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Week by Week

Christopher Edward Halverson

The midwives made me quit work at 38 weeks due to high blood pressure readings at their office (tested at home during week 40, the readings were never high, and they never were high during labor), I never had pre-eclampsia, no protien in my urine and no swelling and you need at least two symptoms to be diagnosed (at least at this practice).

So I spent a few weeks going crazy, laying on my side watching awful daytime TV. I found reading on my side very difficult. In addition to sending me home from work, they asked me to have a biophysical profile (Ultrasound) done. We agreed, mostly because at that point we didn't know I didn't really have high blood pressure. The baby scored 10 out of 10, and was estimated at 6 lbs. 5 oz. This was our first ultrasound (the midwives don't do any unless there is a problem), and it was sort of neat to see the baby, I especially liked the vertabrae. When the baby hadn't arrived by it's due date (June 21st), they started talking about doing an induction. (the back-up Dr's started this, the midwives had to start to consult with them when I had two high blood pressure visits in a row). They were mostly worried that the high blood pressure would hasten the deterieration of the placenta. I was definately against this. By now, we were sure that the high blood pressure readings at the office were spurious, and we really wanted a natural birth. I am terrified of hospitals, mostly because I don't like losing control of what happens to me, and all my hospital experiences as a child taught me that you get no control over yourself. I was sure, that if we did go with the pitocin I would end up with an episiotomy or a c-section, and I didn't want either.

The midwives wanted to schedule the induction for 41 weeks, but we got them to agree to do another biophysical that day and decide based on the results. I spent a very stressful week at home, doing nipple stimulation to try and start contractions and breaking into tears each time I thought of the possibilty of being induced. The baby was still kicking and moving like normal, so I wasn't worrying about it much at all.

Anyway, on Monday (June 28th, 41 weeks), we had our second biophysical profile and then went to see the midwife. Luckily, it was our favorite who was on call, because I was a wreck. (there are three midwives in the practice, one only works one evening and every third weekend). Basically, the results were that they would be willing to wait one more day. Even though the baby was still doing well ( 8 out of 10 on the biophysical), they were worried that things could deteriorate rapidly. By that time, I was so stressed that waiting one more day didn't seem like it would help, and our favorite midwife was on that night and the next day, so we decided to go ahead and let them do the induction.

The plan was, that we would check into the hospital that night, and the midwife would insert a vaginal prostaglandin suppository to try and get the cervix to "ripen" so that when they started the pitocin the next morning it wouldn't have so much work to do. At the time I was 1 centimeter dilated and "soft", but I don't remember what percent I was effaced.

So, we checked in, and did the suppository thing, and some initial external monitoring for a baseline strip. Then the midwife went home, and recommended we try to get some sleep. We did manage to get some sleep (I sure wish the birthing room bed was queen sized, as I would have much rather have had Pete with me than in the fold out chair. We did consider just sleeping on the floor, but figured the nurses might not like it.) , I woke around three having mild contractions every 2-3 minutes. I walked around some, had a shower, and got changed into a hospital gown (over the head even, not one of those silly tie in the back things). Around 5 AM, the nurse came in to do a monitor strip, and that woke Pete up. I was having contractions every 2-3 minutes, and (on the advice of the midwife) was doing some nipple stimulation to try and increase the intensity of them.

The midwife came back Tuesday morning around 7:30 and checked my progress. I was 3-2 centimeters (3 externally and 2 internally) and 50% effaced. The options now were supposed to be: try another prostin, or to go the Pitocin. (The back-up Dr. had wanted to start the pitocin at 4:30 AM, but the midwife had decided she wanted to sleep in till at least 6:30). Our Midwife asked if the nipple stimulation was doing anything and I said I thought it made the contractions stronger, but I didn't know if they were closer together. We tried some on the monitor and they did seem to be more frequent with the stimulation. The midwife said we could have till 11 AM to try nipple stimulation full time and see if we could get labor going without the pitocin. We jumped at the chance and proceeded to spend the next few hours walking the halls, pacing the room and relaxing in the chair, all the while doing nipple stimulation. I was going on the external monitor every hour or so for about 10 minutes.

At 11 AM, the Back-up Dr. on call came in to check on my progress. She called me three centimeters, 90% effaced and waters bulging. She did not want me doing nipple stimulation unless I was constantly being monitored. (we'd been doing 10 minutes per hour, and always standing up, since I refused to get in the bed except for internals). Luckily, when the midwife came back a few minutes later, she talked th Dr. into letting me continue as I was since she was staying full time from then on. BTW, they were monitoring my blood pressure during the external fetal monitoring and it stayed normal throughout the labor.

The contractions were starting to be a bit more trouble now, especially since I could only really find two comfortable positions: standing up and sitting on my side in the big arm chair. Sitting up straight and laying down were just awful. At Noon, the labor became official.. the nurses started my labor log.

We kept on with the nipple stimulation and the contractions kept coming. I spent some time in the shower (hand held massage head), but felt like the labor was letting up while I was in there, so got out fairly quickly. The midwife said it was probably just as strong, only felt lighter with the water massaging me.

