Wednesday, April 8, 2009

Paxton's Birth Story

This story  is very, very long, but since Pax's entry into the world was a long one, it seems appropriate. I also wanted to document everything that happened before it starts to get blurry. Here's the short version: Paxton Densler Willoughby was born on March 29th, 2009 at 8:51 pm. Pictures are available on our flickr page.  If you're interested in all the details, read on :)

Before we became pregnant, we knew that we wanted to have a natural birth experience.  So, when we found out that we would be expecting, we decided to see the midwives at UCSD and to birth our little one at the Birth Center in the UCSD hospital. We decided that this would be the best option for us because we could labor naturally in a large room with a jacuzzi tub, shower, birthing ball, and four poster bed, yet still be seconds away from medical intervention if, for some reason, we needed it. The Birth Center is on the fourth floor and the regular labor and delivery wing is on the second floor. In the event of an emergency, we would be right where we needed to be.

We also hired a doula to be present and support us in our birth. According to DONA International, a doula is "a trained and experienced professional who provides continuous physical, emotional and informational support to the mother before, during and just after birth." We feel so blessed to have found our doula, Kayti Ricker, who provided all of this and much more! 

As we started to reach the end of the pregnancy, we knew that Pax needed to arrive between 37 and 42 weeks for us to be eligible to deliver in the Birth Center. We weren't sure what to expect other than the fact that he would probably be late. We were told that the average first baby arrives about 8 days late. Once we passed our due date of March 23rd, I will admit that I started getting antsy and finally hit a point where I was just done (emotionally and physically) with being pregnant.

After about two weeks of pretty frequent Braxton-Hicks contractions or "just practice" as we referred to them, I finally started to feel the real thing on Friday night (March 27th).  Not only was my belly tightening each time, but I also started to feel cramps and it was happening about every 10 minutes. We decided that the best thing to do would be to go to bed and try to get as much rest as possible. We both had a pretty restless night, but managed to get some sleep. 

By the next morning, the contractions were coming a little closer, about eight minutes apart, but they were very mild and only about 30 seconds long. We called Kayti to give her a heads up and then decided to just keep going about the day. It was incredibly exciting to think that our little man would be joining us very soon! I decided to knit a hat for him that he could wear in the hospital and we also took a walk to the post office to mail our last couple thank you notes.

At about 3:00, Kayti came over to the house and the three of us went on a walk to Morley Field to see if we could get my contractions to pick up some more. They were currently about five to six minutes apart. We walked around the tennis courts and the baseball fields and did lunges up the hill on the way back. During each contraction, Brad and Kayti massaged my shoulders, applied pressure to my hips, and provided lots of support. I'm sure that it was interesting for all the passersby to see a very pregnant woman stopping every few minutes to hug a tree or telephone pole. 

We headed back to the house and the three of us had dinner along with our friends, Chris and Ruby, who had stopped by to bring us some takeout from Zensei Sushi. At this point, my appetite was starting to wane and  the contractions were getting a bit more intense. Brad and Kayti fixed me a bath and while I relaxed, they called the midwife on duty and found out that Rita, the midwife we had seen for the last couple months, was on call. We decided that we would go ahead and make our way to the hospital. We were very excited about Rita being there for the birth.

We arrived around 10 pm and our nurse, Joanna, got us settled in. Rita checked to see how far along I had progressed and I was only 3 cm dilated. She told us that we could go home if we wanted or stay and be admitted, but that the best thing would be to walk around and keep moving. We decided to stay and then did a lap around the hospital and a set of lunges up the stairs followed by a shower. Every hour, Joanna would come and listen to the baby's heartbeat with a Dopppler and his heart was beating strong every time. At 1:30 am and after a lot of laboring, Rita came back and checked me again to find that I had only progressed to 4 cm. Because I was pretty tired at this point, we thought the best thing would be for me to try and get some amount of sleep in between contractions. I was able to find a position kneeling on the bed with my upper body draped over a birthing ball where I could sleep. My contractions slowed down and spaced out a bit and I was able to sleep on and off for about two hours. Brad and Kayti also napped which was great because we didn't realize how much more was in store for us.

