Wednesday, July 16, 2014

the birth of alice (very long post)

As 07/07/14 came and went I was feeling very much like a grenade everyone was hoping to pull the pin on. That evening as nothing happened and we were just going stir crazy, Matt and I got dressed up and went out to dinner at Granville and went to see 22 Jump Street and walked around the mall. As we hoped it would be our last date just the two of us though not as we expected.

That night as I showered I felt a trickle of water between my legs and I stepped away from the shower I could tell that I was peeing myself (it was yellow and definitely pee) but the warm trickle before I couldn't tell if it was my water breaking or just the shower. I gave it all night and I felt no contractions but the next day, 07/08/14 I was still leaking involuntarily. I had a 3pm appointment that day anyway but I called my doctor's office to see if they could see me earlier 'cause I didn't really want to go to the hospital. The doctor's office told me to go though I tried to insist I wasn't sure if my water had broken they didn't want me in the office. Under the concern that what if it was water breaking and bad things could happen we went to the hospital. We told not a soul (except my resident confidant/expert Michelle) because I was sure it wasn't labor but didn't want to take any chances. Like baby Jesus in Bethlehem when we got there there were no rooms at the inn and all 8 of the L&D rooms were full and we had to wait in the waiting room (and watched Germany slaughter poor Brazil). It was HOURS before we got in to be seen and after they checked that I was not dilated at all I went home. By then it was 4pm and I cursed myself for not having listened to my instincts to just stay home and wait 'til my regular appointment because we'd have been home an hour ago. Ugh, annoying.
On the drive home I was feeling pretty disappointed. I knew I wasn't in labor but I just felt the pressure of everyone waiting for me to birth this baby and I was just so so sad. This sort of despair that cuts through all rationale and just hurts and makes you cry. My brother, as always, was able to hear my despair through the benign texts about boredom and he, his wife, my mom, and Angie came by to cheer me up and distract me. Mom made us quesadillas and we walked to Starbucks and then the park. Angie picked flowers for Baby Alice. We talked about life and babies and they prayed for me...
… which is probably why a few hours later…bloody show. I went to the bathroom around midnight and sure enough, pink tinted business and contractions began a few hours after that. I knew the beginning parts of labor take forever so I tried to sleep and handle the pain best as I could by myself and not wake Matt because once it got going he wouldn't be able to sleep and someone in our party should be coherent. I finally woke him up around 6am once I was tired of feeling alone and told him I was in labor. He made sure I was fed and watered and would massage my back in between contractions. The way I handled contractions, which by the way feel like intense period cramps and unfortunately for me included back labor which is intense lower back pain, was either rocking side to side and breathing or on my knees by the bed as if I was praying rocking my hips side to side. Constant movement as well. Pacing. Not being still. My contractions came in threes: the first would be intense, then a few seconds another one that would be less intense, then a few seconds later another that was either milder or on par with the first one. Around 8am I was incredibly exhausted and prayed that I could get at least an hour of sleep because if this was just the beginning I was not gonna make it and I badly needed to rest. Miraculously, I fell asleep. I woke up and we had some lunch and labor continued with back massages and addition of a heating pad and finally at 4ish once they were about 5-6 minutes apart we loaded up the car and headed to the hospital, contracting all the way. We let our family know what was happening and told them to pray and wait for an update.
It was around 5pm and we were sent into a recovery room while we waited for our room to be almost ready and my vitals were checked and we learned that I was at 3.5cm and 90% effaced. This is when I texted my girlfriends and told them to standby. Hopefully soon things would get moving and within a few hours we'd totally be having a baby. Right?
My first nurse was Shawna whom I loved right away and we had a chat about what my plan was and goals and she was totally game about my wanting to do it naturally and if I wanted any pain meds it would come from me and she wouldn't ask me. There were a few things that had to be approved by my doctor though which I dunno if I'd mentioned but at my last checkup, the doctor that I'd been seeing for all my prenatal care was going on vacation and would not be around to do the delivery. While normally this would drive a woman bananas luckily I had met the other doctor in the practice and actually liked him so much I almost switched. My doctor had me meet the backup doctor just so he'd have a face to the name and he just wanted to know my general feeling on natural vs medicated birth. I told him I wanted to have it as "low tech" as possible and he was very pleased. He would prefer that when possible and he was not the type to want to rush things, he would let things move at their pace. I later learned that he comes from a time when midwives and ob's worked together so he had the old school training. Also, he was Irish so he had a cool muddled accent. Win.

