BB6: A Journey to {Induced Hospital} Birth

BB6: Emma Elizabeth Bruffey

DOB: Tuesday, 1 May 2018 (our Mayday Baby!)

Time: 9:52am CST

Location: Conroe Regional Medical Center

Who caught the baby: our midwife, Evelyn Simmons

Who was present from our birth team: Josh and our doula, Debbie Hull, and a few nurses
Date her story was typed and published: 10/12/2019

 

A CHOICE: PREGNANCY AND BIRTH AFTER 2 LOSSES

 

After 2 consecutive losses, my heart was weary and mind wracked with uncertainty. We were delighted at the blessing of having another baby, but seeking care for this pregnancy was a different experience. My heart wanted the more personal, less medical approach that I had enjoyed previously with midwives and yet the anxiety I struggled with drove me to seek a more medical and involved approach to care. I had found a fabulous midwife, CNM Evelyn Simmons, that I saw once while pregnant with Jonathan. Because of that, it was hard for me to think of returning to her office. So, through a local mom's group, I had found a wonderful OB who worked with the MFM I had seen shortly after I moved to Houston and who had kindly gone over my records for Jonathan's pregnancy. So, I started seeing the OB and the MFM concurrently. I loved the frequency of visits and level of care. It helped keep my worry at bay. Though I found pregnancy after loss to be the 2nd hardest thing I've ever endured other than the death of my babies. I prayed SO often and grappled with God. I had an anterior placenta and my sweet baby was not as active in general, so I was constantly plagued with deep fear that she had slipped away. There were several moments when finding a heartbeat took time even at a doctor's appointment and I'd find myself flashing back to the appointment when we learned that Jonathan had died. It was the longest 9 months I've ever journeyed. I knew, having heard so many stories of loss, I felt most comfortable birthing in a hospital with a doula. The Lord brought Debbie Hull into our lives (https://www.debbiehulldoula.com/) and she has been a blessing to know. She was formerly a sign language interpreter and has years of experience supporting birthing families, in live births, bereavement births, and births after loss.

This is the verse I clung to throughout my pregnancy:

 

Overall, my pregnancy progressed as one of my healthiest ever, other than the mental, emotional, and psychological fatigue and worry that I grappled with. At times, I would just sit in a lukewarm bath and pray and cry out to God for the life of my baby and then surrender her days to Him. As a dear family member and I discussed, Josh and I DID trust our God with all of our children, and yet we knew that didn't guarantee that we would get to bring our baby home alive. And that is simply a hard reality. Early in the 3rd trimester, Ms. E flipped breech and stayed that way until 35 weeks. It seemed increasingly likely that I might have a planned cesarean birth. Although it wasn't what I would have wanted, I really just wanted to hold a live baby. During that time, around 27 or so weeks, I started to think increasingly about the CNM, Evelyn Simmons, in our area. I was grateful for the intense level of care we were receiving between our OB and MFM, but I was missing the midwife model of care. I started looking into Ms. Simmons and found that our MFM also worked with her office! I LOVE the MFM we used (Dr. Amber Samuel https://www.mednax.com/practice/obstetrix-medical-group-of-houston/clinicians/amber-samuel/) so was thrilled that we could start seeing a midwife AND continue our appointments with Dr. Samuel, since they work collaboratively.

Around 28 weeks, I started seeing Evelyn and continued care with Dr. Samuel. It was SUCH a blessing. Evelyn Simmons has decades of experience as a midwife, supporting birthing moms both in and out of the hospital. She has run birth centers and knew many in the birth community that I've come to know around Texas. It seemed like the perfect balance of care for us. And God knew we needed Evelyn. She was able to do a mild external version one week and suggest at home exercises and treatment to try and turn our breech baby. Our doula also recommended a special chiropractor who is also an acupuncture specialist here in the Houston area. I started seeing him (Dr. Manh Chung with the Acuchiroclinic), which was such a wonderful experience. Then, at around my 35th week, we had an appointment with Evelyn and she did another mild external version and you could see and feel my baby girl flip! We did an ultrasound with her collaborating OB in the office and sure enough, she was head down! And that is where she stayed until birth! I was so relieved and thankful that we would be able to pursue another vaginal birth. I do know many care providers will support vaginal breech births, but I honestly was not comfortable with that myself.

