(by Rosanne Cornbrooks Catalano, about the births of Sarah Claire, born 08.04.04 and Anthony John, born 10.23.07)Sarah Claire
I had a healthy pregnancy, although I had a thyroid problem that was, in retrospect, under-treated. So I was tired all the time and not as proactive about my care as I might have been. If I’d been stronger, I probably would have changed midwives. My midwife was a professional and cared for my pregnancy very well, but I was not comfortable talking to her and she never really got to know me.
On my due date, Monday, I had a checkup. I had been 70-90% effaced for about three weeks with no dilation. I felt like the baby was ready—I’d always thought she was due sooner than they calculated. The midwife felt her head and found it was asynclitic—just a little to the side. The next day I did a lot of lunges and birthing ball exercises, but still nothing.
On Wednesday at 7:30 my water broke. I made it to the bathroom, so I could see that there was heavy meconium—it looked like grass clippings! Still, we stalled—took a shower and called family. We got to the hospital at about 10:00 and I was carrying bags and feeling great. I chatted while we got signed in, swinging my legs as I sat on the bed. At about eleven o’clock EVERYTHING changed. Within about six strong contractions, I couldn’t stand the sound, sight or smell of anything. I could not get comfortable. The baby’s heart rate was dropping by half and not recovering very quickly, and the contractions kept building.
It was my midwife’s day off, so we were in the hospital’s hands while they found her. This is a where a doula would have really helped us! They gave me terbutaline to slow the contractions, and oxygen, which really helped the baby’s heart rate, and started an amnio infusion, which felt wonderful! One nurse came in with a c-section consent form and when I, shaking from the terbutaline, asked if I had to sign it, no one answered me. I was scared for the baby, so I did.
The midwife got there in about twenty minutes. She and the other nurses kicked out the c-section nurse. Then the midwife kicked everyone out and turned out the lights. We labored in peace as the contractions built again.
Around six I wanted to push—now I know it was too early, but I wanted to then! I was nine cm with a lip, so we tried. The baby’s heart rate was slowing again, so I pushed every other contraction, and rotated positions since they didn’t know if she was facing up or down. When the real pushing contractions hit and I wasn’t pushing with them, I would hold my husband’s hands and imagine hanging from a cliff, letting my body go heavy and down.
When I was pushing, I got really discouraged because I felt no progress. Finally my husband said he saw the head and I got a surge of energy. At this point, my midwife underestimated me. She started talking about getting a vacuum and what came out of my mouth was, “No, I don’t want an episiotomy.” She said, “Well, you’re having one. You and the baby are too tired.” I knew I had the strength, but I was so discouraged. Then our wonderful delivery nurse (natural childbirth mom herself) said, “You can have this baby in three pushes if you get serious!” And I did, with no vacuum, at 7:36pm. She was 20” and weighed 7 pounds, 9 ounces.
Because of the heavy meconium, they suctioned her right away, but then my bare, beautiful girl was on my bare chest under heavenly warm blankets. She “kangarooed” toward the breast while her daddy looked on. Her hand found my cheek and it was the most beautiful moment ever.
The episiotomy scar was poorly stitched and gave me pain for years after, and I suffered almost a year of postpartum depression. I had been prepared to be “tough” during labor, but not to be so scared for my baby. It took a lot of time to process my fear and feelings. But this birth gave me my beautiful daughter, the lessons I needed to be stronger for myself and my baby the next time, and the motivation to make all births, wherever they occur, mother-and-baby-centered.
Anthony John
My thyroid problem was well treated in my second pregnancy, so I felt better. I felt totally comfortable with my midwives and looked forward to my visits with them—my daughter loved helping measure my belly! Our doula, a midwife herself, gave us excellent backup and support.
I began prelabor three weeks before the baby was born. We’d been cool, laidback second-time parents, so nothing was ready when I got hit with three hard contractions one morning. We got the car seat and cradle ready fast, but nothing happened. That began the roller coaster of prelabor—contractions would usually peak around 3pm and 3am, but they never progressed. I repeated my doula’s words over and over: they have to get longer, stronger and closer together to be the real thing.
