Baby #4 – Our Story of Loss

Baby #4 – Our Story of Loss

We found out we were expecting baby Parsons #4 on August 15, 2014. We were a bit surprised at the news, but just like all the other 3 babies, we were very excited. I am not the type who can keep a pregnancy secret for the first trimester. I pretty much announce it immediately. I can’t help it. This time was no different. We told the kids, and the news was out. Our expected due date was April 26, 2015. Perfect timing – only about 2 weeks of school left and we’d be snuggling a newborn all summer. Just relaxing, a slow time for me work-wise anyway, no buses to catch each morning – it was going to be perfect.

I called and got an appointment with the midwife group I used with J, and they told me to plan on coming in for my first appointment at 12 weeks. In the meantime, I settled into bouts of nausea and being tired, all typical first trimester symptoms. I wanted to make sure the date I had figured matched up with an ultrasound, so I scheduled a really quick dating scan at 8 weeks. All looked good. Strong heartbeat, viable pregnancy.

Our first appointment with the midwives fell over Fall Break, and so the entire family got to attend. My labs were drawn, we chatted about my medical history, all the routine first appointment stuff. My history in regards to pregnancy is one most women would love to have. Three pregnancies, all easy, uncomplicated, and the same with the births. No miscarriages, babies all full term, no NICU stays, literally nothing out of the ordinary. Growing and birthing babies is one thing my body does very well. The last thing we tried to do at that initial appointment was detect a heartbeat. We were having a hard time finding it, but that isn’t really unusual that early on. Sometimes the baby is still so small, it’s hard to hear. With a history like mine, and an ultrasound from a few weeks prior verifying a viable pregnancy, you just don’t worry. We’ll definitely catch it next time. See you in 4 weeks. A few days later, my lab results came back – nothing out of the ordinary. Everything looked great. And so life went on…..

 

My next appointment was November 11, 2014, and I was 16 weeks pregnant. I hadn’t felt movement yet, but I knew it was coming. Soon. By around 17-18 weeks, I would definitely be feeling flutters. I happened to decide to call my friend Y to see if she wanted to meet me for the appointment and have lunch afterwards. She was at J’s birth with the same midwife group, and I thought she’d like to see their new location. She agreed, and met me there at 10 am. I had J with me too, and we all filed into the room for our appointment. J played with toys on the floor, and I had Y video the part where we’d get to hear the heartbeat. A and L had been upset that they hadn’t gotten to hear it last time, and I wouldn’t let them skip school today. The midwife’s assistant put the Doppler on my belly and tried to get the heartbeat. She’s very good at what she does, and she still couldn’t hear it. So the primary midwife tried. She couldn’t hear it either and suggested we get an ultrasound that day. Even though they didn’t really let on, I knew this meant there might be a problem. Midwives don’t usually order non-routine ultrasounds, and especially not insisting it be the same day. Not unless there was something wrong.

But in my mind, I just couldn’t go there. Just couldn’t. I told myself there was a sensible explanation. It would all be fine. I always have healthy babies. Always.

So my friend, J, and I all three had lunch and did a little light shopping while we waited until 3:30 pm for the ultrasound appointment. I tried to keep my mind busy. I wondered if we’d be able to tell the sex of the baby today. We had planned to do an ultrasound at 19-20 weeks and do a big gender reveal in conjunction with J’s birthday party. We already had that printed on his birthday invitations. Now I wondered if I found out today, if I could keep it a secret that long.

The ultrasound tech wasn’t as good at keeping her concerns off her face as the midwives had been. She quickly set up her equipment, typed in my information, and put the jelly on my abdomen. As soon as the picture showed up on the screen, I knew something was wrong. The baby should be much, much bigger than that. It was still just a tiny, tiny, oval with an indention at the neck so you could tell the difference in the torso and head. There was no heartbeat. No movement. Just a small, gestational sac with a tiny, perfect baby lying horizontally at the bottom. The ultrasound tech was short, but professional. She wished me condolences and asked if I wanted a picture. I said I guess I did. I was able to hold it together long enough to pay her and get outside. Then I really lost it. I’m so glad Y was there with me. I cried on her shoulder in shock. How was this really happening? The baby measured 9 weeks, 5 days. That meant, I guess, that it had been almost 7 weeks since the baby had died. I had no physical symptoms. Zero. No cramping, no bleeding. And I wasn’t crazy – the ultrasound confirmed it. Everything was still there, my body was taking care of it just like it should – except the baby wasn’t alive anymore.

I was in tears as I called to tell my husband. How do you make a call like that? What words should you say? How do you tell your husband that the baby you’d been planning about, talking about, debating on names for – isn’t coming? I managed to get out the words, “there was no heartbeat”, and he left work immediately to meet me back at the midwife’s office. I had to call my mom too, and mother in law and squeak out those words again, between sobs.

I didn’t get out of the car at the midwife’s office until my husband arrived, about 10 minutes after we did. Y went ahead and left, so we could talk with the midwife privately about what our options were. As soon as I walked in, she ushered us to a private room. She hugged me and let me know it was ok to just let it out. She even made me some herbal tea to sip on while we talked.

She spoke softly and was supportive of whatever it is we decided to do. We could choose to do nothing, and let nature take its course. But we really didn’t know how long that would be. It could be as soon as a few days, or it could be a few weeks, or a month….the ultrasound tech hadn’t indicated any separation of the placenta (albeit very small) from the sac though, so we couldn’t really be confident that it would be in the next few days. I hadn’t had any cramping or anything, so we really assumed it would be a bit longer than that. Or, we could induce the process with medication. Without going into too much detail, that didn’t sound too pleasant. Or, we could go the surgical route and opt for a D&C (dilation and curettage). That could happen in the next day or two, but would mean outpatient surgery, general anesthesia, and the bills that come with that. We went home to discuss it. The midwives were great to suggest we not decide on anything until the next day. We had planned a trip to Colorado for the week of Thanksgiving, leaving on November 23 and returning November 28. That was 11 days away. I really didn’t want to let things happen on their own, and have it happen during the trip. But looking at the calendar, I knew that was probably likely. I knew the kids would be upset at this news, but I also wanted them to be able to enjoy their upcoming big vacation, as well as the rest of the Christmas holiday season. I knew I couldn’t be 100% mom to them if I was walking around wondering if today would be the day. That would be a tough burden to bear. Plus, it had already been 7 weeks. Most miscarriages, though not all, happen by then. Usually by 4, or at least 6 weeks. The next day, we called the midwife and she contacted an OB and scheduled our D&C for the next day.

