Sunday, September 22, 2013

Birth

This is the story of my labor and delivery. While there are no pictures, birth, by its very nature, is graphic. You have been warned that this may be TMI for some people. Reader discretion is advised. 

My blood pressure had been running slightly high since about 36-37 weeks. However, it went back down to normal (from 140s/90-100) when I would lie down so my dr wasn't too concerned as long as it kept doing that. Around 38 weeks, I was informed that if I hadn't gone into labor by my appt at 40 wks 2days, I'd be induced around 41 weeks as they didn't want me to go longer. At almost 40 weeks, I noticed my blood pressure was up unless I was lying down- it didn't matter if I wasn't doing anything strenuous. So Tuesday I called my dr and they told me that if it ceased to go back down when I would lie down to go to labor and delivery. It stayed down when I was down so I called Wednesday and moved my appt from Friday to Thursday. 

Thursday we went in and my blood pressure was, predictably, up. My doctor advised me to go on and head over to L&D, as, while I did not have preeclampsia, she would rather send me over there to be induced now that potentially have it become preeclampsia. We discussed it and the idea was to have me put on pitocin to start labor and see if labor would then progress on its own. 

However, so many things that I wanted from my birth plan- that had been approved by my doctor and that we showed to the nurses- didn't happen. I wish now I had been more of an advocate for myself and argued to have things go as I wanted them within reason. I think things would have gone smoother. 

So we went over to L&D and settled in. It took 5 IV attempts and 3 nurses to get my IV in to start the pitocin drip. My BP jumped to 170/110 with the first BP reading due to the cuff putting pressure on the 4 attempts in my left arm. Hurt like hell. 2 valves were hit, 1 vein blew, and another was a through and through hit. Doesn't mix well with a BP cuff. I was also hooked up to a heart rate monitor for Saoirse. This was all around 2:30 Thursday afternoon. We sat around for a while, with contractions being painless (I had to watch the monitor to make sure what I was feeling was a contraction). I was told I could only have ice chips and no food. Mind you, my IV drip was super slow. I snuck some food and water but not much. In hind sight, I should have just eaten and drank (light, easy things obviously) as I pleased. I was getting next to no fluids or calories for the duration of all of this. We walked some to try to encourage things and Saoirse regularly moved off the monitor. I was about 4 cm. 

At 9:30 pm, my doctor called L & D to see if I wanted my water broken. I was pretty torn on this one. I wanted labor to continue to progress, instead of stalling, but my mom had her water broken during her first labor to try to move things along and we now believe, 28 years later, that that is why my brother got stuck, was because they broke the water prematurely. Joseph and I went back and forth and I couldn't make a decision. Finally, we decided to call my doctor and talk to her about the benefits and risks of each option. He talked to her on the phone and then hung up to tell me what had been said. About 3 sentences in, I felt a gush of water. "I think my water broke." Well, that made that decision easy enough. Upon examination, it turned out my water hasn't actually broken, I had what they called a "high leak", where the membrane tears slightly further up away from the cervix. So there were still membranes across my cervix. But it seemed to have gone ahead and encouraged labor as I was soon 5 cm. 

