Thursday, August 4, 2011

Olivia's Birth Story

As I write this today, Olivia's is 11 days old and we love her so very much it hurts! It's such an indescribable feeling to hold her in my arms knowing she's our baby.

I feel that it is time to share the story of just how she finally arrived into this world. It's difficult to put down in words, as I'm probably still in my post-pregnancy/labor hormonal stage, with lots of emotions that come and go, not to mention an extremely difficult labor that really took its toll on my body.

As some of you may remember, she was due on 31 July, 2011, that would make the pregnancy exactly 40 weeks, according to the way babies' due dates are calculated these days (using the 1st day of a woman's last menstrual cycle prior to becoming pregnant). Somehow I had a weird feeling that she would be either be due on the actual due date of 31 July or would be arriving late. I had secretly hoped she would arrive a bit earlier, but it's obviously not within my control.
So as her due date approached, I began to really put the final touches on everything including her nursery, trying to tie up loose ends at work, and cleaning and doing laundry at home in preparation for her arrival. My mom also booked her plane tickets from 29 July until 9 August. Everything seemed to be going along smoothly, except I was having increasing back pain and often had a hard time sleeping with bouts of insomnia here and there (more on this later).

On the morning of the 27th, a Wednesday, I started to feel kind of uncomfortable. By 3 am, it was enough to wake me out of bed. I came downstairs quietly and started to sit on the exercise/birthing ball and rocked back and forth, alternating between that and going on my hands and knees to take the pressure off my spine. I wondered if I was in early labor (which I was). By the time Nick got up, probably around 6:30/6:45, I was pretty darn sure I was having contractions, although they were still very manageable with the soothing nature of the various exercises I was going through. I used slow breathing techniques to get through each one. I was also a bit hungry but nothing sounded good. I heated up some leftover pancakes but after they were done I had no desire to eat them. I sent Nick off to work, letting him know that I'll call/email when things progressed further. Off he went.

Since my water did not break, I drew myself a bath and sat in there to relax as much as possible. I called my boss and supt and let them know that I was in early labor and would not be there for work that day. By about 10 am things were definitely progressing and the contractions where stronger and closer together, although they were not very regular. Another hour passes and I'm starting to feel very uncomfortable. I ate a small bowl of cherries and a granola bar. I finally called and emailed Nick to come home by around noon/1 pm. He came home and we labored together some more. We were trying to delay going to the hospital as much as possible, knowing that when we got there I would be hooked up to monitors and not allowed to eat lightly anymore. Some more time passes and I'm feeling even worse. I asked for a bowl because I felt like vomiting. I need to add that I absolutely HATE vomiting. I try my best to not vomit at all, but this was involuntary, and it happened, and somehow I felt better, even though I had nothing in my belly.

We finally decided to go to our good friends Mark and Jackie's house on base close to the hospital. We stayed there for probably an hour and decided to make our way to the hospital a bit after 2 pm. I was in triage briefly before the nurse announced I was at 5 cm! We were elated! We thought the labor would advance quickly and I may even have the baby that night - we were WRONG.

I continued to labor naturally even though the contractions were getting much stronger, looking back though, I don't think they were ever very regular, but we were still hopeful. I labored naturally from 2:30 pm until about 9:30 pm. I was checked again, still 5 cm! I was devastated and very discouraged. The pain was really starting to get to me. It didn't help that the resident on call (we'll just say Dr. W) did NOT read my birth plan and asked me if I wanted pain relief multiple times. Her nurse (nurse T) also asked again about pain relief - I wanted to choke them since I had specifically written in my birth plan that I would be the one asking for pain relief, not the other way around. Still, the pain was getting to me and their suggestions did not help. Finally around 10 pm I asked for something mild and was given Nubain. It did provide relief, but wore off very quickly. At this point, in my discouraged state and very exhausted state (having been up since 3 am that morning), I discussed the epidural with Nick and decided to go for it. The main reasoning is that I hadn't progressed at all, I was getting worn out, the pain was increasing and I didn't want to go through the slew of drugs before having to have an epidural anyways. The anesthesiologist was called in and the epidural was inserted around 10:45 pm. I felt relief after the drugs started kicking in and Nick and I finally got some rest.

I can't remember when the pitocin (artificial oxytocin) was started but since my contractions were still not regular I finally consented to having it started. I was pretty sure it was sometime after the epidural was inserted.

