Friday: The Birth Story of David James

The birth story of David James could not have been more different than the prior five for this retired La Leche League leader and home birth mama at heart (who herself was born at home 40 years ago!). While my firstborn was delivered in a hospital, the next four were born at home, and all five without analgesia.

David James' delivery?

• Found out the sex ahead of time for the first time ever--check

• Planned hospital delivery--check

• Anticipated likely induction at some point--check

• Showing up at the hospital alone because neither husband nor doula were yet available--not anticipated, but check!

• Planned epidural--check

• Asking a nurse to please make an exception (at this hospital without a nursery) and take my newborn away so I could sleep--check

• Rapid progression to use of pacifier and formula supplementation--check

So many lessons from God in this very different delivery!

Not a home birth

On Thursday morning, at David's gestational age of 38 weeks and 5 days, my blood pressure spiked above 160/110. With increasing hypertension with the last couple of pregnancies, this is the reason I'd risked myself out of home delivery. I'd always said that "home birth isn't for everyone, it is for the low risk women," and now I got to spend an entire pregnancy reminding myself to accept that truth. My blood pressure had stayed absolutely beautifully low (110s over 70s) until about 36 weeks along, and this time was no different.

On Thursday, I called my hospital midwife and we agreed I needed to head to the hospital. Chris took the children out for two hours to let me rest in silence and finish packing my bag calmly. Meanwhile, we called six people and nobody could babysit. Therefore, Chris and the van full of children dropped me off at the hospital at 1:00, Daddy went home to lay down children for naps, and he continued to seek a babysitter until he found one. (Over the course of the labor, he was in the background finding sitters for each shift: J--- who babysit the first daytime, dear mama M---- who took the overnight shift and sent us text updates so I wouldn't worry about the two little boys crying at bedtime, and the W---- girls who took the entire Friday day shift.)

Later a nurse commented how pretty I looked in the security photo taken of me at the front desk. I replied, "It's because I wasn't in labor and I could smile! I even put on makeup!"

I went through triage alone with a nurse vocally unfriendly to home birth. I'd been told earlier by a hospital staffer to inform all hospital staff that I am a former home birth mama because this hospital tries so hard to accommodate our type, so I was announcing it right and left. The triage nurse made her opinion about it very clear! I was grateful that at 40, I'm finally growing a thick skin.

Over the course of my labor, I would stay through three shifts of teams. My doula was my rock because she was my one stable presence (even Chris had to leave at one point
to go tend to children at home!). The LDR nurse A---- was precious and warmly told me how her best friend has delivered six of her eight babies at home ("where God intended babies to be delivered!"), all the while never knowing that my doula sitting right there was the best friend's home birth midwife at five deliveries! Later, the LDR nurse Manuela (the feminine of "God is with us") made for a wonderful team with my doula. Various nurses told me quietly how to make the experience a lot more homelike, for example how to eat as much as I wanted despite the "clear liquids only" antiquated policy (that ACOG does not even support!).

Back to triage . . . My blood pressure was now something like 165/115 and I was spilling protein, so pre-eclampsia was declared and intravenous Labetalol was in order. (As an aside, if you want to pursue an interesting rabbit trail, try reading up on the medical history of the diagnosis of toxemia/pre-eclampsia and the very muddled diagnostic criteria for pre-eclampsia currently used.)
Chris was able to show up before I was done in triage, and they wheeled me to my labor and delivery room because I wasn't steady enough to walk due to my now crashing blood pressure. Over the hours, my blood pressure would rise and fall like a roller coaster, depending on meds and labor, which caused a lot of nausea and wooziness.

Pitocin was begun at 5:30 p.m. but it wasn't until 3:00 a.m. Friday and the maximum dose (20 units) that I began to feel any contractions at all. What a bizarre experience! Knowing the plan to get an epidural, as devised by me and my doula, around 5:30 a.m. I requested the staff run the requisite bag of fluids, and then the epidural was placed at 6:10 a.m. The doula massaged my feet while the friendly anesthesiologist ran my epidural . . . three times to get it placed right.

I found it fascinating that even a grandmultip with a max dose of Pitocin for 20 hours total progressed so very slowly! It wasn't until noon on Friday that my dilation was complete and David was ready to do his part in laboring down.

Now is when the plan hatched by my doula and me went into action. I had gotten an epidural so my posterior baby could labor down, something I've never been able to do while unmedicated. All six of my babies have been posterior, which I believe shows that something in my pelvic anatomy clearly causes this malpositioning. It is hard to push out a posterior baby and is the cause of many Cesarean deliveries: labor just seems to mysteriously "stall" or "cephalopelvic disproportion" is declared.

I really did not want to push for three hours yet again, so I was willing to try this epidural. It took Baby David 2.5 hours to rotate from posterior to anterior, but then he emerged (at 2:28 p.m.) in about two minutes!

David James weighed 8 lbs 6 oz and was 20 inches long. My immediate recovery from labor was by far the easiest.

I know I've failed to maintain a positive attitude these last few months, especially, but this little soul was worth the pain and suffering!

(Retroactively published to Friday's date.)