Tuesday, March 31, 2015

Oliver's Birth Story

  Oliver was due to arrive on Christmas Eve, 2014, but I knew he was going to be late. In fact, I had informed him (yes, while in utero - I wanted him to get a jumpstart on understanding the chain of command around here) that he had better be a few days late. Let’s be honest: nobody wanted me to be in labour on Christmas, least of all me. We had family in town, places to be, things were busy ‘round here. Better for everyone if he just hung out where he was comfortable, bided his time, and waited till all the festivities were over.
  I’ve got me one agreeable child, you guys.
  Christmas came and went. No baby. New year’s came and went. No baby. Extended family headed back to California on the 3rd of January, disappointed - still no baby. Not only that, there were no signs baby was coming anytime soon. I was having 0 contractions. Not even Braxton Hicks. Oliver was still riding high as a kite in my abdomen. Which, lemme tell you, is all kinds of uncomfortable when you are a very large 41 weeks pregnant. Nothing. Was. Happening.

  Let’s back up, at 6 days overdue I had had a midwife appointment and we started talking about what the plan would be if I didn’t go into labour within the next week or so. They can only let you go so long before it’s considered malpractice. Not a conversation I wanted to have. I had a plan. I wanted a home birth. We had it all set up. I was going to have this baby in my bathtub, drug free, at home, in peace. I had a plan. The last thing I wanted to talk about was a medically induced birth in a hospital. I went home from that appointment angry, afraid, and not a little bit stressed (good emotions to promote a happy, gentle birth) This baby was coming out my way, and I was going to do whatever it took to get him there! I tried EVERYTHING. I spent hours bouncing on the yoga ball. I had countless ridiculous looking dance parties in the living room. I did a million squats to encourage him to drop. I used the breast pump to try to stimulate contractions. I made Derek go for walk after walk with me in the cold, rainy, January weather. Nada.

  Saturday, January 3rd, 10 days overdue, the sun came out. It had been raining all week, Derek had been working. Family had been around. I was done. I was stressed. Over tired. Overwhelmed. I needed a distraction. So we ran away for the day. We turned our phones off. We went for a hike. We went swimming. We went book shopping. We test drove a Chevrolet Corvette, just for fun. We had a date and did everything we could think of that had nothing to do with being pregnant or having babies. It was a blast. It was tiring.
  Saturday night around midnight, exhausted and fully confident that I would be fast asleep as soon as my head hit the pillow, I prepared for bed. Then - I had a contraction.  A tiny, light, painless contraction. 5 minutes later, I had another contraction. Then another, 5 minutes after that. So we called the midwife. She advised me to try and sleep before things got more intense and to call and update her in an hour if I was still awake. Yeah…I didn’t sleep. I was wired. I clock watched. I timed every contraction. I wanted to cry with excitement. The contractions continued. They were light, not painful, and only about 30 seconds long, but they were consistently 5 minutes apart. Around 1am I went to the bathroom and discovered I had started spotting. A few minutes later I passed my mucus plug. So at about 1:30 in the morning, we talked to Monika (one of my midwives) again and she decided to head out to the house. We also called my fantastic Doula, Sharon - Mamas, get a Doula. don’t think about it. Do it. I don’t know what I would have done without mine - and told her to pack up and come out also. Then we texted my mom and Derek’s mom and told them to be on standby. ‘This is happening.’ I remember telling Derek.  ‘We are having a baby today.’
   We didn’t.
  Monika arrived near 4 in the morning. Checked me and reported that I was NOT, in fact, in labour. Irritated uterus, she called it. Baby seemed to have dropped a little…maybe…but contractions were not strong enough cause any progress yet. Sharon arrived shortly after Monika had finished her exam and we decided that Monika would go home, but Sharon would stay the night in case things picked up in the middle of the night. Monika advised I get some sleep and that after resting I would probably wake up in labour. She told me to take an Ibuprophen, have a bit of wine, put some heat on my back, and sleep. I was going to need my energy later.
  I was more than a little shattered. I slept for about three hours and when I got up around 9, my contractions had stopped. Sunday was the longest day. Sharon stayed out with us for the day, all of us still thinking that “real” labour would start at any minute. I had irregular contractions throughout the day, but nothing happened.
  We talked to the midwife Sunday afternoon and she decided she wanted to see me in the office on Monday. (I had an appointment Tuesday, but she didn’t want to wait). She also called and schedule a sonogram for Monday afternoon, just to make sure baby was doing good and my placenta was still functional and to measure my fluid levels.
   Sunday night, around midnight, I started having contractions again. Every 5 minutes. But they weren’t any stronger than they had been, so we decided not to bother the midwife. I don’t know how much sleep I got that night, but it wasn’t a lot. It might not have been any.

