Thursday, November 17, 2011

Baby Miles: A Birth Story

Baby is here!  The following birth story contains all the gory details, so proceed at your own risk.  Here goes:

I am pleased to announce the arrival of

Miles Daniel

Born on November 12, 2011 at 10:20 am.

8lbs, 6oz

21.5 inches long

I had begun having random bouts of regular contractions for periods of time in the weeks before my due date.  I was a little surprised when my due date came and went and I was still pregnant, but I had been feeling pretty good and decided to use the extra time to get things done around the house and relax with Norah. 

I had a routine appointment with my midwife on November 10, where my blood pressure was very high (something like 150 over 97).  Lying on my side for awhile didn’t help it to go down at all, and then it also turned out that there was protein in my urine that day.  These symptoms together usually mean pre-eclampsia, so I was very upset.  Pre-eclampsia often means immediate induction of labor, which I really did not want to do, and would also risk me out of being able to birth at the birthing center, which we had been planning on.  I had bloodwork drawn and went home with an appointment scheduled for the next day.

At that point, I was hopeful that I might go into labor that night and that I might be able to get my blood pressure low enough to still use the birth center if I could get into the tub they had there (immersion in water often lowers blood pressure, at least temporarily).  I was post dates, had been having contractions on and off for awhile, and had my membranes stripped at my appointment, so I thought it was at least possible.  I went and met with a friend for awhile that evening, went to the store and got black cohosh to take to hopefully help me go into labor, got some additional herbs for blood pressure help, and went home to, erm, spend some time with D.  We went to bed around 1 am and I was having pretty good contractions every 8-9 minutes.

 I woke up about 4:00 am not in labor at all and I was very disappointed.  I started having some contractions around 4:45 am that got to about 5 minutes apart, and that lasted until about 7:00, when they slowed down.  I continued having contractions anywhere from 7-10 minutes apart until about 1:00 that afternoon when they more or less stopped.  By 2:30, I needed to leave home for my appointment with my midwife.  I decided to take everything I had packed for the birth, knowing that it was unlikely that I wouldn’t be diagnosed with pre-eclampsia, and that if I were diagnosed I would likely be admitted to the hospital immediately.  Norah went home with my mom, and D and I headed to Auburn for the appointment.

At my appointment I found that my blood pressure was even higher than the previous day, I had more protein in my urine than the previous day, and the bloodwork from the previous day didn’t look good.  I was diagnosed with mild pre-eclampsia and sent up to registration at DeKalb Health.  I was admitted and placed on blood pressure medication.  Later in the evening I was given ¼ tablet of cytotec to start the labor induction.  The plan was to receive 4 doses of cytotec, 3 hours apart and hope that it would cause me to go into labor.  If the cytotec did not work, then I would need pitocin, which would require me to have an IV and additional monitoring, which I really did not want.  As it was I already had to have a fetal monitor on, which was really getting on my nerves.  It kept losing the baby and having to be adjusted, and it made it uncomfortable to try and sleep.

During the night I felt very frustrated at being at the hospital and everything that had happened.  Here we had planned to birth at the birthing center where I don’t think they even have a fetal monitor belt, and where we could do pretty whatever we wanted regarding our birth.  Now I was hooked up to a machine and had to tell someone whenever I needed to pee, waiting for a pill to kick in so I could have my baby.  I was not impressed. 

We had also planned for Norah to be able to be with us at the birthing center, which had toys for her to play with, cozy rooms for her to hang out wherever she wanted to, etc.  Being at the hospital would make that much more difficult since there was really nowhere to go if she didn’t want to be right in the room with us, and since it really wasn’t cozy at all.  As it turned out, the labor happened too quickly for us to even call for her to be brought up to the hospital, and that’s something I feel really sad about.  I don’t like the way our family was split up for so much of the time we spent at the hospital and I really wish we had been able to use the birthing center like we had originally planned.

I received the final dose of cytotec around 6:30 am, and at some point started having a few contractions.  They weren’t really catching my attention much because they weren’t very painful – I’d been having worse ones at home – so I didn’t pay much attention to them.  About 8:45 the contractions started to get more intense and started coming much closer together.  I felt like labor was getting underway, which was great – no pitocin, and so far no annoying IV! 

