A Birth Story: Cassie M.
It was the evening of December 19th and I was finally home. I was tired from a long day and ready for the couch when my husband answered his phone and I heard a male voice coming through. I immediately recognized the voice of Will, the husband of Cassie M. Cassie, who’s fertility story you can read in an earlier blog, was 35 ½ weeks pregnant and I immediately feared the worst. She had been in a car accident what felt like only a few days earlier and I feared placental abruption or early expulsion of the baby due to extreme stress. Will informed me that Cassie’s waters had broken and that there had been blood in it.
He had taken her to the nearest hospital where they performed an ultrasound and her placenta was still attached, thank God. They did a cervical exam, but didn’t provide a full Bishop Score, only telling her that she was 2 cm dilated. She was being transferred to her preferred hospital about 20 min away. They had called ahead and her midwives had agreed to oversee the birth. Cassie was given an IV with antibiotics, as she hadn’t had her GroupBStrep test yet and a steroid shot for baby Harvey’s premature lungs.
I quickly packed my suitcase, moved the car seats to my husband’s car so he could take our kids to my sister’s, and drove 3 ½ hours to Iowa, where I had moved from only a few months prior. We talked a few times on the phone, Cassie updating me on her move, medications, and state of mind. I could hear the anxiety in her voice dissipate as she learned that her birth was still going to happen at her preferred hospital, with her midwives that she knew and loved.
Cassie was in the hospital room when I arrived, chatting with her mom, Marlene, and Will, clearly not in active labor. She was hooked up to an EMF machine for constant external monitoring and had a port in her right hand with fluids and antibiotics running through. She held up her hands, showing me where the nurses in the first hospital had blown a vein in the left one. Cassie hates needles, and she lamented every stick and poke she had endured. She had managed to avoid a port in her first birth and had been hoping to do the same with this one. I was impressed with her good spirits. As I said in my previous blog about her fertility journey, Cassie is a very strong woman. I met the her nurse and got acquainted with her midwife, Dawn. We went over the details of Cassie’s birth plan and how we would need to alter our expectations with a premature baby, the lack of a GroupBStrep Test, and a PROM status (premature rupture of membranes, or her waters breaking early).
It was late, past 11 pm, and I could tell this was going to be an all-nighter. Will and Marlene slept while Cassie and I started working on naturally inducing labor. She bounced on a birthing ball while watching Mulan (claiming watching a movie about a strong woman who took control of her own life would inspire her body to do the same). She danced while utilizing the squat bar and the squat chair to 90’s country radio. Keeping in mind that I didn’t want her thigh muscles to be worn out before pushing time, we took a break to walk the halls, stopping to look at the newborn art and hopefully spike her oxytocin levels. Her eyes kept drifting to the clock, mentally counting down to the 12 hr mark before Dawn would want to start Pitocin.
At 5:30 am, Cassie woke Will up to try nipple stimulation. All of her hard work was slowly paying off, with small tightenings happening every fifteen minutes or so, but we needed more. I sat down with her, going over her options for pain medication and possible interventions that Pitocin might lead to. I wanted her to be as prepared as possible before talking to her midwife. It was important for Cassie to feel her own autonomy, despite the circumstances. Every decision needed to be hers. Her midwife came in to talk about starting the Pitocin and I could feel Cassie silently fighting it. Dawn changed tactics, asking Cassie if she would be comfortable with a cervical exam to see if any progress had been made, giving Cassie more information before making a decision on the Pitocin. Will asked for a full Bishop and Dawn complied; 2 cm dilated, 80% effaced, -2 engaged.
Cassie was devastated and exhausted. It was nearly shift change and I suggested a nap. 80% effaced was great news, but the lack of dealation would more than likely mean Pitocin. We would pick up with the new midwife, Susan, in an hour. I silently prayed over Cassie and Harvey while giving her a massage, pressing my prayers into her muscles, until she blessedly fell asleep. I wondered if I would be able to sleep with all of the adrenaline and coffee coursing through my veins, and passed out as soon as my head hit the back of my chair.
