A Lesson on Birth Plans: The Birth of Mabel

I had a beautiful birth plan. Literally. My friend is a creative director at a local ad agency and created a visual birth plan for his baby born seven weeks prior to ours. He lent me the template. When I turned it into my midwife during a third trimester appointment, she asked if she could show the whole staff. Every nurse ended up gawking at it throughout our hospital stay. Lesson: no matter how beautiful your birth plan is, be fully prepared to throw it all out the window.

I was really pregnant–41 weeks and 6 days, to be exact­­–when I found out I had low amniotic fluid levels and would need to start a hospital induction that evening. I had tried everything to get this baby out of me before the looming 42-week deadline of having the birth center birth we had planned for throughout the entire pregnancy. Walking. Attempted membrane sweep. Eggplant. Acupuncture. Castor oil. I had read all of Ina May’s books. I had picked the room with the couch at the St. Paul Minnesota Birth Center. I had bought an abstract painting of waves to help visualize as I labored naturally through contractions. A hospital induction was not in my beautiful birth plan.

I was admitted Saturday evening to the hospital, and a cervical check proved what we already expected: 1 cm, 40% effaced. Cervidil was placed for the overnight hours, and we settled in with hours of Olympic swimming on the TV.

The Cervidil was removed first thing Sunday morning and showed pretty much zero progress. We switched tactics and began the first of four doses of Cytotec. 10 hours later, my Bishop Score was still barely at a 4 with non-progressing, mild contractions happening about every 4 minutes. At midnight, I had my first Cook balloon catheter inserted with 40 cc’s of fluid on either side.

My third day brought the arrival of my third midwife, and we started the day hopeful as noticeable contractions from the balloon were about 4-5 minutes apart. They inserted an IV for the first time and started Pitocin at 8 am. The Cook balloon was removed in the early afternoon, and I was sure we’d get the good news that my cervix was on its way to laboring. And, there was pretty much no change since the last check.

Welcome to my first utter and complete breakdown. We had already called our doula, Jill, before the check to come in and give us a break from, well, ourselves. It’d been a long three days. A trying three days. And, we still felt no closer to meeting our baby than when we received news we’d needed to induce a full 72 hours prior. Jill motivated me to get up and back walking around the labor and delivery ward again. The laps were monotonous, the scenery unchanging over the course of the days, but she offered a fresh optimism that we needed.

After 11 hours, they turned off the Pitocin. It had done us no good. But, we got the green light to go on a walk. Outside the hospital walls. It was Monday. I hadn’t left the hospital walls since Saturday. It was a dream.

I came back to our room refreshed and ready to tackle the next set of meds. We started Cytotec round 2, but had to stop at two doses, as my contractions were coming too quickly, piling up on each other, while not progressing my labor. My cervix had softened some, effaced 60%, and dilated to 1.5 cm, or, as the nurse described, “one and a wiggle.” I slept until morning.

Welcome midwife number 4. Before she even got to the hospital, she told me to go on a walk. A long one. Outside. It was hot. Humidity hung in the air. And, I felt alive. I had never met Mary-Signe. She normally worked with the Minneapolis midwife team. She stopped all interventions. She told me to breathe. She wanted to send us home. Regroup. Sleep in our bed. Pet our animals. She ordered a Biophysical Profile ultrasound to check fluid levels and baby’s movement. Rather inevitably, I failed. My fluid levels had not magically rebounded despite drinking about 3 gallons of water prior to the ultrasound.

She said, okay. You have three options. Another Cook catheter, Cook and Pitocin, or break my waters. As breaking my waters started a 24-hour clock, I chose to move ahead with another balloon catheter and go from there. She assured me: we will get you into labor. It’s Tuesday. Not a single person had mentioned a C-Section. Baby was a rockstar, being continuously monitored without issues from the time of admittance.

