Welcome Sawyer - When you know better you do better - PART 2

September 4, 2007
Hospital Birth - Second Baby

Part Two: When You Know Better You Do Better

by Jennifer Pinch, RN, BScN

Read Part 1 Here

During a very raw time, when we experienced the loss of three unborn babies due to miscarriage, I began to thirst for knowledge about birth. I could not get enough information. Ironically, amidst my struggle to have another child, I found great solace in midwifery textbooks, natural childbirth stories, and anything writen by Ina May Gaskin. Suddenly, my desire for another child was intensified with the ache to have another opportunity to birth. Instead of getting labour over with, I wanted to be present. I felt that I had somehow missed out on something sacred the first time around. Like something had been taken from me that I could not quite put my finger on.

The cry of our hearts was for another little one. I wanted the chance to naturally birth my child into this world. In God's timing, we were blessed with another healthy pregnancy and were so full of gratitude awaiting the arrival of our second child. The losses between our two children made this pregnancy all the more treasured. We attended classes with The Bradley Method of Natural Childbirth. Despite my husbands initial reluctance to go to Bradley classes, we both came out of it feeling confident. This time, we knew there was a better way.

My second birth: Sawyer Eleanor (September 4th, 2007)
On Tuesday morning, September 4th, I woke up at 4:30am feeling a weird wetness. Did I just pee in my sleep? I got up to walk to the bathroom and felt water going down my legs. Not a gush, but enough to know that my amniotic fluid was leaking. So, I had a shower. By about 5:30am I had been having a few mild contractions & I was sure that I was in labour. With every contraction a little more fluid would come out. So, I sort of just hung out with Darren and kept a towel under me in our bed.
By the time Hayden woke up at 6:30am, I was consistently having contractions every 5 minutes or so. Nothing hard or intense but, undeniable. We called Tanya (my sister-in-law) at about 6:50am and she bluntly answered the phone: "are you in labour?" She very willingly came to pick up Hayden at about 8am.

By the time Tanya and Grace (my 2 year old neice) came to get Hayden, I was putting the "Bradley Method" techniques to work. With every contraction (about every 5 minutes, lasting 30 seconds to the peak), I had to stop - abdominally breathe - consciously relax - and close my eyes (sleep imitation). This is the key to Bradley and I focused on it completely with every contraction. Darren stepped right in with full confidence, reminding me to release tension. His touch and voice anchored me to the moment and helped me focus.

I would say that by 8:30am, as Tanya and the girls were leaving, I was in "active labour". The contractions were getting more intense and I could feel my body working hard. I visualized myself going up the side of a contraction and making myself relax up to the peak until I could get over the top of it. It was such a weird mind game & very effective coping technique! It really made me able to only see one contraction at a time and never let them pile up on top of one another. No matter how much work my body was doing, I could see the peak and tip over the top and then I knew I could rest until the next one began.

We packed our hospital list items & bag. It took a while because I was contracting regularly every 4 minutes since about 9am. And, they were getting stronger. Darren used some counter pressure on my low back for about an hour period when I was needing to labour on my hands & knees. I tried the birth ball but did not like “the smell” of it so it was banished to the basement after only 5 minutes. Most of the time I sat down, leaned forward, or got onto hands and knees to cope and relax into each contraction.
By 11:30 I was starting to ask Darren if he thought we should go to the hospital. We were both very wary of going too soon. We knew that timing was our enemy when we had Hayden, and it led to all sorts of frustration and intervention. Hayden arrived 36 hours after labour began; This was only 7 hours into things, only 3 hours into active labour. Nonetheless, I was feeling uncertain. Darren and I decided to call Rhonda, our Bradley Method instructor. She talked to Darren for about 15 minutes as I had contractions like clockwork every 3 minutes, lasting 40 seconds to the peak. She gave us lomits of encouragement and guidance to Darren on how to watch me for signs of readiness to get going to High River Hospital.

At about 11:45am I looked at Darren and said, "I know I am probably only 2cm dilated and we will have a long haul ahead but, in about 15 minutes I will not be willing to get into the truck". We decided that was reason enough to leave our nest. I had also decided to get one dose of IV antibiotics (for group B strep+) before delivery, especially since my membranes had ruptured. The biggest challenge to my coping was crossing two sets of horrid train tracks during contractions in the truck!

We arrived at the hospital around 12 noon. I had at least 2 contractions making our way from the truck to the admitting desk and then 3 or 4 while we were checking in. At this point I was totally focused on the work my body was busy with and did not care who was around me.

We went into the labour & delivery unit. Our nurses were Sharon & Natasha. They were excellent. I handed over my birth plan & discussed it with them immediately. Sharon was so happy to support our wishes. She is a Lamaze instructor and a doula. She told me later that even if I would have asked for drugs she would have tried to talk me out of it because she saw our commitment to Natural Childbirth, in the way I was working with the labour and the preparation of our birth plan. Sharon kept smiling at Darren when I said I was "not as far along as I looked" and I was convinced I still had hours of work ahead. She made an "executive decision" and put me directly in the delivery room and skipped the assessment unit entirely. She checked the fetal heart rate while I was standing beside the bed. It was 135-140, no concerns. They did my blood pressure & heart rate, normal too. And I kept right on working hard. I could only answer one or two questions between the contractions rolling in. Natasha started my IV and got the Penicillin V antibiotic going while Darren went and got our things from the truck. He was great at making me drink sips of water between each contraction - which made me go pee frequently too. I was standing and leaning forward for most contractions now.

