Second birth, Group B Strep, epidural

After experiencing a nearly perfect hospital birth with my first child, my husband agreed to accompany me to a birth center in Cary, NC for the birth of our second child. I had read about the natural pain-relief provided by a bath and about waterbirths, but we still weren't ready to pursue a homebirth. The birth center provided both the comforts of home, including a kitchenette, bedroom, and oversized jetted tub, and the access to medical care in case of emergency. It was nearly adjacent to the UNC Hospital.

Then we moved to Memphis.

Memphis does not have a birth center with all the comforts of home.

I was 32 weeks pregnant. I wanted an intervention-free birth, but I didn't know how to locate a doctor who would help me achieve that goal. Penny Williams was recommended to me within my first week here by two different sources. When I finally tracked her down, she recommended a doctor who, sadly, is no longer delivering babies. He was very laid-back. He heartily approved my birthing plan to deliver at Baptist. He even agreed that I could refuse the IV.

I had mild contractions on St. Patrick's Day, two weeks before my due date, accompanied by a fever. The contractions continued into the next day, but were much milder than I expected. The weather was nice enough to walk, but I kept the block short so I could come home quickly if I needed to! My husband and I wore a rut in the road that morning. My grandmother drove past and rolled down the window to visit. She asked, "How are you doing?" by way of introduction, and I responded, "I'm in labor." She hastened away!

I alternated walking and bouncing on a birthing ball to alleviate the pain. I called a friend of mine to ask how she knew she was really in labor with her second child, because I really wanted to avoid going to the hospital too early and being sent home. I also had a plan to avoid laboring in the restrictive hospital environment--I would labor as long as possible at home and arrive at the hospital just in time to push. I knew I was Group B Strep positive, but I never suspected it would throw a wrench into my plans.

The contractions continued regularly but mildly until one in the afternoon, at which time, my husband suggested trying to augment the labor naturally. Within the hour, the contractions became so intense that my husband expressed a concern that we wouldn't make it to the hospital in time. I packed some grapes and bottled water, and we hurried to the car. The thick Memphis traffic slowed us down, and my groaning didn't calm my husband. He parked at the door, and we rode the elevator with an older man. I felt sorry for him as we all awkwardly endured the groaning and moaning of a long contraction together.

Penny met us at the hospital and parked our car, but neither she nor Chris could accompany me past check-in until they asked the "safe haven" question. I had several contractions during the very slow assessment in triage. Only after the nurse checked my cervix and found it to be at 9cm dilated did a spring come to her step. Curtains flying, carts zooming by, yelling for my family, strapping me into the bed monitor, inserting an IV. A crew of student doctors crowded around my crotch, eyes wide with anticipation, awaiting this new life imminent in my loins.

And there we sat. And sat. And sat. For four hours. My contractions slowed down to about one every ten minutes. They were long and painful, but no longer productive. My laid-back, naturally-minded doctor was at a conference in Colorado, and no one else there cared about my birth plan. They broke my water and started Pitocin (which makes the contractions so much more painful, by the way.) As each intervention approached, I asked Penny what she would do. I'm so thankful we hired her because she was able to confidently and gently guide us in the right direction.

I asked the nurse if I could get up and walk to help get things moving along, and she said, "No, you're in the best position to have a baby." (I secretly thought, "The best position for you, maybe!") Then she actually said to me, "You have a fever, and you're cooking your baby, so you will probably have a C-section." Well, I didn't want a c-section, but when they tell you that's what they have to do, then you just have to go with it. The nurse said, "Since you'll need an epidural, you might as well just go ahead and get it now." So I agreed without hesitation.

The nurse anesthetist reviewed the morbid list of possible side-effects just before she whipped the catheter in. She made everyone in the room exit during the procedure, but it did take effect almost immediately. About ten minutes later, my eyes widened and, startled, I said, "I think I have to push!" The students had exited long ago, but the doctor scooted in to catch the baby. They rubbed her off and weighed her at 7lb 3 oz. Kora reached her little hand up and grabbed my husband's finger so tightly that he was able to lift her gently off the scales! I finally enjoyed holding the baby after the nurse team finished their obligations.

I was surprised at how long they left the epidural catheter in. I asked the nurse to empty my bladder, because despite the medicine, I could still feel the uncomfortable feeling of a full bladder. She must have used a very small catheter, because she and my husband had a lengthy conversation at the south end while my urine dribbled into a cup... and I still didn't feel relieved. After the nurse left, I asked my husband to help me to the bathroom because I still had to go.

We sent Kora to the nursery during the night because I was exhausted. But the hospital staff still awakened me almost every hour to do one test or another. It turns out that hospital policy dictates that all patients who are GBS positive receive two powerful doses of IV antibiotics four hours apart before the delivery. Since I didn't have time to receive the second dose before Kora's birth, they mandated that she stay admitted for 48 hours, receiving IV antibiotics, even though she exhibited no symptoms. When we finally brought her home, she smelled like a sick dog, and she cried for four months straight. We highly suspect that the antibiotics caused gastric trouble that caused upset stomach and colic.

What I would repeat:

Laboring at home. I enjoyed the freedom to walk outside without stopping to be checked or monitored, to eat and drink, and to, um, "augment" labor naturally.

What I would do differently:

Walk at the hospital. If I had been in any position to argue, I would have hopped off that bed and started walking, squatting, or bouncing on a ball while we waited for the epidural. I firmly believe movement can aid labor as much as Pitocin.

Refuse antibiotics for the baby. I don't even know if you can do this. Plus, Group B Strep can cause fatalities in babies who contract it, which explains the hospital's policy.

Try to get better sleep at the hospital. I came home to a toddler and an infant, and I'm not sure I slept for four months.