Monday, April 26, 2010

Robbie's Birth Story (LONG, with pics)

After having no Braxton-Hicks contractions or “false labor” the entire pregnancy, I wasn’t really sure what to expect labor to feel like. On March 23, I was nervous because I was 10 days past my “due date” and had a midwife appointment the next day. My mom was staying with us and getting worried about me being “past due”, and the last ultrasound had predicted a 10 pound 12 ounce baby, so I was feeling like I needed to hurry up and go into labor or there was going to be even more pressure on me to ask for an induction at the appointment or early the next week, just to hurry up and have the baby. I didn’t want to take any herbs, castor oil, etc, and really didn’t want to use medications for induction either, but I sort of relented and figured I’d try fooling around some with my husband, because I heard it could induce labor, and the natural prostaglandins would help soften my cervix as well. Apparently, it worked, but now I wonder if we didn’t try to rush things too much.

Afterwards, I couldn’t sleep because my lower back was hurting like crazy and I was nauseous and having cramps below my belly button. I ended up Googling early labor signs and started timing the contractions around 3 or 4am, when I was sure they really were contractions, as well as breaking out the Blackberry and “tweeting” a few updates on what was happening. When my husband’s alarm went off around 4am, I told him he might as well call out of work, because I was in labor and we were going to have a baby today instead. I was planning on waiting until my midwife’s office opened and going there first to see if I was in labor, but the contractions were pretty steady and 3-4 minutes apart, so Billy (my husband) woke up my mom while I took a shower, and we started loading up the car to go to the hospital. Over an hour passed and they were still coming about 3 minutes apart, so we figured we’d better go ahead to the hospital (everything I’d read or been told said to do so when contractions were 5 minutes apart for over an hour, and my mom and sister both had quick labors, so we were worried about waiting too late). I was a little confused because the pain wasn’t really bad, but the timing was so close I agreed it was better to be safe, and we left for the hospital a little after 6am.



I was still feeling pretty normal when I got to the hospital, and declined a wheelchair so I could walk to my own room. They checked me and I was only dilated 1cm and 70% effaced but, because I was having regular contractions they decided to monitor me to see what was going on and decide whether to admit me or send me back home. The monitor showed regular contractions about 3½ minutes apart, so they said I should stay a while and see what happened. Part of me wishes I had went home or went out and walked, but I stayed in the hospital instead, because I worried my mom would think I was sort of nuts for wanting to leave the hospital while in labor and go hit the track instead (my original plan had been to labor at home as long as possible, walk as much as I could, and try to wait until I was at least 6-7cm before going to the hospital, but I had no real way of judging that other than relying on timing the contractions). Around 7:50am, they told me to plan on staying, so I had my husband call my doula and tell her I was in labor. He also called the film crew (we were in one of the Discovery Health shows) to let them know to be ready, which turned out the be a pain in the butt because they kept calling back all day wanting to know how far along I was, when he was going to be born, etc, so they could make it there in time but not show up too early – if that was predictable, it would’ve saved everyone involved a lot of waiting and decision making.

I was trying to walk around and move as much as possible, to dilate more, and to get the contractions to pick up – they were still pretty regular, but not very strong feeling (then again, I have a high pain tolerance, and was afraid at first I might me underestimating them, because they were close together and looked strong on the monitor). A little past 10am, my midwife showed up and checked me. I was dilated to 3cm, 75% effaced, and the contractions were coming about 2-4 minutes apart, so they decided to officially admit me to the hospital. My doula had just arrived, and I was snacking on cheese, fruit, crackers, and Propel water to give me some energy, and using the hourly “breaks” when I was stuck in bed on the fetal monitor to update my status on Twitter.