Back in the labor room, Shawna wrote up my plans on a white board. We wanted it to be low-tech, no pain meds, fun, and with the end result of healthy momma and baby. The items that had to be approved by my Irish doctor were the following: I wanted to be intermittently monitored (they monitor your contractions and the heart rate of the baby) instead of monitored the whole time which would mean sitting on a bed tied to cables, very difficult to deal with when trying to labor naturally, I wanted to be able to ambulate (aka move around), and I wanted to only have an IV lock instead of being tied to an IV. The difference being that I would have the IV ready to go on my hand only in case of emergencies vs having the IV tube going into me, once again tying me up to machines. We had no doubt he would approve all these things but he had to be asked, which of course he did. This is where the reading and knowledge came in handy. Had I walked in there not knowing that they were gonna wanna tie me to the bed things would have gotten uncomfortable fast. But since I knew they would and I knew there were alternatives I was able to ask for and be given these things.

Unfortunately Shawna was off at 7pm but she remarked optimistically, hey, I'm back at 7am tomorrow hopefully I'll see you then. Ha! I arrogantly thought, hopefully we'll have a baby by then!

Katherine from Nigeria came next. She had four boys naturally and was totally pro whatever I wanted. That night may have been one of the harshest nights of my life. I was in a boatload of pain, in a hospital, and really tired. Up until this adventure I'd never spent much time in a hospital except for a car crash and when I got hit by a bike last summer and even then it was for a few hours and never overnight. I let Matt sleep a few hours and I dealt with what I could as best I could. Another strange thing that I didn't know about labor was how much I would have to pee. Every contraction made me feel like I had to pee and rushing to the bathroom barely making it each time and a contraction hitting right as I was peeing making it worse. All I could have were ice chips which was fine by me, I wasn't hungry.

Matt was incredible. Having it be just the two of us made a big difference to me: it was our baby and we were a team. He would massage my back during contractions, let me lean on him to sleep, held my hand, kept telling me how proud he was of me, got me water, he was my everything. My strength. My love. I couldn't have done it without him.
Time went on and 7am came and I was checked again and this is when the massive heartbreak began. I was up to 4cm. One measly 1/2 a centimeter after all my hard work that night. Somehow I kept going, took one of the most uncomfortable showers of my life and around 3pm things were getting out of control painful. My previous quiet breathing and medium moans were getting louder and my capacity for keeping it together was getting lower. I asked to be checked and I knew that if I wasn't pretty far along say 7 or 8 I was done with natural labor and was going to get the epidural. In Ina May's book she mentioned stories of some women just being exhausted and needing their body to relax to be able to dilate and that was me all the way. Plus I knew that the pushing was coming and I would have no strength by then to handle it so I told Shawna I was quitting and gimme the numb. At this time my mom came by and saw me and got to see me contracting a few painful ones and told me later once she left the room she started crying. She told me she didn't wanna see me in pain and I was glad she sucked it up while seeing me, holding me tight as I moaned. I told her I was getting the epidural and hang tight and then they could say goodnight while it took effect and we'd see where we'd be in a few hours. I was at a 5/5.5 at this point and was at over 36 hours of natural labor.

My doctor came in and told me he wasn't sure the epidural was a good idea. He thought it would slow things down and we'd end up having to take the eventual steps of water breaking and pitocin to get things moving again. I pleaded with him to give me a chance to see where we'd be in a few hours with just the numb and he checked me. After his check he pretty much knew that Alice would not be born vaginally but instead told me that at this point there was a 50/50 chance of a C-section and that her head was not descending and there was little room for her to fit through the pelvis but he would give me that rest on the epidural. Why make me suffer naturally when I was on a road to C-section anyway?

Epidurals begin a big ole chain of reactions. You are numbed from the waist down so you can no longer move, you are totally confined to the bed. You can no longer control your pee so they stick a catheter in you. You can also no longer feel your contractions so that intermittent monitor is now an all the time monitor. And before you are given the epidural a bag of IV liquid must run through you so that IV lock that once no longer had a tube running into it now did. And epidurals aren't just a one time shot, it's a tube going into your back that has to constantly have medicine flowing to it and that's also on that IV pole. Yes, all of these things now were happening, you can see why I was trying to avoid it.

The anesthesiologist came in and everyone but Shawna cleared out.  I sat up on the bed with Shawna holding me steady and the doc poking me in the back with a big ole needle. This was when I had my strangest pain coping mechanism. I loudly hummed the song from Fivel Goes West "Somewhere Out There" and then hummed "Look out for Mr. Stork" from Dumbo. I think I needed to focus on something rhythmic, I dunno. Well within minutes relief was felt throughout my very weary body. My mom and Gaudy came in to see me and told me they thought I was ultra brave and no one could fault me for getting it after trying so hard. I fell asleep fairly instantly and thought I'd have gotten more sleep but soon my doctor was back and talking about what to do next. He was wrong about the epidural slowing the contractions down, they kept right on going and he acknowledged that. But the baby was starting to show signs of being tired and so were my organs.

