Thursday, May 10, 2012

The Birth Story of Lainey (and the journey it took to get me there)

This is the birth story of my third child, Lainey, who was born at home at 39 weeks. But the story doesn’t just start with her birth. To most accurately share what I went through to give birth at home to a full-term baby, after my first truly health­­y pregnancy, I must also share the stories of her older sister & brother’s pregnancies. If it’s only the birth story you’re interested in, I have separated the stories into two parts – the birth story is Part 2.

Part 1: The Back Story

Our family was first blessed with a baby when our daughter Maia made her arrival on March 18th, 2008. I was a young first-time mom, trying my best to give her a wonderful entrance into the world. I was drawn to natural birth and sought that at a local hospital with a team of midwives. I found myself buying to the idea that I should be “eating for two” and consistently indulged my cravings. I didn’t know much about nutrition then and didn’t keep track of what I ate, mostly just choosing to indulge my whims. I didn’t exercise, either – I didn’t care for it. So when I found myself experiencing swelling at 33 weeks, I never thought anything of it. At 36 weeks I had a high blood pressure reading and some protein in my urine – perhaps the start of pre-eclampsia. At our 37 week appointment, the protein had risen as well as my blood pressure.  Since I was making some progress dilating on my own, the midwives said that an induction was favorable before the pre-e got worse. Delivery is typically the only cure for pre-eclampsia. I was thrilled – I’d get to meet my baby soon! I happily arrived at the hospital to start the induction, still positive about having an otherwise natural birth. And luckily, I got just that. Maia’s birth, despite being started artificially with Pitocin, was otherwise intervention-free and lovely. She was born into her daddy’s hands, and when she was delivered, I was deemed “healthy” again. Pre-eclampsia was no longer a worry to me.

 I’d heard that moms typically get pre-e once and not again, so I paid it no more attention. I didn’t do any research on it when I became pregnant with my second child in 2009. When I became pregnant with him, we were weeks away from our wedding, and eating well and sleeping well were hard to come by. Post- wedding, I continued to eat what I wanted with little regard to my health – I drank a daily pop, ate carbs upon carbs, and despite still nursing my toddler, didn’t keep track of calories or protein intake. I was naively and blindly inviting pre-eclampsia to strike me again, and did it ever. At my 28 week appointment, I had a blood pressure reading of 140/80. The midwives had me do a 24 hour urine test to see if there was protein in my urine - there was. I was then sent to a hospital with a diagnosis of pre-eclampsia at 28.5 weeks, which risked me out of the midwives group and bumped me to their back up OB’s. I spent a weekend being monitored and researching preemies in a daze. I couldn’t really believe this was happening to me. I was then allowed to go home on bedrest after receiving steroid shots, in case baby had to come early. Bedrest lasted approximately 2 days, until I woke up in the middle of the night with extreme, intense pain under my left rib that made it very hard to breathe. I headed into the hospital, and was given a diagnosis of HELLP syndrome & pre-eclampsia. Now my liver and kidneys were being affected as well, and baby had to be delivered ASAP.  At noon on March 16th, 2010, my induction was started with Cervadil, which ripened the cervix. Around 7pm, a Pitocin drip was started. My body knew it was very sick, because the induction was successful. At 1 AM on March 17th, 2010, my 2lb 10 oz baby boy Kieran was born. He was 29.5 weeks gestation…and our lives were turned upside down. The ensuing 7 weeks in the NICU were an emotional rollercoaster for our family. Kieran faced quite a few challenges, but he made it out healthy & virtually unscathed. My husband and I, however, were quite affected by the experience of having a preemie. I remember staying up late one night shortly after Kieran was born, voraciously researching and reading up on what had happened to me. What was HELLP, and why did I get it & pre-eclampsia again? Could it have been prevented? At 24 years old, I had had pre-eclampsia twice – it was finally obvious to me that my body had given me a huge wake-up call and it was time to change things. The emotional toll Kieran’s early birth had on me was significant. When he was 14 months old, I sought therapy to help me work out some of the trauma I’d experienced and address some PTSD symptoms. We also addressed the fact that I desperately wanted one more baby. I wanted to try, for once, to have a pre-eclampsia-free pregnancy, but my husband was not on board. We’d originally planned on having three kids, but the experience of seeing his wife so sick, and having a baby so early was enough to put him off. The therapy definitely got Josh and I talking, and one day in May 2011, he told me that he had a feeling we were supposed to have one more; that I was supposed to try for the pre-eclampsia free pregnancy I’d never had. He saw me working hard on exercising and changing my nutrition habits, and saw that I was doing my research, and that calmed his fears a little. I started preemptively calling homebirth midwives to interview them, so that whenever I did get pregnant, I’d be ready to start prenatal care with the one who felt right. I was going to need a lot of support with my nutrition, so I wanted to start seeing someone right away.

