The last documents I have to share is the story I wrote shortly after my cesarean and the birth announcement. The announcement was written one week after Khady's birth:
It takes a village to raise a child...
With hearts full of joy Kathryn and Matthew Haines announce the arrival of
Khady Ruth Haines
Born May 1, 2003 6 pounds 15 ounces, 20 inches
Named in honor of our friend Khady Niang for her support and love during our years in Mali, West Africa.
Come let us build a new world together
The story of Khady's birth was written two weeks after my cesarean. I discovered it a few years ago (I had forgotten that I had written the story down). It is the story that has made the telling of Khady's birth so long in coming (my cesarean was five and a half years ago). It was not the story I wanted for Khady (don't we always want the absolute best for our children?). I find it interesting that the story's format is rather report like (the title of the document was "labor_report.") There is a disconnect between the beautiful addition to our life that Khady embodied and the story that brought her here. But when I think about it, the birth stories that I hear regularly lack the true face of birth, raw, powerful, ecstatic. Parts of Khady's birth were beautiful, empowering, but the second half of the story was fearful and dis-empowering. The other interesting piece is that upon reading it, I am struck at how painfully important it was for me to believe the cesarean was necessary. There are a few exaggerations. The heart rate didn't drop to zero, the monitor lost the heart-rate, and contractions weren't in the 200's, they went into the 170's. And Charity didn't say there would have been negative consequences for my child, she said there could have been. And my operative report states that there was a loose nuchal cord. But I absolutely couldn't believe at that time that my cesarean was anything other then absolutely necessary. In the end, I am grateful for my cesarean. Without the cesarean, I would never have had a home birth and without the home birth I would never have decided to get pregnant a third time. And this journey in birth has given Khady a mom who is much more relaxed and takes some time to stop and smell the roses and that is a priceless gift.
My Labor Experience
Name: Kathryn Suzanne Haines Delivering Nurse-Midwife: Charity Cooper Hospital: University of Chicago Baby's Name: Khady Ruth Haines Birth Date: May 1, 2003 Weight: 6 pounds, 15 ounces Approximate Time labor began: April 29, late afternoon Time of Delivery: 3:47 a.m. May 1.
My 40-week midwife appointment was on April 29. I was about 2 and 1/4 cm dilated, 50% effaced, and my cervix was, according to Pat, one of my midwifes, ripe. Pat asked if I was interested in encouraging my labor to move swiftly along. When I said, yes! Pat moved her hand vigorously around the opening of my cervix and said that 50% of the time this seemed to bring on labor within 12 hours. Within a few hours I began to feel a mild cramping sensation, similar to menstrual cramps. I slept little Tuesday night, expecting the baby to come at any moment.
The next morning, with no baby in sight, I decided to go to work. I had Matt drive me, just in case. My contractions increased in intensity during the day, consistently coming at 4-5 minute intervals. Around 3 p.m., during an interview, I found it harder to ignore my contractions. I should add here that I have a very high tolerance for pain. At 3:20, back in my office, I sent Matt a message using instant messenger and said that I was going to go home. I intended to take the bus. Matt messaged me back asking if I wanted a ride home. I replied yes, I would be in front of the building at 3:50. I called Charity, the midwife on call, as we pulled into our driveway in Hyde Park. She asked how far apart contractions were and how I was feeling. We decided that I would go to the hospital and have Pat, who was still at the hospital, determine how my labor was progressing. I would call Charity later when I was ready to come in to have the baby.
I arrived at the hospital at about 4:45. By now my contractions felt like strong menstrual cramps and my contractions were often only 4 minutes apart. Pat checked me and said I was 70% effaced and 3 centimeters dilated. Pat said that I could labor at home for awhile, get some rest, and expect labor to progress about a centimeter an hour. Matt drove me home and we went out walking along Lake Michigan. Only a few minutes into my walk, Matt and I noticed that my contractions were already two to three minutes apart. They quickly became stronger and I was almost unable to walk through my contraction. I preferred to squat down or be held by Matt during the toughest ones.
When I came home, Matt fixed me something to eat but I found that I could not eat anything. We called Charity after my attempt to eat dinner because we were confused by the rapid progression of my labor. Charity said that it was up to us if we wanted to come in. She noted that it was difficult to judge how far along I was because although I was only at 3 centimeters at 5 p.m., my contractions were very close together. She told Matt if I was vomiting, or if my water had broken, that I should probably come to the hospital. My water had not yet broken but about three minutes after Matt hung up the phone, I vomited several times. I was determined to take a bath before I went into the hospital. I took a bath, and then a shower, and the water helped to calm me down. Before I got in the tub, I was feeling panicky. I was worried that I was not as tough as I thought I was and I was beginning to feel that I could not control the pain.
