Telling the story of Maeve's birth requires a little bit of a back story about Jude's birth. In Brooklyn, Pete and I attended birthing classes from a very "anti pain medication" woman who in fact had never given birth herself (perhaps a red flag?!). I allowed myself to get a bit brain washed into thinking that was the only way to have a healthy baby and continued my education on the subject by reading Ina May Gaskin's books on midwifery. I thought, "if all these ladies can do it, so can I!" Then began Jude's labor and after 13 hours (with 4 hours of intense back labor), I went to the hospital and found out that I was only 4cm dilated. On seeing my level of pain and assessing that Jude was still very high and I was progressing slowly, my midwife recommended an epidural. She feared I would be too exhausted to push if things continued as they were. I felt totally defeated and out of control of the situation. I felt like I would be letting people down if I "gave in" to having an epidural. However, I would have done anything for the pain to go away so I tearfully agreed. Within minutes of the administration of the epidural, I felt no pain. It was the most amazing thing and I was so grateful for modern medicine! In the end it was a long labor and required 4 hours of pushing partly due to Jude's size and shoulder being stuck. So I am grateful that I was able to rest to get him out safely without a c-section.
So then I found myself in the Netherlands, preparing for Maeve's arrival and feeling very conflicted about my birth plan. I knew that epidurals are not given as freely here. I also knew that a home birth was a real possibility as labor #2 was likely to be faster (my mom claims that her labor was 20 minutes with me in the hospital!). I was worried about having back labor again (more likely when you have it with the first). So my very loose plan was to labor at home unless the pain became unbearable/ I was experiencing back labor, in which case I wanted to be transferred to the hospital (the VU hospital was my first choice) and get an epidural- STAT!
This time around, we hired an American doula, fluent in Dutch. I wanted someone to help with any cultural or language issues we might have. I wanted someone to help with the early stages of labor at home. I wanted someone on hand to help me in case we had trouble finding care for Jude. And I wanted the pre and post natal support that doulas provide. Mari educated me about optimal baby positioning for labor and introduced me to spinning babies. She also came and gave me a killer foot and leg massage in my last week of pregnancy. I felt as prepared and ready as I was going to be.
On Sunday, May 15th, I woke at 5:30 in the morning to cramping that I knew meant labor was underway. I rested as long as I could in bed amidst my growing excitement. Remembering how long it took from the initial cramping to actual labor and subsequent delivery of Jude, I took my time that morning. I rested when I could, tended to Jude and made the final preparations of our hospital bag.
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| Last family of 3 photo- story time in bed while I tried to rest. |
As I was resting in bed, at 9:30, I felt my waters start to break. Soon the contractions started, though not that close together. By 10am, I told Pete to take Jude across the street to our neighbors so that he wouldn't see me in pain. We also placed the initial calls to Mari who said she would leave shortly and be at our house in about an hour. Around 10am, I had the big gush of water breaking and Pete called the midwives. I was going to a practice of 4 midwives and there was one who I felt was the most "anti-pain medication." That was the midwife who was on call. She told Pete that I needed to come to the hospital right away as labor was likely to be quick. She was already at a small community hospital, Amstelland, and told Pete that we needed to come there quickly. All of a sudden, my plans to labor at home and the possibility of a home birth were thrown out the window. My first choice of the VU hospital was also thrown out and I felt anxious about going to Amstelland. It was the only hospital I had toured and I had left the tour thinking, "I don't think I want to deliver here." "Birth plans" really are a joke.
We made it to the hospital around 11, alerting Mari to meet us there instead of at home. The place was dead as it was Whit Sunday. Totally peaceful environment compared to my NYC hospital experience with Jude. I was whisked right away to a delivery room. While we waited for Mari to arrive, my midwife came in and examined me. I was 4-5 cm, "6 when contracting." I told her that I wanted an epidural and that I didn't want to wait as I feared then it would be "too late." She told me that the anesthesiologist was at the hospital, but that she "didn't think I would need one as the labor would be quick." Boy did that anger me! I told her, with Pete's support and confirmation, that I still wanted the epidural. She said that the anesthesiologist was with another woman and that she would talk to her about it. Mari arrived while she was gone and starting assisting with the labor pains, putting cold pressure on my back and doing some acupressure. After what seemed like forever, the midwife came back and said that the anesthesiologist was still with the other woman and that it was probably going to be too late for an epidural by the time she was ready. My biggest fear coming true. In addition to your own midwifes, when you go the hospital for delivery with pain meds, you are assigned to the hospital midwife. The nurse and midwives began talking to me about an alternative pain med, remifentanil, an opiod IV drug. I had heard about this option at both of the "birthing in the Netherlands" talks that I went to and both speakers said that this was a dangerous medication that can cause respiratory distress. I was very against this medication. During the Amstelland hospital tour however, they were singing the praises of this drug, which I later found out is because one of their physicians pioneered the use of this med in labor. The nurse told me that remifentanil had no negative side effects and I called her out on this saying that that wasn't true and looking at my midwife and doula for confirmation. She then backtracked and said that yes, there could be some side effects, but that they would be monitoring me. Not entirely reassuring. While we were waiting for the anesthesiologist to come, I was set up with an IV line in preparation for some sort of medication.
