Permaculture for the Body, Permaculture for the Mind, Uncategorized

Empowered & Humbled: My Home Birth Hospital Transfer Story

I can vividly remember looking up at the florescent, bright lights on the ceiling of the ambulance and wondering to myself, “maybe I could just hide this part of my story…nobody has to know about this…”

And as I reflected on my birth story, I quickly realized that my intense desire to fein some sort of self-defined perfection is exactly why my story needs to be shared.

If you want a refresher on my first (exceedingly more peaceful and predictable) home birth experience, you are welcome to check out my first story, here. Because as we move forward, know that the images, both visually and mentally, will be vulnerable, graphic and depending on your own history, possibly traumatic.

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Heather Nischke Birth Services

 

The Story: Just the Facts

On Wednesday, March 13th at 39 weeks and 4 days, I spent the day as I had most of the previous days…hanging out with my 2-year-old, crossing jobs off my to-do list and dreaming about having my 2nd baby!

As much as I was incredibly ready to have my baby, I was being fairly patient about my labor-inducing tactics. I started my morning with some devotions, breakfast, prenatal pill, evening primrose oil, eating dates, cleaning, and a prenatal appointment. Then I went into the afternoon with a cup of red raspberry leaf tea, took a short walk with my toddler, edited a podcast, while she napped, ate lunch, and did some yoga.

 

4:00pm

I was sitting at my computer responding to some emails and playing “horses” with my daughter, when I felt what I would consider my first noticeable contraction. I had been experiencing a LOT of Braxton Hicks over the previous 2 weeks or so, but this was the first one that required a certain amount of attention. Initially, I tried to ignore it, because I had been having so many “false starts”. Soon, I had another contraction, lasting about 20 seconds.

I called my husband to see where he was, and was excited to find out he was only minutes from home. I started timing contractions and my birth photographer texted me out of nowhere, asking me how I was feeling. I was surprised at her “birth senses”, and told her that I actually thought I might be starting early labor.

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4:28pm

I texted my midwife. I was having contractions about 4-5 minutes apart, lasting 20-30 seconds each. I also told her that I had almost 4 loose bowel movements that day, so it seemed like my body was evacuating. I told her I was going to jump in the shower and let her know how I felt afterward.

I sang songs while I showered and the water felt wonderful on my early contractions.

Danny (my husband) buzzed around entertaining our toddler, and getting birth supplies unpacked and laid out.

5:30pm 

After the shower, I decided to braid my hair.

My parents arrived home, so they were able to start taking care of my daughter, and Danny was free to help me through contractions.

I was still getting pretty significant contractions, but nothing unmanageable. I was secretly afraid that these contractions were going to stop, and I still had not seen any bloody shew or signs of my water breaking, so I was hesitant to actually call this labor.

I texted Erin, with minor updates, and (knowing how quickly my last labor went) she decided to come over.

6:00pm 

Erin arrived and checked all my vitals and checked on baby.

My contractions were starting to become something that I needed to manage with vocalizations. So, I would lean on a ball or remain on all fours, and moan in my deep register, during contractions, but then I would sit on my bottom, and chit chat with Erin and Danny in between.

Erin’s assistant midwife, Melissa showed up. (She had just caught another baby at a different birth, so she was ready for more baby fun! 😉

6:30pm

I waited for Erin to check my cervix, because I was afraid it would not be very far along, and I would be disappointed by the number.

When she finally checked, I was 7 cm dilated.

7:00pm

I was in active labor. I labored on my hands and knees and I wanted NO PHYSICAL TOUCH. In my last labor counter pressure felt good, but this time, I didn’t want anyone touching me. I didn’t appreciate soft touch or hard touch, and so my team (Danny, Erin & Melissa) cheered me on with their words.

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7:30pm 

My water broke.

I had A SIGNIFICANT amount of amniotic fluid. It was like an enormous water balloon popping and on each subsequent contraction, more fluid came out.

