My unplanned hospital birth

The whole family

You may know that I planned on giving birth to my son at home. Jack was born on March 26 in the same hospital where my older son was born after a medically-advised induction of labor at 41 weeks.

Why home birth?

I did a lot of thinking about my first son’s birth once I became pregnant with my second baby last year. I always liked my OB/GYN and felt comfortable delivering with either doctor in the practice when Hugo was born. But I ended up requesting induction when I was 41 weeks pregnant, though there was no medical reason for it. I kind of panicked since Christmas was approaching and my mom was only in town for a week.

Back then, I didn’t know that induced labor increased the probability of a C-section or that I’d be stuck on my back in the bed tethered to an IV pole for 24 hours. I didn’t want any drugs during labor, but didn’t know that the kind of contractions produced by pitocin were a lot stronger, and dare I say, intolerable for the hours that I would be experiencing them. My OB wanted to go home, so he wanted me to get an epidural. Therefore, he dialed up the pitocin until there was no space between the contractions at all. I was stuck at 2.5 centimeters and after an hour of those contractions, I gave in and got the epidural. But then I dilated to 10 centimeters in an hour and was able to  deliver Hugo vaginally. That’s the abridged version!

How this pregnancy went

I knew that a home birth was what I wanted this time. That meant I needed reassurance that everything was fine with the pregnancy, me and the baby before making my plans. I switched to a midwife practice that delivered in a hospital but emphasized natural birth without intervention where possible. Because I’m over 35, they recommend second-degree ultrasounds and genetic screening in the first and second trimester. It was the same when I was pregnant with Hugo.

At 11 weeks, my due date was pushed out about a week when the doctor saw my ultrasound. He also found that there was a small separation between my placenta and the uterine wall. I didn’t know what that meant at the time. He told me it would probably resolve itself but not to lift anything heavy for a few weeks. That meant Hugo, too! It was a big deal for him. I became concerned when I went home and Googled placental abruptions. But when I went back at 19 weeks, I was told that everything was fine, and by the way, it’s a boy!

I made some calls and after some soul searching about the sad state of health insurance that wasn’t going to cover a home birth, chose to switch to a home birth midwife practice at about 20 weeks pregnant. I loved my midwives and the emphasis on not only natural birth, but trusting the mother to take an active role in prenatal care and in the birth itself. I rain into a snag at 32 weeks when the baby turned sideways, or transverse, but he was back in position a week later thanks to chiropractic adjustments and some upside down postures. If he hadn’t been head down well ahead of my due date, I would have had to plan on going into the hospital, and if he didn’t turn during labor, I would have needed a C-section.

41 weeks

My due date came and went, just like with Hugo. I was alternately anxious and serene. My blood pressure spiked at one point, making me afraid that I would have to go to the hospital in case of preeclampsia. But it went back down. I kept watching for symptoms and counting my Braxton-Hicks contractions. I had an appointment with an OB that my midwives worked with when I hit 41 weeks to check my amniotic levels and the placenta with an ultrasound. I had the same checkup at the end of my term with Hugo and thought nothing of it. On the other hand, I had a bad feeling about the appointment. I asked my husband to come with me in case there was bad news.

I asked the doctor if my placenta looked OK and he said “Not really.” What? My amniotic fluid was almost gone and my placenta was calcified (yuck). He recommended that I go into the hospital for induction that evening. I asked if he’d give me a few days to go into labor on my own and he said that though the risk to the baby was minimal, he would not recommend waiting. So that was it. I shed some tears and called my midwives and packed my bag for the hospital. My midwife said she would come the the hospital when I was in active labor, which made me feel better.

Labor and delivery

I was so bummed out when we arrived in the room and I was told to put on the hospital gown. I internally said farewell to the dignity and comfort that I had planned by having Jack at home. I also got a hep lock inserted in the back of my hand immediately, for the pitocin and antibiotics that would follow. The nurse hooked me up to two tight sensors wrapped around my belly with velcro to measure my contractions and Jack’s heart beat. I prepared myself for a long day of waiting and eventual labor stuck on my back in bed.

Things moved much more quickly with this induction. I thought I was going to be able to sleep through the night before my contractions were anything of note, like when Hugo was born. But this time, the pain became notable around 1:00 a.m. Rick was asleep in the recliner for most of the night, thinking the same. The doctor decided to start my pitocin earlier than planned because Jack’s heart rate dropped with every contraction while the effacer was in use overnight.

