Thursday, February 12, 2009

The Birth Story

So, I have a lot to say. I've written about 20 posts in my head in the last week, but today's the first time I've had a chance to sit down and type. I figure I'd better get the birth story up first. Warning, there's a fair amount of TMI here...

I woke up around 2:00 Monday morning (the 9th) and needed to use the bathroom. When I was done, I stood up and, well, there was still stuff coming out. I thought it was probably just some leftovers from the way the baby was pushing on my bladder and cleaned myself up again. Then it happened again. At that point, I figured out that my water had broken. Unfortunately, there was meconium in it, which freaked me out because I always thought that means fetal distress.

So I woke up The Boy and he called the doula. The plan was for her to come over and we'd head right to the hospital (our plan to wait as long as possible before heading in went out the window when I saw the meconium). The Doula (R) would stay with M until my mother-in-law could get here, then she'd come meet us at the hospital.

Made all of the phone calls, then called the hospital to let them know we were coming. The nurse calmed me down about the meconium. She said that I did need to come in, but that it's totally normal for full-term babies to have meconium in the fluid and that the baby was most likely just fine.

So when R got here, we decided just to wait for my MIL. By this time, it was nearly 3 am, and I'd started having contractions. Nothing too bad or intense, but they were becoming fairly regular. I drank a coke in the hopes of waking the baby, since I was still pretty paranoid that she was in trouble and I hadn't been feeling her move. The little stinker kept right on sleeping.

Got to the hospital around 4 am and headed to triage. The resident came in and told me they'd do an exam with a speculum to see if my water really had broken. Her nurse lifted up my gown, saw the chux pad underneath me and said "we have a gross rupture, you won't need the speculum," then proceeded to look horrified and apologized about 5 times for using the word gross. I assured her that I knew she wasn't calling me gross, and we all laughed. They hooked me up to the monitor and there was E's heartbeat, strong and healthy as ever. They also checked me and said I was 1-2 cm, the baby was at -2 and and my cervix was still quite thick.

So, on to the room. By this time, the contractions were getting stronger, but still totally doable. The attending on duty told me they'd give me 4 hours or so to labor on my own, then check to see if I was making any progress. So that's what we did for the next four hours, as the contractions got stronger and closer together. The Boy and R were great, giving me counterpressure and focal points and everything I needed to get through the contractions.

At around 8:30 am, they checked again. 100% effaced, and 3-4 cm! We were progressing exactly as we were supposed to. I spent the next few hours trying different positions and places, getting through the contractions. Ultimately, I liked either hanging onto The Boy or leaning over the birth ball, which was on the bed, during contractions, then sitting down in the rocking chair in between. I also tried the shower, but frankly, it didn't help that much.

And then the Megas began. I'd have a contraction, but instead of ending, it would just kind of ramp down to about 50% intensity for a few minutes before a "new" contraction would start. Whereas before I had a minute or two to sit and regroup between contractions, now I couldn't move. The pain never went away long enough for me to do anything but keep doing my deep breathing/moaning in between then yell for counterpressure as the new peak began. This went on for about 45 minutes, until the L&D nurse noticed that I never seemed to stop contracting. She told me it wasn't normal and called the attending.

And I should say right here, thank heavens for my L&D nurse, D. She was absolutely amazing, from beginning to end. She was totally supportive of my wish to go natural; in fact, she said she was really excited to be with me because most of her moms get epidurals early on. She was able to help us realize that the Megas were a bad thing and to get us help.

So anyway, the attending came in and checked me, and I was at 7.5 cm! Unfortunately, he decided I was actually only about 75% effaced, not 100% as he'd previously told us. He agreed with the labor nurse that the mega-contractions weren't normal, and he offered me a shot of Terbuteline (sp?) to try to space them out. I took it gratefully, and it kicked in in a few minutes. Not only did I start getting breaks between contractions again, but the terbuteline also made the contractions I did have a lot less intense. I was able to sit, breathe and talk, and celebrate the fact that I was getting close to transition.

Terbuteline, unfortunately, is both a quick-acting and quick-clearing drug. I got a good 45 minutes to an hour of relief, but then another mega-contraction began. This time, I got the Terbuteline about 30 minutes into it, but the drug took much longer to work -- it was at least another half hour before I got any relief. In the meantime, I literally could not speak, even "between" contractions. Things just never backed off to the extent that I could do anything besides hang onto my ball for dear life and moan. By this time, I was feeling a little panicky -- I desperately wanted some relief, but could not even muster the words to ask for it.

Finally, the Terbuteline kicked in, and I announced that I wanted my epidural RIGHT NOW. Again, my L&D nurse was wonderful -- she knelt down, looked me in the face and told me she was concerned -- she said I was handling the individual contractions just fine, but that it seemed to her that I was tensing up and worrying about what was going to happen, as opposed to what was actually happening at any given moment. She was right, and I knew that, but I still wanted the drugs. My rationale was that if another mega started, I wouldn't be able to ask for help, so I'd rather have it in place before that happened. To their credit, The Boy, the nurse and R all realized I was serious and were very supportive. They called the doctor to let him know I wanted the epidural.

