Isaac: The Birth Story-Part Two

So here I was…an uncertain and potentially dangerous diagnosis and a slightly unpredictable plan.  

One of the challenges that the change of plans posed was with regards to my parents’ plans.  My mom is 3 for 3 on making it to my births and being a fantastic “doula” (not formally trained but quite effective and helpful nonetheless).  They had planned their annual trip with my aunt and uncle the second week of November because I am never early and it felt like a safe bet they could do the vacation and also be at the birth.  

And since I was going to attempt “natural” induction, the birth-date was still not entirely known.  If I opted for a hospital induction we could pick the date and make sure she could be there but we were both wanting to go the natural induction route if possible.  

Long story short, they graciously decided to cancel their trip and then booked a flight to Indiana with only a few days notice.  

So, natural induction.  You might be asking yourself what this means or how one goes about it.  

Well let me preface with: this is not medical advice.  Don’t try this at home, unless under the care and guidance of a medical professional…etc. etc. etc. Also, it is not advised to induce labor at 37 weeks unless there is a medical reason to.  Babies are best when baked in that oven as long as possible =) 

My midwife told me that I was a good candidate for pushing my body into labor because this is my 4th child, and I was already about 2.5-3 cm dilated.  She said at this point I could probably just sternly tell the baby to come and he would just pop out!  

Anyway, natural induction includes things to prep my uterus/cervix for birth (drinking Red Raspberry leaf tea and taking Evening Primrose Oil).  Pressure point massages with Clary Sage essential oil (prompts uterine contractions).  Curb walking (what it sounds like, one leg up on the curb, one on the street).  Breast Pumping (with an strong-suctioning breast pump- this encourages uterine contractions as well).  Membrane sweep (done by the midwife where they manually separate the bag of waters from the cervix and irritate the uterus).  And the granddaddy of them all…Castor oil.  Now, there are many many mixed messages about the prudence and usefulness of castor oil to induce labor.  Technically it is an external-use oil (seriously, I had to find it in the skin care aisle).  It acts as an intestinal irritant (basically poison to your body *gulp*).  When your intestines and stomach contract, it causes the uterus to contract and can prompt labor.  Most people who take it report digestive struggles such as nausea and vomiting, cramps and diarrhea.   But it IS quite effective.  

Back to the official story.  

My parents flew in on Tuesday night (November 7th).  I had told them I wouldn’t do the more drastic techniques until they landed so on the off chance they worked really well, they wouldn’t miss the birth.  Wednesday I did the mid-level techniques which resulted in sporadic contractions, general discomfort and no active labor.  Thursday we decided to hit it hard.  At 11 am, I took my first tablespoon of castor oil, pumped a bit and then my mom and I went to do some walk/squatting.  We strolled Wal-mart and Goodwill for a bit, I did a lot of curb walking outside, and it actually was producing some uncomfortable contractions…as long as I kept moving.  

I took my next tablespoon of castor oil and kept it up.  By 3 pm I had taken 3 tablespoons and didn’t feel much of anything.  I was just telling Ben that it wasn’t working and I didn’t even have digestive issues when there was a grumbling deep down low and I made a quick stop in the bathroom.  I won’t go into many details, but the digestive issues began.  Thankfully they were minimal and I had no nausea or vomiting at all.  And boy did it work.  All the sudden I noticed I was having regular contractions.  Not strong or long ones, but definitely at regular intervals.  

I decided to start timing them and they were 1.5-2 minutes apart.  Now my track record has been that I have putsy, low-key labors until my water breaks…and then it gets intense and fast.  So while my contractions weren’t painful, their regularity had me a little concerned.  If my water broke at home there was a good chance the baby would be born in the car.  After about 45 minutes of regular contractions, I called the midwife on-call.  I hadn’t seen her in a while (they rotate during prenatal care) and had to get her up to speed on where I was at.  She didn’t seem overly concerned about birth imminence until I told her I took castor oil.  Then she told me to get ready to come in and meet her at the BC in an hour-getting us there around 6 pm.   

