Welcome Ava! (Option 2)

This post has all the details of Ava's birth... If you don't like details or anatomy or birth stuff, stick to the first post and skip this one.  I put all the pictures in the first one for that reason.

After watching the fireworks from our bedroom window, we went to bed tired from a busy Fourth of July.  Just after midnight, I awoke with contractions... Similar to the same as I have had for the last couple of weeks.  Nothing seemed too intense but things did seem to be more wave like and regular, so I decided to have a bath and ask Jason to pack up all of our last minute things.  Timing the contractions revealed one every 4.5 min apart.  We had planned to go to the hospital when they were 7 min apart, which never happened.  I practiced my hypnobabies techniques and listened to a couple of tracts from hypnobabies while Jason packed, told Nana we were going to go, and called both the hospital and our midwife.

We left for the hospital at 2:35am.  I tried to put on my headphones and focus on hypnobabies stuff but every turn and bump required its own focus.  My low back was very uncomfortable and I wanted to move around more than the car would let me.  I tried pillows and the seat heater but was really having to breathe and concentrate on relaxing.  Jason was trying to drive slowly and take corners gently, but I took off my headphones and told him to hurry and get me there!

Getting out of the car and walking up to the ward felt much better.  I went to a triage room where I was checked and told I was 6 cm.  Not surprising, since I had spent the last week at 5cm.  I was doing a great job of relaxing and breathing, drinking plenty of Gatorade and emptying my bladder.  In between pressure waves I felt good and calm and comfortable.  This strengthened me, because when I delivered Rachel I rarely felt like I got a break between contractions - they just seemed to slam into me one after another and after about 5cm or so I felt like I never had a break to regroup.

The next while of checking in was the part about hospital birthing that was annoying.  I had to answer medical history questions in between contractions, despite having already preregistered with it all.  I had to be plugged in to a fetal monitoring belt, which kept sliding off.  I was prepared to do this for 20 min and then get rid of  it, but since it kept sliding off, I think it was on for a while longer.  I could still move around and breathe and listen to my head phones, but I wanted to just focus on myself.  I still did well to relax through contractions in different positions during this time.

Jason called our midwife again at 4am, and left a message.  The OBGYN on call was Dr. Moeller, who we had met once, and who came in and introduced herself but clearly didn't know anything about me.  Our midwife wasn't officially allowed to deliver so the hospital didn't call her, and my own OBGYN Dr. Huynh started at 7:30am.  Everyone pretty much assumed that Dr. Moeller wouldn't be needed and we'd get Dr. Huynh in as soon as she started her shift.

I finally finished all the stuff we needed and went down the hall to the bath.  The warm water felt so good on my low back.  I didn't really think of it as 'back labor' so didn't really think to try anything to flip baby, which might have been a good idea.  The hospital scenario was that I could labor, but not deliver, in the water.

Jason and I were left alone in the bath area and our nurse said she would return in 30 min.  Contractions were getting more intense and I grabbed for Jason's hand for each one.  I had moments of fear and doubt about whether I would be able to do it, because I knew that we were just getting started on the really intense stuff.  During my contractions, I tried to stay focused on the tools I had learned during hypnobabies, but I did better during some contractions than others.  The great thing was that in between contractions, I was able to be totally comfortable and talk/move around/drink/relax and regroup.  So each break gave me a chance to reset my mental focus, and that allowed me to deal with one contraction at a time.

When the nurse came back, we asked if there was an option to be checked again or if that would have to be done back at the room.  She said I could be checked just outside the tub right away or I could wait another 30 min and she would come again and check me then.  She had a portable ultrasound doppler to check baby's heart rate during a contraction to make sure baby was ok.  We agreed to wait another 30 min and get re-checked then.  She said to call her if things were getting more intense.

2 min later, we called her and said things were getting more intense.  I was feeling a lot more pressure near my tailbone.  Checked to be 8 cm.  I decided not to get back in the tub because I wasn't sure I would be able to get out again, and we made our way slowly back down the hall into the room.

