Full Circle Midwifery

Cole Andrew Blastic 3/11/07 at home

When I became pregnant with our third child, I actually considered just going to our local hospital for a c-section because of the awful experience I had with the recovery after my second birth, a VBAC. But then I remembered that the recovery after the C-section wasn’t very enjoyable either. So, I made an appointment with the same office I used  for my VBAC, in Grand Rapids, an hour drive away. I was hopeful that I would be able to talk to the doctors about the horrors of my previous delivery and that they would give me some perineal support this time around to avoid tearing. In fact, I made my husband promise to demand it during labor if necessary. The doctor remembered me of course, because I was the “famous lady whose stitches came out that she’d never experienced before.” I dreaded the drive to the appointments and feared delivery. My due date was March 11^th and here in Michigan we get a fair amount of snow and bad driving conditions still at that time. Which means driving to my appointments all winter long and hoping to make it there safely for the delivery.

Right around the time of my 20 week appointment and ultrasound I met a nurse that worked at the local birthing center (the place that told me they didn’t allow VBACs). We discussed my pregnancy and that I would deliver in Grand Rapids so I could have a VBAC. She told me that I could in fact have a VBAC at the local hospital but that I would have to sign some kind of a waiver form. I couldn’t believe it and was very excited! She gave me the name of a doctor in the area that she thought would be supportive. I made an appointment for a consultation and went to see her. Well, she wasn’t terribly supportive after all, and made it sound like I would have to show up at the hospital in labor, sign this waiver form and then be considered some sort of “hostile patient” from the sounds of it. And she explained to me that basically any little hiccup would send me to the O.R. for a C-Section. Not exactly what I was hoping to hear. I was disappointed again.

During that same week, my husband talked to a guy he worked with about my disappointing news. This man told my husband that he and his wife had had 3 home births and were extremely happy with them. Home birth?! I heard about this during our Bradley classes but we never gave it much thought because we didn’t know anyone who had ever had one and I had no idea there were any midwives in the area. I regained my hope! We got the midwives’ information and I sent an email explaining my situation and asked if they’d take me on at 20 weeks and if they’d be willing to do a VBAC. To my delight, Patrice replied first by commending me for seeking out birth choices and that they’d love to meet with me. My husband and I made an appointment for the next week. We had a million questions and they had a million answers. We were thrilled; we had finally found the birth option we were looking for! I will admit that we were a little nervous in case of complications but they reassured us that if they had any concerns they would have me transported to the hospital; which is only 5 minutes from our house.

I continued the second half of my pregnancy with appointments with the midwives. I should mention that there were three of them: Patrice, Barb, and Amanda of Full Circle Midwifery. They were great to talk to and welcomed questions.

I think my labor started around 10pm. I was having mild contractions that were about 10 minutes apart. I tried really hard to fall asleep because I knew if this was actually labor, I’d need all the rest I could get. But between getting excited about being in labor and the contractions keeping me awake, I could not get to sleep. I called my Mom around midnight and told her I thought this might be it. I knew she didn’t have to work the next day so she could make the 2 hour and 45 minute drive over and be here for the birth and to help watch our other 2 kids during labor. She was on her way! The contractions steadily grew harder; not unbearable, but made it impossible to sleep. Interestingly they seemed lighter if I was up and about. So, I laid down thinking that if the contractions were harder, that labor would be over sooner. I’m still not sure if that was a good idea. I was also getting very tired and hoped I could sleep a little between contractions; I don’t think I ever did.

It was very lovely though to be able to use the restroom at will and be comfortable in my own home. I let my husband sleep through most of it because I knew at least one of us needed to get some sleep! By 6am I started having lower back pains that required my husband to give counter pressure. This is when we decided to call the midwives and tell them I was in labor. Patrice was very reassuring on the phone and advised me to work with the labor and just let it happen. I think she could sense the fear in my voice. I listened to the labor relaxation CD a couple of times and got up to use the restroom numerous times. I was appreciative of being at home.

