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Dalton’s Birth Story – A Comfortable Hypnobabies Pitocin Induction

1/23/2020

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This was my second birth and second Hypnobabies birth. From the start this pregnancy was different from my first. With my first I didn’t really have any complaints aside from SI joint pain in the third trimester. With this baby I had severe acid reflux from 6 weeks, and symphysis pubis pain from 12 weeks on. Then at our 20 week ultrasound our son was diagnosed with ventriculomegaly and hydrocephalus which is enlargement and increased fluid in the ventricles in the brain. My pregnancy went from routine to high risk and I had to start following with the perinatologists at Minnesota Perinatal Physicians. My first son was born at the Minnesota Birth Center with the nurse midwives there so that had been our plan for this baby as well. I had a fetal MRI at 28 weeks to confirm the hydrocephalus and it suggested that his hydrocephalus was due to aqueductal stenosis which is a narrowing in the duct in between the third and fourth ventricles in the brain. I now had to give birth at the hospital, but our plan was to still have the nurse midwives attend our birth. ​
As my pregnancy progressed, the perinatologists became more pessimistic that I wouldn’t be able to give birth vaginally due to the baby’s increased head size. It seemed like almost every appointment with them I would leave in tears. At 30 weeks his head was measuring about 3-4 weeks ahead in size. Due to the increased risk of the pregnancy and birth I decided to transfer to an OB-GYN group at 32 weeks. At the recommendation of our doula, Laura, we chose Dr. Ambur who was supportive of me making my own choices.
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I had signed up for the Hypnobabies class long before we received the hydrocephalus diagnosis so as the start date grew closer I was more ambivalent about participating. In the end I decided to start the class [for the second time] because if there was a chance this baby could be born vaginally I wanted to do my best to be prepared. The perinatologist had decided not to check his head size again until 36 weeks so then we could make a decision about our birth plan. I also think she was tired of making me cry every visit! I tried not to be fearful as the 36 week ultrasound approached. I prayed daily that his hydrocephalus would stop growing and his head size would be relatively normal.

At his 36 week ultrasound his head measured at 41 weeks, which was 35 cm. The perinatologist said I would likely need a cesarean birth, but I could consider a trial of vaginal birth if I wanted. I felt very hopeful as my first son was born at 38 weeks with a 35 cm head.

Because my first was born at 38 weeks after premature rupture of membranes, I thought for sure this one would come early as well. I also started having prodromal waves at 36 weeks in the days leading up to my sister’s wedding. I was worried he would be born before the wedding but it turns out he wasn’t in a hurry to get out. [Doula Laura: We all joked that having a baby was not on the checklist in preparation for her sister’s birth and that I would expect a call the day after the wedding saying it was go time]

My doctor scheduled me for an induction at 39 weeks and 1 day. [Doula Laura: We talked for quite a while the night before Jocelyn’s induction - reviewing birthing preferences, talking about her most recent conversation with the doctor, reviewing ways Hypnobabies and some Spinning Babies techniques can help from the beginning, and pumping up her courage and visualization]. I never thought I would still be pregnant at that point, but I did indeed wake up that day still pregnant. My husband and I were both excited as we went to the hospital that morning. I received antibiotics first as I was GBS positive. Then I opted to have the doctor break my water after an hour or two to see if that would get things going. It didn’t! I did several inversions, lift and tucks and walked around for an hour with absolutely nothing happening. I then opted to start Pitocin which was started at 1:30 pm. I had heard a lot of horror stories about Pitocin inductions but I was not worried about it at all. I think my bar for this birth was very low since I had been told for 19 weeks that I would likely need a cesarean birth. I didn’t care how it went I just wanted him to be born vaginally!
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I had very mild pressure waves for the first few hours as they slowly increased the Pitocin dose. At around 4 or 5 pm they started to pick up and were around every 2-3 minutes and were about a minute long. The waves were not very uncomfortable and I focused on them feeling like a “warm hug”, which they did! I was standing most of the time as sitting caused the external fetal monitors not to read well and was more uncomfortable. [Doula Laura: Jocelyn called me as I was eating dinner and she sounded great! Rocking her birthing waves while we talked, feeling good, and seemed excited about how things were going. I said, why don’t I finish eating and then head over and she thought that sounds great].
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Around 6 pm our doula Laura arrived. I was still pretty comfortable but was starting to feel tired from standing for so long. Laura suggested I kneel on the bed and lean my upper body on the upper part of the bed. This allowed my legs to rest for a while. Then my back got tired so I laid on my right side with the peanut ball. [Doula Laura: I had her husband massager her achilles, inner ankles and feet, as I used some essential oils and did some myofascial work and said Hypnobabies birth prompts]. The waves started getting more intense in that position.
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At 6:45 pm my doctor came and checked me. I didn’t find out but I was 5-6 cm dilated and 90% effaced. [Doula Laura: I went out in the hall to gather to gather the stats from the doctor for my notes to share with the family later and she said Jocelyn and baby were both looking great. He was really low and handling the waves well despite his hydrocephalous. This was great news! I told the doctor to stay close because historically Jocelyn has birthed very quickly at the end. She laughed and said, “OK I’m not going anywhere.” Then I went back in smiling and waited for the nurse to get the wireless monitor on Jocelyn so we could head to the shower.]