Oh, side note.  For several months, Asher had expressed interest in attending the birth.  At the birth center, they encourage any members of the family that want to be present to come.  Given Asher’s maturity level and interest we decided to move forward to letting him attend.  We prepped him with how it might go, things he might witness or noises I might make. We talked about the physiology of birth, what is happening during labor and how it is hard work that might take a long time, so he had to be patient, quiet and out of the way.  I checked in with him one more time before we left and he enthusiastically said he still wanted to come, grabbed his packed bag of activities and jumped in the car with us!

On the way to the BC, my contractions slowed a bit and still weren’t intense (didn’t have to stop/breathe through them).  We arrived and did a non-stress test, which is a 20 minute monitoring of the baby’s heart rate, especially through contractions.  I was really worried things had slowed down too much and they would send me home.  I tried to relax, but as Erin (the midwife) prepared the birth suite, I could feel myself getting nervous/anxious with anticipation.  My body was shaking and I couldn’t settle down.  Erin checked me and I was dilated to about 5 cm.  She told me to hop in the shower, and stay in there and labor for about an hour doing squats and relaxing.  

I took a 45 minute, hot, steaming shower and it was amazing.   My contractions definitely increased in intensity but weren’t unbearable.  The nurse arrived at that time, which meant we were actually going to do this!  

After an hour, they checked me again and I hadn’t dilated too much more, but she could tell that if she broke my water, things would pick up.  Even though I value a low-intervention birth, when she offered to break my water I jumped on it, with only slight apprehension.  I remembered the intensity of my labors after my water breaks and had to mentally prepare for that.  It was 7 pm when my water was broken and I got into the tub.  Asher was the designated documenter, and began taking some pictures.  He was really excited until he realized it might still be a while…then he went back to watching his show until the actual action started.

Within a few contractions, things got much more intense and required more concentration and breathing.  Over the next 45 minutes, the contractions came one on top of another, with barely a few seconds between them.  I was determined to stay present though and not let the pain get the better of me.  It truly was a mind-over-matter situation.  At one point, I was leaning on the edge of the tub, staring into the water, repeating to myself in my head, “Don’t say you can’t do this. You can do this.  The pain isn’t going to take over.  Stay focused.  The baby is coming.”  I pictured waves or surges of pain instead of never-ending pain.  I gave a few test pushes and felt the baby drop lower.  

Unbeknownst to me, the midwife and nurse had been waiting outside the birthing room and apparently there was a change in how I was responding, and they could tell from out there.  They made their way in the room and told me to let them know when I was ready to push.  I told them I was ready and got on my knees.  They grabbed a mirror to hold under me so they could keep an eye on the progress.  I was able to reach down and feel his head and within two pushes, he was out.  I caught him, brought him out of the water and it was such a surreal moment.  With my other births, the intensity and quickness caught me off guard and I was not mentally in a place to remember those moments as it all happened so fast.  But this…this I can remember clearly.  I was in a much more prepared and controlled state of mine, and much quieter too, apparently.  

Asher had come in just before I pushed and when I pulled Isaac out of the water, he immediately became emotional, crying and saying over and over, “Wow, that was so amazing!  He is here!  I can’t believe it, that was so cool!”  Ben gathered him up on his lap and just held him as we all marveled over the whole experience.  The moment was so sweet and I’m truly grateful he was there to witness it.  

They got me back into the bed, delivered the placenta and Asher got to cut the cord.  He was a little worried it would hurt me or the baby, but they told him it didn’t and he was then excited to participate.  

Isaac Joseph was 6 lbs, 9 oz. and 21 inches.  His stats were all perfect, with no issues due to the cholestasis or being 2.5 weeks early.

At that point, Papa Klotzle was on his way back from the cousins house (it was about 9:15 pm) and was able to swing by and pick up Asher to take him home to bed.  It worked out perfectly!  We settled in, I was able to nurse Isaac right away, we ate some food and just hung out bonding, resting and comparing notes of how it all went!  

They sent us home 4 hours after Isaac was born.  We made it to our house and Ben and I got settled in the apartment above our garage, while my parents stayed with the boys in the house.  It was a perfect set-up for a few days of *mostly* quiet, postpartum recovery.  

