Thursday, January 17, 2013

Hospital Birth Story of my 2nd Son

40 weeks! 2 days before I delivered.
Finally finished! This is the birth story of our long awaited 2nd child, a boy, born exactly a year and 3 days after my miscarriage.  It ended up a planned hospital birth with an unplanned epidural, and was a forceps delivery.  Labor was only 18hrs!  So much better than my 1st son's 49hr birth.

I'd had periods of contractions for the last 4 weeks of my pregnancy, but on January 4th at 5 am I woke up with what I thought were 'the real thing'.  They were tough to sleep through, but after I got up I realized I was too tired and should try going back to sleep.  I did fall back asleep, and when I woke again at 7:30am the contractions were gone.  On January 5th I woke again at 5am with contractions even more severe than the previous morning, but this time I decided to just stay in bed.  I figured if I could get back to sleep they'd stop just like the previous morning.  By 6:30 I realized they were just too severe and I should get up.  I started timing them, and though not very regular, they didn't go away.

It was the first time I really had that 'this might be it' feeling, but at 2 days past my due date it was hard to believe it was really time.  I had to make a decision though, my mom was supposed to be called in from 4hrs away to watch DS while we went to the hospital.  I woke up DH to discuss it, and he accurately pointed out that I'd know more than him whether I was in labor or not.  I had to make the decision.  I texted my mom that today may be the day, but I wasn't sure yet, and then decided to try to go back to sleep one last time.  After 30minutes I knew that even if this wasn't labor, I was going to need help with DS anyway and this much activity would surely lead to a baby at least in the next day or two.  I told mom to start driving. 

DH asked whether he should go to work or not.  As a massage therapist, saturdays are his busiest days of the week.  I knew he might potentially lose clients forever by cancelling on them even if he the 'my wife is in labor' excuse.  I sent him to work.  My 49hr labor with DS had made me wary of running off to the hospital too soon, and my mom wouldn't arrive until around 1pm anyway.  He might as well work a half day at the least.  I took it easy that morning, and the contractions continued with varied intensity.  In the morning they were about 8-10min apart and lasting 45 seconds.  Around 11am I decided I just had to have a diet soda even though I'd been off caffeine for more than 5 days.  Our grocery store is only 4 blocks away, but I didn't think I could lift DS in and out of the carseat to drive there.  Plus, enduring contractions while strapped into a seat belt didn't seem appealing either.  I decided to walk there with DS.  That walk brought the contractions to every 2 to 3 minutes, and it turned out I didn't even want the soda.

My mom arrived.  I thought my labor would slow down with her arrival, but that didn't happen at all. She chatted for an hour and played with DS while I labored and asked questions in between contractions.  I'd been walking so much over the last two weeks that DS is used to taking his naps in the stroller. I wanted to maintain his routine as much as possible, so we ended up going for a 2 mile walk while I was in active labor! I know I'm all into natural birth practices, but even for me this seemed kinda crazy.  Contractions got closer together and even stronger while on the walk.  By the time we reached the end of our walking trail and turned around, I worried I'd done too much.  I was eager to get back and get to the hospital.  By then I'd already been texting DH that I was really ready to go and he needed to get back.  But we were so slow on the return trip he ended up getting to the house almost 30minutes before we did.  The last 20 minutes of the walk were the worst.  Contractions were getting difficult to work through and I felt like I already needed a break from the pain.  If I couldn't get a break, then I at least wanted to be at my safe place where I could labor. I hated that I had to walk home, then get ready to travel to the hospital, and then endure a car ride.  I wanted to be wherever I was going to be.

We finally got home, and DH put sleeping DS in bed to finish nap.  I finished packing last minute odds and ends in between contractions.  We realized I hadn't even called the on call OB to say I was going to the hospital, and by then I was so annoyed with no break between contractions and still having all these ridiculous things to do I worried my attitude on the phone with him would be terrible.  Luckily, the OB on call 'Dr. T' was already at the hospital and isn't one to waste time either.  I called, said I'd been having contractions since 5am, and they were now lasting a minute and about 2minutes apart.  He said, "Do you think you're in labor?" I said I thought so, and he said, "well then come on in."  I was so appreciative of his efficiency. 