By the next morning a new shift of doctors and nurses had come in (also very discouraging). Come to find out, the attending there that morning was a surgeon (we'll call her Dr. S) and was very much a surgeon, not personable at all. I understand her concerns but she was very pushy with her talk on me needing a cesarean. Her exact words were"you're dilating too slowly, this is not normal". Even though I had read plenty of literature that talks about every mom being different, and thus dilate differently. Her resident, Dr. H, was also probably pushed by her to keep checking me. Luckily the very best labor and delivery nurse also came on shift, Julee, who was literally the best thing in my labor. She was our advocate all the way and explained a lot of things to us so that we can make the best decisions. Dr. S and Dr. H wanted to insert an IUPC into my cervix next to the baby to monitor my contractions. By this time the baby, poor thing, had been stressed enough that she had had her first bowl movement, known as meconium. I had discharged just a little of it, and it was recorded as "light meconium" - which is kind of a bad sign that she was being stressed in my uterus. There were no immediate concerns yet, but if I started spiking a fever we would both have to be monitored more closely and we would both need antibiotics and she would be presumed infected as well. Common sense told me that introducing this IUPC contraption would not help with limiting infections, so we refused it. Dr. H came in and had a "talk" with me stating that he would have to document that I refused to be checked and refused the IUPC to be placed into my cervix, and that it was against their recommendations. Nick and I agreed that we were okay with that. I was checked again after the attending left but was only at around 6/7...again, very discouraging how slowly I was progressing. Also, as a side note, they were never really sure when my water broke. It probably "broke" sometime Thursday late morning, but it was never a huge gush, but more like a trickle here and a trickle there. I think they had written down maybe around 11 am or so.

Finally Dr. S left, and a new attending Dr. G came on. He was so much better than the last attending, very personable and very understanding. He came in and talked with us for a long time. In his personal and professional opinion, he did not deem the IUPC necessary, nor a cesarean necessary at the time. He said that the baby and I are both doing fine, and really reassured us in our decisions. I told him that as long as the baby was safe we were not opting for a cesarean anytime soon, he agreed with us. I continued to labor and was checked again sometime on Thursday afternoon, I was at 8 cm, but the docs were saying that was "reducible", which we took it to mean that they can somehow try to get the baby out that way, but we weren't sure.

Now we're getting close to 6 pm...and Julee was at the end of her shift...very sad. BUT...she set us up with another excellent nurse, nurse A. She was also very knowledgeable and so calm about everything, which was great. I still wasn't progressing very well and I really did NOT want a cesarean delivery. So, Nick and I discussed it and did the only thing I knew to do at the time. We asked for the epidural to be turned way down so that I can go back to a squatting position as well as get on my hands and knees to try to use gravity to bring the baby down to open up the cervix. We were warned against this, and told that it is very difficult to come down from the epidural once you've tasted relief. I didn't see any other choice. So after awhile I could feel my legs again and started to squat and do other positions to try to encourage the baby to keep descending. After close to 3 hours I felt like I couldn't do it anymore and asked for the epidural to be turned back on. However, this time only my left side was numbed :-(

Nurse A came and decided to put me in a funny position where I'm almost on my belly, on my right side, twisted somewhat with my right arm going straight up and legs somewhat opened up on the table that they bring you food on. She said this was a good position to try to dilate the cervix - boy was she right! After a good 30 minutes I started to feel the urge to push. She said to try to breathe through it. I was checked again and was complete!!! I wanted to shout! I'm not sure when I was told to start pushing but it started later that evening, probably around 10:30 pm on Thursday. I pushed for 2 hours with the bar in a squatting position, and also did the "tug of war" thing. Unfortunately Dr. W from the first day had returned, and mentioned something again about a cesarean section. I tried to just brush her off, although in the back of my head I was dreading to have to go through all of this and end up with a c-section. Nurse A told me it's typical for a new mom to push from anywhere from 1 to 6 hours. But Dr. W gave me a 3 hour limit. Luckily Dr. T, the attending, came on. She had used the Bradley method to give birth to her child and was very understanding in terms of supporting me to have this baby vaginally. She was amazed at my mobility while under the epidural - I think it had to do with the fact that only half of me was numbed, with crazy back pain that was concentrated on my right side.

Now we'll talk a bit about pelvic stations. As the baby descends, the imaginary line that passes across on my pelvis is known as the "0" station. Anything above is a -4, -3 -2 and so on, and anything below this line is a +1, +2, etc. For the longest time I was stuck at +1, and finally reached +2 after a lot of pushing. Dr. T didn't understand why things were taking so long, so she ordered an ultrasound. The ultrasound machine was brought in, and voila, all the back pain and painfully slow labor was explained: the baby was in a occiput posterior, or sunny-side up position, meaning she was facing out, with the back of her head on my spine. This not only causes for intense back labor pain, it makes descent very difficult and is a "dreaded" position by OBs and midwives. Come to find out, most babies turn by themselves on their decent and only 5% of babies are born this way, with almost half of cesarean births occurring because of this position. Dr. T suggested we try to turn the baby internally, which we agreed to. Now this was probably the most excruciating pain I've felt all my life, coupled with the fact that all the drugs were turned way down so I could feel when I pushed. For about 25 to 30 minutes she tried to turn the baby by reaching her hand up through my cervix, and I would be told to push. She needed to turn the baby a full 180 degrees, but every time she started to go past 90 degrees, the baby would start to turn back. I was starting to lose myself in the intense pain but did as I was told every time I heard her yell to push. I don't even know what happened but with all the turning and such the baby finally presented herself and descended enough for us to see her when I pushed! They brought the mirror in to try to encourage me but it didn't help since every time I pushed I would start to see her and as soon as I stopped she would retract. I asked for the mirror to be put away. Did I mention that by this time I was utterly and totally exhausted? I had been up for close to 48 hours with almost nothing to eat, just jello, pudding, popsicles, and some broth. I started to question whether I can do this. I kept telling myself we're almost there and that I can do it. More nurses came in to try to encourage me. I still couldn't get her out. Finally Dr. T asked about either the vacuum or forceps. We chose the vacuum. She warned that we can only break suction 3 times, and that we'd have to use something else if it didn't work. Luckily she only broke suction once and on the 3rd or 4th try our baby girl was finally born at 1:14 am!!! It had been about 47 hours counting back to early labor and about 34 hours after being admitted.