Mary-Signe held to her promise. By that afternoon, I had contractions coming every 5-7 minutes apart, having to pause and breathe through many of them. Pitocin was restarted at 3 pm. Jo, a traveling nurse from Iowa, started her shift. She looked at me and said sternly, “I’m not like those other nurses. I’m not scared of Pitocin.” By 4 pm, contractions were 3 minutes apart. Jo was attentive, adjusting the Pitocin down when they got too close, up when we needed to advance labor. That evening, Lennon and I played hangman to distract me through the early labor that had finally arrived.

We went to sleep in preparation for the real deal. Finally. We knew it was coming. At 2 am on Wednesday, I was awoken by strong contractions. Lennon began to apply counter-pressure and help me with different positions to stay comfortable. I ate chunks of cantaloupe and watermelon. We let Jill know that we’d need her here soon. Around 5 am, at the end of her shift, Mary-Signe broke my waters. With such low fluid levels, we weren’t surprised when nothing really came out. But, it was time. I was in labor.

Midwives had come full circle, and Katie was on call for the second time throughout our long journey. I also had a new nurse, Mary. Mary was probably 60, and immediately came in and took charge. She cleaned up the room. She got me drinks. She was omnipresent but unobtrusive. She was the motherly figure I needed when things got really hard. She held my hand when I cried. Days later, she stopped by our postpartum room to meet our baby.

According to my beautiful birth plan, I wanted to spend as much time in the water as possible. Though I wouldn’t be able to birth in water, I was still expecting to spend much of my labor in the tub. Except I f*ing hated it. I couldn’t get comfortable, and I’d spend so much time looking for a comfortable position that I wouldn’t be ready when the next contraction came. I loved the shower, though. Leaning on the shower wall, the stream of hot water hitting my back. Jill filled the room with a mist of lavender essential oil, and Lennon brought in my portable speaker with my preset labor playlist. It was the only place I was able to find the rhythm that I thought would come so naturally to me in labor.

Things got hard. It hurt. And sometimes felt constant. I had to pee and couldn’t. Baby was still not engaging, her back facing my right side, and we had to get her to turn. My contractions were starting to couple, indicative of malposition. I was tired. I said I wanted to lie down. They warned me it could be more intense. They placed the peanut ball, a yoga ball shaped like a peanut, between my knees to open by hips and encourage the baby around into position. During the first contraction, I kicked the ball across the room and scrambled to change positions to bend over the bed. I got back in the shower. I cried. I looked at Jill and told her I felt defeated. That was all I needed to say to spring Katie into action. “You have options,” she reminded me. In my head, I was already coming to terms with what I thought I’d never do, but couldn’t bring myself to say it aloud yet.

They brought out the nitrous oxide, and got me back on the bed with the peanut ball. Katie knew we had to get her down and in position, or else labor would stall. The first contraction with the nitrous was not as I expected. Everyone sounded very far away. It still hurt. But, it allowed my mind to wander. And, it wandered to: if this is all nitrous does, this is not enough. I made it through half a dozen contractions with the peanut ball, until I couldn’t do any more. Katie quickly moved me to sit backwards on the toilet with my foot up on a stool. More hip opening. More turning. More progress. I labored there for awhile. Katie set up what she called “the towtruck.” I hung from the labor bar with all of my weight at the end of the bed, sitting on a low seat between contractions. I felt her descending with each contraction. I made it through 3 or 4 until I just couldn’t do it anymore.

I asked for a cervical check. If I wasn’t extremely close, I knew what the next step had to be for me. I was 6 cm and zero station. They cheered. I cried. Katie looked at me, “Do you want an epidural?” “Will the baby be okay? Have I done enough to make it okay?” “Yes,” she said, looking me right in the eyes. “It is the perfect time for an epidural. You have done an awesome job.”