I continued trying to walk the halls as much as I could, change positions, and sit/bounce on my birthing ball, but it seemed like every time I really got into a good rhythm or pattern my “hour” was up and I had to get back in bed for the fetal monitor. After 2pm, I was still only at 3cm. Baby & I were doing well, but I was getting impatient with my lack of progress, and feeling like all the laying in bed was slowing things down and I needed to be moving more. I kept thinking I would love to be able to go for a walk at one of the nearby parks – it was the first nice Spring day, 74 degrees outside, and sunny with a slight breeze. One of the nurses was really getting on my nerves, because she kept “forgetting” about me, and trying to keep me on the monitor 30-45 minutes out of the hour, then kept mentioning how I was headed for a c-section if I didn’t progress more, which was the last thing I wanted to hear at that time (she also got pretty bossy about some other things, which led to my midwife taking her aside and talking to her – things got better after that, whatever was said). I remember being so ticked off at one point that I told my doula if I heard the word c-section one more time I was going to go home and have the baby in my living room – at the time, I was half serious.

By 5pm the contractions were getting more intense, around 3 minutes apart, and I figured I had to be dilating more, so my husband started blowing up the birth pool and filling it with warm water. Around 6pm, my midwife came back in to check me and talk with me some. I was 80% effaced, but still only dilated 3cm and -2 station. My midwife said that we could break my water to see if the additional pressure from the baby without the cushion of fluid would allow me to dilate more, but that it would make the contractions more painful. There was also a good chance that there would be meconium in the fluid, since I had gone past 41 weeks, and that would mean I would have to stay hooked up to the monitors. It would also mean we were looking at a possible c-section if labor didn’t pick back up and start progressing within a few hours after my water was broken. We decided the best thing to do would be wait until the next day, so I could rest and see if things would pick up on their own. If I was looking at the chance of a surgical delivery, it made more since not to risk having it in the middle of the night when everyone would be tired and probably not at their best, and I was wanting to hold off as long as possible to avoid that outcome anyway. The best thing is that she changed the orders so I only had to be on the monitor 15 minutes every 4 hours, and told the nurse not to wake me in the night to check me, so I could get some rest, and have time out of bed to try to get the contractions going more.

After the midwife left, my doula massaged my ankles, feet, and hands. It felt great and helped me to relax some, and she was also stimulating some acupressure points to make the contractions get stronger and closer together. Around 7pm, I decided to get in the birthing pool for a while, to help me relax. The water felt great, but I worried about relaxing too much and stopping any progress I was making, so I got out of the tub around 8 and went walking some more in the halls. The contractions would get stronger for a while then fade back out. For a while, my mom and doula both left, and my husband and I tried some nipple stimulation and time together just cuddling to try to relax me and get the contractions to pick back up. It worked some, but I was getting tense because I felt like people were giving up on me and assuming I was heading for a c-section, and it was making me tense because I was aggravated with them and starting to lose faith in myself and my body.

Around 9pm, the Discovery camera crew showed up to film part of my labor for the documentary. I was back in the birth pool at this point, so I just did the interview from their (in a swimsuit top and lycra skirt, so I was covered up). I don’t really remember much of the interview, just that I was glad it was done because Billy was getting ill that they kept calling, and it made me feel like he was mad at me because I was the one who’d agreed to the whole television thing.

Around 10:30, my midwife came and checked me again, and I was still at 3cm with no real progress. She recommended trying to rest and starting over again tomorrow. I think she know how frustrated I was getting, and she even offered to stay the night at the hospital, but I thought it was best for everyone to get what sleep they could in case tomorrow was another long day. At midnight, my husband took my mom back to our house so she could sleep, then came back to the hospital because I wanted him there with me overnight. My doula stayed with me until he got back because I was still having contractions every 3 minutes, just strong enough to keep me awake. When Billy got back, we decided it was best for her to go home and get some rest as well, and we’d see everyone in the morning and hope for some progress.
  
