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Aimee Li Tom, CNM 2016

Elizabeth

Mia was born on 2/21/15 at St. Lukes Hospital in San Francisco. Here is our birth story.

On the evening of Friday Feb 20th, Yve, our doula, called to check in and see how we were doing. She knew that Elie's due date was the following day and was thinking about taking a day trip an hour away where she might be in and out of cell coverage and just wanted to see if that was OK with us and to see how we were doing.. Elie said that was fine and she didn't feel like really that close to labor. Yve asked her a few questions and commented that it sounded like she might in fact be in early labor. Elie thought she was crazy but Yve said she'd check in Saturday morning anyway just to be sure. After our conversation, Elie and Scot walked to a local restaurant and had a yummy dinner. Elie started feeling regular contractions just 3-4 hours later, just after midnight early Saturday morning.

Contractions started about 8-12 minutes apart.  Elie was able to get a bit of rest in between but she was feeling pretty intense back pain even between contractions, which definitely made labor more tiring.  During contractions, she found it most comfortable to be on her hands and knees and take deep moaning breaths through the contractions. Between contractions she'd lie back down on her side and try to rest. By 4 am the contractions were already becoming very regular and more frequent, generally occurring fewer than 6 minutes apart. At our prenatal visits, the midwife at St. Lukes recommended that if it was possible and there wasn't anything unusual happening that we should labor at home until the contractions were 3 minutes apart, lasting 1 minute, for 1 hour (3-1-1).  

At 4:15am, we called Yve and let her know that she was right and probably shouldn’t go on her day trip.  She asked Scot how things were going and he explained what was happening and she confirmed our thoughts that everything seemed normal.  She said she'd come as soon as we thought we needed more support but we expected that there was still a good bit of labor to go so we said we'd touch base later. Around 5:45am, contractions were pretty regularly under 5 minutes and we thought we should give the hospital a call to let them know that we might be headed in soon. They appreciated the call and said we could come in any time if we had questions/concerns but if we felt comfortable laboring at home, that they we could continue to wait.  

Elie's pain was starting to get a little more intense (especially in her back) so we decided to run a warm bath for her to see if that would provide any relief.  It eased the pain but also slowed the contraction back down to 8-10 minutes which wasn't too surprising but it did give Elie the impression that the trip to the hospital wasn't quite so imminent which she clearly wasn't thrilled about. After the bath, the contractions started getting stronger and Elie continued dealing with the contractions on her hands and knees. The best thing Scot found to do was to squeeze the tops of her hips which seemed to relieve some of the pressure during the contractions.  A hot water bag on her lower back between contractions also seemed to reduce some of the back pain.  We stayed in the bathroom for a bit over an hour, during which time Elie threw up once during an intense contraction, before Scot finally managed to convince Elie that moving back to the bed might be more comfortable.  

 

Around 7am, Elie's parents came over. Her mom stayed to help and provide support and her dad took Jackson (the dog) back to their house. Jackson was taking it pretty well but he was clearly concerned for his mama and we thought it might be less stressful for him to be somewhere else. Elie continued alternating between hands and knees during contractions and side lying in between.  

At 9:30am, Elie started to have a bit of bleeding when she peed.  We called the hospital to inquire but the midwife was delivering a baby so she had to call us back. We called Yve again to check in and inquire about the blood and she said it sounded like it was a totally normal amount of blood and that it was a good sign that labor was continuing to progress.  The midwife at the hospital called back to check in and informed Scot that they were currently fully booked with no available delivery rooms so they were currently diverting people to other nearby hospitals. They had a couple deliveries that were nearing completion though and if we could hold off a couple hours before coming in there was a good chance that there would be room. Scot made an executive decision not to share these details with Elie and Scot figured it would only increase her stress.

