Thursday, March 18, 2010

A Birth Story, Part One: Jack's Story

According to the doctor’s calculation, Jackson Edward was originally due to arrive on March 31st, 2007. However, I had been charting my cycles and keeping good track of everything so I knew, and I was able to convince them, that a more appropriate due date was April 3rd, 2007.

I had been researching pregnancy and childbirth in the months that Dave and I had been trying to have a baby, and, due to many reasons, I decided that having a natural drug-free labor would be best for me and my child. Having made this decision I researched as much as I could on the subject, learning many relaxation techniques and how to manage my own pain, as well as educating myself on labor and delivery so that I would know if and when an intervention was needed. I felt extremely prepared and pretty confident in myself, and I was really looking forward to That Moment when my baby would be born and they would put him directly on my stomach so that I could share with him his first moments in this world!

Both of my due dates came and went, and I had still made no progress, so my doctor decided that she needed to schedule an induction- something I did not want. She scheduled me for April 11th, and I spent the days until then praying, and asking everyone else to pray, that I would go into labor on my own before then! I knew that I didn’t HAVE to show up for my induction date, but also knew that there was no way that Dave would let me ignore it. He is very “Modern medicine is pretty great, Rebecca!” and “They have these policies for a reason, Rebecca!”, where I am very “That policy is from the 60s and things have changed by now, David!” and “I’ve done my research and I know that this is medically perfectly fine, even if their outdated policies don’t support it, David!” So I knew that one way or the other, April 11th was Jack’s deadline!

My plan started by laboring at home as long as possible and to be at least 3 cm by the time I made it to the hospital. Easter Sunday, April 8th, I still hadn’t gone into labor. As a matter of fact, until about 4:00 that afternoon I hadn’t even had anything other than very painless and easily ignored Braxton Hicks contractions! Finally though, as I was sitting at Aunt Sandra’s dining room table, I started feeling a slight backache that would come and go and I knew that those were real contractions! They continued for the rest of the day and the day after that, but although they did increase in intensity, they were still pretty easily ignored.

When I woke up on Tuesday April 10th, I noticed that my ctx were stronger than the previous day, and when I got up and started moving around they started getting a little closer together and a little more painful. I lost part of my mucus plug, and so I was a little encouraged that there might be something to the stronger ctx. Dave and I went to a funeral, and then he went to the gym (but only after I convinced him that I wasn’t going to have the baby while he was gone!) and when he got home we went for a walk to see if we could kick things up a notch. Our regular walk didn’t seem to be doing anything so I decided we needed to go one more time around the block- halfway through my ctx got a lot harder and closer together and I decided that I needed to time them again. I spent the rest of the evening timing ctx and trying to restrain myself from going to the hospital too early. At 11 that night my ctx were consistently 3 minutes or less apart and lasting an average of 45 seconds, and I was getting very serious about them, so I decided that it was time to go in. We got to the hospital just before midnight and they checked me and said I was 3-4 cm... my goal was to get to the hospital at 3cm so I was happy!

I went over my birth plan with the nurse and she said that since I wanted to go natural it would be a good idea for me to get up and walk around, so my mom, Dave and I made some laps around the hospital and visited with Amy and Ang, who were in the waiting room. The walk definitely made my ctx stronger, so I was hoping that meant a lot of progress, but a few hours later when they checked me again (and introduced me to the midwife and my new nurse) and said that I was 4-5 cm. They wanted to start my IV but I didn’t want an IV and so I told them that I wanted to get up and walk again so I wasn’t ready for the IV yet. They said that the IV could wait but that the midwife would be in so I should stay in there until she came (which wasn’t for a good while- I guess she was busy). At this point the best way to labor for me was to act like I was sleeping. I lay on my side and concentrated on evening out my breathing. When a contraction came I would change my breathing by blowing out my breaths instead of simply exhaling. Rotating from side-to-side also helped. I’d go through a bunch of ctx on one of my sides and then they’d start to get intense so I’d switch sides and changing it up would help me relax.

