Tuesday, January 29, 2013

Our VBAC Birth Story

       This is written by Mark, and is from his perspective. It is truly a story of redemption. Healing through pain. Never have I worked so hard, and wanted something so bad in my life. After Juniper's birth I was absolutely devastated, and so angry, it just didn't seem fair. I did everything "right", and worked so hard to be prepared and well educated only to have it fall apart around me. The bible tells us that God knows the desires of our hearts, and to achieve a natural, unmedicated birth was my heart's desire.

**If you have not read our previous birth story, I suggest that you do prior to reading this one. It can be found here: http://lifewithmarkanderin.blogspot.com/2010/08/our-birth-story.html


Preface
I wrote down our daughter Juniper's birth story, as it was quite the experience for us. I wanted to accomplish a few things in this next writing. First, to give our son Tilden the same recognition and honor of having his own story recorded; and second, to revisit the physical and emotional journey occurring during this second birth, and the newfound perspective of our first birth.

Friday, December 28, 2012
I'll begin here, though we are all aware that the birthing process started long before this moment. This was the due date the doctor gave and, to be quite honest, I hardly expected we'd have reached this point. Erin had been having contractions for weeks now, some 20-30 a day, spaced or together, sometimes even tight and painful. I had worried that this was a bad sign, remembering the endless string of contractions that came alongside our first birth. However, it had been nearly a week at this point that Erin and I had both given ourselves over to the birth. That to say we had both made conscious choices earlier in the week to surrender ourselves to whatever may come, be it good or bad. I believe the surrendering was a very important part of this birth that we did not allow ourselves the first time. It wasn't to say this time we weren't going to try everything in our power to give Erin the birth she believes her body was made to have, but it was to suggest that we were more ready for additional variables, and prepared for such necessary alternative options, more so than with June's birth.
We visited the midwives that afternoon around 2pm and Erin had her membrane stripped, for the second time, the first being at the prior week's appointment. She continued to measure 2cm, as she had the previous week. Her contractions were more regular on the ride home, and more painful too, as to be expected with any irritation such as had occurred. I do recall asking the midwives how to be sure the contractions were labor and not more of these contractions Erin had been having for weeks, and she instructed that with labor contractions there will be no stopping them or slowing them (no variation brought about by rest, a hot bath, relaxation, etc) as there can be with such contractions as Erin had been experiencing. I had heard this before, but it was nice to hear again, and rested my nerves a bit.
Erin says the contractions were fairly regular and fairly strong after 5pm. Later, as the contractions had been steady for a while, Erin took a half-cap of blue cohosh and an hour later she took a half-cap more. We were instructed not to take more than two doses, because if Erin's body were ready to start labor, that amount may bring it about, but if her body were not ready, it wouldn't do any good taking more of it than that. At 10pm, we made it to bed for the night, and wondered if rest would have any effect on things.

