My second pregnancy was much like my first: uncomplicated. Blood pressure, weight gain, hormone levels, etc. were all within the range of normal. Despite the usual discomforts of being pregnant I was able to maintain an active and healthy lifestyle, which was especially important to me as I prepared for a VBAC (vaginal birth after cesarean).
I’m not going to share all the reasons why VBAC is the safest, most pro-mother / pro-baby way to deliver for a woman of my age/weight/condition. Nor will I attempt to explain why it has the stigma of being dangerous – among the general public and many medical professionals.
What I would like to share, at this point, is that although some women do get induced and achieve successful VBACs, I was not comfortable with that and neither was my doctor. So, we agreed that I would need to go into labor on my own before 42 weeks or we would schedule a cesarean delivery.
Due date came and went and at 40wks + 6days I went in for my second NST (non-stress test) that week. Half an hour of fetal heart rate monitoring showed that all was well, so I strode in confidently to my doctor appointment right after.
I didn’t think it was necessary at the time that Robb join me for the appointment but I’m sure glad he did. The doctor used ultrasound to measure fluids surrounding baby and determined that they were too low – around a 4. (We were hoping for an 8 or higher.) Her advice: schedule a c-section for that evening.
I cried, of course. Robb held me and comforted me like he always does. We called our doula, Talia, to discuss options and review conflicting information.
Some say fluid levels rise and fall naturally, making them not a good reason for surgery but hydrating oneself the priority instead. Doctor said that’s true until you reach 40 weeks, then fluid levels just continue to drop and pose risk to baby. She did concede to hydrating first but said it would have to be via IV and in the hospital for 24 hours.
This did not sound great for a couple reasons: if a c-section turned out to be inevitable after 24 hours it meant one more day away from Claudia, and if I was able to bring levels back up it would only buy me a day or two more to go into labor on my own, and I didn’t feel close to spontaneous labor at all.
Another concern my doctor raised was calcification of the placenta. She said it was shutting down and not providing the baby what she needed. Talia, after double-checking with her mentor and another doula who encapsulates placentas, said that some calcification at that stage was completely normal and again, not a red flag for immediate surgery.
The final kicker was that my doctor, (when referencing my low fluid levels) asked if baby had been moving less. I had to admit that she was. And yet – some days she moved a lot and others she was quieter. I was extremely in tune with her movements and hadn’t had any reason for concern.
The timing was just unfortunate, perhaps, that the day before and that morning baby had been on the quiet side. OR maybe it was fortunate, to catch the low fluids and lack of movement before it became a concern…
So there we stood, mother and father expecting our second baby, trying to figure out a way to have the delivery we imagined without the guilt of going against medical advice.
Our phones didn’t work in the doctor’s office so we talked to Talia in the hallway by the elevators. There, another woman who was probably pregnant but not as far along as I, was also crying into the chest of her partner. 2nd trimester ultrasounds are performed on that floor and I couldn’t help but think that she might be processing news far more distressing than mine.
She might have lost her baby or learned of major abnormalities while there I was, crying because I wanted to deliver my perfectly healthy baby a certain way.
With some sadness, we decided to go forth with the c-section and keep focused on the good: soon we would meet our daughter!
I asked my doctor if we could schedule a Saturday morning surgery instead of Friday night. Fluid levels could’ve been low all week, I reasoned, and baby was doing alright. “Well now it’s documented,” she told us. This struck me as a particularly non-medical reason to rush me into major surgery. What did her notes have to do with my body and the baby inside me? My sadness, admittedly, slowly turned to anger over the next few hours.
We went home, finished packing our bags, made arrangements for Claudia, and headed to the hospital at 4:30pm for a 6:30pm surgery. I hadn’t eaten anything since 8am. At 5:30pm Talia joined us on the Labor & Delivery floor and almost immediately offered me a foot massage, which I welcomed. Around 6pm we were informed that my surgery time was bumped back to 7:30pm because they had so many last-minute cesareans scheduled. Of course they were booked on the Friday evening of a holiday (Labor Day) weekend!
It became glaringly clear that I was one of many women ushered into the convenience factory of scheduling c-sections for semi-questionable reasons, and it upset me. Thankfully, I had the most wonderful doula and the most devoted, attentive, and loving husband by my side.
At 7:30pm things started moving quickly. We left the room, walked down the hall, and as Robb and Talia turned their backs to store our bags in the recovery room the nurses and anesthesiologist ushered me into the OR. Thinking about the spinal injection was much worse than receiving it, and soon I was numbed, prepped, and Robb was at my side again.