I spend most of Wednesday, the day after we found out, just crying. I stayed in my pajamas, drank herbal tea, and just bawled all day. I would have times of feeling a bit better, and I would try to rest. But every time I closed my eyes, I saw the ultrasound picture. I was an emotional wreck. I had planned to go on a field trip with Livi that day, but I couldn’t stand to be around anyone. I just wanted to stay home.

The next morning, we headed out to OKC to the hospital. We did the pre-op check in, and my mom met us there. Everyone there was great. They kept saying, “we’re going to take really good care of you.” The only annoying one was a poor guy who meant well but clearly didn’t know what a D&C was or why most women have them.
“When was your last period?”
“July 17th
“And you’re here for…a D&C?”
“Yes”
“Do they know why you haven’t had a period since July?”
“Because I was pregnant, and I have lost the baby, and that’s why I’m having the surgery.”
Crickets……

It was hard to say that out loud. I had already hired a doula for the birth, and I had contacted her Tuesday, as soon as we found out about the loss. She actually called while I was in the parking lot of the midwives office and talked to me while I waited for my husband. She was able to come meet me at the hospital too, while we were waiting to go in for surgery. She is such a calming presence. I was glad she was there. She brought me a teddy bear to take into surgery with me, “so I wouldn’t leave that room empty handed.” I cried and thanked her, and I took that bear right into the OR with me. I don’t know that they did with it when I was under anesthesia, but it was right on my chest when I woke up in recovery. Now that bear sits next to that last ultrasound picture we got, and a canvas a friend sent that reads, “Heaven holds me.”

After the surgery, the recovery was really quite easy. I was told to take it easy for 2 weeks, and I did. I spent some of that time on vacation in the beautiful mountains of Colorado. I drank hot tea and got a massage, and played with the kids in the snow. It was great.

My doula and midwife team made sure to emphasize to me that it was important to process through all this. Not to “be ok” too soon, when I wasn’t really ok. I took their advice. I let people know what was going on, instead of hiding it. I received so much love and support – from facebook comments, message, texts, calls, flowers – it was so heartwarming to know so many people cared about us and our heartaches. I make the display for the kitchen of the bear, picture, and canvas, and then I used the only other ultrasound picture I had to make an ornament for our Christmas tree. I really think our ornaments tell a story, and this baby is forever a part of that story.

I wasn’t sure how to make the dates on the ornament. Date of conception? Date we found out the baby was coming? Date we assumed the baby died? Date we found out? Due date? How do you make a memorial to a baby you haven’t really met, but you carried in your own body? I decided on putting the date we found out we were pregnant to the date we found out of the loss. I know there were 7 weeks in there that the baby was gone – but in my mind, the baby was still there during that time. The date that will be hard to get through every year will be that one – Nov. 11th. I also ordered myself a necklace to wear in remembrance. It’s beautiful. I don’t need to wear it everyday, but sometimes. On the hard days.

I recovered easily physically from the surgery, and just had to wait it out to see when my regular cycles would start again. Everyone is different. Some women take a few weeks, others 6 weeks, others a few months or more. I joked around with some people that all I wanted for Christmas was my period – not very many have that on their Christmas list, right? Ha! Anyway, I ended up waking up to find my wish came a day early, on Christmas Eve, which for me was 5 weeks and 6 days after my procedure.

I struggled with whether I should post this on my Arbuckle Birth website or not, but I think it’s important to share. So many women have suffered loss, but most of them don’t talk about it. Maybe it’s not proper, but I suppose if you don’t want to read about it, you can just not read this. Some women need to read it. They need to know they aren’t alone. They need to know that miscarriage can happen to anyone. It isn’t your fault. You didn’t do anything to cause it. We all wonder that, even me. I teach childbirth classes, and I know a LOT about birth. But going through this, I wasn’t a “birth instructor” I was a mom. Just like all the other moms, I wondered – was it something I ate? Or drank? Or breathed? The answer is most likely “no”. I still have the video that Y took at the fateful appointment, when the midwives couldn’t get the heartbeat. I can’t really stand to watch it. But I can’t delete it either.

One in four pregnancies end in loss. Every October is Miscarriage and Infant Loss Awareness Month, which didn’t mean near as much to me this past October as it will this next year. If you experience loss, know you aren’t alone. Reach out, ask for support, and take the time you need to process through it all. I had chosen an amazing birth team, and even though this wasn’t how I had planned on using them, they were nothing but 100% supportive and caring of me as I walked this difficult road. I rely on my faith to help me through times like this. I don’t know how I would deal with it any other way. I know that God will work out things like this for good in the end.  I just don’t know how that will all work out yet.  But it will. He will.

Miscarriage and Infant Loss Resources:
Mend.org
An Empty Cradle, A Full Heart: Reflections for Mothers and Fathers after Miscarriage, Stillbirth, or Infant Death by Christine Lafser

J’s Birth Story – Baby #3

When we decided to try for Baby #3, I knew from experience we would probably get pregnant quickly. I got a book that taught me how to try to swing the odds in our favor for getting a boy this time. (Just to be clear, we wanted a third no matter what, and would be perfectly happy with either gender – but I will admit to a part of me wanting to be football and karate mom. We live in a red state. That means boy.) In order for that to happen, you have to very meticulously track your cycle, learn your ovulation patterns, etc. Needless to say, we managed one month of that, and on month two of me trying not to get pregnant and just learn my cycle – we were pregnant. I actually found out the day AFTER my 30th birthday party. I immediately made contact with midwives about an hour away who offer both home births or birthing at their center. Because my dates weren’t quite matching up, they had me to an ultrasound to approximately date the pregnancy. I found out the first week of April I was about 6 weeks along. Estimated due date? Thanksgiving. November 24, 2011. I immediately noticed nausea much worse than with the other two pregnancies. My mother in law was ecstatic about that. She was sure that meant it was a boy. (Turns out, she was right.) I had a relatively uneventful pregnancy, which is good news. I hired the same doula I used with my second baby, and promised her we would not be birthing at the same place L was born. She agreed. I was glad, we worked well together there and knew we would again this time.

