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Your Birth Stories

The Long Wait for William

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By Amy McGovern, co-leader of API of Norman, Oklahoma

Amy's family
Amy’s family

I woke up on a Sunday wondering, again, if this was the day my husband, Andy, and I would get to meet William. After church, I tried to rest but kept waking up with repeated mild cramps. A phone call to my mom confirmed the start of labor. Contractions were ten minutes apart. Excited, we took the dog for a walk to speed labor along, but we had to stop because the contractions began to hurt. We tried to play a board game as a distraction, but I had a lot of trouble concentrating because the contractions were really hurting now. I was completely unprepared for how much they would hurt given how mild they had been earlier! And everyone I knew had very mild labors, so I did not expect it.

By the time the contractions were five minutes apart, I was convinced he was coming any minute! I quickly ate, and we dropped off the dog at our neighbors. As we drove to the hospital 45 minutes away, I called both our parents to tell them what was happening. The contractions hurt so much that I still thought William would arrive in the car, but both moms said I was talking too much for that to happen.

When we arrived at the hospital, they said I was only at two centimeters dilated. They were about to send me home but I vomited. The nurse told me that I was not very far along, and she was not convinced labor would keep going on its own. She sent us off to walk for an hour and then come back for a re-check. We started to make laps, but the area was small and we quickly got bored. We pulled out our board game, and Andy made me walk laps after every turn. We played until I was gasping from the contractions coming every three to four minutes. All that pain had to be worth at least a few centimeters, but I had only dilated one more centimeter. It was about midnight and they were preparing to send us home about midnight, when the heart monitor showed a sudden drop and I was quickly admitted. They offered me some pain medication, and the nurse told me that it would help me to dilate if I could relax. I slept for only a few hours.

Monday

Twenty-one hours into labor, the Monday morning obstetrician said I was only at four centimeters, so she broke my water. I asked for an epidural, because the contractions hurt far more than I had anticipated. I demanded that my epidural be a “walking one” without really knowing what that meant. First, they broke my water and the obstetrician said, “Oh, my favorite color.” I asked what she meant, and she said it was meconium.

When the anesthesiologist gave me the epidural, I started to relax. Then, all of a sudden, the room was filled with doctors and nurses! I was a bit loopy from the medicine and did not know what was wrong. The nurse and the obstetrician kept repositioning me, and I finally ended up on my knees before they were happy. It turned out that the epidural made William’s heart rate drop. Once he was back to normal, I was allowed up but was monitored wirelessly.

Determined to get William here quickly, we went for a walk by the nursery, which helped motivate me for the upcoming pushing. I knew it would be hard, and I wanted to see all those newborns whose moms had succeeded. We walked for a long time and stopped for a grape popsicle in the afternoon. Worn out, I walked back to my room to eat  stopping once to leak water all over the floor. Apparently, William shifted!

After some rest and another exam that showed I was at seven centimeters, I tried to get up to go to the bathroom. No one had told me that if you lie down, the epidural would go to your legs. I started to fall as I tried to get out of bed but the nurses and Andy caught me. Frustrated, I ended up in bed waiting for ten centimeters. Sometime in this time period, a nurse came in and gasped, “She’s cyanotic! She has asthma, aren’t you worried?” The other nurse just laughed and said, “No, that’s the grape popsicles!”

Finally, around 8:30 p.m., the obstetrician on-call came in, examined me, and told me that I was at ten centimeters. I was at last allowed to push! However, I didn’t feel any urge to push, so they put me on Pitocin. I was too exhausted to really argue. All I knew is that I wanted William to get here soon.

The doctor left me with two labor nurses and Andy. I tried to push when they told me. One of them helped me to stand up, and I tried to use the squatting bar. The nurse got very excited when she could see William’s hair. I was pushing as hard as I could but no other progress happened. I kept thinking, “If I push hard, his birthday will be today!”

After about an hour and a half of pushing, the doctor came back, watched me push, and said, “You are not pushing right,” and left. I wanted to shout at him, “How many babies have you pushed out? I’m doing the best I can!” but he was already gone. Besides, I was really too tired to do anything else.

