(written by Lorna Reid Fleener about the birth of Sebastian Alistair, born February 19th, 2009)
I get so moved reading various birth stories on this site for many reasons, but 2 resonate with me in particular. As I was risked out of midwifery care due to my large uterine fibroids, I cry whenever I read of a beautiful home-birth, as that is what I had always wanted. And then when I read of terrible hospital experiences, I once again cry for these women, as although I did not have fully the birth I had dreamed of, the hospital worked with me and allowed me to have as close to what I wanted to have.
I had lived part of my life, both in childhood and as an adult, in the UK, where midwifery is normal practice; and I had gone through school with Heidi, founder of the Rosemary Birthing Center, as my friend, therefore, for me, the midwife birth was the natural choice. On top of this in 2007 I was birth partner for my niece when she had my great-nephew at home, with Harmony as her mid-wife, and it cemented my decision. So, when my husband and I became pregnant 2 years later I was excited to see Harmony and begin my pregnancy journey with her. However, it was not to be, as the estrogen from my pregnancy had already made one of my uterine fibroids grown to 7 inches, at 7 weeks pregnant my uterus already measured 24cm. So I began my adventure with Dr Cohen, recommended by Harmony and Heidi…
Dr C listened to me and my desires and spent a long time with us, we began calling my uterus “the duplex”, baby down one side and my now approx. 10” mass of fibroids down the other. I saw Baron and Hill as I was high risk and had many ultrasounds to check the fibroids as they grew. The pregnancy went well, the only incident was when I had one fibroid degenerate (baby won out and was taking more of my blood supply than one of my fibroids causing it to die) and after 24 hours spent on the couch unable to move due to the pain, I requested my husband take me to hospital. This occurred at 24 weeks and after enduring that pain where I was unable to even move and my husband had to carry me to the bathroom I knew that childbirth was going to be something I could handle. Once I got through this 2 weeks of on and off pain I was officially declared ‘normal’ at 26 weeks and no longer high risk and Dr Baron said no reason to not have a vaginal delivery… so excited…
Amazing things happen during pregnancy – what an amazing time of getting in touch with your body and soul… we had opted not to find out the sex as I had always imagined the joy of the announcement as the baby appeared… However, the universe at other plans for me… It was one week before my due date and Alex and I had gone with some friends to see the wonderful Willie and Lobo play. As I sat listening in the dark I placed one hand on my husband’s knee and one on my fabulous bump and into my mind came the thought ‘I’m here with my two boys’ and I knew from that instant I was having a boy… but I told no one!
After all the drama and constant monitoring of the first 26 weeks it was great to sit back and just be pregnant, I did my birth plan with my doula Laura, whose Bradley birth classes we attended. We had pictures taken, I got a belly cast and we got the house ready. Dr Cohen and Dr Sullivan were great about my birth plan and me having a doula and I got to meet with both of them so we were all comfortable with each other… and after being so high risk I ended up going 2 weeks overdue…
As a result I did end up getting induced… here is where the clamoring starts and I know – we tried many other methods of getting things going – membrane stripping, stimulation, acupuncture, sex, black cohosh, and even the day I was kept in for inductions we ruptured the sack () and all sorts – to no avail – unfortunately with my fibroids they had acquiesced and let me go 2 weeks over and that was it - Dr Sullivan kept me in after my stress test on February 18th, 2009. This was when the issues everyone brings up started… and we gently asserted ourselves. As I was getting settled into my room two nurses came in with the IV (at which point I lost it and bawled) and told me no more food or drinks allowed, I said but why not – and they both actually stood silent and finally said ‘well, that’s just what we do’… so my husband went off and found Dr S… who came back with him and told the nurses ‘Lorna is healthy and the baby is healthy she can eat and drink what she wants and no IV’ – although I did agree to a stint… I was so glad we had constantly been vocal and open with our doctors during the whole pregnancy and worked as a team. At that Dr S turned and told Alex to go get me whatever I wanted to eat (mmm, portabella and veggie wrap – still remember it) –I think it was around 11.30 a.m. at this point…
The nurses they assigned to me were all excited upon reading my birth plan and bustled about getting me a rocking chair and a yoga ball – and thankfully I was in one of the 2 birth rooms with a shower, at this point Laura, my doula, had not yet arrived. This is the point where there was a blip in the day when we had a slight turning point in the late afternoon when my supportive nurse got called away and we ended up with ‘nurse evil’. When she came in she scoffed at my birth plan – showed me the pain chart and told me that by the time I reached the level of the smiley face in the middle I would demand an epidural, then as she exited the room – she looked at me perched on my yoga ball and told me to try not to fall off… on top of this we had heard Dr S instruct her not to put my Pitocin over 6 – this was at around 3 p.m.… when my doula, Laura, arrived at 5.40 I knew I was having contractions, however, nurse evil kept arguing I was not – I kept telling her I knew what was happening and I was pretty sure I was having contractions and that as she kept sticking the monitor on my fibroid she was not picking them up… Laura (formerly an RN at SMH) checked my Pitocin which nurse evil had sneakily put up to 14… she asked nurse evil is shift change occurred at 5.40 and she said yes – so Laura said Lorna – she leaves in 20 minutes, let’s just sit it out… although I did complain about her after the birth.