Fast forward to the end of the pregnancy. Those last weeks seem to take forever, and there is excitement and anxiety not knowing when labor is going to start. Week 38 passed. Week 39 passed. I was due on Thanksgiving, and the family was headed almost 2 hours away, so we sent the kids with them and my husband and I watched the new Twilight movie. Renesme’s birth did not implore J to come, and a few more days passed. I enjoyed seeing people holiday shopping at Target and them asking me, “When are you due?” and replying, “4 days ago.” They get a freaked out look on their face like you might have the baby right then and there. Good times.

My midwife scheduled me for a biophysical profile at 40 weeks & 5 days, which is basically just a very thorough ultrasound. The tech checks in particular for the health of the placenta. Mine was great, no need for concern. That was a Tuesday, the ultrasound in the morning and my midwife appointment in the afternoon. She stripped my membranes (with my approval) at that point, but nothing happened that evening. (I had been having mild, Braxton-Hicks contractions off and on for quite a while, but nothing any stronger than that.) The next day, I went back to Norman and met my doula for some afternoon walking (after a much needed pedicure), and contracts started to pick up. I felt like I should stay nearby, and decided I would call my husband to come meet me and we’d get a hotel. My friend met me there, and my contractions became much more regular quickly. I asked her to drive me back to the birth center, and called my husband to meet us there instead. My doula and midwife arrived, and we called our mothers. We should have waited on that. I got ahead of myself, thinking since my contractions were coming 2.5 minutes apart, that we’d be having the baby soon. Well, they kind of stalled out. We hung out talking in the lobby until late, and I was disappointed thinking maybe I got everyone excited for no reason. I felt like a watched pot, and now no water was boiling. I was very frustrated. I convinced my mom to take our daughters to the hotel to sleep. My mother in law and friend hung out in the lobby with my husband and doula while I slept. Then I woke up. Some cervical change, but not as fast as I expected. My midwife and her assistant were great to keep encouraging me. They kept reminding me that these things take time, and I was progressing. They were happy with my progress. I needed rest, and food. (What a change from the hospital, huh?! The midwives were encouraging me to eat if I felt like it.) After sleeping a while, I woke up at 6 am. The midwife said she still believed I was in early labor, and need to get up and around a bit. She suggested I shower, eat, and walk around – but not go as far as the hour to my home. I got up and took a shower, and had a pretty strong contraction. Hmm. As I got dried off and was putting on my clothes, another one. I was hungry, (big shocker if you have read my other two birth stories, right?) so my friend and I went down the street to Starbucks, for oatmeal and coffee. It was less than 3 blocks away, and I had another one in the car. And another one while I ordered. I turned my face away and tried to conceal from the barista that I was in labor – because who wants a freaked out barista making their coffee? Not me, or anyone else there either. Breathe. We went back to the center, and I told the midwife I wouldn’t be needing to go anywhere. These are the kind of contractions that get babies out. I ate all the oatmeal, but didn’t take but a few sips of my coffee. Your body knows what it needs, and it didn’t need that. I drank water. The contractions that had started around 6 am got gradually closer together for over 3.5 hours. I walked around the center, made deep guttural moans, and swayed on a birth ball. I even handled some contractions leaning over one particular chair. My doula was right by my side, talking me through them. My husband was watching us, staying out of the way but being supportive. We women had our thing going. He was careful not to disturb it. (One thing that’s funny about this birth is that I had found a contraction timer app and downloaded it, which we used to time the contractions. See, I do use some technology at my birth!) I had made it to an 8, and I still had my bag of waters intact. The midwife felt like if the bag broke, we’d be ready to push. Apparently, I had a bag of steel, because through several contractions I tried different squats thinking maybe that would help it break. It didn’t, and I didn’t like squatting during contractions. A little later, I asked the midwife to go ahead and break my water. Contractions were very close at that point, and I knew it was almost time. As soon as she broke my water, I felt the baby’s head move down. Time to push. A couple of contractions occurred while getting situated. I felt like staying vertical, and I ended up on the bed, on my knees, facing the wall. I sort of leaned over and braced my hands on the headboard. Only a couple pushes later, and the midwife asked me to hang on a minute. Baby was crowning. I couldn’t wait too long. I didn’t know why she asked me to, and I counted slowly to 5. Then I had to push again. With that one, J was born! Little did I know at that time, but he was presenting with his hand at his face, and she was trying to release his arm to help me out. With that final push, he actually did a flip and she made an amazing catch! (We were on the bed, so he would have had a soft landing regardless, but she got him!) They helped me turn around and handed him straight to me. I will admit to screaming some during the pushing stage. Yep, I am a little loud, but you always know we are about done! I think my entire pushing stage was 5 minutes long, and less than 9 minutes passed from the breaking of my water to his birth. He was born at exactly 41 weeks, at around 10 am. My mom had arrived with the girls, and they came in to meet their baby brother. He latched on quickly and has been the best nurser of all the kids. I had a shower soon afterwards, and by 3:30 pm we were on our way to the hotel to spend the night. We wanted to stay close, so that J could be seen by the pediatrician the next morning. As soon as that appointment was over, we headed home!

I felt so much more empowered about this birth than I had baby #2. I had more support, including a care provider that understood what was important to me. I waited it out, and the natural birth I wanted was completely worth the wait!

