|Birth story of Gwendolynn Rose
||[Feb. 22nd, 2008|08:32 pm]
February 2008 babies
So when I went into preterm labor at thirty weeks, I had an ultrasound, to make sure all of Gwen's parts were there and such. Was estimated to have an average of 23 cubic centimeters of amniotic fluid- normal is 19, higher than 25 is called polyhydramnios. It's entirely possible that that is WHY I went into preterm labor.|
So, eight weeks and two days of total bedrest after THAT, I have my midwife checkup. I'm measuring 40 cms- three more than last week, and I've gained four pounds in a week. That is, uh, interesting. My midwife, the one I've been seeing for the past six weeks, palpated my uterus, and did a cervical check- 3cms dilated and 75% effaced, but her head was all the way back up, whereas last week she was at 0 station. She asked me if I would be willing to get another ultrasound, to see if she was still headdown and see what the deal was with my huge belly. I was almost positive she was still headdown, but quite frankly, the excess fluid issue bothered me. Being the freak that I am, as soon as someone mentioned that I had a lot of fluid, I Googled it and... basically, it's universally referred to as Very Bad.
My fluid levels were 39 cubic centimeters- more than twice normal. My midwife tracked my husband down (he works at the hospital as well) to tell him to get me to in there NOW to be induced.
Let me make this clear- Ina May Gaskin transfers women for this. There is twice the risk of stillbirth, because of a cord accident- either cord prolapse (the cord slips in before the head when the baby is born, and it pinches off blood supply) or the cord twists and pinches in utero, which as my midwife very vividly described it, "is like someone cutting your jugular." And in cases as severe as mine was, it is extremely likely that the REASON for such high fluid is some kind of defect where the baby is not cycling the fluid normally.
Needless to say, I was freaked. I was excited, too. I was mostly freaked. I was scared out of my mind. I told Mark that any minute now, I was going to freak out. I started crying in the car on the way there and nearly gave myself a panic attack. I was scared the induction would fail. I was scared something was wrong with Gwen. I was scared she would die. I was scared about her coming- the house is still a disaster and I have NO baby stuff to speak of. No more time to think and plan about what to do when I have my stepkids and her- it's gonna happen. Now.
Cue freak out!
So we get to the hospital- I SO LUCKED OUT for the midwives on call. It was a lot of hurry up and wait for the first part- but the one on until seven was Lisa, the first midwife I saw at the clinic and I liked her a lot. We talked about different induction methods- she felt comfortable starting with the Pit because I was already dilated and effaced, and had lost my plug. I had to talk to the OB resident on call, but she REALLY irritated me. Very intervention-happy- she wanted to break my water right away, and she thought it would be "a good idea" to give me Cytotec right after I gave birth because my uterus would be so stretched from the fluid- CYTOTEC. Thankfully, she was not my doctor, she was there for backup for the midwives and everything they wanted to do to me, had to go through the midwives too. Lisa came in after she did, and she said that she didn't see any reason for me to not do perfectly fine with the induction and that she doubted I would need Cytotec. She asked when the last time I ate was, and I said a few hours ago, so she got me a bag of chips and an apple, and some juice.
