Sunday, August 5, 2012

My Son's 49hr Birth Story - March 2010

Here's my first child's birth story, my DS.  I've edited for grammar and added the number of hours into labor for my own reference in a few places, but it's otherwise unaltered from when I first wrote it.  I was terrified to read it.  I remember tearfully typing it out on my phone on many a late night nursing session, but reading it now was surprisingly painless.  It's a story I've told many times.  It's interesting how my perspective has changed.  It seems I felt I had no choice about a lot of things.  Only now do I realize how many other options I had. 

I wish I would have done this sooner. Already the memory has faded a bit.  The pain seems distant and I feel I could do it again. I certainly didn't feel that way immediately afterwards.
I'd had painless contractions the previous 2 weeks, but they didn't seem to help me any. On March 19th I was only dilated 1.5 centimeters, 80% effaced, and we set up another OB appt for the 26th.  At 2:04am on Wednesday, the 24th I awoke from a dead sleep with the worst contraction. Labor didn't come on slow and easy for me like they say. I was sound asleep, not in labor, and then all of a sudden seemed like I was right in the middle of it.  At the time, the pains were awful, but, looking back, I think I just wasn't emotionally ready.  I couldn't endure them in bed, although I did try.  At about 3am I gave up and went downstairs. The pain was debilitating, and even though I tried to clean the house as in my birth plan, I couldn't. I turned off all the lights and tried to endure in the dark, but I was nauseous with each contraction and continued to have diarrhea. This meant I had to have some contractions while on the toilet.  Eventually I gave up all hope of a natural birth. If the pain was this bad, I thought, then I wouldn't be able to do it.  I collapsed at the bottom of the stairs and called to DH for help. I called him over and over again, but he didn't wake up. I took this to mean he needed his sleep, and decided to take one of those pain relieving hot showers people talk about.  It was slow going to get back upstairs, and when I got there the diarrhea continued. The nausea was unbearable. I decided to try and throw up.  I didn't think there was anything in my stomach, but I was quite mistaken. I felt so much better afterwards.  I got in the shower, shaved, brushed and fixed up my hair, and felt great. I was getting used to the pains, and while they still hurt, I could deal with them so much better. I still had doubts about going unmedicated, but I don't think I verbalized them.  I was mostly appreciating how much better I felt after that shower.

Now that I was all ready to face the day, I decided to wake up DH. It was nearly 5am.  I sat on the bed and said, 'hey, how's it going? I'm in labor.' I was really nervous to tell him and didn't know what to say.  He just looked at me and I explained I was having real contractions every few minutes. I showed him my data from his ipod contraction timer app and we discussed whether or not he should go into work. We decided not. Of course, I changed my status on facebook (still heavily debated whether this was a mistake or not) and DH got to watch me go through some contractions. Having him watch me made me feel kind of self conscious of showing pain, and that actually made them easier.  Enduring contractions without a lot of physical drama (moaning, wincing, doubling over) made them easier to endure.  Throughout the morning we texted the world, I cleaned the house, and I nagged an obviously over-tired DH to constantly be doing something.
I hiked up a local mountain at 40 weeks pregnant.
A peice of cake compared to labor!

By 7am (5hrs into labor) I was refreshed by the sunlight, and as we were having unseasonably warm weather we decided to take a walk. From 2am my contractions had been 2 to 4 minutes apart, lasting 45 to 60 seconds without stopping. This confused us because we had heard the 511 rule to go to the hospital, but the birth was clearly not imminent. I decided to walk until 8:30 when my doctors office opened and then call them.  I felt silly walking in obvious pain. At first we stuck to the alleys and then DH convinced me we should walk on the sidewalks like normal people. Who cared what people thought. I still was self conscious, but it didn't slow my labor and allowed us to go farther away from home, hence a longer walk.

My mom began freaking out at around 7:30 due to word of mouth from my facebook status. I told her my plan had been to call her when there was news, which would be after I called the doctor.  I wanted to wait as long as possible to go to the hospital. When I called the doctors I accepted a 1PM OB appt, but after the nurse realized I was past the 511 rule (contractions under 5 minutes apart, lasting a minute, for more than 1 hour) she wanted me to come in immediately at 9. We ended up compromising with an 11am appt (9hrs into labor). We got home, packed the hospital bag, diaper bag, put the car seat in the car, and had a little something to eat. By then it was time to go.