When the doctor came in, he checked me and told me I hadn't made any progress at all since my last check (that had been at around 1:00 pm, and it was now around 4:00 pm). He told me he thought I had cephalo-pelvic disproportion and that I should skip directly to a c-section. He also started outlining all of his concerns that I would rupture, because I was laboring for so long and so hard and not making any progress, and he decided to tell me about all of the ruptures he'd seen and the babies he'd seen die. I didn't know it at the time, but behind my back, The Boy and R were rolling their eyes at Dr. Doom. Frankly, I didn't care -- I knew he was full of shit (cephalo-pelvic disproportion is a fancy way of saying "we think the baby is too big for you to get her out," and I know damn well it's a crap diagnosis that's often pulled out when a mom takes longer than average to progress during labor), but the only thing in the entire world that I cared about at that point was making the pain stop. I asked if I couldn't just get the epidural and see what happened (figuring that if I needed a c-section, I'd get an epidural anyway, so I had nothing to lose), but he explained that this hospital doesn't use epidurals for c-sections, but rather spinal blocks. He agreed to leave us alone for a little while to make our decision.

The following 20 minutes or so were, no kidding, some of the most difficult ones of my life. Rationally, I knew there was no reason I couldn't keep trying to deliver the baby vaginally. I knew that each individual contraction wasn't so bad. I also knew that it was really ok that I hadn't progressed in a few hours -- labor often slows or stalls when a woman is feeling panicky (as I was), and I figured the Terbuteline was also making my contractions less effective. At the very least, I figured, the epidural would help me deal with the mega-contractions and we wouldn't have to use any more Terbuteline.

However, at that point, I was very close to being beyond rational thought. All I could think about was the pain and my fear of another mega-contraction. Plus, The Boy had spoken to the doctor and had been assured that at this hospital, it was policy not to separate the baby from her parents unless absolutely necessary -- at the very least, The Boy would be able to stay with her at all times. Since the main reason we wanted a VBAC in the first place was not wanting to be separated from the baby like we were with M, this knowledge made the c-section very seductive. The pain would be over, the baby would be safely out in a matter of minutes, and we'd be able to keep her with us. Finally, I knew that if I had an epidural, I'd need to wait for two other women in line ahead of me to get theirs before I got pain relief, and at the time I believed that I'd have the c-section very shortly after we made the decision. So, we decided to go with the c-section.

No sooner had we made the decision, of course, than we learned that both of the ORs were full at that point, and it would be an hour before we actually got the c-section. Boy, was I pissed! But there was nothing we could do -- I took it one contraction at a time and made the doctor promise to check me again before I got wheeled back, because if I'd made progress than I'd skip the c-section and keep trying for a VBAC.

At around 5:00, it was time to go - the doctor checked me and told me I'd only progressed another half a centimeter, so we went forward with the section. I walked to the OR and they gave me the spinal. Within minutes, I was feeling great -- I couldn't feel anything at all below my breasts, and for the first time in a good 6 hours, I wasn't in pain. It felt wonderful. I did end up getting sick at one point, and since I had a cold and was totally flat on my back, my nose stuffed up to the point where i couldn't breathe at all. But it wasn't so bad, and the OR staff could not have been kinder. They brought The Boy in and got started.

It seemed to take forever, but finally, she was out. My memory of the moment is a little fuzzy -- I remember them holding the baby up, but all I could catch was a glimpse of her leg before they brought her over to the warmer for evaluation. At that point, she let out her first cry, and I absolutely lost it. I couldn't stop crying and laughing. My girl was here, safe and alive. I think that, until she was born, I really hadn't let myself believe that she'd be ok, so the feeling of relief and joy was overwhelming.

While they stitched me up, we watched them evaluate E, clean her up and take her footprints. Then the pediatrician held her up and guessed that she weighed 7 lbs, 15 oz. I was pretty impressed -- she was off by less than two ounces (so much for that 37 week ultrasound that estimated her at 8 lbs 12 oz, huh?). Eventually, they wheeled me into the recovery room and handed E to me. She began to nurse almost immediately. It was amazing -- we were allowed to keep her with us for an entire 24 hours before we finally decided to relinquish her for her first bath.

Overall, my birth experience wasn't what I had hoped, but it really doesn't bother me at this point. I'm quite proud that I made it to 7.5 cm without any pictocin or pain relief. And while the c-section wasn't ideal, at least I know I wasn't bullied into it. I knew darn well that the reasons the doctor gave for recommending the c-section were bogus, but I also knew that whatever happened, it was my decision. I think that's why having had a c-section isn't bothering me much. This time around, I was able to make an informed choice. From one perspective, I suppose it seems like I gave up or sold out (and, well, I kinda did), but that's ok, too. I can honestly say I'm comfortable and satisfied with how things shook out, and that's not a small thing.


K said...

That is exactly how I felt with Max's birth...I didn't want to have a c-section at the beginning of the pg, but I felt I was allowed to make an informed decision. His c-section birth was no less special, amazing, wonderful or happy than the vaginal births of my other kids.

Congratulations again!

Rachel said...

I'm glad you posted this, and it's so nice to hear that you are proud of how long your labored and ok with the c-section in the end. Contractions without a break sound awful.

chris said...

Hey, congratulations. A future little Disney, fan, eh? You sound like you really hung in there and that's all you can do. Good job! H

The Girl Next Door said...

Oh Congratulations!!! You are so much stronger and smarter than I ever was or could be. I told my doctors, around 28 weeks, that I wanted drugs early and often. I begged for a c-section and they told me I was an idiot (they were right) in the end I delivered both vaginally (alhtough Au came out feet first, Sh having cleared the way so to speak). And, as you know, I never did that again. I am a whimp and an idiot. You, my dear, are an amazingly brave soldier. Brava! And now, once again, I am at work and crying. Thanks!