Anna's Birth Story

This birth story begins long before the first contraction.  There were a few things in this pregnancy that strongly influenced the birth.  Anna's birth was very different than my first two:

- In James's birth (read here), my water broke, nothing happened, we went to the hospital to be induced, I got a narcotic pain medication, and he was born at 9 pounds and 5 ounces.

- In Luke's birth (read here), labor began at home, I had a peaceful time laboring at the hospital in the water, his head was born in the water, he got stuck (shoulder dystocia), I was pulled out of the water and his body was delivered on the bed. It was a peaceful and natural birth until the traumatic ending, but he and I were both perfectly healthy.  He was born at 11 pounds and 8 ounces.  

So - Entering this pregnancy, I had a few goals when it came to birth.

- Grow a normal sized baby so that birth isn't as difficult and baby's life is not in danger

- Have a natural birth and hold the baby on my chest immediately after birth, totally soak in the moment, and be in awe of the miracle of life and the joy and privilege of giving birth

So how was I going to try to reach my goals?  A few ways.  When people hear about the size of my babies, they always assume that I must have had gestational diabetes.  According to the glucose tests that are preformed in the third trimester, I have never had gestational diabetes.  My care providers have always said "you probably just grow large babies."  But after having two huge babies and then watching them grow into small/average sized toddlers, I'm not convinced that my children should be that big at birth.  So this time around, I decided to treat myself like I had gestational diabetes regardless of what the tests said.  I met with a nutritionist in the beginning of the second trimester and she gave me some good ideas about my diet.  But I was still gaining more weight than I wanted to and I decided to do more research.  I bought the book Real Food for Gestational Diabetes and used that as a guide for my diet.  Basically, I cut out the large majority of carbs from my diet from 26 weeks pregnant on.  I didn't eat any grains, bread, potatoes, or obvious carbs.  I also didn't eat any sugar or honey.  I was careful to eat only small portions of fruit, beans, and certain vegetables that are heavy in carbs.  It was hard at times - mostly because it took a lot of effort to always have healthy food ready for me to eat.  We had to cook all the time because just picking up a pizza or most meals from restaurants simply wasn't an option.  But overall it made me much healthier.  From weeks 26 to delivery in this pregnancy, I only gained 8 pounds.  Just to compare, with Luke, from weeks 26 to delivery, I gained 28 pounds.  It took discipline and self control but I was willing to do anything to try to make a smaller baby.  And I did cheat occasionally.  About two to three times a month, I'd allow myself a really yummy dessert.  And a few times when eating with other people and I couldn't avoid carbs, I ate them.  But overall, I was very strict.

As far as how to reach my goal of having a natural birth, I prepared myself the same way I did in preparation for Luke's birth.  Even with all of the craziness at the end with Luke, my labor with him was awesome and I was so thankful to have him drug free.  So just like last time, I did tons of research - the more research I do, the more I want to have a drug free birth - it is by far the safest option for both mom and baby in most circumstances.  And the other huge part in having a natural birth for me is having a doula.  We hired Natural Baby Doulas just like we did last time.  They are all amazing, but Sarah taught our Bradley Method childbirth class when we were pregnant with James and she was one of the doulas there for Luke's birth.  She was my go to person during pregnancy to discuss my concerns and she was an incredible support. I texted her and told her she was hired for a birth in mid June the day I peed on the stick in early October.

I love birth.  I just do.  The days that my children were born were the best days of my life.  Of course it is mostly about bringing life from the inside to the outside and meeting your child for the first time.  But I also love the entire process.  I think it's amazing how our bodies work and how we were made to do this.  I love how the pain is so incredibly intense and at the same time beautiful.  I love how it takes us to places we never imagined and how we come out changed.