It turns out the doctor I disliked the most was on call, but it ended up being for the best. I really wanted to go back home. I didn't think I was close and I didn't want to start the cycle of intervention with pitocin at the hospital. Doctor checked me, I was at 2.5 centimeters. I immediately said I want to go home, but apparently not soon enough. The doctor went on this rant about how if I wanted, I could hang in the waiting room for an hour and he would check me again. Eventually he stopped mid sentence and said, "wait, you want to go home?" I immediately said yes and he seemed surprised and relieved. He said that was probably the best thing and to call if 'something happened'. I questioned him about the definition of that, and he didn't really give me an answer besides the ever popular, 'oh, you'll know'.
I was really happy that I got to go home. My mom was not. I think she was shocked they didn't give me a c-section right there and then, lol. All day and all night she kept telling me to call doctor or hospital, but I knew the path to a natural birth can sometimes be a long one. I knew it shouldn't be rushed.  Mom may be in town for my next birth, but I'm glad she was 4hrs away for this one!
Wednesday was long, but manageable. The most annoying thing was I really wanted to be without underwear, but I kept losing pieces of my mucus plug. Gross, I know. I ended up carrying a towel with me and just having it under me everywhere I went.  We went for walks during the day. In the evening I played a lot of xbox. I took hot showers.  I began to get really tired. I'd been up since 2am, I think around 1 or 2am Thursday morning (24hrs into labor) I realized I had to go to bed, even if the contractions wouldn't stop. That is when the night became unbearable. I still couldn't endure a contraction lying down and they came every 4 to 6 minutes.  I would collapse in bed, only to be awakened 6 minutes later. I would then leap out of bed and lean against the dresser during the contraction, and collapse in bed again. This lasted until 5am (27hrs into labor), when Yerodin decided he was part of the problem. He thought I would sleep better by myself, and decided to go into work. He was right! Although, I still don't understand why.  He went to work, and my contractions spaced out to every 20 minutes. Those long periods of sleep between 5 and 8am carried me through the entire rest of my labor. I'm not sure what would have happened if I hadn't had them.

At 8am (30hrs into labor) I got up, had some toast, took a shower, and got on the treadmill. I didn't want to walk outside, in labor, by myself. I was trying to get the contractions back to every 4 minutes by walking.  They were down to about every 15 minutes by 8:30am when I called my doctors office. Luckily, my doctor was on call!  I was definitely wanting to go in. I knew they might send me to the hospital if I was still only 2cm, but it had been so long and didn't seem like I was making any progress. I wanted to talk to my doctor's nurse, not just the office personnel. They put me to her voicemail and I left a tearful message. She called me back and said she definitely thought I should come in and get checked, but that my doctor wouldn't be available until 1pm. I was fine with that because I was still hesitant about the whole early hospital trip. I planned to spend the entire morning on the treadmill trying to get those contractions more together. Alas, the nurse got nervous I guess and called the doctor in surgery. They cancelled the doctors lunch hour and decided to see me at 11am (33hrs into labor).  I called Yerodin home and we repacked everything. By this time my mom was freaking out about how long I'd been in labor, but I knew it was my first baby and natural labors just take longer. I wasn't scared of pain anymore. At this point I had grown so accustomed to the intense pain of contractions I was confident I could handle the worst. I was afraid that we'd go to the doctor and she'd tell me I was still at 2.5 cm after all that labor. I thought that might lead to me having a c-section just like my mother. We went in and did a non-stress test. All was well, and then the dreaded check. I was 5cm! I was thrilled. I felt capable of delivering a baby vaginally.  My mothers birth story would not be my own. The doctor recommended we go to the hospital and I agreed. Looking back, my expectations of what the rest of my birth would be were naive, but all turned out well because I had confidence in my self and my ability to give birth.
We took a while to find the birthing suite, but my contractions were still fairly far apart. Around 10 to 15 minutes or so. We got checked in, and I had to go on the monitor right away. Contractions in bed were brutal, but not as bad as my night time contractions. They were bad enough to kind of piss me off at hospital procedures though. To check me in I got an experienced motherly type nurse and a nurse in training. It was her first week as a nurse, and being an L&D nurse had been her dream. Her wonderment at it all made me feel lucky to be there, even though she didn't label my blood correctly and it had to be redrawn.  Throughout the hospital experience, my constant annoyance was the worry about the baby when I knew he was fine. I finally got off the monitor, but had to go back on for 20 minutes at the start of every hour to check on the baby. I knew he was fine. There wasn't a doubt in my mind so it all seemed so pointless.  During our 40min bouts of freedom I did laps around the nursery. DH got food at the cafeteria. (for him, no eating allowed for me, but I could drink anything I wanted. Even diet coke.)

At shift change, the nurses and front desk clerks told me they couldn't wait to see the baby tomorrow. At this point I'd been in labor so long I was surprised they'd assume I'd have a baby by tomorrow. I thought since it had taken 2 days to get to 5 cm, we had another 2 days to go.  Around 7pm (41hrs into labor) my doctor checked me and I was almost at 6cm. She wasn't happy with my progress. We'd been at the hospital 3 hrs and not moved a whole cm.  I said no to pitocin.  She said she'd check me again at 9pm and at that point I should really consider pitocin.  She also said there was a thing called uterine exhaustion, that my uterus had been working for a long time and could get exhausted and stop performing. I got into the jacuzzi tub, and my mom called. We talked about it for a while and I decided to go with the pitocin. I was ready to get this over with, and I felt like if they were going to make me do it at 9pm I might as well just do it now.  From the jacuzzi I told the nurse I would agree to pitocin, and the doctor agreed from afar. She never returned until I was pushing, but checked on my progress from afar.  I don't really blame her. She was obviously in for a late night and probably off sleeping.

