Sunday, March 24, 2013

A grumpy birth: Oliver's Birth Story



In which I have a very, very, very bad attitude.

Based on my previous three births, there were a few things I knew about how this birth was going to go.  I knew this baby was going to be born several days past his due date.  I was betting on between 6 to 8 days late.  I knew it was going to be a long-ish labor, more than 10 hours, probably around 12, with a long early labor stage that would give me time to pack my bag, make cookies for the nurses/midwife, shower, etc.  I knew that I would labor at home as long as I could before heading to the hospital.  I knew my water wasn’t going to break on its own until well into labor.  I knew I would throw up at some point, at least once.  I knew when it came time to push that I would be able to get the baby out easily in just a few pushes.  (Asher took only one contraction and two pushes!)  I knew the baby would be somewhere in the 8lb range.  I was also pretty sure that I wouldn’t go into labor until the evening.
There were also a number of things I hoped for from this labor (apart from the obvious healthy mom and healthy baby).   We had invited my mom to attend this birth, and I really wanted it to be a good experience for her.   While she has always been supportive of me doing natural childbirth, I also know that she thinks I’m crazy for wanting to do it, and so I really hoped that she would get to see how peaceful, powerful, and spiritual natural childbirth can be.  To that end, I hoped for a more peaceful and calm birth like Caleb’s, rather than a more difficult and intense labor like Asher’s.  I also hoped there wouldn’t be a need for the midwife to break my water, as there was when I had Asher, because it made labor a whole lot harder, as in please-kill-me-now, harder.
So…this baby was due somewhere between May 7th and May 9th, depending on who was doing the calculation.  My midwives had the date as the 9th.  Of course May 7th, 8th, and 9th came and went with no baby, just as I had expected they would.  If anything, I was almost in denial that I was about to have a baby.  I knew we had passed his due date, but I just did not think he was coming any time soon. By May 10th, between 1 and 3 days after my due date, I still had not packed a bag for the hospital. The crib wasn’t set up and the baby’s room wasn’t ready. I hadn’t bought the new car seat I had recently determined that we needed.  I hadn’t cleaned my room, made cookie dough, or done most of the dozens of things I wanted to do before the baby was born.  I was determined that we would have a very productive day on Friday the 11th, so that we’d actually be more ready for the baby to come.
On Friday morning Scott and I were lying in bed, about to get up for the day.  At 7:15am I started to feel a mild contraction but thought nothing of it because I had been having them for weeks.  But then at the end of the contraction, I felt this little pop, followed by a gush of fluid.  I was completely stunned.  Truly shocked, I turned to Scott and told him that I thought my water had just broken.  I got up and went to the bathroom, where additional gushes of fluid confirmed that yes, my water had broken. 
Unlike a normal pregnant woman who is past her due date, I was NOT happy about this.  In fact, I was downright grumpy about it.  I was not ready for the baby to come that day. I wanted a few more days. I did NOT want labor to start with my water breaking.  I knew it was going to make labor harder.  Plus, I was Group-B Strep positive for the first time ever, the standard protocol for which involves IV antibiotics during labor.  I had requested that they re-test me, however, and was seriously considering declining the antibiotics.  But having your water broken for very long is one of the risk factors for  GBS transmission to the baby, so when my labor started with my water breaking, I no longer felt comfortable declining the antibiotics.  I knew it also meant that the midwives would want me to come to the hospital right away to make sure I got the antibiotics, rather than my being able to labor at home like I wanted. Thus, I was very grumpy.
I called my sister, who lives 2 hours away and had agreed to come take care of our other kids when I went to the hospital, and told her to come on over.  I also called the midwives office to let them know what was going on and was promised a call back from the on-call midwife within 20 minutes.  If I didn’t hear back by then, I was instructed to call them again.
In the meantime, I spent about 15 minutes wandering around the house in a daze, telling anyone who would listen that I couldn’t believe my water had just broken, as if that was an unusual way for labor to begin.  Finally I started getting my hospital bag ready.  Scott, being Scott, asked if I would mind if he went into work for an important morning meeting he had scheduled.  He assured me that I could call him if I needed him to come home before the meeting was over and that he would only be 15 minutes away.  Contractions hadn’t quite started at this point, so I agreed.
Despite not yet having contractions, while I puttered around, eating breakfast and getting everything ready to go I was still feeling rather uncomfortable.  This is way TMI, but my intestines were, shall we say, quite active and that was a contributing factor in the discomfort I was feeling.  The same thing happened when I was in early labor with Caleb, and I hated it and had hoped not to experience it again.  Contractions at the same time as intestinal, ahem, activity is just not fun. Having to use the bathroom repeatedly while having contractions is also no fun.