Saturday, December 29, 2012
12:07 AM
Erin woke up from her sleep, having been dreaming of contractions. They continued painful and regular, probably less than 5 minutes apart.
12:45 AM
Erin woke me up, and informed me of her situation. She told me this would be our baby's birth day. I started clocking the contractions, and nearly an hour later I found them to average a minute long at anywhere from 2-4 minutes apart. I called the on-call midwife, Kirsten, who was actually already at the hospital, busy with another birth. She told us to come on in, as she could phone for backup help from another midwife. We woke her family and told them we were headed to the hospital, to give us a head start and then come along. I also called my own parents and informed them, as they had around a 6 hour drive from Jacksonville, FL.
1:45 AM
We left for the hospital, June in the back seat, everything packed (except a pair of shoes for June). I was much more excited about Erin's contractions than she was. They were painful, and sitting in the car was uncomfortable for her. She had a very serious aura during contractions, and did not like me making jokes or being silly. I believe there were two contractions during our drive that were about 7 minutes apart, and some doubt crept in my mind whether or not this really was the big moment or if things would die down. She was sure this was it.
3:00 AM
I missed the turn for the hospital, as during the tour we had come in from a different direction. I turned around, parked, we walked inside (dreadful enough in and of itself). First thing Erin did was go to the bathroom, and she was so grateful someone had built a bathroom just next to the exit, as difficult as it was to go. She would also note a kind man who held the elevator door for her, even while she kneeled to the ground during a contraction and that annoying alarm went off. He said he had recently gone through the same thing; we congratulated each other.
Arriving at our floor, I had forgotten all the what-to-do's I learned on our tour. The hospital operated a bit differently overnight, and though we had been verbally instructed on what was to happen during these hours, that information was lost when we arrived, and so were we. We walked around long enough to find someone who pointed us in the right direction. Erin soon arrived at outpatient, checked herself in, answered a few questions, signed a few forms, dropped to the floor a few times during contractions, and made her way to a bed for some observation until the midwife arrived. She was measured, and Erin was informed that she was already 6cm, 100 percent effaced with bulging waters. We were so excited to hear this. Kirsten arrived, observed, and told us Meg would be there to accompany us while she continued with her other birth. Erin was wheeled to a Labor and Delivery room, with a tub per request.
3:20 AM
We arrived to the room, and the nurse strapped a wireless heart monitor for baby to Erin's belly. She was also given an IV port in her wrist, as is required by hospital policy, though we aimed not to make use of it. Erin walked around the room a while, stopping with each contraction to labor, usually on her hands and knees. I was there to encourage her and give her any and all support, both emotional and physical. June was escorted by someone, though I don't recall who, to the rest of Erin's family in the waiting room. Erin soon wanted to get in the tub, and was allowed to (the monitor was waterproof and they taped plastic around her port). Meg had arrived at this point and helped here and there, getting cold washcloths for the back of Erin's neck or adjusting the water temperature as it cooled. Between every other contraction I found myself fetching Erin's cup of water or apple juice for her to sip.
4:20 AM
I don't recall specific times, but an anesthesiologist came in and asked Erin a few questions, again per hospital policy. Even when expected, it was discouraging to have to talk to her, knowing that that was a road we didn't want to see any more of than when it was absolutely necessary. At some point I managed to get the iPod dock working and Erin's playlist began in the background, helping to calm her nerves. I believe it was sometime near after 4:15 that Erin was measured again, while in the tub. This time she was told she was "there" with only a lip remaining. The encouragement that came from knowing that was nearly breathtaking. Also while in the tub, I noted that Erin began experiencing what I know as transition, though the mindset that comes with it had been phasing in and out since we were riding to the hospital. This is the phase of labor when the contractions become greater and more painful, and the baby prepares its descent. The inevitability of a child and the pain that comes with it floods the mind of the birthing mother, and the natural response is to run away, avoid it, get rid of it, push it on someone else, shake, scream or cry. I believe Erin managed all of these responses at some point or another throughout the night.
While in the tub, during a contraction, I recall the relief Erin experienced as her eyes widened and she commented, "my water just broke." We briefly discussed the relief and feeling, comparing it to a very full and stretched water balloon bursting inside. I remember wondering about the amount of time between water-break and the need to push. It was a slow process, and I think a part of both Erin and myself expected the baby to just pop out while she was sitting there in the tub. The nurse left briefly to assist with the other birth, and returned shortly after.
5:20 AM
This is where I decided to mark the beginning of the last phase of labor, pushing. Erin was in the tub, and had already asked when she should start pushing. Meg told her when she felt like it, she could. Some time around this point Erin did feel like it, and was repositioned in the square tub to lay sideways with her back against one wall and her legs propped against the opposite side. She pushed and yelled and squeezed my arms, which were wrapped tightly around her chest from behind. Meg instructed Erin to curl herself during the pushes, and Erin did so, though occasionally she would push her head back and arch her back, afterwards apologizing profusely. Meg frequently instructed her to take the energy she was spending on talking and use it toward pushing. I remember feeling unsettled as I looked at the clock, realizing it had been well over 40 minutes and I sensed little progress had been made. I felt Erin feeling this, too. Meg noted that the baby was having a hard time getting under the pelvic bone. At some point Meg mentioned that the baby was at plus 2 station. I would consider this a second major encouragement during the birth, as it lifted my spirits again to know that so much progress had been made.
Part of me in this moment realized what a hopeless position we were in during June's birth, as she never descended past zero station nor was Erin ever fully effaced. I had more time to think on that later. Erin now turned to a new position, and after pushing during a few contractions, we realized this position wasn't going to work and we took her out of the water, dried her off, and laid her onto the birthing bed.

