Monday, October 27, 2014

The Birth of Baby Grant

A VBAC Success!





The story of Grant's birth is one that will always stay near and dear to my heart. It started when his beautiful mother, Ali, had an overwhelming hope for a better and more peaceful birth than the one she experienced before.

 Ali’s first birth had been a scheduled C-section because her baby was in the breach position. At the time her doctor did discuss turning the baby but Ali felt as if the doctor showed no confidence in the success of attempting this. He also told Ali it would be incredibly painful. So of course Ali assumed this was true, took his advice, and declined an attempt at turning the baby. She also knew nothing of the many wonderfully effective, natural techniques to help the baby turn, such as spinning babies.

Other common misdiagnoses causing a huge number of unnecessary C-sections are Failure to Progress and CPD, where a woman’s pelvis is thought to be to small to give birth vaginally. In Ali’s case of the baby being breech she went on to have her sweet baby girl via scheduled C-section. She's such a beautiful little girl and has grown healthy and strong. However, Ali was left with a very hard recovery physically and emotionally and a strong inkling that things could have been different.

She felt that not only was the birth hard on her but that it could have been gentler for her baby. Ali began to feel that this C-section might not have been truly medically necessary. As the months passed during her next pregnancy she followed her intuition and began to look into what complications really warrant intervention and what it would take to have a vaginal birth after a C-section.

Ali wanted more than anything to prove to herself against many people’s doubts that she could in fact have a safe vaginal birth after a C-section. She wanted it, not only for herself but also she longed to give this baby the peaceful entrance into this world that he deserved.

When Ali first contacted me I was shocked and completely ecstatic! I had no idea that she had been doing so much soul searching. After all, I didn't know her very well at this point. Ali would soon become my very first Hospital birth client. On top of it she was my first client who hoped for a VBAC. I wanted to give her the best care and support possible. I was in it, heart and soul! A great resource, that we referred to often and has current evidence based information for support and resources regarding VBAC, is ICAN.

 As with most things worth doing, there were many obstacles to surmount. However, with every bump in the road Ali grew stronger and more determined! Her commitment to do whatever it took left me speechless time and again as we would work out the kinks together. Ali spent hours in childbirth education courses learning everything from the general physiology of birth to the emotional aspect, hospital protocols, informed consent, empowerment, positioning, intervention and so much more.

She truly loved her original doctor but through what she had learned she was able to see that he was not completely in support of her wishes. One of the hardest most emotional bumps in the road, but the best choice Ali made, was changing her care provider.

After days of research and reading Ali took an extensive list of questions with her to her doctor’s appointment.  They discussed her new plans for a natural birth and it was easy for Ali to see that her doctor’s idea for her birth was far from what she wanted. Even though he was a very nice person and said he would support her, his deep rooted beliefs left Ali’s options for birth limited and very medicalized.

The questions were varied but the main purpose of them was to help Ali dig deeper and make her own choice as to weather she felt her doctor really had the same vision for her as she had for herself. Ali had the knowledge and strength now to know what she wanted and how to get it. In no time we were on the phone talking to providers that took her insurance. 

Soon enough we found the midwives at the University of Utah hospital.  I was so proud of her when she finally felt so much peace after talking to her new midwives. They were obviously experienced medically but they were also emotionally equipped to help Ali achieve her goal. Birth to them didn't look the same as it did to her doctor.

Ali's doctor wanted her to start right off with many common interventions that she was actually trying to avoid. The midwives were more comfortable with Ali staying as natural as possible. This was very encouraging and relieving for Ali to hear.

 The day soon came that she had started having some early labor signs. I went to her house and we found ourselves pacing the dimly lit neighborhood in the middle of the night to pick things up. When we finally observed that, though we had great conversation and got to know each other so much more, labor was slowing and the best idea was for everyone to hit the sack.

The next day came with Ali’s appointment and blood pressure still giving her some problems like it had the week before. The hospital wanted to induce Ali that night. Discouraged, She and her husband made the decision to go ahead with the induction. This meant for less mobility in labor due to being hooked up to the IV but I assured Ali that this was not going to stop her and that she was still in control of her birth.


When I showed up to the hospital Ali was up and walking, ready to get the show on the road. I hugged her and quickly set up shop. The essential oils were wonderfully powerful defused into the air for deeper relaxation, they even aided in her dilation. Every time a nurse came in they would comment on how good this room smelt event from the hall. There was a noticeable reverence and calmness that came over nurses when they would enter this environment. We also had calming music playing softly.

 


As the Pitocin was continually turned up her contractions became more and more intense.  I felt so in tune with her. Her sweet husband, Nick and I traded off giving her counter pressure and relaxation through the contractions. Her midwife was fabulous as well in helping to give Ali reassuring affirmations.

Ali stuck to the techniques she had learned and stayed relaxed and calm through each one. When she was up and moving during contractions nick held Ali close and supported her with his body while she swayed through it. This is appropriately called the "hug hold."

