Birth Story, Part 1

Several people have asked me for details about how everything went during the little one's delivery.

Brace yourself. This is gonna be a long one.

(And if you can't handle words like "cervix", do yourself a favor and skip out now. :))

(One more warning - opinions expressed here are about ME and MY birth. I have no opinions about how other people choose to give birth. I know that this subject can be touchy for a lot of people. Just because certain things were right for me doesn't mean I think they should be right for you.)

Let's flash back for a second. At my 37 week appointment, my doctor (with whom at that point I had a very uncomfortable relationship of tip toeing around each other, trying not to aggravate one another) said awkwardly to me, "Your next appointment is your 39 week appointment. If baby hasn't shown up by then, we'll start talking about.... induction." He then high tailed it from the room, fully expecting world war III. I chose to deal with that not unexpected news by ignoring it. I was already so stressed out by the doctors and the perinatologist telling me I couldn't do this and I couldn't do that, and that I was already a neglectful parent, that I honestly couldn't handle another one of their "what if's". Anyway, I was thinking positively. I was using my Hypno tools - I started listening to the "Come Out Baby" CD at 37 weeks. Surely she would be here by then. No worries at all.

Of course, she wasn't. The day before the 39 week appointment, I started having some minor panic attacks. I. DID. NOT. WANT. AN. INDUCTION. Basically I felt like an induction with pitocin was pretty much forcing your body to do something it obviously wasn't ready for yet, leading either to contractions that were too close together or stalled labor, both leading to a c-section... and then all the work, all the fight I had put in to have my natural birth the way I wanted, was all for nothing. Yes, yes, yes. We have all heard a MILLION TIMES that nothing at all matters besides a healthy baby. Tip: Never say that to anyone. I mean, c'mon. It's a given. And saying NOTHING AT ALL matters but that isn't true anyway. That matters the MOST. That's not to say other things don't matter. And this mattered to me. A lot. (I mean, come on, if I was destined to have a C-section anyway, I would have preferred to just schedule it, rather than go through 200 hours of labor just to end up there anyway.)

I started plotting ways to just skip the appointment all together. If I waited til the next week, I'd be 40 weeks anyway... and maybe she'd come on her own by then. I tried every old wives tale anyone mentioned to me to naturally induce labor (except castor oil. Ew.). Not a single contraction. Instead, I conned my husband into coming to the appointment with me, to back me up when the fighting began. (This ended up seriously backfiring.)

That place knows how to build up anxiety. First you wait. And wait. Then the resident comes in. Then you wait some more. Then the endocrinologist comes in to adjust your insulin. At this point, I realized that "CRAZY PSYCHO PATIENT" must be written in huge letters at the top of my chart, because the endo remarked, "They are going to want you to have an induction. Go easy on them. They really are looking out for your best interests." (Are they? How do they even know what my best interests are? I always felt that they were looking out for their own best interests - namely, not getting sued if something happened to my baby.)

Then the OB came in - with an entourage. It was as if he knew what was coming and wanted to have plenty of witnesses when I landed in court on battery charges. He even brought the ridiculous and inanely useless clinic nurse.

He told us exactly what we expected - I was 39 weeks, and they wanted to schedule the induction for that Friday. That was their policy for diabetics. They do this because of the chance of intrauterine death after 39 weeks. And yes, he said pointedly looking at me, he has seen it happen even in very well controlled diabetics.

Unlike the last time we argued, there was a very forced, very fake calmness to the conversation.

No. I did not want an induction.

Wayne asked about numbers. What was the actual risk in waiting, percentage wise? When were the last studies on those numbers done? The OB didn't know. It happens. And I didn't want my baby to die, did I? This was the best thing for everyone's safety. (I hate how, when doctors are trying to convince you of something, They make it seem like you don't care about whatever it is you aren't choosing. Don't want the induction? You must not care about this baby at all!) Wayne pressed the issue a little more. What if we increased the number of non stress tests we were having? Every other day, or even every day? Didn't that prove that the placenta was healthy and getting blood to baby? Apparently not enough to make the OB feel comfortable with it.

"Wait just one more week. One more." She's not ready. My body is obviously not ready.

"Our medical recommendation is induction. On Friday." And that was it.

Then they all, the entire entourage, plus my husband, turned and stared at me. That was single handedly the most uncomfortable few moments of my life. And it felt like forever. All of them just waiting for me to see it their way. I felt very small, and very defeated, but I still whispered, "No." And they continued to stare at me, as if I'd suddenly see the error of my ways and change my mind.

"Maybe we should get another ultrasound," the clinic nurse suggested. "You haven't had one in about a month." As if I didn't clearly see through that move. Maybe the baby's too big! Maybe we can use that angle to convince her!

Fine. Whatever. I was too worn out and stressed out by that point to argue anything else. I was already in tears when the ultrasound tech came in. Poor thing, I'm sure almost all her patients are usually happy. She had no idea what to do with a patient who sobbed when she told her, "Look! Your baby is sucking her thumb!" She must have figured something was terribly, terribly wrong, because she sent for reinforcements - enter in awkward clinic nurse again and yet another doctor, to explain to me again all the benefits of an induction, just in case the tears had potentially wiped my brain clean in the last 5 minutes. Basically the only way we made it out of the clinic was to promise to think about it.

I went home angry and yet very calm in my decision. My husband, not so much. My husband is a scientist - a very logical man who trusts in numbers and research and assessing risks. But we had no real numbers to help us in the assessment of that risk at all. He was caught horribly between supporting his pregnant wife or choosing something that could potentially save his child.