I was surprised how the contractions were all of the sudden pretty difficult, and had D call my sister Michelle and tell her she should head up to the hospital as I felt I would need support from both of them very soon.  The nurse taking care of me came in while I was having a contraction and told me that Stephanie (my midwife) would be there in about an hour to hour and a half and asked if I wanted her to come sooner.  I said I did, so she called her and asked her to come right away.  My plan was to wait for my sister and midwife to arrive, then to get checked and see how I was progressing.  Then based on that, I would decide when to call my friend Carissa to come to the hospital and my parents to ask them to bring Norah up.  Carissa had agreed to be with Norah during the birth and was still planning on helping us with that if Norah wanted to be present.  If not, she could take her to the waiting room or leave with her, depending on what she felt Norah needed.

By 9:00 I was getting very worried because the contractions were difficult for me to get through.  I knew that my previous labor had lasted around 19 hours and I didn’t see how I was going to get through 19 hours of these really intense contractions, especially if they got more difficult.  I didn’t remember them being so hard so early on with my previous labor and wondered if my perception of my labor with Norah was off.  Several times I asked D to talk me down because I was afraid I wouldn’t make it through the whole labor at that rate.  I kept saying, “I can’t do this for 12 more hours.  I can’t do this for 12 more hours,” and telling him I was afraid.  He did a great job helping me feel less afraid and getting through each contraction.  I wanted to ask for drugs, but I realized that no one here had my birth plan and they might actually bring me drugs, which wasn’t truly what I wanted.  It occurred to me that I sounded more like someone close to transition than early labor, but I thought it was because of the cytotec.  I was absolutely not going to let myself think that my labor could be short, because then if it wasn’t, I would never make it through. 

Very shortly I started feeling like I needed to pee.  I kept unplugging the fetal monitor (I needed it due to the cytotec and my blood pressure) and going into the bathroom to sit on the toilet, but I wasn’t getting any pee to come out, just a bunch of bloody show.  The nurse came in after a bit and asked me if perhaps what I felt was pressure from the baby.  I told her I had no idea, I just felt like I needed to pee.  She thought I should come out of the bathroom and get checked, so I did, and she said I was at 4-5.

By 9:45 or so I was having a very hard time not pushing with contractions.  I knew I wasn’t fully dialated, but I couldn’t figure out how to not push.  It just felt like that was what I needed to do.  At some point the nurse checked me and I was at 8 cm, which surprised me a lot since it had been such a short time since I was just at 4-5.

I’m not sure what time Stephanie arrived.  When she got there I was on hands and knees in the bed (which, actually, is how I spent large chunks of my labor with Norah, too), and she checked me.  I don’t think she said what I was at and I couldn’t pay attention enough to care.  I was feeling like if I could just get a 5 minute break from the contractions I could pull it together and get through the rest of them, but I just wasn’t getting a good break inbetween.  I was very overwhelmed.

Someone (Stephanie??) then suggested that I try lying on my side.  I did, and my leg kept getting a cramp in it, but it was working otherwise.  Very shortly I saw that Stephanie was putting on the delivery gloves and smock, and then nurses started putting pads underneath me.  This is when it hit me that I was going to have the baby very soon and that my labor was just going to be really short.  Apparently I really had been pushing the baby down all this time and he was close to being born.  Nothing had really changed about how my contractions felt or how I was handling them for some time, so I just kept pushing with them because that’s what I felt like.

Very soon after this somebody asked me if I wanted a mirror.  I almost said no because I was so focused on just getting through the labor, but I remembered that I had said no with my previous birth and then later wished that I had gotten one, so I said yes.  One of the nurses brought the mirror in and set it up so I could see the baby starting to crown.  Stephanie said, “Look, there’s your baby”, and I was like, “Oh, he’s really right there already?!?”.    She said that, yes, he was right there, and he was ready to be born. 

