Sunday, January 2, 2011

Caleb's Birth Story

For better or worse, this is how Caleb's labor and birth occurred. It's long, so if you make it to the end ... well if you make it to the end you know you have a good attention span. ;)

I still have the range of emotions to work through with all that took place. Thankfully people who know me well enough, know that I never ever would have stepped foot in the hospital (nevermind consented to a cesarean) if it weren't 100% necessary. I can deal with the questions and skepticism from people who don't know me well - because I myself have been guilty of skepticism. If you're up to a long read - here is our story.

Caleb was persistently breech from 34 weeks on. What was ironic about all of this is that at about 30-ish weeks, Jeramy had a birth dream. Let me start by saying that Jeramy has NEVER had a birth dream. I love my husband, but he is not one to be connected to me or baby during pregnancy. It's just how it is. But he woke up one morning and told me that he had an incredibly vivid dream, in which the baby was born footling breech. I was on hands and knees on our bed, and he watched as feet emerged, then a bottom and scrotum, and then he caught the rest of our son. He said he saw that he was covered in vernix, was smaller than our other babies, and had a head full of dark hair. None of our other kids had had ANY hair at birth, and then were blond. I laughed it off, no reason to believe at this point that I would have a breech baby.

I started seeing a Webster trained Chiropractor twice weekly at that point, in hopes of keeping my pelvis (lower back and pelvis were injured in a car accident 10 years ago, leaving me with permanent damage and issues) and hips aligned so that he could turn. In the 7 weeks of this, I only felt and confirmed that he flipped head down twice. Other than that, he was always breech. I had a hard little head right underneath my ribs, and could feel the little movements of feet down by my pelvis. I had never had one of my babies be in the breech position before, so it was interesting to me. Frustrating for a while, as he not only had his head under my ribs, but he was so high up that it made normal everyday things very uncomfortable.

I would love to say that I was 100% comfortable with breech. I have attended breech births that have gone beautifully, without a hitch. But I *was* slightly worried, since I have big babies and he was not just breech but posterior breech. I emailed a few friends that are veteran Midwives to seek thoughts and wisdom. I was planning an unassisted birth, and Caleb being breech wasn't going to change that. Partly because I don't have a Midwife in the area that I would feel comfortable attending me, but mostly because I wanted to give birth with just my husband. With breech, it's a wait and see because babies can always flip even in labor. And there was no way I was going to go into the hospital, even with my incredibly amazing back up OB.

On the day before Halloween I woke up with some pretty strong contractions early in the morning. They began to get closer together and stronger. I lost my mucous plug and then saw some bloody show. I was going to have him early! I was going to have an October baby!! I was so excited. I put a friend who was going to do birth photography on alert, and called my apprentice who was going to come to help with the kids and help my hubby with cleanup to let her know that I thought today was "it". Contractions continued steadily for a few more hours - and then just stopped. I was confused and frustrated. It hadn't been just prodromal labor, so why did it stop? I did this THREE more times before I had him. I actually went into what would be classified as active labor with cervical change (noted by loss of more mucus, more bloody show, cervical needling), only to do it for a few hours and have it stop. It began happening at night to where I couldn't sleep. I'd be up with contractions.

At about 39 weeks I figured out that he was pretty much cemented in the posterior complete breech position. Not good. I broke down one night and just started sobbing. I talked to Jeramy about what was going on - fearing that I was losing my birth. I was starting to feel like things weren't going to resolve, and I was going to end up in the hospital. I was *terrified* of this. My last birth was supposed to be a beautiful unassisted waterbirth. I was supposed to pull my baby up out of the water, and then snuggle into bed to start our babymoon. But at this point, I had no solid evidence that I couldn't birth him or that I would end up in the hospital. I talked things out with a few very close friends and was encouraged to pray about it all, and trust that things would work out the way they needed to. I didn't know why I continued to go into labor and then have it stop - I was just going to have to trust.

