Tuesday, June 1, 2010

The Rest of the Labor Story

(To any pregnant women out there--especially those of you doing hypnobirthing--you might want to wait until after you've given birth to read this. My situation turned out not to be what is considered normal in the hypnobirthing curriculum, since I had back labor and a baby with a giant noggin. I wasn't able to have a serene, relaxed labor and delivery, but I'm sure you can! I'm still glad that we took our hypnobirthing classes (and that our instructor, Kristen, was our back-up doula), and I was definitely able to use the visualizations and relaxation techniques successfully in early labor)

So, my labor story! When we last left off, I was closing in on 48 hours of up and down at-home labor after my water broke, and I had gotten some acupuncture to see if that would help get things going. It actually did work, temporarily. Starting around 8pm Friday, my contractions got stronger and closer together, and this lasted until about 5am the next morning (Gracie came over again to sit with me during the night so Patrick could sleep--so, so glad that we hired her! She was such an amazing resource and source of support during this whole experience). Unfortunately, things slowed down again once we'd gotten up for the morning on Saturday, so it was off to the hospital for a little help.

Before going to the hospital, Patrick and I spent some time tidying up the house (cleaning up the blankets and pillows strewn around from all the different baby-turning exercises I'd been doing) and buying some last-minute groceries at New Seasons (more coconut water!--I went through a bunch of that stuff during early and advanced labor). It was nice to get out into the real world for a little bit after being in my own little labor bubble for a couple days.

We checked in at the hospital around 1:30pm on Saturday, and Gracie met us there soon after. I had thought there might be some discussion with a doctor about what to do next, but it turns out the only option as far as they were concerned was Pitocin, and so they hooked me up to an IV around 2pm, beginning with a pretty mild dose. My hope was that since I'd already had some pretty intense contractions in the past few days, I'd be able to handle Pitocin pretty well and wouldn't need an epidural. At first, things were fine, and the contractions were much gentler than some of mine had been at home. We raided the maternity ward kitchen and ate orange popsicles and chocolate pudding and played Bananagrams with Gracie, stopping so I could breathe through surges. Hey, labor's not so bad after all!

Early Pitocin Labor Not So Bad

Time passed, and they slowly increased my Pitocin dose. Contractions got increasingly intense and frequent and not at all fun.

A Little More Intense

I don't remember things all that clearly, but I spent the whole night laboring, with tons of support from Patrick, Gracie, and the night nurse, Stefanie, and later on from Anna, the nurse/midwife from my doctor's practice (my doctor wasn't on call that night, but I think Anna was a perfect fit for our situation). I feel so lucky that they were there with me. Patrick was my rock--he was there by my side almost the entire time, reminding me to breathe and doing everything he could to make things better for me. When the contractions had gotten too intense, I gave up on what we'd learned in hypnobirthing and just did whatever Gracie told me to--lots of breathing and deep guttural vocalizations (instead of the whimpering and crying that came naturally). It was really intense and awful, but I also felt really powerful. I'm actually glad that I got to experience it, even though I certainly wouldn't want to do it again.

Focus

Since my water was broken, they only checked my dilation a couple times, and I asked that they not tell me how far along I was. I now know that I stayed 8 cm dilated from about 10pm onward, with no forward progress. Later on, the midwife and nurse thought that my cervix had finished dilating, based on physical signs and the urge to bear down, so they had me bearing down for a while toward the end--mostly in a squatting position, supported by Patrick. As far as I remember, I spent very little time laboring in the hospital bed, since the contractions were much worse when I was lying down. With each contraction, I really thought I would be done, and I kept feeling for the baby's head, but it was never there. Around 5:30am, the doctor checked my dilation again and found out that I was still only 8 cm dilated. We now know that the baby was positioned crookedly, preventing him from coming straight down onto the cervix, and so it couldn't finish dilating (and, bonus, he was sunny side up despite all our efforts in the preceding days to turn him, which accounted for the extra painful contractions).

