Wednesday, August 20, 2008

The Birth Story

I meant to post this on the same day it was posted over here, but alas! There's something about having a tiny person to take care of that makes stuff like "blogging" and "remembering things" extremely difficult. Better late than never, I suppose...

The longest birth story ever

The plan:
Midwife-attended, natural homebirth, potentially in the water.
The Husband and I made this choice for many reasons, but mainly because a normal pregnancy is not a disease and does not need to be medically managed. We wanted to have control over the parts of the birth process you can have control over, like avoiding routine interventions, knowing all the attendants, being comfortable in our surroundings, and making choices ourselves rather than having doctors or nurses make choices for us. On top of that, I was radically and irrationally afraid of being admitted to the hospital. I haven’t been to a hospital in the last 15 years or so without becoming lightheaded – and that was just when I visited others!

The preparations:
Find a midwife.
Take Bradley class.
Take many a supplement.
Buy lots of plastic sheeting and cheapo towels and set up birthing tub (sans water, of course).

Prenatal care and due dateapalooza:
After we had found a midwife and decided on the home birth, I saw both her and a midwife at Kaiser for prenatal appointments. Generally speaking, the appointments at Kaiser were awful (low iron! too much weight gain! scary big baby stories!) and the appointments with The Good Midwife (TGM) were great. I was low-risk, happy, healthy, and progressing normally. From the get-go, I had two different due dates: June 17th from Kaiser and June 19th from TGM. Then, Kaiser did the 2nd trimester ultrasound, and on the print-out it said that my due date was June 23rd.
Forward to week 35 of my pregnancy, when the baby dropped (I carried my belly between my knees all of a sudden), and TGM told me that first babies usually arrive four weeks after they drop. So now I considered my “due date” to be between June 12th and June 23rd.

Waiting…:
I didn’t have a baby on June 12th. Nor on the 13th, the 14th, or even on the 23rd. TGM went to a conference in Canada (leaving me in the capable hands of a very sweet stand-in). She was due back on July 1st, which was also my “due date + 8” (first time moms on average deliver 8 days past their due date) from June 23rd. I dealt with some crampiness and mucousiness while she was gone, but I had decided that I would have the baby on July 1st (because at that point I had STILL not gotten it into my blonde head that this was NOT UP TO ME). Starting on Thursday (June 26th), the crampiness progressed into nightly occurrences of pre-labor (or false labor), which was exciting, but robbed both me and The Husband of sleep. And… it didn’t progress into anything serious at all.
I didn’t have a baby on July 1st. Nor on July 2nd. I was getting a little desperate. Okay. A lot desperate.

Finally! Labor! Wooohooo!
Thursday night, July 3rd, I could tell my contractions were different. The Husband and I decided that FINALLY! I was in labor, and called TGM to giver her a heads-up. I took the birthday cake out of the freezer. In between my contractions we talked about how our baby had just waited so he could have parades and fireworks for his birthday every year. Needless to say, we were excited. Of course, being obedient Bradley students, we went to sleep. That is, The Husband went to sleep. I realized that real contractions are a heck of a lot more painful lying in bed that in pretty much any other position, so I walked around and dropped to my knees a lot.
Towards the morning, I felt increasingly annoyed with the contractions and got in the birth tub. This of course slowed the contractions waaaaay down, but I managed to wedge myself in so I could take a floating nap, which was great.
TGM arrived around daybreak. I was only 3 cm dilated and incredibly discouraged. She recommended resting and distracting ourselves during the day and felt sure that my contractions would pick up again at night.
The next night went much like the night before. When TGM arrived at the house early the next morning, I was 3 cm dilated and clearly not in labor. Also ready to jump off a cliff – angry, annoyed, and just way too pregnant to deal with still being pregnant.

Hospital:
That Saturday was a long day. Saturday night was the first night in over a week that went by without so much as a single little cramp from ye olde uterus. Sunday morning, I had a really hard time peeing. By 9am, I couldn’t really pee at all even though I had been drinking water and juice like crazy. I figured that this was just a new nuisance of being extremely pregnant – baby is putting pressure on my bladder (because BOY did I have to go!) and simultaneously sitting on the exit. It wasn’t until I dissolved into tears trying to pee at church around 11am that it dawned on me that something was not right (I’m real bright sometimes, what can I say!). We went home. I called TGM who phone diagnosed me with a UTI (a diagnosis that proved accurate though I shrugged it off as preposterous because it didn’t feel like a UTI) and sent me to urgent care.
Of course, when we got to the Kaiser hospital, we were re-routed from urgent care to labor and delivery.
I was asked to pee in a cup (HAHAHA!) and actually managed to squeeze out a few drops. I had to exchange my clothes for the breezy gown and was hooked up to a fetal monitor. A surly midwife scolded me for not having come in for a biophysical profile at 41 weeks. And this, my dears, is when I found out that Kaiser only adjusts the due date based on the 2nd trimester ultrasound if it is more than two weeks different from the due date based on LMP (which I think is sound medically – I just wish I had asked that question back in January!). In other words, June 23rd had never actually been my due date, which now put me at almost 43 weeks pregnant. I felt like a giant fool. But not for long, because of the commotion – baby’s heart rate dropped! Dramatically! To the 50s! Nurses rushed into the room, The Husband was pushed out of the way, and an oxygen mask was pressed on my face. As soon as the monitor had been adjusted, baby’s heart rate was fine again, but this “random decel” turned into another Big Deal, though I am convinced that it only happened because the monitor moved on my giant belly.
An ultrasound determined that I had next to no amniotic fluid left (not good) and an exam revealed that my bag of waters had ruptured – unbeknownst to me. It had quite possibly (and likely) been ruptured for three or four days (really not good).
So here I was – with premature rupture of membranes, too little amniotic fluid, a “random decel” of baby’s heart rate, a UTI, and 2 weeks 5 days past my due date. Oh, and without any contractions. We agreed to induction, happy that they were offering it rather than arguing for a c-section right away.

