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My Midwife Gave Me Choices

Within a matter of weeks after finding out I was pregnant, I chose to see a group of certified nurse-midwives who attended births at a freestanding birth center as well as a nearby hospital. It was the ideal setup because it allowed me to shoot for an out-of-hospital birth knowing that if I needed to transfer to the hospital for an epidural or an emergency situation, I could still keep my midwife as my care provider. On the big day, I showed up at the birth center in rough shape. I had been laboring at home for about four hours and couldn’t keep fluids down. Despite my midwife’s encouragement and coping suggestions (movement, warm water, breathing, etc.), intense contractions and disappointing progress left me demanding an epidural. It wasn’t what I had planned, but as far as I was concerned, it was what I needed. My midwife heard my request, but asked me to consider another option. “You’re very dehydrated right now, and I think you would feel better if we tried IV fluids,” she said. “We could also try Stadol to help you better relax between contractions.” At first I protested. I wanted to skip straight to something that I was 100% certain would work. But a few minutes later I hit a point where I had to let go and stop struggling with my options. “Please do what you think is best,” I told my midwife. Out came the IV fluids and an injection of Stadol. (Doing an injection instead of putting the medication in the IV helped me avoid getting loopy.) The pain didn’t go away, but it became more manageable. Just two hours later I progressed from 4 to 8 centimeters, and the contractions changed—it was almost time to push. You'd think that pushing and crowning would be the most painful part of labor and birth, but for me, it was the light at the end of the tunnel. My body knew what to do, and I knew I'd hold my baby soon. But things got a little scary before it was all over. About halfway through the pushing phase, my midwife got concerned about the baby's heart rate. It was dipping as low as 60 beats per minute. "Push for your baby, Melissa," she instructed. "For whatever reason, he's not tolerating this." She alternated between telling me to push for my baby and breathe for my baby. The nurse put an oxygen mask on me, and I continued to push with all my might. I reached down and could feel the tip of my baby's head. A couple more pushes and my perfect baby boy was out. The midwife immediately placed him on my chest and gave him a bit of oxygen. He breathed and cried beautifully. Looking back, I am so grateful that I had a full spectrum of choices for navigating labor and birth and a care provider I could trust to guide me through the difficult patches without abandoning my values and wishes. I’ll continue visiting my midwife for my gynecologic care and without a doubt will return for my next birth.

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