My fertility returned shortly after we decided to try for one more – though it may not have been our intention to get pregnant right away, that’s what happened! Suddenly, more fears arose – now that we were actually pregnant, there were a lot of unknowns. We were going to have to take this pregnancy day by day, week by week. I met with a homebirth midwife I had connected with a few months earlier for a consultation. In the consultation, she shared with me a few stories of women who had had pre-eclampsia before coming to her, and then went on to have pre-eclampsia-free homebirths with her. Those success stories were just what I needed to hear - there aren’t many out there. I was now confident and excited that this midwife could help me, so we hired her!

 When it came time to share my pregnancy news, I was extremely nervous about telling my family. After all, they had been worried sick about Kieran and I when he was born early – I knew they’d be worried about me again. I chose to inform my family members of our plans to receive prenatal care from a homebirth midwife. I didn’t want to hide anything from them, so I started a blog to keep them updated and informed about my research, plans & progress. I remember my mom being the most vocal about her worries. She questioned why I wouldn’t go to a doctor, and I informed her that in my experience, doctors know only how to treat pre-eclampsia, not how to prevent it. The natural birth community has a much better sense of how to prevent pre-eclampsia and other pregnancy complications, so I knew it was my best chance at a healthy, term pregnancy.

So day after day, I worked on that goal of a healthy pregnancy. I ate a high protein diet of 150g protein in the first trimester, and 125g daily after that. I started drinking an herbal infusion with skullcap, nettle, dandelion root and red raspberry leaf, herbs known for their positive benefits in pregnancy. I tested my blood levels for various deficiencies linked to pre-eclampsia and HELLP syndrome and made sure I was not deficient in those vitamins and minerals. It got to be quite tiresome, making sure I had my daily protein smoothie and keeping track of protein intake, plus the daily infusion and the host of vitamins I took every night. But it paid off. I felt wonderful the whole pregnancy – vibrant, healthy, and positive about all my hard work.  I indulged in nightly baths to relax and practiced doing my Hypnobirthing relaxation when I took my daily nap. I feel that for once, I finally took amazing care of my whole self. Every month I’d have great blood pressure, no protein in my urine…suddenly the weeks were flying by and I was meeting my personal pregnancy goals – 29 weeks, then 35 weeks, then term! Our dream for a homebirth was so close to a reality now! Friends and family shared in our joy as I posted updates about my health on Facebook. It felt amazing to have so many people cheering me on and keeping me in their thoughts. At 38 and 39 weeks, the most pregnant I had ever been, my blood pressure was actually going down and there was nary a trace of protein. I almost couldn’t believe it. I thought maybe I’d get to term and pre-e would show up again, but instead I was still completely healthy and my blood pressure got the lowest it had ever been at 39 weeks.

Part 2: The Birth Story

On Thursday, March 29th, Josh and I went to my 39 week appointment with my midwife. The whole pregnancy I had been convinced I’d have another March baby (my first two are March babies – though neither were due in March!) and at some point in the third trimester I kept seeing “39 weeks”, meaning the last week of March or beginning of April. But we were nearing April now and I was excited to possibly hit a due date for the first time, and completely content to be pregnant a few more weeks. After the appointment, I lost a large part of my mucus plug, which is a sign that things were moving along nicely. That night, Josh and I decided to see if we could kick-start labor with sex – hey, it’s a tried & true method! Usually when we were intimate before bed, the surges (Hypnobirthing-speak for contractions) would stop when I went to sleep, but these kept up - through the night I awoke to few strong surges, as well as an annoying cat that would not leave me alone. The surges were still strong in the morning as I tried to get ready for work and get my kids off to daycare. I moved slowly that morning, partly because the surges were pretty frequent, and partly because my kids were a whiny, clingy mess that day – not their typical behavior. I called my dad (my boss) to let him know I’d be coming in just a few hours, because I was exhausted after the night and morning. When I dropped my kids off at daycare, the clinginess continued and they both wailed for me and wouldn’t let me go – again, this was uncharacteristic of them as they both do very well with daycare drop-off. I called my husband to vent about the morning, and he remarked that maybe they could sense the baby was coming soon.