 

 

OUR BIRTH CHOICE: INDUCTION & NATURAL HOSPITAL BIRTH

After much prayer and deliberation with both our MFM and our Midwife, taking into account some borderline lab results near 37 weeks (cholestasis labs that I requested due to symptoms I was having), we decided to induce labor at 39 weeks. So, on Monday April 30 when I was 39 weeks and 1 day, we headed to the hospital! The day before, my other 3 children had gone with their grandparents to enjoy some grandparent time while Josh and I had some one on one time as we prepared for another birth journey and newborn season together. I was originally scheduled to be induced first thing in the morning with a check in time at 6am. I woke up at 3am and was getting ready when, around 3:30am I got a call from the hospital saying that L&D was full so our midwife had rescheduled us until Wednesday. I started weeping. I was SO ready to hold my LIVING baby on the outside. For the journey of worry and uncertainty to end. The precious nurse told me she would talk with our midwife and call me back. I then called our MFM's after hours office and it happened that Dr. Samuel was the doctor on call. Between her and Evelyn, they decided to have me come in to be monitored and as soon as a birthing room opened, I could be induced. They told me to get there around 10am. So, Josh and I got ready as planned and headed out to breakfast. Then, we made our way to the hospital. I knew I would have greater peace once my baby was being monitored and I could know that her heart was beating as it should. And that we would soon enough be able to hold her. Well, as GOD would have it, when we got to the check in desk at L&D, the nurse I had spoken (and sobbed) on the phone with was there and told me, "As it turns out, we already have a room ready and can begin your induction!" I started crying and said, "Oh thank you Lord. I am SO relieved!"

I didn't know it, but the first nurse assigned to us was there at the desk and told us as we were getting settled that, because of my response, she was eager to here our story. Of our nurses during our stay, the first was WONDERFUL, as was the third. Our second nurse was more timid and uncertain and so she was a bit more restrictive and obviously not as comfortable with the midwife model of birthing, which proved to be frustrating later because she as our overnight nurse. 

But, backing up, we were settled in and the induction started just before 11am. The first part was exceptionally boring! We had started watching some comedy together and our doula arrived (we had her wait to come knowing that an induction can take a while). She helped post the birth affirmations I had written around the room!

Birth Affirmations

Molly Bears - Jordan and Jonathan

My Jonathan Footprint Necklace

It was around 11pm, almost exactly 12 hours later, that my water broke. THAT was when I got excited knowing that, once my water breaks, labor usually moves forward rapidly. Well, shortly after it broke, apparently baby E slipped down and the external monitor could not find her heartbeat. Within moments, the room was flooded with nurses and they were grateful that I had not had an epidural because they could get me up and moving. I moved onto hands and knees as they sifted my belly trying to get her heartbeat back on the monitor. In situations like this, they give you 10 minutes and then do an emergency C-Section. I. WAS. TERRIFIED. To come so far and lose my baby seemed IMPOSSIBLE, and yet I knew many stories where that was exactly what happened. They were checking for things like cord prolapse, but that was not the case. I heard them on the phone with the on call OB who collaborates with Evelyn preparing her to come in for an emergency cesarean. At that point, I didn't want to wait another minute - I wanted my baby OUT. I didn't care HOW! I remember looking at Josh in absolute terror. He says my eyes were as wide as saucers. At exactly the 7 minute mark, when the charge nurse (who I LOVED - she had a strong commanding presence but was also kind and calm and you could tell she knew what she was doing) inserted an internal monitor (which I don't love, but at that point I was open to ANYTHING just to have a living baby), they again found her heartbeat!! At that point, they gave me something in my IV to slow labor - apparently my body had kicked into gear and I had contracted and it wasn't letting go, which may have been part of what happened after my water broke. They had called Evelyn to let her know that my water broke and what had happened with losing the baby's heartbeat. She came in to check on me and baby and discuss our next plan. To this point, we hadn't used any pitocin. Since my water broke on its own with just the initial induction medication she had placed internally, we agreed to hold off on pitocin and see what my body did. 