On November 12th, just one day after my due date, it was on. I started contracting regularly but mildly that evening. This continued on all weekend until things got really rough on Monday afternoon. I had had very little sleep over the weekend, and tried to rest as much as possible. I got up at about 3am on Tuesday, not able to lie down anymore, and had Jeramy fill up the birth tub. I needed water. Contractions were very hard to work through, because I had them in my back and in my butt. We lit the candles I had gotten out for labor, and put on my labor music. Once I sank into the hot water, it helped a bit. I was able to work through them if I got up on my knees and leaned on the side of the tub. I did this for a few hours, and called my apprentice, Kayce, at about 7:30 or so. We were going to send the older 2 off to school, but I needed Jeramy and he was trying to keep Megan company. Kayce came a short while later, just after I had gotten out of the tub to see the kids off to school and have a birthday breakfast with Megan. She turned 5 that day. Contractions were still very hard, but were spacing out. We decided to have Jeramy go into work since his time off was going to be limited once the baby came, and I would call him back if I needed him. We settled in with a movie and I dozed on and off in between contractions. I hadn't slept more than 2 hours the night before. At about 1pm, the contractions had REALLY spaced out. Once again I was confused, frustrated, and wondering what the hell was going on.

That night I had another breakdown. I told Jeramy something was wrong. This wasn't normal, and it wasn't a good sign for a breech birth from what I knew from my training. Yes, there can be variations in normal for breech births. But everything put together just wasn't good. I was sobbing. I told him I didn't know if I'd make it out of another cesarean, emotionally. I was afraid of going back into the operating room. I was afraid of re-living the experience with Noah. And mostly, I was heartbroken over the idea of losing the birth I so desperately wanted. At this point, there was still nothing solid though. After talking with him for a while, and talking with a dear friend who had known me since even BEFORE my HBAC with Megan, I decided that unless he was born that night that I would go in for a consult with my back up OB. I was thinking about an ultrasound to see if there was any visible reason for the labor not progressing into the birth.

It seems that I had barely laid my head on my pillow when I was slammed with horribly strong contractions. I'd try to sleep and then BAM! I'd get hit with one, and have to jump up onto hands and knees. I did this until about 3:30am when my water broke. I got SO excited, and called Jeramy in. My water broke! Now hopefully things would progress and Caleb would be born soon. I was renewed with hope, trust, and belief. I could do this. I had Jeramy re-light the candles, I put on my labor music, and I got back into the tub. Contractions were very strong, and very close together. I thought it wouldn't be long, and we'd finally meet our little boy. At about 6 or so, I texted Kayce to let her know that this was it. No need to hurry, but it was going to be soon. I texted the birth photographer friend to let her know to be on stand-by. I labored in the tub mostly, but also got into the shower at one point, much to Jeramy's worry. LOL He knew I couldn't go far without having a contraction, and was worried about what I'd do to work through them in the shower by myself. I reassured him that I would hold onto the bar in there and squat if I needed to - which I did, several times before getting out. Just before Kayce came at somewhere around 8:30, my body began pushing. Not very hard yet, but pushing nonetheless. I was so excited. This was it!! I had to have Jeramy do counterpressure on my back with each contraction and push- it hurt *so* badly. When Jeramy had to walk away to handle something with Megan, Kayce jumped in and pushed on my back. I was in quite a bit of pain - more pain than I was in with Megan in her posterior labor at this point. I was cursing with each contraction, and then would apologize after. Haha. I had never felt pain like this, it was different. It wasn't just in my back, but in my pelvis as well.

After a while of this, I decided to check to see where he was. I was able to find him. A very soft little bum, though pretty high up. I couldn't feel cervix around it at all. I was excited to feel him. I could do this. But the pushing sensations were stronger and stronger and the pain became horrible. They were on top of each other, no break. I felt again after a while (had to be over an hour later), and he hadn't moved down. I did this a few more times - probably an hour or so after each other, and he *still* wasn't moving down. I was worried at this point. At the very least, he should have been descending. He wasn't. I cried. I kept thinking that maybe if I kept going, if I pushed harder ... he'd come down. Pushing was strongest while sitting on the toilet, so I did that for a while. No change. I cried more. Contractions were double peaking and SO painful. I asked someone what time it was and was shocked to find out that it was now after 1pm. My body had been pushing for five hours, and he wasn't moving down. I knew he was in the same position as he had been all throughout the very end of pregnancy - not because of checking internally, but from where his head was. His head was in the exact same spot - exact same height - as it had been all along. Waters releasing, pushing for five hours ... he hadn't moved down at all.

