Mar 5, 2009

Home Birth Manifesto II--His Highness...

Part I; Part III; Part IV; Safety; Logistics

The important thing to know about my experience surrounding His Highness's birth is that overall it was really, really good.

I went in planning and hoping for a natural birth, and was able to do just that. All the docs in my OB practice were amenable to the idea (this was Massachusetts, after all--land of the earthy-crunchies), and when I got to the hospital, the nurses were more than willing to support me as well. I'm guessing they ran at least a little bit of interference with the docs for me, because while everything went just fine, it was a long process, and docs sometimes get impatient with the birth when it doesn't go according to averages. I don't know for sure though, and really by now it's a moot point anyway. Regardless, I give all my support folks mad props for helping me do it the way I did.

The good thing about the hospital was that their policies were fairly supportive of letting women choose how they wanted to labor. I had the electronic monitoring, but only about 15 minutes out of every hour. The rest of the time I was able to be up & around, eat lightly and drink, and I walked the entire hospital grounds and more over the course of my labor. I allowed them to put in a hep-lock, but did not have an IV. They had a tub I could have used, but I stuck with just the shower instead. I had a fantastic doula and was able to have friends come visit as well. In fact while the Rootses were there, Roots and the doula and I whooped it up humming and breathing through contractions while the Cat Daddy got to take a break and watch movies with Mr. Roots in what I'm told was a pretty decent waiting room. The room-service-style food was great, and they fed the Cat Daddy as well. And when all was done they sent us home with stuff. A few baby things--thermometer, really good nose-sucker, etc--and even some lotion for me, to help with the dryness due to all the handwashing, I guess. And an umbrella, which I found to be quite random, but I guess one can always use a freebie-umbrella. Everyone I met was kind and encouraging, and seemed glad to help parents & babies start off well.

All that said, and knowing that most of this I couldn't have known except in retrospect, there are some things I felt uneasy about or would change completely...

While my docs were amenable to natural birth, they were also plenty ready to step in and intervene right now. Good if something's wrong or the mother wants to discuss it; bad if everything's fine and they're simply feeling impatient and/or nervous. Over the course of the pregnancy we had extra ultrasounds for a nonexistent problem, and multiple offers of induction because they were estimating His Highness to be a fairly big baby (because they kept doing ultrasounds and, oddly enough, he kept growing). The thing about ultrasounds is that they have a high rate of error, depending on equipment, operator, and just the imprecision of measuring stuff on the inside with equipment on the outside. After the whole thing with finding a potential problem and then ruling it out, we just stopped putting all that much trust in the ultrasounds. In all fairness, their weight estimate was pretty close to his actual birth weight--8 lbs 9 oz--but he came out just fine and there was no reason to think he wouldn't.

At one appointment I mentioned that I would rather just forgo the 35-week ultrasound that was standard in their practice, and the doc nearly hyperventilated while explaining to me that they really needed to make sure there wouldn't be a shoulder dystocia, and to please, please just let them do the ultrasound. I went ahead with it--after all, no needles for me to worry about with an ultrasound--but it bugged me that they put on so much pressure when I was more than willing to take responsibility for waiving the test. I was just tired of the ultrasounds.

Around the time I went into labor they'd done a non-stress test and told me that the amniotic fluid levels were low (based on ultrasound estimates), and that normally they'd just induce me, except they knew it was important to me to avoid induction if possible, so they would "allow" me to wait a bit. This one bugged me because they did not mention that while the fluid levels were on the lower end of things, they were still well within the normal and safe range. They were also taking these estimates first thing in the morning, before I'd drunk the friggin' gallon of water I was taking in daily at the time, which can affect the fluid levels. And again, I could sense the pressure from their end, even though they kept it toned down.

I learned that, while they of course are quite concerned with the safety of moms and babies, the driving concern seems to be one of covering themselves legally. When it comes to litigation, their way of protecting themselves is to err on the side of intervening, and doing so sooner rather than later. On one hand I can certainly understand this. On the other, it annoyed me that they were trying to push medical procedures on me with a basis other than the need for them, thereby making a significant life event more about them than about making the best choices for me and my family.