Laboring Together

From then on, they wanted to keep the internal monitor. I was fine with that because those 7 minutes were so upsetting. We settled back into a peaceful progress. However, this was when the nurse on duty was the more timid, uncertain nurse. You could tell those 7 minutes rattled her as much as it had us. So, she insisted I keep the monitor connected and not go to the bathroom other than in a bedpan. I had used the restroom earlier, not long before my water broke. However, I had learned years earlier the importance of an empty bladder for a birthing mama. We tried the bedpan SO many times and I just could not use it. The nurse even told me that most people cannot. My labor had been picking up but as my bladder filled, labor slowed. and I KNEW that was what was happening. My doula and I were both frustrated by the limitations this nurse was imposing. I had decided that, when Evelyn came in the next morning, I was getting up and moving around no matter what. I'd get forgiveness rather than permission. I KNEW if I could pee, labor would pick back up. I also had concerns about baby hitting against a full bladder causing bladder prolapse. I had worked too hard to have a healthy pelvic floor over the years! I had made up my mind that, at 7am when the new nurse came on duty, I was GOING to the bathroom. Well, at about that time, Evelyn came in to check on me and a new nurse came on duty. I had been praying about this nurse for a few hours and she was amazing. My doula and I asked Evelyn if I could go to the bathroom - I explained I had needed to pee badly for hours and I knew it was stalling my labor. She looked surprised that they had not allowed me to. she said it was fine to unplug the monitor for the short time it would take me to use the bathroom. I hit the ground, unplugged and peed all in about 3 minutes! Within minutes after that, my labor picked back up! UGH! All those wasted hours due to a full bladder. My doula also asked Evelyn if I could move around. In front of the new nurse she said that I could move as much as I liked. And the new nurse was obviously comfortable with that and very supportive. I was so grateful for this new nurse and a new approach to the rest of our laboring journey. Since labor hadn't picked back up to the same point it had been at when my water first broke, we decided to start pitocin at this point.

Over the next 4 hours, labor moved along rapidly going from very little progress to transition. I will say that I learned first hand how DIFFERENT chemical contractions are being driven by pitocin as opposed to natural contractions that are not medically induced. MY GOODNESS they were awful. I mean, I had done unmedicated births before and this was so very different once I got to transition. I found I had trouble breathing because the contractions were not only one on top of the other (which I had experienced in previous labors), but they had this level of sharpness and intensity that was foreign to me. With my previous unmedicated births, I could mentally get on top of the waves of contractions and ride the pain through to its completion. However, with these pitocin contractions during transition, I had such a difficult time getting my mind on top of what was happening to my body. There definitely felt like a disconnect. At one point, when I was right at transition, I just didn't think I could do it. I told my husband and doula, "This hurts!! I want drugs!" I was frustrated with myself but there was no letting up of the waves and it was SHARP - that is the best word I can think of that sets it apart fro my unmedicated, non-induced births. And I could NOT breathe well. I kept using my inhaler when I could. My husband and our doula were both incredible. Debbie would say, if I moaned that it hurt, "I know.... this is how we get your baby out. Let's work through one more." and Josh was just RIGHT THERE... for me to lean on, depend on, to rub my back or hold me up. As it neared 9:30am, Debbie felt like I was close and she and the nurse reached out to Evelyn. 

OUR BABY ARRIVES!

Evelyn came in around 9:30am to check me. Somehow, this peace overcame me and the moaning and feeling like I just COULD NOT DO IT anymore slipped away... I was able to lay in bed to be checked. I could have HUGGED Evelyn when she looked at me and said, "It's time to push your baby out!" I knew I had done it... I had worked through transition on pitocin! And now I could push my baby out!

It took just under 20 minutes, and a few good pushing contractions, and Ms. Emma Elizabeth emerged at 9:52am. Her pushing phase was SO perfect. With Jacob, I ultimately had an epidural and did not feel pushing at all. Ruth Evelyn and Rebekah came so fast, pushing was maybe 2 fast contractions, so I didn't really feel as much with them. But, with Emma, I had to work and push and let my midwife and doula and husband support and guide me. And I could FEEL her descending and emerging. It was INCREDIBLY powerful and amazing and wonderful! And I will never forget THE moment - the moment she was born and held up to me. Crying and pink and absolutely alive and perfect!

Meeting Emma for the first time!

THIS MOMENT!

I looked at Josh and said, "SHE'S ALIVE!"

Once she was born and in my arms, I had the blessing of being able to cut the cord, which I'd never been able to do with my previous babies.

She was able to get a first latch, though it took a few minutes, and we got plenty of snuggle time as the placenta was delivered. After some skin to skin time, I was ready to use the restroom and clean up a bit. Emma got some Daddy time and her first stats were taken! She loved the warmer!

After some bonding time together, we were moved to our room in postpartum. We had a sweet time there. The most precious memories to me were when my mother brought my other 3 children up to meet their new baby sister. They had baked a gluten free, dairy free cake and we had her very first birthday party!

This tenderhearted boy. As he held her, he welled up and handed her off to his Dad and went and crawled in Grandmother's lap to be rocked. He told his Grandmother, "I feel like crying." Such a precious moment after so much heartache.

Already in love!

The postpartum room was amazing!! 

A Surprise Gift from my Mama!

MY JOSH

My husband is truly my best friend. Through 1.5 years we had faced so much heartbreak and change in our lives, and he was a rock. He supported me through prayer and listening and incredible understanding as we grieved together 2 babies and journeyed through a pregnancy after loss together. I a so thankful for the friend and husband and love-of-my-life that he has always been. 