7:45pm

I moved onto my bed. I felt like I could not properly support myself on my hands and knees any longer, and so I laid on my side, and Danny supported a leg.

I began pushing with each contraction. I tried to be super patient. I was very intentional about pushing ONLY when there was a contraction.

8:00pm

My birth photographer, Heather Nischke arrived.

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8:14pm

Baby boy was born with a single loud wail.

The relief. The joy. The floodgates of mental and physical peace. There is absolutely nothing comparable.

He was brought directly to my chest.

I was in love.

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Heather Nischke Photo

8:15pm

Almost immediately, I began to hemorrhage.

I was so completely overwhelmed with meeting my new baby boy, that I was not aware or concerned.

My midwife delivered a shot of Pitocin.

Cytotec was administered.

Another shot of Pitocin was given.

I delivered the placenta, completely in tact.

They pushed on my uterus.

I took multiple drops of helichrysum essential oil.

I continued to lose blood.

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8:30pm 

My midwife told my mom to call me an ambulance.

I was shocked. I looked at my midwife with confusion. I felt fine.

She looked me dead in the eye and told me that I had already lost more blood than she was willing to manage without medical intervention. She did have an IV, and she began to set it up, after telling me that if I could get my uterus to clamp down, she would send the ambulance away.

 

8:45pm

A group of paramedics (mostly men) showed up in my bedroom. The bedroom that had birthed both of my babies. The bedroom that had “peace” essential oil blend diffused and  housed some of my most relaxed and cherished memories.

I was fully stable. I felt high, probably still buzzing from the endorphins and oxytocin of having birthed my baby boy.

The lights were bright.

I only had a sports bra on, and while my midwife made attempts to keep a pad over my lower body, it was mostly unsuccessful. Her priority was manually holding down my uterus to stop the bleeding.

My baby boy was taken by my husband, who promised to follow behind the ambulance.

 

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9:00pm

I was placed on a stretcher. Carried up my stairs, where another man took over manually holding my uterus/fundal pressure.

At this moment, a gentleman standing above me asked, “Do you work at the YMCA?”

At the very least, this made me laugh. I answered, “Yes, I recognize most of you from the YMCA, and those I don’t recognize from there, I remember from high school, so this is humbling on many many accounts.”

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9:15pm

IV was put into my arm.

Ambulance left for Waukesha Memorial Hospital (not the hospital of my OB/GYN, nor the hospital of my preference, but they insisted it was the nearest option for them).

For those who have medical understanding, my IV was put directly into the inside elbow of my right arm. Therefore, for the rest of my trip to the hospital and the entire night that I spent in the hospital, I was unable to bend my right arm without setting off alarms and shutting down IV fluids and/or Pitocin.

 

Once at the hospital…

Even though my midwife and one of the EMT’s called ahead and requested to be taken to Labor and Delivery, I was taken to the ER.

In the emergency room I was met with judgment and disdain by the doctor and some of the nurses. I could immediately sense that they considered me a reckless mother. The EMTs who accompanied me were so kind and so friendly for the entire drive, and they were extremely aware of the annoyance the ER team showed me. One of the EMTs looked at me with compassion and said, “I promise I will get you where you can be best looked after”. I thanked her, because I knew she meant that she also felt the harsh judgment and would make sure she found someone who at the very least, respected my presence as a human being with choice and intelligence.

After a significant amount of discussion, the OB doctor on call came downstairs to the ER, and I was transferred onto another table.

The OB doctor and her assisting nurse were very kind and put me at ease with their peaceful demeanor.

However, then the OB doc proceeded to do uterine sweeps, which were not peaceful. In fact, over the next 10 minutes she accomplished 4 uterine sweeps to eradicate clots that were ultimately preventing my uterus from fully clamping down. These sweeps were possibly more painful than childbirth. (After debriefing with my midwife later that evening, she mentioned that usually they put some sort of pain-killer on board before doing the sweeps, but the doctor said she did not feel like there was time for any numbing sensations.)

She got the intense bleeding to stop.