The doctor had promised that we would keep the pitocin at a low level, and that we could turn it off and try something else later if we wanted. Neither of these were true, and I do feel like they intentionally told me that just to get me to agree.  It ended up being the best thing, so, maybe they were right. I don't know.

Right after they hooked me up to the pitocin I cried because I was so scared of what it would do. I'd heard of pitocin contractions and was terrified of what was in store. Then I got over it. When you're in labor you don't really have a choice. I dealt with it one contraction at a time.  The movie 'Mission to Mars' came on, and we watched it in between contractions. I stood next to the bed for them. DH would do counter pressure on my back. During this time I got a new nurse who was great. She was an annoyingly cheerful type. But later during the pushing stage her rapid push, push, push, and ever cheerful disposition was what I needed.
By 10 or 11pm (45hrs into labor) the contractions began to get really bad. That's when I started moaning, groaning, and saying "OW, OW, OW, OW." I think twice I had to pee and it was this mad dash to the toilet in between contractions. The nurse would have to whip me off the monitor and I'd go with the cords and IV pole across the room and go as quickly as possible. About 4 contractions from 10cm. I began to say after each one that I couldn't do that again. It hurt too much. I'm so glad no one offered me pain medication during this time. I don't know what I would have done. My memory of the whole event from here on out is kind of sketchy, but at some point the doctor did offer me stadol. I immediately said yes, but when she brought it, I said no. I didn't want to be tired and it was hard to believe any drug could take away the incredible pain I was feeling. So, maybe I would have refused an epidural had it been offered. I don't know.
Next, I got this odd feeling during contractions. Apparently, it was the uncontrollable urge to push people talk about. That is not at all how I would describe it.  I was standing for every contraction. For some reason, during the contraction I felt the need to squat. The only way I can describe it is just an odd feeling. My legs would just kind of buckle and I'd squat slightly, then I would return to standing toward the end. The nurse saw me and said, 'don't push!'. I told her, "I don't think I am." The next contraction I did the same thing and she asked me if I was pushing.  I said, 'I don't know.' I still don't know if I pushed during that or not.  I got on my back between contractions and she checked me, said I was at 10 but with a lip. 
Eventually the doctor appeared and we did my first push. I was on my back on the bed. I never changed positions the rest of the time. Looking back, I think I should have pushed in the squatting position.  The nurse kept scolding me for arching my back while pushing. The doctor interrupted her at one point and said the baby was in an odd position and that was actually helping. My instincts were right. To me this means pushing while squatting would have been most efficient, but I was exhausted. I mean, totally beat. I hadn't slept in nearly 48 hours. In between contractions I actually fell asleep on the bed. I don't think my legs could have held me up. Still, I have regrets that I didn't try it.

Pushing us exceedingly difficult, and incredibly uncomfortable, but the pain of contractions goes away completely.  After I started I immediately thought I had been doing it for hours and it would never end. After what seemed like an eternity I asked if I was making any progress, and if it was almost over. The doctor said she knew it felt like a long time, but that I'd only been pushing for 10 minutes. That's when I became more goal oriented. I knew that this was going to take a long time, but eventually it would be over. My goal became to get to that point. I needed to survive until it was over. Push extra hard every time to make it end. 

I have to interject here and say that at some point, the doctor gave me some kind of nerve deadening injection which prevented me from feeling my vagina.  I could feel everything else, just not that.  I don't know what it was.  Just like with the stadol, I agreed to it at first, but when she brought it out I again changed my mind and refused it.  We'd been pushing for a while, and DH had now watched me be in labor literally for days.  He said he thought I should get it because the doctor said it would help me push better, and so I agreed. I was too tired to argue.

There's really not much to say about it, but I feel the need to repeat a thousand times how hard it was. At one point the baby finally turned to be able to come out easier, and everyone freaked out. I knew the baby was fine, but because they couldn't see his heartbeat on their little machine they were going crazy. There was talk of forceps, and they made me get on my side. I had to endure an oxygen mask the whole rest of the pushing even though it just took a repositioning of the belts to get him back on their machine. I knew he was fine the whole time.