They stopped the Pitocin. I laughed. And cried. And breathed a sigh of relief. And joked that I was eating cantaloupe, and my safe word for the epidural was cantaloupe. But, I never had to even say it. Half an hour later, the epidural was in place. But, an hour later, my left side and abdomen still weren’t numb. He adjusted it. No change. His shift was over for the day. My IV line needed to be replaced in my hand. I was shaking uncontrollably. I still hadn’t peed. My contractions were non-existent, Katie urgently said that we needed to restart Pitocin. Now. I was having an anxiety attack. Mary stroked my hair. Jill fed me honey sticks. Lennon held my hand. A new anesthesiologist came in. “I was told I needed to come in with a joke. What do you get when the Pillsbury doughboy bends over? Doughnuts.”

The epidural worked immediately. The catheter was finally placed. And, I slept. Wrapped around the peanut ball, I slept. Contentedly. I sipped apple juice and 7-UP. Honey sticks to give me energy. The contractions eventually picked back up as I dozed. I started needing to breathe through them. And was beginning to feel immense pressure during each one. I was dilated to 9 with just a lip. “Just let us know when the pressure is constant; it’ll still be awhile,” our new nurse Annette said. “Probably 3 or 4 hours before you’ll be ready to push,” Katie added. 45 minutes later, I let Annette know that it seemed like my body was ready to push. I was breathing through each contraction, holding back the urge to push with everything I had. She called Katie. Katie did a quick exam and said, “Oh, yes! You can feel free to push the next contraction!” The nurse Annette worked quickly. She and Katie were in sync like they birthed babies together every day. As far as I know, they’d never worked together before.

I grabbed my legs and quickly got the hang of how and where to push. It was so satisfying. It was so hard. It was so amazing. The baby’s heart rate dropped. They quickly moved me to my side and had me hold through a couple of contractions with an oxygen mask on. They placed an internal monitor on her head in utero. I pushed on my side for a few more contractions. With baby’s heart rate back safe and sound, I returned to my back and used a sheet wrapped over the bar to push. She was crowning. I felt the burning. The pressure. I felt her face as it emerged from my body. One more push and her head was out. One more push and her body was out. My baby. Our baby Mabel was born after four days of induction and just 40 minutes of pushing. And, she was perfect. She was pink. And crying. And placed immediately on my chest to the overwhelming joy and excitement that the last four days had led us to. The last ten months. The last five years of our marriage. It had all come to this overwhelming, thrilling moment.

They had called the NICU team, as they were concerned about meconium aspiration. The team arrived late, and she was already on my chest when they arrived. I will always remember the face of the man at the front of the team, as he looked at me and the baby and said, “Oh. Well. Congratulations!” as he turned and walked out of the room. Mabel Alles Manthe was born at 8:55 PM at 42 weeks and 3 days gestation. 7 pounds, 2 ounces. 19 ¼ inches long. She had no signs of being overdue. My placenta wasn’t calcified. Her fingernails weren’t long. She scored a 9 on the APGAR. They thought she was a 10, but her feet were a tiny bit purple. I just bake my babies a little bit longer.

They ran the Pitocin full bore, concerned about hemorrhaging after all my body and my uterus had been subjected to over the course of our hospital stay. There was no hemorrhaging. I had minor tearing, just barely a 2nd degree.

She was here. And, it was fantastic.

All of the women that we worked with over the course of our hospital stay were amazed by our positivity throughout the induction process: nurses, midwives, our doula. And my response is always the same: what else could we do? A cesarean simply wasn’t an option for me. As long as Mabel was safe, I was determined to have a vaginal birth. So, that’s all we had. We knew I had to go into labor. No matter how long that took. We knew we had each other. So, we watched the Olympics. I danced alone in my hospital room to Tedeschi Trucks as Lennon got us a second round of clean clothes from our house. We played cribbage. Watched Netflix. Walked circles around the ward. Stared endlessly at our baby’s heart rate on the monitor.

Sometimes, your beautiful birth plan is thrown out the window due to things within and outside of your control. And you get through four days of induction at over 42 weeks and realize it was all meant to happen the way it did. And it’s good. And okay. And filled with love. And support. And the best birth team our new family of three could ask for.

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~ Stephanie M.


We love birth stories! If you would like to share your story on the blog, please email karen@theminnesotabirthcenter.com.

