Back Story

Okay, so I’ve been trying to settle in long enough to get this written for about two weeks…..finally, here’s the back story…..(DH thinks I should recommend you get yourself a drink and a sandwich for this ;^)

13 years ago, I married a Philly cop – I was 21 on the day of our wedding, he was 26. About 6 months later, I was pregnant with our first….and until now, only. I was 22 by then, and knew nothing other than to go to the doctor and follow directions. If I knew then what I know now……

I called up the OB/Gyn I had been seeing for my regular care and scheduled an appointment. At my very first visit, I signed a bunch of forms related to my delivery. Circumcision: sure, why not? Epidural: Damn right, I want an epidural, I’ve seen this crap on TV! C-section…..yeah, even then I knew that a bunch of crap and refused to sign. Instead, I wrote something on the form to tune of “should there be an emergency that renders me unable to agree to to a c-section during delivery, I hereby give my husband full authority to make this decision.”

From then on, I had a “normal” pregnancy. No high blood pressure, no sugar problems….low iron, (and supplements that made me miserable) as well as some weird pains in my hip joints, groin and legs that my doctor and nurse practitioner chalked up to the baby sitting on my sciatic nerve but nothing that would be considered a serious concern.

At some point, both my doc and the NP asked if I had any plans to breastfeed my baby.

Um.

Hell. No. Could they possibly be serious? Only hippies and people in third world countries did that, right?

Obviously, I had never in my life had any sort of exposure to breastfeeding. Well, no, that’s not entirely true……I remembered my sister being annoyed after she had my nephew (via scheduled c-section) that the hospitals were no longer passing out the drug they had given my cousins several years earlier to dry up their milk supply. So, yeah breastfeeding was just something only weirdos did and formula is what babies are supposed to eat.

As I went through the pregnancy learning process – remember, this was still the pretty early days of the internet as we know it – I began to think that maybe it might be a good idea the see that my baby at least get some breast milk.  I was still in school then studying to be a medical lab technician and learned more about how certain immunities can be passed through breast milk than anything I had been able to find on the internet.  I got some books and read a bit and decided that I would probably go half and half with formula and breastfeeding and discussed this with my practitioner.  They said “Okay.”  And that was it.  By the time I went to the hospital to deliver, I had decided that I wanted only to breastfeed.  Again, I had let my doc know and blindly assumed that it would be in my chart somewhere.

I was due on  Wednesday, March 29th, 2000.  On that day, I had regularly scheduled appointment.  My doctor did a vaginal exam that involved a speculum and during which I was most uncomfortable.  After the exam, she informed me that I was not dilated at all and that I should try going for a good walk to see if we could get something going….and if I did not have the baby by the following Wednesday, I would be admitted to the hospital and have my labor induced.  I’d never heard of any such thing until I was pregnant – none of my family had ever had to be induced, and really, I’m not sure any of them had ever made it to their due date.  So I figured it meant my body didn’t know what to do and that I’d be in the hospital for an induction the following week.  But I’m not the panicky type when it comes to the medical world so I just took this in stride.

Shortly after I got home from my visit, I did as was suggested and took a long walk from our house to Wawa for some milk and snacks….it was about six blocks away, so twelve blocks round trip.  When I got home, I went upstairs to pee and discovered I had spotted a bit….just a very little bit, but it was there, nonetheless.  As the night went on, I experienced what I still liken to menstrual cramps…..they seemed regular – around every 20 minutes – but they stopped with even small movements like shifting in my seat.  All the next day, it was the same and by the time I went to bed that night the cramping was about every 15 minutes.

When I woke on Friday morning, it was down to 6 minutes.  DH was getting ready to leave for work.  He was supposed to be in court that day but said that he’d call them and let them know he wouldn’t be in.  I thought about it while I got a shower and, since the cramps were now 10 minutes apart, when I got out I told him to just go.  My parents lived less than 3 minutes away by car and my dad was retired and at home so if anything critical happened, I could easily get a ride.  I put a call in then to my doctor’s office and left a message with the service that I thought I might be in labor.  After DH left, I went back to sleep and woke up every 10 minutes on the nose with the same cramping.  My NP called and I explained what was going on….she told me to wait a while and head to the hospital if the cramping got any worse or if the interval between the cramps hit the 6 minute mark again.

I went back to sleep.

Around 10:30, my dad called to see how I was doing.

I went back to sleep.

Around noon, DH called to let me know that his case wasn’t on the docket until the end of the day so he had excused himself and was heading home.

I called my doctors office again and told them that my cramping was till the same and still ten minutes apart.  The assistant on the phone said she would have to doctor on call (the other doc in the practice that I’d never met) get back to me.  I let them know that when DH got home, I was going to head up to the hospital either way – it was a 12 mile drive anyway – and was told that they’d just send me home if there was nothing going on, so it would be best to wait.  I said okay.  Again, I’m not the panicky type and I wasn’t in any kind of pain….but the doc hadn’t called back by the time DH got home around one and that whole going from 6 minutes to 10 minutes and staying there was starting to bug me…..so we left.

