Birth Story: Katie Fitzmier

Katie Fitzmier, a volunteer birth doula, and her husband, Sim, live in Madison, WI with their daughters Bell (6) and Simone (6 weeks). We got to snuggle Simone and chat about Katie’s birth experiences and normalizing birth…

Family of four!

Family of four!

Did you have experience with birth before you had your children?

Not very much. I, like a lot of doulas, have always been fascinated by birth and bringing babies into the world, so I knew a lot just from my own research. But, no, I had not attended any births or seen births of any sort. So Bell was my first!

Had you heard stories about when you were born?

Yes, stories of my birth, and, I have an older brother, his birth, as well as lots of friends who had babies. Personal stories, you know, of people in my life, just not any in-person experience.

All were positive. Definitely most of them included some of that “horror story” birth stuff that you hear. I think it’s pervasive, and I don’t quite understand that. We probably all do it to some degree, so maybe that’s how it creeps into everybody’s stories. For my own experiences, I like to help normalize things for myself and everybody else as much as possible, and I think part of doing that is being honest about hard things. I do think our cultures is full of that. People don’t prepare you for the hard things being part of what you experience, they only talk about good things, often. And then it feels like you need to tell the world about all the horrible things that happened, to give that time and space. When I think about telling someone who’s not given birth who might want to know, I don’t want to scare them. I don’t want to say that things are all negative or things are all the same because experiences can be, and usually are, so varied.

Baby Bell

Baby Bell

What were you most nervous about going into Bell’s birth?

I don’t think I was nervous. I think the unknowns of when labor would start and those sorts of things tend to be things I struggle with anyway. The unknowns are not my friend! No, I wouldn’t say I was overly nervous.

My next question was going to be “Were your fears unfounded?” but you didn’t have too many…

Yeah. We did have some middle pregnancy, 22 to about 26 weeks, really strong Braxton-Hicks contractions that we thought were maybe preterm labor. That was a small worry, but we actually never even had to go into the hospital. We just managed a lot of them over the phone and were told to keep an eye on the intensity. They did last several weeks, but they never got to a point of worry. So I think having that experience early in pregnancy also made me feel like “Well I know that wasn’t labor, so it’s going to feel different likely, and here are some extra things that I know.”

How did your labor with Bell start?

She was 41 weeks, 6 days when she arrived, so 10 days past her due date. I hadn’t done anything at all to move things along and was wondering when things were going to happen. My birthday is 4 days after hers, so that would have been 42 weeks. They told me that they would let me go until my birthday before induction. I was convinced labor wasn’t going to happen, and I would be induced. But I did start labor spontaneously. The morning of April 3rd, I woke up at 3am with just really low level cramps. It was a long lead up. I just labored very lightly at home, taking baths, hanging out in bed, that sort of thing. We had a non-stress test ultrasound that afternoon because she was “late.” It wasn’t until about 2:30pm when I had that test that labor was getting a little more regular. Then by 5, I knew I was in pretty regular labor.

Describe your labor:

Her labor did end up being really fast. Even though the initial lead up was a longer time, once active labor started I had very little time. I would say by 5pm we had called Tehmina, my doula. I was in bed and I was actively laboring here at home. We had a plan to stay here as long as we could before transferring to the hospital. I think by 7 we were on our way to the hospital with contractions coming with no break at all in between. We all thought I was in transition and should get to the hospital. We got there and I was actually 4cm. We thought potentially at that point there could maybe be interesting positioning of the baby that was making things move so quickly. Because it really did feel like I was at a 7 or an 8 already. I went from a 4 to an 8 in not even 2 hours. I progressed very quickly. My doctor was not there, and they couldn’t find her. It turned out she was somewhere else on a family emergency. So they were scrambling, saying “You’re going to meet your baby at any point! Baby’s going to be here before you know it!” Things were hauling along, and then I stalled out at 8cm. We think, again, because of positioning. I stayed at 8cm, just laboring with no epidural or anything, for about 5 hours. I wanted to push, but, of course, I couldn’t. They said “Every time you feel the need to push just breathe as much as possible.” So I just basically scream-breathed for 5 hours! I hung in there. The baby was great until near the end of that 5 hours. We got really low heart tones. At that point I had let them do quite a few things I was not interested in to try to continue to have a vaginal birth like the IUPC, a scalp monitor, oxygen and a thousand position changes. We got in and out of the tub. I tried every 2 contractions to change position. At the end of that 5 hours at roughly 3am, it was just clear that her heart tones were not perking back up. Everybody was starting to get really concerned. So I did end up with a C-section. But I felt pretty good, all-in-all. There was nothing else really I could have done. It turned she was asynclitic. When they were getting her out, you could see she was essentially really low and then tilted. I think that’s what was causing labor to move so fast. She was jammed so low that her head was helping me dilate. But we couldn’t get in a position to help her back out of there and help me dilate those last few centimeters I needed.