It was also at around this point that Dr S came in and said – ‘I am leaving and Dr Cohen is coming in – he will be so happy that he is here delivering your baby’ – how awesome is that!! And my Pitocin got turned down… At 6 my new nurse came on… the wonderful Christine… she told me immediately they put her on the natural births – she had all hers that way and breast fed for 3 years… oh what a sigh of relief did I let out… from here on out I walked, I ate and I swayed… I found sitting too hard at this point and labored always standing in a lunge position holding Laura’s arms… unfortunately thanks to the joy of Pitocin overload from nurse evil I had only 40 seconds between each contraction… according to Alex I made the most of each 40 seconds – I just shut down and retreated and gathered strength – that is how it feels in reflection… there were moments I remember thinking I can’t do it, I need something, and then looking up at Alex and Laura and just meeting their eyes and realizing I could and if I would just wait – it will end - and you will have your 40 seconds… and I remember transition – dashing between the room and the bathroom with Alex running behind me with a basin, feeling like I had to pee and then vomit – and never actually doing either!
Apparently I then collapsed… I remember the lights coming on… being lifted onto the bed and Dr Cohen yelling “she has had too much Pitocin’ and Alex yelling back at him about nurse evil… and then the IV of fluids going in to rehydrate me… both my heart rate and baby’s had dropped… Dr. Cohen had them put an oxygen mask on me and I freaked out –claustrophobia… ugh… so he and I yelled at each other – and he said in his sternest Jamaican accent ‘woman – if you don’t put that mask on I will C-section you’. He did not really mean it, he told me the next morning he knew what to say to make me listen and stop arguing, so we compromised and ended up with Alex intermittently holding it to my face and taking it away.
…And then it was fine – I was fine – the lights dimmed again… and I was having 5 mins between my contractions and starting to do involuntary curls… my uterus was pushing, although I was not yet actually pushing I was curling up involuntarily… Laura and Christine told me what this is called, I can’t remember now…
At this point my mother appeared, when I collapsed I gather I did the normal thing and asked for my Mum… I had originally said only Laura and Alex were to be in the room with me… and my mother who adopted both my sister and I and has NEVER attended a birth said – I’ll come in when the baby is born if that’s okay. Well I wanted my Mum now… so Alex called my sister and said get your Mum and bring her in now… so at some point they both appeared in the room – and I then said to Alex to go get his Mom who was sitting in the waiting room – we can’t have one grandma and not the other. And so it was, as it was meant to be… Alex, Laura and Mum on one side and my ma-in-law, Carola, and dear Sister, Jackie, on the other… they all played a role in some way and were a great source of strength…
In my head I was making a lot of noise as my uterus pushed and curled me up, but apparently I was moaning low – very low and was completely in a zone. My sister held one hand and my mother the other… when the contraction ended I sat back and closed my eyes and just rested. Alex and Laura stood next to my mother – my silent support and Carola kept cool cloths on my neck and back… Christine spent ages oiling and stretching my perineum and then I felt it – my baby did a flip – he had been so quiet, gathering his energy and then he flipped and rolled around and I thought this is it… and the final stage began… at some point after this Sebastian Alistair made his way into the world – one hour and 19 minutes into Pisces (the sign I hoped for)... all 8lbs 4oz and 21 inches… apparently my first question was to inquire if he had hair… then when I saw him I wailed ‘It’s a baby’… I have no idea how long I pushed or how many times, I only know that the entire labor took approximately 10 hours and my mother – she who had never felt a need to see a birth - turned to me and said ‘wow, you made it look so easy’!
They did all the Apgar and baby checks in the room right beside me as requested – and the wonderful pediatric resident stayed until Sebastian latched on, and there we stayed skin to skin in the birth room for an hour or so… and as Dr Cohen sewed me up, he told me later most of the tear was from Sebastian’s hand as he came out…
Everyone there with me was were totally behind me each step of the way and with each choice I made, I was blessed to have the team I did with me that night… there were things that were hospital driven vs. what I would have experienced with a midwife, but in general I held strong and with the help of Laura we advocated for what we wanted and needed.
Once Sebastian had latched on and I was put back together they gave me drinks and got me in the shower and Christine washed me while Alex held Sebastian. Then I was put into a wheel chair and we headed up to mother and baby… the nurses at the birth station all stopped to talk to me… one told me as I went past that she had gone to the Rosemary Court birth center to have hers. Another told me that it was women like me that kept a lot of them still working. It was amazing I felt so empowered, like a rock star! When I got to my room in the mother and baby unit they said let’s get you showered – I said, but they showered me downstairs… she looked at me for a minute and said ‘they NEVER do that’… I said well they did…
Perhaps the biggest threat is the area’s staggering rates of poor birth outcomes, such as premature birth, fetal mortality, and infant mortality. Despite a statewide decrease in deaths among children younger than one year old, the infant mortality rate for African-Americans in Sarasota County has continued to creep upward. And disparities between rates of fetal mortality, infant mortality, and prematurity between blacks and whites continue to be alarmingly present. Sarasota County’s most recent 2008-2010 rolling average data indicates the African-American rates for fetal mortality is more than twice as high as whites; infant mortality is 3.5 times as high; and preterm birth is 1.7 times as high.
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