I’m still waiting for the doc to call.

We got to the hospital around 1:30 and I went into the triage where they discovered I was “only 1 centimeter” so I should probably just go home.  But.  They were picking up no fetal heart rate on the belly monitor, so they sent me downstairs for an ultrasound.  Everything on the ultrasound looked good, though, so when I got back upstairs they did “one last check” before sending me home and found that I was now 5 centimeters.  It was a little after 3:30 by then so in about 2 hours, I went from being 1 centimeter to being 5 centimeters without a ton of discomfort.  And after a chipper “Well, I guess you get to stay!” from the triage nurse they put in an IV (fluids?) and got me into a room.

At around 4:30, they broke my water using a lovely little instrument that looked like a crochet hook.  And about 10 minutes later my epidural was in place and I was hanging out comfortably watching TV with DH.  One of the nurses came in with two long wands and explained to me that they would have to use internal monitors for both the contractions and fetal heart rate because they were picking up neither with the belly monitors.  And from then on, pretty much nothing happened.

They brought in another back to hang on the IV around 6:30.  A little while later, DH went out with his dad to get something to eat since I wasn’t allowed to have any food or anything but ice chips to “drink”.  While he was gone, they drained my bladder and the epidural wore off seemingly simultaneously.  Before he got back, I’d had another dose of the epidural and was again lounging and watching TV.  He got back around 9:30 and I was at about 8 centimeters.

So.  In two hours, I went from 1 centimeter to 5.  In the five hours from the time I had my water broken and the epidural started, I had progressed only 3 more centimeters.  And it would in fact be another 3 hours before I was dilated enough for the doctor to be notified.  Not my doctor.  Not the other doctor at her practice.  The OB on call.

My daughter was born at 1:18 in the morning, almost 12 hours after we arrived at the hospital.  When she came out, the cord was wrapped around her head, neck and body six times so the doctor cut it and passed her immediately to a nurse.  She was fine, she cried, everything checked out good and several minutes later, my spotless baby girl was handed to me all wrapped up with a hat on her head.

Within an hour, they took her to the nursery and I passed out.  I woke around 3:30 in another room with a turkey sandwich and some cranberry juice on the tray next to the bed…..I love cranberry juice and really….it may have been total crap, but to this day I still call it the best turkey sandwich I’ve ever had – lol!  I passed out again after that.

It wasn’t until around 6:30 that my brain was functioning enough to remember that I was breastfeeding and to ask for my daughter to be brought in.  As I tried to get her to latch on, the nurse informed me that she might not be all that hungry because she did just have a bottle about an hour earlier.

o_o

Oh….okay, well I’ll just get her next feeding.

In the meantime, I still couldn’t walk.  So they drained my bladder again.  And then they gave me a bag of ice (cubes) to ease my discomfort from the episiotomy.

o_o

Epis-i-whatomy?

Yes, this is when I learned a) what an episiotomy is, b) that I now had one and c) that it was closed with 23 stitches.

BBv1 was back and forth between being with me and being in the nursery, trying to breastfeed and getting bottles in the nursery because I had nothing to offer her yet.  By mid-afternoon, I still couldn’t walk and had a permanent catheter.  Such was the rest of my day with visitors in and out in between attempts at getting something to work with my breastfeeding.

The next day, I finally started getting the feeling back in my legs – it was like after your foot falls asleep, those pins and needles as you start to get the feeling back…..not very pleasant to have in both your legs at the same time.  By the early afternoon, I was up and about with a little help so they were able to get rid of the catheter….but now I could really feel the horror of the episiotomy and stitches they had given me.

And all I wanted to do now was go home….but as one of the nurses pointed out, I really lucked out with the baby not being born until after midnight; I got to stay for an extra day!  Good thing I hung around, though…….around dinner-time that day – around 40 hours after I gave birth – my lactation consultant came in.  A woman in her early to mid-seventies with a plushie breast and a doll that she used to demonstrate how I should get my child to latch on the my breast.  I’m thinking that the doll and plushie are a little different than me and my baby.  She observed for about 2 minutes and then said we were doing great and was on her way.  Her total visit lasted about 11 minutes.

I could not have been happier to get out of there……72 hours after I arrived at the hospital.  I hadn’t seen either of the doctors from my OBs office, but I really didn’t care – I just wanted to go home.  Over the course of the next month, I struggled with trying to breastfeed and pump, the discomfort from the stitches and episiotomy, a kidney infection with a fever of 104 degrees as a result of having to be catheterized and antibiotics so brutal that I had to crawl up the steps when I had to use the bathroom.  In the end, I was never able to breastfeed.

I can’t complain about my first birth experience.  I came home with a beautiful baby girl that has been nothing but a complete joy to me for the past 11 years.  And really, from the beginning all I knew for sure was that I didn’t want a c-section.  I was 22 and I had no idea that I had a say in anything.  But if I knew then, what I know now…..