The kids were all up by this point and excited to hear that their baby brother would be coming that day.  Though my mom kept them from bothering me, I found that their being awake and in the house was something that really distracted (not in a good way) and bothered me.  (One of the reasons I have never particularly wanted a home birth.)  I was, once again, NOT happy with how things in this labor were going and spent much of my time getting ready to go to the hospital reflecting (grumpily) on whether I really wanted to have a natural birth again.  The sad thing is that I truly was not excited about it or looking forward to it at all.  I was, instead, just very frustrated that none of it was happening how or when I expected and hoped it would.  I don’t think I can overstate how very, very grumpy I was about the whole thing.
Around 8am contractions started.  Still very manageable, but also stronger than what I am used to having labor start with.  I timed them some but they were pretty irregular in their pattern.  By 8:30, an hour after I had called them, the on-call midwife still had not called me back, so I called them again.  This time I got a call back within just a few minutes and was, as I expected, asked to come to the hospital right away so that I could get the antibiotics. So I called Scott, who had to leave his meeting early, and continued packing, though I was in no hurry.  Scott came home, loaded the car, and we were off.  I could tell that we were going in earlier in labor than usual because I was able to ride the whole way to the hospital sitting down instead of kneeling backwards on the seat, as I did on the way to the hospital while in labor with the other boys.
We arrived at the hospital around 11:15am and, after I made my very slow way in, were taken to the waterbirth room.  They placed the IV for the antibiotics, briefly monitored the baby (who was doing beautifully), and, since I was getting antibiotics anyway, I consented to a cervical check.  I was actually rather curious to know where I was at, since usually I am still laboring at home during this stage of labor.  I was 4cm.  It was good to know that progress was being made. I was still feeling pretty unenthusiastic about the whole thing, though.
About 45-minutes or so later my mom arrived. (Scott and I had been taking bets about how long she would take to get to the hospital. It was actually less time than we expected.)  Also around the same time, the nurse asked if I wanted her to fill up the tub. I said yes. In the meantime, I was dealing with contractions by leaning over, moaning, and swaying. I also had to keep going to the bathroom due to the aforementioned intestinal hyperactivity. (As in, I kept having to go poop out these small nuggets, which always brought on an extra long contraction.)
The tub took longer to fill up than I would have liked, and it was the built-in kind with a door that opens and closes, so they filled it up part-way, I got in, and then they filled it up some more. That was all well and good, except that I needed to get out several times to use the bathroom, which meant the nurse kept having to drain the tub some and then refill it some more. The upshot of this was that by the time Oliver was born, the tub was not as full as it would normally be, a fact which would turn out to be somewhat important.
I labored in the tub for maybe an hour or an hour-and-a-half. The water was not nearly as soothing as it had been during Asher’s birth, but it was still better than nothing.  Unfortunately, I never felt like I was dealing with the contractions terribly well. I just kept thinking about how much I didn’t want to be doing any of this right then. I even toyed with the idea of an epidural more than I ever did in my other natural births because I just did not feel like being in labor. (In other words, I was still really grumpy about the whole thing.)
As things progressed, I started to vocalize more and more during the contractions. I was good about keeping those vocalizations low and helpful at the beginning, but as things got further along they got louder and higher in pitch. I wouldn’t say I was screaming, exactly, but I was definitely moving more in that direction than I liked. I remember, during one contraction, the midwife vocalizing with me in a much lower register to remind me to do a low moan rather than a high-pitched scream. It was actually a fairly effective tactic, and way less annoying than if she had just kept telling me to lower the pitch.  As I got further into transition, however, I just started ignoring her. (Have I mentioned that I was grumpy about how things were going?) I also started to get really, really hot.  The nurse made some old compresses to put on my neck and my mom helped hold them there, which was really, really nice.
At some point, I told the midwife that I felt like I might need to use the bathroom again, but I wasn’t entirely sure. I thought it also could just be the baby moving down, and she was pretty sure that’s what it was. Also around that time I started saying things like, “I don’t want to do this anymore!” Somewhere in all of that, and I cannot for the life of me remember exactly when, the midwife offered to do another cervical check, hoping to encourage me, I think. I agreed.
