Monday, September 16, 2013

Will's Birth Story

I finished Will’s birth story. It is for all you Birth Geeks out there but be forewarned: although it’s pretty PG (OK, maybe PG-13) rated, if you believe the stork delivers babies it is not for you. Also, there are references to the fact that I am female and, accordingly, have the accompanying anatomy.


I wrote Harper’s birth story in the days immediately following her birth. It was important to me to get everything in writing before the details started to get hazy. And, as much as I wanted to, clearly I was unable to do the same with Will. Here it is a month later and I am just sitting down now to write his birth story.

Part of the delay can be attributed to the fact that I have not one but two kids to manage now, which has rendered virtually every minor duty I am tasked with to be a major undertaking. But mostly I haven’t sat down because, well, everything was just so different this time. Everything from the onset of labor to my pain level was just… different.

I should explain upfront that I’m going to refer to Harper’s birth a lot. Partially because I had such a clear picture of what I wanted to be different this time around, but mostly because it’s the only other experience I’ve had with childbirth. I have to compare my experience with something.

My sweet baby Harper.
     
Also, with Harper’s birth my pain was really manageable so that I was able to maintain some sort of outward awareness throughout most of labor. Writing her birth story was just a matter of getting it on paper. With Will’s birth, conversely, I really relied on my inner strength and focus. Although I have very clear memories of the event, I have to rely on the short videos Brad and my doula shot and the birth timeline my doula kept to piece together the birth as a whole. My sense of time was completely distorted, which is kind of disarming for a control freak like me. Anyway, this is how it happened, as best as I can make out.

****
I started getting contractions when I was about 34 weeks pregnant; not your ordinary Braxton-Hicks but true (albeit mild to moderate) contractions. They were, however, very irregular. I’d get pretty moderate ones back to back for 40 minutes or so and then nothing for two or three days. Or I’d get very mild ones for several hours on end but they wouldn’t build. By 36 weeks they became almost a daily thing.

I knew myself well enough to trust that I wasn’t going into labor immediately, but was a little concerned I’d go into preterm labor (Harper was born at exactly 38 weeks so chances were good that Will would come at least a little early, too). Everyone, from my husband to my chiropractor, my doula to my midwife, and even my friends and family, agreed that he would make an early entrance. My midwife told me she’d like him to stay put until I was at least 38 weeks along, as if I could just place an order. I told her I’d do my best but I was pretty sure I had no say in the matter.

Then, on the morning of August 6th, at exactly 38 weeks and 2 days gestation, the contractions were pretty steady all morning long and I started to pass a little blood. Not a lot but the contractions were coming and going throughout the day so I was getting suspicious that Baby Day might be on the near horizon. I even posted a very mysterious and non-committal, “Looks like maybe today or tomorrow,” on my Facebook page and received a barrage of questions from enthusiastic yet impatient friends and family. That afternoon I called Brad at work and told him it was likely he’d be out the next couple of days.

I should back up here and explain that I had been chronically sick with a persistent cough for nearly two months at this point (which was later diagnosed as Walking Pneumonia). Just two days before I started spotting my midwife had prescribed a Z Pack for me in anticipation of my delivery. I still had 3 days of medication left and I really wanted to finish the course of antibiotics before going into labor, for my own comfort as well as to minimize any chance of my newborn being exposed to any nasty upper respiratory illness I might be carrying. Unfortunately, the prospect of going into labor that morning was really more scary than exciting, so when the spotting and contractions stopped mid-day on the 6th I was both relieved and simultaneously disappointed.

Then, that evening, the contractions started up again and were strong enough to keep me up for most of the night. I tried to sleep but they didn’t abate until about 3:00 am, and, although they were moderate and not regular or building, I felt certain Will was on his way that day.

By the time Brad got up for work at 5:00 am I really needed to rest (I was guessing that labor would get started maybe midday-ish) so I told him I needed him to stay home. Now this is where our stories diverge. He insists I didn’t tell him I was in labor, which, in fairness, may be true. If I didn’t specify I was in labor, however, it was only because I was, you know, exhausted from all the contractions because I was in (early) labor (and from being sick with Walking Pneumonia, don’t forget), so I kind of assumed he knew what was going on.

