Wednesday, June 11, 2014

Ephraim's Birth Story

I discovered I was pregnant just a few short weeks after moving across the country from Utah to Tennessee.  We had just relocated our little family so that my husband, Nathan, could attend graduate school at Vanderbilt University.

We had been wanting another child for a little while, and I knew that I wanted to do things a little differently than I had with my pregnancy with my daughter. I had a very traumatic emergency C-section with her, and I really wanted to try for a VBAC delivery, hopefully free of medications.

The first thing I wanted to do was to hire a doula.  I was concerned that in moving away from Utah I wouldn't be able to find someone I was comfortable with hiring. I was pleasantly surprised to find that the wife of our Bishop just happened to be a doula, and also a very active participant in the birth community in Nashville.  She helped me to find a clinic of midwives at Vanderbilt that were supportive of my VBAC, a monthly c-section support group called ICAN (International Cesarean Awareness Network), a breastfeeding conference, the Empowering Fearless Birth conference, and also a Hypnobirthing instructor in the area.

I did everything I could to try and make my VBAC happen. However, when I reached 40 weeks with no dilation, my midwives were getting a little wary.  My previous C-section and subsequent NICU stay for Evelyn had been caused by a bad reaction to induction drugs, so I was not willing to go that route and the midwives agreed.  However, because they are associated with Vanderbilt Medical Center and are overseen by the OB's there, they are only allowed to let you wait until 42 weeks without intervening. I was doing everything I could to kick start my labor, even to the extremes of castor oil and 45 minutes on the stair climber at the gym at 41.5 weeks. Even after all of that I was barely 1 centimeter dilated.  The midwives recommended considering either another induction (no way!), or a scheduled c-section.

The morning of May 20th, 2014.  42 weeks pregnant.
We are very fortunate that Vanderbilt Medical Center offers something called a family-centered c-section.  With this option you get to watch your baby be born through a window in the draping, two minutes of delayed cord clamping, and you can have skin-to-skin contact immediately while still in the operating room. As long as baby is doing okay, you don't ever have to be separated.  These were all of the things that I wanted because it was all of the things I didn't have with the birth of my daughter. She had ended up in the NICU, and I didn't even lay eyes on her for 7 hours after she was born. She was on a respirator and wasn't allowed to try to nurse for several days. Because of this she never really took to breast feeding and it was such a struggle. I didn't want that to happen again.

We decided to go ahead and schedule the family-centered c-section for May 20th, the very last possible time my providers would allow, hoping that I would go into labor on my own before then.  It didn't happen, though.

Nathan and I checked into the hospital at 11 am that morning and our doula Rebekah met us there. She was really supportive and helpful, even though it wasn't the traditional birth we had been hoping for.  I got changed for surgery and they checked me one last time, just to see if I had progressed at all.  Nope! Still shut tight and not even effaced a little bit.  The c-section was still on.

I had a lot of fear I had been trying to process over the previous nine months. I believed I had made peace with much of it, but I still had a fear of being left alone in the event of something going wrong with the baby. I didn't want Nathan to leave my side for even a moment. If he had to leave to be with the baby I wanted Rebekah there, so she dressed in surgical clothing just in case we needed her as back-up since we were only allowed one support person in the operating room.  They wanted Nathan stay back while they prepped me and did my spinal block in the O.R., but I begged and pleaded with everyone I talked to to let him stay with me the whole time. After a lot of asking and approving we got the OK for him to stay with me.  They wheeled me back to the operating room.

They have a really special nurse at Vanderbilt named Lacey who's whole job is to attend to the parents during the surgery and make sure that all of the "family friendly" guidelines are followed.  She also takes great pictures for you in the operating room. She stood by my head the whole time and told us what was happening.

Before we started, everyone was making guesses as to how big the baby was going to be. The surgeon guessed 8 pounds, Nathan guessed 10 pounds 6 ounces, I guessed 10 pounds even.

The anesthesiologist is the person in charge in a c-section, and is really important in the operating room. Our anesthesiologist was named Dr. Chestnut and the resident anesthesiologist under him told us that he literally wrote the textbook on labor and delivery anesthesia.  I felt so lucky to get him. He also was the one who said it was okay for Nathan to stay with me during the spinal block.

