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Tatyana
By
Rick and Martiania Cobern
At 41.5 weeks, I finally got in to see my doctor to get my maternity disability forms filled out. I had expected to go into labor 8 days past my "due date’, but the week she was due I caught a really bad virus and my body shut down for a week, including the mild cramping and B-H I'd been having. I was in no way anxious about waiting an additional week, which I figured I'd need. All of my siblings came at 42 weeks. The doctor recommended a biophysical profile, so I took some time at the hospital labor and delivery floor, thanking heaven and all the angels that my plans for a home waterbirth would mean that I would escape the torture chamber I had to endure that day. The nurse was aghast that I did not have an induction scheduled even before she looked at the baby, so imagine her horror when she found out I had low amniotic fluid levels and still refused induction. I spoke with my DEM and the doctor and we agreed I should recheck the levels the next day, at a time when the original nurse-technician was unlikely to be there. I thought maybe she'd made a mistake and I don't trust ultrasound anyway, so we walked out pretty confident that tomorrow would prove more positive.
I went home and drank and drank water -- no luck. When I returned the next day the same technician measured a big reduction in levels (5.7 to 2.3). My doctor was worried and said she would induce if it was herself, but admitted that it was a tough call which path would be more risky. In the end, we checked ourselves out against medical advice, with a stern warning from the nurse that my baby could die.
My uterus did seem funny to me -- smaller and the baby inside seemed more palpable, I began to suspect that there was actually low amniotic fluid and started to try to figure out what that meant. Between me, my husband, Rick and my DEM, we made the decision to not try induction (completely unacceptable to me), labor completely at home and then meet the doctor at the hospital for the birth once I had reached 8 cm, so that the baby could be checked out immediately. Meconium was my midwife's concern and through palpation she determined that, yes, there was a low fluid level.
I spent the next two days dejected, but determined to avoid the induction we agreed would be necessary by Sunday, I relaxed, did castor oil (not nearly as bad as it sounds) and nipple stimulation. Friday night, I couldn't take the pressure anymore, so I sent my husband (who had unbounded faith in me and the baby to work things out) out with a friend after dropping me off at a dance improvisation workshop I used to go to as a teenager. I had been swimming during the early months of pregnancy, but I hadn't used my body in a really physical way the last trimester. There I was, 9 1/2 months pregnant crawling around on the floor, squatting, dancing for 2 hours. I began to feel really powerful and when the friend who drove me there proposed staying the night at our place, I knew I needed to kick him out because I would be in labor by morning.
Indeed, I started having what I later figured out were early labor contractions at about 4:00 am. They kept waking me up and I'd go back to sleep again. By 10am, I knew I needed to let my midwife know that something was happening. She came to check me out with plans of leaving, but my contractions settled into a pattern while she was there so she stayed. They were coming 3-5 minutes apart and she suspected that I was further along than I was showing, because I was in really good spirits. My mother came and cleaned the whole house during this time while I hung out with my husband and chatted with my midwife. At one point I felt like the birth pool would go to waste, so my midwife checked me and discovered I was five cm dilated, Into the pool I went and it was wonderful. It had the effect of concentrating my energies into the contractions and leaving me completely relaxed in between, i.e. the contractions were more painful but I was pain and discomfort-free in between. We talked and joked and sang along to silly German pop music, because my midwife is German and I thought she'd get a kick out of hearing all the old schlock. My husband had decided to grow a beard that he would shave off while I was in labor, so he did that while I got to the point of not being able to talk during contractions. Because he was behind me supporting me with counter pressure to my lower back, it took me a little off guard when we got out of the pool to discover he looked totally different from the man I started labor with.
