Cora Fay

Pitocin induced birth. Epidural due to old pelvis/hip issue. Includes great advice at the end.

I had painstakingly planned Cora’s birth for months. I felt strongly about having a natural and gentle birth, so Bobby and I chose the Birth Center of Gainesville for the pregnancy and birth. I enjoyed the midwives at the Birth Center and was happy with the personal treatment I received during the pregnancy. We planned to birth in the Jacuzzi and Bobby would catch Cora. I wrote out 2 birth plans – one for Plan A (Birth Center birth) and one for Plan B in case I needed to be transferred to the hospital. In the weeks prior to the birth, I practiced hypnosis for childbirth (Hypnobabies home study course), which I felt would help me to breathe, relax, and meditate through the pressure waves. However, I must say that I did not practice the hypnosis daily or follow the homework very closely! Also, I injured my pelvis and left hip several years ago. However, I never thought my hip injury would have any effect on my birthing time, since my hip felt great during the pregnancy. Another factor was that I was GBS positive, which meant an IV throughout birthing time to receive antibiotics. Unfortunately, most of the things I thought would never happen during my birthing time did happen. I think I expected everything to go exactly as planned. Even though it was not the birth I had imagined, it was still the most amazing experience of my life.

On Monday July 3^rd, I woke up and called my boss to see if he needed me to work that day. I had been working from home ever since 31 weeks, when early pressure waves landed me in bed. I had completed my bed rest at 37 weeks, but I continued to work from home since the pressure waves kept coming non-stop. It was physically difficult for me to do anything, and could no longer lay down with a laptop computer. I could only sit up and type for small amounts of time as well, because the pressure waves hurt my back so bad. So I was constantly switching between walking around, lying down, and sitting. I was definitely in the ultra-uncomfortable phase of the pregnancy, and was hardly sleeping at night.

Almost no one was working on the 3^rd, and business was slow so Bill (my boss) told me to take the day off. I had been researching acupuncture for inducing birthing time, and it seemed like something I might as well try. We had already tried everything we could think of since 37 weeks (at which time, we thought she would magically fall out once I got up out of bed). We tried evening primrose oil, sex, long walks, car rides down our bumpy road, raspberry leaf tea, spicy Mexican food (we even tried a specific meal known to put women into birthing time at a local restaurant), hot wings, cervical stretching (by the midwife), etc. My doula, among other people, recommended the acupuncture so I made some calls Monday morning. I was able to get in for an appointment at 2pm that day.

The acupuncture was interesting – it was my first time. During the treatment, I felt lots of tingling and then uterine pressure waves. However, I was skeptical since nothing else had worked and I had experienced pressure waves for months. I made a second appointment for Wednesday in case a second treatment was necessary. That night, Bobby (my husband) and I decided to take a walk and watch some early fireworks from our road. We walked about a mile down our road, and my body was pretty tired when we got back. We settled into a movie, and I kept saying that I felt strange. I could feel Cora pushing on my cervix, and I was experiencing some new shooting sensations down there. Thirty minutes into the movie, I got up to go to the bathroom. I peed, and the pee just kept coming. At this point in the pregnancy, I was only able to pee a few tablespoons of liquid at a time. So it was strange for me to be peeing so much! Eventually, I put some toilet paper under the liquid to take a look at it. It was clear and didn’t have a smell, and this also struck me as strange since I had just taken prenatal vitamins (and we all know they turn your pee bright yellow!) I called my doula and she felt that my water had broken. I called my birth center, and Stacey (one of the midwives) also felt that my water had broken.

