That's Why It's Called a Birth "Preference" Instead of a "Plan"

I have long-struggled to like myself. I hated my body and lacked self confidence in many areas, so finding out I was pregnant just triggered a heightened sense of anxiety for me. Finding out I was diabetic at my first OB appointment made things even worse. As the doctor rattled off the list of awful things that could result, I sat there expecting each to all happen to my baby, and they would all be my fault. I wondered if I could live with myself if I caused such pain for my beautiful growing baby – macrosomia, dislocated limbs during birth, heart and spine defects, respiratory problems… One thing I had been told from the beginning – I would be induced at 38 or 39 weeks due to an increased risk of stillbirth for infants of diabetic mothers. I strongly opposed an induction but wanted to do what was best for our baby.

As the pregnancy progressed and my education on the issues increased, I became “a model patient” (the doctors’ words). My confidence grew as quickly as my sugars and A1C decreased, and for the first time in my adult life, I was actually feeling good about myself and my body. This new-found confidence gave me the ability to try new things (like yoga, which has been life-changing!) And maybe it was my “mama bear” instincts forming, but I was blessed with a feisty courage that I had not previously known to speak up for myself. Did that cause some tension between my doctors and me? Yes. Was it worth it? YES.

At that point, if I pictured our baby’s ideal birth, it would be in a peaceful environment outside of a hospital, calm, quiet, in water, with no interventions. My husband and I took a hypnoyoga birth class and hired a doula. I talked to several midwives; however, they couldn’t deliver my baby, due to the fact that I was taking insulin. I started researching natural induction methods to encourage baby out on her own. I drank red raspberry leaf tea, walked every day, faithfully attended yoga, saw my chiropractor once a week, got acupuncture, used essential oils on acupressure points, and visualized her calm, peaceful birth every chance I had. And still, the induction date (Sunday) arrived with no sign that baby Samantha was going to come out on her own.

As we walked the short hallway to the antepartum wing, I debated escaping. But I was with my husband and his mom, and really, pregnant ladies can’t run that fast. So we checked in, got settled in our room, and I was soon disappointed to learn that I wasn’t even ripe! After three doses of Misoprostol throughout the night, Resident S (that I ended up liking the most) tried and failed to insert a Foley bulb. Also throughout the night, our amazing nurse kept coming in and apologetically asking me to shift positions. He was noticing small drops in Samantha’s heart rate during the tiniest of contractions. (I wasn’t so worried, as that was a normal occurrence from the time I started attending my NSTs twice a week for the previous 2 months.) Finally, after one more dose of Misoprostol and lots of waiting, Resident K was able to get the Foley bulb in. I was hopeful that things would start happening that day (Monday), especially since they moved us to labor & delivery.

By Monday evening, the Resident K was somewhat surprised to learn that the Foley hadn’t come out on its own. So she gave it a tug and it came out…it was Pitocin time! My stomach did some flips thinking about all the stories I’d heard about the dreaded P, but at the same time I was so excited to meet Samantha and I was really ready for things to get a move on. After 24 hours in the hospital, I’d slept about 4 hours and had felt zero contractions. Thankfully we were blessed with amazing and fun nurses, which helped to pass the time. My husband put on my favorite Harry Potter movie, a few visitors came by, and we listened in excitement as the OB on call said we’d be meeting our baby by the end of the day tomorrow.

Here’s roughly how Monday night/Tuesday morning went:

Nurse: “Did you feel that contraction?”

Me: “Nope.”

Nurse: “Let me adjust the monitors; they are slipping.”

Me: “Ok.” (Try to sleep! Try to sleep!)

3 minutes later…

Nurse: “Did you feel that contraction?”

Me: “Nope.” (Try to sleep! Try to sleep!)

Nurse: “Sorry, I need you to move onto your side…her heartrate is not quite cooperating.”

(Repeat 5,000 times.)

And so it continued throughout the night. By Tuesday morning, they had adjusted the dosage of Pitocin more times that I could count – first increasing steadily, then backing off when her heartrate would drop significantly (from the 150s to the 60s…a few times it even went down to 20!) So when Resident K came in that morning, she explained that it was time to break my waters, in the hopes that things would pick up. I still hadn’t progressed beyond the 3cm that she had measured when the Foley bulb was pulled out.

After hearing her out, I told her that I wasn’t ready for them to break my waters. I explained that I was aware of the risks and benefits and that I just didn’t think it was time. (I had hoped getting up and about during the day would help things move along and that my water would break on its own. I’d given up trying to sleep by that point.) Then the OB came in and gave an even longer, guilt-laden explanation about why it was time to break my waters. She started talking about a “failed” induction. Truthfully, I wasn’t really listening. My mind was made up. Earlier my doula had prepared me for this moment and I followed her suggestion in saying to the OB, “I understand that there are risks associated with a labor that’s not progressing, but I am not ready for you to break my water. I would like to continue as things are for now, and if my baby does become truly distressed to the point where she needs to come out immediately, I know that you are very capable of performing a successful c-section very quickly.” After looking me up and down, “Um…actually for a woman your size, a c-section isn’t that quick.” If only there were words for how I felt at that moment. The only thing I managed to say was, “No. Not now.” A few tense moments later, the OB suggested that we take a break from it all. I wasn’t discharged, but they took me off all the monitors, stopped the Pitocin, and gave us 4 hours to walk around the hospital. “Just don’t go outside; it’s wet and you might fall.” (So the first thing my husband and I did after a shower was go outside. I didn’t care that it had been snowing earlier and was freezing…the fresh air felt amazing after 2 days of being cooped up in a tiny room.)

