Thursday, February 16, 34w2d
“The baby is laying with his head on one side and his butt on the other”, but “no need to worry” I calmly texted my husband while my mind raced. Minutes earlier, I had finished my 34 week prenatal appointment. My midwife, Wendy Shaw CNM, assured me that as baby grows, he will run out of room and either his head or butt will go down. When she said it, her calm confidence was convincing, but as the hours passed my anxiety grew. By the afternoon, I was feeling panicked. Sure, he will turn one way or the other, but which way? I was certain, I could push a baby out head first or butt first, but I didn’t want to have to convince an OB that I could (and would). Head first would definitely make everything easier.
That afternoon, I came up with a plan. I would see my chiropractor several times a week, if needed. I would do stretching and exercises from my Spinning Babies training and all would be fine. Do the work and get the results, right?
Friday, February 17, 34w3d
I met my friend and Doula bestie, Natasha Woodard for lunch. I was telling her how overwhelming it felt to be the patient reading the Spinning babies website, rather than the professional. I had even been to a Spinning Babies doula training – yet suddenly figuring out what to do for myself seemed impossible. Natasha did her doula thing and reminded me that there was no need to panic. Exactly what I would tell my own clients. I spoke with Dr Pitchford, my chiropractor, and we made an appointment for Monday. And, I spoke with my Doula, Lindsay Huckabee who also assured me not to worry. Friday afternoon, I walked into my knitting class at the library with mixed emotions. Wondering if sitting in that chair knitting was a waste of valuable time to coax this baby head down. But, I was determined to learn to knit before baby arrived so I could make him a Christmas stocking.
At this point in the pregnancy, I was pretty used to people telling me not to worry. My previous pregnancy ended in a miscarriage at 15 weeks. This pregnancy was clouded in fear. Every single time I went to the restroom, through my entire pregnancy, I looked at the toilet paper with trepidation, worrying that I would see pink (and quite a few times I did). I protected my heart and would not give myself over to this baby. I longed for my first pregnancy. Thirteen years earlier, I didn’t appreciate the wild optimism that comes with youth. With my first pregnancy, I couldn’t have imagined anything going wrong. This time, I worried and then worried about worrying.
Step 1- swim more. Swimming is great for pregnancy and helps baby get into an optimal position. So, I swam. My body was achy, and I was tired, but I went to the pool Friday night. The girls were playing happily and I found myself alternating between swimming and then resting in front of the water jet. The thought of having a baby early never crossed my mind. So, rhythmic visits to have the water jet on my back, didn’t register either. I was having contractions and didn’t notice. After work, my husband, Graham joined us at the pool. I told him I was just worn out, but was figuring out what to do to get our baby head down. We were walking laps back and forth in the pool, just chatting and relaxing. Eventually, I told him, that I was going to get out and take a long hot shower. He could get the kids out in a few minutes.
I rushed into the freezing cold locker room to gather my towel and head into the shower. Every few minutes, I felt water trickle down my thigh. “Ignore it” I repeated to myself. I got out of the shower and stood on a towel in the Kroc Center locker room. “Ignore it” I repeated.
That’s amniotic fluid
It’s just a little leak
It will just seal right up
No big deal
Just a droplet
And then my mind gave in and my heart spoke up:
My amniotic sac is broken, something must be terribly wrong. Is my baby alive? My fear from the moment I saw the positive pregnancy test months earlier.
I texted Lindsay (7p) and after some back and forth we came to an assessment: My water was leaking, It is clear, I don’t know if I can feel the baby, I don’t know if I am having contractions. I am going home to drink water, lie down and listen to my body. I walked out to the pool and told Graham. My deameanor was calm and my conversation to the point. This was not my first time acting this way – This is my “survival mode” that I deploy when I am really, deeply scared. I went ahead in his car while he got the girls cleaned up and followed after me.
It only took a few minutes in the quiet car. I hadn’t even gotten out of Bioxi. It was obvious, I was having consistent contractions. This could definitely not be ignored. Lindsay and Graham met me at home. Lindsay’s role changed from doula to healthcare provider when I asked her to use the dopplar to listen for the baby’s heartbeat. There it was strong, and steady as always. Breathe, Bianca. Your baby is ok, I said to myself. Over and over.
