The Birth Story Part IV, the unpleasant bit

Christian’s home birth was about as perfect as I could have hoped for, but there was a complication after he was born that made the whole experience more exhausting and harrowing than it needed to be. It’s also the reason why I’m still lounging about on the bed, pale and weak. Good thing I made so many casseroles in advance.

After Christian was determined to be beautiful and healthy, the midwives turned their attention to the the delivery of the placenta. Pushing out the afterbirth is the third and often overlooked part of a labor and delivery – I mean, who cares about the bloody mess after the baby has arrived? And there is generally no pain associated with afterbirth once the baby’s head has passed through.

So we sat around on the bed admiring Christian. Intermittently I would try getting up in a squat to push without much luck. My midwife explained the natural progression of remedies she would try and get me to deliver the placenta and mentioned that going to the hospital was a last resort, but a possibility. At this point, I believe I had lost a normal amount of blood for a delivery.

We tried homeopathic medicine, herbal remedies, sitting on the toilet, a shot of pitocin in the thigh (to stimulate stronger uterine contractions), and finally Karen attempted a manual delivery of the placenta. Unfortunately, by this time, 1 1/2 hours after the baby’s arrival, I had major blood clots forming and Karen could not reach my placenta around them. She said that my placenta was very high up in the uterus. Each pitocin-induced contraction was making me expel more blood clots and Karen was concerned about my blood loss. Sadly she suggested that the safest course of action was an emergency medical transport – which would most likely result in a d & c.

So, somewhere around 3-4 am in the morning, instead of resting and enjoying the new human in our laps, we were dialing 9-1-1 and anticipating a hostile reception at the hospital.

What a hubbub it is to call an ambulance.

Inside of 20 minutes, my bedroom was filled with half-dozen burly, fully-outfitted firemen and paramedics and all their equipment. From quiet music and candles, we went to bright lights and lots of brisk business-like questioning. Outside I could hear the high-pitched beeping of the fire engine and ambulance backing up. Inwardly I was groaning and stressing about the neighbors. I hated to give home birth a bad name! But outwardly, I remained as calm and as collected as possible, knowing that it was critical that we were all perceived as having made a safe informed choice with a home birth.

All the firemen and paramedics turned out to be very sweet and gentle. We made it very clear to them that the baby was fine and was not to be admitted into the hospital as a patient and they were gracious about accommodating our wishes. It was just funny how every man there seemed gargantuan to me – at least over six feet each and very muscular – I think this effect must have been magnified by the fact that they were all in heavily padded gear.

I rode in the ambulance with two of the paramedics. The experience was not uncomfortable, but even more sterile and institutional than I had ever imagined. The paramedics were friendly though: one paramedic was leaving for a Memorial Day weekend at the River when he got off duty, and the other was making plans to go to Vegas for her 21st birthday (she was the only girl). I had an IV going in my right arm and an oxygen mask as well.

When we arrived at the hospital, we were expected, so we headed directly up to a private room in Labor and Delivery to wait for the on-call OB emergency doctor. Meanwhile I was still periodically gushing blood, but otherwise feeling okay; just very, very tired.

To our utter amazement and delight we discovered that two of the nurses working with us wanted to become midwives! And so our reception was not at all hostile, but compassionate and curious.

Even luckier for us, the doctor took his own sweet time getting to the hospital. The nurses were not allowed to do anything to me except change out my IV until the doc arrived. The beauty was that after over an hour of waiting around, I began to have very strong and painful contractions again.

And I pushed the placenta out by myself!

Plus lots more blood clots.

So when the doctor finally did arrive, I requested that he check that the placenta was intact and refused an internal “swipe.” He was obliging. But he did gown himself and give me a visual external check. He found one minor tear, which he repaired. And that was all.

We were free to go home.

Whew. It was the best case scenario of an emergency hospital transport that I could have envisioned.

Once at home, the midwives examined the placenta on their own. They discovered that it was an unusual shape: somewhat oblong, with a triangular piece at one end. Karen guessed that the triangular piece might have been lodged up in on of the horns of the uterus, making it difficult to detach. I confessed that because of Bella’s low-lying placenta, that I had done lots of visualizing of a HIGH placenta. We had a bit of a chuckle over that one.

In the end, everything was fine, except that I had lost a lot of blood. I had been given two bags of IV which kept my blood pressure up, but Karen tells me that it will take at least three weeks for me to replace the red blood cells I lost that night. Until then I will be pretty tired, especially when I get up and move around.

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