Friday, November 27, 2009

Why I Don't Regret Planning a Homebirth

As many of you know, I was planning to have a homebirth. I bet that some of you are thinking I'm crazy for wanting a homebirth, with all that can go wrong in birth. In this post I will explain why I don't regret planning a homebirth, but also why I believe that everything that happened to me was for the best.

Hospital Birth Can Be Dangerous Too

The truth is that the United States has one of the worst rates of infant and maternal mortality in the developed world. In the US, birth has become a medical event, where unnecessary interventions lead to more interventions, which then lead to more interventions. Birth must proceed the way the doctor wants it to; a woman must dilate at a certain rate, or her labor is augmented with pitocin. Women are often induced unnecessarily as well, often with Pitocin, but sometimes with Cytotec, even though the drug is not approved for this use and is associated with adverse outcomes. Induction increases risk of needing a c-section, in part because of the increased need for epidurals, to deal with increased pain from stronger contractions. C-sections are more medically risky than vaginal births. Many women choose homebirth after having a horrible hospital birth experience; I chose homebirth after seeing a loved one go through a horrible hospital birth. I highly recommend the book, "Born in the USA: How a Broken Maternity System Must Be Fixed to Put Women and Children First" by Marsden Wagner.

European countries have a high rate of homebirths, and lower rates of infant and maternal mortality. Certified Nurse Midwifes are highly trained and educated in normal birth, which is what most women have. A good midwife also knows when it is necessary to transfer care to a doctor. Only low risk pregnancies are candidates for a homebirth.

For me, choosing homebirth was a perfectly sane, and even smart choice. Unfortunately, it just wasn't meant to be for me.

For Me, Everything Happened The Way It Was Supposed To

I mourn for all the experiences that I missed, both those that pertain only to homebirth, and those that pertain to any birth. I don't even remember meeting my baby for the first time. Many people say that "everything happens for a reason." In general, I don't believe this to be true. But I do think that in this case, it is true.

As I've mentioned in other posts, I have problems with anxiety. I was nervous about if I would be able to handle labor and birth. I was afraid of having a panic attack and freaking out during labor. I believed that my anxiety would be best controlled in a homebirth, because I would have more control over the situation (because I could control who is present, and I wouldn't have to worry about pressure to have unnecessary interventions, etc). Maybe I would have had a panic attack or not handled labor well, I don't know.

Many women report feeling empowered, more confident, and able to do anything, after a natural birth. Well, I think that my experience empowered me. I went through so much: it was scary, nervewracking, very uncomfortable, and I had to confront my vomiting phobia at least 4 times. But I was strong; I got through it. Though I experienced anxiety, it didn't get the best of me.

Everyone knows that breastfeeding is extremely important to me. I never thought my baby would get even 1 oz of formula. But I was so sick that I didn't breastfeed for the first 9 days of his life. However, I was determined to breastfeed if it was possible, and I pumped around the clock, and now I am producing enough for James plus extra to freeze.

I still feel sad for the experiences that I missed, but I feel that I experienced my birth the way I needed to, to feel empowered and confident that I'm able to be a good mother to my son. I know that I am determined to do what needs to be done, so that my son will grow up and be healthy, happy, and secure.

Sunday, November 22, 2009

Birth of James, Part 3

My in-laws came to St. Luke's, and my parents just went straight to St. V's. I was loaded into the ambulance; my husband rode in front. On the way to St. V's, the technician monitored the baby to make sure he/she (we didn't know the gender) was ok. I believe that I started receiving the magnesium sulfate by IV at St. Luke's. Magnesium sulfate is supposed to help prevent seizures, which I was at risk for, due to my poorly functioning liver. I was warned that it would probably make me feel like shit. Great.