They added up the blood that I had lost at home to what I lost on the ride to the hospital and in the ER, and estimated that I was down about 2,200 cc.

I was given a saline IV solution to bring my blood volume back up.

I was given more Pitocin to encourage my uterus to keep contracting.

I was taken to labor and delivery so that the doctor could repair a 2 degree tear I had also experienced during labor. (At least I received a local anesthetic for this repair :))

My midwife and assisting midwife accompanied my dad, husband and baby boy to the hospital, made sure I was comfortable and safe in my final location, before they went home for the evening.

It was suggested that I stay the evening in the hospital to finish the Pitocin drip and confirm that my uterus was cooperating effectively.

Danny (my husband) and my baby boy, just a few hours old, were allowed to stay with me as guests.

I was also given an antibiotic because of the uterine sweeps. (I was bummed about this, because I haven’t had an antibiotic in well over 12 years, and now my gut flora would be cleared…so here’s to all the sour kraut I will be eating and the kombucha I will be drinking ;))

Between the afterpains, the Pitocin and a full bladder, I had an extremely uncomfortable evening in the hospital. I got to cuddle with my new boy, but often I was in so much pain, I was forced to ask Danny to hold him. I was given a Motrin for pain relief, but being that I don’t often take any sort of medication, it made me nauseous, on top of the cramping. I also mentioned that my IV was in the crease of my elbow, so anytime I bent my arm, I set off alarms and stopped the Pitocin.

It was not how I pictured my first night with my new baby.

I prayed through the night.

 

6:00am

When the sun came up, so did my spirits.

They did not administer another blood test because the doctor said that my iron levels had been so good upon arriving at the hospital, that there is no way my blood results would show the correct effects of my hemoglobin loss, at that point. She said I would absolutely be anemic in the next couple days, but that she did not feel the need to do a transfusion, given how well my body seemed to be handling the loss.

Instead, she recommended that I get a lot of iron into my diet and take an iron supplement.

As soon as I was able to do a full walk around the hallway, and eat food without becoming light headed or plummeting my blood pressure, I was free to go home.

10:00am

I left the hospital and went home to rest and cuddle with my newest little.

My midwife did her first of 4 home visits over the next 2 weeks, to check on my and my baby’s health.

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My Thoughts on the Experience.

I think one of the greatest struggles in this experience is my frustration with my own body and my inability to see how this glorifies God.

I believe everything happens for a reason. I believe there is a great controversy playing out around us, and there are good and evil angels vying for position on this great battlefield, called earth. And I sincerely believe, even amidst the terrible parts of life, God is always in charge, and when we get to heaven, we may be able to see how His will was always ultimately just and good.

But even knowing that truth, I am one of those people who would like to see the “grand plan of goodness” laid out before me…but this was one of those situations that doesn’t have an easy answer.

If I am being completely vulnerable, I fight the feeling that my body somehow failed me in this birth experience. My body is created to birth a human being. It has done it, quite successfully, before. I had prepared in every way I know possible, to create a successful birthing atmosphere; physically, emotionally, and spiritually. And yet, as I research postpartum hemorrhages, I find that they are completely unpredictable and almost entirely unavoidable. I so desperately want someone to tell me that I could have “worked out” differently, or eaten more dates, or prepped my uterus in some other fashion, and yet, the type of hemorrhage that I experienced cannot be anticipated, it can only be managed, once it presents itself.

For someone who loves control and thrives on preparedness, this is a type of “surrender” I have never experienced.

I had to let go of the reins, not because I wasn’t an adept horseman, but because my reins weren’t even connected to the horse.

Herein lies the first lesson God has taught me in this… Health is a sort of idol in my life. I spend the majority of my life researching, living, and sharing a health and wellness message, as if we can “earn” our way to perfect health. And we can’t. Yes, I believe that we have been given the Holy Spirit, which is Christ working in us. And yes, I believe that He is able to transform our lives day by day. And yes, I believe we have some agency in our wellness journey to listen to His still small voice. But at the end of the day, you can do everything “right”, and yet still need to fall humbly at the feet of Jesus, because He is our only salvation.

