Monday, February 27, 2012

Everett's Birth Story

I had every intention of going past my due date. I had been gearing up for the inevitable induction battle with my OB for weeks. I had no signs that labor was approaching, and at 38 weeks Rose came down with bronchiolitis that brought us to the ER in the middle of the night on Christmas. A few days later Tim and I were sick too. I was fine with my baby staying put until we were all better. At 39 weeks and 3 days I decided to launch a house-cleaning initiative. Since I was feeling too pregnant to do much, this meant that I put Tim to work. I decided we would divide the house into five zones and clean one every day so that the house would be spotless by my due date.

That night I had frequent but only mildly uncomfortable Braxton-Hicks throughout the evening. I went to bed around 9:00. At 11:45 a strong contraction woke me up just as Tim was getting ready to come to bed. I couldn’t sleep after that because the contractions kept coming before I could drift off. I watched the clock. They were 15 minutes apart, then 12, then 10, then 7…at 2:00 I got out of bed and ate some cereal. From 2:00 to 3:00 they were 3-5 minutes apart and quite uncomfortable. I would stop what I was doing and just breathe calmly until they ended. I considered calling Mom, and I considered waking up Tim, but then at 3:00 I suddenly felt sleepy. I sat down to read, and the contractions spaced out some. I went back to bed and drifted off, going in and out of sleep as they continued for the rest of the night.

I woke up at 6:45 to the worst one yet. For the next couple of hours they were very irregular, about 10-20 minutes apart. My daughter woke up, and about 9:00 she was sitting on the potty and I was sitting next to her when I had a strong contraction. I had to get on my hands and knees and moan to get through it. But I thought my body might just be warming up and that the contractions would just fade away at some point.

For the next hour, we tried to get cleaning done, stopping to deal with each contraction as it came. We fell into the following routine: I would tell Tim another one was coming, get down on my knees and lean over something nearby. He would kneel behind me and rub my lower back hard in a circular motion. That ended up being the only strategy we used the entire labor – it never stopped being effective.

At some point during the morning, Tim asked me what the contractions felt like. Drawing upon our shared experiences on our Tanzanian internship, I said they felt a lot like dysentery. Then I amended that to say they felt like someone standing on my bladder while I had dysentery.

Around 10:30 my vocalizing was starting to scare Rose, so we called Mom at work to have her come to our house. She arrived, distracted Rose, and observed us. She said it looked to her like this was the real thing, and she thought we ought to head to the hospital. We started packing up, but we were being casual about it. We called our doula to tell her this might be the day. As I packed, I became more distressed and contractions became more painful. I started to feel urgent about leaving, so we hurried to get ourselves moving. Partway down the road we realized we had left our cell phone at home, so we stopped at my grandmother’s house to borrow hers. She was very excited to be able to help us out.

We stopped at my parents’ house, intending to labor there for a while with no one home. We called the doula again and said contractions had been 7-8 minutes apart for some time, but were becoming intense. She said it probably wasn’t active labor yet and that if we decided to go to the hospital now we should be prepared to resist interventions. I was discouraged to hear that. I ate a cereal bar and then told Tim I wanted to go ahead and leave. We still had a 70-minute drive to get through, and I was starting to wonder how I could cope with the contractions in the car.

While en route, I would turn around and drape my head over the car seat when I felt a contraction coming on. Tim would drive with his left hand and use his right to massage my back with the omni-ball. The pain of the contractions got to the point where I sometimes had to bite down on the car seat, and I was very loud but tried to keep my voice low-pitched. I started to think that if this was still early labor, I wasn’t going to be able to handle it when it got much worse. I decided that if we still had a long way to go when we arrived, I would need to consider an epidural.

Once at the hospital, I had Tim drop me off at the regular entrance to use the public restroom. I made it in and out between contractions, although I’m sure I looked bedraggled to the other people there, and then I had one contraction out by the vending machines with Tim holding me up. We went back out to the car, and I told Tim we should find someplace else to labor for a while, that I didn’t think it was a good idea to get admitted. Contractions were still 7 minutes apart, so I thought we were not progressing yet. He said we needed to go ahead and check in, so I consented. That was a good move.

