About four days before my due date, I went in for one of those lovely prenatal appointments. I had done my best to go see my midwife the very minimum of times throughout this pregnancy. I mean, this was my fourth pregnancy, and other than nausea and exhaustion, nothing out of the ordinary had happened in any of the pregnancies. I considered myself a pro at this by now, and didn’t need a nurse, doctor or midwife to check me out every week, and tell me that I was still pregnant and that the baby would be coming soon. I mean, seriously, tell me something helpful!
So I was at the appointment that I couldn’t get out of, and the tech was checking my blood pressure and taking my weight, and generally bugging my hormonal 39 week pregnant self. And then my midwife Mary came in the room. Mary is a sweet, gentle, compassionate woman who makes you feel instantly comfortable and in capable hands. She was concerned because my blood pressure was a little elevated, and when I mentioned that I had been seeing blurry lines at the edges of my vision, she was a little bit more concerned. She felt that I was at a risk for pre-eclampsia, and told me that I would need to come back tomorrow to check my pressure again. And that if it once again was elevated, that they would probably need to induce me. Mary is well aware of my aversion to medicine, hospitals, medical intervention… the list goes on and on. So she knew that I would not be happy about induction, especially because I was induced with Javi and it was a terrible experience. So we agreed that I would go home and take it easy, and she would run the necessary bloodwork to determine if I did indeed have pre-eclampsia, and we would make a plan from there.
On Wednesday my midwife called and told me that the bloodwork had indeed come back positive for pre-eclampsia, and that I needed to come into the office that day to begin the induction. The kiddos’ last night of Awana was that night though, and I really wanted to be able to go see them get their awards, and honestly, I was just trying to delay the process as long as possible. I had just barely tested positive, my levels were really low and I was feeling okay, so my midwife agreed to let me wait until Thursday to come in to start the induction.
On Thursday I headed back into the office and met with one of the other midwives, Lauren, to discuss the results and what our options were. Lauren is young and was very informed about all of the ways that we could attempt to start the eviction process. Luke came with me because at the end of my pregnancies, he takes over being the level headed, logical one while I turn into the hormonal, crazy pregnant female. He asked lots of good, clarifying questions so that we could make the best choice for me and baby.
One of the other things that had the doctors and midwives concerned is that I had once again tested positive for Group B Strep bacteria, which is common in pregnancies and had happened during Declan’s birth. The routine treatment is to flood the mother’s system with an aggressive course of antibiotics during early labor, so as to kill off any bacteria that might infect the baby on their way out. This is the recommended treatment, so it is what I did with Declan. But the antibiotics severely messed with my system, and I’ve had some pretty serious digestive issues since then. So when I tested positive again, my midwife Mary and I discussed what the other options were. If the mother chooses to not have the antibiotics, then mother and baby are kept under close observation for an additional 24 hours in the hospital to make sure that the baby is not showing any signs of infection. I agreed to this, plus my midwife knew that historically once my water breaks my babies come very quickly. We had discussed this since with each baby I had needed outside intervention to break my water, and once that was done I quickly progressed to the point where I could deliver. Since the length of time the baby remains in the birth canal increases the likelihood of infection, and my kiddos tend to spend minimal time in there, Mary felt comfortable that there was even less risk.
But now, the combination of Group B Strep risk and Pre Eclampsia risk was making the midwives concerned. And of course, Mary was off for the weekend, so I was dealing with a different midwife that didn’t know my case as well. So we finally settled on induction being necessary, but we took the most natural method possible – a Foley bulb. In regular people terms it’s a water balloon that they inflate inside of you to put pressure in all the right places to encourage labor to begin. There are no drugs and it either works or it’s removed and they try something else. So it seemed like a good option to start with. I was having no contractions, and no feelings like labor was beginning, but we were hopeful that Foley would kick things off. So Lauren the midwife got it all into place, which is not a comfortable feeling at all, and they told me that it would either come out on its own in 24 hours, which meant that labor should begin after that, or it would not work, and I would need to come in to the hospital at 9am to start the induction.
A friend came over that afternoon to pick up the three older kids so that we could go to the hospital whenever we were ready. I was a bit of a basket case sending them off, I was just feeling so stressed from the possible risk for the baby, the fear of going through another induction, and having to send the kids away for an indeterminate amount of time. Inductions that begin from zero can take FOR-EV-ER, so I didn’t know how many days I was sending the kids off for. They of course were crying and emotional too so that didn’t help.
