Wednesday, April 8, 2009

A birth story

I know this is long, and please don’t feel obligated to read it, but I want to have everything I remember written down.

First, I should mention what the “plan” was. My biggest thing was that I didn’t want to have a c-section. I’ve fulfilled my quota of surgeries lately and didn’t want to have to recover from another. Because of that, I wanted to do everything I could to encourage a vaginal birth. I know that being induced greatly increases the chances of a c-section. Also getting an epidural, especially getting one too early, also increases the chances. Because of that, the plan was to go natural for as long as possible and hopefully avoid an epidural all together. I would do things that would naturally induce labor if my body was ready but I wouldn’t medically induce. I also wanted it to be just Jonathan and myself in the room during the birth and I didn’t want our family listening at the door. All of this was laid out in writing and we knew that it was just a plan.

Everything started on Monday the 30th when I had my weekly doctors visit. We got there on time but the doc got called away for an emergency surgery and a delivery and because I was past my due date they wouldn’t let me see a nurse, it had to be the doctor. When they finally took me back they hooked me up to the monitors to make sure the baby was doing okay. The only thing that was close to being worrisome were his fluid levels, they were still in the OK range but just. The doctor was vigorous with the exam to try and get my cervix to do something. I was still only ½ cm dilated but was now 25% effaced.

Up to this point I had tried everything I could think of to help start labor, accept one thing… the dreaded castor oil. So when I got home from the appointment I broke down. Desperate times call for desperate measures. I took ½ the amount recommended mixed into a chocolate shake. I figured at worst I’d spend some time on the toilet.

Nothing happened for a few hours after I took it. Then I took a few trips to the bathroom and had a few contractions. It was still light out so Jonathan and I took a walk. Shortly after, the contractions became very regular and got stronger. I think it was about 8:00 pm at this point. That’s when the contractions got strong enough and regular enough for me to decide to start tracking them. I had a contraction timer application on my iphone that I used and they went from 4-7 minutes apart to 2-4 minutes apart. Once they had been 3 minutes apart for a few hours and I really had to concentrate and breath through them we headed for the hospital. I though it might be a little early to head in but Jonathan was reading the instructions from the doctor that said to call when they were 5 minutes apart and he was getting a little anxious, so we went.

The car ride was horrid because I couldn’t move. At home when I could move I could find positions that would work and could focus on relaxing during the contractions. In the car I noticed that the whole lower half of my body would tensed up and there wasn’t anything I could do about it. It was about 1:30 am when we got there and checked in. The nurse we had was awesome. She hooked me up to the monitors but would let me stand next to the bed, move where the cords would allow, and sit on the birthing ball. Unfortunately the contractions slowed down at the hospital and my cervix hadn’t changed therefore classifying it as false labor. They gave me the option of staying and being induced because I was past my due date but I knew the chances of a c-section greatly increase with induction so instead we did the walk of shame and went home.

It was back into the car to head home. As we were leaving the hospital the contractions picked back up and started coming 1 ½ minutes apart. Contractions are timed from the beginning of one to the beginning of the next meaning I had about 30 seconds rest between them. We got home at about 3:15 am and I told Jonathan to get some rest and I would try and do the same. I had no luck at all. The contractions stayed 1 ½ minutes apart and great increased in intensity. I got into the tub and tried to relax there. We think this is where my water broke because when the doctor went to break it during labor he couldn’t find it. I only stayed in the tub for a bit because sitting didn’t work well for me and the intensity of the contractions was getting worse. I could feel the baby moving down and I felt like I was sitting on his head. I was moaning through them and I found that the only way I could get through them was to have the exercise ball in the laundry basket so it was about waist high and then lean over that. I was also wearing my tens until which helped a little too.

Around 6:00 am I started to get a little panicky. How in the hell could this be “false” labor? Before even waking Jonathan up I called the on-call doc and told him what was going on. I’m sure he could hear the panic in my voice and he told me to get back to the hospital. I either wanted this to get going or I wanted drugs and I had been up all night at this point. I also knew that if we waited much longer we would have to wait several hours longer to avoid traffic.

Another horrific car ride later and we were back at the hospital. I remember telling them that I wanted drugs as soon as the nurse walked into the room. They hooked me back up to the monitors but the nurse I had this time wouldn’t let me out of the bed. I wasn’t happy about that. The contractions slowed to about 3 minutes apart though so at least I had a bit of recovery time between them. When they checked me I was 1 ½ cm dilated and 80% effaced. YAY! Because I had made progress they were keeping me and I was having a baby.

From here, my time line gets a little blurry. The nurse that I had also had an intern with her and this was her first day in the maternity ward. She was the one who started my IV, which I was very nervous about at first but I figured whatever pain she inflicted couldn’t be any worse than what I was already in so I just went with it. I insisted on not having the IV in my hand, which the main nurse wasn’t thrilled about, but I didn’t care. She said it would be harder to start elsewhere and I told her I didn’t mind being stuck a few times if that is what it took. The intern was clearly very nervous but she got it on the first try and did just fine. While taking blood after she stuck it in she had some issues with holding it still but she eventually figured it out. Shortly after the IV was in they gave me some kind of pain med. It instantly knocked me out for about 20 minutes. After I woke up I still felt really groggy but was getting no pain relief from it at all. They said they could give me another dose but I could only imagine if it was doing that to me what it must be doing to the baby so I said no.