We were finally ready to leave.  We wished mom good luck with DS and I hobbled out to the car, relieved we were finally leaving and all the more closer to baby.  Having contractions sitting still was tough, but not nearly as tough as every bump or turn.  Being jostled was so painful and uncomfortable I groaned or yelled at an annoyed DH with every one.  It's only 15min to the hospital, but I was relieved when DH offered to drop me at the door while he parked.  I was so annoyed with the car by then, and my brain was starting to shut down as I retreated into myself  to deal with the contractions.  Our hospital complex is very large and confusing, and so I decided to save time by asking the desk how to get to Labor and Delivery instead of making DH do it.  A bored and rude young man gave me clear and accurate directions which I forgot immediately.  I was too far along in my labor to pay attention and DH had to ask again.  I don't even remember the walk/elevator ride to the birthing suites.

We got to the room, answered the standard questions, and I was asked to change into a gown.  I'd been in an identical room at the same hospital for DS's birth, and it was actually comforting to be back there again.  It was also great to be without pants! I was starting to feel downward pressure and back pain.  Though many women often experience labor stall due to nerves when they arrive at the hospital, this is where I wanted to be.  I immediately felt comfortable and relieved after the stress of the morning.  I felt like I could finally have the baby, and so my labor began to intensify shortly after we arrived.

The nurse put us in the computer, and said she'd be back for me to sign the rest of the paperwork if Dr. T chose to admit me.  She knew he would, but wanted to follow procedure.  It was fine by me not to be bothered, although I didn't really think that through.  Obviously, this meant I'd be bothered later when I was in even more pain.  She came back one more time to check me and I was 2.5cm.  That was only .5cm more than at my last appt, but I wasn't upset with the slow progress.  I was already convinced I was in for another long labor, and still happy to finally be in the hospital.  At least now every contraction was one less I had ahead of me.

I don't want to say I had horrible back labor because my back pain wasn't as bad as contraction pain, but I do think I had some form of back labor.  While between some contractions I did have a break, with others it seemed the contraction would peak and then the pain would retreat into my lower back and stay there until after the next contraction.  I'd moan through a contraction and the moaning wouldn't stop because the pain wouldn't stop.  My previous labor I wanted to handle every single contraction standing up, leaning over the bed or on DH.  But now I wanted to change positions often.  The prospect of each position change was daunting, but once I got the idea in my head that I wanted to move it only took a contraction or two in the 'wrong' position to motivate me to change.  I don't remember all the positions I was in, but I remember frequently thinking my legs were getting tired.  That's so odd because with DS I never exercised while pregnant and my legs didn't get tired during the long labor, now I've been walking miles a day during pregnancy and my legs were so tired. lol.  I think it was another way my body would get me to change positions.

About 2hrs later I was on my knees on the bed facing the side.  The back of the bed was up as far as it would go and I was laying against it in the middle of a stretch of back pain that seemed unending.  In truth it was probably on it's 3rd contraction.  The end result was I'd been moaning loudly and rhythmically for several minutes.  When my water broke in the middle of a contraction, I totally freaked out.  I'd never experienced anything like it before and absolutely panicked even though I knew what it was in my mind.  I guess it was the typical popping sound followed by a gush, but my gush was Niagara falls.  It was warm and pooled on the bed over my legs and poured onto the floor from both sides of the bed.  My loud rhythmic moans immediately changed to panicked yelling, and all of a sudden the room flooded with nurses and Dr. T.  "My water broke!"  I kept yelling, but I felt like I had to say it several times for them to catch on.  Dr. T checked me and I was 5cm.  I wasn't disappointed because I'd always heard women progressed rapidly after their water broke.  If anything I thought they were checking me rather infrequently, and wished they'd waited about 30min to see if water breaking progressed me further.  My fluid had been measured via ultrasound and was declared to be an average amount, I think my spectacular water break was because I was 5cm dilated and because his head was still fairly high at -1 station.

My labor had already been difficult, but I don't think it was anymore difficult after the water break than before.  Since this baby was slow to descend, there was no more pressure on my cervix and contractions weren't any more painful.  The problem was the continued back pain.  The contractions wouldn't disappear, but would just move to my back afterwards.  At this point time slowed down.  A football playoff game was on, and after what seemed like hours would pass, I'd look up and see the game clock had only advanced five or ten minutes.  I started commenting to DH on how long everything was taking. 

