Tuesday, October 8, 2013

Elliot's Entrance

**This post was seven months in the making.  Sorry for the delay!!**

Throughout the third trimester, I was told quite frequently that I wouldn't be making it to my due date.  My due date was June 23rd.  I didn't.  But I did make it to my goal.  Possibly through sheer force of will.  Here's your recap.

About 6 weeks prior to my due date, I found out that my midwife would be on vacation.  It felt very much like the scene in the movie "Knocked Up" when Katherine Heigl realizes her practitioner who she interviewed about "being there for her" would not...be there.  Nonetheless, when receiving very personalized care, this is one of the drawbacks and one that I was prepared to deal with.  By holding my baby in until my due date.  My midwife would be on vacation from June 16th-23rd, so I'd just have my baby after her flight landed, of course.  It would be perfect, because that was when I was due.  

Many pregnant ladies I've encountered get to the end of pregnancy and they are DONE.  I get it, I totally do, but I just wasn't like that.  I had a very comfortable pregnancy and I like babies to cook just as long as they need.  With that said, Cece arrived a week ahead of schedule, so the fact that my midwife's vacation would be during my 39th week was a smidge stressful. 

While I wasn't considered to be a candidate who needed to go to the hospital as opposed to the birth center, (because I was NOT diagnosed with polyhydramnios - yay Natrum Muriaticum!) I still wanted to visit the hospital where I could end up...just in case.  With the possibility of going with a "backup" midwife a reality, there was a higher likelihood we would be in the hospital.  If any other patients from either of the two practices was in labor at the same time and needed to go to the hospital, I would need to go also to receive care from a midwife.  So, about 4 weeks before D day, we went to visit Einstein Montgomery Medical Center.  It is amazing!  It is a brand new facility that works with midwives in the area.  The only hospital to work with midwives in the area, so it had my support in that regard.  I had also been assured that so long as I was not a high risk case, I could be treated by a midwife in a room as if I was in a birth center.  It was comforting to visit, if even just to know what entrance to go to and where to go once inside.  As it turned out, time was of the essence and it was very good to have a clear head as far as directions were concerned.

The following week, we visited our "backup" midwife, Ronni Rothman of Woman Wise Midwifery.  Ronni is awesome.  We gave her the recap of our history as it pertained to my first labor and birth experience.  She was very laid back, direct, but also very warm and funny.  She was someone I knew I would be comfortable having by my side during birth.  She made a very positive impression on Jeff, so that he was hoping I went during week 39 so he could "hang out" with Ronni more.

So, we had all our ducks in a row.  My goal was to make it through the last day of school and that is what we did.  The last day of school was Monday, June 17th.  It was a half day with students though as an encore teacher, I would be covering one assembly and presenting at two assemblies.  Easy.  At midnight on Sunday, my water broke.  With my first pregnancy, my water did not break until we were in the hospital so this was a new experience.  I think it was important that my water broke first so that I could take any contractions seriously.  Up until then, I had pretty regular contractions but had dismissed them as Braxton hicks.  If my water hadn't broken, I very likely would have had a baby in the car by myself.  When my water broke, I called the midwife.  I was advised that if the fluid was clear, I was safe to labor at home and wait until labor progressed.  There was no nursing coverage at my birth center during the overnight hours that night so if I were going to get checked it would have been at Einstein Montgomery and though they are quite liberal, they are still a medical institution and like others, if I went in with my water broken I would be staying in.  I took all this to mean that there would be nursing coverage the following day (a mistake I probably should have clarified).  

So I came up with the following plan.  Jeff should sleep and get as much rest as possible.  I ate "breakfast" in case I was in more intense labor and less inclined to eat at a more traditional breakfast-ing time.  I decided that if labor pains weren't crippling that we should go to school.  Jeff would drive and stay with me.  Cece would stay home with my mom.  Since then people have shared with me that this was crazy. But if you know my daughter you might realize that laboring at home would have been far more stressful than laboring at school, in a lovely quiet library by myself. What would you choose?  

Anyway, I labored at school walking around, sometimes pausing to lean on the circulation desk.  Jeff reflected that students were coming in to check in items and I would assist them, breathing a little more carefully at times.  I presented at two assemblies.  During the first, I ended up being last in the order so for the second I asked my principal if I could go first for reasons that were obvious only to myself.  If I mentioned that I was in labor, moreover that my water had already broken, I would have earned myself a first class ambulance ride as far as my principal was concerned.  There was one and then two and three teachers who became aware.   One asked if I could cover the second assembly.  I explained that I wasn't comfortable doing so because I may need to leave with short notice.  This left her a bit frazzled and a teacher who encountered her down the hall put two and two together and kept checking on me periodically.  