Details and facts for me get hazy from this point forward, as things seemed to happen very quickly.  The room was incredibly hot.  The idea was not to cool the room down too much because a baby would be there shortly and the baby would be better in a warmer room.  I remember:
- It was very, very hot and I wanted ice and water and cold compresses all the time
- I tried several different positions to see if I could get more comfortable
- I firmly requested Jason push on my low back hard during each contraction, because my low back was so uncomfortable
- I vomited and regretted having so much Gatorade
- I lay down on the cool bathroom tile during one contraction because the cold tile felt great
- I felt a lot of pressure on my low back, tailbone, bottom and couldn't quite figure out what I was feeling
- The nurse kept chasing me with the doppler to check on baby, even during pushing which I was annoyed with because it felt like I had a lot of hands on me at the same time
- I was checked to be 9.5 cm
- Shortly after this check, I had the urge to push and started pushing, even though I knew I wasn't 10cm yet
- My water finally broke after a few pushes, which felt so great
- I pushed on my hands and knees for many pushes, and the low back pressure subsided so Jason switched from pressing on my low back to having his hand squeezed very hard during each push
- My legs started shaking quite a bit and I didn't feel like I could keep myself up on all fours, so I switched to a strange sidelying position that seemed to be just perfect
- The doctors kept asking me to channel my energy into bearing down and pushing and trying not to use my voice.  I think this was their nice way of asking me not to scream... but I couldn't seem to hold in the urge to be loud.
- I didn't have a sense of how long things were taking or how much progress we were making, even after I touched the head.  But at one moment I couldn't physically move my leg because the baby's head was in the way, and I knew it was about to come out so that gave me strength to do a few more good pushes.
- Everyone has asked me since how long I pushed for, and I have no idea, but it didn't feel like a very long time.  I was trying to take my time in between pushes and keep things slow and even whenever possible, but Jason thinks the whole pushing phase was about 20 min.
- The baby's head came out, immediately followed by the whole body.  (This was such a different thing than Rachel's head, who came out but many things happened before her whole body came out.)
- Baby was put immediately on my body, and Jason checked to see that it was a girl!
- Jason cut the cord after a few minutes
- I looked at Jason with a big smile and said 'We did it!'
- It took a while for me to have any urge to push the placenta out, but it came out nicely and was all together without issue.  (This was also a blessing, because the last 2 pregnancies I had retained and then query of a retained placenta, and needed a D&C the first time and petocin and monitoring the second.)  Good job, placenta!

I never would have thought that I could have pushed out a baby that weighed 8lbs, 11oz without medication or intervention.  Other than some stitches, I didn't need any intervention and neither did Ava.  She came out face up, which explained all the back pressure, and possibly some of the lower back and tailbone discomfort I've had over the last few weeks.  She latched well right away and everything was great.

As far as hypnobabies success goes, I would say it was very helpful.  I wasn't a perfect student during the study time or during my birthing, and I think that the class itself can offer more than what I made of it in the end.  I did have trouble keeping focus at times as things seemed to go quicker than I could wrap my head around in the moment.  But, there were many things about this process that were amazing to me.  First, the class and information and practice made me go into the birth with confidence and not fear.  Second, during each break I was able to come back to complete comfort and calm relaxation so if I did have fear or any anxiety it felt very short-lived and then I was able to re-focus.  Third, although it was not pain-free, it certainly gave me some relief because if I focused on the tools I had with it, I was much more comfortable than during the times that I forgot to use it.  I wasn't great at using it during pushing, because pushing hard and fast seemed so much more natural to me than trying to slow things down and stay calm, but it was still very helpful.

My recovery this time has been completely different than with Rachel.  With Rachel I had a very comfortable pregnancy right up until the end, and then had a significant amount of tearing and couldn't walk comfortably for days.  I think it took me a full year to feel completely recovered.  This pregnancy was very uncomfortable for the last few weeks, and I felt better by the afternoon and more mobile than I had in the weeks before.  I can walk far, squat, bend, crouch, pick up Rachel, do house work, etc if I need to without any issue.  My pelvis and back and midsection feel so much better than they have in some time!  I feel eager to run and ride my bike and hike as soon as I can.

Emotionally, I am so thrilled.  I feel like I've accomplished a huge goal and I'm very proud of myself.  Somehow, although I know it's totally irrational, I always felt like I'd chickened out or shown weakness by having fentanyl during Rachel's birth.  Emotionally, Rachel's birth was very frightening to me and afterward the whole process wasn't something I was proud of, but something that I was scared of.  It was really important to me to be able to do this without medication... and I am very proud of this birth.  It was still intense.  There were very tough moments.  I was loud and messy and not graceful.  It was not quite like the beautiful birthing videos we saw during class.  But emotionally I felt calmer and more confident.  I wouldn't have changed anything about it.  Jason was a huge support for me and he made me feel safe and empowered.

The rest of the hospital stay was spent eating and moving slowly, trying to get to know Ava and help her sleep and eat.  A few people came to visit, including a very excited older sister and Nana.

Both of our little gals looked very similar on day 1.  Both were born at 40 weeks + 1 day.  Rachel and Ava will now have an interesting time getting to know each other.  All of us will enjoy the excitement and challenges that lay ahead in our family of 4 as we get to know these new dynamics.