We have a picture like this of him with all of our living babies at birth.

OUR RAINBOW GIRL

Our precious baby girl. Named after your great grandmother and your cousin - 2 incredibly strong women of faith! And also after Queen Elizabeth II, just like your mama. Another strong woman. I am so glad you were strong as we walked through this hardest pregnancy together. I love you more than words can express and am SO very glad you are in our arms here on earth! Thank you for filling my arms and bring laughter and joy into our home! 

 

THANK YOU

 

 

 

To those who journeyed with us through this longest pregnancy, THANK YOU. For your love and support and kindness and compassion and listening and friendship... we are forever grateful. To our church family at Woodhaven Baptist Deaf Church - THANK YOU for your outpouring of love and the beautiful shower. To Morgan, my hope bearer - you'll just never know what your friendship and support means. To my prayer warrior friends who encouraged me - to Thara and Rachel for reminding me of "GOD!" That He is sovereign and to cling to His truth beyond my feelings... I love you both and am grateful for our friendships. To Virginia and Maren - my sisters - thank you for being there, for sharing worry and love and prayer for me and all my children. To Dr. Amber Samuel - for taking every worry and tear seriously and keeping a thorough, watchful eye on our daughter for so many long weeks. For never dismissing my concerns - I am forever thankful God brought us you. To Evelyn Simmons - THANK YOU for welcoming us as we entered our 3rd trimester and for having faith in our baby and her life and her birth. And to Debbie Hull, our doula - thank you for your prayer and care and being THERE, especially in those moments of transition - I can still hear your calm, confident voice of encouragement, "I know it hurts... this is how we get your baby... let's work through another one." As chaos seemed to swirl in my mind, you stayed calm and serene and guided me through so that I got to birth how I really wanted to. Thank you for that. So very much. To the nurses that cared for us at the hospital and rejoiced with us as our daughter was born alive - thank you for your service and care. Especially to the charge nurse whose name I have now forgotten - your confidence during those awful 7 minutes kept a peace in the room that was otherwise filled with worry and fear. Thank you so much. And to my best friend, Josh... my beloved... my best friend. What a journey these past few years have been with uncertainty and heartache and hope and tears and joy. Thank you for standing by me and our family. Thank you for your commitment as a friend, husband, father, and man of God. Your faith in Him regardless of our mountains or valleys is a leaning post of strength for me. I love you and remain, always, yours.

FINAL NOTE:

 

It took me almost 18 months to type up Emma's birth story. I have grappled with typing it for 3 main reasons. First, the fact we chose induction. It was a hard decision but ultimately, with the borderline labs we got back and my own mental health, it was the best choice for our family. There were so many powerful and beautiful things about her birth, though I wish that loss had never been a part of our story and that pregnancy could be like it was before we had 2 babies die... months of joyful dreaming and planning and homebirth with candles lit and peace all around... but death changes those whom it touches and leaves behind. We found peace amidst the medical and joy within the journey of a hospital induction. But it has been hard for me to find peace in that decision completely. Though we are convinced it was the wisest medical choice for the health of our baby and her mama. Second, those 7 minutes. Those 7 minutes were terrifying. Given my already ragged spirit and soul... I had to really process the trauma of those 7 minutes. 7 minutes when we just didn't know if, after all we had been through, we had lost her after all. It has been hard to talk about much less process through writing. And third, transition... when I asked for drugs. Afterwards, I felt shame for even asking. But, as I processed her birth, I realized that I did work through that with my husband and our doula. And I worked through and birthed my baby without those drugs. But I had never even considered asking for pain relief drugs when my other girls were born. And for the 1st 25 hours of my firstborns labor, we were unmedicated. And, with him, we got an epidural at the recommendation of my midwife so that I could rest and be able to continue with a malpositioned baby. And my dear doula, after Emma was born and I was processing how transition had gone, encouraged me with the fact that pitocin contractions ARE different than natural contractions. Even knowing that, though, I still felt regret over even asking. I had never had such an intense moment in labor before. Where I felt THAT done. So, writing it all down took time to process. Both the losses and her pregnancy and her birth. But I felt it was time. Time to document her birth as I have her siblings before her. There was much that was beautiful and precious to my heart that I want to hold onto. We have spent the past 17.5 months enjoying this precious life that came to us after the greatest storm we'd ever known. Her birth represents so much - the ups and downs, joys and sorrows, valleys and mountaintops - that is life. And we are forever grateful that she is in our family!

 

The Lord did indeed hold us close and carry us through. Though Emma filled our arms, our hearts will always long for the babies we don't get to hold and nurture. We are thankful for all 6 of the children we carry in one way or another.

~ Elizabeth