Guest Post - "The Exact Birth I Wanted To Have"

Declan Lewis Durbin
April 17, 2014 
8:23 am
7lb 2oz
21 inches long

I woke up the morning of April 16th around 5:30 from contractions that I could no longer sleep through, so I got up and started timing them even though I had previously decided I wouldn't time my contractions. They were lasting about 20-30 seconds long and coming anywhere from 10-20 minutes apart. I told my best friends and my mom about them but told them not to get too excited in case it was a false alarm. I think around 3 hours later I texted my doula, Ashley, and let her know about the contractions, and she said don't get too excited, get some rest, and to let Sally, my midwife, know. Sally also said to get some rest.

Well I couldn't sleep, and I was hungry so Derek and I went to IHOP and ate. Then we went to Walmart to get some last minute supplies and food. The contractions were staying about the same. When we got home I tried to rest, but every time I would start to fall asleep I would have a contraction that would keep me up. This all continued throughout the day and into the evening. The contractions would get closer together and last about a minute, but then there would random ones that would only last around 20 seconds.

 I don't exactly remember when, maybe around 10pm, I told Sally the contractions were getting pretty painful, and I couldn't sleep anymore. She told me to take a bath and to try taking some Unisom to help me sleep. The bath felt amazing at first until my body got used to it, and right after I took the Unisom I threw up. Then I got back into bed hoping maybe the Unisom would work. Nope. At this point Derek was timing my contractions for me. I think they were coming around every 5-6 minutes and 45-60 seconds long. 

I'd say around midnight was when we called Ashley to come over. I remember already asking for some pain relief like Tylenol or something. When she got here, while Derek set up the birth pool, she did some techniques on me with the rebozo wrap for some pain relief and to try to get Declan in a better position I think. 

From then on it was a blurry mixture of laboring in so many different positions, groaning through contractions, being fed apples and water, and throwing up. I got in and out of the pool a few times. It would feel good at first, but once my body got used to it, it wasn't as comfortable. My favorite spot at first was sitting on the ball and leaning over the coffee table on some pillows. Then standing up started to feel better. The whole time Ashley and Jenn, my second doula, would push on my hips during the contractions. That felt so good. At one point Derek even filled in that position while one of them took a break. In between contractions they would give me back rubs, and those felt SO GOOD. Another thing that really helped was Ashley reminding me to do a low groan. It was much more effective than whining or screaming.

At my 36 week appointment I had tested positive for GBS, so I needed to receive antibiotics through an IV which I was not thrilled about. I remember not wanting Sally to arrive because that would mean I had to get a needle in me. Jenn promised that would be the least of my worries, and she was right. I would take 10 IVs over the pain of contractions!

When Sally and Shelly (her assistant) arrived around 3 or 4 in the morning they set up shop. Derek said they basically took over the living room. He was pretty impressed. I laid on the mattress we had set up in the living room while I got my IV antibiotics. It really was no big deal. After, I stayed there for a while. My blood pressure started to rise, so they were all rubbing an essential oil blend on my hands, wrists, and chest. They were miracle oils because my blood pressure was back down in no time!

At one point, Sally told me to let her know if I felt like I needed to push so she could check me to make sure I was fully dilated before I started pushing. I asked her to check me now because I wasn't sure I would know what it felt like to need to push. When she checked me I was almost fully dilated, just a little lip left. From that point until when I started pushing felt like eternity. 

“The temptation to quit will be greatest just before you are about to succeed.”  

- Chinese Proverb

 I kept wondering what was taking so long since I was already fully dilated. Ashley said the baby was moving down, and with each contraction she kept saying “down baby down”. It's burned into my brain she said it so much ;) During this time was when it became very unbearable. I really felt as if I wasn't getting any breaks in between the contractions. I decided to get in the shower for some relief. I tried sitting. I tried standing. Nothing helped. It was just awful. I had a whole debate in my head about wanting to transfer to the hospital for them to just cut him out of me but not wanting to ride in a car for 45 minutes. I couldn't remember that this meant my baby was almost here!

My water broke finally during a contraction. It was, of course, on the only part of the living room carpet that wasn't covered in plastic. When the next contraction came, I could tell my body wanted to push so I got into the birth pool. I pushed on my hands and knees, and in between contractions they would push the gatorade (or water? I can't remember) bottle under my face so I could take a sip. It really did feel good to push. I liked being able to feel everything because I could tell when I was stretching too much and needed to stop to let his head form into a nice shape for me. After a lot of pushing and encouraging words and coaching from my birth team, I pushed his head out, and I knew that I just needed one more contraction to push the rest of his body out. That contraction came, and, after only 30 minutes of pushing, at 8:23am on April 17, 2014 Declan Lewis Durbin was born!  

When he came out the cord was wrapped around his neck and arm, but Derek said Sally just calmly and quickly “unwrapped him like a present” and pushed him through my legs so that I could lift him out of the water for him to take his first breath. It was such a relief! I just remember being so thankful the pain was gone and that my baby was here. Almost immediately he started babbling, telling us his story of what just happened!

After a minute or two they helped me out of the pool and onto the mattress where Derek cut the cord after it stopped pulsing. It was taking a little too long for my placenta to come out, so Sally had to gently tug on it while I pushed it out. Finally it came out nice and whole. After that, I laid back on the mattress wrapped in blankets with my perfect little baby boy, and ate a banana and a Reese's easter egg.

It wasn't until we all talked about it and reflected back on it that I realized I had the exact birth I wanted to have (which I heard doesn't happen that often). I couldn't have asked for anything better. I had the best and most supportive birth team ever. They treated me like a princess waiting on me hand and foot, and I couldn't be more grateful for them! Shelly told me she predicted that my birth would be smooth and powerful, and she was exactly right :)

 

 Danielle Durbin is a mother of one, her little man Declan Lewis. You can follow their story at Instagram @missusdurbin or you can read her blog here.

 

 

The Importance of Birth Plans...

Birth Plans are a great idea for any pregnant person to have ready! We all know birth is unpredictable and having a "plan" in place is no guarantee that anything will go in any particular way. However, the great thing about putting together a Birth Plan is that it makes you think about how you'd want things to go ideally…and it helps prepare you for the alternatives.

There are so many interventions that you may wish to avoid (or elect to have) during your birth experience, and preparing your Birth Plan is a great way to discover what all these interventions are and what they mean for you and your baby. I found that for my pregnancy, the easiest thing for me to do was find a template for a birth plan (BabyCenter has a good one HERE) and then researched the options in each section to determine what best fit my preferences.