Time seemed to creep by for Ali in the beginning. She was doing great with her mobility, changing positions and using the birth ball. Her nurse again increased her Pitocin and soon each contraction was considerably harder. I suggested Ali get in the tub full of hot water to help her relax.

Once she entered the water she became completely focused through each contraction. The only sound was of her steady breathing and my voice periodically assuring her she was doing wonderfully. Nick and I kept her head cool with cold wet cloths as she continued to allow her body to do exactly what it needed. I couldn't help but snap a picture of how beautiful she looked as she surrendered deeper into each contraction.

Now time flew by. She was in the tub for quite some time, a few hours, yet it felt like minutes. I asked her if she would like to change positions. She was definitely ready to switch it up and get out. Boy was there a shift in the mood once she exited the tub. It seemed the water helped do its job as far as helping her relax enough for a good length of time because the contractions began coming full force.

The nurse checked her and Ali was disheartened to hear that her progression was slow and she hadn't dilated much since her arrival. She was now at three centimeters. I wanted Ali to know that regardless of her dilation that she was doing fantastic and that it didn't matter at that point.

She could easily and quickly dilate at any given point and that dilation was not an indication of how much longer she had to go. After some up and down position changes on the bed, trying to find out where she felt most comfortable Ali’s breathing had suddenly become more rapid and was accompanied by a higher pitch sound. This familiar sound was so exciting for me to hear!

I knew that it could mean the transition stage, the hardest stage of labor, was very near and that soon after she could have the baby! I quickly assured Ali that the noise she made during these hard contractions was great but that I would like her to follow my voice with hers into some deep low noises.  We know that lower noises help the pelvis to relax, the cervix to open, and the baby to move down. Whatever your mouth and jaw are doing the cervix tends to follow.

So we were striving for low sounds with an open loose jaw. Ali was wonderful at following this guidance.  It must have sounded like two women were in labor as we made the low noises together through each contraction. It was a critical point in labor, where she could either loose it or find the strength to carry on, and I felt extremely connected to her. As her noises became deeper and more intense with mine I literally had a moment where I fought to hold back tears from my eyes as I marveled at the inner power Ali was summoning to her aid.

We moved Ali back to the bed in the all fours position. This is when we knew it was go time! Ali became totally enveloped in her own world. Her body seemed to take over. Her water burst and she was thrust into the pushing stage. In a short time from getting out of the water she completely finished dilating!

Ali bore down with her face in the bed. She surrendered her body to the uncontrollable urges to push. I began softly letting her know that she was doing perfectly, to let go, that her body knew what to do, and that her baby was almost there. Again it was so moving to see this amazing woman on the cusp of what she was striving to achieve. 

Nick held her hand tightly and whispered in her ear that she was strong and that she was doing this for baby Grant. I suggested that Ali try using the squatting bar to help gravity work for her. As soon as she was in that upright position everything seemed to be working flawlessly in her favor. Grants head was very close and she was almost there!

Unfortunately the midwife suggested that Ali now lay on her side to finish pushing. Ali complied and in doing so, she said later, that she lost sense of control over the birth at that point. As a new doula I assumed Ali wanted to lay down but if I could go back in time I would have asked Ali myself if she wanted to move or stay.

I would have advocated more for her in that moment that she was doing great right where she was. I've spent hours upon hours reflecting about this and I've had to accept that I'm human and that she was my very first client. Since then I’ve learned to run every suggestion anyone makes past the mother first. This way I can make sure she is comfortable and doesn't end up doing something she wasn’t ready for because she didn't have the opportunity to speak up or give me any indication otherwise. I’m thankful to learn new and valuable things continually as I go forward with this work.

The side laying position seemed to have less progressive impact on Ali's pushing. She didn't have full control or the help of gravity. However she was still progressing and was getting very close. Ali’s photographer had not yet showed up and I knew it was really important to Ali to have photos of grants birth. Nick was at Ali’s head being a wonderful support and Ali was definitely focused. I grabbed her camera to catch many of the first moments.

I was positioned at Ali’s feet next to the midwife and I was encouraging Ali to do whatever felt natural to her. She didn't need anything other then gentle reassurance that she was doing excellent listening to her body’s prompting. Soon the room filled with excitement as the midwife announced that the head was emerging.

Ali was strong and was able be present and un-medicated as she let her instincts guide her. She took in long deep breaths and roared out each contraction with a low, rumbling groan of power and determination. The miracle of birth was unfolding. Grants head soon easily and gracefully emerged.

As Ali pushed a little more the monitor showed very large heart D-cells in Grant. It was clear that he was not budging at this point and that he had shoulder dystocia. This happens sometimes when a baby’s shoulder gets stuck behind the pelvic bone. In a quick seeming panic the midwife was able to dislodge the shoulder.  In a mater of seconds beautiful baby Grant fully emerged into his new world letting out a loud, vibrant cry. It was a clear sign he was alert and breathing effortlessly!

