Here's what I've been thinking about at 3am during Estelle's feedings the last few days. The feedback from my post on Estelle's birth story... mostly positive, some not so much. Maybe I came off whiny. Poor me and my birth experience. I'm not a professional writer, I'm like 3 steps below amateur blogger. It wasn't a crafted piece. It was free thought and processing. Heck, my husband, who is always correcting my grammar, doesn't even proofread posts before I post them.
I'm not advocating for or against hospital births, for or against midwives or OB/GYNs. I started this blog to help me process and heal from having a second trimester miscarriage. The OB that took care of me during this experience was amazing. Compassionate, caring, and truly helped me get through that situation. She gave me her personal cell phone number. She followed up with me and checked in weeks later. I appreciate her so much. She is the reason we delivered where we did and with the practice we did, with her and her partners.
I am not mad at the OB/GYNs who were part of my delivery. I do not think they did anything wrong. I think they did everything they are trained to do to make sure me and my baby come out of the experience alive and healthy. And we both did. I am absolutely grateful. I love my daughter. I did not mean for her birth story to give any impression otherwise. A comment I received said this person hoped my OB/GYN never reads this blog. But if she did, I don't think she would find any of this offensive. It's not personal to her. It's only personal to me.
I'm disappointed I didn't have the birth experience I wanted and prepared for. I made the decision to have a c-section. I believe my husband and I did everything we could in the moment to moment to keep in line with our birth plan and we made informed decisions with the medical team working with us. To boil it down, this series of posts says that I am disappointed. And that should be ok. It should be ok for me to say that without anyone taking offense.
I'm not an OB or midwife, and this isn't to attack or really question what the OB team did as wrong. Birth isn't a moral issue. There's no right and wrong. They did nothing wrong, based on their training and the information they had and their liability. It's about how I might've achieved my ideal birth given the information I had. Wanting a healthy baby and an amazing experience isn't wrong either.
In my previous post about Estelle's birth story I noted some points where I might've done things differently.
Point number 1: I wish I would have said no to the ultrasound at my 38 week appointment. I already knew she was head down. I might have been able to leave the office that day and never gone down the path of IUGR.
Point number 2: I wish we would have gone home and not started the induction until 39 weeks. I wish we could have tried some natural induction methods. I wish we would have asked what my Bishop score was to see if it was favorable for induction. To some people this probably seems crazy, but I wish I would have eaten more dates. I wish we could have gone home and had sex a bunch of times! I wish I could have kept using my Clary Sage oil.
I wish we would have put off breaking my water and the internal monitor. I didn't have any pain meds while I was laboring. Potentially, I could have lasted longer if they hadn't broken my water because the contractions were much stronger and more painful afterwards. Estelle also might've tolerated the labor longer.
I don't know that any of this would have helped us achieve a vaginal birth. The risk of waiting could have meant a stillbirth. This is what it comes down to, we have a healthy baby.
I think the most traumatic part now in the recovery from a cesarean is the risk for future births. I want to deliver out of hospital next time. There will be restrictions given the history.
I'd love to hear from ya'll about your birth stories. Was it exactly as you wanted? Any seemingly minute detail you would have changed?
You should be able to tell your birth story. And you should write it down. Maybe especially if it's traumatic? Maybe always, but I guess I won't know until I have another one to compare to. I don't actually feel that my birth story is traumatic, but it certainly wasn't an amazing, everything I wanted birth. Serena Williams withdrew from the French Open earlier this week. Probably nothing to do with her birth, but it was big news that this is her first major back after having her little one, and that she was devastated by having to have a C-Section. She had blood clots and a PE, which is a waaaayyyy better reason IMO to have a cesarean than mine. Anyways...
Estelle is 7 weeks as I start this.
We did a lot to prepare for birth in my opinion. Bradley classes (check) Birth plan (check) Review birth plan with birth helpers (check)
Estelle took this checklist and threw it out the window. Or maybe I did.
We prepared and planned for a natural, non-medicated birth. We had many discussions in our Bradley classes and with each other about whether this was possible in a hospital setting. We'll come back to that.
At my regularly scheduled 38 week appointment (Tuesday) I had a quick ultrasound to make sure she was head down and ready to come out. (This is my first point of contention with my decision making in my 20/20 hindsight) She was, but my OB was concerned about the amniotic fluid level. She sent me for an actual ultrasound, and the fluid level turned out fine, but then there were concerns about how small she was. They told me she was measuring in the 5th percentile. So basically, I was diagnosed with Intrauterine growth restriction (IUGR). The medical advice was to induce at 39 weeks, which would have been the following Monday.
