Tuesday, September 12, 2023

(10.16.21) A Birth Center Birth Story

 Our fourth daughter is quickly approaching TWO YEARS OLD and I am FINALLY sitting down to write out the details I can recall of her pregnancy and birth.  It feels like a lifetime ago in many ways, and yet she still feels so new to our family.  We knew we were pregnant quickly, because I have routinely had intense morning sickness right away.  I was still nursing our third daughter at the time and once again had to wean her more for my sake than anything else.  We were seen by the same OB/GYN practice we used last time at about 7 weeks along since we had one previous miscarriage.  We asked my parents to watch our oldest two daughters, claiming we needed to take our youngest to a doctor's appointment.  She came with us to our first ultrasound and when we saw a healthy baby squirming around on the screen and heard a steady heartbeat, we were so relieved and thankful to God for the unbelievable gift of doing it all over again :) When we got back to pick up our other girls, we showed my parents the ultrasound pictures, to their great surprise, and the celebration began!  One of my favorite memories was telling our three daughters about their new sibling by having Naya read a riddle in the form of a poem.  She had just begun reading with ease and it was so fun to see her try to figure it out as she went.

Because we had a history of miscarriage, our OB/GYN recommends progesterone injections and regular blood draws.  That meant that, similar to our pregnancy with Zara, twice a week my husband gave me a shot (so uncomfortable and awful for both of us) and once a month I went to a lab to get my levels checked and my dose adjusted all in the hopes that the extra progesterone would keep Baby growing. In my dread to begin this protocol again, I hadn't picked up my prescription or started the injections right away. We later learned that my level was an 11 at that first blood draw.  Our midwife commented that in her years of experience, anyone with 10 or lower almost always miscarried.  She was very surprised that our pregnancy continued along well, especially considering we hadn't start the injections on time.  I tucked that comment away in my heart as evidence of God's hand alone sustaining this child.  I had been vomiting constantly, eating almost nothing of nutritional value, and not taking the medicine and yet He had kept this baby safe and growing, regardless. What a beautiful reminder of his care!  This pregnancy we ended up doing the shots for more weeks than we did last time, and my levels did improve some, but they were still always lower than what is considered the normal range. 

One key difference in this pregnancy was that we knew from the beginning we would prefer to deliver at the birth center instead of the hospital.  The providers we were seeing deliver at both places, but previously our insurance hadn't covered the birth center so it wasn't feasible for us.  Now, after our insurance had changed, that was one of the biggest things I was looking forward to:  less interruptions, less prodding, less explaining.  I knew they were comfortable with how I liked to labor and they wouldn't question or burden me.  

At our 20 week ultrasound I was alone because my husband got called for jury duty, of all things!  We were both disappointed, but I was able to record video and send pictures to him as a second best option.  We decided we wanted to be surprised about Baby's gender (as we had in the past), but as a funny twist, I actually ended up watching the entire ultrasound by mistake! I was so paranoid that I had ruined the surprise by accident, but I honestly didn't know what I had seen either way. They did comment that they couldn't get a clear picture of Baby's feet to rule out club feet, so they wanted another ultrasound to double check later. I was hoping that meant my husband would get to come along and see the baby, so I didn't mind too much.

But, what we had no way of knowing at the time was that the very next week, my husband would suffer a major injury that would change the course of our year.  He ruptured his Achille's tendon, and had surgery to repair it soon thereafter.  He was in a lot of pain initially and our lives really changed as we tried to figure out how to have him work from home, how to make our home accessible for him, and how a pregnant woman could do things that an able bodied man normally did around the house, ha. Anyone who knows him can imagine how difficult it was for him to feel like he was burdening me as I was pregnant.  And anyone who knows me can imagine how difficult it was for me to feel like I couldn't help him or comfort him, either. A memory that sticks out to both of us is one evening our girls were playing outside and we were both sitting in the garage chatting and watching them. We hollered to our nearly 2 year old to turn around and walk back towards us, and instead she took off running the opposite direction.  We looked at each other and realized I was going to be the one to have to catch her.  You can visualize my pregnant body hobbling as fast as I could down the sidewalk as our neighbor about fell over laughing at it all. Oof.  It was a very hard season for us, and I largely put the pregnancy in the back of my mind for a season as we focused on the more immediate issues for our family.

The older girls enjoying some outside time as Dad props up his leg.