By the time the midwife came (this is where the hours start to blend together for me- I stopped really paying attention to what time it was) I was at 6 cm- they put my IV in because they didn’t want me to walk around the hospital after 6 cm so I wouldn’t be too far away from L&D if I progressed quickly, but they were ready to move me out of my closet of a labor room and into the nice labor and delivery room, so I walked to that room (on the outside of the door there was a bassinet and I totally teared up thinking that soon Jack would be using it!). When I got there I remembered that my friend Debbie had said that the only thing that made her feel better during labor was to sit on the toilet, so I went straight into that restroom and saw that I had lost more of the mucus plug. I didn’t want to sit on the toilet though- I didn’t like sitting there all by myself, so I didn’t stay in there too long. I sat in that room and labored for a while- I had the bed sitting straight up and was testing out the Bradley pushing position, but my ctx were getting stronger so I was having a harder time relaxing- I had to push myself up on my arms to take the pressure off my tailbone.

While I was in there they came in and checked me and said I was still at 6 cm (my mom says that has to have been around noon) and asked me to think about letting them break my water because it had been 12 hours and I had only progressed 2 cm. I said I’d think about it,but they never came back to see what my answer was and by the time they did come back we had all forgotten about breaking my water. When they did finally come back, they told me that they had to move me again, because that was the only room that they could give an epidural in and there was another girl who wanted an epidural. They asked if I wanted them to wheel the bed in and the nurse who was attending me said “No, she’ll walk, she’s been doing great and she wants to walk!” Took the words right out of my mouth! So I got up and walked to a smaller room (that was still bigger than the closet I was in before!) and since they were wheeling the bed separately, I once again walked straight into the restroom to sit and relax- and lost what I thought was the rest of my mucus plug. I was starting to really feel a lot of pressure in my hips and lower back, but since I was progressing slowly I didn’t want to lay down. To my knowledge I was still at 6 cm and I wanted to move things along. This was when I really started to need Dave’s help. I hung on him and sagged my belly during ctx, and I also leaned on my elbows on the bed and sagged my belly, sometimes doing squats, hoping gravity would give me a hand! I hung on him and swayed and sagged and concentrated on That Moment! Thinking of That Moment when they would take my fresh-born baby and put him in my arms was great motivation to get me through the contractions.

I must have started going through my transition at this point, because I finally decided that I needed to get back on the bed and try relaxing completely- my ctx were getting stronger, and I was starting to have a harder time relaxing. I labored on my side like I had before, but it was a lot harder to relax and I was starting to not handle it very well. My hips and lower back were hurting so badly, and poor Dave felt like he needed to do something so he came over and started to rub my lower back. Suddenly I remembered about counter-pressure and told him to rub as hard as he could during the ctx. My David gives the absolute worst massages in the world, but that was exactly what I needed at that point- the friction was a good distraction from the ctx, and the pressure made me feel like I was fighting the ctx without actually fighting them, so I could relax better. I’d roll onto my back to change my position and while on my back I had Dave lean on my hips- one hand on each hip pushing them back into the bed. That helped tremendously so when I moved back to my side I had him rub my back with one hand and push my hip down into the bed with the other. My mom told me later that she was afraid that he was going to crack my hips because he was leaning so hard!

All of the sudden I turned to Dave and said “I’m peeing! I can’t stop it! Am I peeing or did my water break? You have to check!” So he peeked and said he thought it was my water. The nurse just happened to come in at this point so he didn’t have to leave me to get her, and she checked and said “Ooooh bloody show!” (which meant that I definitely lost the rest of my mucus plug and my forebag broke) and announced that I was at 8 cm. I went back to laboring on my side and having Dave lean on me, and I added a new relaxing technique- vocalizing. Instead of just blowing out my breaths I started saying “Mmmmmm”. It felt really silly at first, but once I realized that it really was helping I changed it to “Ooooooooh.” As my ctx got more intense I got louder and more pained sounding, and I started to have a really hard time relaxing between ctx. I was really starting to doubt myself and Dave was amazing- he was against my going natural from the beginning, but he knew it was important to me so he kept telling me that I was doing great and he knew I could do it. My mom also chimed in with the encouragement, and said that all the nurses kept telling her that they were all so excited because they hardly ever had a birth like mine anymore and I was doing great. I kept focusing on That Moment- I was going to get there!