What was that experience like, going from laboring to the C-section?

It was interesting, as a first time mom, not having experienced it before. I was very much one of those laboring mamas who was afforded the space by my support team to just be in my labor zone. I remember everything about my birth, but I really was quite in my zone that whole time. I was able to really focus in on that and not focus on what was happening around me. Probably that last 10 minutes before a C-Section was decided I must have come out of my labor zone just enough to realize just how nervous other people were getting. There were tons of people in the room. There were people over in the corner, but they were starting to talk, instead of to me, amongst themselves and consult. I remember coming out of it and saying “What did they just say!?” to Sim and he was like “Honey, it’s ok. They haven’t said anything new. You can keep breathing. I’ll let you know.” That’s the only time I ever felt, scared isn’t the right work, but a change. I was much more out of my labor zone. I realized something was shifting. That was a little anxious. I was anxious about that change.

They were very respectful and everyone consulted me on everything, but they said “We really feel like at this point we’re compromising Baby’s safety, and potentially your safety, to not get the baby out.” We very quickly said we were not willing to compromise Baby’s safety at all. For Sim, I know that it was a little bit different and hard. I was really glad we had a doula because she ended up doula-ing him more than she did me at that point. I think because I had been doing all the actual work physically, it felt a little bit less jarring than for him. He describes that one second he’s helping me labor, giving me wet washcloths and then in 3 seconds he was scrubbed up, the room was full of people, the lights were all on, everyone was racing all about. And then before he knew it, he was standing in a hallway all by himself waiting for me to be prepped before he could come in. He was lucky enough to come in with me, but it was like “Oh! Scary!” He said “I was kind of freaked out ,and Tehmina helped sort of normalize things for me and say what’s going to happen next.”

And then Bell arrived!

She was here and very healthy!  

Was labor what you expected?

I don’t know if I would say it was what I expected, but I think I was prepared very well that it’s something that could happen. Especially because of how fast it moved and how I was very efficient with dealing with contractions, I wasn’t prepared for that part. It really didn’t seem like until the very end that we weren’t going to have a vaginal birth. All labors are different, but they were clearly expecting that I’d have that baby in the next 20 minutes. They kept saying that. I think that was a surprise.  

In labor with Simone supported by Tehmina

In labor with Simone supported by Tehmina

What did you do differently for Simone’s birth?

Because I’d had the first C-Section, I was attempting a VBAC. I did a lot of prep work figuring out how I could pull that off, potentially. Along with that, and because I was a VBAC patient, I discovered all sorts of insurance/doctor/hospital policies regarding whether or not I could stick with my family practice doctors. Almost all of my pregnancy I was told “No, you can’t keep your doctors.” I could keep seeing them until 32 weeks, is what they said, and then I’d have to go find an OB from some other clinic who is VBAC-supportive. I kept saying that didn’t make any scientific sense to me because I can’t even guarantee that particular OB will be at the hospital in case I need a C-Section. In the case of anybody else who needs a C-section, if you need a C-section you get it from whoever’s there to do the surgery. I never got any good answers except “This is insurance policy” and “This is how we do things.” We were quite annoyed. I also got rejected by the midwives because of my VBAC calculator score. They have this questionnaire that essentially tells them their chances of dealing with you as a liability. It uses very few parameters like age and BMI. I think you have to be a 70 to be considered, and I was a 52. There was no discussion. It was just like “No, you don’t meet that. Sorry!” I went through a whole series of meetings with OBs that I thought would work ,and I did agree to work with one who was VBAC-supportive. This took several months of meeting at clinics all over the place. Then at 35 weeks, right before I was supposed to transfer to this OB, my family practice doctors were given the freedom of one last VBAC patient, and they chose me! We had a random 35 week appointment, and they walked in smiling saying this had happened in last couple days and they’d like me to be their guinea pig. I was like “Really!?” We were thrilled! It was lovely. My main doctor was at the birth the whole time and was able to do all the prenatal care. I didn’t have to change to a whole new set of people. Everything we did was to try and hope for a successful VBAC.

How did labor start with Simone start?