One interesting thing we did with this birth that we didn’t know about with the other two was encapsulate the placenta. Within a few days of the birth, I had over 100 ‘happy pills’ to help promote milk production and level out that hormone drop that occurs a few days after birth. I know it sounds bizarre, and I don’t think ingesting the placenta any other way is something I could do – but put it in a capsule and it’s no different than any other supplement in the way it tastes. When I first told my husband I wanted to do it, he was a little put off. After seeing the difference it made for me postpartum, now he talks it up to other dads!

I Hate Knockoffs

I hate knockoffs. Ok, not all of them, but most of the time. (At any given time, you can usually find Frosted Mini Spooners in our cabinet. I honestly can’t tell the difference.) But I usually can. I don’t drink a lot of soda, but when I do – you can bet it’s the real thing. No diet, sucralose, aspartame, fake sweetener for me. People have told me I could get used to it. Why in the world why I want to get used to it? It tastes awful. In fact, my favorite soda is a once in a while treat of buying the Coke with real sugar, imported from Mexico. Aaahh.

I am the same way about other things too. I love Coach purses. I haven’t ever coughed up the money to own one, but I also refuse to carry a fake one. I bought my Ergo baby carrier from a local official retailer, in order to make sure I got a real one. I have a mild addiction to Etsy because I love real, authentic, and especially handmade items. There is something to be said for something that someone took their time, talent, and effort to make. Most of the times in my life when I have gone the ‘knockoff’ route, I have been disappointed.

For me, birth is no different. Guess what? Pitocin isn’t the same as oxytocin. It’s a synthetic version. I can attest to this from personal experience. If you read my birth stories, you will see that I caved to an induction with Baby #2. (It’s a pretty funny birth story, you should read it.) Anyway, I had experienced natural contractions with my first baby, and Pit contractions with my second baby. No question. The Pitocin contractions were much more difficult to handle. My body literally didn’t know how to deal with this intruder. Most women will go ahead with an epidural once the Pit starts flowing. I can understand why.

This article from about.com talks about 5 specific ways Pitocin differs from oxytocin. Here are the bullet points from the article:

Pitocin is released differently.
Oxytocin is released into your body in a pulsing action. It comes intermittently to allow your body a break. Pitocin is given in an IV in a continuous manner. This can cause contractions to be longer and stronger than your baby or placenta can handle, depriving your baby of oxygen.

Pitocin prevents your body from offering endorphins.
When you are in labor naturally, your body responds to the contractions and oxytocin with the release of endorphins, a morphine like substance that helps prevent and counteract pain. When you receive Pitocin, your body does not know to release the endorphins, despite the fact that you are in pain.

Pitocin isn’t as effective at dilating the cervix.
When the baby releases oxytocin it works really well on the uterine muscle, causing the cervix to dilate. Pitocin works much more slowly and with less effect, meaning it takes more Pitocin to work.

Pitocin lacks a peak at birth.
In natural labor, the body provides a spike in oxytocin at the birth, stimulating the fetal ejection reflex, allowing for a faster and easier birth. Pitocin is regulated by a pump and not able to offer this boost at the end.

Pitocin can interfere with bonding.
When the body releases oxytocin, also known as the love hormone, it promotes bonding with the baby after birth. Pitocin interferes with the internal release of oxytocin, which can disturb the bonding process.

 

How many of the pregnant moms out there got this information from their care provider, particularly one who is pushing use of Pit? My guess would be very few. The OB I dealt with during L’s birth didn’t tell me any of that. Face it, as much as we’d like to think that our level of technology is to a point that we can “man-make” anything as good as nature – we can’t. Babies can survive on formula, and formula certainly has its place. But formula companies strive to make their product as close as they can to the standard nature sets, human breast milk.

Our bodies know more about birth than our logical brains do. (A good reason to take Birth Boot Camp? To teach your brain what your body already knows.) Our body knows what hormones to create, when to release them, when to back off. Oxytocin is one of those hormones. It’s one of those real, authentic, products that your body took time and effort to make just for your birth. Nature has had hundreds of generations to get it right. Most of time, nature does a fine job on its own, if just leave it alone.

L’s Birth Story – Baby #2

Be warned – this is the birth I am bitter about. Yes, still to this day, I get straight up angry when I think about it. Angry with my care provider and angry with myself too. For anyone who thinks that ‘the way the baby gets here doesn’t matter, so long as it’s healthy’ should talk to a mom like me (or one with a much worse story), and see if she thinks it matters. It does.

So with one natural birth under my belt and a 13 month old, we decided to try for #2. Once again, within a month we were pregnant. By this time, we had moved, and the midwife I used with Baby A was no longer catching babies. (I was so sad about that – I really would have probably driven 3 hours to see her!) Anyway, I had to find a new care provider. I knew I wanted a midwife, and I knew that there was a chance this baby could come pretty quickly – Baby A did. I was excited to find out that a hospital only 40 minutes away used midwives to attend the low risk mothers. I decided that would be perfect! Little did I know at the time that all midwives are not created equal. Some are much more medical minded. These would fall into that category. But they put on a good front, and I was duped.

I told them right up front that I would be delivering naturally, declining an epidural and induction. They said they were fully supportive of that (they weren’t but they said they were.) At my first appointment, they asked if I’d like to have an ultrasound – not because I needed one necessarily, but because they like to do them to confirm the estimated due date (EDD), and they weren’t too busy in the office. I agreed, which I now regret. (I will preface this by saying very early ultrasounds are typically very accurate, and the accuracy level drops significantly as baby grows. Early ultrasounds can be useful and appropriate at times, but in this instance it really wasn’t needed.) The midwife did the ultrasound, and said she saw 2 sacs. At that point, only one had a detectable heartbeat, but at this early stage the second one could be viable but the ultrasound could miss picking it up. I’d have to come back in 3 weeks, at which time another ultrasound would be done to determine if there were in fact one or two viable babies. Talk about a LONG 3 weeks. I told my mom, and she was ready to make plans to put a camper in the yard to help out with the twins. Finally, after 21 long days of wondering, we had the second ultrasound done, only to find we had one sac, one baby, one heartbeat. The other sac was no longer there, which is typical. Whew. Dodged that bullet! I wasn’t sure if I could handle twins!