As it happens, the hospital where I had my daughter did away with their labor and delivery ward several years ago.  I am still a patient of the same gyn I was going to back then….I’m really not sure why, I stuck around….at the time I think it was just a matter of staying with the doc that knew everything I’d been through and since then, I’ve just been lazy….figure I only go once a year, is it really worth the hassle of trying to find a new doctor?  I don’t know what I would have done had I needed obstetric care again.  Now that the hospital she’s associated with no longer supports obstetric care it’s pretty much a non-issue anyway.

But after I had my second positive pregnancy test in November of 2010, I called the office so they could refer me to an OB.  They refused.  Their answer was that they have no one to whom they can refer me.  That translated to me that they didn’t want to refer me to anyone and be on the hook for the referral should something go wrong.  That also meant that I was free.  I could check around a little and investigate my options.

For being such a huge city, Philly is kind of lacking alternatives.  There is a birthing center fairly close to home that was high up on my list.  But I know that I’m a product of the medical industry.  Not just that I think it’s the norm….but it’s an industry I’m used to dealing with.  I’ve worked in major hospitals in this city since my daughter was 5 months old.  I’m used to dealing with doctors and nurses and administrators now and I know when they’re BS-ing me.  And after considering birthing at home or in a home-like setting I decided that I’d be a wreck at the birthing center because I’m afraid of making a mess at someone else’s house – yeah, I know….dumb but that’s the way I’d be thinking.  If I were to actually stay at home…..I dunno, I think I’d be okay for a while at home but…..I just don’t think it’s for me.

So I started my search for an OB associated with an excellent Catholic hospital only 4 miles from both my home and my work.  I found a woman pretty close to my age with a daughter the same age as BBv1.  Very pleasant and good with with my questions and demands that I’m pretty sure any other OB would have fired me for long before now.  My first question for her was “What is your rate of induction?” to which she replied that roughly 10% of her patients were induced.  Sounds good.  Second, “What’s your c-section rate?” She hesitated for a moment and then said that her number of c-sections seems to run in direct correlation with the number of people that are induced.  These answers made me happy and since then I haven’t had a single thing to complain about.

Trust me, I know there are OBs that can be absolute nightmares but I think – yes, I’m keeping my fingers crossed – that this chick is gonna be the exception to the rule.  I told her the story I’ve just laid out here and explained that I want this to be different, if for no other reason than this time, I do not have the “luxury” of an extended recovery period.  Come the beginning of September, I must be back in the lab…..and there is no tip-toeing into the water, I have to be able to jump right in.  It is also critically important that everyone understand that I am planning on breastfeeding and to that end expect the new baby to “room-in” so I will not be able to be catheterized, stitched up and unable to walk for three days.  She kind of looks at me like “Duh!” and what I’m saying is what already goes on….and maybe it is now.  But that’s not what my first experience was.

I mentioned earlier that with my first pregnancy, I dealt with pain in my hip joints, groin and legs that was assumed to be the baby was sitting on a nerve.  Since around week 17 – which would be about when it started last time as well – I’ve had the same pain.  At one visit, my OB was checking my baby’s heart rate on the doppler.  I was uncomfortable and shifted on the table.  When I did, it was possible to hear my pelvic bone crack.  It was then that she realized my pain really had nothing to do with the nerve, it was a condition called Symphysis Pubic Dysfunction.  For quite a while, a maternity girdle and/or support belt have been a great help.  Since around the beginning of June however, the supports only seem to make my discomfort worse.

My OB has been trying to get me to take my leave from work since then but with the overall suckage of maternity leave here, had I gone out at the beginning of June, I’d be getting ready to go back in 2 weeks and as of today – July 4th 2011 – I haven’t even had the baby yet!  At my visit this past week, I informed her that there is no way that I can recline and be comfortable.  Both sides are now painful and my back is excruciating so I am concerned over my options when I go to the hospitals as far as laboring.  I was actually just making sure that I’d be able to park myself in a chair or on the sofa and not have to fight over anything with the L&D nurses.  She said it would be fine for me to do whatever I need to do to be comfortable and it’s already in my chart that I am suffering from SPD and that it’s not recommended for me to labor on my back…..she pointed out – without me having to ask – that the hospital does not provide a birthing pool, but if I would like to bring one, they can accommodate.

I am happy to have found this OB, I think she’s just what I needed – a doctor (DO, not MD) with a midwife mentality.  Did I mention that I haven’t had an internal exam throughout the entire pregnancy?  She asked me last week if I wanted one to see if I had dilated or anything yet…..I said thank you, but no.  But she asked!

So that’s my story.  And that’s what I’ve based my birth plan on.

In big letters, on the cover it reads:

• No epidural.
• I’m not getting in that bed.
• No stitches.
• The baby stays with me.

……figured I’d cover the big points in bold, just in case the L&D nurses don’t feel like reading the fine print.

Incidentally, I plan on sticking with this doctor as my gyn once the baby is born.