I did my best to sleep that night, and each time I got up to pee I checked to see if Foley was doing its job. No water balloons had fallen out yet, so each time I just went back to sleep. But at 6am, once again woken up by my uncomfortable bladder, the Foley bulb came out and we were put on a new timeline! I called the midwives and left a message that we would not be coming in that morning for an induction, as the next step after the Foley came out on its own was to wait for contractions to start on their own. We slept a little longer and then spent the day alternating between resting on the couch and going for long walks to get things moving. After I got really stir crazy and stressed out at home, we headed to IKEA to walk around there instead. After a couple hours of furniture testing and lots of steps put in at IKEA, we headed back home to rest. Contractions would come on in tiny waves, two or three at a time, and then immediately peter back out. So we went back to home to sleep for a bit, hoping that the rest would encourage things to move along.
Meanwhile, the midwives never checked their messages and therefore never relayed to the hospital that I was not coming in for the induction. So throughout the day I had a variety of panicked people calling me, telling me that I was expected, and where was I, and why wasn’t I showing up for my medically necessary induction. So I spent quite a while returning calls, explaining all the miscommunications between the medical people, and letting them know that at this point I was having contractions, but they weren’t strong enough to warrant coming in to the hospital yet, and I was going to manage them at home. Lauren was not working that day, so I had moved on to dealing with a third midwife, Shana. I had only met Shana two other times, but she seemed to be trying to get up to speed on my history and agreed to let me wait until the contractions were serious to head in to the hospital.
Around 11pm, I felt like I had had enough contractions to finally warrant a pattern, and they weren’t tapering off as soon as I sat down or lied down. So we headed to the hospital, finally. The staff there was relieved that we were finally under their supervision, and immediately started doing all of the medical stuff; retaking my blood pressure, checking my labs, getting a pattern of the contractions, etc. I told them that I was hoping to go without an epidural this time, and that I wanted as little monitoring as possible. I had to keep making this request, as hospital policy always prefers to have you hooked up to their little machines, rather than be on your own. I understand it, but it’s annoying. The nurses told me that they had called my midwife (Shana) and that she had a relayed a message that she had just finished a delivery and was headed home, but would check on me in the morning. To be honest, the fact that she didn’t come in to check on me ticked me off, since earlier in the day Shana had been so upset about me not coming in for the induction, and had gone on and on about how worried she was about me.
We spent the next several hours alternating between resting in the room and walking around the halls of the maternity ward, trying to keep up a good pattern of contractions. They were steady and intense when I walked, but would level out when I laid down. Around 4am I fell asleep, and when I woke up at 6am from a nurse coming to check on me, my labor had stalled completely. No contractions, nada. I spent another hour or so resting in the hospital bed while we waited for Shana to come in for the day and get her opinion on what to do next. We were torn between heading home and waiting for things to start up again, and wanting to move things along to get this little baby out safely. In a sense, I felt like a ticking time bomb – as long as the baby was inside me, with all of the health issues that were going on, the medical professionals were getting more and more impatient to move labor along and do things according to their level of comfort.
When Shana came in, we had a long discussion about the pros and cons of continuing an induction. She talked with us for a long time about the options that we had, and told us that if we decided to go home she would back us up. But because of the pre-eclampsia and the group b strep (and my request to not do antibiotics) she needed a doctor to sign off on letting us go home. We talked about it for quite a while, and then asked her to leave us alone for a few minutes so we could discuss it in private. I was really emotional at this point – tired, worn out from worry, and trying to make informed, wise decisions while still protecting my little baby. On Wednesday I had been adamantly against any kind of induction, but now, on Saturday morning (her actual due date) I was feeling like we needed a kickstart to get things going again. We finally decided on a round of Pitocin to begin contractions again. The midwife was confident that because I was so far along, and labor had started (even though it had stalled) that a Pitocin drip would be the kickstart I needed to get things moving. I struggled a lot with the decision since I knew I was giving up the intermittent monitoring, and also because I was afraid that once I started Pitocin there was no going back if it didn’t work. But Shana assured me that if nothing happened, then they would just turn it off and we would consider our other options. So they gave me all the stuff I needed to start pitocin – saline drip, half hour of monitoring, etc. Then they started the Pitocin, and ramped it up over the course of about a half an hour. Contractions started right back up, and by the end of the hour they were strong enough that I was shaking as I bounced on the big birthing ball and breathed through them. I spent about two hours managing the contractions with the Pitocin, and the nurses kept slowly ramping up the dosage until I was in a pattern of solid contractions that I couldn’t talk through.