The verse that came to me as I journaled over this experience is Paul’s writings in 2 Corinthians 12:9…

And He said to me, ‘My grace is sufficient for you, for My strength is made perfect in weakness.’ Therefore most gladly I will rather boast in my infirmities, that the power of Christ may rest upon me.

Bad things will happen in life. Unexplainable things will happen in life. Totally unjust things will happen in life…but this is not our home. The sooner we give up control, the easier it becomes to say, this was a rough ride…But God is still good.

And God is glorified in our weakness.

This was not the way I would have had it, and I still don’t completely understand why God allowed my story to play out this way, but I am slowly becoming ok with “not knowing”. I am accepting that He knows why it needed to happen like this, and therefore, it is still well with my soul.

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Not Just a “Woe is Me” Story.

In the midst of the chaos, I also have a LOT to be grateful for.

My labor gratitudes:

  • Another fast labor. About 4 hours start to finish. My labors are fast and furious. When active labor hits, I become exceedingly grateful that each contraction seems to really make waves in moving my baby out. Whew…they are not fun.
  • A healthy baby boy, who was brought directly to my chest. He was not “cleaned off”, or given shots/medication or any other intervention that I would have had to decline in the hospital. His cord was cut WELL after it turned white and stopped pulsing.
  • Typically high iron levels. My iron runs pretty high, and I believe this is why I was not more poorly affected by the large loss of blood. I stayed completely awake and aware during the entire ordeal. I am grateful for a strong body and strong circulatory system.
  • My birth team. My midwife, who was unwavering in her decision to call an ambulance, even though I was determined that I could get my body to stop bleeding. She kept me safe, and did not allow the risk to become more dangerous than it already was.
  • My husband, who navigated getting our newborn baby, and the suitcase I sort-of-but-not-really packed, into the car and to the hospital to be with me.
  • My parents who watched Montana, and took care of all the happenings behind the scenes.
  • All of the family members and friends who were praying for me. I truly believe those prayers were heard and answered in ways I will not fully comprehend on this side of heaven.
  • The fact that my toddler fell asleep RIGHT before all of the excitement went down, so she woke up completely unaware of all that had gone on around her.
  • The Mukwonago Fire Department & Mukwonago Police Department & Waukesha Memorial Hospital. Thank you, for being there when I needed it.
  • Life. I am grateful for another day.
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Heather Nischke Birth Services

Do I still Recommend Home Births?

My view of home births has not changed. I still believe that if a person is a low-risk pregnancy, and has a competent birth team, home is still the most peaceful and natural environment. I write more about my thoughts behind why home birth is a great option here. I also talk about the difference between OB/GYN and Midwifery care here.

Home Birth is as much for the mom as it is for the baby.

What this has taught me, is to remember that I cannot control the uncontrollable. I talk about how a person can train for birth in this blog, and I still believe that there are a lot of things we can control….the way we eat, the way we workout, the way we think, the way we plan….there are a lot of things surrounding birth that we have a part in. However, I was smacked in the face with the fact that there are pieces of birth that are unpredictable and unpreventable. 

My midwife was a great example of what a home birth team should do in the case of an emergency. Her job is to mitigate risks. Having to transfer to the hospital is VERY unlikely, and of course she knew that I did not want to go. But she did not wait until it became a dire circumstance, to make the call. While I am not proud that my birth became one of “those” statistics, I am proud of the unwavering decision of my midwife and her assistant. I am proud that my birth represents how a “bad” situation can be handled “correctly”.

We have emergency medical teams and hospitals for EXACTLY this purpose, and while I would have liked to go on existing in a false reality that I was somehow “above” needing the help of medical professionals, I happened to be one of a very low percentage of births, that actually required the help of western medicine. And so for their aid, I am forever grateful.

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Would I Plan for Another Home Birth?