On 08/29/14 at 8:10pm Farrah Jane Thompson was born!
After a long minute of suctioning she was in her daddy’s arms and laying her head on my chest. My arms were both free to move and I was able to stroke her face while offering words of comfort.
Just two weeks before this delivery, Providence St. Joseph Medical Center declared “gentle c-sections” their standard policy, keeping babies in the OR after delivery for skin-to-skin contact. (Many places whisk babies off to the nursery right away.) It was extremely important to us to have that option where we delivered.
What I hadn’t anticipated, however, was how difficult it was – emotionally – to lay next to my fussing newborn and not be able to comfort her much. I couldn’t hold her or nurse her and it made my heart ache.
Trying to offer comfort to Farrah while being “put back together” and stitched up was another thing. It took me out of my concentrated breathing. It made me feel less strong and in control. My arms shook wildly and though I knew it looked crazy that seemed the only thing I could do to hold it together.
I’m proud of myself for staying awake through the process but don’t feel like I handled it very well. A tender spot on the upper part of my torso hurt and I was confused because I’d been told I would feel pressure, not pain. Maybe it was just pressure but my brain sure registered it as pain.
Even though it wasn’t the ideal situation, it was wonderful to spend the first moments of Farrah’s life with her. Only after our time together did she get weighed and measured: 7lbs 2oz and 19.25in.
Soon I was wheeled into the recovery room where Farrah nursed immediately, much to my delight. Though it may sound cliché, I’ve no other way to describe what I felt other than this: I fell in love all over again.
I’m still amazed that my heart can hold so much love. How is it possible that I can love this baby as much as I already love her big sister? I don’t know but I do.
My prenatal yoga instructor, Jessica, once offered this metaphor: the universe is both infinite and expanding – a concept that is difficult for the human brain to comprehend. Our love is like that, too. We have an infinite amount of love for our children and yet it can expand to include more. Our brains may not be able to understand but that makes it no less true.
Sweet Farrah Jane has made us a family of four. Her mommy, daddy, and big sister Claudia are all so full of love.
Melissa and Claudia’s Birth Story
I should probably start by saying that I had a very uncomplicated pregnancy. Every step of the way, baby and I checked out healthy and the weeks surrounding baby’s due date were no different. My intuition told me she wasn’t going to arrive early and I was right. At 41 weeks, scheduled to be induced, I still didn’t feel like she was ready.
But we had tried all the non-medical suggestions (spicy foods, walking, sex, etc.) and were not interested in signing an AMA (Against Medical Advice) to prolong the inducement.
So into the hospital Robb and I went at 9am on Monday July 23rd and found out I was only dilated 1 cm with very little effacement. I received an ultrasound to check fluids (good) and estimate the baby’s weight (8 lbs give or take a pound and three ounces) so my doctor stuck with his decision to induce and started me off with Cervidil.
The next 12 hours went something like this: laid in a reclined position for 2 hours (no breaks to pee), walked the hallways (all four of them) for 30 minutes, laid in bed (hooked up to monitors), walked hallways, laid in bed, etc. We were happy to hear that I was having contractions despite not feeling anything and pretty excited when I started feeling them in the eleventh hour. So at 11:30pm I was reassessed, and only 2 cm with little effacement.
My doctor decided that a second Cervidil was the best course of action, rather than Pitocin. We were moved to a different room so that a woman in active labor could use the Labor and Delivery room we had settled into. This just seemed to drive home the point that I never should have been induced and another wave of sadness and anger flowed through me.
My body rested for 2 hrs before being rechecked (still 2 cm) so the second Cervidil was inserted around 2am. Knowing I was in for another 2 hrs without being able to pee, I cut back on how much water I consumed. Unfortunately, this led to being hooked up to an IV and unable to walk around. They also gave me oxygen and compression socks so I had wires all around: 2 monitors on belly, IV in palm, oxygen on face, and a compression “sock” on each leg.
The unit was extremely busy so we had a team of nurses all aware of my situation, as they never knew who would be available when I needed something. We were informed that baby’s heart rate was dropping for a moment after some of my contractions. It would happen for a while, go back to normal, but then always happen again.
After six hours of monitoring, they pulled out the Cervidil and kept watch while my body continued contractions on its own. My pain level was about a 6, I suppose, and Robb massaged my lower back continuously. After over an hour of the same pattern, my doctor recommended a c-section.