My midwife wanted to check me, even though I felt like I couldn't be much further along than I was when I got in to pool. Somehow, I thought labor would be much more difficult. It turns out I was already at 8cm and the decision was made to slowly make our way over to the hospital. What a disaster! My mom had repacked all the bags and we left half of them in the midwife's car when we got there. I strolled into the ER wearing a black velvet, ankle-length gown, because the thought of putting on and pulling off pants seemed silly. On the way over, I was still joking around and acting chatty with everyone, at one point asking my midwife very pointedly about when everything was going to get difficult, because I was still in such good spirits. My contraction were like very consistent period cramps, with a beginning and end, but no obvious peak and I was once again able to chat through them after getting out of the pool. My doctor had pre-registered me at the hospital, so I was able to just walk into the room and shut the door to the world. I found out later that when I told the nurse calmly that I was pretty far along she snickered at my midwife and joked, "Well, we'll see, maybe you're 8 cm". Much to her amazement, it was assessed that I was, indeed, in transition. With newfound respect, she didn't blink much when we proceeded to, I'm sure, break protocol at every turn. I think she was pretty impressed with how well I was coping and how strong a support my mother and husband and DEM, now officially my "doula" proved.
I got in the shower which didn't really do what I needed it to do which was to focus the contractions like I'd done in the birth pool, so that I could rest in between. So I let the Jacuzzi tub fill up and I finally plopped down. The jets didn't work - the nurse admitted to not having ever seen anyone use it at all so nobody knew how to operate it - but it did the trick of letting me rest and doze between contractions. I was supposed to be on intermittent monitoring, but that plan was let go and my midwife took charge, checking me with the aqua doppler occasionally. Everything was going OK, so I was left to myself with my Rick spraying the showerhead on my lower abdomen, Eventually, I was encouraged to leave the tub to figure out why I was not developing a pushing urge. I was getting cold anyway, so I readily agreed. The doctor really wanted to check the head position to figure out what was impeding descent. Turns out the baby had turned its head to the left, squarely away from the Doppler! Before my doctor even told me which way the head was turned, I knew, because the contractions had developed a lopsidedness. She wanted to stay lying on the bed on my side but I refused and developed my own funky ducky birth dance instead. I could fell the baby's head slip every once in awhile and when I was ready I agreed to get on the toilet to see if I was feeling any pushing urges. I should mention that, after the last exam, where the doctor had found the head turned and checked on a cervical lip, (she applied arnica gel and checked it through a contraction to see if it would stretch back) I threw all my support people out and also my midwife, who had been doing all the monitoring thus far.
After getting on the toilet and finally feeling a pushing urge, I began to push for about 15 minutes. I thought about breathing the baby out and I found that the deep breathing I had been doing instinctively during the whole labor served me just as well for pushing. Each push came at the end of an exhalation. I found the toilet uncomfortable and planned to go into to the room and maybe get on the birth ball. I was extremely annoyed when the doctor asked for another internal exam to see if the head had moved. Dang it, I knew I had gotten the head to move! I told her, only under the circumstance that I could be on my hands and knees. I got on the bed in this position and my midwife, who had ventured back in while I was on the toilet, disappeared, only to return with my moter and my husband. I was happy that they were back, as I thought the 1 1/2 hours more of pushing I needed would be difficult. I had only been pushing for 20-30 minutes, and I had always read about 2-hour pushing marathons for first-time mothers. No one bothered to tell me I was crowning! I continued to push in a very controlled way for about another ten minutes, while the pediatrician was called to suction the baby, who had passed meconium. At some point, I really started to feel the head fill up the stretched opening. The nurse said, "If you reach down, you can feel tour baby's head." I turned around and joked,"Oh, I can feel the head just fine!". Then the question came, if I waited to catch the baby. After contemplating how I could possibly do that on my hands and knees, I realized they were speaking to Rick. He did catch her and she lay for a few moments wriggling on my legs (what a feeling!) He ripped off his shirt and followed her over to be suctioned I could see her well from my vantage point and was happy at how pink and LOUD she was.
I turned over to hold her and deliver the placenta. She latched on well. I was pleased to learn that I didn't tear and that the placenta was in good shape. Tatyana was a little "mature-looking", but otherwise showed no signs of problems or complications from the me conium.
Waiting and letting nature takes its course was the right decision, in this case. It was a very blessed birth! Birth time: 1/19/03 at 5:37am 8lbs,6 oz, 21 inches long.