22 June 2012

birth story

This is my long story of the day Eliad was born. There are lots of details about the way I remember things that day. For an artist, I took a lot of health and science classes in school, so medical stuff is just biology to me. While I didn't want to share personal medical info about myself during the pregnancy, I'm okay with sharing now because I want to encourage others. I had two drugs during my labor; an antibiotic and pitocin. I want other ladies to know that you can have a labor and delivery with pitocin and not take any pain medicine or have an epidural. It's hard work, but I did it. And ladies that are going to be having a baby, yall are welcome to ask me more questions. I want to help and encourage you.

Wednesday, March 21, 2012

A little before 6:30 Wednesday morning, I was kind of between awake and asleep, thinking I probably wanted to turn over, but wondering if it was worth the effort. I began to feel what turned out to be my water breaking. I headed to the bathroom. Every doctor and nurse I talked to that morning wanted to know "in a gush or a trickle?" my response every time: "it was a substantial amount." After determining that my water breaking was very likely what had happened I woke Jonathan up and told him what was going on and that I was going to take a shower before I called the doctors' office. Jonathan got up took care of Ben, ate breakfast, and packed his own bag for the hospital. I started some laundry, took a shower, finished packing my things and the baby's suit, hat, diapers and wipes for coming home. I had already decided what I would wear home from the hospital-- but I couldn't figured out what to wear to get there. I finally settled on some comfy clothes.

I called the OB office about 7:30, talked to the operator, and she paged the doctor on call at WakeMed. Dr. Bass called back within 5-10 min, and I told him what was going on. He decided to have me go to the office to get checked out there before going to the hospital. I wasn't feeling contractions yet, but because I needed to take an antibiotic I was going to have to go on in to the hospital, rather than waiting 6 or so hours to see if things moved along on their own. I ate cereal and orange juice on the way to Raleigh. I hadn't had orange juice to drink in forever because it was too high in unnecessary sugar, but since I wasn't sure how my day was going to go, and when I was going to want to eat again, I wanted the extra calories that morning. For 8 am, traffic wasn't too bad-- heavy, but not slow.

At the doctors office, I ran to the restroom, and Jonathan checked me in. They didn't make me wait, there was a nurse waiting for me when I came out of the restroom. I talked to the nurse, and got set up in an exam room. While we were waiting for Dr. Smith, I emailed our potential doula. I had received her email address to contact her on Monday, I emailed her on Tuesday, and I hadn't even heard back from her yet, but I still wanted her to know what was going on.

It was obvious my water had broken, so the doctor got to skip the usual test for that. He did check my cervix and said it was closed-- but I knew it was dilated a little over 1 cm because I had been checked the Friday before. But for baby birthing purposes, it was basically closed. He explained that I was going to need to start pitocin at the hospital since I wasn't having contractions yet.

We headed to WakeMed and I called daddy on the way to let him know what was going on, and that Ben had been in his kennel since around 7:45. We got to the hospital early enough that there were still plenty of parking spots in the deck by patient registration. We got checked in, and they made me ride in a wheel chair to get the 4th floor. I objected to it, but it turned out to be good because it was so far to the elevator we had to take. The lady delivering us to the 4th floor took me to the triage area, where they were waiting for me. I got to skip the triage procedures since I had just come from my doctors office. One of the nurses walked us to the labor and delivery side-- 4B-- and we went straight to my room where my nurse for the day was getting things set up. I changed into the awesome hospital gown and undies. Then I answered lots of medical history questions, some pregnancy questions, and talked to her about some of my labor and delivery preferences. I hadn't written up any kind of birth plan, so the main thing I wanted to communicate was that I did not want to be offered any pain relief drugs. If I wanted anything, I would ask for it. We talked about getting me an exercise ball, and I told her that squatting was a comfortable position for me if I needed to do that. (I understand that it isn't comfortable for lots of people, so I didn't want her to assume it wouldn't be good for me.) I also got set up with the monitor to keep tabs on the baby's heart beat and my contractions. It turns out that I was having contractions about 7 min apart, but I had thought they were Braxton hicks contractions.