I made the very difficult decision to go into the hospital. Poor Jeramy was upset. He wanted to make sure that I was 100% sure, and ready for it. He was worried about me. The car drive to the hospital was excruciating. My body was still pushing, and this time I wasn't able to get on hands and knees or have someone do counterpressure. It was horrible. We live about 15-20 minutes from the hospital. When contractions are roughly 2 minutes apart and double peaking, this feels like FOREVER. I called my back up OB on his cell phone on the way to the hospital, explaining the situation as best as I could, and asked if he would be willing to meet me there.

We got to the hospital and I had at least 3 pushing contractions on the way to the nurses station, allowing for strange and concerned looks from people on the way. I explained to the nurses that I was a Midwife, my baby is in the complete breech position, I had been laboring for 24 hours (I fudged it so they wouldn't freak out even more if I had said nearly 48 hours!), and waters had released at about 3am. I said that I had called Dr. C to meet me there and I wanted to talk to him about my options. Eyes went wide. I'm sure they were wondering what options I was speaking of, since baby was breech. Haha. And I'm not sure why I said that, because I knew that a cesarean was needed. I had some idea in the back of my mind (no sleep, and active in the 2nd stage here) that maybe if I just got an epidural, he would come down. Maybe an epidural would relax everything enough, allowing for him to come down and out. But I knew that wasn't the problem.

I was taken into a L&D room for assessment, and roughly 10 flipping people followed me in. It was like they were in panic mode, which was annoying to me in labor. Jeramy was NOT thrilled about this turning into a circus, and I could see the frustration on his face. The nurses were trying to rush about me, and I had to put my hand up to stop them each time a contraction came on. One tried to tell me to stop pushing. HA! I know you don't see it in the hospital much, but my BODY had been pushing for nearly 6 hours at this point. *I* wasn't doing a damn thing. I told them what position and what station baby was at. They kept asking me how I knew. Had I had an ultrasound recently to confirm position? I said no, that I am a Midwife. They didn't get it. How do you know? I told them that if I didn't know what position my *own* baby was in, I wasn't a very good Midwife. ;) The nurse asked for permission to do an internal exam to confirm, and I consented. She seemed surprised to find him exactly as I told her he was. :sigh: Another nurse tried finding where his heart was for the monitor, and I had to place it on my belly because she wasn't listening to me. Mom couldn't possibly know, even if she claims to be a Midwife, right? It wasn't until Dr. C walked in that the atmosphere calmed down. He walked in and casually sat down in the chair next to the bed, and asked ME what was going on. Everyone else settled down, and a few people left the room. I explained to him what was going on. He knew how hard it was for me to not only be there, but to be heading into surgery. I had spoken with him when we first met, about my first cesarean and all that had happened. He knew that this was difficult for me, and reassured that he would do whatever he could to make this experience as bearable as possible given the circumstances. He asked what my wishes were - what I wanted done and not done. I ran down the things we would be refusing, and he said he would make sure the staff knew. I spoke with the anesthesiologist and told him I didn't want ANY narcotics in my IV during surgery. With Noah they had put one in routinely without telling me, and I was incoherent and falling asleep the entire afternoon after surgery. I wanted to be awake, coherent, and able to breastfeed immediately. After warning me about the pain I'd be in after the spinal wore off, he agreed not to add anything. I relaxed a bit. Someone was not only listening to me, but respecting me. Thank you God.