I got to work and my dad ran through a list of tasks for me before he headed out of the office. I was working at my desk just a half hour before I suddenly felt warm liquid between my legs. I waddled out of my office with wet pants, past the front desk to a nearby bathroom and sure enough, my water had broken - confirmation of the conversation Josh and I had just had about the kids intuitively knowing, ha!  I stuffed my underwear with some paper towels in case more came out and went back to my desk to do a silent dance of joy. For the first time, things were starting spontaneously!  I called my husband and our midwife, Nickie, to tell them things had started, and went to meet my husband at home. Once home, my bag of waters continued to leak , and after putting down a bunch of towels and going through far too many pads and underwear, I asked Josh if he could pick up some Depends for me at my midwife’s suggestion. It certainly would make things easier! We straightened up the house a little, had some lasagna for lunch and then Josh started preparing the birth tub. We decided we would blow it up and just add water when things started to pick up. At this point, surges were not picking up and were about 7-10 minutes apart and barely noticeable – they felt just like the Braxton Hicks (practice contractions) I’d been having for weeks – so Josh decided to grab the Depends from Target and run another errand while I listened to my Hypnobirthing CD and took a nap. When I woke up, Josh still wasn’t home. He was just on his way to Target after running his other errands and would be home soon. It was about 3:30 now, and I was eager for him to get home so we could try to get things moving. He called me from the Target parking lot shortly after that, though, with some interesting news: he had locked his keys in the car! I suggested he call the police non-emergency line to see if someone would be sympathetic to the man trying to get home to his laboring wife, and sure enough, they offered to come out….except no one ever showed up. He waited nearly an hour, and finally he just decided coordinate a ride home with our friend who was picking up our kids from daycare. When our friend `arrived home with the kids, Josh headed back out to Target to meet a locksmith and I worked on preparing our son to go stay the night with his aunt. It was about 6pm by the time Kieran headed out for the night. Our four year old daughter had opted to stay home – she wanted to watch the birth, so we had prepped her for months with stories and videos of home waterbirths. But once her brother left, she flipped out. She started crying and begging to leave, so we called my grandma to see if she could get her – no answer. Luckily, my mom, who is very rarely free, was able to take her for the night, but wouldn’t be able to pick her up until 8pm. We put a movie in for Maia while I called and texted my midwife, the birth photographer and best friend to update them on my progress, or lack thereof. Things still hadn’t picked up, and I started running a bath simply because I was bored and needed to keep busy. Finally, it was 8pm and Maia left excitedly for a sleepover at my mom’s. We said our goodbyes and Josh went to my mom’s car to put her carseat in. I took that long-awaited moment of silence to sit on the birth ball and talk to my baby. “Everything is calm now, baby. Mommy and daddy are ready for you, and you can come out whenever you’re ready.”

With the kids out of the house, I told Josh I’d like to go on a walk to see if we could get surges to pick up, but first I had to go to the bathroom. But once I got to the toilet, I couldn’t get back up – I had two very strong, back-to-back surges. I started getting extremely hot, and then Josh came into the bathroom to ask me a question, but I couldn’t answer him coherently. He said, “uh…honey? We’re not going on a walk. We’re calling the midwives.” I was definitely in transition – moving from early labor to active labor. It was about 8:15.

