by Kristi, USA

On a Thursday I went in for my 40-week check up, complete with a biophysical profile and non-stress test to check on baby’s activity. The ultrasound showed low, but within normal limits, amniotic fluid. The nurse practitioner scheduled me to come in the very next day for a follow-up ultrasound. I inquired why that would be necessary; wondering if much would change in a day. She was somewhat dismissive and said they just want to keep an eye on things.

It didn’t seem urgent, so I didn’t think much of it when I called the clinic shortly after and left a message for the NP that I wouldn’t be able to make the appointment because I didn’t have childcare for my other two children. I didn’t hear back from the clinic over the weekend and finally called them back the next Tuesday to see if I could make another appointment – now 5 days post due date. The NP jumped on the phone and said “please come to the clinic asap, we’ll squeeze you in.”

This time the ultrasound revealed less than acceptable amniotic fluid to sustain the baby for much longer – a condition they refer to as oligohydramnios. My doc made the decision to admit me to the hospital that evening, then they would begin an induction first thing in the morning. Thankfully, my mom had just flown in and literally walked through the door when I said “Mom, are you cool with watching the boys? I have to check in to the hospital to have this baby.”

At the hospital I prayed so hard to go into labor spontaneously. I didn’t want to face the contractions caused by pitocin. I had had two natural births already under my belt and I knew the use of drugs, such as pitocin, could lead down the road to multiple interventions. No such luck though. Even after doing laps of squats around the maternity wing, no spontaneous contractions were to be felt. I barely slept a wink and, like clockwork, the nurse came in at 6am to start my IV and hook up the artificial uterine-contracting drugs. I had two girlfriends volunteering their time to be my doulas. One had assisted in my second son’s water birth, and the other was an OB/Gyn resident who, miraculously, was able to switch her call rotation to attend my birth. And, of course, my husband was there to be fully supportive and keep everyone up to date on the labor progress. I was in good hands.

After just the first half hour on pitocin, the nurse said the baby had a couple of “desats” on the monitor. This was only the beginning of fanatical focus on the fetal monitor. The desats subsided after I lay on my side for a few minutes. At this time, I wasn’t feeling any contractions but they were showing up on the monitor. The nurse needed to update the doc that I had this one desat. S

he came back to me to tell me that the doc would like to insert a fetal scalp monitor to keep a closer eye on baby. I was very hesitant to do this because they would have to break my water, lightly screw a metal probe on to baby’s scalp, and I felt it would confine me more to my room because they would be able to monitor every little nuance of baby’s activity. I just wanted to be free to labor the way I knew how. I was not new to this and I wanted to just guide baby out as naturally as possible with the least amount of interventions.

I thought it was much too hasty to talk about any interventions at this point. I gave it thought and ultimately refused the fetal scalp probe at that time. Within a minute of my decision, my hospital room phone ran with my doc on the other line – I heard words like “concern”, “safe mom and baby”, “C-section”. I couldn’t believe it – she was, in my mind, completely overacting to the situation. I was fighting back tears and knew that I needed to be an advocate for myself. Her tone softened when she sensed that I was choked up. I understood fully what she was saying, but also knew that it was too soon in the game for her to be heading down the road of interventions.

I hung up the phone and labor continued; business as usual. My girlfriends had arrived and we began walking the halls. My OB friend mentioned that the pitocin dose should be increased because I was laboring too effortlessly. Soon, the dose was increased and began to pick up the contraction intensity. Every time I returned to my hospital room the nurse would put me on the monitor and have difficulty picking up a signal. I hopped in the tub – still more difficulties with the monitor. The monitor, the monitor, the monitor. The nurse could not get the monitor to work and continuously rearranged it on my belly to pick up a semblance of baby’s heartbeat. While I was contracting, her hands would be fiddling with the darn thing. At one point, I sternly moved her hands away. I was sick of her interrupting my intense concentration and zen-like state.

Not long after that, I agreed to have her place the fetal scalp monitor – thinking it would keep her out of my hair. I was now about 8cm dilated and thought it might help to have my water be broken. There were two failed attempts to insert the fetal scalp monitor. After that I just ignored everything else around me and tried to listen to the encouraging words of my sweet doulas. There was the clamoring to find a good signal, the nurse fumbling to check and recheck why the equipment was acting up. I continued to let the nurse worry about all of that and I would just keep having this baby.

I was about 7 hours into labor at this point and was intensely feeling every contraction. I fully submitted to one big contraction when I felt baby sink very low into the birth canal. I climbed into the hospital bed and my instinct was to just see what happened if I pushed. My nurse had just left the room to update my doc about my labor progress. My two doulas were left with a fully dilated, laboring multipara mama who was beginning to push. My first push was strong. My second push revealed baby’s head. I could hear my doulas whispering – at this point, my girlfriend who is an OB resident changed her position to be in a baby-catching position. My husband went to fetch the nurse. This baby was coming. One more push and baby popped his head out. The nurse came in just in the nick of time with her entourage of helpers behind her. The next push, baby was out. Killian was born 7 pounds 3 ounces, 20 inches long at 2:04p – he was perfect, perfect, perfect.

A rounding doc came in a few minutes later to assist with the placenta, stitches, etc. After Killian’s cord was cut, they tugged on the cord to release the placenta and nothing came out. This, my friends, is a very unfortunate thing referred to as a retained placenta. The doc had to manually extract the placenta with her hand. She actually placed her entire hand into my uterus and carefully pulled the placenta away from the uterine wall; an incredibly painful experience. Once the placenta was removed, all pain subsided. The doc commented on how floppy and unhealthy the placenta appeared; she was surprised that Killian was so plump and healthy despite this. This ‘aged’ placenta was likely the reason for the oligohydramnios. Killian was snuggled very tight by his dad, 2 big brothers, 2 loving doulas, and grandma until late in the evening. This birthing experience was very different from my first two, but I am incredibly grateful for a healthy mama and baby in the end.

Killian at 2