8:20p Lindsay called Wendy with an update. Wendy was able to answer my questions: Is there medical treatment for preterm labor at 34w3d? YES, steroids and magnesium. and Should I go to Garden Park Hospital as planned? NO. If I do not have the baby immediately, I would be transferred to Memorial or if I have the baby and he needs NICU care, he would be transferred. I needed to go to the hospital best equipped for preterm birth. And, with OBs providing care, rather than a midwife.
Standing at the foot of my bed there was a moment of stillness as reality sunk in. The decision was made. I was going to the hospital, in labor. “I guess we need to take the car seat?” It hit me, next time I was in this house, I would have our new baby with us. Not what we were expecting at all.
By 9:30p Graham and I were driving down the beach toward Gulfport, with Lindsey following close behind. In 2 1/2 hours, I had packaged up my big emotions and was focused on the work of preparing for the arrival of our baby boy. I was in work mode. I texted my friend Tina Fritz (NICU nurse and IBCLC) asking, “Where can I find documentation for the best care for a baby in the NICU?” If only such a document existed... I did read a few research articles and quickly realized I could not prepare from what was ahead. I would have to trust and depend on the professionals at Memorial Hospital. Contractions continued.
Since Caprie was born in 2009, I have been at over 30 births as a doula. I have helped about 100 families prepare for the birth of their baby. Of course, I had a vision of how I hoped my baby would enter the world. I wasn’t at all concerned about managing painful contractions. In fact, I was looking forward to the hard work of labor. My dreams for this birth were all about greeting my baby. I hoped to be more “aware” at the end of labor, then I had been at the births of my daughters. I wanted to feel my baby crowning. I wanted my daughter Caprie to catch her baby brother. I wanted to lift my baby to my chest and cover him with warm, soft blankets. I wanted to greet my baby in total peace. I wanted my daughter Luci to cut the umbilical cord. All of this had been discussed with my midwife and doula. Now, I was thrown into an entirely different world of possibilities.
We arrived at the hospital and I was still hopeful that my baby would be born in peace. I had my family, an excellent doula, and the confidence to communicate with my new care providers.
With a mix of confidence and fear, I walked into Memorial Hospital. The security guard proceeded to ask questions for what felt like forever, until my Doula did her Doula duties and said “She is in preterm labor, we are going up to L&D now” and off we went. We walked into labor and delivery and a wave of familiarity washed over me. I remembered standing confident next to my laboring clients as they moaned through contractions, eager to be assigned to a room. Now, here I was, feeling vulnerable and not interested in speaking for myself. The nurses spoke back and forth about which room to put me in. Standing, waiting, worrying for just a minute and yet I felt like I was intruding in something, interrupting their plans for the night. I just wanted someone to take care of me, to take care of my baby.
(This is the point that my memories get really fuzzy, perhaps a mix of medications and self preservation)
I went into room 1. I was offered a hospital gown but explained that I would continue to wear what I was wearing. I would just lift it up for monitoring. My nurse was Michelle. She did a vaginal exam. I felt relieved before she even told me what she was feeling – I knew right away that I had some time before the baby would be born because my cervix was still posterior (she had to really reach to do the exam). I don’t know how dilated I was, but I later sent a text to loved ones saying “I was so relieved to find out that I had dilated very little. As this meant I had some time to wrap my head around this change of plans AND get the medications going to help give this baby a good start.”
It felt weird not seeing a doctor to discuss the care plan. I know that is how it goes, but I was eager to speak to a doctor. I was connected to continuous electronic fetal monitoring, given a shot of steroids, and started on a drip of magnesium sulfate. Steroid shots help the baby’s lungs develop. Magnesium Sulfate does two things, it can slow or stop contractions and it helps develop the baby’s neural system. My baby’s transverse position was a blessing. If his head had been pressing on my cervix, those contractions would have resulted in dilation. His position helped delay birth and give us time to administer these beneficial medications.
Magnesium Sulfate impacts people differently, but it almost always has side effects. The best I can remember was that kind of discomfort when you have a fever. I seemed to be fading in and out of lucidity. I was hot (my nurse was kind enough to bring in a box fan that was blowing directly on me). My skin was sensitive and hurt. I couldn’t think clearly. I was just miserable. I have asked my husband if he remembered if we slept any that night. Neither of us can remember.