After a nervewracking ride in the ambulance, we arrived at St. V's.  I was taken up to a room on the 7th floor.  I remember they told me to drink this super sour nasty stuff, in order to neutralize my stomach acid, in case I would vomit during the c-section.  I was told to drink it like a shot.  I can't drink shots.  I've never drank one the way you're supposed to. I sip them.  Thus, I've only had 1 or 2 in my life.  So, I sipped it some and finally tried gulping it.  After all that I'd gone through already, I had to have an impatient nurse who acted really annoyed that I wouldn't hurry up and drink it.  Well, gee, I'm sorry if you have to wait a couple minutes.  Oh wait, no I'm not.  Of course, as I knew it would, the nasty stuff came back up.  Maybe not all of it, but some.  It was horrible.  Did I mention I have a phobia of vomiting?

Ok, so my liver and kidneys aren't functioning well, and they're worried I might have a seizure.  I have to have my baby a month early, without any of the benefits of being in labor.  So, I'm pretty nervewracked at this point.  But there's more.  First, they tell me I can be awake during the c-section.  My husband can only be with me during the c-section if I'm awake.  They give him scrubs to change into.  He goes to the bathroom to change, and while he's in there, they tell me that I can't be awake.  My platelets are too low; they are worried about my blood clotting abilities, and so they don't want to risk having an epidural in my spine.  I must have the baby under general anesthesia. So Greg changes into scrubs, comes out, and is told that he will not be able to present for the birth.  Poor guy.

So, I'm taken alone back to the operating room.  I hear that they are waiting for the anesthesiologist to get there.  I hate the waiting.  They begin preparing me for the c-section by tying my arm to the table.  I have anxiety issues, and I didn't like this.  I was hoping they would hurry up and knock me out.  They put the oxygen mask on my face and told me to take deep breaths.  One of the last things I remember is someone saying "Look, she has hives all over her back."  Great.  On top of everything else that is wrong with me, I now have hives.

I don't remember much after that.  The next couple days are a blur.  I really don't have any clear memories until Tuesday.  I remember coming out of anesthesia with the oxygen mask on my face and having a difficult time taking in a breath.  I'm not sure why - maybe my anxiety.  I vaguely remember my friends ( the 2 that were planning my baby shower that I missed) visiting on Sunday, as well as my sister-in-law.  That's about it.

But here is what I've been told happened:

After the c-section, my baby was taken past my room (which I was not in, but my family was waiting there), and my family got to see him.  A boy, which we hadn't known before, 4# and 9 oz, 17 inches, James Irving Gillen, named after my grandfather.  Anyway he was taken past my room on the way to the NICU. He actually was in very good shape, however.  He received antibiotics, because he had swallowed some meconium (the first baby poop) inside me. Because of this, they were worried that he might develop pneumonia.  He didn't.  He had an IV, and oxygen, although he was already breathing pretty well.  It was just a precaution. He spent 2 days in the NICU, and then was tranferred to the regular nursery.  He ate well, and had no problems.

They believe my hives were caused by an allergic reaction to the antibiotics I had taken for my "sinus infection."  So now, I'm apparently allergic to Z-pak and amoxicillin.  I still had hives on my back, and I was super loopy, so I would try to scratch them, and then my IV would beep because of occlusion and the nurse would have to come in and fix it.  So, they gave me Benedril so I wouldn't itch anymore.  Again, I don't remember this. Apparently, I also asked to see my baby repeatedly.  I kept forgetting that I had asked already not that long ago.  I kept falling alseep and  was in and out all day Sunday.  In fact, my poor husband actually had to feed me, I was so out of it.  And then, he would have to tell me to swallow my food, and I would think that I had, when in fact the food was still in my mouth...

Why was I so out of it, you ask?  Oh yeah, because they had givien me tons of mag sulfate, and my kidneys weren't functioning, so the mag sulafte was not getting filtered out and was instead building up in my blood.  Apparently they hadn't thought of this earlier.  So, they decide I need a dialysis treatment to get rid of it.  My family is told that the dialysis will start around 2pm and be done at 5pm, and I might get to see my baby.  But it actually starts around 8pm and gets done around 11pm.  I don't actually get to see my baby for the first time until Monday evening, 2 days after I had him.  And, I was still really tired from the past 2 days events, so I don't even remember it.  I have lots of pictures of this joyous event, but no actual memories.  I don't think I have any real memories until Tuesday morning, when they tranferred me to the regular postpartum ward, with the baby nursery.

