John Luke’s Family Centered Cesarean Story

I was on track for a home water birth, but baby was postdates so I had to go in for a visit with a nurse midwife/OB team to have a biophysical profile done. My homebirth midwife had a good relationship with them, and if a hospital was needed, we would be established with them. When they checked my blood pressure it was very high. Even when they double checked it with the manual blood pressure cuff and stethoscope it was high. They admitted me for observation of my BP and to run blood work, also to monitor the baby and make sure it wasn’t having any adverse reactions to my condition. My liver enzymes and uric acid were elevated officially making my case one of preeclampsia. Since we were now in the care of the most mother friendly nurse midwife/OB team anywhere around us we needed to move forward with an induction, something that we definitely hadn’t planned on. I had to send my husband home with a long list of things he needed to bring back. Even still, I would be able to have my medication free water birth, just with a location change.

They inserted a balloon to encourage my cervix to dilate past the 2-3 cm it had been at for the past few weeks. Hopefully that would start my labor without needing to use any drugs. After a little while of having the balloon placed my BP climbed higher so it was decided that some Pitocin needed to be started to try to get labor going. The Pitocin was set on the lowest dose, and the nurses very slowly upped it overnight, letting the balloon and the medicine work together to dilate my cervix. By the next morning I was beginning to swell drastically, my hands, feet, and face were very puffy. Magnesium was suggested again, we had denied starting it the day before because if it was started I’d be bedridden and lose my water birth and have to have much bigger doses of Pitocin. Being stuck in bed took away my biggest pain relief method of standing during contractions and resting on the birth ball between, and I knew if I was stuck in bed with a catheter and unable to get up I’d need an epidural to manage my pain, which I was set against. My husband and I talked some more about our situation and decided we would see how far dilated I was since the balloon had fallen out and if I was close to fully dilated we’d continue to deny the Magnesium. I was 5 cm dilated with a bulgy bag, which wasn’t as far as hoped. We decided the best thing to do would be to break my water and try to encourage labor to really take off and hopefully I would progress enough that we wouldn’t need the Magnesium. We would try this for at least an hour. The nurse midwife agreed, but not without letting us know that she really felt that I should have started the medication the day before, so we were really pushing the envelope waiting longer. She also said she didn’t feel comfortable with us moving to the water birth part of the hospital farther from the OR and the rooms, so they would be bringing in the inflatable pool for my birth.

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Not long after this was decided my blood work came back and for the second time in a row the numbers were getting worse. I was now risked out of the water birth in total, which I was upset about, but around the same time I began to feel pressure like I needed to push, so on the other hand I was excited that I was nearing the end. After what I was hoping was my final check I was actually still only 5 cm and it was found my pelvic muscles, like the rest of my body, were beginning to be very swollen from the preeclampsia. My baby wasn’t going to come naturally; my body wasn’t going to be able to dilate any further. We were going to have our baby via Cesarean and I needed the Magnesium quickly to make sure I didn’t start seizing or have a stroke. I was sobbing after hearing this news, but we were given time, just my husband and I, to be together and mourn the loss of our ideal delivery and to boost each other up for what was to come. I was started on a bolster of Magnesium, a concentrated dose that made my skin red and my whole body feel hot. Prep for the surgery was handled very caringly, besides a gruff anesthesiologist, who wasn’t happy with my slouch for the spinal. It took 4 attempts to get the numbing medication in correctly.

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I couldn’t believe I was in an operating room, getting the dreaded spinal that I had spent more than the length of my pregnancy not wanting. I was in such good hands though, the nurse midwife and OB worked as a team during the C-section to do what they call a gentle C-section. I was not strapped down and I was able to have my whole support team there, my original midwife, my doula, as well as my husband. Since we had all of our helpers in the OR with us one was able to film the birth and the other was able to take pictures for us, so my husband was able to focus solely on me. Everyone in the OR was reminded that we didn’t know the sex of the baby and that my husband was the one that wanted to say what it was. The surgery started and I was able to just be with my husband, not worrying about anything else that was going on. When it was time for the baby to be born they dropped the drape and my husband and the anesthesiologist helped prop me up so I could watch our baby being born! My husband told everyone that he was a boy and he was placed directly on my chest by the nurse midwife. They left his cord attached to completely drain to him. He was checked for temp and suctioned etc. right on my chest. The surgeon let me know that the cord was empty so they were going to cut it long, leaving plenty for my husband to cut later when baby got weighed and measured. I only let the baby go away from me during the surgery when I felt the pushing and movement of them closing me up, because it made me nervous that I might drop him, probably something that could not have happened, but my IV was in the crook of my elbow, I felt numb pretty high up, and the bed was tilted so that I felt like I was laying downhill. When I handed him off to daddy he was taken to the side where he was weighed and measured. We opted out of any eye ointment or shots, so he had no real reason to cry, he was content, getting wiped down and bundled up.

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They gave him back to me as we were taken back to our room. We nursed instantly after reaching our room, there was no stay in a separate recovery area. We stayed in the hospital a total of 5 days, from arrival and start of the induction on Monday, birth on Tuesday, and going home after breakfast Friday morning. During our whole stay no one pushed us to do anything we didn’t want to do. Our little boy was not poked or hurt in any way, no vaccinations, no circumcision, no leaving for weigh-ins or baths. He wore nothing but a diaper and I stayed topless for 24 hours after his birth and besides some family holding him we stayed skin to skin the whole time, establishing our nursing relationship. None of the nurses or other staff said anything about me or my husband sleeping with our baby. We even got to see a lactation consultant, not because we were having trouble, but because that is protocol for the hospital to make sure nursing mothers have all the support the need. I was sore, and it was hard to get up and around for the hospital stay, but seeing that baby, smelling him, feeling his skin against mine, and feeling his breath was the best thing that has ever happened to me, and it was worth it all. I’d do the whole crazy experience again without a second thought. Did I want a C-section, no, but what we got was the best care that we could ever expect after a long time of us getting to explore our options and try our best to have a natural delivery until it was truly urgent. We are so happy with the care that we received that we already plan on using the same nurse midwife/OB team for our next baby, trying for our VBAC in the water.

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Thanks to Megan Ray for sharing this amazing story. Notice how the drape was lowered and Megan’s head was raised at the time of birth so she could see her baby being born. Her arms were left unrestrained and she was able to immediately hold her baby, whose cord was left intact until it had stopped pulsating. The baby was skin to skin from the time of birth and throughout recovery.

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