It was 11 pm., so Stacey told me I had until 11am to get myself into active birthing time. Since I was GBS (Group B Strep) positive, it was imperative to start this time line since broken membranes can more easily allow bacteria to reach the baby and cause infection. I wish at this point, that I had asked Stacey to test to make sure my water had broken. If this happens next time, I will most certainly ask. I called mom to let family know that I thought Cora would arrive on the 4^th of July, since it is 3 hours earlier on the west coast. Everyone was excited! After putting the last-minute items into our bag and packing up the food we wanted during the birthing time, I went to bed. Pressure waves were coming, but nothing too close together. Bobby slept on the couch so I could sleep better, and I fell asleep listening to the Hypnobabies birth CD. As it finished, I woke up and continued to wake up about every 15-30 minutes throughout the night with pressure waves. I finally got up about 3 and took a shower, and was able to rest better after that. I got up about 7:30 and ate an egg breakfast, knowing I only had a few hours to really get my pressure waves to pick up.

As Bobby and I tried to game plan what we would do, Kaitlin (assistant midwife) called and told me to drink castor oil as soon as possible because we didn’t have much time to get things going. This caught me off guard since I thought my body would have more time to warm up, but Stacey and Kaitlin were pretty insistent. Suddenly, I was really upset. I called Kym to talk about it, and she pointed out that my military background made this difficult for me. I felt that I had failed and that I somehow wasn’t trying hard enough to get birthing time going. Feelings came back from when I broke my hip at West Point and was unable to measure up the way I had before. Lots of people at West Point see injured people (especially women) as “worthless” and I struggled for many years to redefine myself as a leader and a person of worth despite my injury. All these feelings of inadequacy came flooding back, and I felt better after talking to Kym about it. She said “This is not a situation where you can try harder. Your body has not failed, and you have no control over it.”

I sent Bobby to the store, and got our things together. We were told to come to the birth center as soon as possible to start the antibiotics for the GBS, and then we’d be able to come home. I called our doula Kym and let her know what was going on, and she agreed to meet us at the birth center. I made a shake with 2 ounces of castor oil (about 9:30am), and off we went.

At the birth center, Kaitlin checked me and I was still only slightly more than 1cm and 75% effaced. It was the end of Stacey’s shift, so Jennifer arrived to say hello and take over. Kaitlin only needed 2 more births to graduate, so she was taking charge and I felt comfortable with that. We had specifically requested Kaitlin and Jennifer, so I was happy that they would both be tending to me. At this time, Jennifer asked if they had done the tests to make sure my membranes had ruptured, but Stacey was confident that we didn’t need to.

Kym, Bobby, and I went back to our house and started the wait for the castor oil to kick in. I took another dose (a total of 4oz) and kept waiting. Bobby later reminded me that my stomach processes food 1/3 slower than other people’s (something we found out a few years ago when I was having stomach trouble), so that may have been why it took so long. I sat on the birth ball, Kym massaged my feet and pressed on Spleen 6, and started watching the movie Where the Heart Is (which ironically has this crazy quick birth scene where the girl has a baby in a Walmart). We noticed 2 deer walking through the front yard and we wondered if they sensed that a birth was about to take place. One was a young buck, and one was a doe. It was a treat to see them during that special time.

We asked the midwives to come to our house for the next few rounds of antibiotics, since we weren’t sure when the castor oil would kick in (therefore, diarrhea!) The first time they drove out to our house, they forgot the antibiotics and had to go back to the birth center! But they came back out and it was good to have them there. I believe it was around 2pm that I really started to get the runs and spent a lot of time in the bathroom. I felt pretty sick, but the pressure waves still were only about 5 minutes apart and not making much cervical change. It was good to have Kym there – we talked a lot all day. At 2:25 pm I was 3cm and 80% effaced.

I didn’t use my hypnosis or listen to the CDs for most of early birthing time, because I felt that I didn’t need it. But I did use some relaxation techniques when the midwives did cervical checks and other uncomfortable things. Looking back, I think it would have benefited me if I had started the hypnosis and relaxation earlier in the birthing time rather than waiting until it became difficult to manage.

