Birth goals
For the births of both children, my target was a healthy mom (A), healthy baby (B), and to avoid major surgery (C).
For my first birth, as a first time mom, I decided to go about this by birthing in a hospital. I had a doula, labored at home as long as I could, and ended up getting an epidural, pitocin augmentation, and having an uncomplicated vaginal birth after a few days in labor. I enjoyed my hospital stay.
This birth, my second, I decided to go with a different approach than with my first birth. My goals were still: a healthy mom (A), healthy baby (B), and to avoid major surgery (C). But this time, I wanted to target an unmedicated birth: because I wanted to avoid some of the minor pitfalls I found in my first birth experience. My experience in the hospital taught me that my coping techniques and the hospital environment were more conducive to an epidural, and that even with an epidural there were many elements of discomfort that I wanted to avoid. So this birth I decided to learn new techniques and stay out of the hospital environment if possible. I still wanted to be closer to medical resources so I chose to target birth in a birthing center: a place with nurses also certified as midwives with a controlled, peaceful environment, a few minutes from a major hospital in event of dire emergency complications.
Birth program: Hypnobabies
I chose to train with new techniques with a program of studied hypnosis and childbirth education called Hypnobabies. It was perfect for me and this birth. Hypnobabies, for me, was all about focusing on the positive while recognizing birth is unpredictable, and helping my mind let go of fear and anxiety that isn’t helpful to relax into birth. It can be a bit hokey at times because you use different language to refer to common birth events — “birthing time” instead of labor; “birthing” instead of delivery; “guess date” instead of due date; “pressure waves” or “waves” instead of contractions. Although the language felt stilted at first, its intent is to help promote a new attitude and I found the language really worked. I also think now of hypnosis in a different way: more like a relaxed, deep focus, a sense of executing without thinking, being “in the zone”.
This program involved daily listening to hypnosis tracks in preparation for birth including daily positive affirmations. With everything going on in the world (pandemic, and more) and my pregnancy these tracks really kept me on track and regularly helped me sleep. I liked the program as well because it has lots of options for how to use it during birth (audio tracks, a partner reading, or your own mind working with it) so it seemed there was a plan and a contingency for every element. The course leading up to the birth was 6 weeks with dedicated tracks for each week and reading material. Then during birth, a few tracks and techniques only to be used on the birth day would be available, in addition to a selection of the tracks practiced with during the course.
When it came to my labor (“birthing time”) Hypnobabies delivered on its promises as I delivered (“birthed”) my baby. This is the story.
Second Birth
Last pregnancy I worked up until my due date/40 weeks (“guess date”) but ended up giving birth about a week and a half past the guess (41 weeks+3 days). This pregnancy I took off work at about 37 weeks with the hope that both as a second time mom (babies tend to come earlier) and with less work stress I’d have a baby in my hands earlier. 42 weeks is generally considered the deadline by which to have a baby; after that it is increasingly more likely to have placental and other complications. So if I reached 42 weeks I’d need to head to a hospital for medical help to start the birth process. My hope that taking off work early might lead to an earlier birth did not come to pass, this pregnancy I again went past 41 weeks. At 39 weeks I got a sporting related back injury from Kung Fu; I was able to walk but had a lot of sciatic pain when putting weight on my right leg.
Leading up to the birth day, the day before 41 weeks (40+7) I started to feel some nausea which was a sign of the onset of birth with my last baby. The day of 41 weeks (41+1) I had an appointment with the midwives at 41 weeks to do a “non stress test”; after 41 weeks there is monitoring every few days to make sure the pregnancy seems safe to continue. The test went well, and we even saw some contractions (“birthing waves” or “pressure waves” or “waves”) on the monitor that I wasn’t feeling but that appeared. We discussed options for speeding birth along: these included a membrane sweep, a castor oil smoothie, and later potentially a Foley bulb to dialate the cervix. We decided to leave things as they were, to not do a cervix check, and at the next appointment in a few days (41+4) to do the sweep/smoothie, and the appointment after that (last chance before the hospital) to do the Foley bulb (41+6). I went home. My back was still very difficult to walk with, but I was starting to increase my walks. I walked a few blocks that night.
