Monday, May 16, 2011

Birth Story, Episode Two

Sorry to keep you all hanging with the birth story episodes.  It's such an important event in our lives as women when we bring a child into this world, and even though sometimes I think I'd like to forget everything about childbirth, in the end I don't want to forget it.  It's the beginning of my beloved children's lives on this earth, and I never want to forget the moment when I first held them or heard their voices.  There's something important about sharing our birth stories, too.  We don't usually write them down, but don't we all love (or hate to love) sharing our birth stories with each other?  My husband would rather not relive any of the experience by talking about it, which I completely understand.  Sometimes it's harder to be the spouse who is standing on the sidelines when the other is hurting.  There are times when he is more able to talk about his cancer journey than I am, especially with others who have been through it.  I find that even women who haven't given birth in decades are usually ready to recount their stories.  I think there's some therapeutic value for those who have experienced childbirth in sharing our stories with each other, and hopefully there is some power in our stories to inspire and give confidence to women who are heading toward the journey of bringing a baby into this world for the first time.  
Everyone's birth experience is different, so I hope that my story doesn't plant any fear in the mind of anybody who is about to have their first baby.  One of my relatives, who is of a very petite build and has four children, gave birth to her first child in three hours, start to finish, and said that she really didn't experience a lot of pain!  So please don't think that my birth stories are the way that it unfolds for everyone.  I think it's important for women to know that childbirth can be painful, otherwise you might think you are a huge wimp if you do experience pain, or that something is going wrong during childbirth if you experience pain and were not expecting to.  But it's also important to know that our bodies were built to do this, and that any pain is temporary.  Even when there is pain, there is nothing in the world quite as exquisite like holding your baby for the first time.  
I've edited out some details of the birth story that are a bit more personal because this blog is open to everyone.  But I think the resulting story is true to what I can remember from the day my sweet second boy arrived.  