When I checked into the hospital the night before, I requested a birthing room that had a large tub in it. My goal with this baby was to not get an epidural, and I knew that a tub would help me get through that really hard middle part of labor where things are really painful but it’s not time to push or anything yet. I had been waiting for that tub until I felt like I was really going to lose it, using it as my reward, something to look forward to that would help ease the pain. I could tell by the way that the contractions were intensifying that we were making progress, and I asked my midwife to check me. She said that I really hadn’t progressed much more beyond where I had been a few hours ago, and I once again brought up the fact that I need my water to be broken before I finish progressing to the pushing stage. She didn’t listen and told me to keep managing the contractions. So I asked Luke and the nurses to start filling the tub as I knew I needed something, at least psychologically, to help with the pain.
A big huge tub of water always feels great to me, and this time was no exception. Yes I was in labor, and yes the contractions were getting harder and harder to get through, but once I got in the tub I was able to relax between the contractions and get somewhat comfortable. Once I felt a contraction coming on I would hold Luke’s hand and try to breathe through it the best that I could, and then lay back and rest in between. I wasn’t able to get as comfortable as I would have liked because of those dumb monitors, but it was still better than anything else.
After a little while in the tub, the contractions began to feel different. It was an instinctual thing that I couldn’t place my finger on exactly, but I called the nurse and told her that something had changed. She called Shana, who came in and wanted to check how far along I was. She insisted that I get out of the tub for this part. Here’s where I wish I had just stayed put.
Everyone helped me get out of the tub, and as soon as I did, it was huge, wracking contractions that I could barely manage. I somehow managed to get into position on the bed, and the contractions were unbelievably strong. I vaguely remember thinking “if I haven’t progressed, I’ll have to get an epidural now” Shana checked me and I was a 7, which was frustrating. While checking me, she repeatedly told me to relax and not tense and to breathe through the contractions. I remember thinking, “that is LITERALLY what I am trying to do!” Then she said, as if the idea had just come to her, and wasn’t something we had discussed repeatedly over the last six hours, “what if I break your water?” In between all of the terrible contractions, I agreed emphatically. She proceeded to break my water, and then I fell into an overwhelmingly awful contraction.
My body just kind of took over at that point and I pulled myself up, desperate to find a position that felt right. I turned around and hung over the head of the bed, with my head resting on the top and my arms hugging the mattress. From a distance, although I could no longer hear the midwife’s voice, I could hear the nurses objecting to my position. But it did not matter, my body had literally taken over and I could not have obeyed anyone’s instructions at that point. I was aware that Luke was still there, but other than that, I wasn’t aware if anyone else was in the room. The contraction was immense and all consuming, and it immediately stretched into another contraction. I ground out, in the middle of this horrible contraction “I can’t do this!” I heard a nurse say, “of course you can honey” and it barely registered. Inside I was frantic, trying to figure out how to get away from this pain, how to make it stop. And then the third contraction began and I suddenly felt the baby begin to move. Somehow I knew that this was it, and I screamed “SHE’S COMING!” And it felt like slow motion, I could feel it as she descended and left my body and it was surreal and horrible and incredibly painful and also relieving all at the same time. It felt like time stopped, and I felt the baby drop out of my body, and then I think I blacked out a little. Where I had been all tense muscles and agony and pain before, now I had collapsed into an exhausted pile of less pain. I laid on the bed, only partly conscious, aware that everyone was panicking. There was yelling and people running into the room, and in the middle of all of the confusion, I head the baby start to cry. They were trying to pick her up off the bed, taking her from Luke’s hands, trying to untangle and cut the cord… it was chaos and confusion. I still couldn’t move but I heard someone say “she’s okay” and I assumed they were talking about the baby, who I could hear, as if from very far away, crying.
Luke told me later that from the time that the midwife broke my water, and the time the baby fell out onto the bed, was just thirteen minutes. I had three contractions after she broke my water, that basically just stretched into one long contraction. After the midwife finally broke my water, she left the room to go check on another patient that had come in for a routine check up. My nurse was working over at the computer, teaching the other nurse something about charting. So I was literally left alone with Luke, and those contractions brought me to the point where my body delivered the baby all on its own, in thirteen minutes. Cassandra literally fell out of me, onto the bed headfirst, and Luke gasped and grabbed her, and the nurses, who had been alerted by my scream (and apparently had said something like “don’t push yet!”) turned around and were like “oh my goodness!” They paged the midwife who came running but by then the baby was already out.
