Wednesday, July 2, 2008

BIrthstory



Note for the Squeemish: If something gross is about to be mentioned I will preface it with this: (YUCK)

3:00 am(ish)
I wake up with regular cramps and think to myself, "I'm in labor, but that's...ok". My sleepy brain decides that if I am not uncomfortable enough to jump up and call for help then I can get in a few more Zs. Sort of like when I was in college and decided that today's class was just a lab and I really could hit snooze a few dozen more times.

4:15 am
As the swelling cramps became more noticeable I woke a bit and started rolling from one side to the other, which is hard to do gracefully at 41+ weeks pregnant. I was getting pretty close to waking Tony up with all my sloshing around so I decided to head into the living room with my favorite pillows and Tony's college dorm blanket (the only unusable guest blanket in our house because it is so very fuggly). I waddled to the couch and made myself a little nest of blankets and pillows. Then I set up a lamp so I could have some reading light. I was dying to get into my nest and try for more sleep but I am a freakshow who can not go to sleep without reading something first.


For some reason I picked MAUS by Art Spiegelman. If you haven't read it then please do so right away. It an anthropomorphic retelling of his father's memories of Nazi Germany and the concentration camps at Auschwitz. I don't know why I decided to labor with MAUS but something about that family's love and devotion to each other and the clever survival instincts of his father were very comforting and encouraging to me as things got more intense.

6:00 am
After a while sleep seemed unlikely and I needed to get under hot water so I took many "showers" which consisted of my holding the shower faucet over my tummy and breathing deeply. The water was great but I wanted to lie down again and the living room seemed too far away. The sun had risen and there was light in our bedroom, so I crawled back into bed with Tony. Because I must always read in bed I took a copy of "The Birth Book" by William and Martha Sears.
(shout out of thanks to Gillian for lending me her copy!) I flipped to a random page and read that the uterus itself does not have pain receptors but the muscles that surround the uterus get fatigued by all the cramping and that is what hurts. So presumably if you can encourage all those muscles to relax while you are in a contraction it will be more manageable. I had read this maybe 10 billion times before in my years of internet baby birthin' research, but it didn't sink in until right in that moment.
I had been clenching my teeth and sucking in my abs (such as they were) during the contractions, while deeply breathing...which was stupid. Now I just made everything in me that was freaking out calm down and let go. Soon the contractions became warmer and more acceptable. I started finding positions that eased my mind instead of sending me into a panic.

7:00 am
(YUCK)
I leap up from the bed and vomit loudly in the restroom which wakes Tony. I had wanted him to sleep as much as possible but when I got back to bed his eyes were open and he asked if I was ok.

I decided that this relaxing breathing thing was nice and all but I needed other people to feel my pain. So I gently told Tony that we might have to skip my 8am OBGYN visit because I might be in labor. Tony (bless him) leapt up and started pulling stuff together for the hospital. My contractions were about three to four minuets apart so I was limiting my communication to forced calm commands,
"Find the IPod. Put my pillows in the car. Go eat breakfast. Pet my back. Get the carseat. Wake up Mom."
and sappy love declarations,
"I love you so much, thank you for being so sweet. You are really the best person in the whole world."
Mom suddenly appears at my side fully dressed and ready to go. She massages my back while Tony calls the Dr.

7:45 am
We call the OBGYN's office and tell them that I am most likely in labor. My Doctor will not be in until 8am but they want me to come into the office anyway and if this is true labor they will send me over to the hospital. I am pissed because I know very well what this is and I want to go straight to the hospital. Also I want a big mac and another 8 hours of sleep.
We toddle to the car and before I get out the door I lock eyes with the cat who is looking at me like I am a crazed water buffalo. "It's ok kitty." I say, but he is not convinced.


8:20 am
We are driving to the hospital and the seat is hot on my back (thanks Texas) and the air conditioning is cool on my face (thanks Chevy) so I actually feel pretty good. The labor is not intense enough to make potholes uncomfortable and I am happy to be in the car with Tony going on a drive. We start joking about taking this car to Mexico and forgetting the whole birth thing. Tony is looking a little freaked around the edges but he handles everything like a pro.

