My AAR

[eema.gray]

That's an After Action Report, Army talk, lol.

Last week was a little stressful.  My midwife, Carol, was doing everything she could to help me avoid the practice OB's forcing her hand and insisting on an induction.  So Monday the 19th, I went in for a biophysical profile and non stress test.  The BPP looked really good.  Baby was moving around, we could see breathing and facial movements, I had plenty of fluid present, and the placenta was in fine shape.  The non stress test was "equivacol."  This means that during the test time, baby didn't move in ways I could feel as much as the test standards dictate.  Because we were getting good heart accelerations and we'd seen good stuff on the BPP, Carol decided the best thing to do was to have a repeat NST done the following day, at a different time.

So on the 20th, I showed up in the afternoon, hoping for a better test result.  Baby slept through it again.  Again, we had the bare minimum number of kicks but good heart accelerations.  Even better, the test recorded a number of textbook contractions and baby's heartbeat didn't change a bit during them (it's fairly normal for baby's heart to slow down a little during contractions).  Still, I was nervous about the lack of recorded movement because Carol wasn't in the office and one of the OB's was going to be looking at the test results.  I really expected him to come in and tell me to go straight to the hospital for an induction of labor.  Instead, he said the test looked great, on the basis of the accelerations and behavior during contractions, and sent me home.

On the 22nd, I was back in the office for my regular weekly check up, plus BPP and NST again.  BPP still looked great and, due to a late afternoon appointment, we finally got a decent NST kick count out of baby.  Carol and I were both surprised that I was even there because all week, I'd been having strong contractions and lots of cramping.  She sent me home saying she hoped she'd be seeing me at the hospital later in the evening (it was her on call day) or else on Monday, when my induction was scheduled.  I suspect she hoped I would go into spontaneous labor before my appointment time.  The rest of Thursday was pretty uneventful.  Occassional contractions but nothing serious.  

Then Friday morning came.  Woke up with a vague sense that today was the day.  Within an hour of getting up, I started having somewhat regular contractions.  Got through the morning pretty easily; roasted a chicken, made pizzas, ground a slab of beef into hamburger, cleaned the kitchen, put Yeled down for a nap.  Decided that while he was napping, I really should lie down as well.  Of course, that's precisely when my body decided to get serious about this labor thing.  Unlike my labor with Yeled, I was completely unable to nap.  I'd only been aware of labor for five hours or so and spent my entire nap time talking myself through contractions.  When Yeled got up might have been a good time to go to the hospital.  But I stayed home.

In late afternoon, Ranger Daddy and Yeled went out to run some errands.  He wanted me to go out as well but I was having trouble walking during contractions and decided to stay home while they did their thing.  This would also have been a good time to go to the hospital.  The entire three hours they were out, I spent curled up in bed, having built a little nest for myself and not wanting to go anywhere else.  When they got home, I made myself get up and act normal, or as normal as possible.  Deboned the chicken, warmed pizza for them, helped Yeled get ready for his pre Shabbat shower with Ranger Daddy.  As soon as their food was on the table, disappeared back into the bedroom.  In retrospect, this is when I really should have gone to the hospital, about seven that evening.  I couldn't carry on a conversation during contractions, couldn't walk through them, couldn't even stand up during them.  Yeah, we should have taken pizza on the road and gone in right then.

Instead, I stayed the in the bedroom for another hour.  Came back out to put Yeled to bed about eight pm.  This was a major mistake.  See, once he was in bed, I really didn't want to leave the house because I wanted Yeled to get as much sleep as possible before we had to wake him up again.  At the same time, I started paying attention to the time, and timing of contractions.  They'd been very intense since early afternoon.  I was tired, exhausted really, hungry, and wanted to be done with the whole thing.  I started worrying that I'd gotten stuck at a certain point in labor and was going to need help to get this baby out.  I felt like things had been the same for hours.  Decided that if my pattern of contractions didn't change within an hour, we'd go to the hospital about nine pm.  Lo and behold, things did pick up during that hour.  Maybe that decision gave my body permission to keep going or something.  I don't know.  Anyway, that's definitely when we should have gone to the hospital.