I didn’t get much sleep, but I tried to relax and put myself in a more positive frame of mind. About the time I was dosing off, around 3:30am, the nurse came in to put me on the monitor – I remembered my midwife saying not to wake me up, but she’d already woken me, so I figured it was easier to let them do it than to try to argue and end up waking my husband as well (he was sleeping like a baby the whole time). My midwife came in at 7:30 and checked me again. No change, but she said that not unusual since I had been relaxing in bed all night. She said she’d be back around noon to check me again. My doula had arrived a little beforehand, and she walked with me out in the hallway some more while my husband warmed up the birth pool again. I had planned not to get in the pool until I was past 5cm originally, but at this point labor wasn’t really going to slow down much more, and the warm water was helping me relax, which I needed badly. I was having regular contractions again from the walking, but was getting so tense and sore in my lower back – I wonder if all the tension wasn’t keeping my body from relaxing enough to open up. One crazy thing that started the night before and continued all day – I kept having to pee like crazy, but never felt like my bladder was emptying – it’s like everything in my body was just claming down and refusing to let go. My doula reminded me to keep drinking water to stay hydrated, and I ate a little more fruit, cheese, and crackers for energy, because I figured I’d be put on NOP (no food/drink) soon if I hadn’t made any progress. My husband talked to me some about the baby, name choices, etc, to try to distract me, but I felt like everyone had pretty much given up on any hope of a natural birth, and it was wearing me down and keeping me from getting into my “zone”.

My midwife came around 12:15pm, and I was still only at 3cm. I was 100% effaced and baby was still at -1 station, so she asked if she could break my waters as a last attempt to get things moving (we had agreed no pitocin, cytotec, etc ahead of time – I did not want any of these medications because of risks, and she did not like using pit for large babies or “failure to progress” because she said usually there was a reason if they were taking a while to come, and the meds just ended up causing distress and more problems in those cases). Because there was meconium in the fluid, I had to be kept on the monitor until the birth. I knew that if I hadn’t made any more progress or dilated further within 2 hours, then she’d call the doctor and plan for a c-section that afternoon. My husband and doula began emptying the birth pool and putting it away to make more space in the room, and I was sad that I wouldn’t be able to have my baby in the water, but hopeful that my labor would pick up and I’d still be able to have him vaginally, because the contractions certainly hurt much worse while stuck in bed (I had no pain medications during labor, didn’t really need/want them even at this point, but it was lot more uncomfortable not having the water or as much movement to help deal with things).

At 2:15pm, my midwife checked me again, and there was still no change. She told me she was so sorry that things weren’t working, but we’d tried everything we could, and I would probably have to have the baby by cesarean. She asked me if this was OK, and I agreed to it, because I didn’t see any change happening either, especially now that I was stuck in bed, and didn’t want to wait too long and risk having problems. She told me she would check one more time just before the surgery, but that we would go through with it if there was no change then. I cried for a while after she left the room, because I didn’t know what else to do. I’d tried so hard to plan and do everything to have the best birth I could, and things were just not turning out that way. Everyone was supportive and tried to comfort me, but I don’t think anyone really knew how much it would’ve meant to me to be able to have the kind of birth I had planned, because I really wanted the first few moments of my baby’s life to be calm, peaceful, and bonding with me, not sudden, sterile, and surrounded by strangers. My midwife told me the surgery was scheduled for 5:30pm, and they’d come get me around 5 to put in the spinal for anesthesia. Waiting until then was the hardest part of the whole labor – I was still having contractions, and now they really hurt since I was laying on the bed and just physically and emotionally drained, plus it seemed so pointless to me to be having these contractions now without an epidural or pain medication since I was having a c-section anyway.

While I spoke with the anesthesiologist and signed the consent forms, my husband dressed in scrubs so he could go to the OR with me, and my doula explained to him what was going to happen, and tried to prepare him as best she could. They stayed outside the doors while I got the spinal, then my husband came in to be with me, and my doula went and got my mom so she could wait with her to see the baby.