I stayed on the toilet because the surges were pretty consistent. Josh called our birth team and told them to come over, and then he started filling the birth tub while I breathed through the surges and swayed and moaned. In my previous labors I used Hypnobirthing techniques to “go inside myself” and stay relaxed, and this one was no different. In a short break from surges, I decided to get up from the toilet and put on my Hypnobirthing CD in the living room. On the way to the living room, I got a slight urge to push, then another intense surge. I kneeled on the ground, hunched over the couch clinging to a pillow and shortly after my move to the couch, I heard my midwife’s assistant arrive. She came over to chat with me and check my progress, but things were moving quickly and it was hard to answer her, so Josh helped answer for me while he rubbed my back and held my water cup for me to drink from. I started feeling “pushy” again. I asked if I could get in the tub, but the water was filling up so slowly that it wasn’t ready yet. I started moaning a bit louder because the urge to push was coming frequently, and I could feel the baby descending. I moaned “I want to get in the tub!” but with baby definitely in the birth canal and the tub not even halfway full of water, that wasn’t an option. My midwife arrived and then I remember things getting even more intense. This was definitely NOT what I had imagined things would be like! Even in my other two births the pushing stage was nothing like this. I felt like this baby was just sitting there and that really HURT! Then Josh told me they could see the baby’s head, and while the surges were intense, I only pushed when I felt the urge to. But a minute or two after baby’s head started to be visible, my midwife urged me to try a different position with my legs. She said, “Brittany, I need to help the baby out and you need to push. This is probably going to hurt a little.” I said “but I don’t feel like pushing!” It’s hard to push when you don’t feel the urge. “You HAVE to,” she said. So I tried breathing baby down while bearing down, and then I let out a huge, primal roar as my midwife manually helped turn the baby. Finally, baby was able to slide out, caught by my midwife. She went to hand her to me through my legs to bring up to my chest, but I couldn’t grab her.  “I can’t….put her down,” I said. She was gently placed on the pad below me, and I took that moment to recover, to breathe, and to revel in the intensity of the last few minutes of her birth, which completely took me by surprise. Finally, I was ready to look at her, this beautiful pink little thing writhing below me, crying out. We saw it was a girl, and I managed to happily sigh “sisters…,” because my daughter now had the sister she so desperately wanted. And then, I was ready to pick her up. I brought her up to my chest and Josh sat behind me, easing me back so I could relax into him. It was 9:18 pm when she was born - just about an hour since we had called our midwives and just over an hour since I'd sat on the birth ball and told her we were ready for her to come out when she wanted. Our birth photographer walked in right then – she had missed the birth by just a few minutes. She still managed to capture some amazing postpartum photos. 

As I waited to birth the placenta, we were all chatting about the birth and my midwife mentioned that we had encountered mild shoulder dystocia. Ah, so that’s why I felt her sitting in the birth canal and not moving! When she came down so quickly, her shoulder got hooked on my pelvic bone, and while her head was out, she started to get a bit more purple by the minute (I have some pictures to prove it!) Her head was out about 3 or 4 minutes before Nickie helped manually unhook her shoulder. Her speedy trip down the birth canal combined with the shoulder dystocia made for quite the experience! But while I was disappointed I didn’t get my waterbirth, I was overjoyed to have given birth in the comfort of my own home. From beginning to end, there is nothing like it. And the sense of accomplishment that comes from overcoming pre-eclampsia? There’s nothing like that, either. The joy of a beautiful, healthy, term baby in my arms, on top of the overwhelming satisfaction in myself and my long journey to get to that point kept me on a hormonal high for weeks! I could not have asked for anything more – we truly got everything we’d hoped for.

A special thanks goes out to my midwife, Nickie and her assistant Janine, for believing that I could have a healthy pregnancy and supporting me to that goal every step of the way. Because of their care, I had a truly healing & inspiring experience that has left an enormous imprint on our family. To my friends, family & community for cheering me on, however nervous they might have been through it all – your support and belief in me was essential to my morale. And most of all, a HUGE thank you to my amazing husband Josh for trusting me, sharing in the fears and excitement with me on this journey, and taking amazing care of me – I love you and I could never have had such a beautiful pregnancy, birth and postpartum experience without you!

Saturday, March 31, 2012

Birth announcement, aka WE DID IT!

We had a beautiful baby girl last night! Lainey Marie was born at 9:18pm in a beautiful, intense homebirth - didn't quite make it to the waterbirth tub because she wanted out! 8lb 1 oz, 21 inches long & absolutely delicious! We are so blessed and thankful to our awesome midwives - what a seriously amazing experience! Birth story to follow!