You can start putting together your preferences as early as your first trimester, although the recommendation is to have some sort of idea ready by your 5th month of pregnancy. It's important to know as early as possible what is important to you (for example, perhaps you absolutely DO NOT wish to have continuous monitoring so you can move freely during labor, or maybe you absolutely NEED to eat and drink during labor) so that you can discuss these things with your care provider. The reason it's best to do this early is because it gives you the best chance of finding a doctor or midwife you LOVE, should you decide your current care provider is not the best match for the type of birth experience you have in mind. *By the way, remember you can ALWAYS change doctors…even at the very VERY last minute!

If you and your care provider agree that your plan is feasible and safe, and you are SURE your provider is giving you the best possible care and not just considering what is most convenient for THEM, then a good idea is to have the doctor sign your birth plan. It's not in any way a binding contract or anything, but the idea is that if you go into labor and arrive at the hospital or birth center before your care provider does, you can have something to show the nurses and support staff that shows that your care provider is on board with your preferences. It's also important to have several copies on the day of the birth for the nurses, your doula, etc. Every one that comes in contact with you during your labor should see your birth plan, to avoid miscommunications or misunderstandings.

You can include things in your birth plan regarding pain management, what you wish to happen to the baby immediately after birth (like immediate skin to skin and waiting to do newborn exams for an hour so you have a chance to bond, for example), and your plans for feeding your baby (bottle or exclusively breast feeding?).

It's definitely important to be flexible and be ready to forgive yourself if things don't go exactly as you'd hoped…The most important thing is to be educated about all of your options so that if things DO need to go in a different direction, you are equipped to make the best choices for you and your baby. Remember, even if your Birth Plan doesn't come to fruition, preparing one is always beneficial because it familiarizes you with your options (and their risks and benefits), and the policies of your care center and provider.

What advice would you give a first time mother about preparing a birth plan? What is something you think every plan should include?

Guest Post: "How I Met My Littlest Valentine"

At 41 weeks and 1 day pregnant around 6:30pm on Thursday February 13 I changed positions on the sofa and felt some type of liquid come out of me. Assuming that I peed myself I headed into the bathroom but there wasn’t the smell of pee. I sat back down and went onto my online pregnancy support group asking if they thought it was pee or amniotic fluid. I called my doula and she said to call the midwife and figure out what to do. I put another pair of underwear on to see if I was still leaking and sure enough I was. I woke up Evan and said “My water broke. I think this is it. I think we’re having a baby today.” Evan shot right up and got out of bed in a total panic. He had to shower, his bag wasn’t totally packed, the house was a mess. I called the midwife and she said to head to the hospital. My plan was the birth center so I was a bit panicked. I was terrified of not laboring fast enough, being pumped with drugs, and getting forced into a cesarean. Evan kept telling me everything would be okay and we were probably just going to the hospital because the birth center had closed that day due to the snow and the parking lot was most likely not plowed. I called my Mom and told her I thought my water broke and I needed to go in to get the fluid tested. 

My parents came over as quickly as they could. Fitting the four of us, our bags, and my birth ball in my Dad’s truck was not an easy task. On top of that my mother thought I would be cold so she had the heat up. I was sweating my butt off and asked them to open the windows. There was some where between 6 to 12 inches of snow on the ground and it was still snowing when we were on the road.  We got to the hospital and I totally forgot how to get to the maternity ward so I waited in line at the front desk and got directions. We got checked in and Evan sat with me in a room waiting for someone to come in to check me. The woman who came in was very ill mannered and seemed annoyed that I had questions. I wasn’t sure what was going to happen because I didn’t have a hospital birth in my mind and I was confused about being Group B Strep positive and having my water break before labor. The woman told me I needed to be checked in and that it was amniotic fluid and we had to start an induction. Tears immediately began for the fear of needles, air bubbles in the line, medical interventions leading to cesarean. I felt so rushed from the doctor, nurses, the millions of questions my parents had, and the amount of emotions I was feeling on top of worrying about how Evan was. After arriving in the delivery room the nurses came in for the antibiotic IV and pitocin. My midwife was in the room and told the nurses that my veins are hard to find and they would need the IV team but the nurse was convinced she could do it herself. She couldn’t. It hurt quite a bit while she wiggled the needle around in my arm trying to figure out where it needed to go. She finally gave up and called the IV team. Another nurse catalogued my belongings and asked if all my jewelry could be easily removed in case there was a cause for a cesarean. That made my mind race even more than it already was. During all this time I was crying and trying to remember to stay calm and breathe. After being hooked up to everything the midwife checked me for dilation and I was about one and a half centimeters. 

Once everything settled I called my doula who was upset that she wasn’t able to be there from the very beginning of everything. She arrived sometime around midnight and told me what to expect. She suggested I try to get some sleep but since Evan works nights I was sort of on his schedule and he was wide awake. We watched Mob Wives and Couples Therapy and then the local news. Evan and my doula eventually fell asleep and I tried to sleep as well. I was hooked up to a blood pressure cuff that had to go off every 15 minutes. Because I’m fat I need an adult thigh cuff for an accurate reading. I was constantly woken up from the machine going off on top of the fact that the cuff didn’t fit and made my arm twitch and go numb. A nurse periodically came in because the readings were off and I tried to explain what size cuff I needed. The nurse told me that size didn’t exist and moved the cuff to my forearm which didn’t really make a difference. I’m not sure how much sleep I got but I did sleep a little bit. 

On Friday February 14 we woke up sometime around 7:00am. At 9:00am I was checked and was 4 centimeters dilated. Evan left to get breakfast while I was with my doula. I sat on a birth ball bouncing up and down waiting for a nurse to come in so I could get on wireless monitoring. After being on wireless monitoring I was able to walk around the room, sit in different positions on the bed, lean against the wall, and do whatever I needed to manage the pain. Evan came back from breakfast with some juice and a rose for Valentine’s Day. He must have spent a fortune in the gift shop but he didn’t want Valentine’s Day to pass without giving me a rose. Laboring was much different than I hoped it would be. The IV was annoying and the wireless monitors kept moving plus I had to get my blood pressure checked every half hour. Luckily the nurses that came with the shift change were so much more pleasant than the ones from overnight. They let me go longer in-between blood pressure checks to not stop my concentration and stopped readjusting the wireless monitors as often as they should have. They even informed every one of my birth plan and wrote a note on my door specifying quiet voices, natural lighting, and to keep the door shut at all times. The midwife came in I think around lunch time and asked if I wanted to be checked. I told her no because I was worried if I wasn’t as far as I had imagined that labor would stall due to my mental state. During breaks between contractions I read birth affirmations and listened to a hip hop play list, I had a classical music playlist but it didn’t distract me enough. My doula told me to turn on whatever music I normally listened to or else I wouldn’t be able to block out the pain. Evan stood behind me massaging my lower back while I was on the birth ball, then my doula would fill in with different massages and suggest other positions. I decided I wanted to walk the hallway. Walking was terrible. I had to stop walking during contractions so I gave up that idea and headed back to my room. 