We kept the overhead lights off and I got Jonathan to open the curtain so we could have the pretty natural light come in the window. I also kept the tv off all day. I didn't want a bunch of background noise to annoy me. 
At some point early on, Dr. Bass came in to basically say hello, and say that the pitocin was going to make me hurt A LOT. He said that if I was going to end up getting an epidural at some point that there was no reason to mess around with other (narcotic) medicine that was going to affect the baby. That's about all I remember from that visit.
Jonathan had forgotten his headphones, so we all thought it was a safe time for him to go get some.

The nurse got me set up with penicillin which burned my arm, so she adjusted the IV machine to make it hurt a little less. When it was time to start the pitocin I cried. I was sooo disappointed that strong contractions hadn't stated on their own before my water broke. I had prayed and asked others to pray for me that contractions would start on their own so I wouldn't have to have pitocin. But that is clearly not how things worked out. 

Jonathan returned, and things were pretty boring for a while. I texted/chatted with Austin at work. Left Em a voice mail, and texted Nia to let them know I would (hopefully) be having the baby that day. I distracted myself with my phone-- facebook, pinterest, and words with friends. Other than immediate family, we didn't tell anyone that I was at the hospital. And I didn't give family updates about what was happening. Although Jonathan might have-- I don't know.

The doula called and I let her know what was happening-- boringness. She said she was available that day, and around noon she left me a message that she was heading to the hospital. I thought it was premature, but by the time she got there, contractions were strong enough that I only wanted to talk between contractions.

I think the hard contractions started around 1:00. Not the worst contractions. But definitely hard and strong.

I signed Kim's papers and I really don't remember what we talked about. I ignored her when she asked me to do things that weren't my style-- like holding her hands during a contraction. We kind of had to work out her role as we went along since we hadn't met before that day. But, I also could have never known how inwardly focused I was going to be.
I didn't want a lot of attention from Jonathan, the nurse, or the doula. I mostly asked them for water, juice, Chapstick, or to please make the iv machine stop screaming at us.

One of the IV regulating machines kept malfunctioning and being really loud. It was the one that regulated the penicillin, but I only had to have that every 4 hours. Unfortunately it decided to mess up during my second dose of penicillin. I didn't even notice it at the time, except for the burning in my arm, but when the machine messed up and started beeping loudly, all the drug in the bag left the bag and went into my arm. A couple minutes later when I looked up at the bag and it was empty, we figured out what had happened, and I realized why it had hurt so much at the time. And probably because of that, my arm was super sore the next couple days. Or maybe it would have been sore anyway. 

I worked through contractions rocking on the ball, sitting cross-legged on the bed. I tried standing some, but leaning on Jonathan didn't work bc he was too tall for what was comfortable to me and it hurt my arms. I stood by the bed and leaned over on my hands or forearms, but that never lasted more than a few contractions and I would end up crawling onto the bed. We had the head of the bed sitting all the way up so I rested on my knees facing the head of the bed and leaned on it. At one point I tied lying on my side but I couldn't handle that even through one contraction. I mostly focused on breathing during the hard contractions. During the really really hard stuff  I thought about how I was getting closer with every contraction. And that this was the only time I had to feel this contraction. I never had to have this contraction ever again. I thought about staying relaxed so my back and shoulders wouldn't get tense. I wanted to cry because I was hurting so bad.

I think I remember at one point when contractions were in the 2-3 min apart range, the nurse saying i would probably need to labor like this for a few hours. But before too much longer, i needed to push against the contractions-- i wasn't actively trying to push, it's just what my body needed to do. I was kneeling on the bed, leaning on the upright head of it-- sometimes burying my face in the mattress. I had Jonathan put the railings of the bed up so I could hold on to them. I asked Jonathan later if I was grunting or whatever during that transition part of labor, and he said I was pretty quiet the whole time. But the nurse recognized my change in posture or behavior and probably the sounds I was making too, and ask me if I felt like I needed to push. I told her I couldn't help it. I was feeling a lot of pressure. For the first time since I left the doctors' office that morning, I was asked if my cervix could be checked. She checked me out while I was still kneeling backwards on the bed, and her response was "that's a head!!! I feel a head!!" She said she couldn't feel the cervix at all. She immediately got on the phone to locate my doctor-- who was in the OR. So she requested the doctor from another practice who was on call to come in. Nurses or aids also came in to prep the room for delivery-- mostly just wheeled a bunch of stuff in from what I could tell.