Friday, March 23, 2012

Meeting term means lots of emotions!

37w3d with baby #3

When I hit 37 weeks last week, it was a BIG deal. I definitely did a little dance and high-fived and hugged my husband lots - we did it! TERM! To us, term means no preemie, and the "okay" to give birth at home with our homebirth midwives. When we hit 29, 30 weeks it was a weight off our shoulders. We had made it at least as far as with Kieran. Each appointment, each week I still felt wonderfully healthy, a little bit more anxiety was shed. For the longest time I kept wondering how I'd feel when I got to term. I wondered if I'd just be waiting for the other shoe to drop - for pre-eclampsia to rear its ugly head at me at 38 weeks or something. So when I got to term, and then to the day I had Maia...I just felt fantastic! 37 weeks was a very important goal, but the ultimate goal is a pre-eclampsia free pregnancy. And at 38w2d, I can say that it's still pre-e free, and now I am truly  believing that it's 100% possible I will not have a single pre-e symptom this time. What an AWESOME feeling that is! Things could always change, but at this point, I highly doubt it.

Hitting term and still being so healthy brings up other emotions, too. Like pure excitement about going into labor! I am so ecstatic that I will go into spontaneous labor this time! I had two medically-necessary inductions, and while I don't judge the women who choose them, because everyone has their own varied reasons, I do have to wonder...WHY!? The joy and excitement and anticipation! It's all a surprise and it's exciting to me! I cannot understand choosing to induce for most reasons, I just can't. This time, my baby gets to choose its own birthday, whenever it feels ready!

So, being term, being so close to my all pretty much rocks. I feel way too amazing to be 38 weeks right now. I feel lucky and blessed. I am just weeks (or less!) away from meeting my third baby  now!

Appointment updates!

Well, I am pretty behind on appointment updates....but honestly, I wouldn't have much to say! They've been BORING! And that's what you want when you've had the pregnancies I've had :)

It goes sort of like this:
34 week appointment - perfect blood pressure of about 120/60, no protein in the urine
36 week appointment - our HOME visit! The midwives came to our house, checked out our birth kit and the house layout, and I had another perfect BP reading.
37 week appointment - BP 118/62, slight protein in urine, but cause is most likely from recovering from the 24 hour stomach bug so we're not worried...also - I AM TERM!!!!!!!! Also, my big belly measures 39+ weeks!
38 week appointment - again with the perfect BP (118/62) and not even a slight trace of protein in the urine! Measuring a normal 38 weeks now, and we estimate baby is about 7lbs :)

38 weeks...can you even believe it. I have never been so pregnant! Maia was induced at 37w3d so I'm in uncharted territory now!

Friday, February 17, 2012

32 week appointment update

I am now 33 weeks, but figured I better update before 34 weeks hits and we have our next appointment! We are every 2 weeks now - the 34 week one takes place at the midwife's office, but the 36 week one takes place at our home! Exciting!

Anyways, 32 weeks appointment was somewhat boring - and that's a good thing! We went over labs and my liver panel was great, everything else looked good, only thing that had dropped down since my first trimester blood draw was Vitamin D, which I chalk up to the winter, so I added another 2,000 IU pill to my daily regimen (from 4,400IU a day to 6,400IU a day.) My blood pressure was taken and wasn't ideal at 139/74, but then my pulse was high, too - about 104 - so I thought my positioning must have been off and we decided to retake it. My blood pressure is pretty sensitive to how I'm sitting, it seems. If I have crossed legs, I need to have them uncrossed for awhile beforehand. In this case, I was sitting on the daybed and one of my legs seemed to be tucked and bent under the other beforehand, so I made sure to sit back and straighten my legs out for a long time beforehand. The next time we did my bp & pulse, it was perfect :) 128/60-something, I believe? Something like that, which is my baseline this whole pregnancy. Yay! We discussed some things about homebirthing, such as when to start gathering and ordering supplies, and I mentioned how crazy it felt to actually be talking about a homebirth! I think I so badly wanted to get to 29 weeks that I never thought about the time AFTER 29 weeks...which I now get to do!

