Tuesday, 23 February 2016

My Breech Water Birth Story

Wellness Mama Breech Water Birth Story 200x150

Wellness Mama Breech Water Birth Story

Looking back over the past decade, I realize that even after giving birth to six children (read all of my birth stories starting here), I’ve never had what would be considered a “normal” birth and this one was no exception as I had a complete breech water birth at home.

The Beauty of Birth

My labors and deliveries have run the gamut, as I’ve had the “typical” hospital birth with all of its interventions, a 26-hour natural labor and hospital birth, a life-saving c-section due to placenta previa, a 25-hour hospital VBAC, a 15-hour breech home birth, and now a 3.5 hour breech water birth.

Some of these birth experiences were not what I wanted them to be, but in hindsight, they were all exactly what I needed at the time, and I’ve learned to be grateful for what each one of them has taught me:

  • My first birth taught me the importance of having a truly supportive birth team and the importance of environment for achieving the birth you hope for.
  • My second labor taught me that I am stronger than I realized and the importance of endurance and relaxation during labor.
  • My third birth was my most difficult, as I never thought I’d have a c-section and it was a scary experience for me and for our son. It taught me that I am not in control and that sometimes the best plan is not the one I wanted or expected.
  • My fourth birth was in some ways my easiest, but it taught me not to have expectations about labor and birth (I was hoping it would be shorter since she was our fourth).
  • My fifth labor taught me to trust my body and fight for my birth choices, and was my shortest labor at the time (also a breech birth).
  • My sixth was my fastest and most intense and taught me that breech is a variation of normal (at least for my body) and that no two births are the same.

My Breech Water Birth

I really thought that after giving birth five times already that I kind of had this labor and birth thing figured out, and I was so sure of that I just “knew” how things would go. As all of our babies have been at least somewhat early (usually around 39 weeks), I fully expected to have this one at least a week or so before my due date and planned on this.

Turning things upside down…

At about 36 weeks, we found out that this baby was breech. I was disappointed but not entirely surprised, since two of our other kids had been breech at this point in pregnancy (one flipped and one was born breech). I started the protocol on spinningbabies.com to encourage her to flip, played music low down on my stomach, put a bag of frozen peas on the top of my stomach, tried acupuncture and all of the other methods that are often recommended to get a breech baby to turn heads-down.

For whatever reason, this little one wanted to enter the world bottom-first as my attempts to turn her were unsuccessful.

Contractions? Or not?

My had a week-long business trip when I was 37 weeks and I wondered if I would have the baby while he was gone. Not surprisingly, I started having contractions three days after he left. They started at about midnight and were strong enough to keep me from sleeping. I timed them and they were 4-5 minutes apart, eventually getting as close as three minutes and lasting up to a minute long.

They were definitely uncomfortable and I’d compare them to 4-5 cm contractions in previous labors. I called the midwife, she came to check on me, and at about 5 AM… the contractions completely stopped.

I’d never had a false alarm for labor before and felt embarrassed, thinking I’d only thought I was in labor. I was grateful, as I wanted my husband to make it home before the baby came but I couldn’t figure out why the contractions had just stopped and I felt bad for calling the midwives before it was time.

The next day, just as I was starting to fall asleep, the contractions started again. And lasted until 5 AM again. And stopped AGAIN.

I chalked it up to the stress of my husband being out of town and the fact that we had gotten 10+ inches of snow and ice and were essentially snowed in. This pattern repeated itself every night. Contractions from around 1 AM until 5 AM each night… not the best for sleep!

My husband finally got home… but the contractions continued each night 1-5 AM like clockwork. They weren’t “painful” but were intense and uncomfortable enough to make sleep close to impossible.

After a solid week of this, I realized that I was having prodromal labor. This is more common in moms who have had 3+ babies and when baby isn’t in the right position (breech) as the mom’s body attempts to move the baby into the correct position. Unfortunately, my body decided to do this work in the middle of the night while I was trying to sleep, instead of normal business hours!

One week of prodromal labor each night and I was exhausted.

Two weeks and I was in tears each night, just wanting to sleep.

Three weeks of prodromal labor and I was doubting my sanity.

After four full weeks of prodromal labor and a full week past my due date, I resigned myself to the fact that obviously this baby was never going to come out and just started obsessively cleaning (not realizing I was nesting…)

Moving on up… or down?

That night, the contractions started like clockwork, just as they had for weeks. 5 AM came… and they didn’t stop. I figured that they had just decided to start lasting even longer to keep me from sleeping ever.

All day, the contractions continued at 4-5 minutes apart and lasting 45-60 seconds. Uncomfortable but not painful as I could still talk through them. I just assumed that prodromal labor was going to be constant at this point and angrily cleaned, cooked, baked and organized (so obvious in hindsight that I was nesting and would soon go into labor!).

