Monday, October 22, 2012

The secrets no one tells you about labor and birth


On the anniversary of my labor with the twins, I always re-live the day in snippets.  Yes, even now, 11 years later, it's vivid.  Remembering the journey.  It is one I am proud of.  It was not an easy journey.  Not by any means. I mean really.  Look at me in that picture!  It was the night before I was induced.

What made it all the more memorable was that I was totally in control of the experience.  It was one of the most amazingly empowering experiences I have ever had.  It changed me forever on so many levels.  

I enjoyed my labor!

Are you ok?  Yes.  I enjoyed it.  Have you ever heard anyone say that about their labor and birth before?  Especially a medically induced (pitocin), 21-hour long labor, un-medicated vaginal hypno-birth of twins at 39 weeks?!  Oh, with one a footling breech?

Everyone thought I was nuts.  Except the midwives and doulas of course.  :-)

Secret #1 -  Birth is empowering!

Women have the opportunity to embrace confidence, assertiveness, strength and power through their pregnancy, labor and birth experience.  They can realize the power of their womanhood.  They can bring forth new life!  It's a freaking miracle.  Growing and birthing that baby or babies, no matter who you are, is a miracle.  As women, we are gifted with the experience.  The gift of motherhood, no matter how much help we might have needed to arrive here, is nothing short of amazing.

Granted, I was well informed.  I was a type-A information whore of a birth doula, childbirth educator and health care professional.  Some would say I have a way of speaking my mind.  I'd birthed before and knew what I did and did not like about that experience.  I knew the potential risks of twins.  I knew my body, my physiology and the science behind the 'medicine'.  I knew what I wanted.

I wanted to give my babies the best chance at a healthy and happy full term birth.  That meant sacrifices by me. I had to do less and eat more.  I had to eat better.  I had to learn to listen to my body.  To let go of my anal retentive need to clean constantly.  When I had contractions all the time, I had to spend most of the time on house arrest.  It made me crazy.  I did it happily.  It wasn't about me, it was about these babies.  So much of parenthood is like that...

I did my research.  I asked questions.  Lots of questions.  I wanted an un-medicated birth.  As much because the pain was about me, not about what's best for the babies as it was about the fact my blood pressure is so low and my body so sensitive to narcotics that there was a good chance I'd risk myself into a more interventive birth if I opted for pain meds.  I didn't want to go there.  I wanted a Hypno-birth. I wanted non-pharmacological pain control.  A few hours of pain for me would be nothing if it meant my babies could have the lowest risks possible (not to mention to lower my risk as well).  I prepared for it religiously (and it worked like a charm!)   I also initially wanted a water birth in a birth center.  I wanted a home birth ideally, but got risked out of both with the twins.  My husband at the time was not comfortable with a home birth of one baby, let alone twins.  I had two kick-ass midwives and an OB practice that equally rocked in a hospital that was mother and baby friendly.  I picked my battles.

I made it to 38 weeks and 4 days.  Baby A was breech until it became clear she was really Baby B and he was head first.  Ultrasounds were showing signs that her umbilical cord and placenta were getting 'unhappy'. We had a long talk.  My gut told me it was time to induce. I agreed with the medical evidence presented and I researched it to my satisfaction   A Saturday ultrasound and membrane stripping and a scheduled pitocin induction on Monday if no spontaneous labor.  Contractions every 5-10  minutes all weekend, but no real labor, no change in my cervix.

I started pitocin at 9 am Monday am.  It was a party.  Awesome nurses.  Awesome midwives.  Awesome OB's.  I had my own personal 'dream team' for labor. I negotiated time off the monitor for good behavior and I walked with one hour heart rate checks.  I bounced on the ball.  I ate a turkey sandwich for lunch.  By afternoon I was feeling the contractions from the pit and needed a nap.  My doula got me in the zone with the Hypno-birthing and I dozed.  I felt no pain, only intermittent belly tension.  Hours felt like minutes.  7 pm rolled around.  Still no change in my cervix.  Talked with the midwives.  They were busy with many other laboring moms.  I was tired and disappointed progress was lacking.  Babies were happy.  We decided to call it a day and try again in the morning.  They turned off the pit.  I was still 2 cm where I'd been for weeks.  Damn cervix of steel...

By 8 pm my contractions were 3 min apart and by 9 pm I was 5 cm.  Another secret they don't tell you.

Secret # 2 - Pitocin can mess with your body's natural rhythm and if your body and baby are not ready, it probably won't work!

I had that lovely dilemma many women on pitocin do.  If they turn it up enough so you get strong contractions, they either last too long, are too close together or the baby heart rate drops.  If it's one level lower, it's not enough.  That and the fact if your body isn't ready, it probably won't work.  Eliminate the artificial override, and my body gladly took over.  I can't help but wonder what would've happened if we turned it off hours earlier.  Maybe I'd have had Libras instead of Scorpios!