Intervention carnival:
Before I knew it, I had an IV with fluids and antibiotics. My bladder was catheterized (oh, sweet relief!), fetal monitoring was done internally (sorry baby!), and I got an infusion of amniotic fluid. Once everything was situated, they hooked me up to Pitocin.
Fast-forward about 12 hours. I was stalled at 7 cm but felt veeeery pushy with each contraction. Baby’s head was tilted (not good) and his heart rate continued to have “random decels” (Pitocin side effect). TGM had come to the hospital to support us, and at this point, she recommended I get an epidural to give me the chance to continue dilating without having to try not to push, to relax me so that perhaps baby’s head would move into a more favorable position, and to allow me to get some rest. I went for it, and it really helped. I dilated to 9 cm while I took a little nap. Baby’s head turned. I got a second wind. But… I had to keep the oxygen mask on at all times to prevent baby’s heart rate from dropping (and take slow, deep breaths). Baby had turned posterior (no wonder - I had to labor on my back!) and I stalled at 9 cm with my cervix stuck between baby’s head and my pubic bone.
We decided that at that point, a c-section would be the best option to get the baby out safely.
Noah was born at 10:15am on Monday, July 7th. He was covered in Meconium, but had APGARs of 8 and 9. His daddy fought the nurses for skin to skin contact while they were cleaning and suctioning him and then stayed with Noah until they had sewn me back up. I was able to hold and even nurse Noah in recovery – before I could even wiggle my toes (or actually really feel my boobs).

The aftermath
Healing from a c-section is no picnic. Getting into and out of bed was nearly impossible for the first few days – even in the hospital. At 16 days post-surgery, I still cannot carry Noah and the diaper bag at the same time. I don’t stand a chance lifting the stroller into or out of the trunk of the car. Sneezing, coughing, and blowing my nose are extremely painful – I feel as though those things rip me apart at my incision.

Healing emotionally
I’m actually doing pretty well emotionally. I certainly have learned a lot.
One of the reasons why I chose a home birth was my fear of hospitals. I didn’t want to have to assert myself and to fight for the natural birth I wanted. In many ways, homebirth was the path of least resistance for me. Not only did the hospital turn out to be very accommodating of all of my special little requests, but I never felt judged for my decisions (like refusing the eye treatment and Hep B vaccine for Noah). My wishes were actually respected (I told the first nurse I did not want pain medication offered to me and nobody ever mentioned it after that.)! I felt well taken care of the entire time I was in the hospital, and I realized how strong I was. I was able to get what I wanted without having to drop-kick anybody (or even arguing for it).
I know that I did everything I could to have a natural delivery. I feel that all interventions were medically necessary. Sure, the Pitocin led to the random decels in baby’s heart rate which ultimately led to the c-section, but I did need the Pit to get me to go into labor. The stalling at 9cm and baby’s poor position could have been avoided (or remedied) had I been able to move around while in labor, but again – with the issues I came in with, laboring on the bed was my only option.
And so I learned that the hospital is not an evil place (though choose your hospital wisely if you’re planning to birth there), that I am stronger than I thought (I sort of want to cross-stitch “12 hours on pit with not pain meds” into a pillow), and that even though it can sometimes appear as though they are, medical professionals are NOT the enemy (but… do your research! I’m always amazed at people making decisions based on little to no background info. One of the nurses actually asked me if I was a nurse because of how much I knew about labor and birth.).And to end the longest birth story ever told (which is fitting since it felt like the longest pregnancy known to womankind), here are some photos:
labor
first family portrait
still numb from the chest down

2 comments:

tweetey30 said...

That last photo looks like he has a slight grin on his face too. I know new borns dont smile but it sure looks like he is content with his mommy.

bethany actually said...

I just re-read this and was amazed to see I didn't leave a comment the first time I read it. I love the Noah-burrito in the last photo! How is it possible that all happened 3+ years ago!?