Thursday, November 20, 2014

The birth story

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I know I promised to have the birth story up within a few days, but getting it all written out in a nice way just had to wait.  I jotted down a short version so I could go back and improve it though.  If you aren't interested in birth stories, feel free to skip right over this post.  I don't really feel like this is a particularly difficult birth story to read, but it's up to you :-)

I'll start by saying a few things about birth and my feelings about labor in general.  First, I would highly recommend that anyone having a baby, especially for the first time, should take some kind of birth class.  This is even more important if you are hoping to do a natural or unmedicated birth.  But even if you're not, I think your odds of having a less stressful and/or less scary birth experience are much better if you have an idea of what to expect.  I was lucky enough to have witnessed births and have a lot of knowledge about the birth process, but even with that I think it was still best to take a class, especially for the benefit of my husband.

Second, I did have a birth plan, but I made a point of telling everyone that it wasn't all that specific and I promised not to get hung up on things since being a nurse I know enough to know that trying to plan your birth with a typed sheet of paper can be silly.  (Anyone seen What to Expect When You're Expecting and love the part where Elizabeth Banks freaks out about how this isn't in her birth plan?)  As it turned out, most things if my birth plan went the opposite, but it's not like I ended up with an overall feeling that everything went wrong.  On the contrary, I thought my birth was a good experience and I'm more than ready to try it again.

I didn't know it at the time, but apparently I began having some contractions Thursday night.  I pointed out to Brice that my belly was very square-looking, but I assumed it was just the position the baby was in.

The next day I had a midwife appointment at 2pm.  She asked if I had been having any contractions, to which I said "no".  She didn't really believe that could be true, so she kept watching my belly during the appointment.  When she went to use the doppler my belly got square again and she said "These are contractions".  Oh, how about that!

I had taken my car to have two recalls repaired in the morning so when I got home I went to pick up the car, still having some contractions.  Apparently telling men at a car dealership that you are currently having contractions is a way to get your car brought to you really fast!  When I got home I still had a follow-up with a client.  I was still having the contractions and I told the client and just kind of tried to pay a little bit of attention to when they were coming.  It varied a lot, but it was probably 10-12 minutes apart most of the time.  After I got home from meeting with her the doula we hired wanted to know if the contractions were timeable and what they were.  (She was in Vermont for the weekend and wanted to figure out if she needed to come back.)  So a little after 6 I went up to my bed to try to time the contractions and see if they might be slowing down and going away or if this might be it.  They were still irregular, but not stopping.  Our friends were going out to celebrate someone's last day of work before starting a new job, but I just didn't think we should go sice activity was not going to help the contractions slow down and I still thought it might be just a false alarm.  So we decided to order Chinese food.  When we were eating, I had a feeling that this might be my last meal.  After we ate we decided to watch the episodes of the Office where Pam was in labor and wouldn't go to the hospital :-)

It got worse while watching the Office, around 9 or 10.  I even began to throw up a couple of times--very familiar to my past experiences with my monthly visitor.  Brice sat with me through them, but he went to bed at midnight, with my encouragement.  He wanted me to come up, but I knew I wouldn't be able to sit still in the bed and would keep him up.  (I still wasn't really sure if this was it).  I stayed on the couch, but I definitely couldn't sleep and just kept using the timer on my iPod to keep track of contractions and texting the doula.  I continued to feel sick to my stomach and throw up.  I think it was around 5am when she asked me to check in and I said they were less than 10 minutes apart so she got ready to drive back.  I ended up waking Brice up at 6am.  I told him that if I had any idea how helpful he was going to be during contractions I never would have let him go to bed!  I laid down on the bed and we did contractions there for a long time with music and counter-pressure on my back from Brice.  Brice was in touch with the midwife and the doula.  She suggested getting in the shower so I tried that and it turned out to be really wonderfully helpful.  I kept telling Brice that labor actually felt very familiar to me from my past experience with my monthly troubles.  The doula arrived at our house around 10 with electrolyte replacement drinks.  This was a bit of a concern for everyone since I was headed into hard labor dehydrated.  We all decided to go to the hospital at 11 when my contractions were less than 2 minutes apart.  I made sure Brice took one last bump photo:
Isn't this like the best face ever??
It really was a beautiful day as we left for our super-quick drive to the hospital (3 minutes if we hit green lights).

