Monday, November 30, 2015

Home Birth

The months leading up to our due date of November 8 were a little more tense than normal.  The kids and I left Chad because of possible instability in the country.  We had planned to leave after another month anyways to deliver in America, so this was just a little extra time for me to fatten up in America.  

Olen stayed behind at the hospital in Chad.  Five and a half long weeks.  He made plans to leave at a moment’s notice if anything worsened in the country.  

I began to feel the anxiety at 36 weeks when Olen wasn’t sure when he would be coming to join me.  He was trying to wait until another doctor would replace him (my Dad, Papa Bland).  Meanwhile I imagined all kinds of outcomes while being alone with three children.  Thankfully Gamma Netteburg was around a lot to help out.  My last children delivered quite quickly, and we were a good 45 minutes away from a hospital in Virginia.  Awesome.  That’s all I needed was a delivery in route to the hospital with all three kids watching!  Or worse yet, something gone wrong with a delivery, which I see quite frequently in my OB world.  

Most women in Chad deliver at home.  Typically OB doctors are against home births.  I’m more so in Chad.  It’s at home in a mud hut, no running water or electricity, no ambulance in case something goes wrong… just bad conditions.  So when things go wrong, they tend to go really wrong.  Or things get really delayed even getting to the hospital.    And when they do get to a hospital, often the staff isn’t even trained correctly in OB.  All of this leads to distrust and increased morbidity and death.  I get the privilege of caring for these women in need.  We do our best at our hospital to make them feel valued and cared for.  Each mommy and baby matters.  

There is nothing worse than not feeling comfortable about your delivery plan.  I can see both sides of this story.  As a provider, I just want to do what’s best for my patient and her baby.  Realizing that emergencies are real and do happen.  But providers have different opinions as to “what’s best.”  In America, legal matters are on the rise.  A provider may be quicker to cut than need be.  This fear of providers may be one reason for the increased trend in home births.  Or maybe new mommies just want to have their space at home.  I’m not sure.  I can understand it though.  

As a patient, I wanted to feel respected and listened to.  I wanted to feel safe.  It’s nice to have met the person at least once that may be making life and death decisions about you and your baby.  To know that they are competent.  It’s also nice to have a little privacy, while knowing that in an emergency, those extra people needed would in fact walk in the room and be available in a moment’s notice.  Competency, skilled surgeon, anesthesia, nicu, caring and skilled nurses and staff, compassion, all traits sought after.  

With Lyol, it was a no-brainer where we were going to deliver.  I was on call when I went into labor.  A co-resident checked me and I was already 5cm.  So I was admitted, got an epidural, pushed for almost 3 hours, begged for an episiotomy to relieve the pressure (felt like my coccyx was going to break into a million pieces), and out came a healthy boy, face up!  I never told patients again that their “pressure” was not pain with an epidural!  

I delivered at a random hospital in New Jersey with Zane.  We were TRYING (albeit stupidly retrospectively) to make it BACK to our old hospital.  Pulled up to a hospital off the New Jersey Turnpike in labor.  They lied and said they had OB there.  ER doc speculumed me to see if I was crowning.  Awesome.  Got transferred to another hospital 20 minutes away by ambulance and delivered 10 minutes after arrival.  Even with my last minute arrival, and self-prenatal care in “Africa.”, most people were very nice.  All except the last nurse of the day who treated me like a crack-addict.  

Addison delivered at Baystate.  We were 5 minutes away and still only in the room for 20 minutes before delivery.

So me and the kids waited for Daddy…in Northern Virginia…not knowing the provider, the hospital or the future.  I didn’t fly half way across the world to deliver on the side of the road!  I could have done that in Chad!  (As a side note, there are doctors/midwives in Virginia, but chances are you won’t actually deliver with the one that you actually have met!)

Well at 37 1/2 weeks our family became complete.  No, not with a new baby, but with Olen.  He made it home because he loves his fourth child!  And he knew his life would be in danger if he waited any longer.  Not from the dangers in Chad, but from me.  

At 39 weeks we left the three older children with Gamma and Gampa and headed up to MA.  We made it to our “obstetrical home” at Baystate Medical Center, the place where I felt at ease and comfortable.  The place where I knew my care would be superior.  My baby was even considerate and waited until I had fit in a week’s worth of practice sessions for oral boards with Baystate attendings.  I also enjoyed morning visiting sessions with Tanya, an amazing pedicure with Beth, a few dates with Olen, and a nice Friday night visit with the Moores.   

Then our baby decided it was time.  Exactly on her due date.  We had the most beautiful home birth imaginable, right in our obstetrical home in the hospital.  Everything was available, though we didn’t need it.  

At 11am, I had my doctor check me, as the contractions were actually feeling good, and I wasn’t sure I was in labor.  Ha ha, they weren’t feeling good, but they were not that intense yet.  I was 4cm.  Shortly thereafter I was 7cm and admitted.  I hadn’t planned on a shower in my birth plan, but it was actually a good idea.  (And, no OB would make a birth plan. It just begs for disappointment.  You might think it, but never put it in writing, along with not saying no to residents or med students.)   My doctor and nurse duo team were so patient and caring.  I seriously couldn’t have asked for a better team.  

The shower did it’s best to distract me from the pain.  It all happened so fast thankfully.  

Then, there’s that moment when I wished I would have gotten an epidural.  You forget that pain with time, but I can understand why patients say they are going to die.  Because that is what you feel.  You seriously can’t see to the other side of the pain.  I really wanted to refuse the delivery, but it’s not really an option at that point.  So instead I just closed my eyes.  And remembered I was in good hands.  And out of all the places in the world, we were in the most perfect place.  

2:12 pm.  Our new baby came out.  She was plopped on my belly.  Olen said she was perfect.  My eyes were still closed.

Our new beautiful baby girl and I did lots of skin to skin, then Daddy put her on his chest for more skin to skin.  Our perfect little girl.  How could God make something so perfect after already doing it three times before?  I will never understand.  

You are perfect baby girl.  We love you.

Mommy and Daddy

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