About 11:30am, Elie's contractions were back down to 5-1-1 and we called Yve to ask her to come help. She arrived at 12:30pm and watched a few of Elie's contractions and was very impressed with how well she was coping with them. She asked about what labor positions Elie had been in and we told her that she'd been in hands and knees pretty much the whole time. Yve suggested that Elie might want to try some different positions. While hands and knees is a good position for labors involving back pain, it was possible that Elie might want to deliver in that position so she thought it might be a good idea to rest those muscles. She tried sitting on a yoga ball leaning over a bed for a few contractions but it made the contractions more painful so she returned to hands and knees. We also tried using cold instead of heat on the back but that also didn't seem to make things better.  

Yve suggested that we might want to try walking a bit which Elie thought was a terrible idea. After a bit more prompting though, she finally agreed to take a walk around the block. As we walked, Yve showed Elie how to lean on Scot for support during contractions which seemed to work pretty well. As soon as we started walking, Elie's contractions quickly got a lot closer together.  She went from about 4-1-1 to 2-1-1 in a matter of minutes.  Only in San Francisco can you walk around at noon, stopping every 2 minutes to stand and moan in public and basically draw no attention from passing pedestrians.

After the first trip around the block we decided to take one more lap around the block. About 30 seconds into that lap Elie had two contractions almost back to back and we decided maybe it was time for the hospital. We packed the car and left for the hospital at 2 pm. Elie was back in hands and knees in the back seat for the trip. At 2:15pm we checked in at the hospital and they said they had just freed up a room for us. If we'd arrived 15 minutes earlier they likely would have diverted us to another hospital. At 2:30 Laurel, the midwife, came in to do a vaginal exam and see how the baby was doing during contractions. Laurel asked if we wanted to know the number of her cervical dilation.  Elie was a bit worried it wasn't going to be that high but asked to hear it anyway. She was 9.5 cm! Full dilation is 10 cm so she was almost there. She also confirmed that Elie's water had not yet broken but labor was progressing well so they didn't think there was any reason to pop it at that time.

They transferred us to a delivery room and Elie was right back into hand and knees. Laurel watched a few more contractions and asked if Elie was feeling the urge to push. Elie said she was so Laurel told her that during the next contraction she should try pushing. Elie had a few more contractions pushing when there was a loud pop and her water burst like a water balloon and sounded like a car backfiring! It was quite shocking to everyone around and certainly gave Scot quite a start as he was right next to her with his hand on her back.

As Elie continued to push during contractions, the fetal heart rate monitor kept showing a decreased heart rate during her contractions. The rate would jump right back up between contractions which is good but it was enough to cause some concern.  After about 30 minutes, an OB came in to monitor a bit closer. This was slightly concerning to us since we'd been told that if everything was normal, a midwife would deliver the baby, but if there were any risk of complications, an OB would get involved. The OB watched for a few contractions though and was satisfied that if the heart rate continued to recover after each contraction that there was no danger to the baby.

They thought Elie might be able to push better in a different position so they convinced her to switch to a position lying on her back/side.  It's hard to tell if it helped but the midwife seemed pleased with the progress. Around then it became apparent that Elie’s mom had called her dad and told him the room Elie was laboring in - but probably not exactly what was going on since he showed up in a scenario he was clearly not prepared for.  Laurel looked back and asked, "Does anyone know who this man is?" Everyone turned to see Ed standing there in stunned silence, the color all drained from his face. He quickly left the room and everyone laughed. Pushing progressed.

 

Elie continued to push and it was clear she was getting frustrated. The baby was continually moving down the birth canal farther each contraction but in between contractions it would slide back up to where it had been. To Elie, it felt like she wasn't making any progress even though it was clear to the midwife that she was. Laurel assured her that she was making good progress, and offered suggestions on when and how to push.

