Thursday, May 21, 2015

Birth Story of William Jeffrey Madsen

After a less than idea birth experience with my daughter, I knew I wanted more for my son.  Clara’s birth wasn't necessarily traumatic, but it was full of interventions I didn't want, and didn't exactly need.  I ended up with PPD, and had a very difficult time enjoying my maternity leave, as I was constantly anxious and had trouble recovering. 

Soon after I got pregnant with Baby #2, I began to research birth centers and midwives in the Milwaukee area.  There weren't many options.  I knew I did not want to birth at the same hospital that I did before, and to move meant finding a new OB (there were no in-hospital midwives in my area), or forgoing the hospital altogether in favor of a birth center, which didn’t really make me comfortable. 

It turns out this search wasn't even necessary, because right after my 20 week ultrasound (it’s a boy!), our family moved across the country for Paul’s dream job in Richmond.  I did tons and tons of research on hospitals in the area, with the help of a data-oriented friend.  I discovered two hospitals with very low c-section rates (an indicator of a hospital that is evidence based and natural birth friendly).  Reviews from the 2 friends I had in the area told me to go to one, my gut told me to go to the other.  As soon as I arrived in RVA, I toured both hospitals and knew immediately that I needed to be at VCU (Medical College of Virginia) with their midwife practice. 

At my first meeting with one of the midwives, Leslie, I cried.  I was so relieved that she took the time to listen to me, to all my fears and anxieties about birth.  She told me that if I was a patient of the midwives, I would be committing myself to an un-medicated childbirth, barring any serious complications.  She gave me some great books to read, and assured me that I would have a chance to fully discuss my birth plan as the time grew closer.  The part that really assured me was when it came time to measure my belly and listen for the heart rate, Leslie asked permission to touch me.  That little step told me so much about the care I was to receive. 

By the time I was 36 weeks pregnant, I was totally ready to give birth.  I was confident, I was knowledgeable, and I was huge.  I was so ready to meet this baby.  At a previous appointment, Midwife Amber told me it was time to stop reading books about the birth process and technical details, and just relax.  Got it.  I received an amazing mandala coloring book for Christmas along with a set of sharpies, so I spent any free time I had coloring in fine details with colors that relaxed my mind and body. 

I should add at this point that I was part of VCU’s volunteer doula program.  I had two student nurses who were working toward their doula certification who would be on call to attend my birth.  Stephenia and Tammie were so kind and gentle and caring, and were truly excited to walk with me in childbirth.  As my story digs deeper into the actual labor, I’ll include their voices, which weren’t clouded by the hormones of birth. 

Early Monday morning, January 12, I was awoken by some discomfort in my back and belly.  I had been having Braxton Hicks contractions for weeks now, but when these kept me awake and began coming more frequently, I decided to get out of bed and start timing them.  I also figured this would be a good time to write out a list of instructions for my mother in law, who would be taking care of Clara when we went to the hospital.  Since I was only 37 weeks pregnant, I didn’t have any of this ready.  And of course I didn’t have a bag packed.  Or a crib set up.  Or anything, really, since we had just moved into our house, Paul had been working crazy hours, and I was too grossly pregnant to unpack much on my own. 

Around 4 or 5am I woke Paul up to tell him I was most likely in labor.  He asked if he could go back to sleep until I was sure.  I knew that a well-rested husband would be key in helping me deal with active labor, so of course I agreed.  I was texting with my two besties, Annette and Heather, this whole time, so I had all the moral support I needed.  By the time Clara woke up, I was pretty sure this was real labor, so I called the midwife on-call at the hospital.  Brenda told me that it could be prodromal labor, since I was a little early, and that if I hadn’t progressed by evening I should have a glass of wine and go to bed.  I was ecstatic about that!  However, it wasn’t to be.  Paul had gone in to work to wrap a few things up, and in that 2 hours, labor really got moving.  Clara was mostly left to her own devices (playdough) while I alternated coloring and leaning on the birth ball into stronger but still manageable contractions.  I texted Paul to let him know that he shouldn’t dawdle, and also that he should bring lunch. 

We were supposed to attend our nephew Bruce’s 3rd birthday that day.  It ended up that Clara got to attend, while Paul and I headed to the hospital to deliver her baby brother!  By the time we took her to my sister-in-law’s house, I was waddling quite a bit more than usual, baby was waaaay down in my belly, and my MIL seemed terrified that I would give birth right there.  I was just focused on not going to the hospital too early like the last time!  It was really hard to say goodbye to my baby girl, but she didn’t care one lick!  She was off playing with her cousin.

So, 4pm, I managed to pose for a photo at the entrance to Labor and Delivery.  My contractions slowed down a bit during paperwork, but I expected that.  Brenda was still there, and she assured me that they would start up again soon.  My doulas were finishing up a class, and would be there as soon as they could.  When Brenda finally checked my cervix (after waiting until I was ready), I was at 4 or 5 cm, definitely in active labor.  I was told I couldn’t get in the tub until 6 cm, but that I was welcome to use the shower.  Right now, the most uncomfortable part of the experience was the IV in my hand.  After about an hour I begged for it to be taken out, because it was keeping me from relaxing.  I sent Paul to get some food for himself while I sat on the birth ball in the shower, blissfully alone.  I managed to direct the hot water just on my lower back, while I stuck the upper half of me out of the shower to text with Annette and Heather some more. 