​The waves were increasingly intense and I wanted to get in the shower. It seemed like forever before I was able to get in the shower. The nurse had to switch out the monitor for the waterproof one and had to cover my IV. I was starting to feel some pressure in my 
bottom so I was worried I wouldn’t get in the shower at all! At last the nurse finished getting me ready and I was able to get in the shower. She warned me that at the first sign of pressure or feeling pushy that I needed to get out since I had to give birth in the OR.

The shower felt wonderful but my waves intensified greatly. I swayed back and forth in the shower to cope. I started to have thoughts like “I don’t think I can do this” and I was fearful that the baby would get stuck. Looking back, those were obviously thoughts that are typical during transformation but at the time I was just scared. [Doula Laura: As Jocelyn expressed her fears we talked and did some visualization about there being plenty of space for her baby to slide down and out easily, quickly and gently.]

​I think being told by the doctors for 19 weeks that his head was too big (which was a legitimate concern) contributed to my fear. After one big wave I felt definite pressure in my bottom and the urge to push. [Doula Laura: This wave was definitely different. Jocelyn just kept saying, “Yes, yes, yes!” so I asked if she felt rectal pressure. She did so I said after this wave we were getting out.]

​I had felt that with my first, so I knew that meant the baby was coming soon. Around 7:15 pm I got out of the shower and onto the bed. Dr. Ambur then checked me and I was 8-9 cm and baby was very low (I again didn’t find out). [Doula Laura: Jocelyn doesn’t remember this but Dr. Ambur told her she could stay in the room a bit longer or we could go get set-up in the OR since we had to be in there due to the high risk status. Jocelyn looked at me and asked what I thought. 
I said, “I think we need to go. Even if we have a little time (which I didn’t think we had to spare based on history) we should at least get where we are supposed to be.” She said yeah that sounded good.]

The waves were one on top of another and I knelt on the bed. My body started involuntarily pushing and so I blew “raspberries” to try to slow things down. The nurses quickly threw a blanket on me and surgical cap while wheeling me down the hallway to the OR. It was rather crazy as my body was pushing while everyone was racing me to the OR. As soon as we got to the OR I felt an immense pressure in my perineum and then his head popped out. I did not have any pain when he was crowning. I asked, “was that his head?” Dr. Ambur lifted the sheet and saw his head was indeed out! [Doula Laura: This was such a hilarious, joyous whirlwind. We left the room at 7:22 and got to the OR. I could see Jocelyn bearing down. She asked if his head was out and the Dr. and I lifted the blankets off her and indeed there was a perfectly molded head sticking out of her with lots of hair. Dr. Ambur said, “Why yes there is!” and laughed as she had been turned away from Jocelyn getting her gloves on. She told her to give another push and her baby would be out.]

I then pushed his body out easily in one push. He was born 2 minutes after we got to the OR at 7:25 pm and the NICU team wasn’t there yet! I was able to hold him briefly afterwards [and do a little unexpected delayed cord clamping] and then he was taken to the resuscitation room for evaluation.

I then birthed the placenta and Dr. Ambur sutured my second-degree perineal tear. Dalton returned from the resuscitation room and they let me hold him for 20 minutes since he was looking great. [Doula Laura: We couldn’t stop smiling and talking about how things could not have gone better and then on top of it Jocelyn’s husband walks back into the room holding their baby and says the NICU team don’t need to take him yet since he looks so great and she could do some skin to skin and see if he wants to nurse.]
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Dalton’s birth was very different from my first son’s birth, but I wouldn’t change any of it. It was overall a very positive experience. To me the waves from the Pitocin were not more uncomfortable then what I felt with my first birth. I was comfortable up until the last half hour when I was in transformation. I think if I had not been fearful I would have been more comfortable as well. I credit Hypnobabies for allowing me a mostly pain-free birth as well as the support from my husband and our wonderful doula, Laura
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