Friday, February 3, 2012

thoughts on heart health & preeclampsia on Go Red for Women Day.

Did you know today is National Go Red for Women Day? I forgot, until I saw something on TV about it over my lunch break at work. It was started by the American Heart Association as a way to bring attention to the high number of women with heart disease. The show on TV was "The Revolution," and they were talking about risk factors for heart disease. One of them guessed it, pre-eclampsia. The doctor on the show mentioned that having pre-e was like a failed stress test for your heart.

I think it was sometime in late 2010 or early 2011 when research came out saying that pre-eclampsia is linked to heart disease risk. From

"Women who have had preeclampsia are at a roughly twofold increased risk of cardiovascular disease in later life, compared with women who did not have preeclampsia," said lead researcher David Williams, a consultant obstetric physician at the Institute for Women's Health at Elizabeth Garrett Anderson Obstetric Hospital, University College London. "Specifically, these women have an almost fourfold increased risk of hypertension, and a doubling of the risk of heart disease, stroke, and venous thromboembolism," he added.
I first heard that news story on the Today Show and it hit me - hard. I was 22 when I had pre-e the first time, and I had already been diagnosed as having high cholesterol by then. But I've never topped out past 135 lbs at 5'8"! I didn't LOOK unhealthy. Then at 24, I get pre-e and HELLP syndrome at 29 weeks along in my pregnancy, and after that, it hit me. This was my wake-up call. It was my "girl, you have GOT to get healthy" call. I had to change my ways. And I have chronicled most of that in this blog here. Many things I am doing just in this pregnancy, but before I was pregnant, I had started exercising and had revised my diet - a high protein diet filled with a variety of healthy options and less junk and carbs. I also quit drinking pop - because pop consumption is linked to heart disease, too.

So today, I wanted to post about the link between the two. I had to change my lifestyle or I was just asking for more trouble. And the many things I've done to improve my health will not be stopped when this pregnancy is over, but will continue for the rest of my life. I have to do everything I can, with the increased risks, to live a long, heart-healthy life for myself, and for my kids. And I have to educate my own children about heart health and instill these health values in them as well - particular my daughter - because of my increased risks, she is also at risk of pre-eclampsia & heart disease, just because she had a mom who had pre-e. I feel like I'm doing a small part in raising awareness, at least in my own circle of family and friends, anyways :)

protein is my drug!

This is from a personal journal of mine, one where I tend not to capitalize words, but I thought it was worth sharing some thoughts I had today on my high protein diet.

"i have to believe that a LARGE part of the reason i had pre-e the last two pregnancies and not this one (so far, knock on wood) is my diet. honestly, i know it was a large if not the largest part. i still can't believe sometimes how positively my body responds to protein intake, either because it's used to it or it needs it - probably both. i was so naive before and i had so little nutrition knowledge, it's no wonder my body shut down on me. to think if i'd not changed things with this third baby...i would have probably had a preemie earlier than 29 weeks. 

it's like a drug, almost. tired? eat protein! cranky? eat protein! the response my body has to protein is super quick, too. and let's not even think about what my day would be like without the protein smoothie first thing in the morning. i literally can't function without it - the other day i was super behind in making it when i cut my finger on a can and had to deal with nonstop bleeding for about a half hour. in that time, my body was FREAKING out at me. once i had the smoothie...ahh. all was well. it's like my body breathes a big sigh of relief and thanks me. today, i was unfocused, tired and cranky at work. i realized the last time i had protein was about 10AM, and it was nearly noon - time for some protein! i had turkey jerky and within like, 5 minutes, i was zippy and alert and feeling NORMAL!

i wonder what my nutritional needs will be in the postpartum period. late summer 2010 is when i started watching my intake of protein and carbs (like, my body responds to carbs if eaten alone, but if eaten with protein it's fine, or when i wake up from a nap, eat protein ASAP, etc.) i imagine i'll need to intake a fair amount again, though not 125+g like in this pregnancy. maybe 75-100? i don't know. i'm sure i'll be nursing two kids. i am a little sick of this protein smoothie business, but it's so helpful, so i'm sure i'll have to keep that up for a long while."