Around 6pm the midwife was going off duty and the part time one was coming on. When she came in they said they would like us to consider having my membranes ruptured if I hadn't made any progress when she did the 6 pm internal. Pete and I discussed it, but decided that if we'd made any progress at all, we'd like to keep trying. The internal came up at 4 centimeters and we decided to wait till 8 pm and check again. By now, I had started having back labor and was only comfortable standing up. The time I had to be in bed for the internals was hell. At 8 pm. I had only made about 1/2 a centimeter at most and we let them do the amniotomy. In retrospect, I probably should have held out longer. I was really uncomfortable with my waters broken, with fluid gushing out at every contraction. The baby showed some cord compressions after that, so they insisted on monitoring in the bed in different positions for a while. Pete finally talked them into letting me stand up again just as I was about to lose it and start screaming. The midwife decided that the baby was responding fine and set me free of the monitor. I don't remember much of the time between then and 12, except that I was really having bad back labor, and the only thing that helped was driving my thumbs into two spots in my back. Pete's thumbs in the same place didn't work. I spent a lot of that time leaning against the head of the bed, or leaning backwards against Pete.

At midnight, they check me again (this was when the midwife said she thought the baby was posterior) and I knew it was bad news when the midwife went to wash her hands before she said anything. No progress. Now, she started talking about the pitocin again. She said the Dr. really wanted to start it because she was afraid I'd be too tired to handle the rest of the labor, but that if we really didn't want it, she (the midwife) would be our advocate with the Dr.. We didn't have to decide right then, so I decided to take another shower, and the midwife sent Pete on a rest break and stayed with me. The shower really felt great. I could direct the water just where I wanted it, and it really seemed to lessen the pain. The nurse on this shift used to be a Bradley instructor (we had taken bradley classes), and she helped a lot. We did some hip circles and things to try and get the baby to rotate to an anterior position, and she did some back rubs that really helped with the back labor.

I showered and labored till around 2:30. I was about ready to give in then, I was tired and in pain and felt like nothing was working. I still didn't want the pitocin, but I wanted pain medication. What kept me from taking anything was that I knew they all tend to slow down the contractions and that was the last thing I wanted. At 2:30 I got another internal, and MIRACLE I was 7 centimeters. That put an end to all thoughts of Pitocin and Pain medication. Of course, if we hadn't been so tired, Pete and I might have remembered from our Bradley classes that I was showing all signs of being in transition, but in our bleary state, we missed it.

I got back in the shower again, and while it felt good, it wasn't as big a help as before. I couldn't even think of sitting down in there like I had a few hours earlier. I told Pete I thought the baby was going to come out rectally, because I felt so full. We got out of the shower around 4 and were drying off when the midwife stuck her head in the door and said "sounds like you're ready to push." I said "what?" she said she had heard me grunting and that usually meant it was time to push. When we came out, they had transformed the room into delivery mode. I couldn't believe it. I also couldn't stand the thought of getting in the bed to be checked, so we walked a little and took some contractions with me hanging between Pete and the nurse. Finally, I was ready to try the internal. The midwife said I just had a little tag, and she would hold it through a contraction till the head passed it. That was another bad moment, but I was so glad to be ready to start pushing, that I didn't really care. The midwife said the baby was really close and I didn't have far to push, but of course I was thinking of all the horror stories I had heard of 3 hour pushing sessions and worried that I wouldn't be able to last. She was right though, I only pushed for about 30 minutes and at 4:53 AM, Wednesday June 30, Christopher Edward Halverson greeted the world ( 7lbs 7 oz and 19 1/2", I missed his apgars) . His first act (while just his head was delivered) was to bite the midwife when she went to suction him. He was really thrusting his head around, like he wanted to see the whole room before the rest of him was born, and he still is a real "looker", when he's up on my shoulder he's always turning his head back and forth and looking over my back. If you put him on his belly, he lifts his head up and looks all over. Sometimes he even works up enough steam to throw himself over on his side and then roll to his back. I expect he'll lose this ability as he grows, before he gains back autonomous turning over.

Talking with our favorite midwife while she checked me out prior to discharge the next morning (I wanted to leave earlier, but the pediatrician wanted to keep the baby for a minimum of 24 hours.), I found out that the midwife who delivered our baby had really had to hold off the back-up Dr., not only at midnight, but actually all through the evening. I really credit the patience of the two midwives who worked with us as the reason we were able to end up with the unmedicated birth we wanted. They may have been a bit conservative regarding the blood pressure and agreeing with the Dr's that I should be induced in the first place, but they really took our feelings into consideration and worked with us to help us have the birth we wanted AND a healthy baby. If there ever is a next time, I definately will use a midwife again, and if we're still in this area, I'll use this practice again for sure. (If anyone is in the area and wants a recommendation, send me e-mail.) Next time, I might even have the courage to have a home birth. Basically I was against it this time because I was worried that if something was wrong with the baby it might take too long to get to the hopsital (the one I delivered at is ahbout 20 minutes away, but the one most of the home-birth midwives use as back-up is 40+ minutes away).

Anyway, we had his 3 week check-up yesterday, and he's up to 8 lbs and 20 3/4 ". So far life with Chris is marvelous, I hope it stays that way :-).