I continued the magnesium sulfate and steroid. Sharon was my nurse. My children came to the hospital to see me. It broke my heart that their experience with birth involved feeling sick and getting shots. At aged 12 and 7, the birth of their brother would impact their perception of birth. I had wanted to show them the hard work and joy of labor. Instead, they saw me sick and in bed. My heart was breaking for the lost opportunity for my daughters. But I also felt so much better just having seen them. I was worried about them because I didn’t really have a chance to say goodbye yesterday. During their visit, we listened to the baby’s hiccups on the monitor. Caprie held my hand as I got a shot.
I had an ultrasound done and the baby was head down. YAY!!!! What a huge relief. Lindsay came to spend time with me and we talked about a birth plan and wrote one out on a notepad. I had visits from Dr. Robinson, Dr. Taylor and Dr. Gaddy, each on different days (Saturday, Sunday and Monday). Each one spoke with me at length about my birth history, desires and concerns. We discussed breech birth, premature birth and induction.
With my amniotic sac ruptured (preterm premature rupture of membranes pPROM), the primary concern was infection. I was taking antibiotics, taking my temperature frequently and having blood drawn to measure white blood cell count. Each doctor explained that the longer the baby stayed put, the better the outcome. There is a pretty big range of health status for a baby born around this time. Babies born 5 weeks early, often have short and long term health concerns. And we had no idea what the health status of our baby would be. He could be perfectly healthy or need a lot of medical care.
I decided to count every 12 hours as reason for celebration. Every 12 hours, my baby was stronger and more developed than before.
Saturday night at 11:30pm the magnesium sulfate treatment was complete and the IV was stopped. I also had another steroid injection. I wondered if contractions would start as soon as the magnesium sulfate wore off, but they didn’t. I was able to get some sleep.
I was pretty sure that everyone in the field of birth work that knows me was pulling in favors to make sure I got the best care. Maranda Nybo stopped by to see me. I had a feeling she asked the nurses to be extra kind to me. Each of the nurses and doctors completely respected me and my knowledge and history. Not a single nurse appeared to be bothered by my plan to use as little intervention as possible, even if a breech birth happened. I wish every woman got such wonderful maternity care.
Sunday, February 19, 34w5d
We moved out of labor and delivery and over to the postpartum area. After the frequent assessments from nurses and medications, this felt like I was suddenly on my own. And the fog was lifting from the magnesium sulfate induced haze. I could finally think straight. I asked Graham to get me some Vitamin C, echinacea and garlic to help keep me healthy and fight off infection (along with the antibiotics of course). I also started wiping with alcohol pads to try and keep that area as clean as possible. I was communicating with Lindsay who confirmed that Vit C, hydration and regular vulva cleaning were the best ways I could reduce risk on infection. We also chatted about a birth plan if I did start showing signs of infection but was not in labor.
My blood was drawn several times a day and temperature taken, to assess for infection. My family visited me. The OB reminded me that I could be there a day or a week or more. As long as baby was healthy and I was healthy, staying pregnant was the best thing. I focused on being still and relaxed. I counted every hour pregnant as a success. Graham continued to stay with me. I believed baby to be in a head down position, so I was prepared for a vaginal birth. I thought of how I would keep my premature baby skin to skin so he would have the gentlest transition- kept warm and calm by my body. I stopped worrying that he would need special care. And, it didn’t cross my mind at all that we may face breastfeeding challenges. I envisioned a healthy, peaceful, vaginal birth. Just the day before I was expecting a NICU stay, but now I had decided that wouldn’t be needed. My determination would keep baby in the womb until he was strong enough to be in my arms.
In the afternoon, I felt some mild contractions, but they didn’t get stronger. Around 5:30p, I went to the bathroom and saw a dark red glob in the toilet. Having seen many mucus plugs in my time and being certain that I would not have this baby tonight, I decided it didn’t mean anything. The power of the mind to deny reality is pretty remarkable. I texted Lindsay a photo (doulas love photos of mucus plugs, haha). She said “It’s safe to say you are dilating at this point.”