After two weeks of prelabor my three-year-old daughter went for vacation with her grandparents, so I could concentrate on keeping my emotions steady. She had a great time! I was free to walk, eat or sleep when I wanted to. In that last week, we had three visits to the hospital to have the baby monitored, two with ultrasounds to check the fluid levels. The last one was on Monday morning. By then, I had lost the mucous plug days ago, and had five days of diarrhea. I was so ready to have the baby, and struggling with the thought that I was somehow stopping labor.
At the end of the visit, I was 5cm, with one-minute contractions coming every six minutes. The midwife said that I’d be more comfortable at home, but that they’d save a room for me!
I ate dinner and went to bed. At midnight, I woke up and went to the bathroom. There was lots of bloody show, but I fumbled around for my paperwork to see how much I had to have to be in real labor! I’d just found the paper when I was hit with a drop-to-the-floor contraction. I made it back to the bedroom and woke my husband from my hands-and-knees position. I stayed there through the strong contractions while he called the doula and then tried to find the right pressure to rub my back. I still felt my sense of humor through all of this—to the point of laughing (inside) when my husband couldn’t decide whether to get dressed or rub my back!
I was really uncomfortable and firmly in transition when the doula arrived and immediately coaxed me into the car for the drive to the hospital. But through it all I felt so strong and conscious and proud, very healthy and in control.
We got to the hospital at around one in the morning, and a group of nurses escorted us down the hall, with me dropping to hands and knees when I needed to. I felt like a celebrity with an entourage! The doctor of the practice was on call that night rather than my midwives, but at that point I knew he would only catch.
I was nine cm when I got there, and I felt a clear change soon after. I rested a bit, they broke my bulging bag of waters and then I felt the real pushing contractions begin. I squatted and pushed, feeling the baby slide down my tailbone almost effortlessly. I was safe, with my husband on one side and my doula on the other. I saw all the feet of the doctor and nurses lined up doing nothing, waiting for me, and I felt so in charge!
I was worried about crowning because I hadn’t felt it the first time, but it was just a stinging feeling. For the last push, the doctor insisted that I be on my back because the baby might be big. It wasn’t what I would have chosen, but my son was born easily anyway. When I first saw him, I thought, “Wow! What a big baby!” He was born at 2:34am, 21 inches and 9 pounds, 8 ounces. Like my daughter, he had meconium in the water and was suctioned, but then he cuddled right up and started eating.
The nurses were wonderful, allowing us to co-sleep and calling me “super-mom”. I didn’t really feel like I was super-mom; I just did what I was meant to do. But it was nice to hear.
As soon our daughter woke up, she brought her brother the gift she had picked out and our new son spent the morning surrounded by loving parents, grandparents and sister.
I only had slight tearing along my episiotomy scar, and it healed easily. I felt so empowered and so strong that I had given birth on my terms.
Yesterday, I took a tour of the model Labor & Delivery and NICU rooms for the new replacement patient bed tower at Sarasota Memorial Hospital. This project is scheduled for completion in the fall of 2012. Taking me through the rooms were Debra Boterf, R.N., Business Manager for Women's and Children's Services, and Sheree Davidson, who is guiding tours for the public through next week.
Next, we visited a model Labor & Delivery room. All Labor & Delivery rooms will have couches and seating for family members. The infant warmers are right near the doors, Debra explained, so that the mothers could see their babies from their beds. This was modeled after the Labor & Delivery Unit at Tampa General Hospital. I suspect this decision was actually driven by a need for efficiency by the hospital staff.
The Labor & Delivery room I saw is a 'normal' room, but there will also be three 'low-risk rooms' included in the expansion, which Debra pointed out on the floor plan. These low-risk rooms will include Jacuzzi tubs, wide hallways for increased mobility with intermittent fetal monitoring, and an adjacent family lounge. This is a very big step in a positive direction. I commend Sarasota Memorial wholeheartedly for creating an environment of support for movement during labor, alternative pain relief (water), and space for doulas, friends and families.
The current building that houses Labor & Delivery, the Mother Baby Unit, and the NICU is over fifty years old, and has seen several expansions. These expansions have resulted in a piecemeal situation where the rooms differ from one to the next, making the job of the nursing staff more difficult than necessary. During the schematic design phase for the new replacement tower, the staff nurses were consulted and had integral design input. The result of this input is what looks like a huge improvement in efficiency. For example, there will be nursing stations between every two NICU beds, and all obstetric units will be on adjacent floors with private connecting elevators.
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