25 October 2011

Jack's birth story

My estimated due date for this pregnancy was October 12—exactly halfway between my 39th and 40th birthdays. Each of the girls had been born near to their due date, within 48 hours one way or the other. I'd been having more and more noticeable Braxton-Hicks contractions as the date drew near. I wasn't too worried about "going over" both because I knew it was nothing to worry about, so long as baby and I stayed healthy, and because given my experience it seemed unlikely to happen.

In fact, I was more concerned with the possibility the baby might come early. Not as much for his sake (I didn't think he'd come that early) as because I was having trouble getting to everything I wanted done before his arrival. I had set myself the deadline of being ready to be out of the office as of the Friday before he was "due" (October 7) and for a while thought I wouldn't get everything done. We had an appointment with the midwives that day, and by the time we headed for Goshen, I was all ready.

The midwife appointment was fine, rather dull in most ways. The highlight was that when she checked my iron levels, they'd come up nicely. Not normal, and I still needed to take the supplement, but close enough to normal to no longer be a big worry. The midwife checked me and I was only about 2cm, but that didn't overly concern me—plenty of time to get where I was going yet. There was one of the midwives we hadn't met yet and in order to schedule my next appointment with her we scheduled it for a week from the next Monday. I doubted I'd make it to the appointment.

And then ... nothing happened. My due date came and went. I went to work and found things to do and smiled when people said, "You're still here?" I came home and rested and walked around the block. By the end of the week, I was starting to wonder just how late this baby was going to be. I went to a hockey game Friday night.

On Saturday, after going out with my folks during the day, I made it to Chris's pipe band's annual fund raiser party in the evening. I went to church on Sunday. I kept my doula and family updated on whatever changes in my own condition I could observe, but nothing indicated the birth was imminent. I felt increasingly anxious and ready for baby to be born.

After church on Sunday, I was exhausted—worn out both from the physical realities of being 40+ weeks pregnant and from the mental stress of waiting and wondering. I went to bed and slept most of the afternoon. After dinner, despite being worried I wouldn't sleep well after the long nap, I went to bed more or less on time. And I slept, as well as I had in months. In the morning, I decided to take the day off from work as a "mental health day"—I just couldn't handle the thought of another day smiling and saying, "Nope, no baby yet!"

We headed down to Goshen at the end of the morning for the appointment I'd been so sure I wouldn't need. The baby's head was most definitely NOT engaged in the pelvis, but still free enough to wiggle about, and I was still only at 2 or maybe 3 cm. We talked with the midwife about what would happen if I didn't go into labor on my own: when and how to induce, what to watch for in the meantime, what I could do to encourage my body to get started on its own. It was a rather depressing visit for me, to be honest, though it was good to know rather than wonder and to hear the baby's heartbeat.

Monday night, when I laid down to sleep, I felt the contractions pick up in strength. I thought about getting up and walking, to see if I could bring them on stronger, but decided to see if I could fall asleep first. Amazingly, I did for a couple hours. That was the last good sleep I would have for several days. When I woke up later in the night, the contractions were strong enough to keep me from falling back to sleep. I rested, and slept a couple stretches of half an hour to an hour, but was mostly awake from about 12:30 on. I again thought about getting up, but I saw no reason to prevent Chris from getting what sleep he could while he could, and when I had labored alone before Dorothy's birth I had found it extremely depressing—not what I wanted.

We had a more or less normal Tuesday morning. Chris got the kids up and ready for school, and then drove them in. I called Tracy and my mom, to let them know things were picking up but that they should go about their days as normal for now. I waited till Chris got back to take a shower, but that was about the only concession I made to the stronger contractions and the fact that I'd had other signs things were progressing. I called our doula (Maureen) when I guessed she'd be home from delivering her kids to school, and we discussed what I could do to encourage things to keep moving along.

One of the things that most "what to expect" sites say is that if the contractions slow down when you get up, it might not be "real labor". These definitely slowed down, despite another walk around the block and sitting on an exercise ball and such, but I knew this was it. I was extremely tired from the lack of sleep, though, so towards the end of the morning I went back to bed to try to get some sleep. As soon as I lay down, the contractions got stronger and more intense.

After half an hour of being unable to fall asleep, I grabbed my iPod and started timing the contractions. What I discovered was that they were lasting longer and coming more regularly than I had thought. After timing them for an hour, I decided to call and talk to one of the midwives. We had an hour drive to get to the hospital, and I knew both my mom and Chris's were concerned we'd leave too late and have the baby on the way there. That didn't seem likely, but it did seem we could possibly head down now. The midwife on call (Patty) agreed, after hearing how things were going, so we brought Dorothy to my folks and headed out around 2:00 p.m. It felt weird to be heading to the hospital in the middle of the day—with each of the girls, we'd gone in while it was night (albeit the end of the night with Dorothy).

We got to the labor and delivery unit at 3:15, just moments after the midwife. The car ride hadn't been fun, but it was bearable—I could even knit between contractions. After getting settled in to our room, Maureen and Tracy arrived. I changed into a gown and Patty checked me for progress. The good news: I was 7 cm! Chris and Maureen teased me that I didn't react more, but I was very pleased—I'd been hoping for as much as 5cm. The less good news? The baby's head still wasn't really engaged, and that lack of pressure was keeping things from progressing further. Patty made some suggestions for helping with that, and we all settled in to see what would happen next.