8:35 am
OBGYN's office. Doctor Hart says, "Lets see where we are." and does an internal exam. Then she looks me in the face and says "Oh my gosh! You are five centimeters! Do you want to check into the Hospital or would you prefer to labor at home?"
"HOSPITAL!!" I say and she bounces a little bit with excitement. Dr. Hart has already told them I am coming and everybody is ready for me to check in.

(YUCK)
I throw up in the hospital parking lot. Note: Mangos are not so bad coming back up. Gross I know but I'm just saying, there are worse things to be sick on.


9:00 am
I had Alice at Seaton Southwest here in Austin and I couldn't recommend it more. This place is wonderful. Big rooms, one to one ratio of nurses to patients. It is quiet and sitting in the middle of the green hill country. The lady who took me up to my room had a bitchin' tattoo sleeve on her arm. She told me about the birth of her daughter and how she decided on orange blossoms and tigers for her shoulder ink. Contractions notwithstanding I was having a pretty fine time.

9:30 am
The dreaded monitoring begins. The lovely nurse Michelle is ready for me when I wheel into the room and she takes my vitals and hooks up a IV lock (with the help of nurse Maria). The lock takes a long time and a few tries because I am a very white lady with tiny veins. Also all of the (YUCK)throwing up and my lack of sleep since 4am (ish) has left me dehydrated. Then they put the two monitor belts on me to follow the progress of the baby's heartbeat and my contractions. Now I already knew all about the monitors from my research and I didn't think they were a bad idea because I wanted the baby's heartrate monitored. However, what I failed to realize is that the relaxing trick during contractions is almost impossible when two tight belts are constricting the area you are trying to relax. Not only that the kid's heartbeat kept disappearing. So I would be imagining bunnies twitching in a field next to a babbling brook (or something equally relaxing) and suddenly someone would have to jerk my monitors around and re-attach my belts. Not only that the kid started to kick against the belts from the inside. Relaxing was no longer feasible.

1:00 pm
I have banished everyone from the room (except nurse Michelle, who is required to re-do the monitor check every 45 minuets) so I can lean back in a barcalounger covered in a blanket and think about bunnies. After a while bunnies are too stressful and I start panicking trying to imagine more placid animals. Deer, wombats, snakes, squirrels, and fish are all quickly discarded. Then my brain lands on the image of a tiny truffle pig snuffling through the woods. This is perfect. I concentrate on my little piggy and follow her progress as she looks for food. After this is all over I will be nursing my daughter and marveling at the similarities between that little piggy and my Alice.
This whole time I am trying to sleep between contractions as the nurses continue to do their thing.
Tony and Mom sit in the waiting room for hours doing who knows what (you will have to wait for Tony's account to see what Daddy did during this time) and they only stepped into the room very briefly to check on me and then retreat when I groaned that everyone needed to leave me alone because I was TIRED.

4:00 pm
Dr. Hart has checked me and I have stalled out at 6 centimeters. This is disappointing because I labored so efficiently at home. The hospital setting was lovely and the barcalounger was comfortable, but neither was effective at getting babies out.
Dr. Hart suggested breaking my water. I was reluctant because I knew how much more painful it would probably be once there was no cushion between my cervix and the baby's head. But Dr. Hart convinced me it was the thing to do (and I agree in retrospect).
(YUCK) Dr. Hart took what looks like a crochet needle and stuck it up inside me to rip the amniotic sack. Suddenly I felt like I had peed my pants. I couldn't see it but Tony said that a mass of water and baby poo came pouring out of me. This poo is called meconium and was cause for concern because it isn't good for babies to swallow too much of the stuff. It wasn't a surprise that I had lots of meconium since the baby was overdue, but it ment that a Pediatrician had to be at the birth to suction the baby and we had to consider how long I was going to labor.

5:00 pm
You know how I said that breaking the water might make contractions more intense. Yeah...no joke. Now I didn't want to be alone and I insisted that Tony and my Mom be constantly available to pet me and arrange my birthing equipment (exercise ball, pillows, glass of water, etc). I was officially dehydrated so they started me on a series of IV drips. The monitoring was continuing and I also had a blood pressure cuff. So I was covered in tubes and belts and machines of all sorts. This made relaxing somewhat of a joke. But I decided to roll with it and remember all the skills I learned in pre-natal yoga. If something wasn't working for me I would try something else. I moaned and made noise, more to prove that I had control over the situation than anything else. Tony (bless him) moaned with me so I wouldn't feel stupid doing it alone. I rocked around and buried my face into things (Tony's chest, Mom's back, a roll of toilet paper). At times I escaped all the tubing (between monitoring sessions and after my fluid bag was empty) and let Tony take me into the shower. Tony brought shorts for the occasion (bless him) and held me up while I sprayed water on myself. He also held me up when I couldn't stand and let me bitch and whine about how crappy I felt. He kept assuring me that "Yes" he did eat dinner (liar) and "Yes" his back didn't hurt from holding me up (unlikely).