After three hours of pushing with no further progress, the nurses called the doctor back in and he examined me again. He told me that I had to have a Caesarean section. By this time, it was 11:30 p.m. I was so exhausted that I barely had any energy to move, but I argued with him that there had to be another way. We finally agreed together that William needed to get here soon, for his sake and mine. As we made the decision, the doctor turned off the Pitocin drip, and the contractions immediately stopped.

Tuesday

Around midnight, as the night dissolved into Tuesday, the nurses wheeled me in the OR. I told the nurses that Andy did not like the sight of blood so they whisked him away while they prepped me. However, I was terrified and began to shake uncontrollably, but the kind nurses held my hand and told me it was just hormones. I joked that the extra anesthesia didn’t work, because I could still wiggle my toes.

Andy finally was allowed in when surgery started. I felt a lot of pulling and tugging, and the nurse and anesthesiologist narrated for me. Finally, they pulled William out, but he didn’t cry. I kept asking, “Why isn’t he crying? Is he ok? What is wrong?” They kept reassuring me that he was fine and he was being cleaned out. The Neonatal Intensive Care Unit (NICU) team was there, and I suddenly heard a loud wail. I was so relieved! Shortly after that, the NICU team announced, “We are all set! Congratulations!” and they left.

The doctor told Andy that William had been turned 90 degrees and had gotten stuck. Looking back now, I wonder if the reason labor hurt so much was that it was back labor? Apparently this was the doctor’s way of apologizing for telling me that I wasn’t pushing right: by telling me it wasn’t my fault.

The nurses finally held William up for me to see, since I was still being sewed up, and asked me to name him. I was so exhausted and relieved that I started to cry. Andy told them proudly, “William Robin.”

Around 2 a.m., I was wheeled into the very cold recovery room. We called our parents, and my mom tried to talk my dad into coming right then but he told her that he needed to sleep before driving for eight hours. She stayed up the rest of the night researching Caesarean sections, and he drove them up later that morning.

Around 3 a.m., a nurse appeared and said, “It says on your chart you are breastfeeding. Is that right?” She came back with William and said, “Ok, here you go! Twenty minutes on each side!” I had no idea what to do, so she helped to get him latched on and she left. I sleepily watched him for 20 minutes, and she came back to make sure I switched sides. Afterwards, they took him to the nursery. Around 4 a.m., they unhooked me and wheeled me upstairs. Exhausted from labor and surgery, I feel asleep quickly.

Around 7 or 8 a.m., I woke up with a start and demanded my baby now! Andy brought him in, and I finally got to examine him carefully from head to toe. He was wonderful – our sweet William Robin!

Your Birth Stories

The Rocky Arrival of My Twins

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By Pam Stone, co-leader of API of Merrimack Valley, New Hampshire

Pam's twin sons
Pam’s twin sons

On a Wednesday afternoon, several weeks before my twins were due when I was on bedrest in the Maternity part of the hospital, I started having contractions about five minutes apart. My doctor was out of town, so his midwife came to check on me. I had dilated some, but she wasn’t certain whether I was going into active labor or if it could be stopped, so I was transferred to Labor and Delivery. Thankfully, my doula, Joan, happened to be visiting at the time and she was able to go with me. I don’t know what we would have done without her.

The fabulous nurses in Maternity allowed my husband and daughter, Greg and Sophia, to keep the room here so that we didn’t have to move our things and they could continue to spend the nights. The covering doctor did not suggest doing anything more to stop the labor since I was beyond 34 weeks. He wanted to wait to see if I was going to go into active labor. So, we were waiting patiently when all of a sudden, I developed unbearable headache and stomach pain like I had never experienced. I was vomiting frequently. Greg was tending to Sophia until his mom could arrive to help, and Joan and the labor nurses were there to give me strength. It didn’t seem long before I was begging for an epidural  not for the contractions, but rather to stop the pain in my head and stomach.

I don’t remember much from around this time, but I know that my lab results came back indicating severe preeclampsia, and the situation suddenly became very crazy. They started me on several medicines, including magnesium sulfate to avoid seizures. I remember the doctor saying that if I were to progress quickly, we could still do a vaginal birth, but that we couldn’t let things go for too long. He said that the best way to stop the preeclampsia was to deliver the babies, Nico and Kian. He broke Nico’s water, and I was given an epidural.