The midwives kept telling me to try nipple stimulation to get the pressure waves to be stronger. Kym gave me some massage oil and I started doing this. It only took about 5 seconds of stimulation to get a contraction going, and then I was supposed to start again once the contraction ended. I was able to do this for about 2 hours, with lots of emotional difficulty. I finally went back into the bedroom and lay down, listened to the affirmations CD, and cried. I cried for about 30 minutes and thought about why things were so difficult for me. I decided I needed to talk to Kym about it. I went back out to the living room and told Kym about the problems I was having with the nipple stimulation. I explained that I felt like I was forcing my body to perform by doing something that felt dirty to it. I know these feelings came up due to some things in my past, and they needed to be addressed. I didn’t want to have these huge negative feelings about my body and my birthing time – I didn’t want those feelings anywhere near my baby or my birth experience. Bobby came in to the conversation a few minutes later, and I was ok with that. They needed to know, and talking felt better. Kym said that my birthing time was not going to progress if I was doing something that felt so wrong. Plus, she said I had looked sicker during the past 2 hours than ever before and she knew that something wasn’t right with me. I made the decision that I would rather have Pitocin (if it came to that) than to continue the nipple stimulation. The nipple stimulation didn’t seem to be making much cervical change anyway. Once I talked to her about it, I looked and felt so much better. When Jennifer and Kaitlin arrived for my next antibiotic dose, we all talked about it and they were really supportive.

While they were at the house, we did some tests to see if we could find evidence that my membranes had truly ruptured. Of course, the tests all came back negative and I was frustrated. They decided that either I could have had a high leak that had sealed, or that it was never ruptured in the first place. This was really upsetting to me, because if the membranes had not ruptured then I would not have been put on the ridiculous time line to get birthing time started. However, since they weren’t sure if there had been a high leak, Dr. Buchanan (back-up doctor) wanted to treat it as thought they were ruptured. So we continued to wait for the pressure waves to pick up. They checked me at 4:30 and again at 7:00, and both times I was still at 3cm and 80% effaced. Kym went home at 7 to get some rest, and I waited for more instructions from the midwives.

The pressure waves had been coming at 3 minutes apart pretty consistently for hours, with little cervical change. At 10:30pm we went to the birth center to be checked, and I was still only at 3cm and 80% effaced – no change since earlier that day. So Jennifer said we needed to go to the hospital to be induced with Pitocin, since it had been 24 hours since the leak occurred and I wasn’t in active birthing time (they wanted to me to be at least 4cm dilated). This was Dr. Buchanan’s rule, which is even more relaxed than most OBs. Jennifer and Kaitlin went with us. It was pretty eerie hearing all the fireworks going off around us and smelling BBQs all around the neighborhoods while we drove to the hospital. We checked in to Shands at AGH, and the nurses seemed great. Jennifer spoke with my nurse Ginny and shared some of my history and that I would like her to explain things to me before she does anything. She also gave her my birth “plan” (I call them wishes), since I had created one for the birth center and one for the hospital. The nurse read this over, and talked to me a little about it. I was certainly hoping that I’d have Cora prior to 7am when Ginny’s shift ended, since she was a great nurse. Kaitlin, Jennifer, Bobby and I chatted for a few hours until Kym arrived around 1:30am. Then Kaitlin and Jennifer headed home with instructions for us to call them when I started pushing.

Immediately after I checked in, they started my Pitocin drip, along with IV fluid and more antibiotics. Something I had noticed all day is that the antibiotics gave my pee a really strange distinct smell. (I could actually smell this in Cora’s pee for several days postpartum, and it drove me nuts!) The Pitocin slowly started working, and my pressure waves got stronger. As the night progressed, I felt better up and walking (although I could only go a few feet with all the monitors on me). I also sat on the birth ball and listened to my Hypnobabies CDs. The baby’s heart monitor kept moving and giving an error, but my nurse was nice enough to fix it a million times and let me stay on the ball. The back of the monitors had little bumps, which were hurting my belly so bad (especially during pressure waves). They were driving me crazy, and of course added to the annoyance. I also birthing timeed on the toilet quite a bit, which felt good also since I still had diarrhea from the castor oil. I remember I kept staring at the shower and thinking, “I wish I could use hot water to help with this birthing time!” I thought about the birthing tub at the birth center, and I was sad I was unable to birthing time there.