Shortly after nine, Ranger Daddy came in to check on me.  Husband intuition quickly told him I'd waited far too long to leave the house.  He started throwing clothes at me, saying we were leaving now.  I insisted there was no way I could get up, walk, sit in the truck.  He said he was going to call 911.  I think he might have thought if he threatened 911 I'd somehow find the ability to get myself together and to the hospital.  There was no way.  I could feel the baby's head by then.  If we'd left at that point, I'm dead certain we would have had the baby in the truck, even though we're less than 10 minutes from the hospital.  So RD called 911.  I remember wondering why he had to confirm our address with the dispatcher like, three times, before he was even asked the nature of the emergency.  The dispatcher told him I needed to lie down (I was on my knees next to the bed).  I said I couldn't possibly do that.  He insisted some more.  After a couple minutes, I figured out that on my side I could put one leg up on an office chair we've got in there and that might be reasonably comfortable.  Dispatcher started telling RD what he was going to need and what he'd have to do.  He told her (dispatcher) that baby was just about crowning, and that's when the EMT's showed up.  

For my husband's sake, I'm glad the EMT crew arrived when they did.  I know I could have birthed that baby without their help but RD was/is less than confident on that point.  I'm not sure why but his worst fear is that I would have hemmoraged and bled out right there, never mind that it almost never happens in healthy women who have uncomplicated, unmessed around with labor and birth.  It's kind of like the irrational fear I have in the middle of my pregnancies that baby is going to get into a really bad position and need a c section.  I fear surgery, he fears uncontrollable bleeding.  Anyway, once baby was born, her Apgar's assessed, and cord cut, we went to the hospital.  I held our daughter in the ambulance, didn't get that much contact with Yeled right after his birth.  The doctor on call was a little annoyed to be called in and that showed very clearly in her face and manner.  But she gave my body time to do it's thing and we had a normal delivery of placenta about an hour after Yalda was born.  Oh, and she started nursing just as soon as she could at the hospital.  I'm positive that helped with the placenta, which was my other major fear about this birth.

We came home barely 24 hours after her entrance into the world.  Yeled was, and is, absolutely entranced by his little sister.  He gets upset when he thinks we're going to leave her behind.  He has appointed himself official diaper changing helper (puts the dirty ones in the trash and brings me clean ones).  He helps rock her in her car seat when she wants to be awake and all our hands are too busy to hold her.  It took a week to get the evidence of him kissing her (Yeled is a camera hound so it's hard to catch him in the act; he turns to the camera and smiles every time he hears it turn on).  He howled every time we told him he couldn't pick her up, until we showed him how he could hug her while we hold her.

On the one hand, I wish we'd gone to the hospital earlier in the evening.  It would have spared Ranger Daddy a lot of frustration and fear if I hadn't been so stubborn about that.  On the other hand, I'm sort of glad we had Yalda at home.  Her labor was so intense and painful that I probably would have given in to the temptation of drugs if I'd been at the hospital.  This is especially true because I wouldn't have had any of the support I was expecting to rely on.  Our hospital, three days before Yalda was born, instituted a policy of no non-patient children under the age of 12 on the premises (flu control, in theory at least).  Since we'd been told the entire pregnancy that Yeled would be allowed to be present, we hadn't made any childcare arrangements.  As it was, RD wasn't with me at all during my day at Memorial, due to Yeled being well under the age limit.  And since Carol wasn't on call either, there wouldn't have been anybody familiar with me and my goals in the room.  That would have been hard to deal with.  Upshot is, despite the lack of planning, there were things about having Yalda at home that we both liked; therefore, we are going to plan an attended home birth with our next baby.  Colorado has state licensed midwives in abundance (certified professional midwives, who can attend home births) and we're going to use that avenue for the next one.  Our insurance won't cover it (Aetna does not believe home births are "safe"; I have a letter from them to that effect) but I'm sure we can figure out a suitable payment plan.

[emslala]

Nov. 1, 2009 at 11:33 PM

Yay!! Congratulations on a great homebirth!  :)

[Mommy2seven]

Nov. 2, 2009 at 2:13 PM

What a great experience, I'm so glad everything worked out :)

[SandraRh]

Nov. 2, 2009 at 2:40 PM

congrats.  Planned homebirths are definitely great.  If I were you I'd get an empty oatmeal container or something like a piggy bank and start saving.  I don't know about colorado but here in AR it is 2500$ for a HB MW.  So start sticking a little money back every now and then...and by the time your ready for the next baby you will be one step closer to that planned home birth.

[willibums-mama]

Nov. 3, 2009 at 12:58 PM

Congrats!

I think it must've been a good experience considering you're already talking about the NEXT one! LOL

[rpowers12]

Nov. 4, 2009 at 12:35 PM

Congratualtions. She is beautiful. Commends on the fact that you went through your day as normal in Labor.