At 4:00pm I asked to be checked. At that point I was on my birth ball and in a world of pain. I wasn’t sure how much longer I could do it. When the midwife came in and checked she told me I was at 7 centimeters. I laid on the bed thinking there was no way in hell I would have been able to stay at home until this point like I had planned. I had wanted to labor at home for as long as possible and head to the birth center around 7 or 8 centimeters. I think I would have panicked long before this point if I had been at home. I remember telling anyone in the room that would listen that I couldn’t do it much longer. I repeatedly said that it hurt really badly and I couldn’t do it. Evan was behind me in a chair and I was on the birth ball. I leaned back onto him during each contraction. I don’t know if I looked like I was having a difficult time or if it was because I kept saying I couldn’t do it but with every lean back he would whisper in my ear and tell me how strong I was. Hearing him tell me I was doing well was what I needed. It was still awful but I thought if Evan believed in me then I must be able to do it. I asked how long they thought I would be in labor and my doula told me at least two more hours. I looked up at the clock and cried. Contractions came and went and I looked at the clock again. It had only been ten minutes. I thought  to myself “Shit. It’s been ten minutes how the hell can I do this for two more hours?!.”  

After spending almost two hours on the birth ball I decided to go on my hands and knees on the hospital bed. The hospital bed had a setting where the bottom part dropped down and you could sit on the top part with your feet on the bottom part sort of like a chair if that makes sense. So on all fours my knees were on the lower part of the bed while I leaned over the top. I asked Evan for the ultrasound picture of our daughter. I laid that picture on the pillow in front of me and with every contraction I kept telling myself this was all for her. If I could just make it through this contraction I would be one step closer to meeting the sweet baby in the picture. I’m not sure how long I was in this position before I told them I felt like I had to push. My doula told me to wait for the midwife. There was a shift change. I heard them whispering the name of the midwife that was on her way. The second I heard her name I felt so defeated. I knew I was going to end up getting a cesarean. This midwife was the only one during my pregnancy who brought up complications that were going to happen because of my weight. She never spoke to me as though they could happen, it was always they will happen. I had proven her to be wrong up until this point. I was so worried that with the first little thing to go wrong she would tell me I was done and I would have to go to surgery. After those fleeting negative thoughts I remembered the picture on my desk top. It said “Wake up every morning and tell yourself you’re a bad ass bitch from hell and no one can fuck with you. And then don’t let anyone fuck with you.” I pushed all the negativity out and said to myself “You are a bad ass bitch from hell. Do not let her fuck with you. You can do this. Suck it up and do it.” When the midwife came in she checked me and told me I wasn’t ready to push but I told her I had to. She asked me to wait and I was there on the bed wondering how to stop myself from pushing without totally screwing up the labor process. I didn’t understand and I still don’t understand. I don’t get how you can just hold in a baby as if you’re holding in your pee. I pushed. I said it again “I seriously have to push. I can’t not do it.” I heard my doula say “Okay then push.” With her support I started pushing with each contraction. I looked at the clock and it was 6:00pm. I was mad. They told me it would be at least two hours. I had it in my head that by this time I would be holding my baby. I pushed as hard as I possibly could and my God did it hurt. I was pushing, and pushing, and pushing and I finally started yelling at everyone. I yelled “CUT HER OUR OF ME.” I screamed. I screamed and my doula told me to focus. She said “Bring it back in. Control it.” Evan remembered something I had researched. I read that loud noises contract everything tight and low noises open everything up. I heard him say “Growl, Felicia. Get low.” So I did. I made super weird low growling sounds I have never made in my life. I tried to practice these sounds a few weeks earlier but I felt stupid so I gave up on it. I took a deep breath as I felt the contraction growing and as it peaked I pushed my body toward the midwife and growled. I heard the nurses sounding happy with their chatter and my doula said “Yes!! Get mad at it. That’s it.” I continued growling and pushing for what seemed like an eternity.  Evan left to get me more water and when he left I started screaming again. He told me he could hear me from the nurses station, which was pretty far from our room. Again and at least twenty other times I yelled “JUST CUT HER OUT!!” I kept telling them I couldn’t do it and every time I said “This really hurts!” the midwife would say “Well yeah Felicia, it does hurt.” When Evan came back I told him I needed medication and that I couldn’t do it any more. He and my doula both told me I had to be the one to ask. I didn’t want to ask. I didn’t want to be the one to give up. I told them again that it hurt and I couldn’t do it. My doula said “You’re scared. Stop being scared. Stop fighting it. You can do it, you’re just scared.” I realized she was right. I was scared. I was never in labor before. I never felt contractions before. I never pushed out a baby before. I prepared myself for every part of labor and delivery. I researched terminology and knew almost every procedure they would try to do. I remembered I had a right to say no and that they were not in charge of my birth. It was MY birth. What I didn’t prepare for was the pain. But how do you even prepare for something you can’t even begin to comprehend? I had never even broken a bone before. I had no idea how badly labor would hurt. I was scared and I had a right to be. I thought back to my desk top. “You’re a bad ass bitch from hell. You are a bad ass. You can do this.” The growling continued and I got back into my groove. I was doing well but I was totally exhausted. I fell asleep between every contraction and I only opened my eyes to look at Evan. I remember I looked over at him because I couldn’t take it anymore. Evan must have seen in my eyes that I was ready to give up. He grabbed my face and said “You are so strong. You can do this. I’m so proud of you.”