I was started on the Pit right when Lisa, the first midwife, was about to leave. She wished me luck and the next midwife on call was Claudia- the one I really, really wanted to have for my labor, and she would be there for 12 hours. SCORE! And the one after her? Was my regular midwife, the one who ordered the ultrasound. DOUBLE SCORE. I was so relieved. Claudia was amazing. During the Pitocin, I was really nervous. It didn't hurt, all of the fluid I had cushioned it. I was sick of things not hurting. They didn't feel "real". Like they counted. I was so frustrated. I wanted pain. Pain would get things done. Pain would go away. (I will soon eat these words.) I was scared that they didn't hurt- it felt like one more way my body was weird. EVERYONE I knew who had a Pitocin induction said that it hurt so badly... and I felt like I had gas. I stayed like that for six hours, and up to seventeen times the starting dose. Claudia was just awesome. She totally did not agree with the OB resident that she should break my water, or that I would need Cytotec. She came in and watched TV with me while she did her charts and just took my mind off it. She had never seen Sixteen Candles before, so that was fun. It felt like I was just chilling with a friend. The nurse I had (Amy?) was also REALLY cool. They both just treated it like a normal thing that I wasn't in pain- whatever, that's how my body is going to work, so we'll work with that. I walked around, bounced on the ball, got in the tub. I took the monitors off (the one that measured the contractions HURT!) and locked myself in the bathroom and just soaked for awhile. They didn't give me any crap for taking the monitors off without asking. I sneaked a cookie in from Mark- thankfully I'd eaten a late lunch that day with him, so I wasn't really hungry. I sort of just wanted to say I snuck food in. =P
Claudia checked me, and I was maaaybe 4 cms, but 100% effaced. They broke my water at about one, which felt GREAT. OH MY GOD. You have NO idea how much my belly went down- it was like a deflating balloon. I literally looked three months less pregnant. It felt sooo good. They had four people holding her in place as they broke it, so that she wouldn't disengage from my pelvis. EVERYONE was like, HOLY CRAP when it broke because I just GUSHED everywhere- and I had two more big gushes, and then lost a ton more when I actually gave birth. I soaked every towel, washcloth, and liner in the entire supply cupboard by the time I was done! After that though, all hell broke loose. I could all of a sudden FEEL how tired my uterus was after six hours of Pitocin contractions. Even though they didn't hurt, it just ached so much, even before the contractions started to hurt. Then... they started to hurt. At first, I was excited- things were FINALLY going! Then they started to hurt more. A lot more.
I labored naturally for a while- honestly I do not remember how long- bouncing on my ball and with Mark applying counter pressure to my back. He was fantastic, he really was, the whole time. Gwen was posterior, brow presenting, and ALL I had was back labor, I had NO pain in my front at all. I tried hands and knees, and leaning forward on the bed, but both of those positions made me feel like my pelvis was just going to split in two, so I got sideways on the bed. That worked pretty well for a while, but I still had 100% back labor and she wasn't moving. Claudia said as she was walking out, "I'm going to get the nurse to turn off your Pitocin" and I thought she said, "Turn UP your Pitocin" and I nearly cried. When she came back I was like, "WHY ARE YOU TURNING IT UP?" and she was like, "No! OFF! You're having them one right after the other with no breaks at all!"
I asked about pain medication because I just could not get myself to move around like I needed to to get her to turn. I decided to give laboring in the tub a shot, and that helped SO MUCH. It really made me feel a lot more "alone" and self-sufficient, like I could get through the pain without the counter pressure or people talking me through it. I ended up getting fetanyl to start with- I felt like it was more important to be able to turn her than to go med-free after all this. The contractions were doing what they had been for weeks- radiating up my back and making it spasm, not to mention absolutely killing the muscle knot around the fracture in my back. Except way, way worse.
I labored in the tub some more, with my legs spread and bouncing up and down like I was on a ball through the contractions. I randomly started purring to exhale through them- it helped me exhale slooowly and fully and to be able to tell when I was out of breath. Claudia was really impressed and liked that idea. That made me feel good, that I just started doing it.
I started to panic soon after that. Just outright panic. I wanted someone to touch me to get my mind off the pain- no, sensory overload, I don't want that. I wanted someone to tell me to breathe- no, that's distracting. I wanted someone to tell me I was doing a good job- no, that's just annoying. I couldn't find a pattern, I couldn't get into a rhythm. I wanted so badly to reach that sort of dissociation when you don't really feel things yourself, but I was SO SCARED. Just outright terror. I couldn't figure out why, I just... I was shaking, I was in pain, and I wanted it to stop. I felt as tight as bridge cable all over. Like if I could just get a ten minute break, I would be able to keep going. I wanted numbness. I wanted painlessness. The closest feeling I could come up with was when I was still a cutter and I wanted that rush and I wanted it NOW DAMMIT. I had spent this whole pregnancy wanting a natural childbirth, because I didn't want to feel cut off from my body like that... and when push came to shove, I couldn't do it. I wanted that numbness again.
I asked for the fetanyl, and got the smallest dose possible while I was still in the tub. That didn't do anything, really, so she doubled it, what they usually start people at. That made me kind of dizzy, but really just took the edge off. I tried to focus on breathing, and on breathing out the pain, working the visualizations and trying to get my mind centered- but every contraction felt like a panic attack. It was taking all of my willpower and energy to not start screaming. I haven't panicked like that in years. All I wanted was for the pain to stop. At that point, I would have taken a C-section. I told Mark that maybe I should think about the epidural. He asked what was wrong and was I sure. I said I didn't know.