By about 1pm Sharon asked me if she could do a quick check and see where my cervix was at. She checked during a contraction because it helps get a more true picture of dilation.  I was totally amazed and encouraged to learn that I was about 7cm dilated and 70% effaced. I had made it this far and now I knew I could do it without drugs! It was the news I most wished to hear and most doubted I would get to, without many more hours behind me.

The IV was done and locked (not hooked to the pump anymore). I had a few more contractions and was feeling restless now. I couldn't decide what position I wanted to be in. I listened to Sharon's advice and got onto my left side for a few to move the baby into a better position and that was intense. I could feel the baby shifting her head from transverse to the posterior position. It was strange to feel. I needed to go to the bathroom again. This is where things really picked up. Darren came with me. I went pee and then I had about 3 contractions on top of each other on the toilet. I started to feel afraid. I told Darren, "I can't do it" and "I don't want to do this anymore". I wanted out of this situation entirely. Darren knew immediately that I was in transition and he just calmly reminded me that this is what I was prepared for, I could do it, I was in fact doing it, and I was doing great. I needed to refocus & get in the game again. Sharon & Natasha were near the door and got us back to the bed.

I climbed up onto the bed and felt sudden pressure like crazy in my bottom. I felt the baby's head push down hard. It was on its way out and there was no going back now. I said "it is coming out". Sharon asked if I was feeling pushy. I couldn't even answer her. She asked if she could check me because I shouldn't push if I wasn't fully dilated yet. I said "do it quick". She checked me again (only 2 times during the whole labour) and I was 10 cm and fully effaced ready to push. She gave me the go ahead and put the back of the bed totally upright. I turned around and leaned into the back of the bed up on my knees with my backside to the small audience of 3 great nurses (Sharon, Natasha & Carol). Darren stayed right beside me at the head of the bed. I heard them phone Doctor Amy Gausvik and tell her I was pushing. Amy arrived a minute later and I was too into my work to even say hello.

I cannot even find words to describe the pushing phase. The contractions went from a squeezing tightening sensation to a forceful downward ejection. It took a few of those new kind to get my mind into it. At first I was in such disbelief that the baby was about to come out of my body, that I felt a brief sense of panic for about 2 contractions. I was hot and my hair was in the way. Darren pulled my hair back and got ice water and started using a wet cold wash cloth on my face and forehead repeatedly. That felt much better. I remember thinking to myself and internally talking to myself, as I leaned on the bed upright on my knees - Do not try and escape this, Jen. Feel it and be present. Do not try to miss this moment. Be here and get into it. You will have very few moments like this in your life, do not let pain or fear get in the way. Be in it. I was half praying to God and half talking to myself. The mind game was amazing!

Darren reminded me to take 2 good breaths first and then do the pushing breaths. He also had to remind me to keep the noises low and my chin to my chest and not waste energy with high noises. Do not fight labour, work with it. With his prompting I got down to business and pushed. I felt her head come down. I felt it on a few contractions come partly out and slide back when the contraction ended. I felt it crown - right on the verge of out, and then I stopped pushing and let it slide back slightly. I was remembering the importance of letting the back and forth motion ease the baby out and prevent tearing. I pictured the video image of the back and forth movements of the baby's head from our Bradley class. Sharon told me "get used to that feeling of the baby's head keeping pressure down." I knew it was time to give it all I had and that in her own gentle way, Sharon was reminding me not to try and escape. It was a crazy feeling in light of the fact that I truly believed that I did “feel” the head being delivered with my first birth. (insert eye roll). The feelings of an unmedicated birth are absolutely indescribable, especially when you have chosen and planned to birth in that way. What an amazing thing! The next contraction I pushed all the way and out her head came. I was in awe! I could feel her head out and her shoulders trying to manipulate their way forward. On the next contraction I pushed hard and felt one shoulder and then the second one, and then her body quickly followed. She was out! It was amazing. I was so thrilled that I had done it! It was possible, with Darren's coaching and the kind and gentle guidance of the nurses and doctor just letting me do it my own way. I had to turn around to see the baby and climb my knee over the cord linking the little one to the placenta still inside of me. I picked up my baby to my chest. She was alert and perfect. She did not need any suctioning. (Only with the blue bulb in her nose and mouth). She breathed easily and calmly. We waited as planned, until the cord stopped pulsing and turned white, about 3 minutes. Then the doctor gave me the cord clamp and metal clamp and I applied both and cut in between and lifted the baby to my own body. She was beautiful and healthy. I delivered the placenta about 5 minutes later in one very easy push. Sawyer Eleanor Pinch in my arms.
I apologized to the birth team that they had to look at my behind for 20 minutes! They all assured me that they were not about to tell me how to deliver my baby. So, upright on my knees facing away from them was how it was done. I reminded Amy (my doctor) that I wanted to go home in 4-6 hours after delivery, as I had written in my birth plan and discussed with the low risk obstetric group ahead of time. She agreed and came back at 6pm to reassess us and write discharge orders. We were healthy and home by 9:30pm. We slept in our own bed.

I could write a book about the adventure and pure awe of natural childbirth, now that I have been blessed to experience it. If we have more babies, I will never do it any other way! I would not want to miss a thing. It was amazing. I am so thankful. God is so good. What a Creator and what a gift. The great birth was not "luck"; In the words of my friend Eleanor Bertin, after whom Sawyer is named, it was "by design".

 

Jennifer Pinch is married to the love of her life, Darren. Together they have two beautiful daughters. She is a Registered Nurse with a passion for educating women. She teaches natural family planning, breastfeeding, and has just started the adventures of being a labour support person for other mama's with a heart for natural childbirth.