I was doing well until I thought I was going to poop. The midwife told me it was fine and all the nurses said it wasn’t a big deal but I was on all fours and I thought if I pooped it was going to go everywhere. Worrying about pooping hindered me and I needed to switch positions. I layed on my left side while Evan held my right leg up. When I was in this position the midwife told me she had to move my cervix because it was in the way. She told me it would feel like being checked for dilation and that she had to wait for a contraction. With the next contraction she put her hand inside me and moved my cervix. It hurt a lot worse than being checked for dilation. I remember looking at her straight in the eye and saying “OW!” as if my whining would make her stop. I laid there on my side and continued to push like that for an unknown amount of time until I heard the midwife say “I can see a head and there’s a lot of hair.” I yelled “WHAT?! You see the baby?! Am I seriously about to have a baby?!” I looked at Evan and he was crying. Later he told me that once someone could actually see her he realized it was real. You know that saying that women become mothers the moment they are pregnant but men don’t become dads until they hold their child. Evan became a Dad at that moment. He was so happy. I don’t think I have ever seen him that happy. The nurse on my left told me I could reach down to touch the head. This was in my birth plan and I was glad she asked but I said no. She said this was my only chance and I could do it but it grossed me out too much to actually feel a baby down there. I pushed so many times . I was sick of waiting to have my baby in my arms. I felt the burning and I knew it was almost time. I knew the burning was her head coming out and I knew that the moment I felt like I couldn’t continue was the moment she would be out. I have no clue how many more times I pushed but eventually she was lifted out and placed on my stomach. She was perfect. I asked if it was a girl and once they said yes I counted her fingers and toes and told her happy birthday. I kissed her on the head and said “We did it, baby girl. We did it.” Coraline Paige was born at 8:14pm on Valentine’s Day. I was in the hospital and had to have antibiotics and pitocin but I didn’t get anything for the pain and it was an overall positive experience. Pushing for two hours sucked but in the end I got my Valentine’s baby.

The rest was a total blur. Evan cut the cord, my doula took pictures, I was in complete shock. I remember that they said my body had taken over and I wasn’t on pitocin but they turned it back on to deliver the placenta. I told them to make sure no one took the placenta because I was taking it home to be encapsulated. At some point they took my baby to be measured and weighed and I think that’s when I was getting stitched up. They gave her back to me and covered us up. I think they tried to clean the floor a little bit while Evan went out to tell our family that she was here.

Things that happened but I don’t know where they fit in:

-At some point during labor the wireless monitors were not picking anything up and there was trouble with my daughter’s heart beat. I was asked if I wanted internal monitoring and I had remembered that I didn’t but I couldn’t remember why so I just agreed because I thought a cord inside me would be much more tolerable than those annoying plastic circles and a huge piece of gauze around my stomach. I think this was when I was on all fours but I don’t quite remember the time line of everything.

-I threw up twice once I was on my side pushing but I don’t know if it was towards the beginning or end.

-The antibiotics for GBS burned so badly I was in tears until my arm was covered with a wet wash cloth. 

-When it was all over I opened my eyes and realized how many people were in the room. I think there was Evan, the midwife, Doula, and three nurses. I said hello to all of them and apologized for not paying attention to them during the labor process.

-The entire time I was in labor I asked Evan if he was okay and if he needed anything. I was worried about him passing out or not being able to take seeing me in pain. He surpassed every expectation and was completely amazing. 

-The first set of numbing shots before getting stitched up didn’t work and I felt the first few stitches. After telling her to stop and trying to wiggle away the midwife gave me three more shots of numbing stuff and then continued.

-I didn’t realize how warm the amniotic fluid would be or how much there was. My water breaking was a little trickle so as it gushed down my legs during labor I was completely disgusted. I remember the nurses laughing at me because I sat there saying “Ew” over and over again. 

There it is. My birth story. The hospital wasn’t what I wanted but it wasn't the total hell I had imagined. After being in a delivery room in the birth center for my postpartum check up I realized I probably wouldn’t have been able to deliver there. With my anxiety I think I would have panicked and needed the hospital because my pessimist mind wouldn’t have felt safe. I think for our next child, if we’re blessed to have another baby, I will plan on a hospital birth from the begging. I think having the midwives and a doula helped me get the birth I wanted. I’m about 90% sure that if I had an OB there’s no way I would have been allowed to labor and push for as long as I did. 

 

 

Written by Felicia T., momma of a beautiful little girl from Reading, Pennsylvania. She is a Domestic Goddess for a living and a human rights activist. Today, Coraline Paige is 5 months old!

Guest Post - "A Breech Birth at Home"

I remember the first time I even heard about breach births. It was in one of my high school textbooks and it sounded scary. A couple years later I watched a documentary about “freebirthing.” One woman gave birth to her baby in the bath tub completely on her own, and the baby was breach. The baby was fine though. I remember thinking, “Is she crazy?! Her baby could have died!” Fast forward many years later... I’m already a mama of one precious boy, born in a hospital but with no drugs whatsoever. I’m pregnant with a baby girl and have decided that since I had such an easy time with my first labor that I’m going to go for a home birth. It’s funny how time and research can change your mind about anything. I never imagined as a teenager that I would be one of those women giving birth at home.

 As the time to give birth came closer and closer I was just excited as can be. All my midwife appointments were great, the pregnancy was progressing normally, and I was confident that everything would turn out just fine. Well, it did turn out fine, but not without one big surprise.

 My contractions started on a Monday morning and two hours later I was already in the birthing tub getting ready to push. I was in intense pain. With all my might I pushed that baby out and felt some relief. I looked down into the water and all I saw was legs and a body. Her head was still inside of me. I didn’t know what to think. There had never been any indication throughout my pregnancy that she was breach. “Is she stuck?!” were the only words I could manage to spit out. “No, push,” my midwife told me. So I did. And out she popped. I held my baby girl in my arms. She was perfect. I couldn’t believe she was breach. I couldn’t believe she had come out with such ease. I couldn’t believe this was our story and how blessed we were.

 I used to be afraid of breech birth, but through my own personal experience I learned that it doesn’t have to be scary. Thankfully my midwife knew what she was doing (she had recently completed some training on breach birthing) and didn’t panic. My home birth was the most amazing experience and it taught me that women are incredible and capable of so much.

Kristel is a stay-at-home wife (to Alex) and mom (to Liam and Isabel). She lives in Miami, FL and blogs about faith, family, and fun over at Glowing Light. You can also find her on Facebook, Twitter and Instagram. 