He left to prepare for surgery, and Jeramy sat down where he had been so he could make eye contact. He looked so upset. I got teary and just told him over and over that I was okay. It was going to be okay. That I knew this is what had to be done. The baby wasn't moving down. Still hadn't moved down, even though my body was still pushing. We asked for a disposable camera since we had ran out of the house without anything. They took me into the O.R. to get my spinal while they got Jeramy a surgical suit. The contractions while in the bed were unbearable. My back was starting to go numb at this point from the pain. As hard as it is to admit, I was desperate to get the spinal in place and working. I worked through things at home relatively well, when I had my water and different positions and someone to push on my back. In bed it was beyond doable. I had a contraction after getting down off of the bed they wheeled me in on, and apologized for the mess I made on the floor with the meconium coming out in strands from the baby and the fluid. The nurses and anesthesiologist laughed and told me it was okay - they were used to it. Thankfully the spinal got placed without any problems - even though I had a contraction mid-placement. Jeramy came in and smoothed my hair, kissed my cheek. I could see the concern on his face. I just wanted to get this over with. I was back in my nightmare, and just wanted to focus on the baby.

To my surprise, Jeramy decided to stand up and watch the whole surgery. It was taking longer than I thought, and Dr. C told me that I had a ton of scar tissue - more than what he should be seeing for only one prior cesarean. Jeramy told me later that he saw how much he was having to cut through. It took a while to get to the baby. As soon as he got through to the uterus and was opened, Dr. C told me that the baby was literally sitting *on top* of my pelvis, cross-legged. Jeramy later told me that he watched as Dr. C reached in my uterus to get the baby out, and it seemed his entire arm was inside of me - that's how high up he was. I'm not sure he was even out all the way yet when I heard a nice, strong, vigorous cry. I was relieved. Things were VERY different than with Noah, but I was terrified of having him not be able to breathe, and needing NICU assistance. He cried beautifully. I listened as everyone remarked on how BIG he was. What a big boy! Jeramy looked down at me and chuckled, and said he was quite big. He was put in a blanket, and then they actually handed him to Jeramy!! I was pleased with this. Jeramy walked him out to be checked out, weighed and measured, and was right back by my side to let me check him over. He told me that he had a lot of hair, and that it was black. So these parts of his dream were confirmed. Breech baby, and dark hair. He told me that our "little" boy was 10 pounds 6 ounces, just 4 ounces shy of what Megan had been. He also told me that he agreed on the name Caleb (one he had been fighting) and gave him the middle name of Eliuddin. Eliud has a biblical meaning of God's majesty. Jeramy added the -din years ago, as he really liked it. Caleb had definitely been waiting to be born. His skin was extremely dry, peeling, and cracked. His nails were so long that they had begun to curl under into his skin. Poor guy had been trying to be born for weeks, I believe, and just couldn't.

As Dr. C was finishing up, Jeramy took Caleb back to the room I would be in for about an hour. I followed them just 10 minutes later. As soon as I got settled, Jeramy handed me our son. I got my first good look at him and couldn't stop kissing him. I looked at Jeramy, and he had tears in his eyes. He told me that this experience was almost healing for the experience with Noah. This one we knew was necessary. We were treated with respect. Caleb was handled gently, and had no drugs or anything else in his little system. He was latching on and breastfeeding within 30 minutes of delivery. This wasn't what we wanted or what we had planned for. But giving the situation, it was the best we could have asked for.

Caleb never left my sight after that. The nursing staff was amazing with me. Incredibly respectful, incredibly sweet and understanding. Weight check was done in my room. Hearing exam was done in my room. He didn't get a single vaccine, and wasn't poked once during our stay. I refused the initial PKU test there, as we decided to wait until the 2 week one. I refused everything else...and didn't meet any resistance in doing so.

My recovery wasn't what I would wish on anyone. I received the gift of horribly bad hemorrhoids for my 6 hours in pushing. I was exhausted and incredibly sore from the nearly 48 hours of laboring that I had done. The next day when Dr. C came to see me, I asked about the surgery. He said that my bladder and a loop of intestine had been adhered to my uterus. Caleb had also been wrapped a few times in his cord - including around his neck. He said that the combination of these things along with the scar tissue was probably what impeded Caleb from being able to turn, or descend. I'm glad that Jeramy watched the surgery, because he confirmed the cord being wrapped so many times. Dr. C said that the way that Caleb had been sitting on top of my pelvis hadn't helped anything either. He didn't comment on his weight at birth being any reason - as he said that he knew I could have birthed him had he been vertex.