I must have glanced at the clock in passing a few times during this last part of the birth, but no notable time comes to mind, as these last hours were spent very focused on other things. Erin was now in the hospital bed on her back, pushing through each and every contraction. Meg was able to do more now that Erin was out of the water. Push by push I stood near Erin's head with her hands in mine as she curled and pushed. Occasionally, Meg and the nurse would get excited with a push, and this excitement further motivated Erin to give all of herself up to each and every push. Sometimes at the end of a contraction, I could feel slight disappointment from the midwife and nurse, and felt again as if no progress was being made. Between pushes Erin would sometimes cry or dread the inevitable next contraction, which always came too soon, but she was quickly encouraged to take that time to rest and build strength for the next push. I enjoyed the fact that the baby's heart rate, still being monitored wirelessly, was 120s to 130s, rarely reaching 140. I recalled June's being 190 and found new strength in knowing the baby was not showing signs of distress.
As time wore on, I found myself holding her legs as she grabbed them to help push. I was able to watch what was going on, but I didn't see any of baby's head, even though the midwife said she could see as much as "the size of a dime." I was slightly discouraged. Erin was also discouraged, and in a lot of pain. She mentioned that if she weren't 100% set on doing things this way or if there were anything in her mind that thought any others method of birthing came without more risks or hazards, she would have opted for them. Once she even told the nurse to just pull the baby out via vacuum. After the nurse made mention of following this path, Erin stopped her and told her that she just needed someone to complain to, and that there was little substance behind her words.
A few pushes later, I was able to see some hair sticking out, and it remained even during the "rest time" between contractions. It seemed to me that for every two steps forward during a contraction, between contractions we slid one step back. Erin reached to feel the head and hair, but she was unable to identify anything. Slowly, and I mean very slowly, I remember looking at the quarter-sized portion of a head that was to be seen, and after the contraction finished, I remember thinking that even though it seemed the baby moved back to what looked like a dime-sized amount, it was still more than it had been before I could even see the head, which meant progress. Meg poked a bit and said the baby looked asynclitic, and suggested Erin turn to her side. Erin did so. The baby wiggled slightly, which Erin felt as a significant source of pain. The second push on her side and I could easily see the difference in the amount of "steps forward" we achieved in a single push, as baby turned more and Erin hurt more. I was quick to encourage her, relaying the fact that progress was truly being made. In fact, the only two pushes I recollect that didn't seem to provide some sort of progress were those times when Meg had to step out of the room for one reason or another. It seemed as though when she left, our spirits and motivation left with her. She may have done this hundreds of times, but I'm not sure if she will ever know just what a vital part of our child's birth she played. Her strength, her brief instances of both scolding and praise, and her confidence filled so much of what we needed to see things through to the end. Even though we loved our nurse and she did a wonderful and very sincere job encouraging Erin, while Meg was out of the room there was a presence lacking that I daresay any other nurse or midwife would have had trouble replicating.

Again on her back, with renewed confidence at the progress we had made on her side, Erin kept pushing, and with each push came more progress and more baby. Some pushes baby seemed so close to just popping out, but would then subside. Meg assured us this baby was coming out, and it was too far along for any kind of surgery, so we might as well run with it. Further assurance came when Meg gowned up in her medical attire. I had little doubt at this point that anything would go wrong, and as late in the story as it may be, that's a good feeling to have. I think Erin shared the feeling, as she took deep breaths going into the contractions and pushed harder and harder each time. I tried to encourage her to own each contraction and use it instead of working against it. She knew this, of course, but she wanted to be reminded of it.
Had it been any contraction outside the final, I may tell it differently, but as it happened, Erin told me she was ready. She closed her eyes and pushed harder than ever with the contraction, at this point unable to make any screams or other noises. Suddenly, out popped baby's head, tight squinty face looking straight up at me, eyes shut. It was a lot bigger than I thought it would be. Erin's eyes opened as she questioned, "What was that?" "That's the head!" I exclaimed automatically. Erin took another breath and pushed again, this time sending the rest of the child into the arms of our midwife, who was a lot more ready to catch than I was. Meg bid me join her as she handed me the child. I lifted the baby up and onto Erin's chest, and with prompting, identified the child, "it's a boy."
Nurses dried and suctioned him as he lay on his mothers chest. Erin, having not even heard me announce, peeked for herself at the gender as I washed my hands quickly in order to grab a picture with my phone. I heard the midwife talking to the nurse, relaying the time as 8:17am, and exclaiming how the baby was face up, OP. She said with all his hair and how it lay she thought she may have been looking at a different part of his head than she was when he arrived. She went about her work cleaning, helping to deliver the placenta, and sewing up a tear (which we think occurred when the head arrived), but we hardly noticed as we were both too enthralled with our newborn child and this redemptive miracle Erin was able to experience. Occasionally, during the afterbirth, which neither of us recall seeing, Erin would flinch at the pain of hands pressing down on her stomach. It felt like 15 minutes or so before they clamped the cord and allowed me to cut it (which contained a bit more blood than I would have thought). Afterwards, when we were ready, the child was weighted at 7 pounds 6 ounces and measured in at 20.5 inches, all without leaving sight of mother. His footprints were recorded and he was back in his mothers arms, with overflowing joy on all of our faces. It was after all of this that we sat down and decided to go with the name Tilden, and hours later Wyatt as a middle name. Thus, Tilden Wyatt Houser came to be.

