The birth of my first child with my wife was an experience that unfolded like Ron Howard’s Apollo 13, only my crew was an amazing birth team consisting of my wife; Barbara Herrera, our midwife; Nova DeLovely, our doula; and myself.
Our goal was not as lofty as a manned space flight; we just decided we wanted to have a child. My wife and I both had prior marriages and she has two amazing kids from hers. Two years ago we got married at 34 and 38 years old. We began trying for a child knowing that the biological launch clock was ticking down against us. We didn’t realize just how challenging that would be.
During those two years we experienced several miscarriages, fertility testing (that told us there were no problems), gestational diabetes, an entrenched medical system that was only willing to let you do things its way, and a self-education that gave me more knowledge than I thought would be necessary to support my wife in delivering our child. Suffice it to say you probably know more people who have had these experiences themselves than you are aware of. The last pregnancy “stuck”, and we both held our breath many times hoping that things would go positively for us.
“Apollo 13 this is ground control. We are go for launch!”
04:00 Hours September 16th 2010:
I assumed this was yet another of the regularly occurring two-hour bathroom trips my unborn son had been subjecting my wife to for the last couple of weeks. The baby’s due date was September 14th and we were just over a day past that. My wife had been having irregular surges (contractions) for a few days and we had both entered this state of alertness that my son could start his arrival at any time. With some disbelief, the surges were coming regularly at around four minutes apart and we rested her through the next hour and a half while.
“Freddo, how long does it take to power up the LEM?”
We called Barbara, our midwife. Why have a midwife? Don’t they assign one when you go into the hospital once labor begins?
To answer this question, I need to give you a bit of the back story. As I said, my amazing wife already had two fantastic children when I met her. Both had been delivered via C-section; one was breech (bottom first, not a position that makes vaginal delivery much of an option). The other was a “failure to progress” after 36 hours of labor (my wife would find out later that the baby was posterior/face-up, which could have been corrected during labor if anyone had been paying attention).
My wife turned 40 this year. I will be buying flowers and making up for outing that for a while, but it is relevant. We had been dealing with the realities of trying for a kid at this late stage in her fertility span and because we had those experiences, it was important to us both that she have the opportunity to have the birth that she wanted, which meant vaginal. She did not want another surgery, period.
Our health care provider (one nurse midwife and three obstetricians) shot that notion down very quickly stating that their policy was no VBAC2 (Vaginal Birth After 2 Caesarians). She was not even allowed to go into labor at all, let alone attempt a vaginal birth. In short we deliver in the hospital and only via C-section. We were less than thrilled at this news.
They explained to us the many risks, the most severe of which is a rupture in the uterus during labor which could result in my wife bleeding out internally. In the worst case scenario, this is catastrophic and could result in the loss of both my wife and my son.
That is a pretty harsh reality to have to face but we did what we always do in situations we don’t understand – we researched. It turns out that the risk of uterine rupture is 1.5% after two C-sections. The risk is as high as 4% when Pitocin is used to induce labor (which is common practice nowadays). To look at our situation from a different angle, my wife would not be allowed to labor and try for a vaginal birth because she only had a 75% chance of success. We took a hard look at those odds and decided that if our health care provider would not support us laboring with them then we would do it at home ourselves. We really believed that the small risk of a uterine rupture did not negate the higher risks of the numerous things that could go wrong during a C-section, which is a major abdominal surgery.
My younger sister and I were both home births in the UK with the assistance of a midwife, so the idea of a homebirth was not a radical notion in my experience. In fact, it seemed far more normal to me than the way births are handled here in the U.S.. We began looking locally here in San Diego for a midwife we could work with. For the most part many would not touch us due to my wife’s two prior C-sections. When we made the mistake of telling our healthcare provider that we were considering a home birth, I was told point blank that I was going to kill my wife and child and I am not saying this for dramatic effect.
Through a reference we found Barbara Herrera (http://www.navelgazingmidwife.com/) and interviewed her. One of the first things Barb said during that interview was no matter how badly we may want a VBAC or HBAC (home birth after C-section) she would not allow us to put my wife or the baby in danger and that if we worked with her and she made the call to go into the hospital we went, no arguments.
During the course of the entire pregnancy Barb was a fantastic resource in helping us to educate ourselves in many different aspects of pregnancy, labor and birth. We received way more support and expert advice from her than we did from our healthcare provider. There is no way to compare the level of care we received from her against an HMO system; two-hour prenatal visits, discussions about our emotional and mental health as well as my wife’s physical health, visits to our home as opposed to a doctor’s office, just to name a few differences.
In one of those ironic moments in life two months prior to our due date, ACOG (American College of Obstetricians and Gynecologists) updated their recommendations around letting a woman try for a regular birth after two previous c-sections: http://www.medscape.com/viewarticle/725597. It was too late in the game to change hospital policy, therefore not really affecting our choice, but it did give us a little more ammunition with the OBs at our HMO.