Next contraction... I asked for it. I was so tired. I hadn't slept well the past three nights because of contractions, and I'd been awake since four AM on Thursday. I felt so worn out and so beaten. I just wanted it to stop. Claudia asked if I wanted her to check me, to see how far along I was, if that would encourage me- except I couldn't bear the thought of the pain of a cervical check. I broke down then and there and started crying and said I just couldn't do it anymore. I was just so tired. I was so tired I didn't want to feel my daughter be born. I didn't want to feel anything.
They got the anesthesiologist in, and he started to explain how it worked, and I said, very pitifully, "Do you really have to describe it...?" which cracked everyone up and made me smile. He was very good. In between contractions he would do each step, and waited to touch me until they were done. At that point I didn't want ANYONE to touch me or talk when I had a contraction- mostly cause I would shriek, "'TRACTION NO TOUCH PLEASE STOP TOUCHING ME". Only hitch? I had been wearing my own shirt, not the gown. He got the epidural in beautifully, it didn't hurt at all... and my shirt fell down on it. He lifted it up, and it pulled the catheter out. He was behind me, and Claudia was in front of me, and I saw her eyes widen. I was like, "What? WHAT?" and he said, "I have to do it again... your shirt fell and the cath came out..."
I started sobbing. I sorta felt like the Natural Birth Powers That Be were like, "NO EPIDURAL FOR YOU HAHA." But he did it again, and five minutes later, my feet felt funny. Ten minutes later, and I wasn't crying anymore. I fell asleep almost right away, at around five. Claudia checked me, now that I was numb, and I was only 5cms dilated. More than three hours after they broke my water and one centimeter. On the bright side, she DID turn- she was occiput anterior and firmly engaged. My hard work in the tub did do something.
I slept about an hour, then woke up and felt a lot of pressure in my birth canal. I woke up, very sleepy and drugged but much, much more calm and much happier, and asked Claudia to check me. I was fully dilated! Claudia showed me how to pull my knees up, and Mark and the nurse held my feet up for mt. I could still feel the contractions. I wasn't totally numb, but not in so much pain that I was panicking. I was very very glad that I could feel it. That is what scared me the most about getting an epidural, that I would be numb from the armpits down. But it wasn't like that at all. I started pushing and it felt REALLY good. Claudia said I was great at it. She could see a little bit of her hair even start to come out. The nurse I had was a GREAT labor coach. She was very encouraging but without making me feel like I wasn't trying. Mark was great, again. Claudia had to go check in another patient, so it was me, Mark, Amy the nurse, and a very nice medical assistant. All went well for the next two or three pushes. I breathed well, I was doing a sort of bastardized pranyama breathing from yoga, I was pushing really strong and she was moving!
Then, I don't know what happened- I don't know if the epidural was wearing off, or if it wasn't strong enough to make the pushing as painless as I wanted/needed, but it started to HURT. I think nearly all of my problems were from going from no pain to OH MY GOD SHOOT ME NOW PAIN. I went from weeks of nearly if not completely painless false labor to "This is your uterus contracting. This is your uterus contracting after six hours of Pitocin." "This is pushing. This is pushing after being asleep and numbed for two hours." The pushing itself didn't hurt- it actually felt wonderful to push. It was after I was done with one or in between contractions- I had that "MY PELVIS IS GOING TO SPLIT IN TWO" feeling again. I lost my head completely, I forgot totally how to breathe, I started crying and saying I couldn't do it, I didn't want to push anymore, I couldn't keep myself from screaming. I really started to hyperventilate and they put me on oxygen. Amy said I could rest through a contraction and see how that felt- that sucked HARDCORE. So I decided to just keep pushing, and I pushed with the next one- by now my legs were nearly completely feeling again and the contractions were making my back spasm again. I said I wanted to stop for a bit- Claudia had talked to me about resting even now that I was pushing- quality pushes over quantity. So we did that. I got on my side and had Mark or Amy help me just breathe through them. Around then, Melissa, the other midwife, came in with Claudia at the shift change.