By this point the girl who needed my L&D room had had her baby (so many women who came in after me had their babies way before I did- it totally felt like the Friends episode where Rachel comes in and all these women come in after her and have their babies before her and she’s still only dilated 3 cm!!!!) so they moved me back into that room- I was no where near able or willing to get out of that bed so they wheeled the whole bed in there with me on it. The bed vibrating as they moved me was also a great help to relax- my easiest ctx during that time was while that bed was rolling. Good thing because Dave couldn’t lean on my hips while I was moving.

When I got into that room my ctx were even more intense and I was really doubting myself. It really didn’t help when they checked me again and said that I was still at 8 cm after three more hours. The midwife talked me into letting her break my water at this point, and when she did she saw that there was meconium. When I heard that I got really scared that Jack would swallow some of it- something that is really dangerous for babies. She told me that he was looking really good, but she wanted to flush it out and put in a monitor. She explained that the flushing was just to “swish the water” and make sure that the baby didn’t swallow any of the meconuim so I agreed. I asked about the monitor and she said it was just an internal ctx monitor and it wasn’t a fetal monitor so it wasn’t attached to the baby at all. After I had my first ctx with the monitor in, though, she pulled up a chair and said that we needed to talk. I had been stuck at 8 for a long time, and with the look of that ctx it seemed that my uterus wasn’t contracting hard enough on it’s own, and she wanted to give me picotin to make it contract harder. I really didn’t want the pitocin because I was having a really hard time relaxing between ctx and was really doubting myself even without the pitocin (which causes unnatural contractions on top of the natural contractions the body makes).

If she hadn’t put the internal ctx monitor in I wouldn’t have believed her about my uterus not contracting hard enough. I wondered if there was another reason for lack of preogress and asked her “Are my bones okay?” She said my bones were beautiful and it was just that my uterus was too tired to do it on its own. She gave me a minute to think it over and I asked Dave what he thought after explaining to him why I really didn’t want it- he said “Honestly, I think if you don’t get it we’ll be here forever. You’re strong, you can do it without the pain meds. You don’t have to, but I know you can do it!” I knew he was right and I was so ready for it to be over at this point- I was so ready to experience That Moment that I had been dreaming about- so I told the midwife to give me the pitocin. It worked right away- immediately I could feel my ctx getting more painful and I managed to glance at the monitor and see the arc getting higher than before. The midwife came in and introduced me to my new doctor (another stupid shift change!!!) and to my new nurse (I loved that nurse!), and said that I’d be pushing in another hour. I was at 9 cm after the first dose, so they gave me another one, but I was still only at 9 cm. At this point I was so the queen of self-doubt- I kept saying I didn’t want to do this anymore and I couldn’t do it any more. My mom said “Oh that means that it is almost over!” I told Dave that I was at my limit and I needed some pain meds. He asked if I was 100% and I said “Yes!” At that moment the nurse came in and said it was time to start pushing, and I completely forgot about my desire for the pain meds, and Dave didn’t say anything (later he said that even though he wanted me to get the meds he didn’t want me to be disappointed that I had made it all that way on my own and then get the meds at the last minute).

I still was at 9cm, and I didn’t have the urge to push still, but I was so happy to actually be doing something other than lay there and let me body do what it needed to do.

She asked if she could stretch me and I said yes- I thought she meant stretch my perineum, but my mom and Dave said that she had her hands all up in me so she was stretching my cervix to get that last cm.

First she had me in the ‘Bradley Pose.’ I still didn’t really have the urge to push, but after she stretched my cervix a little more I suddenly felt the urge and it was such a relief to be able to push! She was stretching me the whole time I was pushing and for every push she would say “Push my fingers out!” It really helped to have her do that because it gave me the extra urge to push. She said that she was going to have me push in different positions so that the baby would decide which way to turn his head to come out. I don’t know how long I was in each position, but the whole process took three hours (totally didn’t seem like 3 hours, though- I was busy the whole time!) I started pushing at 4:15.

The next position I pushed in was on my back with my feet up on the foot rests and pulling my upper body up with handles on either side of the bed. Then she had me lay on my right side with my knees bent- I’d relax in that pose and then when a ctx came I’d open my legs, wrap my hands around the one that was up in the air and pull myself up to push. It was in this position that I finally got to see some progress- I pushed that ctx monitor right out of me, so I knew that he had to be moving.