When I did go into labor (3 days after the due date), I already had a non-stress test scheduled that day, so I kept the appointment, where they found me 5-6 cm dilated. This was fantastic news, and they asked if they could just admit me because anything could happen at any time. I didn't really want to be admitted, but I agreed because I was already so far along.

This is the number one thing I would've changed--I would have gone home. There's no way to have known how it would turn out, but His Highness was not born until over 24 hours later. I suspect part of that time lag was due to the excitement of being admitted, and being in labor, and being watched, and all that. Adrenaline & stuff can slow or stall a labor, and with my being a nervous-type, when I get all ramped up it takes a while for me to relax. My labor never stalled, per se, it just went very, very, very gradually.

Had I gone home it might or might not have taken as long as it did, but either way I'd have passed the time putzing around in my own comfy space, probably baking yummy treats, and I definitely would have done so without a friggin' needle in my arm. True, a hep-lock is not the same as an IV, but it was still a needle, and I hated it. As for all hell breaking loose at any moment, we lived 2.4 miles from the hospital and could've been there in under 10 minutes at any time. I even knew the back roads from jogging the area so many times.

And as for the 48 hours after His Highness was born...like I said, it was good as far as hospital experiences go. It's just that I had never before been in the hospital as a patient, and I was rather unimpressed. The idea was to get some rest, which just didn't happen for me, even during the times when His Highness was off gallivanting in his little roller-bed-thingy. My vitals, his vitals, people checking in, phone calls & visitors (the good distractions), nursing, diapers, charting his nursing & diapers, trying to remember to order lunch, and then to eat it. And being so dang...aware of the fact that I had a brand new kiddo. Who had been in my belly, but definitely wasn't in there anymore, but the belly was still there in a somewhat smaller and squishy form. Trippy, I tell you.

While I felt a little weird leaving the 24-hour support of the hospital, it was a big relief to get home and get on with figuring out how our new little family worked. And to sleep--sporadically, but comfortably in my own bed.

Next time, how all of this transitioned into a decision for home birth...

3 comments:

Bee Repartee said...

I'm all for no drugs, 9lb kids and all...however, the only thing that kept me from homebirthing? Dude...the clean up. That cannot be fun. Of course, I gag at runny noses..oh, stop laughing.....stop....are you done now?

My first two were au natural..and again the only way to go, but the next two were breech. Stinkers. but I'm thankful there was an ER standing by for what was my 'just in case'.

REGARDLESS...it's a personal decision made by you and your hubs..that I respect. You know what's best for you and the oh, so kissable baybeeee. No objections here.....

just make sure you have a good wet/dry vac, haha.

Skerrib said...

Breech? I think you should ground them for life for that one.

As for the clean-up...I'll address that in another post. The secret is that the midwives do it. YES!!

heidip said...

You are seriously my hero! I'm with you on the letting labor start on it's own thing. My husband and I were both adamant that babies come when THEY are ready--not when the Dr. is :) I didn't want to be induced. Period. It's a long story (I'll tell you if you're interested, but don't want to clog your blog), but a total God thing because it happened the way we wanted it to--at 41 weeks (41 wks, 1 day by the time he was born)

Same thing with our second. No inductions. Period. She came at 39 weeks, 6 days.

I feel the same way you do about needles (exactly). As much as I hate needles, I hate pain more. I decided needles were more tolerable than pain :)

The nurses at my hospital were AMAZED that I had two kids, full-term, where I went into labor on my own and had two vaginal deliveries. I'm a Scottsdale anomoly :)

You are my hero for not doing the pain drugs! With my first I kind of kicked myself later for getting the epidural right away and not waiting to see how far I could go on my own. With my second I'd decided I'd wait it out. The contractions were much harder and much faster right away so by the time I got to the hospital my contractions were coming every 90 seconds and I was ready to be hooked up :) The only "intervention" I had was the pain meds and it was only 8 hours from my first contraction to holding her. (As opposed to a much longer, scarier, and more difficult birth with the first)