I'm not sure the exact order of events here, I was in labor land and not really paying attention to what was going on.  I guess I was checked, and I'm not sure how many centimeters I was.  Either still 5 or could have been 6 or 7.  I don't remember.  I know I was at a loss of how to continue, and the nurse and I got the idea for me to go into the jacuzzi tub at the same time.  I was so ready for some relief, and had read so many birth stories where the laboring woman got in the water and all the pain went away.  I was so pleased at first when it worked, but was soon hit with another too hard contraction.  I was in just as much pain, there was just more time in between the contractions.  One would think this would be a relief, but if one of the contractions ended in back pain I had to wait all the longer for another contraction to come to perhaps take it away.  I now think it was before I got into the bath that the nurse mentioned pitocin, but it didn't really hit me until I started to find the bath uncomfortable.  I thought about trying to get out, and then I remembered her saying they were going to add pitocin.  That wasn't true.  The nurse had said that if I didn't progress in the next two hours that they were going to add pitocin, but all I heard was my nightmare word.  During my pregnancy, I thought I'd be strong at the mention of that word.  I thought I'd say, "NO! If mother and baby are fine, than I want more time to progress without the use of pitocin."  But in that tub, thinking about pitocin, I lost my confidence and faith in myself to complete the birth unmedicated.  I first mentioned to DH that I was thinking about an epidural.  He seemed surprised and asked me if I was sure.  I said I couldn't do another 49hr labor.  He said if that was what was happening, an epidural wasn't going to make it any shorter.  I was like, "no, but it would make it pain free!  I can't do that labor again."  Memories of my son's pitocin induced labor took control of my thoughts and emotions.  Looking back, it should have been obvious to me that my first birth was not being repeated, but once I heard my trigger word I guess I was a gonner.  Perhaps I was looking for any excuse, or I really was that scared of getting pitocin again.  I'd been so committed to not asking for an epidural, it took me a few minutes to change my mind.  I called the nurse, and said I couldn't do it anymore.  She said I was doing a good job.  I was unable to say epidural out loud to her, so I just looked at her for almost 30 seconds of awkward silence.  She asked me if I wanted an epidural, and I responded that I certainly did if they were going to do pitocin.  She said that was fine, but she had to locate the anesthesiologist.  She didn't even know if they had one in the hospital.  I said OK.  A few minutes later I told DH to go tell her I wanted the epidural.  He asked me if I was sure.  I asked him if he was mad at me for getting it.  He said it was up to me, but I'd always said I didn't think I needed it.  I next remember the nurse running in and saying directly, "The anesthesiologist is going into surgery.  If you want an epidural, you have to get it right now!"  Despite this, I can't say they rushed me or didn't give me time to think about it.  My mind had been made up the moment I heard the word pitocin.  I yelled back, "OK, let's do it!" and the room became a flurry of activity.

Still have a crazy bruise from the messed up IV
I got out of the bath, and am pretty sure I went straight into transition.  The contractions over the next hour were the worst of my life.  The pitocin contractions during my son's birth don't compare.  I can't imagine an analogy for the pain, nothing compares.  I'd had a hep/lock placed when I arrived, but the nurse didn't seem very confident in it.  Indeed, when they tried to use it to place an IV it wouldn't work.  The anesthesiologist was a grumpy old man and was furious he would be delayed from his surgery even further.  I'm pretty sure he placed the epidural before they were able to set up an IV.  Getting it in wasn't that bad.  I had a few bad contractions during the placement, and I had left moaning far behind.  I was now yelling through them, but they were nothing compared to what was to come.  I barely felt the needle go in, it was only contractions and the lower back pain that I was feeling.

