Wednesday, October 17, 2012

Birth Story

WARNING: Gynecological-related language.

Introduction:

When I was "preparing" for childbirth, the main books that helped me were "Ina May's Guide to Childbirth" and "Natural Hospital Birth: The Best of Both Worlds." I read lots of information and changed my mind several times. And of course, there were many aspects of labor that were different from what I had expected.

At first I read a lot about natural childbirth, and it turned me off from the way hospitals handle childbirth. I started to get nervous that my labor would stall as soon as I set foot on hospital grounds, and that I would be subjected to various procedures against my will.

Then I ran across some stories about "home births" gone wrong, and I decided I would feel better being in the medical setting of the hospital, even with its sterile environment. As it turned out, David needed help breathing when he was born, so we did need medical intervention. But then again, who knows if my labor would have been as long as it was in a different environment. In any case, we are all alive and healthy.

Now for the details...
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Pregnancy:

I had a fairly uncomplicated pregnancy, except for a few weird things they found on ultrasounds, like a bi-cornuate uterus and an umbilical cord cyst. By the time I was in the U.S. at 33 weeks being examined, they couldn't see either of those.

Meanwhile, I found the "dating" system confusing. Ultrasounds, OB/GYN visits, and my own calculations all yielded different results. They kept saying growth was "behind" by 5-6 days, but since it was so consistent, I wasn't worried.

The baby was breech at one point, but then turned head down. However, the doctors seemed unable to tell me what his position was, other than that. And when I felt the baby moving around, I found it very hard to tell what was what!

I also had very few signs that labor was imminent, so I fully expected to go past my "due date" of July 6th. I felt fine and didn't have any contractions.

Due to things I had read, I felt that regular cervix checks were unnecessary and inaccurate in predicting when labor would start, so I refused them a few times, until my 40-wk appointment when I was found to be 1 cm dilated.

I will say that I appreciated not feeling rushed by the OB-GYN practice I used. They didn't force me to accept certain procedures and they didn't mention inducing labor or there being anything wrong with my not having labor symptoms. They mentioned that the baby seemed smallish, but didn't make any comments as to how much weight I had gained, what I should/shouldn't eat, do, etc. There are times when you want more feedback, but it was nice not to feel judged.

Labor:

Friday evening, July 6th: When I went to bed, I was having cramps and it felt like the baby was having a party in there. I couldn't sleep and felt very restless and uncomfortable, all night.

Saturday: The pains got down to 6 minutes apart. Books I had read said to "ignore" early labor, partly to save pain-management techniques for later. Of course I was like a watched pot (so to speak) at this point, so it was hard to act like everything was normal. I went to the grocery store with my mom and of course we ran into tons of people we knew, while I was sort of in the "zone." I think my mom managed to whisper to everyone that something was happening. Of course to other people it was exciting, but to me...yuck.

Saturday evening: I had managed to get through the day sort of "ignoring" symptoms while keeping a vague idea of how regular cramps were happening. I decided to try to sleep.

Sunday morning: Things had slowed down overnight, so I was glad I hadn't gotten my hopes up. Then the cramps slowly started intensifying again. At first I still had a good appetite and felt pretty upbeat. Then a couple things started happening over the course of the day, like losing the mucus plug and going to the bathroom a lot. And then by dinnertime I didn't want to eat anymore and felt pretty nauseous.

Sunday evening: It was looking like I was in labor. The main symptoms were the cramps, but it didn't feel like the baby was dropping at all. And my water hadn't broken. I wanted to stay at home for as long as possible, because I could have a while to go and I didn't want to get to the hospital too early and be "on the clock" and pressured to be induced or whatever.

My sister was calling to see if she should come up from Connecticut. I wasn't able to talk on the phone at that point but decided that I wanted her to come, even if I wasn't really in labor yet. Having a toddler, the childbirth experience was fresh in her mind, and she could help me cope.

Now my birth support team was assembled: my sister, my mom, and Andrei. I tried to remember all the advice I had heard/read. I tried walking around, but my feet hurt too much carrying all that weight. We couldn't figure out the counter-pressure and all I could really do was lie down. I tried to eat to keep my strength up, but wasn't hungry. Contractions were down to 4 minutes apart or so-I don't really remember, but they were regular.

Sunday night: Around 1 am we left for the hospital. I think I was just ready for doctors to assess me, and to get the car ride over with. We headed out to the car, and a skunk had done its nightly spray...yuck.

I was just starting to get pukey at this point, and had to bring a bag with me in the car. When we pulled up at the hospital, I was in the middle of a contraction/vomiting. Fun.

A nurse from labor/delivery came down to meet us. On the way up, she was asking some questions and I was sort of aware that I was being assessed as to my demeanor, etc. I don't think I actually had any contractions on the way up there, of course that always seems to be the case.