Everyone was in a panic and flustered and they were all trying to get me cleaned up enough, and things moved out of the way enough to get me down from being draped over the top of the bed, and into a safer position. The neonatal nurses were checking Cassandra over and she was fine, and they even brought her over and laid her on my chest. But I was so exhausted I couldn’t even lift my arms to hold her, and I asked Luke to take her and keep her safe. I was shaking all over and felt dull, almost drugged because of the crash after all that adrenaline. The midwife kept insisting that I move into a certain position so she could check to see how badly I was bleeding, and I heard her, but I still didn’t have control over my body. The midwife determined that I hadn’t torn too badly, and I wasn’t hemorrhaging, and then said “okay, I’m going to sew you up now.” I looked at her with complete exhaustion and said “can we wait a little while til I feel better?” My legs were still shaking uncontrollably, and I still couldn’t barely move. Shana looked at me and was like “no, we need to do it now.” I was in no position to argue, so she started right up. Since I hadn’t had an epidural, she gave me a few shots of lidocaine, which of course is a needle being inserted right into parts that just delivered a baby like a rocket. Then she immediately started sewing me up and it was just incredibly painful. She kept telling me not to move, and I kept trying not to, and my body just kept moving away from her. It was horrible and just felt so insensitive after the delivery I had just experienced. I kept telling her that it hurt and she kept saying “It shouldn’t be hurting!” which is just the stupidest thing ever to say to someone that just had a baby.
Finally, a nurse took my hand and said to the midwife “I think maybe she needs more lidocaine.” Shana finally looked up and was like, “Oh, okay, I’ll try that” After more lidocaine the pain was at least at a manageable level while she finished. Then, all I wanted to do was get some warm blankets and try to relax and the midwife said “oh wait, I think I lost a needle.” and spent the next ten minutes looking for it and debating whether or not she had sewn it up inside me somehow as she repaired the tears. One of the nurses eventually found the needle that she had absentmindedly set down somewhere. I think it’s safe to say that she is the worst midwife ever. When she came to check on me the next day, she asked how I was doing and I said, well, I’m really tired. And she was like “oh, yeah, I am so tired too!” and I wanted to be like, “did you deliver a baby all by yourself too?” but I managed to suppress the snark.
Cassandra Lucia was born on May 13th, 2017 at 3:01pm. She was our smallest baby, weighing in at 7lbs 13oz and just 18.75 inches long. Although she got a little banged up on her way out, she was perfect and beautiful and healthy. After all the worry about the group B strep, she wasn’t in the birth canal long enough (only seconds, really) to pick up anything. And after all the fighting with the doctors to find a plan that protected me, but didn’t put her in harm’s way, we were so relieved that we got her out in a safe way and she was perfect. She definitely needed some prodding and convincing to get her out, but in the end everything turned out great. I told a friend that, in a nutshell, her birth story was like …no, no, no, no no…FINE!!!!! And then she arrived.
And her personality has turned out to be very similar. Very relaxed, not hurried, pretty easy going. But stubborn as all get out, and once she’s mad she lets you know about it! She has loads of personality, and is the funniest, silliest baby ever. We love her so much! After she was born, my other kids came to visit and they sat there on the bed with their new baby sister, and I took a picture of the four of them and my heart exploded. It was the very best Mother’s Day gift!
It’s taken me a long time to be able to talk about Cassandra’s birth without experiencing a ton of emotional upset and feelings of anxiety and frustration. I’ve never been one of those girls that goes into a birth with a 4-page birth plan with tons of specifics, I’ve always had the singular goal of leaving the hospital with a healthy baby. But the entire experience this time just left me feeling unsupported and vulnerable at a time when I really needed to feel safe and heard. I did have the expectation that my midwife would be an advocate and a support system, and she was neither of those things, and in fact made things a lot worse.
So, in the end, I didn’t have the birth experience that I had hoped for, but I did accomplish my goal of leaving the hospital with a healthy baby. I was able to protect my baby from undue stress and unnecessary medical intervention, and she is wonderful and perfectly healthy and hilarious. If I could change anything, I would be even more vocal about my needs and preferences, and I would have requested to see a different medical professional when I did not feel heard or cared for by my midwife.
It’s funny to think back over my four kids’ different birth stories. Each one of them is different and unique, just like each one of my kiddos. I’m thankful that each of them is healthy and that I am healthy and here to enjoy each moment of their days. Everything else is out of my control. Most of all, I’m just thankful to be their mom!