Friday, February 17, 2012

Lyra's Water Birth

I wrote Lyra's birth story a week after I had her. I'm just now getting around to posting it up here. This is a direct copy-and-paste from my post on a natural birth forum.

Lyra was my second unmedicated birth. My first was in a hospital and I felt like I was constantly fighting off offers of drugs and interventions even though everything was going great my labor was relatively short -- sixteen hours from water breaking to birth, ten of those hours in active labor. With my second pregnancy, I started out at the same OB practice I had my son with, but switched at 21 weeks when our insurance changed to one that was in-network for the new free-standing birth center opening nearby. I transferred to the midwives and my anxiety about having another hospital birth immediately disappeared. The birth center officially opened in September and the day after Thanksgiving I hit 37 weeks and was cleared to give birth there.

I woke up at 4 am on December 8th with contractions. They felt like intestinal cramps, so I just laid back down and tried to sleep. I'd been having GI issues for two weeks and was having prodromal labor on and off for the last six days, so I figured it was one of those causing my discomfort. An hour later, the contractions were still keeping me awake. I got up to use the bathroom znd wiped away my mucus plug. I started leaking fluid about 5:30. It came in intermittent trickles, but was slightly pink-tinted so I knew my water had broken. I was having a lot of back pain already so I took a shower and waited for my husband to wake up. When the alarm went off at 6, I told him, "I think you're getting a Get Out of Work Free card today."

We hung out downstairs for a little while and made sure we had everything we needed for the birth. Unlike last time, I was GBS- so we didn't have to worry about rushing to get antibiotics. My husband put together a birth announcement template and I woke up my mom, who was staying with us to help with our two year old son, and told her what was going on. At about 7:30 we drove do my husband's office so he could pick up some things and be closer to the birth center. We called the midwife on call at 8:30. She had just gotten home from attending another birth the night before, so we arranged to meet her at the birth center in an hour. We had an hour to kill, so we wandered around Whole Foods and picked up some food to get us through the day. I was having contractions strong enough to make me stop walking and lean over the shopping cart. We got out the contraction timer on the phone and timed them at 1 minute long and 3-5 minutes apart.

We went to the birth center at 9:30 and got checked in after the test strip confirmed I was leaking amniotic fluid. I was having fairly strong contractions with a lot of back pain already so agreed to a dilation check to find out where we were starting from. At 10:30 am I was still only 2-3cm dilated, but my midwife commented on the stretchiness of my cervix. We decided to put our coats on and go for a walk outside. The birth center is in a heavily wooded corporate park and it was about 40 degrees outside, so it was a nice place to walk. Partway through our walk, I had to grab my husband's arm and just sway back and forth as a multi-peak contraction hit me and hung on for several minutes. By the time we got back to the birth center 20 minutes later, I was having contractions I had to focus to breathe through and was in pretty obvious active labor.

I accepted the pain as progress and let my body tell me what positions and movements were best. Lyra was posterior so I spent some time on my hands and knees with my husband holding a phone playing music at the base of my spine. This worked and she flipped to face the right direction, but she flipped back to posterior at some point later and stayed that way. I was standing and using the windowsill for support for most of the labor so I could move through the contractions and let my body take over. I also sat on a birthing balland did hip spirals and bounced and got on my knees and leaned over the ball so I could rock. I tried to lay on my side to rest for a few minutes and that triggered a lovely tetanic contraction. I had to get on my hands and knees while still on the bed as it started and then went into the bathroom to see if emptying my bladder helped, but it continued for about six minutes. I jumped almost immediately into transition and every contraction was significantly stronger than the last. I was becoming really noisy, but concentrated on keeping my jaw open and kept my moans and grunts low-pitched.

I finally got in the tub as the contractions continued to intensify. The fatigue in my legs lifted almost immediately and I let the water support my weight. I got myself into an odd lunge position and stayed there. I was feeling a huge release of fluid and bloody show during each contraction. My midwife did one last cervical check (I only had 3 the entire time). I was at a 9 and Lyra was still high up. All of a sudden, I started involuntarily pushing. I couldn't control the rapid-fire pushes in quick series, like a jackhammer. It wasn't an urge to push, more like hiccups or muscle tics that I couldn't do anything about. It was terrifying but I couldn't fight it. I felt an extreme amount of pressure and thought I was going to the bathroom. I jumped onto my knees without leaving the water and reached down to feel her crowning.

My husband and the nurse helped me to sit back so my feet were in front of me and I felt intense burning as her head crowned and emerged face-up and my body continued to push on its own. I managed to take control just enough to slow down the rest of her coming out while the midwife helped ease out her shoulders because her hand was by her face and we didn't want to hurt her shoulder or collarbone. I helped catch her, but I was in a state of shock after the involuntary pushing, so I needed some help to bring her to the surface. Lyra was on my chest four minutes after that last dilation check. It was 4:23pm. Lyra was alert and looking around, but it took her almost four minutes to start taking good breaths, which wasn't a huge problem since her cord wasn't cut. My midwife said she was probably shell-shocked from coming out so fast so needed a few minutes to get oriented. The pain was gone and I suddenly felt really good, though a bit shaky.

We hung out in the water for a little while while the cord stopped pulsating. My husband cut the cord and took off his shirt so he could hold her skin-to-skin while I was helped out of the water. We laid on the bed with Lyra on my chest so I could deliver the placenta. My damage from the rapid delivery and nuchal hand was surprisingly light... three first-degree periurethral and labial tears, but none on the perineum, although that was already showing bruising. Lyra's face was a little swollen and bruised, but not too bad, and it was fine after a couple days. The midwife stitched up two of the tears while Lyra nursed, something it turns out she was very good at from the first latch and has needed almost no adjustment since (she was already back to her birth weight at 5 days old). We did skin-to-skin on my chest for about four hours before any weighing or measuring were done, and my mom and son visited during that time. Lyra ended up being 6lb 4oz and 18.5 inches, just an ounce smaller than her brother was and the same length.

We came home at 10:30pm. We had the option to stay overnight, but I was feeling pretty good and we wanted to sleep in our own bed. I had the shakes on and off for about twelve hours after the birth from the endorphins and adrenaline, and couldn't sleep until about 5 am.

This labor from beginning to end was far more intense than my first one and a bit shorter (12 hours vs. 16 hours from first sign, <6 hours of active labor vs. 10 hours, and fetal ejection reflex vs. 20 minutes of controlled pushing). I just let go of any fears and doubts and went with the pain, allowing my body to dictate positions and movement. I don't know how much being in the tub actually helped, since I was only in it about an hour and during that time my body went insane. It took me a while to process what happened at the end, but it helped to find a name and reason for it -- fetal ejection reflex. My labor was mostly undisturbed and the midwife and nurse were hands-off and quiet except for occasional heart rate checks with the doppler and when I asked them for something. I felt safe and instinctual, unburdened by the presence of people I didn't know and trust and unrestricted in movement. I probably would have had a lot more damage from birthing a posterior, compound presentation baby if I hadn't been allowed to labor and birth her as my body instructed me. It still is an awesome feeling knowing I could trust my body to do exactly what it needed to.

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