I'm thrilled to announce the arrival of Marian Alice Elmer, aka Mae, born Tuesday, January 17 at 2 pm. She weighed 7 lbs 8 ounces and measured 18 inches long, and is in every way perfect. Here's our birth story.
At my 40 week appointment, my midwives were concerned that Mae's position felt different and that her heart tones were registering much higher on my abdomen, so they sent me in for an ultrasound to confirm position and also to measure amniotic fluid levels, which I would have had to do at 41 weeks along with a non-stress test. Wouldn't you know it - after thinking she was head down for weeks, Mae was in a frank breech position.
This was definitely not the news I wanted to hear. At 40 weeks I would usually be scheduled for an immediate cesarean, and I feel very fortunate that Dr. Karen Crabtree works at the Ukiah hospital. She agreed to try an external version on me the next morning, so Carson, my friend and doula Katie, and I headed in at 7:30 am. I put on a hospital gown, got an IV to make me extra hydrated (ironically I wasn't allowed to drink anything beforehand), had a blood draw, and had another ultrasound to confirm her position. Although I loathed being in the hospital I immediately liked and trusted Dr. Crabtree, who has done extensive work in Africa and is experienced with versions and breech births. Unfortunately, after three excruciating tries lasting one or two minutes each - the third with a shot of terbutaline to relax my uterus - Mae was unwilling or unable to flip. I handled the attempts well and was able to breathe and moan into them ("Like a mini labor!" I thought to myself), but it was intensely painful. I might have yelled a not-nice name at our daughter after the third attempt.
Again, at that point I should have gotten a cesarean since I was full term and already in the hospital with an empty stomach and an IV and an available doctor (legally, my care had to be transferred from the birth center to the hospital). Luckily, the kind Dr. Crabtree agreed to give me four days to see if Mae would flip and if not, to at least wrap my head around the new circumstances. After 9+ months of working with the amazing midwives at Bloom and preparing for an unmedicated, out-of-hospital birth, I was suddenly staring down the barrel of the exact opposite of what I wanted. I needed some time to sit with that and adjust. I also wasn't keen on a Friday the 13th baby, and 01/17/17 seemed like a much better birthday.
Mae has always had a lot of room to move around so we were hopeful that she might - with some encouragement - get her head down where it needed to be. I took Pulsatilla, a homeopathic remedy that is known to help babies get in the right position; I did daily inversions; I got a chiropractic adjustment; I had moxibustion done by a local acupuncturist; and I meditated and talked to Mae and prayed a lot.
Tuesday arrived and a new ultrasound confirmed that Mae was still breech. F#%@!!! I had spent a lot of those four days talking about my options with my midwives, Katie, and Carson. I had the choice to go to the UC San Francisco hospital, which delivers frank breech babies, but they require you arrive in active labor and get an epidural and even then the odds of having a c-section are still fairly high. For many reasons, I declined that option. I also had the choice to wait to go into active labor, but I liked and trusted Dr. Crabtree so much that I was worried I would end up under the care of a different OB/Gyn. She also explained that if I waited, Mae might get distressed and then they'd have to rush to assemble an emergency operating team, which is not ideal for anyone. So I decided to undergo the c-section that day, with my doctor of choice, on a great birth date, while Barack Obama was still president. It was one of the hardest decisions I've ever had to make;10 days later, I'm crying writing about it. But it was the right decision - Mae's cord was quite long and she was wrapped up several times in it, so trying to labor likely would have caused her distress.
I am so grateful to my surgical team; the anesthesiologist was a kind and calming presence, the nurses and midwife were all very supportive of my choices (i.e. opting out of everything except a vitamin K shot), and Dr. Crabtree was a godsend. Even so, I'm profoundly disappointed that I wasn't able to labor and deliver naturally. I don't plan on having another baby, so I've missed my only chance at this particular rite of passage. After weeks of anticipating what it would be like to go into labor, to feel my water break, to experience delivering my baby in one of Bloom's incredible birthing suites, I got none of that. Instead, I got a lesson in total surrender. That is certainly a valuable lesson for someone who likes to be in control; if I hadn't fully accepted it before, I realize now that I cannot truly control anything.
Overall the procedure was smooth. The epidural numbed me from the waist down and it felt like being underwater with a heavy, hot blanket on top of me. As long as I didn't try to move my legs or feet, I felt okay about it (again... surrender). I was most afraid of getting a catheter (even the word makes me cringe) but I didn't feel it going in and when they took it out a few hours later it barely registered. My blood pressure dropped and I felt nauseous several times, but the anti-nausea medication worked almost immediately. Once I was all set up they let Carson in to sit at a stool by my head and hold my hand. I tried very hard to maintain calm, but the instant I heard Mae cry I broke down and sobbed for the three minutes it took them to get her to me. In those three minutes Carson was by her side, playing her song and holding her hand, and then he was able to hold her next to my head for a few minutes before they started my repair. Carson and Mae spent that time together in our room, skin-to-skin, while I adjusted to the new reality that I was no longer pregnant and was now, in fact, a mom. I'm someone's mom! The reality of it is still hard to comprehend.
My initial recovery was fairly smooth, apart from some projectile vomiting of orange Gatorade. I kept Mae in bed with me all night and she was able to nurse. After a noisy night in the hospital I convinced Dr. Crabtree and the pediatrician to let us go home the next day, which is relatively unheard of (standard is 48-72 hours) but we were both doing great and had incredible support waiting for us at home, including home visits from our Bloom midwives. So, 23 and 1/2 hours after being born, Mae was strapped into her car seat for the five minute drive. I was offered a wheelchair but chose to walk out instead, moving at a snail's pace but in high spirits. As we were leaving I was presented with the bill: $35,000, not including anesthesia. Luckily we already met my (stupidly high) deductible through Bloom! (Of course now Mae has her own, separate deductible; don't get me started on insurance.)
In the 10 days since then we've all made great progress. I didn't need to take the prescription narcotics and am off ibuprofen at this point. Nursing has been a little rough but we are getting the hang of it. Mae is beautiful and expressive and a good eater and sleeper. Carson is totally confident and loving with her and it makes my heart ache to see her snuggled up in his big arms. Katie is keeping us all sane and I have no idea what we'd do without her. And our amazing community has been bringing us delicious and nutritious meals every night. My cup runneth over. I think I might burst open from love, for Mae and for everyone else in my life.
Thank you for following along on our journey!
Photo: Mae on day four of her young life.
TagsBirth Birth stories Great Expectations Birth Center Cesarean Midwifery Care Cesarean Surgery Obstetrician Breech Cesarean recovery Elizabeth and Mae Frank breech Postpartum recovery