With Susan came Pitocin, another steroid shot, and a renewed energy from our nap. We began to move again, focusing on the squat chair and birthing ball as those felt the most effective to Cassie. She remained chipper, with small but mostly painless contractions slowly getting closer together. With the addition of Pitocin and the length of time it had been, Cassie’s birth team began to focus more on the EMF. Every movement Cassie made required the monitor be readjusted for Harvey’s heartbeat. Eventually Susan came in and explained the situation, she needed a clear and constant read from Harvey’s heartbeat. She couldn’t tell Cassie what to do, but strongly recommended we move to internal monitoring to increase her mobility.
Cassie was once again devastated. Susan sat by her side, allowing Cassie to come to terms with where her birth was going. After a short pause, Susan asked Cassie to say her thoughts out loud. She reassured Cassie that Harvey couldn’t feel the monitor, being quite squished already. They compromised, deciding to internally monitor contractions but not heart rate. When they were done talking, I leaned down to help Cassie adjust for the monitor insertion. I told her about two students I had in my Bradley Method birthing class who had used internal monitoring. I reassured her that their baby had no signs of the monitor. She listened quietly, then turned to Susan, and gave her permission to use both internal monitors. I was once again blown away at the power of a woman in control of her own birth, respected by everyone in her birth space.
After the monitors were in place, the Pitocin turned up, and the hospital staff beginning to leave, Cassie asked me if I could pray. Susan immediately asked if she could join us and Cassie reached for her. It was a beautiful moment, every person in the room laid hands and came to Christ together. I thanked God for this amazing birth team, life saving medicine, and reminded him that both Cassie and her baby were his children who needed his help and protection. Cassie’s labor began to pick up, with sensations running down her legs. Will would push on her hip while massaging whichever leg was on top (depending on which side she was laying on) while I massaged the other and walked her through relaxation meditations. Cassie’s mom stayed by her head, massaging and running her fingers through her hair. As time passed, the Pitocin kept being turned up and her contractions began to regulate. Cassie announced that the baby was coming.
Susan was called back in and did another cervical check, 7cm. I was surprised by the low number, Cassie really did look ready to push. She later told me that the urge to push was so strong that she was allowing small pushes with each contraction. Within minutes, her body took over and began to push whether she allowed it or not. She once again declared her need to PUSH and Susan checked her again. Fully dilated. Still in the side-laying position, Will holding her left leg up, Cassie began to push in earnest. I held her hand, allowing her to pull against me with each push, while her mom called out encouragement from her other side.
In between pushes, Cassie asked to be unhooked so she could catch Harvey, and she did. 28 hours after her water broke, 13hrs of Pitocin, 10 minutes of pushing and this powerful woman lifted herself up to catch her own baby as she birthed him into this world. He was a healthy 6lbs 4oz, 19inches. There was a rush of oxytocin in the room as Cassie lifted her son to her chest. He latched like a champ. Cassie self expressed while I stroked his cheek to encourage sucking and he was nursing on his own in no time.
Her placenta stuck a bit, which isn’t unusual with Pitocin births. She held her newborn baby, while shaking from post-birth adrenaline wearing off, and pushed to expel her placenta all at the same time. Her placenta was thin, translucent, with small calcifications. Susan wondered allowed if this was why Harvey had been born early. After Harvey was done nursing, he was taken to the NICU accompanied by Will and Marlene. I stayed with Cassie, who was having a hard time giving her baby to a stranger after finally getting to hold him. We sat on the bed together, talking about the birth and ordering much needed pizza with chocolate cake and pudding.
After Will and Marlene came back and everyone was fed, I turned to leave. I was quickly informed that I was not driving home without sleeping first, Cassie’s orders, and ended up falling asleep for six hours. When I woke up, the family was doing beautifully. Harvey impressed everyone, eating and gaining weight like a champ. He was able to visit his parents in their room when they were awake and was out of the NICU after only three days.
As always, thank you for reading and God Bless!
Photo Credit: Kara Vorwald Photography