Check out more information on breech babies in this post, and read about Felicia's cesarean due to breech here. I hope this series has helped provide some insight into breech presentation and shown that the right environment and a supportive care provider can make the difference in getting the birth you want and deserve!

Good to know about birth!

My Birth Plan Revisited

 Originally posted in 2011 at Plus Size Preggo

 Spoke to an OB at my practice yesterday (they rotate so you get to know everyone), and I was pretty disappointed with what I was told about my birth plan, even PO’ed at one point…As I told my sister, who came to the appointment with me: “Unless something magical happens during birth that makes me want to blow everyone in that hospital, I am NOT going to do a hospital birth with the next baby!” (Blunt but true story LOL)



* I’d like the following people to be present during labor and/or birth: My husband, my sister, and my mother. “OK”

* I’d like to wear my own clothes during labor and delivery. "OK, but you probably won’t want to"

* I’d like to take pictures and/or video during labor and delivery. “Only allowed BEFORE labor, AFTER birth and NOT during newborn tests”

* I’d like the option of returning home if I’m not in active labor. "OK"
* Once I’m admitted, I’d like my partner to be allowed to stay with me at all times. "OK"

* Once I’m admitted, I’d like to eat if I wish to. "Not going to happen"

* Once I’m admitted, I’d like to try to stay hydrated by drinking clear fluids instead of having an IV. "Not going to happen, either"

* Once I’m admitted, I’d like to walk and move around as I choose. “You’ll be strapped to a monitor so you can walk as long as you’re not far from the edge of the bed” read: NO.

* As long as the baby and I are doing fine, I’d like to have intermittent rather than continuous electronic fetal monitoring. "We can do it, but it’d be a nuisance." read: "Not going to happen"

* As long as the baby and I are doing fine, I’d like to be allowed to progress free of stringent time limits and have my labor augmented only if necessary. "OK"

* If available, I’d like to try a birthing ball, birthing stool, squatting bar, and/or a birthing tub/pool. “What are these things?” I WISH I was kidding.

* I’d like to try the following pain-management techniques: bath/shower, hot/cold therapy, massage. "No bathing or showering, stay home and do that until you MUST come to the hospital"
* Please don’t offer me pain medication. I’ll request it if I need it. "Make sure you tell them that at the hospital" I thought that’s what the point of THIS was?

* If I decide I want medicinal pain relief, I’d prefer regional analgesia (an epidural and/or spinal block). "OK"

* When it’s time to push, I’d like to be coached on when to push and for how long. "OK"

* I’d like to try the following positions for pushing (and birth): semi-reclining, squatting, hands and knees, whatever feels right at the time… "We’re not equipped for that" read: "Not going to happen"

* During delivery, I’d like to give birth without an episiotomy. Again, “Make sure you tell them that”. Um, will do.

* After birth, I’d like to hold my baby right away, putting off any procedures that aren’t urgent. "OK"

* After birth, I’d like to breastfeed as soon as possible. "OK"

* After birth, I’d like not to get oxytocin (Pitocin) after I deliver the placenta unless it’s necessary. This is where I got pissed. "Well, we will do that so you don’t bleed. I mean, you’re going to bleed anyway…but we’re physicians. This is what we do." Uh-huh. So basically, fuck yourself. We’re medicating you one way or the other.

* After birth, I’d like my partner to cut the umbilical cord. "OK"

* If I have a c-section, I’d like my partner present at all times during the operation. "OK"
 
* If I have a c-section, I’d like the baby to be given to my partner as soon as he’s dried, if appropriate. "OK"

* If I have a c-section, I’d like to breastfeed my baby in the recovery room. "OK"

* I’m planning to bank cord blood privately. "OK"

* After delivery, I’d like all newborn procedures to take place in my presence. "OK"

* After delivery, I’d like my partner to stay with the baby at all times if I can’t be there. "OK"

* I’d like 24-hour rooming-in with my baby. "After the birth, ALL babies go to the nursery for a bit, but then he’s all yours" I almost clawed at her face when she said that. I’m going to fight this one.

* I plan to breastfeed EXCLUSIVELY. "OK"

* Do not offer my baby: formula, sugar water, a pacifier. "OK"

* I do NOT want my baby circumcised. "OK"

* I’d like to wait and see how I feel before deciding about the timing of hospital discharge. "OK"



So I reiterate…I knew I’d be disappointed because I was expecting too much from a hospital, but for the most part, I expected this. Next go round, once I know I can successfully have a birth without complications, it’s birthing center all the way!!!

My Birth Plan

 Originally posted in 2011 at Plus Size Preggo


* I’d like the following people to be present during labor and/or birth: My husband, my sister, and my mother.

* I’d like to wear my own clothes during labor and delivery.

* I’d like to take pictures and/or video during labor and delivery.

* I’d like the option of returning home if I’m not in active labor.

* Once I’m admitted, I’d like my partner to be allowed to stay with me at all times.

* Once I’m admitted, I’d like to eat if I wish to.

* Once I’m admitted, I’d like to try to stay hydrated by drinking clear fluids instead of having an IV.

* Once I’m admitted, I’d like to walk and move around as I choose.

* As long as the baby and I are doing fine, I’d like to have intermittent rather than continuous electronic fetal monitoring.

* As long as the baby and I are doing fine, I’d like to be allowed to progress free of stringent time limits and have my labor augmented only if necessary.

* If available, I’d like to try a birthing ball, birthing stool, squatting bar, and/or a birthing tub/pool.

* I’d like to try the following pain-management techniques: bath/shower, hot/cold therapy, massage.

* Please don’t offer me pain medication. I’ll request it if I need it.

* If I decide I want medicinal pain relief, I’d prefer regional analgesia (an epidural and/or spinal block).

* When it’s time to push, I’d like to be coached on when to push and for how long.

* I’d like to try the following positions for pushing (and birth): semi-reclining, squatting, hands and knees, whatever feels right at the time…

* During delivery, I’d like to give birth without an episiotomy.

* After birth, I’d like to hold my baby right away, putting off any procedures that aren’t urgent.

* After birth, I’d like to breastfeed as soon as possible.

* After birth, I’d like not to get oxytocin (Pitocin) after I deliver the placenta unless it’s necessary.

* After birth, I’d like my partner to cut the umbilical cord.

* If I have a c-section, I’d like my partner present at all times during the operation.

* If I have a c-section, I’d like the baby to be given to my partner as soon as he’s dried, if appropriate.

* If I have a c-section, I’d like to breastfeed my baby in the recovery room.