I can’t remember if we called them back or if she called us to check in but Barb came over around 10am to check on me. I was so excited about my free access to the bathroom that one of the first things I told her was “I already pooped 4 times!” (I still had my fear of having a BM during delivery). She checked me and I was dilated only to 4cm. She asked if she could check during a contraction, which would be more uncomfortable but would give her more information. I said “sure.” To my delight I was at 7cm during the contraction. She got on the phone and called Patrice telling her that she should come over (it’s about a 45 minute drive from Patrice’s house to mine). While waiting for Patrice I was in the bathroom yet again and lost the mucus plug. Things were moving along and I was getting more and more excited. The contractions hurt, but they were bearable; especially when I used the relaxation techniques learned during the Bradley classes. Labor was not as painful as I had experienced in the hospital. I attribute it to being comfortable at home and probably because my water hadn’t broken yet.

Patrice arrived as well as Amanda. I remember joking between contractions which seemed odd and made me wonder how much longer I’d be in labor. Sometimes I sat in my rocking chair, other times I laid on my side. Freedom of movement is essential!

Around 1pm I started feeling the urge to push. Patrice checked me and I wasn’t quite there yet, only about 9cm I think. There was still a “lip” of my cervix that hadn’t completely thinned out yet. I had a few more contractions and I was able to push a little to relieve the pain of the contractions. The baby’s heart rate slowed way down when I was lying on my left side, so they had me roll over to my right side which seemed to solve the problem and I began pushing for real. I was not pushing as hard as I had with my second birth because I was afraid of the complications I had experienced previously. I didn’t seem to be making much progress. Patrice began to try to push the lip of my cervix over the baby’s head while I was pushing to try to get it out of the way. Not pleasant, I’ll admit, but it worked. I started making faster progress with that lip out of the way. I also realized that I could push harder to get things moving because Patrice was giving me full support on my bottom and perineum. The baby’s heart rate slowed again and I got very serious. When the head finally crowned all I could think about was my 3^rd degree tear from my previous birth and the 8 months of recovery that followed. It was all I could do to not push, but I listened to Patrice and waited for it to stretch. I asked for oil to douse the burning sensation which Barb quickly applied and gave me relief. I think Patrice was holding the head in with all her might. Finally she said I could start pushing a little and the head eased out. That stretching time seemed like 10 minutes, but I bet it was closer to 10 seconds. He was born with the next contraction. She immediately put him on my chest. He did not cry at first and my husband and I started to panic. The midwives were calm. She had me rub his back and told me to talk to him. Since the umbilical cord was still attached, his heart rate was fine so there was no reason to panic. I rubbed his back somewhat vigorously as she showed me and talked to him. He started crying and turned a nice pink color; we were relieved. I then delivered the placenta, barely realizing what was going on because I was too busy admiring my new baby. The umbilical cord was about 36 inches long! No wonder his heart rate was dropping; I’m sure it was getting pinched in there somewhere. I think I probably would have ended up with a C-Section if I were in the hospital because they would have panicked. Simply changing positions solved the problem.

Patrice then checked me and discovered I had NO tearing! (he weighed 9 lbs 5oz) I was so excited! I could already tell that it wasn’t painful and had no hemorrhoid issues either. I could sit up in my bed and start nursing; the only discomfort was with the contractions that came with nursing.

They stayed for a couple of hours to clean up and make sure we were ok. We were all very tired but we were fine. Our other two kids came up to meet their new brother. Kelty asked if he could come downstairs to play with them.

My husband brought me dinner upstairs and the baby and I worked on nursing for the evening. The three of us slept for a solid 8 hours; we all needed some rest! Again, I was grateful to be at home and allowed to sleep uninterrupted. At the hospital for my previous births I was awakened several times during the night for various reasons which seemed unnecessary.

Barb came back a couple of times over the next few days to check on us. We were doing great! I was thrilled with the experience; especially with the fact that my bottom was already recovered from the delivery. At my 6 week check up with them I told them I enjoyed it so much that I wanted to have another baby just so I could do it again.