We walked into L & D, having one contraction on the sidewalk on our way in, and went to the registration area. I told the lady, “I think I might be in labor.” Then I got on the floor for another contraction. I think she was convinced, because she started moving through the paperwork very quickly. One more contraction and a few signatures, and we were ready to go. She told me I was doing a really good job, and that meant a lot to me. I was feeling a little frazzled by that point.

In triage, I changed into my gown and got hooked up to the monitor. Contractions were harder to handle lying down, but not impossible on my side. The nurse checked me, which was more painful than any contraction I’d had. I said, “Please tell me I’m at least a little dilated.” She said, “Honey…” and the way she said “honey”, I was sure she was going to say I was barely started, but she said, “You don’t have much further to go. You’re at 8 cm.” I could have kissed that nurse.

Tim called my mom and the doula (who was shocked). The nurse said, “We better get your water broken.” I said I didn’t want them to break my water. She said, “Are you sure? It’ll go a lot faster once your water is broken.” I said, “I don’t need it to go faster”, which was so true. A couple contractions later, my water broke on its own…

And that’s when I went berserk.

I immediately had the urge to push. I told the nurse, and she said I couldn’t because I wasn’t complete yet. I ignored that because there wasn’t really any way not to push. Some nurses hurried in, and they wheeled me on the bed from triage to my LDR room at the other end of the hospital. I was insane at this point. The physical pain and pressure were suddenly completely overwhelming, and I had just gone from not being sure I was in labor to pushing in a matter of minutes. I was not prepared for that. I was screaming through contractions, and I was pushing even though the nurses kept telling me not to. I would push until the peak of the contraction was past, and then I was able to blow through the rest of it. I started yelling, “No!” and “I can’t do this!” and “Help me!” and “Get him out!” and all the stuff that you hope you won’t say when you’re having a baby.

I had my eyes clenched shut and had a death grip on the side rail of the bed, and I was oblivious to what was happening, but Tim said our trip through the hospital was pretty epic, with the nurses trying to move as fast as they could, me screaming, people dodging to get out of the way, the bed fishtailing…wish I could have seen it. I do remember them telling me I had to let go of the side rail, and in my craziness I wouldn’t. It turns out the bed would just barely fit through the door of the room, and they needed my fingers out of the way so they could squeeze through.

Once in the room, they checked me again and said I was complete (no surprise there; I could have told them that) and directed me to blow through two more contractions while my OB got her scrubs on. By this time I had gotten into the habit of saying no to everything. I was lying on my side, and they said to get on my back, and I said no. They said that if I was going to push like this, then I needed to pull my leg up, and I said no. One of the nurses told me I was putting all my energy into screaming, and it was keeping me from pushing effectively. I continued to scream.

I could kind of tell we were getting nowhere, and I felt like I needed to get on my hands and knees, so I did. Tim said they all looked at each other, and the OB said, “That’ll work.” So I pushed in that position for a couple of contractions, and the baby really started to move and got around my tailbone.

They were having trouble getting the monitor to pick up the baby’s heart tones because my belly was hanging down. One of the nurses said, “The baby’s not doing so well. You need to flip over on your back.” So I did. I honestly don’t know whether they were seeing a problem with the baby, or whether they just weren’t picking anything up because of my position. In any case, I ended up pushing on my back, but by that time, the baby was close enough to coming out that I was able to push him out relatively quickly in that position.

I felt the ring of fire for a couple of pushes, and then they said the head was out and that I should look down and see him. I looked, but my big belly was in the way, so I couldn’t see him yet. A little more pushing, and his arm and shoulder came out. And then all of him. At that point, I felt so relieved, and my sanity instantly returned. I didn’t say anything, because I didn’t want to say anything stupid. They put him on my belly, and there he was. I thought he was nice. No fireworks really, no supernatural/hormonal surge of maternal instinct, but I liked him.