I was ushered into my own room, and my husband started the forty minute drive home to retrieve a few things that I had forgotten to put in my hospital bag.  I didn't have any comfortable shoes since we were just at our Easter dinner, and I hoped to be able to walk around comfortably during labour.  I was starting to get hungry, since I hadn't eaten anything since Easter dinner about six hours earlier.  The nurse told me that I couldn't eat anything because of the pitocin, but talked her into "letting" me have a granola bar.  Her reasoning was that I might get sick later on if I ate now, and that would make me uncomfortable, but I was feeling uncomfortably hungry already, so I decided to take my chances.  I'd like to think that I would have eaten it anyways even if she had said no, but it's harder to follow though on things that you think you are going to be assertive about when you are nervous and feeling very alone.  The nurse asked me if I would be okay with having a student nurse insert my IV.  I only felt a little bit badly about saying no; I didn't want to start the birthing journey as a human pincushion.  Perhaps I should have invited better karma and said yes, because the nurse botched the first attempt in my arm and had to put the IV in the most awkward spot on the back of my hand.  Seriously, I think it was the worst IV placement I've ever had because it was so tricky to tape down to my hand to prevent it from catching on everything, and I couldn't flex my right wrist without significant discomfort in my hand.  In retrospect, I should have just asked her to try again on my other arm.  The other annoying part about being on pitocin is that they then want to have you hooked up to continuous fetal monitoring.  The two giant elastic bands with monitors attached to them are pretty uncomfortable pulled tight around your belly, and they slipped out of place about every three minutes.  The night shift nurse was pretty reluctant to let me move around and sit on the birthing ball because it made the elastic bands slip off even more frequently.  I spent most of the night in the bed, breathing through the contractions and resting in between them.  My poor husband, unbeknownst to me, was dealing with the beginning of a 24 hour flu.  I had told him to try and get some rest anyhow, since he had been awake since 5 am the day before, and I knew I would need his support later on when things got hairy!  
I had three doses of penicillin in the night because of the group B strep.  When the nurses had their shift change at 7:30 a.m., they checked me for the first time to see how dilated I was.  The night-shift nurse said that she wanted to stick around if it looked like baby would be coming soon.  I suppose it would be a bit anti-climatic as a nurse to support a patient for their labour and miss the delivery.  I was only at 3 cm though, so she went home.  
I was more determined to get out of that bed and move around with the break of day, and, thankfully, the day-shift nurse, Cynthia, was much more supportive of whatever I wanted to do.  I did lots of walking around, and tried different positions to will that baby downwards.  The contractions were getting more intense, and a little bit closer together; about four within a ten minute period.  My husband and I discussed a name for the baby if it turned out to be a girl in between contractions.  Isn’t that crazy that we still hadn’t decided after all?  We finally decided on a name, but I was feeling pretty certain that it was going to be a boy!  We tried to distract ourselves by making up scattergories categories and seeing who could think of more things for each category.  Pretty soon I was done playing games and finding it harder to cope.  One of the midwives was on call that morning, and she arrived at around 11:00 a.m.  She was accompanied by a second midwife who was in the process on joining their practice.  She had been a midwife for twenty years in another community, so I felt fortunate to have two experienced midwives and a fantastic nurse with me for the remainder of my labour and delivery.  As a side note, doesn’t it seem like most nurses are great people?  I suppose it’s a profession that draws people with sensitivity, empathy, and great care.  I say most nurses because I spotted a nurse at the nurse’s station on one of my walks around the hallway who was at the hospital where I delivered O.  Many of the nurses moved to the new hospital when it opened, so I wasn’t surprised to see her, but I was hoping to avoid another negative interaction with her, especially when I was in labour.  I’m sure that my fragile state at the time greatly informed my impression of her when she gave me the heave-ho from the hospital when O. was still in the NICU, but I didn’t want any negative emotions slowing down my labour at that point, so I nonchalantly inquired to my own nurse about which nurse would be covering her meal breaks.  I was in the clear, so thankfully I didn’t have to create an awkward situation by requesting a different nurse to cover her breaks! 
Before my midwife checked to see dilated I was, I tried not to think of a number so that I wouldn’t be disappointed.  Despite my best efforts not to imagine a number, I was hoping for at least 6 cm based on the difference in the intensity of my contractions, and the effort I had put into walking around and moving about.  My midwife checked me and I was still only at 3 cm.  “But it’s a stretchy three!” she said, trying to encourage me.  I felt like I had been playing Settlers of Catan for 12 hours and still only had three points (you start the game with 3 points).  Twelve rather uncomfortable and exhausting hours.  More like playing Monopoly for 12 hours; I detest that game and I actually enjoy Settlers.  I did my best not to let the disappointment take over, but it was another low moment.  The nurse asked me again about pain relief options, and I said I was starting to think about using the laughing gas.  My midwife gently talked me out of starting the laughing gas at that point.  She probably knew that I still had quite a journey before this baby was ready to come out!  She reminded me how much I wanted my baby to stay with me right after the birth, so that renewed my resolve to hold off on drugs as long as I could.  She also discovered that somehow my bag of waters had sealed itself back up.  My midwife was questioning whether my water had actually broken the night before, and I assured her that it had.  She later confirmed this with the doctor who had seen me when I first checked into the hospital, and he agreed that my water definitely had broken, so it’s a bit of a mystery how it sealed itself back up again.  It seems my body was determined to keep that baby inside!
I had been on the maximum dosage of pitocin that midwives and general doctors are allowed to prescribe since 6:00 a.m., so for about five hours already.  The midwife explained that to help my labour to progress, we needed to either bump the pitocin up to a higher level after consulting with an obstetrician, or try to help things move along by doing some more walking around.  Some serious walking around.  Given my experience with pitocin last time, I chose the walking around option, although I didn’t realize how vigorous this walking exercise was going to be!  After they switched all my monitors and IVs to portable versions, I set off on my marathon.  We walked the hallway, my midwife explaining that I needed to walk like I was climbing a mountain, and that I couldn’t stop walking during the contractions.  It was … rather challenging.  I seemed to have contractions at the same points along the walk each time around, so I started naming the spots in my head.  Contraction Corner, the Hallelujah Hall of relief, Anticipation Alley, the Crying Corridor where I heard another woman in pain and prayed for her between my own contractions.  After close to two hours of walking around, all the while my husband was bravely hiding his own flu symptoms, the battery on the portable monitors died, so I had to go back to my room.  Thank goodness for weak batteries, because I was done!