My hip and lower back were really starting to hurt. Between the birth ball, standing, the hypnosis CDs and the toilet, I was able to manage the pain pretty well. But I was only at 5 cm dilated, and it had been hours since the Pitocin had started. My doula and I agreed that since my hip and back were so worn out and hurting, that it would be beneficial for me to try to sleep for a while. The nurse checked me and I had only progressed a centimeter, so I was 4cm dilated and 80% effaced. My husband was sleeping in a rocking chair, and my doula slept in a chair next to me. I got in bed but forgot to put my headphones on to listen to the hypnosis CD. I slept for about an hour, and then at 5:45 I suddenly awoke with severe intense pain. I yelled “I have to go to the bathroom!” and stumbled out of the bed. I was shaking violently, and my pressure waves were coming about a minute apart and SO intense. I was suddenly in so much pain, that I thought “this better be transition.” But the nurse checked me, and I was only at 5cm – far from transition. I was out of my mind thinking “I can’t do this for another 5 cm”.

My water really broke at this point, and it gushed everywhere all over the floor on my way to the bathroom. I kept going back to the bathroom, and I called Bobby over to sit with me. I just wanted to hold his hand, and I needed encouragement. I began to vomit in the trashcan, and I think he was really scared. I was shaking so bad. It was 6:45 and I had been struggling internally regarding the epidural. I really felt like I needed one, but didn’t want to give up on natural birth. At this point, I could not stand on my left leg and I could hardly sit on that side of my bottom. Kym kept saying, “try listening to the CDs.” So I did that for a little while, while I sat with Bobby on the toilet, but I was so overwhelmed. I wonder if I had listened to the CDs while I was asleep, if it would have helped me. I think it would have. Kym told me later that she had seen the nurse come in to the room twice to turn up the Pitocin during the hour I had been sleeping. This is why I woke up suddenly in so much pain. My body did not have time to adjust to the increasingly strong pressure waves, and I had no way of dealing with them mentally.

At about 7:12 I was still at 5cm and was so discouraged. I told Kym and Bobby that I just didn’t think I could do this without an epidural, and I requested the anethesiologist. It became clear to me that my pain level had already surpassed me being able to manage it with the hypnosis. My hip was hurting so bad, that I was standing on one leg and I was moaning so loud. I really learned how to vocalize, but it didn’t make me feel any better. It just allowed me to survive each contraction. I asked for the anesthesiologist, but he had to tend to an emergency so it took him about an hour and a half to arrive. I felt like I was going to go insane. I sent Bobby to check to see how much longer he would be, although I knew it didn’t matter. I just needed a timeframe to focus on. The pressure waves were so close together and so powerful, I was just getting louder and louder. I felt like they were 30 seconds apart and were 20 seconds long. During this period of time, I was definitely a bit scared and I’m sure this didn’t help. I was scared of each contraction arriving, because it meant intense pain. The pain in my hip and back were so awful. During all this, the nurses switched over and I remember attempting to say hello to the new nurse as I vomited in the trash can.

The anesthesiologist arrived (finally at 8:30 am) and he prepped his tools. Bobby saw him prick his finger, so he asked him if he was going to wear gloves. (we had read about an epidural that killed a woman because the doc didn’t wear gloves and passed bacteria into her spine). So the doctor was kind of a jerk, but he explained everything he was doing to Bobby. This was helpful, and gave me some reassurance. The hardest part was having several pressure waves during the insertion of the epidural. But once I had it, I felt much better. I have had epidurals in the past, so I was familiar with the feeling. My skin itched a lot, and my arms tingled (so I was a little nervous). But after a little while, everything leveled out and I believe I had the perfect epidural (for a person who did not have an injury). I could move both legs, and even squat on the bed to push. But we waited for a while and I just relaxed, enjoying a bit of comfort and rest for the first time in many hours. I was finally in my right mind to properly introduce myself to the nurse. Her name was Lynn. Also, Kaitlin arrived and I was happy she was there.