Brice was able to leave the car at the door and come in with me in the wheelchair while the doula was parking.  He did exactly what he was told to do in our class when I had a contraction--he told the guy that was helping us that he needed to stop and be there with me when I was having a contraction.  It was really cool to see him doing so well.  I got my bracelet and was registered and then the doula came in to stay with me while Brice got the car parked.  My nurse came and got me and the doula and got me settled in the room (it turned out to be the same room the where the doula had her third baby).

I was 6cm when the midwife first checked me.  I was so glad she was the midwife on call--she was who I was hoping to get and she was totally awesome the whole time.  I had hoped to have a water birth so I tried the tub.  Unfortunately, the baby was still turned the opposite way of how he needed to be (the back of his head was at my back) so I was unable to be in a comfortable position that would also help the baby turn while I was in the tub.  (This position for him also led to lots of back labor.)  I ended up getting out of the tub and into the shower instead.  I spent a long time in the shower again, and then back to contractions on the bed.  I also ended up getting a bag of fluids (I didn't want an IV) because of my dehydration.  I tried putting a foot up on a stool and rocking to see if that would help him turn.  When the midwife checked me again I was still at 6cm.  I was having a lot of pressure so I thought it would be better than that.  The midwife decided she should break my water, thinking there might be less pressure for me and that it might help me dilate more.  I continued to go back and forth between the bed and shower, standing bent over the bed with my foot up on the stool, swaying, trying to get him to turn still.  When the midwife checked me again I was still only 7cm at around 9something that night.  Since I still hadn't made much progress the midwife recommended pitocin, but also epidural for rest since I'd had no sleep.  She was really awesome and gentle about what she recommended and didn't push me, but I could tell it was what she thought was best.  Brice and I talked a bit and the doula as well.  I didn't want the epidural, or the pitocin (it was all the opposite of my birth plan), but I remembered our childbirth instructor in the back of my head warning that it was most important to get my vaginal birth.  Knowing what I knew about chances of a c-section if I continued to not progress, it seemed like the best plan to go ahead with the pitocin.  If I had gotten any sleep (at this point I had been awake since 7:45 on Friday morning), I would have considered trying the pitocin without the epidural.  But I definitely didn't want to get stuck and exhausted while trying to push.  I wanted to do everything to avoid a c-section and this seemed best and everyone agreed and supported it.  I was really, really scared of the epidural though.  (I was quite scared of not being able to move during contractions since I was contracting hard and fast at that point.)  I didn't have to wait for the epidural (which was good since I was so nervous about it).  The guy came in around 10something.  This was definitely where I lost my cool and got very upset and started crying.  I started saying the Hail Mary to try to be calm and Brice was awesome and was saying it with me.  (The doula later said she was so impressed with how we handled that together.)  Of course now that I had the epidural, I had to have fluids constantly and have the fetal monitor on constantly.

I calmed down after it was over and then it was very weird to see contractions happening but not feel them.  There was a lot of activity as everyone tried to get settled and I kept thinking I had to go to the bathroom :-)  We eventually got to sleep for maybe an hour and a half.  The nurse came to check on the monitor a few times and the third time or so I told her I felt like I needed to push.  She was excited and had the midwife check me.  I was fully dilated!  I began getting ready to push--I texted the doula to come back in from where she was resting, I donned my "pushing" headband, my necklace with Malachi's name, and my glasses.  I got my Rosary beads (the same ones we used when we prayed for both babies) and I read some prayers from my Mother's Manual that my friend gave to me at the start of this pregnancy, including one for the midwife (she appreciated this!).  I also texted friends and family to let them know I was about to start pushing around 1:20.