The other doctor in her hot pink scrubs came in, and had me lie down so she could accurately check out my cervix. She described it as "a lip." no number. I didn't need to actively push yet because if the cervix was still in the way, that could cause it to swell, which seemed like a really bad thing.

I asked if I could rest on my back for a little while, and the nurse and doula said YES, since I hadn't been in that position before. They didn't seem concerned about it slowing down my labor.

Dr. Bass came in soon and said he was surprised I was the patient he was paged for. He said a couple times, that he thought he was paged for the girl in so in so room. He was also surprised I didn't have an epidural-- maybe because I was lying down-- but I was thankful for that break.

He checked me out again and talked about how he wanted me to push. Almost apologetically he said he wanted me to stay on my back and curl up, because of the lip of cervix on one side (posterior?) that needed to get out of the way. With strong arms and loose legs I held my knees toward my chest during contractions, and the nurse and doula supported my legs between contractions so I could rest. I pushed a few times with the doc in the room. Then the doctor left and I continued to push. The doula asked about me holding my chin to my chest while pushing, and the nurse agreed that was a good idea. Jonathan helped me remember to do that. I drank sips of water between contractions, but after a while, my stomach started to feel just a little blah, so I stopped with that, even though my mouth was super dry. I didn't want to add one more feeling to everything else already going on. At some point I started to be able to feel the progress of the baby moving down on the way out, but it was a little frustrating feeling him move back in. The nurse gave me direction in pushing-- mainly really encouraging me to stop and breathe then continue pushing through the end of the contraction. I didn't want to stop pushing. I didn't want to stop and breath. But with everyone saying "breathe breathe breathe," at some point I realized they were probably afraid I was going to pass out. So I did my best to follow their directions.

Jonathan was super encouraging. He seemed genuinely impressed with the work I was doing, so that helped me a lot. He helped support my head while I was pushing, then fanned my face between contractions. It was hard work, but when things slowed down briefly, we did talk some about my labor and pushing, between contractions. I'm sure my end of the conversation was super short phrases. After some particularly hard contractions and pushing I told them I was ready for the baby to be out. 

The nurse did some massaging as the baby started to make his way out. And at some point she suggested I try to hold the pressure or whatever between contractions so the baby wouldn't go back in as much while I wasn't pushing. As the baby was moving down, he needed to turn his head a little more, so the nurse started massaging just right to left to hopefully help him make that last little bit of turn. Dr. Bass came back in and was a huge help for me with what I thought was more specific, better direction in pushing. He had me wait longer into the contraction before I started pushing so I could do better work during the peak of the contraction. He also told me to watch him when I guess it was time to deliver the baby, so he could give me direction about when to back off from pushing. But I don't remember specifically getting that direction. It probably happened though. 

Then at 5:38 the baby was super stretched out in the doctor's arms. Kinda purple-y, his head was toward my right, legs toward my left, arms stretched out, and he was facing me. I felt the biggest relief and happiness. I was sooo thankful he had safely arrived and so thankful that the hard labor and delivery was over. I immediately thought about being so glad that was done, and I had my baby, and I never had to go through that again unless I wanted to. And I was glad it was still light outside. From the time I started pushing until Eliad was born was 53 minutes.

The nurse knew I wanted him immediately, so she helped unsnap my gown and helped put him on my chest. Jonathan cut the umbilical cord, which has always seemed weird to me, but didn't seem quite so bizarre at the time. And the baby pretty quickly pooped on us. I have no idea how much later I delivered the placenta, but it didn't seem like very long. I had a 2nd degree tear, so I got some local lidocaine and got stitched up.

Jonathan called our families to announce Eliad's birth. I tried to talk to my mom because I needed her to bring me a couple things. But it was really hard to talk to her because the doctor was still in the room, and I was afraid I was going to miss something, so I gave that up. 

After a while, a nurse took Eliad to weigh and measure him (they stayed in our room; 8lbs, 10oz, 21.75 in). They toweled him off a little, and put a hat on him. Then the nurse helped me try to nurse Eliad, which mostly consisted of him checking things out. Some latching happened, but it never lasted very long.