9:00 am: The nurse checked me and I was 9 cm!! The epidural relaxed me enough for me to finally make progress – I went from 5 cm to 9 cm in less than 30 minutes. About 45 minutes later Dr. Buchanan arrived and checked me - I was completely dilated. About 10:30 I started pushing gently. I could feel my left hip, but it was not really hurting. I could also feel the pressure waves and learned from Kaitlin, Kym, and Lynn how to push. For the half hour or so, I pushed and actually enjoyed it. I remember saying “its like a game where I see how far I can push the baby!” Bobby stood on the right side of me and counted to 8 during each push. That was really helpful. Kaitlin was on my left and coached me the whole time. Kym was all around the room helping orchestrate everything. The nurse was “down below” telling me how things were going and letting me look in the mirror. We tried several positions – on my back, on my side, leaning over the back of the bed in a squat, and squatting facing forward while leaning on Bobby and Kaitlin. I didn’t use the hypnosis at this time (or listed to the pushing CD), because I felt like things were going great. Then they started to go downhill so quickly that I didn’t even think of using hypnosis. I was just focused on getting the baby out.

After the first half hour or so, the pain from my hip really increased (so much for the epidural) and it became more and more difficult for me to handle. I still pushed and pushed, and we could see Cora’s head crowning in the mirror. I felt her head, and it was rewarding. But I was still in a lot of pain. The nurse called Dr. Buchanan (12:45 pm) since Cora’s head seemed to be pretty close to coming out (when I was squatting). But when I turned to lie down, Cora pulled back inside me. When Dr. B arrived, he was a little annoyed because her head didn’t seem to be as far along as the nurse had said. But he asked me to give a few pushes so he could see. Suddenly, Dr. Buchanan said that we needed to get the baby out right away due to her heart rate decelerating. It was 150 throughout the whole birthing time, and now it was plummeting to 65. (It was a blessing that the nurse had called him when she did). He said he would try the vacuum and the forceps first, but that I needed to be ready in case of emergency c-section. The room was bustling with people scrubbing up and preparing for whatever might happen. He handed me papers to sign, and I was vomiting over the side of the bed and shaking again from the pain. Everything was blurry in my vision. Bobby was feeling woozy, too -but it was because of the chaos that was beginning all around us in the room. At that point, Kym said, “Bobby, you need to stay positive for Ariel right now.” Kaitlin calmed me while Kym calmed Bobby. I signed my name to the papers, and when I looked up I saw the room filled with strangers in scrubs. It was so surreal, and I have to admit it was scary. However, I was in so much pain that all I could think about was getting the baby out safely. I was completely focused on doing whatever Dr. Buchanan told me. Dr. Buchanan kept saying “Ariel, listen only to my voice and follow what I tell you.” I knew that a vacuum extraction meant he would have to cut me, but this was better than a c-section.

I closed my eyes and listened for his voice. He kept telling me NOT to push, and this was very hard because the pressure waves were coming close together and strong. And then he began to pull with the vacuum and told me to push HARD! I pushed harder than I have ever pushed. We did this several times, and I just kept pushing over and over with no break. I believe Bobby put oxygen over my face. I was so scared that it wouldn’t work, so I just told myself I would push the baby out if it killed me. It was scary to have something pulling with that kind of force on that part of my body. Finally, I felt a release and the baby’s head was out. Kaitlin whispered to me “Her eyes are open.” But I was still too scared to look. Dr. Buchanan said “Dad get over here!” Bobby said “But I don’t have any gloves.” “I don’t care, get over here,” the doc said. I can’t believe that he let Bobby help deliver Cora amidst all the craziness. I must have opened my eyes at that point, because I remember a nurse putting a blanket on me, and I threw it off because I wanted Cora on my skin. After the shoulders were out, Bobby pulled Cora out the rest of the way and put her on my belly. It all happened so fast, and it was amazing. Cora’s eyes were open and taking everything in. She wasn’t crying, but she was whimpering immediately. I was so overwhelmed. I believe I said something like “Hi baby,” and just kept petting her. Bobby and I both cried. I couldn’t pull her any further than my navel due to the cord. Dr. Buchanan went to cut the cord, and I stopped him because I wanted her to receive all her cord blood. After several minutes, Bobby cut the cord and it was a great experience. Then I pulled her up to my chest and just loved on her. She was so amazing, I couldn’t believe it. Other than the large bubble on her head from the vacuum, she was perfect. And the bubble went down quickly. She was so alert, and recognized our voices right away. She was born at 1:02 pm.