By late afternoon, I wondered if labor was starting as I was cooking dinner. When we finished eating at around 6:30 PM, I had the first contractions that were uncomfortable enough that I sent a text to my midwife:

Contractions are getting more like 4-5 mins at this point and more uncomfortable but still not bad. Think it is fiiiiiinnnnnnaaaaallllyyy labor for real but afraid I’ll stall if you guys come too soon. Long way of saying, I don’t need you yet but just wanted to keep you posted…

Still thinking that labor might just be getting started, I cleaned up from dinner and my husband and I got the kids ready for bed. We tucked in the kids at about 7:30 PM and the contractions immediately picked up. They were now about three minutes apart and definitely uncomfortable. Since the midwives were over an hour away, I texted them that it was definitely labor and was glad to get this reply:

Already left home. simple smile  Had a feeling it was time.

Since my previous labors tended to be 24+ hours, I figured I still had a long way to go, but I was also a little bit nervous because the contractions were getting increasingly difficult to work through and the idea of another 20+ hours of them was daunting to say the least.

The midwives arrived just before 9:00 PM I think (time got a little hazy at this point), and I remember saying things like “I can’t do this for another 20 hours” and “Why do I always think this is a good idea? Some of my friends love epidurals,” (note to self- this is usually a sign of transition!).

I also started needing my husband’s support during the contractions at this point, calling him when each one started and leaning on him while moaning through the intensity. I still had pretty good breaks between contractions (4-5 minutes, I think) and was able to talk and even joke between them so I was mentally preparing for the long haul and hoping I’d have the baby before noon the next day.

The contractions continually got tougher and sometime around 9:30 ish, the midwives suggested I try getting in the tub. I told them that I was afraid it would slow my labor down (laughable now) and they responded that they really didn’t think it would at this point.

Oh the Water…

The water definitely took the edge off the contractions or at least provided a welcome distraction. I tried to relax as much as possible and at about 9:45 PM, I felt a “pop” as my water broke (the fluid was clear). This is about the time that I started to have the “doula battle” with myself internally.

After being a doula for several years, labor has become an interesting internal conversation between my rational doula side and my not-so-logical laboring mom side. This time, the conversation in my head was going something like this:

Doula Me: “You water just broke and you are questioning why you don’t get pain medication… you are almost done.”

Pregnancy me: “No, I’m not. Stop trying to get my hopes up. My water broke before labor with my first baby. I still probably have hours of this left. Is food burning in the oven? How did I miss that spot on the grout of the tub when I was cleaning… Ugh… Another contraction.”

I didn’t feel pushy immediately after my water broke as I had with previous deliveries, which is normal when baby’s head isn’t pushing on the cervix. I was encouraged though, because I realized I was at least now in “real” labor but was still in denial about just how far along I was (despite the discomfort of definite transition contractions).

At this point, I also started feeling a LOT of pressure on my pubic bone and front right side. I had absolutely no back labor at all but had the equivalent in my lower abdomen because of her position. I could feel her move down and the pressure on my pubic bone continued to increase.

This was the point I somewhat remember saying something along the lines of “I don’t think I can do this,” (classic about-to-push sign for me).

The midwives suggested that I get in a forward-leaning hands and knees position, which I did with the help of my husband. The pressure intensified almost immediately and I felt baby move down quite a bit. I was simultaneously trying to relax but also having trouble relaxing (a friend who was planning to photograph the birth was still a few minutes away and I wasn’t exactly excited about the pushing phase…)

I also knew (from my previous breech delivery) that it is important to wait until I was completely dilated before attempting to push so even when I started feeling push-y, I tried to focus on calmly breathing (which externally looked more like a mixture of grunting, moaning and cursing… I was totally calm…or not)

My husband sat on the edge of the tub and I was able to lean on him for comfort and support at this point, which really helped me relax.

The urge to push…

I’ve always thought that the term “urge to push” was funny as I would more accurately describe it as” the-overwhelming-and-impossible-to-ignore-reflex-to-expel-a-baby.”

Whatever you want to call it, I felt it.

Having now vaginally delivered a breech baby twice, I can also say that while the desire to push is just as strong with a breech presentation, it also feels much different. Many women describe pushing as feeling like they are having a bowel movement and this isn’t the case (at least in my experience) with a breech. In fact, it felt much more like my public bone was being snapped in half and my hips being pushed out of their sockets.

At 9:55 PM I officially started pushing. I pushed somewhat slowly for a few minutes as I felt her slowly move down. Once the “ring of fire” started, I decided that I’d had enough of this and pushed a lot harder. This part is somewhat hazy, but I remember thinking that I had to actually work a lot harder in pushing her out than I had with my others.

This is the mentally toughest moment of labor for me, in realizing that I’m almost done and at the same time that the only way to make the pain stop is to push through it and create more pain in the short term. I always wished I was like some women (including my mom) who feel some relief during the pushing phase and actually think it is less intense than transition.

