By Missy Swanson
As a mom of three WBWC babies and a nurse who had attended a few hundred WBWC births, I thought I had seen and done it all. Then along came Iris to show me just how unpredictable birth can be.
My fourth pregnancy was pretty straightforward. I felt sure I was having a girl and was looking forward to having another daughter to balance out the family. My blood tests and ultrasounds were all normal. However, as I approached 35 weeks, the baby kept flipping out of a head-down position. My third child had also liked to play that game, but he had settled down to vertex around 39 weeks and stayed. This child had other ideas. I did all the baby-turning things (moxibustion, acupuncture, inversions., etc.), and sometimes she was vertex, but she never stayed. Every time I came to work, I had the midwife put her hands on my belly. Every time, the baby was in a different position. Sometimes she’d be breech at the beginning of a shift and transverse by the end.
My due date was September 1. We made a plan to schedule a version followed by a midwifery induction on September 7. As luck would have it, the baby was vertex on September 7, so I got to skip the version. My cervix was essentially closed, but Sarah bound up my belly and sent me home with a regimen of herbs and castor oil, and hopes of an easy birth. Sarah had been at all of my labors and caught two of the three. Those babies also had to be induced with castor oil, and although that part was disgusting, my labors were quick.
My parents came to take care of the big kids, and my husband Andy and I had a nice morning to ourselves. We went for a walk, listened to music, and relaxed. After a few hours of herbs, the contractions kicked in a bit. I finally got the nerve to take the castor oil around 3 PM. By 5 PM, the contractions weren’t very strong, but I headed over the birth center to get checked and make sure the baby was still vertex. Sure enough, she was still head down, and I was 4 centimeters dilated! Sarah swept my cervix, and we headed home to eat dinner with the family.
Shortly after dinner, the castor oil kicked in, and things got serious real fast. I labored in my bedroom on the ball, running back and forth to the bathroom. Soon I needed to get in the tub. Around 7:30 PM, I let Sarah know things were starting up, but I wasn’t quite ready to come in. A few contractions later, I knew it was time to go.
When we arrived at the birth center, I was working hard through the contractions. Laura, who was a nurse then, stayed after her shift to be with me, and another nurse, Brynn, was there, too. They could all tell I was serious. I threw myself onto the bed in the peach room, and Sarah checked me. “Well,” she said, “you’re completely dilated. But you have a bulging bag of water, and once that breaks, you might actually be more like 8-9 centimeters.” I was thrilled with that news. I hopped off the bed, ready to have a baby. In all my other labors, transition had never lasted more than 30 minutes. So I knew that even if I were only 8 centimeters, my baby would be in my arms soon! Andy called my parents to let them know they could bring the kids, because the baby would be here any minute. Kallyn, our wonderful birth photographer, was there already, too. I just wanted pictures of the birth, not the labor, so we figured we had timed it perfectly, and she could come in the room in a few minutes when it was time to push.
But instead, my contractions slowed down. And when I did have an occasional contraction, it didn’t hurt. We all figured I just needed to settle in to the new environment, and then things would get going again soon. It was kind of nice to get a break after the intensity of the previous three hours.
By 10 PM, it wasn’t cute anymore, and I asked Sarah to sweep my membranes. During the sweep, my water broke, and my cervix was officially more like 8 centimeters. My contractions stopped all together. The baby’s heart rate was great, but no labor was happening.
Around midnight, I went out to update my family that instead of having a baby, my cervix was now un-dilating and they should probably go home because there was no clear end in sight. Laura, Kallyn, and Brynn joined me in the kitchen to eat some pie that was left over from my baby shower, and then I got settled back in the bed.
Over the next few hours, I had occasional runs of contractions that felt promising, but I could tell my cervix wasn’t changing and the baby wasn’t moving down. I was starting to lose my patience with the ridiculousness of the situation. What person with a history of rapid labors shows up completely dilated and is still pregnant six hours later?! Sarah came up with a plan for me to get into the shower and do some nipple stimulation and augment labor with some herbs. That seemed like a great idea to me, and soon the contractions were coming regular and strong again. However, I could still tell that nothing was really changing.
After a while in the shower, Brynn heard the baby’s heart rate drop to the 80s during a contraction. She got me back to the bed and alerted Sarah and Laura. The heart rate came back up between contractions, but dropped again during the next two contractions. Sarah made the decision to call EMS and get us to the hospital. This was not something I had anticipated at all, but hearing my baby’s heart beating so slowly changed my priorities about birth pretty quickly. Laura and Brynn got me the oxygen mask, started an IV, and gave me a shot to slow the contractions. I was worried about the baby, and it felt like it took the ambulance forever to arrive (about ten minutes in reality), but I knew I was in good hands. While we waited, Sarah called UNC and told them to expect us and what interventions she wanted to happen.
Sarah rode over with me in the ambulance, and Andy followed behind in the car. As soon as we got up to a room on L&D, two nurses were there to assist Sarah with the interventions she requested, and an anesthesiologist was there minutes later. The contractions at this point were mild, but the baby’s heart rate was still dropping with each one. The plan was to get the contractions to stop and give the baby some time to recover, and then try Pitocin. However, despite all the interventions, the contractions were still coming, the heart rate was still dropping, and my cervix was still 8 centimeters. I was worried about my baby, and I needed to have her safely in my arms. We decided to go to the OR.
I got a little panicky in the OR while we were waiting for the baby to be born, but Sarah calmed me down. Since I couldn’t see what was going on (they routinely use clear drapes now, but didn’t at the time), I asked the anesthesiologist endless questions about what was happening. She talked me through it all, from incision to birth.
Iris Aurora was born at 7:04 AM on September 8, 2015, and weighed 7 pounds and 7 ounces; she was pink and screaming and healthy.
The reason her heart rate had been dropping was clear right away – her cord was wrapped around her neck several times, and around her body and leg. They brought her to the warmer briefly to dry her off, and then she came over to me to nurse. I couldn’t get enough of that sweet baby who had scared me so badly! She didn’t leave my side the whole time we were in the hospital.
There was nothing about her birth that went the way I expected, but now that I know Iris a little better, that totally makes sense. It was scary at times, but I felt a strength and bravery that I didn’t know I had when it came time to make decisions for my baby. Even though I never imagined I’d need a cesarean after three vaginal births, I was so grateful to have the OR available and a midwife who knew when to change plans to keep my baby safe. I also know we tried every option before choosing cesarean. I was respected, listened to, and kept informed throughout the whole experience. I feel like I bonded with Iris more immediately after birth because of what we went through to get her earthside. The actual moment of birth felt surprisingly similar to when my other babies were born (minus the ring of fire!).
Iris still does things her own way, and she helps keep me humble whenever I start to think I’m getting the hang of things and know what to expect.