Last time, I had increased levels of pitocin in my IV for about 12 hours before my contractions got strong. This time, they started me at about 4:00 a.m. and the pain and frequency of my contractions were what I called “intolerable” by about 7:00 a.m. This was with a much lower dose, too. My doctor was in a meeting when I decided that I needed to know where this was going because my contractions were 60 seconds apart and beyond painful. How dilated was I? How much longer could I hold out? I didn’t want an epidural but I couldn’t bear that level of pain for much longer.

I couldn’t tweet or text between contractions anymore. My nurse finally checked my cervix when I felt something change and she said I was 5 centimeters and “very stretchy.” She thought it wouldn’t be too long. I had to keep rolling back and forth because Jack’s heart rate continued to drop when I had a contraction. They said it was because he was lying on the umbilical cord. It turned out to be a little more complicated than that.

I texted my midwife that the pain was horrible and my doctor wasn’t around. She left her house around 8:00 to be with me at the birth. My doctor came in to check me and said I was now 7 centimeters and it wouldn’t be long. The nurse gave me an oxygen mask to suck on during the contractions and a cold cloth for my forehead. I just squeezed Rick’s hand and put the mask over my face and got through it. Rick told me afterwards that he thought that the birth was still a long way off. He was texting his friends and taking pictures (that I hope I will never see again). The nurse told me to call her when I felt the urge to push. She left the room.

Rick’s phone rang, and I guess he answered it because he was holding it. Then I felt like pushing. They had already dropped the end of the bed for me, which was cool. My midwife wasn’t quite there yet and I was no longer able to text her back. I called the nurse and she and the doctor came in. Rick was trying to extricate himself from the conversation he was having with a potential client. I pictured Jack coming out like I had seen in videos and books. Head first, pause and turn, shoulders, then the rest of his body. And that’s how I pushed. It took about 3 minutes and he was born at 9:20 a.m. They said they were impressed by my control! Also that I didn’t get an epidural even though the contractions from pitocin were so intensely horrible.

My midwife was in the building on her way to my room when Jack was born. The staff wouldn’t let her in until Rick went out and got her.

Jack

I heard the doctor mention that she saw some merconium before Jack was born. He pooped at some point beforehand and was completely covered. Also, his umbilical cord was super long and wrapped around his neck twice and his body twice! That explained the dip in his heart rate when my uterus contracted, also some of his movement patterns near the end of my term. He was more active some days than others, even though I tried not to notice since that’s supposed to potentially be a really bad sign. He was so tangled up! The doctor put him on my belly but he was quickly whisked away to the cleaning station in the room to get the poop off of him. I was told that he didn’t require NICU attention that merconium babies usually do because he cried immediately.

Mr. Poop (Merconium) Head

He was such a little peanut! Only 6 pounds,  7 ounces when he was a week overdue! I think it was because my placenta was so beat. The doctor showed me the calcification and general grossness of it. Luckily Jack latched on well immediately and turned out to be a great breast feeder. He gained a pound in his first week of life, which made me feel better about my sad placenta.

I felt like a million bucks because I hadn’t had an epidural that required recovery time and I didn’t tear at all. What a difference! I didn’t notice that my body wasn’t 100% until a day or two later. My midwife said that I should stay in bed for four or five days, which came as a shock. But my mom was staying with me for the first two weeks so there wasn’t a lot of pressure.

Big brother Mr. Go

Hugo loves his baby brother but has let me know in other ways that he is displeased with the change in family dynamics. Sleep “deprivation” from Jack is a walk in the park. He wakes up every two hours (with one three hour stretch) to nurse. He sleeps next to me in bed, so doesn’t cry and I don’t have to get out of bed. Alternating between Jack’s feedings and Hugo’s screaming is a different story, though. Rick has started to get up when Hugo cries at night with varying degrees of success.

I am a lot more laid back this time. I know everything unpleasant is a phase and it will pass. I am loving the time I have at home with Jack (and also the time that Hugo spends at preschool). In fact, everything seemed perfectly reasonable until I fell down a couple of stairs on my butt this morning while I had Jack in a sling. He is unharmed and I am hoping that my tailbone isn’t broken. It’s starting to feel better, thank goodness.

I had always hoped for two children but meeting Jack made me want another baby. I’m not serious. I think.

He smiles