Birth story - Kristen and baby Hazel

❌ Warning: mention of contractions (not negative for me), stage 1 tear

To all the ladies who shared their stories before me, thank you. You are all amazing and inspirational. Thank you to Siobhan and the PBC team!

Long lead up:

Even before I was pregnant I had ideas about the “perfect birth” and how I envisioned things going when it was my turn to have a little one. One of the most poignant things anyone said to me during my pregnancy was about birth plans and that in her opinion birth plans are one of the number one contributors to someone’s disappointment with their birth. I think it is important to have a birth preference but not be 100% tied to this. Being flexible was key to my birth.

In addition to reading positive birth stories I listened to the birth hour podcast. I listened to all the stories because sometimes its how one works with adversity that ultimately resonates with you in the moment. You never know what path you will end up on and I found this particularly true.

I am so grateful to have found the PBC early on in my pregnancy because not only was it tremendously helpful for learning about labor and delivery, it helped me as my pregnancy started to not go to plan. I found out I was pregnant a day before my husband’s birthday and was so excited to share the news with him! What a birthday gift! We live in the area that was figured as ground zero for COVID-19 in the USA, so my visits with my OBGYN were all solo except my 20 week scan. Most of my friends never saw me during my pregnancy. I continued to work full time as did my husband— we are both nurses.

My pregnancy cooked along pretty uneventfully until around 24 weeks where I was just plain exhausted. We opted to complete my GTT early due to vision changes, fatigue, and significant weight gain during the first 20 weeks. I failed, just barely. To say I was devastated is an understatement. I had been attempting to do everything I could to stay healthy. What helped me out of my self-depreciation was the positive affirmations for birth and pregnancy. I listened to these every night before bed and it was a literal reminder of how much my body was going through and that it is an amazing process. I ended up needing medications in addition to a very strict diet to control my diabetes. It was probably a good diagnosis for me in the end. I did not gain any weight after 24 weeks, which is not unexpected in tightly controlled GDM patients who have already met their anticipated total weight gain. I continued to walk walk walk and lift weights (in moderation) until I was advised to stop the weights at 34 weeks due to an uptick in Braxton Hicks.

I was able to practice utilizing the BRAIN 🧠 method several times during pregnancy due to gestational diabetes and the extra care that comes along with the diagnosis. I was sad about the potential loss of going into labor naturally. In the US most OBs recommend induction of GDM women between 39-40 weeks due to the increased risk to the baby after 40 weeks. I actually found the non stress tests that I was asked to have routinely comforting because I knew baby girl was doing okay. We added biophysical profiles at 36 weeks due to concern about my fluid levels, happened to be a fluke as the next 3 I had were spot on 15cm of fluid.

I am lucky to have a good milk supply. I was able to start harvesting colostrum at 37 weeks. This is not a common practice in the US however the NHS recommends this for women with GDM. I was able to save 30 mls for my delivery. My provider encouraged me to collect due to the hospitals policy regarding supplementing newborns with donor milk if their sugars are not stable. Due to my harvesting I was able to use my own supply!

Throughout my pregnancy my provider and I had conversations about labor and that I really wanted a vaginal delivery without medications if possible if I needed induction. We also discussed all the possible alternatives and why we may need to go that route. I am so thankful to have a provider who took the time to listen, understand, educate, and share the process with me. Due to being placed on medications for GDM at 32 weeks, induction was advised, I agreed. This was actually a good thing for my sanity because I knew the latest she would arrive!

Labor:

At my 38 week appointment (38+5) I had a cervical stretch completed, not a full sweep as I was only 1cm dilated. I lost my plug 2 days later. As much as I was hopeful that I would go into labor spontaneously over the weekend I was thankful I didn’t because my provider was not on call and at the end of the day I really wanted her to deliver my baby. Going along with the non-medication induction plan, I was scheduled for and completed a Foley insertion at 39+2, the evening before I was due to show up at the hospital. The Foley worked wonders at getting my cervix dilated, it fell out around 4am the morning following insertion, so I knew I was around 4cm at that time. No noticeable contractions.