In any event, around 9:00 am the contractions started up again so I finally got out of bed.When I used the restroom I could see that I had some pretty significant spotting. I also discovered that my request to Brad about staying home that morning had apparently fallen on deaf ears because I found my mother-in-law in the kitchen alone with Harper. This led to the following curt phone exchange:

Brad: “Hello?”
Me (fuming between contractions): “Where are you?!?!”
Brad (confused and viscerally afraid of me): “At work.”
Me (pacing): “I told you to stay home! Why did you go to work?”
Brad (meekly): “Because I finished everything at home.”
Me (exasperated): “I’m in labor!”
Brad (genuinely shocked): “You are?!?!”
Me (frothing at the mouth): “Yes! COME HOME!!!”

Now I realize in retrospect that I wasn’t particularly nice to him but, again, I was in labor for heaven’s sake and my husband had gone to work while I was in labor, so I don’t really feel like I should be held accountable for my actions here. I am confident that any woman who’s experienced even one contraction would back me up on this one.

Sorry, Brad.

I left a message for my doula updating her on my status (my contractions were approximately every 10 to 12 minutes and about 45 seconds in duration). Then Brad came home and got the last few items packed in the hospital bag while I got in the bathtub. The thing was, I was still exhausted from the previous night, and I was dreading going into labor so tired. I was hoping a bath would slow things down enough to allow me to get another couple of hours of rest. It worked, and by around 10:00 am I was able to get some sleep.

I awoke refreshed around noon, and, I don’t know how to explain it, but even though my contractions were still irregular (at this point they still ranged anywhere from 4 to 12 minutes apart and were 40 seconds to a minute in duration but were finally coming in waves like “real” contractions ) I just knew labor was about to get serious (and it would!). That was actually the first of the two big revelations I had during this process; that I should just trust my gut when it comes to my health because I know my body really well. But I digress.

I checked in with Brad and my mother-in-law, Ann, who was trying valiantly to keep Harper occupied. Ann offered to make me a sandwich and Brad made me a smoothie while I called my sister-in-law (to reaffirm the tradition of calling her every time I’m in labor, I suppose). Our conversation went something like this:

Me: “I’m in labor.”
Bess: “Right now?”
Me: “Yes. We’re going to have a baby today.”
Bess: “How exciting… to have another nephew! How far apart are your contractions?”
Me: “They’re still pretty irregular. Hang on, I’m having one now.”
(Breathing on my end for about a minute.)
Bess (concerned): “That is one long contraction.”

When Bess said that I knew I needed to call my birth team. Bess has had four (yes, FOUR!) babies and really knows her way around a natural birth. For her to sound like she thought I might be delivering in my bathroom made me realize I needed to get some professionals to my house ASAP. I got off the phone immediately and asked Brad to call the doula, chiropractor and midwife. It was about 1:15 pm.

Shout out to Doula Emily of Birth Sister Doula Services/The Birth Collective of Tampa Bay. She was fantastic! http://www.yourbirthsister.com/

Both Doula Emily and Chiropractor Alexa asked Brad about my contractions (presumably to determine what phase of labor I was in) and he relayed their questions to me. This is where I confess that I fibbed a little bit. The truth is that my contractions were still varying wildly but I was afraid if I were forthright they’d delay in coming over and I knew that: 

1. I was progressing quickly at this point and…
2. they were both at least a half an hour away.

I told Brad that my contractions were about 5 minutes apart and about 45 seconds in duration, and they both agreed to come over immediately.
  
Dr. Alexa got to my house at about 1:45 pm. I had arranged for her to adjust me while I was laboring because I have Grade I Spondylolisthesis which predisposes me to an increased risk of having an OP (occiput posterior) baby. My primary goal was to go into labor in the best possible condition so the baby could get in to the best possible position before delivery, as OP babies can lengthen labor and pushing time as well as lead to increased risk of complications and cesarean section, among other things. (I had experienced all of the above but the C-section with Harper, who was born both OP and oblique. And, although my labor with her had been short and I had a successful vaginal birth, I pushed for 3 hours before she was born and ended up with related complications that took months to resolve.)