For a short time, things seemed to be back on track. Then, just as quickly, Kian started showing distress at every contraction. The doctor recommended an emergency Caesarean section, and in what seemed like an instant, we were in the operating room and the boys were here! Nico Dennis was born at 10:28 p.m., weighing four pounds, six ounces and measuring 16 inches long. Kian Albert was born two minutes later, weighing four pounds, four ounces and measuring 17 inches long.

Nico did well from the start, scoring 9 out of 10 on his Apgar. Kian struggled a bit. He wasn’t breathing and only scored a 1 or 2 on his first Apgar. I remember someone commenting that it was good that they got him out when they did. Within a couple of minutes he was OK, and he scored a 9 out of 10 on his five-minute Apgar. I was allowed a quick kiss before they were whisked away to the Neonatal Intensive Care Unit (NICU). Greg went with them.

Back in my labor and delivery room, I wasn’t feeling well. I wanted to go see the babies, but I was too unstable. The side effects of the magnesium sulfate, along with the after-effects of the anesthesia, left me in rough shape. I stayed in my room during the night.

I was able to see the boys twice, for about 10 minutes each, on Thursday. I began pumping milk for them. I was achy and tired and had blurry vision, but I was OK. Then, my stomach became distended and my suture line looked swollen. I began running a fever. I was started on two I.V. antibiotics. That was the beginning of the next downturn, which started Friday morning. The nurses suspected I had a case of hospital-acquired C. difficile, a bacteria that causes intestinal illness, and put me on contact precautions, meaning that everyone who came into the room had to wear gloves and gowns and I couldn’t go to the NICU to see Nico and Kian. It was a very hard day, but Greg kept me updated on Nico and Kian, who were doing marvelously.

The initial C. difficile test came back negative, and I was told that if my fever stayed away for 24 hours, I could go to the NICU again. But before we had time to celebrate, the final C. difficile results came back positive. Nobody was really sure what to do, and there wasn’t an Infection Control doctor in the hospital because it was the weekend. They wouldn’t let me see go to the NICU on Saturday and wouldn’t let me send up any milk for the boys, either. I also wasn’t able to hug, kiss, or even touch Greg and Sophia.

We were told I’d need more antibiotics for ten days. I was still suffering from the side effects of the magnesium sulfate, and adding the C. difficile on top of it was miserable. I cried a lot.

By Sunday morning, I was already feeling a little better. My body was starting to win the battle against the C. difficile, and the effects of the magnesium sulfate were wearing off. I called to talk to the NICU, and they had been able to reach Infection Control during the night. I was going to be able to see my babies! I could breastfeed directly and could send up milk. I was so relieved.

The Labor and Delivery department needed my room, so I moved back to Maternity early on Sunday morning. Finally, my doctor visited on Sunday and removed the contact precautions. Good hand-washing hygiene would do. My platelet count was recovering, so they could at long last remove the epidural catheter, and my doctor began treating the massive rash that had broken out due to an allergic drug reaction. I was allowed to hug my family, and spent several hours in the NICU visiting Nico and Kian. They were fabulous. I met with a lactation consultant and was able to breastfeed them both. Things were beginning to turn around.

Nico and Kian still battled the many challenges that many premature infants face, but today, they are home and are doing well.

1. Pregnancy & Birth, Secondary Attachments: Fathers, Grandparents & Other Loved Ones, Solo Parenting: Divorced & Single Parents

Family Bonding Begins Before Birth for Unmarried Couples

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From API’s Communications Team

FamilyA University of Maryland study shows that, more than marriage, involving the father during the prenatal period leads to a stable family life.

The Fragile Families Child Well Being Study, published in the December 2008 Journal of Marriage and Family, found that fathers involved during pregnancy were significantly more likely to remain involved in raising their child at age three.

The study shows that an emotional investment in fatherhood is, not surprisingly, more important than getting married without a sense of real commitment.

To read the entire article go to www.newsdesk.umd.edu/sociss/release.cfm?ArticleID=1805.

