Wednesday, September 18, 2019

the story of Dd's pregnancy and birth


As Dd’s first birthday approaches, there are some things I’ve been meaning to share and document about his birth and our pregnancy.

I am not accustomed to feeling proud of my body but both of my kids’ births have been powerful exceptions to that. 

From the large volume of birth stories and statistics I have heard and read over the past five or six years I know that childbirth is a nebulous mix of choices, actions and uncontrolled circumstances.  Most of life consists of a similar blend, but pregnancy and birth are tidily defined and acute.  This is to say that we can never be sure how our choices affect our results.

Our kids’ birth experiences have been very positive, with delightful outcomes. I know enough to grateful for my good fortune and genuinely compassionate for women with less positive birth experiences, yet at the same time I want to celebrate some of the things I am most proud of here.

My pregnancy went smoothly except for a few rocky parts in the beginning.  At five weeks while walking up the steep part of Yesler Way from downtown I had alarming cramps and bleeding.  I spent a miserable weekend worrying continuously, rather than just frequently, about a miscarriage.  Then an early ultrasound confirmed Dd’s strong heartbeat.  At this point I moved from my Fit 4 Mom HIIT classes to the Fit 4 Baby classes, which I did once a week up until a month before Dd was born.   Exercising with other pregnant women was fun, motivating and just the right amount of amusing.  Picture pregnant ladies doing burpees or planks where their stomachs touch the ground.  I learned that jumping consistently made me bleed, so I modified exercises and the class was great for me.



Then at 20 weeks the ultrasound suggested Dd was in the 99th percentile for size.   I was able to look back and see that D was also massive at 20 weeks. Some of my providers got very serious about this and vacillated between saying things about my “proven pelvis” (Thanks D!) and terrifying complications like shoulder dystocia.  They do not recommend elective c-sections for large babies, but I think it is still done.

Estimating fetal size is a very inexact science.  Ultrasound size measurements can be off by as much as 30% and the estimate from the hands of an experienced midwife are actually more accurate.  More importantly, shoulder dystocia is about the interaction of the size of the baby and the size and of the mother, so it unfortunately happens with small babies too. 

I worked really hard to not let the specter of an 11 pound baby freak me out.  We took a refresher birth class and spent time rehearsing birth positions that open up the pelvis.  I was simultaneously worried about labor not progressing due to size and labor progressing too fast, based on the speed of my mom’s deliveries and on the relative speed of D’s birth, considering his size and status as a first-born.  Fear is not good for labor and I am really proud of how I trusted my body and kept my worries in check. 

I started off my pregnancy with Dd much heavier than I started off my first pregnancy, but I gained only half has much weight.  The concern about fetal size motivated me and I was trying to not gain too much, but really it was about 10 times easier than my recent non-pregnant weight loss experiences. 

Those same long terms weight struggles, a few injuries (knee, wrists) which somehow have felt like my own fault have eroded the confidence I once had in my body, which probably peaked at age 15 when I was a decent runner.  Birth and breastfeeding build me back up. 

Enough about pregnancy.  Now, for the record, here is the story of Dd’s birth.

As with D my labor began with three weeks of slow dilation, with no noticeable contractions.  This type of labor is absolutely not covered in any of the books and sites I read, which I found frustrating.  It felt like he could come any day and we were ready, especially since we didn’t want him to grow too big as we sailed past his due date.  Here's what I looked liked, one day overdue.





I had acupuncture twice, bounced on a yoga ball, walked, had my membranes swept 3-4 times and followed all of the other advice to bring on labor.  I worked until the day before my due date.  My parents returned from their trip to Maine without missing anything exciting.  We planned to have an induction, as with D, on Monday, Oct 1st, when we were five days overdue.  Swedish was full though so Jack and I wandered around the Mount Baker neighborhood, looking at houses and waiting to see if space opened up.  It turns out that my water broke with a slow leak during the walk but it was really hard to tell and the advice on how to check didn’t really work.  Dd was pushing down hard enough that hardly anything leaked out.   Kathy came to take care of D in the event that we got a spot, then returned home again.

In retrospect we were glad that there was no room for us at the hospital on Monday because Tuesday morning I woke up at 2:30 am with strong contractions that were about a minute long and about 12 minutes apart.  Kathy came back to watch D again.

Even with my history, the midwife on call suggested we wait until contractions were 5-6 minutes apart.  I was really not okay with that idea because I expected things to go fast and I was supposed to have an antibiotic administered four hours before birth for strep B.  She was accommodating enough to let us come in anyway, so we left for the hospital at 4 a.m. on a clear starry Tuesday morning.

My contractions were still 12 minutes or more apart, but they were strong.  At the hospital a few miles from our house we found our way out of the labyrinthine parking garage to the room waiting for us, arrive at 4:30 a.m.  They got the IV in on the first try, unlike the hour it took with D’s birth, and I started the antibiotic at 5.

The contractions sped up to an interval of about 6 minutes.  I threw up a bunch all over the floor and a little bit in to a trash can.  Jack asked me several times if I wanted to walk around a bit, just like a good birth partner.  I definitely did not want to.  I leaned back against him for a while and somehow managed a bizarrely deep sleep in between contractions.  We didn’t know my water had already broken they did not check my cervix (which they do as little as possible to avoid contamination).

We talked with the midwife, Hilary, about waiting to see how things progressed and then breaking my water at about 7:30 am.  Around 7:40 she checked my cervix and I was already 7.5 cm and we learned my water was already broken.  I was feverishly hot and I threw up a bunch, again, although my stomach was empty.  Yuck.  I rambled about epidurals.  Then I got in the tub, which felt a little better.  The contractions were much more frequent.  After 10-15 minutes in the tub I got out to use the toilet, and quickly realized I had mistaken my bodily urge.  It was time to push, RIGHT THEN.  Jack and I were on our own in the bathroom.  He called everyone back in, using complete sentences, which seemed excessive given the urgency I felt.

They got me back in bed, confirmed I was at 10 cm and Dd was born about five minutes later at 8:05 (?).  I think I only had two or maybe three contractions in the bed, but Hillary had me push continuously, rather than with contractions.  I yelled a lot and it was a blur.  Jack did not get to catch him, because of the speed and the fetal monitor cutting out.  Hillary turned him as he came out, to unwrap the cord.  He was quiet and fairly blue, but he came right up on my chest for the first hour and nursed pretty well.   We found out he was a boy.  Happily he was a whole pound less than D, though still big enough that they checked his blood sugar often. 





We went home about 28 hours after birth.  Jack and I were eager to go for many reasons, including the fact that we both had painful sore throats, presumably from the AC in the building.  In no way do I wish I’d had a home birth, but the hospital is certainly not a place for peace and quiet.   Nurses, doctors, midwives, audiologists and photographers came in.   I was amused to realize that we didn’t know the last names of our midwives, with whom I was intimately acquainted.  The visits from family were welcome interruptions.

I felt glad that I insisted we come in when we did and to have chosen providers who respected our instincts.  They said three hours of antibiotics was close enough to four to be protective.

The immediate recovery was way faster than with D, though the longer term changes to my body linger.    Nursing a newborn is a mix of mother and baby learning and I was surprised by how much my experience helped.  Dd grew beautifully.   Though he was smaller than D at birth, he was bigger by three months and now, at 11 months, has achieved the 99th percentile predicted by that unnerving ultrasound.  




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