I got put on the monitors right away. I had planned on sort of avoiding the monitoring as much as possible. But now that we were at the hospital, I didn't care. I think in many cases it's best to just do what you're told so that the medical staff can be calm and in turn help you stay calm. But the monitors did get annoying later on.

The monitors showed that my contractions were very regular, but when the doctor checked me, I was only 3 cm dilated. She was completely unemotional and said, "You've got another 10-12 more hours." I could see my mother and sister reacting sympathetically.

Coping with the pain

Well, who needs to look at the clock anyway? I tried to avoid doing so myself. The first method to try was the birthing tub. We got it all filled up and I climbed in, but to be honest it really didn't help with anything.

Every 90 minutes or so I got hooked up to the monitors again.

I tried to walk around, but it was too painful. I tried sitting on a birthing ball...nope.

I tried to keep drinking liquids so I could avoid an IV. However, I got to the point where I was throwing up during/after each contraction. I was really thirsty, but just couldn't drink enough to stay hydrated. So eventually I had to get the IV, which obviously restricted my movements....

Here I had come to the point which they warn you about in the natural birthing literature. Once you get hooked up to an IV, you can't move around, labor doesn't progress...blah blah blah. Well, that may have been true, but my thinking was that I wanted to still have energy to push my baby out. I hadn't planned on throwing up so much during labor and it prevented me from staying energized without medical interventions.

A few more hours went by; it had probably been 8-9 more hours by this point. The doctor came by to check me before her shift ended, but I refused a cervical check. She said the baby was still really high and definitely posterior. Thanks.

Failure to progress?

Eventually another doctor started his shift and checked me to find that I was only at about a 5. At this point the talks of inducing labor began, except that they don't call it that, of course. He said he could break my water, or maybe start me on some Pitocin. I was torn as to what to do, and he said he could give us 30 minutes to think.

Now if the doctor gives you time to think, you know that you're not in an emergency situation. I thought that on the one hand, I could go on laboring without intervention for several more hours, and let nature take its course.

On the other hand, the IV fluids didn't seem to be helping much. I felt really thirsty and weak, and when I thought about several more hours of contractions PLUS pushing, I felt that I needed some help.

Also, I can't remember when, but something was going on with the fetal monitor and sometimes the nurses would rush into the room to check. I didn't want to end up with an emergency C-section because the baby was in distress. I have heard that the readings can change due to contractions or the mother's position, but there is still a risk of something happening that many hours into labor.

I decided to go ahead with the doctor breaking my water. Meanwhile, he had warned that contractions would pick up after the amniotomy, but they had ALREADY been intense for 10 hours or so. Therefore I agreed to some painkillers via IV.

Crazy medical staff

It really is how they describe it...the nurses are in your face too much and the doctors are elusive when you're giving birth.

In the wee hours of morning there was a shift change and we got a new nurse. For some reason the night nurse didn't do registration and the morning nurse did, so now that my contractions were worse and I didn't feel like talking to anyone, I had to answer a barrage of questions. The first round included questions that I had written on the forms. I couldn't understand why the nurse couldn't just get my information from there. Then there was a round of very odd questions such as "what is your learning style?" This was in the MIDDLE of contractions. I basically would ignore the nurse and shoot a look at one of my support people to help out, or answer "No," when the nurse asked, "Can you tell me....?". According to hospital protocol, medical staff should regularly ask the patient for his full name/birthdate. I suppose it can confirm lucidity and also confirm that medication is being given to the right patient, etc. But it is not something you ask of a woman in labor! There was a point there when I did not want to be answering questions, and I didn't want anyone else in the room to be discussing anything, either!

Too much pain!

I thought I had heard that having the doctor break your water was no big deal. Well, I found it fairly uncomfortable. Afterwards, they kept turning me from my back to my side and back again and changing the pads under me as everything got soaked. Very messy! I heard the doctor saying that there was meconium in the waters, and that the baby would need to be checked when he was born.

The contractions did get more painful, and there was this confusion with the doctor being in a C-section and needing to be tracked down to approve the order for painkillers. The nurse had promised to put the order in, but I never really felt relief. Meanwhile, they had supposedly given me morphine and I didn't remember what the effects of it were supposed to be and I didn't have time to find out. I suppose it may have made me sleepy between contractions, but I'm not sure.

My support people were taking turns napping one at a time while the other two would help me breathe through contractions. It seemed like everyone had his own rhythm, though! Also, the contractions on the monitor didn't necessarily correspond to what I was feeling. Sometimes one of my support people would start doing the breathing before I felt the contraction! Or I would hear "here comes a big one," uh oh!

The pain really felt unbearable at this point. I can't remember if I was still vomiting, but I started to raise my voice more, and I had a sore throat for several days afterward. I didn't want people touching me except in certain ways (that sounds weird, but you know what I mean). The nurse usually violated these orders and would sometimes do something like press on my abdomen in the middle of a contraction. I remember yelling, "my stomach!" However, there was no swearing or yelling at my husband that I hated him.