 Very soon after this she asked D if he wanted to come and catch the baby, so he went to help her while a nurse stayed with me to help me labor.  Michelle arrived a few minutes later and took over for the nurse.  Baby’s head was halfway out when she came into the room.  My water broke at some point while I was pushing out his head, but I don’t remember when.  I was able to see his head being born via the mirror they had set up, and that was pretty cool.

Pretty soon his head was out and Stephanie started unwrapping the cord from around his neck.  It seemed like she was doing this forever, and it turned out it had been wrapped 4 times, which surprised us all.  Once that was done it took a few more pushes to get his body out, and D put him onto my belly.  He was really blue, and even though I know babies often come out blue, for some reason this got me a little panicked, I think maybe because he was so still.  He was being rubbed down with towels on my belly and pretty soon he pinked up and moved around and I felt so much better.  I held him for awhile and I remember talking to him, but not what I said.  I was so happy and just overwhelmed with how perfect he was and how wonderful it was to have him earthside.  I was really thrilled to be so coherent and happy right at this moment because I had been so disoriented in the hour or so right after Norah’s  birth and I don’t feel like I got to have this sweet moment with her right away.

Pretty soon I delivered the placenta and tried to nurse the baby, but he wasn’t very interested.  Stephanie checked and found I had no tears or anything that needed repair, so that was good.  I had my sister call Carissa and I called my parents so that they and Norah could be the first ones to come and meet him.  I still feel really badly that Norah and Carissa missed the birth, but there’s no way we could have known he would be born so fast.

I stayed at the hospital for the full two days after the birth on account of my blood pressure not stabilizing very well.   At the moment I’m still taking some blood pressure medication, and I have to check in with Stephanie once a week until it gets back to normal.  She said this could take up to 6 weeks, although I’m feeling really good, so I’m hopeful that it won’t take that long.

I’m also working through my disappointment at not being able to birth at the birthing center.  I’m a bit surprised that I’m not more upset than I am, but I’m feeling ok about it.  I’m obviously bummed out that we didn’t get to have the birth center experience, and I really wish things had turned out differently.  The main things I’m upset about are not getting to have the spontaneous labor experience, having to use the fetal monitor the whole time, Norah and Carissa not being with us, and my family being so split up for the days I was at the hospital.

However, I understand why we couldn’t use the birth center and I am thankful that we had access to a hospital where we were able to birth without a lot of interventions and where the staff were supportive of the kind of birth we were trying to achieve.  I’m very thankful that Stephanie gave me options for induction that were gentler than typical hospital inductions (I found out later breaking my water would have been another option before resorting to pitocin) and that I was given as many choices along the way as possible.  I also realize that policies like the one that risked me out of the birth center are an integral part of what make birth centers safe options.  Pre-eclamptic people shouldn’t be birthing in places without access to continuous monitoring or emergency medical care.  By eliminating as many risks as possible, the birth center ensures that the people who do birth there are safe.

I don’t know why I developed pre-eclampsia.  I know that high blood pressure is common in my family, so I wonder if that is a factor.  Stephanie also wondered if the cord being wrapped up so many times may have contributed to my high blood pressure.  I wasn’t sure how that could be related, but she said if the cord had too much pressure on it or was constricted when baby was trying to drop, it could have restricted the amount of oxygen he was getting, and that my body may have compensated by pumping a lot of extra blood.  I don’t really know a lot about blood pressure or how oxygen makes its way through the cord, so I really have no idea.  Stephanie did say that she felt future pregnancies would be safe for me on account of not having had it in my first pregnancy and it developing so late in this one.  I’m not sure if we will have more children or not, but I’m glad that I have it as a safe option.

We are all home now and doing well.  I feel really good aside from minor soreness and general newborn-at-home tiredness.  Norah absolutely loves her little brother – the very first thing she did this morning was to find him and give him a kiss.  Dan is off work for the rest of this week, so we are spending some time together as a family of 4.  Overall, life is pretty good around here.

1 comment:

Rachael said...

So glad everyone is healthy and happy! I'm glad things went as well as they did given the circumstances. He is such a precious baby, and it sounds like he's been pretty calm, which I'm sure is helping ease everyone into the transition of being a family of 4. If you guys need anything, let us know!