7:00 pm
I was seven centimeters (close to 8) and Dr. Hart was not encouraged by the slow going. However, she didn't press me because she and I both know that labor can slow down near transition to give a lady a break.
Then...transition was upon me. The contractions were right on top of one another and I was in frustrated tears. I went back to the shower and was told I could only stay in there a few minuets because with my water broken they wanted constant (not intermittent) monitoring. The nurses found a monitor that could be worn around my neck so I wouldn't be tied down to the bed. But the thought of trying to keep the baby's monitor functioning, being strapped around the stomach, and dealing with these non-stop contractions all at the same time was too much for me to handle. I stayed in the shower with Tony well beyond the time they wanted me back and thought about my sister-in-law Karen and how she had said that if she could give a present to any woman she cared for it would be an epidural.

I have never had anything against the epidural personally. I think it is just a tool in the birthing box. My concern was that my labour might stall out if I got the drugs too early. Since I was eight centimeters and contracting hard I thought "What the Hell." I leaned into Tony (now completely soaked by the shower) and admitted that I might want an anesthesiologist. He reassured me that it was fine and that I was fantastic for what I had done so far. He said anything I wanted to do would be the right decision.

9:00 pm
So it was done. As many women have said in the past, it is difficult to be still during a contraction while a needle goes into your spine. I kept my cool by digging my nails into Tony's back while the anesthesiologist wiggled into my spine. It was a very wrong feeling for a little bit. Then it was a warm numbing right feeling. I didn't get a large dose so I could feel and move my legs and also feel the contractions, but they were more like the 4am contractions. The only downside was that all of my adrenaline had nowhere to go and I got a case of the shakes and couldn't sleep.

10:00 pm
Dr. Hart checks and there is no progress at all. I have stalled. An internal contraction monitor is inserted along with a catheter. Now she wants me to try Pitocin to augment my labor. This is exactly what I was trying to avoid and I very upset at myself, and her, and the world. So Dr. Hart suggests (YUCK) nipple stimulation, which is just what it sounds like. I would be mimicking the motions of a baby nursing with two warm washcloths to get my uterus to contract. She wants my contraction monitor to be above 60 (it is at about 30) for each contraction. So I get to work on the ole' nipples. I tell you I rubbed away a layer of skin on the poor girls! But it worked and my monitor did show larger and faster contractions.

11:00 pm
All for naught. The baby was not getting stressed by the contractions and wasn't really moving down. I talked to Mom and Tony and decided to throw in the towel on the whole Pitocin issue. So Dr. Hart put me on the drug and told me we would wait 4 hours and check me again to see if we could get to the pushing stage.

1:15am
So here I am lying in a dark room. Tony is in the barcalounger getting some much needed sleep. Mom is decidedly NOT sleeping and pretending to watch a show about home renovation on HGTV. I am feeling the nausea that comes with not having eaten in 30+ hours and having thrown up all my reserves. I am shaking and my blood pressure is dropping.
I start considering the possibility that in 4 hours I might be fully dilated, but then I will be 4 hours more hungry and more tired and facing the prospect that this kid might be too big to fit through me without doing some major damage. This is where the hours and hours of birth research does me right. I know all my options and all the possible outcomes for me and the baby. I have done everything I can to have an uncomplicated vaginal birth. So internally I make a firm choice in my own mind to pull the plug on this game plan and go in another direction.
Externally I say "Mommy...I can't do this."

My Mom comes over and is very calm and respectful. She discusses the pros and cons with me as if we are talking mutual funds over coffee. Then she says that I am a informed patient of this hospital and she agrees that my decision is final. Mom talks to the nurse (excellent Kathy) who check me out and finds that not only have I not progressed but that I am swelling back up to a smaller cervical size. I tell Kathy to let Dr. Hart know I am ready for my C-section.