What followed can officially be known as "The Week From HELL." As Wayne saw it, no matter how miniscule the risk was (and we didn't know exactly how miniscule that was) - it was still a risk. And it was a risk with dire, dire consequences. Or, as he put it, a 0.001% risk x 0 child can still equal 0 child. It was a pretty morbid week.

I will never be able to explain my reasons enough for anyone out there to understand why I would continue to refuse something once told that my child could actually die. It sounds, and feels, horrible to type. I couldn't even get Wayne to understand it. At one point it we wondered if we were being "greedy", or "selfish". After all, we had waited so long for this baby, gone through so much for her, struggled and argued and fought for her sake - maybe we were asking for too much? Just how important was this "experience" for me, anyway?

I just knew that my daughter was healthy. Mother's intuition? I don't really know. Every ultrasound showed she was perfectly formed, and a perfect size. My A1C's had always been comparable to a non-diabetic's. My non-stress tests had been stellar. She moved and kicked with clockwork regularity. Maybe that's not enough. But I knew.

Wayne stressed over the issue to the point he made himself physically ill with a cold all week. All the poor guy had to go on was my assurances that baby was fine, and doctor's insistance that the induction happen.

I started walking insane distances around our little town. I walked and walked and walked, frantically trying to induce labor naturally in the three days that I had before the forced eviction. And I started to talk to everyone I knew who had had an induction, chose not to have an induction, knew anything about an induction... I scoured the internet boards for any other diabetics who had refused to be induced, without much luck. What I did discover was that while OB's across the board do generally recommend induction for diabetics, there seems to be no agreement as to when exactly that induction needs to be. People talked about being induced at 37, 38, 39, and 40 weeks.. absolutely no consensus or reasons WHY that date in particular was chosen. That soothed a smidge of my guilt over my decision. Again, what I was asking for was NOT out of the realm of reasonable requests.

I changed my decision daily. Friday came and went. One moment I couldn't handle the emotional stress any longer and I was ready to schedule the damn thing. The next I was angry at the doctors' for taking my decision away from me, along with everything I wanted in my birth and a lack of support for my choices or my autonomy as a patient. My gut always said that the induction was the wrong thing for both of us.

I guess in the end there were three things that helped change my mind and prepare me mentally for an induction. I had a long chat with a friend's sister, who happens to be a long time labor and delivery nurse. I learned that the statistics for an induction going to a C-section, while high, where not the 50/50 split I had thought they were - they were more around 30%. Which definitely made me feel better about my chances. I also learned a little more about the drugs used during the induction. I had been petrified of pitocin after my cousin had an induction using it. Her feelings were basically, "Sure, you can do natural childbirth! That's awesome! Oh, yeah, unless they use pitocin. Then forget it. That stuff's so nasty you don't have a chance and you wouldn't even want to think about it without drugs." Apparently, because there are a couple of drugs they use to get things started pre-pitocin, an induction didn't necessarily mean I'd need that either. And if I did, there were levels of pitocin and I could request starting at the smallest dose possible and move up very very slowly from there, to decrease the chance that the contractions would be too fast or too strong. So I could still have my natural birth, even with the induction. Honestly, I learned more about the induction in that one half hour conversation than my doctors gave me during the week long discussion and fight over it.

Secondly, I spoke to everybody I knew who had actually had an induction. I wanted to know what their experiences were, bad or good. I wanted to know how they looked back on their birth. What were the steps and pathways of decision making that their doctors' took in the process, and were they similar to mine? And, of course, did the one medical intervention lead to others, in the end? The resounding answer seemed to be no, in general. Most of my friends hadn't ended up with C-sections, and their interventions seemed to be based on their own decisions pre-delivery (like the use of an epidural). People tended to have a positive outlook on their birth experience overall, even if the induction wasn't a first choice.

Lastly, and probably most importantly, my amazing doula gave me some emotional exercises to work through some of the messy upheaval I was dealing with. What I discovered was that I depend a lot on authority figures' approval and support. Maybe that should have been obvious, right? What was obvious was that I was going to achieve neither in this specific situation. No matter what I did, I was never going to both gain their support and protect my daughter and achieve what I felt was best for her. I also didn't want to feel like I was making a wrong decision just to say "FU" to the doctor. And years later I wanted to be able to somehow explain myself to my daughter when she asks me, "Why did you risk that, Mom?" or "Why did you give in to them?" Mostly, I very badly wanted to bring my daughter into the world with feelings of excitement, joy, and peace. I felt like they had sort of ripped those away from me and replaced them with dread and resentment. I needed some resolution to those issues from within myself so I could be excited about my birth again. After I did all that prep, I came to a place where I was ok with the induction. Not "yippie" and excited about it by any means, but at least accepting enough to schedule it for Sunday night and feel good for the possibilities, and not absurdly angry at medical personnel.

So, I know - this is crazy long and I haven't even gotten to the actual birth yet. But I think it was important for me anyway, to hash through all the stuff that came first, because even now it has a huge impact on how I view everything that followed it.

Part two to follow later. :)

Miracle, revisited

As most of you know, my little bird arrived on the afternoon of August 27th.

I could easily sit and stare at her for hours.

Yes, I am sleep deprived.

Yes, I'm up at midnight. And 3 AM. And 5 AM.

I get absolutely nothing done during the day.

And I love every single stinking, spit-up covered minute of it.

Because she needs me.

And because we are so blessed to finally be a family.