First I pushed normally, basically on my back but turned a bit to one side and the other.  Brice was awesome at remembering all of the specific instructions about how to push (something he was good at paying attention to while I was kinda like, yeah, general idea, etc, etc!)  After a few pushes, I finally began making progress.  I felt confident during everything since the midwife had told me the birth would be vaginal, no matter what since he was low enough at this point.  I did have to ask to have the epidural turned down some because I couldn't feel well enough.  They ended up turning it back up later though because they thought I needed it, but I didn't feel like I did.  This led me to believe that things were happening that I wasn't seeing and probably didn't want to see!  I tried pushing with this bar across the top of the bed and a sheet tied to it to hold onto and I liked that a lot.  I had some very good pushes that way, but I couldn't seem to get the baby's head under part of my pelvis.  I wanted to try pushing in some other positions, but he was having some signs of distress (heartrate dropping when I pushed) and I had to stay in a certain position.  At one point they did see some meconium so the midwife told me that we needed to have a pediatrician present at his birth to check him out.  She also told me she needed to call for the back-up physician to come just in case.  To her credit, the midwife was really good about staying calm, but I knew it was a bigger deal than that.  I could see on her face that the doctor was going to be needed.  When she arrived the midwife and the physician watched some pushes and the monitor and then decided vacuum assistance was needed.  And then the doctor said I needed an episiotomy.  Cue second freak out.  This one was much shorter  though as I was assured that this really was a better idea than tearing naturally (the doula was looking and told me later that my swelling was more than she'd seen and she agreed with the episiotomy).  Remembering that I had the epidural to get me through the repair process anyway, we went ahead.  I was told to return to pushing normally and the vacuum was used very briefly to quickly get the head under that part of my pelvis that was causing the problem.  And then I just pushed him the rest of the way out!  They threw him immediately onto my chest and instead of crying like I thought I might, I laughed because I couldn't believe there was a whole baby on my chest!  I had such a disconnect with what I was doing and the result somehow.  It was just too weird to think that this was the little thing moving inside of me.  Brice did cry :-)  He was taken away right after that.  His cord had to be clamped right away due to the meconium.  We listened for him to cry as they were doing all of his checks.  His Apgars were 8 and 9 and he weighed 6lbs 12oz.  They brought him back to me for a few minutes and he did latch and had some colostrum.  The peds NP explained that his breathing was off so they would take him away for assessment.  Brice went with him and they tried to do the EKG he needed because of the possible heart block (the reason I had all those fetal echocardiograms while I was pregnant).  Brice was gone with him for over an hour and then ended up coming back without him since he was frustrated at how the EKG was being handled.  It was good he had somewhere to go though while I was getting stitched up and it gave us all a chance to get a good look at the placenta, something he would not have enjoyed :-)  The doula stayed with me until Brice got back, but it had already been such a looooong labor for her so she left before they brought the baby back.  All of his checks were fine and I didn't get upset about him needing to be gone so long.  It was all fine in the end.

So very little from my birth plan went the way it was supposed to, but I didn't walk away disappointed.  Everything that had to be changed came individually and was addressed one thing at a time and there were good reasons for each change.  I wouldn't change anything unless I had the opportunity to make labor progress faster so that those changes didn't need to happen :-)

As far as the epidural...while some women might be disappointed to have gotten to the 11th hour and then had an epidural, I am glad I went as long as I did.  I know what labor is like and I know I can handle it on my own without drugs.  I had a very long and hard labor and I did it on my own for a long time.  I certainly always wondered what labor really felt like and since most women seem unable to describe what it feels like I would say that I'm happy to describe it to any woman who doesn't know.  I also think that my past experience with very similar pain made it so much easier and not as scary for me and I can definitely see how women without my experience would be much more nervous and doubt their ability to deal with labor.  And this would be compounded if you have an epidural early.  I would certainly doubt my ability to handle labor naturally for a future birth if I had an early epidural with a first birth.  But in the end I would tell women they can definitely do it, but only if you want to and it's important to you.  Knowing that I had the advantage of labor feeling familiar to me I can tell how hard it would have been without it and natural birth is great--if that's what you want.  I hope the next time goes a little more like what I hoped this time would be, but even if it doesn't, that's fine, because it's not a good idea to be rigid about something so out of your control.

I also ended up being absolutely amazed at how well my husband handled everything.  He told me he didn't think natural was what he would have chosen, but he was really supportive of me wanting to do it and he did so, so well.  (Medical things and blood are not his thing at all.  Tip for similar husbands: take off your glasses at the end--very easy way to cope!)  Again, I think the class we took was really beneficial for him.  I was also extremely glad that we had the doula and I would definitely recommend that route as well.  (And I want to point out that I never once yelled at him and told him he did this to me or that it was all his fault!)

So let's see...I did not have a waterbirth like I wanted, I did have an IV, I did have an epidural, I did have pitocin, I did end up on the continuous fetal monitor, I did have an episiotomy, the cord was clamped immediately instead of waiting for the pulsing to stop, and I did not get to hold him for very long on my chest at all (though I did get him for a minute, maybe 2).  But I didn't have a c-section and I was fine and healthy and so was he.  So it was all great :-)


  1. So awesome you were able to keep everything in perspective :) When my mom had her fifth, and she's a nurse too, she had to be induced with pitocin. Because she had worked in OB for over a year, she insisted on the epidural first before they started pitocin because she remembered how awful the pitocin contractions were! :)

  2. Wow! So amazing. Thank you for writing that up. And congratulations on your beautiful little boy. :)


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