The rest of the pregnancy went relatively smoothly. I saw three different midwives there, who rotated shifts. You never know who will be working when you are in labor, so it’s good to meet them all. Everything was going well until my 37 week appointment, at which time my midwife asked if I’d like to be induced. I told her no, and she reminded me that if I changed my mind I would need to call and get on the schedule.

The next week, I was offered again, and declined. I felt like they were trying to talk me into it, and it bothered me a little. Then again, at 39 weeks. No thank you. I will go into labor at some point. Now keep in mind, I went into labor with Baby A at 38 weeks and 1 day. I honestly assumed I just cook babies quickly, so surely this one would be early too. By 39 weeks I was getting impatient, but stayed strong. My next appointment was on my due date. Still no steady contractions. At that appointment, my midwife did a procedure called ‘stripping membranes’, which I agreed to have her do. It involves her separating the amniotic sac from the uterus slightly, in a circular motion. For some women, it will get labor going, for some it doesn’t do a thing. I was the latter. Nothing happened.

Here’s where I start getting upset. At this point, the midwife starts getting antsy. She started acting like I was some kind of leper for wanting to let things alone and wait for labor. She insisted that I come in 2 days later for a non-stress test (NST). There was no medical reason why one should be done, but she seemed to be worried. I was trying to be complacent so I went. I passed, all was fine. But wait, now I need to come back in 2 more days for another one. What?! Ugh! A NST involves me having to sit with an electronic monitor on so it can attempt to measure the baby’s movements and heart rate. I went. I sat. Baby was fine. My poor doula. I had hired a doula, who was also an RN (not at this hospital). She went with me to one of those NST appointments. We walked together to try to see if labor would get going, but no contractions were steady. I was told by my midwife that I just couldn’t go to 41 weeks. (I knew at the time that it really wasn’t a big deal, but she was stressing out big time about it.) When you start playing the ‘what if’ card with a mom who is now pregnant 3 weeks longer than she was the first time, sometimes she caves. I did. Emotionally, I was ready to meet this baby and was exhausted with the waiting. If I had a supportive care provider, I could have been encouraged to let nature take it’s course. But no, instead, she was gravely persuading me to agree to an induction.

I was very conflicted. I was tired of being pregnant and was disappointed that contractions would start and stop, never staying regular. But inside, I knew that my body had worked just fine before. I knew it would again. But the constant badgering from the midwife caused me to come to the table with an offer. I would agree to the induction, if it would be done as naturally as possible. I really felt like if my water broke, that hormones would kick in an labor would start. (This was a very bad idea. I cover risks of amniotomy in my Birth Boot Camp class. In hindsight, I would NOT have done this again. But this is the story of what I did, so here goes.) I agreed to show up on my 40 weeks and 6 days date, if the midwife would agree to break my water and leave me be. I wanted to walk the halls and see if labor would get going. She agreed.

The night before, I was nervous. I knew it didn’t feel right, and I even called my former midwife (I still had her number) and cried to her for advice. She assured me that no induction police were coming to drag me to the hospital in the morning, and it was still up to me. She felt like, given my ‘stats’, I would probably respond to an induction and get a vaginal birth, but that if I didn’t want to go, I should stay home. That’s what I should have done. But I didn’t. I went.

I arrived at 6:30 am, as scheduled. I was so well hydrated I could pee clear water. I didn’t want an IV, and I somehow (miraculously) convinced the night nurse getting ready to head home to just hook me up with a ‘piggyback’ instead. This way, if an IV was needed, the needle was set, but nothing was hooked up. I wanted free movement to walk around. So, we waited….and waited, and waited….finally, around 8 am, the midwife arrived to discuss our plans. She left and would be back to break my water (an amniotomy). However, she didn’t come back alone. She came back with her boss, the doctor. I had never met him, because he only sees the high risk moms. The midwife looked scared. Great. He swaggered in and proceeded to talk to me like I was stupid. He said as part of my induction, I would be getting ‘medicine’ along with the amniotomy. I told him that no, I wouldn’t be getting any Pitocin (yes, Doc, I know the big word.) He argued that I shouldn’t be here if I didn’t want to follow induction procedures. I told him I was only here because the midwife pressured me to be here. I explained I had a natural birth previously, and I thought my labor would pick up fine after the amniotomy. He sneered tried to explain that these things take a while, and basically said he didn’t want an emergency after 5 pm. You know, for my sake. He’d have to come back and that could take a while. I really should make sure my emergency takes place before he heads home. I was furious. He told me he’d give me until noon, but at that point I may have to have Pitocin if contractions weren’t coming.

He left, and the midwife and nurses knew I was livid. They performed the amniotomy and I started making laps around the hospital. I kept having to come back every 20 minutes to be hooked up to the electronic monitor to check for contractions. (Hmmm. Maybe we could just ask the me if I’m having any? Hello!?) That is how it went from 9 am to 12 noon. Me, my husband, and my doula….walking, getting monitored, walking, getting monitored. I was sneaking food I brought in during monitoring sessions, and the nurse was getting mad at me. I brought granola, yogurt, and grapes. Not a T Bone. Chill out, lady. (Yes, I am planning to be a giant pain in the butt today. Smile.)