My husband and I ate some lunch, climbed (crab-walked, jumped, lunged) 10 flights of stairs, and visited the postpartum clinic to look at cute baby stuff…and not one contraction. I was so discouraged. I’d truly hoped that my body would take over and decide to bring Samantha into the world! I lost my mucous plug, but that was it. I am so thankful for the support my husband gave me during that time – he had my back through all of this and did everything he could to get me laughing and having fun. I’ve never had so much fun climbing stairs.

Defeated, we returned to the room and I told them I was ready for them to break my water. They did, and I was back on the Pitocin. Things finally picked up. OF COURSE there was meconium in the water, so I knew that she would have to come soon! As the contractions became much stronger, I bounced on the ball, walked the halls with my husband, and stayed on my feet as much as possible. Standing was the most comfortable way for me to labor, but I knew I couldn’t keep it up forever. My mom and my husband’s mom stopped by for a visit as they had each day, and it was sometime during their visit that I realized it was getting too hard to talk during the contractions. And that’s when all sense of time left me. Was it minutes before the doula came? Hours? Not sure. My contractions were lasting 40-60 seconds and coming a minute or less apart. Sometimes there was no break between them at all. Things picked up quickly and soon I wasn’t able to stand through the contractions. My doula suggested kneeling over the back of the bed so I could rest between contractions. How long had it been since I’d slept? Probably Sunday night. I was exhausted. And these contractions were no joke! And my back…my lower back started hurting so bad. Counter-pressure on my sacrum did nothing, hip squeezes did very little. But I was able to turn inward as I’d been practicing and breathe, focus. Through the toughest moments, I could also hear Samantha’s heartrate dropping. A few times during those drops, I panicked inside and I’d lose control. I felt myself crying out or breathing too quickly. I started to feel like I couldn’t do it. Finally, I asked to get in the tub, and the hot water felt amazing. My husband faithfully knelt by, feeding me ice and refilling the leaking tub.

At some point, I fell asleep. (My husband said I was even snoring and he was so relieved that I was getting rest.) Maybe it was only for a second, but I felt so much better. Sure, some of it was the hot water, but mostly it was because my labor had slowed down considerably. Samantha’s heart rate had continued to drop with the big contractions so they were decreasing the Pitocin drip. Meanwhile, I heard some commotion outside the bathroom – my doula was packing up our stuff! The charge nurse had decided that she wanted to close the wing we were on, as there were only 3 other patients on the floor. My husband protested, asking her if she really felt like it was right to move a woman in labor. She relented and told us we could stay. Calmly explaining the situation, my doula told me what was happening and how they had already packed up everything, but we could stay if I wanted. She also suggested that walking to the other wing might help move things along without the help of the Pitocin. That seemed appealing, so they helped me out of the tub. I remember thinking it was funny that they were trying to help me into a gown…at that point I didn’t even care what anyone in the hallway saw.

As we walked through the corridors between the two L&D floors, I stopped to squat through each contraction. By the time we were almost to our new room, I was approached by Resident S.

“Things just really aren’t moving along like we thought they would, and Samantha is in quite a bit of distress during your contractions,” she explained. As I attempted to wrap my sleep-deprived mind around what she was trying to say, I remember sinking onto the bed and asking, “If you can give me advice, what would you do?”

After a long pause, a big sigh, and a bit of a frown, she said, “Well, I think I would have a c-section.” She really knew it wasn’t what I wanted, and I trusted her that at this point it was the best option for Samantha.

It’s shocking how fast you get prepped for a c-section. It seemed like only minutes went by before I’d expressed my “demands” (drop the curtain as soon as she’s coming out, immediate skin-to-skin with me or my husband if I wasn’t able…) and asked questions about the surgery, met the anesthesiologist, and walked to the OR. My doula and husband were both with me the entire time, which was incredibly comforting. The worst part of the surgery was the uncontrollable shaking! I felt a sense of calm going into this surgery, because I knew I was going to meet our dear, sweet baby so soon.

It’s just like they described…it feels like someone’s sitting on your chest. At one point I felt nauseated, several times I felt like I was hyperventilating, and the whole time I was shaking uncontrollably. But then I heard someone say “She’s out!” and I tried to wave my useless arms around and tell the anesthesiologist to move the curtain. I desperately tried to see my baby girl being lifted into the world, but I only saw her once the doctor was carrying her over to the warming table. It felt like an eternity that they were looking her over, and I was calling out “Is she ok? Why isn’t she crying? Stop wiping her down! Just bring her over here!” My doula reassured me that it was only a minute or two, but I was just so ready to hold her! My husband cut the cord and carried her to me. At that moment, I absolutely lost it. I was sobbing, still shaking, and loving my little girl in a way that I’d never thought possible. She was 5 pounds, 14 ounces of pure, seriously adorable perfection

My husband and I had joked throughout the pregnancy that Samantha was a stubborn girl. She just wasn’t ready to come out and wasn’t going to let someone make her! Born on International Women’s Day, Samantha came out literally holding her head up, quietly observing the world around her. My prayer for our sweet girl is that she will grow up a strong woman with the confidence that I only found once I became her mother.

_____

Every time my husband proudly handed off the stunning visual birth plan that I’d designed and he laminated, we’d joke that it was only a birth “preference” because we know that things can’t always go as planned. It still feels like the only thing that went as planned was that our little girl was born, happy and healthy. Today, her 2 month birthday, I’m still struggling with that. And I anticipate that I will continue to struggle for quite awhile. After a bout of high blood pressure and worries of postpartum preeclampsia, extremely low milk production despite 7 weeks of my best efforts and awful-tasting supplements, complications with my incision (two pinky-finger deep holes that aren’t not healing), and postpartum depression and anxiety, I look down at the often smiling face of our sweet Samantha and know it’ll all be ok.

Photo by Tricia Croom – Doula Services.