Thursday, April 28, 2005

Following up on my post from before my kid's birth on natural childbirth, I want to talk a wee bit about our experience with the Austin Area Birthing Center (henceforth known as AABC).

The AABC solicited a birth story from us for their website and birth book (which sits out in the lobby for mothers-to-be to read). However, they felt that the story, which will follow this brief diatribe, was too negative and refuse to print the story without editing it. We won't allow that. As you'll see in the story, our experience was mostly positive, but there were some dangerous moments, and we believe that those moments, as terrifying as they are now for me to remember, should remain. If we had been in a hospital, I'm positive that they would have insisted on an emergency Caesarian for the simple reason that a C-section has known, somewhat controllable risks. At AABC, C-section was not an option, and we're happy that we had the natural, drug-free childbirth we wanted and that everything worked out well, with no small thanks to the AABC staff. I think that the risks associated with our natural childbirth and the risks if we had been pushed into a C-section (especially considering the point at which the staff identified the problem) would have been roughly the same for our son: potential brain damage, potential death (just writing this takes my breath away). With a C-section, my wife would have had to undergo major abdominal surgery as well.

However, as in the birth story, the AABC staff handled the situation admirably, and we have a healthy and flat-out stunning little boy. My wife has healed over time at a quicker rate than she would have if recovering from a C-section. We couldn't have asked for a sweeter experience.

But apparently the threat to our child is not something AABC wants to share with people. Perhaps this makes sense from a business standpoint, but not from the standpoint of being upfront and truthful with mothers-to-be. They should know that there are risks associated with natural childbirth, just as there are risks associated with medicated and/or Caesarian childbirth.

I have two other quibbles with AABC: first, they screwed up their estimate for the cost of the birth by not including our deductible and failing to submit two expensive lab tests to our insurance provider. This isn't that big of a deal (I mean, yes, it's a big deal in terms of how it's affected our budget, but they're just human, after all), but it is frustrating that they are unwilling to figure out how they messed up and apparently haven't put much work into the intricacies of dealing with our insurance company (BCBS of TX, by the way, not just a fly-by-night) so that there would be no problem here on the back end. I mean, their explanation is that the insurance company has hidden allowable costs. Well, actually, providers can learn about the allowable costs by calling in advance and that's not the problem here. Second quibble: AABC needs to learn how to recommend working with pre- and postpartum doulas, rather than discouraging it, as they did with us. We would have greatly benefited from bringing in a postpartum doula immediately, rather than 3-4 weeks later. AABC provides a postpartum nurse, but, bless her heart, she ran through the information about how to take care of our new critter quickly, and it's safe to say that we were a bit dazed anyway. An on-hand lactation consultant would be a smart move for AABC, too.

But those are relatively minor quibbles. We are happy with our choice to go with them for Li'l Sphere's birth, and very sorry to learn that they choose to view our birth experience in our own words as undeserving to be associated with them. With no further ado, here is that birth story, as written by the lovely, amazing, and brilliant Mrs. Obscurity. Besides us, the remaining cast is Jean, the owner of AABC, Kristen and Michele, our wonderful birth team, Rosewitha, our postpartum nurse, and Joan, another very helpful nurse midwife at AABC.

The Story of Li'l Sphere's Precipitous Birth
By his mother

Not long before I delivered, I read Ina May’s Guide to Childbirth by Ina May Gaskin, who has been a nurse midwife for 30 years. It inspired me to see natural childbirth as doable, that despite differing circumstances and experiences women can and do deliver healthy children naturally in an environment that is empowering to both the woman and her family. It was just the thing I needed to get “pumped up” for the birth. In the spirit of that book I am going to tell you all of the details of the birth so that you will see that you too can do it, and if you have given birth yourself, that others have shared in some of your experiences.