At noon, the midwife came in a softly murmured that the doctor wanted me on Pit. Contractions weren’t coming as long and often as he’d like. I agreed to a very small amount. Remember, my doula was also an RN. I asked her to check and make sure it really was a small amount. It was. It wasn’t long after that, the contractions started. Not too bad at first. Then after 40-45 minutes, they started getting much stronger. The stupid electronic monitor wasn’t picking them up, so I’d have to have my doula squeeze the belt when I told her one was starting and stopping. The midwife came in after the Pit had been on for an hour. She watched me have a contraction and looked at the paper. She was going to turn the Pit up a little. Um, no. Turn it off. She was reluctant, but I told her to turn it OFF. She did, and for the next 2.5 hours, I had the worst labor ever. It was awful. Pit with no epidural. The contractions were much more difficult to handle than the ones I experienced with my first baby. My body was all out of sorts. I was sweating, then would be cold. I was standing up, rotating my hips in kind of a dance with my husband, then leaning over the birth ball. At one point, I felt like my entire body was on fire. My head started feeling like it was spinning and my ears starting ringing. I felt very close to passing out. I put my fingers in my ears, and my doula noticed immediately. She asked, “Are your ears ringing?” I said yes, and she ran out into the hall and had someone find a fan. We plugged it in and she held my hair, talked with me in front of the fan until my faint feeling passed. I was struggling not to faint, because I knew without a doubt I would be immediately wheeled in for a C section. The deck was stacked against me, the doctor’s attitude told me he wanted me to fail. I would NOT let him win. After the faint feeling passed, labor continued and I told the doula I was feeling like it was time to push. The doula told the midwife, and she took her sweet time coming in to check me. (From the point of Pit on, I was hooked to an IV and dealing with all of that mess anytime I moved. It was frustrating.) At the point of pushing, the midwife, nurses, my husband, and doula were all in the room. In terms of other people, I know I really wasn’t pushing all that long, but it felt like it was taking forever. My back was hurting (had been the entire labor), and I was doing my best to be as upright as I could in the hospital bed (I had it inclined almost all the way and was kind of sitting/squatting.) I noticed the midwife say my baby was bald, so I knew she must be close to crowning. Push…push…push….I started noticing the midwife and staff getting looks on their faces that wasn’t too comforting. One nurse told me to be quiet and not to scream. (Really?!) Finally, the midwife makes the realization that my baby is ‘sunny side up’, or posterior. (Not breech – head down but when the baby is presenting face up instead of face down.) What that basically means is that the baby doesn’t rotate or move as easily through the birth canal, which means much more work for mom. Finally, after what was realistically probably more like 25-30 minutes of pushing that felt like forever, Baby L was born! I had done it! I was exhausted, sore, and the labor was awful, but I did it! With the deck stacked against me, I did it! My daughter was here.

Literally, as L was still on me, and we were being cleaned up (I don’t even think I had delivered the placenta yet), guess who came to visit? Yes, The Good Doctor. His exact words? “Guess you didn’t need that C-section after all.” Yes. I kid you not, that is what he said to me. It was all I could do not to get up and punch him in the face. JERK! What a way to try to ruin the bonding moment we were having. The midwife wasn’t too keen on waiting for the placenta to detach on its own, and literally began tugging on it. It hurt so much – not like it should have been done. Afterwards, she ended up giving me a Pitocin shot to control the bleeding. “You’re a bleeder”, she told me. Really? You don’t think you playing tug of war with that cord might have something to do with that? I am fortunate I didn’t end up with a life threatening complication of having a retained placenta from the way she did it. At one point very soon after L was born, the nurse tried to take her away for her bath, etc. I ignored her. My husband sternly said, “Leave that baby with her mama.” She left.

L nursed soon, and I couldn’t wait to get out of there. Unfortunately, protocol is to wait 24 hours after baby is born. I hated it in there. The one positive I can say is that they do ‘rooming-in’, which means the baby stays with you instead of taking them to the nursery. However, at that time, the rooms were not private and I was sharing with another mom. I think between me, Baby L, the other mom, and her baby, we had 3-4 different nurses in and out all during the night. Hospital rules said no one could stay in the room with us. Not even our husbands. I had done this before, so I sent my husband home per the rules, but this other first time mom was having a really hard time. Her baby was having its blood sugar checked before and after every feeding, and nursing was a struggle. I told the nurse that it was fine with me if her husband stayed – he didn’t need to leave her alone on my account. She promptly let me know that “it wasn’t up to me” and sent him to the waiting area. This was in 2008. I mean, really?

Anyway, we were bothered all night long with something, and I was chastised for asking for an extra pillow, “this isn’t a hotel, you know.” Yes, I know. Clearly. We finally got discharged around 4 pm the following day. I was counting the minutes to getting the heck out of there.

Needless to say, looking back, I wish I had been stronger. I wish I had been more adamant about this being MY birth. I shouldn’t have allowed myself to be pushed around or pressured into things. My biggest mistake was hiring the wrong care provider. I should have seen the red flags. I was duped. And I don’t like feeling stupid. I was very upset about how the entire thing happened, and I know I narrowly avoided getting a C section. You shouldn’t feel like you are going into war when you’re in labor. You should have supportive people with you. Without my husband and doula, I don’t know what I would have done. They were the two supportive voices all day long.

I wouldn’t call it severe, but I did have some postpartum depression after this birth. Is it any wonder? I had a hard time letting those feelings go; feelings of defeat, struggle, being duped, and feeling like I should have known better. All of that combined with lack of sleep and adding a newborn to the mix with a 22 month old makes for a cocktail of tears. I would say it took a good 2.5 months before I felt like myself again. I think all moms need someone to be looking out for them, especially with PPD. Let the mom tell you about her birth – her feelings about it do affect her ability to bond, care for the baby, and cope with the stresses newborns can bring.

Once I was past the PPD “baby blues”, I promised myself I would not have the same situation again. I had learned a significant lesson, and I can speak to others now from the experience I had. It wasn’t until Baby L was 2.5 that we decided to try for #3……

A’s Birth Story

You might think someone who is a childbirth educator would only have amazing, wonderful birth experiences to tell about. Well, not so much. Many of us got interested in natural birth because of some of our birth experiences. Here is the story of my first birth, Baby A, whose birth was wonderful but the getting there was rough!