I got in the tubby.  It was heavenly.  I dozed.  After an hour I was grunty I guess, so I got out.  8 cm!  Yay!  The OB was called at 11 pm.  Oh, it's the one who won't catch breech.  NO, thank you.  I refused him.  They knew I would if he were on call.


Secret #3 - you can say no!

The midwives called my favorite OB, who had gone off call at 7 pm and came back, expecting to catch my babies and go back home.  Instead, he slept in the call room all night, patiently waiting for my babies to decide they wanted to be born.  I changed position, I showered, I slept, I was massaged, I had popsicles and graham crackers, I threw up, repeatedly (I'm a transitional puker, not so much a secret, but yeah, lots of women are) I was in transition for a good 7 or 8 hours.  My doula and midwives kept me in the zone. I dozed through most of it feeling tightening but little pain.  I had no epidural.  I refused to talk to anesthesiology or sign the consent until I needed it.  I didn't plan on needing it.  The OB was convinced I had gotten the epidural I was so still and quiet.  I did not.


Around 4 am I agreed to breaking my water to try to speed things along.  It took forever.  Amniotic sac of steel too!  It didn't help much and it stressed baby B.  Classic risk.  I knew it going in.  Change of position and fluids helped a bit.

Secret #4 - PROTEIN WORKS!

Around 5 am Baby B (girl) was starting to show signs of being unhappy.  I was still 8 cm.  I agreed to turn the pitocin back on.  It only took a few contractions with the extra 'juice' and Baby A big head finally started to descend.  I remember the very bumpy ride to the OR (twins are birthed in the OR in hospitals even if vaginally just in case of the need for an emergent cesarean).  That ride sucks on a stretcher nearly fully dilated even with hypno-birthing!

Some of my battles were lost once there.  I was ok with it all.  I trusted my birth team.  They knew my wishes and desires and I knew if they could, they'd follow it, if they didn't, it was for a good reason. I was finally going to meet these babies!

Secret #5  - Memories are funny things

Here's what I remember of the next 20 minutes


  • the bright lights of the OR
  • Recognizing the eyes of the OB (all I could see)
  • How cold and uncomfortable the OR table was and how hard it was to scoot over to it while feeling pushy! 
  • How my pillow moved every time I picked up my head to push
  • I had no idea where my husband or doula were but my nurse and second midwife were right at my side and I could feel the love and grounding effect of their touch and presence
  • The anesthesiologist holding the induction mask in his hands as I looked back at him and I distinctly remember thinking "Oh, I don't think so" and I pushed my son out 
  • My yelp (and wondering who the hell made that noise, not realizing it was me!) as I tore a bit when he was born with the aid of a vacuum (more so because of his big not quite lined up right head and the urgency to get his sister out faster, her heart rate was low).  It was 6:00 am!
  • How much better I felt to have one baby out!  I could see my toes again!  I could breathe more easily.
  • The midwife reminding me I had another one to birth!
  • My son crying like a baby sheep (seriously, he sounded like a sheep)
  • The way the staff respected my wish for quiet during their births
  • Meg being born feet first, I hardly felt it.  Not hearing her cry right away.  It was 6:04 am!
  • My asking to see them and the staff parting like the red sea and holding my son up so I could see it was in fact him crying like a sheep and no, he did not look at all like a sheep.  
  • The staff peeking in the window of the OR, vaginal footling breech births are rare, especially in un-medicated twin sets
  • Thinking "Holy crap.  I did it!"
  • The shakes so many women get after giving birth.  I was my own earthquake!
  • The midwives counting placenta vessels and asking me how many I saw.  Looking at their placentas in wonder.  Hers was so much smaller. Yes, he had a 2 vessel cord.  
  • The nurse handing me my son.  Thinking no wonder I made that noise, his head is huge!
  • The midwife handing me my daughter moments later.  My DAUGHTER! She was so tiny!  She was wrapped like an Eskimo baby!  I swear my smile was brighter than the sun at that very moment.  One in each arm!
  • holding both of my babies as they wheeled me back to my room.
  • The look on our midwives face as she opened the OR doors for us.  I felt like a queen! 
  • Thinking, OMG, I have two babies!  And a three year old...and I'm hungry!!
  • The OB coming in later and apologizing to me for having to use the vacuum and for deviating from my birth plan but explaining why, joking he lost a few hairs on that one (he was bald) and asking if I had any questions.  I did not.  I trusted him.  I thanked him for everything.  THAT is why I chose him.  
Secret # 6

No matter how you birth, it's your story, it's your experience.  There is no right or wrong.  There is only right for you.  Trust your body, trust your baby, trust your caregivers and no matter what kind of birth day you have, it's yours and it's perfect.  You will remember it forever.  It will change you in ways you cannot fathom.  You.  Are.  Woman.  Roar momma, roar!  You rock!  





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