MORE BIRTH STORIES FROM THIS MOM:

Kelden “Kelty” Andrew Blastic 10-3-03, Licking Memorial in Newark, OH

Early on in my pregnancy I learned from my good friend Megan about The Bradley Method and the benefits of natural childbirth. I read books such as “The Thinking Women’s Guide to a Better Birth” by Henci Goer, “Husband Coached Childbirth”, and the like. Frankly, I was a bit frightened to have my baby in a hospital after reading those books! There were no natural birthing centers in our area and we never really considered having a homebirth at the time. So we opted to find a midwife who practiced out of an OB/GYN doctor’s office. We found a Bradley Method instructor 45 minutes away and began weekly classes at around 25 weeks.

At my 37 week appointment with the Midwife she checked the baby’s position and he was breech; which was confirmed by ultrasound. I freaked out. They would not deliver a breech baby. They scheduled an External Version for later in the week. In the meantime I consulted my Bradley Instructor and the internet to try to find a way to get my baby to flip on his own. I was determined to deliver vaginally. I tried EVERYTHING that was suggested: laid upside down on an inclined ironing board (that was painful!) with frozen peas on the top of my uterus and a flashlight at the bottom every night, went to the YMCA pool and did handstands in the water, visited an acupuncturist to have moxibustion (she burned something by my pinkie toe), made several trips to a Chiropractor that performed the Webster Technique, did cat stretches and pelvic tilts. Nothing worked. I reluctantly went in for the Version; thinking that this medical procedure would be worth it if I could avoid a C-Section. There were 2 male doctors on either side of me; one pushing the bottom and one pulling the top of my belly with all their might. THAT was NOT pleasant. But, again, I endured because I was determined to deliver vaginally. It didn’t work; he would not be moved. I was about 38 weeks by this point they told me they would schedule a C-Section at my next appointment the following week. So, I cancelled the appointment and decided to give it at least another week to let him turn on his own. All those books I read taught me that taking a baby early leads to potential problems so I wasn’t about to go along with that. I spent another week or so laying on my ironing board every night along with the other things trying to get him to turn. My water broke at 6am while laying in bed, 2 days before my due date. I called in and talked to the doctor on call, who happened to be one of the doctors who did my Version. I told him the baby was probably still breech and he said, “aren’t you the lady we did the Version on a week or so ago? Why haven’t you had a C-section yet?!” I told him that I wanted to give the baby a chance to turn on his own; he didn’t think that was very smart. I did not appreciate his tone or that he tried to make me feel like I was an idiot.

I had read that if you have to have a C-section it is better to labor for a while first. So we took our time getting ready to go to the hospital. I showered, my husband let the dogs out… they ran away…he was outside for about an hour waiting for them to come back while I sat on the couch; finally starting to have mild contractions.

We finally made it to the hospital around 9:45; my contractions were still mild and about 10 minutes apart. I was relieved to find a new doctor on call who didn’t yell at me for not having scheduled it sooner. They doubled check by ultrasound that he was still breech and then prepped me for the surgery. (Why can’t they put the catheter in after the spinal so I wouldn’t have to feel it!??) It all went very quickly. During the surgery I was awake and was able to watch most of it in the reflection from the anesthesiologist’s glasses. I told the doctor upfront that I wanted to have a VBAC next time so please do whatever she needed to do to make sure that could happen. She did. Kelty was born at 10:30AM. Weighed 7lbs 4oz and was 20 inches long. He was doing fine. I wasn’t able to hold him until about a half hour later when I was in post-op. We started nursing right away. I was sad that I couldn’t deliver vaginally, but was thrilled to have my baby.

I wasn’t able to get out of the bed for 24 hours. I hated having to call a nurse to hand me the baby so I could feed him when my husband wasn’t there. And they wouldn’t let me just keep him in bed with me. The nurses, bless them, but it seems like they were constantly bugging me with tests, blood work, diaper counts, breastfeeding time, etc. It was very frustrating and I wanted to get out of there. I was able to leave after 2 nights. Did I mention the pain? I was hesitant to take much pain medicine because I was worried about how it would affect the baby. The first few days were pretty rough. It was a major effort just to sit up in bed to try to feed him. I think it took about a month before I felt somewhat back to normal. It took about 6 weeks to finally get the hang of breastfeeding. (It’s not supposed to hurt!) I ended up with a few breast infections which were very painful. Antibiotics took care of them.