 

A “Late” Birth: The Birth of Reed

My due date came and went. This left me feeling quite anxious considering my first was a 38-weeker. I had been having Braxton Hicks contractions on and off since about 36 weeks, usually stronger in the evenings, but fading as I went to sleep each night. The week leading up to my due date I started doing all those things that gently encourage labor: an adjustment, a massage, more walking, spicy foods, and some quality time with my husband, Ross. In the early hours of my due date, a Saturday, I found myself unable to sleep, so I made a spring cleaning list. Ross and I spent the day deep cleaning the entire house. Must have been that pre-labor burst of energy!

That Sunday morning dawned bright and beautiful with a promise of temps near 60! We finished up some laundry and after my 21-month old daughter Linnea’s nap we headed out to Wood Lake Nature Center to enjoy the warmest day of the year so far. We walked the marsh loop and I noticed more Braxton Hicks as we ventured on. While out on the boardwalk I paused in goddess pose or in squats as they came to encourage labor, and laughed as my daughter struck the poses as well. Towards the end of the trail she started to get fussy so we headed back home, and it turned out she had spiked a fever. We spent the rest of the evening cuddling and watching Juno, which my virtual doula Ashley had told me would be good to get the oxytocin flowing. The cuddling, not the movie.

I went to bed early with Linnea since she wasn’t feeling too well, and we snuggled and fell asleep together. Around 2am I woke up to a strong crampy feeling, but was able to fall right back to sleep. About 10 minutes later I woke to it again and decided to start timing them. They continued to come 10-11 minutes apart, and I really had to start breathing through them. Around 4am I decided I would have to get out of bed or I would wake up Linnea. I told Ross that I thought things were starting, and I was going to go out into the living room and let him know if I needed him. As soon as I got up and went to the bathroom things picked up. Contractions went from 10 minutes apart to 5 almost instantly, and by 4:30am I went to wake up Ross. He didn’t seem to want to get up though, and I found myself having to convince him. “Hey Ross, you have to come see this!”

When he joined me we turned on Pandora to my relaxation station and lit a candle. Ross helped me through contractions with a rebozo while I breathed through them on my hands and knees, moaning “Oooooooooooo” for open. I soon realized that things were definitely moving along, and I had Ross call his mom to come stay with Linnea. When she answered Ross asked, “Hey mom, are you busy?” Then I decided it was time to call our midwife and let her know what had been going on, though I had wanted to wait as long as possible so as not to wake anyone too early.

When Kaitlin answered I told her where I was at and she suggested we meet at the birth center at 6:00am. I thought it might be too soon, but that we would call her back in half an hour once Grandma arrived. I decided to call our doula, Marla, as well, to let her know the tentative plan. As the next 30 minutes went by my contractions certainly grew in intensity, and while Ross loaded up the car I worked through a few on my own on a yoga ball. Soon Grandma arrived and I called Kaitlin back, and the only thing I recall telling her was that “6:00 sounds great! We’re on our way.”

Ross wondered if I needed anything to eat, so I ate a few spoonfuls of Nutella while we finished grabbing everything. I recall telling Grandma that Linnea had her big sister t-shirt hanging in the closet as we were leaving. As we were driving down the street Ross wondered which route we should take, and I definitely preferred Mississippi River Blvd, deciding I had more patience for stop signs than red lights. I only had to work through three contractions in the car, and the early hour saw only a few other cars and a handful of dedicated joggers along the river. We laughed, however, that I was working harder right now.

We arrived right before 6:00am, Marla pulling in behind us moments later. As I walked into the birth center and slipped off my shoes I immediately leaned on the counter in the hallway to work through another. Kaitlin greeted me with a gentle hand on my back and the kindly whispered “nice job.” As I walked into the birthing suite I wondered why on earth there was a vacuum running, only to realize it was the tub. The tub was filling up for me, for the birth of my baby.