I found this in a book and read it over and over
I surrender my birth over to the Divine Mother. I let go of all my expectations, my plans and my desires. Thy will be done. As I do this, I birth a human being who is unencumbered by fear. My highest and best unfold when I learn to let go and let God. I am eternally immersed in God and God is eternally immersed in me. I enter the sacred space of nurturer and sustainer of my child, and the triumphant sound of gratitude rings through my baby’s voice, my action and state of being. So be it. Amen.
Certainly, a beautiful prayer. And as I read it, I believed it to be true. In reality, I was still planning a birth on my terms – vaginal and peaceful. I had not handed over the reins to the divine.
Eventually, I fell asleep and hand another night of rest.
Monday, February 20, 34w6d
I felt settled and confidant. My job was to stay healthy and calm. Don’t get out of bed. Keep baby safe and secure in my womb. Dr. Taylor came to see me. He said that if I were to start getting an infection, my body would know before they would and my body would go into labor. This was good news, because I did not want to develop an infection and then face induction. He said when women are in the hospital with water broken, the average time to birth was 7 days. I hoped for me it would be even longer. He ordered the leg pressure cuffs to my calves to prevent blood clots. He also ordered another ultrasound to assess fluid level and position again. The ultrasound revealed that my fluid level was 6.6 - which is great because I didn’t even have clinically low fluid despite the constant leaking of fluid. But, I couldn’t even hear that good news because baby had moved back to transverse. I cried. I said “I know everything will be ok.”
I told Graham to go home for the night. I was sure that I wasn’t going to go into labor. He needed rest and the girls needed to be with him. I don’t know why I was sure I wouldn’t be in labor. I was having contractions all afternoon and even told Lindsay that they were uncomfortable.
My last message to Lindsay was at 11:38p – “Well, the contractions are keeping me awake.”
Tuesday, February 21, 35w
Lindsay arrived in my dark, quiet hospital room to find me leaning over the end of my bed, swaying side to side. It was obvious that my baby would soon be born. “Have you called Graham?” I think she was a little surprised by my answer of no. I hadn’t told a nurse or Graham or even myself the reality of what was happening. Part of me wanted our baby to stay put and keep growing, in the place he was supposed to be. But mostly, I was enjoying being alone in the quiet room, savoring each wave of tightness across my back and wrapping around to the front of my belly. Having given birth twice before I knew the bliss of completely turning off my mind and letting my body take the lead. I fell into that state of mindlessness easily. I wanted to stay in that moment, where I didn’t need anyone.
The moment was short. I called Graham and told him I was in labor and for him and the girls to come to the hospital. He must not have been ready because he said, in groggy sleepy voice “Are you sure?” – Yes, I am sure. Lindsay alerted the nurse that I was having contractions. She wheeled in the electronic fetal monitoring system and proceeded to strap on the monitor for the baby’s heart beat and another for contractions. The nurse wasn’t in a hurry at all. I could sense that Lindsay was starting to get frustrated.
It was obvious I was in labor and yet, this nurse said she must verify that I was in labor by having it printed out on the EFM strip. I was wondering if this was her first day on the job. She was having difficulty picking up the baby’s heartbeat and even more difficulty picking up a contraction. Lindsay, being that she is a trained midwife, knew what to be listening for. She marked on the EFM printout when I was having contractions, so that the printout would be useful to anyone who saw it. Lindsay urged the nurse to notify Labor and Delivery that I was in labor. The nurse said she couldn’t do that until she could get the contractions on the monitor. Lindsay knew that the baby’s position was uncertain and regardless what the monitor said, I WAS contracting. I too was frustrated with the nurse, but felt a level of comfort having Lindsay with me. She would know if the baby was in distress.
Thankfully, Lindsay walked down the hall to Labor and Delivery and returned with a nurse. A nurse who knew me from a just a couple days earlier. She asked me to lie down for a cervical exam. The exam seemed to take forever. Finally, she looked at me and said that she felt arm/shoulder as the presenting part. A cesarean would be necessary. Suddenly, things started moving very quickly. And suddenly, I wasn’t enjoying the contractions. Fear led to tension which led to pain.