At this point, things started being painful. I started having to breathe through contractions. Joseph did hip squeezes while I sat on the yoga/birth ball, just trying to be more comfortable than I was in the bed.  My lower back was starting to really hurt. I asked to get in the tub. They detached me from the monitors and covered the IV site and I got in and turned the jets on. We turned on my iPod to 30 Seonds to Mars and I maneuvered around in the tub for a while. The contractions were getting stronger and more painful. I was feeling crappier and crappier. I eventually decided to get out because I was cold, despite being in warm water. I shook horribly as I stood to get out of the tub, my husband doing a lot of supporting me as my mom helped get me back into a gown. I got back in bed despite my back hurting badly because I was freezing and I didn't want to sit up on my own or stand. I got a heated blanket. I labored on my back and my side for a while, warming up. The pain in my back was getting really bad so I switched to being on all fours. I was unfortunately really tired at this time and supporting myself in that position was hard. Hip squeezes now hurt. I eventually went into the bathroom, hoping maybe the toilet would be a helpful position to help move her down. It just hurt. Sitting in any position hurt. My contractions were rough, courtesy of pitocin (that was still being edged up), but what made it worse was that my back was killing me through everything. It didn't let up. The contractions would have been tolerable if not for that. If I had had any kind of break. I eventually asked for some kind of pain relief. I absolutely did not want an epidural, but I was exhausted and hurting badly. About 2 am or so, I got stadol. I spent the next 2 hours lapsing in and out, getting some rest punctuated by contractions. About 4 am, I started counting the minutes until 5 am when I could have some more stadol. At about 4:30 or so I was at 7 cm. The stadol was letting me relax some and make progress. We asked a couple different times to back off the pitocin so I could relax a little, make the contractions a bit less intense. It always had to be upped again to keep my contractions from spacing out too much. I had more stadol at 5 am. Somewhere around 6 am, I started feeling like I needed to push. Pushing was the only way I could handle the contractions. But I was only at a 9, so they didn't want me to. I did it anyway. I couldn't help it. At about 6:30, they had me start pushing. I was told to push on every contraction and also informed that there was no going back once I started this. Kind of a "if you want a c-section, now is your last chance to ask for one." I was exhausted, lapsing in and out of awareness in between pushes. They brought out the support bar for me to pull myself up on, but between being tired and the pain in my back, I had trouble getting to the bar to hold myself up. My husband and my mom ended up helping a lot, helping me hold my legs and curl into myself to push. I just had almost nothing left in me, courtesy of a lack of food or fluids. My IV was running a saline/dextrose mix in at a snail's pace. I didn't even finish a bag in the ~18 hours I was hooked up to it. I had nothing to run on. They brought in the mirror, so I could see what was happening. I didn't watch much, that took more effort than I cared to exert. At some point, the nurse left to go page the doctor and I asked Joseph for a c-blok from my bag. It's a kind of energy bar thing used by runners for marathons and such. I'm glad I got it because I was so tired. When the nurse came back, the doctor had suggested I push on my side. My mom helped me curl for the pushes and held on thigh while Joseph held the other. It was all I could do to touch my thighs, let alone pull against them. I found out later that at some point in all of this, they couldn't find Saoirse's heartbeat. We figure she had just wiggled off the monitor again, but we have no way of knowing. The nurses were concerned though. And the fluid coming out had some meconium in it. I knew none of this at the time. I was just pushing on contractions and lapsing out in between, getting a few seconds of rest. The nurses told me they could see her hair, that she had a head of it, and to keep pushing. 

Then I was told to stop pushing so they could get the doctor. I must say, that is one of the most ridiculous requests I have ever had made of me. My body was contracting and pushing on its own and as exhausted and weak as I was, that was the only option really. The only option was to follow my body. Finally the doctor, not my normal doctor, came in and introduced himself and we kept going. I pushed and holy cow, did that hurt. Given the state of things (missing heartbeat and meconium), I wasn't able to do crowning slowly like I wanted to. I remember saying owowowowowowowowowow as she came out in a gush of fluid. I looked down and she wasn't crying but she was looking around. They were suctioning her mouth out, trying to keep her from inhaling fluid (which is why she wasn't crying, they were actively working to keep her from doing so). The doctor asked if Joseph  wanted to cut the cord and I bounced in, saying we wanted to delay the cutting. The doctor then informed me that there was meconium and he wasn't comfortable delaying the cutting given the circumstance. I had plans, but many of those plans had been thrown out the window that night for far less good reasons. I watched Joseph cut her cord and she was whisked off to the nurses and waiting NICU staff (there because of the potential heart issue seen on ultrasound- she was fine and they weren't needed). The doctor then proceeded to see what damage was done. I had a 2nd degree tear he had to sew up, along with something that required stitches on the right side inner lips. Saoirse was brought to me while he did his work and the first thing she did was grab my finger. I was so tired, but for the first time in hours, I was awake. And thirsty. After the doctor finished his things, the nurse cleaned me up and we took pictures. Saoirse laid on my chest and we all slept for a while, getting over the ordeal. A bit later, they weighed and measured her. 8 lbs 1.5 oz and 20 inches long. Perfect. 

I think next time I may do a home birth. And next time I'm telling them screw it and eating and drinking within reason as I please if I am at a hospital. And I sure as heck don't want pitocin. Very little went as planned but I didn't end up with a c-section, which I really didn't want. And we both came out of it well and healthy. That's the important part in the end. 

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