Anna Mae Blastic 8-25-05 at Spectrum Butterworth in Grand Rapids, MI

We moved back to Michigan a few months before I became pregnant with Anna. Before I was pregnant I sought out a doctor’s office again with a midwife that was willing to allow a VBAC. I found a great place in Spring Lake with a midwife that I loved. She explained that the doctor would have to be present during the delivery because it was hospital policy but that she would catch the baby and handle most everything. I was thrilled. I became pregnant and started the regular appointments with the midwife. At my 20 week appointment I had to meet with the doctor to start to get to know him. As he was looking at my chart he noticed that my previous birth would be 23 months before my due date for Anna. He announced to me that they could not allow a VBAC because the hospital policy says the births need to be 2 years apart. He explained to me that the hospital requires all O.R. staff to be present during the labor of a VBAC patient in case of emergency and they are trying to get out of allowing VBACs altogether because of the costs associated with having the staff on hand. I practically begged him but he said there was nothing he could do. I was devastated. The other hospitals in the Muskegon area did not allow VBACs. My midwife gave me the name of a doctor’s office in Grand Rapids that had a midwife and that hospital allowed VBACs. So, I started driving an hour to my appointments to see doctors at this office. They would not allow the midwife to deliver a VBAC; one of the doctors had to do it. Disappointed again.

My water started leaking on a Monday I think. I wasn’t sure if it was amniotic fluid or urine… by Wednesday night I finally had my husband get down there and look to see if he could see where the fluid was coming from (what a site!). We decided that it probably was amniotic fluid and I was having a few contractions here and there. By about 3am the contractions were about 10 minutes apart, but not very hard. Of course I was excited to have this baby so I called the doctor. Since we lived an hour away from the hospital he told us we should come in. I knew better from my Bradley training. I knew I should stay at home to labor as long as possible, but since we lived so far away and I was impatient we left around 6am. Contractions were still 7-10 minutes apart, but not hard. (Of course at the time, I didn’t know they weren’t very hard since this was my first real experience with labor)

We arrived at the hospital around 7am and they put me in a triage room and hooked me up to monitors. I was only dilated to 1cm Things were not picking up; in fact I think they became irregular. Around 9am they came in and took a sample on the fluid to determine if it was in fact amniotic fluid. If it wasn’t, they were going to send us home (or to the mall to walk around). If it was, they already suggested a C-section since I wasn’t progressing. We had to wait for the results. I was very upset that they would even suggest a C-Section so soon. We decided we needed to do something to get labor going. My husband consulted our Bradley Handbook and decided to try nipple stimulation. Well, I found out in a hurry what a “hard” contraction was like… it popped the bag of waters… we heard it! I told him he wasn’t allowed to do that again! Just after the intern returned with the results and told us that it was indeed amniotic fluid and that I would be staying. I showed her the puddle I was now laying in and agreed. We walked around the hospital for a while and the contractions really picked up in intensity now (ouch). They moved me to a labor and deliver room by around 11am.

Since I was a VBAC I had to be hooked up to all the monitors and have an IV put in as a precaution. Labor very painful and I was very uncomfortable. I felt the need to go to the bathroom often but had to wait for a nurse to come in to unhook me before I could. I used my Bradley techniques to relax and try to work with the contractions. My husband followed the Bradley book through the stages of labor as I progressed. We don’t remember the time, but the next time they checked I was dilated to 4cm. I remember being so disappointed because I felt like I had about enough. I was determined to have this baby naturally so I laid there, strapped to the monitors and tried to relax as I was taught. As the baby moved down I experience a great deal of pressure on my lower back. My husband gave me some relief during contractions by pressing on it with the palm of his hand as hard as he could. I remember laying there and the slightest noise would make the contractions hurt more. I remember “shushing” people a few times. My Mother arrived around 2pm and sat there crocheting the baby a blanket (in silence because I shushed her too). We had a CD of relaxing labor music that I listened to one time through. I think it helped some.

I remember feeling like I needed to have a bowel movement each of the few times I was able to get up to use the bathroom. But I couldn’t. I don’t know if it’s my fear of having a BM out of the comfort of my own home or if it was my fear of having another contraction on the toilet (hard to get comfortable and relax through a contraction while sitting on a toilet with no back). I had a great fear of having a BM while delivering the baby. I had heard of this happening and thought I would die of embarrassment. So I tried to go; but couldn’t.