At 5 am, Rita checked again and I was now 5 cm dilated...five at five. At this point, the midwives and nurses changed shifts, but Rita promised to check in later to see how things were going. We found out that Jennifer would be the next midwife on duty. Again, we were thrilled because we had met Jennifer during our pre-natal appointments and we both really liked her. We continued to labor and I will be honest, things are a bit blurry from this point. I do remember trying very hard to focus on relaxing through the contractions. The body's initial reaction to pain is tense up and I knew that I needed to do just the opposite to get things to progress. I found that many of the techniques we learned from our Birthing from Within class came in very handy, but I did not expect that the vocalizations we did during the Coyote Circle exercise to be one of my main coping techniques. I had actually thought I might be a somewhat quiet laboring woman...just one of the many things I learned about myself during this journey.

Jennifer came in after a while with Kandace, a student midwife with two weeks left in her program, who would be helping out. They checked me again and I had gained one more cm...slowly but surely, I had dilated to 6 cm which would now put me in "active labor" and they would be checking the baby's heartbeat every 30 minutes. Being 6 cm also meant that I could get in the birthing tub. They had wanted me to wait until I was 6 cm because they were afraid that if I got in any earlier, I might slow the contractions down. The warm water felt wonderful and helped me to really relax in between contractions. I continued laboring throughout the morning and afternoon using a birthing stool, birthing ball, the shower, and all sorts of support from Brad, Kayti, and Kandace. 

At some point in the afternoon, Kandace decided I could begin to push if I felt the urge. I had dilated to somewhere between 9 and 10 cm and they would now monitor the baby's heartbeat during every contraction. Never once did his heartbeat show any signs of distress. At this point, the baby was low enough that they were able to determine that his head was not quite at the right angle for birthing and there was a lip of the cervix left. This is common when the baby's head is not applying equal pressure to all parts of the cervix creating uneven dilation. With some help from Kandace during a couple contractions, we were able to get the baby through the lip and I was now completely dilated to 10 cm. I continued pushing, but only occasionally did I feel a very strong urge to bear down. Jennifer then came in to check as well and slowly they started to determine that there were a couple of issues we would need to deal with. The baby was in an acynclitic position meaning that his head was at an angle and he was also posterior or "sunny side up" and both of these things would make delivery difficult. 

I was told that I could continue to push, but that the baby would need to tuck his chin and turn his head in order to progress through the birth canal. We tried many different positions in an attempt to get him to move, but we had no idea how stubborn the little guy was going to be. In the mean time, Jennifer was communicating with the doctors on the second floor who were wanting to have me brought downstairs. The agreement was made that if I continued to make progress, I could stay upstairs. At one point, we did make a bit of progress and the midwives were even able to see a tiny bit of his head. I thought for sure we would make it, but after somewhere around seven hours of pushing and little to no progress by the little guy, the decision was made to go downstairs.

So we ended up downstairs in the labor and delivery wing and they hooked me up to the continuous fetal monitoring system. In my room, I was now joined by Brad, Kayti, Jennifer, Kandace, Elizabeth (the midwife coming in to take the next shift), two nurses, and the doctor. I have to say that I am forever grateful to have birthed at UCSD and that I feel very blessed to have been surrounded by such a wise and skilled medical team. The doctor checked me and it was very comforting to have her tell me exactly the same thing that the midwives had determined. Everyone was definitely on the same page and I had two options at this point: 1) a Cesarean birth or 2) an epidural with some time to rest and then Pitocin and possibly an assisted (forceps or vacuum) vaginal delivery. I was told that because of the position of his head, it might be very difficult to have an assisted delivery and that they would have to consult with the other doctor. While having a Cesarean birth had been one of my biggest fears during pregnancy, I was also very wary of assisted deliveries because I have always felt that there is a lot of room for error. My gut feeling was that the Cesarean would have the least risk for the baby. Brad and Jennifer both agreed. Because the Cesarean would not be an emergency procedure, I was given time to ask lots of questions and never did I feel pressured into something I didn't want or need. I truly felt treated with respect by everyone involved.

The entire procedure happened very quickly. Since Kayti is also a volunteer doula at UCSD, they allowed her to be with me during the prep for the surgery. Because I was still managing the pain from contractions, I was very glad to have her there. They gave me a spinal to numb my body from the belly down. Once the warming sensation started to flow through my legs, the contractions were gone and I felt incredibly sleepy. They then draped the blue sheet in front of me and gave me a tube with a bit of extra oxygen. As soon as everything was prepped, Brad joined us. They allowed us to bring in our own music so we were able to listen to some of our favorite songs which was wonderful.