As we settled in and turned on some music Marla and Ross helped me through a few more contractions on hands and knees with the rebozo. Then I took off my clothes and lay on the bed so that Kaitlin could check my progress, and found that I was at 5cm, nearly 6cm! After that she asked if I wanted to get in the tub, to which I replied “yes, but I’m going to the bathroom first!” (You see, funny story, when I was in labor with Linnea and finally got to get in the tub I immediately had to pee when I entered the warm water. I ended up peeing in a bag and promptly handing it to Ross.)

As I entered the water it was gloriously hot, and immediately provided relief and calm. I was able to chat animatedly with Ross and Marla in-between contractions. The next few contractions were so calm that I wondered out-loud if the water had made them fizzle, but Kaitlin reassured me if things slowed down she would get me out and moving. Sure enough, however, the next contraction was a fierce one and had me eating my words.

Soon Martha, our second midwife, arrived as well, and baby got down to business. I couldn’t believe that within a couple more contractions I started feeling intense pressure, and quite frankly I started to feel a little afraid. I guess I had expected a little more time to labor, to get used to the intensity, to chat and think about baby coming down, but it seems like in an instant I had the urge to push. Marla worked on applying pressure to my hips and I grabbed Ross’ hands and nuzzled my head down into his chest and began to cry. I wasn’t able to keep my steady “Oooooo’s” during the next few contractions, I felt my voice getting higher pitched and started taking shallower breaths.

I’m not even sure who said it, but I heard a kind voice say to me “Jenn, you are exactly where you need to be to have your baby.”

At that moment I accepted that this was happening, and certainly knew I was close. I began to bear down during contractions, but my fear of tearing and, honestly, pooping, definitely held me back. I just didn’t want to poop! Martha, however, assured me that I needed to let it all go to make room for baby. I really needed that guidance and reassurance.

I switched from hands and knees in the tub to my back, and let every primal roar I could muster come out of my mouth. Ross continued to hold my hand while I grabbed the bar from the side of the tub and pushed as my midwives coached me. I finally felt like I was able to get a good bearing once Martha grabbed my knee and at 8:04am, a mere two hours after arriving, six hours from when I noticed the first true contraction, my baby boy was born.

He certainly came out a lot more calmly than I had been just moments before. Kaitlin gently raised him out of the water and laid him on my chest where he peacefully and calmly rested. Kaitlin confirmed that he was indeed a he, and we began to rub his back, eliciting his first glorious cry. He was here, welcomed earth side through the waters of birth and brought forth gently by the loving hands of midwives, a partner and a doula who together supported and trusted me and my body. And to make it even more special, Grandpa was there immediately after his birth to capture these moments.

After waiting a few minutes to let the cord finish pulsing Ross took him skin-to-fur while I got out of the tub to birth the placenta. I walked to the bed and lay down, taking in the next few contractions gladly knowing this part would have no bones when it came out! And despite all my fears I ended up with no tears at all. I looked over at Ross to find our baby boy, Reed, snuggled up with a death grip on Ross’ beard.

The next couple hours we spent recovering and cuddling, sharing the news with family and friends, and completing his newborn exam. We had a perfect, healthy little boy, 7#5oz, 20in long. We said goodbye to our amazing doula Marla, then began preparing to introduce baby Reed to his big sister.

When Grandma arrived with Linnea, I had Ross hold Reed as she walked over to the bed. I picked her up and kissed her, and said, “Look, it’s our baby.” Linnea was a little tentative at first, but after a minute or so she said “nose” and quickly poked it. She then found his mouth, and head, and elbows as well, and quickly dove in for a hug and a kiss. We had her sit in the middle of us and brought him into her arms so she could hold him for the first time. I think she took to him rather well.

 

 

 

 

The whole postpartum experience was just wonderful, almost luxurious. I have no idea how they do it in hospitals, but I think this really is what makes the birth center experience so incredible. We were able to enjoy a delicious breakfast from Maria’s Cafe that Jenna (my cousin-in-law and the kiddo’s godmom) brought us, relax in a large, comfy bed, and then we kicked everyone out so that our new family of four could relax and take an herbal bath together. It was so special to be able to include Linnea in this process.