Finally, the anesthesiologist came. I was 7 cm. She said that I could still get an epidural if I wanted one, but that she didn't think it would start working until after the baby was born. She said it would take 20 minutes to take effect. I called her out on this (I was apparently feisty that day!) and told her how my epidural with Jude worked instantaneously. She countered that they don't give as high a does here or some such nonsense. Now she too was telling me about remifentanil and how it would help "take the edge off." I consulted with Pete and Mari and feeling like I didn't have much of a choice, consented to the remifentanil. I was given a button and told to push it after each contraction as the medication is short lived in the body. To be honest, I don't know if it helped. I was still in a lot of pain and feeling everything that was happening very quickly. It did make me dizzy though and perhaps that high feeling helped me through.
Throughout the short labor, Mari continued with her pressure on my back as I lay on my side. Pete was in front of me holding my hand, rubbing my shoulder and offering encouraging words of support. Just like in the movies, during contractions, I couldn't stand the sound of his voice (or any noise for that matter) and had to push him away from me! Sorry, honey!
All of a sudden, I felt the urge to push and was told it was time. With Jude, I was told when to push as the epidural blocked the sensation. I didn't know when I was supposed to be pushing this time around and was frantically asking for help. Once I started, I didn't want to stop. I wanted her out to end the pain! The screaming began (my voice was hoarse after delivery). I felt her moving down. My eyes were squeezed shut the whole time to concentrate. They told me she was coming and I couldn't believe it was happening so fast. I was told that she was stuck and to stop pushing and lower my legs. They did some maneuver to free her shoulders and out she came after just 8 minutes of pushing at 12:48pm. Everyone exclaimed what a big baby she was. We were also told the placenta was really big. She came screaming to my chest and our little Maeve was here!
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| With Mari, doula extraordinaire, recovering. |
After she was born, we were totally left at peace. No one whisked her off to do anything. She had excellent apgars and stayed with me. It wasn't until much later that they took her to weigh her- the whole time we were left in suspense of how big she was. 4250 (9lb 6 oz)- what a surprise! They don't measure babies length here as they don't think it is safe to stretch babies legs out after delivery. So we still have no idea how long she is. They also don't measure head circumference at birth. They don't put ointment in the eyes and they don't give an injection of Vitamin K. This we have to give orally for the first 3 months. Maeve was never tagged with a hospital ID and we were told that we would be home in time for dinner.
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| A brief check up by the hospital midwife. |
The nurse returned to remove my IV and help me shower. During that time, she remarked on my blood loss and I felt very dizzy while showering. Some blood was drawn to check my hemoglobin. The hospital midwife came in to manually contract my uterus- ouch! The blood loss was still too much. They thought maybe my bladder was full and preventing my uterus from contracting. So they put in a catheter. That was not the issue. They discussed that they wanted to start me on an IV drip of oxytocin. At this point, the staff switched and there was a new male midwife and a new nurse (who had given me the hospital tour). Another IV had to be inserted and I was told the drip would take 5 hours. I was transferred to a private recovery room and the drip began. Immediately, I started having cramping again, as painful as in labor. And this time with no pain relief. I started throwing up from the pain. Nothing could be done to help me except giving me paracetamol (tylenol). The drip lasted more than 6 hours. Thankfully after the first few hours, the pain subsided. Pete and I were curled up together on the hospital bed trying to sleep, Maeve sleeping in the bassinet next to us. Around 10pm we were deemed ready to go home. So we packed our stuff away, put 9 hour old Maeve in the car seat and just walked out of the hospital not really believing that it was that easy to get away.
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| Heading home in the dark! |
Overall, I had a positive birth experience. The feeling that the midwives were stalling the anesthesiologist to deny me an epidural was not pleasant though. In the end, a home birth was not for me. I needed pain relief and with the blood loss, I would have ended up in the hospital anyway, which would have been a major bummer. The midwife who delivered me did an amazing job dealing with the shoulder dystocia and I didn't need any stitches. And of course it was empowering to give birth without an epidural. The swift arrival of my healthy baby girl made it all worth it!