Overnight, each night, the nausea went away; this pattern continued, and I was disapointed as it seemed birth progress was dialing back. I continued not to feel any birthing waves, though my husband Casey said he could feel my belly tighten on occasion. I told Casey to get everything ready to go in the car, and the nausea came back the next day (41+2). I went to bed that night and at midnight I happened to wake up. I often used my Hypnobabies audio tracks if I woke up, as I needed to listen to many a day to practice and this was a convenient time, and they also had the side benefit of relaxation and helping me to get back to sleep. I’d wake up a lot in late pregnancy due to back pain and pressure on my bladder. I decided to listen at 12:01am on 41+3 to a track reserved for when you thought it might be the birthing day! There weren’t any physical signs yet, and the nausea had again dialed back at night, but I just decided 41+3 is the day. So I listed to the “birthing day affirmations” as I fell back asleep.
I woke up the next day feeling great physically: I had a good night’s rest, and the nausea was again gone, but disappointed emotionally. I was ready to meet the baby, and although I was less anxious about running over time, I was not looking forward to the coming appointments with the midwives. My husband said he was going to go for a long walk with our toddler, which invovled a large hill and possibly an entire hour of walking. Walking is known to help get the birth process going and I decided, since today was the day, I’d go on a walk with my husband and toddler to kick it into gear. He asked if I was sure, especially given the state of my back and seemed dismayed at first that I’d be holding back the speed of their walk (with my back I walked even slower than the toddler), and I said yes I was sure and it’d be worth it if the birthing process started. I brought my phone and headphones to listen to my Hypnobabies tracks if I was right.
We headed out at around 10am and soon we were all having a good time. I began to feel some pressure waves, just at the peak of the wave, with no need to stop due to discomfort. It was great to finally feel the sensation of the waves and we kept walking. My main discomfort was from my back. When I reached the bottom of the hill, around 30 minutes into the walk, I told my husband and toddler to continue on and I’d meet them at home. When we separated, I put on my Hypnobabies track “My birthing time begins”, which is a reminders and kickoff to the birthing day. I walked up a few flight of stairs on the path and continued to feel the peaks of birthing waves. When I made it home I decided to make some lunch, and put some quinoa in the instant pot to be mixed with fresh vegetables and kidney beans. I continued listening to my tracks and started timing when I felt the birthing waves. I was feeling maybe 5 seconds of them with any intensity, but could sometimes tell when my stomach was tightening. They seemed pretty close together already: 7 minutes apart, about 45 seconds each. The midwives had said that should be about the time to come into the birth center, but given that I couldn’t really sense much, I didn’t take that too seriously.
When Casey got home around 11am we had an easy lunch together, with me still listening to “My birthing time begins” in one ear using my Apple Airpods. After lunch I said that today really was the day, and he should call the midwife on call, and call our doula and the friend that would be caring for our toddler during the birth to get on their way. By this time I switched over to listening to the “Easy First Stage” Hypnobabies track. Casey first went to put our toddler down for a nap, who must have sensed that something was off, because the toddler didn’t sleep easily. Here my pressure waves started getting intense enough to use some active Hypnobabies techniques to put myself in a deep state of relaxation during them, and I moved up to our bedroom to relax on the bed: using these techniques my eyes would close and I’d focus inward. I had stopped timing the pressure waves, reasoning everyone was on their way and it was distracting to my relaxation. It seemed the were growing apart a bit, although they had gotten more intense. Casey gave up putting the toddler down for a nap and went to call the midwife. I could hear the toddler grumbling and decided to go over there to comfort them.
Although the toddler and I had spoken many times about the baby on the way day, reading books, and discussing the progression of events and the process of “belly squeezes” I hadn’t practiced the eyes closed relaxation tehcnique in front of them and it tended to freak them out. I was reading the toddler stories, and would need to take breaks to invoke my Hypnobabies techniques. I also had a stead stream of the Hypnobabies audio from “Easy First Stage” in one ear. After a few eyes closed pressure waves I decided to move to an eyes open technique where I would also be able to move; this seemed to calm the toddler down. Eventually my husband came in to relieve me, and I transferred downstairs while he was able to successfully put our toddler down for a nap. I lay on the couch sidways, and Casey came down to join me. He also took the hypnobabies course and was able to help support me during my pressure waves. By this time it was about 1:30. Brittney, who was to take care of our toddler, got stuck in a little traffic, and our doula Dawn hadn’t quite made it yet either.
The waves were getting more intense, and suddenly I felt my waters break! We had been planning to leave for the birth center soon after everyone arrived, but at this point it felt even more urgent. Luckily I was wearing some padded underwear, which I learned during this pregancy and last are great for during the birthing process and after, so it caught all of my waters and didn’t ruin the couch,. Unfortunately , when we checked, they were brown. Brown means there is meconium, or baby poop, in them, which means for safety’s sake giving birth in a hospital setting was best. The baby could have inhaled this poop, or there could be other complications. Casey confirmed this with the midwife, and unfortunately let our doula know; the hospital’s policy was not to let doula’s in due to the COVID risk. Brittney arrived just a few minutes later, and we immediately headed to the hospital.