I think my doctor came in at this point. He said the baby’s head was low and everything looked great. Sometime in here I asked for the epidural. Had I been allowed out of the bed I would have gone longer but I remember looking at the clock and calculating that I had been in labor for about 15 hours at this point and awake for about 25. I needed rest and had determined that the hospital is not conducive to natural labor. Plus I think the IV drugs weakened my resolve a bit. Sometime after that the anesthesiologist came in and administered the epidural. Getting the first part of it where they put the stent in wasn’t a big deal, but putting the little tube into that was horrid. I had shooting pains down my right leg plus the contractions. I just remember making a lot of noise and Jonathan almost passing out. He wasn’t even looking but he got really woozy.

After that the intern put in my catheter and checked me. She got instructions from the nurse and did fine with it. She was really excited when she checked me and could feel the baby’s head. It was very cute. I was 4 cm at this point and I think they started some pitocin to speed things up a bit but I don’t think they left it on for long. The nurse was a little overly cautious about the baby’s heart rate. She though he was having what they call d-sells meaning that with every contraction the baby’s heart rate slows a little but takes a little longer than normal to catch back up when the contraction is over. When the doctor came in he said the baby looked perfect and wasn’t concerned at all.

At some point my mom came in and hung out with us for a while. Jonathan was able to eat and give the people in the waiting room some up-dates. I continued to rest and get rolled from side to side. We went through 4 different nurses total so there were some shift changes happening too. I remember getting checked and I was 7 cm dilated. I don’t know if the doc tried to break my water at 4 or 7. Either way he couldn’t find it and we determined it had broken on it’s own at some point. The next time the doctor came in I was 9. At this point it was about 5:30 pm and he thought I’d be pushing by 6:00. Sometime toward the end I developed a low-grade fever but I don’t remember when.

My cervix was thicker on the right side so they left me on my right side longer. All of the epidural meds drained to the right and I could feel the contractions on the left, and they were strong. I had a button that I could push for a boost of the epidural but I knew I was getting close to pushing and I wanted to be able to feel enough to push. Plus while laying on my right side the meds would just drain to the right and not go where I needed them to go. Eventually I was allowed to sit up which helped a bit. I was breathing and moaning through the contractions and the nurse pressed the boost button twice during contractions. I couldn’t tell her not to because I couldn’t talk. Shortly after they laid me on my left side and Jonathan discovered that the boost button wasn’t actually plugged in. Jonathan plugged it in and I pushed it once. It took a while to kick in but eventually I got a little relief. They talked about having the doc give me a big boost of the drugs but I refused because we were close. It took forever to get from 9 to 10, I think about 2 hours. But I also felt the baby moving down a bunch during that time. The doc originally thought we’d be pushing by 5:30 but we didn’t start until 7:30.

When the doc came back to check the nurse told him that the baby’s head was still high. He said that baby’s head was right there and had me push a few times. Jonathan got all excited because he could see the top of his head. The doctor left and the nurse got everything ready and we started pushing. Jonathan stared to get emotional at this time and I had to tell him to cut-it-out, I couldn’t take being emotional and pushing. They told me that one way I pushed was more effective than another but I couldn’t really tell the difference. I asked for the mirror and when I could see what was going on and what worked things went much faster. I was also shocked to see hair on the top of that little head!

The pushing part was the best. I was motivated, I could see that lots of progress was being made, and I knew it was almost over. I could feel each contraction coming on and knew when to push. It was two steps forward and one step back for a while. When I could push he would come out some and when the contraction was over he’s go back up a bit. The contractions were almost 3 minutes apart so I had plenty of time to rest between pushes. After about 20 minutes his little head crowned and there was suddenly lots of commotion. About 7 people were in the room. They had a neonatologist (preemie/newborn doctor) there because they hadn’t seen my water break and so they didn’t know if the baby had his first bowl movement in-utero.

When the doctor was there and they told me to push again I think it took 2 contractions to get his head out. The doc suctioned out his nose and mouth and all the fluid was clear. With the next contraction the rest of him slid out and this little wiggly person was placed on my chest. He was perfect in every way. I was stunned that a whole person had just come out of me. A nurse was there rubbing him down to clean him up a bit and encourage him to cry and clear his lungs. Jonathan cut the cord and they took the baby to get him cleaned up and do his first checks.

The doctor collected the cord blood and then delivered the placenta. I felt so much better after that thing was out, and then the doc stitched me up. I had a small tear. We spent a little time with the baby, nursed for the first time, and then had some family in to meet him.

The whole experience was very surreal. I’m still amazed that I grew this whole person and that he came out of me. The only thing I can think to compare it to is sky-diving. There’s tons of suspense and anticipation followed by the biggest thrill you can imagine.

Overall I’m very pleased with how things turned out. I’m glad that I got the epidural and I’m also glad that I waited as long as I did to get it. I’m not thrilled that everyone had their ears pressed to the door listening to me give birth, as I had specifically listed in my birth plan that I didn’t want that, but there’s nothing that can be done about it now. IF I were to do this again I would want a doula to help things go more how I want them to and to help me go naturally a little longer.

1 comment:

Jennifer Harris said...

Clearly your doctor missed that part in the plan too, as he was the one who told us to listen outside the door.