   The plan was to go to the sonogram first on Monday afternoon, and then meet the midwife at the office afterwards. But about 2 hours before we were supposed to go in (1ish in the afternoon), my contractions picked up again. I gotta tell you, this was all kinds of frustrating, folks. Still not painful, but slightly longer and stronger than they had been. So we called Debra (my other midwife) and she said she’d meet us at the office on our way in for the ultrasound. Once again, my exam showed no progress. Still just pre-labour. Ultrasound tech said baby was good, and we headed home. Debra called in to check every couple of hours throughout the day and I continued to have contractions every 5 minutes. Finally around 9 she decided she would come out to the house and see if anything had changed. It hadn’t. I was still not dilated. At. All. And we were back where we’d been two nights earlier. Take a bath. Have some wine. Get some sleep. You’re going to need if you wake up in ‘real’ labour.
   Sleep. Yeah. That didn’t happen. I tried everything. Laying down made it hard to breathe through contractions, so I tried sleeping sitting up on the couch. That didn’t work either. My contractions went from every 5 minutes, to every 3 minutes, and back. There were a few I may have dozed off in between, but not many.
  At 6 am Debra called to check in. I told her I hadn’t gotten any sleep and she recommended I get up, make some thing to eat, take a walk. So I showered, ate, walked, read. And then eventually laid back down and actually managed to get about an hour of sleep.  I called Debra again around 9 and she decided she was going to head out and bring some things to naturally encourage progression. If I wasn’t getting any respite, we needed to kick things into gear and get labour going before I got too weary.
  Once again, we called Sharon and told her to head out, and put everyone else on standby.

  Debra and Sharon arrived around 10. Debra examined me a found that I had dilated to 4cm! Yay, progress! My horrible restless night hadn’t been for naught! They hooked me up to the breast pump for an hour (off an on) and gave me some grotesque tasting herbs to try and strengthen my contractions. It worked.
   After an hour on the breast pump they let me labour an hour. Have some food. Hangout on the yoga ball for a bit. Then they checked me again. Still 4. Back on the breast pump I go. Except, then I had this horrible, insane, four minute long contraction. It just wouldn’t end. It built and then started to die, and then went straight back to peak again. I was not doing that. That was the end of the pump. Time to try something else.
   So we went for a walk. It was gorgeous outside. We called my parents and my best friend around 3 and told them to head out as soon as my dad got off work. I spent some more time on the ball. I tried to lay down in bed with Derek for a while. That didn’t last long. We filled the tub and a soaked in the warm water for an hour or so. Water is the greatest during labour, folks. I highly recommend everyone have a tub. It was so relaxing. Pretty sure I started to fall asleep at one point (good thing Derek was in the water with me!).
   My mom and dad and my friend, Hannah arrived as I was getting out of the tub (around 6:30 pm, I think), and Debra checked me again. No progress. None. At this point, I had been having contractions off and on for almost 3 days; regularly for 30 hours, and I had been at 4 cm for at least 8 and probably more like 12+ hours. Not cool at all.
    I remember Debra looking at me and saying ‘We’re not ready to throw in the towel if you’re not, but…’ And I knew. It hit me in that moment: I was not going to have my home birth. Oliver was not going to be born in the water in my bathroom in my house with only the people I love around us. They were going to take me to a hospital, and hook me up to machines, and make me labour flat on my back, and a stranger - a stranger - was going to be the first person the see my son’s face. ‘But’ she said “you’ve been at this a long time, you’ve got a lot more to get through, and at some point we may have to accept that you just need a little bit of help’. This was NOT what I wanted. And I was not handling it well.