When it came to Anna's birth, there were times when I was afraid that I wouldn't be able to experience a natural vaginal birth.  When you experience shoulder dystocia like I did with Luke, you have a 12% chance of it happening again (in general, there is a .5-2% chance of it happening in any normal birth).  Because of this, I was qualified to have an elective c-section if I wanted it.  During my first trimester, I had an appointment with a doctor at my practice who seemed to push the c-section option.  I left that appointment feeling discouraged.  I decided not to see that doctor again for the remainder of the pregnancy.  And then Anna was breech (her head was up rather than down) or transverse (sideways) the majority of my pregnancy rather than how she should have been - vertex (head down).  Babies can be born in a breech position, but my care providers (and most in the United States) will not deliver a breech baby due to risks with that kind of birth.  If Anna was breech or transverse at the time labor began, I would have to have a c-section.  I never want to take away anything from mamas who give birth by c-section... It is absolutely giving birth and it is intense!  It's a major surgery and takes way more recovery time than most vaginal births and it comes with way higher risks to moms... c-section moms are amazing... I just didn't want to birth that way if I could have a vaginal birth and Anna and I both be safe.  

So - at 38 weeks pregnant, I went to the hospital and one of my doctors preformed an external cephalic version (read about that here) to turn Anna from being breech - her head was under my right ribs and her feet were in my pelvis - to a vertex presentation.  It worked!  And she stayed that way... for awhile.  I had an appointment at 39 weeks and 3 days and Anna looked great, was head down, and was measuring exactly where she should be.  I had ultrasounds at 30, 34, and 38 weeks to check on her size since Luke was so big and she was between the 45th-66th percentile in all of them, so we were not concerned about her size at all as her due date got closer.  At my appointment, my doctor felt her head and it was down, but it wasn't low and engaged in my pelvis.  Because of this, she told me that if labor started or if my water broke, I needed to come to the hospital right away - she said she'd probably stay head down, but if she was transverse or breech at the onset of labor, they'd need to do a c-section right away.  And if my water broke and she wasn't head down, there is a chance that the cord could fall out (cord prolapse) and Anna could die from that within a matter of minutes. My doctor said that she wasn't normally concerned about most moms with a baby's head were Anna's was, but since Anna was so active and she had so much room to move since she was smaller and my uterus was more stretched out, she wanted to be cautious.

So I left the appointment feeling good about things.  I was pretty sure that since her head was down that she'd stay in that position and just get more engaged as labor neared.  That appointment was on Friday, June 10.  Ray's mom picked up the boys on Friday afternoon and his parents watched them for the weekend.  I was having signs that labor was near and I wanted to have the opportunity to rest and nest before we brought a baby home.  We had a fun, relaxing, and productive weekend.  On Sunday afternoon, I laid down to check on Anna's position.  This is something I had done several times a day since we turned her at 38 weeks.  I knew what her butt felt like up in my ribs (it moved from the right to the left side) and I could usually feel her head down in my pelvis area too.  But on Sunday afternoon, I laid down to feel her and things were different.  I felt very empty at the top of my uterus.  And anxiety set in as I felt a large bump on my left side and another large bump on my right side. I was pretty sure I was feeling her head and butt in my sides and that she had turned sideways.  I told Ray and I decided to call my providers.  Vicki, my favorite midwife, picked up the phone.  She knows my history and birth goals without me needing to explain anything.  She gave me the option of coming in the office on Monday to check, but I asked if I could go to the hospital right then to be seen.  I knew my body was close to labor and I didn't want to waste time if Anna was in the wrong position.  She said that was fine and we got ready for the hospital.

