Posterior Baby

ONLY ONE CENTIMETER TO GO:
THE BIRTH STORY OF MY OP BABY
By Sarah Witholt

previously published in Birth Issues Fall 2012

SarahWitholt04

When my husband, Greg, and I found out we were pregnant, we were ecstatic. We had tried hard to get pregnant and persistence had paid off. Mixed in with the feelings of excitement, were feelings of nervousness of the unknown. Being my first baby I didn’t know what to expect from pregnancy or the experience of giving birth. I have known many people who have given birth and from their experiences I knew what I didn’t want.

After loads of research, we decided to enlist the help and support of a senior Edmonton doula. I had interviewed a few doulas, but she was the right fit and I could tell from the first time I met her. Although Greg seemed sceptical of having a doula at first, I think as time went on it began to put him at ease that he wouldn’t be the only support available for me. He actually still likes the idea of the husband waiting in the waiting room with a scotch and a cigar!

We had met with our doula numerous times throughout the pregnancy, which progressed perfectly. We became educated about childbirth and my options. Greg was supportive of whatever I thought felt right. I had decided that I wanted a very calm birth, with minimal interventions. In my mind, I believe that the more unnecessary medical interventions used to facilitate a birth, the higher the chance of complications. I wrote up my birth plan and presented it to my doctor, who said, “You can’t plan a birth”. I didn’t want an epidural, IVs, or constant fetal monitoring, but I wanted delayed cord clamping. Why couldn’t you plan that? So although it wasn’t my doctor’s plan, it was my plan.

SarahWitholt01On Saturday January 24th 2009, one week before the predicted due date, Greg and I decided to go out for dinner and a movie. After enjoying a nice dinner we decided to skip the movie and come home. We were both worn out from the week, so we had an early bedtime. After crawling into bed and reading a book for a while, I started to feel restless. Around 11:00 p.m. I got up to get a snack and use the washroom. And to my surprise, my water broke while using the toilet. The water was clear and I made an informed decision to stay home where no one would put pressure on me to give birth within a certain number of hours1.

I left Greg sleeping while I continued to read my book and wander about the house, wondering when the pain was going to start. With nervous excitement, I couldn’t get over that fact that I would soon welcome my baby boy into the world. Around 12:30 a.m. the contractions were becoming uncomfortable enough that I had decided to wake Greg and let him in on the early surprise.

Greg called our doula at 2:30 a.m. asking that she come over. I was sure that this baby was going to come soon. The contractions were 2-3 minutes apart and lasting 30 seconds long. They were becoming terribly painful and to ease the pain, I crawled into a warm bath, hopeful that the warm water would be soothing. Although it was, I found the bathtub to be quite confining and I wasn’t able to switch positions.

Our doula arrived at the house around 3:30 a.m. Sunday morning. I was starting to experience strong back labour and finding a comfortable position was very difficult. So as soon as she arrived, we actively started searching for a more comfortable position for me to labour in. I am still not sure if I ever found one. I spent a lot of time sitting on the ball while leaning on the bed. With the TENS machine2 that I had purchased, the double hips squeezes that my doula was applying on my back and the emotional support I had from Greg, the contractions and back ache became a little more bearable. I was most definitely in active labour!

I am not sure how many times we went from the bedroom to the bathroom and back to the bedroom. After numerous trips and lots of bloody show (showing that my cervix was effectively dilating), I felt it was time to go to the hospital. At 6:30 a.m. Greg and our doula had gathered up our stuff and off we went. It was a clear, cold night and the sun was starting to rise. Today was going to be a good day.SarahWitholt02

That car ride was the worst ride of my life. I don’t know if I have ever been so uncomfortable and in so much pain. I thank God that we did not get pulled over by the police, because I am sure I did not sit on the seat once. After the 20 minute drive, we arrived at the Grey Nun’s Hospital in Edmonton.

After being examined by the obstetrician on call, I was found to be 8-9 cm dilated and 80% effaced, with some swelling in my cervix. I was ecstatic; although I am sure I wasn’t able to show it. I was sure it was all going to be over soon and we would be welcoming our baby into the world any moment. The nurse too was excited. She immediately got busy setting the room up for delivery!

The contractions were very strong and along with them I had this overwhelming urge to push. I wasn’t supposed to push because my cervix was not fully dilated. But I had been a little and this was causing my cervix to swell. To decrease the swelling and dilate the remaining 1 cm, I adopted less gravity friendly positions and had to concentrate on not letting go of the urge to push. Easier said than done though.

The hospital had a flower border that ran around the entire room right where the wall meets the ceiling. They were old-school purple flowers. Those flowers became my focal point. Every contraction, no matter what position I was in, I could look up, breathe and focus on those flowers. I will never forget them. The only thing I remember of the next few hours to come was the hip squeezes, the TENS and those flowers.

