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Archive for Nisan 2013

Kimberly

Visit Kimberly’s blog for her tips on natural birth in Turkey.

It’s hard for me to decide exactly when Liam’s birth story begins, because it seems like my actual labour started days before he was born, but then stopped. On the Tuesday September 6th, myself, Richie and Paul Scott (who was visiting from the U.S.), took a walk into Beşiktaş for dinner, and on the walk back, I started feeling some not-too-strong contractions. I’d felt these before, usually when out walking, but this particular evening they seemed a little bit stronger and I needed to take a few small breaks and even lean on Richie during a couple. I sent a text to our doula Amy when we got home to let her know, but then everything stopped.

I had my regular weekly visit to my doctor on Friday and I was about 3cm dilated, having gradually gotten to that stage over the last couple of weeks. Dr Gülnihal said that she thought my labour had started but stopped again for some reason and asked me how I was feeling about everything. This was the point when my thoughts on the previous Tuesday came back to me, and I realized that maybe I was resisting things a bit. During the walk home that evening I remembered thinking that I just wasn’t ready. I hadn’t thought I was anxious or nervous about the upcoming experience, but suddenly it all seemed so much more imminent and I did feel a bit nervous about all that was to come.

During the visit, my doctor told me that my blood pressure was a bit too high, and we needed to monitor it carefully. I think the condition is called gestational hypertension and it is potentially dangerous, although I think mine was only minor. It’s quite common with first time pregnancies, but still, to be safe, she wanted to induce labour on Monday morning if nothing happened over the weekend, because with this condition you usually aren’t allowed to go past full-term. So, over the weekend, I had to go to a pharmacy every day and have my blood pressure checked and text her the results. And on Sunday she told me I should have a fetal non-stress test at a local hospital to make sure all was well with the baby. In the non-stress test they monitor the baby’s heart-beat and movements, which is printed out on a line chart to send to the doctor. So, when I went, my blood pressure had returned to normal and the baby was fine, but then she rang me to ask how I was feeling, because according to the test results, I was having regular contractions every five minutes. I hadn’t even really noticed!

That afternoon Amy came over to try and get my labour started naturally so I wouldn’t have to be induced the next morning. She used some massage, aromatherapy, did some stuff to various pressure points, and then we took a long walk around our neighbourhood. I did feel slightly stronger contractions during the walk, but again, when we got home, everything seemed to stop. We got home, ordered dinner out (I had to eat some salt-free chicken/veggie dinner because of the blood pressure issue) and then after we ate, Amy headed home. We were all pretty tired so at about 11 o’clock we headed off to bed.

About an hour later, I woke up with this pelvic pain that I’d been feeling every night for at least the previous week. I’d been waking up feeling really uncomfortable, so in addition to going to the bathroom a million times, I also needed to do some swaying and stretching and sitting on my pilates ball making circles with my hips to work out the kinks. For nights and nights I’d been doing this every couple of hours. On this particular night, I woke up feeling so annoyed I nearly wanted to cry. I was so sick of this painful interruption to my last precious nights of sleep before the baby eventually arrived. I tried my usual routine, but tonight it hurt worse than usual, and I even decided to try taking a shower to relax. I ended up on all fours in the shower trying to work out the discomfort, but even that didn’t work. At about 12:40am I went back to our room and asked Richie to call Amy to ask what I should do, because I was too uncomfortable to talk. She suggested a couple of things, but those didn’t work and actually felt terrible.

I got up again to go to the bathroom and suddenly felt like I was wetting myself. Now, my bladder had definitely been squished like crazy over the last weeks, but I felt like suddenly I’d lost control of myself altogether (a bit embarrassing). I was standing in the bathroom trying to figure out what to do about the situation. I went back to the bedroom again, and sheepishly told Richie I was peeing myself a bit and couldn’t do anything about it (it didn’t occur to me at that moment that my waters had broken!). I was sitting on a towel on the bed and we tried to time the pains I was feeling but there was no real distinction between them, although I did seem to get more uncomfortable every 5 minutes or so. It was definitely stronger than anything I’d had before and so Richie called Amy again to tell her, and she told him that we should just go to the hospital. She checked the traffic online and called back to say that everything was clear, so we should be able to get there in less than 30 minutes. Richie got everything ready to go, and by this time Paul Scott was up too so he helped me walk down the stairs of the apartment and down the hill to where Richie had stopped a taxi. Off we went to the Asian side in the middle of the night. The taxi journey didn’t take too long, but the driver, used to working on the European side, didn’t know where the hospital was in the Göztepe neighbourhood, so we circled around for about 5 minutes at the end as he asked random passers-by. I was getting pretty annoyed by this in the back seat and just wanted to get there already!

