Tuesday, April 20, 2010

Max's Birth

**As I've never been one to leave out details (relevant or not) this is a pretty wordy post. Drink some coffee before you sit down to read, but it pays off in the end with some great photos! Enjoy!

3am Friday morning April 9 I woke up to go to the bathroom. I went to sit up and felt a gush. I knew it was my water, though it wasn't all of it. My doctor had told me a few days earlier that I had a "bulging bag" of water, meaning that there was a small amount of water below the baby's head and then his head was blocking the rest. This is probably the reason that labor didn't start at that moment when my water broke.

My worst fear about this birth was that my water would break and labor wouldn't start naturally, which would eventually lead to the need for pitocin or some other labor-inducing drug. You see, when you're having a hospital birth there are certain protocols to which you must adhere - one of them being that you only have about 24 hours to have the baby once your water breaks. My labor was clearly not starting so I decided not to call my doctor yet.

7am I'm having some contractions but with no regular pattern. They're not very painful, maybe a 2 or 3 on the pain scale, and some only last 20 seconds.

In the last few weeks of my pregnancy I saw an acupuncturist for "labor preparation". My doctor highly recommended this - there is new research that it shortens labor time, helps to get the baby in a good position for birth, and helps to soften the cervix. It also did wonders for my hip pain in those last few weeks. My 36th week was pretty miserable - I wasn't sleeping well because my hips hurt so badly and was just very uncomfortable. I was thinking it was going to be a long 4 weeks until I was due, but I really noticed a difference once I began the acupuncture in my 37th week.

My acupuncturist, Andrea is a very kind and gentle woman. She was a great resource in those last few weeks - recommending some herbs to make a tea that would help me sleep, and also giving me some chinese herbs to help build up my strength for the task of labor. She had mentioned to me that if by chance my water broke and labor didn't start that I could call her and she would come to my house to help induce labor with acupuncture.

10am same type of contractions still with no real pattern. Steve's getting ancy and thinks I should call the doctor. I've left a message for Andrea and am waiting to hear back from her and see if she can come over. In the meantime I decide to call the doctor, and of course, she says to come right in to the hospital. I told her that my labor hadn't really started and I'd rather wait at home until it starts. I don't think that made her very happy and she reiterated that she thought I should come in. Unfortunately my doctor - the one that I saw for my whole pregnancy was on her honeymoon and I had never met the doctor who was on call that day, and who would be the doctor to deliver for me. I think we started off on the wrong foot!

11:30am Andrea came over with her bag of tricks. Our doula, Karen, arrived shortly after. I had seen Andrea the day before and she had done something called "e-stim" which stands for electromagnetic stimulation. She put some needles into my sacrum (the lower part of the back) and then attached wires that give a slight pulse into the needles. It's attached to a dial so she can adjust the strength of the pulse - ideally you should be able to feel it but it shouldn't be painful. Once she had everything hooked up she asked me how it felt. I told her it felt about the same as it had the day before. Later, before she left my house she told me that she had turned the dial up twice as high as it had been the day before, and the fact that it felt the same to me meant that my body was already producing oxytocin (the body's natural labor-inducing hormone).

Once Andrea had all the needles in my contractions began to have a regular pattern of about 5-6 minutes apart, though some of them were still only lasting about 30 seconds. I felt a lot of the pain in my hips and down my legs, so Andrea put these glass suctions on my hips to help relieve the pain. At this point the pain was still pretty manageable - I needed to concentrate through a contraction but I would still say about a 3 or 4 on the pain scale. She left the needles in for about 30 minutes. During this time I also drank some chinese herbs to help give me strength for the work that lay ahead.

When the acupuncture was done Andrea gathered her things and left. It was so kind of her to come over, she even shifted around an appointment that she had so she could stay and leave the needles in a little longer. She was definitely one of the 'team' of people that I feel helped me to have the labor and birth I desired.

So at this point labor had definitely started and it was time to get ready to go to the hospital. I wasn't in a hurry at all, mostly because I felt like I had a long way to go since my contractions weren't too terribly painful. I was feeling pretty excited and very happy that things were calm and moving slowly. I realized at this point that I had envisioned my labor coming on really quickly and expected things to feel out of control, having to make a mad dash to the hospital and scrambling to get Jackson to a caregiver's house. But instead everything was very calm, it almost felt surreal. Steve's parents were in town and had just gotten home from picking Jackson up from preschool. Our bags were packed and ready to go. So we all ate some lunch and then some yummy blueberry cobbler. We talked to Jackson about coming up to the hospital to see Sharky later that day. It was really nice, and all I wanted to do was stay at home and have the baby there. But obviously that wasn't the plan, so around 1:30pm we headed to the hospital. Karen drove us so we could leave our car for the Dales to come up to the hospital later.

