First some back ground information to out everything in context. I currently live and work in Rome, Italy. The Italian health care system can be a bit out dated with regards to L&D so even before I became pregnant I had decided that as long as I was having a healthy, low risk pregnancy I wanted my primary care giver to be a midwife and was going to opt to deliver at a birthing center. Feeling comfortable during such an intimate time was very important. This decision didn't come lightly (prior to working in Rome I worked almost 10 years as a pediatric emergency nurse), so I was all to familiar about the risks. 

Finding an English speaking midwife didn't leave many options and I decided to go with a more experienced midwife (over 20 years). For the most part my pregnancy care went well and my partner enjoyed the longer personal appointments. However, we chose to ignore the talks about the moon and our star signs.  

Now on to the birth story. I 38 weeks and 4 days and finally on maternity leave. I had somethings to get done before delivering most of which included writing 3 papers for my Master's degree (due 1 month after the little ones due date) and I had been procrastinating so much the week before. I starting my day off with a dog walk, 15 minutes into my walk I felt a huge gush then water running down my leg and into my Uggs soaking my track pants. I pick up the dog poo, waddle home (15 min away), up the elevator, where I had to clean due to the puddle. I let my husband and midwife know and continued my day. My contractions were no more regular then the premodial labor I was experience for the past few nights. 

I continued to labor at home bouncing on a ball, writing my paper and watching Grey's. My midwife came and checked me and told me I was progressing and she will be back later in the evening.  I had asked her not to tell me how many cm dilated I was fearing a number or no progression would make me overthink things. Around 3pm I took the dog for a long 3km walked and about  3/4 of the way things were picking up. Through out the evening after my husband came home things were getting more intense and contractions closer together and I was no longer able to sit on the ball or at all during the contractions. I had my own way of coping and making it through the contractions. The one thing that didn't stop after the contractions was the lower back pain (I should have cluded in). My midwife checked me at 9pm and at 10:30pm my husband said we should go. He was timing the contractions and they were 4 to 5 min apart.

We arrived at 11pm and was checked again. While my midwife prepared the pool I got an overwhelming feeling of nausea and my contractions were way more intense. The only way to cope was to be on all fours since I was having back labor. The pool was a life saver. Within 2 hours I felt the urge to push, I was checked again and my midwife said go ahead. I was looking forward to pushing as I was told it was something to focus the contractions to. Almost like a relief, with the 1st push I felt intense pain in my sacrum (tailbone), as if it were about to explode. However, I continued pushing. After 2 more hours in the pool my midwife suggested to get out and change positions. So I sat was squating and pushing during each contraction, the pain was worse in the position but the hope was to move the baby down the birth canal more. It did somewhat work and after an hour I could feel the very top of his head. My legs were shaking and numb so I got back into bed on all fours. My contractions also slowed down. At this point my husband was exausted mentally so he had to step out a bit, my midwife was there and stated she would stay with me. Well she didn't, she left the room. At first this was ok, I was able to really focus on what I needed to do and I felt that I was able to progress more. After about 20 minutes, the pain was started to get intolerable, I started to panic and was alone. My husband and then the midwife came in and since I was pushing for 4 hours asked what the next step was. We got no answer. 

So I kept pushing, the babies head was out a little bit more but everytime I check from hour 4 to 5, the head had not moved. My contractions slowed to every 10 minutes, but due to the constant back pain that would increase with pushing my body would no longer relax enough to allow be to push properly. Again at 5 hours of pushing my husband asked how long can I push for, again no answer. At that point, I said I think we should go to the hospital. I just felt something was not right. The baby was being checked the whole time and was fine. It another hour to get to the hospital. I was told the midwife was checking who was on call at the private hospital we registered at vs the public hospital. Turns out the ob on call at the private was not the best. So off to the public hospital we went. 

In Italy when you are in labor you must go to the emergency room where the emergency OB sees you then decides what to do. I get there and they want to check me, I told them there was no way I was lying down. They insisted, however my Italian is not the best especially exausted in labor so I just pulled my pants down and showed them. The nurse was super surprised that they could see the very top of the head and hair. At that point my contractions were 15 to 20 min apart but lasting 90 seconds. They rushed me upstairs and started to prepare me for a c-section. In Italy they don't do assisted deliveries via vaccum or forceps. They also do not give you an epidural if you haven't had a pre appointment with the anesthesiologist. As I was getting examined and the baby checked. They were noticing that the heart rate was no longer recovering. So rushing me through the consent and registration I asked my midwife to translate for me, I am a nurse but L&D is not my area of expertise. Her response, "don't sign it, don't get a c-section". I was in disbelief. I signed it and within 5 minutes I was in the OR getting ready. The c-section took longer then expected since the doctors had to push the baby back up. It turns our the baby had turned and was sunny side up with the head tilted sideways. The back of the head stuck on my tailbone. Despite all of that my husband and I welcomed a healthy baby boy (despite some bruising) at 7:20am February 19th, weighing 6lbs 4 oz. 

My stay at the hospital was good, the staff of midwives, doctors and nurses took good care of us. And I improved my Italian. However I came out with a distrust and disappointment in my midwife and her lack of communication. I also feel she personally didn't want me to have a section because it reflects poor on her (which is not the case). I don't see my birth story as a bad or negative one, just a different one. I am happy that everybody was healthy and there were no bad outcomes. Things never go as planned. I gave my midwife the feed back, but the lack of communication will lead me to seek different care when and if I choose to have another.