Monday, July 14, 2014

A's Birth Story: My Hospital Based Water Birth  (Part 1)

This post is brought to you in collaboration with Dragonfly Doula.

I mentioned a couple months ago when I told you K's Birth Story (read it here), that there were a few things we wanted to do differently the second time around. It was a rough journey but I made it through and don't think I'd change anything in the end.

I didn't want an epidural

Honestly. Five years ago I would have told myself I was crazy to give birth sans meds. The truth is, though, that the epidural I had for my first baby was far from the fabulousness that moms hear about. It was not a pain free childbirth.

First, it wore off to the tune of about 20% efficacy by the time I was pushing out a 10+ pound baby. Which may not be awful in and of itself, except for the fact that it wasn't covered by my insurance and that sucker cost me a little more than $1000. I definitely did not get $1000 of pain relief out of it. 

Second, the after birth side effects were kind of awful. Following the birth, I would sporadically get these pains that felt like a shock from a lightening bolt shoot up my spine from the insertion site up to my brain. They HURT and they were unpredictable. And there was nothing my doctor could do. It's just a known side effect of epidurals. And it was awful. I really didn't want to go through that again.

Strategy 1: Work with a Doula

When I evaluated why I ended up with an epidural last time it was because I was unprepared and didn't feel like I had anyone to help me cope. For K's birth, I had my sister (who had a better epidural experience), my stepmom (who has not birthed a baby herself) and my father and husband - both of whom just looked worried. All great people - just not helpful in dealing with birth pain! I decided I needed an expert who knew more about natural birth than me and who could assist me with techniques and things to try to make it through an epidural free birth.

I knew even before I had become pregnant that I was going to want a doula but at 20 weeks pregnant I found myself doula-less still. I'll write more about how I found my doula in a minute, but let me say that I do wish I'd found my doula sooner. Don't procrastinate like me.

Strategy 2: Waterbirth

My second strategy for avoiding an epidural was to attempt a waterbirth - or giving birth in a warm water tub. Most waterbirths that happen in the United States currently happen at home but due to my tendency to have crazy crazy medical things go wrong with me, home birth just isn't for me. Plus I love my doctor and she delivers babies in hospitals. 

We brought up the idea of waterbirth to my doctor at our first prenatal appointment and were really happy to learn that the Legacy Good Samaritan hospital in downtown Portland was creating a dedicated waterbirth unit on the maternity floor. My doctor also happens to deliver there so it worked out well all around.   

Finding Marta

At about 16 weeks pregnant, I started looking for a doula. The primary places I looked were on Craig's List and by Googling "Doula Portland." After looking at some websites and trying to get a feel for these women online, I found a few that I thought were potential candidates. I shot off some emails to them with info about me and asked them some questions about their experience with waterbirth. They each wrote me back but then I got busy and never followed up.

At 30 weeks I realized I needed to get on this doula business ASAP. I met one doula at at indoor playground so my son could play and I could talk to her without being interrupted every 3 minutes. She was young, nice, and had about 8 years of experience as a doula. While I really valued her history of experience and I thought she was the kind of person I'd probably want to be friends with, a couple things she said made me pause and feel like she might not be 100% on board with what I wanted for my birth. 

A couple weeks later my husband, four year old and I met Marta of Dragonfly Doula at a restaurant in downtown Portland. Even though Marta was a newer doula and had only recently completed her DONA certification (DONA is an international body that certifies doulas), she had more experience with attending waterbirths than the first doula I interviewed. I also really liked her positive attitude and felt like she and I were on the same wavelength and that she'd be able to back up my birth plan and be a gentle advocate for me at the hospital. 

I'm glad my husband was able to meet her, too. He had been initially very skeptical of the idea of a doula but said if I found I doula I liked that he'd make sure to get along with her. Having him there to meet Marta was good, though, and Marta was able to explain some of the things she does to both assist me as well as empower Joe to assist me. 


Before I get too far, I want to talk about something that was happening in the middle of me trying to find a doula: I had started itching. BAD. I had whined about it in a Facebook status and got a lot of "just use cocoa butter" advice. I'm telling you, friends - this was an itch that went way beyond cocoa butter. 

When I had PUPPPS with my last baby, I started getting itchy and then developed spots that looked like mosquito bites. This was itchy like that - but worse. And no marks. I told my husband a few times that I was so itchy I wanted to die - especially since I was so itchy I wasn't getting more than a couple hours of broken sleep each night.

I have a couple friends who had a condition called ICP - or Intrahepatic Cholestatis of Pregnancy - with their pregnancies and they said they thought it might be that and to ask for a Liver Panel and Fractioned Bile Acid test from my doctor. My doctor agreed that the intense itching wasn't normal and ordered the tests.

The way you diagnose ICP is based on bile acid levels in your blood. Total bile acid of 10 or higher or a cholic acid level of 3.1 or higher mean you are positive for ICP. My total bile acid was 9 and my cholic acid was 3.0 - so not technically positive but really close - plus I was super itchy. 

Since I wasn't technically positive for ICP I wasn't put on the medicine normally given to ICP moms. On a recommendation of a mom in an ICP support group on Facebook, I started taking both dandelion root and milk thistle supplements to help with the itching. After just one day, I felt SO much better. I continued with the supplements and after about four weeks, the itching was mostly gone. My doctor had been continuing to monitor my bile acid levels which were not going up so we decided the supplements must have been keeping my body from developing full blown ICP so we didn't plan to schedule an early induction as is normally called for in ICP moms.

(Intense itching during pregnancy is NOT normal. If you are pregnant and experiencing intense itching, talk to your doctor specifically about ICP. ICP is not a common condition so many doctors may not be familiar with it. You can specifically request a fractioned bile acid test to check for it)

15 hours of labor and no baby!

On May 31st I woke up to contractions that were about seven or so minutes apart. I got up, took a shower, ate some food and the contractions kept coming. They were not terribly uncomfortable but they kept coming even though I was doing things that should have stopped Braxton Hicks contractions in their tracks. 

I asked my husband not to go to work that day and since we had plans to go to the farmer's market with my dad and stepmom already, we met them there and figured walking around would be good for me. Throughout the day, the contractions kept coming. After lunch, we decided to go walk laps at the park near our house while my dad and stepmom kept an eye on K at the playground. 

While I was walking laps, contractions started getting more intense, causing me to have to stop and concentrate in order to breathe through them. I'd been keeping in touch with Marta via text message and she said I didn't need to head to the hospital until they started getting so intense I could not talk through them.

Even though I wasn't quite at that point, because I'd had so many vivid dreams in early pregnancy that I didn't make it to the hospital on time I decided I wanted to at least head downtown - even if we just picked up walking around there instead of checking in at the hospital. 

Joe and I headed home, walked the dogs, grabbed a couple last minute things and headed downtown, leaving my son with his grandparents. On the way downtown, I realized I was pretty tired since I'd been up since about 3 am with the contractions and decided to try and get some sleep in the car. I dozed off and woke up as my husband was pulling in to the parking garage at the hospital. 

Joe asked me how I felt and after a few minutes I realized I wasn't having contractions anymore! After 15 hours of almost non-stop contractions, they'd quit. 

Since we'd never actually gotten a tour of the maternity ward (they'd always been too busy to see us), we called to see if now would be a good time for a tour and they said yes. We got a tour, walked around downtown and got dinner. Since the contractions still weren't doing anything at that point, we decided to go home.

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