A Natural Birth, With A Spinal Postpartum

I keep posting birth stoires and each one is so different!  Isn't that amazing?  A wonderful story with a Hypnobabies mother who barely notices her posterior baby.
Enjoy!!!
As a first time mom, I was greatly looking forward to my birthing time starting naturally! I planned on having a natural childbirth all along and thankfully the hospital I work at had an in-hospital birthing center. (The only one in the state!) I started studying the HypnoBabies techniques at around 28 weeks and was really looking forward to labor and a water birth!

At my 38 week appointment, the midwives checked me and I was 1-2 cm, 70-80% and my baby girl was low as usual. My due date was July 5th and I knew the next full moon was July 3rd! (I work in the NICU and see often how busy the labor and delivery unit gets around the full moon!) Around 39 weeks, I started having some pressure waves but they didn't stick around.

On Monday July 2nd, I woke up around 4am realizing I had been having pressure waves and they started waking me up. I finally got up around 6:30 am and started timing my waves (just for fun mostly :-) ) They were typically every 3-5 minutes apart lasting around 30-45 seconds, some spacing out to 8 minutes but never farther than that. I labored all day with the pressure waves following that pattern, and around 10pm I started getting a little frustrated because they weren't progressing, but they weren't stopping either and I had also been losing my mucus plug all day.

I called one of the midwives and she said it did sound like early labor and to try to rest overnight and see where we were in the morning. I went to bed around midnight, although sleep was difficult, waking up with each pressure wave. At around 4:30 Tuesday morning I finally got up and moved to the couch because laying down to sleep was getting too uncomfortable. I finally gave up trying to sleep at all and got up around 6:30am. My husband, Nick, got up and went to work to finish a few things he had to get done and I continued laboring at home. My pressure waves were closer to 3 minutes apart, about 30 seconds long. I called the midwives at 8:30, she said it didn't sound like my labor was far enough along to come in and to labor longer at home. It was pretty easy to get through the pressure waves so I was fine with that. My mom and sister and brother came over shortly after that and Nick came home around 9:30. I did have some slight discomfort in my lower back and I joked that could provide my own counter pressure to take away the discomfort. Around 10:30 I talked to a nurse at the midwives office when it got more difficult to walk and talk through contractions and she said to go ahead and come in.
I got to the birthing center around 11am, and was disappointed to find out I was only at 3cm although I was 80-90% at least. I labored on the birthing ball like I had at home. My dad had come to the birthing center as well as my other sister so we all played a game of Phase 10 in between pressure waves. The midwife came in around 3 and asked me to walk around a while to try to get things moving. I walked around the birthing center and my pressure waves definitely picked up, requiring me to lean on my husband or back against a wall to help with the tightness in my lower back. At 5pm, the midwife wanted to check me again and unfortunately I was only 5-6cm! I was very disappointed hearing this and was surprised my labor wasn't progressing more quickly. I continued laboring back in my room and this is where time started getting a little fuzzy. At some point I got into the birthing tub which was as amazing as I had heard it would be! Later in the night I realized I started sleeping between contractions which at times was not a good idea because I wasn't able to use my Hypnobabies techniques as I felt the pressure waves coming on, making them much more difficult. I used the Peace and Release cues constantly throughout my birthing time!
Around midnight, I asked if we could break my water or something to get things moving more quickly. The nurse got me out of the tub and checked me and I was dilated 8-9cm. The nurse talked to the midwife and reported back that the midwife didn't want to break my water yet because the baby was posterior! POSTERIOR??? Why are you just NOW telling me my baby is posterior?!?! I knew I had some lower back discomfort like a posterior labor would but it was manageable and not nearly as hard as I had heard a typical "back labor" would be, so I didn't think she was posterior.

So my nurse and I spent the next few hours trying to turn her using various positioning techniques and FINALLY got her turned using the Rebozo technique! I was surprised we were actually able to get her turned! At this point I was quite exhausted, it was around 3-4 am on Wednesday morning July 4th.  I never once felt like I wanted an epidural, I just wanted it to be over and asked the nurse a couple times in my daze if we could just cut her out and be done. Obviously and thankfully there was no need for that! They asked if I would like some "therapeutic rest" and I had no idea what that was so I asked.

The nurse said "Well, we give you some Nubain and let you get some rest before trying again later", I immediately said no and continued laboring. At various times through the night I got in and out of the tub and tried many laboring positions. The nurse had me start pushing when I thought I might have a slight feeling to push. She had me make this odd grunting noise during the pushing which resulted in only a sore throat the next day! The midwife and her student came in to check on me asking what I wanted to do and I honestly didn't know what I wanted to do, I was so out of it. They decided to go ahead and break my water and gave me an IV bolus of fluid since it'd been a long time since I'd eaten anything.