Shout out to Dr. Alexa of Totally Chiropractic. Thank you for everything! http://totallychiropractic.net/

As soon as Dr. Alexa walked in the door I came clean about my little white lie but I don’t think it mattered much because she could see I was in real (not messing around) labor. She had to stop several times while she was adjusting me so I could breathe through a contraction. By the time Doula Emily got there (about 10 minutes later) my contractions were exactly three minutes apart and one minute in duration. When I heard that I decided it was time to go to the hospital.
      
Both Alexa and Emily asked if I wanted to get in to the tub for a while but I believe my exact response was, “If I get in that tub I’m never getting out.” What I should have said was, If I get in that tub you should prepare yourself to assist in delivering my baby there, because I am not going to be able to muster the strength or desire to get out.

With Harper’s birth one of my indications that I needed to go to the hospital was that I was dreading the car ride, and this time I wanted to arrive at the hospital a little earlier in labor so that I would have time to labor in the tub in the Labor and Delivery suite before pushing (with Harper my labor went so quickly that I was pushing as soon as I got into L & D). Yet here I was dreading the car ride again, with contraction closer together than they had been the first time, so I was afraid I’d missed that window. I quickly finished eating and we loaded into the car.

One of the things I had been very clear about when discussing my birth plan was that I didn’t want to talk during labor unless I absolutely had to (who wants to talk while they’re breathing through contractions?). Brad and Emily had both agreed to answer any questions the hospital staff had for me, and I had written all of my personal information in the preamble of my Birth Guide for that purpose.

Those of you who read Harper’s birth story know that there was a comedy of errors that started the moment we arrived at the hospital intake (where Brad got performance anxiety and forgot my birth date not once but twice). Let me just state that I was determined that the same mistakes would not be repeated so I had written an inordinately specific and lengthy Birth Guide this time, and everyone got a copy. Brad had a copy. Emily had a copy. Alexa had a copy. The intake nurse, the triage nurse, my midwife, the midwife in training, my labor and delivery nurse, the postpartum nurses, pediatric nurses and even the dietician all got copies. So you’d think it would be smooth sailing when it came to something as simple as, say, getting my birth date right, which was clearly printed and emboldened dead center on the very first page of the Birth Guide. Not so, as it turned out.
   
Actually, everything did go smoothly until we got to Triage. For those of you who aren’t familiar with it, Triage is the modern day equivalent of a medieval torture chamber. First of all, they have a particular penchant for being staffed by either the newest hospital hire who doesn’t quite know how to use the computers yet (who we got last time) or the most irritatingly cheery and detail-oriented nurse who also happens to have the most grating voice on the planet (who we got this time). Then they tell you matter-of-factly that they have to assess how the baby is handling labor, so you have to lie perfectly still, on your back, for at least twenty minutes, while they monitor the baby’s heartbeat. While in labor. I hate Triage. I’m pretty sure it’s one of Dante’s Circles of Hell, and I had told my doula as much. So as soon as we got checked in Emily went to see where my midwife was to hurry things along. Brad stayed with me, his copy of the Birth Guide clutched in his hand.

My Triage nurse.

So there I was, trying not to move, on my back, with back labor, breathing through contraction after contraction, and all the while Ms. Nasal-Tone (I didn’t get her actual name) was asking me inane question after inane question, my Birth Guide resting uselessly in front of her. The following is an excerpt from the actual conversation that occurred about that time, as I remember it.

Ms. Nasal-Tone: “Date of Birth?”
Brad (hesitantly): “Um… Five?”
Me (experiencing back to back contractions): “No.”
Brad: “No, um… seven? Nine? Nineteen seventy… three?”
Me: “No!”
MNT: “Height?”
Brad: “I don’t know. Like, Five two?”
Me (annoyed): “No.”
MNT: “That’s OK. Do you know how much she weighs?”
Brad: “Um… one hundred sixty five?”
Me (very annoyed)*: “NO! Brad, read the Birth Guide!”
This is when Emily came back in the room and caught just the tail end of the conversation.
Emily (calmly): “It’s OK. You don’t have to answer any questions. We’ll do it all for you.”
Me: “He’s answering everything wrong!”
Emily: “Oh.”
*I was thinking, Who does he think he married, a Hobbit?