Cora spent about 45 minutes on my chest while the doctor stitched me up, but we didn’t breast feed yet because I wasn’t in a good position. Kym said this is the longest she’s ever seen the nurses leave a baby on the mom’s chest before evaluating her. Even though I didn’t have much control over what happened during the birthing time, all my wishes for Cora were followed and I was happy for that (we had to keep reminding them, though). The nurses asked permission to take her across the room for her evaluation. I said ok, and Bobby went with her. We decided to give her the vitamin K, since the vacuum left quite a bruise at first. We asked the nurses to wait until after she breastfed to give her the eye ointment, which they did. Dr. Buchanan was amazing, and took a long time to stitch me up. We birthed the placenta, and it looked intact and very interesting to me. I kept thanking Dr. Buchanan for getting Cora out and he said “Don’t thank me yet, you have a 4^th degree tear.” I had to ask Kaitlin if that was bad, and she said it was the worst kind. I knew I had a bad tear, but was in denial until this point. I had torn through to my rectum. Since I was high from the baby, I didn’t really care at the time. Kym and Bobby held one leg (switched off), and Kaitlin held the other while I was stitched up. Cora got a 9 on the apgar, and she was returned to me. Once the stitching was complete, the room kinda cleared out. Kaitlin had to go, so we gave her hugs. Bobby went outside to call everyone on our list, and Kym stayed with me. Kym then helped me breast feed Cora and she was an instant pro. The room was quiet and I was happy. After a while, I told Kym to go home and I was alone with Cora. No one came to check on me for a long time, but we were ok. I had fallen in love!

I still believe that natural birth is possible and good for the majority of women. I also still feel that a natural birth is possible for me in the future, but there are some things I can do to optimize that possibility (see ideas below). I also believe that hypnosis is a powerful tool that can be used to minimize discomfort and pain during birthing time, and turn it into a transforming experience. I also believe that birth does not have to be painful. Honestly, I don’t feel that the pressure waves were the root of my pain during the birthing time. If not for my hip injury and the Pitocin that sped my pressure waves up so quickly, I am confident that I would have been able to handle the pressure waves without pain medication. Hypnosis, relaxation techniques, varying your position, movement, and warm water (and avoiding interventions) all seem to be very helpful tools in managing the pressure waves. I am sad that I was unable to have an intervention-free birth, and I am sad that I was unable to experience the birth in a peaceful environment (and I really wanted a water birth!) But at the same time, I feel it was meant to be that we were at the hospital and were able to receive the care that I needed – and Cora needed. Next time, I will be aware of the possible issues that might arise for me. I would like to try for another water birth, but I will be ok if we need to transfer due to my hip or other problem. Being open to change is so important.

Birth plans – I am glad I created one for the hospital as well as the birth center, so that I didn’t have to translate or change anything once we got to the hospital. All my wishes were spelled out for the nurses. I also reviewed the birth plans with my midwives (and doula) during prenatal visits, so they were familiar with my wishes.

Doula—I believe if I didn’t have my doula that my birth would have been much less positive and pretty scary throughout the whole thing. Kym helped me make decisions, explained so many things to me (about my body and about the hospital protocols), and she acted as a therapist in so many ways. She even helped me throughout my early birthing time at 31 weeks and throughout the pregnancy. She helped my husband to help me, and this really strengthened my relationship with him. I think it could have gone the opposite way very easily. Since I knew her previously, she may have given me a little extra treatment. But I suggest that ALL first time moms have a doula. I will definitely ask her to be my doula again next time.