The pushing took a little under 2 hours. The longest of my life. I couldn't feel him go forward at all with my pushing, but after each contraction I could feel him go backwards.  I was constantly asking how much longer and if I was even doing anything.  Then, finally, they started telling me it was going to be soon. They called in their help, and after each of the last 3 contractions they told me he'd be here on the next push. I saw/heard the doctor do an episiotomy. At that point I knew they were supposed to make a birth 20min quicker and I was thrilled she was doing it. I don't remember if he came on the next push or not, but he did come. It was such a relief to feel him slide out.  (2:48am, Friday, March 26th. 48hrs, 44min after my first contraction.)  I saw them raise him up to show me, and I knew he was mine immediately. He looked exactly like he'd felt.  The foot that had been kicking me and sticking out was still out a little from the rest of him. I guess I mean to say that even though I'd never seen him before, I recognized him immediately. They asked me if I wanted to do skin to skin or blanket. The blanket looked so warm and he looked so slimy I choose blanket under him on my belly. He was there for about 10min. I looked at DH and said 'we did it', he kissed me. I think before that he cut the cord. I was so exhausted my memory of this has faded.
(Video taken immediately after the birth)
They decided to take him over to the warmer. I yelled at DH to go with him and the nurses laughed at me because the warmer was just 5 ft away from my bed. They put a blanket on him and DH got to walk around with him and the nurses took their picture. (Nurses said he was 7lbs 4oz, and 19in) At some point I remember accidentally kicking the doctor in the head while she was trying to stitch me up. Even though I'd had an episiotomy, I had a 3rd degree tear as well.  So much for preventing tearing. I'm still glad I got it if it saved twenty minutes of pushing, but I don't know that it did.
I think the doctor did pull on the cord to deliver the placenta, but I didn't feel that at all.  I did feel the placenta come out. That was gross. Felt like the largest, slimiest blood clot ever. I wish I could have seen it.  I also wish I could have seen the cord.  Just curious about what they looked like.

The nurses then said the baby had mild breathing problems that they were going to monitor. His pulse ox was good, but he was breathing really fast. He was still crying a lot and all alone in the warmer. I feel like that was the problem. I think DH was too nervous to get in the nurses way and put a hand on him, but I thought that was all he needed.  They made me take a shower. I was fine with that at the time, but, looking back, I think that first hour after the birth was really traumatic for DS. I kind of blame our breastfeeding issues on that, at least partly. If I'd had the time to focus on him I know I could have fixed his breathing and calmed him.

8:30am After we nursed for the 1st time
I took the bloodiest shower ever, and did lunges in the shower to stretch out.  My muscles felt so tight. Then everyone left us alone, but promised to be back to check the baby's breathing.  DH collapsed on the couch. I stood next to DS in the warmer and put my hands on either side of his chest, holding down his arms. I told him it was OK, and he could calm down.  I was there for about 20min, and when they came to check on him, he was fine.
Swell much?!  Pitocin caused me to swell for the first time in
my pregnancy.  I don't show this pic often, but I wanted to
show what pitocin did to me.  This barely resembles me! 
It took me a long time to write this, just a little at a time when I had a free moment, and as the days passed I began to see things in a different perspective.  Why didn't I phrase it that the doctor lied to me about being able to go off pitocin if I changed my mind? Why did I say it was for the best that I went to the hospital even though it didn't seem like birth was imminent?  I made a lot of excuses to protect myself from what had happened, and as I began to realize the truth over the coming days, I was unable to continue the story, or draw any conclusions from it.  I shouldn't have gone to the hospital when I did.  I shouldn't have agreed to pitocin, or I should have at least waited as long as possible.  I should have demanded to breastfeed my baby instead of letting him scream his head off for an hour.  He spent the first hour of his life crying for me and I didn't respond.  I still have guilt over that.  I was not able to breastfeed for four hours after the birth due to both his breathing issues which I now believe were caused by the pitocin, and the L&D nurse saying we needed to rest.  This isn't a nightmare birth story, I accomplished a 49hr birth with no pain meds!  There's more good here than bad, but it's hard to overlook all the things I wish had gone differently, especially when I feel so much guilt over what happened to DS. 
Taken on the 27th at 7pm.  He already has his color and is
starting to look like himself.  Laying on my giant lap! LOL

I thought I'd be emotional and have flashbacks while reading this, but it was actually no trouble at all.  I hope that means I've made peace with what happened.  This is the story of how my son joined us!  Sometimes I feel like it's when my real life started, and while I hope my next birth is an improvement, this birth experience was an empowering gift.  Enduring that long labor gave me patience, taught me strength, and so many other things I probably don't even realize.  It even improved little everyday things like my ability to push myself during gym workouts.  It has positively effected so many aspects of my life that I would never say it was a bad experience. 

Now that I've taken a moment to remember this birth, I'm sure I'll spend the next few days and weeks processing and come up with some more thoughts, strategies, and goals for next time.  I know I can't control what happens, but I can control how I react to those events, and I want to make the best decisions I possibly can.

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