Amy was already at the hospital when we got there, and we got settled in our room. I was having pretty strong and distinct contractions now, and frequently, all the while leaking amniotic fluid. I quickly found my favourite position for the whole labour experience, which was a standing-squat with my arms around Richie’s neck and him holding me up. I gave him quite a work-out over the next 14 hours! When I was checked shortly after our arrival, I was already about 6 or 7 cm dilated.

The details now get a bit hazy for me, so I’ll have to let Richie fill on some of the blanks for you. I remember Dr Gülnihal arriving not too long after I was examined. I continued to hang off of Richie during contractions while Amy massaged me. At about 4 o’clock, after being checked by the doctor, I was advised to lay down for a bit and try to sleep, to save my energy and relax. The first contractions laying down were awful, but Amy and Richie helped me to relax and I did sleep for about 30 minutes. After that I was up again, gradually getting closer to full dilation. The doctor checked my dilation at about 6 o’clock, and drained my bladder, since she thought that it might be acting as a cushion under the baby’s head, reducing pressure on the cervix to open. After that she asked me to try resting again. I didn’t want to have to lie down, since it was really painful every time I was on my back for a contraction, but I managed to get another half hour’s sleep.

 RICHIE: By this stage both Amy and I were starting to nod off from lack of sleep, so I couldn’t imagine how tired Kim must have felt by now. We’d only had about an hour of sleep before labour started, and as it went on it was getting further and further from when she’d last eaten, so her energy level was a worry too.

Richie continued to hold me up and Amy rubbed my lower back. I was brought to the examination/delivery room about once every hour or two to be checked, and then returned to our room. I was fully dilated by about 9 o’clock. I remember thinking I must be in the transition phase because I was walking with Amy to the examination room, and I started crying and saying I couldn’t do it and things along those lines. I also remember thinking that it felt good to cry.

So, into the next phase of labour and we thought it’d be over soon. Little did we know! I was in the pushing phase of labour for about 5 hours and progress was so slow and intense!

RICHIE: I’d had the time to text some people to say that labour was starting while we were in the taxi, and I was able to send a couple again while Kim was asleep after 4am and again after 6am. Because I was supporting her during contractions that was all the free time I ended up having. I did try to send a text at one point between contractions, but Kim very politely said “Could you please not do that right now.” The texts I’d sent my mother had been “Doctor’s here. Looks like it’ll be soon. ” at 3:16am, and at 4:36am “Kim’s sleeping now. Almost completely dilated but contractions have eased before the big push. Been about 4hrs of labour so far, not too rough yet”, so naturally when she didn’t hear anything more for another 8 hours she was having conniptions. I must remember to be more non-committal in any future labour bulletins.

I wanted to stay on my feet as much as possible because I wanted things to go faster and laying down felt awful and painful. I was taking small sips of juice and water between contractions, but was really running out of energy. I remember leaning on the counter in the room, staring down at the tiny dots on the counter tiles, just focusing on those dots like they were the only things that existed in the world. I continued to use a standing-squat for contractions, pushing during most but resting for some, but now with Amy holding me up on one side and Richie on the other.

RICHIE: By this time we’d heard the first call to prayer, about an hour before sunrise, and then I could see creeping daylight through the shuttered window. After 9am, I think that Amy and the doctor expected that it wouldn’t take long, but then things seemed to slow. I remember thinking of how Kim had said she’d prefer not to have the kid on September 11th, and that because of the time difference it was gradually becoming September 12th across America. I think he waited long enough that by the time he was born I think it was perhaps only the 11th in Fiji.

I leaned on the counter in between contractions. I was completely covered in sweat and at times I just started shaking all over. All the time Richie was encouraging me and saying loving things. I wasn’t really very responsive at the time, but it meant a lot and it was all slowly trickling through my brain the whole time. Now even the supported squatting left my legs feeling extremely tired and I felt wobbly on my feet. I know I thought a couple of times that I just wanted them to give me a c-section so it could all be over. At some point I said to Amy that I couldn’t do it any more. She told me I could. Then I said I didn’t want to do it any more, and she said that that wasn’t the same thing. Those words really stuck in my brain.

