Monday, July 29, 2013

Esme's Birth Story

My official due date was a Thursday, but for some reason, I had always anticipated giving birth on a Sunday. That first Sunday came and went; not surprisingly, since Maren had been five days late. The following Saturday was my birthday, and that weekend passed without event as well.

I woke up on Sunday July 29 at 5:00am with a significant amount of wetness in my pajamas. Not enough that I was convinced my water had broke, but enough to get up and change clothes. I laid down and waited to see if any contractions would start. None did, but an hour later, my water definitely broke.

I didn't want to wake up Michael or Maren, so I went downstairs to call Erin (my primary midwife). I knew women whose labor started with the breaking of the waters but whose contractions didn't start for hours, even days after, so I was prepared to keep waiting. However, the moment I hung up the phone, at 6:15am, I had my first contraction.

Labor with Maren was only 10 hours, and we expected this one to go even more quickly, so I decided I should make myself something to eat while I still had a handle on things. My early labor began just like my first one, with short (30 second) contractions coming every 3-5 minutes. Unlike my first, I knew what to expect, so I was able to breathe easily through them.

I woke Michael at 8:00am and told him I was in labor. My contractions were coming about every 2 minutes by this point and lasting a little longer, 60-90 seconds. Even though they were more intense, I remembered some breathing tricks and moved around to manage the pain. We checked in with Erin sometime around 9:00am and she asked if she could head over, since things seemed to be moving quickly and, again, we all anticipated a fast labor. My mother-in-law also arrived and took Maren to church to get out of the house for a bit. Maren was very hopeful that she would have a baby sister by the time she returned. My dear friend Kristi and our other midwife Jeanne also arrived sometime before 10am.

Soon after that, my contractions became much more intense, and I also began having back labor. This is an entirely different category of birthing experience, which I would never have anticipated and would never, ever want to endure again. I instantly went from joking between contractions to torturous screams of pain. By 1:00 pm, I had entered transition. Contractions were very hard, came very close together, and lasted longer at this stage.
All photos copyright Adrian Meg
For me, the back labor was incredibly painful by this point. I could barely tell when one contraction stopped and another began because the back pain never let up. I was not getting any breaks between contractions and could not relax because of the continuous pain in my back. I kept yelling at my team, "I cannot do this! I need you to tell me I can!"

Perhaps in a futile attempt to escape the pain and try to speed things up, I labored in every position and every room possible. I laid in my bed, pushed against the walls in the hallway, bore down on the toilet, squatted in the birth tub, got down on my hands and knees. The pain was constant, deep, and overpowering. I mentioned (actually, screamed, more than once) that if I were in the hospital, I would be taking drugs. There seemed to be no relief.

After about 3 hours of transition, Erin checked my cervix. I knew that something must be wrong then, because with Maren, the midwives never did a single check - everything progressed smoothly and quickly. She told me that the cervix felt a little swollen and also that only one side was fully effaced. The left side was still thick and covering baby's head.We were monitoring Esme's heartbeat, which was strong and consistent, so my midwives were not expressing a lot of concern at this point. They told me that I would have to work to get the other side of the cervix to thin out and had some suggestions for me to try. They said we could wait another hour or two but if the baby still hadn't entered the birth canal, we would need to consider other options (i.e., going to the hospital).

I did everything they offered. I started by lying on my side on the bed with one leg pulled across my
body. Then I wanted to move again, so I headed for our staircase. With every contraction, I made sure my left foot was a step higher than my right and, during the contraction, I lunged/leaned into my left side. I hadn't thought it was possible for my labor to get even more intense and the contractions to get even closer together, but doing stairs while in labor certainly kicked everything up a HUGE notch.

During these stair lunges, I could feel my body opening up but baby was still not dropping into the birth canal. The back pain continued, so I wanted to keep shifting positions. Back in the bedroom, we had a stepstool that I put my left foot up on and then squatted, with it raised, during contractions. Over and over again, I willed my body to open and cried out for that baby to come down. I asked God to help me and to bring this baby forth.

Sometime around 6:30pm - having now been in transition for 5.5 hours - my midwives calmly began encouraging us to consider transporting to the hospital. They reminded us that this was not an emergency situation, since baby's heartbeat was still healthy and strong and I was able to continue laboring. But because transition had lasted for such a long time with no progress, we had to start asking what the problem may be.

Michael started to figure out which hospitals our insurance covered, and Jeanne checked my cervix one last time. Much to our surprise, she told me that it had thinned out and she could feel Esme's head right there. She said that if I gave a small push with my next contraction, she could manually lift the cervix over baby's head so that baby could enter the birth canal. She didn't have to say it twice! With Jeanne's hand on my cervix, I gave a small push, she slid it over the head, and Esme dropped down.

Everyone got really excited and started saying that baby was almost here. Ever the realist, I replied, "no she's not. I've got at least another hour of pushing to get her out!"

Back labor was still going strong but at least now I could push during contractions and feel baby making her way out. The work felt far from over and it went more slowly than we all would have liked. Once she crowned, I climbed into bed and decided I wanted to deliver on my hands and knees, which is how Esme Nicole entered the world at 7:50pm.
My birth position meant that I couldn't see Esme when she came out, but apparently, she was quite blue and not breathing. Her eyes opened quickly and she was very alert, but Erin administered a quick mouth-to-mouth while Jeanne rubbed her intently to bring in the color. I'm sure it felt long to everyone who was watching, but I felt like I heard her cry fairly quickly and she was soon in my arms.
Our midwives had 3 theories about why Esme was unable to enter the birth canal on her own. Her fist was by her mouth, adding another 1-2 cm that my cervix needed to dilate. Also, her head came in at a slight angle, which may have been her effort to get into the canal because the cord was wrapped around her like a harness: under one arm, behind her head, and under the other arm. With a short cord, and so much of it around her body, we guessed that each time she tried to push down, the cord pulled her back up. This may also be the reason that she was 17 days past due!

We didn't name her that evening, but on Monday morning, Maren woke me up by saying, "Mama, I have the perfect name for my baby sister. What do you think about Esme?"
It turns out that both Michael and I had immediately wanted that name when we saw her the night before, so it became a unanimous family decision.
Happy Birthday, lovely little girl!

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