We entered the dimly lit room, which smelled like a blend of essential oils. The room smelled like an absolute spa. Paul was sitting by the bedside as Jessica was finishing in the warm shower. At this point, she was 5 centimeters along, and the contractions were increasing in strength and frequency. Jessica emerged from the shower and walked over to greet us. She got a contraction as she leaned over the counter, and Paul dutifully walked over to provide her with counter pressure on her hips and encouraging words like “Breathe”, “Relax”, and “Match my voice.”  This was my first time watching them interact, and together they, as a team, help bring this baby in the world. I broke into a wide smile as I saw this man love his wife and engage in the labor.

At one point, the nurse joined me in the shower with the portable fetal monitor.  Everything sounded good, and it seemed to be time to exit the shower for another cervical check.  Brenda had left, and Midwife Kathryn had taken over.  I heard her starting the water in the tub, which I knew was a good sign.  My doulas had also arrived and we were chatting through contractions, which were getting much stronger and closer together.  I was getting really tired, and wanted to lay down for awhile.  The nurse needed to do an official 2 minute fetal monitoring before I got in the tub, so laying down wasn’t a terrible idea.  My favorite memory of this really hazy time is lying in bed on my side, with Tammie rubbing my legs with heavenly smelling lotion, Stephenia putting pressure on my back with a hot rice pack, and Paul pressing my hips with his big strong hands.  Seriously, everyone should have 3 birth assistants.  It was amazing. 

Tammie and I (Stephenia, doulas) arrived at the hospital around 5:45 pm just an hour or two after Jessica had. When we walked into the room I remember how relaxed and peaceful it felt with the smells of essential oils, bible verses sitting on the side table with drinks out for Jessica, the birthing ball sitting out and the room nice and orderly.  Jessica seemed at peace and ready to have her baby.

After the 20 minute monitoring, they did another check, and I was deemed ready to get in the tub.  I had mixed feelings about the labor tub.  At this point, it was really difficult to change positions.  So the act of walking to the tub and climbing in was quite uncomfortable.  But once I was in the hot water and buoyancy felt so good.  I was really able to relax between contractions.  BUT, it was difficult to get in a comfortable position on my knees during contractions, which were getting MUCH more intense.  I sent Paul off again to get a soda, since we all figured I would be in the tub for awhile.  Nope.  After a few extremely intense contractions, during which Stephania and Kathryn were urging me to lower the pitch of my moans to make them more productive, and I was resisting and screaming instead, I felt a huge gush of water, and my contractions instantly went from really uncomfortable to OH MY GOSH THE PAIN IT HURTS SO BAD!! I immediately started to unravel.  It was during transition with Clara that I ended up getting an epidural because I just couldn’t progress, so I was sure this phase was going to last forever.  I started to get really discouraged, but my midwife and doulas just kept urging me on and telling me how wonderfully I was doing.  Paul came back during all this and was shocked, since he wasn’t gone for long and I had completely changed demeanors. 

One of the most beautiful things of the whole birth was seeing Jessica and her husband’s connection throughout labor. Paul was an amazing support to Jessica as he moaned with her during contractions and encouraged her. He would often say during a contraction “match the sound of my voice.”

Kathryn told me it was time to get out of the tub, since the baby would be coming soon.  I didn’t really believe her, and didn’t want to get out of the tub, but she told me I wasn’t allowed to have the baby in the tub.  Every single movement hurt.  I tried using a birthing stool, and couldn’t relax or get enough leverage to push.  All I really wanted to do was lie down, but in my mind lying in med was completely contradictory to natural birth.  But I did it anyway because I couldn’t support my own weight.  Once in bed, I still couldn’t push effectively, because everyone wanted me to curl up and grab my knees, and I just couldn’t.  I felt completely unable to do anything except scream with the pain.  I kept saying that I couldn’t do it, and crying. 

In between pushing, I took a moment to tell her “You are so close Jessica. He’s almost here. You’re going to have a baby boy in your arms very soon at the end of this. You have loved him for 9 months, and he is ready to meet you”

One nurse that was in there was really encouraging.  I can’t remember what she said, but I think she was giving me specific directions on how to push, and it helped. 

Jessica screamed as she bore down. Sharon, the night nurse, said to Jessica “Take that pain, Jessica. Pull it from inside of you and push through it. I know it’s hard, but I also know that you can do it.”  I could see the head of the baby turtling out, but then it would go back in. She rested between each push, completely releasing the tension in her muscles. I wiped her hot and sweaty face and chest with a cold towel. Paul held her hand, stroked her, and told her he loved her. Steph whispered in her ear “God is with you Jessica”. Gentle coaching and soothing words turned into commands. “Go! Push! Yes you can!”  