I wanted to give my presentation on Friday. So I was stubborn and put everything off until after. My doctor wanted me to have a non-stress test, and she gave me the option to go to the L&D floor on Saturday to have it done, instead of in the clinic during normal business hours.
Estelle had decelerations of her heart rate during the NST. More evidence to induce. Like now. Don't leave the hospital. (This is second decision making point) Let's start your IV.
I got into a room, about 2:30pm, they started my IV, pitocin and I kept the electronic fetal monitoring on from the NST. I could move around though and I did. I labored for a while, before any other interventions happened. The EFM was not doing a good job of recording my contractions, and the strength. Anselm was timing them on his phone, and they were getting stronger. Eventually, (maybe around 10pm?) they wanted to break my water and use the internal monitor. We had delayed this basically as long as possible, we kept refusing and wanted to keep trying different positions. Then at some point, they put water back in, and stopped the pitocin for a while to see if I would contract in my own. I was, and I was having strong contractions, but I eventually learned I had only gotten to 5 or so centimeters. I had been at 3 before starting the induction. I had requested the OB not tell me after the cervical exams, and only tell Anselm of my progress. We kept trying to change positions, and pitocin was eventually restarted, but by 2:30am I was ready meet her, and the OB team was really putting the pressure on for us to consider changing the method of delivery to a cesarean. Estelle's heart kept decelerating and not recovering well after contractions, so we decided it was time.
The OB team got everything ready, and surgery started. Dr. Powell asked if she was going to have hair, and I said "Definitely!" Then I heard them say something about how much meconium there was. They got her cleaned off, Anselm got to see her first and cut her cord, then they brought her over to me to take some quick pictures and they whisked her away to the NICU.
She had aspirated her meconium, pretty badly. She ended up spending 10 days in the NICU.
Estelle is almost 9 weeks now as I'm finishing writing this.
I'm going to write about my points of contention in my decision making in another post, long with my thoughts on recovering from a cesarean and our experience in the NICU.
Started 4/29/18
I don't know where the saying comes from, "if you want to make God laugh, tell Him your plans" but I think there's something to it. I'm not totally a type A personality, but the portion of me that is loves planning.
If you haven't already seen on my other social medias, we welcomed our baby girl, Estelle, 2 weeks ago. She spent 10 days in the NICU but we've had her home with us since this past Wednesday. She's so sweet.
I'll do a separate post on Estelle's birth story, but I was thinking about this sorta silly saying recently, and it's just helped me process everything that's happened in the whirlwind of the last two weeks.
God certainly foiled my plans for Estelle's birth. I did however successfully finish my first clinical instructor experience, and my first major presentation at a professional conference. Estelle was born 2 days later :)
What is pelvic floor PT?
Pelvic floor PT is physical therapy from specialized physical therapists for diagnoses or conditions related to functions of the pelvis. This includes anything related to the bladder (peeing), bowel (pooping), or sex. It also includes any kind of aches or pain in and around the pelvis. This would include the groin, the pubic bone, low back, and abdomen. This could be for women at any age really, and some men too. There’s also a lot that a pelvic floor PT who has some obstetric training (like me!) can do during pregnancy and postpartum, since all that happens in the pelvis too.
What happens when I go see a pelvic floor PT?
The PT will talk with you about your complaints, your goals, your daily habits. Then usually there will be a physical assessment of your muscles, your movement, your posture. This could include an internal assessment of the pelvic floor muscles or not. It depends on your comfort level and if the PT thinks it is indicated. There is no need to do anything internal on the first day. Your PT should always explain the process to you and ask for your consent before proceeding! After this evaluation, your PT will be able to decide your baseline and plan the steps to help you achieve your goals.
Then what?
You and your PT will work together to create your plan of care. This might include exercises, or other things for you to do on your own at home, education, and/or lifestyle changes to make to help you achieve the goals you set out. You and your PT will decide how often you are going to meet, and if those meetings will be in person as is traditional, or perhaps a combination of in person and virtual.
I often find in my practice that I function as a health coach and a coordinator of patient care with other specialties that may be needed. Your PT should spend time with you to hear about the other members of your medical team. It’s important for everyone to be on the same page!
What questions do you have about pelvic floor/pregnancy/postpartum PT? Send them over so I can answer in a future blog post.