In the car I began to feel the contractions picking up in intensity, and I also began to feel a lot of pressure in my pelvis, which I knew was a sign that the baby was slowly moving down. I began to feel like maybe I was further along than I thought.

We checked into the hospital around 2pm. They put us up in a room and started checking me in - taking my vitals and asking all those ridiculous questions like if you have any false teeth that might fall out during surgery. I was very calm and needed silence during a contraction but was fully able to rest and talk in between. We settled into the room and put some classical music on. At one point I mentioned to the nurse that I had been dilated to a four for nearly three weeks. She said something like "oooh" and went to call the doctor. When she came back she said the doctor had instructed her to check me right away to see how far along I was.

I was stuck at 5cm for so many agonizing hours in my labor with Jackson until I finally got an epidural. At this point the pain I was in did not come close to the pain I remembered from my labor with Jackson, so I kept saying "if I'm still at a four I'm going to be pissed!" Karen had been telling me all day that she thought I was further along than I thought. She is very gifted and seems almost prophetic about her predictions so I wanted to believe her, but I was also nervous that I was going to repeat my labor with Jackson. As far as my contractions not being as painful, Karen explained that because I was on pitocin during my entire labor with Jackson I never felt what a natural, drug-free contraction was like. She explained that a pitocin-induced contraction comes on very quickly, spiking up in pain and staying there for a full minute and sometimes more. And that a natural contraction can be much more manageable in that it comes on slowly, peaks, and comes back down in intensity.

I got into the bed for the nurse to check me, and she announced that I was dilated to 9cm! What?! I was practically laughing I couldn't believe I was that far along and hadn't thought once yet "I can't do this...it's too painful". I had learned during pregnancy that the part of labor called transition, which is dilating from 7cm-10cm can be the most painful, with sometimes no break between contractions. And that often there is a period of rest between transition and pushing. So I was feeling pretty good that I had made it that far and I was so excited for getting this baby out!

At this point Karen and Steve began the mad dash of setting up the water birth tub, which is something that the nurses typically do but my nurse still hadn't finished fully checking me in and asking more ridiculous questions. Thankfully Karen has a lot of experience with water births and new exactly how to set the tub up. It's basically this huge blow-up tub the size of a large kiddie pool. The tub itself belongs to the hospital, but for sanitary reasons there is a large disposable liner that fits over the whole tub and new hosing for each birth. I continued to move about the room as I labored through contractions and the tub was being filled.

With each contraction I was having (at this point about 3 minutes apart) it seemed like my body instructed me as to what position to be in. And it seemed like with each one I wanted to be more and more bent over - first just leaning a bit on a chair, then bending over with my hands on the bed, until finally I felt like I needed to be one my hands and knees. It was so amazing to just listen to my body and to feel so in tune with what I was doing.

The first contraction I had on my hands and knees I heard a quiet "pop" and my full water gushed out. I let out a little yelp because it was a bit of a surprise, and a funny feeling. Everyone thought something had gone wrong but realized it was just my water! The tub was just about full and it seemed like a good time to make my way there. I decided to use the bathroom before I got in. As I made my way there Karen warned me that since my water had just broken I may have some new "sensations" and that I might need help getting out of the bathroom. I was glad she warned me because when I sat down on the toilet I had a contraction, and I suddenly felt like the baby might just fall out. I was able to make it out of the bathroom and into the tub. Ahh, the water was so relieving, and my body instantly felt so much lighter.

The tub was oblong shaped had a little step on one of the narrow sides for the mom to sit on. Karen and Steve had set the tub up in the corner of the room with the step also in the corner so that I would be facing out toward the room. But I felt such intense pressure from the baby moving down the birth canal that I didn't want to sit on the step. So I sat at the opposite end so I could have my hands down on the bottom of the tub and have my butt lifted off the bottom. That was the only reason I positioned myself that way, but after the fact I was so glad I had because it allowed me to feel like it was only me, Steve and Karen in the room. The rest of the room was behind me, so I was oblivious to all the commotion of the doctor getting suited up and nurses standing by with the baby warmer..etc. I was able to concentrate on Steve and Karen's faces and nothing more.