* I’m planning to bank cord blood privately.

* After delivery, I’d like all newborn procedures to take place in my presence.

* After delivery, I’d like my partner to stay with the baby at all times if I can’t be there.

* I’d like 24-hour rooming-in with my baby.

* I plan to breastfeed EXCLUSIVELY.

* Do not offer my baby: formula, sugar water, a pacifier.

* I do NOT want my baby circumcised.

* I’d like to wait and see how I feel before deciding about the timing of hospital discharge.


I’ m sure a lot of these won’t be do-able (I’m looking at YOU, eating during labor and no IV!) but I’m going to take this to my OB appointment tomorrow and talk everything over with my doctor to see what I am willing to compromise and what MUST be.


(This nifty PDF was a big help in articulating just what I wanted during my labor and delivery.)

Guest Post: "My long, long, long story."

I've been overweight my entire life. At the beginning of this journey, I was 300lbs. I'm 5'2, so that's quite big. I was diagnosed with PCOS when I was 13. I was immediately put on birth control to control the symptoms of PCOS, as well as metformin. As time went on, I stopped the metformin because I wasn't trying to conceive as a teenager and thought it was dumb to try.  So at the time I became pregnant, I had been dealing with PCOS for 13 years. Most of those 13 years I was on birth control. About 6 months before I became pregnant, I was tested for PCOS again and it came back that I very obviously had mild to severe PCOS. I was put on metformin and aldactone. A few months later, I moved from Tennessee back to PA and stopped taking the metformin, aldactone, and birth control because I wasn't in a relationship at the time and wasn't able to get my medication because I no longer had insurance.

 I met the father of my baby in July of 2012 and we became a full blown couple in August of 2012. We used condoms, but weren't extremely careful. I wasn't worried because of my history of PCOS.  We broke up September 15th, 2012. Two weeks later (after he moved back to California to be with his family - I live in Pennsylvania. That's 2000+ miles) I found out I was pregnant. For about a week, I had been feeling tired and nauseous, but I just assumed it was from the stress of the breakup and PMS. My mom asked me if I could be pregnant and I told her "Well, technically, yes. But I highly doubt it". She asked when I was supposed to get my period and I told her it would be about a week before I could test, but I was sure my period was coming.

Fast forward to 4 days past when my period was due to start. I worked my 3-11 shift and decided to go to the drug store after work to get a test. I bought a two pack of digital tests because I didn't want any question about the lines. I didn't want to think I was seeing things when it was really negative. I got the tests and went home. Ate something as I always did and went to bed. Around 7am, I got up to use the bathroom and decided to take the first pregnancy test since it would be first morning urine. I sat the test on the sink and went about finishing up. I glanced down at the test less than a minute after taking it and it said "Pregnant". I closed my eyes for a few seconds and looked at it again. Still "Pregnant" I picked up the test and held it close to my face, staring at it. It didn't change. I turned the test every which way, still the same. Still "Pregnant". I took the second test out of the package and tested again. Same thing. "Pregnant" came up before a minute had passed. I started shaking and crying. I went to my bedroom and called my mom. At first I couldn't speak. She became panicked, thinking there was an accident or I was hurt. I squeaked out "I'm pregnant" through my gasps for air. All she said was "You're pregnant? That's not a bad thing!". She's always wanted me to have kids.

So, there I was: 26, 300lbs, major history of PCOS, just broke up with the father of the baby I was apparently carrying, living alone 2 hours from my family, working a full time, physically demanding job. It took me a little while to wrap my head around it. I took pictures of the test and looked at them because I was still in disbelief. A couple hours after taking the test, I called the baby's dad. We had still been in touch since we broke up, so it wasn't terribly weird talking to him. I basically told him to sit down where ever he was. I explained that I took two tests and that we were having a baby. He was in shock, as any man would be in his situation. He didn't talk for a little while. I was crying. I told him he didn't have to come back and that he didn't have to have anything to do with the baby if he didn't want to. I just wanted him to be able to make the decision. He decided he wanted to come back to help me out and be a part of his baby's life. He was back in Pennsylvania 2 weeks later. We decided at that point to work on our friendship because we wanted a healthy relationship (whether it be friendship or romantic) for the baby.

He came with me to my first real appointment at 8 weeks pregnant. The first thing I asked the nurse was "Do women as big as me often have healthy pregnancies and healthy babies?" She let out a little chuckle and said "I see women bigger than you every day that have healthy pregnancies and healthy babies. Don't even worry about that!" I knew then that I was at the right office with the right people. The doctor didn't mention it, she only suggested that I have an early glucose test because of my PCOS history. They tracked my weight like they would any other pregnant woman. They didn't treat me any differently. I ended up losing 10lbs in my first trimester due to my morning sickness. At 10 weeks, they found my baby's heartbeat and I cried. It sounded so perfect. I had my first ultrasound at 13 weeks and my baby looked perfect. I was worried that they would have a hard time seeing the baby because of my weight, but the ultrasound tech didn't seem to even notice.

Everything carried on as normal for a few months.  I wanted to have an all natural birth, but I also knew that things can happen so I decided not to get too used to the idea. The baby's dad and I re-developed feelings for each other and decided to make a go of a romantic relationship with the understanding that we need to make it work. If it ends, it ends for good. Either way, we needed to be mature and civil for the baby. We decided to move closer to my family for support and for childcare after the baby was born. I worked up until the day before we moved (I was 28 weeks), but wasn't able to get a job after we moved. The worst part was switching doctors.

I went to a women's clinic in town and was severely disappointed. The female doctor I saw was horrible. She looked right through me. She ignored my worries about my blood pressure. She did mention my weight and I simply said "I've only gained (this much) and that isn't a problem." After two appointments like this, I decided to find a doctor in my hometown that is an hour from where I live. I'm so glad I did. I went to a new practice that had an OBGYN and a midwife. They were both so wonderful. Never mentioned my weight, but did address my blood pressure. It was only slightly elevated, but they didn’t want to take any chances. I was put on Labetalol twice a day to manage my blood pressure starting at 34 weeks. I had no real side effects from the medication, but it didn’t completely control my blood pressure. At 38 weeks, my doctor decided that inducing me no later than 40 weeks was the best option. This was because of my blood pressure, my family’s history of pre-eclampsia, and also because baby was measuring weeks ahead on every ultrasound since 33 weeks. Luckily, I didn’t develop pre-eclampsia.