Baby was cleared of club feet by the following ultrasound. Great!  Then I failed my glucose test for the first time.  Bummer. After many more pokes and prods I passed the 3 hour test.  Great! Then our doctor's recommendation about the new vaccine changed and I should get it before delivery instead of after.  Bummer. Then I got super super sick from that dose (like almost passed out at the grocery store, sick). Big bummer.  It felt like one thing after another for weeks;  nothing major, just something else that added some complication to our very strained, very limited energy and time.

I purchased a online pregnancy workout, a few resistance bands, and even a door anchor (very cool!) to feel like I was training and prepping my body for labor, but I think my husband ended up using the supplies more for his physical therapy than I ever did. As he strengthened and stretched his tendon and went to his appointments, I went on as many evening walks as I could, did lots of stretches, spent loads of time on the exercise ball, and also went to chiropractor appointments much earlier in my pregnancy than I had before. We went to an additional educational class to make sure we were prepared for birth at the birth center, and we hoped and prayed that AJ's ankle/foot would feel strong enough to support me in whatever form labor took.  

I remember overanalyzing lots of feelings/symptoms in the final month or two of pregnancy, and trying to determine if that really meant labor would start sooner, or if it just meant I would feel like it was the end for a longer amount of time.  Our last pregnancy had surprised us by ending in labor starting right at 39 weeks, so part of me assumed that might happen again this time! My one sister was going through a major move and living with my parents for a brief time, and since my parents were our plan for our other children when labor started, there were a few weeks when the timing might have been a little tricky to say the least.  However, in God's good timing, nothing really progressed until right at 40 weeks.

38 weeks 

I woke up early the morning of Saturday, October 16.  I felt a few contractions as I got ready in the morning, but they didn't seem stronger or more concerning than the few I had felt at various other points throughout my pregnancy, so I didn't pay much attention to them. Around 9am I wondered if my water had broken, but it was nothing dramatic, and not much changed afterwards, so I decided I wanted to finally finish the second curtain for our bedroom.  I began pinning, ironing, and sewing.  For the first time, I realized how often I had to stop my work to sway through a contraction or lean over the ironing board.  I remember mentioning to my husband that labor was definitely starting as I headed back to try to hang up the curtain around 11:30am.  I ended up laying on the bed in the dark room as my husband hung up the curtain and our curious girls gathered around, wondering why I was acting so strange.  At this point, I began using the app "Full Term" to time and keep track of my contractions.  I called my midwife to touch base with her, and I called my mother to ask what her day was like, just in case.  The timeline is a little fuzzy to me now, but at some point my mom decided they would leave their house right after lunch and come get our three girls.  My sister was able to ride with my mom, so that someone could then drive our vehicle full of car seats.  By the time they got there and we chatted and got everyone loaded up, I had made up my mind that we were leaving right after them to make the hour drive to the birth center.  

I know that as we arrived at the birth center close to 3pm and walked inside, I was so surprised and relieved to be taken seriously.  The midwife met us, did a quick assessment, and never even performed a cervical check.  She said she could tell I was in active labor by how I was talking, and they could get a room ready for me right away.  I decided I wanted to go on a brief walk outside, because I wanted to get my mind off of everything and relax, plus it seemed like my contractions weren't consistent.  They were sometimes 10 minutes apart, or even a little further, and then every two or three would be much closer together, more like 2-4 minutes apart.  My midwife watched the machine and said it seemed like I was having smaller contractions in between the bigger ones, and sometimes I wasn't even realizing I was contracting because they never got as intense as the others. After a short walk (and picture :) ) in the cool breeze, squeezing my husband's hand, we decided to go back inside and settle in. 

Walking around 3:50pm after arriving at the birth center.

 I know I got in the shower fairly quickly and labored with the warm water hitting my lower back.  I had enjoyed that throughout my pregnancy, so it was a "go-to" when labor started to pick up.  I really thought I'd like to give birth in the tub, so they started to fill it, just in case.  For a while, I got out and dried off, and walked around the large room.  I remember an assistant, a nurse and our midwife popping in every once in a while, but they largely left us alone, as we had mentioned we would prefer.  I held on to my husband's shoulders and let my head hang down, as I tried to relax through contractions and let him support me.  I used a birth ball for a while:  me on my knees, draped over the ball, rocking through contractions.  At one point, I remember two of the ladies coming back into our room and saying, "Ok, that one sounded different! We're just going to get some stuff ready for you." I smiled as I realized how in tune they were with the whole process, even though they were out of sight.  I did get in the tub for a while and it felt so relaxing, but my contractions started stretching back out and lessening, so we decided to try the shower again, instead.  I have a distinct memory of looking at the clock right across from the tub and realizing whatever time it was (5:30ish?) I mentioned to the birth assistant that all our other children had come between 7:45-8:45pm, and I was discouraged that it might still be that long.  She looked at me with a smile and said, "Oh, I think this one will be a bit earlier than that!" I remember hoping she was right and feeling so encouraged that she thought things were progressing.  