Eventually we could see the baby's hair and soon after her head began to appear.  It was clear that the birth was imminent and they called in the pediatric unit (a pediatrician is present at all births to take the baby's vital signs and give the APGAR score). They called the pediatric unit about 4 times with increasing urgency as she got closer and closer. Luckily they showed up just in time and Mia was born at 4:53 pm right on her due date. She was absolutely perfect. She was born at 6 lbs, 12.8 oz and 19.5 in long. They put Mia on Elie's chest and she started nursing within the hour. During the birth and afterwards, a street musician played jazz music outside our hospital window.

 

The last dramatic moment of the day came when they took Elie to go to the bathroom before being transferred upstairs. While Scot held Mia, the nurse walked her over to the toilet but had left something outside the bathroom. She called Elie’s mom over to watch Elie while she grabbed it and Elie took that opportunity to faint for a moment.  Her mom caught her and she was conscious again in a second but the nurse was obviously concerned. She asked Elie how she felt and Elie replied, "Confused."  The nurse asked her if she was sure that was the word she wanted to use (It seems that "confused" has a particular medical definition and the nurse didn’t want to elevate the concern if it wasn’t needed). They asked if she knew where she was and she said, "the hospital". They asked who the president was and she said "Obama".  Her dad said, "It's actually President Obama". Then her dad asked, "Who's the Secretary of Defense?" to which she replied, "That's a trick question because he was just confirmed" (Ash Carter had just been confirmed 3 days earlier), and we all knew she was fine. She'd lost almost a liter of blood and hadn't eaten or slept much in in the last 40 hours, thus the fainting. We eventually were transferred upstairs where we remained for the next two days.

 

 

 

 

 

Owen was born on 1/17/18 at Alta Bates Hospital in Berkeley. Here is our birth story (warning – it get’s kind of gross!) ☺

 

On Monday 1/15, Elie went in to see Aimée (our midwife) to have her membranes swept. She was 41 weeks and 3 days pregnant. She hadn't had a vaginal exam in months, so had no idea how 'ready' her body was. Aimée said she was 3cm dilated, but that the cervix was so soft she jokingly said she thought she could stretch Elie to a 5cm with her fingers (no worries - she didn't - it was just for reference!). She swept her membranes and we discussed how the hospital would want to induce her on Saturday if she wasn't in labor yet (she would have been 42 weeks 1 day that Saturday). So we talked about induction and also about the possibility of taking castor oil at home and how it was an option if she wanted it. For those who don't know, castor oil is a laxative that causes contractions in the bowels, which in turn stimulates uterine contractions, and therefore can induce labor. That night Scot bought castor oil and at this point Elie was pretty much over being pregnant, and did not want to be induced, that she decided she would do the castor oil on Wednesday afternoon if she needed to. That gave her about 48 hours to try to go into labor ‘naturally.’ The next day she went on a 5 mile walk and visited a chiropractor, but still nothing.

 

On Wednesday, Scot went to work but we decided he'd be back about 1pm to be with Elie as she drank a castor oil smoothie. We also decided that Elie’s mom should pick Mia (our 3 year old) up from preschool just in case - and if nothing happened, Mia could just sleep over at their house and come back the next day. At 1:15pm Elie downed the castor oil smoothie. She continued to do things around the house, took the dog on a walk (but stayed close to the house in case she needed to be close to a bathroom!). We then decided to watch some TV and just take it easy. Nothing happened for 2.5 hours, not even a bowel movement. At 4pm, Elie needed to use the bathroom, and was suddenly having some intense pain in her bowels. The castor oil started to do it's work as a laxative. The pain got worse though, and Elie felt like she was maybe in labor - but it didn't feel at all like contractions, just strong constant pain in her stomach, so she wasn't positive it was labor as she thought maybe it was just super intense bowel contractions from the castor oil. Scot tried to time them, but we couldn't find any pattern - the pain would get worse, and then slightly better, but still bad and it wasn't similar to the labor pains she had with Mia. Nothing was consistent, and the intense part of the pains varied in length - from 10 seconds apart to 2 minutes apart. Scot called Aimée who heard Elie in the background moaning and suggested we head to Alta Bates ASAP. We got in the car around 4:45pm, just in time for rush hour! (Note: we recently moved to Alameda and after some back and forth, we decided to switch prenatal care to a midwife in Berkeley. We luckily found Aimée who happily agreed to take Elie at 25 weeks pregnant. We love St. Lukes in the city but we didn't want to deal with crossing the bridge during labor, potentially during times of high traffic. In hindsight, we're SO glad we made that decision. Aimée and Alta Bates were great, and it would not have worked to cross the Bay Bridge at 5pm)