When we got there, we went back to triage right away and Vicki met us there.  She felt my belly and felt what I was feeling.  They brought in the ultrasound and it confirmed what we suspected.  Her head was in my left side.  She was sideways.  So we talked with Vicki and decided to try to turn her again - another ECV - early on Monday morning.  If turning her was successful, we would induce labor right away so that she would be forced to stay in that position and not turn back.  Lots of emotions came over me - I had worked so hard and wanted so badly to just have a natural birth.  I just wanted things to happen easily and was frustrated that she wasn't cooperating.  My main concern was if the ECV didn't work.  Most people do ECVs at 37 weeks and those are only about 50% effective.  What were the chances of turning a baby easily 1 day before my due date?  It worried me.  If she didn't turn, we could wait a few days, but I'd need a c-section.  But I still had hope because she obviously turned easily all on her own 2 days before my due date and the first ECV was easy.  And then I was also concerned about the induction if the ECV worked.  I wanted a natural birth, but I knew we would need to use drugs to get labor started.  I had never been on pitocin before, but it is a very intense drug and it makes contractions more difficult to manage than natural contractions.  I cried and Ray held my hand as I was expressing my concerns to Vicki.  Vicki was amazing and made me feel validated about my concerns but at the same time reminded me that everything they did would be to ensure the best outcome - a healthy mom and baby.  

We left the hospital excited because we knew we'd probably get to meet our daughter the next day.  And we also left nervous because we knew we had several large obstacles to overcome before she arrived.  We went out on one last date to Green Valley Grill to make sure to get a great meal.  I'd have to fast after midnight to prepare for the ECV.  When we got home, we did more cleaning and packing.  And then we rested and watched Pirates of the Caribbean... I needed to watch something to take my mind off things.  We finally went to bed at midnight, but neither of us slept much at all.  We were both restless.  I really wasn't too anxious or nervous at this point - I was more excited that we were finally going to have a baby because this pregnancy seemed to last forever.  By 5:20 in the morning, I was up and getting ready to go to the hospital.  

We got to the hospital at 7:00am and our doula, Sarah, met us in the waiting room.  We got to the room at 8:00am.  I was in the same room where we did the ECV two weeks earlier.  They like to do ECVs in that room because it is right beside the operating room.  There are chances that turning the baby can put them in distress and you'd need a c-section right away.  Being right next to the OR isn't exactly comforting.  My favorite doctor, Dr. Stringer, was there to do my ECV.  He delivered Luke and we love to call him Superman because of how he lifted me out of the birth tub when Luke got stuck.  I was so glad to have him do the ECV this time.  At 9:30, I was prepped and ready for him to do the version.  Jessica, one of the midwives, was there to assist him.  Her head was in my upper left side, her back was across the top of my uterus, and her butt was in my right side.  Dr. Stringer seemed very confident about the entire procedure.  Once he started, I really had to focus on my breathing.  This ECV was more painful than the first one.  I had a round ligament spasm during it and that was the most painful part.  But before I knew it, they were done and she was turned in the right direction.  They put the monitors back on me to make sure that she was still doing well and she looked perfect.  

After the ECV, we immediately started discussing the best way to induce labor.  There was no way I was going to leave that hospital just to risk her turning back again.  Dr. Stringer checked me and I was 2cm, 50% effaced, but she was still floating pretty high in my pelvis.  He explained that we needed to get contractions going because those would force her to move lower in my pelvis and really get her head engaged.  Once her head was lower, we could then break my water.  We couldn't break my water right away though because she was so high - doing this could result in cord prolapse which is life threatening for the baby and results in an immediate c-section.  So - we decided the best way to induce labor was to start on pitocin.  

Ray went out and got food for us because I was hungry due to fasting and I knew I'd need the food to be able to labor well.  I debated what kind of food to get knowing that I've been nauseous at some point during labor with both boys.  I decided to go for a bland sandwich from Panera.  It was such a nice treat to have a sandwich because I had not eaten one in months.  I ate the sandwich around 10:30 and it was exactly what I needed.  

Our nurse, Susie, was wonderful and she waited to start the pitocin until after my food had had a little time to digest.  I don't understand much at all about the doses of pitocin - but Susie told us that the max dose of pitocin is 48.  She started me at a 3.  She monitored me and Anna and would turn the pitocin up by increments of 3 every 30 minutes or so as long as we were tolerating it well.  I couldn't feel contractions at this point even though some were showing up on the monitor.  Sarah encouraged me and Ray to nap if possible.  I never really fell asleep, but I closed my eyes and rested and it was helpful.  In these early hours of pitocin, I was somewhat worried.  What if my contractions wouldn't start? What would we do then?  