Clean and in comfortable clothing, Matt and I left for the hospital, a short five-minute drive from our home. We were admitted at about 8:50 p.m. I was 7 centimeters dilated and my labor was progressing rapidly along. Although my contractions were consistently 2-3 minutes a part, and extremely painful, I was managing to stay in control of the pain by using deep breathing. My vomiting had left me dehydrated and so I was hooked up to an IV while the staff monitored the baby and I waited for Charity who soon arrived. After Charity and the nurse were confident that the baby was doing ok, I was allowed to go to the room where I would do my labor. In the room, I used the birthing ball, which was a great help during contractions. Charity asked if I would still like to have the water birth that I planned. She thought that my labor was progressing so rapidly that I would not have time to do much laboring in the tub, since it takes a while to fill, but that I could at least give birth in the tub. As it turned out, I would have more than enough time to labor in the tub. The water helped me to relax and better manage the pain. I continued with deep breathing, the only type of breathing I used throughout my labor, and as I entered the transition phase of labor, I moaned through my contractions. Matt, who was in the tub with me, would pick up water from the tub and pour it over my arms and back, gently rubbing his hands over my skin as the water ran down. Matt repeated this over and over in a cycle that matched my contractions.
Soon after I entered the tub, my friend Trina joined us in the room where I was doing my labor. Having Trina and my husband there to encourage and support me made the labor process much easier. Matt was able to feel comfortable leaving my side from time to time, knowing that Trina would be there to hold my hand and urge me on. It also helped having such a strong and nurturing woman by my side. At first I was hesitant about having someone besides Matt with me but Matt asked me to consider the possibility that my labor might be long and difficult and that he might need some help. I decided to call my close friend Trina and asked her to be there when the time came. When Trina walked in the door of my labor room, I was greatly relieved that I had asked her to be present for the birth.
I spent close to two hours laboring in the tub. When I left the tub I was over 9 centimeters dilated. Around midnight, I had to leave the tub because Charity was concerned that the baby was not handling my contractions well. For several hours, my contractions had been coming two to three minutes apart and were lasting a minute and a half. This left both the baby and me with only a thirty second resting period. The contractions were so intense that the baby's heartbeat was decelerating during the contractions and then speeding up immediately afterwards. I had to lie down on the bed, probably the worst place to have contractions, and I was hooked up to the fetal monitor. A monitor was placed on the baby's head as well to better assess what was happening. As Charity suspected, during contractions, the baby's heart rate would decelerate dramatically, and then after the contraction was over, it would speed up, hitting 200 on several occasions. Twice the heart rate stopped completely in the middle of a particularly intense contraction. I was barely able to move and Charity and Sylvia, the nurse, rolled me over to my left side, at which point the heart rate returned.
Although I did not have the urge to push, the baby was at 0 station, I was fully dilated, and the baby was distressed and needed to be born. Thus began three hours of pushing without the urge to push. I pushed every other contraction, giving the baby time to recover between pushing. After about two hours of pushing, Charity became concerned that the baby was becoming too distressed and that I might need a cesarean section if I wanted a healthy baby. Doctor Fishman, the doctor on call, came to assess the situation and said that it seemed that the baby was not descending at all. The anesthesiologist came in to discuss the procedure and I signed a consent form. As part of a last great effort to have a vaginal birth, Charity gave me Terbutaline to stop my contractions long enough to allow the baby to recover. For twenty minutes, my contractions lost their intensity and baby and mom had a brief rest. When the contractions returned, we continued with pushing every other contraction and the baby continued to be distressed. At 3 am, Doctor Fishman returned and checked the progress of the baby during contractions. She confirmed that the baby was not budging and recommended that a cesarean section be done as soon as possible. At about 3:10, after Charity concluded that this was the best way to assure that we would have a healthy child, we decided to proceed with a cesarean. Charity said that my baby probably could have been born vaginally but it would probably have taken at least another 6 hours of labor and there would have been negative consequences for my child.
I was rushed to the OR, Matt put on his scrubs, and I was prepared and given a spinal so that I could breastfeed as soon as possible after the surgery. At 3:47, Khady Ruth Haines, our beautiful and amazing daughter was born. The cord had been tightly wound around her neck and Charity guessed that the cord was preventing our daughter from descending down the birth canal. A look at the printout of the cord gasses later confirmed that we were lucky that the cesarean was done sooner rather than later.
U of C is a great place to have a child. The midwives are incredible. The nurse that worked with Charity was wonderful and we are keeping in touch. I would advise everyone to take the childbirth classes and to pay close attention to the part about complications during labor and delivery. The one thing that I did not plan for was having a c-section. Having Matt and Trina there to affirm that I was doing the right thing, and having a midwife who was so determined to help me have a vaginal birth made it easier for me to accept the fact that I needed a c-section. When you plan on having a vaginal birth, it can be hard to learn that your plans are not feasible. In the end, if the goal is having a healthy child, you do whatever you have to do to make that possible.