Barb arrived did an exam on my wife and identified that she was indeed in the first stages of labor and that mum and baby were both doing well. She camped out on our couch for the next couple of hours keeping an ear on baby and mum.
Barb is a licensed midwife and thus cannot prescribe pain medication so my wife would be going through the delivery drug-free. Barb recommended that we consider attending HypnoBirthing classes, so we signed up with Carol Yeh- Garner (http://www.awelllivedlife.net/).
We learned many valuable techniques in helping both me to stay calm and my wife to ride each of the surges, breathing and focusing her way through the sensations. We were also lucky to share those classes with a great group of people who, through their own experiences, were looking for less medical intervention focused births for themselves.
Baby and mum keep progressing slowly but steadily. All indications were that we could be in for a long labor as she was dilating at about a ½ cm per hour. Prior to all of this I had illusions of kicking back in my man cave watching movies, reading books and playing video games. The reality was that I lay with her stroking her hair and skin, encouraging her and verbalizing the visualization techniques we had learned.
Surges began getting more intense taking more focus by my wife. We could no longer chat through them, she would breath and I continued to gently stroke her softly telling her positive affirmations. We decided at this point to call in our doula.
A midwife and a doula? Hell YES.
Yup, while the midwife is focused on the physical well-being of mum and baby and the biological processes of delivery and birth, the doula is focused on just the mum. They help to keep her hydrated, encouraged, supported, physically comforted, and loved providing the emotional element of the equation.
Nova (http://www.wombservice.com/) was recommended by Barb and was someone who immediately filled in a gap in our delivery team that we did not know existed. She has the sweetest, calming disposition and truly embraced the opportunity to nurture and care for my wife, and I, during the pregnancy and delivery.
“Houston, we have a problem.”
My wife had more frequent and more intense surges as the day progressed. Around this time she was using the bathroom and felt like her waters had burst. When a woman has her waters break a clock starts ticking because the amniotic fluid that surrounds the baby begins to drain out of the womb and the risk of infection increases. Many health care providers will insist on an antibiotic IV being administered to counteract the infection risk.
Unfortunately, it was not her waters that had broken. Instead she had passed a bright red blood clot which is indicative that she has been bleeding inside. Barb did a check of the baby’s heart rate and it had begun to spike and dip erratically.
This was exactly the reason why we had a plan B to our home birth. We quickly and calmly gathered my wife up and our pre-packed bags and headed to the hospital while Barb called ahead. I’m sure that I must have looked like I had been shocked with a cattle prod but due to our planning I was reacting the way I needed to; safely taking care of my wife and child.
“Just a little while longer Freddo. Just a little while longer, we’re gonna hit that water in the South Pacific. Open up that hatch. It’s 80 degrees out there.”
The drive to the hospital took me 25 minutes. Immediately after and even now, ten days later, I can recollect very little of it. I know I obeyed the traffic laws. I did not speed or run any red lights. I was hyper aware that things had gotten scary but I had entered a calm, or as medical types call it; shock. Nova came with us in our car and she continued to sooth my wife and breathe with her to help her ride the intense surges.
They were working together so well at one point I looked over at my wife who was completely calm and serene and I thought she had passed out. She hadn’t – she had just ridden that particular surge very deeply. I don’t think she was trying to kill me with the glare she gave me but it might have been close.
I, on the other hand, was processing that I might actually lose my baby and possibly wife. Strangely enough, you would think I would be begging the universe or God to intervene and keep them safe. Instead I had a quiet calm that things would work out. My wife and son were stronger than this.
We arrived at the hospital and I transferred my wife to a wheel chair and sped to Labor and Delivery while Nova took care of parking the car. Again I managed to not mow down any human obstacles along the way.
“Houston, we are venting something out into space.”
We arrived at the triage check in and were slowly being processed until my wife had another contraction. It was another intense one because we were suddenly in an examining room being looked at by a staff midwife. This time we were told my wife was 100% effaced and 4cm dilated. Barb insisted on checking the baby’s heart rate and he appeared to be holding okay but my wife continued to bleed.
We were moved into a delivery room shortly after that. The whole situation took a comic Monty Pythonesque spin that I did not expect at this point. My wife was now triple peaking with her surges, having three back-to-back with no break. She had turned into a low guttural moaning focus of attention. The comedy came as one of the nurses began asking us questions as they hooked my wife up to IVs and monitors.
“When did your wife eat last?” 6am…
“Has your wife…” the question was annihilated by 45 seconds of intense moaning from my wife.
“Has your wife gone poo-poo today?”
The entire birth team exchanged glances and everyone burst out laughing simultaneously. This one question had pierced the tension bubble that we had been in from the moment my wife passed the first clot.
“Are you in…” more groaning as another triple peak hit.
“Are you in any chronic pain?”
Again more glances between the birth team, only this time I caught my wife trying to psychically slap the nurse for asking the question. My wife was able to communicate her discomfort and we requested an epidural.
At this point we thought we might still be able to vaginally birth in the hospital.
“Let’s work the problem people. Let’s not make things worse by guessing.”