I called Graham (or maybe Lindsay did) and told him I would be having a cesarean very soon and he needed to arrive quickly. My friends and family later told me that they had received a text from Graham announcing that the baby was coming and it seemed like only minutes later that I was having a cesarean and not long after that a baby announcement. This was all moving quickly.
My bed was wheeled down the hall to the Labor & Delivery department. I was asked if I wanted to change into a hospital gown and I did not. I want to wear the short nightgown I was wearing. The nurses said it could get dirty with blood and I said, it didn’t matter to me. I wanted to wear it. It’s funny how something as simple as a familiar nightgown can make you feel safe. With everything moving so quickly and not having any loved ones there with me I felt like nothing was familiar. I was in unchartered waters and I needed something to hold on to – and that was my nightgown. The nightgown I bought at Walmart along with 4 others for my mom and 3 sisters for our girls weekend at the beach a couple years earlier. That nightgown connected me to the people I loved and I wasn’t going to give it up.
The nurses gave me a dose of sodium citrate (Bicitra) to drink. This is supposed to neutralize your stomach acid and reduce the risk of lung damage if I were to inhale stomach contents if I were to vodmit.
Over the last 77 hours at the hospital, I had considered many possibilities of how this birth was going to unfold. I was prepared for a breech vaginal birth or even a cesarean birth. I was not prepared for what Dr. Taylor told me when he arrived. He was kind and considerate, but that didn’t change what he was saying. Due to the fact that my water had been broken for some time and my white blood cell count was elevated, he prefers general anesthesia for this cesarean surgery. I couldn’t believe what I was hearing. I said to him, “After this is done, I don’t want to research this and discover that epidural would have been just as safe.” He assured me that he was confident that general was the way to go and avoid the risk of introducing infection into the spinal fluid. I believed him. I believed he was advising me of the safest was to deliver my baby. But, I was really scared and feeling very alone. He said we would be going to the OR very soon. Lindsay spoke up and asked if we had time to wait until my husband arrived. He said, well, it depends on how long it will be. I called Graham again and with my voice shaking. I urged him to hurry because I needed to go into surgery right away. He said he was in the parking lot.
They explained that as soon as I was under anesthesia, they would need to move very quickly. So, they needed to have everything ready for surgery before administering the anesthesia. The nurses shaved the area where the incision would be. And then inserted a bladder catheter. It didn’t feel good.
Graham, Luci and Caprie arrived. The girls were tired and groggy, but eager to meet their baby brother. Graham leaned in to give me a hug before I was quickly wheeled to the operating room. All I could say was, “I’m scared.” In my mind I was thinking, I hope I don’t die. I can’t leave them without a mother. I don’t know why I was thinking such catastrophic thoughts. Perhaps because my mother died when I was a child, so it is always a little fear tucked away in my heart. Or maybe it was just that everything felt so out of control that anything was possible.
I was wheeled down to the OR and lifted off my bed and onto the operating table. I was freezing. I was scared. I was crying. I was shaking. Wendy Shaw, was in the room with me and the only person that seemed familiar at all. I held on to the sound of her voice. Everyone was busy going about their work. Suddenly, I remembered PEACE. There is a phrase in one the guided meditations that I have read dozens of times with my childbirth class. “Breathe in Peace and breathe out anything that is not Peace.” I said it over and over and then I was asleep.
3:19a – Robbie was born. I was later told that it was a difficult cesarean. I did not handle the anesthesia well. I was fighting and trying to get up off the bed. I needed to be restrained. A nurse needed to push Robbie’s shoulder back up from my vagina. The doctor was trying to remove him quickly due to the general anesthesia. The OB said during the surgery that if he didn’t come out with this last try, an additional vertical incision would be necessary. Thankfully it was not. The baby was taken directly to the warmer and then the nursery. Graham was taken from the hospital room to the nursery to greet Robbie. Lindsay followed to take pictures (which I had told her were very important to me). Caprie and Luci were left in a room waiting. Caprie was very scared and now, even two years later remembers being scared as the primary feeling of the day her baby brother was born.
I did not die. My baby was healthy. I would recover. I acknowledge all of that. However, my baby did not arrive into the world in peace and love. I have done my best to show him peace and love every day.
Robert Todd Wooden
Born at 35 weeks
5 pounds 0 ounces
(postpartum and breastfeeding story will follow, eventually)