Due to the COVID-19 pandemic, I had not toured my backup hospital where my OB who served as backup to the midwives worked, which wasn’t the same hospital I gave birth in with my first baby. We had gone on a drive there previously luckily: it is tucked in the hills near JPL where we worked, and has a very beautiful environment; it was 30 minutes away. I also had met the OB virtually via a tele-medicine appointment. She had a nice demeanor, and we talked about tandem nursing, which I had also done. The fact she worked with midwives closely gave me confidence that she’d be a good medical partner. I had also practiced pretend pressure waves, with my hypnosis techniques on this drive, so I was ready. With my previous birth, although the hospital was only 7 minutes away, I had been unable to use a seatbelt and remember a lot of pain from positioning. With this birth I was confident using my hypnosis techniques I could relax and use hypnosis and would be able to sit comfortably with a seat belt. I buckled in and I was right! The pressure waves were really intense, and I felt the need to vocalize as they were coming on saying “another wave” to tell my husband. I had the tracks on, now playing in my headphones that were also an eye mask, and I found that during waves I wanted to pull the eye mask down over my eyes.
We arrived at the hospital and went to the entrance. They asked if I wanted to walk or have a wheel chair, my husband said walk, I corrected and said wheel chair. By now the waves were really intense, and the wheel chair allowed me to use the eyes closed hypnosis technique which I found very powerful. The hospital had a big red carpet and I was wheeled straight to my birthing room. I was very thankful the checkin process didn’t involve a lot of time in triage, which my last birth did. During my previous birth triage was part of the most painful of the process, because my coping techniques had invovled a birth ball and movement and my doula, and neither was available. This birth they just wheeled me right up.
It was probably around 2pm by this point and when I reached the room. They asked me to put on my hospital gown, and I said I brought my own. Unfortunately in the hurry to get it on between pressure waves, I turned it around and wore it backwards, which meant I was fairly exposed (although I did not care at the time). They transferred me to the bed and hooked me up to some monitors. I felt very hot in the room but they said they could not turn the temperature down, there was a minimum temperature to be safe for baby (72 degrees) that the thermostat would not go below.
The nurses asked if they could check my cervix, a standard part of the hospital check-in procedure, or even birth center for that matter. In a very non standard manner I declined. I knew I was birthing and the baby was close, and that I wanted an unaugmented birth, and I did not think it would give me any information at the moment that would change my medical course of action. In my previous birth I recall the cervix check being both painful, recurrant, and discouraging. Since my water hadn’t broken in my previous birth I wasn’t on the clock (doctors and midwives shoot to get the baby birthed before 24hrs after the water breaks due to risk of infection), but the low number I got put me on a mental clock that stretched out the timeline of the birth for weeks mentally, although this couldn’t have been true: I had been 3cm on checkin the previous time (where 10cm is close to meeting baby) and being so little dialated and in so much pain and with the painful triage procedure, I discouraged myself into an immediate epidural. Even with the epidural the cervix checks seemed painful. In addition each cervix check after the waters break introduces a chance of infection.
Hypnobabies gave me the courage to ask for what I needed from this birth, and at the moment of checkin to the hospital I needed only faith and confidence and not a number. With some trepidition the nurses agreed and said they would call the doctor in; since it was a Saturday it might take her sometime to reach there. I requested to get off the monitors, but they said I needed to stay on them until the doctors arrived. In my previous birht having to be still on the monitors was absolute torture, in this birth I continued to listen to my “easy first stage” track, and sat in a frog leg position and moved just a little. I started vocalizing some of the words I was hearing in the track as a wave came on, and always pulled the mask over my eyes, and I was able to comfortably stay seated.
When the doctor arrived around 2:30pm I again asked to get off the monitors, and she said since there was meconium in the waters I needed to be on the monitors. I askeds for the chance to do a wireless mosnitor, and the nurse said they didn’t work very well, but the doctor encouraged the nurse to look into it. The doctor said she really did want to check my cervix so that she would have a plan to keep tabs on my birth, and I consented this time. In my previous birth the doctor wasn’t present during the pushing phase, which meant that since my pushing phase was very short, a nurse caught the baby. This was another reason why I didn’t want to do a cervix check: it might not say as much about when I’d push the baby out as the doctor thought. But I consented this time as I really had the confidence my birth was progressing, and with the doctor there I was ready. At this point it might have been around 3pm. The doctor checked my cervix and with a surprised sounding voice (to me) said you’re at 9cm and station 0 (the baby is ready to decend)! 9/10 isn’t bad. I felt very encouraged and told myself mentally, when you are ready to push, push.