His little arms stretched out, eyes wide open, and ears listening for the familiar voice of his momma. The room was overflowing with joy. Because of the little guy’s rapid entrance Ali didn't have time or the option to slow her pushing and she ended up having a pretty significant tear. Because of the rush of the delivery the midwife made the choice to immediately send Grant off the to the warmer with the nurses.

At this point I knew Ali would want me to follow the baby and advocate for what Ali wanted for him. Grant had great Apgar scores and was thriving wonderfully. He was crying in need of comfort so I nicely but promptly asked the nurses to stop the vigorous rubbing of the baby because Ali had stated she did not want that to go on. The nurses told me they were just doing their job. I understood that they are just doing what the typical hospital protocol is no matter how unnecessary or upsetting it is to the baby. I asked "the baby is doing fine, is he not?" They said “yes.”

I asked them to stop again while picking up the camera to film them. They immediately slowed the rubbing and just stared at me. I went to baby Grants side, held his little hand and began whispering to him, "it’s ok sweet boy, your momma wants to hold you now."  I was deeply moved at the calmness that overcame him as his awareness and attention seemed to completely focus on my voice.

He seemed calmer and ready to receive anyone who was validating his needs. It reaffirmed my belief that babies are aware right at birth, they need human love immediately, compassion and gentle touch. They are not animals to be routinely run down a conveyor belt of protocol and cold, quick movement and handling. These babies are the closest people to God that we have on earth. They deserve reverence and the utmost compassion and respect starting from the moment they enter this world. 
Fortunately Grant was not separated from his mom for long! I soon asked Ali if she was ready to hold her baby boy. The midwife had just delivered Ali’s placenta which was pretty uncomfortable but Ali didn't care she was ready, eager to touch him, hold him tight, and comfort his sweet cries.

Again the nurses gave me resistance at this request. I had to then have the midwife tell them it was fine for Ali to hold the baby. I again got resistance from the nurses on letting Ali do Skin to Skin like she requested. They were determined that Ali would hold the baby swaddled for warmth. I don’t blame the nurses at all, they are just doing the best they can with what they are trained to do. As soon as they were walking the swaddled baby to Ali I cut in and unwrapped the baby myself right as he was reaching her, laid his radiant naked body right on his mothers naked chest with a blanket then placed over the two of them.

They were ready to receive the many benefits of mother and baby skin-to-skin contact at birth. It was as if Grant knew exactly who was holding him now! He became calm and peaceful the moment he heard his mothers loving voice. This is exactly what Ali had envisioned. In this moment all of her blood, sweat, and tears from the past 9 months had finally paid off. She had safely delivered her baby all on her own, the way she knew she could. He was finally here: healthy, happy, and basking in his mother’s warmth and love. She not only gave him life, but the gift of a peaceful entrance into it.

Ali was in perfect connection with her perfect baby. I was so proud to see her instantly go into mommy mode as she held baby Grant. Her words were soft, comforting and so uplifting to his spirit. One of the sweet things Ali told him was that he had a big sister just waiting to see him! Mother and baby connected deeply as they had moments of gazing into each other’s eyes. Ali’s natural oxytocin was able to release and allow for easy, immediate breastfeeding. Ali and Grant communicated perfectly without any words as Grant followed her guidance to her breast and latched right on.

As I was gently helping Ali get in a more comfortable position the midwives were checking Ali’s tear. They began to stitch her up as she was holding Grant and it became painful for her. Suddenly Ali asked Nick to come over and hold the baby for her until they were done stitching her up and like an informed, empowered mom would do, she demanded Nick to take off his shirt and do skin to skin with Grant!

Right away, like an informed, supportive husband would do, Nick pulled his shirt right off with little hesitation! It was beautiful to see a dad have the opportunity to bond so closely with his son at birth and offer some of the same amazing benefits the mother was! Nick was confident and calm as he held Grant close. His body warmth regulating his baby boys body temperature, dad's steady heart beat regulating his son’s heart beat, a father’s scent serving as a comfort that will always be there for years to come. What wonderful moments for a loving father and new son. 
When Ali was ready to hold baby Grant again I slipped out of the room for a bit to allow them the peaceful alone time they needed to bond. I'm so grateful I had the opportunity to get to know Ali and Nick on such an intimate level. I'm especially grateful to have had the chance to see first hand what a woman has the power to do when she puts her mind to it.

Ali overcame so much negative criticism, so many bumps in the road, and several setbacks yet still found the divine feminine power within that allowed her to create and carry out the peaceful birth she wanted! Ali is an inspiration to all women and especially those who also dream of having a vaginal birth after a C-section. Thank you Ali and Nick for allowing me to be a part of your beautiful story and letting me share your journey for others to see.

No comments:

Post a Comment