Wednesday, January 16, 2013

Birth story 1.0 version 2.0 aka EMOTIONS

So I had an excellent time reading about birthing times from SRB over at Little Chicken Nuggets, A at Mellow in the Midwest, and at The Wild Rumpus this past week.  Big conversations about it all, because let's face it, it's a complicated and emotional deal this "giving birth" thing.  It inspired me to re-read what I wrote before about when the kid was born, and I realized that it was her story for the most part.

So here's my half of things. It's long... also note, I am writing about MY experience and MY preference to have any future children in a hospital because it's what works for ME.  There is no judgement intended and if you're reading that, then my bad.  Me, way too chicken to have a home birth.  You?  That's your deal and I am happy if you are happy and have a certified midwife (aka a med student with zero experience in labor and delivery in the woods somewhere is not a good idea, so just say no and go to the ER... not that I know someone who thought it WAS a good idea and needed a vast quantity of stitches when she did get to the hospital... ahem...).

At my "and now you are 40 weeks and still pregnant with nearly too high blood pressure" visit on my due date, my doc scheduled a non stress test for 4 days later, saying, "But I'll probably see you in delivery before then."  After the NST was normal and I was still pregnant (effaced but no change in dilation in weeks), I was scheduled to come back in another 4 days to decide how soon to induce because my blood pressure was staying right there at the line of scary and normal.  I was a little tiny bit worried by the blood pressure, but mostly just really exhausted.  I had contractions starting at 35 weeks that would last for almost a minute, sometimes up to 5 an hour, and then they'd quit, so I figured there was no hurrying things along.  Kid had her very own schedule to keep all along.

I have to say that I was thrilled with my doctor, a family practice doc.  She figured out what was wrong when I was bleeding at 13 weeks that 2 previous docs had missed, she understood my weird food allergy/sensitivities (that never happens, sometimes not even with docs who specialize in allergies...), and was all-around awesome.  She even came in early one day to visit me when I had my appendix out (which I think was optional as the hospital doc was officially in charge of me).  I didn't feel pushed at all into plotting an induction because I had researched the pants off of hypertension in pregnancy and I knew the stats got icky after a while... and I was soooo tired and ready to be done gestating.  I'd also spent about 10 days only leaving the 2nd floor apartment to go to the doctor so I was stir-crazy.

So when the actual, official, for keeps contractions started (on day 3 since prior appointment), I was fairly unimpressed for the first 3 hours.  I charted them and figured that either this would be it or not, but whatever.  I fought with my math homework and lost, so I watched terrible broadcast TV (we got 3 channels, two of them FOX, arg).  When the contractions got to be more like every 9 minutes I was more interested in them, possibly even excited that this might be it.  No pain yet really, just crampiness and "oh that again" sorts of things.

At about 8 minutes apart for 30-40 minutes we called our doula to join us milling around.  In the hour from our call to her arrival (more than an hour? no real concept) I'd say that it felt "real" to me.  We were really going to have a baby and soon.  This was probably 10pm or so, and nobody was tired, so there was more bemoaning the awful TV choices, chatting, I glared at my math textbook some, and mostly things were comfortable.  Since we weren't tired until about 2am and by then my contractions were getting hard to talk through, there was no sleeping.  At 3am-ish, I couldn't talk through them anymore and decided it was time to go to the hospital, since the contractions had been 4 minutes apart for an hour.  I remember feeling really focused and confident that I could do it, that this whole birth thing was no huge obstacle.  I'd started on some self-hypnosis to manage pain and it was working pretty well, because I wasn't really in much pain, just I had to only focus during contractions rather than doing anything else.

We got to the hospital, got checked in, and verified that nobody was making me get an IV port since I really didn't want any pain meds.  This was probably helped along because the nurse who spent an hour trying to get an IV set up when I had my appendix out just 21 weeks earlier was my nurse.  I think she was thrilled to not have to repeat the process.  At home I'd been snacking and drinking as much as I could to stay hydrated and avoid the horrid IV.  The snacking turned out to be a bad idea...

Sidenote: you'll note that "the nurse" doesn't have a name, and that's because I'm pretty sure I never saw the same nurse more than twice while I was in labor.  It was a new person every hour or so.

Eventually in the next couple of hours, my water broke and I started throwing up with each contraction.  Right then, the pain was very disruptive and I probably panicked a tiny bit, but the nurse was in and declared me "in transition" and once I heard that, it clicked.  I knew that this was the most pain and that if I could get through it, I was home free for the rest of the birth (not sure how I knew that but I felt sure of it, so that's what counts, eh?).  After maybe 4 or 5 contractions, I was so tired that I slept between contractions (and maybe during some too?).  Lots of pain but after the first few throwing up, I figured it couldn't get any worse.

I am pretty sure that with the sleeping and the hypnosis, I was in and out of being aware of anything for a few hours here.  I vaguely remember a nurse coming in and being concerned that I wasn't dilating fast enough and she "was going to talk to the doctor" but I don't remember a doctor coming in before mine turned up at 9am or so (can you tell I focused on the clock when conscious enough to do so?).  As it turns out, every room in L&D was full and they'd claimed an additional room for a woman in early labor from recovery, so I imagine the doctor on call was busy with someone else.  I remember the girl down the hall screaming a lot and the nurse commenting that the 16 year olds always screamed so much, and the woman next door swearing a lot.  Mostly I just focused and tried to breathe.

At some point the kid moved so nobody could get a heart rate on her externally, even with the handheld doppler.  Apparently her heart rate had been doing something funny before they couldn't track it, and my amniotic fluid was yellow, so there was some cause for concern.  I came to enough to realize we were talking about internal monitoring and that meant I'd have to stay in bed, but since I'd been laboring laying on my side anyway, I wasn't fussed, so we went with it.  It did mean itchy tape, but eventually I quit letting it distract me and got focused on the clock again.

