Friday, December 7, 2012

Deliver Me- Sophia's Birth Story

Disclaimer- this took me so long to write I'm not bothering to proofread. Excuse the errors.

So they tell me I'm supposed to write this down ASAP before my memory changes. Of course my memory of the actual labor is already a little fuzzy. John said he has to help me with the times because I'm off :)

If you read my previous post, you know we had to decide about being induced. We decided to go ahead and try that, starting at 7am Wednesday the 28th.

Day 1

Showed up at the hospital, still 2cm and 70% effaced, firm posterior cervix and -2 stations.

I had an excellent nurse named Melissa who I got along with so well. She was SUPERB. She did have to poke me twice for my IV, since the first one blew. Nice lump and bruise there. But I could not have asked for better care staff. We also found out that my former midwife Robin was working in labor and delivery as a nurse, since she hasn't been able to find a practice to take on a midwife. I was so happy I nearly cried. She wasn't my nurse, but did come in to check on me several times.

We went in at 7 and by 8 my midwife had placed the first 25mcg dose of Cytotec. I got a tub room! (Only 2 of the 6 labor rooms have tubs). Thankfully I never had a single problem from the Cytotec, which I was so concerned about. I started having irregular contractions, maybe 3-5 an hour and not very painful. Compared to what they would become, they were a tropical vacation :)
At lunch I had a second dose of Cytotec to see if we could convert to active labor. I was still 2cm and 70%, although a softer cervix and a tad more anterior. Things started to pick up a bit, but not too much.

At 2pm I started nipple stimulation at the suggestion of a nurse. It was really effective and my contractions started coming 2-3 minutes apart, more painful, but still manageable. I would just take deep breaths, do hip circles and concentrate. I alternated between walking and rocking on the birth ball. I played a lot of Flow Free and we listened to music. No one else had to help me. I was thinking "I can do this, not so bad!". John was really excellent, just being with me. We were both fairly quiet. He gave me lots of encouragement and compliments.

Unfortunately when the midwife came at 5:30 and did the exam- I was only 3cm 80% -1, cervix softer and more anterior. We had already decided before going in that if it did not work and we could go home, we'd go home and wait it out and see what happened. That's what the midwife suggested. She said I was in early labor, try and rest. I was asked to come back if things got serious where I couldn't handle the contractions. Otherwise, come in Friday at 8am for re-evaluation.

At 7pm we went home.

Once I went home and quit the nipple stimulation, my contractions started to space out. I still needed to stand and blow through them, but since the midwife advised rest, I took a big dose of melatonin and went to sleep.

Day 2

I actually slept decently and by morning contractions were 10-20 min apart, less painful and more irregular. We decided to try acupuncture to induce labor with a local chiropractor who specializes in it. His assistant told us to be ready to go because often times women go straight to the hospital. I a needle in each small toe, inner calf, hand and one in my neck. Then one leg and one hand were connected to a stimulator. I had a couple extra contractions but nothing big. I was asked to return that evening for another treatment.

Once at home I tried nipple stimulation again. Not very much success with that. Contractions were 3-12 minutes apart, irregular and not that painful. And you can't do nipple stim all day :) So we took a couple walks and tried to get things going. Only they slowed down even more. I did a second acupuncture treatment that afternoon. Not a single contractions during it. Nada. We were send home with acupressure points to work on. We made sure everything was ready for the hospital. I had a meltdown over having to more than likely get Pitocin and being upset feeling that my body had failed me.

Day 3

We arrived at the hospital at 8am. I knew this time we weren't leaving without a baby. The midwife came in and checked me. I was pretty much unchanged, except I think maybe she had moved down one more station. In fact, my cervix had moved a little more posterior again. The midwife suggested we try Cytotec again because I was still not a good Pitocin candidate without a soft anterior effaced cervix. I was glad to try it again because it had worked before at least some. I got the dose, and again not too much went on until I got the second dose. They gave me a double electric pump to do more nipple stimulation. Around 4pm contractions were closer together and I really had to focus during them.
I decided to walk in the hall again. I made it about 10 feet when a fairly strong contraction came on and I then saw two wet droplets appear on the ground. I told John "I think my water just broke, or I peed myself". I was fairly certain it was the former. He went and got my nurse (and former midwife, who was my actual nurse that day) and she tested the floor drops and then me. My water had indeed broken. It was 5pm.