I continued listening to my tracks and vocalizing softly their messages things like the pressure waves “feeling like a hug”. I remember feeling surprised how intense the sensations were, which seemed like maybe the hypnosis program wasn’t working. But it was! Firstly, the fact I’d be surprised that that far into labor I’d be having intense sensations after a lifetime of programming that birth was painful and awful, slightly reinforced by some of my experiences of the last birth, was a testament to how the hypnosis program had reprogrammed my thoughts to expect birth to be a comfortable easy thing; secondly the fact that though I was internally surprised at the intensity, externally I was coping fantasticly; able to deal with the curveballs (long car ride, sitting in place with monitors) physically and just take things one wave at a time. Several times my husband stepped in to encourage me to relax even more with hypnobabies cues, and he noticed when I was holding a little bit of tension a few waves. This inability to relax and just let the waves roll over me, in my last birth, I think was one of the reasons why I arrived only 3cm dialated, but I’ll never know.
Shortly after the doctor said I was at 9cm I started “feeling pushy”. In my last birth, although I had an epidural, both the nurses and my doula encouraged me not to push until I was fully 10cm dialated. What this meant in practice is that during my last birth, when I reached about 9cm it was several more hours of resisting the urge to push, which was about as uncomfortable as resisting the urge to have an explosive poop. Immensely uncomfortable. On top of that, with my epidural during my previous birth I had to be in all sorts of strange positions to get the fetal monitors to track, my back was twisted. I had felt like I was in an airplane seat, forced to stay in the same position, having to poop but trying not to poop my pants in my previous birth, for literally hours. On top of that I felt ungrateful because I had an epidural, so I was reticent to complain, because it could be so much worse. However this birth I discovered it was so much better without the epidural. In my previous birth when they finally checked me and said I could push, they then changed their mind, then changed it again because I had a cervical lip.
This birth I was having none of that, and went with mother directed pushing. I felt like pushing so I did. I took off the monitors, climbed on the bed on all fours, and pushed. At some point the doctor checked me without my consent, and said I was still at 9cm. When I pushed back at why she had checked without my asking, she said she thought she saw the head and reached in there. I was a bit discouraged and worried I would be reqeusted to stop pushing and apologized (because I was still pushing). However shortly I did feel the head… and pushed the baby out. The doctor later said that although she worked with midwives, this was her first birth on hands and knees.
The doctor went to cut the cord, and we had planned on delayed cord clampoing and my husband pointed that out. However I said “it’s fine” as I really wanted to hold the baby. I regret this and wish I would have waited. After making so much trouble in my birth with the refused cervical checks and strange positions and pushing at the “wrong time”, I was ready to stop making trouble and hold my baby ASAP. The baby was placed on my chest and we had a good snuggle and a small breastfeed. Then, because the baby needed some asistance due to meconium aspiration (why we were in the hospital instead of the birth center in the first place), they took the baby to the warmer with apologies and the doctor and I focused on the placenta. Again I had put on my birth plan no pulling on the placenta until it was separated from the uterine wall, but it seemed to me the doctor was pulling on it before this happened. I asked about it and she said it would help and asked why I objected. She mentioned problems from this usually resulted from inexperienced residents. In any case, during the course of this dialogue the placenta did come out and it felt a relief like when my waters broke.
We kept the baby in the room for an hour, mostly on the warmer but also on my chest and on dad’s chest. However since the baby’s oxygen saturation levels never quite stabilized, the doctor determined a NICU stay would be best. They took the baby to the NICU, my husband followed and suddenly, strangely I was alone after all the dramas of birth. I was very proud of the birth and felt accomplished. I did it. But also I felt extremely empty, after all this here I was in a room by myself. Soon I was able to reunite with my husband and baby, and all go home safely. Now, four months later, I’m extraordinary grateful for the modern medicine that helped my baby thrive after birth, and for being able to rely on my body throughout the birth. This birth was much more pleasant and satisfying than my first birth for that.
I still have flashbacks to the feeling of the baby’s head coming through and out, the power, strength and excitement I felt. With my two births I am grateful to have reached my thee goals of healthy mom, healthy baby, avoiding major surgery, and with the second having the added bonus of an easier, more comfortable birth with the help of the Hypnobabies program.