Let me emphasize, first, that we are QUITE content with our family as it is. I feel our family of 4 is complete!

However, if God had other plans (or if I don’t figure out how to correctly navigate the Fertility Awareness Method ;)) I consulted with both Danny and my midwife about whether I would still be considered a good candidate for home birth.

And while this may or may not surprise you, the answer is I’m not positive, but I think I would.

Even given this experience, I believe I would still tend toward wanting another home birth.

My midwife explained that there is no research to suggest that a person can have a predisposition to intense hemorrhages. Losing as much blood as I did is unpredictable but also uncommon. (About 1-5% of births have a postpartum hemorrhage and the majority of hemorrhages happen in a C-section. In addition, a woman is more likely to experience a postpartum hemorrhage in a hospital setting. ALSO, most of the typical tools used to manage a postpartum hemorrhage are available to midwives.)

A hospital setting would greatly influence the freedom and the tranquility of my labors. I would not enjoy laboring in a medical setting, with anything attached to me. In addition, I have very quick labors. Both of my labors were about 4 hours start to finish. Therefore, I believe trying to get to the hospital would be frustrating and stressful. The idea of rushing to a hospital, laboring in the hospital, and then dealing with the cascade of potential hospital interventions for both me and my baby, makes me think I would absolutely plan for another home birth.

And yet, if I am being honest, I would have to fight the doubt in the back of my head. I would have to wonder, “what if” during my entire pregnancy. I don’t know how the fear of another ambulance ride might influence my pregnancy and labor, emotionally and physically.

If I did decide to do another home birth, my midwife explained that we would have 2 shots of Pitocin prepared and she would also have an IV prepared, in the case of needing to put fluids into my system. In addition, I would notify the Fire Department about my home birth intent and tell them what hospital I would like to be taken to, should anything go awry.

Overall, I feel as though this experience has humbled me, as an individual, but has also made me even more confident in the abilities and decisions of my midwifery care team. My midwife obviously supports the home birth practice, and she believes in allowing a woman’s body to take the lead, but she is also not willing to risk the lives of mama or baby. I have become even more confident in the systems in place to manage potential risks. Therefore, if I had to make the decision whether or not to birth at home, I would need to spend a lot of time in prayer and getting my mind in a space of confidence and peace.

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*A possible “why”*

This blog has become a catch all for a wide variety of thoughts, which is very difficult for someone who believes in having a clearly defined thesis. However, I wanted to share one idea about WHY this could have occurred…

I have a few reasons to believe that I originally conceived twins. I had significant bleeding, in the beginning of my pregnancy (I estimate it was about 5 or 6 weeks in, and lasted for 9 days, before I knew I was pregnant). Looking back, the length and type of bleeding seems like it could have been a miscarriage. This threw my dating off, because I thought it was a period, which was corrected at my first ultrasound. I also had numerous dreams I was having twins, early in my pregnancy. In addition, my dad was a fraternal twin, and the gene for ovulating two eggs is carried by fraternal male twins and passed to daughters. Finally, I had a significant amount of amniotic fluid. In fact, looking back my midwife would define my pregnancy as Polyhydramnios, which is the medical term for having too much amniotic fluid in the womb. This condition could explain why I felt SO incredibly stretched and only birthed a 7lb 13oz baby, and it could also explain why I had such an intense hemorrhage.

Whew! So, there it is. For better or worse…but hopefully, always for better.

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6 thoughts on “Empowered & Humbled: My Home Birth Hospital Transfer Story”

  1. I always enjoy reading your reflections. Your journey is a thoughtful and provocative one and I appreciate your clear and vulnerable sensibilities. Looking forward to meeting B.

    Like

  2. I always enjoy your reflections. Your journey is an interesting and provocative one and I appreciate your clarity and vulnerability.

    Like

  3. I just read your story….wow! I am glad things turned out well after all the trauma. Congrats on your beautiful baby 👦. You are a gifted writer with great insights. Blessings to you and your lovely family!

    Like

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