Once they broke my water (which was QUITE uncomfortable doing so during a contraction). At this point I still had a small anterior lip on my cervix so the midwives left again to let me labor some more. My pressure waves picked up in intensity and frequency, although I still tended to sleep in between. Around 5:30am the nurse had me push through a pressure wave while she tried to stretch my cervix back and push around the lip. I got through that and stood up to push with one leg up on the bed at the suggestion of the midwife. I had lots of family at the birthing center and everyone started coming in the room at that point although I had no idea they were in there because I was in such a daze. I went into the water shortly after and my pressure waves spaced out a good little bit allowing me to rest in between.

As part of my birthing preferences, I wanted to catch her and bring her up to my chest so the midwife reminded me (as I had requested) and I told them to remind me to open my eyes :-) I pushed through a couple pressure waves, feeling her come down and slide back up a little. I held a little pressure to keep her down between pressure waves and pushed her head most of the way out with the next pressure wave. When I saw her head I was like "Oh my God." as in, wow there really is a baby in there coming out! The fourth pressure wave I was determined to get her head out so I pushed and delivered her head and her little body slipped on out after it and she was put directly onto my chest. I never felt the "ring of fire".

I continued to say "Oh my God." I leaned back onto my husbands legs (he had them in the tub supporting me) and just sat there relishing in the amazement of having just given birth to this amazing little baby. We waited to cut her cord until it stopped pulsating, I got out to deliver the placenta and get checked out. My little Ayla weighed 7lbs 15oz and was 20 inches long born at 6:05 on the 4th of July! I had a small tear requiring one stitch and some small lacerations just inside the vaginal opening that they weren't worried about. I laid skin to skin with my new sweet baby, breastfed her and settled in with my husband for a little shut eye!!! It was wonderful!!! However....
Later that day around noon I got up to take a shower and I had a few clots come out (much more bleeding than earlier that day). I showered and had blood streaming down my legs. I knew the water made the blood look worse but this still concerned my husband and me. I had a couple visitors at the time and could feel more clots being expelled. When my guests left I told the nurse and she got the midwife. I apparently had an artery on one of those small inside lacerations that started bleeding. The midwife tried stitching me up but couldn't get the bleeding to stop and called in the doctor on call. By the time he got there she had pretty much gotten the bleeding to stop and only required one or two more stitches from the doctor. I took some Motrin after the suggestion of the nurse. As the afternoon and evening went on, I started having more and more pain/pressure and I started feeling the pressure going down my leg almost in a sciatic location. I never had any afterpains aside from this issue! Around 8pm the nurse checked me and said she didn't think it felt like a hematoma but that she was going to get the midwife. In my mind I'm thinking, "A hematoma?? That's just a bruise why would that be a big deal?". The midwife came in and said it was definitely a hematoma and called the doctor back in. I didn't even know that was a possible complication! My nurse said she had been there 8 years and this was the 3rd hematoma she had seen.
I got up to go to the bathroom with the nurse and almost passed out in the process, the nurse had to push the Staff Assist button and get another nurse in there. I got back to the bed, got an IV put in and a bolus and they took me back to the operating room. Nick stayed in the room with Ayla while I was gone. Before the doctor got there, I asked the anesthesiologist what options I had and it was either general anesthesia or a spinal so obviously I went with the spinal (I was wondering if local anesthesia would be an option). The doctor got there around 9:30pm, I got the spinal and a little Versed and half an hour later they were done! The doctor drew a little diagram and said he removed a softball size hematoma from inside! He said sometimes they spontaneously open and drain which is what he thinks happened earlier in the day. It re-accumulated when they stopped the bleeding. Now I might add, having the spinal with the complication was wonderful! it was great to be able to feel completely free of discomfort, however I would never, EVER want to feel like that during my birthing time!! 

In the recovery room, the nurse sat me up in bed (a little too quickly I think) and I felt like I was going to pass out again and really struggled to maintain consciousness! The nurse took my blood pressure and gave me another fluid bolus. My blood pressure was 64/45!! Once I started feeling better they brought Nick and Ayla in to see me and I laid skin to skin with her for a while. After we got back to my room I was able to start recovering, and thankfully I didn't need a blood transfusion like they thought I might! We went home Friday July 6th! Everything was great and we were enjoying our love at home. However...

Two weeks of age I noticed a lump on Ayla's left shoulder area. Since I am a NICU nurse I was pretty sure I knew what it was but we took her to the pediatrician. Sure enough, Ayla had a broken clavicle! :-( She never acted like she was in pain and never favored her left arm so we were happy about that! She is now a month old and gaining weight and nursing well. We are VERY happy having our little girl home and growing big!!!

Comments

C. Beth said…
Wow, such an awesome job with a long labor! What an inspiring story! And an excellent example of why our modurn medical system is valuable.... The doctors could help you with anesthesia and surgery *when you needed it* (for the hematoma) but you were able to accomplish the birth naturally. I wish it worked like that more often!
My second born daughter also had a broken clavicle and they didn't do anything for it; we were just careful with her. She did develop torticollis due to it but because we caught it so early she only had 2 or 3 physical therapy sessions because we were so hands-on with the stretches at home.

All that to say - so glad she is alright and that you are alright! What a blessing to have the natural birth you wanted without having to worry about the other issues until later!