1. Pregnancy & Birth

Rates of Unnecessary Childbirth Interventions is Alarming

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From Lamaze International

BirthDespite best evidence, health care providers continue to perform routine procedures during labor and birth that often are unnecessary and can have harmful results for mothers and babies.

The Centers for Disease Control and Prevention’s (CDC) most recent release of birth statistics reveals that the rate of Cesarean surgery, for example, is on the rise to 31.1 percent of all births — 50 percent greater than data from 1996. This information comes on the heels of The Milbank Report’s Evidence-Based Maternity Care, which confirms that beneficial, evidence-based maternity care practices are underused in the U.S. health care system.

What the Research Says

Research indicates that routinely used procedures — such as continuous electronic fetal monitoring, labor induction for low-risk women, and Cesarean surgery — have not improved health outcomes for women and, in fact, can cause harm. In contrast, care practices that support a healthy labor and birth are unavailable to or underused with the majority of women in the United States.

Suggested Labor and Delivery Practices

Beneficial care practices outlined by Evidence-Based Maternity Care, a report produced by a collaboration of Childbirth Connection, the Reforming States Group, and the Milbank Memorial Fund, could have a positive impact on the quality of maternity care if widely implemented throughout the United States. Suggested practices include to:

  • Let labor begin on its own.
  • Walk, move around, and change positions throughout labor.
  • Bring a loved one, friend, or doula to support you.
  • Avoid interventions that are not medically necessary.
  • Choose the most comfortable position to give birth and follow your body’s urges to push.
  • Keep your baby with you — it’s best for you, your baby and breastfeeding.

“Lamaze is alarmed by the current rate of Cesarean surgery, and furthermore, by the overall poor adherence to the beneficial practices outlined above in much of the maternity care systems in the United States,” said Pam Spry, president of Lamaze International, www.lamaze.org. “We are continuing to work to provide women and care providers with evidence-based information to improve the quality of care.”

Lamaze International has developed six care practice papers that are supported by research studies and represent “gold-standard” maternity care. When adopted, these care practices have a profound effect –instilling confidence in the mother, and facilitating a natural process that results in an active, healthy baby. Each one of the Lamaze care practices is cited in the Evidence-Based Maternity Care report as being underused in the U.S. maternity care system.

A Need for Balance

“As with any drug, we need to be sure that women and their babies receive the right dose of medical interventions. In the United States we are giving too high a dose of Cesarean sections and other medical interventions, which are causing harm to women and their babies. Yet, there are many countries where life-saving medical interventions are under dosed, which can also cause harm,” said Debra Bingham, chair of the Lamaze International Institute for Normal Birth. “Every woman and her baby needs and deserves the right dose of medical interventions during childbirth.”

The research is clear, when medically necessary, interventions, such as Cesarean surgery, can be life-saving procedures for both mother and baby, and worth the risks involved. However, in recent years, the rate of Cesarean surgeries cause more risks than benefits for mothers and babies.

The Danger of Cesarean Sections

Cesarean surgery is a major abdominal surgery, and carries both short-term risks, such as blood loss, clotting, infection and severe pain, and poses future risks, such as infertility and complications during future pregnancies such as percreta and accreta, which can lead to excessive bleeding, bladder injury, a hysterectomy, and maternal death.

Cesarean surgery also increases harm to babies including women giving birth prior to full brain development, breathing problems, surgical injury and difficulties with breastfeeding.

About Lamaze International

Since its founding in 1960, Lamaze International has worked to promote, support and protect normal birth through education and advocacy through the dedicated efforts of professional childbirth educators, providers and parents. An international organization with regional, state and area networks, its members and volunteer leaders include childbirth educators, nurses, midwives, doulas, lactation consultants, physicians, students and consumers. For more information about Lamaze International and the Lamaze Institute for Normal Birth, visit www.lamaze.org.

1. Pregnancy & Birth, The Editor's Desk

When It’s OK to Induce Labor, and When It’s Not

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By Rita Brhel, managing editor and attachment parenting resource leader (API)

One in five pregnant women will have her labor induced, for varying reasons. Some of these reasons are valid; others are not. Catherine Beier of www.givingbirthnaturally.com weighs in.