I am not unaware that this was truly a best-case scenario given the circumstances.  The “straight paths” that God led us down were very smooth and happened to align with what I had hoped for.  This isn’t always the case, and I am humbly grateful for the experience and give all glory and credit to God for orchestrating it despite all my apprehensions.  

You may wonder why I share such detailed stories (and below, pictures).  I have become increasingly passionate about the birth experience and have encountered many people who don’t know there can be more than one way to give birth.  Maybe you are someone who had a scheduled C-section.  Maybe you wanted an epidural.  Maybe you’re most comfortable in a hospital with all the resources immediately available in case something goes wrong.  None of that is bad or wrong.  We live in a country that gives us so many choices.  

Maybe you had some really hard circumstances, medical emergencies or last minute adjustements to your birth experience.  I have had a traumatic birth and know the feeling of it not going how you expected, not being respected, lots of pain and frustration (especially after the fact).  

But there is another experience too. And I want to bring awareness and celebration of that kind of birth.  The one where things are healthy and on-track.  Where you might choose low-intervention, allowing the body and process to progress in an unhindered way.  The way you get to know your body and the birth process in a deep way.  How to advocate for what YOU want and having providers who hear you and respect you.  How to build a relationship with a provider so that when they DO suggest intervention, you are able to trust that they are doing it with respect to your desires and also an understanding of the circumstances.  

I’ll leave it at that, but if you’re curious about the less main-stream ways to give birth, I’d love to chat more and answer any questions you might have!  It can be a lovely experience and isn’t always represented fully as a viable, safe option.  

Okay. Pictures.  (disclaimer: Some of these may feel like "too much" to share.  But Ben and I are both comfortable with me sharing them.  I tried to choose ones that were fairly modest considering. Again, I do so for those who aren't familiar with how this kind of birth can go.)

I was in the Mother Mary Suite.  They are set up like a bedroom in your house might be.

This is the bathroom.  There is a large birthing tub and then a full walk-in, stand-up shower around the corner (made large enough for several people to be in it, if that is where delivery ends up happening)

The bed; also an option for delivery, and where we hung out for recovery

After the shower laboring (couldn't find a picture that I was comfortable sharing online), I did tub laboring.  It mostly looked like this with me leaning over the edge, and Ben or my mom putting cool cloths on me. 

Meanwhile, during the more "boring" times, Asher stayed occupied 

Before things got intense, we were able to chat between contractions. 

Asher was documenting and decided to capture his excitement with a selfie...I just happened to be mid-contraction ;)

I only pushed for 2 minutes and Ben happened to grab the phone just in time to see him born!  

He had more "frosting" (vernix) on him than any of my other kids.  

All wrapped up

The Team!  

The other part of the team!  These ladies were a fantastic nurse/midwife team.  Calming, confident and encouraging.  

How we spent most of the 4 hours post-birth

Asher doing skin-on-skin later at home

Toby loves Isaac snuggles!

Gabe probably asks to hold Isaac the most out of everyone.  And needs a bit more supervision! 

If you made it this far...thanks for sharing in the journey with me!  

Isaac: The Birth Story : Part 1

It is clear I don't update this blog much anymore.  But writing out the boys' birth stories is one thing I like to document in this space.  As I've said in the past, I will give a relatively detailed account of the birth...mostly for my own records, but also because I know there are people out there who enjoy reading detailed birth stories! 

I am going to start a few weeks before the birth to give some context.  

One night around 34-35 weeks, I was laying in bed and out of nowhere my neck and shoulders began itching.  And it wouldn't stop.  It isn't uncommon for there to be itching in pregnancy, but mine had been localized to my stretching stomach.  My neck and shoulders didn't make a lot of sense, since that skin wasn't really stretching too much.  Within about half an hour, my arms, legs and back began itching.  Insatiably.  It is a really strange feeling to itch so intensely with no relief.  I, of course, Googled what might cause intense itching in pregnancy.  The list included the regular culprit of stretching skin, as well as double checking things like new soaps, laundry detergent, lotion etc...  But then I came across a "less common, but more serious" condition:  Cholestasis of Pregnancy.  

In short, this is where the liver isn't processing bile, and bile acid builds up and spills into the blood stream, causing potential toxicity to me and the baby.  Worst case scenarios were preeclampsia for me and stillbirth for the baby.  But they said that the itching is usually concentrated to the palms of the hands and soles of the feet.  I breathed a slight sigh of relief because mine didn't itch at that point.  