To  be continued...

Birth of James, Part 2

After my doctor appointment on Friday, I went home and told my husband that I had to go to the ER, and he came with me.  It seemed like a long wait before I was finally taken back to a room/unit.  During the wait, they took some blood. 

Once I was finally taken to a "room" (there's no door to the room, just a big curtain) in the ER, they hooked me up to an IV.  Then there was more waiting, because there wasn't really anything to do but sit there and wait while the fluids flowed into my body.  I was feeling shaky as well, and I was looking forward to feeling much better once I was rehydrated.  I waited a while, but didn't feel any better.  Then a nurse came in and told me that my blood sugar was 49!!!  If it was any lower, they would expect me to be passing out.  So they gave me some glucose through the IV.

The OB/GYN on call was in charge of my care.  Her name is Dr. Twombly.  Normally in a story like this, one would expect more horrible anecdotes to follow about how horrible the doctor was.  But actually, I would recommend Dr. Twombly to anyone.  I feel very lucky that she was the doctor on call that day, and I plan to transfer my OB/GYN care to her permanently.  She's very blunt but also very caring and kind.

 Dr. Twombly came in and told me my labs were awful, specifically my liver and kidney tests.  She said that she couldn't let me go home with numbers like that;  I would have to spend the night in the hospital.  She also said I couldn't go home until I started eating, because I would just get dehydrated again.  At this point, she thought my awful numbers were due to the dehydration.

It was a few minutes later that I remember I had my baby shower the next day.  I asked one of the nurses if I would be released in time to get to it, and she said she didn't know.  I would realize later on just how ironic this question was.  So, we had to call the friends that were throwing the party for me, the night before the party, and tell them I wasn't coming.  :-(  I felt really badly, because obviously they had spent a lot of time planning and preparing for the party.  But there was nothing I could do. 

Eventually I was taken up to a room in the Family Birthing Center and hooked up to a fetal monitor.  The fetal monitor showed that I was having some contractions, but I couldn't even feel them.  They gave me a shot to stop the contractions, and told me that the medication might make me shaky and make my heart race.  Great.  I was feeling really shaky, but I thought it was due to my low blood sugar.  I was really scared about that, but the nurse said I was shaky from the medication they gave me to stop the contractions.  Later, I was apparently still having contractions, and they gave me another shot.  I asked if they could give me some more glucose, and the nurse said no, that that wouldn't help my blood sugar, that I needed to eat.  In fact, for the next week or so, people were really good about scaring me and making me feel guilty about not eating.  Ever tried eating when you were really sick and had no appetite?  It's near impossible.  And then to have people tell you that you're going to get sicker (or, as my mom did, imply that I might die and basically abandon my baby)  if you don't eat?  It's a horrible feeling.

I was hooked up the fetal monitor all night.  I remember watching the numbers that displayed the baby's heartbeat, and getting worried as they went up and down.  The nurse said the numbers were okay though.  I had blood drawn at 6am on Saturday.  I had been rehydrated with IV fluids.  My numbers should be much better now.  Unfortunately, they weren't.  And that's pretty much when the drama started.  That's when we realized that the situation was much worse than simple dehydration.

I don't remember much about that day except the scariest parts.  I was told that I had to be transferred to St. V's and that my care would be handled by maternal fetal medicine.  Also, St. V's has a NICU.  My baby would have to be delivered by c-section that day.  I cried when they told me that.  It was very scary, and yet hard to believe that I would have a baby at the end of the day.  Dr. Twombly considered inducing me, and the maternal fetal medicine doctor she was consulting said that might be ok, but to check my labs at noon.  Well, my labs changed so drastically from 6am to noon that inducing me was not an option.  The baby had to be delivered ASAP.