Things get blurry for me at this point, but as I made my way to the bed, I remember the midwife herself suggesting that I kneel next to the bed (because I had labored that way at some point).  I thought it would be difficult for her, so I was attempting to get on the bed, but she insisted she could sit on the floor and see just fine.  I remember feeling the urge to push as the contractions got much more intense and I felt so much pressure.  My husband sat on the bed holding my hands and rubbing my neck and encouraging me, as the midwife sat on the ground behind me, applying counter pressure to my hips some and reassuring me that Baby was coming soon. I still couldn't tell how close I really was, but I remember AJ saying as one contraction ended, "OK, Alison, this is your last chance.  Final guess: boy or girl?!" I looked at him incredulously and shook my head saying, "I can't even think right now! I don't even know!" and everyone laughed.  Maybe three or four pushes later, our baby was born. I sat back a little as I pushed and reached down to catch Baby myself.  What sweet relief! This exact moment was unique because I was sitting on the floor and wanted to get up to the bed.  The only issue was, Baby's umbilical cord was much shorter than the others I was used to.  I remember having difficulty holding/picking up the baby because I could only get them as far as my belly button instead of all the way to my chest.  With some help, I got up to the edge of the bed and sat with my eyes closed just soaking in the feeling of a precious little body in my hands, thanking God for this miracle of life.  When I finally looked at the Baby for the first time, we discovered we had our fourth daughter! We were both laughing, shaking our heads in disbelief and so so happy.  

We named her Indie Jill, and later found out she weighed 8lbs 4oz and was 20.5 inches long.  She did break our "norm" of later evening births and was born at 6:22pm, less than 3 and a half hours after arriving at the birth center.  Shortly after she was born and we were just getting settled, our midwife had to go to another room quickly because three of us were delivering all about the same time!  She had ended up calling another midwife to help because she realized how close we all were going to be.  We heard the familiar newborn wail not much longer and rejoiced alongside whoever else was celebrating a new life down the hall :)  We ordered dinner from one of my favorite restaurants, took pictures and made phone calls, and before long we decided to leave.  We could have stayed up to 6 hours, but we left at about the 4 hour mark because we felt good and we had an hour drive home.  



The only slightly negative things I remember about our otherwise ideal experience at the birth center, was when it came time to deliver the placenta I felt like they sort or rushed or forced it more than I was expecting.  Perhaps they were concerned for some reason and just didn't tell me, but I assumed I would be allowed to do that on my own, and instead I think they pulled on it and I wasn't a fan.  Additionally, we quickly found out in the days to follow that Indie had a prominent lip tie that greatly impacted our breastfeeding experience.  I didn't know to request them to check for that at the time, but knowing what I know now I'm surprised they didn't.  I had a decent amount of discomfort (not the excruciating pain others describe) and Indie had a hard time controlling the flow of milk, so she often spit up a lot, coughed, sputtered, etc.  We met with lactation and our pediatrician and then drove to a specialist to have it revised and follow up with more lactation help .  They made the comment that if I hadn't already breastfed three other kids, they suspect Indie would have struggled to gain weight or we would have had more issues, but my supply ended up compensating for how inefficient we were at the start.  It was a headache added to postpartum that I wish we would have gotten a head start on instead of waiting four weeks to get it all figured out. 

We praise God for sustaining us through this difficult season in our family and bringing us to the point of having Indie here with us on the outside, safe and sound, growing and thriving.  AJ was healed enough to be comfortable and unrestricted while supporting me during labor, when even two or three weeks earlier it would have been more challenging for him.  We are so thankful for the freedom that our providers advocate for and celebrate in their practice.  They trusted us and largely stayed out of our way, while being there when we needed them most.  God is good. God provides.