it” because another mom next door was pushing and they couldn’t deliver us both at the same time. (#eyeroll) I had been in labor for 34 hours and was SO CLOSE! She had only been there five hours. Why couldn’t she hold it? A little over an hour later my midwife appeared and asked if I was ready to push. I was BEYOND ready. I had the baby out in about 30 minutes.
I knew not to expect a crying baby to slip from my vagina the way they do in the movies, but I sensed a sudden change in the room when Addy came out. A couple of the nurses held their breath so I held mine too. The room was silent. I looked down. They were clamping the cord, but I remembered my midwife telling me they practiced delayed cord clamping. Why were they clamping it? My doula had said probably 100 times that as long as the cord was attached and unclamped the baby was breathing. Why would they clamp it? Then I saw the midwife unwrap the umbilical cord from the baby’s neck. Addy was purple and not breathing, dangling limp in the midwife’s hand. I panicked. I couldn’t breathe at all. My breath was stuck in my chest, like I had swallowed a bowling ball. They told T if he wanted to cut the cord he would need to do it quickly. I watched him cut it and the whole time I was thinking “No, no, no. You can’t cut the cord! She needs the cord because she’s not breathing on her own,” but no words would come out. I couldn’t speak. My eyes went wild. I freaked out. All I could do was stare at her tiny, limp, blue body.
They swept Addy off to the warming table about eight feet away. They were rubbing and patting her hard all over her body. Maybe six people were working on her doing God knows what. One of the nurses rushed out into the hallway. I heard someone say she was looking for a doctor.
I wasn’t aware at all what was going on down between my legs. I vaguely remember pushing out the placenta and seeing it plop into a bowl. I heard my midwife say there was a small tear, then something about a blood clot, and then she said I lost 700-something of blood. I had no idea what was really going on. I wasn’t processing anything. All I could do was stare at Addy while a swarm of people in scrubs poked, patted, rubbed, and suctioned her.
In my head I was begging, “Please, Addy girl, please breathe, baby. Just breathe. Come on, Addy.” Someone told me later that I was speaking out loud. Another doctor (not the pediatrician we chose in advance) came in right as Addy started crying. I heard her saying “Oh, good. Good.” Addy’s cry was shrill, almost blood-curdling, but it was the most beautiful noise I’ve ever heard in my life. Her color started turning pink almost immediately and I felt myself take a breath for the first time in five minutes. (She literally didn’t breathe for five minutes!) I remember the midwife arguing with them about her APGAR score but I didn’t really register what was happening. They wiped the baby off a little and laid her on my chest. All I could do was cry. T was pushing my hair back off my face while he rubbed her little back and kissed my forehead. I’ve never been so scared or so relieved ever in my life. Then, I suddenly felt this very sharp pain in my vagina. I realized I could feel my midwife stitching me up. I told her I could feel it and she said, “Just one more stitch”. A quick, sharp pain and it was done.
Once the room cleared out a little the midwife explained Addy was just fine. She said they should have given her more time once she started breathing before they did her APGAR score. She encouraged me to ignore whatever score the hospital gave her because it was really not correct and not important anyway. No one ever even told me what it was. It’s been over two weeks and I haven’t looked or asked for it. Her chosen pediatrician came to our room that night and said she was perfect and there was nothing to worry about. Maybe I should care more about the numbers but I really couldn’t care less. All her vitals were perfect and the pediatrician seemed pleased. She was eating and doing all the things newborns should do, so who cares about the damn APGAR score? The baby had a bit of a cone head (which went away in about two days). There was absolutely nothing else that kept her from being 100%, absolutely perfect.
Part of me felt foolish. If I had skipped making a birth plan would her birth have gone smoother or faster? Would her APGAR score have been higher? Would she still have come out blue and not breathing? If I hadn’t asked for Cytotec would it have gone differently? If I had waited for my labor to accelerate on its own would my contractions have synced up better and allowed me to dilate completely naturally? I really didn’t want Pitocin and ended up not having a choice but to take it to force contractions because I was facing a c-section. If I had been more patient could I have avoided drugs altogether? Some women go all the way to 42 weeks. Should I have waited longer – or should I have taken Pitocin and/or the epidural sooner? Did my desire to go “as natural as possible” (but as early as possible) make my birth plan an overall failure?
I had been telling myself I wouldn’t feel guilty if I couldn’t go naturally, and that I wouldn’t let anyone tell me I did anything wrong – particularly if my baby was healthy, and she was. So, why was I letting it bother me? Well, because these nurses are supposed to be the people supporting me through and immediately following my labor and I felt more scolded than supported. They were shaming me for wanting something different from their “set in stone” method for handling childbirth. The hospital’s “business as usual”, run-of-the-mill birth plan doesn’t work for everyone and NO ONE should just have to accept it as their individual path. Every mother has options, and they should be allowed to create a birth plan which works best for them, even if that plan has to change along the way.
I wish I could say I fared as well as Addy. I lost a LOT of blood. My blood pressure dropped really low. I ended up with six stitches because I tore all the way down between my labias minor and major on the left side. One stitch popped two days after labor and was poking me in my clitoris until it fell out about 9 days after birth.(#ouch) Two weeks later I still have horrible hemorrhoids. I became severely anemic. My hemoglobin was 6.7!!! (They usually do a blood transfusion if it drops below an 8.) To avoid a transfusion my midwife prescribed weekly iron infusions. We are hoping the one I did this week is the last one. I’ll do blood-work again at my next OB appointment in May. Two weeks after birth I weigh almost 10 pounds less than I did before I got pregnant. Losing weight that quickly is not encouraged, but I just can’t keep weight on right now between caring for a newborn, breastfeeding, and trying to stick to a healthy diet for breast milk quality. It has NOT been an easy recovery for me, but Addy is doing SO great.
Personally, I don’t think our birth plan failed. We stuck to it as much as we could considering it was being sabotaged by some of the people meant to help us. I don’t think ANY birth goes exactly as planned. In fact, I would love to hear from someone whose birth went exactly the way they expected. From what I experienced I think some hospitals try to force all births to go THEIR way, unless the mother speaks up for herself, KNOWS what her options are, and enforces what she wants. Even with a birth plan I felt bullied by some of the nurses into making decisions I might not have made otherwise. I think most women go in not knowing what to expect, without a plan, and that’s the way the nurses like it so it can go the way they’re used to doing it. While I do wish it had gone differently, I don’t believe I failed at a damn thing. If we decide to do this again (that’s a big IF), I will still make a birth plan, and I will do a better job of enforcing it. I totally encourage every other mom to do the same!