Talking openly with doula and midwives – if I had not been open with my feelings about what was happening, I would have had to do things I was not comfortable with. Also, I would have been unable to process the changes and disappointments that were taking place and it would have made the birthing time every more difficult (and could have prolonged it, ending in a c-section). Being able to talk through the issues while they happened allowed me to accept what was happening and to embrace the good things and move forward.

Making sure nurses knew my preferences (and reminding docs/nurses along the way) – I had some help, since my midwives talked to the nurses for me regarding the birth plan. But Bobby also talked with them, and Kym reminded him of our preferences throughout the birth. Even though the doctor and nurses meant well, they tend to do things out of routine. If I had not caught the doctor before he cut the cord, my wishes regarding that would have been overlooked. So its great to let everyone know ahead of time what your wishes are so they can all be watching.

Have a breast feeding plan ahead of time – the nurses did not help me breast feed, or even ask me if I wanted to. So I am glad that I learned about breastfeeding ahead of time, and had my doula there to help me with it. I also consulted the lactation consultant at the birth center before and after the birth, and this was really helpful. Most hospitals have a lactation consultant, but lots of people do not know they can ask to see one. Breastfeeding is difficult unless you have some help your first few times! Definitely learn about your options ahead of time and take a class if you can.

Connect with your partner during the birthing time – I tried to seek ways to include Bobby and communicate with him. I realized that several times I could have pushed him away, but I took a chance and included him even when he (or I) felt uncomfortable. I know that in the end he felt empowered being able to help me, and I was so happy that he did. It definitely brought us closer, and when Cora arrived it really felt like a team effort.

Start hypnosis earlier, and practice every day leading up to the birth – I am the kind of person that thinks you can just cram for a test (it worked in college, right?) Well, this isn’t the kind of thing you can cram for. I wish I had taken more time prior to the birth, and I also wish I had not been so overly confident because I put off using it until it was too late during the birthing time. Of course the Pitocin sped things up so quickly that I couldn’t see it coming, but I should have started earlier anyway.

Discuss potential issues ahead of time with a therapist, and your care provider (and doula)- If you have had any trauma in your past that may impact how you feel about your birth (even if you aren’t sure how it might impact it), be sure to discuss it with your care providers and work through it with a therapist well before the birth. This might include abuse, rape, negative past birth experiences, an injury, negative body image, eating disorder, strained family relationships (especially with your spouse or mother), etc. It is amazing how emotional birth can be, and you want to be ready for old feelings to be pulled up. Negative feelings can actually stall birthing time and lead to other complications, so it’s a good idea to work through these ahead of time. This will help you to game plan what to do if they arise during the birth. Also, your provider will be able to help you if they do come up. It is also helpful to let any nurses know about this, so that they can be sensitive to any specific needs you have.

Have doula and husband be more involved and more familiar with hypnosis – I think this would have helped me to start earlier and they could have helped me when I couldn’t help myself (when it got painful). I relied too much on myself and didn’t involve them. So they were in the dark and could not help me.

If you think water is broken, get tested! – if I had been tested the night of the 3^rd, and it was negative… then we would not have had many of the interventions we ended up having. I wish I had asked to be tested, no matter what holiday or how late in the evening it was!

No pitocin (if possible) – avoid it if possible. Your body needs time to warm up slowly to increasingly strong pressure waves, and I feel I would have been able to handle the pressure waves without the epidural (and maybe the hip pain as well) if I had not had this.

Keep active, healthy, flexible before the birth – Being on bed rest probably decreased my chances of having a natural birth, because my body just wasn’t in good shape.

Know limitations (injury) and take them into account – I completely discounted that my hip would be a problem during the birthing time. Next time I’ll have different expectations and will be ok with the fact that I may need pain medication for my hip. I had no idea that the injury would make it more difficult for Cora to descend or that it was going to be so painful. I should have been doing physical therapy leading up to the birth to minimize the probability of having problems. I will do this next time (see Dr. Cassanova – teaches at the midwifery school – understands how birth effects the pelvis).

Cora Fay's Birth