After that she had me do the same on the left side, but I had a ctx while I was trying to get on my other side so she had me push for a few ctx on my back before getting to the other side. Then I pushed on my back again while they converted the bed for delivery and the doctor came in. My mom had my left leg and Dave had my right leg – my feet were braced in the crook of their shoulders and I would wrap my arms around my legs to pull my upper self up and push.

I had my eyes closed pretty much the whole time- I was dead serious about relaxing between ctx and pushing with all my might during them. I would run out of breath by the time the ctx would peak, so I had to wait to push until the ctx really started getting going, so when I’d feel it come I’d have to relax and count to three until I could feel it starting to peak and then push. I ignored the counting to 10 and pushed as I had the urge- sometimes I’d run out of breath at 7 and I’d take another breath and keep pushing, but sometimes I’d push to the count of 12 (which annoyed the nurse but I didn’t want to stop!). I was oblivious to a lot of what was going on in the room since I had my eyes closed tight ( I had them closed on purpose, but after Jack was born I realized that I couldn’t have opened them if I wanted to because they were swollen shut!). I had my mom and/or Dave feeding me ice chips in btwn ctx, and I concentrated on praying for Jack and visualizing him coming out of me. I couldn’t wait for That Moment!

After a while Dave and my mom and the nurse kept telling me “He’s coming, he’ll come on the next contraction!” but then he would go right back up in between ctx. Finally the doctor said that he kept going right back up where he was before the ctx so I should think about using the vacuum. I thought about it and everything I had read about it, but then I thought about Jack and how he needed to come out and I agreed. So the doctor got the vacuum and tried to put it in, but she said I needed an episiotomy in order to get it in. So she gave me an episiotomy (holy freaking, ouch!!!) and then put the vacuum in, and then on the next ctx Jack was born!

That’s when the chaos started.

I could have sworn I heard someone say that the doctor dropped him, but my mom says that what I actually heard was the doctor saying that his cord snapped- apparently his cord was wrapped around his neck, and it snapped when the doctor went to remove it. Dave told me later that the doctor had actually said "Oh shit!" (great, the first words my baby heard outside the womb were "Oh shit!". Nice.) My mom said that the nurses all dropped everything and caught and clamped the cord right away- I only remember thinking she dropped the baby and then opening my eyes to hear him cry and see her pulling Jack up from me and giving him to the pediatrician. His cry was the most beautiful sound I’d ever heard and I was sooo happy to have my baby finally... except That Moment never happened! The Moment that I had dreamed about and relied on to get me through labor! And not only wasn’t I able to hold him, but I couldn’t even see him! The stupid nurse was standing in the way while they were checking him- I understood that they were doing their job- a lot of things that were potentially dangerous had happened- but I wished they could have at least stepped aside when they were done with the important stuff and let me see him before doing the measuring!

Dave was able to go over there and watch them, though, and they did let him trim the rest of the broken cord. And, since I couldn’t see Jack, I started talking to him… my mom said that as soon as he heard my voice he calmed down a little and started to search around for where my voice was coming from. I wish I could have seen that.

Finally the nurse stepped aside, and my first sight of Jack took my breath away! My little boy was as white as Casper the Ghost and had a serious conehead straight from the Planet of the Apes but he was the most beautiful thing I’d ever seen!

Dave said that as soon as he was born it was like I was a different person- I started talking again and smiling and it was like I hadn’t just gone through what I did, it’s true that the moment the baby is born there is nothing else in the world but love for your child. Finally after they were done stitching me up (I tore pretty badly on top of having an episiotomy) and I had delivered the placenta and they were done checking Jack, they let Dave pick him up and bring him to me. The moment that Dave picked up Jack I forgot how much I wanted to hold him myself- all I could think about was how my husband was holding our son- it was the sweetest moment.

Then finally I got to hold my little boy! I was soooo happy to finally have my baby boy in my arms!!!

I had been pretty (okay, very) disappointed not to have That Moment, especially after all I had gone through, but I was so thrilled to have Jack in my arms that it wasn’t hard to get over for a while. Jack was here, he was safe, he was perfect, and we knew that we were so blessed!

Jackson Edward was born on April 11th, 2007, at 7:06pm. He weighed 8 lbs, 3 oz, and was 20.5 inches long.

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