All About Rowan's Birth

(copied from my previous blog, original blog date February 4, 2010)

So Baby Rowan was born on Saturday, January 30th (the full Wolf Moon) at 3:41 PM at SF General Hospital. Nothing about this birth was according to our plan, but it turned OK anyway.

Our plan was to birth in a birthing center in SF (Sage Femme) and if we had an emergency, we would go to UCSF (because of our private insurance). Anyone following my pregnancy knew it was rife with medical “issues” that caused stress but never materialized into actual problems after all. First, at 19 weeks, an ultrasound indicated a “complete placenta previa” meaning I could kiss my VBAC (Vaginal Birth After Cesarean) goodbye unless it rectified itself. And the doctor assured my midwife that because of the placenta’s positioning, it would not fix itself.

So, my partner and I called upon our spiritual community for prayer and magick to move that placenta. We envisioned it moving up and back along with hundreds of others all over the world. We had our second ultrasound about 6 weeks later and lo! Completely out of the way, paving the way for a VBAC!

Then came the “low amniotic fluid” scare. My third ultrasound indicated very few “deep pockets” of AF, which could be a problem that means the placenta isn’t doing its job, and could harm the baby. Now, all throughout my pregnancy, it should be noted that my midwife was on me for not staying hydrated enough. My bladder being the size of a walnut and having to get up hourly (I shit you not) to pee (even from a sound sleep) was unbearable after a while. So I was simply not drinking enough. Plus, the last ultrasound indicated that fluid was indeed flowing quite nicely from the placenta and it was healthy. I saw this new extra test as another freaking medically-imposed burden, as the baby was healthy and moving and all my test results were good.

They did the AFI test and said I was low but fine. Since it was low though, they recommended getting at least one more before my due date. I did not follow that advice. I got one after I was a week overdue, as is customary. In fact, the day I went in for the test, I had started laboring, and my contractions were 15 minutes apart during the testing. The labor had been triggered by my MW’s pelvic exam the day before, which indicated that my cervix was soft and fully effaced, and I was at 2 cm already.

Shockingly, the AFI test this time indicated NO fluid at all. None. Now this was a problem. I was advised (lobbied hard, actually, by 4 nurses and 2 doctors) to stay at UCSF that day and get an induction right then and there. I was not prepared to do that. I had a million loose ends to clear up before having a baby! My animals needed to go to caregivers, I had student loans to pick up to pay my rent, blah blah blah.

So I checked out “against medical advice” and told them that if my labor had not kicked in by tomorrow naturally, I would come back for the induction they were so trigger-happy for. Sigh. An induced labor in a hospital was looking more and more likely, and one intervention often leads to another, causing a cascade of treatments ending in C-section. I was nervous about that.

Back at home, after a day of errand running, the contractions stepped up quite a bit. At 3 AM, they were more painful than the prodromal labor I had experienced the week before (I had 4 days of “early labor” that never progressed the week before). And these newer, more painful contractions got much closer together.

Still, my MW was unconvinced over the phone that I should come into the birth center. Since I had never labored before in actuality (my previous C-section followed a several hour induction that did not work- I never dilated at all), this birth was going to be more like a first birth- and could be days at this level of labor. I was probably better off going to the hospital, she indicated- getting pitocin to get a baby out that may be in danger. I was crushed. I wanted a chance to labor in a non pathology environment, ya know?

Judi, my MW, could tell I was upset by this pronouncement. After a few minutes, she called back and said- “How about you come in to the birth center around 2 PM, and I’ll examine you. If you are far enough along, we can try to birth at Sage Femme- but we really do need the labor to begin in earnest today- for the baby’s sake. No amniotic fluid is dangerous. If you are not progressed, you can head over to UCSF.”

I was thrilled just to get the chance. I knew (don’t ask me how- I just did) that I would be dilated to at least 4 cm when she examined me. In fact, I was at 5 cm. Now Judi was prepared to take the labor seriously! She started to monitor the baby during contractions and was immediately dismayed. His heartbeat was dropping way too low (70 BPM) during contractions to be safe for him. He needed out of me, and fast! An ambulance was called, sending me into a hospital panic.

The paramedics insisted that I go to SF General instead of UCSF, as it was closer, and this was a real emergency. So I wound up in a hospital I never visited before. Scary. We (Judi the MW, Wolfy the Doula, and I) arrived in the ambulance and O’bee followed in the car with our stuff. He actually got there before we did!

They wheeled me in and all of the sudden, my support team was gone. I was being wheeled into an OR (gulp) for examination and 12 or so doctors and nurses are all talking to one another (not me) about me. It was scarily reminiscent of the first C-section and it was freaking me out. “Why am I in an OR?” I demanded between contractions. “I don’t want a C-section!” “Where are my people?”, I kept asking. Hardly anyone talked to me directly, and kept examining me and talking to one another about what to do to me.