In any event, just after 3:00 pm, as I was lying on my back my midwife, Karla, came in and checked me. I was 5 cm, 90% effaced and Will was at a zero station. I was kind of surprised that he hadn’t descended more but was more surprised when we got the results from the fetal monitor. Will was tolerating labor well. In fact, he was asleep. This was my first big indication that the baby about to enter our lives was going to be a pretty tolerant and easy-going kid.

Shout out to Midwife Karla of Women's Health Care, who caught both of my babies. Thank you, Karla! http://womenshealthcaretampa.com/ 

Emily’s tactic of tracking down Karla and pestering the Triage staff worked because we were escorted into an L & D suite right after they finished with me. I could not get into the tub fast enough, and the warm water really helped take the edge off the contractions. I felt best laboring on my hands and knees but would rest in a sitting position between surges. Brad and Emily took turns putting pressure on my back with each contraction to counter the back labor (which wasn’t terrible, I feel I should note, but it was certainly nice to have some comfort measures). However, I was feeling a lot more uncomfortable overall than I had during Harper’s birth, so I was concentrating a lot more.

After about an hour and a half in the tub the water wasn’t relaxing me like it had been and I started to feel like I wanted to get out. About that time two nurses came in and had me stand up while they monitored the baby. When I stood up I felt like there was a bowling ball in my pelvis. I knew that a lot of women feel like they need to use the restroom when they get close to pushing, and I was starting to feel that sensation, so I tried it.

When I got off of the commode I felt a really strange sensation. The only way I can describe it is to say that it felt like I had sat on some Saran Wrap and that it had adhered to me. In my altered condition I could only speculate that I was feeling the pressure of the unruptured amniotic sac in the birth canal, and almost at the same moment I had that thought I felt an urge to push. It was a little after 5:00 pm.

I told Brad and Emily I wanted the midwife to check my progress again. Emily knew I had experienced a long pushing phase with Harper due to complications brought on by my underlying spinal problem, and had spoken at length with my chiropractor about how to best assist me in labor. Their plan of action was to keep me vertical as long as possible, and not “officially” start pushing until the last minute. (Hospitals put you on the clock once you start pushing, and if they arbitrarily deem the pushing phase too long they can call for an Emergency C-Section.) Because I was predisposed to a long pushing phase and wanted to avoid a cesarean unless absolutely necessary, she and Brad coaxed me into getting through just a couple of more contractions before deciding if I still wanted to call the midwife back.

After two more contractions I was positive I was ready to push and insisted I wanted to be checked again. This part gets really fuzzy for me. I know I started laboring on the birthing ball and that I was checked again shortly after I asked for the midwife, but I don’t know what order things happened in and have absolutely no sense of time for this phase of labor. I do know I was feeling a definite urge to push at this point. It was sometime between 5:00 pm and 6:00 pm when Karla announced I was 8 cm, 90% effaced and that Will was still at a zero station. I couldn’t believe it. With Harper I had dilated from 4 to 9 cm in a half an hour and here I was going slower my second time around. No one goes slower their second time around. To add insult to injury Karla told me not to push yet, which was totally a moot point because my body was doing the pushing with or without me.

This was the hardest part. I remember leaning on the side of the bed while laboring on the birthing ball. I think I said, "I'm dying!" at one point and I know I said, "I cannot do this!!!" Every time I felt a contraction I would stand up and lean over because the pressure was so intense I was sure a baby was coming out of me any second. It was there, my forehead pressed against the tissue on the labor bed, eyes clenched shut, that I had The Epidural Epiphany. I finally understood why some women wanted to end the pain by any means necessary. I also had my second major realization throughout this process: that there was no way I could do this alone. I really needed every single person in that room to help me bring Will into the world.