About five minutes after he was born, my doula Marisha arrived. She felt terrible for missing the birth, but she jumped right in advocating for me. I got to hold Everett for quite a while, almost all the time they were stitching me up, which I think really helped me relax. I had a second degree tear along my episiotomy line from my last birth. I had been afraid of getting stitched without an epidural, but it turned out not to be all that bad. Marisha helped me get started nursing him, and he stayed at the breast for about 45 minutes.

The recovery from this birth has been far and away better than last time. With my first, I had an induction, epidural, episiotomy and vacuum extraction after about 2.5 hours of ineffective pushing, and ended up with a third degree tear and hematoma. This time pushing was much faster, my tear was less severe, and my body was generally not as traumatized. I was up and around some by the next morning and was able to sit in a chair and nurse as soon as we got home. I’ve had more energy to take on breastfeeding and care for my kids. My dad came to see us a few hours after the birth and said how much better I looked this time, and Tim has said the same thing many times over the course of my recovery. I’m very grateful for that, as it was one of my main reasons for wanting a natural birth. I am able to enjoy my baby much more when I am not in so much pain.

As for the birth experience itself, up until the urge to push started, it really was manageable. Very painful, but not excruciating. I think because my contractions never got close together, I was really blessed to have lots of rest time in between them to stay calm and regroup. The experience as a whole was probably the most painful experience I’ve had, but no individual contraction was the worst pain I’ve had. The pushing stage, however, was extremely painful and panic-inducing. I did not find it to be a relief. I felt like my body was out of control and if it lasted very long I wouldn’t be able to take it. I would gladly have asked for something to reduce the pain at that point if I had been able to form a complete sentence or known what to ask for. This was not what I expected. I really wanted an NUCB so that I would have control during the pushing stage, since I hated the feeling of not being able to tell my body what to do when I had my epidural. As it turned out, I still didn’t feel like I had control because my body was doing whatever it wanted against my will, and I couldn’t think clearly to be able to cooperate with the people around me.

As for next time, I have some ideas. I definitely want to find a new caregiver. Even though I have a good relationship with my OB, I never felt she was totally on board with my hopes, and it caused a lot of stress because I started to feel like I couldn’t trust her and didn’t know what she might throw at me in the middle of giving birth. I ended up pushing on my back with my feet in stirrups, and I’m still not sure if it was warranted. She forgot to delay the cord clamping; admittedly, I didn’t give her enough notice to be able to go over my birth plan at the last minute, but I just feel like she wasn’t all that interested in it. When I tore, she said it was “right along the dotted line”, as if she thinks having the episiotomy last time was good for me. The next day, when Tim told her how much better I was recovering this time around, she said something about having to get that first one out of the way so that the second one can go easier. I felt like she was minimizing all the work I did to keep myself healthy and plan for a better birth this time around, instead giving all the credit only to the fact that this was my second birth.

I’m not sure if I want to try to find another place to deliver next time. On the one hand, I didn’t feel totally supported in my birth plan at the hospital. Also, having such a long drive to get there really complicated things. On the other, I kind of feel more secure knowing I have everything the hospital offers to fall back on if things don’t go well - both the medical care and the interventions - should I need them. I know for many people it helps not to have an epidural available, but for me I think it actually helped me to be less panicked. I didn’t put pressure on myself to go natural at all costs, just for as long as I could handle it. As it turned out, we weren’t there long enough for them to interfere a lot with our plans. The postpartum care at our hospital is excellent, and the lactation department is simply fantastic.

All in all, Everett’s birth was a good experience for me, and I do feel empowered by it. At the same time, at the very end it was scarier than I expected. Tim feels very positive about it. He said the whole thing looked much healthier and less scary than Rose’s birth. He was a bit traumatized by seeing all that went on while I was delivering Rose (he had a better view than me!) and has often said, “It looked like they were hurting you.” I felt the same way, that I was helpless and maybe even a little victimized while giving birth to my daughter. This time my body got the baby out on its own, and that was much better all around.

We are enjoying having Everett in our family. I am anxious to see his little personality come out in the coming months, and I can’t wait to see my children become close as they grow up together. We are truly blessed to have had a good birth, and much more so to have an amazing, healthy son.

Everett Christian
January 4, 2012 at 2:55 PM
7 lb. 9 oz. – 21 in.