Finally, around 4:00, I started to feel some mild contractions, but I had to stop to pay attention to them.  My midwife, Jessica, checked in with me at that point.  She told me she'd come back at 6:30 to see if there was any progress.  Sarah left to go check on her kids for an hour or so and Ray and I decided to take another nap.  I actually did fall asleep for a little while this time.  

Around 5:00, Sarah called to tell us she was on her way back and asked what we wanted for dinner.  My contractions were picking up a little at this point and I didn't really feel like eating, but Sarah and Ray decided to get Thai because they knew that if anything would make me want to eat, it would be Thai food in the room.  Once Sarah got back, I was up and walking between the contractions and squatting or lunging during the contractions.  I was doing everything I could to get her lower so that we could break my water and see progress by the time Jessica came back to check me at 6:30.  Contractions at this point were short in length, but close together.  But I had a complete break between contractions, so they were very tolerable and I was able to manage the pain on my own without Ray or Sarah helping.  Once Sarah got back, around 5:30 or so, Ray and Sarah ate dinner.  I looked at the food and it actually looked good to me.  I took a few bites of chicken and rice between contractions and it gave me a nice energy boost.

Jessica came in at 6:30 and my pitocin was up to a 24 at that point and it never needed to be increased after that.  She checked me and Anna had dropped down in my pelvis more, I was 3cm, and we were ready to break my water!  I have never had this done, so I was a little nervous about it.  For the most part, it was painless, but it took longer to do than I thought.  When it broke, not much fluid came out.  She wanted me to sit upright in the bed for a few minutes just to let gravity work so that Anna would drop even more.  

I got out of bed around 7:00 and things were obviously different with my water broken.  I needed Sarah to make me move to different positions.  I stood through some, sat on the birth ball through others.  Sarah rubbed my back and used counter-pressure while I was on the birth ball.  The pain was very intense.  I needed someone to touch me in another part of my body to distract myself from the contraction, so Sarah would rub my back or Ray would massage my hand or my foot.  I know it sounds strange that I wanted him touching a hand or a foot, but it was very helpful.  I was so glad that Sarah was there to make me move because the contractions were on top of one another and I just couldn't get a break.  

Around 7:30, my new nurse, Becca, came in to ask some questions.  I have no idea what she asked and I don't remember what she looked like at all.  Around 7:45, Sarah noticed that there were a few contractions where Anna's heartrate dipped to 90/100 during a contraction.  At this same time, I begged for my midwife to come see me.  It was a new midwife, Kim, because the nurses/midwives change shifts at 7:00.  I told her she had to turn down the pitocin because I needed a break.  I had just had 5 contractions in 8 minutes.  When Kim came in, she looked at the monitor and immediately dropped the pitocin to 12.  She wanted to check me to make sure I was still making progress.  I could tell you, I was making progress!  But finally, I was able to get in bed and she was able to check me quickly between contractions.  I was 4-5cm, 80% effaced, and baby was at 0 station which is low.  We asked if I could get in the birth tub, but Kim didn't want me to since I was still on pitocin and Anna had had some dips during contractions.  I was fine with that because I was making progress and even though it was very intense, I was able to cope well with the help of Ray and Sarah.  Kim left the room around 8:20.

I got up and went to the bathroom.  I hated going to the bathroom because sitting on the toilet was very painful.  But laboring with a full bladder is painful too, so I made myself use the bathroom frequently.  After using the bathroom, I just stood up and was holding on to the counter over the sink and the contractions were so intense that it made my legs shake uncontrollably.  I was vocal at this point and I just tried to remember to make deep groans / noises because that's much more calming and productive than screaming.  