 

 

 

 

 

 

 

After our bath, Linnea went home with Grandma to nap, I was able to take a shower, and we packed up and headed home for a much-needed nap around 1:30pm. Linnea and Grandma were there to welcome us in, and the big sister was certainly excited as she exclaimed, “Baby, baby!” as we walked in the door.

As I lay down to nap and snuggled with my new little baby I struggled to quiet my racing mind. What a wonderful and beautiful birth, and how great it was to be home already, in our own bed, ready to begin our lives as a family of four.

~Jenn R.


We love birth stories! If you would like to share your story on the blog, please email karen@theminnesotabirthcenter.com.

 

Happy 1st Birthday! Nora’s Birth Story

We anticipated that Nora would be born a little early because of how active I was during remodeling the house and chasing 18 month old Emmi around. We were so wrong. I very impatiently awaited her arrival starting at 39 weeks pregnant. I went for walks, bounced on an exercise ball, used clary sage oil on my big round tummy and nothing worked. I even had false labor starts three times. I was so frustrated and tired of being pregnant.

I got to 41 weeks and had my first non-stress test to check Nora’s movement and amniotic fluid levels, all of which looked great. I then waited a few more days and had my second NST, and everything was normal. My third NST was done when I was 41 weeks and 6 days. The midwife stripped my membranes and told me to go home and take 2 oz. of castor oil and use a breast pump to start contractions in a final attempt to still be able to deliver at the birth center before I was a full 2 weeks over due. I also took a bath with clary sage and Epsom salt. This was all after we had dropped Emmi off with Nana and Papa at the Baker Park Campground for her first night away from Mom and Dad.

Contractions began shortly after I started pumping; though they weren’t very strong they were close together. I called the midwife at 8pm after mild contractions were 5 minutes apart for an hour. I wasn’t sure what to expect when inducing labor versus naturally letting it occur. The midwife called back and told me to come in. Although I was hesitant because I thought the contractions would stop, I was really glad she told us to come when she did.

On our way there the contractions continued to be the same and I only had one contraction that I needed to breathe through. We arrived at the birth center and my contractions stopped for 45 minutes. I thought for sure we would be sent home with no baby in hand. But then at around 10pm I began to have horrible diarrhea from the castor oil which was then followed by active labor contractions on the toilet while puking and my husband holding my hips to counter pressure the back labor. Sorry, babe. The diarrhea finally subsided and I was able to return to the bed. At some point they put an IV in my arm to be able to give me Pitocin after giving birth due to a postpartum hemorrhage with my first. Hunched over a stack of four pillows, I labored for two hours and suddenly felt the distinct need to push. As I began pushing the midwife told me to slow down as she ran to get help from the nurse in the other room who was actually helping a friend of ours bring their little babe into the world at the same time we were. I only pushed for a minute or two – three pushes and Nora made her appearance at 12:03 am on June 24th, 2016. Cole, my husband, got to see her entrance and she was handed to me and laid on my chest. She was beautiful. 

After a short time I then delivered the placenta. I was really nervous about bleeding too much as they massaged my uterus because of my experience with my first daughter’s birth. I ended up bleeding a little more than normal but they were able to manage it with Pitocin and one other drug that I can’t remember the name of. The midwife was able to show us the placenta and explain all the parts of it. Cole and I found it fascinating!

Nora and I lay skin-to-skin for three hours before we took an herbal bath together. Cole and I were given homemade fresh baked bread with butter and honey on it. Oh my goodness, nothing has ever tasted so good. Nora weighed 8 lbs, 10oz. The midwife did our checkups and we were sent home five hours after the birth. We arrived home around 6:30 am and were thankful to be in our own bed with our beautiful little daughter, Nora Laine.

~ Michaela G.


We love birth stories! If you would like to share your story on the blog, please email karen@theminnesotabirthcenter.com.