The catheter or whatever delivers the medicine was placed, and they laid me on my back.  Flat on my back while going through transition!  If you've had a natural birth before then you know exactly how ridiculous and torturous this was.  There was not a moment without pain anymore, and I was in the worst possible position to deal with it.  My lower back hurt as much as a peak contraction at all times, contractions were a million times worse than they had been at any point thus far.  I began to shake which is a common side effect from the epidural, and my yelling turned to screaming.  In between contractions if I wasn't yelling from back pain then I was crying for fear of the next pain.  The anesthesiologist and nurses kept asking me if my legs or toes were getting tingly.  I kept saying 'maybe?' or 'I think they might be' in a desperate attempt to wish them numb.  The anesthesiologist kept saying he knew he had everything in the right position, it was ME who was just refusing to go numb.  He put a different medicine in the epidural to prove it was in the right place and declared that it was.  Eventually he became fed up with me, said I was just slow to take effect, that it would work eventually, and hurried off to his unjustly delayed surgery.  Despite his attitude, he was right.  Soon, each contraction seemed less painful.  I was back to moaning through them, and talking between them.  It had taken 20minutes to place the epidural, and 40minutes for it to work, but then it worked great.

Even immediately after that horrific experience I was so glad I had made that choice.  I was without pain! I finally had a break!  Dr. T checked me and I was at 9cm.  At first hearing this made me question whether I should have bothered with the epidural. I'd suffered so much for only a few minutes of relief before I pushed the baby out and it was all over anyway?  Dr. T suggested we try some directed pushing to see if the baby was ready to come out, but after one push he said I had an anterior lip that wasn't moving out of the way and the baby wasn't that low.  He suggested we wait an hour to see if the baby would descend before we pushed again.  I was SO on board with that plan.  Getting the epidural had taken everything out of me.  Just the idea of pushing exhausted me.  I needed a break!  That's what I'd been asking for ever since that walk with my mom in the morning.  I'd just wanted a break.  Thankfully, I finally got one before we started pushing because I think that mental block would have been one more obstacle for what turned out to be a very difficult delivery.

By then it was about 9:30pm.  I was happy, writing facebook updates, and texting friends and family.  I'm a sportsfan and I was finally able to actually pay attention to the football playoff game we had on.  Humorously, I was telling everyone we'd have a baby within the hour. HA! If I'd only known we would barely keep his birthday on the 5th.  We started pushing at about 9:45, and by then I was so completely numb.  I wasn't getting any feedback on my pushing and doubted I was pushing at all.  "Am I doing anything? Is it working?"  I couldn't feel a thing and the contractions seemed so long.  I'd have to push 4 or 5 times and by the last push it felt like I was only pushing in my face.  Often, they'd say, "Feel my hands? Push right HERE."  I couldn't feel a thing.  I had no idea where they meant, but I seemed to be making progress.  They saw a bit of the baby's head for the first time, so I realized I was doing ok even if I couldn't feel what I was doing.

After about twenty minutes of mediocre progress the nurse started to say she thought the baby was in a bad position.  As soon as she said this I knew he was facing my left, with his spine on my right.  I'd done so much to avoid this situation and was kind of flabbergasted he was still in this position.  While he'd been like that the last weeks of my pregnancy, I'd been doing all the recommended exercises I could find online and even started seeing a chiropractor.  The baby often would briefly turn and be in the correct position or even have his spine on my left side.  Because he was so mobile, it seemed that the strong contractions of labor would move him into the proper position.  I'm still confused as to why they didn't.  How could he have moved so drastically earlier, and not during my labor? I was in all sorts of positions during labor. I can't believe he didn't move.  My husband had been against a doula, but I wonder if we'd had one if she would have known of better labor positions to try and move the baby. 

Dr. T came in and confirmed the baby was stuck exactly as I thought, and decided to try and turn him both between and during contractions.  I suffered a tear during this process, and while he didn't seem confident that he'd been able to turn him, whatever he did allowed me to continue pushing and make progress again.  We pushed for about an hour more until I again stopped making progress.  This time the nurse was much less positive about it.  I kept asking for the doctor to come in and questioning why they were making me push if we weren't doing anything?  During that hour I think we tried every possible pushing position for a woman with an epidural.  I was holding my legs, using a modified squat bar, playing tug of war with a nurse holding a sheet, and more that I don't even remember.  We kept trying different things because what we were trying wasn't working.  By this time I could also see the head.  It was less than an inch out and so pointy.  It made me worry how long the baby could hold that shape!

