Natural Childbirth
"Only about 15% of medical interventions are supported by solid scientific evidence...This is partly because only 1% of the studies in medical journals are scientifically sound and partly because many treatments have not been assessed at all." ...Richard Smith, editor of the British Medical Journal
Alexander's Birth Story
It is amazing how much about Alexander's birth has become fuzzy, mother natures' way of making sure we carry on the species! I developed pre-eclampsia (pregnancy induced hypertension) towards the end of my pregnancy with Alex. On a Friday afternoon, I went in for my regular pre-natal appointment and my blood pressure was elevated. The Nurse practitioner decided to have me come back in on Monday to see if it was still elevated. When I went back in on Monday it was higher than before. She made me lie down on my left side for half an hour and checked it again. It did not go down very far so they set up an appointment with my OB for Thursday afternoon and told me to "Stay in BED!" (So much for my pre-natal classes!)
When I went in to see my OB he put me on strict bed rest and started having me come in every Monday and Thursday for non-stress tests. A week latter he decided that I should be induced if Alexander's lungs were mature enough. He scheduled an amniocentesis for the following Monday to find out how developed Alexander's lungs were and scheduled the induction for the following Thursday. I had been having contractions off and on for the previous couple of nights but as I was not dilating and was barely effaced he said it was probably just Braxton-Hicks contractions.
Now, I had a big paranoia of needles and I wanted absolutely nothing to do with having an amniocentesis so I went home and willed myself to go into labor. I had contractions 20 to 30 minutes apart for three hours that night but nothing the next day. Then Friday evening they started up again 15-20 minutes apart. I ignored it because I felt it was just wishful thinking and they were not very strong. On Saturday, October 15, when I woke up in the morning there was a teeny-tiny little wet spot on the sheets and I thought, "This is it! My water's leaking." But it did not continue. After breakfast I noticed a pinkish discharge and realized that I was still getting the Braxton Hicks contractions 15 minutes apart so I called my mother in a panic. I tried to call my doctor because I thought my water was still leaking but could not get through to him and the nurse told me to go to the hospital and get checked. I called Phillip at work and told him he had to come get me and take me to the hospital because I might be in labor. He flew home in a panic and whisked me off to the hospital. We arrived at the emergency room around noon and I was admitted (mistake #1, going to the hospital too early).
The nurse said I was not leaking and that I was not dilating yet but she wanted to call my OB just to be safe. Around 4 O'clock he ordered another non-stress test and told her to send me back home if it was normal. While they were hooking up the monitor my water broke and there was no hope of going back home. I was starved, forced to lie on my left side, hooked up to an IV, monitored, poked and prodded and basically miserable for the next 16 hours.
Around 7 O'clock my family (mother, step-father, sister, maternal grandmother) arrived at the hospital. They drove down from Michigan when I let them know it was definitely time. At that point I was about 3 cm. and having contractions 10 minutes apart. It went on like this for what seemed like forever.
My OB arrived around 10 O'clock and declared it would be a long night (gee thanks). Around midnight my contractions slowed down to around 20 minutes apart and he ordered a pitocin drip without even consulting me (so much for informed consent). Up until that point I was handling labor really well. Once the pitocin kicked in I started having trouble coping. Sometime around 2 O'clock the pitocin induced contractions were literally coming one on top of the other without a break. The nurse was out of the room and I, not so nicely, told Phillip to find her and tell her to turn the damn thing off. Well, she would not turn it off but she did turn it down some.
By 4 O'clock (or was it later?) I was still only at 3.5 cm and was not dealing with the pain very well. I was starving, I was tired, and I was getting emotional. The nurse had been practically begging me to take a pain killer for nearly an hour and I finally gave in to the pressure. I asked for half a dose of Nubain (mistake #2). It made the pain go away for about an hour. By 5 O'clock I was begging for the other half of the dose, which she happily gave to me. I got very dizzy but the pain did not go away. I asked for more drugs but they would not let me have any as they were trying to get a hold of the anesthesiologist for an epidural. About this time (my memory is really blurry here) they lost Alex's heartbeat on the monitor so my OB came in and put me on an internal monitor, again without even telling me what he was doing or why. Of course, I could not get up at all after that.
Around 6 or 7 O'clock on Sunday morning the anesthesiologist finally arrived. Phillip and my mother were asked to leave the room while he did the epidural. The anesthesiologist proceeded to yell at me and tell me that if I didn't calm down and stop screaming he wouldn't give me the epidural - I meekly complied. I was still at 3.5 cm when he started the epidural. I remember very clearly that I had three very intense contractions while he was administering the epidural. The nurse was eye to eye with me a few inches from my face breathing with me while she held my hand. It seemed to take forever before he was done. When the epidural was in place Phillip was allowed back in but my mother would not come back (she was a nervous wreck by that point and couldn't take it anymore). Just a few minutes after the anesthesiologist finished hooking up the epidural I told the nurse I needed to push...now! She said that there was no way I should be ready to push because I was only at 3.5 cm when she last checked me 15 minutes ago but she sighed and checked me anyway. She seemed very surprised to find that I was at 10 cm.