Pushing

After a few more hours, I was fully dilated! Of course it was good news, but I didn't have any urge to push, whatsoever. But the good part about pushing is that you have something to do during the contraction, other than just survive it.

Here again I was hoping to try an alternative method, something more intuitive, less painful, more effective, whatever.

But I didn't have any inklings as to what would be best! The doctor actually said I could do whatever was comfortable, and I started out on all fours. After some practice pushing, he said it wasn't a good position.

So I asked the doctor for his opinion as to a good position, considering the baby was posterior. I thought I had heard something about a squatting bar, but somehow that never made an appearance. I ended up...you guessed it, on my back with the stirrups. The doctor claimed that it would help gravity do its work. Really? Okay.

I pushed for about 90 minutes. I really gave it my all because I was so ready to be done! Some people like it quiet at this stage, but all the encouragement of my support people was really helpful. We had just gotten a new nurse and she was standing up by my head looking into my eyes and saying I was doing a great job. And I believed her! But I REALLY couldn't have done it without my husband. Whenever I felt like I was pushing my hardest, he would tell me to push just a little harder, and we would make progress.

It was a little disappointing each time I pushed because I kept hoping this would be it, and then it wasn't. Over and over again. But everyone's encouragement helped me keep going.

The room was bustling with people prepping the room for delivery. I think the pediatrics team even came and introduced themselves.

Finally one of the pushes was "the one," and there was this huge fountain of poop-tainted fluid that splashed all over everyone! Then David was whisked away, where his dad and aunt watched the doctors work on him and my mom stayed with me. I've already written about that here.

David was 8 lbs 2 oz, and I have to admit I was a little proud for carrying that around, especially after my doctors had kept saying he was on the small side.

They brought him over to me all swaddled and all I got to do was give him a little kiss before they carried him off.

Meanwhile, the doctor was still working on me. I heard him tell them to add more painkillers to the IV as he worked on fixing me up. The placenta was detached or something and he had to go in there and remove it manually, pretty unpleasant, but successful.

When it was all over I just lay there and the nurse would come periodically and change the pads under me.

My mom called my dad to come meet his namesake. Arrangements were being made for David to be transferred to a NICU in another hospital. They explained that they can't usually arrange for the parents to stay there too. We could have tried to work something out, but decided to just spend the night in our hospital.



When David was all hooked up to a machine and ready to go in the ambulance, they brought him in so I could say "goodbye." It wasn't as upsetting as it could have been because I was pretty out of it. Andrei later showed me a little video of David lying there crying in the nursery, and that was sort of upsetting considering I couldn't be there with him, but I guess you could say our bonding was just delayed a little.

Eventually everyone left and things quieted down and some friends came by to congratulate us, and then we had our hospital dinner and went to our room.

Oh, David was born at 3:35 pm and we had gotten to the hospital at 1 am.

Maybe I will write the postpartum story later. For now, at least I've gotten this far!

9 comments:

  1. Congratulations Elizabeth. I am glad you posted this. I know we haven't spoke since college, but I am glad I can keep up with you in small ways. I hope you and your family are doing well.

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  2. Thank you, Kim! Good to hear from you.

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  3. Thanks for posting your birth story, Elizabeth. I'm getting closer and closer and feel like reading other people's experiences prepares me a little...hopefully! At this point I am still hoping for a home birth but we'll see how things go.

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  4. So glad you updated your blog, Stephanie! Yes, reading birth stories helps. You can see the combinations of events that can occur. You'll do just fine. Your body knows what to do, even if it ends up needing a little help. May God give you peace!

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  5. Hi Elizabeth-- thanks for posting your birth story!I've been reading your blog for a few years now and rarely comment.But I could relate to so many things you say, that my husband often jokes that we could be best friends :) Ok, don't think it's creepy :) I had a baby girl Katya on July 2! I had a very different birth than you (to start with-- she was 6 weeks early), but definitely can relate about sad state of hospitals and staff asking rude questions, not answering questions, being pushy etc...I even read the same books as you in my preparation of birth! Can't wait to read more about your life in Russia with your little man who is only 7 days younger than mine!

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  6. Is your name Masha? I'm so glad your little girl is okay! Do you have a blog? It would be interesting to compare notes.

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  7. Ah no blog, but I've started writing Katya's birth story about oh, you know, 3.5 months ago-- so once it's finished I should email it to you! But yeah-- nice to meet you-- I'm Masha :)


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  8. Wow...I love your birth story!!! So proud of your efforts!!! You are amazing!!!

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  9. Masha, that would be interesting to read!

    Thank you, Karen! Can't believe you did it 4 times! :)

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