Eventually they did, though, and I began to get concerned that maybe I had this condition.  Long story short, I asked my midwife to do the blood test to confirm.  Even though I could tell she didn't think I actually had cholestasis, she was very respectful and kind and very readily agreed to do the test to rule it out.  I am grateful for a provider who took me seriously and was willing to check into it.  Unfortunately, the test takes a long time to get back results.  My midwife got back an initial liver enzyme result, which was in normal range, and said she would be surprised if my bile acid levels came back abnormal.  

But then several days later they came back and were elevated.  Ideally the number would be below 8.  Mine was at 26.  More severe cases are above 40, with numbers in 90s-100s being quite emergent.   So I didn't have a severe case, but enough to trigger induction protocol.  Baby needed to be out between 37-38 weeks.  This completely changed my birth plan, as induction usually means pitocin, which can only be administered in the hospital...which meant I couldn't birth at the birth center.  

I was disappointed.  After 3 babies, I had finally felt like I was confident and was even looking forward to this baby’s birth.  The Holy Family Birth Center aligns with so many of my preferences and philosophies surrounding birth and the providers are truly top-notch in my experience.  But these feelings were also mingled with concern and fear of what this meant for the safety of baby and myself.

I should mention that the clinic and birth center are owned by a husband/wife team.  He is an OBGYN who delivers babies at the hospital, and she is a midwife who delivers babies at the birth center.  They work together to provide the kind of birth that each person wants and can transfer care seamlessly if need be.  So I would still be under the care of the midwives, with the same mission and goal and care just with a hospital delivery.  

The plan felt a little vague for a while because the timeline and severity of cholestasis is really difficult to pin down.  It could get bad, but maybe not for a while.  It is hard to know where the line is that it turns detrimental, and there are also risks with taking a baby earlier than absolutely necessary.

 I was finally able to have a straight-forward conversation with the midwife who owns the birth center and we laid out a plan.  She told me that she knew how much I wanted to birth at the birth center so they were going to offer me some choices.  Basically, she told me I could still give birth at the BC if I was a minimum of 37 weeks and if I was able to kickstart my body into labor without Pitocin (they do not utilize medication induction at the BC).  Then she said that if that if I was not able to do that before 38 weeks, they would schedule a hospital induction, since time was of the essence.  I found out later that some rules were generously interpreted for me to be able to do this, and I was grateful they were willing to work with me to get the kind of birth I was hoping for.  At that point, I also just wanted the baby here safely and was pretty willing to do whatever that took.  

I should mention here that this whole experience was stretching and growing me in some important ways.  Each step of the way, I had to keep holding my plans loosely.  I was able to use a word picture that I learned years ago:  If I’m honest, my plans were fairly tightly gripped in my fist.  I knew how I wanted things to go and I didn't want to let that go.  But as each change came, I could feel those plans getting pried from my tight grasp and it was painful (as pried things often are) and my anxiety and fear would spike.  So in the spirit of trusting the Lord and leaning not on my own understanding, I decided to open my fist willingly…with the plans laying in my open palm. And then I would intentionally lift my open hands up to God where I then dumped those plans into his open hands.  He takes them with the promise that he cares more for my desires and plans than I could ever imagine.  He then reaches down and grabs my open hand, void of my carefully laid plans, and walks alongside me down the path that now lays before me.  One I didn’t necessarily want.  One that feels unknown, foreign, scary etc.  The promise is that if I place my trust in him, he will make the path straight.  The promise isn't that it will be easy, but that he will faithfully guide me on the way forward.  This combined with the promise that he works things together for my good (and his glory) was comforting.

This is how I had to picture it, and when my anxiety would tend high, I kept coming back to this because giving plans over to God is rarely a one-time thing.  We I like to try and snatch plans back, or offer God some suggestions on how to perfect the plan because I think I know better.  But gripping his hand instead of the plans has served me much better through the journey.  

That was longer than I intended initially, but felt like a relevant back story!  

I am going to write out the actual birth in a Part 2…so check back in :)