Things between here at 3am the next day are kind of a blur, at least time wise. I do know not too long after my water broke I got in the tub. My support person Sarah came. I know I met my night nurse while being half naked in the tub moaning. So that was around 7-8pm. The water did help some, I think. By this point I was having a decent amount of back pain. I remember telling my night nurse that I hoped I didn't have to go through 8 hours like this. Her name was Shannon and she was awesome. My midwife delivered her little girl 14 months ago. They took the clock off the wall for my benefit.

Sometime before midnight, since I seemed to be in a decent amount of pain with my contractions, Shannon suggested we check me. I was scared to death of having a contraction out of the water, but I got out. She checked me and didn't say anything. I knew this likely meant I had not made much progress, but I didn't ask what she found. At that point I was still in a wet bra and had a towel on my head, but I didn't care. I did some contractions in the bed and then didn't feel like getting back in the tub. In retrospect I think I was in too much pain to think all that clearly. I do think my contractions were like 2-4 minutes apart at that time.

Sarah and John were there for every contraction. I was having super bad back pain. Like torture. The worst pain ever. They were taking turns leaning their fists and weight into my back with all their might just so I could make it through a contraction. I was doing my best to breathe, moan, and hip circle with each one. I tried standing, sitting on the ball, kneeling on the bed with my torso resting against the back. It sucked, major. I did manage not to curse, though I very much wanted to. I kept thinking- "I can't go on like this".

Shannon came in to discuss doing nipple stimulation or a little bit of Pitocin. Unbeknownst to me my contractions had spaced out to like 6 minutes apart. I wanted to cry. I was praying for and end to pain or less pain, not more! Shannon called and spoke with my midwife. She did not want to do Pitocin just yet. Instead she wanted me to try laying in bed on my side with one leg in the stirrup, a position called "fire hydrant". Along with an ice pack on my belly to try and make Sophia turn. Due to my amount of back pain we were pretty certain she was backward facing (occiput posterior). I tried this, but contractions every 6 minutes kept me from resting. Sarah went home, but John stayed with me. Sarah had work that day and hadn't slept.

While laying in bed I started feeling I had truly reached the end of my rope. I wanted drugs. At least something IV to try to take the edge off. John wanted to consult the midwife first. My nurse called her, and she came into the hospital to help support me and help decision making. By the time she arrived I was certain I wanted something. She persuaded me to get back in the tub and have the hot shower jet sprayed on my back as I contracted. This helped some, but not enough I thought I could go on, let alone have more frequent contractions. They gave me 100mcg of Fentanyl while in the tub. It felt so good to relax, to be able to focus on something other than pain and breathing.

But, IV meds only last so long. About an hour. I could feel the strength of the medicine waning during contractions. And my contractions had spaced out to about 10 minutes apart. I knew something to augment them was in my future, and I couldn't bear the thought. John was sitting on the tub and I talked to him. I felt like I was giving up at that point, but I just didn't care. I was exhausted and afraid. I told him "I know you're going to be disappointed, but I want an epidural." He gave the best response possible: "I'm not disappointed. You've done so much more that most people, you've been so strong and gone a long time."

So when my midwife came back in, I told her my feelings. She and John both asked me to consider trying Pitocin without pain meds, but I just couldn't. The midwife admitted that my contractions would be closer and possibly stronger than before. After having relief I just couldn't face it again.

So about 4:30 or 5am, I got out of the tub. They checked me, and I was 6.5cm, but could be stretched to a 7. Still a ways to go. Just as the anesthesiologist was about to start the epidural, Sarah came back. She had worked some and couldn't sleep. I know the epidural went in at 5:30am. I hated the way it made my legs feel, but it was better than the alternative. I did also get the shakes, but they went away after awhile. It didn't drop my blood pressure thank goodness, or give me a fever.

At this point I passed out (slept) for somewhere between 2-3 hours. The nurses turned me from left and right "fire hydrant" to modified sitting up with "frog legs" in order to help my pelvis continue to open. I know I woke up at 8:30 and told Sarah to go on home. My mom came in for a visit. Then she left and I napped again for about 30 minutes. Then John returned. I found out he'd gone to our postpartum room and taken a nap. Apparently he looked pretty bad and had the shakes. I found out from him that he'd eaten breakfast, but then developed hot and cold sweats and thrown it all up. He had the nurses take his temperature, and it was fine. I think he was just exhausted and his body shut down.

The nurses kept checking me, and by noon I was able to start pushing. My midwife said my body had relaxed a lot since the epidural. Although I still had a stubborn lip of cervix that took some maneuvering for them to stretch away.