To be continued...

Thursday, November 19, 2009

The birth of James, Part 1

It's hard to know where to begin with my birth story.  It really starts about 2 weeks before his birth.  No, I wasn't in labor that long, but the events leading up to James' birth started 2 weeks and 1 day before he was  born, as near as I can tell.  It was the night before my first baby shower, given by my sister, sister-in-law, and my mother-in-law.  I felt achy and gross.  I thought it might be the flu, and I don't believe I've ever had the flu before, so I wasn't sure.  The next day was my baby shower, and I was still feeling sick.  I really just thought it was either stress related or was a normal part of pregnancy.  After all, I was nearly 8 months pregnant; there's bound to be some aches and pains, right?

Well, I got through my shower, and afterwards my husband took me home. I took my temperature and had a slight fever, so I realized that I must actually be sick.  Yuck. So, I went on feeling like crap and Monday I called in sick to work.  I went to my doctor, who told me it was a sinus infection.  She said it was possible that I also had the flu, but she wasn't going to test for it; she only wanted to treat the sinus infection (with antibiotics), and she also claimed that flu medications are not safe for pregnancy anyway.  That is not true.  Anyway, with hindsight I now believe that I had neither a sinus infection or the flu, but something much more serious that was just starting to take hold of my body.

I called off work again Tuesday, and even though I still didn't feel well, I felt obligated to return on Wednesday.  Wednesday is the day I stopped eating.  Not completely, but I ate very little.  At the time, we thought I wasn't eating due to my anxiety, due to my history of not eating when my anxiety is acting up.  I was also exhausted and felt nasty.  I sat at my desk at lunch, trying to choke a little of the lunch I had packed, but mostly just wanting to nap.  This continued for the next week and a half.  I called in sick again on Friday.

I was taking the antibiotic Z-pak, but it was having no effect, so I went back to the doctor on Friday, and she prescribed a different antibiotic, amoxicillin.   I started the new antiobiotic the next day and was really hoping that my 4 day weekend off (since I took Friday off and Monday was a holiday) of resting would restore my health.  But no, I was still feeling sick come Tuesday.  And it was very difficult for me to take the amoxicillin.  I hate pills, and it was a big one.  I would often gag when I took it, and I had to take it 3 times a day.  My husband would have to coax me to take it.

Speaking of my husband, he was getting pretty worried about the not-eating thing.  Over the next week, he tried to cook my favorite foods, or blend up smoothies so that I didn't have to eat - I could just drink.  Even that was difficult, but I did choke down the smoothies he made.  My husband is so sweet.  I forgot to mention that for these 2 weeks of illness,  I slept on the recliner in the living room.  I'd done this before, but this time, my husband slept on the couch to be with me.  I kept thinking he would be uncomfortable and decide to go back to bed, but he didn't.  He stayed with me every night.

Toward the end of the week, I stopped taking the amoxicillin.  The previous night I had gagged and threw up, so I wasn't about to take another of those nasty pills.  My husband wasn't happy, but maybe it was for the best after all.

TMI alert - Around mid-week of this 2nd week of illness, my urine turned deep, deep orange. I had never seen it this color.  I looked it up on the Internet, wondering if it could be caused by the medication I was taking.  Sure enough, it was on the list of side effects for amoxicillin, and was even one of the ones that you're supposed to tell your doctor about.  This was on Thursday. So I called the doctor's office, and they said they wanted to follow up with me. So I made an appointment for Friday around my lunch break.  I didn't have any more sick time ( I just started this job in July), and I didn't want to take any more time off work.  In the parking lot on the way to my car, I gagged and vomited.  Again, I attributed it to my anxiety problem.  I often gag when I have anxiety, although I don't vomit.

My doctor told me that I should go to the ER to get rehydrated with IV fluids.  I considered not going, as I didn't want to have to tell my boss I wasn't coming back after lunch.  But thankfully, I did decide to go. 

To be continued...