My husband and I proceeded calmly to the hospital at 7am. The hospital highly recommends continuous monitoring, particularly for patients receiving Syntocin. When I arrived I was having pretty regular contractions every 4 min lasting 45 seconds but I was none the wiser. We started Syntocin at around 8am. My provider was due to follow up again at 11am. Our nurse that day was amazing. We had a genuine conversation about what my provider was likely to recommend at 11am and what the alternatives were and why. We opted not to have an exam at 11 but continue to let the Syntocin increase and marinate until 1pm. During this period of 8-1pm I walked every 30 minutes for 15 minutes, rotated between bouncing on the ball and rocking standing up. My nurse was a huge proponent of UFO (she did let me sneak in one nap while she was on lunch!).

On my last walk around 1pm I felt a sticky gush and we quickly waddled back to the room to be met by my provider. We all agreed to an exam and to fully break my waters at that time, thought was that I had a small tear in my fluid sack during the walk. At this exam I was 5cm (still!) but 85% effaced. My provider saw that I was gutted, all that time and 1 measly cm. She was great and reminded me that the effacement is just as important. My waters were broken at 1:21 pm. I was advised to stay in my room due to the continued potential for “dumps” of fluid from then on. I was okay with this, we had plenty of space, it was calm in the room and it was a beautiful day out the window. It took a bit for labor to start to ramp up. I was officially labelled in active labor at 3pm when I could feel my contractions, they required me to pause and breathe, and they were 2.5 minutes apart. At around 4pm we started to slowly reduce my Syntocin drip and happily my labor continued to tick along on its own. This was also the time I started to rely heavily on my husband to help with acupressure and my nurse to help us with decisions on position changes. I think I tried them all due to some tremendous back labor. My job was to focus on my breathing and relaxing into the surges.

In the middle of my pregnancy PBC posted daily moments on Instagram to practice different techniques. I could visualize the post in the middle of a surge and it helped me sink deeper into them.

I knew I was in the middle of the transition phase when I started to have a minor meltdown about my back. Nothing we tried was helping. My bestfriend showed up about this time, it was lovely to have her energy there. The final position I ended up in was a left lateral sims position, basically laying on your side with your left leg stretched out and the right one bent and headed towards your breast. This allowed baby to rotate. Suddenly, I needed to push. My nurse checked me, 9cm! She told me then to get through 4 contractions and let her know if the sensation changed like I needed to poo. Well, ladies, that occurred around the second contraction right as my provider arrived. She suited up and did my last exam and gave me the exciting news that we were ready to push! 🙌🏻

My nurse had told us during our initial morning meeting that pushing for new moms usually takes 1-3 hours. My provider told me to push for the ceiling. I really did not want to be on my back, I ended up in a half side half on my back position because baby was coming so fast. Out she came in 3 contractions and 9 pushes with a very primal roar. I was so happy she came so quickly. I did have a stage 1 tear that needed to be sutured. We were immediately able to have skin to skin. My provider allowed the cord to stop pulsating and go limp before my husband cut it with her. My placenta decided it was done with the party and delivered quite promptly after the cord was cut. We opted for assisted delivery to prevent hemorrhage, I was okay with this since I already had a cannula and Syntocin.

Due to my GDM baby had to have glucose checks every 2-3 hours and at 12 hours old. We ended up needing to supplement her on 2 feeds due to borderline sugars. Thankfully, I had harvested my colostrum. I am grateful for the internet and having access to education outside of the US for this birth as I would have never known about harvesting had it not been for the breastfeeding program I took or looking up protocols from the UK.

As much as this birth was not anything that I had dreamed of it was perfect for me in the end. I knew when she would come. I knew she was the perfect size for my body. I knew I was strong enough to have her without pharmaceuticals for pain. I knew the team I had surrounded myself with was on my side and my baby and I were safe.