Harper was delivered in a terrible position; a one-in-three-thousand-births kind of position. So bad, in fact, that that she was blocking (and ultimately damaged) the major nerve that does all the pain sensing for that particular area of the body. The result was that I had comparatively less pain, even during delivery, than the average birth. So, while the good news was that Will was in a much better position than Harper had been, the bad news was that I was suffering the full experience of unmedicated childbirth for the first time, and it was a real kick in the teeth. I kept recalling the old saying that once you feel you've reached your limit in labor, you're almost done, and trusted I was close.

I started thinking about requesting they rupture my membranes. I thought, if an intact amniotic sac is the only thing holding up labor let’s get this show on the road! I asked Emily to review the pros and cons of membrane rupture with me to make sure I hadn’t forgotten any important cons, and as she was answering me I got another surge, leaned forward, and my water broke. Talk about good timing!

Contrary to popular belief, this does not happen when your water breaks. 

Shortly thereafter, at about 6:15 pm, the L & D nurse realized I was “grunt pushing” and called Karla back into the room to recheck me and… hallelujah! At 6:20 pm she announced I just had an anterior lip and was ready to push. She actually manually manipulated the lip back against Will’s head with my first push so it would stay put (yay for midwives!). It was such sweet relief! I just wanted to get done with labor but I had a history of a nasty tear so Karla kept telling me to take it easy with the pushing.

Then, after what seemed like only a few minutes, Karla told me that the baby was getting a little stressed so she wanted me to get him out with the next contraction. After all the holding back I thought, Great! That’s an option? and pushed with everything I had. I pushed and pushed and pushed. I pushed past my contraction. I was DONE. Done with being pregnant, done with labor, done with it all. And I did it.

Wilson Joseph Loren Booker was born OP (of course) at 6:38 pm, after only 18 minutes of pushing! They handed me his warm, wet, slippery little self and I held him to my chest. I marveled at him; he was so tiny and perfect. Then, after a moment of reflection, the first sentence out of my mouth was, “Thank God that’s over.”

In the meantime the L & D nurse was constantly rubbing him allover to try and get him to cry because he was so quiet they were afraid something was wrong. (As it turns out he is just a really contented kid.) Because he had been a little stressed at the end of labor they requested to cut his umbilicus prematurely so they could test its acidity. Brad and I were both disappointed and disconcerted but acquiesced. Then the nurse took him briefly to check him and get his Apgars, which were a healthy eight and nine.
 
It was during this time that Karla, who had also delivered Harper, asked me if I thought he was bigger, smaller or the same size as Harper (who had been 6 pounds, 13 ounces, and 19 ¾ inches long). “Oh, definitely bigger,” I said, “… mid sevens, maybe low eights.” “Really? I think he’s about the same,” she stated. “We’ll see…” she mused. The nurse proved me right when she declared 8 pounds, 3 ounces, 22 inches. “In your face, Karla!” I gloated (by this time the post-delivery adrenaline rush was starting to kick in). “Yeah, I’ve been off all week,” she retorted.

Daddy and his boy.

Brad helped bathe Will and then I held him and got him to nurse while they did some minor suturing. Later we were escorted to the maternity suite. Emily stayed with us until we got situated and then went home for some well-deserved rest.
   
That night, while Brad and Will slept and I was experiencing my typical post-delivery insomnia, I reflected on the day. Giving birth to my two children has been, in both cases, easily the most exciting, scary, exhausting, beautiful, impossibly miraculous event of my life and I wanted to savor every second of the experience each time it happened. That’s why I write the birth stories: I don’t want to forget anything. I want those moments to be suspended in time, forever.

Post Script:

So how long was I in labor? I don’t know. I think a good argument could be made for two weeks, but since I didn’t have that, “Oh yeah, THIS is labor!” feeling until about 1:15 pm on Baby Day I consider that the start time, which adds up to a grand total of about five and a half hours. Is that cheating? Maybe. No matter. The important thing was that, in the end, we got our perfect baby boy. Welcome to our family, little Will! We love you so much!





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