The midwives checked me again, and now I was at 6 cm.  Which would have been great if it had happened about four hours earlier.  They decided to bring the obstetrician in for a second opinion to see if they needed to up the pitocin after all anyway, since my labour seemed to have the motivation of a snail.  She came and checked me too, and said to just keep doing what we were doing, and that I had made good progress from the walking.  
At about 1:00 p.m., I was starting to not be able to stay on top of the contractions just with breathing and visualizing.  My husband asked me if I wanted to think about the laughing gas, which I had totally forgotten about at that point.  I think I had forgotten my own name at that point.  I agreed and my fabulous nurse had the little mask in my hand before the next contraction.  This brings me to the ugly part of the story, and I’ve decided to just recount the funny parts for the sake of my friends who haven’t had babies yet, especially the pregnant ones, and for my own sake too in case I want to have more babies some day!  Because despite what I wrote in a previous post, you do forget the pain of childbirth.  Even if you think you’ve remembered, you realize when you are going through it again that you did forget. 
I used the laughing gas for about half an hour before the pushing stage.  I tried to make a mental note of what the laughing gas feels like when I was using it so that I could describe it later, because I found it so hard to describe after the first time.  You can still feel the pain, but it somehow helps you not to think about it.  It’s kind of like being in that strange place between sleep and wakefulness, or right before you are about to pass out.  Kind of.  It’s still hard to describe, and I have a feeling that it might be different for everybody.  I remember after having O., the doctor remarking that the laughing gas doesn’t usually work that well for everybody.  I thought that it didn’t work that well for me, even though it helped, because I could still feel the pain.  After having T., one of the midwives made the same comment to me, and it was then that I realized that they weren’t talking about the pain relief aspect, but rather the ability to make someone so detached from their usual sensibilities.  Oh goodness, I am glad that there was no recording of me made during that half hour.  Over the past couple of weeks, something random will trigger a memory of something that I said or did during that half hour, and I have to sheepishly ask my husband “Did I really do x?” or “Did I actually say x?”   A couple of rich tidbits for you: Certain things seemed hilarious to me, like all the noises the machines were making.  So I imitated all of the noises – the beeping, the humming, the alarm sounds, etc.  Then I would laugh uncontrollably until I had tears coming down my face.  When I laughed, everything sounded echo-y so that it sounded like the baby’s heartbeat was beating a million times a minute.  So I would go from fits of laughter to panic that the baby’s heart was beating too fast.  I made all sorts of funny faces, and thanked my husband over and over for suggesting the gas.  I could tell that he was concerned about me from his voice, and told him not worry because I was much better than before.  I think I heard someone say to him at that point that he’d better not let me ever get close to using real drugs. I remember laughing because it sounded like I was talking with my Mom’s voice for some reason, and I kept picturing the scene from The Little Mermaid when Ursula morphs into a pretty girl and has Ariel’s stolen voice in a seashell necklace.  When the pains came faster than the gas, I remember saying "Oh Jesus, help me on Easter MONDAY!"  really loudly (it was Easter Monday, so at least that part made sense).  Pretty soon, the pain starting pushing through even my best efforts to suck back the gas as fast as I could.  They tried to persuade me to breathe some regular air, and I told everyone to stop talking to me!  There may have been some obscenities thrown in there too.  I started to feel the urge to push, which was so powerful and surprising to me since I never felt that sensation with my first, as the doctor just told me when to push.  I lied about it at first when they asked me if that was what I was feeling, because I knew that they would take away that lovely laughing gas for the pushing stage.  I remember saying “Please don’t take it away, I’ll be a good girl.”  Somewhere in the fog of the gas, I realized that even though I didn’t want to do this anymore (which I may have mentioned a few dozen times) that it was almost done and my baby was almost here.  I’d like to think I gave up the gas voluntarily, but I think they shut it off and I eventually realized that the mask wasn’t doing anything anymore.
They put T. right on my chest after he finally came out, and he was crying like a champion.  After a while, I realized that I still didn’t know if he was a boy or a girl, so I lifted one of his legs and said “It’s a boy!”  It was such a surreal, magical moment for me to be able to discover the baby’s gender; I would definitely want to do that again if I have another, or let my husband be the one to discover it.  He started nursing right away, and stayed latched on for maybe a whole hour or two.  It was so peaceful and wonderful, and different than our first experience bringing a baby into this world.  I don’t think I realized how traumatic O.’s birth experience was for all of us until I had T.  It was like we were holding our breath for the first little while after he was born for something to go wrong, but it was just…peaceful.  We didn’t even weigh him for the first while until he was done nursing, and then we called our families and friends while the midwives weighed him and measured him, and cleaned him up a little bit.  I had a wonderful hot shower, and my bed was freshly made up for me when I came out. 
I had to stay in the hospital for 24 hours for observation since I had been on the pitocin for such a long time.  I was kind of hoping to sneak out the back door after the performance I had given everyone.  I brushed off the midwives’ and the nurses comments that I had done really well, because all I could remember was the crazy things I said and did during the last hour of labour and delivery.  I was feeling pretty embarrassed to eventually have to leave my little room and see people who had heard me.  Let’s just say that there was some choice language coming out of my room quite unbefitting of a “pastor’s wife,” and a few really, really good screams.  I was apologizing to the nurse a couple of hours later for my string of obscenities and rather loud vocalizations, and she finally said to me that I shouldn’t feel embarrassed because I did do really well, and my baby had a very gentle birth.  She said that she’s only ever seen one other woman give birth while on pitocin without getting an epidural, and that woman had a shot of narcotics.  Not to toot my own horn, but that made me feel better about my craziness in that last hour.  Although…I think I might opt for the epidural next time, if there is a next time!  Just kidding.  I think.  