So, after realizing that I still wasn't fully dilated after 8 hours, Anna had me lie down, and everybody gathered around me, and she told me that I wasn't fully dilated and we needed to try something else. Her suggestion was to do an epidural so that she could manually turn the baby so that his head could drop down. If this worked, I would hopefully finish dilating quickly, and then we could finish delivering the baby, still vaginally. If it didn't work, a C-section would be our only choice.

I remember feeling so relieved to hear her suggest an epidural and/or C-section, and I gladly agreed to whatever she wanted to do. I had so strongly wanted to have the birth I'd been envisioning, but I was so exhausted and in pain and totally ready not to be in labor anymore that anything sounded good at that point. I'd spent over 80 hours in labor--I think I gave the natural birth thing a decent shot, you know? :)

So around 6am, I got my epidural, and they turned off the hated Pitocin drip, and after a few more contractions, I was blissfully numb and free of pain. Oh my gosh, I was so happy and relieved at that point. After the epidural kicked in, Anna did her best to reposition the baby, and then we waited for about 30 minutes to see if my cervix had finished dilating. Unfortunately (or fortunately--whatever), it stayed at 8 cm, and it was C-section time! Everybody looked kind of sad and apologetic, but I tried to make it clear that they shouldn't feel bad--I was so ready to be done. And, as it turns out, the baby's head was 14 and 3/4 inches around, which my doctor told me this morning would never have fit through my pelvis. So it's a good thing we had the option of doing a C-section; otherwise Arlo and I wouldn't be in such good shape right now (it's actually pretty amazing that he hung in there with strong vitals through all the labor craziness. What a champ!).

C-section prep went quickly, and soon I was wheeled into a bright operating room, and they brought Patrick in wearing scrubs, and Arlo came out into the world at 7:08am, caterwauling and red. I was so exhausted at that point that I had a hard time keeping my eyes open, but I managed to stay awake and see my new baby before they carried him over to the warming table. Patrick went with him and got in some father-son bonding time, they put me back together, and we headed back to our room for recovery.

Not a Doctor

Totally not the quiet natural birth followed by skin-to-skin bonding that I'd envisioned, but we still got our awesome baby out of it, and I don't think he'll become a serial killer because he didn't get to do the breast crawl first thing out of the womb :) (and there was about a half hour of quality boob time after we got back to our room)

New

So that's the story! We've spent the last few days at the hospital, recovering, and we're heading home tomorrow morning. I had some nausea following the C-section, but I was able to start drinking juice Sunday night, and I graduated to an awesome vanilla Tillamook milkshake Monday morning. I'm back on solid foods at this point, and I'm feeling pretty good, though I'm still hobbling everywhere--not surprising since I'm recovering from abdominal surgery. I've been so impressed by the kindness of everybody here, especially the nurses--such sweet, nurturing people. And Patrick has proven to be a totally awesome dad, taking care of diaper changes and swaddling and whatever else has been needed. I knew he'd do a great job :)

Patrick and Arlo

Arlo from Stem to Stern

We've had some stress yesterday and today because Arlo has been having some breastfeeding issues (mostly just falling asleep after a couple sucks instead of keeping at it) and has been losing weight. We've had a few people mention that we didn't want him hitting the 10% weight loss threshold, though nobody said what would happen if he did. We had an awesome lactation consultant come visit us this afternoon, and she laid out exactly what would happen and what we should do to fix it, which is good, because she did a little off-the-records weighing, and it turns out Arlo had just hit the 10% weight loss mark. Anyway, the solution is to supplement breastfeeding with finger-fed formula for about the next 24 hours until my milk comes in, and then we should be back on track. I feel so much better now that we have a plan for getting his weight back up. What a relief. I'm all for taking the natural approach to birth and childrearing when possible, but this whole experience has definitely taught me that science and medicine can come in handy too. It sure is good to have them available when you need them.

We're heading home tomorrow morning, so I'm expecting things to be quiet around here for a little while as we get used to being at home (and not having food available whenever we want it). Also there's that impending crazy hormone time coming up any day now, so it would probably be good for me to stay offline as much as possible during that time. I'll be back when things return to some semblance of normalcy :)