|Renae and Alexander David
vaginal delivery, overdue, induced labor, spinal block, episiotomy
The story of the birth of my son really begins about two months prior to his actual birth. Since I am stationed in Vicenza, Italy, I looked long and hard at what birth options were available to me. I could go to any of the military hospitals in Italy or Germany. I could fly back to the States to have my child. Finally, I could have my child in one of the local Italian hospitals. After hearing the horror stories about how children are delivered here in Italy, I was convinced that I would at least be going to an American military hospital. That was until I meet my midwife, Signora Artemide Pozza. Signora Pozza works at the Vicenza City Hospital. I found out afterwards that she has been working as a midwife for 45 years. It's no wonder that she made me feel at ease even though we do not speak the same language.
From the moment I met Signora Pozza, I knew that she was the person I wanted to help me birth my baby. She agreed to follow my birth plan as much as possible, and would not make any decisions to deviate from it without consulting me. Each time that I had an appointment to see her (I took a friend to translate for me), the more convinced I was that she was the midwife for me. She even encouraged having my husband with me (something that does not always happen in Italy) and encouraged using the Bradley Method to help avoid using any painkillers. I thought that I had worked out every detail that I could before labor even started. I read every birth story that I could find, religiously practiced my relaxation exercises, laid out every detail of my birth plan and mentally prepared myself for the pain. I knew that come February 20th (my due date) I would be ready.
Well, February 20th came and went, and still no labor. I waited and waited and waited some more. When I was 1 1/2 weeks overdue, the doctor said he wanted to admit me to the hospital to be induced. My answer was no way! Then I spoke with Signora Pozza. She told me that the baby was quite large and that to wait even another week might result in a necessary c-section due to the baby's size. Well that decided it for me. I didn't want to be induced (it goes against everything the Bradley Method advocates) but I REALLY didn't want to have a c-section. So on March 1st, I was admitted to the hospital and received the prostaglandin gel at around 11:00 in the morning. Shortly after getting gelled, I started having some light contractions. I thought, "WOW! It's finally starting!" The nurse checked me both for dilation and with the external monitor. I was told that I was a fingertip dilated, but was not having any contractions registering on the monitor. I figured a fingertip isn't much but it was a start. To my disappointment the contractions (I know I was having them!) stopped about 2 hours later.
That evening around 7:00 (Daddy's visiting hours) I began to have pains again. This time they were stronger and harder, but still nothing too painful. I visited with my husband, Dave, my in-laws and some friends from 7:00 to 9:00. By the end of visiting hours, the pains were definitely stronger. The nurse checked me again with the external monitor and for dilation. This time I was 1 cm dilated, but was told I was not having real contractions since they were not registering as large peaks on the monitor and I was not feeling them in my back. I had my friend Monica (my translator) call Signora Pozza to let her know my status. My husband went to get some dinner and I got ready for a long night. I knew I was in early labor even if no one else believed me.
At about 10:30 that night as I was in the bathroom vomiting for the second time, one of my roommates offered to call the nurse for me since I was obviously not feeling well. When I came out, Signora Pozza was there waiting for me!! I can't tell you how relieved I was to see her! She looked at me, felt my stomach through a couple of contractions and said that I was definitely in labor. When she checked me, I was 3 cm dilated. They called Dave back to the hospital at around 11:00 that night. He was there helping me 15 minutes after he was called. Little did he know, he was in for a very long night.
By this time my contractions were coming about every 1 1/2 minutes and lasting for a minute or more. (I was still not feeling them in my back and still had no large peaks on the monitor, only very tight little scribbles that kept climbing higher and higher on the chart.) I was vomiting or dry heaving between each one. I had only reached 6 cm, but was feeling a strong urge to push. I figured I could continue to hold on without any medication and have the natural birth I had planned. Then my water broke. From that moment on, it was a relentless cycle of vomiting and contractions that did not give me a single moment's rest. My contractions had pegged on the top line of the external monitor. I still think that I could have handled the contractions if that was all I had to contend with, but combined with the vomiting it was more than I could take. I asked to get something to stop the pain. They tried one shot, but all it did was make me vomit more. I kept telling Dave that I didn't want it to hurt any more. He tried to take the good coaching route by explaining to me that I could deal with the pain, we wanted to do this naturally, I might regret getting drugs, etc., etc. I told him quite plainly, "I DON'T WANT THIS TO HURT ANY MORE!!"
Then they called in the anesthesiologist. He gave me a spinal block (single dose, no catheter). It was like night and day for me and Dave. No more vomiting, no more pain but I could feel each contraction and could move my legs. It was heaven compared to what I had been experiencing. It did slow my labor a little, but I kept progressing steadily. By 1:30 that morning, I was ready to push. We started with pushing on the labor bed in a seated squat position until the baby's head began to crown. Then I got up and walked (YES, WALKED) to the delivery room. I tried pushing the baby's head out through two contractions. When I made no progress, Signora Pozza decided that I had to have an episiotomy. (Even though I knew I would refuse this when I made my birth plan, I gave absolutely no objections when I was in labor.) It was a pressure episiotomy as outlined in my birth plan. Another two contractions and still there was no progress. That is when Signora Pozza and the doctor decided to use the Krystaller method (the doctor places his forearm on the woman's abdomen and helps to push the baby during a contraction. I knew that I would refuse this when I made my birth plan too!) Again they got no objections from me. I was tired and just wanted labor to end. I figured that it was not as bad as using the vacuum extraction or forceps.
Once last contraction and the head was out, the shoulders were turned and my baby was born. I let out this yell/growl that to this day, I don't know where it came from. It was so primal to feel my baby coming out. I couldn't have held it back if I tried. I was immediately lifted to see my beautiful baby boy, Alexander. He was so alert and beautiful (bloody but beautiful). He scored 9 and 10 on his APGAR's. I was allowed to nurse him for almost an hour on the delivery table. Then they took him away to be cleaned.
In all of this time and despite nursing, my contractions had stopped. They never resumed. The placenta was still very tightly secured to my uterine wall. Despite manipulating my abdomen, the placenta would not come loose. About two hours after Alex was born, I was knocked out and a D&C was performed to remove the placenta. Nothing like birthing a baby and then having the placenta aborted to take the oomph out of a person. I lost nearly two liters of blood and did not receive a transfusion. I took me almost a month to fully regain my strength (during which time my husband, also in the Army, was deployed for training).
I later found out from Dave that Alex was 9 lbs 1 oz and 21 1/2 inches at birth!! No wonder I had such a hard labor!!
Despite these hardships, Alex and I are thriving together. I am so happy to have such a perfect little boy. That was truly my goal. The birth plan was of little importance once things started progressing. I guess that is why I wanted to share my birth story with StorkNet. It's just my way of saying that to plan and prepare for a birth is essential, but you cannot get so caught up in the details that you forget the real goal, safely birthing your baby. I'm not saying that a child cannot be born naturally (that is again my goal for the next one) but that a woman should be flexible enough to recognize when she and nature may need a little help.