When it’s OK to induce labor:

  • Pre-existing medical conditions in the mother – These may include heart disease, a seizure disorder, hypertension, cancer, or another serious health issue, although many women with these disorders can still give birth vaginally.
  • Pre-existing medical conditions in the baby – If the baby is known to have a congenital or other medical condition that requires intervention or intensive care immediately after birth, induction may be the safest way to ensure the baby gets the care that’s needed.

And when it’s not OK to induce labor:

  • Overdue pregnancy – While the American College of Obstetricians and Gynecologists warn against induction before 39 weeks, the average pregnancy worldwide lasts 42 weeks. For medical doctors who don’t want to wait that long, they should consider accuracy of a woman’s due date, which is calculated on a 28-day menstrual cycle with ovulation on day 14; for women with long or irregular cycles or late ovulation, this due date can be significantly inaccurate. For these women, a reliable estimate of the due date, within one day, can be obtained with a transvaginal ultrasound at eight to ten weeks of gestation. As the pregnancy progresses, ultrasound becomes a less reliable predictor of the due date, as the weight estimate can be off by as much as two pounds.
  • The baby is too big – The vast majority of women are able to give birth vaginally to their babies, even those who are larger. Because hormones during labor relaxes and stretches the hips and pelvis, for those very few whose pelvis is too narrow to birth a full-term baby, it’s impossible to know until the time of childbirth.
  • The mother is too tired or uncomfortable – Remember, it’s called labor for a reason. Labor can be rather long and hard with the first baby especially, but it is normal.
  • It’s more convenient to know when the baby will be born – Whether induction on a certain day is better for the baby’s family or the medical provider, this does not take the baby into account and not a true reason.
1. Pregnancy & Birth, The Editor's Desk

Morning Sickness as an Attachment Education for Baby’s Father

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By Rita Brhel, managing editor and attachment parenting resource leader (API)

Pregnant women know better than anyone how connected they can feel to the new, little life growing inside them – even if the baby is so tiny that its kicks can’t be felt. From the moment, a woman learns she’s pregnant, she begins counting down the months and days until she can meet her baby face-to-face.

Morning sickness, while irritating, is a sign that the pregnancy is going well, according to the American Pregnancy Association – which is especially assuring to a particularly anxious mother-to-be or someone who experienced a threatened miscarriage early on.

Morning sickness also provides a time for fathers-to-be to connect to their babies…by way of better connecting with their wives. After all, one of the best models of a healthy relationship for a child, in addition to the parent-child bond, is the mother-father interaction.

Just as new fathers often enjoy putting a hand on the mother’s pregnant belly and reading stories to the unborn child, they can begin bonding by providing comfort to the mother-to-be, which will also keep the adult-adult relationship close during a time when exhaustion and mood swings may threaten to push them apart.

Australian filmmaker Troy Jones explored this in his documentary Being Dad: Information and Inspiration for Dads to Be, as reported by Tara Taylor of www.parentspress.com: “A few topics always came up in the group conversations. The first was how to help your partner with morning sickness. Many expecting fathers felt helpless in the face of nausea.”

First and foremost, mothers-to-be must understand this feeling from their partners and to focus on ways he can stay connected during the pregnancy, especially when the women are not feeling their best. Here are some ideas to help you better involve your husbands’ or partners’ desire to help when morning sickness, fatigue, mood swings, backaches, and other pregnancy discomforts begin taking their toll on your relationship:

  • Encourage honest and open communication – This was the most important tool offered by R. Morgan Griffin’s 2003 article “Advice for Expectant Fathers” on www.medicinenet.com. Not only will talking help you release your frustrations and fears about pregnancy, childbirth, and parenting, but it provides a way for men to voice their anxieties, too, and be able to help you by providing emotional support.
  • Put him on nutrition duty – According to www.mrdad.com, the father-to-be can be a pregnant woman’s personal cheerleader, not only in reminding you that morning sickness is a good thing but also in encouraging you to drink enough water and helping you to choose healthy foods – when you’re able to keep food down. The same encouragement may be needed when it comes to taking the prenatal vitamin and letting the mother-to-be know that it’s OK to go to bed early or take a mid-day nap, rather than continuing to try to do everything you could do before getting pregnant.
  • Give him specific requests – Also according to MrDad.com, if you know of something your husband can do to help you feel better, let him know. Perhaps, it’s bringing toast to your bedside in the morning or giving you a backrub or making sure that the fridge is cleaned out of odorous foods.