I sat on some ice, and got some instruction from the doctor about pain medication. The nurses needed to change shifts, so the new nurse helped me to the bathroom and in the bathroom. I couldn't pee, so I just cleaned myself up as much as I could, and washed my face. I got a little light headed, so they brought a wheel chair in for me, and that's where I stayed until it was time to move to the postpartum wing-- in the wheel chair, not the bathroom. Jonathan went to the cafeteria to get me a sandwich. The nurse left and I held Eliad and drank apple juice while we waited to move. 

I don't remember what clued me, maybe he started to fuss a little, but Jonathan and I decided I should try to nurse Eliad again while we waited. That time we did get a good latch (after a few painful tries) and he nursed for a while-- including as we wheeled to our new room in 4C.

There were 2 new nurses when we arrived at our new room. One stork nurse who took care of Eliad, and my nurse. Both the nurse from l&d and the new nurse helped me to the bathroom, where I did pee, to everyone's satisfaction. Eliad was given a bath during that time-- over 2 hours after he was born. I didn't care at the time, because I was preoccupied in the bathroom, but in hindsight, I might have asked to delay his bath little longer. After his bath I held him on my chest, under my gown. I ate some cold super that was waiting in the room-- but I didn't care, because I was so hungry and thirsty.

We invited my family in to visit, and Jonathan video chatted with a lot of his family that were in FL, including some extended family. My family left around 9 because the nurse had told me she was coming back around that time to check on us, and I wanted to be able to focus on that and the baby. But they didn't leave before they all made plans about when they would visit the next day.

Eliad was slow to warm back up, so he ended up needing to go in a warmer for a little while before we went to bed. (which is why I think I should have asked to delay the bath longer.)
When we finally settled down for the night I thought I was never going to get to sleep. I was so excited and wound up from my eventful day. While I was lying wide awake in bed, wishing I was asleep bc I knew the baby was going to be up soon to eat, all I could hear is what sounded like his heart beat. We had been monitoring and listening to his heartbeat all day long, and the rhythm still sang in my head all night.

Reflections:

As I mentioned I was very disappointed about needing to take pitocin. For a few days I really questioned God about why He said "no" to my prayers that contractions would start naturally. I wanted to be able to labor at home as long as I could, in the tub or shower if I wanted, and I was concerned about one intervention leading to another and another. I finally came to a peace about God taking care of Eliad and me on my baby's birthday. Eliad was head down and in a good position, the doctor on call was a good fit for me, I had a nurse who was supportive of my desire to not have pain medicine during labor, my body responded well to the pitocin and getting ready for the baby to be born. The nurses that day said that if we have a next time, and my water breaks first again, contractions would likely come pretty quickly on their own.

Jonathan and I took a childbirth education class with The Birthing Well. I think those ladies had a great class to help me be prepared for labor and delivery.

If we have another baby, (which we probably will, but not anytime soon) I will want to labor with no pain relief drugs again. I will also ask if another position would be ok for pushing. I trusted the doctor, and everything went well, but I do wonder how things would have gone if I had tried something besides being curled up on the bed.

WakeMed Raleigh and Cary follow the Baby Friendly Hospital Initiative to help support breastfeeding. I think it was a great help to be in a place where the nurses, doctors, and staff encouraged breastfeeding, and taught and gave us lots of help to get us off to a good start. I nursed Eliad within the first hour, they have no nursery so Eliad stayed in the room with me, they don't have pacifiers available, and we were told not to give him a paci til after he was 4-6 weeks old, they do not have the diaper bags and formula samples from the formula companies to send home with the new baby, all the nurses offered assistance with breastfeeding, and I had visits from hospital lactation consultants both days we were there, and they sent us home with info about LLL and Nursing Mothers of Raleigh, as well as the phone number of the on call lactation consultants at the hospital.


minutes after Eliad was born. 

   




Eliad and me with my mom, sister, and brother in the postpartum room

1 comment:

Devin and Callie said...

You did it!! What a great story! Its great that you were able to go pain-med free even with pitocin, and its encouraging that more interventions weren't needed! I love that your hospital follows the baby friendly initiative, too! Sounds like you made a lot of great choices for your little one! <3