On the day of his birth, I was taking a class at work. During a bathroom break at about 9:45am, I noticed that my mucous plug came out, but I continued taking the class, despite having very mild contractions. I called my husband around noon to update him and told him that I’d let him know when the contractions got closer together. I finally had him come to get me at 3:00. We went home, took a walk around the neighborhood, and then decided it was time to go to the birthing center. We got to the birthing center at 5:30. Michele Fitzgerald, a midwife, and Kristin Elliott, a doula and midwife trainee, told me that I was 3 cm dilated (for you uninitiated, your cervix opens gradually and you are able to push the baby out when you are 10 cm dilated), but Michele pushed on the cervix a bit and it went to 4 cm, meaning that the baby was definitely on his way.

Although Jean was originally supposed to work that evening, she was just leaving after a birth that morning when we arrived. The staff decided that Kristin could monitor me while Michele got dinner, and Michele could attend my labor when she returned. They ran a bath for me to labor in, but it was not for me. I could not get comfortable. I preferred being able to walk and to hang onto something during the contractions, which, by the way, really didn’t hurt. They were all-consuming feelings, and I had to pay attention to them, but they weren’t painful. It is hard to explain, but the pain was minor.

At one point, I felt nauseous and told Kristin that I was going to throw up, which I promptly did. I remember thinking, “oh well, there goes those yummy chile rellenos I had for lunch!” (Yes, that is gross, sorry!) My water broke as I was throwing up.

Things took a turn afterwards. Kristin asked me to lie down on my left side because “the baby would like it better.” I really appreciate how Kristin handled that because I knew enough to know that the baby’s heart rate must have gone down if she was asking me to lay on my left side. She gave me oxygen and I thought, “oh crap, this isn’t good,” but Kristin was calm, saying, “this will give the baby a boost.” I am grateful for Kristin’s calm demeanor. The contractions were really uncomfortable on the bed because I could not move much and perhaps because my water had broken.

About that time Michele came in and checked my cervix. I was at 9 cm dilated, but because the baby’s heart rate was dropping so low (I think I remember hearing that it went to ½ what it should be) she pushed the cervix out to 10 cm and told me that it was time to “get that baby out.” I pushed a couple of times, during which I guess the baby’s heart rate went even lower because she pulled me around and gave me an episiotomy (which is a cut to enlarge the vaginal opening). She apologized but I could tell that her concern was to get the baby delivered sooner than later so that she could be sure it was healthy and OK.

I was in a “whatever it takes” mode as well because I could tell from her intensity that she was concerned/scared. I was too, but didn’t have time to focus on that emotion.

I think I tried to push again on the bed, but that was not working. Michele got me to squat wide, put breast pumps on my breasts to increase the contractions, and told my husband to simulate the breast pumps with his mouth (heh). I pushed really hard probably three times and she told me not to “tea pot it” because I was letting my air out as I pushed. Then she said “this is it. Get that baby out now. Hold your breath and push.” I heard her tell Kristin to get some “pit” shots ready, which I knew was pitocin, a drug that increases contractions and is reportedly very unpleasant. So, darn it, I was going to get that baby out. I hugged Michele as I squatted wide and I heard her say, “this is it! I can see brown hair!” and she and Kristin said “push past the hurt!” I could hear my husband holding his breath as I held mine. All of a sudden I felt the baby come out and my husband pulled me back onto the bed as Michele had instructed him to. He was on his back, and I was on my back on his stomach. Then all of a sudden I had a really warm blob on my lower abdomen. My eyes were still closed from pushing so hard. I remember saying, “help me I’m going to drop it.” Then I could hear Michele say, “look what you have” as she held the baby up closer to my face. I opened my crusty eyes and said “it’s a baby!” then she kind of pointed to his genitals and I said “it’s a boy!” (OK folks, birthing is tiring!) I had Li'l Sphere at 7 PM.

Michele and Kristin were so sweet and got my husband and me focused on the baby as the placenta was delivered and as she sewed me up. They were so positive and congratulatory and told me what a good job I did.

After they left and the postpartum nurse, Rosewitha, came and helped me to the bathroom I noticed that I pushed so hard I had broken blood vessels on my face, chest, and back, which looked like a rash and didn’t hurt at all. It was still surprising to see though, and totally unexpected. Rosewitha even pointed out that I had broken a blood vessel in the corner of my eye. I really did push hard!!!