As it happened, what happened next was not much. A nurse set me up for my IV, and shortly thereafter they administered the antibiotic for me being Group B Strep positive. We hung out in the room, I sat or bounced on a birthing ball (basically the same as the exercise ball I had at home). I had contractions, but they'd calmed down some both in terms of frequency and intensity. Still, I wasn't too concerned. Heading in to the hospital had caused things to slow down a bit, for a while, with the other births, too.

After a while, the midwife offered to check me for a progress again. Not encouraging: 5 or 6cm and if anything the baby's head was less engaged than when I'd arrived! I was feeling so very, very tired by then that this part is rather a blur to me. At some point I ordered up dinner (turkey, with potatoes and vegetables—no clear liquids only with the midwives, thank heavens!), and Chris, Maureen and Tracy got themselves something to eat in shifts, so as not to leave me entirely alone. I think I tried to rest next, without a whole lot of success.

Tracy and Maureen had left when I was trying to rest, so as not to disturb me. While they were gone, Patty came back and we started talking about my options at this point: I could take something to try and get some real rest, I could try a low dose of Pitocin to try to strengthen the contractions, or she could check and see whether I was progressing enough that breaking my bag of waters seemed reasonable. I'd had my membranes ruptured with each of the girls' labors, but it's always something to be careful with—there can be a risk of compression if the cord is near baby's head and there's too much room for it to drop down with the waters. If baby's head was farther down, we could try this route, but if he still wasn't engaged enough it would be off the table.

I didn't know what to think at this point. I was too tired to think, really. All I wanted was to sleep. I knew I didn't want to make this decision on my own, though, so Chris went to get Maureen and Tracy, so I could talk it through with them. Once they arrived, I set out the three options, as impartially as I could. I knew I wanted to take the meds and sleep, but it didn't feel like the right decision entirely. After I'd laid things out, Chris spoke up. You always do better with information, he reminded me, and in this case that means getting checked first. See where you're at and then decide where to go from there. This made so much sense, I knew it was what I needed to do—even while part of me was having a fit at the thought of not resting.

So, Patty checked me. I don't remember the number but she looked at me and said the head was down and she was willing to break the membrane—what did I want? Let's do it, I replied, not letting myself think about resting. I felt the familiar warm gush, and there was a lot of water. I don't know if it was more than with the girls, there just seemed to be a lot. I heard the nurse ask if the waters were clear and Patty replied they were okay, though stained.

As soon as I got up, the contractions began coming faster and harder. I opted to walk in the halls, trying to replicate or recapture some of what had worked when I had Dorothy. I had walked before having my water broken in that case, however, and these contractions hurt more—especially in my back. After a while, we went back in my room. I was feeling pushy sometimes, and wanted to be checked for dilation again. 8cm this time—an improvement, but not time to push yet.

I went through some contractions kneeling and facing the raised head of the bed, another position that had worked in the past for me. Not so good this time, and I was feeling increasingly tired and unable to cope with the pain in my back. At some point, I started to talk about wanting to take something for that pain; my support team looked at each other and ... well, they didn't ignore me, but they didn't respond to what I was saying, either. They could tell I was close to giving birth, even if I couldn't. As Chris observed to me later, hearing me say that confirmed his suspicion that I was getting close, he remembered me reaching that point with the other labors, too.

Patty suggested I try moving from the position I was in to a side-lying position, so between contractions I shifted onto my right side. Everything went really quickly at this point, so I can only write it as I remember it—I'm not certain it's what actually happened. As soon as I was on my side, the need to push became much stronger—irresistible, in fact. Chris told me later that he felt the change, almost like there was energy being drained from him through me, through our joined hands. Patty went to check me, and was about to say something to the nurse, but when she got a better look at me what she said was, "Never mind!" In my mind, I was thinking No, I'm not supposed to push yet! but my body had other ideas. And then I heard someone say, "The head is out!" and I felt this simultaneous wave of relief and, well, guilt—I hadn't been supposed push. I think I even tried to apologize.

Patty just looked at me and said, "I need you to push his body out." I looked blankly back at her for a moment, thought but I'm not having a contraction right now..., and then bore down to push him further out. Patty said, "Okay, now reach down and pick him up!" I really did need to be told, too, I was so overwhelmed and disoriented. I lifted him to my chest and it hit me: I'd done it again, I'd given birth!

The baby was rather grayish in color, and he didn't cry much despite being rubbed vigorously, but he was wide-eyed and so very alert. I remember looking under his leg, to verify for myself that he really was a boy. I think I asked if he was okay, because of his color. (He pinked up pretty quickly.) Mostly I just marveled at how wonderful he was. :-)

The rest of the time in the birth room (and for that matter at the hospital) went by quickly. The baby nursed. Chris and Tracy called family to tell them he was safely arrived, though nameless for the moment. At some point the nurse said something to the effect of, "Let me know when you're ready for us to measure him." and that was the last I heard about him being anywhere but with me, until I was ready. We snuggled and nursed for an hour or more, until I felt ready to move on. It was fantastic!

I feel like I could or should write more, but I'm tired and this is long and I'm ready to post it. It was a good birth in the end, but a hard birth going through—rather like the pregnancy, actually. Jack is totally worth all of it.

1 comment:

Shelley said...

Awesome story! I'm glad you had such a wonderful birth and that you and Jack did so well. Great job! :)