I needed it not to hurt. I couldn't think of anything to do besides make it not hurt. I needed to be numb. Both of them were very very understanding about and told me it was really common and to not beat myself up about it, that body memories were real and it was okay. Claudia went to go hunt down the anesthesiologist again, and Melissa stayed with me. She turned the lights down and just sat with me and rubbed my back and talked me through each contraction. She got me on my side again, and a hot compress, and did great counter pressure through the contractions. She upped the epidural I already had, and then the anesthesiologist came in. Melissa explained what was going on, and what I wanted. I said that if we could just get the same level of numnbess I had at the beginning of pushing- where I felt the contractions and pressure, but not pain, I could do it. They put in a different kind of epidural, and gave me a shot of lidocaine near my tailbone, and made it so we could up the epidural as much as we wanted. That took effect almost instantly. Melissa said she wanted me to rest and sleep some more if I could. Gwen held up GREAT through everything. Her heart rate never dropped or spiked at all. By the time Melissa came back, I felt so much better and calmer and like I could do it. The pain was totally bearable. I wanted to push again.
Then... the new resident OB and the high-risk OB specialist came in. Both of them wanted to do a C-section- they were incredibly unimpressed that I had been dilated to 10 cms for three hours, yet I didn't have the head down farther. Uhm. Because I had a severe reaction to the pain and my body responded by sucking her back up because it didn't feel safe. I was pushing through the pain AND fighting the urge to clamp my legs shut and clench my vagina tight. I had also only pushed for an hour before I stopped to rest, and had two hours of lying down and crying. Melissa said that from what she heard, I was a fantastic pusher even when really numbed up, and that if we could just get my pain under control, I would do fine. The two of them basically parroted each other about how having so much fluid was consistent with big babies, and the woman says to me, "You're not a terribly large woman... your baby isn't getting through that pelvis if she isn't there already" and it was all I could do not to smack her. Melissa said, "I think we can do this. Can you check her now, and then give us forty-five minutes and then you can check her again?" They agreed to wait on the C-section if I showed progress (gee thanks) and walked out.
I pushed and did just great- then the OB resident, the woman, came back. She checked me and was like, "No change... I have another C-section to do, so I'll be back in an hour and we'll get you prepped for one." Melissa looked PISSED. She kept telling the resident heinous bitch, "She moves the head down wonderfully when she pushes. She is making progress. She's basically only been pushing for just this forty five minute period." The resident said I could keep trying to push so long as Gwen stayed stable. She left again and me and Melissa talked. I asked what the risks of delaying a section were- basically none. My water had been broken for less than 12 hours. Gwen was not in distress. I was feeling much better and a lot more capable. I asked if I could refuse the section, and Melissa turned to me and said, "You are going to have a baby in your arms when she gets back, okay?" She drained my bladder- and figured out why I hadn't been able to push her down- I had 700 milliliters of urine in there! That's almost THREE CUPS! I was trying to push her head past a water balloon! As soon as that was done, I pushed and pushed and really hit my stride. I would push four times, eight seconds a piece, each contraction. It really hit when Melissa was like, "Push harder! GET MAD! You are GOING to have this baby!" And she started to crown! They got a mirror, and I could see her head. More pushes, and her head was out. Melissa guided my hands down, and I caught my baby!! I started crying immediately, and she cried back! She was totally covered in vernix. I pulled her to my chest and of course started babbling and cooing to her, and she settled right down. Melissa clamped the cord, and handed me the scissors, and I cut it myself. Gwen curled right up between my breasts and to all appearances, passed out cold. She had dark, wavvy hair and her hands and feet were blue- which is nearly universal here in Utah, because of the high altitude. But other than that, she was perfect. She stayed on my chest and finally started to open her eyes while Melissa stitched me- I have a 1 degree vaginal tear and a 1 degree labial tear- not bad at ALL for my first baby, and for one that came out pretty quick! They just didn't stop bleeding so she did like two stitches a piece. Melissa showed me my placenta, which made me happy. I think they're cool. My baby started to nurse less than twenty minutes after she was born, and she did it perfectly. Latched on great, no pain at all, she swallowed and suckled just fine. I didn't do anything, she just started rooting around and I scooted her over to one breast, and she just popped it right in her mouth.
Pictures here in my journal!