Afterword
It is important not to dwell on the hard times, though they may sculpt us into who we are to become, they are not things we wish to have happen, to ourselves or to others. It is important also to share in the good times, as they may offer hope or comfort for those who seek it, and the calling of thanks for those who have it. I now go back in my mind and I can replay Tilden's birth as it follows each step of the birthing process. I can match different times in the night with different stages of labor, and things seem to fit so well. It's what we wanted and expected with June's birth, but did not receive. Only after having had the second experience can I look back and adequately perceive our first.
We were new to the process with June's pregnancy, and if there's one thing I heard everyone tell us during that first pregnancy and birth, it was that everyone is different, and what may happen for one person may not for the next. It's what I told myself as Erin experienced contractions nearly non-stop for hours. I sit here now and I list off in my head some of the things that stood against us in June's birth: back-to-back contractions, baby in distress, baby OP, baby on the right, meconium staining in the water, 24 hours laboring, failure to descend, never fully effaced and still a lip, heavy baby, two weeks past due… I do find slight comfort in knowing that even if we had been prepared for any or all of these (and we weren't prepared enough or aware enough), we would still not have been able to have had the birth we mapped out in our heads; that without a c-section I honestly believe mother, baby, or both would not be here, and I am thankful for such an option. It is after having had this second birth, even as Tilden was delivered right side OP, that I realize how far from success we were the first time. However, with that said, let me state if we could go back two and a half years and do it all again, though we would be more prepared for possibilities outside of our plan, we would make the same choice to labor as long and hard as we did against such an inevitable end, because without having given everything in ourselves to the birth we wanted, we may have found some room somewhere to blame ourselves. Even having given it all, we were scared to accept the idea that Erin's body may simply not operate like it was designed to, an idea that followed us through this birth as well, which is why it was so important that we released our hold on ourselves before the birth, saying what will be will be. It is an unspeakable relief for Erin to discover in this second birth that her body is indeed capable, where we knew her spirit and mind were willing.
So Erin has now had a successful VBAC, and I am proud and privileged beyond words that she was able to do it, that she did it. I pray I have gained understanding throughout her journey, and may our story go out to those individuals who finds themselves facing a similar challenge as words of encouragement, to those who question their own confidence as words of assurance, or to those who have experienced past failure as words of comfort, knowing, though our experiences may differ, that our hope is in a more fortunate future wherein your own perspective may go on to help another in such a situation.



Wednesday, December 12, 2012

Preparing June for Baby

   Since we have once again chosen to not learn the gender of our baby until it arrives we find ourselves preparing for both possibilities. We have a girl outfit and a boy outfit for newborn baby, and plenty of yellow and green sleepers. All of our baby gear is gender neutral, as well as our baby bedding. That is the easy part. The real challenge is not even the waiting game, though it seems harder this time than it was the last. Perhaps it is all of the other expecting moms around me that make me ready to know what this baby is, and believe me they are everywhere! No, the real challenge is preparing June.
   
     At 2.5 years old I feel that she is exceptionally smart, and very logical (I know every parent says that, but really my kid is!). I assumed she would take the possibility of having either a brother or sister in stride, much like she does everything else in life. I expected questions, even tough ones (she is the master of the unanswerable question!), but I was not prepared for her reluctance to even consider that we may be having a baby boy! She is beyond insistent! I say thing like "if our baby is a boy, he might like to play with ______, or wear _______", to which she replies "no, my baby is a girl". I tell her that if our baby is a boy he will be a little brother and that will be so exciting! She doesn't buy it. Everyone we run into says "oh, that must be a boy your are carrying", June simply replies with her usual "no, my baby is a girl".

       I feel that we have done all we can to prepare for the possibility that this baby is a boy, and have to just take the reaction however it comes if we do in fact have a brother for June. I am thinking that perhaps with all the excitement of the birth June will forget her objections and accept whatever baby we present her with. Hopefully I will be able to report back that all went well, and that Juniper is thrilled with her new sibling! Perhaps she is right after all, and she can be like "what? I told you". We will know soon enough! Baby is due in just over 2 weeks!

