overdue, unmedicated, birth center/midwife, bleeding complication (LONG)

Aubrey was due April 9, and we were exactly sure when she was conceived. My son Owen arrived between 39 and 40 weeks (depending on which due date was used), and on average, second babies come 3 days before the first. My mom was convinced she would arrive March 30. In any case, we weren't expecting her to be late. But April 9 came and went...

Prior to being overdue, the pregnancy was uncomplicated except for one thing. Aubrey decided to stubbornly stay breech, just like I had when my mom was pregnant with me. We tried everything under the sun to get her to flip over - acupuncture, the Webster chiropractic technique, moxibustion (Jason hated that one), homeopathics, laying upside down, cold packs on the fundus, playing music or shining lights down low, visualization CD's, talking to her... you name it, we tried it. In the end, all it took to get her to flip to vertex was one tiny push on the head from an OB the night before we were scheduled to have the external cephalic version (during the routine ultrasound to confirm her position). I didn't even feel her flip. That was at 36 weeks and 6 days.

At my 40-week appointment, I had my membranes stripped. The next morning I lost my mucous plug. For the next week I had some random contractions, but nothing painful, and they would always stop after a few in a row. At my 41-week appointment (actually at 40 weeks and 6 days), I had my membranes stripped again. We also scheduled the induction as a last resort, at exactly 42 weeks, since I couldn't birth at the birth center past 41 weeks and 6 days anyway. I was kind of hoping the eviction notice might scare her out. But nothing happened during those two days.

At 41 weeks and 1 day I went back in to get a Foley bulb inserted, hoping that might get things going. It was a Friday morning (April 17), and the midwives don't put them in over the weekend, so I wanted to do it then, in case it didn't work and we needed more time to try other methods. There was also a big spring snowstorm, with really heavy, wet flakes, so I thought that the pressure change might help too. This was about 9:30 AM.

I had regular, somewhat painful contractions all day. Jason stayed home from work and was a big help. I kept thinking it was our last day as a family of three, which was scary but also exciting. My body dialated to 4 cm, at which point the Foley bulb came out. Holy crap, was it huge! That was about 3:30 PM. At that point the contractions completely stopped. I was irritated but knew that I had at least gotten to a 4, so that was progress.

Just when I was going to bed at 9:30 PM, the contractions started up again. From the beginning they were about 5 minutes apart or less and pretty painful. Jason had to help me though them with visualizations, massage, and counterpressure. I knelt by the side of the bed but also sat backwards on the toilet. With every contraction I felt the urge to pee but couldn't actually do it during one; I had to wait until the end and only a small amount would come out each time.

At 10:30, when things kept accelerating, I knew it was time to call my dad to watch Owen, as well as the midwives. Sarit was on call. Dad got to the house at about midnight and settled into the guest room. We left for the birth center. Jason actually ran a red light on the way, not because it was an emergency, but because he couldn't get the turn signal to trip and was tired of waiting for it. The roads were completely deserted but really slushy (thanks to the spring snowstorm) and bumpy. I sat backwards in the seat, hanging on to the head rest during every contraction. I think I had about 3 in the car on the way there - good thing we live close to the birth center.

We arrived at about 12:40 AM, and Sarit had the big room with the log bed ready for us. She checked and I was 8 cm, completely effaced, with baby's head at +1. So I knew I was pretty close. I went pee (for the last time before the birth) and then got into the tub - HEAVEN! Jason pulled the rocking chair over to the side so I could lean on it during every contraction. He also talked to me, poured water over my back, and gave me massage and counterpressure. Sarit was in and out since there was another mom there in a different room, and she kept telling me what a great job I was doing. Sarit would monitor the baby occasionally and Aubrey always sounded great. The nurse Kate was also there.

Things started to intensify and I said I couldn't believe how hard it was. Sarit reassured me that when I was feeling that way, it meant that it was almost over. I also said that I really needed to pee but I just couldn't do it. They all laughed and said that it was fine to pee in the tub. I couldn't have cared less where I peed, I just wanted it out and it wouldn't come out, but I don't think they understood that. My bladder felt so full and it was causing me a lot of pain. I was also getting a lot of back pain during the contractions, but not
between them, so I was reassured that Aubrey was not in a posterior position.

At about 2:25, I felt a huge pop during the middle of a contraction and I said "Oh f***, I think my water just broke." There was no meconium, which I had been worried about since she was overdue. With the next contraction I started pushing, and it was another world. I kept my eyes closed, clenched the side of the tub, and made crazy sounds with every push. I started pushing on my knees, but then Sarit had me put one foot down, and then two, so I was squatting. Aubrey was crowning but not coming out, so I got out of the tub and on to the birth stool. That was extremely hard to do with her head at a full crown and the high sides of the tub. It took two more pushes on the stool and she was out, at 2:51 AM. Sarit joked about my perineum of steel and said that she had considered asking me if she could do an episiotomy (which I had at Owen's birth, although then the OB had not asked for my consent first). Thankfully it didn't come to that. I did tear a bit along the old scar tissue, but it was only a first degree and required just a few stitches for repair.

Aubrey had Apgars of 6 and 9, with the first being a little low because she had been crowning for so long before she came out. They did wave the oxygen tube under her nose while I was holding her, but she was breathing from the beginning so I wasn't really worried.

I moved to the bed and the drama began, since like with Owen's birth, my body refused to give up the placenta. It didn't come out until I had some pitocin, about 40 minutes after she was born. (Nursing and herbs didn't work.) And then, because of my extremely full bladder, my uterus couldn't clamp down effectively and I started losing a lot of blood. The contractions were really painful even after the placenta came out because my uterus was filled with clots. They had to give me some methergine, tons of painful manual external uterine massage, and a catheter (I really couldn't pee on my own and my bladder was so full) to get all of the clots out and to get me to stop bleeding. In total I lost over 2 liters of blood. I was really pale and sweaty. But after all the clots came out and the bleeding stopped I instantly felt a ton better. Sarit was extremely capable and kind through the whole ordeal and I had total confidence that she knew exactly what to do to handle this complication.

Aubrey was 8 pounds, 11 ounces, and 21 inches long, with a 14 inch head. She still had a tiny bit of vernix, and really long and wrinkly fingers and toes. We stayed at the birth center until about 8:00 AM. I had an IV to get rehydrated from all the blood loss, and finally I was able to pee on my own. We ate cheese and crackers and the protein smoothie I had brought. I always forget to bring more food for after the birth because when I'm packing it while I'm in labor I'm not hungry. It snowed the whole time we were there and it was so peaceful to lay in bed and watch the big flakes coming down. After we got home, we had only missed about one hour of Owen being awake, and he was happy to have Grandpa to play with for that time. He also loved the sock monkey jack-in-the-box toy that "Aubrey" had brought for him.

This was a great birth and I wouldn't change anything about it, except maybe having her come earlier! But I know she wanted to do it on her own time and of course she was totally worth the wait.

Oh, and it was only the second time in the history of the birth center where they had three women in labor there at the same time. I still got my first choice of rooms though. Of the three, I was the first to give birth, and had the biggest baby. I would suggest that someone give me a prize (ha ha), but I realize that I already have Aubrey and she is the best prize in the whole world.