During the procedure, Brad and Kayti stayed by my head and talked to me. As soon as Paxton was born, they told me everything that was happening. From the moment I heard the first little cry, I started crying too. Brad was able to cut Pax's umbilical cord and be near him as they gave him his 1 minute and 5 minute APGAR scores which were 8 and 9, respectively. I had to wait until the second APGAR was given and I have to say that those 5 minutes were the longest of my entire life. I could not wait to see him for the first time. As soon as possible they brought him over and I was able to have skin-to-skin contact with the little guy. It was the most joyous moment to see and touch our baby for the first time! Brad and I were able to hold him and cuddle him while they finished the procedure. 

At 8:51 pm on March 29th, 2009, Paxton Densler Willoughby joined the world....all 8 lbs, 5oz and 21 inches of him!

At this point, something very magical happened. We realized that the song playing on our iPod was "Careful Not to Draw Your Maps in Pen and Ink" by the Cobalt Season. We have always loved this song and everything that it says about letting go of your plans and just living incredibly relevant in light of everything that had just happened! After months of "planning" our birth experience, we were forced to let go and take things as they happened even if they were far from what we imagined they would be. It was also very poignant that a Cobalt Season song was playing because the first time we heard the name Paxton was when they came to play at Missiongathering and brought along their son, Paxton. 

After the birth, we were able to put some more pieces together to figure out exactly what happened. We were very fortunate to have had Dr. Lisa Stellwagen, an amazing pediatrician at UCSD, check in on Pax. Very quickly after seeing him, she was able to explain to us what caused the delayed labor and the "stuck" baby. She asked if had spent a lot of time in one position in the womb and I told her that he lived almost exclusively on the right side of my belly. She said that sometimes, this can cause babies to develop torticollis which is a tightness in the neck muscles (she had just published a paper on this very condition). She showed us that his head could easily turn in one direction, but only part of the way in the other direction. His one ear was also flatter than the other and his lips pulled a little higher on one side, all symptoms of torticollis. Apparently, Pax's muscles were so tight that during labor, he wasn't able to straighten out his head and come out through the birth canal. This was what caused labor to progress so slowly and explained why he wouldn't come out even though I pushed with everything I had in me. She gave us a few exercises for his neck and we have already seen a huge improvement. Within a few weeks, it will probably not be noticeable at all.

In addition to the torticollis, Pax also had some jaundice which made for an extra long stay at the hospital. Because there was a history of severe jaundice in my family, Dr. Stellwagen decided to test his bilirubin very early at 12 hours. It was a good thing that she did because it was already high. So, they brought a special BiliBed into our room and Pax was able to sleep with the lights in our room rather than being whisked away to the NICU. He was allowed to come out to nurse, but otherwise had to stay exclusively on the lights. It was a little tough to not be able to hold him and cuddle him all the time, but I am so glad that we had him right by the bed. Between the lights and the feeding (both important to clearing the bilirubin), he was looking great by Thursday and we were all able to go home!

Now that we're home and adjusting to life without sleep, we love just staring at the little guy and learning all his squeaks and sighs.  We're so blessed to have a healthy baby and are treasuring each day of his brand new life.


  1. way to go merrilee, i can't imagine what it was like to go through all of that but by the looks of things it sure seems to be worth it. congratulations.

  2. Beautiful story guys, thanks for sharing. Now that it's all said and done, I really can't imagine Paxton's birth any other way. Way to go!

  3. I was moved to read your birth story (which is shocking similar to my own -- both in expectations and outcome).

    I offer my congrats to you for enduring everything that you did. You are a strong woman.

    Best of luck to you and your new family member.

  4. What a story! Thanks so much for sharing the details. I got so emotional reading it, knowing that we will also have our own birth story in just a few days. I can't wait to meet Paxton, and let the party begin!!!

  5. Congratulations you guys! It was great to read your account even though it made me a little more nervous about the labor process. We our expecting our son at the end of May. My wife Chelsea is jealous of your cute nursery - we're still working on ours.

  6. Hello guys! It is so nice to 1. hear your story told in such a poignant way and 2. find that BFW really worked for you! I look forward to hearing more and you have such a great mindset about all that unfolded. We will have a reunion soon in the next month.



Design by: Blogger XML Skins | Distributed by: Blogger Templates | Sponsored by Application Monitoring