I did not expect a Sunday when I was 38 weeks to be the last full day of my pregnancy.
And I did not expect to be faced with the birth experience that I feared the most.
That Sunday morning, I left home to spend a day with a girlfriend in nearby Temecula, CA, getting pedicures at the spa, swimming in the salt water pool, and then planned on staying the night away with my husband so we could relax and connect, just the two of us, before our new baby arrived.
At 38 weeks, I had every expectation that I would be pregnant for another two weeks or so. My pregnancy with Little J had gone to 40 weeks and 2 days, I just expected more of the same. With a pregnancy that was normal and straightforward from the beginning, just 6 weeks earlier, my awesome OB, Dr. Capetanakis (Dr. Cap), had told me that my baby was head down at 32 weeks, and things were as straightforward as could be.
I knew I didn't want to give birth in the hospital again, which is the only place my doctor delivers, so after trying for months, unsuccessfully, to get my insurance to cover a home birth, I took my "straightforward as can be" pregnancy, and finally transferred my care to the nearby birth center, Tree of Life. I loved their birthing rooms, the midwives, and the experience I could see myself having if I gave birth there, all the midwives had hospital privileges, and they often worked closely with my OB, too.
But my 36 week midwife appointment revealed that my baby was in a breech (head up) position. This was not straightforward, and the midwives were not legally allowed to deliver a breech baby at the birth center. I immediately starting employing all of the tools I know to help a baby turn, and I thought it was working. I often felt things in my belly that led me to believe he was vertex (hiccups down super low, little kicks up high) but then it would seem like he flipped head up again.
Soon, I fully believed that he was turning up and down at will. So I kept hoping he would go head down when it was time to be born. I was mildly worried, but I continued with my care at the birth center, believing I could help baby get into the right position in time. I wanted to cover all of my bases to ensure a positive birth experience, so I opted to get co-care with Dr. Cap and Tree of Life, so that no matter what happened, I would be having my baby with someone I knew and trusted, rather than an on-call doctor after a potential emergency transfer to the hospital if things didn't go the way I hoped.
Sans our 2-year-old boys that fateful Sunday, my friend and I were ready for some much-needed pampering and as we settled into our massage chairs, I started to unwind like I can never do at home. We painted our toes in happy colors, snacked on cheese and fruit and talked birth predictions poolside, and I decided to hop in the warm pool for one last attempt to get my unmistakably breech baby to turn.
I am blessed that Dr. Cap knows how to, and will, deliver breech babies! Not all OBs are trained in breech births, and many won't do them, preferring instead to perform c-sections because they they're taught that it's "safer." I had read that the level of risk for a breech vaginal birth and a breech cesarean section are actually the same (although the risks are different), but the older school of thought still prevails, making a c-section the go-to "fix" when a baby is breech.
If I was unsuccessful in turning my baby head-down, I knew I wanted to try for a vaginal birth even though he'd be coming out bum (or feet) first. I'd watched several videos of breech births, I saw how normal these births were, and I knew my body could handle it with ease. Breech birth can be just another variation of normal, and after multiple lifesaving surgeries a decade ago, and braving the ensuing pain and uncertainty about recovery, the idea of MORE surgery was just not an option for me. I was willing to do pretty much anything to avoid being cut open AGAIN.
I swam laps of breaststroke and did countless underwater handstands in the pool, but I never felt the desired, dramatic roll or flip of position in my belly. I had yet another earnest and serious conversation with my baby about why he needed to be head down (for a cozy birth center birth, versus a clinical hospital birth) but... nothing.
When I got out of the pool, water left my body and ran down my legs. "Huh, guess it was all those handstands," I thought. Then a few minutes later it happened again. I still didn't think much of it. I got dressed and went to get gas for the car and noticed my seat was wet when I got out to fill up my tank. "Wow, that's a lot of water. Must have filled up completely with all that time upside down." But throughout the rest of the afternoon and evening, it kept happening, and I was in TOTAL denial about what it really was.
Before dinner, I did at least check the color (clear) and odor (chlorine), but with absolutely no labor symptoms, my brain hung onto the "it's just pool water" fantasy. Because amniotic fluid doesn't smell like chlorine, right? So I put on my little black (maternity) dress, let my hair down, and went out for a fancy dinner with my hubby and we had an awesome date night.