My OB had to be woken up and he arrived just as Alex was starting to crown. He told me to breathe through the next contraction so he could do an episiotomy because I was about to tear (actually I would have preferred to tear but at that point I was too focused on birthing Alex to care). The cord was prolapsed which caused some concern but Alex was born a few pushes later and was taken to his little incubator across the room and scrutinized, poked and prodded. The OB tugged on the cord trying to pull the afterbirth out (why, I still do not know). The cord stated to tear and he decided to manually remove the placenta by reaching his hand up into my uterus and pulling it out. It was painful and I was screaming and I distinctly remember the anesthesiologist making a sarcastic comment about me having a low pain threshold. When he started to stitch up the episiotomy I felt the needle and I told him so. He argued with me and said I could not feel anything because I had an epidural. I told him that it obviously was not working properly because I could most definitely feel it! He sprayed the area with a local anesthetic and finished stitching the episiotomy. Meanwhile Phillip took Alexander down to the nursery and gave him his first bath.
Everybody left and the nurse came in and got me ready to move down to my recovery room. They brought me some breakfast which I devoured while I waited for them to bring Alexander to me. Shortly after I finished breakfast Phil and a nurse arrived with Alexander. I made sure to tell the nurse to write on his chart that he was not to have a pacifier and was to be brought to me on demand for feedings (even though he was rooming-in with me). I wanted to nurse Alexander but found it awkward trying to position him while laying down so the nurse helped me get him positioned properly. He latched right on and nursed beautifully right from the start.
We went to my room and settled in. Phillip went home and took a shower and a nap. A nurse came in and told me that I was going to get sore nipples if I kept letting Alex nurse as long as he wanted to and suggested I keep it down to ten minutes per side, luckily I knew enough to ignore her advice. Alex stayed snuggled in my arms and nursed peacefully to sleep. I was way too wired to sleep so I just laid there and watched him in silent awe. My family was in and out, Phillip stayed with us most of the time but went home at night. Alex stayed with me most of the time except for when the wanted to poke and prod at him for this test or that immunization. Despite my wishes he always came back with a pacifier. I kept throwing them away, there must have been half a dozen in the waste basket when we left. Sunday night the pediatrician on duty decided Alex needed to be fed two bottles of formula because his blood sugar levels were a little low. Unfortunately I did not know any better so I accepted it (mistake #3). Phillip fed him the bottles and I felt unhappy.
Monday we were supposed to go home. Alexander's real pediatrician came in to tell me that his billirubin levels were a little high (12) and they wanted to keep him under the "billi" lights for a while until it came down. I could not stay another night in the hospital because my insurance would not pay for it even though my blood pressure was still high. The nurses offered to let me stay in an empty room that night but I would be officially checked out so I had to take care of myself and Alex could not stay in my room anymore. Alex was very sleepy and when the nurse brought him to me for his feeding he would not wake up to nurse. Half an hour later she was back for him and I was in tears because he would not stay awake and I had not gotten to nurse him yet. She was sympathetic and showed me how to wake him up and let him stay until he had his fill. A nurse on the night shift was either sympathetic or forgetful and left him with me for four hours for which I was very grateful. We survived the night and were hopeful that they would let Alex come home.
Tuesday morning the pediatrician told me she wanted to keep him yet another night because his billirubin levels were still a little high (still 12). The hospital would not let me stay another night and the pediatrician told me to go home and get some sleep, let the nurses give him bottles and just pump a couple of times. I cried and cried. When Phillip arrived and found out his temper flared - he wanted to pack us up and take us home, I should have let him. I contacted W.I.C. and told them that I needed a pump and a few hours later their breastfeeding counselor showed up at the hospital with a pump for me to use. I stayed at the hospital until midnight. When I finally went home (mistake #4) I told the nurses I would be back at 7:00 am and not to give Alex a bottle in the morning. My milk came in that night and I felt as if I was coming down with the flu. I got up every two hours and pumped but I was still painfully engorged.
When I got to the hospital Wednesday morning I found Alex under the "billi" lights with a half empty bottle and a pacifier lying next to him (grrrrr!). A few hours later the pediatrician came in and let us know that Alex could go home but that she wanted to see him in her office every day for a heal stick until his billirubin levels came the rest of the way down. Looking back I realize I should have checked him out against medical advice. The first day his levels were only a few points higher than the acceptable "average." When they finally did release him his levels were at their highest (15). It really did not make a whole lot of sense -- his levels never even reached the "dangerous" level. Chalk one up to live and learn.
Despite everything that went wrong in the hospital I did get a wonderful healthy baby - I wouldn't change that for anything in the world, but the experience left me emotionally traumatized. Despite bad advice, bottles, pacifiers, and separation Alex and I got off to a fairly good start breastfeeding. He nursed on demand, usually every one and a half hours around the clock for about half an hour to forty-five minutes per feeding. He doubled his birth weight by two months of age and aside from having colic from three weeks of age until about two and a half months of age, he was a very happy baby.
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Natural Mothering: Alexander's Birth Story
First on-line: 01/30/1998