I made it out of the bathroom and sat on the edge of the bed.  Ray sat across from me on the birth ball and I held my arms over his shoulders and just clung to him during each contraction.  This position seemed to work well for the moment.  But after a few contractions there, I told Ray, "I can't do this! I need some pain medication!" And of course he encouraged me telling me that I could do it and that I was doing it.  And then in the very next contraction, I thought that I felt the urge to push.  I was shocked by this feeling because just 30 minutes earlier, I was only 4-5cm.  I told Ray what I thought I felt, and he got excited for me... but I was still hesitant.  In our birth class, Sarah taught us that you can have a "wishful" urge to push where you want to push, but your body isn't ready.  You really shouldn't push at this time.  She said that you need to wait until you have an "overwhelming" urge to push.  So during the next couple of contractions I just listened to what my body was telling me.  After a couple of contractions, I started yelling at the nurse who was in our room to call for my midwife to get there right then.  The nurse who was in the room was not my regular nurse - she was just fixing my IV bag.  

At this point, Sarah told me I had to get on the bed.  She saw the position I was in and could tell baby was right there and she was a little concerned that baby would fall out on the floor if I stayed where I was on the edge of the bed.  After what seemed like forever (although I'm sure it was only a minute or two), Kim was back in the room along with a couple of other nurses.  I was back on the bed and Kim said "I need you to calm down and listen to me.  I need to put on my gloves."  I was in a bit of a freak out moment because I still wasn't sure if I was actually getting ready to have a baby or if I was just going to be in intense pain for the rest of my life.  I finally figured out that I was getting ready to have her when they turned on the intense lights that are just turned on for delivery and the nurses brought in delivery tools on a table.  Once I realized that, I was able to take a moment to breathe and take it all in briefly.  And then I asked Kim if I was in a good position to push.  She said I was good.  She told me to go slow because her head was right there.  I started to push and then I briefly stopped because it hurt.  I know that probably sounds crazy.  Of course it hurt!  But I truly had not yet wrapped my mind around pushing my baby out because it was happening so fast.  Kim told me to open my legs because I was actually involuntarily closing them.  After that, I embraced the pain and pushed and she came out up to her ears.  I pushed again, but not as hard, and the rest of her head was out.  Then Kim asked me if I wanted to catch my baby.  I didn't know what to think and Sarah said "Yes!  You want to catch her!"  And Ray guided my arms down to where she was.  I pushed one more time and I pulled her body out and put her on my chest.  And in an instant all the pain was gone and incredible life was breathing on my chest.  I was in awe and in crying within seconds.  I wanted that moment so bad and I embraced every part of it.  It was perfect.  She was born at 8:58pm.  She weighed only 7 pounds and 15 ounces and was 19 inches long.  My whole pregnancy, I wanted an 8 pound baby and she was just one ounce shy of that!  

Sarah took several pictures from 8:55 (when I got on the bed) to 8:59 (the minute after she was born) - Here are some of them...

In this picture I'm looking concerned because I don't know if I'm getting ready to have a baby or if I am just making myself crazy thinking that I need to push when I don't.  My midwife explained shortly after that I could push.

 Ray almost had to hold me back a little bit when I was initially having a panic moment due to the pain since it was all happening so fast...

 Reaching down to catch her was an amazing experience... 

 This moment. A baby on my chest without complications.  This was the desire of my heart my entire pregnancy.  

 After a few minutes, Ray cut the cord.  This was especially special this time since I don't even know who cut Luke's cord due to him needing to be seen by the NICU team immediately.  

 Kim, my midwife, and Dr. Stringer.  Dr. Stringer wasn't there for the delivery because it happened so fast, but he came by to visit right after she was born.  

 I couldn't have reached by birth goals at all if it were not for Ray and Sarah!  

 Ray getting to hold Anna for the first time... 

 My perfectly normal sized baby!  Only 7 pounds and 15 ounces!  

There were so many details that needed to fall into place to have the birth I imagined.  I could just say that they all fell in place.  But I know that God is one who cares about the details.  I know that He has known the way Anna would enter the world long before I did.  He was so gracious to us to allow us to have an easy and uncomplicated delivery and I am so thankful.