Finally Dr. T came in and I now understood why the nurses had been hesitant to get him.  He was talking c-section.  I'd been pushing for 90minutes and the baby wasn't out.  For at least the last 30 minutes we hadn't made any progress at all.  He said our last chance was to try forceps, and if that didn't work we would do a c-section.  I remembered that if mother and baby were fine, then there was no reason to agree to surgery and I was prepared to buy myself more time through arguing if needed, but what if this didn't work?  What if no amount of time would get this baby out?  I immediately began to cry, and the nurses told me crying would waste my energy.  They said I had to save everything for this push.  I stopped crying, but just shook my head.  I couldn't feel if I was even pushing at all!  How could I give it everything I'd got?  I could only give it as much as I'd been giving it.  I looked at my husband who said, "remember, we just want a healthy baby."  He was already giving up.  I couldn't believe it.  I looked to Dr. T who was busy setting up for his effort.  We finally made eye contact and I said, "Please.  We've got to make this work."  I was trying to give him license to do whatever was necessary to get the baby out, right now, without surgery.  I don't know if this made him try extra hard or take extra risks or not, but at that moment I was willing to take them.

The next contraction came and he waited while I pushed.  He didn't seem hopeful or positive.  He inserted the seemingly giant forceps with great difficulty, and then we waited for another contraction.  I'm pretty sure I stopped breathing due to nerves and desperation at this point and the nurse gave me an oxygen mask.  Perhaps she was giving it to help me push better.  Another contraction came and despite my numbness, and my focus on pushing, I could feel how hard Dr. T was pulling.  My husband later told me I was being pulled off the bed and he and the nurses pulled back on my legs to keep me from moving further towards the doctor.  As I was taking breaths between pushes I saw him pulling and moving the forcep handles up and down trying to find a way to get this kid out.  I didn't feel it, but the head came out.  You'd think everyone would cheer, but it was more like a collective sigh of relief.  I couldn't see anything because I was laying back so far, and even though I could tell by the look on everyone's face that the storm was over, I needed to hear it.  "Is the head out?"  Funny enough, no one answered me!  I spent the whole rest of the delivery clueless.  With the next contraction the shoulders came out and I could finally see was holding a baby. I started to cry with relief and the Dr stopped me.  "You've got to push him the rest of the way out.  I can't pull him!" Lol.  Just a brief push and it was finally over. 

Dr. T took forever holding him and cleaning him up well.  I bet it was longer than a minute.  Then he let DH cut the cord, and finally it was my turn.  I bawled.  I told baby how long I had waited for him and how much he was wanted.  The nurses let us hold him and try to nurse as long as we wanted.  He didn't latch right away so we just held him and took him in.

When it was time for him to be weighed, the nurses and Dr kept throwing out ridiculous guesses of a 9lb baby.  I thought they were joking about how difficult the delivery had been and trying to make me feel better, but they weren't!  He weighed in at 9lb 5oz.  A full 2lbs heavier than his older brother had been at birth.  Dr. T joked that you're supposed to have difficulty pushing out the first one and the second is supposed to fall out.  He said I did things in reverse order.  Little does he know my first was just as hard to push out, or at least as time consuming.

I'm left with more questions than answers about this birth, but I'm not upset with the experience.  Pitocin was avoided, making this birth far superior to my first.  I ended up choosing an epidural.  Did that cause the delivery to be so difficult?  Or did I chose the epidural because of the baby's position and how difficult the delivery was.  I wish I'd tried some labor positions known to help spin a poorly positioned baby, but I'm not confident they would have worked.  While part of me is curious how the delivery would have gone if I could have delivered in the squatting position or something more favorable to helping a big baby descend, the other part imagines how awful the experience would have been if I'd needed forceps anyway and not had any pain relief as the doctor pulled with all his might. 

Some of my friends have asked if I plan to get an epidural for my next birth.  It seems early to make that determination, but I imagine I'd wait and see.  During my first birth I decided against it, and during my second I decided to have it.  They were very difficult birth experiences that were hard for very different reasons.  I'm not overly optimistic that my next birth will be a breeze, but that doesn't necessarily mean I'll need an epidural.  Despite it's challenges, this birth was much easier than my first.  It's possible this is a trend and each one will be easier than the last!

The next morning.  DH is proud as can be, DS is confused and scared,
and I look and feel like I just delivered a 9lb baby. HA!

We named him Jackson Bay

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