In the meantime, I put Jeff to work doing some heavy lifting.  I needed some overhead projectors moved and would have done so myself, but since he was there.... He needed some "busy-work" as he was getting antsy.  My first labor experience was speedier in one sense so he wasn't used to all this waiting around nonsense.  He expressed that he could have gone out to Starbucks...he kept asking, "Anything!?!"  I kept replying, "Really...really?!?"  

Sometime around 10 AM, the midwife checked in and I explained that I was at work.  She chuckled.  I explained that it really made the most sense.  And it did because my workplace is ten minutes (if that) from the birth center.  Then she broke the news to me that unless I could hold out until 6PM, I wouldn't be having the baby at the birth center.  There was no nursing coverage there.  So we would be at Einstein Montgomery.  That's a little further away. I was comforted before at being close to the birth center.  Things started to pick up a bit but contractions still seemed somewhat erratic.  They didn't seem to be evenly spaced or always getting closer together.  There was also an end of year luncheon I was really hoping to make it to, but that would not be happening.  A mere 20 minutes before the luncheon, it was time to go.  To at least get closer to our final destination.  

I called the midwife to let her know my next plan.  I told her we were going to drive in that direction, pick up lunch, maybe go for a walk to get things moving along.  She laughed and asked if we were going to Plymouth Meeting Mall.  I told her I was thinking of the Farm Park, a large park with a walking trail that just so happens to be (literally) across the street from the hospital campus.  So we went.  And we picked up hoagies from Wawa.  At that point I was still hungry.  Evidently, two breakfasts were not enough.  We parked at the Farm Park and I got out of the car.  I started to walk to a lovely picnic table then remarked to Jeff that instead I would sit on this rock right here in the middle of the parking lot.  This behavior he was familiar with.  During my first labor on the way into the hospital, I sat on a speedbump.  He said something to the effect of, "This is more like it."  We eventually made it to the table but by that point I knew it was time to cross the street.  I encouraged him to eat his lunch as we didn't know how long the next portion of our journey would take.  Sadly, I looked at my sandwich and couldn't imagine eating it at that moment.  I called the midwife again and she surprised me that she "knew" and had left after our last conversation.  She had called ahead, the hospital had my room ready and she would be there in five minutes.  

After Jeff finished, we somehow got back to the car and across the street.  He dropped me off at the  outdoor eating area tables by the front door while he parked the car.  He got to me.  He then went back to the car to get the only thing we really needed inside: a cooler.  More on that in another post.  In the meantime, Ronni arrived asking if I was out for a refreshing afternoon and we all walked in together.  I felt so supported by both my husband and my midwife.  We joked in the elevator and as we walked back.  We went directly into our room and got down to business.  We arrived in the room at about 2:30.  

Unlike my first birth, I had complete freedom to move as I saw fit.  I still went very internal but tried things that were suggested and spoke up when I didn't like something.  Monitoring was still necessary as the baby's heart rate was hard to gauge.  But Ronni did the most amazing thing.  She literally followed me with the monitor.  I went to the bathroom, she followed and monitored.  I changed positions, she followed and monitored.  If monitoring has to happen, that's the way to do it.  Like with my first birth, I knew the best way to figure out what might be causing any issues with the baby's heart rate was to figure it out outside my body. Being free to get into a natural birthing position,  he was born quickly at 3:59 PM.  His cord was wrapped around his neck but Ronni deftly removed it and he revived right away.  She advocated for any measurements to be done quickly to get my baby back to me but she also was realistic about some repairs that needed to happen on my end too.  

The nurses kept asking if she wanted pitocin.  I was so confused.  First, the baby was already here, why on earth would I need/want pitocin now?  I have since learned that research has shown pitocin post-birth helps to significantly reduce the chance of uterine rupture and has become a standard of care.  There is a high likelihood that I received pitocin after my first birth and was never even told - add that to my list of grievances.  Generally speaking, pitocin is a synthetic form of oxytocin which is produced naturally when a baby breastfeeds so if immediate skin to skin and breastfeeding are encouraged, oxytocin will follow which will also reduce the chance of uterine rupture.  Off soapbox.

When Elliot returned to my arms, he latched right away and ate like a champ.  I was filled with bliss.  He was and is perfect.  

Elliot Orion Zschunke
8lb 2oz

While we did not experience a birth center birth (technically) we truly had a positive and liberating experience to birth in a natural way within our four walls that just happened to be within a hospital.  I am so happy that institutions exist that still trust women's ability to bring babies into this world without unnecessary interventions and that support midwives to do the work they do best.

Family Selfie
Skin to Skin with Daddy
Our amazing midwife, Ronni Rothman
Heading Home!

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