The birthing center has a nice postpartum atmosphere. There were candles lit in the fireplace and the surroundings were soothing. As we were laying in the bed together as a new family my husband remembered to put on an Etta James song that I had been fixating on for the past few weeks, and only discovered the name of it the night before. Luckily he had burned it on the “birthing CD” just that day. I hugged my baby and listened to the lyrics and just cried. It is a beautiful song, and I could certainly feel the “at last” part. Intense labor and postpartum are certainly dreamlike and surreal in many ways, and the song captured that perfectly.

“At Last” by Etta James.


At last

My love has come along
My lonely days over
And life is like a song

Ooh, at last
The skies above are blue
Well my heart was wrapped up in clover
The night I looked at you

I found a dream
That I could speak to
A dream that I could call my own
I found a thrill
To press my cheek to
A thrill that I have never known

Well

You smile
you smile
Oh and then the spell was cast
And here we are in heaven
For you are mine at last

I am full of gratitude that Michele was concerned enough about Li'l Sphere to help me to get him out quickly. She was thoroughly professional the whole way, and empathetic enough not to let a stressful birth be stressful afterwards. It turns out that his cord was wrapped around his neck twice, and because he descended so quickly it was squeezing him. Luckily, his Apgar scores were 8 at one minute and 9 at five minutes. (Apgar scores quickly evaluate a newborn's physical condition after delivery and to determine any immediate need for extra medical or emergency care. Scores of 8 and 9 are good.) I pushed him out so fast that he had a colorless bruise on his head from my pubic bone.

I want to leave you mothers-to-be with a few words of advice. I was sorer than I thought I’d be. Eleven days after the birth I finally was feeling back to normal, so expect that as a possibility. I would advise having a lactation consultant come to your home within 2-3 days after birth. It will help a lot! Also, I can tell you that a postpartum doula would have made our early days with our son more joyful and less stressful, even though my mother was here to help.

The birthing center staff was excellent after we went home too. We called a few times and talked with Kristen, Michele, and Joan, who was very helpful with advice and perspective from her own births and children. All were generous with assistance and advice, something I had not expected postpartum, but I very much appreciate.

Thanks, Austin Area Birthing Center! We are glad we chose your facility and staff to help bring our son into the world.

6 comments:

Mrs. Obscurity 9:30 AM, April 29, 2005  

My problem with them not wanting to post our story is that I think that if you gloss over the truth by only telling about the non-complicated births, then people have unrealistic expectations about birth. I expect the birthing center, of all places, to tell the truth about birth. I can also understand their wish to not "scare people" and to maintain a robust business. There must be a middle ground. Oh well, no matter.

Randy Porter 1:44 PM, May 01, 2005  

I'm glad you had, for the most part, a good experience at AABC, especially that Abe and mom are well and healthy. Just reading Hayden's take on the possible dangers of C-section birthing more than freaked me out. (As a non-breeding male, that info was news to me.) And that was a lovely ending to your story, too, Mrs. Obscurity, mentioning playing Etta James' "At Last" as a perfect end to, ahem, a laborious day.

Hayden Childs 10:36 AM, May 02, 2005  

Thanks, Randy! Mrs. Obscurity was absolutely amazing throughout the whole birth (and, of course, she's amazing at all other times, too).

JBJ 11:41 AM, May 06, 2005  

Thanks for sharing, y'all. And congratulations again on your good-looking healthy boy.

jen 3:47 PM, August 16, 2006  

Hi, I'm writing for Michele Fitzgerald, she'd like to use your birth story on her new website. Please contact me at jen@steamybowl.com if you're willing to let us publish it. Thanks!

shares 6:51 PM, December 10, 2007  

hi, just happened to find your page through a google search as i'm trying to learn more about AABC. i'm so glad you posted your story! i don't feel like your story is negative, and i feel it actually presents the ableness of michele and the aabc staff well. it's wonderful to hear you were able to have a normal birth and that your baby is healthy =)

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