Maia’s birth

by Diane

September 6, 2001

On Tuesday afternoon while getting ready for my 38 week midwife appointment I noticed that my shorts had become wet with clear fluid. Fairly certain it was not urine I called Evan to come home – I thought my waters had broken, and let the midwife know I would be a little late.

At the midwifes Suz seemed fairly certain it was not amniotic fluid but explained the risks of PROM (premature rupture of membranes). She did an internal exam and 3 amniotic fluid tests – the tests were positive. Evan and I were stunned to discover that we would need to have the baby very soon and that I had to go into labour within 18 hours in order to have our planned birth center birth.

During the evening and all through the night Evan and I used every trick we could find to encourage labour to start – nipple stim, long walks, castor oil: I started getting regular contractions by 10 pm and worked to visualize them as effective. I had an image of the contraction being a wave that washed over me. Every so often this image would shift uncontrollably to being a huge wave that would pick me up and hurl me under. Overwhelmed I shifted to a new image. I saw the baby glowing slightly in a sea of phosphorescent amniotic fluid. With each contraction my uterus and the baby would shift through the colours of a sunrise getting brighter as my contraction got stronger. I saw the baby moving down and pushing on my cervix – try as I might I could never get my cervix to glow and open, it stayed black and unyielding.

By 6am Weds my contractions had lessened and we returned to the birth center to see Suz. She determined I had not dilated or effaced beyond the 3cm and 30% that I had already been since 29 weeks. We decided she would strip my membranes to encourage more contractions and Evan and I were sent for a long walk and to eat. If I was not in active labour by 11am I needed to transfer to the hospital for antibiotics and pitocin.

Once again I started to get strong regular contractions but once our walk ended they again stopped. We returned to the birth center with all of our bags, me in tears and images of the birth we had worked so hard for slipping away.

At the birth center I declined another internal letting Suz and Misty know that I knew I was not any further progressed. They encouraged us to go into the labour room and I bounced on the birth ball and cried. Misty gathered up the birth ball and CD player and we headed to the hospital. Misty arranged for antibiotics but held off on the pitocin until it was clear that my contractions would not progress without help.

I was settled into a nice looking private room. I was given a mobile IV and remote monitoring belt for the fhb and contractions. Before the nurse came in Misty and I went back through our birth plan and we decided together which parts we could still follow and which ones I needed to compromise on. Aside from being in the hospital with the IV etc the only thing I gave up was an attempt at a water birth. Evan and I would still be left to labour alone unless we requested support, I could still eat and drink as I desired, I would have no exams or blood drawn unless I requested it or it was a clinical necessity, I could move, shower and walk as I desired and I was to be part of every decision even to the point of consenting to standard hospital stuff.

When we were happy with the plan our nurse was invited in to discuss it and agree to it. This was redone at each shift change and with all but one nurse Misty chose them herself.

The midwives start with a very low dose of pit and increase gradually to ensure that contractions do not get overwhelming or stress the baby. The hope was that the pit would boost start my labour then as my body took over the drug would be reduced and stopped.

Our Wednesday afternoon nurse Ann, has had a home birth and her first was a birth center transfer. She not only fully respected and supported us but also ran interference. We never had anyone in our room aside from us and a nurse or midwife. Her shift ended at 11pm but she felt that I was doing so well that she stayed to support and encourage us until 3am – suggesting positioning changes, visualization ideas etc. When the night nurse came on I was well on my way it felt like and I was feeling wonderful (in a contracting sort of way). Around 4am my contractions started to ease and I decided to labour in bed and try for some rest. Suddenly I woke up at 6am and realized my contractions had all but disappeared. The night nurse did not follow our plan that she was to tell us that she was reducing the pit because I was doing so well and when my contractions eased she never followed through on increasing it again.

I didn’t know this at the time but Misty told me later. She was very upset for me and we started again. By 11am I was in strong active labour but emotionally I was feeling like I couldn’t do it. I didn’t trust my body and felt that I was never going to progress. Around this time I also developed excruciating hip and pelvic pain. I fractured my pelvis last year and when I over do things walking and much movement becomes really tough. The only positions I could labour in and stay focused were sitting in the shower or on the birth ball. My day nurse began to get anxious about my remote monitoring unit when I was in the shower and requested that we hook up to the standard one. She also asked me to lie down to get a good reading. This change completely threw me. Labouring in bed caused me more pain than I could tolerate and I really began to give up.

At this point I asked for an internal. I needed to know I had made some progress and that the end was some where in sight. I was devastated to discover I was still only 3-4 cm and 90%. I started asking for an epidural. Everyone reminded me of my birth plan and went patiently through the risks. I was told it was my choice but that it would likely lead to a c-section. I was moved through position after position to try and ease the constant pain but nothing was working. Finally Misty told me she was breaking a birth plan agreement not to offer me any drugs and wanted to suggest I consider Stadol. She went though the risks vs. benefits and what I might expect. I really absorbed only that I might have some relief and went with it. I had to get into bed and received the shot.Immediately I got a break from the anxiety I was feeling. My contractions seemed to suddenly go from constant and back into manageable waves. Evan rubbed me and spoke softly and I think lead me through visualizations. This time they were easy. The baby seemed to communicate that she was moving do my birth canal and that it was time to push. This seemed alarming to me but I told Evan and Misty did the check. I was 9 cm! Ann was back on at this point and surprised I had not delivered. She quickly changed patients and became my nurse.

My laboour at this point became this incredible communication between the baby and I. No one spoke but simply moved me as I indicated. We played a Celtic lullaby cd and I felt the baby moving down. Misty suggested I try to push but I clearly felt the baby still moving one her own and knew it wasn’t time. Everyone simply waited.

Eventually I felt the need to push with my contractions. This proved to be really hard for me. Learning how to push effectively when I was as tired as I was and limited by my hips in what positions I could use made me feel like giving up. Misty suggested a mirror so I could focus on the baby.

I also used visualization from a kayaking trip. We were on the west coast paddling to a remote Island. A large storm came up and try as we might it was impossible to make headway. Turning back was too dangerous so we paddled as hard as we could in the gusts just to stay in place and in the lulls we tried to gain distance. The baby’s head and the island merged into one and I began to work harder than I could have imagined.

The baby was delivered into Evan’s hands (yes he caught her!) to tears and quiet. The 3 of us rested and we slowly explored the little body. Eventually I noticed she was a girl. Evan and Misty waited until the cord was completely white then clamped and cut. My placenta delivered a moment later. The 3 of us continued to cuddle and Ann gently latched her on while Misty gently sewed me up. Two hours later we decided we should inform our likely frantic families.

Ann’s shift had long since ended but she continued to stay. Her and Evan rubbed the baby a little cleaner and decided only to wash her hair. During the wash a large hematoma and additional bruising was found on her head. Both Misty and Ann advised us that the severity of the bruising warranted the vit k shot. We consented and Evan held her and soothed her while it was done. Then he weighed her and carried her back.

Ann stayed, cleaned up and kept all the nurses who wanted to poke and prod us away. She was there until we all settled to sleep and let us know that no one would bother us until the morning.