Posts tagged pitoc
The Birth of Acelin Amelia 2/15/21
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The first time I sat with Merrilee I knew we would get along! We covered the gamut in that first “interview”. When I left over two hours later, I felt like we had orchestrated a plan to change the culture of birth. Merrilee definitely had a fire within her and a strong idea for the sort of birth she wanted for herself and her daughter. She believed in her body’s design and she didn’t seem nervous or scared either! This was her first baby but it didn’t seem like it.

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We came together rather late in her pregnancy, so we fast forwarded through the prenatal visit a short time later and spoke specifically about her goal of a natural childbirth with as little intervention as possible. She would labor at home for a lot of it and then go to the hospital late in active labor. But even the most committed and prepared birthing women can have a wrench thrown into the plan. And this was certainly Merrilee’s situation. Abnormal blood work following an otherwise normal appointment had her on the fast track to induction. They wanted her to go to the hospital that day but Merrilee advocated for a day’s delay to wrap her head around the drastic change in plans and got enough time to feel ready.

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As is the case with most inductions, it was a gradual process. They went in overnight once a bed was available, and the process began with Cytotec. A few hours later a foley bulb was inserted. Merrilee was not dilated initially so they hoped her body would respond with some dilation and a better Bishop’s Score before incorporating Pitocin. She felt “sensations” pretty early on, but they were very manageable. Later that day the bulb was removed and Merrilee’s cervix was dilated to 5 cm and she was 70% effaced. Her water was broken around 5:00 pm in the hope that contractions would naturally stem from that. Merrilee really wanted to avoid Pitocin. She had patient providers who waited with her through the evening and into the night. But after 8 hours with no notable contractions and cervical change, it was time.

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Merrilee was a master at minimizing her attention to the contractions. She breathed and remained calm and centered for the large part of her labor. Things picked up in intensity about 3 hours into the Pitocin drip, requiring her to breathe and move with her contractions in a way she hadn’t needed to before. (In fact she had been resting and asleep for much of the evening.) We positioned the bed upright so she sat upon it like a throne. It really helped to have gravity bring her baby down upon her cervix and encourage stronger contractions and more cervical change. The Pitocin was another smart tool as well. Merrilee also labored on the birth ball, swirling her hips and leaning back against her husband for support. And her contractions intensified.

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With the new intensity of labor, Merrilee and Braelen moved into the shower where the warm water really helped with relaxation. Merilee labored upright, on hands and knees, always with Braelen right beside her under the water. The closeness did her labor good hormonally too, as the oxytocin washed over her just as the water did, an important complement to the Pitocin. We dimmed the lights and it also gave some privacy, minimizing the need for intrusions to just an occasional quick listen to baby’s heart rate with the doppler.

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Once out of the shower, Merrilee used the rebozo to squat and dangle through the transition and she vocalized with such power that we could literally hear her baby moving down to open her fully. Braelen was her steadfast partner, always cheering her on and telling her how incredible and strong she was. He supported her as she squatted into him. I saw his legs shake over the course of that hour, but he stayed strong in solidarity with Merrilee who was the one doing the work. He would comment on that very fact often. Merrilee squatted against the door for an hour and she felt her baby descend to the point of “feeling like I have the poop.”  (If you’ve given birth, you can probably identify with that landmark feeling!) She began her rebozo work at 8:05 am and she was completely dilated by 8:58 am! Merrilee returned to the bed for birth and began pushing on her side at 9:03 am. Her baby’s heart rate dipped, most likely due to second stage and all of that pressure, but with a watchful eye and a light hand on the Pitocin pump, Merrilee was able to push with hardly any of it. (The pump had been turned off and then resumed at the lowest level). Her body had taken off and she was pushing her baby out just fine!

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Acelin Amelia was born at 9:34 am on February 15, after just 30 minutes of pushing. (I credit Merrilee’s short second stage to all of the squatting she did with the rebozo, laboring her baby down!) Acelin’s cord was wrapped around her neck, body, and leg so no wonder her heart rate dipped later in labor! It’s not an unfamiliar occurrence and usually doesn’t pose a problem. Acelin had a gorgeous head of hair (like her parents!) and was absolutely adorable. Her daddy wiped away tears at the sight of her and Merrilee’s dimpled smile needed no words. She was over the moon to have her sweet baby girl in her arms at last!

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Acelin weighed 7 lb. 3 oz. and measured 20 in. long. She came into the world by way of her determined and dedicated mom, who dug deep within herself to find the strength and commitment to continue her plan of an unmedicated birth, even in the face of an induction. While there is no way to know how a birth will play out, I can assure you that Merrilee’s mindset and her husband’s unwavering support, not to mention her patient and flexible nurses and providers, made all the difference. Her doctor was intrigued by the rebozo and was even talking through ways to incorporate their use from the ceiling in that particular hospital. Merrilee’s birth may very well have changed some thinking for some birth workers. And I know that would make her so proud! Congratulations to this couple on the arrival of their daughter and the journey of becoming not only parents, but advocates, more committed partners than ever, and ambassadors for better birth options. I’m so honored to have been part of your team!

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