I kept trying to bring labor on naturally. Walking, bouncing on a yoga ball, walking up and down the steps, and increasing intercourse (the boyfriend loved that!). I had a few contractions off and on, but nothing significant. So, at 39 weeks and 4 days, I began the induction process. They decided on Prepidil because I was already 1cm dilated and 75% effaced.  The worst part was that I had to stay in bed for 90 minutes after they inserted the Prepidil. It causes spontaneous contractions that, at times, are very painful. I was able to get out of bed and into a jacuzzi after the first round of Prepidil and it was heaven. My contractions evened out and I was handling them well. Sadly, they stopped a couple hours later. I kept walking and trying to bring the contractions back on, but nothing. I did this all day long with very little progression. At about 10pm, they offered to break my water and try another round of Prepidil. I opted for sleep because we had been up since 3am.  They gave me a shot of pain killers to help me rest.

The next morning, they checked me and I was still the same. We did another round of Prepidil. Same thing, eventually my contractions stopped again. I got to 4cm and they broke my water (Strangest feeling ever!). They also gave me some Cytotec. Nothing happened. I made it to 5cm and they said that it was time to try Pitocin. The baby was tolerating everything really well, but there wasn’t much we could do besides the Pitocin. At this point I was exhausted. I had been through about 36 hours of medications, contractions that weren’t doing anything, and plenty of cervical checks. I had heard about the effects of Pitocin and how strong the contractions can be and I decided that it was time to get an epidural. The anesthesiologist wasn’t very nice and it took a few minutes to place the epidural, but it was worth it. I got some relief from the spontaneous contractions and was able to rest. It was also worth it because I couldn’t feel the very uncomfortable cervical checks anymore. They placed a monitor on the baby’s scalp to monitor the heartbeat, and also placed an intrauterine monitor to track my contractions. The pitocin ran the rest of the evening and into the next morning. They jacked it up to the highest setting. My contractions still would not regulate. At about 4am, the baby’s heart rate dropped just a little bit, then again an hour later. My midwife and OBGYN told me that, if I hadn’t progressed any, that it was time to start thinking about a c-section. They checked me at 6am and I was still at 5cm. The baby’s dad and I talked with the midwife and OBGYN and because I wasn’t progressing, plus the baby was starting to show signs of distress, it was time for a c-section. What was nice was that it wasn’t an emergency. Yet. Luckily, all the doctors and anesthesiologists had just come in for their shifts and no one was in the operating room yet, so I didn’t have to wait. Within minutes of getting the order, everyone was in my room, calmly preparing me for surgery. My epidural was working well enough that we could use it for the surgery. Within 30 minutes I was being wheeled away. The baby’s dad joined me in the operating room, of course. All dressed up in those scrubs. There was a second anesthesiologist that was helping with getting me prepped. I called him “the nice one” because he was very friendly and was wonderful at keeping my attention. While he helped wheel me into the OR, he looked at me and said “I think you’re the calmest c-section I’ve seen in a long time!” My reply was simply “I’ve been at this for 48 hours. I’m ready to meet my baby.” He was great. He talked to me the whole time and kept the baby’s dad from looking over the curtain. It felt like an eternity, but eventually he said to me “She’s on her way out! She was very far down into birth canal.”

There was a lot of tugging and pulling and then there she was. They held her up and she looked so mad! They rubbed her a little bit because she didn’t want to cry, but she did a few seconds later. I lost it. I just started crying. They cleaned her up enough that she could open her eyes and made sure she was breathing okay, and then they laid her on my chest. I was so excited to be able to have skin-to-skin contact like that. She laid there in my arms for about 10 minutes and then I began feeling nauseous so I had her dad take her. I watched while they weighed her and finished cleaning her up. The doctor gave me some nausea medication and I actually dozed off on my own. I heard a nurse ask if they had to sedate me and the doctor replied “No, she’s just dozing off on her own! After 48 hours, I’m sure she’s exhausted.” I had to ask for pain medication because my shoulders were killing me. They told me that sometimes gas gets trapped and it’s a pretty common side effect. After that, we were wheeled to my room. We weren’t allowed visitors for an hour. It was just me, my baby and the baby’s dad. Luckily, the pain medication worked well enough that my shoulders quit hurting before we got visitors.

My midwife came to check on me shortly after I got to my room. I was holding my baby and asked her what the red lump on the side of her  head was – if it was from one of the monitors or what. She smiled and said “No one told you? That’s where your baby was trying to come down into your birth canal. Her head was tilted. That’s why she couldn’t move any further down and that’s why you only dilated to 5cm. She was never coming naturally with her head tilted that way. She tried, though. She was pretty far in there!” So, in the end, there was nothing wrong with my body at all. It was simply that my baby girl got a little confused and tilted her head just enough that she simply couldn’t move any further into the birth canal.

My boyfriend had to take care of the baby most of that day because I didn’t get out of bed until later that evening. He was great. Changed all the diapers and would bring her to me any time she looked hungry as I was trying to breastfeed. My pain was being managed well, but I was still exhausted. I basically demanded that they get me out of bed that evening into the chair. They told me that most women don’t get out of bed until the next day, but I was determined.

The next day was pretty rough since my epidural had completely worn off and I could feel my incision. I got up and was walking around, the nurses and my doctor were all surprised I was up. The baby was doing great, latching on like a pro. I went home 5 days after I was admitted.

The first night the baby was home, she screamed and screamed. The hospital had arranged for a home health nurse to come see us because the baby had lost quite a bit of weight in the hospital. Well, she lost even more in the 18 hours that we were home. I had to start supplementing with formula. My milk never came in. I cried and cried, but still tried to breastfeed her in hopes that my milk would come in. Once she started formula, she was a happy camper. She started gaining weight and all was well. My milk never did come in and she’s fully a formula fed baby now.

Two days after we got home from the hospital, I had increased pain and tenderness in my incision site. I called my doctor. It was infected. I don’t want to go into the gory details, but I had some very painful doctors appointments and three rounds of antibiotics. I also had to have home health come in to take care of the wound once a week while my boyfriend took care of it every day. This went on for a month.  I couldn’t see it, thank goodness! I didn’t look at the scar until it was completely healed. It’s nothing. You can barely tell anything is there. My boyfriend was amazing with the whole thing. He diligently took care of my wound, helping me heal physically and emotionally.  He’s also been a great dad. He loves his baby girl and I can see it in his eyes.