By about 11am, because I was so exhausted and things were moving so slowly, it was decided that I needed an IV with some electrolytes to help me out. By this stage I hadn’t eaten in 14 hours, and the doctor was concerned that I wouldn’t have the energy to keep pushing. Although I wasn’t fully aware of it at the time, apparently the IV made a huge difference in perking me up. I think it was about this stage that I made a conscious decision to not look at the clock again or think about time. I stopped even thinking about the end result of all this- for now there were only contractions and pushing and overwhelmingly intense feelings of all kinds. I couldn’t think of anything beyond that and I knew that being impatient for it to end would only make things harder for me.

So we continued like this for ages. The baby’s heart was monitored frequently to make sure he was holding up okay. Everyone seemed very impressed at how well his little heart was handling things, and it seemed to have effected the doctor’s decision to let me keep pushing. Eventually when Dr Gülnihal examined me she said she could feel the baby’s head. During contractions nurses or the doctor would look and I kept hoping someone would tell me they could see the head, but nothing. Richie says at one point Amy and Dr Gülnihal were talking to each other and looking at him, and they were having a look at his head shape because our large-headed baby just was not moving down!

RICHIE: By now, Kim was so tired that pushing lying down was more comfortable, just because there was no weight on her legs and she could relax completely between contractions. While they tried some hard pushes in this position, the doctor thought that in between pushes the baby’s head was drifting back up, since there was no gravity to keep it down, so she asked Kim to stay standing for a while. Kim pushed for about an hour, then the doctor checked again at about noon, and then Kim pushed for another hour again. As the morning went on I could tell that the doctor and Amy seemed to be getting more concerned.

Eventually though, gravity did its work and all those standing-squats paid off. I was told it was okay to lay down now if I wanted because the baby had moved down enough that laying down wouldn’t make him move back up after pushing. I took rests on the bed with my legs in the stirrups, sleeping strange sleep between contractions. At one stage, while I was half dozing, Amy told me that Dr Gülnihal was back and in her scrubs, which meant that something was finally happening. It was encouraging!

RICHIE: Kim was obviously exhausted now, and I can’t say that the nurses were making things much easier. They weren’t used to active births, which caused some problems, added to the communication difficulties of the language barrier. If it hadn’t been for Amy it definitely would have been a much worse experience, and I think it probably would have gone to a c-section.

Now with each contraction I was pushing as long as possible, sometimes four big pushes for each contraction. Amy and Richie were holding my hands and holding my head up to help me. More pushing and more pushing. Dr Gülnihal gave me the option, via Amy, of having an episiotomy, because I was likely to tear and it would make things move a bit faster. At first I was hesitant, but a contraction or two later she asked me again and I agreed. She said that she wouldn’t do it straight away though, and would wait until it looked like a tear was inevitable without it. So, after pushing and pushing, I had the episiotomy because the baby’s head was just too big!

RICHIE: Each time Kim was examined, I could see what was happening better than she could. With each push the doctor was trying to help the baby’s head down, and I could judge from her hands how far was left to go. Very, very slowly I could tell that he was making his way down. Kim felt much more pain after some pushes, which Amy said was due to the head moving down into a different position, and coming up against a new tight spot, which at least meant progress.

While I pushed, Richie was telling me that his head was 20% out, 40% out, etc., and that was really motivating for that final painful bit. Then his head was out, then the rest of him was out. I wasn’t even fully aware that he was all the way out, until he was put on my chest. There he was, all purply-looking, crying and amazing! I was laughing and crying and holding him and Richie kissed me. What a moment! Thinking about it now makes me teary-eyed!

Just yesterday, we went back to the doctor for a check-up. She said that, after full dilation waiting for 1 hour is normal, so a 5 hour wait is really exceptional. She said that after about 4 hours she was thinking of doing a caesarean, but because Amy was there she felt confident enough to wait another while, and fairly soon after that she could finally see some real progress being made, so it seems that it was a very close thing.

So, it was without a doubt the hardest thing I’ve ever done, but after many gruelling hours, our strong little son made it into this world and I’m so proud and happy that we did it and he’s here with us now!

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