The surgery itself wasn’t as bad as I’d expected, but it was still pretty freaky just knowing what they were doing and not feeling or seeing anything. My midwife had asked my husband if she should come, and he told her I’d feel better with her there, which I did, and my pediatrician had just gotten off call, so she also came to the ER, so she was able to check my son immediately after birth. They kept me informed about what was happening, sent in a nurse with a digital camera to take photos for us, and followed as much of my birth plan as they could, which I really appreciate, and the doctor and anesthesiologist were both talking to me to help keep me calm. Two things I appreciate, that I didn’t realize are not the norm, is that they did not restrain my arms – just told me to keep them flat and behind the drape, and they did not do a regular catheter, just an “in and out” under anesthesia to drain my bladder because I told them I’d been having trouble peeing all day. I knew when they got my baby out, because I heard one of the nurses say “Oh, my God”, and the doctor quickly assured me that he was OK and looked healthy, and I heard him come out screaming (so loud they said you could hear it at the end of the hall, past 2 sets of doors, where my mom & doula were waiting).  I remember asking If he was OK, and then saying “It’s not twins, is it?” when I heard that – it turns out the cord was around his neck twice, and his head was turned partially facing my hip, which was keeping him wedged up high and not giving him enough slack in the cord to descend, which is why I didn’t dilate more – his head wasn’t pressing on my cervix enough for it to open and, if it had, there could’ve been complications that would’ve made the birth much more risky. It took what seemed like forever, but was probably a few minutes, for them to check his first Apgar score, then they brought him over for me to see and touch him before taking him to the nursery. My husband and mom went to the nursery with the baby, and my doula stayed to wait for me and accompany me back to the room (they have the surgery suites on the L&D floor, so I was able to recover in my room, which also meant they could get the baby to me much sooner). I asked my doctor about a possible VBAC while he was sewing me up, and he said that he thought I’d be a good candidate for one, and would talk to me at my next midwife appointment about the possibility (he’s very open to them, just wants me to wait at least 18 months between births to give everything plenty of time to heal, but said that he’d be fine with it even with another baby post-dates or expected to be big). He did use the double layer sutures on my uterus, which are supposed to be stronger and safer for births after cesarean.

While I was being cleaned up and changing clothes after the surgery, they filled me in on the details – Robbie was born at 5:43pm, weighed 10 lbs. 3oz., and was 22 inches long. His Apgars were 8 & 9, which are very good (and explain the loud crying at birth - good, strong lungs).

My pediatrician came in and double checked with me about what procedures we did and did not want done in the nursery, so I am very glad she stayed. I had already discussed with her, and had in my birth plan, that we were not circumcising him or getting the Hepatitis B vaccination at birth, and that we were also declining the Vitamin K shot to give oral drops instead and wanting to delay the Erythromycin (eye drops) until after he’d breastfed (I didn’t want them at all, but was under the impression that they’re required by law because of one of NC’s administrative health codes). The nursery nurse had an issue with this and, when Billy told her we were declining all of the above and he wanted the baby to see more before getting the eye drops, threatened to call social services over it. The pediatrician told me I could decline it all and, if an issue was made of it, she’d speak up on our behalf, so she went back and told the nurse we were waiving everything but the PKU (heel stick) and blood sugar check (because of his size), and that he was to be brought to my room immediately. I am so glad she was there to help stick up for us, and that my husband never let the baby out of his sight.

By 7pm, Robbie was brought in to the room with me, along with my husband, my mom, and my doula (yes, I’m vain, but I didn’t want anyone in there until I had been cleaned up some and changed gowns). Robbie breastfed immediately and the nurses said his latch was great. From that point on, he did not leave my bed or the bassinet right beside of it – there was no way I was going to send him to the nursery without me, so all tests, including the hearing test, were done right there in the room. They were going to bring in a warmer at first because he was a little cold, but I got the nurse to bring us a bunch of warm blankets for the bed, and managed to keep is temperature up with him laying on my chest under the blankets instead. It was so great finally getting to hold him and bond with him.