Morning sickness also provides a time for fathers-to-be to connect to their babies…by way of better connecting with their wives.

1. Pregnancy & Birth, The Editor's Desk

The Rising Rate of Cesarean Sections in the U.S.

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By Rita Brhel, managing editor and attachment parenting resource leader (API)

One in three women (31.8%) in America is now giving birth to their children via a Cesarean section. The highest rate in history for this nation, it is also much higher than the recommendation by the World Health Organization of 5% to 10% — not to mention that the rate of Cesarean sections in the U.S. has increased by 50% since 1996.

The U.S. began at 4.5% in 1965, the first year Cesarean section rates were measured here. At 15% or higher, Cesarean section rates indicate that this procedure is being done unnecessarily, according to a study highlighted by the article “Why the National U.S. C-Section Rate Keeps Rising” on www.childbirthconnection.org.

The article outlines several reasons for the increasing rate of this procedure. But, first, there are two widespread myths about the rise in Cesarean sections to counter:

  1. The number of women asking for an elective Cesarean section, without a medical reason, is NOT increasing; and
  2. The number of women who genuinely need a Cesarean section is NOT increasing.

In a 2005 survey by Childbirth Connection, it was found that only one in 1,600 respondents in the U.S. reported she had a planned Cesarean section with no medical reason, at her own request. The article cited a study that revealed this rate to be comparable with other countries.

Reasons given for the higher rates include women waiting to give birth when they’re older and more prone to developing medical complications, and more women giving birth to multiples. But the article reported that researchers show that the rate of Cesarean sections is going up for all women regardless of their age, health problems, race/ethnicity, or number of babies they are having.

What this means is that the reason behind the increasing rate of Cesarean sections is not on the part of the woman but rather lies with changing standards in the medical community. According to the Childbirth Connection survey, one in four respondents who had a Cesarean section said they received pressure from a medical professional to have the procedure.

According to the Childbirth Connection, here are the true reasons behind the increasing rates of Cesarean sections in the U.S.:

  • Lower priority is being given to non-surgical methods of correcting potential birthing complications, such as turning a breech baby or encouraging labor progress through positioning and movement and comfort measures.
  • Higher rates of labor intervention methods that make Cesarean sections more likely, including induction, getting an epidural early or without a high dose of oxytocin, and use of continuous electronic fetal monitoring.
  • Fewer hospitals and/or medical doctors are willing to deliver a Vaginal Birth After Cesarean section, or VBAC. In fact, only one out of ten women who have had a previous Cesarean section has access to medical facilities and/or doctors who would allow a VBAC.
  • The overall attitude toward Cesarean sections is that this procedure is no longer considered the major surgery that it is.
  • Lower awareness of the increased risks associated with Cesarean sections over vaginal births, such as infection, surgical injury, blood clots, emergency hysterectomy, and intense and longer-lasting pain in recovery in mothers in the short term. In the long term, mothers are more likely to have ongoing pelvic pain, bowel blockage, infertility, and injury during future surgeries. Future pregnancies are more likely to be ectopic, result in uterine rupture, or have problems with placenta previa, accretia, and abruption. Babies born by Cesarean section are more likely to have surgical cuts, breathing problems, difficulty with breastfeeding, and childhood asthma.
  • More doctors fear malpractice claims and lawsuits.
  • More doctors are receiving incentives to practice more efficiently. Planned Cesarean sections can organize hospital work, office work, and the medical personnel’s personal lives. In addition, average hospital charges are much greater for Cesarean sections than for vaginal births, which mean more profit is gained by the Cesarean section.

About Childbirth Connection
Childbirth Connection is a national U.S. not-for-profit organization founded as the Maternity Center Association in 1918. Its mission is to improve the quality of maternity care through research, education, advocacy, and policy by promoting safe and effective, evidence-based maternity care and providing a voice for childbearing families. For more information, go to www.childbirthconnection.org.