Eventually, Judi got a nurse to give her scrubs and ran into the OR and appeared upside down over my head as I lay on the table. She was invaluable- as she was the only one there I knew and trusted. She ran interference and translated for me. Thank heavens for Judi.

Luckily, they decided to fully examine me before cutting me open. They learned that I had dilated to 9+ cm during the short time between Judi’s exam at 2:30 and then. I had successfully willed myself to open open open! I was happy when Judi told me I had a window of time to try and push myself, before they opted for a C-section. “Make these contractions count”, she said.

So push I did. Holy Fuck, did I push. I had three more contractions in which to push the baby out and I have never felt anything like that in my life. Nothing in birth class or in reading books prepared me in earnest for what it felt like or the extreme nature of my situation. Judi was amazing at helping me keep my focus and directing my pushes and breathe out my ass, not through screams and moans from my mouth.

It was around this time that O’bee (my partner and the baby's father) also appeared in the OR- he got there to witness the actual birth and see me split apart to bring our son into the world. I was too dazed to register him at the time verbally, but I remember thinking, “he wasn’t here just a minute ago…” I was glad he was able to get in- not just to see what birth is like, but now he would be able to be with the baby after he was out, since I could not be.

After the second set of pushes, they let me know that they were going to guide the baby out using a vacuum extractor- not much, just a little. After that third round of pushing, he was finally out. I could not believe it. They immediately took him away to examine him and I stayed lying down, and the placenta plopped out of me.

The baby was covered in meconium (prenatal baby poop-eew) and they worried that he had swallowed and inhaled it as well, possibly leading to an infection. They immediately removed him from the OR and passed him through a window where they began suctioning him. O’bee followed the baby to supervise the activities (and make sure they didn’t circumcise, vaccinate, or do other unwanted things to him). I was merely able to view a crowd around the baby and hear his crying while this was going on.

I ended up tearing a bit, so I stayed in the OR (impatiently) while they worked on the baby. As they were wheeling me out to recovery, I asked, “When can I see my baby?” They responded that he was having trouble breathing and he needed oxygen in the NICU. As soon as I was able to not be in bed, I could see him there. ARGH!

Again, my plan was to bond with the baby, skin-to-skin within the first hour of life on the outside, and start to breastfeed. “When will that be? An hour? Two?” They responded that in a few hours they would be happy to wheel me there, but that I had lost a lot of blood and they were making sure it slowed down first for my own sake.

I was taken to a room and my doula was there to help. I stayed there impatiently until we were told that I could see the baby in the NICU. I got into a wheelchair so that I would not gush blood everywhere (gravity is not your friend in this regard post-partum!) and Wolfy wheeled me there.

Rowan looked so small, and was attached to an IV (sugar water, for energy, since he could not feed right away) and monitors for his heartbeat, breathing, and oxygen saturation in his blood, as well as being under a little oxygen dome. He had very little human contact that wasn’t poking, prodding, or against his will. I was a little choked up seeing him like that. I stroked his little hands, and got as close as I could to him, hoping that he could focus and see me.

They then told me what the plan was for him- they were gradually cutting back on the amount of oxygen in the mix he was breathing, all the while monitoring his blood saturation. When I visited, he was on a mix that was 40% oxygen, and regular room air is 21%. Once he was down to 21% and his saturation stayed in the ninetieth percentile, he would not need to be in the NICU anymore. He was also being given several antibiotics, since the meconium issue reared its ugly head. But after the oxygen was resolved, he could get his antibiotics without having to stay apart from me.

At about 5:30 AM on Sunday, he was finally wheeled into my room, where he stayed with me for the rest of my hospital stay. I was so happy to be able to hold him and start breastfeeding and bonding. That first night, my doula stayed in the hospital with me, and O’bee stayed at a friend’s in SF (I am only allowed one overnight person at a time). When he arrived the next day for visiting hours, he got to see Rowan and do skin-to-skin contact right away.

We were there for 2 days- to ensure both baby and I recovered fully and to be sure the blood cultures of the baby’s didn’t grow anything funky that needed to be treated. While we were there, we got great tips on breastfeeding from several people- lactation consultants, my MW, and some nurses that really worked out well. By the time I left, my milk was starting to come down and the baby’s latch was great.

We got home Monday afternoon and were so grateful to have time to sleep as a new family and slowly acclimate to our new way of life. On Tuesday, I picked up my birds and we started to resume what would become our normal life.

My pain is present but manageable. I don’t know exactly how many stitches I ended up having, but I need pain meds to get around right now. Hopefully, they will heal quickly and stop aching soon. The baby is doing great- eating up a storm and we lucked out- he is mellow in temperament and not fussy.

That’s good, because I plan on doing PantheaCon again this year, this time with a newborn in tow!