There's an article in me that I just haven't seemed to be able to write, although I think about writing it most everyday. I don't know if it's going to come out the way I want it to. Actually I have the distinct feeling it won't. But I'm going to try.
I feel like in some ways I've gone through a transformation.
My life, or my outlook on life, hasn't really changed, but I have changed my view about something very special and important to me, and it has filled me with excitement and curiosity and passion that is so refreshing.
It's almost like there's the whole other world out there that I never knew about or never cared about, and now I am exploring it for the first time.
The crux of it is this: I am planning a natural birth.
What is a natural birth? Well, it means something different to everyone. Some consider any vaginal birth a natural birth. Others consider a birth sans epidural (but including pain medication like an IV narcotic or "gas") to be a natural birth. The most common idea of a natural birth is a vaginal birth that includes no form of pain medication whatsoever. And then there is definition that requires little to no intervention, possibly even something like an unassisted home birth. Some literature now refers to a natural birth as a "normal birth".
In the past I always thought it was pointless to refuse pain medication. It's not like you get a reward or a medal for it, right? Better to be comfortable and enjoy the experience.
So I was medicated with all three of my previous births. Birth one was an induced labor (pitocin), I received demerol, and had an epidural, along with a routine episiotomy. I received a routine IV, constant external fetal monitoring, and I labored and delivered flat on my back. I was young, bewildered, unprepared, and my only concept of birth was one where I was barely even ranked as a participant and the medical staff were in charge and would call the shots. I was not disatisfied with my birth experience, but what did I have to compare it to?
My child had difficulty latching for nursing and he was very sleepy. He was also jaundiced. Additionally, he became very ill within days of the birth. On my end, healing from the episiotomy and the tearing was very uncomfortable and a long process.
I unsuccessful in my attempts to nurse my child and received absolutely zero colostrum and absolutely zero mother's milk. He was hospitalized with a respiratory illness within a few days of birth.
I felt more prepared with baby number two. I had spontaneous rupture of membranes (after having my membranes stripped earlier in the day, that is having the amniotic sac lifted up off the cervix, potentially releasing labor-starting chemicals) and was admitted to the hospital pretty much immediately. I had an epidural, and as usual requested it as early as I was allowed to be given it. My labor was short, but I did have a routine IV and constant external fetal monitoring. I didn't have an episiotomy but did have tearing, AGAIN.
This time my baby was a healthy nurser and had no health complications.
By number three, I felt I knew all I could know about how things go down. I had few requests...I just wanted to wait a bit for the cord cutting and I wanted to nurse the baby right away. Other than that, a medically micro-managed birth was all I knew to expect. And I got it, again.
I was induced for what I thought was a great reason...my husband was about to have to go back to Iraq without having met his daughter. My body was not ready for labor, despite being 4 days post dates. I received pitocin and a routine IV. My labor progressed sloooowly, not helped along by my early requests for medication (I received a stadol and phenergen combo, presumably the phernergen was to combat potential narcotic-related nausea). I received an early epidural as well. The uber strong vanc the doctors decided to use (I am GBS positive, and treatment protocol includes a minimum of 4 hours of IV antibiotics during labor and since I am allergic to Keflex, which was then extrapolated to mean all cephalosporins, they just went straight for the big guns) caused a lot of discomfort, which they remedied with IV benadryl. IV benadryl + IV phenergen = OMG I couldn't wake up even if I wanted to.
I slept through most of that labor, which was long compared to my previous labors, simply because my body (particularly my cervix) was not ready. I had an amniotomy (amniotic sac is ruptured with an amniohook...looks like a crochet needle), after which my body progressed rapidly, going from early labor cervix dialation to complete dilation in an hour. Amniotomies augment labor by increasing pressure on the cervix. When the amniotic sac is intact, the amniotic fluid cushions the baby from the contracts (which, btw, are MUCH stronger and harder on the baby with pitocin (synthetic oxytocin) than with hormonal oxytocin, which is the natural labor hormone) and also provides a cushion between the baby's head and the cervix. With that cushion gone, the pressure of the head resting directly on the cervix often aids dilation, but the baby and especially the umbilical cord are more compressed by the contractions and there is the potential for cord prolapse if the baby has not moved down fully prior to rupture of membranes.
Aaaanyway, I dilated very quickly from that point. I was extremely groggy when I was informed that it was time to push (funny, huh, a mom having to be TOLD when it's time to push!). My epidural was particularly strong this time and my legs felt like heavy dead meat attached to me. I felt nothing in my lower half. I am a champion pusher, and despite lacking sensation, I push with all my might and get my babies out in a matter of minutes. I always thought, how good am I? See how fast I am! Little did I realize I was, along with help from the obstetric management, was the source of the tearing with every birth.
Baby was born healthy, but slightly jaundiced, and lacking the interest in nursing. I recieved my usual stitches for external tearing, but this time I had to have stitches in my cervix. Now my doctors would never tell me this, but my cervix could not have torn if I had been completely effaced and completely dilated. When the cervix is ready, it has pulled itself completely out of the way. It softens, it shortens, and then it dilates. I should not have pushed yet.
Shortly after delivery I had hemmorhaging. Massive bleeding. I had asked the nurse to check my pads (the nurses do this for you and change things out for you at first until you are up and about) because I felt wet like the pads needed to be changed. Now, postpartum bleeding is normal. It's called lochia, and it's the uterus' way of cleaning out all the fluids and padding that nourished and protected the baby during pregnancy. Hemmorhaging is not normal. It means there's a problem.
The nurse checked under my blanket and became concerned. I looked down and saw blood covering my bedding, my gown, my legs. Lots of blood. I began passing out. Suddenly there were nurses surrounding my bed, and pitocin was administered to help my uterus contract, which is needed to stop the bleeding. I was given the MAXIMUM dose of IV pitocin. I have never experienced so much pain in my entire life. It literally felt like someone was sawing through my hips with a dull blade. I bucked and I screamed and I cried. I begged for some sort of pain relief. The nurse standing by my head barked at me, "Stop crying! It doesn't hurt that much! You have to stop crying!" She was very irritated by my behavior, but I was helpless to stop it.
Eventually the pitocin was turned off, and I was given a Roxicet. I did continue to pass very large clots for days afterward. When I say large, I mean the size of the head of an infant. Nursing was not going well, although I wad determined and continued to try. My baby was jaundiced and losing weight. It is normal for an infant to lose weight after birth as fluids are lost. Extensive IV use (which I had) can cause an infant to have a very large amount of fluid at birth, which when lost and not immediately gained back (which it wouldn't be, after all, it's not actual baby weight...it's excess fluid), concerns doctors and begins the push to give the baby formula. A misunderstand about jaundice also typically preceeds call for formula supplements.
I was so fortunate to have a nurse who was pro-breastfeeding. I had a lactation consultant visit me once after delivery to tell me I could call her if I needed help, but when I requested a LC, she never came. My nurse, though, my nurse was great. She had faith in my ability to feed my child and because of her, I was able to take my baby home.
My baby and I did eventually get the hang of nursing, but it was a heart-breaking struggle over a period of a week and an experience I do not wish to repeat.
After my ordeal in the hospital post delivery, I told my husband I never wanted to go through that again. I would not have any more children, and further I never wanted my daughter to go through that. It was traumatic, and I honestly believed that I almost died.
And here I am, pregnant and planning a natural birth.
I'll tell you what changed, why I'm so excited, and what I plan and hope for in my next article.