Apparently I grow babies to 41 weeks 5 days because she was the same number of days past her expected due date as Bell. For about a week before birth, I had been experiencing lots of nights thinking “I’m going to wake up in real labor.” Low level cramps, just lots of things seeming like they were picking up. I knew my body was starting to get ready. It was still happening at 41 weeks 3 days. I was starting to get concerned about what might be happening in there. Doctors were starting to get concerned because of the dates and the VBAC attempt. We didn’t start discussing induction until very late in that time period, but we definitely talked a lot more about induction that before. I had a non-stress test on Tuesday night. I went to the appointment and, again, was experiencing those contractions. The doctors were like “You’re contracting! Can you feel that?!” I was like “Yes...and remember how I told you that?” It was not a set of doctors I knew, they were random doctors who happened to be at the clinic that night. We had an induction appointment scheduled for 9pm that night, but they thought we should just go right then. They were seeing some heart decelerations then that they were starting to get concerned about.

We went to triage. My doctor met us and said to get just get me up to a room. We were still discussing what method we should use to induce me. Breaking my water was one option. Cook catheter was one option. We spent several hours with my family practice doctor and OBs who were on-call trying to determine which route would be safer and which route would be more expedient and successful for a VBAC. The concern with breaking the water was the cord could prolapse and slip out, but it would also put me on a timeline to labor quickly to reduce the risk of infection. We went with the catheter. 9pm that night, we did the catheter. Her head was super low! They had trouble getting around her head to put it in.

I was 4 or 5cm. Very similar labor. It started working pretty quickly. Contractions were just coming without much break. Pretty intense right away. Pretty much the same thing. In not much time at all I got to a 7 or 8. It was more intense than with Bell. The contractions were harder for me to get through. I threw up quite a few times, which I hadn’t done with Bell. I did a good job laboring, position changes and the tub. I remember I loved the sink and was just hanging. “I’ve found this, and I love this!” They would laugh atme because I would be like “I need to brush my teeth! Hold on a minute!” I’d brush really fast between contractions and then hang from the sink. Right around 8 cm, we talked about putting in an epidural, not for pain relief but to help my pelvic floor relax because it seemed like I was starting to stall out like I did with Bell. They tried to put an epidural in, but it didn’t work. I was not numb at all. I was still contracting. They tried again, in a space very close to the other epidural, and we were talking about letting that kick in. We were hoping it would let me sleep and let my pelvic floor relax. And then heart tones dropped really scary. They were in the 40’s. I remember it was more scary than with Bell. My doula’s face went white. The resident who was young and int training didn’t know what to do, so my doula was like “Get the doctor immediately!” and hit her arm. About 10 seconds later there were like 15 people in the room. This was faster than with Bell’s birth. My doctor said we should just go straight to C-section. It wasn’t an emergency C-section, but there was no discussion. Because we’d done so much work, it was a little harder. I’m not a crier at all, and I definitely cried. Essentially I started crying right away, but I said that I knew it was the right call, but it was a lot to deal with in a short period of time. It was a very anticlimactic end to all this prep work. On a dime, it just switched. I was much more worried. I was not in a labor zone at all, even though I was still contracting. It was just a lot. It moved very quickly after that. She was born at 5:10am.

Baby Simone

Baby Simone

I was still curious about all the early come-and-go labor. It was just sort of staying in the back of my mind. I was curious about the cord and the placenta. They’d been checking for that on non-stress tests and everything was fine, but there’d been no explanation. I was still hoping for answers. My doula reminded me that previously I’d asked “Do you think there’s a cord wrapped that’s not letting her descend?” After the surgery, I asked the surgeon and he said the cord was wrapped decently tight and that he would not be surprised if that’s what was causing the heart decelerations in labor. I was very interested to know that. My doula was like “You know, we don’t really know, but you asked that 3 weeks ago and that’s very likely that’s what was happening all along.” I just had a feeling.

But she was great! She was smaller than Bell by 8 oz, which surprised all of us! But she was great! And she was here! My family and I, these babies, that’s why surgery exists. I’m super grateful to have been so close to technology and help with safety. This is why these services are available. I feel very much grateful that I was able to have healthy, good feelings about my birth experiences afterwards because I personally know a lot of women who did everything they could, had C-sections and still have feelings to this day of failure or really struggling with the fact that they had to have surgery. I know it’s not easy for everyone. I’m very much a realist, not a super emotional person, so for me it was much more cut and dry. But I know that’s not the case for everyone. I feel very happy to feel content and feel very much at peace with my births.

Bell meeting Simone

Bell meeting Simone

What words of wisdom do you have for expectant parents?

I think I would just rely heavily on education and try to normalize things and let people learn to advocate for themselves and get help advocating for themselves as much as possible. I think asking tons of questions of all your providers is huge. If you can’t do it, get a team of people who can help you do it. Just arming yourself with as much information as possible and then having a support system that helps you wade through all that information. Feel strong in your decisions, and feel strong in your knowledge. Trust your body.

Thank you so much, Katie!

Maggie Mehr