Saturday, October 6, 2012

Boy or Girl?

      Anyone care to guess what this baby is? I was so certain June was a girl that I would have been shocked if Mark had said "it's a boy" in the delivery room. This time however, I have no idea what this baby is.

Here are the only things I can say as to a hint:

This baby is a lot lower than she was

My belly seems to be the same size, and always measures right on target

All other symptoms have been the same as last time other than the fact that my list of things I won't eat is different


Here is a side by side (taken tonight)



28 weeks with baby #2
(none of my shirts cover this thing, it is just down too low)




Tuesday, October 2, 2012

Crafts for the season

       Juniper loves doing "projects" as she calls them. Today we are embracing the change in season (though reluctantly) and using the fallen leaves to our advantage. We went out and collected pretty leaves of all different sizes and colors. June is gluing them to a paper and drawing pictures to go with them, mostly of Mr. Potato Head. This kid loves her glue stick, and it keeps her happy and busy for an hour at a time. She always saves her creations to surprise Daddy at the end of the day.

       We are also roasting pumpkin seeds for snack. June helped me prepare them and is very excited about her snack when she is done with her leaf project.


Thursday, June 21, 2012

Why Hello there Baby!

       Today we had our very first even ultrasound! We never had one with June, and would have done the same this time if it were not for some dispute over a due date. It was super fun to watch the baby wiggle and dance around! It is crazy how much wiggling is going on in there that you cannot feel or see on the outside. The little thing was so wiggly it made it hard to take measurements. We did get them done, and sure enough it was consistent with the EDD we had already estimated. So we can expect baby #2 sometime around Christmas/New Years.

      All in all it was a fun experience. We will probably decline any further scans, but enjoyed the one we had. The sent 2 pictures how with us, but they are not very clear, and you really can't make out any distinct features. So, I am not going to bother scanning them, but they will make a nice keep sake in the baby book.

Friday, June 15, 2012

Thanks NC BOM

       Ok, we hired a CNM (legal in NC) for a homebirth for baby #2. This is our desired birth, and we thought everything was in line to make it happen this time around. Four days prior to our first appointment (and the signing of our official contract) the NC Board of Medicine ruled that the ob who had previously been reviewing and signing off of home birth candidates for 7 NC CNMs was no longer allowed to do so. This left a lot of women with no where to go and no one to deliver their babies, even those due right then. A lot of hearts were broken over this ruling, and 7 midwives shut their doors. We were not official clients yet, so we got no referral to a new practice. We were lost.

       I called everyone around me, all the hospitals, women's clinics, and every CNM I could find both in NC as well as SC. I ran into a lot of "sorry no vbacs", and difficult hospital policies such as vbacs must deliver in the OR with continuous fetal monitoring (restricting my ability to walk or move around). I didn't want restrictive rules that may hider labor, or to be stuck in a bed for hours. I also didn't want a practice with 6-8 OBs who may or may not be the one on call when I go into labor. I feel that my success will be more likely if I have some by my side from start to finish.

      Completely exasperated, and so tired of rejection I followed a tip from a friend for an OB in Asheville that calls her model of care midwifery style with an ob. I called them with high hopes only to find out that they are booked for December... They told me to call New Dawn Midwifery right next door to them. Finally success!

       New Dawn is an independent midwifery clinic (the last legal/open one in our state). It is made up of 3 CNMs and 2 Nurses. They are backed by an OB off site. They do home births, though not out as far as we are unfortunately, and not for vbacs. They deliver at Mission Hospital which has a great reputation for respecting women's choices as well as repeating the care offered by the midwives. They have 4 birthing tubs, and all the rooms have real beds, a table and chairs, day bed for Daddy, and refrigerator. It seems like the best of the hospitals I contacted.

       We prayed about our choice to have a home birth this time around, that if this was not a good choice that God would shut the door to the option and give me peace about the hospital I end up at. I was heart broken when I got the e-mail telling me about the BOM ruling and the fact that I was loosing my midwife. I was angry, and frustrated to say the least! Now that I have interviewed and started care with New Dawn, I am coming to peace with the change of events. If this is where I need to be who am I to argue. Their model of care is exactly what I want in a midwife and I am very comfortable there. Sometimes things don't turn out the way you thought they should, but often times the change is for the better. I may never know if there was good reason for us to be in hospital instead of home, but I will accept it graciously and hold onto faith that God will bless my choices as I make them with a desire to do right by my baby.