I got to the point where I actually told my husband that I didn’t think I could do it anymore. He knew I was in transition. Then I started feeling the urge to push. Somehow the nurse could see it on her monitor because she came busting in to check me and asked if I felt like pushing. I was only dilated to 7cm at about 2pm. I wanted to cry. (I may have?) She told me NOT to push. I told her that I thought I needed to have a BM and she said it was just the baby. Well with the next contraction my body was sort of convulsing because it was pushing whether I wanted to or not and sure enough, I pooped on the bed. She had to clean that up. I wasn’t embarrassed; at that point I didn’t care anymore. For the next hour I tried not to push as my body fought against me. During this time there was a shift change and a new nurse showed up a little before 3pm. She checked me and said “whoa, you are ready to go!” She had to call the doctor because no one from my office was there. A half hour later of trying not to push, one showed up. She was assisted by an intern that kept telling me to “push, push, push” even though in the birth plan we specifically asked for non-directed pushing to allow me to push as long and hard as I felt I could.

Now, I had also heard stories of women pushing for HOURS to get their babies out. I did not want to be one of those women. I was at the end of this exhausting marathon and was ready to cross the finish line. I pushed with all my might because I wanted to win this race. Unfortunately I had forgotten during this time about the importance of allowing for stretching of the perineum. And the doctor seemed pleased to get this over with in a hurry as well because she never told me to slow down or stop until the head was out. They gave me NO support to my perineum, no oils, no massage, nothing. I ended up with a 3^rd degree tear and hemorrhoids that never completely went away.

Anna was born at 3:30pm. Weighed 8lbs 2oz and was 21 inches long. They handed her right to me and we started nursing immediately. I was exhausted but thrilled. The doctor had a shot of Pitocin ready and asked if she could give it so I would deliver the placenta right away instead of making her have to wait for it. I didn’t care anymore so I agreed. I wished I hadn’t after those contractions started back up again (ouch, again).

The doctor supervised as the intern started to sew me up. He assumed I had an epidural I guess and started sewing without any local anesthetic. After a loud “ouch” on my part, the nurse informed him that I didn’t have an epidural.

I finally got moved again to my room to get settled in with my new bundle of joy. I found that after a vaginal birth it was still really painful to try to sit up as my bottom was very swollen, bruised, and painful. This was not expected. Again with this hospital stay we were regularly poked and prodded by the nurses doing their duties. I did stay 2 nights as my bottom was still very sore from hemorrhoids, very swollen labia, and the stitches. No one checked my stitches before I left.

About a week and a half after I had been home I developed one of my famous breast infections. Since my bottom still hurt (I couldn’t stand up for more than 5 minutes because it felt like my insides would fall out), I had still been taking the 800mg Ibuprofen and wearing ice-packed baby diapers. I didn’t know what was normal after a vaginal birth but was thinking that maybe the C-Section wasn’t so bad after all…. So I called the doctor to ask for an antibiotic for the breast infection. By this time it had developed into flu-like symptoms, with chills, etc. She asked if it was painful and I said I thought so but it was hard to tell because I was still taking the Ibuprofen. She said I should not still need pain meds. I started thinking that I had lost my pain tolerance and maybe I was just being a baby. She made an appointment for me to see her in a couple of days. She couldn’t believe what she found. My stitches had completely come out and my 3^rd degree tear was just hanging there. No wonder it hurt. She said that has never happened that she knew of and had to consult with the other doctors in the office to figure out what to do. They scheduled me for surgery a couple of days later to sew me back up. It was an outpatient procedure; they gave me a “sedation” which basically knocked me out. I felt relief immediately when I was able to stand up. Whew, thank goodness. It took a long time for it to heal properly though. I had many return trips to her office (an hour away) to remove some scar like tissue called a granulation. It made sex very painful and I was afraid I’d be “broken” forever. It took about 6-8 months to get back to normal. I finally did because I soon became pregnant with our 3^rd child.