I found out I was pregnant in February of 2006. I had just finished college a few months before, and my husband was graduating soon. We were very excited! I wasn’t sure how long it would take to conceive, and to our surprise, we were pregnant the first month. I wasn’t sure who to choose for my prenatal care, so I had my husband ask around at work. I got the name of an OB from several women who give him rave reviews. (Much after the fact, I found out all these women had C-sections. That would have been good to know, but I didn’t think to ask.) This was great, right? All these women love him, it’s good enough for me. I could only hope to be accepted as a patient! Well, Doctor Wonderful did accept me as a patient, and I excitedly awaited my first appointment. While there, I noticed I was one of countless women being herded into the waiting area. This guy and his partners must be SO popular, thank goodness they took me. They must be popular for a reason! My name was finally called, and I was taken back to an exam room where a nurse took my vitals. Dr. Wonderful swooped in for literally maybe 2.5 minutes, which was the first time I was able to hear the baby’s heartbeat. I was ecstatic, but that was short lived. The doctor then left, and the nurse returned with a stack of papers and a copy of What to Expect When You’re Expecting. I was to review the papers and then next time, I could ask questions if I had any. In and out in no time. Wow. What just happened?

Anyway, like a good student, I went home and began looking over my book (which by the way, is one of the most worthless pregnancy books ever in my opinion) and the papers I was given. I remember seeing in capital letters the words: SOME WOMEN DO NOT NEED EPISIOTOMIES, BUT MOST OF THEM DO. (My husband now lovingly refers to Dr. Wonderful as Edward Scissorhands.)

Then I looked up what exactly an episiotomy entailed. Um, no thanks. Each appointment was roughly the same. I had mixed emotions because I loved hearing the baby’s heartbeat and getting reassured that the pregnancy was going well, but I did not feel comfortable with my doctor. At the same time, I had a couple of friends pregnant as well. They chose a care provider near them, about an hour and a half away from us. As we were talking one day, I realized they weren’t seeing an OB. They were seeing a midwife. Huh? What? Who does that? Amish? Hippies? But as they talked, they went on and on about how they loved going to their appointments, which lasted 2 hours each and included childbirth education class. They were very well educated on what was going to happen, the normal birth process, etc. I’ll admit it. I was a little jealous. I was not having the kind of wonderful pregnancy experience they were having. But there? It was 1.5 hours away. I decided to take a day and go check out the birth center and midwife that my friends were raving about. As soon as I stepped into the office, I could understand why. I immediately felt at ease with the midwife and doula (I didn’t know what a doula was at that time) who greeted me. After talking with them, I knew I wanted to transfer care. I didn’t care that it was going to mean a lot of driving. For me, it was worth it, even though people told me I was nuts. I called my current Dr. Wonderful and told them to send my records to my midwife. They did so, and didn’t give me any flack about it. (Some women seem very worried about ‘breaking up’ with their doctor for another care provider. I promise you, it’s not a big deal. They will probably not miss you, and they are certainly not going to cry about it. It’s not a divorce, it’s business.) Anyway, I was about 20 weeks when I transferred to my midwife. I attended my first class/appointment soon thereafter, and I knew I had made the right choice. I thoroughly enjoyed the rest of my prenatal care there. I was educated about birth, nutrition, breastfeeding, labor….and since I had information, I actually had questions. I was never made to feel like my questions were stupid or an inconvenience. I was made to realize this was MY birth, and I had a responsibility to take care of myself if I wanted to have a natural, out of hospital birth. My midwife fully expected me to read the materials before the next class and participate in the activities and discussions. She wouldn’t force anyone to do it, but reminded us that she wouldn’t be giving birth for us. She was attending OUR birth, not delivering our babies. We would be birthing our babies. She highly suggested we prepare ourselves as best we could and offered tons of options that I never knew I had. It was there that I learned what a doula was, and told my husband (who due to work couldn’t attend most of my prenatal appointments) that I wanted to hire one. Best decision ever. She is still a friend to this day.

Now, to the birth part of the story –
I had been having a difficult time walking for a couple of weeks, and knew that my hips were opening up to get ready for labor. On a Friday, my husband’s birthday, I treated myself to a massage before going out to eat and to a football game. We arrived home late, and I went to bed. Around 4:30 am, I woke up to use the restroom and I realized my water broke. Weirdest thing ever – I would take a step, gush. Another step, gush. I woke up my husband, and I called my midwife. She suggested I get some sleep, but I was too excited. She then suggested we go ahead and come to Enid, get a hotel room, and then try to rest. I’d be needing my energy for labor. I decided I was hungry and my husband whipped me up a bowl of oatmeal while I finished packing our things. We headed out around 6:30 am, called our parents, and drove to the town where the birth center was. I was sitting half naked on a towel (remember, my water was leaking), praying to God we didn’t get pulled over. How was I going to explain that without being mortified? We arrived around 8 am and checked into a hotel. I lay down for a while, but still couldn’t really sleep. I got hungry again, and called in an order to IHOP (Belgian waffle with strawberry topping and hash browns), which my mom picked up for me on her way to the hotel. She was baffled – who eats during labor? And all this? I ate every bite. Yum.
They decided since I was now full and sleepy, they would run out and get some lunch themselves while I stayed at the hotel and rested. I did for a while, and then had a weird cramp. I went to the bathroom, thinking I needed do have a bowel movement. Then 5 minutes later, it happened again.  And again. I started noticing a pattern here – shortly they were only 4 minutes apart, and I realized it was the real thing. This was labor! I called mom and my husband, who had just gotten their food. They scarfed it down and headed back. By the time they arrived, my contractions were 3 minutes apart. I had what is called precipitous, or fast labor – which is not what I expected to happen! Anyway, as we got loaded up into our suburban, they contractions kept coming. I do not suggest laboring in a car if at all possible. I HAD to move around, and I am sure my husband thought I was on the verge of crawling out of the car at one point. I was holding the handles above the door and yelling at him to hurry up. Of course we hit a stinking stoplight. Ugh! Although it was only a couple of miles, it felt like forever. I had called the midwife and she was headed to the birth center, as was my doula. I beat them there and continued having contractions in the car waiting. They finally arrived, and thank goodness it was a Saturday and the birth center was closed. I literally started stripping off clothes as I came in the door. I left a trail down the hallway (keepin’ it classy, I know!) and walked out of my sweatpants into an exam room. I couldn’t even begin to get up onto an exam table, so we went straight to the ‘bedroom’ style room where I would be having the baby. I wanted to get in the water, so my doula ran the water for me. I stayed in there for a while, with her by my side and soon my doula said, “Are you pushing?” Um, yes. We moved to the bed and just a few pushes later, my daughter was born. My midwife and doula were right there the whole time, talking about how great I was doing. My husband said he wasn’t sure what all was supposed to be happening, but he couldn’t be nervous with these ladies talking calmly about how great everything was going. At 38 weeks and 1 day, spontaneous rupture of membranes at 4:30 am, contractions starting at noon, my little girl arrived around 2:15 pm. No episiotomy – no tearing. Only 2 hours and 15 minutes of active labor! My daughter was placed on my chest immediately. It truly was a wonderful birth experience! She didn’t feed right away, but did after a few hours. (She may have gotten quite the energy boost from all the food I took in right before she was born!) We were at the birth center for about 6 hours before we all left for the hotel. We stayed Saturday and Sunday night, coming home Monday. We stopped on the way home at my husband’s office to say hello and introduce our new addition, and his co-workers couldn’t believe I was walking around. (Huh?) They said I should be sitting on a pillow, and then I remembered they had referred me to Edward Scissorhands. That would explain their surprise.