“How does 8cm sound?!” she asked me enthusiastically, obviously expecting excitement from me.   “It doesn’t sound like 10,” is what I thought (but didn’t say).  I was unimpressed but continued to labor on. Not too long after that, I could tell Oliver had descended more and I started to feel a little pushy. I have always had very short, very effective pushing stages, so I was relieved to get to that point. I started to feel the so-called ring of fire, and so I began pushing, expecting to have the head out in just a push or two, which is all it has ever taken before. Instead it took me a couple of contractions to get his head out. (Making me, once again, very grumpy that nothing was going how it was supposed to.) I was on my knees in the tub at this point and was working to push his shoulders and body out, something that has always been the easy part of pushing for me. But try as I might, I could not get his shoulders out.
After I tried for a contraction or two, the midwife said in a very serious and commanding tone, “Stand up. Stand up!” I stood up. Oliver’s head was out but his shoulders were a bit stuck. The midwife tugged on him this way and that, trying to get his shoulders free. It took less than a minute, and finally I was able to push the shoulders out. (My mom said it was crazy to watch all the pushing and pulling she was doing.) The rest of his body followed and I reached down to pull him up, but the midwife had to tell me to wait a minute while she untangled Oliver from his cord, which was wrapped several times around his torso. Finally she handed him to me, and I sat back down in the tub.
Oliver, though, was blue and floppy, with no muscle tone and little movement. It was a little scary. No one took him away from me, though, so I knew we weren’t having an emergency yet. I stroked his face and kept telling him, “Breathe, baby.” The nurses and midwife rubbed him some and gave him some oxygen (all while leaving him in my arms) and finally (seemed like it took a few minutes) he started moving, pinked up, and began to cry. And he did not stop crying for at least a half-an-hour. Nothing I tried soothed him, not jiggling, rocking, sushing, breastfeeding, nothing. Apparently he was pretty grumpy about the whole birth experience, too. He also took a really long time to open his eyes. This was in marked contrast to all my other babies, who cried only for a few seconds and then looked around curiously. (The blue floppy baby experience was very similar to the one you can see on the Inga’s birth part 2 video here: http://rixarixa.blogspot.com/2011/03/ingas-birth-story-part-1.html  It’s about 2/3 of the way down the page. The part I’m talking about is from 7:48 minutes until 10:11 minutes, or so. It’s a little disturbing to watch. Mom knew neonatal resuscitation techniques, though – it was a homebirth that was an unplanned unassisted birth -- and baby was ok. The funny thing is I had just seen this video a few days before Oliver was born, so I guess I was prepared for it in a way.)
I delivered the placenta and then moved to the bed. Scott cut the cord after it stopped pulsating. No one took Oliver from me.  He stayed skin-to-skin with me for at least a couple of hours. They asked which procedures I wanted and which I didn’t. They asked me if I wanted to keep my placenta. (I declined, but I appreciated that they asked. We were really, really impressed with how mother-baby friendly the hospital was.) Finally, when we were ready and at least a couple of hours after he was born, the nurse weighed and measured Oliver. Since everyone had remarked on how big he was, she asked us to guess his weight. I didn’t think he looked particularly big, so I guessed somewhere in the upper ranges of 8lbs. My mom guessed a little higher than that, and then I think Scott guessed 9lbs 2oz. The nurse was surprised at our guesses and said, “Really? I’d have guessed at least 10lbs.” Then she put him on the scale and, sure enough, he was 10lbs even. I was shocked. That’s a full pound-and-a-half bigger than my other babies. He was also 22 inches long.
After the weighing and measuring we moved to another room, as someone else needed the tub. Scott and I settled in and talked names. I had been hoping to name the baby Micah, but Scott had long been partial to the name Oliver. When it came down to it, I looked at the baby and just felt that he was Oliver, so that’s what we went with. Before we left the hospital, I was able to ask the midwife who delivered Oliver why she had me stand up as I was pushing. She said partly she needed more room to work since the shoulders were stuck, and partly she was concerned that because of the lower water level in the tub and the way I was pushing (on my knees) that the baby’s head might end up going in and out of the water as I was pushing the body out, which could ultimately result in him inhaling some water. Having me stand up just seemed like the safest thing to do under the circumstances. So now I tell people that Oliver was both a water birth and not a water birth.
So in the end, very little about the labor went the way I expected it to. The day it happened, the time, the way it started, how not calm and peaceful it was, what pushing was like, how big the baby was, how long the labor was (6 ½ hours from when my water broke and 5 ½ from when contraction started), even whether or not I would throw up – none of these things went the way I expected them to. Which just goes to show that the more you think you know, the less you actually know. But at least after I held my baby in my arms, I got over being grumpy about the whole thing.