This was, of course, not what we wanted. But Robb and I told the doctor what we had always said between ourselves, “Whatever is best for the baby.” At that point I no longer felt anger or sadness, mostly just relief. It meant that I didn’t need my cervix checked anymore. It meant that the pain of contractions- though nothing compared to what I would feel for a vaginal delivery- would soon end. And most importantly, it meant that we would soon have a baby with us!
The time was 9:40am and they scheduled us for a 10am c-section. Yep, 20 minutes! I was quickly shaved, used the restroom, and walked with a nurse around the corner to the operating room. Robb got ready in the postpartum / recovery room and says he waited maybe 10 minutes. I was led to the operating table and sat while the nurses prepared.
The anesthesiologist joked around- in a nice way- and said they were all getting ready for a birthday party. He was talkative and light-hearted but I didn’t feel like talking or smiling at jokes.
I wanted to tune out, trust the professionals, and find peace in my own head. It was difficult with him talking and I knew he was trying to be nice so I didn’t say anything. I just focused on my breathing throughout the whole experience. The spinal was administered quickly and kicked in quickly. I was laid on my back, my arms placed to the sides, and in no time I was numb from the chest down. Then Robb was at my head, stroking my forehead, and after some pressure at my stomach she was out!
Activity really picked up once Claudia was born, at 10:30am on the dot. (How’s that for scheduling!?) There were suctioning noises and then- a baby’s cry! That’s my baby, I thought, and it was the sweetest sound in the world. Robb was somehow able to comfort me, take some video, take photos, cut the cord, be with Claudia, tell me how beautiful our baby was, etc.
I was feeling pretty jostled around on the table and in one spot there seemed to be pain rather than just pressure. Maybe I was feeling fear more than anything, I don’t know, but my whimpers turned to moans. The anesthesiologist was right there and ready to administer more medicine. They held him off just long enough for me to meet Claudia and get a photo with her. Then I was out.
I woke slowly in the postpartum / recovery room. I couldn’t focus my eyes but was vaguely aware of my surroundings. “Take a deep breath, Melissa,” I heard from across the room. (The nurses were monitoring me from a desk about ten feet away.) I took a deep breath and felt at peace.
Once I had woken a bit more, the nurse came to my bed and explained that the umbilical cord had been presenting, and was also wrapped 1 1/2 times around baby’s neck. So, chances are, had we gone forth with active labor I probably would’ve ended up with a crash c-section.
When my baby was ready for me I was less groggy and finally ready for her. Robb wheeled her in and placed her in my arms. She was so alert and beautiful, with a head full of dark hair! To my immense joy, Claudia took to breast feeding immediately and I suddenly felt like a mom.
Days and nights blur together when I think of our stay in the hospital. I was still connected to an IV and catheter for the first 24 hours, so Robb had all the responsibility of diaper changes, helping me be comfortable, and bouncing Claudia when she cried. My job was to rest, take medicine when it was brought to me, and feed our baby girl (which came quite naturally).
That first night, she was inconsolable. We got her to stop crying for a couple minutes before she’d start back up again. When she started to make gagging faces, Robb asked me to call in the nurse. We watched as she did everything we did, to no avail (which was kind of nice, though still worrisome).
The nurse determined that Claudia had some mucous leftover in her lungs and there was little we could do. A little sugar water, however, settled her just enough for her to empty her bowels and get some sleep. I have never cheered about poop so much in my life as in those first days of my baby’s life!
Claudia’s weight dropped a bit, as expected, but when she lost 9% of her body weight by Day 2 we started to get worried. Thankfully my milk came in on Day 3 and everything got better after that. Claudia ate better, slept better, and the number and color of her diaper messes matched the charts perfectly. We appreciated the extra days in the hospital so that every question could be answered.
We are not without fussy spells, but for the most part Robb and I feel pretty steady in our parenting abilities. Every day gets better. Oh, and our yoga ball is magical! The gentle up-and-down motion must imitate life in the womb because it soothes our fussy daughter in seconds (for now anyway). Recovery, for me, will be 6-8 weeks with careful movement, no lifting, no driving, etc. but with slow walks (and sleep when possible) it is going well.
Looking back, I am quite happy with how everything played out. Before being induced, I knew that my anxieties would disappear after holding my baby, but that didn’t help the feelings go away. I remember how upset I was in the days leading up to our scheduled inducement, but the importance of it has (of course) disappeared. Being a mother is such an incredible feeling and I am overflowing with love and happiness – sometimes literally so, as I have been known to cry tears of joy while gazing into the face of little Claudia Leigh.
~ Melissa Thompson, proud and happy new mama