It was going to be a surgery. That hit me like a ton of bricks and I wanted to cry but I had no strength. We could have waited a few more hours to see what would happen but I was starting to be convinced that even if I got to 10cm what was going to happen was I'd be pushing for more hours and then we'd realize she was still not fitting and now we were talking about an emergency c-section instead of a regular one. I had Shawna describe to me exactly what the procedure would be like step by step, when would I see my daughter, how long would we be apart, where would my arms be, etc. etc. Matt alerted our family and told them to come to the hospital and wait by the L&D entrance where they would meet Alice through a window. I was laid flat and moved to the OR, Matt put on scrubs. I don't remember posing for this photo but it's me just before I went under the knife. I labored like this the majority of the time in just a nursing sleeping bra. Enjoy this picture internet, it's what vulnerability looks like.
A curtain was lifted to block my view of the yucky stuff and I was numbed even more than the epidural. I could feel no pain, only pressure. They gave me an oxygen mask and I didn't like it so he moved it to the side of my face. I felt like I was gonna pass out and when the anesthesiologist  asked me how I was feeling I said "I feel like I'm gonna pass out" which got little to no reaction out of him so I figured that meant that was normal and then I felt better and more awake. I heard my doctor say "okay here we go", clearly felt the slice of the scalpel and then in 3 minutes felt the pressure of something large being wiggled and removed from my body. It was Alice. I heard her cry a polite cry and I was so happy and relieved to hear it. One of my nightmares was for my baby to be born silent and blue and have to be resuscitated so that cry was heavenly. The next thing I heard from the doctor was confirmation that we had made the right call at the right time. "Oh, there's a little bit of meconium, not too bad, just a little brown." Meconium is inside the womb baby poop and it's no good for babies to poop that stuff. During the stress of labor and delivery they can swallow it and it can cause lung infections, it's no bueno. She was tired and it showed and that was enough to let me know we had made the first right parental decision of a long road ahead. I felt body chills all over and they put a warm blanket on me.

Matt was able to go over the curtain to where they were cleaning her up and doing baby things to her. I was still on the other side of the curtain yelling out questions like "it is a girl right?!" "does she have hair?!" The doctors kept working on me and I waited for the first glance of my daughter. The daughter I've been baking in my body for the past nine months. Finally, Matt rounded the corner carrying the most beautiful sight these eyes had seen.
I had always imagined that the first time I'd see my child I'd have pushed it out of my body and meet it immediately and start crying but I couldn't cry when I met Alice. I just stared at her and smiled and smiled. I think I was just too exhausted to cry but not exhausted enough to be thrilled. A few days later as I recovered, I couldn't look at these pictures because I'd start crying and it hurt my incision.
On top of the meconium, the other proof that we made the right call with the C-section was if you can see the top of Alice's head here there's a little bump, that was where her head was stuck trying to come down and making no progress. That's why I wouldn't really dilate, her head wasn't pushing open the door the way it was supposed to, she was sunny side up and not coming down on her own.
While they continued putting me back together, Alice was taken to the nursery to be weighed and given her eye drop ointment and Vitamin K shot. The family anxiously waited on the other side of the window to see her and the nurse lifted her up Lion King style and they all cheered and then booed when she put her back down. The moms all cried and then they waited their turn to hold her.
Meanwhile I've been wheeled to the recovery room, the same one where I first met Shawna and was monitored and given medication and they took my vitals and after all these hours informed me that I still couldn't eat since I just had surgery and had to wait a few more hours. I wanted the strength in my arms to return so I could hold her, I knew that was coming soon and I wanted to start nursing her and was worried that we'd have a rough time at it since she wasn't laid in my arms right away after birth. Someone asked if mom was ready for baby yet and I said YES. I had barely any strength but Matt helped place her on me and she started moving her head down right away looking for her first meal.
After she was done with one, she moved onto the other one and there we stayed for about an hour checking each other out. Mother and daughter.
After we were done the family came in twos to hold this creature we'd all been waiting to meet for so long. My dad and brother then mother, stepfather, and Angie, then Dan & Jill, then Mari and Gaudy. Everyone stayed for about 5 minutes each and went home. Matt, Alice, and I were wheeled upstairs to the recovery floor to begin our new life as a family.

So, in retrospect do I regret having labored like a sucker for 36 hours and ended up getting sliced anyway? Heck no. Not for a second. I will always look back and feel proud that I tried really really hard to get this girl to come into the world the way it was meant to be and I could have made it if those road blocks hadn't been in the way. I may look back and wish I could have delivered differently but in the end I got all that mattered: a healthy baby.

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