 

Elie was in a good amount of pain by the time Scot convinced her to get in the car. During the drive, she was in the backseat in hands and knees, leaning into Mia's car seat and holding on for dear life to the straps of the car seats. Pulling on them made the pain more bearable. Putting her mind at work at pulling the straps as hard as possible helped her take my mind of the labor pains. However, she was starting to feel the pain was too overwhelming and began to feel out of control (Note: she never felt like any part of her labor with Mia was too much to deal with, so this was a new and semi-scary feeling for her). The drive to Alta Bates took about 20 minutes, and luckily she didn't need to poop the entire ride there, quite the feat (especially with our light beige car upholstery!). We pulled into the labor parking spaces at Alta Bates. These parking spaces are directly across the driveway from the bus stop in front of the hospital. It was 5:10PM when we arrived, so there were dozens of people who had just gotten off work, all lined up and waiting for the bus. Elie got out of the car, reluctantly, and suddenly felt an intense urge to push - and she did because she couldn't help myself. At this point, about 25 feet from the dozens of people at the bus stop, two things happened simultaneously. 1. Her water broke, soaking her pants and creating a puddle under her. She didn't know it was my water and so between screams she yelled "ahhhh I'm PEEING!!!" really loud. 2. about 2 seconds after that, tons of diarrhea came out of her (thanks Castor oil!), streaming down my pants and joining the puddle of water that was under her.  She yelled very loudly, because she was in shock and pain "ahhh, I'm POOPING!!!!!" she then started to cry - from embarrassment, pain, exhaustion, and ya know.. poop in her pants.  She was SO embarrassed, but couldn't really feel embarrassed at that moment because of all the other things her body and brain were going through. Oh well, we hope this provided all those people with a good story, or maybe they just saw it as another day in Berkeley...

 

At this point, she refused to leave the car, and was just kneeling in front of the open back door (yes, still in sight of the bus stop). Scot and a nurse brought a wheelchair to her, but she refused to get in it, and insisted very loudly that she was going to have the baby right there in that parking lot. However, they eventually convinced her to sit down. Scot raced Elie through the lobby, into the elevator, and up to the labor floor. She has short but vivid memories of seeing Aimée ready for us when we got off the elevator, and seeing her immediately put Elie at a little more ease. Then 2 nurses plopped her down on a toilet in the delivery room, pulled her poopy pants off her, and hosed her clean with 4 peri bottles (they each had two in each hand). She was completely freaked out at this point, but Aimée did an amazing job calming her down and helping her harness the intense feelings she was having. She was able to calm down and my memories at this point start to become more pleasant. After she was all cleaned up (thanks nurses!), she walked over to the bed, and Owen was born about 25 minutes later, at 6pm. He weighed in at 8lb 14oz and was 21.5 inches long. After almost 42 weeks of pregnancy, she was SO happy to have that kid out of her. 

 

Sadly, her placenta never came. We waited, waited and waited. They did everything they could to encourage it out, but in the end she was given some fentanyl and they (Aimée with an OB from the hospital) manually extracted the placenta. That was super fun for her (not!) but it actually wasn't too bad because she finally had our baby on her chest and we just concentrated on him (and I'm sure the fentanyl helped too!). 

 

In hindsight we have some very humorous memories of the labor, but it was also scary in a way Elie wasn't expecting. Even though it was only two hours long, the precipitous labor was very intense. We were so lucky we had Aimée guiding us.