Once I got into the tub my contractions changed drastically. They were VERY intense with nearly no break in between. The first few I had I kept my eyes closed and just tried to concentrate on breathing, but I was beginning to get scared and wasn't breathing enough. I suddenly had a sensation through both of my arms that felt like electricity running through them. I had to hold them both out in front of me and it was the craziest feeling. They told me I was hyperventilating and that I needed to concentrate more on breathing. For the rest of the contractions I concentrated on looking at Karen and she helped me breathe through them. Even though I wasn't actively pushing I could feel the baby moving down with each contraction. The water is so deep that they use a flash light to shine down into the water to watch as the baby comes down. I could see Steve's face of amazement as he was able to slowly see more and more of the baby's head with each contraction.

At one point they tried to get the baby's heart rate and I began to have another strong contraction. They waited and then tried again. It took a moment for them to get the Doppler in the right spot to hear the heartbeat, and it was a moment of terror for both me and Steve. But they found it and it sounded good.

It was the strangest feeling to feel the baby coming down without actually pushing. And it was also incredibly painful, a type of pain that I never felt during my labor with Jackson since I had the epidural by the time he was coming down the birth canal. As the baby's head got closer I got feel it burning and stretching. I was so afraid to actually push, and since I could feel my body involuntarily pushing I figured his head was going to come out soon whether I pushed or not. But the next contraction was so painful and I didn't want to have to live through another so I gave a slight push and out popped his head! (OUCH!!!)

Steve took some pretty great pictures of this whole process but since they all involve my most private area there are only a few that I've been able to crop and share.

As soon as the baby's head came out I expected to wait for another contraction and push his body out. I'm not sure what happened at this point but something indicated to the doctor that there was a problem and she instantly was in the water having me push and she began pulling the baby out. It all happened very quickly and as confusing as it was for me at the time, it was too quick to process or even ask what the heck was going on. This is the one really disappointing thing to me about Max's birth. From all the research I did on water births, all the conversations I had with my doctor, and all the water birth videos I watched, I had assumed that I would deliver my baby. I would push his head out, wait for another contraction or two, push his body out and pull him up out of the water on to my chest. I don't think I'll ever know exactly why the doctor intervened. I found out later that it was her first water birth ever, and I think she may have just gotten scared that his shoulder was stuck - a fear which my doctor told me is every OB's worst nightmare. I was quite angry about the whole thing for a few days after, but I had a really good conversation with my doctor about it and I feel more forgiving toward the doctor who delivered Max than I initially did.

In total we were at the hospital for about 2 hours before Max was born just before 4pm. My total time in the tub was less than 30 minutes. By 7pm the Dales and Jackson came to see us and brought us dinner. The time felt just right, not too fast, but not too slow either.

I didn't so much as get a single poke of a needle during my stay at the hospital. I guess it's standard procedure to give a mom a shot (or IV) of pitocin after birth to allow the uterus to contract down more quickly, but I asked to let my body do the work and it did just fine. There were some very marked differences in my recovery and also in Max from this birth as compared to Jackson's. Max was alert from the moment he came out, he nursed well 30 minutes after he was born and continued to through the night. I can't say for sure why it was but Jackson was pretty lethargic after he was born and the first night. It may have been from being in the birth canal so long (I pushed for nearly two hours) but I also think it could have been from the drugs I was receiving. After I got the epidural with Jackson I no longer could listen to my body to tell me what to do. I couldn't feel when it was time to push but rather waited for the doctor to instruct me to push. And even as I pushed for so long I couldn't feel what I was doing. I couldn't even hold my own legs up. With Max I was so in tune with my body and I was aware of everything, could feel everything. And yes, that meant feeling more pain, but for me it also meant that I was the one in control of things.

Within an hour after Max was born I was stitched up, he had nursed, and I was strong enough to take a shower. And in the days after even though I was very sore it was nothing compared to the pain I was in after Jackson's birth.

After my experience of two completely different births I can say for sure that I would much rather do it without the drugs. There is definitely a time for intervention - for pitocin, for pain meds, for epidurals and cesarians...but I am really thankful that I was able to realize the true, unbelievably amazing experience of a natural birth.

Big brother brought flowers for me and a present for Max.

Love at first sight.

Ready to come home.