Emily’s Story: Birth Center to Hospital Transfer

Baby G born at United Hospital in St. Paul, MN

When I first got pregnant, I did all the things. Read the books, listened to the podcasts, took some classes, and of course, made my birth plan. My son is my first born and I wanted it to be as positive of an experience as possible. After doing a lot of research, I decided what was important for me was to make sure I had a good doula, to use as few interventions as I could get away with, and to give birth at a birth center if possible. They say plan for the unexpected, and I did my best, all the while thinking that everything should be able to go as planned because I had a healthy pregnancy and no significant health history.

I decided the week before my guess date to start prenatal acupuncture. The day after my first session I lost my mucus plug, which was encouraging. I hadn’t had any Braxton Hicks so I kept waiting for another sign. Feeling just fine two days before my guess date, I decided to do a little holiday shopping to move and try and get the ball rolling. After browsing a couple of stores, I drove across the street to the mall. Just as I was getting out of my car, I felt that gush of water like you see in all the movies. After a split second of thinking my bladder had given up, I realized what was really happening. I got right back in my car, simultaneously realizing there was a woman parked in front of me who witnessed my quick trip out and back into my car. Feeling a little embarrassed and self-conscious (did I mention, I had selected to wear light gray sweatpants for the occasion), I made a quick call to my midwife who helped me confirm that this was happening. She wanted me to check my waters for any discoloration or scent, which was not a task I was prepared to do while sitting in my car in the parking lot across from this stranger. So, I made the 30-minute drive back home, where I experienced a second and third gush of water (I had thought this only happens once and learned quickly that it can happen more). Unfortunately, there was meconium present with particulate, so we were instructed to come to the birth center for further monitoring.

In my mind, we would get baby boy checked out, things would be fine, and they would send us back home for a nap before returning to the birth center for the birth. Afterall, it was an hour and a half after my water broke and I still hadn’t felt any contractions. Just in case though, I had my husband throw in our overnight bags. On the drive to the birth center, mild contractions started and were still 25 minutes apart. They monitored baby boy’s heartrate which had some desaturations. This in combination with the meconium in the waters led to us needing to transfer to the hospital just to be safe. I learned that risk of infection for the baby goes up significantly if there is particulate in the waters and the baby is not born within 48 hours. Since things were barely progressed, this was deemed a necessary step for his safety. I finally let the tears fall. What I had thought would be a funny start to the birth story ended up being a little more worrisome. This was not accounted for in my birth plan. We had selected a hospital but not done much planning for a hospital stay beyond that, thinking we had slim odds that we would end up there anyway. Lesson learned.

Contractions started picking up on my way to the hospital and were about 15 minutes apart (still not very close), by the time I was checked into the room. Some of our family friends were on staff and came by to give hugs of encouragement which boosted my mood. We were moved from one room to another quickly because the oxygen valve on the wall was leaking in the first room and needed to be fixed. The nurse gave me Pitocin, which I was a little bummed about, but again we agreed it was necessary based on the risks and the current progress. My husband left at this time to grab some more things from home since we had packed and prepared for a short birth center stay instead of a longer hospital stay. During his short trip to grab supplies and get us dinner, my contractions started to come every 5 minutes. Our doula was also working to come as quickly as she could, as she had another birth she was attending that day. I was excited that we seemed to be getting somewhere and wishing my husband was back with me already. He arrived after what felt like an eternity, and I ate the delicious brisket mac and cheese, needing to pause every now and then to breathe through a contraction.

The intensity started to pick up shortly after dinner (at this point it was closer to 8pm), and our doula arrived with little tea candles and a calm that helped to settle my nerves. We quickly got into a routine as I found my rhythm. I found sitting on the toilet backwards to be a helpful position for a while. I lost my dinner (not fun) and transitioned to laboring in the tub which felt nice but did not provide the relief I had hoped for as I started to have double and triple contractions around this time as well. I don’t know what I would have done without my doula and husband there for support. I did agree to a cervical check as things had been wild, and I wanted to know what to expect going forward after a long afternoon and evening. It was disappointing to learn that I was only at 1.5cm at 1am. Exhausted, I decided to move forward with getting an epidural so I could get some rest.

The epidural did provide the much-needed rest and relief for me at that time. I had not been able to take a nap in the afternoon due to the need to transfer to the hospital and everything had felt a little chaotic up until that point. The team was still closely monitoring my son, and we were finding that some positions caused his heartrate to desaturate again while others provided more stability. By 11am I felt more rested but a little like I was on an emotional rollercoaster that followed his fluctuating status. One moment he was doing great and the next moment the staff were on alert in case his heartrate didn’t return to where it needed to be. Since my water broke 24 hours prior, we decided an amniotic flush would be beneficial to help support him and my body. I was still only 3cm which was also emotional and discouraging. It felt like I had 24 hours of labor with nothing to show, and I was halfway to the timeframe when the risk of infection would increase.

After much discussion with my team, we decided to put me on Pitocin again to try and help with progress. I also snuck in some more snacks as my energy level was low, and I knew my body needed fuel to make more progress. Sure enough, shortly after 3pm I was finally closer to 10cm. I was refueled and so ready. All afternoon there had been talk of needing a vacuum or a c-section if his status didn’t change so I was oh so grateful it did. I was ready to push by 6pm. After a few practice pushes, my midwife wasn’t satisfied with how things were going and called the doctor in for a second opinion on whether a vacuum was needed. This turned out to be a blessing in disguise. The doctor came in, coached me in a more effective manner, and we began making great progress. It was around shift change so between both shifts, the NICU team who was on standby, and my husband and doula, it felt a little like a party room. My son was born within the hour, with no need to use the NICU team. He was healthy.

We were discharged from the hospital two days later, and in the days to come were really struggling through getting him to latch. He was stubborn and, even with lactation consultations, which I highly recommend, it took him 5 weeks to finally figure out how to eat directly from me. This was surprising as my milk supply was great, he had no tongue ties or other oral ties or issues, and I was using all the steps I had learned to help him along. The persistence paid off though, and I am so glad I pushed through. I also went to pelvic floor PT starting at 8 weeks postpartum as the pubic symphysis pain I had had during the final weeks of pregnancy was persisting. I was committed to being consistent with this as I knew following the process would help ensure I allow everything to properly heal. I signed up for a half-marathon a year and a couple months out from his birth and want to make sure and train smart.

Processing my 32-hour labor has been a slow process. As someone who is type A and likes to have a plan, my world was rocked when it felt like just about everything did not follow my plan A or B. For having a healthy pregnancy, I am amazed and humbled at how many things could and did change once labor began. I am still working on processing the switch to the hospital, if it means anything for my future birth plans, whether an unmedicated birth is something that I still want to pursue at a birth center, and how I can gain my confidence back again. I am hopeful time will continue to heal. And in the meantime, I remind myself I had a healthy baby without the need for any emergency procedures. There is so much to be grateful for. And I am.