   Derek and I asked everyone to go across the street to his parents’ house while we discussed our options. And I fell apart. My husband is amazing, you guys. Not once did he doubt my strength. He was fully committed to stand by me no matter what I wanted to do. He believed I could do it. I didn’t. I was tired. I was defeated. I just wanted to go to sleep. I just didn’t think I could keep going.
   So we called in a transfer to Seton Main. We packed up and loaded into 5 different cars, and we caravanned to downtown Austin. Around 11 pm, we checked into Labour & Delivery.
  Debra explained to the doctor that I wanted to deliver as naturally as possible but that the ultimate goal was a vaginal delivery. Mostly, I just needed some sleep. We were hoping if I could get that, my body would get it’s Sh-- together and I could continue to labour relatively drug free.
  The people at Seton were amazing, and understanding, and supportive. They started me on an I.V. drip and then gave me a dose of Fentanyl, which is a mild pain killer, administered intravenously, that they said would give me about 2 hours of pain relief so I could get some sleep. I got 45 minutes. Then I tossed and turned for another 2 hours.
   Around 2:30 am the Dr. came in to check my progress (there was none, still 4) and discuss our next option. She recommended we try breaking my water to see if we could get the baby to drop lower into my pelvis and maybe that could get things going. We decided if we were going to do that, I wanted to get an epidural first so I could continue trying to get some rest if things got more intense.
   So - Epidural at 3. Bag of waters broken at 3:30. The next few hours passed excruciatingly slowly. I slept some. Ate very little. Talked a lot. I don’t regret the epidural, I needed the relief, I needed the rest, but lord, labouring flat on your back is BORING. I counted way too many of the minutes. I stared at the monitor just to make sure that I was still having contractions because at this point I couldn’t feel anything, which is the most frustrating thing when you’ve been stalled in early labour for 20 something hours. I had this weird paranoia that I would just be in perpetual labour and this baby would never come out. Can’t imagine where that fear came from.
  Around 5:30 the on-duty nurse came in, woke me up, stuck an oxygen mask on my face, and flipped me onto my back. She told me baby’s heart beat had started to dip lower than they would like it to during some of my contractions. It was coming back up again immediately and they weren’t too concerned, but wanted to be sure that the baby was getting enough oxygen.
  About an hour later the Dr. came in to discuss the next steps with us. She checked me again and I was at 4 cm still. Breaking my water had not gotten the baby to drop at all, and so his head was still not putting enough pressure on my cervix to get it to dilate, and my contractions were still not strong enough to push the baby down. The Dr. expressed some concerns with starting on Pitocin since Oliver’s heart rate was still fluctuating so much. She told us she was going to go talk to the other resident’s about our options.
  They decided they would start me on the Pitocin at the lowest dosage possible and slowly increase it, provided Oliver’s heartbeat stayed stable enough. They started the Pitocin at 7am, which is when the doctors and nurses have shift change. My new nurse (Roni) was AMAZING. She had had a homebirth herself and kept telling me how sorry she was that I wasn’t getting the birth experience I had dreamed of. She was super sweet and supportive, and I am immensely grateful for her. She told me that the new on-shift doctor was going to give me four hours on the Pitocin and let me rest and let the meds do their stuff and that she would come in to see how I was progressing at 11. Roni came in every hour and bump up my Pitocin and help me roll from one side to the other (we discovered that if I changed side periodically it help to get blood flow to the baby and stabilize his heart rate.)
   The doctor came in about 11 to check on me. I was praying for any kind of progress. I knew that if I couldn’t move forward in labour even with the drugs, that our only option left would be a cesarean. I don’t know that I’ve ever prayed for anything harder. We had everybody in the room when the doctor came in. My parents, the midwives, the doula, Derek’s mom, my friend Hannah.
    The doctor, Kimberly, examined me and pronounced “I have good news.” She paused, and checked me again, nodded. I’m pretty sure those were the longest moments of my entire labour. Then - She told me I was complete. 10 cm, and Oliver had finally dropped all the way down. I had slept straight through transition! She said they were going to let me ‘labour-down’ for an hour and then Roni would be back in to prep me for pushing. I’m not gonna lie, I bawled like a baby. Derek did too.
   I started pushing at 12:25 pm, (They set up a mirror so I could see while I was pushing, which I thought would be kind of weird until I saw my baby’s head and then I decided it had been the greatest idea ever),  and with the awesome support and coaching from my doula, midwives, and husband, Oliver was delivered less than an hour later a 1:21pm. Nearly 48 hours from when labour had started, and 14 hours after our arrival at the hospital. 8 pounds 7 ounces, and 21.5 inches long.
   When they had broken my water it had been meconium stained, so Oliver was immediately whisked away to the corner of the room by a nurse practitioner from the NICU to have he lungs checked and make sure all was well. They brought him back to me for a few minutes before the nurse practitioner declared “This baby is too hot”. And he was pulled away again. It would seem that he and I were both running high temperatures. (103 and 102, respectively), and they were concerned that he might have picked up an infection on his way through the birth canal. They wanted us both on antibiotics. They let me nurse him (he latched immediately and ate like a rockstar!) and then they were going to take him upstairs to the NICU and administer antibiotics through an IV. I would get the same antibiotics in my IV. Derek was able to go up with him, and  I could go nurse him again as soon as I was transferred and settled into the postpartum ward. That took them four hours. FOUR long, excruciating hours before I was able to see my baby again. Those four hours took longer than 48 hours of labour had. I hated everyone of those nurses.
   Once he was through the initial NICU evaluation and first round of antibiotics, they moved him down to my room and he was able to stay with us except for going up for his meds every 12 hours. But he was only on the meds for 36 hours before his blood test results came in and showed he didn’t have an infection at all! We were released from the hospital less than 48 hours after he was born.



So, if you’ve gotten all the way down here, let me just say, kudos! I wasn’t going to write the birth story down. Which is why Oliver is almost 3 months old and I’m just now finishing it. I wasn’t going to write it down because it wasn’t the story I wanted, it wasn’t the birth I had planned and prepared for and dreamed about. I didn’t want a written reminder of how I “failed” at birth. I’ve had a lot of shame. A lot of what-ifs. A lot of regrets since Oliver’s hospital birth. But in writing this I’ve realized - it’s all bull-shit. I didn’t fail at anything. I was tired. I fought my way through a long, hard few days, and my body was weary. I wanted an unmedicated, peaceful, water birth in my home. But those were just my desires, and not one of them mattered in the face of doing what was necessary to make sure my baby was delivered healthy and protected. I gave up a lot of things I wanted and made decisions based on what I believed was best for my child. While I do hope that we can have the home birth we desire next time, I refuse any longer to feel like we couldn’t have it this time because I was not strong enough, or prepared enough, or gave up too quickly. So, if you made it all the way though this, congratulations, but I didn’t write it for you, I wrote it for me. To remind myself of how beautiful and fulfilling the birth of my son was.