6 comments:

  1. Oh Andrea. HUGE kudos to you for getting through pitocin without an epidural! You are amazing. Good thing laughing gas works so well for you!! What a wonderful story. Gas was the only form of drug I had as well, and I took it only b/c the midwife highly suggested it when we knew it was going to be a long time of transitioning...and I found just breathing into that thing properly took a lot of concentration, taking my mind of the situation at hand (but I don't think it relieved any pain), but I do know it made me fall asleep in between contractions. That was somewhat useful after being up two night in a row.

    I LOVED the part about Easter Monday. If my daughter wasn't napping I would be laughing hysterically.....oooooh my. SO FUNNY!!

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  2. Thanks Katherine. I remember looking the mask at one point and saying "how do I fit my lips inside here?" even though I knew my lips were supposed to go on the outside because I thought it would be funny. Then the contraction peaked and I regretted wasting any time with jokes!
    It is strange how we don't seem to get a good night's sleep the night before having a baby. You'd think our bodies would realize we are going to need some extra energy!

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  3. You're awesome, Andrea! I love your story, you are so strong! I loved it. Not how you had hoped it to be, but restorative nevertheless. It never ceases to amaze me how redemptive birth can be.

    As for the oxytocin, it is true that oxytocin contractions are stronger and more painful than non oxy contractions. You are very strong to have gotten through everything but the last half hour with no pain meds, and then only Nitrous for pain. I've had one doula client who made it through with no pain meds, but she had a two hour labour from start of oxytocin to baby out, so that's just ridiculous. At the end her hair wasn't even messy!

    The other thing is that as a paramedic one of our main methods of pain control is laughing gas. Everyone reacts differently but don't worry, everyone who works with this med has seen the type of reaction you describe. We all know it's the gas! Don't be embarrassed!!!

    I also really really relate to holding your breath after your healthy baby is born, because of your previous baby being born with problems. Been there, done that. I kept wanting to yell, "YOU'RE ALIVE!" at Amarys when she was born, but I knew it would be weird and not all that accurate so instead I sort of semi whispered, "You're awake! You're awake, oh I'm so glad you're awake!"
    Riley was born unconscious. It's not like he was dead, but I was so relieved Amarys was born alert that i wanted to yell that she was alive. So funny.
    =)

    Huge happy dance that this time was better. I bet third time will be au natural, and surprise you with its gentleness....because what are the odds that THREE times your water breaks and no contractions? =/

    Oh, and the waters don't actually reseal, just that a small break can be compressed behind the head and thus no longer leak. A very small leak can reseal over several days to a week, but what you describe sounds like maybe a high break, and then the baby's head drops or shifts to hold closed the hole or block the water from exiting. That's as far as I understand it, anyways.

    Thanks for sharing your story. I loved it. <3

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  4. Thanks for reading, Melissa! I'm relieved to hear that other people react to laughing gas like that too - now I don't feel like a complete lunatic!
    I'm so glad for you too that Amarys was born alert and healthy. She is such a cutie - I love that picture of you and her at the tulip fields on your blog header.
    We'll see about #3! Maybe third time lucky?!
    PS. does the fish oil really help with anxiety?

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  5. Yeah, nitrous reactions like yours are common: there's a reason they call it laughing gas! lol. I had it after Riley's birth while they were sewing me up, and I kept making stupid jokes and laughing really loudly. A couple times I farted while she was sewing me up and I would yell, "WOOPS I TOTALLY FARTED IN YOUR FACE WATCH OUT THE FART LADY IS IN TOWN!!!" and stuff like that. WOW. lol.

    Third time lucky for sure!

    And fish oil really does help with anxiety: without it I'm a crazy lunatic and with it I'm very stable. Seriously. This link is a very comprehensive look at meds for depression (same meds are used to treat both anxiety and depression since they are both linked to low dopamine and or seratonin levels and both respond to the same treatments), specifically depression in breastfeeding mothers. It covers everything from fish oils to MAOIs:
    http://www.nhbreastfeedingtaskforce.org/ppd_curric_final_2009.pdf

    For example: I forgot to take my fish oils for a couple of days and I'm awake at 4:22 a.m. commenting on your blog....INSOMNIA IS NOT MY FRIEND!!! It works for me bigtime. I also take B complex vitamin, multivitamin for prenatal, vitamin d, and calcium magnesium. Everything but the calcium is for my anxiety disorder. Although Calcium IS supposed to help you sleep (I ran out of that one so maybe I am double hooped right now as far as sleep is concerned!).

    Good luck!

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  6. Thanks for the link and the info, Melissa. Interesting article. I think I will give the fish oils a try! It sounds like it helps with all sorts of things from other info that I've read. Post-partum anxiety seems to be one of those things that people don't really talk about but seems pretty common when I've asked other moms about too. I remember one night in the middle of the night while feeding T. the first week he was born thinking that we could never go camping again in case one of the boys fell into the outhouse! I gave my head a shake and realized I was not being logical, but clearly I could do with a little less crazy!

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