I was kept in the hospital the next day for recovery from the birth and surgery, and was up walking around by that morning (no catheter, so after using a bedpan once because I couldn’t get up, I made my mind up to walk to the bathroom a couple hours later). Most of that day was spent bonding with my baby and nursing him every couple hours, trying to get some rest in between. The doctor came by to check on me, the pediatrician checked the bay, and my midwife came by (on her day off) to see how we were both doing. The next morning, I was walking around and sitting up a fair amount, baby and I were both doing well, so we were released to go home. My mom stayed for a few more days, and my husband had 2 days before he had to go back to work, then I was pretty much on my own during the day time. It was overwhelming at first, because it took a lot of time and energy trying to take care of a baby and recover from surgery, but in a way I was glad to have some alone time with the baby and a chance to get some rest.

6 comments:

  1. Oh Mama, congratulations! Don't let anyone make you feel bad or ashamed for consenting to the c/s - it was obvious that it was needed. You have a beautiful baby, and you're off to a wonderful start!

    Many blessings on you and your beautiful family. :)

    ReplyDelete
  2. This sounds so similar to my sister's labor and c-section last year. She never went beyond a 4 during 50 hours of labor, then had a 10 lb 3 oz baby at 5:03 pm via cesarean. She started off at home though and transferred to the hospital at 40 hours of labor. Baby was posterior and acynclitic (sp?).

    This is how she described her feelings about it:
    "I know that without modern medicine that Claire and I might not be here. I know how blessed we are to have a healthy baby that we got to take home. But that doesn't mean I haven't planned and hoped and dreamed of this birth for years. It doesn't mean that it doesn't still hurt. My sweet baby girl is perfect and beautiful and healthy and she just wasn't going to come out on her own. My mind knows this and knows that it's ok, but my heart is sad. I'm confident in the decisions we made, in how long we stayed home and when we transferred. I would do it again even if I knew how it would end. I will always have questions that will never be answered, but it's getting better. I have the sweetest little girl that gives me the most gorgeous smiles, and I can't imagine loving her any more."

    Oh...and I think I saw your blog on twitter...or thatwife or something like that. Don't remember now!

    ReplyDelete
  3. Thanks for sharing this story. I, too, wish I'd gone home when I got to the hospital and found out I wasn't as far along as I thought.

    Have you ever had any surgery or procedures on your cervix? Just curious b/c that can slow or prevent cervix opening.

    ReplyDelete
  4. Thanks for the comments.

    Overall, I feel OK about things now. Not really blaming myself much, since it seems like the c/s was going to happen anyway, but still disappointed about not having a natural birth & missing my baby's first hour. I've never had any procedures on my cervix or anything - possible PCOS, but was never even checked out for that, just assumed based on infertility and blood test result. I still wonder if part if it wasn't being so tense (major stress & family issues at the time) that I just couldn't relax

    ReplyDelete
  5. What a journey! I can't believe you went home so soon after a c-section, you are wonder woman. At the hospital I went to (I'm in Australia) if you have a c-section it is a minimum six day stay, just to let you recover and bond with your baby without having to worry about the outside world.
    Congratulations!

    ReplyDelete
  6. Glowless, that sounds awesome. I'm sure that would be great. Unfortunately we don't have nearly free health care here in the states. So they charge us an obsene amount of money for things. Like acare basket that has some socks, tylenol, some tooth paste, shampoo and conditioner in one and all travel size, gets charged for $300. And they try to give you a new one for each time you're moved to another room. Of course, if you have health insurance the under writers can work them back down on prices for you. Its insanely expensive to go to the hospital. I had a scopic surgery just to remove gout crystals from my ankle, plus 2 days of hospital stay afterward, and they charged me over 60 thousand for it.

    ReplyDelete

Related Posts Plugin for WordPress, Blogger...
Some links on this blog may be affiliate links, for which a receive a percentage of the purchase price. See disclosure policy here.