My wife gets the epidural and slowly begins to get relief from the surges. The doctor comes in takes one look at the bleeding my wife has been having, one look at the triple peak surges and one look at the baby’s heart rate during and after the contractions and informs us that viability for the delivery is declining and we should consider a c-section.
We did not hesitate and agreed immediately. This is exactly why we had our backup plan and this is exactly one of those situations where a c-section is necessary. The next few minutes became a blur as I was stuffed in a Smurf suit; blue scrubs, booties the works while they prepped my wife to be transferred to the OR.
Nova came to me with a pot of yogurt and asked me to eat. I declined as I could not possibly eat – I was very much lost in the moment. Now understand that Nova is about five foot three and almost elf-like in her body frame. I am six foot four and built like an ogre. She stared me down and pushed on me again to eat. She was right – I could not risk passing out in the OR. Our Doula was caring for us when we were focused on taking care of mum and baby.
I followed the hospital staff as my wife’s bed was wheeled down to the OR.
“I’ve been going over the numbers again”
I sat in the recovery room while they prepped my wife in the OR. I had a chair in a single bay facing a large LED clock. It slowly taunted me through the longest half-hour of my life. Each second my paranoia and fear tried to convince me that something was wrong; this should not be taking this long. Was my wife suffering a uterine rupture? Had the blood loss caused problems for my son?
It was one thousand times worse than the time it takes for a CHP officer to walk from his car to yours after pulling you over for speeding.
“So long, Earth. Catch you on the flip side. “
I was escorted into the OR. My wife laid on the table with a screen blocking view from just above her chest. The moment I sat down the procedure began. “Incision started 16:01!” My wife laid there with her head supported by some rolled up towels, her eyes red. She was still the most beautiful woman I know. I held her hand as they began the procedure. She had asked me to not look beyond the curtain to see what was going on, which was fine by me. I had seen enough of the process on Discovery and had no desire to be that intimate with my wife’s inner workings. We talked softly, reassuring each other that everything was okay that our son was okay.
“16:09 baby delivered”. They held him up for me to see and were followed quickly by “16:09 placenta delivered”, which mercifully they did not hold up for me to see.
I watched as the nurses began cleaning him up. His body was long, gangly, and a purple grey color at first, and he was quiet. They worked on him for a few minutes assuring us that he was fine and allowed me to get up and take a picture as they weighed him.
Duncan Thane was born at 16:09 on 9/16 (something that very much appealed to my geeky nature) at 7 lbs. 11 oz.
They swaddled him and let me hold him while they continued with the procedure, stitching my wife back together. There were two things that I was totally unprepared for during the procedure. First, the smell; they must have used some sort of cauterizing tool because the metallic tang of searing flesh was very sudden and strong. Second, the violent shaking that my wife started to suffer from the anesthetic.
Duncan is the most beautiful kid I have ever laid eyes on, yes I know I am biased, and we both were very happy and grateful to have him here, healthy and with us. “16:34 procedure completed!”
It turned out that the placenta had already started to come loose during labor and that was the source of the distress. While not a uterine rupture a placental abruption is something that is serious and warranted the C-section.
We were put in the recovery room with my wife and son and a nurse. My wife had been diagnosed with gestational diabetes in her second trimester and had done a fantastic job of keeping her levels so low as to be barely borderline, just through diet and exercise. Still, they needed to check my son’s glucose levels. At first he was 90 in the OR, but within an hour had dropped to 45 and the nurse was saying we needed to give him formula. We wanted to give my wife the chance to breastfeed but had been having trouble getting him to latch on. I spoke with the nurse and let her know that Barb is also was a La Leche League leader with 20+ years of experience with nursing moms and if they would let me bring her back to recovery she could help us. After a couple of calls they agreed and Barb had the wee fella feeding in no time flat and his glucose levels started to rise consistently over the next 24 hours. Yet one more reason why having a Swiss Army Midwife is a good thing.
“Imagine if Christopher Columbus had come back from the New World and no one returned in his footsteps.”
Saturday, September 19th, we were released from the hospital. Mum and baby both got a clean bill of health.
It’s not convenient or cheap to have the birth that you want for your wife and child but embrace the responsibility before the delivery date, educate yourselves and make your own informed decisions. I am a better, stronger and more educated person than I was when we started on our ‘space program’.
My deepest gratitude and thanks to:
Barbara Herrera for helping us to have the pregnancy my wife deserved and for seeing her potential, and not problems. You saved the life of my wife and child with your decisive thinking.
Nova DeLovely for being the emotional pillar on which both my wife and I could lean on, for nurturing us both, making me eat, and for capturing moments on camera that we were too involved in to think about.
Carol Yeh-Garner for giving us the tools to own our birth and help my wife without the need for medication and for helping us prepare for the birth eventuality that we needed.
Family and neighbors for rallying to feed us and support us while we recovered.
Our friends for their love and support through our miscarriages and celebrating the arrival of our son.
Finally to my incredible wife who showed more love, endurance, certainty and strength than I ever could. You are amazing.