Through all of this - every painful and scary minute, having a baby was worth it. I’d go through it all again in a heartbeat. Anna Sophia is beautiful, healthy, and happy.






Guest Post written by Elise Shute, 27 year old momma to Anna, who is named after Elise's grandmother. Elise resides in Pennsylvania, is a pet mommy to a dog and two cats, and enjoys crocheting when she's not playing with Anna

Advice to fellow plus size preggos

You absolutely CAN have a healthy pregnancy at any weight! I weighed 285 when I got pregnant and got up to 318, with no hypertension, high blood pressure, diabetes, NOTHING!

My advice: BE YOUR OWN ADVOCATE! Read and research everything, and don’t take anything your doctors tell you at face value. A lot of doctors don’t have a lot of experience dealing with overweight/obese moms-to-be and might default to giving you generalized advice assuming your health is crap when it may or may not be, regardless of your weight.

I labored drug-free for 46 hours (!), and only ended up having a c-section because I would not dilate past 3 cm…my weight was not a factor. I researched all my options fully (google was my best friend!) and was very strong in my convictions of how I wanted my labor and delivery to go, but only because I learned enough to confidently push back against the doctors and hospitals when I felt they were taking a course of action not because it was safest, but because of their ignorance or because it was more convenient for them.

It’s your labor, your delivery, your child, your life…you CAN do it! And don’t let anyone tell you or make you feel different. I feel I am a much stronger person overall BECAUSE I was a plus size preggo!!! :)

and CONGRATULATIONS!!!!!!!!

VBAC vs RCS risks

VBAC vs Repeat CS Risks as presented by iCAN

VBAC or Repeat Cesarean
What is safe? What are my options?
If you have had a cesarean delivery and are planning another birth you have to make a decision to have a Vaginal Birth after Cesarean (VBAC) or a Repeat Cesarean Section (RCS).  This can be a hard decision with all the misleading information out there on both topics.  Lets look at some of the facts.
VBAC (Vaginal Birth after Cesarean)
The biggest concern with VBAC among women is uterine rupture. Permitting labor to begin naturally with a low transverse scar ("bikini cut") VBAC after one previous cesarean carries a risk 0.4% of uterine rupture with an increase in an augmented or induced labor. (Landon, 2004)  Successful VBAC's have lower complication rates than planned RCS which have lower complications than a "failed" VBAC. (Landon, 2004)
VBAC is a safe and appropriate choice for most women with one prior cesarean and for some women with two prior cesareans according to ACOG, 2010.
"the chance that a VBAC candidate will require emergency surgery, is for all practical purposes, no higher than that of any other pregnant woman" and "the risk of VBAC is not substantially greater than the risk of any type of childbirth" (Bruce Flamm, MD, Birth after Cesarean)
VBAMC (Vaginal Birth after Multiple Cesareans)
Here is a link to a study done in 2006 by Landon, Risks of Uterine Rupture with a Trial of Labor in Women with Multiple and Single Prior Cesarean Delivery.
The study of 975 women with multiple previous cesareans found a rupture rate of 0.9%. They also showed VBA2C within two years of a previous cesarean delivery to have a 1.1% rupture rate. Not nearly as high as many doctors tell you. Those risks are still lower than those risks of a 3rd cesarean.
Landon concludes, Vaginal birth after multiple cesarean deliveries should remain an option for eligible women.
Overall trial-of-labor success rates were 73%Single prior cesarean delivery success rate of 74%Multiple prior cesarean deliveries success rate of 66%Two prior cesarean deliveries success rate of 67%Three prior cesarean deliveries success rate of 55%
Cesarean
When a cesarean is necessary it can be a life saving procedure for mother and baby.10 true reasons for a Cesarean
Cesarean Risks include placenta accreta, hysterectomy, blood transfusion, ICU admission, which increases with each surgery and uterine rupture. Whereas with successful VBAC uterine rupture and other labor related complications decrease significantly.
The risks associated with RCS increase with each cesarean performed.
Maternal death is very low with each option: 0.02% with VBAC and 0.04% with RCS. (Landon, 2004)

Make an informed choice about the risks of Repeat Cesareans vs. VBAC's
1st C-section Risk of hysterectomy: 0.65%Risk of blood transfusion: 4.05%Risk of placenta accreta: 0.24%
2nd C-section 1st VBAC Risk of major complications: 4.3% Chance of successful VBAC: 63.3% Risk of placenta accreta: 0.31% Risk of uterine rupture: 0.87% Risk of hysterectomy: 0.42% Risk of hysterectomy: 0.23% Risk of blood transfusion: 1.53% Risk of blood transfusion: 1.89% Risk of dense adhesions: 21.6%
3rd C-section 2nd VBAC Risk of major complications: 7.5% Chance of successful VBAC: 87.6% Risk of placenta accreta: 0.57% Risk of uterine rupture: 0.45% Risk of hysterectomy: 0.9% Risk of hysterectomy: 0.17% Risk of blood transfusion: 2.26% Risk of blood transfusion: 1.24% Risk of dense adhesion's: 32.2%
4th C-section 3rd VBAC Risk of major complications: 12.5% Chance of successful VBAC: 90.9% Risk of placenta accreta: 2.13% Risk of uterine rupture: 0.38% Risk of hysterectomy: 2.41% Risk of hysterectomy: 0.06% Risk of blood transfusion: 3.65% Risk of blood transfusion: 0.99% Risk of dense adhesion's: 42.2% NOTE: "Major complications" include one or more of the following: uterine rupture, hysterectomy, additional surgery due to hemorrhage, injury to the bladder or bowel, thromboembolism, and/or excessive blood loss.
All VBAC stats for this chart are taken from the Mercer and Gilbert study, 2008 which includes induced and augmented labors. Additional studies have shown lower uterine rupture rates (especially with spontaneous labors) and higher VBAC success rates with non augmented or induced labors.

According to the World Health Organization (WHO) Countries with some of the lowest perinatal mortality rates in the world have cesarean rates of less than 10%. There is no justification for any region to have a higher rate than 10-15%.
In all 50 states VBAC is legal and in some states it is legal for a midwife to attend an OOH (out-of-hospital) VBAC. However of the women interested in VBAC 57% are unable to find a supportive care provider or hospital.
With the new AGOC (2010) guidelines in place we hope to see VBAC's increase and have more women find supportive care providers!You CAN birth!!