1:30 am
A flurry of activity. Tony is awakened and informed that he has to put on paper booties. My anesthesiologist returns to pump my epidural up to a spinal block. I am dislodged from my tangled web of tubes (YAY!) and rolled into the freezing operating room, hefted onto the table and strapped down again (Boo.)
I start shaking like I have never shook before. The whole table is moving. Dr. Hart comes over and puts a warm hand on me. She looks down and very kindly says that the shaking is normal and that trying to stop it will probably just make it increase. She says that everything is going to be fine and she is not worried. They put up a sheet and start prepping my tummy for the incision. My arms are strapped down like...well like Jesus on the cross minus the divinity. I feel some tugging and Tony walks in all in a gown and paper hat. Later he told me that they had already started the surgery and he walked in on my open tummy! Tony tried to put my glasses on my face (bless him) so I could see the baby when she came out. But Tony has perfect vision so he doesn't know from glasses. My frames were halfway inside my left ear and way above my right so I could see like 40% of the view in front of my face. Then I felt like a truck driven by an elephant wearing a concrete jumpsuit landed on my chest. I gasped in shock and suddenly I heard chirping and wailing coming from the baby!

2:16 am
I swear to you I recognized her voice from the very beginning. She sounded a little bit like my sister Jesse and a lot like me. I knew she was fine with the meconium issue and that her lungs were healthy. Tony (bless him) ran right over to her and came right back to me "She's healthy, she's fine, she's BEAutiful!" After a lot of suctioning and crying they brought the baby over to me. She looked very familiar and annoyed. I said "she's lovely" and "please take her away" because I was going into shock and had to throw up my pre-op anti-nausea drink.
I told the anesthesiologist, "I am going to throw up, could you fix my glasses, push my mask off, and I am going to throw up RIGHT NOW." Being a highly trained medical professional he took care of the situation with great efficiency. He even gave me some intravenous nausea medication through my IV before I had to ask for it. Lovely man.

3:00 am
Dr. Hart has finished sewing me up and everyone who saw my incision over the next few days remarked on how small and perfect her stitches were. The scar will be minimal because she rocks pretty hard. I am very pleased that we chose her as our doctor. I never felt like she was forcing me to do anything and she never made me feel bad about my wishes. If you are looking for a great surgeon and respectful OBGYN in the Austin area I would recommend Dr. Chris Hart.

I am returned to my room totally dehydrated and shaking. Then somebody hands me a baby. I say hello. She says "..."
I nurse her right away and for some reason it seems totally easy compared to everything else that happened tonight. The kid is big and some of the nurses are laughing about her 14.5 inch head. Apparently 15 inches is the biggest they have seen. She is a whopping 10 pounds 10 ounces. I am smug and satisfied with my c-section decision. Then everybody sort of disappears and it is just me, the baby, Tony, and Mom.
We all look at the baby and she looks at us.

That is pretty much what we have been doing for the past six days of her life. We look at her, she looks back at us.

6 comments:

Leanne said...

"Note for the Squeemish: If something gross is about to be mentioned I will preface it with this: (YUCK)." Thanks for the note!! I can't believe you had a baby last week and you were able to write down sooo many details!! You are amazing! I'm impressed!

MAUS , huh? Interesting.

Yeah- more pictures!

Have an enjoyable holiday weekend. Talk to you soon.

Bethany said...

Cool. Congrats again.

Bethany said...

Also, thanks for the note on mangos. I do appreciate tips like that.

Dwija {House Unseen} said...

I love this. When I posted my birth story on my blog, I was afraid no one but me would care much, but I think I was wrong, because I loved, loved, loved reading yours. And on a mostly unrelated note, Cancerian babies are the absolute best babies in the whole wide world- the kind of babies that make you feel that, yes, you *can* do this. And oh, my Elizabeth was born on June 28th. They're kindred spirits!

holt said...

Our babies are one day apart and have the same name? Clearly great minds think alike! My girl was born on her great-grandmother's birthday (who was the 2nd Elizabeth in a line of 6 Elizabeths including me and my baby).

Oh, and you did read the birth announcement correctly. The kid was 10lbs 10oz at birth... Oh yeah!

I am going to go check out your Facebook page and blog! Thanks for posting on mine.

holt said...

Hey, the mangos tip is free. Always happy to gross out my nearest and dearest!

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