After they had done the spinal block (the scariest part for me!), they draped everything and I felt quite relaxed.  I had had a moment of panic right before the spinal block, but that passed and I was feeling very relaxed.  The operating room filled with people quickly.  Vanderbilt is a teaching hospital and so there were many people who were simply there to watch.  I mostly closed my eyes and held Nathan's hand while the smell of cauterizing and the tugging sensations began on the other side of the curtain.  I teased the surgeon (who was a resident) that my last c-section had healed really well, so the bar was set pretty high.  Things were relaxed and happy.  It was such a different feeling from my last c-section.

When they were ready to birth the baby, they opened the window in the draping.  It was angled upward so that I could not see my own body, only the space directly above it.  We watched through the window as Ephraim was born. He came out screaming, and it made my heart so happy to hear that sound! I cried and cried as I could very clearly see that he was healthy and fine. That was the first of many prayers that was answered. Everyone kept saying how big he was! They stretched two hats over his head to keep him warm, and they held him close to the plastic window.  Someone set a timer for two minutes, and we waited for the delayed cord clamping.  Delaying the clamping of the cord benefits the health of the baby, and I had never in my wildest dreams believed they could do that in a c-section. For two minutes I talked to and kissed my baby through the plastic sheeting. As soon as he heard my voice, he quieted and opened his eyes. It was magical.

At the end of two minutes they cut the cord and the pediatric team gave him a clean bill of health.  They quickly weighed him and everyone gasped as the scale read about 5000 grams, or 11 pounds 1 ounce!  Everyone was floored! Lacey said he was the biggest baby she had ever seen born in her time as a nurse.  Everyone kept asking if I was diabetic, and I assured them I was not!  The nurses said that if we had tried to induce, there was no way he would have come down. He was enormous!

After weighing him, Lacey placed him right on my chest for skin-to-skin.  As soon as she put him there, he began looking around for food, and with a little direction he latched on and began to suck.  He continued to breastfeed for the entire 45 minutes I was still in the operating room being stitched up. This was the second big answer to my prayers. I had feared breastfeeding would be difficult to initiate, but here he was doing it on his own!

They took him from me for a minute to get all of his stats while I was transferred back to my bed.  They placed him back on my chest for the ride back to labor and delivery.  As they wheeled me through the halls I felt so happy and peaceful. This birth was not what I thought I had wanted, but it was still perfect and lovely. I had gotten everything I had wanted. I felt like a queen on a float in a parade, waving and smiling at everyone we passed, who cooed and awwwed over my beautiful boy.

When we got back to our room, Rebekah was there waiting. She helped a little to make sure Ephraim was latching correctly and nursing well, and she stayed with us until we were settled over in our room in the mother/baby unit.

Vanderbilt has a rooming-in policy where no babies are kept in a nursery but rather stay with their mother's in their room at all times.  So from the very first moment he barely left my side except for his hearing screening and a few other tests over the next two days, but even then Nathan stayed with him. They watched his blood sugar closely just to check for diabetes, but just as I had assured them we were both healthy and definitely not diabetic.  He is just a really big baby!!  Nurses would stop in just to take a peek at this unusual child.

We were able to leave the hospital after only two days. We took our precious Ephraim Nathan home with us very happy and healthy.

Every single day for nine months I had prayed to have a vaginal unmedicated birth.  Every day I had prayed that my labor would start on it's own or that my water would spontaneously break on its own.  I trusted that Heavenly Father would answer my prayers.

What really happened was so completely different than what I had prayed for, but it just shows me how well Heavenly Father really knows me. He knows me so well that he gave me exactly the things that I had wanted (healthy baby, skin-to-skin, immediate breast feeding, delayed cord clamping, not to be separated from my baby) in a way that I can only trust was best for me. I do not know exactly why my body didn't go into labor on its own, or if it would have if we'd had more time, or whatever else.  I did not know that I could have a beautiful birth with all of the things I wanted in any other way, but I did.  I had prayed for the means that I believed would give me what I really wanted, but he blessed me with a different way to get those exact same things.  I really believe that part of the reason we were supposed to move to Nashville was to deliver Ephraim here in this remarkable hospital.

I left the hospital feeling an emotional healing that I didn't know could happen from another c-section.. and I am so grateful.