Sunday, November 8, 2009

My First Birth: A 36-Hour-Long Lesson

Posted with permission.

"I will never give birth without a doula."
~Jennifer, after the birth.

Jennifer's water broke at 3am this past Thursday. 35 intense hours later, her son, Andrew, was born. Here is what I learned.

1. Doulas are crucial for not only unmedicated births, but also--maybe even more so--for births where interventions are used.

Jen and Keenon had been preparing for a natural labor and delivery, and Jen had been reading and practicing Hypnobirthing, which uses relaxation, visualization, and meditation to cope with the pain of labor. Many hours after the broken bag of waters, though, her contractions were just too weak and far apart to be helpful. But the doctor was very patient, and waited until 6:45 pm to start augmentation with pitocin. It took an hour or so for contractions to really get started up, but when they did they were pretty painful, continuing to get stronger and closer as time passed. Jen did an amazing job of staying focused and breathing through each contraction, and Keenon was such a strong support to her. I suggested different positions and tried to create a relaxing environment for them to labor in. When things really started getting intense, she settled in the bed for some concentrated focus and relaxing. I was reading a meditation script to her, which helped get her focused, and after that she came up with her own ritual (a sign that she was really coping well). She started repeating in her head, "in love, out pain" with each breath, as I stood by her side and repeated that mantra out loud. After about eight hours of laboring with pitocin, the nurse checked her and she was still only 1cm dilated. This was awful, disheartening news. The good news was that her cervix was 100% effaced, or thinned out, which is what we had been accomplishing for the past eight hours. This was probably a low-point in the labor--Jen was so discouraged, and in her discouragement expressed that she just wanted to get a c-section and be done. Keenon was also in a state of disbelief, and very concerned for his wife. I knew, though, that they were speaking out of pure emotion, and in the end would most likely regret it if that was what happened. The nurse (who had been rather prickly up until this point) really came through, and with me, encouraged an epidural, some rest, and to go from there. Which brings me to point number two...

2. Epidurals can be very, very helpful.

Under normal conditions, I believe that women have an innate strength to get them through labor, if they are well-educated, prepared, and have a strong support system around them. This was not a normal circumstance, though, and the options were either an epidural and some rest, or a c-section. Thankfully, they decided an epidural would be the best way to go, and this was given at 3:30 a.m.

3. It is impossible to sleep in the waiting room, no matter how tired you are.

Heather (Jen's best friend, who was also a part of the support team) and I left the room so Jen and Keenon could get some much-needed sleep. We begged the nurse for some hospital blankets and headed out to the waiting room. After 2 hours of twisting and turning from floor to chair to small-hard-couch-thingy, we headed back to the room to see how things were progressing.

4. When working as a doula, I hold up just fine on zero sleep.

I walked back in the room, bright-eyed and feeling like a million bucks (well, almost). The nurse came to check Jen at 6am, and she had progressed to four centimeters! The baby was also moving down. This was awesome news! We still had quite a ways to go, but we were making progress. Friday morning was less intense than the night before, but still required constant vigilance and attending to Jen. I felt totally awake and sustained by the prayers of friends who were praying for me and for Jen and Keenon. What a blessing.

5. The "24-hour rule" can be bent if both mom and baby are doing well.

Typically, after the bag of waters breaks, the clock starts ticking--doctors say they will have the baby out 24 hours later one way or another because of the risk of infection. But as we were well past the 24-hour mark and there was no talk of c-section, I was hopeful that her baby could still be born vaginally. (After the birth, I asked a nurse why they let her go so long without operating, and she said it was because the baby's heart rate was strong and Jen was doing really well. It would have been nice to know this was a possibility!)

6. Emotions are ten times stronger when running on no sleep and adrenaline.

We didn't know this at the time, but around 11:00 the doctor had told the nurse to get the papers ready for a c-section and to bring them in for Jen to sign, but to check her one last time just in case. So she came in, checked her, and said, "I don't feel any cervix!" I couldn't contain myself--I was so happy I started crying. They asked, "Is that good?" I said, "Yes, this is so good! We made it! You can start pushing!!" It was a beautiful moment. Our awesome new nurse started rushing around to get the room ready for a baby!

7. Women can be strong. So, so strong.

Before she was checked, Jen started feeling the contractions getting stronger. She started having a urge to poop, and I was suspicious that we were nearing the end (having felt that same sensation not too long ago myself). She started having to really focus on her breathing during each contraction, and soon, it seemed like she didn't have the epidural at all. She also started getting pretty emotional, and losing her focus (which we later discerned was a sign that she was in the transition stage of labor--between 7 and 10 cm). Thankfully, her friend Heather knew just how to calm her down and talk her through it. Then I informed her that the pushing stage was going to get very intense again, and that she was going to have to draw from all her inner strength. The room was ready, the spotlights turned on. Heather and I each grabbed a leg while Keenon stood by her head, and the nurse coached her on how to push. She was in so much pain, and could feel everything, but she was so strong for her baby. For two hours, I counted to 10 for each push, which was 3 or 4 times per contraction. She was exhausted, but so focused, and took advantage of every second between contractions to rest. After almost a day-and-a-half of no sleep and barely any food, I was blown away by her strength. She pushed Andrew out into the world at two o'clock pm.

8. The minutes after birth are the most beautiful, spiritual, and love-filled moments ever.

Their new baby was placed on Jennifer's chest. There were tears, kisses, and so much love between their new family. I was crying and taking pictures, doctors and nurses were bustling around attending to Jen and the baby as she held him. But they were in the zone. Nothing could distract them from the miracle of what was happening. I am so blessed and thankful to have been a part of this incredible journey.