They put her on my belly briefly and I started to sob uncontrollably. They had to take her away quickly because of the possible infection and the fact that she was hyperventilating somewhat. Nick followed her out.

Nick came back in and told me she was 7 pounds 10.7 ounces and 19.25 inches. The midwife's student had guessed she would be maybe 6 pounds!!! Good thing I believed in the 6 pounds, because I would of had a mental block thinking she was that big!

Now comes the next part...the normal delivery of the placenta should take from 6 to 30 minutes...it was going on 50 minutes and my placenta was still very much attached...everything that can possibly go wrong did, with the exception of needing a c-section. The docs were massaging my stomach to try to induce contractions to help the placenta out. I honestly don't remember how but it eventually came out and I took a brief look at it - it really is amazing, even though I'm sure most people would think it was utterly "gross" but to think that it was the lifeline of the baby for the past 10 months is no small feat.

Because of her positioning, I tore very badly (3rd degrees) and needed a lot of stitches. Nick walked in briefly but had to leave because he said it was utterly a blood-bath in there. Tons of towels were soaked up in blood. Nurses were rushing around earlier to get more sutures - not good. I was told I lost between 900 ml to 1 L of blood!!! After the suturing was done, I dove into a somewhat delirious state. I was in kind of a dream world coupled with the real world. I also had a fever, I was so incredibly hot, and Nick said I was really burning up. I didn't know at the time but I was being taken off all the drugs and I was literally having withdrawal symptoms. I was shaking uncontrollably for I don't know how long, and my muscles were exhausted with the shakes. I eventually drifted off...

Upon waking, Nick told me I was saying random things that really didn't make much sense. I do remember some of this. In my head I had a story line all figured out that was kind of a play-byplay. When I closed my eyes I played out the scenes, but when I opened my eyes Nick didn't say the things I "expected" him to say. He told me I was delirious and needed rest. After awhile I finally drifted off again...

I was up and about by 9 am later that day on Friday, the 29th, Olivia's birthday. All the nurses were surprised but I really needed to go...so I was up. We had to stay and be monitored and the baby had to wait for cultures to be done, which luckily came negative 48 hours later. The first two nights at the hospital were hard because my milk had not come in yet, so the baby cried a lot. We managed to get through it somehow. I was grateful that the nurses and med techs would watch her for a bit when they were not busy so that I could rest.

We were discharged at about 11 am on Sunday, the 31st! It's since been a little over a week and we are recovering well. Here are the pictures Daddy the photographer took:




5 comments:

  1. Oh Veronica, it sounds like you really had a rough time! In hind-sight, my doctor's advice was pretty accurate - you can have all the birth plans you want, but so much of it really comes down to things that are really out of your control, like timing and the baby's position. You can't control whether you'll go into labor in the morning after a good night's sleep, or have to go through multiple sleepless nights in labor, or if you'll have a baby who just really wants to be sunny side up. It's good that you were able to hang onto some parts of your birth plan, even if there were a whole lot of other things that didn't go the way you imagined. It is really easy to start feeling down about your whole birth experience when you hear about other women who were able to "tough it out" and do everything completely according to their birth plan, or who had really easy deliveries, but no two labors are alike and having a baby really can be difficult, so you should be proud that you got through it and have such a beautiful little girl!

    P.S. Henry was born at 1:14 am too! How funny!

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  2. Yes Aimee, you're definitely right...I had a birth plan but I knew that it's wise to "go with the flow", I just was hoping that it wouldn't have been so hard. It is VERY hard when I had plenty of friends who had such easy labors and birth experiences but then again, we're all different. Thanks for your encouragement :-) Yes, how awesome that Henry and Olivia were born at the same time!!!

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  3. Wow, Veronica...you go girl! I am so proud of you. After reading your story, I am thinking...only someone as mentally and physically tough as Veronica could go through that birth! I'll admit, it scares me a bit...still being on THIS side of the whole birth experience! But, like you said, so much of it is out of my control...We are just praying that regardless of how it goes it is a joyful and positive experience. Lots of love to you and your little sweetie...

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  4. Emily - thank you so much for your encouragement! Yes, it was very difficult and I'm thankful I had great nurses (one was literally an angel and we're friends now!) and a few great OBs who really helped me out. Don't worry too much, I think my experience was probably more rare, I think most people have fairly straightforward deliveries - the baby was just in a bad position. Thinking of you, Monty and little Michael and sending my love your way...

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  5. Wow. I also want to avoid an unnecessary c-section. I think it's horrible that a) the doctors didn't read your birth plan (something I will be working on today), and b) they kept trying to push the c-section. I applaud you for sticking it out even when you were in such intense pain. You are an awesome mommy. Thank goodness its over!

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