I was sold on midwifery care, and knew that I would have a midwife for any future pregnancies. I was educated, empowered, and I knew I could do it. All my births would be this great, right?

Then, pregnancy #2……

Considering the Costs

Some of you might be thinking, “Birth Boot Camp sounds great, but $295! Is it worth it?”

I believe it absolutely is worth every penny, but I teach the class so you might figure my opinion is biased (you would probably be right.) So, I am compiling some evidence so you can objectively decide for yourself if Birth Boot Camp is the right childbirth class for you.

First of all, consider what you get with your tuition. Your $295 class fee includes over 20 hours of face to face class time from an instructor who has completed a quite rigorous list of requirements, which includes having a natural birth AND breastfeeding one child for at least one year. This ensures that your instructor has BEEN THERE, DONE THAT. Who wants to listen to someone teach how to birth who hasn’t actually done it? Would you take a driver’s ed course from someone who has never driven a car? I should hope not. If you do, you should expect results that reflect it. So point #1 – experienced instructors. (A friend of mine just wrote an entire blog post on this topic, which you can visit here). On top of that, you receive a full color 150+ page student workbook to keep, JAM PACKED with articles, information, illustrations, photographs, and more to supplement class topics. Books on pregnancy and birth that aren’t nearly as good as this workbook will run you $15-20 each. This is worth much more than that. You also get Breastfeeding: The Ultimate MRE, a breastfeeding class on DVD taught by lactation consultant and Birth Boot Camp Board Member and Instructor Mellanie Shephard. A very reasonably priced breastfeeding class in my area recently advertised for $50, and having a lactation consultant conduct a home visit will run $75-150, according to Kellymom.com. This DVD is like having a lactation consultant available 24/7, and if you do end up needing some one on one help, your Birth Boot Camp Instructor is ready with local resources.

Now, consider the cost you will save on the interventions that you won’t be needing if you are well prepared and achieve a natural birth. Imagine, no charges for such things as: IVs, epidural anesthesia (both the medicine itself AND the anesthesiologist), instrument delivery, episiotomy, fetal monitoring, breaking of waters, or cesarean delivery. While it is difficult, due to lack of insurance transparency, to find average costs, for these interventions individually, I did find this.

 

 

Table found at:
http://transform.childbirthconnection.org/resources/datacenter/chargeschart/

Sources

U.S. Agency for Healthcare Research and Quality, HCUPnet, Healthcare Cost and Utilization Project. Rockville, MD: AHRQ. Available at: http://hcupnet.ahrq.gov/

American Association of Birth Centers. Uniform Data Set. Perkiomenville, PA: AABC, 2010.

Notice the cost of a birth center vaginal birth in 2010: $2,277. If the birth is at a birth center, you can be relatively sure that there was little to no interventions, such as those listed above. Now, notice the cost of a hospital vaginal birth with ‘no complications’ (this does not specify what is defined as a complication): $10,166 in 2010. That number is nearly 4.5 times more expensive than its birth center counterpart. Add ‘complications’ but still achieve a natural hospital birth for an additional $3,004. End up with a cesarean, even without ‘complications’, and the total skyrockets to $17,052. Cesareans with complications averaged $23,111. That is 10 TIMES more expensive than the birth center vaginal birth. You can clearly see how the cascade of interventions used can impact the cost of giving birth. These numbers should alarm you. You should also understand why some hospitals might be more inclined to prefer surgical birth – it means more money. These numbers are United States nationwide averages, and if you click on the link above you can actually find state by state data as well. If these are averages, that means some states costs are lower and others (gulp!) are even higher.

Depending on your insurance, you may only be responsible for part of this fee, but if you pay a percentage, the higher the cost means the more you pay.

Also, keep in mind that these statistics do not include costs associated with the Neonatal Intensive Care Unit for the newborn, which can be very expensive as well.

Part of Birth Boot Camp’s mission is to provide instruction and support for breastfeeding as well. I mentioned above the cost of meeting privately with a lactation consultant, but I have yet to mention the cost of formula feeding for comparison. If new moms do not get a strong start breastfeeding and do not have proper support, they often turn to formula. Using even less expensive formula, the cost for a year will average $1100, with more expensive formulas running closer to $2,000 for a year supply. This is JUST the formula cost, not including the bottles, liners, etc., that may be needed.

If you consider the increased cost of birth with interventions and costs associated with not breastfeeding, the $295 class fee is nominal in comparison. Attending a Birth Boot Camp series will empower you to take charge of your birth experience, and you will be able to make INFORMED choices about your care.

I hope to see you in class!

~D’Andra Parsons
Birth Boot Camp Instructor
Additional information on charges for vaginal vs cesarean birth:

http://transform.childbirthconnection.org/wp-content/uploads/2012/05/Oklahoma.pdf