Back at our room, I was still leaking, and we googled a bunch of things, but I was adamant that I was fine and it was just pool water, and my loving husband kept his doubts to himself. That night, I woke up around 1am, and my sheets were SOAKED. I knew this was strange but nothing felt "wrong" or anything like contractions, so I STILL clung to this idea that somehow it was still water from the pool! I did google how much water a vagina could hold, though, and how would I know if my water broke while swimming.
The internet was NOT helpful and I so went back to sleep.
When I went into labor with J, my contractions started as soon as I woke up and my water didn't break until late afternoon. And then when it did, it was a small leak, followed by a dramatic "KERSPLOOSH" all over my living room floor. Then the pushing contractions started. It was a totally different experience and I just didn't know what to make of what was happening now.
I wasn't even to 40 weeks yet! I knew that "2nd babies often come early" and "breech babies often come early" but my brain just couldn't grasp it. When I woke up in the morning, and the towel I'd placed between my legs was also soaked, and when I sat down on the toilet to pee, MORE water leaked out of me before I'd even started peeing, I finally thought, "OK. Time to call the midwife."
* * * * * *
Let me rewind to the beginning of my pregnancy for a second. When I conceived this baby, I decided early on that I REALLY wanted to have a home birth this time. My experience of racing to the hospital to have J was no fun, and actually left me with some pelvic floor pain because I was trying to hold him in while my body was trying to push him out!
And my experience with one of my labor and delivery nurses actually contributed to that pelvic floor pain because her fairly aggressive and painful uterine massage after I delivered caused me to store that pain in my pelvic floor as well. That deserves its own blog post but I'll just say that emotional "stuff" causing physical pain is a real thing. And it left me feeling less than safe birthing in the hospital.
I knew I could birth this baby, and so aside from wanting my OB to be there, I had no desire to have another hospital birth. I just wanted to stay at home and have my baby. I wanted no interventions and to be pretty much left alone except for my husband and doula's support. So I applied to my health insurance company to have them cover my out-of-network home birth at the in-network level. Due to family health stuff, we spent a lot of money and hit our deductible over the summer, and "just paying for" a homebirth midwife out of pocket just wasn't an option. And despite looking high and low, I discovered there are NO midwives near me, in network with my insurance company, who attend home births. So I applied for what's called a "gap exception" since the lack of in-network midwives constituted a "network gap."
This is also worthy of its own post because the process was long and complicated and frustrating, but eye opening in terms of how to deal with health insurance companies.
In the end, though, my request was denied.
And that's how I ended up at Tree of Life, and it seemed to be working out that it was really the best outcome. I was excited to birth there. But when my baby was definitely breech at 36 weeks, my mind raced. I immediately thought of all the possible scenarios and I knew that more than anything, I DID NOT want to end up with an on-call OB I didn't know, if a transfer to the hospital became necessary.
So I requested co-care with Dr. Cap and Tree of Life. It's not an uncommon thing for them to do as they work together often, and it was simple to start seeing them both. More expensive, certainly, but after hitting our deductible, I didn't care. I needed the peace of mind that no matter what happened, I'd be under the care of people I knew and trusted.
But at my appointment just before Thanksgiving, Dr. Cap told me, "just don't go into labor this weekend."
It was his one weekend off that month, and if the baby came, and was still breech, I would end up with an on-call doctor.
"I won't," I said with a laugh, confident this baby was still weeks away.
When I woke up with the barest tightening in my tummy and a slight low back ache, my sheets and the towel I'd put between my legs soaking wet, I knew I had to call someone. I had no idea when Dr. Cap was returning, and Monday was not one of his usual clinic days, so I called the birth center to talk to one of my midwives. Susan answered the phone, asked me a few standard questions, and she agreed I should come in a get checked out. I I had a 45 minute drive home, and we had to get our son to his preschool, so by the time we were about to head to the birth center, I had several text messages on my phone, telling me to go straight to Dr. Cap's office instead.
We arrived at around 9am and went immediately into an exam room. I was nervous, but excited.
"So, what's your plan?" he asked me.
"Ha! Plan? I have no plan. I was not expecting a baby this early!"
* * * * * *
CONTINUED . . . READ PART 2 HERE
* * * * * *