Paul, or I, or someone, suggested using the stirrups on the bed to keep my legs up, since I couldn’t hold them myself.  Again, this seemed to go against my “natural” plan.  Looking back, it’s kind of funny, because even the nurses weren’t totally sure how to get the stirrups up, since they never use them!  But it was a good move, because I could just leave my legs up instead of trying to curl up and lay back down every push. 

I clearly remember Jessica saying she can’t do this and looking afraid. Her husband told her she had made it thus far and was doing an amazing job and that she could do it. I told Jessica to look me in the eyes then I said “don’t be afraid Jessica, God is with you, you can do this.” All of us encouraged her to channel all her energy into pushing the baby out. It was amazing to see the moment on Jessica’s face when she was sure she could do this and was determined to push baby out. Two pushes later babies head was out and then another push later and William was on Jessica’s chest. It was a beautiful sight to see the three of them bonding and to see Jessica’s excitement that she did it! She delivered little William naturally and the way she had dreamt her birth should be like.

I’m not totally sure what happened, but after a bit of really ineffective pushing, and me fearing that I just wouldn’t be able to have this baby, I decided that to get the pain to go away, I needed to push this baby out!  It was kind of the way I get motivation towards the end of a really hard run, where I just can’t do it anymore, but I say, “You can do it, Madsen.  Just keep going.”  And I did.  I won’t go into too many details of this next part, but the next thing I knew, I had a squirmy, wet baby on my chest, and he was covered in vernix, and just simply beautiful and perfect.  He started squeaking and making little noises.  Not screaming, just little sounds that seemed to say, “Hi mama!”  All kinds of stuff was happening at the end of the table, and I was surprised that the pain hadn’t gone away yet, but I had my baby boy.  We had our beautiful Magic Time, where he crawled to my breast and started feeding like he had been doing it his whole life.  Later, the nurse told me they wish they had videotaped that, because it was a great example of what the Magic Hour should look like. 

Finally, with one strong, silent push and all the determination in her eye, Jessica pushed William into the world. Catherine guided him out and immediately laid him on Jessica’s chest. Jessica held her baby and kept him warm as she and Paul greeted him into the world. Catherine waited until the cord has stopped pulsing to cut it. William bonded with his mother as he found his way to her breasts. Jessica and Paul rejoiced in their newborn son and their love. Paul told Jessica, “I knew you could do it, there’s nothing you can’t do that you put your mind to.” They announced his name as William Jeffrey Madsen, and laughed over what the correct spelling of “Jeffrey” was. I was so honored to witness that beautiful moment of love in this family’s life. I hope that Jessica felt empowered and strong that day, and I wish the Madsen family and their new addition all the best!

After a little bit, little William started to scream, peed on me, and started turning blue.  Super scary!  They rushed him over to the incubator and took all his vitals, and he was fine.  We think he probably just got too smooshed into my breast while he was eating and couldn’t breathe.  After that I made sure his nose was always clear during nursing! 

After William got weighed and measured (7lb 4oz), and I got cleaned up a little bit, we got to spend another 2 hours just relaxing in bed and enjoying our new little family.  Paul got some skin to skin time, I got a sandwich, and then William got lots more milk!  We then got wheeled to our postpartum room, where we were delighted to discover a REAL extra bed for Paul to sleep on, instead of just a recliner or futon. 

Here’s what I loved about our postpartum time at VCU:
  • ·        The nurses were extremely attentive.  A nurse accompanied me to the bathroom every single time for about 12 hours, because I was light headed.  I felt very cared for.
  • ·         William slept like a champ in his bassinet the first night!  It was so refreshing to actually be able to sleep after giving birth, which didn't happen the last time.  I credit the lack of medication in his system. 
  • ·         My physical recovery was very quick.  I only had a 1st degree tear, and felt ready to be up and active by the next day. 
  • ·         Food was actually pretty good!
  • ·         William never left my room for any reason.  All tests were done right in the room.  He was bathed when I was ready, not when someone else told me it was time. 
  • ·         I got great breastfeeding support when I needed it, from nurses, midwife, and Lactation consultant. 
  • ·         I didn't get yelled at when, after not sleeping well on Night #2, I brought William into my bed and we both got to sleep.  I was so used to the militant anti-cosleeping movement in Milwaukee, that it was refreshing when I could parent the way I knew was best.
  • ·         No visitors.  I know some people love having visitors in the hospital, but I do not.  Too much pressure.  I loved that it was just quiet alone time for Paul, William and me. 

To wrap up, say what you will about natural birth being unnecessary in this day and age, or how much you loved your epidural.  I am so so happy that I was able to achieve an un-medicated childbirth in a peaceful, gentle environment.  William Jeffrey is an extremely laid back baby who generally sleeps very well and is usually happy and smiling.  My physical recovery was very quick, and my emotional recover as well.  Thank you, midwives, doulas, and nursing staff of VCU/Medical College of Virginia! 

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