With a really hard push, the burning intensified and then I felt some relief as she “rumped” (the word used instead of “crowned” with a breech baby since they present bottom-first). At this point, the midwives were actively monitoring me and baby but not touching her (this hands-off method is often recommended for breech deliveries to avoid startling baby and causing her to raise her hands before they emerge).

Out came her bottom, legs and feet all at once.  This is known as a complete breech presentation by definition, not a frank breech as my last had been. This also explained why I felt I had to push harder with her… I was pushing out abdomen, legs and feet at the same time!

Sweet relief…

With another strong push, her hands and head emerged and the midwife lifted her out of the water.

That moment of relief and joy right as she emerged immediately replaced the intensity and discomfort of the previous few hours and I leaned against my husband’s chest, saying “I did it! I can’t believe she is finally out!”

I turned over and was able to hold her for the first time… and 41 weeks of pregnancy, a month of prodromal labor and just over 3 hours of intense labor immediately became worth it in an instant as I stared into her eyes.

Her APGARs were 10 and 10, starting her trend of trying to beat her siblings at everything. (So far, she wins the awards for my longest pregnancy, shortest labor, biggest baby and highest APGARs).

Natural childbirth is definitely hard work, and this is the point at which the intensity and work are worth it. I was able to get out of the water and deliver the placenta and then sit in my own bed with my beautiful newborn.

I was shocked when I looked at the clock and realized that it was only just after 10 PM! I was used to REALLY long labors and was very surprised to realize that the tough part of my labor had only been just over 3 hours! Not only were our other kids still sleeping peacefully upstairs (shockingly after my not-so-quiet pushing phase), but my labor had been so fast that we were even going to get some sleep that night!

I was also extremely grateful for experienced and intuitive midwives who could tell even from my text when it was time, as they wouldn’t have made it if I had waited until I really thought I was in labor to call them. In some ways this was my easiest labor (based on time) and it some ways it was my toughest (intensity and pushing). It was without a doubt my favorite labor so far, as it was the first one where I’ve felt truly supported and completely trusted my birth team.

Shorter Labor… What Made the Difference?

In the days following her birth, I’ve wondered what made the drastic difference in the length of my labor this time around (over 12 hours shorter than my previous shortest and over 20 hours shorter than most of my labors). I think these things all contributed:

  • A Birth Team I Trust– This is without a doubt the biggest factor in my shorter labor this time. Sadly, it took until my sixth birth to have a birth team that I completely trusted and felt safe with. With previous deliveries, I always had circumstances that made labor more difficult (and likely longer too), such as being told I “wasn’t allowed” to get out of bed, even with an uncomplicated natural labor, or being told by nurses that it would be easier on them if I’d just get an epidural and be quiet. This time, I was supported, encouraged, and told that my body was doing exactly what it was supposed to do… and it did.
  • Eating dates – I don’t have any proof of this, but I added dates to my protein smoothies for the last few weeks and there is some evidence that natural compounds in dates can shorten labor.
  • Prodromal labor– The one silver lining of my month of torture (I mean, prodromal labor) is that it may have sped up labor. I couldn’t find any statistics on this, but there is an abundance of anecdotal evidence and women sharing their experience in forums who had prodromal labor but very short active labors. Midwives often say that not all contractions may dilate the cervix, but they are all accomplishing something, and all of those contractions during prodromal labor were likely helping my body prepare to labor effectively.

Did I Use the Peanut Ball?

Another question I’ve already gotten is if I used the peanut ball or not. I wrote about the fascinating research about peanut-shaped yoga balls and their potential to shorten the first stage of labor by opening the pelvis and encouraging baby’s descent, and said that I was planning to try this method and see if it would shorten labor for me this time.

Unfortunately, since she was breech, I was trying to give her time to flip if she was going to and wasn’t trying to encourage her to engage or move down until she did. She ended up being born breech so I never had time to give the peanut ball a try, but have had three friends try it over the last couple of months and they had their shortest labors this time.

Was my birth illegal?

Sadly, home birth is not a supported birth option in my state (Kentucky) or in quite a few other states in the US. It wasn’t technically illegal for me to birth at home, but Certified Professional Midwives are not licensed in our state (though many are in other sates) and have to work much harder to find access to important supplies, labs and testing for the women they serve. As our state has one of the highest c-section rates in the country (over 40% in our local area), home birth is one way we could work to reduce these statistics (as the World Health Organization has called for a reduction in any c-section rate over 15%).

This year, we are working to pass legislation that would support Kentucky midwives and make it possible for CPMs to be licensed in our state. If you live in Kentucky and are reading this, please consider following the KY Home Birth Coalition on FB here to check for updates and to find out ways you can help!

Other Pregnancy and Birth Resources:

I’d love to hear your birth stories! Please share them in the comments below! 

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