At 10:50 a.m. the obstetrician came back to check my cervical dilation. I was 9 cm dilated, but with reduced swelling. This is also when I was officially told that our baby was direct OP (Occiput Posterior). He was facing “the wrong way”…sunny-side up… the back of his head firmly against my sacrum looking directly out at my belly. That was not what I had wanted to hear after labouring for so long. His posterior position was the reason for my long transition stage. My baby’s head had to mold and mold and mold to fit in the pelvis. It also took extra time, in this position, to corkscrew himself down and out.

The obstetrician had advised to “let nature take its course”. He was not going to intervene, which I was grateful for. He knew I was determined to have a natural unmedicated birth. So that is what we did.

IMG_2531By 11:15 a.m. I was tired and I cried. Contractions were only 6 to 8 minutes apart now, still lasting 1 minute. I was getting tired. The nurse started putting pressure on me to accept augmentation3 and the epidural. I only accepted to take some laughing gas, to help me cope with the intensity. It was very effective for me. I fell in a half-asleep half-awake daze and I just focused on the flowers. With the help of dimmed lights, soft music, Greg and our doula working together as my support system, I knew I could do this.

Unfortunately, two hours later our baby still had not turned. I decided that maybe my body needed some help to dilate the last centimetre. I accepted the augmentation so that my contractions could get stronger and turn our baby in a more optimal position. Wow…the pain became incredible. Indescribable. But at the same time, empowering. The TENS machine was worth its weight in gold!

After allowing some time for the augmentation to take effect, our obstetrician came back. He made me sit up on the bed and with every contraction he would insert his fingers around my cervix and manually help turn Gavin by gently pushing with a rotating motion on his head. It wasn’t exactly comfortable but by 2:50 p.m., he turned! I was warned not to hold my belly tight when he turned and to just breathe out and let my baby reposition himself. It was an incredible inward motion. I was 9.5 cm dilated and the swelling was gone. I was elated. Actually we all were. Everyone was all smiles. The nurse almost cried.

My obstetrician left and let me continue my labour. I already had quite a strong urge to push and I was having great difficulty preventing myself from pushing. Our doula did the “take charge routine” by making me look up at the ceiling and blow (pant) in a fast breathing pattern, as if there was an imaginary feather that I could not let fall on the ground. This is hard to do. Try to stop a natural automatic ejection reflex, you will understand what I was being asked to do.

By 3:20 p.m. I don’t think it was physically possible for me to not push anymore. This is the moment that I had been waiting for, it was time to push. My body took over. After 12 hours of labour, I found the energy somewhere within myself to give it my all. Every contraction I pushed with everything I had, hoping that it would be the last push and we would see our baby. It took 2 hours, but I did it.SarahWitholt03

At 5:25 p.m., Sunday January 25, 2009, we welcomed our baby, Gavin, into the world. He was a healthy 8 lb, 8 oz and 21 inches long. He was everything that I had imagined him to be and more. Still to this day I am in awe at the miracle of his birth and of him. I think back to his birth and although it was long and tiring, I wouldn’t have wanted it any other way. It was my birth and I can’t think of anything more empowering in my life. I am very grateful for the medical team that attended Gavin’s birth. They were unbelievable supportive of me and played a huge part in helping me achieve the birth that I wanted.

Sarah is 30 years old and currently resides in Wainwright, AB with her husband, Greg and son, Gavin. She spent her first 16 years on a farm near Onoway, AB. After graduating from NAITS Biological Sciences Program, she started her career as a Research Technician at the University of Alberta. In 2009, Sarah and her husband welcomed their baby boy into the world.  It was then that she decided to stay home as a full time mom. She is pregnant with her 2nd child due in the Summer of 2013.

Editorial notes:

1. Caregivers like to know if your membranes break because there is a slight chance that the umbilical cord gets trapped while the water flows out, which could affect the proper oxygenation of your baby. Caregivers will want to listen to baby, check for fetal movement and the colour of the fluid. If the water is brown or green and thick like pea soup, your caregiver will insist on checking on baby as it may indicate that your baby is compromised.

2. TENS stands for transcutaneous electrical nerve stimulation. This machine consists of a small box with four wires connected to sticky pads. It gives out little pulses of electrical energy. The pulses stimulate your body to release its own, natural, feel-good substances, called endorphins. It is also distracting and makes you feel in control! It takes about an hour for your body to respond to the electrical impulses by releasing endorphins, so start using it in early labour. The best place for the pads is on either side of your spine on your lower back. You can rent it at a physiotherapy equipment store, pharmacies, or online.

3. An augment, or augmentation, involves a ‘drip’, which administers the synthetic form of oxytocin (either called pitocin, syntocinon, oxytocin) via an IV and a pump. This makes contractions come more frequently and last longer. These stronger contractions can be more effective at turning a baby that is in a posterior presentation.

Advertisements