Coming home was emotionally difficult. The birth tub was still up, the birth supplies were still out. When I had a breakdown nearly 2 weeks later, Jeramy said he hadn't even thought of putting them away due to this, and hurried to do so. I was grateful to know beyond a shadow of a doubt that the cesarean had been necessary, but was mourning the loss of the birth I had dreamed of. Caleb is my last baby. I will not have anymore. I lost forever the birth that I wanted so badly. My last birth was supposed to go so differently. Have a much different ending.

I am still dealing with physical and emotional healing, 6 weeks later. My incision hasn't fully closed yet. It was mildly infected at 3 weeks postpartum as well. My pelvis is still causing pain, which makes sense now knowing that every contraction and push was pushing him *onto* it. I slept out on the couch for 2 1/2 weeks because I could not sleep on my side, and it was easier to get on and off of the couch. I have my days where I can acknowledge that the whole experience was even somewhat empowering. I gave Caleb the gift of labor. I didn't go in simply because he was breech - I waited until I knew 100% that it wasn't possible for him to be birthed vaginally. I stood firm on what we wanted and didn't want while in the hospital. He had no drugs and didn't get poked once while there. This was the very least I could do for my son.

Then I have my tantrum days of "WHY?!?!", and jealousy when I hear of perfectly smooth and beautiful home births. Especially unassisted ones.

One day I'm sure I will have maybe an inkling of understanding of why this all happened the way that it did. I firmly believe that everything happens for a reason - even the bad things in our lives. I am grateful for an amazing doctor who respects the birthing process, respects women, and who understands what it can be to a woman when things don't go as planned. I am grateful that the hospital staff bent over backwards to make sure that we were listened to. This experience could have been much worse.

I will have pictures soon to post, once I finally get around to taking the disposable camera in for developing. I have no idea what shots Jeramy got in the OR, or how I'll do when I see them. But they are there.

All in all - I lived through it. And I am not as emotionally screwed up as I thought I would be, having gone through surgery again. I am thankful for a husband who truly gets all of this. Who is there for me when I just need to cry, even though it's been weeks since the labor and delivery. Even though our son is healthy and an absolute joy. Not once has he said "But at least he's healthy", or compared this to our experience with Noah. He understands this time. And that has made a huge difference.

2 comments:

  1. Christine, This is Gail Tully. Thank you for sharing your birthing journey with us. Now this is a birth where you did EVERYthing. Sometimes it is just how everything is, cord, angle into the pelvis, size, all together where alone.... well. Reading your story shows me what a strong, centered woman you are. Thanks for sharing this. I'd love to link to it from Spinning Babies. We had a couple of other breeches in the community with quite similar stories, sans cord. But they couldn't slip in. Usually posterior breech is Good. Jane Evans shares RSP is the optimal starting position for breech. But how the legs were bent with restriction from the scar tissue and the cord preventing more rotation makes much sense. The start and stop labor was definitely a clue as you say, though many breeches can do this if they can at last swing into the pelvis. Sigh. Again I thank you for sharing your heart, your soul and your determination.
    We have a lovely OB, much like your Dr. C, who is attending Breeches as Jane Evans and Dr. Louwen suggest, entirely hands off and w the mother on her hands and knees. He sat patiently w a 5-hr pushing and a 7 hr, 5 actively. But small progress was made with the bigger contractions. But also, certainly, we've had some that switched to surgery. The wide spectrum. You know your story so well, the causes and effects... who can know all, but you pick out the aspects that make much sense to me. I hope you have a lovely postpartum, between the tears, and wish you lots of milk and nuzzles with your boy. He's gorgeous!

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  2. Dear Gail,

    I never saw this comment. This brought tears to my eyes, on top of the communication that we have already had between the ICAN conference, and the emails. Thank you so very much for your input and your kind words.

    If you are sill interested, nearly a year later, you are very welcome to share this on the spinning babies site. Thank you.

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