I came across this article about gentle C-sections on NPR yesterday and wanted to offer some commentary in the context of my own experience with giving birth, but then I figured I should share that experience in its entirety first. And OK, I just couldn’t resist writing up Little Boy’s birth story. In the interest of making it a little more readable, I’ve broken it up into two parts.
Early in my pregnancy, I decided that I wanted to try to give birth without pain medication. Although most of the anti-epidural messages out there are nonsense, epidurals do lengthen the pushing stage of labor, which can indirectly increase your chances of a C-section. But to be honest, I just really wanted to try “natural” childbirth. I wanted to see what it felt like (experienced moms, feel free to laugh maniacally here).
So I read up on techniques and attended a natural childbirth class. My husband and I practiced massage, counter-pressure, aromatherapy, and breathing; we discussed how he’d know when I really meant it if I changed my mind on medication mid-labor. Our local hospital is extremely supportive of natural birth, so there were no problems there.
Meanwhile, I mentally prepared myself for the fact that anything can happen during labor. I told myself that I wouldn’t be disappointed if our plans didn’t work out, if the pain proved to be too much for me, or if a medical emergency threw all our planning out the window. All I could do was give labor my best shot.
The earth shook the day Little Boy turned. Literally, not metaphorically.
It was late evening when the couch started to vibrate behind my back. My first suspicion was that the cat was trying to climb up the back of the sofa and attack my ponytail again, but a glance around the room revealed that she was sleeping innocently by the bookshelf. The weird feeling continued, so I got off the couch and knelt on the floor, at which point it seemed to stop.
Back on the couch some time later, I felt Little Boy vigorously kicking my lower back. This was a new sensation, as he had previously been showing off his skill at kicking the top of my stomach. There is a picture taken from the night before in which both his grandmothers have their hands on my belly, feeling his movements. This new lower back kicking felt different, but not unlike the odd sense I’d had of the vibrating sofa. Oh, that must have been what it was.
It turned out that the shaking sofa had not actually been caused by my newly-breech baby, but by an earthquake! We do not live in an earthquake-prone area; in fact, I’d never felt an earthquake before, which explains my inability to figure out what was happening.
Where I live, a breech baby means a C-section, especially for a first-time mother. But my OB-GYN urged me not to worry: there was still plenty of time for him to flip head-down. The doula who led the childbirth class suggested some exercises – crawling on hands and knees, bouncing on a fitness ball, laying with my hips propped up – and I tried them all, despite strong reservations about their scientific basis. I even went so far as to try some decidedly-unscientific methods, like putting ice on the top of my stomach and playing music at the bottom.
In spite of my efforts, Little Boy decided he was awfully comfortable with his head up by my rib cage. Four weeks from my due date, he still hadn’t re-oriented himself. There was still some chance he might turn again on his own, but frankly, he was running out of space to do so. Our last remaining hope was to schedule a procedure called an external cephalic version (ECV, or just “version”), in which a doctor would attempt to manually manipulate Little Boy into turning.
An extra ultrasound and maternal-fetal medicine consultation later, and I had an ECV scheduled for 39 weeks, 3 days pregnant (i.e., 4 days before my due date). I knew going in that we had at best a 50-50 chance of success. A compliant baby, and I’d likely be able to go home and wait for labor to start. A stubborn baby, and I’d be headed straight to the OR for a C-section.
It took a while for me to deal with the idea that I might not even get to try labor. I was disappointed; I hadn’t prepared myself for this. I looked up a lot of statistics on breech babies and ECVs and what conditions maximized the chances of a successful ECV and why breech births are considered dangerous. (One of the biggest risks, it turns out, is a lack of experience with breech delivery. The American Congress of Obstetricians and Gynecologists flat-out mandated C-sections for breech babies from 2001 to 2006, although the “breech = C-section” equation has been around for decades before that.)
In the end, I mostly came to terms with the situation. There were a few pluses; for instance, if the ECV failed, I’d get my own doctor for the C-section rather than whoever was on-call. I was still really hoping it would work, though.
The registration process at the hospital was agonizingly long. I had submitted the appropriate pre-registration forms, but the woman at the front desk seemed to drag … everything … out … on … and … on … all in an extremely-Texan accent. It was 5 a.m., I was exhausted and hungry (no breakfast allowed, of course), massively pregnant, and ready to get things going.
We finally made it back to a room, where we waited some more. My husband and I danced a little, a slow, gentle rocking to pass the time.
A nurse came and hooked me up to the contraption that would monitor Little Boy’s heartbeat while I lay on the hospital bed and waited some more.
I played some FreeCell on my husband’s iPad, and we waited.
The placement of the epidural didn’t hurt. My mom tells me that getting her epidurals started while having contractions every three minutes was rough, but I wasn’t in labor. I was about as comfortable as you can be in a hospital gown while 9 months pregnant and desperately wanting to sleep.
Once the epidural took hold, however, I felt like crap. My blood pressure crashed, making me terribly nauseated. They gave me something to raise my blood pressure and tipped me slightly on my side, and the desire to throw up slowly went down.
Eventually, I was deemed sufficiently anesthetized for the ECV to begin. A quick ultrasound to check that Little Boy was still head-up, and it was time.
The level of epidural medication that you get for an ECV is not the same as you get for a C-section. You’re not supposed to be completely numb, just desensitized enough to relax while the doctor pushes at the baby in your stomach.
I focused on breathing through the pain while the maternal-fetal specialist tried to gently disengage Little Boy’s head from my rib cage and coax him into a somersault. Two tries, then three, and it almost worked. I felt the child get part of the way into a turn before slipping back. The doctor tried again; fives tries, six – but Little Boy just kept turning back.
The doctor’s arms were shaking with effort, but my baby was stuck. I was given the final say as to whether we were done trying, and I made the call. Little Boy was going to be born by C-section.
Stay tuned for Part 2, in which I learn that laughing gas is available in the operating room.