Eventually I felt like pushing, so my doula or the spouse fetched a nurse and I was at 10 cm on my side but not quite 10 when I rolled over (maybe onto my back, maybe the other side).  This part I was not a fan of, the having to wait.  It wasn't more than a few contractions before the army showed up and I was warned they were turning on the blinding lights, but my doctor was there, so I was very comfortable, even with the light.

I was just whispering at this point, and I was really glad that the nurses and my doctor followed my lead and were also very quiet (or at least not loud).  After maybe 20 minutes or so of pushing, the kid's heart rate quit doing what it was supposed to during a contraction and it wasn't coming back up fast enough afterward, so my doctor explained the options quickly: we could try another push or two but with what her heart rate was doing, it was getting dangerous, and since she was so close to crowning, we probably needed to do an assisted delivery if she wasn't born right away.  I said OK to one more push, and made zero progress (for the 4th or 5th contraction in a row, and I was getting frustrated), so that was it.  Another army of people turned up, the giant tray of implements of destruction was opened and things were handed over, and just before the next contraction I got some novo.caine and an episiotomy.  With the contraction, I pushed and using the fancy vacuum-extraction deal, the doctor pulled, and there was a very blue baby.  I think a nurse cut her cord as soon as her head was out since it was very much around her neck.  She got some chest compressions with face suction from what I could see, I rested and held the spouse and my doula's hands, and then there was wailing.  Then there are pictures of me and the spouse crying together, because sheesh! It was scary at the end there.  Everyone not talking really fast over by the warmer let out a breath all at once, and they bundled the kid off to the nursery after a few seconds by the bed so I could see her.  Someone realized she didn't have an ID bracelet yet, so her foot got uncovered quickly to put it on, and the spouse went with her to the nursery (carrying an ID bracelet that I presume got put on when they arrived).  It was a bit scary but I was in a good place and I figured there was no need to panic.  She was in good hands.

After the placenta business, I got a bunch of stitches for the 3rd degree episiotomy and another 2nd degree tear.  Then the army of people was suddenly all gone and the L&D nurse was insisting I drink something, at least two glasses, or I'd have to have an IV.  I had some tea and some apple juice, then sent my doula down to the nursery with the camera to take some pictures of the wee tike for me since I had to hang around for a bit longer in bed.  About the time she came back, I was inspected again and cleared to get up and be about (so it had been an hour or two somehow magically since the army left me mostly alone).  When I got to the nursery, the kid was un-blue enough to be allowed out of the oxygen hood (no cool nasal prongs for babies at this hospital) and the nurses had me get settled to try nursing in a rocking chair.  No dice, so since her something level was too low, she had a tiny cup of formula (drank 5 mL as I recall, and that was it until she got cow's milk at 12 months).  Eventually the spouse and I decided we were hungry and the kid was dozing in her hood, so we left to get food and move to a regular room.  I think because we had a complicated delivery we got a few extra hours to hang around in the delivery room, and it was nice.

In a few hours the pediatrician cleared her to come room in with us and we had a lovely time figuring out how this "nursing" thing was supposed to work (which is to say, not doing spectacularly but muddling along).  The next day I woke up soaked because my milk came in while I was asleep (from say 2am to 7am, sleepy kid).  I'd sort of felt like a failure for getting the kid stuck right at the end there, but mostly I was at peace with it as really necessary. 

From here, it's a story of milk oversupply and the challenges that go with that (the choking, the reflux, the eating all the time because there's never any hindmilk) and me whining about my hatred of smelling like milk all the time. I suppose I should write about oversupply some time because it's a scary and challenging thing to deal with too, not just some kind of gift horse.  Trojan horse I say!

In the immediate aftermath, I was scared but grateful.  This tiny person that I was mostly the boss of had come quite close to dying, had an x-ray to rule out a heart defect, and now spent hours nursing and then spitting up most of what she ate (and she nursed 12-14 times a day, at about even intervals in that first two weeks, then cut back to just 10 times a day with a cluster in the evening before the colic howling).

I'm really glad that I had a doctor, that I had a doctor I trusted, that we knew enough about what bad things might happen and when they were needed so we could make a quick decision without the doctor rushing us, and that I had a doula to run interference with the nurses so they weren't bugging me too much.  We saw the free hospital lactation consultant at least twice in the hospital and 2 or 3 times postpartum, and I went on my way disliking nursing but being all right with the birth experience.  Sometimes  I feel like a failure for needing help at the end of delivery but not usually.  Mostly, I just hope that this time, with a set of doctors I'm not wild about and who tend to see me as a baby factory rather than a person, things will come close to going as smoothly (pre-delivery at least, that last 10 minutes could be smoother).  With these docs though, I'll push hard if they want to induce for anything but pre-eclampsia or 42 weeks even because I'm not sure how far I trust them to know what's best and I'll demand a second opinion.

I will say that I don't talk about my birth experience at all, ever.  It's my deal and I don't like talking about it in person.  Possibly it's a reflection of the fact that zero of my age-mate friends and relatives are having children (and they are not, or not on purpose), possibly it's that it was scarier and more traumatic than I usually think about it being, but I think fortunately the trauma was circumstantial and not created by anyone.  It's a lot easier to live with, knowing that scary things happen, and sometimes it's totally all right.  I'm sticking with that thought and assuming that Little Monster will wait to turn up until after my spring break just for fun or spite or being on hir own schedule.

1 comment:

  1. Wow! That's a scary story and yet also a not-so-scary story because everything turned out well. Mostly, nobody screwed up AND, as you say, the trauma was not created by anyone. I love reading birth stories. Thanks for posting yours.