And then started the pushing. Lots and lots of pushing. From every position they could get me in to. I don't think I'm a great pusher, especially with an epidural. Although it had started to wear off across the tummy and down my left flank at that point. My favorite pushing position was using the squat bar. I did have enough feeling in my legs to support my weight if they were propped right under me. But I also did traditional style pushing, tug of war pushing with the nurse, pulling on a towel tied to the squat bar, using handles on the bed and I can't remember what else. It was SUPER hard work. Especially since I'd been about 12 hours without food (bad choice on my part).

They gave me the mirror to hopefully encourage my pushing. I told the midwife several times I didn't think I could do it, and that I was giving it everything I had. Since they kept telling me that's what I had to do :)
I didn't think I'd be able to get her out, but finally, I saw her head come out to about her nose.

And then things changed.

I heard my midwife say "Oh (expletive), where's the doctor?" They immediately put me back into regular pushing position, a nurse took each of my legs, another nurse started pushing on my pubic bone, my midwife got up on the table with me and another nurse supported her. John says there were like 4 people who "jumped' on top of me. The midwife started yelling for me to push as hard as I possibly could. It scared us both. I heard the midwife say "We've got a hand, and a shoulder."
This meant her hand came out by her face, and her shoulder was stuck (technically, an acynclitic presentation with her hand wrapped around her neck and shoulder dystocia). Boy was I glad I had that epidural, because next I saw scissors and I heard the sound of flesh being cut. My flesh. Glad I didn't feel it.

I saw the midwife deliver Sophie and rush her to the warmer. She had her under the shoulders and her arms and legs were hanging limp at her sides. That's when I really started to freak. The room filled with about 10 or so people. About 5 for Sophie and four or five for me. The regular nursery nurse, the special nursery nurse, the pediatrician, a tech, 3 or 4 delivery nurses and the midwife. I was so traumatized I didn't cry. But I did start calling on Jesus to save my baby. Quite loudly. At this point John was able to get close enough to hold my hand. I heard her cry after a few minutes, really weak like a kitten. Then the doctor showed up and they set to work on me. The midwife only repairs 1st and 2nd degree lacerations, and she had needed to cut a 3rd degree episiotomy in order to get Sophie out quickly. I was concerned for Sophie, but I was also freaking out about myself at this time. My epidural had worn off in places and I was freaked out at the thought of getting shots to numb me. I also developed the shakes again. I asked for something for pain or to calm me. They gave me another 100mcg of Fentanyl. Thankfully, I couldn't feel the repair stitching. I don;t know if they gave me numbing shots that I didn't feel or if the epidural alone was enough.

Back to Sophie. I finally got to hold her about 25 minutes after she was born. So much was going on it seemed like only 5 minutes. But I found out that she came out not breathing, and required 45 seconds of bag mask oxygen. Her 1 minute Apgar score was 2. She had a heart beat, and that was about it. However her 5 minute Apgar was a 9 and her 10 minute was a 10. So thankfully she recovered well. I cannot thank the team in that room enough. They knew what to do for me and her. She also has pretty large petechial hemorrhages in the outside corners of both eyes. But these will go away in time. But they are proof she got quite the squish. The midwife thought I would have some on my face and eyes the next day too from pushing so hard, but I didn't.

After this, things went pretty normal. She latched onto the breast well. Her blood sugars were normal. She had a little bit of fast breathing and a couple low-ish temps, but nothing that needed intervention.

I of course am having lots of fun taking care of my episiotomy.

And so that's it. Hours of slow progress and then horrifying minutes of frenzied activity. The midwife said I should not go very much past my due date next time. Although she was only 8 pounds 6 ounces, she was not a good fit for my pelvis.

My mommy amnesia hasn't fully set in yet. I'm a bit traumatized and not in any hurry to do that again. But, I do love her very much. I am glad she's here and were both healthy, but I don't want that particular experience again.

Most of all, I am thankful to God that his hand was on us. Just reading the definitions on the links I placed throughtout this post was enough to make me cry. Things could have been much worse.

Now that she's almost a week old, there is more to share. But since it has taken me a week to complete this post, it'll have to wait. Being a new mom is really tough, but I'm told it gets better :) And holding, feeding, changing and swaddling takes priority over blogging right now, as it should.                          

The day before I delivered.

After the epidural. There are no photos in between :) Just lots of labor.

Using the squat bar, and likely telling the midwife to just pull her out :)

She made it!

My fantabulous midwife who spent 11 hours with me prior to delivery and probably 36 hours in the hospital (two days being her "off" days) over the time I was there. She is a saint and it is a calling.

First meeting. I looked way better than I felt.

Skin to skin bonding with dad

Sweet angel

Going home day. I wore this same dress home 28 years ago.

Just about to leave the hospital

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